Performance Assessment is the tools which give clear indication about the construction status of the project which finds out the strength and weakness of project implementation and examines the effectiveness of technical social and environmental parameters of the Road construction project. Strengthening the National Rural Transport program (SNRTP) is introduce to fulfill the aim of GON to provide all-weather road access to all Village Development Committee (VDC) by gradually upgrading the District Road Core Network (DRCN) and providing proper maintenance. Assessment of the project’s measured the project output, budget, time deadlines, quality, deliverables, and specifications. The study was focus on finding out different stage, parameters, process used in road construction project and checking compliance of Technical, social and environmental parameters with prescribed design standard. Geometric parameters, road safety and maintenance, bio- engineering and plantation works, implementation on VCDP and GAP was not found as per requirements. Project was completed 18 months behind the original completion date so the project management has failure to control the time overrun.

In 1924, Jean Darier and Marcel Ferrand described for the first time dermatofibrosarcoma as a true clinical and histological entity. It is a fibrous tumor of the skin with high local malignancy, progressive and with a high potential for recurrence. We report an unusual location of recurrent dermatofibrosarcoma protuberans of the vulva in a 58-years-old patient. The clinical examination showed a large, rounded mass of firm consistency. The surgical resection was complete, passing to 5 cm laterally with economy of normal tissue leaving the minimum of functional and aesthetic sequelae. Histological examination of the operating piece confirmed the diagnosis. This observation illustrates the voluminous nature of the mass, the local aggressiveness of the tumor and the potential difficulties of wide excision laterally and in depth of the lesion in an important anatomical region. This excision results in large losses of substances whose cover is a real challenge for the surgeon.

An experimental convection drying cassava forced study was conducted using a solar dryer with forced convection, an oven and a precision balance. This study identified the cassava drying kinetics at different racks of drying. These kinetics were obtained by comparing first on each rack and between racks. Threads rotate about the influence of the distribution of the products on the trays, then the position of the trays and finally to the hot air supply of the drying cubicle. The conclusions obtained require us to take account of these findings in the design of indirect solar dryer.

Background: The nasal index determination is one of the most commonly used anthropometric parameters in classifying human races. Aim: The objective of this study was to determine the normal parameters of the external nose (Nasal height, width and nasal index) in the south Indian population. Subjects and Methods: The study was conducted randomly on healthy subjects of both sexes. Nasal height and width were measured using a vernier caliper. Then, the nasal index was determined for each subject. The obtained data were subjected to statistical analysis (SPSS Version 21). Results: A total of 143 subjects, 73 males and 70 females, aged 18-23 years, were enrolled in the study. The study showed the existence of sexual dimorphism in nasal morphology, appearing after the age of 20 years. The mean nasal index in the investigated adults was 42.1 ± 8.4 in males, and females were 31.7 ± 3.8, respectively. The dominant nasal type was Leptorrhine in male 46.5% (n=34) and female was Mesorrhine 41.4 % (n=29) respectively. Conclusion: This study can help in understanding the need for those who want a more "shapely" nose. Forensic medicine, Genetic counseling, Anthropological research, Cosmetic, reconstructive surgery, Orthodontics, and specific manufacturing industries, benefit from age- and gender-based data of the study.

Asthma is one of the chronic respiratory conditions. A large Number of patients still experience a high level of morbidity .Much of the morbidity from Asthma is believed to be due to factors such as a chronic condition, poor knowledge of the disease process and medication understanding on the use of and poor self-management. Patient education is becoming an essential area of service provision. In this study30 Patients who were diagnosed as asthma with PFT and attending Pulmonology OPD at SRMC were included and were given a mini AQLQ questionnaire containing 15 questions regarding the level of asthma and limitations of activities, to test their knowledge about Asthma and quality of life, with particular reference to the knowledge about the disease and answers were analyzed to test the knowledge of the Patients about Asthma. It was done twice, first visit and after 3 weeks. These patients were prescribed with bronchodilators (SABA or LABA), Breathing exercises were explained and Inhaler technique was checked and proper technique is taught to the patient. Results showed Educating the patient about disease and teaching inhaler technique, breathing exercise resulted in more improvement in both PFT and quality of life of asthma patients with significant improvement in lung function.

The orthodontic treatment includes the use of varied dental devices like headgear, braces and plates to enhance the beauty of smile, improves the speech and the biting ability. The treatment that causes the movement of the teeth and also results in decrease in bone density of the teeth. The loss of bone around the tooth may be temporary or permanent. A proper plan need to be considered before orthodontically treating a a patient to reduce the alveolar bone loss. The survey included questions to collect the demographic data of the dentists and also to determine the knowledge and awareness about the bone-loss management during orthodontic treatment. 35 (35.6%) dentists feels than duration of the orthodontic treatment plays an important role in the bone loss after the orthodontic treatment. 79 (80.7%) of the dentists feels that continuous, interrupted and intermittent forces all together acts together during the orthodontic treatment. 93 (94.8%) dentists are familiar with the fact that bone loss occurs after the orthodontic treatment. Proper guidelines and advice need to be given to the patient prior and after the orthodontic treatment to manage the bone loss after the orthodontic treatment.

