Objective: Simultanaeous testing for serum antineutrophil cytoplasmic antibodies (ANCA) by indirect immunofluorescence (IF) and by anti-proteinase-3 (PR3)/anti-myeloperoxidase (MPO) antibody assays may identify patients with PR3-ANCA or MPO-ANCA despite a negative IF (IF negative MPO/PR3-positive); however, the significance of this result is not clear. We sought to determine whether IF-negative MPO/PR3-positive results identified any cases of clinically meaningful systemic vasculitis at our institution. Methods: We conducted a retrospective analysis of all ANCA positive RPGN patients either by IF or ELISA identified at our institution from August 2017 - July 2018. Results: Out of 265 samples 45 were positive for both IF and ELISA, 220 were IF-negative. Among IF negative, 6 samples (2.7%), tested positive for MPO-ANCA or PR3-ANCA. Two IF-negative ELISA positive patients were subsequently diagnosed with ANCA-associated renal limited vasculitis. Two IF-negative ELISA-positive patients were previously diagnosed and treated for AAV, both with positive IF and antibody tests prior to treatment. 1 patient had SLE and 1 had inflammatory bowel disease. Mean age of patients 58±4, 56% were males and P-ANCA 67% and C-ANCA 33% only 1 pt had both C- ANCA AND P-ANCA patterns positive. Conclusion: In our study both IF and ELISA, ELISA positivity without a positive IF rarely led to a definite diagnosis of systemic vasculitis, and was more likely to occur in the context of a non-vasculitis inflammatory condition. Our results suggest that concurrent IF and MPO/PR3 testing may be important in preventing a missed diagnosis of new onset renal limited AAV.

Nowadays, development takes place under different historical conditions and different places. Contemporary societies are confronted with comparable phenomena such as social breakdown, the crisis of social movements and the expansion of informal activities. Generally, written or spoken interaction appears as a means of communication, which is highly used on the social media. Youngs are writing and speaking for communication. The writing or Use of different message has a phatic and expressive dimension. These communication forms appear as a mean to chat without be with someone, to be absent but present in the group, to create intimity by preserving the usage of spatial distance.

A special swimming program for the students with disabilities was started in summer year 2016 when the researcher was privileged and invited to make a physical education program in a Special Education (SPED) School in Quezon City, Philippines, through the initiative of its directress to offer a swimming lesson specifically designed for learners with disabilities (the activity just stopped due to Covid-19 pandemic). The school has 70 students with different disabilities and level of mental health problems. The directress was in need of physical activity program that she believed will enhance the total personality development of her students [22, 11]. She was hesitant at first to have the outdoor program due to the high risk responsibility, a venue outside the school, and how the students react to the environment, in a swimming program that is new to them [13]. The partnership envisioned that the water activity provides significant benefits for children with disabilities [32, 33] that regular participation in the program would also promote positive advancements physically, can increase competency in gross motor skills, enhance fitness level, improve self-esteem, social skills, encourage and maintain a motivation to improve their health and raise their level of enjoyment [9, 21, 10].

Background: Morningness and eveningness is a phenomenon which looks at the differences among individuals regarding their diurnal preferences, sleep-wake pattern of activity, and alertness in evening or morning. Morning chronotypes are known to exhibit better physical and mental health, greater self esteem and academic performance. Evening chronotypes has been to be associated with several mental disorders, infection prone and have poor sleep quality. Students of Medicine have an average of sleep duration of 6 hrs per day in contrast to 8 hrs of sleep which is seen in other groups. Objectives: To study the morningness eveningness preferences among first year medical students. Methodology: With the approval of Institutional ethical committee this cross sectional study was carried out among 130 first year medical students. Informed consent was taken and the British version of the Horne and Ostberg questionnaire was administered. Confidentiality was maintained and the recorded responses were analyzed using Microsoft excel and Epi Info 7. Results: 34.61% (45) of the study population belong to moderate evening category and 13.07% (17) to definite evening category. Ours study also reveals that 9.23% (12) belong to neither of the morning or evening categories. Our results also show that 26.15% (34) belong to definite morning types and 16.92% (22) belong to moderate morning types. Conclusion: Our study shows that the study population which is first year MBBS students show more inclination towards eveningness. Scheduling of academic activities based on the chronotypes will help the students to improve upon their academic performance.

Background: The sleep pattern of students varies between the types of professional students (4). Medical students are a group of people in the general population who are vulnerable to poor sleep due to their long and demanding academic assignments and clinical duties including working overnight which is challenging and demanding. Sleep disturbances are known to affect the quality of work and academic performance of the students. In the last decade the rapid diffusion of gadgets especially smart phones among students and the cultural changes as led to the change in the sleep pattern of young adults. Objectives: To study the sleep pattern among first year MBBS students and to assess factors influencing sleep. Methodology: A cross sectional study was carried out among first year medical students. A self structured questionnaire was administered to all the 130 students after explaining the nature and purpose of the study. Informed consent was taken and the confidentiality was maintained during the process of this survey. The responses were analyzed using Microsoft excel and Epi Info 7. Results: 68.46% of students reported to have sleep duration of less than 6 hrs. 93.84% students of the study population agree that use of mobile phones and laptops were affecting their sleep pattern. 64.61% of the study population reported sleep latency of 30-90 min. 78.46% of study population reported waking up for 1-2 times from sleep and 55.38% reported that it takes 10-20 min for them to return to sleep after waking up.

