Cerebral sinus venous thrombosis is a very common condition and it is an important cause of stroke especially in the peripartum setting and is one of the common causes of stroke in young patients. The present study has been undertaken to describe the clinical profile, diagnosis, and prognosis of CSVT. Methods: This cross-sectional prospective observational study was conducted in the Department of General Medicine, Prathima Institute of Medical Sciences, Nagunoor, Karimnagar. Based on the diagnosis 50 patients were included in the study, meticulous history, clinical examination, laboratory investigations including complete blood count, ESR, RBS, serum urea, serum creatinine, LFT, serum electrolytes, Urine electrolytes, ECG, CSF analysis were done in addition to imagining of the brain. Results: Out of 50 patients 25(50%) belong to the puerperal group and 25 (50%) belong to a non-puerperal group. Out of 25 non-puerperal patients 5 were female and 20 were male patients. The 25 puerperal cases the CSVT was seen in 18 cases in the first 10 days post-parturition and 5 cases were between 11-20 days and 1 case each of 21 -30 days and > 30 days were seen. In the present study, 24 (48%) of CSVT had a sub-acute presentation followed by 18 cases (36%) with an acute presentation. The clinical signs were hemiparesis and papilledema in 20(40%) of cases and pallor in 16(32%) and dysphasia was in 9(18%) of cases. In the study out of 50 patients, 17 were anemic, accounting for 34% and the mortality was higher when the degree of anemia was severe. Anticoagulant therapy with subcutaneous LMWH in 33 cases and intravenous unfractionated heparin infusion in 17 cases and later changed to oral anticoagulants. 5 patients required decompressive craniotomy out of which 1 patient died. Additional treatment included antiepileptics in 33 patients and anti-edema measures in 38 patients. Conclusion: CSVT is not an uncommon condition. Clinical presentation is extremely varied and symptoms may evolve over hours to few weeks. Neuroimaging plays a pivotal role in diagnosis MRI with MRV is the current diagnostic modality of choice. Management with unfractionated heparin, LMWH, and oral anticoagulation is appropriate. Surgical decompression is helpful in the cases of continuing deterioration, in spite of maximum medical management

Skeletal muscle metastases are an exceptional mode of revelation of broncho-pulmonary cancers, we report a case of a patient with lung cancer disclosed by skeletal muscle metastasis. The patient consulted for a painful mass of the left calf with significant weight loss, the medical imagery shows an intramuscular process and the ultrasonography guided biopsy shows an infiltration of the muscle with metastatic adenocarcinoma, immunohistochemical patterns suggested the pulmonary origin, the treatment included muscle resection and chemotherapy. Skeletal muscles metastases from lung cancer are rare and although indicative of a poor prognosis, the treatment is poorly codified and differs from case to case.

In this paper, we compare the difference of non-monotone strategies to solve the wedge trust region method for derivative-free optimization. The wedge trust region method based on traditional trust region which is designed for derivative-free problems. Considering the effectiveness of the non-monotone strategy compared with monotone ones, we combined the non-monotone strategy into wedge trust region methods. The computational results show that the both two strategies have their respective advantages.

Mental health disorder is one of the major health problems, which requires early & effective treatment. WHO global burden of disease 2001 estimates four main psychiatric causes leading to disability, which is Depression, Alcohol abuse, Schizophrenia & Bipolar disorder. Although current psychotropic medicines have remarkable effect on mental illnesses, their utilization in clinical practice needs to be done regularly hence, current study aims to observe the utilization and prescribing pattern of various drugs used in department of psychiatry, according to various WHO drug use indicators. It is a prescription based prospective, observational study conducted on 1200 prescriptions of patients attending department of psychiatry for 18 months. Total of 3632 drugs were prescribed in 1200 prescriptions analyzed, where 48.4% (581) were males and 51.6% (619) were females, majority of the patients 56.25% (675) belonged to age group of 21-40yr, 85.67% (1028) individuals were married. Out of total drugs prescribed 2971 (81.80%) were psychotropic drugs. Average no. of total drugs & psychotropic drugs prescribed per encounter was 3.03 & 2.48 respectively. 1680 (46.26%) drugs were prescribed from the WHO EDL formulary (2016), all the drugs were prescribed by brand names, percentage of prescriptions with injectable drugs accounted for 4.75%. Polytherapy (>5drugs) was observed only in few prescriptions 26 (2.17%). This study advocated an overall rational utilization of psychotropic drugs with fewer deviations due to the prescription practices of healthcare providers, which needs an improvement, to ensure rational use of drugs.

