Optimal management sequence for the primary tumor and the liver in synchronous colorectal liver metastases (SCLM) is still controversial. Except reviews, studies comparing the 3 surgical approaches are infrequent. The present study aimed to describe the surgical management of patients operated of SCLM. In particular, we compared short-term outcomes and survival according to the surgical strategy. A multicentric retrospective study was conducted on 125 patients with SCLM. Surgical strategy was defined as classic (colorectal first approach), combined and reverse (liver-first approach). Between 2008 and 2013, 87 patients completed the classic strategy, 24 combined strategy and 14 reverse strategy. The 3 groups were comparable regarding pre-operative data. Liver metastases involvement was significantly higher in reverse group. Severe cumulative postoperative morbidity was 39.2%, similar between the 3 strategies. Ninety-day mortality was higher in combined group (12.5%, p>0.05). Failure rate of liver first approach was 17%. The 3-year overall survival (OS) was 73% in classic group, 78% in combined group and 93% in reverse group. The 3-year disease free survival (DFS) was 29%, 30% and 19% for classic, combined and reverse strategy respectively. There was no significant difference with regard to OS and DFS between 3 groups. We demonstrated that liver first approach is safe and feasible with acceptable perioperative and survival outcomes despite initially worse prognostic criteria. Reverse strategy can be applied to a vast majority of patients independently to the liver tumor burden and should be considered progressively as a reference in the management of SCLM

Dermatoglyphics is the branch of science concerned with the study of prints on the fingers, palm, soles, and feet. This branch of science is an offshoot of anatomical sciences. Dermatoglyphics as an aspect of science has been studied widely by lots of ardent researchers and have been used to solve lots of problems relating to peoples’ identity and ancestry. Although, dermatoglyphics can be studied at three levels (1, 2, and 3) only level 1 (arches, loops, and whorls) have been explored. 99.9% of the works on dermatoglyphics is at level 1 but very few Nigerian indigenous works have been done at level 2 (bifurcations, trifurcations, bridges, ridge ending, enclosures, dots, opposed bifurcations, double bifurcations, island etc). This raises the question, what about level 2 and 3 study? Aim & Objectives: It is possible for one to think that the reason researchers have not dealt extensively on level 2 dermatoglyphics is lack of procedural knowledge and the understanding of the concept. Hence this study was done to explicitly showcase the procedures dermatoglyphics at level 2. Materials and Methods: Data Capture: The use of digital print scanner with very high resolution not less than 9000x4800 dpi (Hp G3110 Scanjet Scanner) which ensures the images are clear and visible. 2)Transfer of Prints: The captured prints are then transferred to a laptop system (computer) via a set of USB cords for examination. 3)Examination of Prints: The prints are assembled into the various categories following the objectives, each print intended to be studied will be zoomed and magnified using the magnification tool in the laptop (computer) for clarity and visibility. I) Make a straight horizontal and vertical line across the print on each finger or toe which divides it into quadrants. II) Examine each quadrant for digital patterns present. Taking note of the morphology of the patterns known. III) Identify and group the patterns seen for each finger or toe. IV) Summation- sum up the patterns for the left and right hands or foot, V) Compute into a statistical tool for analysis. Conclusion: There was marked difference between the males and females in the distribution of the patterns with the females having consistently higher values. Though the females had higher value of the Paul’s Index.

In the past 15 years, awareness concerning natural changes was evidently expanding among population and industries. International agencies and national governments have expanded their endeavors concerning natural resources depletion, ozone depletion, gas emissions and waste reduction. Therefore, the main purpose of this paper is to examine the existing literature on the relationship between just-in-time (JIT), total productive maintenance (TPM), total quality management (TQM) and organisational performance. In total, 20 articles were empirically reviewed, all published in peer-reviewed journals between 2014 and 2018. The articles are analysed in terms of several general variables such as type of research and theoretical viewpoint, and the perspective taken on organisational criteria. The empirical reviewed indicated that JIT, TPM and TQM, maintained by human resource practices, have a significant prospective to develop the organisational performance. However, a simultaneous implementation of JIT, TPM and TQM does not certainly lead to greater performance. As prospective purpose for this, human resources are viewed as restrictive factor both improvement programs draw on. Therefore, this limited resource is acknowledged as vital element with respect to organisational performance when implementing JIT, TPM and TQM concurrently.