Background: Nurses are the frontline healthcare workers and during the current pandemic COVID-19, they are at increased risk. Considering their work patterns and the pressure of the work, they experience stress. There is very little data available regarding the incidence of stress among nurses during this pandemic. Methods: This was a cross-sectional study which was done at Security Forces Hospital, Riyadh, Kingdom of Saudi Arabia. The objective of this study was to examine the presence of stress among nurses working in a tertiary care hospital. We calculated the sample size as 57. We used the Perceived stress scale (PSS) in our study. We gave the questionnaire comprising PSS questions to nurses from different wards. We calculated the mean, standard deviation, frequency count, and percentages for the perceived stress. Results: The mean PSS-10 score was 20.8 (SD: 4.61) with a range between 11 and 29. Two (3.3 %) nurses had low stress and 52 (86.7 %) nurses had moderate stress while 6 (10 %) nurses had high stress. Conclusion: The majority of nurses in our study experienced a moderate level of stress during this COVID-19 pandemic.

Objective: The study is conducted to evaluate the relationship between testicular volume measured by ultrasound and sperm parameters (volume, count, motility, significant leukocyte and morphology) in Sudanese infertile males attending KDTH, andrology department. Methods: Prospective cross sectional, investigational hospital based study .A total of 100 males were investigated for this study. The testicular volumes of all subjects were measured by ultrasonography. The serial semen samples were collected by the process of masturbation after 3-5 days of ejaculatory abstinence and were analyzed by CASA according to WHO criteria 2010. Results: 74 out of 100 of patients with low Testicular volume had low motility (74%).Correlation between testicular volume and volume of semen, sperm count, morphology and presence of significant leukocyte revealed no significant correlation. Conclusions: Testicular volume had a significant correlation with sperm motility. No significant relation between testicular volume and semen volume, sperm count and sperm morphology. Measurement of testicular volume cannot be helpful alone for assessing fertility at the initial physical examination.

In 2003, Sudan joined the ignoble league of States disparaged for monstrous crimes against their citizens. The administration of Omar al-Bashir quickly garnered notoriety for genocide, war crimes and crimes against humanity perpetrated against the people of Darfur. Upon a UN Security Council referral, the International Criminal Court (ICC) made a futile attempt to arrest five persons most responsible for the atrocities. Following the fall of al-Bashir in 2019, there has been renewed zeal to ensure accountability for perpetrators and justice for the victims of those crimes. The Sovereign Council, Bashir’s successor, has so far failed to deliver on this, despite promises. The UN Security Council has so failed to render any assistance to secure their arrest. Hope for accountability and justice now rests on the implementation of ICC’s subsisting indictments and warrant of arrest and it cannot afford to fail.

Rheumatoid arthritis is chronic rheumatism characterized by symmetric, inflammatory, peripheral polyarthritis with a highly destructive potential. Systemic lupus erythematosus is a multi-system autoimmune disease that combines visceral involvement with very frequent and disabling joint damage. These two pathologies share many clinical manifestations and may coexist in a patient. Such condition defines the Rhupus syndrome, which is a rare overlapping syndrome. The exact etiopathogenesis remains unknown. Serious visceral damages, particularly renal, are exceptionally reported during Rhupus syndrome. We report the case of a male patient diagnosed with Rhupus syndrome who presented with glomerulonephritis.

SS homozygotic sickle cell disease combines chronic hemolytic anemia with vaso-occlusive and infectious complications. The association between Sickle cell disease and pregnancy is a maternal and fetal high-risk situation. Case description: A 27-year-old woman carrying a pregnancy on a sickle cell field with a history of miscarriage and hospitalization in critical care department for post-abortion septic shock. Her pregnancy was followed in our department in collaboration with internists, under aspegic, acfol and tardyferon and during the pregnancy, she received three blood transfusions and a caesarean section was planned at 39 weeks of gestation. She gave birth to a newborn weighing 3600g in good condition. The post-partum was marked by a fortuitous discovery of IVC thrombosis. Conclusion: Sickle cell disease and pregnancy is a high-risk situation as we illustrate in our case. In addition to the absence of complications during pregnancy, post-partum also remains a period of risk even without obvious clinical manifestation

Take Baker’s Economic Policy Uncertainty Index, and use the generalized impulse response function method and variance decomposition method based on the vector autoregressive model to empirically analyze the impact of economic policy uncertainty on the price level and its classified price index. A systematic and in-depth study of the impact of economic policy uncertainty on UK stock market not only can effectively explain the characteristics of the “policy market” and “information market”, yet in addition significantly affects improving the proficiency of national decision-making, fortifying business sector oversight and settling the advancement of the financial exchange. From the perspective of the impulse response function, the exchange rate, CPI, and price indices of all categories are negatively affected by the uncertainty of economic policies. By constructing the VAR model, the impact of economic policy uncertainty on the stock market is studied from the perspective of yield and volatility. Starting from the mean spillover test, the VAR model is estimated, and the Granger causality test, impulse response, and variance are used. By means of decomposition and other supplementary arguments, it is concluded that economic policy uncertainty does not have an average spillover to the stock market, and in turn, stock index returns are Granger reasons for changes in the EPU index.

