Persistent Genital Arousal Disorder (PAGD) is an uncommon female sexual dysfunction that was first described in 2001. It is a condition that has been under-researched and not fully understood for so many years. Its prevalence is estimated to be between .5% to 6.7%, but it is believed to be under-reported because of the stigmatization of the disorder, as it is characterized by prolonged periods of persistent subjective feelings of genital arousal that are recurrent, intrusive and distressing, which usually subside by masturbation resulting in orgasm. These symptoms are not associated with sexual thoughts or urges, which prompted sex therapists and researchers to change its name from persistent sexual arousal disorder to PGAD. Now that we have a better understanding of its risk factors and pathophysiology, this review article will guide gynecologists, general practitioners and pelvic floor physiotherapists to diagnose, investigate the cause and treat patients with PGAD.

Oral mucositis (OM) is a common inflammatory complication among cancerous patients as an adverse effect of chemotherapy and radiotherapy. The aim of this study is to evaluate the healing effects of hydroalcoholic extract of Psidium Guajava leaf on oral induced mucositis induced by 5-fluorouracil using histopathologic and tissue antioxidative markers assessment in male dark brown rats. In a prospective randomized double blind animal study, OM was induced in 64 male dark brown rats that allocated in 4 groups by 5-FU (60 mg/kg) on days 0, 5, and 10 of the study. The cheek pouch was scratched with a sterile needle on once daily on days 3 and 4. Starting from day 12, gel base, topical form and 600 mg/kg dietry form of hydroalcoholic extract of Psidium Guajava leaf were administered per day. Pouch histopathology score, superoxide dismutase, glutathione peroxidase, total antioxidant capacity were evaluated on day 14 and 18. DPPH scavenging activity and total phenolic content also were measured. Histopathology scores of mucositis were lower in the systemic and topical treatment groups than the gel base and control groups (P<0.05). Higher activities of SOD, GPX and TAC were detected in the topical and systemic treatment groups in comparison to the others (P<0.05). The extract was rich in total phenolic content as antioxidant. The use of extract of Psidium Guajava leave may be associated with reduced intensity of OM, increased concentration of SOD, GPX and TAC on induced OM in dark brown rats undergoing 5-FU consumption. This may be due to appropriate antioxidant activity and phenolic contents.

One of the most common chronic diseases in closely all states is Diabetes Mellitus. The world occurrence of diabetes amongst elderly (20-79) in 2010 was 6.4% distressing 285 million adult and all ages and probable to be increased to 7.7% distressing 439 million adult in 2030. In Pakistan Diabetes Mellitus (DM) the recent occurrence of type 2 diabetes mellitus is 11.77%. The prevalence is advanced between male than females, the occurrence of (DM) Diabetes Mellitus in urban areas are more common than rural areas. (DM) Diabetes Mellitus is a set of diseases categorized by great level of blood glucose causing from faults in insulin excretion, and its action or both. We compared the echogenicity of pancreas with the surrounding organ superior mesenteric artery (fat around (SMA). The size of the pancreas is slightly decreased as compare to the normal individuals. To determine the sonographic differentiation of pancreatic appearance between diabetic and non-diabetic individuals of age 45-55years. A cross sectional comparative study was conducted at Gilani ultrasound clinic Lahore. Total 150 individuals of both diabetic and non-diabetic were included in this study to compare the sonographic appearance of pancreas in diabetic and non-diabetic individuals. Peoples from the age group of 45-55 years are only included in this study. According to the result Fatty pancreas was seen on ultrasound hyperechoic and the normal pancreas was hypoechoic. The size of the pancreas is slightly decreased in diabetic patients as compare to non-diabetic individuals. Glucose level in diabetic patients was more than normal individuals. The mean age group was 49.9133. Out of 75 patients 43 patient pancreas were seen hyperechoic. The mean of pancreatic head was 22.22mm, pancreatic body was 21.11mm and pancreatic tail was 21.87mm. In our study female were more than male. Highly echogenic pancreas is associated with diabetes mellitus (DM).

