A cross-sectional comparative study was conducted at Rajiv Gandhi Medical College, Kalwa, Thane, in Maharashtra state, India on 61 first-year MBBS students to compare the scores obtained by students in Objective Structured Practical Examination (OSPE) with that obtained in Traditional Practical Examination (TPE). In the TPE, each student performed red blood cell count, which was followed by viva-voce on the same procedure and marks out of 30 were assigned by the examiners. Students were oriented regarding OSPE and the marking system. At the “procedure station” of the OSPE (maximum marks = 20), the examiners were provided with a pre-validated checklist containing 10 steps for performing red blood cell count within an allotted time of 10 minutes. Two marks were given for correct performance of each step mentioned in the checklist. At the “question station” (maximum marks = 10), students had to write answers to 10 short-answer type questions carrying one mark each. The total marks obtainable during OSPE were out of 30. The mean OSPE score was 23 +/- 2.41 (95% CI: 22.40 – 23.60) while that for TPE was 17 +/- 3.58 (95% CI: 16.10 – 17.90). The difference in the mean OSPE and TPE scores was highly significant (Z=10.859; p<0.00001). The gender difference in TPE scores was statistically significant (p=0.017) but that in mean OSPE scores was not significant. Although the stations where most students committed identical mistakes were noted and feedback regarding their performance was given, extra training may be required for few students with lower scores. Periodically conducted faculty development programmes would assist in creating a pre-validated OSPE question bank.

University academic society should be made aware that implementation of good governance does not only pose an obligation, but rather a necessity. Along with the increasingly fierce competitive situation, a University must consistently apply good university governance as a system attached to the university dynamics. Implementation of good governance values at universities can be integrated into a higher education culture. This research for the first year aims to identify the concept of the implementation of good governance at private universities in the city of Medan. This research is expected to increase efficiency, transparency, and consistency within private universities in Medan. In order to measure the implementation of the concept of Good Governance at the Private Universities in The city of Medan, the parameters of the aspects of transparency, participation, legal sovereignty or compliance with regulations, accountability, and effectiveness were used. The results of this study revealed that Good Governance has been implemented in Private University in The city of Medan and the aspects of transparency, participation, law supremacy or regulatory compliance, accountability, and effectiveness have well been implemented.

This is a theoretical paper with a charge to examine the scope and character of gender equality in the education systems of Uganda, Rwanda and South Sudan through a review of cross-national literature using feminist lens to interpret their connotations. While Uganda and South Sudan have invariably sought to enact affirmative action geared at achieving increased access for girl children, Rwanda has by and large focused on shifting from affirmative action to more holistic genderresponsive strategies in its crusade. This, perhaps, is the most convincing notion of salience among the three East African countries; confirming that formal opportunities for equal treatment of girl children ensure neither a shared starting point nor equal outcomes because of different cross-national milieus of change. In Uganda, the flagship of government initiative is the 1997 UPE which has since its launch spurred a big rise in the number of school girls across the country. The extension of the free education policy to 12 years represents Rwanda‟s best bid to attain gender equality; while the Go to School Initiative is South Sudan‟s rarest case of success in promoting access and participation but remains largely embryonic and sporadic. Cultural thinking, economic insecurity and social disadvantage immensely affect the way poor and rural households decide about investing in their girl children‟s education. There is need, therefore, to emphasize the intrinsic developmental value of education over and above the compulsion for productivity and employability. It is audaciously mistaken to establish that gender inequality could be altered by education or within the education system without restructuring sexual division of labour in the home and the market at large. To achieve gender equality in their education systems, Uganda, Rwanda and South Sudan must decode the cultural capital of their social classes and use that knowledge to empower women and girl children at the family and community levels while schools offer prospect. If these initiatives could be further institutionalised, resourced, and embedded in durable policy visions, it is possible for schools to become standard for broader societal transformation.

