Hemangiomas are one of the most common benign soft tissue tumors. Vascular tumors of the female genitalia are unusual and pedunculated vulvar hemangiomas are extremely rare .Usually they are asymptomatic and quite small in size. Here we report a rare case of pedunculated vulvar hemangioma in a 46 year old patient who presented in the gynecology department with a painless mass in vulva for duration of 2 years.

Food allergies are serious health issues around the globe but people often neglect them. In current survey, large and small both cities were randomly selected to determine prevalence of food allergies and obtained results showed that major sufferers are teenager. Whereas gender based comparison showed that females are at more verge of exposure than males and in addition to this, female patients also don’t take proper medication for recovery. The possible routes of allergens are intake of unhygienic water and improperly cooked food. Commonly reported symptoms are nausea, vomiting, diarrhea and skin itching. So it is need of time to address these issues and finding of their remedies along with programed general public awareness to reduce prevalence of food allergies.

The purpose of this research is to analyze and examine: 1) the regulation of diversion requirements in the current juvenile criminal justice system is not based on the value of justice; 2) weaknesses in the regulation of diversion requirements in the juvenile criminal justice system which is currently not based on the value of justice; 3) reconstruction of diversion requirements regulations in the juvenile criminal justice system based on the value of justice. This research is a qualitative research, with a sociological juridical approach, descriptive analysis, using primary data and secondary data, using the Grand Theory: Lawrence M. Friedman's Legal System Theory and Pancasila Justice Theory; Middle Theory: Law Enforcement Theory Soerjono Soekanto; and Applied Theory: Progressive Legal Theory Satjipto Rahardjo. The research findings are: (1) The regulation of diversion requirements in the juvenile criminal justice system is not currently based on the value of justice because the regulation of diversion requirements in children's cases is contrary to the values of Pancasila justice, and in the perspective of legal norms, the diversion requirement with restrictions is punishable by imprisonment under 7 (seven) years is discriminatory compared to the case of adults who can mediate or peacefully are limited by criminal threats, (2) The weakness of the regulation on diversion requirements is not based on the value of justice, because the regulation on diversion requirements is regulated in Article 7 of Law Number 11 of the Year 2012 concerning the Juvenile Criminal Justice System is discriminatory between child cases and adult cases. (3) Reconstruction of the regulation on diversion requirements in Article 7 of Law Number 11 of 2012 concerning the Juvenile Criminal Justice System based on the value of justice, especially paragraph (2) whose initial phrase reads Diversion as referred to in paragraph (1) is carried out in the case of a crime committed: threatened with imprisonment under 7 (seven) years; and is not a repetition of a crime. Reconstructed into Diversion as referred to in paragraph (1) is carried out in the event that the crime committed is not a repetition of a crime.

Background to the study: The use of insecticides have been encouraged in most Nigerian homes in the eradication of insects that could harm humans despite the side effects of exposure to these insecticides. The study aim was to examine the toxic effect of inhaled dichlorvos (DDVP) on the histological architecture of the testes of wistar rats on short-term exposure. Methods: Twenty (20) albino male wistar rats weighing 140g – 180g were recruited for this research and were randomly placed into four (4) groups of five (5) rats per group. Group 1 was control group, while groups 2 – 4 were given 10ml DDVP/90 ml distilled water – v/v, 20ml DDVP/80 ml distilled water – v/v and 40ml DDVP/60 ml distilled water – v/v, respectively. At completion of exposure, rats were anaesthetized with chloroform, sacrificed and their testes were harvested for routine histopathology procedure. The stained sections were morphologically evaluated and the pictures of the slides compared. Photomicrographs were obtained with the aid of Am-scope camera fitted on an Açu-scope microscope. Results: Results obtained from the control group showed that the testes presented with a normal histological make-up depicted by the presence of normal seminiferous tubules, no signs of germ cell distortions. However, experimental groups showed graded levels of degenerative changes in germinal layers of the seminiferous tubules as well as notable vacuolations. Conclusion: It can be concluded that prolonged exposure to dichlorvos inhalation could be toxic to the reproductive system of male wistar rats.

