Generalized lymphadenopathy is a common cause of concern for both patients and clinicians. Causes for kikuchi fujimoto’s are infections and malignancies. Kikuchi Fujimoto disease (KFD) presents with fever, lymphadenopathy it also presents with systemic involvement. We report the cases of a 5 patients who presented with generalized lymphadenopathy, high fever, skin vasculitis and polyserositis. The lymph-node biopsy shows histiocytotic necrotizing lymphadenitis, suggestive of Kikuchi’s disease.

Objective: Highlight the different clinical and surgical features of this pathology. Bring the experience of the service and the chirurgical specificities encountered during the care of these patients. Materiels and méthods: Retrospective study of 24 cases of paranasal sinus mucoceles collected and operated in our department since January 2017 to December 2019. Results: The average age was 41 years. We noted 22 cases of ethmoid-frontal localization, 1 case of maxillary localization and 1 case of sphenoidal localization. The most common symptoms were swelling of the inner corner of the eye and exophthalmia. Complicated superinfection of orbital cellulitis was revealing in 3 cases. Facial computed tomography confirmed the diagnosis in the majority of cases. Magnetic resonance imaging (MRI) was requested in 3 patients. The surgical treatment consisted of a wide marsupialization by the endo-nasal route in 24 cases and by combined approach in 1 case. A recurrence was observed in two patients, after an average delay of 12 months. Conclusion: Mucocele is a relatively rare benign pathology, its symptomatology depends on its location. CT and MRI of the facial sinuses represent the key exams for diagnostic assertion. Treatment is surgical. Endonasal endoscopic marsupialization is currently the treatment of choice.

The electric vehicle as its precious control will be applied widely in agriculture manufacture and transportation that is thought. They are applicable and have future focus in electric vehicle by now. The main advantage is it precision and rapidness to compare traditional vehicle. The second is clear and safe to our environment that will protect energy over use. The third is that cost decreasing due to their unified specification. It allows us to produce rapidly and largely in every area.

In this study the market of Japanˎ Korea and China is researched from actual. It is found that the automatic productions are popular in common. The automatic line and seller is developed direction in future. Meantime consumer of daily production is important in the future as well. The turns are Japan to China in this respect according to writer traveling. Korea is key ie. Middle position in these countries. So combining these three countries to common aim will be subject in future.

Administration of oral of morphine for pain management to adult cancer patients has remained a great challenge. Nurses working in medical wards of Kenyatta National hospital have been faced with challenges of inadequate knowledge and attitudes of oral morphine administration to adult cancer patients. Oral morphine would provide relieve of pain in adult patients suffering from moderate or severe pain resulting from cancer. The main objective of the study was to establish nurses’ knowledge, and attitudes on administration of oral morphine for pain management to adult cancer patient in medical wards, Kenyatta National Hospital. A descriptive study was carried out and a total of 34 nurses participated in the study. Data was collected using structured, open-ended questionnaires for respondents. Data was analysed using the Scientific Package for Social Sciences (SPSS) software version twenty-one. Majority of the respondents 71.2% (n=24) received training on administration of oral morphine through on job training, (48.1%) respondents were undecided on administering oral morphine. Majority at (76.9%) nurses underestimated patients’ pain and all nurses agreed their reluctant to administer oral morphine because of respiratory depression. The study concludes that adult cancer patients with pain are not adequately relieved of pain and majority of nurses have inadequate knowledge and attitudes on administration of oral morphine. This study recommends continuing education programs on administration of oral morphine to adult cancer patient for nurses to facilitate acquisition of skills of oral morphine administration to relieve pain to adult cancer patients.

The most talented and wise teachers with a lot of training and expertise in most cases become unable to contribute effectively in developing learners’ skills when unfortunately their teaching styles do not meet learners’ needs. So, it is definitely important to evaluate teachers’ teaching styles by the learners for getting clear conception about teaching effectiveness. Though this is not the only means of assessing effective teaching, it is still an unavoidable concept where the reflections provided by both male and female learners require to be considered equally and accordingly. Universally, every individual is unique in his/her thinking with certain differences and sometimes he/she also keeps similar understandings with others on some points – this is also true for language learners. Keeping this in mind, this paper attempted to collect the opinions of tertiary level Bangladeshi English language learners concerning their teachers’ competencies with main focus on checking out whether there are thought differences or similarities between male and female learners regarding the issue. For the purpose of the study, data from 99 students (39 male, 60 female) of Level-1, Semester-1 under the Faculty of Fisheries, Bangladesh Agricultural University (BAU) was collected who took part in the survey for evaluating the qualities of their existing three English language teachers.

