The basic aim of our study was to develop and evaluate the polyherbal soap by using different extracts (extracts of neem leaves, papaya leaves, aloe leaves, turmeric and tulsi leaves) having greater antioxidant and antimicrobial potential. Pre-eminently, basic soap was prepared using Coconut oil and NaOH (lye) and the different extracts were incorporated into the basic saponification reaction. The herbal formulation thus prepared was then consigned for the evaluation testing for the analysis of pH, Moisture content, foaming ability, foam retention time, saponification, Total Fatty Matter determination and antimicrobial activity. The results demonstrated that pH 7.5 – 8, moisture contents 8.6%, foam retention time 1.20 minutes, Saponification value was 210.375 mg/ml, 30% TFM for polyherbal soap. Also the evaluation tests showed that the poly herbal soap has satisfactory antimicrobial results as compared to standard antibiotic. Some human infections which are majorly caused due to wounds, acne or blisters; these strains of microorganisms are of greater benefit. Moreover, oils and extracts used are added to treat various skin infections and are perfect for daily usage.

The aim of the study was to study effectiveness of inhalation sevoflurane with the laryngeal mask airway (LMA) in children undergoing surgeries below umbilicus. Thirty premedicated children 3-12 years old with the American Society of Anaesthesiologists physical status of I to II were enrolled and received induction with sevoflurane 7% by face mask and maintained with 50% oxygen and 50% nitrous oxide mixture followed by 1.7% sevoflurane with LMA. Demographic data, induction time, number of attempts, LMA insertion, removal and recovery times, haemodynamic parameters, complications, Aldrete score and child’s behaviour score were recorded. LMA insertion was successful at the first attempt in 93% with sevoflurane. LMA insertion, removal and recovery times were (1.26±0.36, 2.76±0.51, 5.16±1.6 minutes respectively). Perioperative minor complications were there. Recovery milestones including Aldrete score in the group was (9.03) t 5 minutes and comparable at 15 and 30 minutes. There was a greater incidence of excitatory phenomena with sevoflurane. Haemodynamics were studied. Sevoflurane provided short LMA insertion, removal and recovery times in children undergoing minor surgeries below umbilicus with little perioperative complications. Agitation was seen with sevoflurane.

Gender based violence is rising. Bangladesh stands second in the world in terms of violence against women in different forms like women battering, wife beating, domestic and dowry-related violence, acid attack, rape, physical and verbal harassment, fatwa, sexual harassment in the workplace, trafficking and prostitution, polygamy and child abuse. The rate of violence against women has dropped by 4.9 percent in between the years 2011 and 2015. Abusing rate was 87.1 per cent in 2011 which came down to 82.2 percent in 2015 and in the Daily Star newspaper came down to 80 percent in 2016. Around 72.6 per cent of women who are married in Bangladesh experience one or more such forms of violence it the hands of their husbands at least once during their marriage and 49.6 percent of lifelong married women suffered physical violence, 28.7 percent emotional violence, 27.2 percent sexual violence and 11.4 percent financial violence according to the Bangladesh Bureau of Statistics. Gender discrimination also leads to women having less opportunity. The literacy rate for women in Bangladesh is only 43.2%, while 61.0% of Bangladeshi men are literate. The unemployment rate for women is 70.7%, much higher than the 12.4% unemployment rate for men. Most of the victims, around 39.7 percent, of forced or coerced sexual intercourse, are aged between 15 and 19. Child marriage that legitimizes sexual abuse of minors must be stopped immediately. The government should enhance legal and criminal justice systems to prevent further violence and need interventions to change male attitudes.

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.

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

The repair of eyelid needs a good knowledge of reconstruction techniques. The goal of this work is to study epidemiological and technical aspects of eyelid defects in our context, and to evaluate their functional and aesthetic repair. We report cases concerned by loss of eyelid tissue operated between September 2011 and September 2016. Epidemiological, clinical and histo-pathological aspects are described, the repair processes and various surgical techniques are discussed. Among the identified cases of eyelid defects, 74% were malignant tumoral pathology, while 26% were benign. The repair techniques used were suture, direct healing, skin graft, flap of Mustardé with mucous chondro graft, frontal flap and sub-mental flap. The eyelid defects need functional and aesthetic valid repair, the various reconstruction means should begin from the simple ones to more complex.

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.

PLMA is a recent, complex, and ingenious development with some added features of Classic LMA like Modified dual cuff ,Drain tube, positive pressure ventilation at higher peak inspiratory pressure. Study was to evaluate and compare the use of Proseal laryngeal mask airway and endotracheal tube with controlled ventilation in patients undergoing gynecological laparoscopic procedure. 100 patients, ASA risk I & II, posted for elective laparoscopic were recruited in the study. All the patients between 18 to 45 yrs of age were randomly divided in two groups Group PLMA and Group ETT (50 patients each). Attempt of insertion of airway device, Leak pressure, pulmonary ventilation, Hemodynamic; heart & MAP, gastric distention were recorded. All patients were of middle age group, comparable in weight. Mean duration of laparoscopy was comparable in both the groups. Significant rise in heart rate and mean arterial pressure seen in group ETT after induction of anesthesia .Changes in the end tidal CO2 and peak airway pressure after induction of anesthesia, before & after peumoperitoneum were comparable in two groups. After head low position peak airway pressure is slightly raised in Group PLMA. Gastric distension was noted higher in Group PLMA (8%).Incidence of sore throat (22%), nausea vomiting (14) airway trauma (14%) was higher in group ETT. Hemodynamic stability was better in PLMA group at time of induction and comparable in two groups at time of pneumoperitoneum and trendelenburg position along with pulmonary ventilation. Post operative sore throat, nausea vomiting was higher with endotracheal tube.

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).