Introduction: Magnesium (Mg) is the second most common intracellular cation after potassium (K). Mg is a cofactor in many enzyme systems in human cells and it has a predominant role in normal myocardial physiology. The role of magnesium in cardiovascular disease has received widespread attention. Magnesium has been implicated in the complications like arrhythmias in acute myocardial infarction. Objective: To know the serum magnesium level in patients with acute myocardial infarction and its relation with arrhythmia. Study design: Descriptive cross sectional study. Study place & period: Department of Cardiology, Rajshahi Medical College Hospital, Rajshahi from July, 2013 to November, 2013. Subjects: 50 patients with acute myocardial infarction admitted to the Department of Cardiology, Rajshahi Medical College Hospital. Methods: Data was collected from patients of any age and both sexes with acute myocardial infarction as determined by clinical features, ECG evidence and biochemical report. Blood sample for estimation of serum magnesium level was collected as early as possible within 24 hours of admission and 5th day of admission. After admission to CCU every patient was under continuous cardiac monitoring to see and record any arrhythmia within 5 days onset of symptoms. Results: A total of 50 patients of acute myocardial infarction were included during the study period. The male to female ratio in the study group was 3.17:1 and the maximum incidence of acute myocardial infarction was seen in 5th and 6th decade. The most common presenting symptom was chest pain which was present in all patients and was associated with sweat in 60% of patients and breathlessness in 64% of patients and palpitation in 50%. In the study, the most common risk factor found was smoking (70%) followed by diabetes (36%) and hypertension (30%). Anterior wall MI was found to be the most common type of MI (42%). Arrhythmia developed in (52%) patients and in majority (57.7%) of with anterior wall MI. In the study group mean serum magnesium level in 50 patients on day-1 is 1.86±0.39 and on Day-5 is 2.26±0.5. Mean serum magnesium level in 26 patients with arrhythmia was 1.65±0.26 on day-1 and 1.98±0.25 on day-5. In the study group, mean serum magnesium level in 24 patients without arrhythmia was 2.05±0.41 on day-1 and 2.48±0.52 on day-5. The difference between the magnesium level in patients with arrhythmia and without arrhythmia is statically significant on both day- 1 and day-5 (p<0.001). PVC was the most common type (42.5%) of arrhythmia. Conclusion: serum magnesium levels are significantly low in patients who develop arrhythmia in acute myocardial infarction.

Background: Postnatal sepsis is one of the problems that threaten the lives of mothers, although it can be avoided by taking the necessary precautions. The nurse and midwife represent the cornerstone in preventing and treating infections during the postpartum period. Study Design: This semi-experimental study Sudan, River Nile state to evaluate the effectiveness of designed guidelines for midwives regarding postnatal sepsis management, during the period March 2017 to January 2020. Sample Size: The study included 73 midwives. Data Collection Tools: Data were collected in two stages using a standard questionnaire and a list of observations before and after the training program. Data Analysis: The data were analyzed by a computer software program (SPPS) version 23. The result showed that the level of knowledge is improved significantly after guidelines interventions, where Nursing assessment and management 20.8% had bad practice while this is improved 82.6% very good practice. only12.5% of respondents scored very good Skills full of maintaining vulval hygiene and Maternal hygiene, which change to 100% very good score after interventions. concerning counseling regarding prevention and management 29.2% considered as bad practice changed to 91.3% Very Good Practice after interventions of guidelines. Conclusion: The study concluded that the majority of nurses midwives had high knowledge score in the post-test compared with pre-test and they demonstrated good practice which indicated that the postpartum infection management training guidelines program was effective.

One of the medicinal species used as raw material for the tisanes preparation is the boldo leaf (Peumus boldus). This plant is commonly used as treatment for a variety of conditions, such as digestive and hepatobiliary disorders. It is traditionally known for its choleretic, cholagogue, diuretic, and digestive properties, among others. The objectives of this work were to evaluate the quality of four batches of boldo tisanes of a brand commercialized in Costa Rica through various physicochemical and microbiological tests established in the Central American Technical Regulation (RTCA) 11.03.56.09, and to identify the reproducibility of the quality parameters for the four batches employed. For this reason, the following tests were done: labeling, organoleptic characteristics, foreign matter determination, minimum fill, lead limit, arsenic limit, loss on drying, total ash, microbial enumeration, and specific microorganisms (E. coli and Salmonella sp). The four analyzed batches were in compliance for all assays, except the labeling test, since in all cases only 2 of the 4 items established for the primary packaging (batch number and expiration date) and 3 of the 19 items indicated for the secondary packaging (qualitative-quantitative composition, interactions, and adverse effects) were not found. In addition, the batch 2 had a browner color compared to the others, not complying with the organoleptic test specifications, specifically the color. This is reaffirmed by obtaining a greater percentage of branches in its composition during the foreign matter test. For these reasons, greater controls must be made on the raw material used for the product preparation to achieve reproducibility between the quality characteristics required for the different batches.