Ankle fractures are the most common type of fractures treated by orthopedic surgeons in daily practice. Most of these fractures are complex type and difficult to manage. If not treated properly, may produce significant long-term disability and complications like pain, instability and early degenerative arthritis. Good functional results are obtained by surgical management of bimalleolar ankle fractures. Early weight bearing, and mobilization is achieved in these patients. This study was conducted at Prathima Institute of Medical Sciences, Karimnagar from January 2016 to December 2017. 40 adult patients with bimalleolar fractures of ankle who underwent open reduction and internal fixation were included in this study. Follow up was done at regular intervals of 6 weeks for minimum of 6 months. Baird and Jackson’s ankle scoring system of subjective, objective and radiographic criteria was used for the study. 24(60%) cases of medial malleolar fractures were fixed with malleolar screws, followed by cancellous screw in 4(10%) cases, tension band wiring in 10(25%) cases and K-wire in 2(5%) cases. 28(70%) cases of lateral malleolus were fixed with plate (24 with one-third tubular plate, 2 with 3.5mm DCP and 2 with 3.5mm recon plate) followed by malleolar screw in 4(10%) cases, Rush nail in 5(12.5%) cases and K wire/TBW in 3(7.5%) cases. Average time to union in our study was 10.4 weeks. However, most (80%) of the cases (80%) united by 8-12 weeks. Excellent results were achieved in 23(57.5%) cases, good results in 10(25%) cases, fair in 5(12.5%) cases and poor in 2(5%) cases. Open reduction and stable internal fixation of unstable bimalleolar ankle fractures restore the articular congruity of the ankle joint. Operative results in our study were satisfactory in 82.5% cases, with good to excellent functional outcome. Functional results were much better in younger age groups and men. Early weight bearing, and mobilization is achieved in these patients

The realization of the principle of justice in proving the settlement of consumer disputes through arbitration in Indonesia is important, with three reasons, namely first, there is a weakness of the consumer protection law because the formulation of substantial norms and formal law is contrary to other laws so that the formulation is not in the framework national legal system and difficult to be harmonized. Second, the legal norms for consumer dispute settlement with an inverse proof burden system have created injustice for consumers and producers and open up opportunities for other parties to manipulate adverse evidence. Third, no matter how well the consumer dispute resolution process, does not guarantee that justice is achieved unless the judge (arbitrator) is right and correctly divides the burden of proof and provides an assessment of the strength of the evidence submitted by the disputing party. Discussion of the problem of proof, using the normative legal research method that refers to norms and legal principles in the legislation or court decisions. This discussion is explorative on thought, concrete legal norms in the Indonesian consumer protection law and is prescriptive to offer the concept of problem solving of the problems presented. The conclusion of the discussion is that the consumer arbitration verification system in Indonesia is a model that comes from the presumption of liability principle with a reverse proof burden. The realization of justice in this system cannot be harmonized so that it needs to be adjusted to the principle of justice that is universally adhered to and the principle of justice characterized by the legal personality of the Indonesian nation, namely Pancasila justice.

Many patients with gastrointestinal (GI) symptoms go through endoscopy often unnecessarily and without indication. Observational studies have generally shown poor adherence to international guidelines of endoscopy. This study aims to identify the common indications of GI endoscopy and the subsequent findings among the population of Al Kharj Province, KSA. We conducted a cross-sectional study on 516 patients who underwent upper or lower GI endoscopy at the Endoscopy Unit of King Khaled Hospital, Al Kharj, KSA in the period from March 2017 to March 2018. GI bleeding, dyspepsia and reflux symptoms were the most commonly reported causes for referral to endoscopy (26.8%, 19.6% and 10.7% respectively). Normal endoscopic findings were reported in 33% and 37% of the patients who underwent gastroscopy with dyspepsia and reflux symptoms, respectively). Only six patients (1.8%) of those who underwent colonoscopy had an indication of colorectal screening. Almost half of the patients 45 % (45/100) with dyspepsia 53% (27/55) unnecessary gastroscopy. High rates of unnecessary upper GI endoscopy are performed for inappropriate indication such as dyspepsia and reflux symptoms. Also, colorectal screening strategy has not been adopted by the physicians. We recommend the implementation of the recent international guidelines when referring patients to endoscopy to avoid the unnecessary invasive procedures.

Based on Lillian’s (2008) and Chen’s (2016) studies on women’s courtesy titles, this study makes a comparison and contrast of women’s courtesy titles in mainland China and Taiwan, with reference to those in the Whites and Blacks. It is based on a survey of a questionnaire, which is almost the same as the one used in Chen (2016) that was modelled on the one used in Lillian (2008). The results confirmed that age is an influential factor in the selection of courtesy titles for women of different marital status. It also confirmed Lillian’s observation that a woman’s occupational status may outweigh her marital status. However, even mainland China and Taiwan belong to the same Chinese community, they have statistically significant difference in women’s courtesy titles, especially in the use of XJ (Miss). Its fill-in-the-blank method of collecting women’s courtesy titles, rather than fixed-choices method, also seems to be effective.