The strong hope of realizing a just, advanced, and prosperous Sambas community is an ideal that has been embedded for a long time, especially after the Madurese and Malay Ethnic Conflict in Sambas Regency in 1999. In an effort to help realize this goal, the writer feels the needs to conduct research on this subject matter with the main problem discussed in this article that are divided in to what factors that cause inter-ethnic conflict in Sambas and to then analyze the new construction of the legal culture of the society that was developed by the Madurese and Sambas Malay ethnicities in order to further increase the conflict recovery based on the value of justice. This study uses a constructivism paradigm with a socio-legal research approach. The results showed that the ethnocentric and exclusive attitude of the Madurese ethnic group made social interactions with the Sambas Malay ethnic destructive, in the form of a social conflict that ended with the expulsion of the Madurese ethnicity from Sambas Regency. This is exacerbated by differences in origins, cultural values as the basis for differences, also due to the ethnocentric and exclusivistic character of the Madurese as a trigger for conflict, and the weak rule of law as a factor that further widens the life gap between the two ethnic groups where in this case, is a new reconstruction of legal culture, that the Madurese ethnic needs to reposition cultural values in the context of adaptation/adjustment, so that they can be accepted back in Sambas Regency, because they are able to adapt socially and adapt, in the form of multiculturalism education for basic education and middle school, Islamic boarding schools, and aculturation in a form of marriages between Madurese and Dayak as the People of Sambas.

Health promotion officers at Public health center need to have competition in implementing and managing health promotion programs. This study aims to determine the competence of health promotion officers at Public health center in the aspect of empowering Posyandu cadres for toddlers in Aru Islands District. This research is a qualitative research with a case study approach. The informants in the study were thirteen people who have criteria as main informants and supporting informants. The informants are determined using purposive sampling technique. Data were collected using in depth interviews, FGD (Focus Group Discussion), document review, observation and data were analyzed using constant comparison methods. The results showed that the ability of health promotion officers at the Public health center, both with a background in health promotion education and a non-health promotion background, in the process of empowering Posyandu cadres for the awareness stage of toddlers, have not been able to grow and increase awareness of cadres because activities are still limited to refreshing cadres once a year, guidance and direction to cadres by involving cross-programs at the Public health center. There is a need for training and technical guidance for health promotion officers at Public health center to empower Posyandu cadres.

The potentiality of yoga to improve V̇O2max is often questioned because of its low exercise stimulus. Considering the positive effects of Yoga Breathing Maneuvers (YBM) on cardio-respiratory systems, its effect on V̇O2max needs to be studied. So, possible role of YBM in improvement in V̇O2max in yoga training was observed.32 healthy male students of 19 to 21 years of age were divided into two equal groups of 16 each. One group (YG) practiced yoga (Yogasanas, YBM and meditation) for 40 minutes every day for 6 days per week for 3 months. YBM were progressively inducted by increasing practice duration throughout training. Other group (CG) did not practice Yoga. Their basal heart rate (HR) and respiratory rate (RR) were recorded in the morning in bed. Predicted V̇O2max was measured on them by Queen’s college step test. HR was recorded before, during and after exercise manually and with Polar sports tester. All the parameters were recorded at baseline, 6th and 12th week end of yoga training.In YG, V̇O2max improved from baseline (47.5±3.7 ml/kg/min) to 6th week (49.4±3.3 ml/kg/min, P<0.001) and 12th week end (53.03±3.3ml/kg/min, P<0.0001). YG showed significant reduction in basal RR, HR and resting HR at 6th and 12th week end compared to their respective base line values. CG did not show such changes. V̇O2max was correlated to basal RR(r= – 0.463, p=0.0009), HR (r= -0.235, p=0.107) and resting HR (r= -0.414, p=0.003). YBM facilitated the improvement in V̇O2max possibly by its effects on cardiovascular and respiratory systems.

According to the three-layer airport runway, based on spherical cavity-expansion theory and considering interface effect of concrete-macadam-soil by analyzing kinetic energy projectile penetrating layered target of concrete-macadam-soil, penetration models of concrete cratering, concrete pore-forming, macadam pore-forming and soil pore-forming are established. In addition, numerical solution of control equations is carried out by using Runge-Kutta method. And the Time-history curve of residual velocity is obtained. The theoretical analysis shows that because of the interface effect, the penetration resistance of projectile suffered on concrete layer and macadam layer when moving , is related not only to penetration velocity, mass, projectile shape and medium character, but also to penetration depth, which is the biggest difference compared with penetrating into single layer. Finally, by means of finite element simulation, the process of oblique penetrating into multilayered medium of airport runway is simulated by three dimensional numerical analysis. Thus, the influence of the penetration velocity and the boundary of the runway on the penetration process were studied. The results show that the presence of the multi-layer media interface of the runway accelerates the attitude of the projectile body; the smaller the penetration rate is, the more obvious the phenomenon is. At the same time, the overload response of projectile body is changed. The research results have laid a foundation for the further research on the technology of the composite medium penetration into the airport runway. They also have reference value for the research on the failure of civil engineering materials under the action of dynamic loads.

