Both United Nations (UN) and Convention on Biological Diversity (CBD) recognized the importance of protected areas (PAs) as a key strategy for biodiversity conservation and sustainable development. This makes global protected areas an important contribution to achieving these commitments. However, PA coverage alone does not effectively measure the overall effectiveness of the protected areas performance or conservation success, thus the effectiveness of the curved or designated PAs needs to be monitored. This paper investigated the Effectiveness of National Parks and Game Reserves in Tree Species Conservation in Dry Region of North-East Nigeria by comparing Gashaka-Gumti national (GGNP) park and Yankari Game reserve (YGR). Wandering quarter method of vegetation analysis was employed as instrument for data generation where five sampling points (five vegetation zones in GGNP and four angles and centre in YGR) were established in each of the PA for data collection. Basal area, percentage frequency, relative density, relative dominance, importance value index were determined on each species encountered. Mean distance between tree stands, mean area as well as number of trees per hectare were also calculated. Results obtained indicated higher species diversity in GGNP over that of YGR (53 and 22 respectively). Basal area records indicated highest (34, 552.6cm) at GGNP on Uapaca togoensis against highest at YGR (25, 598.2 cm) on Khaya senegalensis. Same trend was observed on measures of Relative density, relative dominance and importance value indices (IVI). Going by the IVI, the vegetations of the PAs were described as Uapaca-Crossopteryx-Danielli complex and Kyaya-Combretum-Danielli type of vegetation in GGNP and YGR respectively. Values for mean distance (dm) between Trees, mean area (MA) occupied by Tree and Density of Trees per hectare indicated 3.4m, 11.6m & 862 in GGNP respectively against 6.2m, 38.4m, & 260 in YGR respectively

A 68-year-old postmenopausal woman presented with pain lower abdomen and a palpable mass. Physical examination and radiological findings were suggestive of a large calcified fibroid uterus. Patient was taken up for total laparoscopic hysterectomy with bilateral salpingoopherectomy after all necessary pre-operative work up. To, our surprise, the fibroid was extremely hard, as a result we failed to morcellate or cut it even with high voltage pure cutting current. So, we did a mini-laparotomy to remove the fibroid. Blood loss was minimal. The size of the extracted fibroid was 1 kg. The patient was discharged in stable condition on post-operative day 4. The histopathological examination was suggestive of extensively calcified intramural fibroid and other rare finding of cavernous hemangioma in one of the ovaries. The extensively calcified fibroid in postmenopausal patient and the presence of cavernous hemangioma are rare findings with very few cases reported till date. We managed the case laparoscopically followed by mini laparotomy to retrieve the specimen with the advantages of minimal blood loss, need for blood transfusion and early recovery.

This complete enumeration, cross-sectional comparative study was conducted in the Physiology Department of a municipal medical college in Maharashtra, India to determine the gender differences in scores obtained by students in objective structured practical examination. After explaining the purpose of the study and the procedure of the Objective Structured Practical Examination to first-year MBBS students (n=60; 30 females and 30 males), written informed consent was obtained. The examiners were provided with a pre-validated checklist for assessing the students’ performance at the procedure station. After the procedure station, the students shifted to the question station for writing answers to ten short-answer type questions. The overall mean score (out of 20) in the procedure station was 18.57  1.88 (95% CI: 18.09–19.04) while the mean score in the question station (out of 20) was 10.98  4.05 (95% CI: 9.96–12.01). The gender differences in mean scores were not significant (p=0.499) at the procedure station that primarily assessed the psychomotor domain at the “shows how” level of the Miller’s Pyramid. However, male students obtained significantly (p=0.015) lower mean scores at the question station that chiefly evaluated the cognitive domain at the “knows” and “knows how” levels. This implied that while both male and female students were equally proficient at performing the procedure (psychomotor domain) component of the practical, the male students were deficient in the knowledge (cognitive domain) component of the practical, when compared with their female counterparts.

Background: Asthma affects around 300 million people worldwide [1]. Asthma is characterized by chronic airway inflammation. The current treatment regimen is low dose inhaled corticosteroids plus long – acting beta agonist (LABA). Effective control is achieved by taking inhaled medication in proper technique which lead to effective drug deposition in lung. Compliance with inhaled respiratory medications is 40-50%. Low value of 15% also reported [7]. Objective: Determination of compliance towards inhaled medication in asthma patients one year after being prescribed and factors influencing patient’s compliance to inhaled medication in asthma. Methodology: Compliance to inhaled medication assessed by standard set of questionnaires in 260 Asthma patient who were above 18 years from both sex taking inhaled medication for one year. Patient who attended pulmonary Medicine OPD from March 2016 to March 2017 were assessed. Results and Discussion: Mean age of the patient was 57.67 years. 65% of the patients were female. Among the 260 patients, 40% of the patients were having elementary school education. Percentage of patients using inhaler regularly is 26.6%. Percentage of patients trained to use inhaler properly is 23.9%. Good technique of using inhalers has significant association with proper training to use inhalers (P value – 0.0001) and also with proper counselling. (P value – 0.0001). There is also significant association between counselling regarding use of inhalers and its regular usage. Conclusion: Factors affecting the patient’s compliance to inhaled medication is proper counselling regarding the use of inhalers and proper training to use inhaler. Compliance can be improved by providing adequate knowledge about disease and its control, teaching the patients about correct technique of using inhaled medications