Background: The existing literatures comprehend the prevalence of various myths related to dentistry amongst general public in different parts of India. Continuous efforts are being made by Public health dentists and other healthcare workers, to spread awareness and promote good oral health care across the nation. This study was done to assess the prevalence of myths related to dentistry among people of Lucknow. Material & Method: The study was carried out amongst the patients visiting the dental outpatient department of King George’s medical University. 250 subjects were questioned about myths related to oral hygiene, teething and childhood, tobacco use, dental problems and dental treatment. Results: The results of all 23 questions were obtained in 3 sections ie ‘Yes’, ‘No’ and ‘Don’t Know’ and percentage calculation was done for each question. In this study the maximum participants belonged to Upper lower class according to Kuppuswamy socioeconomic scale. The myths which were still prevalent in the population under study, were, cleaning teeth with a twig is better than toothbrush, falling of teeth with aging is a natural process and an ulcer which do not heal for a longer duration always lead to cancer. Conclusion: The results of this study concluded that there is increase in knowledge amongst the public of Lucknow city. The percentage of people who did not believe in the various myths questioned in this study was more than the people who still believed in it or were unaware of any such myths. Thus, we can say that the efforts been put up by various healthcare workers to create awareness are effective in eradicating the false traditional believes of Indian citizens but still there is a need to put in more hard work to demolish it completely and attain good oral health for all.

For the unsuspecting clinician, a common cause for non-surgical endodontic treatment failure in mandibular premolars is missed roots or canals, as the root canal morphologies of these teeth can sometimes be aberrant. Even in the absence of state-of-the art, three-dimensional imaging techniques, it is prudent clinical approach to have detailed pre-endodontic periapical radiographic assessment of these teeth. Evaluation of sudden changes in the density (fast break) of the root canal space, periodontal ligament contours, root bifurcation, if any, are important points to note, pre-operatively. Bifurcation of mandibular second premolar roots in the mesio-distal axis is very rare and even rarer when it occurs bilaterally. Radiographic exposure of asymptomatic contralateral teeth may also be necessary, to help uncover latent pathologies and evaluate the bilateral presence of anomalies, if any, to justify simple, early restorative intervention to obviate the need for later, more complex root canal treatment.

For centuries, mankind is dealing with deadly infectious diseases. Broad-spectrum antibiotics are commonly used against these bacterial infections. However, due to the excessive use of antibiotics, several bacteria have developed resistance against these therapies. Many advanced methods are being developed to overcome this issue, wherein bacteriophage therapy is included at the top of the list. Bacteriophages are “bacteria-eating viruses”, have more sensitivity, specificity, host range, and efficacy than antibiotics, and are now being used as an antibiotic replacer in different food items, guarding pregnancy, treating surgical wounds, and protecting aquaculture. Bacteriophages are currently being synthesized and commercialized in all three; solid, liquid, gas forms. Due to continuous mutation in bacterial genomics, different modifications are being applied, like crisper and endolysin that increase the efficiency of bacteriophages and decrease the survival probability of the bacteria to its minimal level. The current text will elaborate on the recent advancements and applications of bacteriophage therapy in eliminating bacterial infections, especially in the food and aquaculture industry, and due to its increased therapeutic applications, considered to be a strong candidate to prove its true potential.

Pediculus humanus has always been the most obstinate ectoparasites that evolved with human beings and persist till today throughout the world. These wingless nemeses are extremely hard to deal with, because they prefer the human body temperature for their existence and propagation or reproduction. Numerous studies have been conducted to exterminate these blood feeders by the employment of several natural as well as synthetic regimens but not with an ideal proficiency. Anyhow, a multifaceted product would be beneficial for killing and removing the lice and their stubborn nits from the human hair shafts permanently. Our current focus is to introduce an all rounder treatment with a marvellous fusion of deltamethrin (DMT) and diisopropylfluorophosphate (DFP) along with dimeticone (PDMS). The tonic lotion with the amalgamation of aforementioned antilice candidates will stop lice reproduction, accessory gland secretions that are mediated by corpora allata, nit formation, neurotransmission and behavioural responses which will ultimately lead to clearance of these hematophagous insects. So as there is no promising solution to this global discomfort at present, our novel proposal will hopefully pave a new way to eradicate lice forever.