Aim: To study the correlation of varying degrees of iron deficiency anemia with reactive thrombocytosis. Introduction: Iron deficiency anemia is a very common entity in women belonging to reproductive age group of 15-49 years. Iron deficiency anemia is also a causative factor for reactive thrombocytosis in most cases. The relationship of thrombocytosis in iron deficiency anemia is not yet understood properly. This study was undertaken to correlate the various degrees of thrombocytosis in association with various degrees of anemia. Materials and methods: A total number of 500 female patients belonging to the reproductive age group of 15-49 years, attending the out-patient and in- patient departments, who were identified to have iron deficiency anemia and thrombocytosis which was confirmed with relevant hematological studies including peripheral smear studies done in Sree Balaji Medical College and Hospital, Chennai were included in the study during the period of November 2018 to May 2019. Results: The current study helps in correlation and evaluation of varying degrees of iron deficiency anemia and reactive thromocytosis, which can be used to determine the treatment approach.

Sphingomonas are ubiquitous bacteria, widely distributed in the nature, soil and water including the water sources in the hospital environment, contains at least more than 30 species, which of only paucimobilis is an occasional pathogen.1 It is one of the non-fermenting Gram-negative bacilli that is emerging as an opportunistic pathogen [7]. S.paucimobilis is considered to be the organism of low virulence likely owing to absence of endotoxin and typical polysaccharide and thus responsible for less mortality and morbidity but sometimes can lead to septic shock. To support this, retrospective study conducted at our hospital on total 1580 inpatient (IP) blood samples for culture yielding positivity of 0.44% for the growth of S.paucimobilis, did favour the survival of the all the patients. All the blood isolates produced distinct white or off-white coloured colonies on blood and chocolate agar hence referred as “Bleached Sphingomonas paucimobilis.”

The risk of international trade transactions occurs because of the risk of fluctuations in foreign currency exchange rates. Hedging derivatives is a part of risk management carried out by companies to overcome significant impacts on unexpected changes in the value of foreign currencies. The purpose of this study was to determine the effect of leverage, company size, growth opportunity and financial difficulties on hedging decisions. This research was conducted at manufacturing companies listed on the Indonesia Stock Exchange for the 2016-2018 period. This study has a total population of 420 and is calculated by purposive sampling in accordance with the criteria for a sample of 216 out of 140 companies observed. The results of this study indicate that there is no effect of leverage, growth opportunity and financial difficulties on hedging decisions, while firm size has an effect on hedging decisions.

Neurodegenerative diseases (NDD) are a major global public health concern and a leading cause of disability-adjusted life-years, moreover, therapeutic options are limited. Brain targeting has always been challenging due to the presence of various physiological barriers, of which one of the most robust barriers is Blood Brain Barrier (BBB). The BBB consists of endothelial cells which are the tight layers surrounded by astrocyte foot processes, and these anatomic features together constitute a significant barrier that hampers the delivery of drugs to the central nervous system (CNS). In the past few decades, the nose-to-brain targeted delivery has received a great deal of attention because of factors like the rapid onset of action, increased bioavailability, manageable surface area and avoids the first-pass metabolism, thus considering it as a non-invasive, convenient and reliable approach that may overcome the challenges associated with nose-to-brain targeted delivery. However, this strategy still possesses significant limitations, which led to the development of nanotechnological approaches like solid lipid nanoparticles, polymeric nanoparticles, nanoemulsions, liposomes and polymeric micelles, thus circumventing these barriers. The present review article highlights a complete understanding of every aspect related to nose-to-brain delivery: mechanism involved in the transport of drugs from nose-to-brain via BBB by complex pathways, strategies to overcome the barrier-BBB, recent examples, and applications of nose-to-brain targeted delivery using nanotechnologies for brain gliomas and other neurological disorders.

This study aims to determine the diversity of fish at various water levels in Batu Bumbun Reservat, as input material to formulate management activities that must be done to save the reserve. Research was carried out by survey method, in the dry season (April-June) and rainy season (November-December) 2016. Parameters measured, water quality (DO, pH, temperature, TSS, TDS, alkalinity and brightness), fish community structure diversity, uniformity, relative abundance, diversity and dominance), water levels, and sedimentation. The fish community data obtained were analyzed by the Shannon-Wiener index. The results showed that: (1) Changes in water level resulted in the Batu Bumbun Reservus ecosystem having experienced severe degradation, characterized by fluctuations in water level during two extreme seasons. When the rainy season occurs extreme floods, while the dry season, there is siltation to dry. (2) Community of fish caught in Batu Bumbun Reservus ecosystem of 29 species, consisting of 23 genus and 16 families. When the rainy season is dominantly caught fish community (white fish), with fish density 7.015.000 head / km2, while the dominant season is dominant caught is a community of swamp (black fish), with density of 2,334,000 fish / km2. Based on the analysis of fish community, the value of diversity index (H ') ranged from 1,188-0,825 means low-moderate species diversity, dominance index (C) around 0.0827-0.2147 means no dominant species and uniformity index (E) , 8295-0.6710 means that in a balanced state, there is no competition. It is concluded that the Batu Bumbun Reservus ecosystem has experienced severe degradation, with indicator of fish community change. It is recommended that the management must be done to save the Batu Bumbun Reservus ecosystem is, Dredging, Weed cleaning, Local Fish Restocking, illegal fishing Prevention, Increase of reservat security facility.