Abstract: Protein- energy malnutrition, wasting and inflammation are frequent complication among patient with Chronic kidney disease (CKD). Malnutrition is associated with cardiac co-morbidity, inflammation and poor survival in CKD patients. Serum albumin is a well-known negative acute phase protein, marker of nutrition in CKD patients. C-reactive protein (CRP), the major acute phase response (APR) protein is elevated in these patients. High CRP levels are linked to the degree of atherosclerosis in coronary, peripheral, and extracranial brain arteries. The aim of the present study was to investigate nutritional factor (albumin) and CRP levels in CKD patients. This cross –sectional study was carried out in the Department of Biochemistry in collaboration with the Department of Medicine, Guru Gobind Singh Medical College & Hospital, Faridkot .Study involved 100 pre dialysis CKD patients (age 40.5 ± 12.3 years) admitted indoor and attending outdoor .Following investigations were carried out –CRP by fluorescence immunoassay method utilizing latex particles coated with CRP monoclonal antibodies (I-chroma). Serum albumin levels on fully automated chemistry analyzer Renal function by estimated glomerular filtration rate (eGFR). The data was later statistically analyzed. The study patients included 57 males (57%) and 43 females (43%) with average age of 40.5±12.3 years. The mean GFR was 38.3 ± 16.4 ml/min/1.73m2. The mean value of CRP was 10.93 ± 1.42 mg /dl. 67% of patients had elevated CRP (> 6 mg/L) with low serum albumin levels were present with mean value (3.02 ± 0.17 gm/dL). This study showed that low albumin and high CRP levels are the main predictors for death. There was a significant difference between CRP and albumin levels in CKD patients (P<0.001). Measuring CRP as a marker of inflammation can be helpful in managing these patients and Low levels of albumin are a marker of poor nutritional status in CKD patients. Our results indicate that CRP(as marker of inflammation) and albumin(as marker of nutritional status ) were very closely related to each other ,as the levels of CRP increased the albumin goes on decreasing due to degree of inflammation , malnutrition and decreased synthesis by liver exists in pre-dialysis CKD patients.

The purpose of the study was to investigate the effects of constituency bursary provision timings on internal efficiency of public secondary schools in TransNzoia County Trans-Nzoia County, Kenya. The study was underpinned on Human Capital Theory developed by Schultz in 1971. The study adopted a descriptive survey research design with a target population of 77,337 persons. 78 (30% of 261) schools were randomly selected 16 from each sub-county with the exception of Endebes with 14 schools. A sample of 399 respondents was selected using Fischer formula. These included 306 form three students, 78 principals and 5 DEO, 5AEO and 5 CBF. A maximum of 4 form three students were randomly selected from the sampled schools. Data was collected data using questionnaires, documentary analysis and interview schedules. The instruments were validated by the three experts. Reliability of the instruments was determined through a pilot study where the Pearson‟s correlation coefficient of 0.73 was obtained, hence the instruments were considered reliable. Quantitative data was analyzed using descriptive and inferential statistics, and presented in tables, while qualitative data from interviews was organized into themes and subthemes. The study established that, there was a significant (p= .001; α = 0.05) relationship between constituency bursary provisions and internal efficiency in public secondary in Kenya. It was therefore recommended that for enhanced internal efficiency in public secondary schools, there should be greater stakeholders‟ involvement during the bursary provision time.

The aim of the study is to determine the knowledge and practices of nurses towards postoperative pain management. The data collected from 92 participants were female nurses. In this study cross-sectional study design was used and self-administered structured questionnaire was conducted in government hospital Layyah Pakistan. Likert scale was used in this instrument. After data collection, it was analyzed by SPSS version 21. The results were analyzed in terms of descriptive statistics frequency, percentage for data analysis. A total of 100 questionnaire were returned from 120 questionnaires distributed to participant. Results of the study revealed that nurses have good knowledge about post –operative pain management but practices were not good Overall, study shows that knowledge of pain management of nurses statistically and significantly is good but practices were poor. In conclusion, patients are still hurting because of poor practices of nurses towards pain management thus the hospital management should focus on these factors to improve the nurse’s practices.