Ankylosing spondylitis and rheumatoid arthritis are the most common chronic inflammatory rheumatism. Their localization at the level of the hip stresses severely the functional prognosis. We report a retrospective series of 40 total hip prostheses performed in 32 patients with inflammatory coxitis, collected in the Traumatology and Orthopedics Department at the Mohammed V Military Hospital in Rabat between 2008 and 2016. The average age at the time of the intervention was 42 years with a clear male predominance. All patients were followed in consultation with a clinical and paraclinical examination. Coxitis following ankylosing spondylitis is the most frequently encountered in our series (65.6%). The rating of Postel Merle d'Aubigné was used to assess the functional status of the hip before and after surgery. The total hip prosthesis was cementless in 37 cases and cemented in 03 cases. The clinical results for the 32 patients after a mean follow-up of 04 years were very satisfactory in (88%) of the cases. The objective of this study is to evaluate our functional results and to show the interest of total hip arthroplasty in this type of pathology, in order to improve the quality of life of these often young patients

This research investigates the impact of the global financial crisis on the performance of Nigerian stock market from 2004 to 2013. The main aim of the research was to examine the impact of global financial crisis on the performance of the N.S.E. Data for this research was sourced from a secondary source. The data were statistically analyzed using descriptive analysis and Kruskal-Wallis H test statistical tools. The analysis showed that Global Financial Crisis has no significant effect on Market Capitalization, value and volume of shares traded on the floor of the N.S.E. From the analysis, the researcher concludes that Global Financial Crisis has no significant effect on market capitalization, value of shares traded and the volume of shares traded in Nigerian stock exchange.

The purpose of the study was to find out whether school feeding programme affect retention of learners in primary school education. The study was done in 10 primary schools in Mogotio Division. The unit of analysis constituted of 70 respondents (Head teacher/ Heads of school feeding program, Teachers, parent representatives and pupils). Purposive random sampling was used in this case whereby all the 70 respondents were picked to fill the questionnaire. Descriptive statistics analysis was used whereby the SPSS (Statistical Package for Social Sciences) programme is used. On retention, the study concludes that there were transfer cases in the center. Most parents take their children to private schools citing many reasons, which range from poor performance in public early childhood education centres, poor teaching methods, lack of skilled staff in public centres, and to a little extent due to poor feeding habits in the local primary schools. The findings of this study may be of use to the various primary schools for it would assist them understand better the issues related to school feeding programmes. This would see school managers in the various centres provide learners with balanced feeding programs and create awareness to parents on its importance to proper learning and holistic development of their children. The study would also go a long way to helping the government in making relevant policy to safeguard the wellbeing of primary school learners by providing well balanced feeding programs to these centres as well as budgetary allocation to the same.

The present study examined the anticonvulsant activity of the methanol stem bark extract of PK in mice and day old chicks against maximal electroshock (MES), pentylenetetrazole (PTZ), picrotoxin (PIC), and strychnine (STR) induced seizures. The CNS depressant ability of the extract was also investigated using diazepam-induced sleep test, and it was observed to significantly and dose dependently increase the sleep duration in the diazepam sleep test. The extract and fractions significantly and dose dependently increase the latency to onset of seizure in the PTZ and picrotoxin tests. In the strychnine test, the extract significantly increased the latency to seizure onset at the highest dose of 200 mg/kg, though none of the mice was protected from seizure as was the case with PTZ and PIC induced seizures. Considering the overall effect of PK, it may be concluded that the extract contains bioactive principles acting via enhancement of GABA inhibitory activity, and a second possibility via antagonism of the glutamate-NMDA receptors

Dermatoglyphics is the branch of science concerned with the study of prints on the fingers, palm, soles, and feet. This branch of science is an offshoot of anatomical sciences. Dermatoglyphics as an aspect of science has been studied widely by lots of ardent researchers and have been used to solve lots of problems relating to peoples’ identity and ancestry. Although, dermatoglyphics can be studied at three levels (1, 2, and 3) only level 1 (arches, loops, and whorls) have been explored. 99.9% of the works on dermatoglyphics is at level 1 but no Nigerian indigenous works have been done at level 2 (bifurcations, trifurcations, bridges, ridge ending, enclosures, dots, opposed bifurcations, double bifurcations, island etc). This raises the question, what about level 2 and 3 study? There exist a large vacuum at level 2 dermatoglyphics which should be filled by researchers especially indigenous authors which will help create database for level 2 details in Nigerian population. This to large extent could be used to solve problems relating to ancestral origin which has become an issue in most African populations especially Nigeria. This review serves to help provide a step by step procedure to doing a study on dermatoglyphics at level 2 in Nigerian indigenous populations and Africa at large. The review of papers on this subject serves to expose the gap in this area as compared to the several works done at level 1 and to spore researchers to do more studies on this subject to raise an indigenous data bank for Nigerian populations