Introduction: Lower respiratory tract infection (LRTI) is one of the major causes of mortality in children with estimated 1 million deaths every year. Hyponatremia is the most common electrolyte abnormality seen in LRTI. The objective of study was to find association of hyponatremia (serum sodium<135meq/l) with severe LRTI. Prospective cross sectional study design was used for study. Settings: Pediatric Emergency, Ward and Pediatric Intensive Care Unit of Tribhuvan University Teaching Hospital (TUTH). Subjects: Children between 2 months to 16 years presenting with cough for less than 3 weeks, fast breathing and chest in drawing. Methods: Children between 2 month to 16 years of age having cough, fast breathing and chest in drawing admitted in emergency, ward or PICU of TUTH were screened and among them, children having pediatric respiratory severity score of 4-5 were enrolled in the study. Serum sodium was sent during admission and collected within 2 hours. Daily follow up was done to find need of respiratory support, duration to resolve hypoxia, total duration in hospital and final outcome of patient. Statistical test applied were Chi-square test and Fisher exact test. Results: 47.5% of study population had hyponatremia, of whom 65.79% had mild hyponatremia 26.31% had moderate and 7.89% had severe hyponatremia. Association of hyponatremia with need of non rebreathing face mask (p=0.001), ventilatior (p=0.009), duration of hospital stay (p=0.047) were significant. The study also found the association of severity of hyponatremia with need of non rebreathing facemask (p=0.001), ventilator (p=0.01), outcome (p=0.001), duration of stay (0.002). Mean time to resolve hypoxia in children with hyponatremia (4.5 days) was longer compared to normal sodium (2.58 days). Four patients died during the study period and all of them had hyponatremia. Conclusion: Association of hyponaremia and severity of hyponatremia in severe LRTI with need of non-rebreathing face mask, ventilatior, outcome, duration of stay was significant.

Young people’s education has become, today, the first priority of national and international meetings or policies although most of them are dying of hunger, starvation, and during non-authorized immigration, resulting from unemployment and other forms of criminality and delinquency. To better understand and explain these enigmatic social issues so as to find out the real causes of the failure of educative strategies, including its negative consequences, as well as the required solutions for a better future, from the context of the novel, Psychoanalytic Criticism has been used through its psychological, human, social, sociological, political and economic dimensions, sharing exactly or not the writer’s perception. Very well educated or trained, talented young people, with secured employment for sustainable development, are expected contributions, in the end of this analytical and critical study.

This work conducted a study of language medium and the teaching of science and technology through the medium of mother-tongue in North-East and North-West Geo-Political Zones, Nigeria. a case study research design was used in collecting data for the study. We investigated some selected public primary school students in the two geo-political zones of the North-East and North-West. There are an estimated 100,000 primary school students in the two zones. Each zone is stratified along with the component. 18 schools were selected at random for the study from each geo-political zone. A minimum of 30 students were equally selected at random from each school from the zone under investigation. Questionnaires, oral interviews, and informal interactions were employed simultaneously to elicit information. The Sapir-Whorf hypothesis which holds that our thoughts are shaped by our native languages; and that speakers of different languages, therefore, think differently was used as the theoretical framework of analysis. The work discovered among other things that the science and technology learning area has various challenges as pointed out by the participants. On the whole, the work concludes that the people’s language is not only part of their socio-cultural heritage; it is the natural medium of thought, expression, and communication within that culture.

Introduction: Usually, eclampsia is the commonest cause of convulsions in pregnancy next being epilepsy. Moreover, in developing countries like Bangladesh, perinatal condition in eclampsia is a major concern of infant injury. So, proper treatment planning and initiatives against eclampsia can save many lives by decreasing the total mortality and morbidity of child and mother. The aim of our study was to assess the perinatal outcomes of pregnant women with eclampsia in a tertiary care hospital in Bangladesh. Methods: This cross-sectional observational study was conducted at the Department of Obstetrics and Gynaecology in Rangpur Medical College, Rangpur, Bangladesh during the period from January 2020 to December 2020. Proper written consents form all the participants were obtained and the ethical committee of the mentioned hospital had approved the study before starting the intervention. In total 78 pregnant women with eclampsia were selected as the study population. A predesigned questioner was used in collecting patient data. All data were processed, analyzed and disseminated by using MS Office and SPSS version 23 as per need. Result: As final outcome we observed, there was not any case of multiple pregnancy or maternal mortality. Among total 78 fetus, cases of stillbirth (SB), early neonatal death (END), perinatal death (END + SB) and death after birth were found as 8%, 12%, 19% and 4% respectively. So, total case of neonatal death was found 35% whereas the survival rate was 65%. As neonatal complication among survived babies, frequencies of jaundice, septicemia and respiratory distress were found in 27%, 24% and 18% babies respectively who were noticeable. As maternal complication, cases of ICU admission, acute kidney injury and haemorrhagic stroke were found as 4%, 3% and 1% respectively. Conclusion: Stillbirth may be considered as the main component and prematurity may be considered as another important cause of perinatal mortality in obstetric management of delivery in pregnant mothers with eclampsia. Early referral of eclamptic patients, early resuscitative measures as well as good neonatal care can improve perinatal outcomes in such cases.