The provision of education in Kenya has been tremendous over the past years. Notwithstanding the fact that a major stride through the secondary education policy has been attained, the current indicators exhibit high levels of inefficiency. This is evidenced by high national poor performance in national examinations in many schools. The quality of education, including its relevance to the country’s needs has also been questioned. The study intended to highlight the role of leadership among secondary schools principals in improving academic performance among students. Leadership is viewed as an ingredient in accounting for differences in the success of schools. The study utilized quantitative survey approach and involved 364 respondents in Trans Nzoia County. The study found a positive correlation between the role of principals and quality academic performance. It recommended that school principals should be pivotal in transforming their schools into successful institutions through enhancement of curriculum, development of instruction and learning environment and leadership styles. Principals are pivotal in transforming their institutions.

The objective of the study was to evaluate the aphrodisiac property of the aqueous extract of Panax ginseng C.A. Meyer rhizomes (Zngiberaceae) in albino and normal male rats of the Wistar strain. Colorimetric and precipitation methods were used to highlight secondary metabolites of the plant. The acute toxicity test was conducted according to OCDE guideline 423. Four lots of 6 animals were used to evaluate the aphrodisiac property of P. africana. The positive control received sildenafil citrate (5 mg/Kg) and the negative control, distilled water. The test lots received the extract at 500 and 2000 mg/Kg for 8 days. The copulatory parameters were observed on days 1, 4 and 8. The phytochemical screening revealed the presence of ginsenosids, alkaloids, tannins, saponosides and tri terpenes in the extract. No changes in the general appearance of the rats and no mortality were recorded during the toxicity test, highlighting that P. africana is non-toxic. The extract significantly increased the sex parameters of the tested rats. This aphrodisiac effect of P. africana attributed to identify secondary metabolites justifies its use in traditional medicine as a sexual stimulant.

This theoretical paper uses document analysis to probe South Sudan‟s new National Curriculum Framework (2014) as an official text and its implications as a change agenda with a view to arriving at a perspective about the task of the school in the world‟s newest country. The study notes that the country‟s curriculum change policy seeks to enact a curriculum model that provides both equality and quality with a pedagogic philosophy that is humanistic in essence, transformative in outlook and historical in perspective. The new model shifts from subject-specific to generic curriculum that offers more student choice, relies on environment and accentuates social and life skills in a broader milieu of competencies. The new arrivals on the subject scene are information & communication technology, vocational education & enterprise, and values education in the form of environmental sustainability, life skills and peace studies to consolidate civics and cement the country‟s diverse society. However, the facility of the Framework to promote inclusive education is constrained by its design possibilities and the practical realities of school education in South Sudan as its official launch date of 2019 approaches. The scope for broader learner experience beyond conventionality will remain largely rhetorical or even inimical in as far as the resources for emancipatory practices are held back by the dual force of curriculum novelty and state priority. The prospect of wide gaps between planned, delivered and experienced curriculum is, therefore, real and vexed. It remains to be seen if the Ministry has a strategy at all to deal with any eventual knock-on effect. The fact remains, too, that the Framework is heavily prescriptive in nature and as such could potentially prove counter-productive to teacher agency with drastic consequences for local teacher appraisal practices. Thus, implementing a new curriculum short of resources and through the political doldrums of shifting timelines is principally an unmitigated disaster. It could lead to a tacit rejection of curriculum change, more out of repulsion than upon reflection. The fortunes of South Sudan‟s National Curriculum Framework (2014) are thus defined; and the broader discourse of reform duly confined.

Abstract: The promulgation of the Belt and Road Initiative brings to fore the shift in world economic power to the east. The relations between members of Initiative and the changes of their positions will determine the long-term success or otherwise of this Initiative. The paper adopts social network analysis to set up the network relation between member countries, studies the network structure and its evolution trends, and identifies the position and role of members in the Initiative with data from bilateral investments for the period 2005 to 2015. We conclude that the network structure of Belt, Road Initiative’s broad purpose of ensuring a greater level of economic integration between and among countries on the Belt, Road corridor with regards to bilateral investments is gradually being achieved although at a slower pace than may have been expected by framers of the Initiative with less influence being exerted by China. The beneficial economic integration will be very much enhanced with China in the core position.