Hyperuricemia is commonly seen in subjects with cardiovascular disease and it one of the risk factor for morbidity and mortality with cardiovascular diseases. Uric acid is a product of synthesis from nucleic acids, amino acids, and Kreb's Cycle. Uric acid is biologically active and can stimulate oxidative stress and endothelial dysfunctions, inflammation, and vasoconstriction. The present study tries to evaluate the levels of uric acid in patients suffering from an acute ischemic stroke in comparison with normal subjects. Methods: This prospective cross-sectional study was conducted in the Departments of General Medicine and Biochemistry Prathima Institute of Medical Sciences, Naganoor, Karimnagar. A total of 80 subjects were included in the study. They were divided into two groups. Group I [cases] (n=40) consisted of patients reporting to the Emergency Department within 24 hours of onset of symptoms of stroke. The Group II [controls] (n=40) were the age and sex-matched patients attending the General Medicine OPD with minor complaints. Results: The mean age of Group I (n=40) was 61.42 ± 2.99 years and Group II was (n=40) 48.9 ± 4.53 years. The numbers of the male in Group I were 29 and female were 11 and in control, Group was 20 male and female each. The blood urea Group I was 38.7 ± 5.59 mg/dl and in Group II 30.12 ± 8.86 the p values were not found to be significant. The serum creatinine was 1.13 ± 6.61 in group I and in Group II was 0.91± 0.17 mg/dl and the p values were found to be significant. The uric acid levels were 7.32 ± 2.25 mg/dl in group II and 4.95 ± 1.5 mg/dl in Group I the values were found to be significant. Conclusion: Within the limitations of the present study it can be concluded that serum uric acid levels are significantly associated with ischemic stroke in this group of the population. The other important factors for the risk of ischemic strokes include Hypertension and Diabetes mellitus. There is growing evidence that uric acid may play a key role in the development and progression of cardiovascular diseases

Present studies at home and abroad on V.S. Naipaul‟s novel In a Free State is not enough in the aspect of textual analysis. The in-depth studies in this aspect are wanted. This thesis aims to analyze the image existing in the title novella of In A Free State, one of the five novellas in the collection of In a Free state. By discussing the symbolic meaning of the three images and then comparing the symbolic meanings of these images, it can be inferred that Naipaul tends to criticize the mimic of the western civilization but praises the traditional African civilization.

Systemic lupus erythematosus (SLE) is a prototypic systemic autoimmune disease with variable multisystem involvement and heterogeneous clinical features. Haematological abnormalities were common findings in patients with SLE. Sometimes, haematological abnormalities can be caused by the pathophysiology of SLE itself, but at other times the anaemia may not be directly related to the SLE. This retrospective study included patients who were diagnosed according to the American college of rheumatology criteria and treated for SLE from April 2015 to March 2018 at Olabisi Onabanjo University Teaching Hospital (OOUTH), Sagamu, Ogun State, Nigeria. The Demographic and haematological parameters at diagnosis were recorded. A total of 26 SLE patients were seen. All the cases were females and the mean age was 33.3± 8.9 years. Twenty-two (84.6%) had haematological abnormalities. Anaemia was present in 20 (76.9%) patients with a mean hemoglobin value of 8.6 mg/dl at the time of first presentation. Leukopenia was seen in 6 (23.1%), lymphopenia in 17 (65.4%), thrombocytopenia in 8 (30.8%) and 2 (7.7%) patients presented with anti-phospholipid antibody syndrome. The most common hematological abnormality among our patients was anemia which has a multifactorial aetiology. Lymphopenia was far more common than leucopenia.