Intravenous induction agents Propofol and Thiopentone are commonly used in obstetric anesthesia. We in the present study tried to compare the effects of Propofol and thiopentone on hemodynamics, Heart rate in the pregnant ladies undergoing Cesarean sections. Methods A total of 60 patients were included in the study. They were randomly divided into two groups. Propofol group (n=30) and Thiopentone group (n=30). The dosage was calculated to body weight 5mg/Kg for thiopentone and 2.5mg/Kg for Propofol. The mean induction time in Propofol group was 20.95 seconds and Thiopentone group as 26.5 seconds. There was smooth induction in 86.67% of the patients of Propofol group and 13.33% had disturbed induction. In the Thiopentone group, 76.67% had smooth induction and 23.33% had disturbed induction. No induction failure was encountered in this study and all patients were unconscious after 45 seconds. The total duration of surgery in propofol group was 70 ± 20 minutes and in thiopentone group was 85 ± 27. The time to extubation in Propofol group was 8.5 ± 2.60 and Thiopentone group was 7.0 ± 3.56. The Arterial Blood gas analysis after surgery shows average values of PaO2 in Propofol group and 87.5 ± 2.1 and thiopentone group 88.6 ± 1.8 and PaCO2 in propofol group 38.6 ± 2.05 and thiopentone 38.4 ± 2.5 mmHg. The mean SBP at the baseline of Propofol group was 124.05 ± 10.5 mmHg, while for Thiopentone group it was 124.05 ± 10.5 mmHg. The mean DBP at the baseline in propofol group was 76.5 ± 10.2 and thiopentone group was 78.8 ± 6.8. The heart rates were 80.5 ± 7.8 beats/min and 83.5 ± 8.8 beats/min in propofol and thiopentone group. The mean changes at the time of induction in heart rate of propofol group were 18 beats/min and the mean change of heart in thiopentone group was 23 beats/min. The mean SBP change during induction in Propofol group was -2.8mmHg and DBP change was -2.0 mmHg. In thiopentone group SBP change was -2.55mmHg and DBP change was -1.3 mmHg. Conclusion: Propofol has rapid actions and does not have any adverse effects on the CVS. The amount of pain produced due to propofol was also lesser compared to the thiopentone group and the induction was smooth in propofol group compared to thiopentone group and overall outcomes of Propofol were better than the Thiopentone group. Therefore propofol appears to better induction agent than thiopentone for obstetric anesthesia

Photoxidation of palm oil, like other forms of oils/lipids oxidation has adverse effects on the physicochemical qualities of the oil including depletion of essential antioxidants and formation of free radicals which could be injurious to tissues. Unfortunately, this widely consumed edible vegetable oil is usually stored or displayed for sale in plastic containers under direct sun light and unknowingly subjecting the oil to photoxidation. This work therefore sought to evaluate the possible effect of long term consumption of palm oil exposed to light on some reproductive parameters in male wistar rats. Male wistar rats weighing 85g to 120g and aged 19 to 23 weeks were randomly divided into a control and photoxidised palm oil (PPO)-fed groups of five rats each. The control group was fed on normal rat chow while the PPO diet group was fed on photoxidized palm oil diet. The duration of feeding was 13 weeks after which the rats were euthanized, blood samples collected while testes were harvested from them for determination of relevant parameters. The result showed a significantly reduced seminal pH in the PPO-fed group compared with control (P<0.01). Sperm motility (%) and viability (%) were significantly decreased (P<0.01 and P<0.01 respectively) in the PPO-fed group compared with control. The PPO-fed group had significantly decreased (P<0.001) sperm count and a significantly increased percentage of morphologically defective sperm cells (p<0.05) compared to the control. Serum testosterone, follicle stimulating hormone (FSH) and Luteinizing hormone (LH) were significantly decreased (P<0.001, P<0.01 and P<0.001 respectively) in the PPO-fed rats compared with control. In conclusion, long term consumption of PPO diet impairs reproductive function in male wistar rats