Since 2014, the crude oil market has experienced declining oil prices around the globe. Speculations are that there has been over-supply in the market and lower demand than expected. In particular, the oil industry's oil industry in the United States took analysts and experts to surprise and the crude oil supply was not calculated in the forecasts. The production of this resource was preceded by the US, which gained extensive experience in the development of oil shale. Consistent developments in mass oil production coupled with the development of new technologies, which ensured a significant growth in the production of this hydrocarbon resource is believed to have significantly affected the global crude oil market. This article seeks to foster better understanding to the nexus of oil shale production and its impact on crude oil prices, as previous scientists have studied dating from the year 2002 to 2018 streamlined towards articles related to the impact of shale oil production on global crude oil prices. The study findings reveal that while some studies postulate that indeed US shale oil have negative impact on global crude oil prices, other studies also show that current lower crude oil prices could be attributed to several factors other than the mass production of US shale oil. Adversely other studies were indifferent with their findings and attributed the lower crude oil prices to both relatable factors such as the growth of US shale oil production, the slowdown of global oil demand, reduced cohesiveness of the OPEC cartel and production ramp-ups in other non-OPEC countries.

Complicated UTIs (cUTIs) are one of the leading causes of the gram negative bacteraemia which occur in patients who have a functionally, metabolically, or anatomically abnormal urinary tract. The primary objective of this study was to compare efficacy of Piperacillin/Tazobactam (PT) and Cefoperazone/Sulbactam (CPS) combinations in complicated Urinary Tract Infections. At entry, total 92 patients admitted in the hospital due to cUTI were enrolled. Among of 92 patients, 49 patients were given PT while 43 patients were given CPS combinations. Clinical symptoms were registered and scored as mild (1) moderate (2) or severe (3). The follow-up were done daily till the patient is discharged. Thereafter, one follow up visit was done within 4 to 9 days of after discharge, termed as test of cure (TOC). Furthermore, one late follow up visit after 6 to 8 weeks was done, known as late follow up visit (LFU). Clinical assessments and microbiological analysis were done at the time of TOC and LFU. The mean baseline clinical score for PT and CPS were 10.89 ± 2.23 and 10.28 ± 2.33, respectively. At TOC visit, PT and CPS groups, clinical scores were 0.86 + 2.35 and 1.36 ± 3.48, respectively; suggesting significant improvement from baseline (p< 0.001). Rate of clinical improvement at TOC visit was 92.68% and 87.50%, while microbiological cure rate was 87.80% and 93.75% with PT and CPS groups respectively. While, at LFU visit, clinical scores in PT and CPS groups were 1.32 + 3.37 and 1.65 + 3.56, respectively, suggesting significant improvement from baseline (p < 0.001). Clinical cure rate at LFU visit was 87.80% and 87.75% while microbiological cure rate at LFU visit was 82.92 and 77.00% in PT and CPS groups, respectively. These results suggest that both regimens have no significant difference for the treatment of cUTI. PT and CPS, both the combinations, are equally efficacious in treatment of cUTI.

This study is to examine and analyze the influence of internal factor and external factor on devidend payout ratio and the impact on stock return. The internal factor in this study consists of liquidity (current ratio), solvability (debt to assets ratio), profitability (return on equity), activity (total assets turnover) and firm size,while external factor consists of GDP growth rate. The population of this research is all companies listed on The Indonesian Stock Exchange during 2012 until 2015. From a population of 521 companies, with purposive sampling as samples determining methods, 43 companies meet the criteria to be the sample. The result shows that debt to assets ratio, return on equity, and firm size have significant influence on devidend payout ratio, while the other variables have unsignificant influence. It also shows that debt to assets ratio, return on equity, firm size, and GDP growth rate have significant influence on stock return,while the other variables have insignificant influence. The result of this study also shows that devidend payout ratio have insignificant influence on stock return.

A study on the level of fibrinogen in Type 2 Diabetes patients and its influence on Peripheral Arterial Disease. Three groups (Group A- Diabetes patients, Group B- patients with DM+PAD, control group of healthy volunteers) of patients were included. Plasma fibrinogen level of all the patients were measured and is correlated with age, sex, BMI, WHR, HbA1C, FBS and ABI of the patients. PAD patients were identified with the help of ABI measurement. PAD is an expression of systematic atherosclerotic disease, if it is not diagnosed in the early stage it will lead to serious complications like Myocardial infarction, stroke and death. Role of haemostatic factors particularly Fibrinogen in vascular disorders has gained considerable interest. Comparatively increased fibrinogen concentration was seen in patients with both DM and PAD (414.97±28.73). We have also found that fibrinogen is increased in some diabetic patients with poor glycaemic control. This elevated fibrinogen can be considered as an indicator for cardiovascular disorders in diabetic patients. These results underline the possible relation between fibrinogen and presence of PAD in diabetic patients and thus the study reflects the importance of proper maintenance of glycaemic status in Diabetic patients.

