Pseudomonas aeruginosa is a true opportunistic pathogen and is responsible for causing a variety of infections in clinical settings in both immunocompetent as well as immunocompromised hosts. However, in most cases, P.aeruginosa infections occur in patients who have been compromised in some way, e.g. chronic Diabetic Patients. Methods: In this study a total of 280 (10.98%) P.aeruginosa isolates were obtained out of 2549 samples collected for a period of 5 years. The isolates were selected on the basis of their growth characteristics on Blood agar, MacConkey agar and Nutrient agar medium. Colonies were subjected to series of biochemical tests to identify the species. Antimicrobial susceptibility testing of all the confirmed P.aeruginosa isolates was performed by automated walkaway 96 using NBC 42 and conventionally comparing with Kirby–Bauer disc diffusion method for further confirmation and results were interpreted according to CLSIs guidelines. Results: The prevalence of this pathogen was 10.98% and most of the isolates were mostly isolated from pus/wound swab cultures, followed by urine & sputum cultures, mostly isolated from critical areas such as ICU’s.

Chronic Obstructive Pulmonary Disease is associated with increased inflammatory cells. Combination of long acting beta agonist and inhaled corticosteroids are standard treatment. Roflumilast targets inflammatory cells and decreases the frequency of exacerbation. This study looks at the effect of Roflumilast on inflammatory cells in sputum and inflammatory markers in the blood when used as add-on therapy in COPD patients. This observational comparative study conducted in Department of Pulmonary Medicine for 1.5 years duration. 70 COPD patients were divided into two Group A (Roflumilast + Standard treatment) and Group B (Standard treatment). Pulmonary Function Test, Sputum Eosinophil & Sputum Neutrophil, CRP were measured at baseline and after 4 months of treatment in both groups. Intergroup analysis between Group A and Group B was done at baseline and after 4 months. Mean age of patients in Group A was 64.3 years and in Group B was 61.2 years. Maximum patients were in age groups 51-60 and 61-70 years. Of total 70 patients, 60% were males and 40% females. Majority of patients in both groups had low BMI. Sputum inflammatory cells were significantly lower in Roflumilast group. Pulmonary function parameters showed significant improvement in Roflumilast treated group. There was no significant decrease in CRP when compared between two groups. Roflumilast, add-on therapy to standard treatment in COPD patients have improved lung function and decreased level of inflammatory cells in airway significantly.

Tuberculosis, inspite of advances in diagnosis and therapeutics still continues to be the leading cause of mortality and morbidity in many developing countries even today. It is one of the major killer infectious disease. In recent years, two important factors which heavily complicate the treatment outcome of tuberculosis patients are MDR-TB and XDR-TB.The mortality in Tuberculosis mainly due to delay in diagnosis. India has the highest TB burden accounting for 1/5 th of Global incidence. The most common form of TB is pulmonary tuberculosis. The sputum microscopy and culture both of them are backbone for the diagnosis of Tuberculosis. The present study aimed to compare and evaluate the of Trisodium Phosphate solution as sputum concentration technique by smear microscopy (Zeihl Neelsen Technique), to compare the smear microscopy. Sputum samples of suspected 150 cases of pulmonary tuberculosis attending Thoracic Medicine and General Medicine OPD at Thanjavur Medical College, (Tamil Nadu) were collected and processed for smear microcopy. Among the 150 sputum samples, AFB positivity in unconcentrated sputum microscopy by Zeihl Neelsen Technique-33(22%),AFB positivity in concentrated sputum microscopy by Zeihl Neelsen Technique-37(25%).The present study confirms that the importance of Trisodium Phosphate solution for sputum concentration technique for the smear microscopy by Zeihl Neelsen Technique.

The present study aimed to investigate role of Attitudes towards medication, subjective norms and Perceived Behavioral Control in predicting Intentions of patients to take Anti-TB medication. The sample comprised of 147 patients with pulmonary TB, recruited from Gulab Devi Chest Hospital, Lahore. Correlation Research design was used. Urdu translated version of Theory of planned behavior questionnaire was used for assessment. Results showed that, Distance to hospital and Attitude of doctors and staff negatively predicted Intentions. However, Monthly family Income, Attitudes towards medication and Subjective Norms positively predicted Intentions. Results also revealed that high and low intenders were significantly different in terms of Behavioral, Normative and Control Beliefs. Findings of the present study highlighted the importance of environmental and patient related factors influencing the decisions to take medication. These factors should be considered while developing interventions to promote future medication adherence behavior as intentions drives behavior and patients has to be motivated in order to perform the behavior.

Mesenchymal hamartoma of liver is the second most common benign liver tumor in children after hepatoblastoma. First described in 2006 as multicystic biliary hamartoma, it generally presents as large multicystic mass in less than three years of age.We report one such case in a 3 year old male child who came with history of fever and rash and was incidentally diagnosed with a cystic mass in the liver. Partial hepatectomy was done which on microscopy revealed epithelial structures in loose connective tissue stroma along with cystically dilated spaces lined by columnar and flattened epithelial cells, typical of Mesenchymal Hamartoma of liver. We are presenting this case because of its rarity.