Suxamethonium is the drug of choice for muscle relaxation for endotracheal intubation with its rapid onset and short duration of action. The newly introduced non-depolarizing drug rocuronium has got rapid onset and intermediate duration of action. The aim of the present study was to compare the intubating conditions of rocuronium bromide with suxamethonium chloride. Aim: To compare the onset and duration of action of Rocuronium Bromide and Suxamethonium Chloride. Methods: it is prospective randomized controlled study carried on 90 adult patients with age groups of 20-60 years of either sex. They were posted for elective surgery in MGM’s Hospital Aurangabad. They were randomly divided into two groups of (n=45) each. Group I (R) patients received rocuronium at the dose of 0.9mg/Kg and Group II(S) patients received suxamethonium at the doses of 1.5mg/Kg. Results: In Group I (R) group there were 14 (31%) male patients and female were 31 (69%). In group II (S) there were 14 (31%) male and female were 31 (69%). In group II (S) suxamethonium showed acceptable intubating conditions in 100% of cases at 60 sec out of which 93.24% were excellent. In rocuronium group I(R) 100% cases had acceptable intubating conditions at 60 seconds out of which 77.7% excellent and 22.3% had good intubating conditions the P values were significant. In both the groups there was no significant difference jaw relaxation as well as vocal cord movements. There was the significant difference in response to intubation in Rocuronium group 6 (13%) patients had a mild cough on intubation whereas no patient in suxamethonium group II had any cough. In the Group I 24% patients had slight diaphragmatic movements on intubation and in group II 11% had diaphragmatic movements. There was no significant rise in HR difference in group I and group II preoperative, post muscle relaxant, 0 minutes after intubation, 5 minutes after intubation, and 10 minutes after intubation. Conclusion: Rocuronium bromide at the dose of 0.9 mg/Kg produces excellent and good intubating conditions in patients although slightly inferior to that provided by the Suxamethonium 1.5mg/Kg but there is more hemodynamic stability with rocuronium then suxamethonium. Therefore Rocuronium bromide may be considered as safe and good alternative to suxamethonium for endotracheal intubation. Hence rocuronium bromide can be used for a rapid sequence of induction and intubation if there is no prediction of difficult intubation

A combination of ethinylestradiol and drospirenone is used as an oral contraceptive and also for the treatment of premenstrual dysphoric disorders, acne and hirsutism. In this study, a derivative spectrophotometric method has been developed and validated for the simultaneous determination of drospirenone and ethinylestradiol. First order derivative spectrum was used for the determination of ethinylestradiol at 211 nm and drospirenone at 298 and 302 nm. The developed method was linear over the concentration range of 0.25-2.5 μg/mL and 20-200 μg/mL for ethinylestradiol and drospirenone, respectively. The within-day and between-day precision and accuracy were acceptable for both compounds (CV<2.5% and error<2.4%). The proposed method was used for simultaneous determination of ethinylestradiol and drospirenone without any separation before analysis

A study was conducted to assess effectiveness of structured teaching programme on knowledge regarding psycho social interventions for the caregivers on caring the mental health needs of mentally ill inmates. The study was conducted in Shivamoga Beggar Relief and Rehabilitation Centre. Total samples were 10. Non probability purposive sampling technique was used. A structured questionnaire was used as an instrument to measure the level of knowledge of caregivers. It was seen that the pre - test mean (6.8+_2.7) was lesser than post – test mean (23.7+_1.9). Here p value is (<0.001*) which is highly significant. The study revealed that the 60% samples had poor knowledge and 40% of them had average knowledge in pre- test. But in post-test 80% of samples had excellent knowledge and 20 % had good knowledge. The study concludes that structured teaching programme was effective in improving the knowledge of caregivers regarding psycho social interventions. We have performed Fishers exact test to know the significant association between knowledge and selected demographic variables. We observed that there is no significant association between knowledge and selected demographic variables.

This complete enumeration, cross-sectional comparative record-based study was conducted at a municipal medical college in Maharashtra state, India. First-year MBBS students undergo formative assessment (one terminal examination and one preliminary examination) before they appear for First MBBS University examinations (summative assessment). Marks scored by the First-year MBBS students in terminal and preliminary practical examinations during the seven year period (2011-2017) were statistically analysed. In the terminal practical examination, the gender difference in the average marks scored in terminal practical examinations was statistically significant (Z=2.226; p=0.026) only for Batch 2013, while in the preliminary practical examination the gender difference was statistically significant for Batch 2011 (Z=2.094; p=0.036) and Batch 2017 (Z=2.139; p=0.032). The marks obtained in preliminary practical examination exhibited less variability as compared to that in the terminal practical examination. This study may serve as a springboard towards further research on student assessment in the subject of Physiology

The aim of the study is to explore the psychological concerns and complexity in human relationships in D.H Lawrence‟s selected novels. D. H. Lawrence is a well-known English novelist whose novels represent an extended reflection upon the dehumanizing effects of modernity and industrialization. In them, some of the issues Lawrence explores are emotional health, vitality, spontaneity and instinct. The novelist has a great concern for the welfare of man who has lost faith in domestic life. His novels which discusses the complex human relationships and explores the ways of strengthening the domestic life.