Introduction: cystic adenoid carcinoma of the Bartholin gland is a very rare tumor with a low incidence of 1% of female genital malignancies; it is characterized by its aggressive nature and frequent recurrence. Case report: We report a case of a cystic adenoid carcinoma of Bartholin's gland in a 38-year-old female patient who was treated surgically with good evolution. Conclusion: Adenoid cystic carcinoma is a very rare tumor of the Bartholin gland, whose diagnosis is based on the anatomopathological study.

Background: Partograph is a simple, of low cost but most important tool for record of progress of labour In the developing country like ours, where both pregnancy and maternal mortality rate is so high, the use of this inexpensive partograph is essential. Objective: To assess the importance of partographic control of labour in preventing prolongs labour and its consequences, thereby decreasing maternal morbidity and mortality and improvement of neonatal outcome. Method: This study was done in the Obstetrics and Gynaecology department of Institute of Child and Mother Health, Matuail, Dhaka. Total 196 patients were included in this study. Data were collected by predesigned data collection sheet. Data were analyzed by using Statistical Package for Social Science (SPSS) version 14. Result: 74% of these patients had spontaneous vaginal delivery, 7.14% required assisted delivery (forceps or ventouse) and 18.9% needed caesarean section. Caesarean section was done in 18.9% patients because of fetal distress (32.4%) and prolonged labour (67.6%) due to malrotation and cephalopelvic disproportion. Patients with non-engaged head in labour required more intervention than who had engaged head. With the use of partograph, unnecessary interventions were reduced. It was found that 66.7% of the patients were delivered within 7 hours and all patients were delivered within 10 hours from active phase of labour. Thus prolonged labour and its consequences, such as obstructed labour and ruptured uterus, can be avoided by using partograph. In 100% of the patients, crossing the action line in partograph required interference, but 92.5% within alert line of partograph delivered vaginally spontaneously and 7.5% required assisted delivery (forceps or ventouse). When IDR was 1 cm/hr 85.1% women delivered spontaneously. When IDR was <0.4 cm/hr, 100% of patients required some kind of interference. Thus, the maintenance of partograph in labour enables the obstetricians to recognize very early dystocic labour and act accordingly. Conclusion: With the help of a partogram, time of delivery can be estimated and if the progress is slow, an appropriate interference at the right time can be instituted before the labour becomes dangerously protracted. IDR very helpful in making early decisions about the prognosis for the type of labour. With the use of partogram and its scientific application, the result showed that operative interventions were reduced, duration of labour was within normal limit and there was no obstructed labour and no maternal or perinatal mortality.

The study evaluated the effect of water accounting on employment generation in Bayelsa state. The general objective of the study is to assess the effect of water accounting on employment generation in Bayelsa state. The study was anchored on protection motivation theory. Survey research design was adopted in the study and data collected were analyzed using z-test and descriptive statistics. The findings show that water accounting has significant impact on employment generation in Bayelsa state. There is high level of relationship between water management in employment generation in Bayelsa state. It was recommended that government should provide clean and portable water for its citizens through proper management and accounting of water resources. Government should also put in place functional water management system. Government should ensure public enlightenment to debunk the idea that services provided by the government should not be paid by her citizens.