Introduction: Sarcoma is a rare entity with the primary pancreatic sarcoma represents a diagnostic challenge. Material and Methods: I reviewed articles particularly radiology studies in English language found in PubMed that were published recently to draw conclusions. Results: The common presenting symptom is vague abdominal pain. The described imaging appearance of such entity which shared between the different subtypes is a large heterogenous solid mass with frequent cystic degeneration/necrosis. The regional lymph nodes are rarely involved. Overall, poor prognosis of primary pancreatic sarcoma was reported. Conclusions: Although primary pancreatic sarcoma diagnosis remains a challenge, imaging differentiation from pancreatic ductal adenocarcinoma may be possible.

Purpose: the current study was to compare between the effect of polarized light therapy (PLT) and betamethasone phonophoresis in the Treatment of psoriasis. Subject: fifteen patients were included in this study. Their ages ranged from 25 to 60 years. Each patient was divided into two sides Procedures: Group (I) received polarized light therapy (PLT) with a specific energy den¬sity of 40 mW cm. The light is brought and applied to the required area at constant intensity and very low energy but it is constant at 2.4 joule cm2 per min. In addition to topical corticosteroids for 4 weeks, 3 days/week. Group (II) received 4 weeks of treatment with betamethasone diprobionate phonophoresis (BDP) using continuous mode for 5 min, with 1 MHz and 1.5 W/cm2, 3 days/ week while. Group (I) received 4 weeks of treatment with topical corticosteroids only while. The measurements were done before the study and after one month of treatment for all groups by using Ultrasonography. Results: of this study showed reduction in the thickness of skin after the treatment for Group (A), (B) and (c) with a percentage of 41.66%, 29.16%, and 8.69% respectively for the thickness of skin. There was a highly significant difference between groups after the treatment. It was observed that PLT was more effective than betamethasone diprobionate phonophoresis. Conclusion: It could be concluded that. Biptron light therapy (BLT) is more effective than betamethasone phonophoresis in treatment of psoriasis.

The antifertility potency of Marijuana had been revealed in our recent study. Hence, investigating its effect on other body systems became necessary. This study was setup to determine the effects of inhaled marijuana and Vitamin C on serum lipids and serum proteins of male rats using the following parameters; Total Cholesterol level, Triglycerides level, High density Lipoprotein level, Low density Lipoprotein level, Albumin level, Total Bilirubin level, Direct Bilirubin level and Total Protein level. This study was carried out with a total of forty (40) male wistar rats randomly divided into four groups of ten (10) rats per group. Group 1 was the control and was treated with distilled water, group 2 was the low dose group (exposed to marijuana smoke for 5 minutes daily), group 3 was the high dose group (exposed to marijuana smoke for 10 minutes daily) and group 4 was the high dose + vitamin C group (exposed to marijuana smoke for 10 minutes and orally gavaged with vitamin C at 2.8 mg/kg body weight daily). The animals were sacrificed on the 29th day and blood was collected by cardiac puncture into plain bottles. The collected blood was allowed to clot and centrifuged at 300rev per minutes for 20mins. The serum was collected with the aid of a micropipette for the biochemical analysis of lipid profile and serum protein according to George, 2009 and Bjorsten et al., 2007. The results were as follows; Serum albumin and Total bilirubin levels were significantly decreasing (p<0.05) down the groups. Direct bilirubin level was significantly increased (p<0.05) in the low dose marijuana (LMJ) treated group when compared with the control group and was significantly decreased in the high dose marijuana + vitamin C (HMJ+Vit C) treated groups when compared with control and high dose marijuana (HMJ) treated groups respectively. Total protein was significantly decreased (p<0.05) in the high dose Marijuana + vitamin C (HMJ+Vit C) treated groups when compared with control group and within the other groups. Total cholesterol levels was significantly decreased (p<0.05) in the high dose Marijuana + vitamin C (HMJ+Vit C) treated groups when compared with control group. High density lipoprotein levels was significantly decreased (p<0.05) in the high dose Marijuana + vitamin C (HMJ+Vit C) treated groups when compared with control group. Triglycerides level was not significantly different in the low dose Marijuana (LMJ) treated group and high dose Marijuana + vitamin C (HMJ+Vit C) treated groups when compared with control group and within the groups. Low density lipoprotein level was significantly increased (p<0.05) in the high Marijuana + vitamin C (HMJ+Vit C) treated groups when compared with control group. This study has shown that inhaled Marijuana negatively affected various liver metabolic pathways leading to decline in albumin levels; elevated Bilirubin and lipid levels.Co-administration of oral Vitamin C was found to lower serum Bilirubin levels. Levels of total Cholesterol, High Density Lipoproteins and Tryglycerides were also lowered in rats treated with Vitamin C. It is possible that the use of Vitamin C may be beneficial in individuals at risk of cardiovascular diseases.

