The formation of the Libyan Stock Market (LSM) has been greatly affected by instability in the country. The stock market has been active, inactive, active and inactive since its inception in 2006. On the other end, there has been a growing concern and existence of constant pressure to activate the stock market for the benefit of the economy. The factional disagreements and a weak security environment that persist pose heavy challenges for developing and re-activating the stock market. The economic outlook for Libya remains uncertain. It remains difficult to forecast economic outcomes with any degree of confidence because of high uncertainty linked to political and security developments. The times when the stock market was active, significant contribution was brought to the economy, and such has been confirmed by many stakeholders. If re-activated the LSM is expected to play vital role in capital supply for investment, which in turn drive economic development in Libya. For effective contribution, LSM should be established on strong and stable foundations.

Rhizoctonia spp. which was earlier considered a minor disease causing pathogen under Punjab conditions now is a major threat to crops grown in Punjab. The present study investigated the morphological and cultural variations in Rhizoctonia population, pathogenic behaviour and extent of genetic differentiation between infecting populations of R. solani from different hosts. By species specific primers, Rhizoctonia species in Punjab were identified as R. solani (87.8 %), R. oryzae (11.1%) and R. oryzae-sativae (1.1 %). Morphological characterization of Rhizoctonia spp. based on the growth rate, colour of mycelium and sclerotial characters. A high degree of variation among these R. solani isolates was established. Potato isolates belonging to the different geographic areas of the state were clustered together and cotton isolates also related. R. solani isolates from maize, rice, wheat and chilli formed two major cluster groups. The molecular data on AG specific primers revealed that 46.8% of the isolates belonged to AG1-1A, while AG1-1B (10.1%), AG2-1 (13.9%), AG3 (12.7%). Using interspecific sequence repeat primers, isolates were clustered into three major groups (I, II, III). Group III consisted of isolates, mostly from Ludhiana irrespective of the hosts, indicating existence of genetic similarity among these isolates. Isolates were also found to partially group according to place of origin and the host. Further a partial relationship between the level of severity on rice was observed. The diversity and relatedness in hosts of R. solani isolates from Punjab indicates the need to consider the cropping pattern to reduce the inocula in the soil.

Objective: Unsafe abortions among the various age groups of women due to unintended pregnancy and socio- economic constraints have a deleterious effect on their reproductive and mental health. Hence, review and modification of safe abortion practices are crucial, owing to the rampant availability of over-the-counter MTP kits and D&C by unskilled professionals resulting in Maternal Mortality and Morbidity. This study provides an estimate of the outcomes of unsafe abortions. Methods: WHO [1] defines unsafe abortion as the termination of a pregnancy by people lacking the necessary skills, or in an environment lacking minimal medical standards, or both. The present study is a cross-sectional descriptive analysis of outcomes of unsafe abortions at a tertiary care center, GGH Kadapa. The study data includes all the women admitted to the emergency obstetric unit and treated for unsafe abortions between January 2019 to June 2020. Age group of the selected population is between 15-45. The sample included 342 cases of recent induced abortions. The primary outcome of the study is to emphasise the burden, causes, setting and the morbidity of unsafe abortions. Results: Total number of deliveries that occurred between Jan 2019 to June 2020 is 13787 and the total number of induced abortions during this period was 342. Out of which, 211(61.7%) were unsafe abortions. Among them, 53 women (25.11%) presented with shock. 89 women (42.1%) needed blood transfusions. 8 (3.79%) women went into DIC. One woman had a uterine rupture, and underwent uterine rent repair. Four women had uterine perforation with associated bowel injury. Bowel repair was done in 1 case, and a colostomy was required in 3 cases. Emergency laparotomy was performed in these 5 cases. Conclusion: Unsafe abortions are one of the leading causes of maternal mortality and morbidity in a developing country like India. This is mainly attributed to socio-economic constraints, poor awareness of contraception, and cultural beliefs against sterilization forcing the pregnant women to indulge in unsafe abortion practices. Creating contraception awareness in reproductive age group, strict laws against unsafe abortion practices are to be implemented to reduce the maternal morbidity and mortality due to unsafe abortions.