Macroeconomic risk is one of the variables which can arbitrage the market condition to determine return volatility in capital market. One of the most famous methodologies to determine macroeconomic risk in capital market is Arbitrage Pricing Theory (APT). Using monthly data of Indonesia composite index return and sector index return in five years (2013-2017), it has been known that there is no economics risk factor of APT model which can explain the movement of stock return in Indonesia Capital Market. This condition is able to show two posibilities. First, investors act irrationally. Second, investors tend to consider the performance of company than considering sistematic risk that can influence the overal condition of market and industrial.

This study evaluated the tendency for Cocos nucifera juice to be effective in management of hepatic and renal anomalies in a human design. 180 male subjects were used for this study. With treatment A as the control, Cocos nucifera juice was administered in 3 doses; B, C, D-50ml, 100ml and 150ml respectively. The experimental period lasted for 42 days. The biochemical assay protocols were aimed at investigating changes relating to hepatorenal function. Biomarkers assayed for include aspartate transaminase, alanine transaminase and alkaline phosphatase for liver function biomarkers, creatinine, cystacin-3 and interleukin-18 for kidney function biomarkers. There was a dose dependent change in both liver and kidney function biomarkers. This study revealed an inverse relationship between Cocos nucifera juice ingestion and the serum level of these metabolic biomarkers. There was also a time dependent reduction as well as a progressive decrease in harmonic mean of the assayed biomarkers for all dose treatments. Cocos nucifera has the potential to be applied in the management of hepatic and renal dysfunction.

The placenta is a vital organ for maintaining pregnancy and fetal development. We studied the influence of placental morphometric measurements (weight and diameter) on the body mass index (BMI) of the newborn. The present study was carried out at Dr. BR Ambedkar medical college and KC General Hospital Bangalore. Hundred and eight mothers who gave birth to uncomplicated singleton pregnancy, and their newborn were examined. Placental weight, diameter, birthweight and crown to heel length were recorded immediately after delivery by electronic weighing balance, Infantometer and measuring tape. BMI was calculated in kgs/m2. 58 Females and 50 Males new born babies were classified on the basis of body mass index (kg/m2) into 3 groups. Group I BMI <10, Group II BMI 10-13 and Group III BMI >13. The mean placental weight (in gms) and diameter (in cms) for the male babies in the Group II and III were 466.01 ± 78.23, 524.4 ± 39.51 and 16.9 ±0.69, 18.2 ± 1.05 respectively. However there were no babies in Group I. The mean placental weight (in gms) and diameter (in cms) for the female babies in the 3 groups were 409.6± 42.74, 489.7 ± 43.57, 521.4 ± 48.7 and 15.8 ± 1.01, 17.0± 0.81 and 17.2 ± 0.76 respectively. There was a statistically significant correlation between placental weight and diameter with BMI of the newborn in Group II and III for male babies and Group I and II for female babies (P<0.05).

To evaluate the effect of metformin therapy for more than three months on serum ghrelin and adiponectin level and to assess the relationship between them with insulin resistance parameters in obese patients with polycystic ovary syndrome (PCOS). A case-control study design was adopted in the Fertility and In Vitro Fertilization (IVF) Center at AL. Batool Teaching Hospital Mosul City/ Iraq, in the period between 1st of November 2013 and 1st of May 2014. This study included a group of 41 obese women with PCOS of reproductive age who used metformin for more than three months (metformin users) with another age-and body mass index (BMI)- matched group of 44 obese women with PCOS who did not use metformin (metformin non-users and served as control). A 10 ml of fasting venous blood sample was taken from each PCOS woman of the two groups. The sera were used to measure serum ghrelin, adiponectin, insulin and fasting serum glucose (FSG) level by using commercially specific kits, whereas; BMI and insulin resistance represented by Homeostasis Model Assessment (HOMA) was calculated by using especial equations. The results of this study revealed that there were no significant differences in the mean BMI, waist to hip ratio (WHR), serum ghrelin, FSG and fasting serum insulin (FSI) and HOMA-IR between the metformin users in comparison with metformin non-users obese PCOS patients groups. This study found that there was a significant higher mean serum adiponectin level of the obese metformin users in comparison with the obese metformin non-users PCOS patients. There was a significant positive correlation between BMI and insulin level, BMI and HOMA-IR and between FSG level and HOMA-IR. Also there were a very high significant positive correlation between insulin level and HOMA-IR. In conclusions, metformin therapy for more than three months in obese PCOS patients was associated with a significant higher mean serum adiponectin level than in metformin non-users group. There were non-significant changes in the mean FSG, serum ghrelin level and insulin resistance parameters. Also there were no significant correlation between neither mean serum ghrelin nor adiponectin with the insulin resistance and anthropometric parameters.