A study was carried out in a less anthropogenic forest stream, the Abouda stream, an affluent of Nga stream in the Mefou watershed, to evaluate the health status of this lotic hydrosystem. Physico-chemical analysis showed that the water is slightly acidic, well oxygenated and poor in suspended solids, conditions which are favourable for a better development of benthic macroinvertebrates. Significant differences of dissolved oxygen, ammonium and phosphates were recorded. Benthic macroinvertebrates were sampled using the multi-habitat approach and the biological results revealed a total of 1951 individuals belonging to 5 phyla, 6 classes, 15 orders, 74 families, and 79 species. Most of the organisms sampled belonged to the phylum of Arthropoda, the class of Insecta and the order of Hemiptera. The Hierarchical Ascending Classification (HAC) showed a high similarity between stations Abouda 1 (A1) and Abouda 3 (A3). Furthermore, the Multiple Correspondence Analysis (MCA), which gives the level of affinity between physico-chemical and biological variables, divided the stations between groups according to their affinities. The diversity index of Shannon and Weaver and the equitability index of Piélou showed that, stations A2 and A3 are more diversified and therefore favourable to a better development of benthic macroinvertebrates. This high diversity is confirmed by Sörensen’s similarity coefficient whose values are above 60 % indicated a high resemblance between stations A2 and A3.

The platelet transfusion must necessarily meet the concepts of safety and transfusion threshold. Asking for an indication and prescribing a platelet transfusion remains complex and must take into account an increasing number of parameters (indication, quantitative and qualitative choice of product, the notion of the threshold, clinical situation and finally the cost).The study that we conducted is a retrospective descriptive and analytical study, over a period of 2 years, from January 2017 to December 2018, with the objective of studying the stages of preparation of platelet concentrates, their indications, their complications, and to report on the experience of platelet transfusion within the Avicenne Military Hospital in Marrakech. During this period, 777 platelet concentrates (753 SPC and 24 APC) were delivered to 107 patients. The department of internal medicine where a hematology-oncology unit is located is the most demanding department. The average of transfused bags is 7.5 bags/patient. The indication was curative in 55%, dominated by thrombocytopenia of central origin. The pre-transfusion platelet count was 54 10³ / mm³ for standard platelet concentrates (SPC) and 27 10³ / mm³ for apheresis platelet concentrates (APC). Finally, the platelet transfusion yield was greater than 20% in 50% of the cases. These data make it possible to demonstrate compliance with the indications for platelet transfusion in the most demanding departments, but raise the question of the dose that must be respected in order to improve platelet yield.

Background: End Stage Renal Disease is the common cuase of morbidity and mortality in patients suffering from diabetes and hypertension. Loss of transferrin and renal impairment in diabetic patients might lead to microcytic anaemia. Progression of nephropathy in these patients can be prevented by checking the hemoglobin levels. Objectives: This study is aimed at identifying the relationship of transferrin levels and anaemia in diabetic nephropathy. Methods: The study included 100 patients who were categorized as 20 normoalbuminuric, 40 microalbuminuric and 40 macroalbuminruic based on urine albumin levles. Serum Transferrin, Hemoglobin were measured in all the three groups. Results: The data obtained concludes that the levels of hemoglobin are significantly reduced in macroalbuminuric (9.0 + 1.61) than mciroalbuminuric (11.5 + 1.71) as compared to normoalbuminuric (13.1 + 1.91) patients. Serum transferrin levels were significantly reduced in macroalbuminuria (207 + 33.7) as compared to normoalbuminuria (263 + 51.8), which in correlation to hemoglobin levels. Conclusion: Anaemia was often seen at an early stage in diabetic nephropathy than in patients with chronic kidney disease. It is, therefore, crucial to monitor anaemia to prevent the progression of renal disease in diabetic patients manifested as microalbuminuria. Plasma transferrin levels are decreased in macroalbuminuria though the synthesis is increased in diabetic nephropathy as the response doesn't compensate for the loss of transferrin in the urine. Further understanding of the mechanism and providing the therapy may improve patient outcomes.