With this work it has been wanted to demonstrate that the reconstruction of any person, does not have limits. We have absolutely all and each of the tools to solve problems of aesthetic nature to patients. Many of these tools should be manufactured individually for a particular case. Oral and Maxillofacial Surgery and Cosmetic Surgery should not be divorced from Maxillofacial Prosthesis. The resolution of three cases is presented with prostheses specially made for a particular person, with their own measures and forms. It will be very comforting for each person to know that they have reached the exact place where they solve their aesthetic problem with special devices built for them. We have worked together with the surgeon and the prosthetist in order to study each case and build the most appropriate device for the type of problem to be solved. A work team will be essential to achieve excellence, because it represents a new alternative of care

Traditional medicine is the oldest form of health care system that has stood the test of time. The African continent holds an enormous resource in terms of floral biodiversity and its medicinal plants have remained a main reservoir of phytochemicals for pharmaceutical drug development. Plants used for traditional medicine contain a wide range of substances that can be used to treat chronic as well as acute infectious diseases. In Cameroon, many plant species are used as traditional medicine to treat infectious diseases, and several interesting openings have originated for further inquiry following in vitro antimicrobial activity evaluation. Typhoid fever is a systemic infection transmitted through food and water contaminated with human feces. Its causative agent, Salmonella, is a primary cause of food poisoning worldwide. The aim of this study was to investigate the in vitro antimicrobial activity of methanol fractions of five mixtures of Cameroonian medicinal plants, Enantia chlorantha, Echinacea angustifolia, Acalypha indica, Alchemilla vulgaris, and Vernonia guineensis on strains of Salmonella typhi, thus bringing out the importance of considering Traditional medicine as an important aspect of health care delivery system in Africa. The general objective was to show the efficiency and potency profile with which Enantia chlorantha bark, Echinacea angustifolia plant, A.indica leaves, Alchemilla vulgaris plant, and Vernonia guineensis have on strains of salmonella enterica serovar typhi, first as individual extracts, then as a recipe mixture, thereby demonstrating the possible use of this mixture in the effective treatment of typhoid fever. The specific objectives was: 1) To do a phytochemical screening that will permit the identification of the plants phytochemical components, 2) To prepare individual methanol extracts of each of the plants used in the composition of the typhoid treatment mixture, and use each of these extracts to test for antimicrobial activity on salmonella typhi serotypes, and then test for any antimicrobial activity of the methanolic extract of the entire mixture of all possible combinations of all the plants and come up with possible results observed. Antibacterial assay shows us that while having antibacterial effect separately, the plants used in our recipe have a much more potent activity when associated together, and we can notice that there is an additive effect. With all the parameters put in place, we, rather than selecting either E24 or E25 as our most potent extract, decided to bring out, as our most potent extract, E30, containing the mixture of all the plant extracts (E. angustifolia, A. vulgaris, A. indica , V. guineensis and A. affinis), in its right proportion, with each plant having a role to play, and with an MBC/MIC value of 0.09.

Evaluation of the lateral ventricle in second trimester is an important indicator for normal brain development. We sought to analyze the difference in the mean fetal lateral ventricle in second trimester among the consanguineous and non-consanguineous marriages in Indian population, in this retrospective cross sectional study. Study was carried out in the Department of Radiology, Sree Balaji Medical College and Hospital, Chennai, from June 2017 – June 2018. A total of 1067 patients in their second trimester (18 – 24 weeks of gestation) were included in this study (740 Non consanguineous and 327 consanguineous marriages). Lateral ventricle measured in true symmetrical axial plane at the atria of lateral ventricle and glomus of choroid plexus, opposite to the parieto occipital sulcus. Mean lateral ventricle dimension was 6.40 mm in consanguineous marriages and 6.42 mm in non consanguineous marriages. There is no significant difference in mean lateral ventricle size in consanguineous marriages and non consanguineous marriages at this period of gestation.

Preconception and pregnancy care is important for better pregnancy outcome. Awareness of both male and female is necessary for reducing maternal and neonatal morbidity and mortality in developing country like Nepal. The objective was to find out level of awareness on preconception and pregnancy care among bachelor level students of Dharan. Descriptive design was used for the study. Purposive sampling method was used to select 50 students from each college. Four colleges were selected through simple random sampling from 16 colleges and a total of 200 students who were studying bachelor final year were selected for study. Data were collected by self-administered Semi structured questionnaires. The result shows that 24.5% of total respondents heard about folic acid. Among them 7% were male respondents and 17.5% were female respondents. Majority (89%) of respondents accepts that male’s awareness is important for better pregnancy outcome. Female (mean awareness=55.2) were more aware than male (mean awareness=52.61) respondents on preconception and pregnancy care. Female were more aware on both preconception and pregnancy care. The source of information (media, newspaper) is associated with level of awareness. (p=0.010). Awareness level is related to employment status with higher proportion of employed individuals showing average awareness level (p=0.014). An equal to half (50.5%) of respondents have average awareness level on preconception and pregnancy care. The study concludes female (17.5%) have more good awareness level than male (7%) respondents.