This paper addresses the inconsistencies that exist between the stated objectives of the National Policy on Education and the delivery of the content of the national curriculum in the educational system of Nigeria. This stems from the fact that what is intended in the curriculum is different from what is perceived by learners. This concept which has been identified as the hidden curriculum is what this paper strives to relate as the root cause of some unhealthy relationships in the society. It reveals ultimately the reason why education in Nigeria has not been able to provide the needed thrust visa-a-vis the three key values necessary for national development. In view of this exposition, recommendations are made towards a redirection of focus on the educational delivery to strike a balance between what the curriculum intends and the final outcome on the learners.

Abstract: As professional’s teachers in the field of education, at least, they have the duties of teaching, mentors, class administrators, curriculum developers, professional developers, and community relations builders. Competence in the educational perspective is a necessity, because a professional job, in this case, the teacher, have to be based on the field of the knowledge. The purpose of this study was to describe teachers’ social competency in improving students’ extracurricular skills that extra-curricular activities can influence development in academics, social skills, and school completion. This study was literature research that discusses the social competence of the teacher in applying at school for improving students’ extracurricular skills surrounding Batam area. Over half of a student's time is spent being involved in some sort of structured activity. It is important for teachers, counselors, and parents to know the overall impact of participating and being involved in out-of school activities. Social competence of teachers as part of the community to communicate and socialize effectively with learners, fellow educators, education personnel, parents of learners, and the surrounding community. The school educates students to be smart and they must have a teacher who is competent in the field. If the teacher already has the competence then the student relationship with the teacher goes well, the achievement will also be good. The teachers need social competence because they share their knowledge to the students. Therefore the only teacher should learn a lot from communicating to be clear and cautious.

Teachers play an important role in the implementation of secondary school curriculum. However, implementation of secondary school curriculum has not been effective. The study was guided by the persistent burnout theory. The study adopted mixed methods approach and used the concurrent triangulation research design. The target population for this study was 806 respondents from which a sample of 243 was selected using the Central Limit Theorem. Questionnaires were used to collect quantitative data from secondary school teachers whereas interview guides were used to collect qualitative data from school heads and education officers. Validity was established through expert judgment whereas reliability was determined using test retest technique and reliability was obtained using Cronbach Alpha Method. Credibility of qualitative data was ascertained by involving multiple analysts, whereas dependability was established through detailed reporting of the research process. Qualitative data were analyzed thematically along the research questions and presented in narrative forms whereas quantitative data were analyzed using descriptive statistics and inferentially using ANOVA and presented in tables and charts. The study established that teachers‟ emotional exhaustion influence implementation of secondary school curriculum. Thus, the study recommends that school management and Ministry of Education need to devise ways of motivating teachers by providing incentives, instructional resources and physical facilities. Teachers need to develop positive selfesteem, attitude and positive perception towards oneself.

Complications involving the lungs as a sequela of a systemic disease process are not uncommon, and in fact, pulmonary involvement could be the first or even the only manifestation of systemic disease in a handful of clinical cases. Inflammatory bowel diseases are characterized by mucosal inflammation involving the GI tract that can follow a relapsing-remitting course. Respiratory tract diseases in the setting of IBD can be quite variable and warrants clinical recognition and proper treatment as it could have a significant impact on the patients' health. Here I summarize the potential pathological involvements of the respiratory system in the cohort of IBD patients and summarize the clinical assessment steps necessary to achieve the proper diagnosis.