This complete enumeration, comparative, before-and-after study (without controls) was conducted on 60 first-year MBBS students (30 females and 30 males) at a municipal medical college in Maharashtra, India. The outcome studied was the difference in cognitive domain scores after attending didactic lectures (by a pre-test) and integrated teaching with case scenarios (by a post-test). The participants included all first-year MBBS students, who gave written informed consent after the purpose and procedure of the study was explained to them. Didactic lectures on anaemia were followed by a pre-test and integrated teaching with case scenarios, conducted by the same set of teachers. Next, the post-test was administered using a questionnaire that was identical to that of the pre-test. The difference between the overall pre- and post-test scores was highly significant (Z=5.966; p<0.00001). The differences between the pre- and post-test scores for female (Z=3.463; p<0.00053) and male students (Z=3.636; p<0.00027) were also significant. In the pre-test, the mean score (out of 20) was 8.40  2.92 (95% CI: 7.36–9.44) and 8.07  2.55 (95% CI: 7.16–8.98) for females and males, respectively and the gender difference in scores was not significant (Z=0.466; p=0.641). In the post-test, the mean score (out of 20) increased to 11.40  3.74 (95% CI: 10.06–12.74) and 10.53  2.69 (95% CI: 9.57–11.49) for females and males, respectively and the gender difference in scores was not significant (Z=1.034; p=0.301). The study results reveal that blending integrated teaching with case scenarios significantly increases cognitive domain scores.

Responsive Governance requires the government to be responsive to changes in situations / conditions that can accommodate people's aspirations. The Makassar city government can better understand the wishes of the city community through the application of smart city applications so that decision making in service delivery is more responsive to the demands of the community. Through the glasses of Responsive Governance, a concept that emphasizes the point of view of decision making involving all components involved in governance by linking interesting issues about smart city (specifically the application of Tangkasaki and Dottoro'ta Trucks) which are focused on responsive aspects of governance this research can provide impact in the form of an understanding of responsive governance that still lacks research literature that discusses the concepts and theories of responsive governance and helps the Makassar city government in finding new approaches and perspectives in promoting the existence of Makassar's smart city concept

Objective: The purpose of this study was to see the behavior of accounting student to obtain chartered accountant certification, where the behavior is seen from attitudes, subjective norms and perceived behavioral control. This research was conducted on 250 respondents who legitimately filled out the questionnaire in August-September 2018 at the University in Palembang, Indonesia. The collected data was analyzed using Partial Least Square. The research findings revealed that attitudes toward behavior, subjective norms, and perceived behavioral control had a positive and significant influence on obtaining a chartered accountant certification. In addition, the interest of obtaining chartered accountant certification has a significant influence for the behavior of interest in obtaining chartered accountant certification.

Therapeutic modalities for metastatic breast cancer have not stopped progressing in recent years, in particular hormonotherapy targeting hormonal receptors (HR), and targeted therapies targeting Human Epidermal Growth Factor Receptor-2 (HER2), which allowed to improve the overall survival of patients over expressing these receptors, however, the high risk of metastatic relapse makes the prognosis remain impaired. Among the causes of these relapses, the phenotypic instability, which would be at the origin of expression change of the HR and HER 2 on the surface of tumor cells.This discordance of phenotypic expression between the primary tumor and the metastatic relapse leads to an assessment of therapeutic modalities initially undertaken? Through this work, we will compare our study about 17 female flight crew with metastatic breast cancer, conducted at the aerospace medical center of the military hospital Mohamed 5 of Rabat, with literature data

Loranthaceae are epiphytic hemiparasitic plants that cause considerable damage to cultivated and spontaneous woody plants around the world. These plants are also used locally to treat many health problems. The aim of this work is to identify the various potentials of Phragmanthera capitata exploited by tradi-practitioners of traditional medicine. An ethnobotanical survey based on direct and semi-structured interviews was conducted among 121 tradi-practitioners in the city of Douala. About 52.9% of the surveyed tradi-practitioners knew only P. capitata as a hemiparasitic plant while 47.1% knew about other Loranthaceae species. In the latter group, 56.2% differentiated them only through flowers. 26 plant species have been recognized as host plants to P. capitata, 73.1% of which are woody species. The most cited species were Persea americana, Dacryodes edulis and Psidium guajava. 64.5% of the tradi-practitioners surveyed used P. capitata only for medicinal purposes (UV = 0.64) and the rest added ritual practices (UV = 0.71). The inventory identified 38 health problems treated by this species among which, hypertension, diabetes, nerve pain, cancer, heart disorders and mystical diseases are the most concerned. The leaves (93.3%) and stems (56.7%) are mostly used. This study showed the importance of P. capitata in the traditional pharmacopoeia of Cameroon despite its pernicious nature. Phytochemical and pharmacological investigations are envisaged to highlight certain medicinal properties of P. capitata.