The plants are very important for living organisms, there would be no life on earth if plants did not exist. Furthermore, when animals or humans consume many plants, they can have negative consequences. Plant toxicity is associated with a multitude of chemical toxins such as alkaloids, glycosides, proteins, and amino acids. There are numerous examples of poisonous species present in different families, one of them Euphorbiaceae. Euphorbiaceae is one of the four largest cosmopolitan families of flowering plants with 313 genera and around 8100, species. Morphological, phytochemical properties and medical uses for 11 wild species of Euphorbiaceae growing in Saudi Arabia were collected in this paper. Two species (Euphorbia fractiflexa and Jatropha glauca) don’t have data for its chemical and medical properties and need a lot of study. For the species growing on the Saudi Arabia, all studied species need further study except for Euphorbia granulata and Ricinus communis.

Background: Many advanced radiotherapy techniques had been employed in breast cancer teletherapy, purposely to significantly reduce dose to organs at risk (heart and lungs) with marginal or no compromise in planning target volume (PTV). Majority of used techniques yielded rewarding results in developed countries where facilities, manpower and skills are available. In Nigeria, significant number of post mastectomy breast cancer patients received chest wall irradiation using manual hand planning, therefore, the dose distributions to target volume and organs at risk (OAR) were uncertain. Sokoto centre being the first in the country to use treatment planning system (TPS) focused on identifying planning skills (normalization points) with good 95% dose coverage to PTV, and minimizing dose to OAR. Methods: Eighteen post mastectomy patients (ten rights and eight lefts chest walls) were simulated via computed tomography scan (CT-scan) in supine position with breast board and fudicial markers to demarcate tumour bed borders. Planning target volume (PTV chest walls) and OAR were contoured from the acquired CT images and bi-tangential portals were applied. The energy used from Elekta précised Linac was 6 MV, and dose of 50Gy in 25# was prescribed to each patient. The Upper 1/3rd normalization point (UNP), Lower 1/3rd (LNP) and Inter-field (INP) were sequentially applied as dose normalization points on each planning CT image, dose to PTV and OAR were evaluated using Clarkson and pencil beam calculation algorithms. Statistical analysis was conducted using SPSS Software to study dose distributions of the normalization points. Results: Patients simulated were between the ages of 29-56yrs with mean age of 42yrs. The mean percentage doses from normalization points on left chest walls ranged between 81.7-107.7% to PTV, 13.3-17.8% to the lung and 5.5-6.8% to the heart, the reported hot spots were between 110.7 to 141.5%. Similarly, the mean doses from normalization points on the right chest walls ranged between 81.5-108.8% for PTV, 17.8-23.5% to the lung and 2.7-3.7% to the heart, with hot spots of 108.8-137.9%. The statistical differences using independent-t- test for the normalization points on both left and right chest walls shows p-value < 5%. Conclusion: The three normalization points influenced dose distribution to PTV and OAR differently. The UNP and LNP showed a desired dosimetry with marginal compromise in 95% PTV coverage compared to INP.

Background: The haematological changes are common in cirrhosis of liver the cause of which is multifactorial. It should be correlated by determining the underlying pathology accordingly. Objective: The objective of the study was to evaluate the pattern of change in Haematological indices in Cirrhosis of liver. Methods: This is a cross sectional prospective study conducted on purposely selected (non-probability) hospitalized patients admitted to Medicine, Gastroenterology and hepatology departments of Dhaka Medical College Hospital, Dhaka, Bangladesh. A total of 100 cases of cirrhosis were selected as per inclusion and exclusion criteria. After selection clinical history, meticulous physical examination and rational investigations were done. Data were collected as per a structured standard questionnaire and checklist. Data analysis was done using statistical software package SPSS 22.0 and was compared with other studies. Results: Anaemia was found in 81 cases out of 100 patients. Anaemia was morphologically normocytic in 46% patients which is the highest number in this study group. It was microcytic in 40% patients and macrocytic in 14%. Regarding Leukocyte count it was normal in 70(70%) patients, Leukopenia in 12(12%) and Leukocytosis in 18(18%) patients. Regarding platelet count it was normal in 46(46%), thrombocytopenia in 51(51%) but thrombocytosis in 3(3%) of cases. The average platelet count in thrombocytopenic patients was 90 X 1091 ± 23 X 109/L. Lastly, pancytopenia was present in 14(14%) patients. Among them, 10 patients (71%) had splenomegaly. Iron Profile was done in all patients of microcytic anaemia and it revealed 68% of them were iron deficiency anaemia. Prothrombin time was done in all patients and it was prolonged in 54 (54%) and its average value was 16.13±.2.9 seconds. Conclusion: Haematological changes are common in cirrhosis of liver, the cause of which is multifactorial. Iron deficiency anaemia is the common type (68%).Prolong prothrombin time (54%) and thrombocytopenia (51%) are the common features.