CT scan is a revolutionized diagnostic imaging modality that allows threedimensional visualization of a region of the body in different planes. Besides its advantages, CT has disadvantages as well. The radiations used in CT scans are ionizing X-ray radiations which increase the risk of cancer progression. The rate of unnecessary CT scans has increased over the past few years which has resulted in increased exposure to the patient and increased healthcare cost as well. The aim of this study was to determine the actual rate of unnecessary CT scans in a tertiary care hospital of our country. The study was conducted on 385 patients in the Aziz Bhatti Shaheed Teaching Hospital, Gujrat in time duration of three months. It was an observational cross-sectional study. Scoring of the results was done by the co-supervisor having an experience of over 15 years. The scoring system was categorized from score 0 to score 2.Score 0 had no pathological finding, score 1 had suspicious finding and score 2 had confirmed pathological finding mentioned in the request form. A total of 385 patients were included in this research 162 females (42.1%) and 223 males(57.9%) with a mean age of 38.2±22.5-year (1-100 years).In this study 147 patients(38.2%) were categorized underscore 0 they were having no pathological finding and their results were normal,25 patients(6.5%) were categorized underscore 1 they had suspicious findings and were considered for follow up scan and the remaining 213(55.3%) patients were categorized underscore 2 they had confirmed pathology. Results concluded that the rate of unnecessary CT scans performed in this country is 38.2% which is considerably high. Unnecessary CT scans can lead to the risk of developing contrast-induced nephropathy (CIN) due to radiation exposure. The high cost of this test may cause a delay in the treatment of the patients.

The aim of the study was to of ventricular remodeling in patients with chronic heart failure (CHF) I-III functional class (FC). In patients with CHF left ventricular remodeling leads not only to re-structure of left ventricular (LV) which accompanied by dilatation and thinning of the cavity, reducing myocardial contractility, but also to changes of geometric shapes of left ventricular and to diastolic dysfunction of LV with domination of the disturbance of relaxation.

Indonesia is one of the countries with a large number of corruption cases. Criminal acts of corruption in Indonesia have been pervasive and have entered into all walks of life. Its development continues to increase from year to year, in the number of cases that occur and the amount of state financial losses and regarding the quality of criminal acts of corruption carried out more systematically that has entered aspects of community life. Increased uncontrolled corruption will bring impacts that are not only limited to the life of the national economy but also to the life of the nation and state in general. This study uses a normative and empirical juridical approach. Normative research is carried out on the theoretical matters of legal principles relating to law enforcement in the case of corruption in Indonesia. This research method uses several approaches to produce a reasonable conclusion. The strategy of prosecuting policies in certain crimes must pay attention to the nature of the problem. If the nature of the problem is more on economic or trade issues, it should take precedence over sanctions for action and/or fines. The formulation of sanctions between Article 2 and Article 3 of this Law is contrary to the general provisions concerning sanctions regulated in the Criminal Code. In the Criminal Code determines if an act is carried out because of position and violates the authority. It is a criminal weight, while in this law in Article 3 which is an act as stipulated in Article 2 but carried out by misusing the authority, opportunity or means that exists because of the position or position but the threat is lighter than in Article 2. If the special law makes a particular minimum criminal threat, then it must be accompanied by rules/guidelines for its application such as comparative problems between specific minimums and maximal in particular. There should be a unique pattern that should be followed in other Article formulations. For example in Article 2 paragraph (1) the comparison is 1: 4 while in Article 3 the comparison is 1:20. There should be a similar pattern applied in each Article in the formulation of specific minimum provisions.

To determine antimycobacterium and dTDP rhamnose inhibitor activity of the synthesized azetidinone, thiazolidinone derivatives of thiazole, we studied different derivatives for the activity. One pot synthesis of 2-amino-4-methylthiazole-5-carboxylic acid ethyl ester has been carried out and synthesized different derivative compounds. Compounds were tested for antimicrobial activity against different strains of microorganism and antitubercular activity against M. tuberculosis H37Rv. Compounds 7c, 7d, 7i, 8d, 8e, 8g and 8h, were showed antimicrobial activity against Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Salmonella typhosa using Gentamycin as standard, while 7b, 7e, 7f, 7i, 8b, 8e, 8f and 8i showed very strong antimycobacterial activity using rifampicine as a standard. Thiazole derivatives especially with carbonyl group scaffold inhibit an enzyme RmlC, which is an essential component for the biosynthesis of dTDP-rhamnose and produce good antimycobacterium and antimicrobial activity.

Hypertension is an important public health problem in both economically developed and developing nations. Worldwide, 7.6 million premature deaths were attributed to high blood pressure. Hypertension has been associated with increased risk of coronary artery disease and is an independent risk factor for cardiovascular and cerebrovascular diseases. The aim of this retrospective study about 312 cases was to determine differences in treatment and control rates of hypertension between male and female and to research the frequency of associated cardiovascular risk factors in the hypertensive population in Zaatari camp deployed in Jordan for Syrian refugees [9]. Our study confirmed the high prevalence of hypertension and associated cardiovascular risk factor. Although women are better treated, much remains to be done to reach BP goal for themselves and also for the rest of the patients.