Introduction: Sjögren's Syndrome is a complex and chronic autoimmune disease that affects the salivary and lacrimal glands, however the immunoregulatory and immunosuppressive effect of vitamins has been related to the disease. The objective was to know the vitamins related to the Sjögrens Primary Syndrome compared with a control group. Materials and Methods: A review was made in the PubMed database with the key words (Vitamin and Primary Sjogrens Syndrome and Primary Sjögrens Syndrome) without restriction of date until November 2, 2018, only studies conducted in humans and published in English were selected. Results: We identified 50 studies with the search criteria, 5 studies were conducted on animals and were excluded, 7 studies were written in a language other than English and were excluded, only 38 studies were eligible and 7 of them were included. The vitamins A, D, E, and 25 hydroxyvitamin D3 were analyzed in the pSS compared to a control group. Conclusion: The vitamins D are important to balance calcium, phosphorus for the development of bone tissue and in patients with pSS the musculoskeletal system may be affected.

The purpose of this research was to identify the internal and external factors to formulate strategy and to prioritize alternative strategies for increased local tax revenue BPHTB. The research are using Internal Factor Evaluation and External Factor Evaluation, SWOT analysis and Analytical Hierarchy Process (AHP). The results indicated that the emergence of factors that affect the goals are (1) facilities and infrastructure (2) BPHTB regulation (3) updated NJOP (4) the growth of the industrial property (5) the integrity and capacity of human resources (6) awareness and knowledge of the taxpayer. Actors who influenced in this study is the tax payers, tax officers, internal Auditors and Notary Public/PPAT. The increase of capacity and integrity was selected as the priority strategy based on AHP research. Managerial implications of the human resources improvement program is oriented on increased local tax revenue BPHTB based on the principle of good governance. This research was the top recommendation of the deregulated of regulation BPHTB to anticipating the loss of potential revenue BPHTB and for the Central Government BPHTB along with the House of Representatives (DPR) for the amendment UU Nomor 28 Tahun 2009

The aim of this study is to find out the relationship between corporate governance (measured by: institutional ownership; board of commissioner; and independent commissioner), tax avoidance, leverage and company size to earnings management. Based on previous research, we identify some factors can make the company doing earnings management such as corporate governance, tax avoidance, leverage, company size. This research took population and sample from banking companies that listed in IDX 2015-2017. The results show that institutional ownership has significant effect to avoid earnings management. These results also showed that tax avoidance, leverage, Size Company has no significant effect to avoid earnings management.

Nasal obstruction (NO) is defined as a single or bilateral nasal breathing disorder, recent or old, permanent or intermittent. It is a frequent problem in pediatrics and underestimated because of the absence of complaint in young children or unknown when the complaint is unilateral [1]. Although the majority of causes of ON belong to the infectious pathology, one must know to think of a syndrome malformative or tumoral [2]. The ON can cause significant troubles both locally and generally [1]. It is necessary to objectify the cause quickly especially in the newborn because of the vital consequences that this obstruction can cause [1].

Dermatoglyphic analysis is one of the most authentic biometric technologies that provides authorized certification of identification. The present prospective study involves 114 female nursing students on an attempt to find out a correlation between the fingerprint pattern and ABO blood group system. It is a double-blind study wherein attentive supervision were done while examining the blood groups and collecting the fingerprints. The results unveil the fact that all the patterns are distinctive. The count of samples is far more in blood group „A‟, „B‟ and „O‟ as and when compared to that of „AB‟. Based on the prevalence of palmar sequences, loops are found to be the most common pattern, followed by whorls and arches. A further in-depth study suggests that the incidence of loops was more in the thumb, middle and little finger whereas whorls are prevalent in the index finger of A, B, and O blood group of both the hands. Definitely, a close association is found between the palmar patterns and individual digits of the left and right hand with the blood groups.

The malignant hyperthermia is a rare autosomal dominant disease of the skeletal muscles. Triggered by volatile anesthetics and succinylcholine which leads to excess release of calcium from sarcoplasmic reticulum that leads to hypermetabolic status of the body and it could be fatal. The incidence between 1:10000 and 1:250000 anesthetics. It is more common in males than females, and the young more than old people. MH cause by mutation in RYR1, CACHA1S or STAC3 genes. Symptoms of MH are muscle rigidity, tachycardia, hypercapnia, hypoxemia and hyperthermia. The symptoms of MH could be mistaken by other conditions and therefore delay the treatment. Treatment is by stopping the triggering agent, symptomatic treatment to prevent complications and the only pharmacological agent that reverses the MH is Dantrolen. IVCT is the gold standard to diagnose MH but it is invasive. Genetic testing is less invasive and also help in diagnosis of MH and identification of the affected gene, but it does not replace IVCT.