Background: Stabilization of weather factors especially temperature, pressure and humidity in bunkers that housed the Linear accelerators is necessary for safety of equipment and their efficient function for our patients. Daily variation of such factors can lessen the performance of Linear accelerators resulting to an error in their output and wrong dosimetry. Sokoto centre being located in the North-Western region of Nigeria with three unique seasons (Dry hot, Harmattan winter and Wet raining seasons) require a study of this kind to ascertain the influence of those harsh environmental factors on bunker's internal air condition. Methods: Daily records of Linac bunker temperature and pressure were measured using Precision mercury-in-glass thermometer and Opus barometer (OPUS 10 THI) from January 2019 to December 2021. Similarly, the corresponding daily external environmental temperature and pressure for the study period were obtained from Nigerian Meteorological Agency. The values were grouped according to the months of year, mean values of temperature and pressure for each month of the year were generated and graphs and bar-charts were plotted for both bunker and external environment. Similarly, an overall mean score for both temperature and pressure of each month of the three years period were generated and graphs were plotted with those values for bunker and external environment. Results: The overall mean external temperature for the study period was 35.7°C, ± 3.82 as standard deviation (SD) and with a range of 26.0 – 43.6 °C, while for the overall mean bunker temperature it was 27.1°C ±1.7 SD and a range of 23.1 - 31°C. For the external environmental pressure, the overall mean value was 78.1hpa ± 1.5 as SD and a range of 68.1– 83.1hpa, while for the bunker it was 977.2 hpa ± 2.55 as SD and a range of 966.9 – 988.7 hpa. Using the pearsons correlation, it indicate that there is a significant association between environmental and bunker temperature (p-value=0.002). Conclusion: External environmental temperature showed a significant influence on bunker temperature despite the presence of chillers. But for environmental and bunker pressure, the relationship is complex and non-significant. Similarly, the seasons of the year also influenced bunker temperature.

Introduction: Insular carcinoma is a rare tumour with frequent tumour necrosis and micro follicles. Materials and Methods: Female patients with swelling in front of neck, USG and FNAC were carried out. FNAC showing follicular neoplasm were followed up with histopathology and 2 cases are presented here. Observation: Two female cases with swelling in front of neck with cytology depicting follicular neoplasm were studied. Discussion: Insular carcinoma of thyroid arises from follicular epithelium hence have abortive follicles with necrosis. Its prognosis lies between well and poorly differentiated thyroid carcinoma. Conclusion: It is necessary to recognize the tumour for better prognosis.

Background: Palliative external beam radiotherapy (PRT) had been reported as an indispensable tool for an effective pain relief in cancer patients with metastatic bone pain. Although many scholars reported a link between pain perception and ethnic background of an individual, but its role in cancer patients with interplay of other tumour factors needs to be evaluated to ascertain the actual impact it may have on pain perception and responses to radiation analgesia. Methods: We retrospectively reviewed patient’s data of breast cancer with metastatic bone pain between 2015 and 2018. Patient’s demographic factors like age, sex, ethnic group, tumour histology, RBS grade and sites of metastasis were extracted and grouped accordingly. Other Radiotherapy doses used for palliation of pain were extracted. Visual analogue pain assessment scale (0-10) was used by doctors (majority from Hausa-Fulani ethnic origin) to asses’ pain at presentation and four weeks post-irradiation. SPSS version 23 was used for data analyses; univeriate and multivariate analyses were conducted to test for any significant associations between predictive factors and dependent variables. Results were presented in pie-charts, bar-charts and tables. Results: A total of 161 patients reviewed during the study period, 159 (99%) were females and 2(1%) were males with mean age of 45.2 years, the age groups of 20-29 yrs presented with highest pain score. Among the three major ethnic groups, Yoruba constituted 31.7% with mean pain score of 7.5 ±1.4, followed by Igbo (26.1%) with mean pain score of 7.1 ±1.4. The commonest histology were invasive ductal (IDC) and invasive lobular (ILC) carcinoma with each having 7 as the highest mean pain score. Patients with grade 2 and 3 were the commonest and presented with mean pain score of 6.9±1.4 and 6.7±1.6 respectively. Patients with spinal cord compression (5.6%) presented with highest mean pain score of 7.3±1.3, followed by metastasis to long bones with pain score of 7.0±1.5. Pain alone was the highest presenting symptom (92.5%) from bone metastasis and Conventional X-ray was the common imaging modality used in confirmation of metastatic sites (68.3%). Common palliative radiation doses used were 11-20Gy in 4-6# (60%). Overall mean pain score at presentation was 6.8 ± 1.5 and 0.6 ± 0.7 four weeks after irradiation. In univariate analysis (binary comporason) only ethnicity was highly significant (p-0.001) in pain perception pre-radiotherapy and the significance exist after controlling other influential factors using multivariate analysis (p< 0.001). In post-irradiation using univariate analysis, ethnicity and metastatic sites shows significant association with pain relief, after multivariate analysis when influential factors were controlled, it appeared only metastatic sites with p-value of 0.008. Conclusion: Ethnicity of three major tribes in Nigeria played a role in pain perception from bone metastasis at presentation, with Yoruba higher pain perception compared to Hausa-Fulani and Igbo. But ethnicity appeared insignificant in response to radiation analgesia. Similarly, tumour factors appeared in significant in pain perception and response to radiation analgesia. However, metastatic sites influence response to radiation analgesia, with good pain relief in patients with metastasis to ribs and long bones.