Strong writers actively and metacognitively involve themselves in the writing process by spending more time recursively planning and refining their writing by actively monitoring and adjusting the text they are generating and by maintaining an awareness of their audience. Research shows that training in Meta-cognition Strategies that are used to Improve Writing Disabilities and performances have been successful. The purpose of the present study was to study Comparison of Using Metacognitive Strategies on Writing Performance in Private and Government Schools in Jordan. We have investigated the effect of Meta-cognitive strategy training through the use of explicit and teaching intervention strategy instruction on Improve Writing Disabilities among 12th Standard students. To reach the goal of the study two groups of Writing Disabilities in 12th Standard students were randomly assigned to a control and an experimental group. The experimental groups received instruction on Meta-cognitive strategy training through a 12- week period of instruction while the control groups received traditional way. The result of the study showed that explicit Meta-cognitive strategy training has a significant positive effect on Improve Writing performance and Disabilities in 12th Standard students. The collected data were analyzed by using SPSS software version 23.

β-Lactam antibiotics are commonly used to treat bacterial infections. Increased use of antibiotics, particularly the third generation of cephalosporins, has been associated with the emergence of ESBL producing bacteria, most commonly in E. coli. And Klebsiella pneumonia. Infection due to ESBL producers range from uncomplicated urinary tract infection to life threatening sepsis. This study was undertaken to assess the prevalence of ESBL producing E.coli and Klebsiella isolates. Patients taking treatment in P.D.U. Hospital and Medical College, Rajkot- a tertiary care hospital in Gujarat, India, were included in study. During the half year period from July 2014 to December 2014, a total of 600 E. coli and Klebsiella isolates from various clinical specimens were included in the study. The isolated organisms of E. coli and Klebsiella were characterized for their production of ESBL. Out of 600 E. coli and Klebsiella isolate, E. coli were 224 (37.3% and Klebsiella spp. 376 (62.7%). The overall rate of production of ESBL (by phenotypic confirmatory test with double disc diffusion method) in total isolates of E. coli and Klebsiella spp. is 22.5% (135/600). The rate of production of ESBL in E. coli is 29.9% (67/224) and in Klebsiella spp. is 18.1% (68/376). ESBL producing E. coli and Klebsiella showed high prevalence in present study. Routine laboratory testing for ESBL is needed in order to optimize antibiotic management to reduce ESBL associated morbidity & mortality.

Primary immune thrombocytopenia (IT) is one of the common causes of thrombocytopenia in otherwise asymptomatic adults. Though most of the patients with IT are asymptomatic the presentation can be varied from mild petechiae to severe hemorrhage such as intracranial haemorrhage. Subconjunctival haemorrhage is an extremely rare presentation of IT. We report a 15 year old previously healthy boy presented with bilateral subconjunctival haemorrhage which was ultimately diagnosed as immune thrombocytopenia which was resistant to Steroid as well as IV Immunoglobulin therapy and managed with Rituximab successfully.

Derivatives have been around in the global market for a very long time. The evidence of characteristics of derivative contracts can even be found in the incidents that date back to the ages before Jesus Christ and in India in epic as old as Mahabharata. The first recorded instance of futures trading appears to have been occurred with Yodoya rice market in Osaka, Japan around 1650. Futures are one of the most popular derivative contracts in India as compared to traditional securities market. The stock exchanges in India have been in existence for more than a century now. Bombay Stock Exchange (BSE) is a stock exchange located in Mumbai, Maharashtra and was established in 1875. Subsequently, the National Stock Exchange (NSE) was set up in November 1992. The road for stock exchange traded derivatives contracts was cleared with the removal of prohibition of options on securities by way of amendment to Securities Laws through Securities Laws (Amendment) Ordinance, 1995. A Bill was introduced on October 28, 1999 and was converted into an Act on December 16, 1999 making way for derivatives trading in India. This study focus on the understanding the price movements and behaviours of futures market in India with special reference selected futures. The study also reveals the relationship among various future contracts of different companies.

The growth in cement demand in 2016 amounted to 60.6 million tons, which is a potential for the cement industry and the like. The average increase in cement demand in Indonesia is 3.4% per year in a volume of 2.5 million tons, according to data informed by the Ministry of Industry. Cement Mortar is a type of conventional cement substitute which is better quality and easier to use. Every building construction that uses concrete, always uses mortar, either as an adhesive, plaster, or pickle for construction. Cement Mortar potential is a market share that is a conventional cement user, of which 60 million tons of cement is needed in Indonesia, only 5% are cement mortar users. The trend of an increase in consumption of mortar types on average increased by 20%, Product supervision is due to several factors including media marketing, company promotion and brand image. Survey research method with quantitative descriptive statistics Quantitative research is an objective research approach, emphasizing the testing of theories through the measurement of research variables with numbers and conducting data analysis with statistical testing methods. In this study will take all retail parts of building materials that become direct partners of the company, while the number of retail building materials is 150 outlets. In this study quantitative methods will be used in which to measure an object related to the phenomenon that occurs (Sugiyono, 2012). The data collection in this study was carried out by simple random sampling technique. Which is assisted by a questionnaire. As for the weighting of the Likert scale.