The tibia is the strong weight bearing bone of the leg. It has usually a single nutrient foramen. Of late, tibia is gaining importance in determining the stature, sex and race of individuals and in the identification of missing persons. The dry bone specimens were obtained from the department of anatomy of our institution. A total of seven morphometric parameters were obtained for the study. The number of nutrient foramen present and their location were recorded. The cross sectional index, cnemicus index, length-thickness index, and the proximal - distal surface index were arrived from the data obtained. A single nutrient foramen was observed in the study; located in the upper one third of tibia in its posterior surface. The results are presented as descriptive statistics (mean ± SD); and standard errors of estimate (SEE) for right and left tibia and total tibia. The mean differences obtained are not statistically significant. The confidence interval of SD or SEM is less than 1. The two – tailed P value equals less than 1and is not statistically significant. Tibia has a single nutrient foramen in the upper one third of tibia in its posterior surface. The morphometric parameters obtained and the indices derived differed widely among the different studies. The differences may be due delicate variations in the measurements. There is a need for defining the parameters by further studies for the better utilization of morphometry of tibia.

Recurrent pancreatitis is associated with minor duodenal papilla. Minor and major duodenal papillae are necessary for the endoscopist to perform the dilation, stenting, or papillotomy of the minor papilla. 50 formalin fixed cadavers (Male - 41; Female - 9) with age group ranged between 35 - 60 years from the departments of Anatomy, J.J.M Medical College, Davengere, Karnataka & Chennai Medical College, Trichy, Tamilnadu were utilized to study the position of minor duodenal papilla related to major duodenal papilla in pancreatico-duodenal specimens. The minor duodenal papilla was present in 46 (92%) out of 50 specimens whereas in 4 specimens (8%) the minor duodenal papilla was absent. The position of the minor duodenal papilla in relation to that of major duodenal papilla was recorded. In 37 specimens (80.43%) it was anterosuperior to the major papilla and in 9 specimens (19.56%) it was directly superior to the major papilla and opens at second part of duodenum. The distance between the minor and major papillae varied from 1.3 cm to 4.3 cm, the average being 2.35 cm was noted and recorded in the present study. Endoscopy assisted surgeries need anatomical knowledge in understanding the position of the minor duodenal papilla relation to the major duodenal papilla and its clinical importance.

Tea is common drinks in Saudi Arabia, as in the overall world for its desirable aroma, taste and putative positive physiological functions. According to recent estimates by FAO, approximately 5.35 million tons of tea were produced in the year 2013 with a total of 3.52 million ha land area under tea cultivation. Estimates show that approximately 70 % of the total world population consumes tea infusion (i.e., water extract of made tea). Contaminants may vary in the soil, air, or water in which the plants of tea are grown. There is an abundance of literature demonstrating the adverse health effects of various heavy metal and metalloid elements on the human organism. Our objective in this research is determination the trace metals which have directly effect on the human health and pollution of the environment. The samples were randomly collected from the markets and hyper markets in Eastern region, the collected samples of tea powder were stored at room temperature in dry containers for further process. The diluted digests analyzed by using Inductively Coupled Plasma (ICP-OES). The concentrations of anion groups in the selected samples were high and might affect the health of the consumers of the tea as the result showed; SO4 was ranged between 16 to 35 mg/L, NO3 was ranged between 0.1 to 5.8 mg/L, NO2 was ranged between 0 to 0.012 mg/L, PO4 was ranged between 0.29 to 1.28 mg/L and NH3 was ranged between 0.36 to 0.49 mg/L. The concentrations of nontoxic heavy metals in tea samples also were high e.g., Ca concentration (mg/kg) the maximum concentration was 173.31 and minimum concentration was 48.55, Fe concentration (mg/kg) the maximum concentration was 49.861 in some of the samples. K concentration (mg/kg) the maximum concentration was 158.96 to 101.69, Mg concentration (mg/kg) the maximum concentration was 150.24 and minimum concentration was 24.913. About toxic heavy metals in tea samples such as Al concentration (mg/kg) the maximum concentration was 47.276 and minimum concentration was 18.925, Cd concentration (gm/kg) the maximum concentration was 0.0339 and minimum concentration was 0, Cr concentration (mg/kg) the maximum concentration was 1.9132 and minimum concentration was 0, Pb concentration (mg/kg) the maximum concentration was 72.317 and minimum concentration was 0.1185.