of the jaws. Rather than true neoplasm, odontomas are considered to be hamartomas. Usually odontomas are found to be asymptomatic, although a few incidences of swelling, delayed eruption of permanent tooth and in severe cases, infection or lymphadenopathy has been reported. Multiple complex odontomas pose a therapeutic challenge in some cases especially in the mandible due to proximity of vital anatomic structures. They have also been associated with complications like cystic transformation. Here we are presenting a case of multiple complex odontomas in the maxilla and mandible in a 32-year-old male patient.

The term “pigmentation of oral mucosa” is applied to a wide range of lesions or conditions featuring a change of color of oral tissues. Common causes of mucosal coloration including petechiae, purpura, ecchymoses, hematomas, vascular tumors and exogenous substances are not true pigmented lesions. In contrast, melanin which is synthesized by melanocytes, is a true pigment and usually imparts a brown, blue or black appearance of the mucosa. Oral pigmentation affects about 3%of the total population and most likely in those with dark skin, more prevalent in females than males during the 3rd or 4th decade of life. In this review, we are describing the oral manifestation and dental considerations associated with common pigmented disorders which will allow the practitioner to have a holistic approach in diagnosis and management of these patients.

Background: In Ayurvedic classics Diarrhoea is described with the name of Atisaar. In modern science it is closely correlated with watery Diarrhoea which is defined as having loose or watery stools at least three times per day or more frequently than normal for an individual. Diarrhoea caused by bacterial pathogens is a global health problem, especially in developing countries and enteric bacterial pathogens are the main cause of infectious Diarrhoea. Ayurvedic literature have lot of unexplored or least tested medicine, Shadanga Ghrita is one of those Ayurvedic formulation used in the management of Tridoshaja Atisaar. But it has some disadvantages such as bitterness in taste, unpalatability, feasibility and inconvenience in transportation. Considering these, here an attempt was made to transform it into a new dosage form i.e., Ghana Vati. Aim & Objectives: Aim & objectives of present study was to evaluate the anti-bacterial activity of Shadanga Ghrita and its new dosage form on Diarrhoea causing enteropathogens. Material and Methods: Samples of Shadanga Ghrita & its Ghana Vati were prepared as per Sharangdhar Samhita Madhyama Khanda. All the samples of finished products were analyzed on organoleptic and physico-chemical parameters. Anti-bacterial study was done by using Well Diffusion Method and Muller Hinton Agar Media was used to evaluate anti-bacterial activity against S. aureus, E. coli, S. enterica, S. boydii, Y. enterolitica, A. species, and C. perfringens. Result: Both samples showed significant anti-bacterial activity against Diarrhoea causing enteropathogens. Conclusion: Shadanga Ghrita is more effective Antibacterial agent, as it was formulated by Sneha Paka Kalpana method; Gou- Ghrita has potentiated the anti- bacterial effect of it.

MTA® is considered as the biomaterial of choice because of its excellent characteristics. Biodentine™ has been introduced into periapical surgery and has proven its efficacity in sealing root-end cavities. Despite of the desirable properties of BiodentineTM, there are limited published cases that described the use of BiodentineTM in periapical surgery.