The mouth is regarded as a mirror and the gateway to health. Various dental treatment modalities frequently require appointments, which are more than one in number for completion of the entire treatment program. Missed dental appointments are an issue which has been noticed for years but very little research has been conducted around it. To assess various factors responsible for missed dental appointments among the patients attending a dental college. A cross-sectional study was conducted among the patients attending various departments of the college. A sample size of 960 was calculated based on the results of the pilot study and the patients who missed their appointment at least once during their treatment procedures were included in the study. A self-structured 19 item questionnaire was used to measure various factors responsible for missing the appointment. The collected data was subjected to statistical analysis by using SPSS version 21.0. Among 960 patients, 53% were females and 46% were males. Various reasons for not attending recall were assessed in patient’s perspective and college perspective. Lack of time (63%). fear (62%) were cited to be the most common factors for not attending recall in patients perspective and inconvenient appointment timings (47%) and dissatisfaction with the reception area(44%) were cited to be the most common factor for missing the appointment in college perspective. This study concluded that patients who miss appointments cite the most common reason as lack of time, fear, lack of transportation inconvenient appointment timings. The key in dealing with the issue of missed dental appointment lies in altering patient’s psychology during the first appointment. Counselling and motivation is required to be done at first dental visit to reduce the chances of missed appointment.

Abstract: Diabetic retinopathy is the most common cause of vision loss among people with diabetes and a leading cause of blindness among working age adults, it is a serious sight threatening complication of diabetes. Hs-CRP is a marker of low-grade inflammation and its levels are raised in patients with diabetic retinopathy. The current study was undertaken in 60 subjects. 30 diabetic retinopathy patients and 30 non diabetics as normal control group. The aim of the study was to assess the serum levels of hs-CRP in diabetic retinopathy patients. hs-CRP is significantly much higher in diabetic patients with retinopathy compared to control group. TC, TG, LDL-C and VLDL-C levels where significantly elevated and HDL-C levels were significantly lower in cases when compared to controls. Hence it is concluded that the serum levels of hs-CRP appear to be useful as markers of diabetic retinopathy and provide valuable information for proper medical intervention.

The parasitic weed Striga hermonthica poses a serious threat to sorghum production in Northern Cameroon. To evaluate the response to S. hermonthica of 24 genotypes of rainfed sorghum and the effect of sodium carbonate on this parasite, field and pot experiments were conducted at Touboro (North Cameroon) in 2016 and 2017. In pot and in field, under striga infestation, results showed varietal responses of sorghum for the number of emerged Striga, the height of sorghum, the stem diameter, the number of leaves per plant, the panicle weight and the grain yield. Globally, Striga infestation significantly reduced the height, the stem diameter, and the number of leaves, the panicle weight and the grain yield of sorghum accessions by 28.94%, 19.54%, 17.78%, 28.24% and 44.17% respectively. Application of natural sodium carbonate salt reduced significantly the emerged Striga and the host plant damage by 74.29% and 41.94%. Under Striga infestation, sodium carbonate also increased the growth and yield sorghum accessions. Among the 24 studied genotypes, complete resistance was no recorded, but landraces LMO-LT18, LMO-LT22, KW-CP09 and LMT-21 appeared as the most resistant and tolerant to S. hermonthica. Combination of sodium carbonate with resistant and tolerant genotypes should be investigated as a major component of integrated packages to the effective control of Striga on sorghum in northern Cameroon.

Marketing efficiency as a concept is strongly linked to many of the core organizational results, such as long-term growth, stability, customer satisfaction, competitive advantage, and strong market orientation. Marketing effectiveness depends on the company's goals. Due to the growing demand for marketing professionals, one needs to focus on a system where both short-term and long-term financial impact can be measured on the company's market investments. Marketing effectiveness measurement is a business process that shows the results of specific marketing decisions. The effectiveness of marketing activities should be defined as the return on the funds invested in these activities.

To study the antibacterial activity of Tabernaemontana divaricata (Apocynaceae) secondary metabolites capped silver nanoparticles (SNPs). In the present investigation, SNPs were synthesized using an aqueous extract of T. divaricata flowers. Flower aqueous extract was mixed with 1 m M silver nitrate for the biosynthesis of nanoparticles. The antibacterial activity of SNPs was determined against various bacterial cultures including laboratory isolates using the agar well diffusion method. The SNPs showed the highest antibacterial activity against Grampositive and Gram-negative bacteria. The present study envisions on the biosynthesis of SNPs from T. divaricata plant which are emerging as antibacterial therapy in modern medical applications.