Background: Use of several anesthetic agents to induce anesthesia is not new and they are used to achieve different effects such as sedation, muscle relaxation and pain relief. Propofol has been accepted as an alternative to thiopentone for intravenous induction and is commonly used as an inducing agent and its action is more rapid. Objective: To compare co-induction with a small dose of ketamine is a better option compared to midazolam in reducing induction dose of propofol. Methods: This was a prospective, randomized, double-blind and interventional study conducted at Department of Anaesthesia, Institute of Child and Mother Health (ICMH), Matuail, Dhaka, Bangladesh from January to December-2019. Fifty two adult patients undergoing elective surgery to be performed under general anesthesia were randomized to receive 0.3 mg/kg of Ketamine or 0.03 mg/ kg of Midazolam intravenously as co-induction agent. A minute after administration of co-induction agent, anesthesia was induced with Propofol 40 mg bolus then 10 mg every 10 seconds until the loss of verbal response. The hemodynamic response at 0, 1, 2, 5 minutes respectively and the induction dose of Propofol were noted. Results: A total of 52 patients (n=26 in each group) who met the inclusion criteria were included in this study. The patients where between age group of 20 years to 71 years and weight of 40 kg to 80 kg and had ASA physical status 1. As there were no significant differences in age, sex, weight and ASA physical status of patients, between the two groups, both of the groups were comparable. The mean arterial pressure heart rates were significantly lower at 1, 2 and 5 minutes in midazolam group. However, mean arterial pressure and heart were within the physiological range in both the groups. Propofol dose requirement for induction between the two groups was similar (p>0.05) but co-induction significantly decreased the induction dose of Propofol as compared to standard recommended dose for induction. Conclusion: Our study showed that hemodynamic variables were maintained within the physiological range with midazolam and ketamine co-induction. However, lesser degree of decrease in mean arterial pressure was seen with ketamine but the heart rate was higher. A similar reduction of induction dose of propofol was achieved with both the drugs.

The stomach is one of the frequent sites of metastasis from invasive lobular carcinoma of the breast. The clinical presentation and the endoscopic findings for metastasis carcinoma are nonspecific and may mimic that of a primary gastric tumor. The distinction between these two neoplasms may be very difficult but essential as the basis of the treatment is different. Histological and immunohistochemical analyses are the gold standard for establishing the diagnosis of the primary site. We report the case of a 68-yearold patient with metastatic breast cancer mimicking a primary stomach cancer.

Commercial Papers (SBK) or often referred to as Commercial Paper (CP) are securities that are classified as promissory notes and appear in practice as an alternative to corporate funding. In 1995 Bank Indonesia issued Bank Indonesia Decree No: 28/52/KEP/DIR and Bank Indonesia Circular No: 28/49/UPG concerning Requirements for Issuance and Trading of Commercial Paper through Bank Indonesia. Then in 2017 Bank Indonesia revoked the decree and again issued Bank Indonesia Regulation (PBI) No: 19/9/PBI/2017 concerning the Issuance and Transaction of Commercial Securities in the Money Market. This study seeks to examine matters related to SBK or CP after the issuance of PBI NO: 19/9/PBI/2017, especially the problem of formal requirements for SBK as securities; the parties involved and their legal responsibilities in the SBK or CP transaction. This research is a normative legal research with a descriptive type that is sourced from legal materials, both primary, secondary and tertiary legal materials and analyzed qualitatively. The results of this study indicate that the formal requirements for SBK follow the provisions of the formal promissory note as stipulated in Article 174 and Article 175 of the KUHD. PBI No: 19/9/PBI/2017 does not stipulate other formal requirements, but stipulates the criteria for SBK (CP) to be issued for transactions through the Money Market. The parties involved are issuers, issuance support institutions, Bank Indonesia, transaction actors and transaction support institutions, administration and settlement of SBK transactions. Each of these parties has a legal responsibility, namely the issuer has legal responsibility in terms of payment of Commercial Securities issued. The issuance support institutions have legal responsibilities in protecting consumers (investors) while transaction actors, transaction support institutions, administration, and transaction settlements have the responsibility to create a credible SBK or CP market and trade.

Background: Acinetobacter species has emerged as an important pathogen globally in various infections especially in hospital acquired infections. Objectives: This study was conducted to determine the antibiotic resistance pattern of Acinetobacter species from wound swab samples. Materials and Methods: A Cross sectional study was undertaken in Department of Microbiology, Rajshahi Medical College (RMC), Rajshahi, Bangladesh from period January 2014 to December 2014. A total 13 Acinetobacter were collected from 292 wound infection patients of surgery word and its allied brances in Rajshahi medical college hospital (RMCH). Isolation, Identification and sensitivity of Acinetobacter species were performed by manual method. Results: Out of 292 patients 13(4.4%) patients showed growth of Acinetobacter species. Resistance observed to Meropenem was 38.46%, Piperacillin -Tazobactum 61.53%, Amikacin 53.84%, Ceftazidime 76.92%, Gentamicin 61.53% and Levoflaxacin 67.23%. This data suggest that Acinetobacter isolated from hospital exhibits resistanace to multiple antimicrobial drugs. Conclusion: The study will help to implement better infection control strategies and improve the knowledge of antibiotic resistance patterns of Acinetobacter species in our region.