This study aims to analyze the effect of organizational structure and readiness for change on employee engagement and good governance at the Department of Cooperatives, SMEs and Industry of Samarinda City. The sample is 71 permanent employees of the Department of Cooperatives, SMEs and Industry of Samarinda City who are involved as respondents and are given a questionnaire containing questions that must be answered by giving a score. The data analysis method used is the Structural Equation Model (SEM) analysis using the SmartPLS application. The results showed that there was a significant influence between each organizational structure on employee engagement, readiness for change on employee engagement, readiness for change on good governance, and employee engagement on good governance. However, it is found that readiness for change on good governance does not have a significant effect. Based on the results of the study, almost all variables have a significant effect, but only readiness for change on good governance does not have a significant effect, so whatever changes the organization do, employees of the Department of Cooperatives, SMEs and Industry of Samarinda City some are being not able or even not willing to implement the changes.

Introduction: Despite ongoing advances in the treatment of chronic kidney disease (CKD), the mortality rate, and level of health-related quality of life (HRQOL) for the CKD population remain significantly higher than for the general population. The importance of measuring end-stage renal failure (ESRF) patients' quality of life in relation to healthcare lies in not only providing absolute survival but also the quality of that survival. Due to cost constraints, the profile of chronic kidney disease patients and their treatment in Bangladesh is almost identical to that of India, with patients frequently requesting a reduction in the frequency of dialysis sessions, the use of less expensive dialyzers, dialyzer reuse, and the absence of erythropoietin therapy. Hence, augmenting the QOL may perhaps be a challenge and an observable fact of specific interest for renal healthcare teams. This study is intended to assess KDQOL among patients receiving hemodialysis for 8 hours, and 12 hours per week, patients receiving CAPD, and patients of CKD stage V who decline any form of renal replacement therapy, and remained on conservative treatment. The aim of the study was to assess the quality of life among patients of CKD Stage V. Methods: This cross-sectional study was carried out at the Department of Nephrology, Dhaka Medical College Hospital and BIRDEM general hospital. The patients who received consultation at the Outdoor Department of selected hospital from November 2010 to October 2011. The study assess the of Quality of Life, and Cost Effectiveness on different modalities of treatment among the patients of chronic kidney disease stage V, and also to find out the best modality of dialysis. A total number of 134 consecutive patients were enrolled in this study, out of which 42 patients who were advised to commence renal replacement therapy, and after counseling opted to remain in conservative treatment were considered as GROUP I, 39 patients who received hemodialysis 8 hours per week were considered as GROUP II, 30 patients who received hemodialysis 12 hours per week in one or more centers were considered as GROUP III, and 23 patients who received Continuous Peritoneal Dialysis at least 3 exchanges per day were considered as GROUP IV. Result: Mean age was almost similar in all four groups, and most of the patients were 5th decade, and above. Male was predominant in all four groups, and the male-female ratio was almost 2:1 in the whole study patients. Diabetic nephropathy and glomerulonephritis were more common etiology of CKD in all four groups. Monthly expenditure was significantly (p<0.05) higher in group IV, followed by group III, group II, and group I in all three follow-ups, however, monthly expenditure was almost similar between group III, and group IV (p>0.05) but the mean monthly expenditure was higher in group IV patients. Mean serum Creatinine was lowest in group IV followed by group III, group II, and group I in descending order. Serum albumin was low in all the groups but almost parallel in all follow-ups in group II, groups I, and group IV, whereas the lowest was in group II followed by group I and group IV, but declined in group III during the 2nd, and 3rd follow-up from 1st follow-up. Hemoglobin level consistently remained within the target range in group IV in all follow-ups but below the target range in group I followed by group II, and group III in ascending order. The physical component score increased significantly in Group III, and Group IV at consecutive follow-ups, however, it was higher in Group IV. Similarly, the mental component score was recorded highest in Group IV, followed by group III, group II, and group I. Regarding mortality, it was observed that more than half of the patients were expired in group I, one-third in group II, and 16.7% in group III, and only 8.7% in group IV during final follow-up. Conclusion: Patients receiving continuous ambulatory peritoneal dialysis achieved the best clinical parameters in terms of control of blood pressure, and volume overload. On the other hand, parameters were a lot away from the desired target in patients receiving hemodialysis for 8 hours per week, and they did not have significantly better parameters in comparison to those who were only on conservative treatment. The scenario of serum albumin, and serum creatinine, though complicated by the existence of malnutrition, were in best approximation to the desired level in these patients. According to the age-sex-matched risk categorization of the patients, it was found that the majority of patients on conservative treatment were in more than the average risk category.