Introduction: Placenta is a functional unit between the mother and the foetus. Human placenta is discoid, deciduate, haemochorial, chorioallantoic, labyrinthine and endocrine gland which connects developing embryo by umbilical cord to the endometrium of mother’s uterus. It develops from two sources. Material and Method: This is a prospective study conducted at Department of Anatomy and Physiology, at Tertiary Care Teaching Hospital over a period of 1 year. Inclusion Criteria: Totally, 70 healthy mothers who gave birth to uncomplicated singleton pregnancy, and their new-borns were included in the study. Exclusion Criteria: Subjects with diabetes mellitus, hypertension, anaemia, vascular diseases and multiple pregnancies were excluded in this study. Result: The New-born body mass index (Kg/m2) was measured and the majorities (55.7%) of the new-born were within 11-13 followed by 25.7% of the new-born were more than 14 and the lesser proportion of 18.5% was <10 BMI (Kg/m2). The mean placental weight (in gms) for the female babies <10 BMI (Kg/m2) were 386.62±45.72. The Mean placental weight (in gms) for the male and female babies of BMI 11-13 (Kg/m2) were 398.53±43.74 and 478.63±49.48 respectively. The mean placental diameter (in cms) for the female babies of <10 BMI (Kg/m2) were 14.64±1.23. The mean placental diameter (in cms) for the male and female babies were 15.64±1.53 and 16.64±1.42 respectively of BMI of 11-13 (Kg/m2). Moreover, mean placental diameter (in cms) for the male and female babies were 17.54±1.67 and 16.68±1.86 respectively of BMI of 11-13 (Kg/m2). Conclusion: This study confirms that morphometric observation of placenta is associated with foetal weight. So, an early examination of not only the fetus, but also the placenta by non-invasive techniques like ultrasonography will be helpful to predict and to avoid low birth weight babies with better preventive measures. This study will also make the physicians and researcher to focus on the placenta.

Aim of the study was to find out the role of biochemical markers in diagnosis and prognosis of pancreatitis and compared this value with healthy subjects of Rajasthan. Total 200 subjects were selected in which 100 were selected as patients group and 100 were normal healthy subjects. Out of 100 patients 75 patients were male and 25 patients were female. patients were distributed age wise .Most of the male patients were alcohol abused And suffering from abdominal pain and most of the female patients suffering from gall stone and abdominal pain. Trypsin was estimated with sandwitch Elisa kit method and other biochemical parameters were performed by commercially available kit on fully auto analyzer. In male patients of age group 15-55 years Mean serum total and direct bilirubin level was 7.49±3.86 and 3.46±1.81 respectively. AST level was 268.22±71.74 and in control group mean AST level was 28.69± 5.85.P-value was found highly significant.(P≤ 0.0001) .as well as serum alkaline phosphatase level was found 779.86±456.77 and in control group mean ALP level in serum was 107.0±15.34 IU/L. mean value of amylase and lipase 486.86±154.20 and 2040±745.85 respectively. Mean serum level of trypsin was 461.16±200.72.in female patients all these parameters were also increased. We conclude that all biochemical parameters are increased in pancreatitis. Serum amylase and lipase both increases in pancreatitis but lipase is a specific test for alcohol induced or alcoholic pancreatitis. Trypsin can be used as a marker of pancreatitis.

The purpose of this study is to find out how the perception of price, process and quality of Product influences purchasing decisions with a case study of sharia KPR financing products in PT Bank Permata Syariah Business Unit. There was significant gap between target and sharia KPR finance realization achievement until August 2018 because the target was not achieved. In addition, the ranking of Bank Permata Syariah which is still far below shows that the contribution of KPR financing is not yet high. This is caused by many factors including the price / margin factor offered to customers who are still less competitive, the financing process and product quality that still need to be improved. The design of this research is explanatory. The samples taken in this study were the customers of Bank Permata Syariah in the South Tangerang Region who already had Sharia KPR financing and filled out questionnaires. They were taken by using the accidental sampling method with some specified criteria. The sampling technique was Purposive Sampling Method on 1504 of total population of customers of Bank Permata Syariah in the South Tangerang Region. By using the Slovin formula, 100 customers was obtained as samples. Analysis method of this research was qualitative method with Multiple Linear Regression as analysis tool, and helped by SPSS version 23.0. Before the analysis was carried out, the questionnaire instrument test was carried out with validity and reliability tests and classic assumptions. After that, it was analyzed by Multiple Linear Regression followed by a test of determination analysis (RSquare), partial hypothesis testing (t test) and simultaneous (F test) with a 5% error tolerance level. The results showed that there was an influence of price perceptions on purchasing decisions partially, the process of purchasing decisions partially, product quality on purchasing decisions partially and perceptions of price, process and product quality simultaneously influenced purchasing decisions for Sharia KPR financing products at Bank Permata Syariah