This paper investigates the mechanical properties of an aluminium oxide reinforced Eposand composites. The matrix a brand of epoxy was obtained from Shell Petroleum Development Company (SPDC) and reinforced with particulates of alumina in micro-scale. The resin and hardener were mixed and compounded in the ratio of 2:1 and through the application of centrifugal force was thoroughly compounded with the fillers. Two main mechanical tests of tensile and compression where carried out to obtain tensile, compressive, and yield strength of the composites. Four samples of 10%, 20%, 30%, and 40% by weight of alumina with five replications each were prepared and subjected the tests in accordance with ASTM D3039 and ASTM D3401M for tensile and compressive tests respectively. Maximum compressive strength of 133.3 MPa was recorded for 30% of filler, while maximum tensile strength of 7.9 MPa was obtained 10% of filler. An optimal yield strength of 3.4 MPa was recorded at 20% weight of filler. The analysis showed that the compressive strength increases with increase in percentage weight of alumina.

Metacognitive awareness can improve students‟ writing proficiency. Engaging and supporting students in the writing process can increase their metacognitive awareness. One of the major factors that impede the smooth acquisition of writing intelligibility by EFL learners is the transfer of L1 linguistic elements into L2, motivation is another alarming factor that affects Arab EFL learners‟ performance and anxiety is another predicament to students‟ performance in writing. The aim of the study is to verify the relationship between metacognitive strategies and other external factors L1 transfer, motivation, and anxiety. The researcher used descriptive statistic methods and the correlation coefficient between Metacognitive Strategies and others factor. Questionnaire technique is used as a method of data collection; the study group was formed from secondary school students Al-Mazar, Irbid. Data were generated through distributing the questionnaire from twenty-two students selected purposively from Irbid secondary school, Jordan. Only students from experimental group were eligible for answering the questionnaire. The data were analyzed by using SPSS program. The results showed that there is a positive and significant correlation between metacognitive strategies and motivation, L1 transfer and anxiety. Metacognitive strategies played an important role to enhance the writing performance among students, whereas the majority reported that they enjoy the writing actives during the class by using metacognitive strategies.

This study seeks to examine the relationship between Foreign Direct Investment (FDI) and Real Effective Exchange Rate (REER) volatility in Nigeria. Using annual time series data from 1980 to 2016, the study adopted the Exponential GARCH model, Ordinary Least Squares (OLS) estimation technique and the Error Correction Mechanism. The major findings of the study reveal that there is a negative correlation between Nigeria’s past and future REER, which further implies that negative shock has less effects on exchange rate volatility when compared with a positive shock. It also found that exchange rate has a very significant effect on FDI in Nigeria while there also exists a long-run relationship between them. The study therefore advocates for a strong foreign exchange policies by the CBN to attract FDI. It also suggests that CBN should be keen on monitoring the financial news in the economy as it could heighten exchange rate and financial market volatilities; which may not be good for the economy’s overall growth and development in the long-run.

Naso-Orbito-Ethmoidal fractures can occur in single entity or in conjunction with other craniofacial fractures. Most often they are associated with frontal Le Fort II or Le Fort III fractures. It involves nasal bones including bony septum, the frontal process of the maxilla and nasal–orbital–ethmoid complex bilaterally. Open and Closed reduction are the two ways of management which are adapted by surgeons according to the situation and severity. This article describes a case report of 21-year male patient with history of road traffic accident who is diagnosed with naso-orbito-ethmoid fracture and was treated with open reduction and internal fixation

Transfusion of Fresh frozen plasma is relatively common in neonatal intensive care units. Most common indications for transfusion being neonatal sepsis, deranged coagulation profile or co existence of both these conditions. However a universal protocol for FFP transfusion in neonates is lacking, leading to injudicious administration of FFP to neonates in many hospitals and thus exposing them to untoward risks of transfusion. This is our attempt towards analyzing the use of FFP in our neonatal intensive care unit and our compliance with the established guidelines (AIIMS protocol for FFP transfusion in neonates). Data was collected retrospectively of all the neonates who received FFP transfusions in our hospital from January 2014 to December 2017 and relevant analysis was performed. Most of the neonatal transfusions (93%) at our hospital during the study period were compliant with AIIMS guidelines. Most common indication for transfusion was bleeding manifestations followed by sepsis and deranged coagulation profile. However on analysis of pre and post transfusion coagulation parameters in these babies, no statistically significant improvement was seen. FFP was often used in accordance with the published guidelines in our study. However evidence based uniform guidelines need to be established and implemented to increase the benefit and minimise the risk associated with transfusion, especially in newborns.