This study sought to investigate the students‟ perceived social factors that contribute to examination malpractices in Eldoret West Campus of Moi University, Uasin Gishu County, Kenya. The objectives of the study were; to analyze strategies to curb examination malpractices in public universities. Descriptive research design was used. Simple random, stratified and purposive sampling techniques were used in choosing the sample size. The target population for the study was the student counselors, Dean School of education, Chief Examination officer and third year students from the school of Education. The sample size for the study was third year education students. The research instruments used to collect data were questionnaires, interview schedules and document analysis. The analysis of data was done using both qualitative and quantitative. It was found out that lack of accommodation facilities, limited provision of guidance and counseling services, poor orientation into the university system and work study programmes contribute to examination malpractices while limited provision of catering services and allowing students to operate business in the university premises do not contribute to examination malpractices in the institution. It was therefore recommended that there is need for the institution to put in place active student counseling services to deter students from engaging themselves in examination malpractices since most students believed that there is lack of guidance and counseling in the institution. The findings are expected to benefit in formulating university examination policy. Similarly, there is need for ISO standards to be adhered to during lecture hours and examination hours to curb examination malpractices in the institution

The Aim of this study was to compare the clinical efficacy and safety of non-fixed combination (NFC) of dorzolamide (2.0%)/timolol maleate (0.5%) versus NFC of latanoprost (0.005%)/timolol maleate (0.5%) regarding reduction of intra ocular pressure in patients with primary open angle glaucoma. This was a 12-week, randomized, open label, parallel group study with primary open angle glaucoma (IOP range: 24 – 36 mmhg), which included 40 subjects in dorzolamide/timolol group [dorzolamide (2.0%) instilled twice daily and timolol maleate (0.5%) twice daily] and 40 subjects in latanoprost/timolol group [latanoprost (0.005%) instilled once daily, timolol maleate (0.5%) twice daily]. IOP was measured at baseline, 4 and 12 weeks at 10 am. Adverse events were recorded at each visit. The difference in reduction of IOP in two treatment groups from baseline to 12 weeks was the main outcome measure. Mean IOP was similar at baseline for both groups. Absolute reduction in IOP from baseline to 12 weeks was 9.6 mmhg in dorzolamide/timolol group (P <0.001) and 9.7 mmhg in latanoprost/timolol group (P <0.001). No significant difference was found regarding reduction of IOP between the groups (P < 0.85). Both treatments were well tolerated. NFC of dorzolamide/timolol and latanoprost/timolol showed comparable efficacy in reducing IOP. They were also comparable regarding safety profile.

This research aimed to improve written expression (composition) skills of twelve grade students of the Al-Mazar secondary school by using the Tamer-Aien intervention model. The intervention model was designed by using metacognitive strategic concept, techniques, symbols and diagrams. This study was conducted at AlMazar secondary school in Jordan. A total sample of 22 students‟ from the same grade was chosen for the study. The baseline assessment was carried out to explore the preintervention writing skill score of the students prior to the intervention cycle one. Later, intervention and writing skill support strategies were carried out for twelve weeks. In the end, post-test was carried out to explore the differences occurred in the writing score of the students as a post-intervention effect. The findings obtained from the quantitative data showed the improvement in the written expression skills of the students. It was observed that through taking the above-mentioned measures, the teachers can help students improve their writing skills. Data were analyzed using the independent Mann-Whitney U test followed by Wilcoxon Signed-Rank test. The results showed that there was a positive effect on the students writing performance from the pretest at the beginning of intervention program up to the posttest at the end of the intervention program. The findings have implications for pedagogy as well as for research.

Electrolyte abnormalities are common cause of morbidity and mortality in ICU patients. Quick and accurate results are required for immediate treatment. Conventionally these are measured in serum by electrolyte analyser but now point of care analysers are available to determine them in arterial blood by ABG. To measure electrolyte levels in venous and arterial samples and to evaluate the difference in them. The study was conducted in the department of biochemistry, GGS Medical College and Hospital, Faridkot. It was conducted on the total of 115 patients of either sex admitted in the intensive care unit (ICU). Arterial blood sample was collected for ABG and venous blood was processed in the electrolyte analyser. Results show that there is quite a difference between the mean values of these parameters in venous and arterial blood, with sodium having mean of 124.22 ± 9.18 in arterial blood and that of 137.09 ± 8.71 in venous blood. The mean value for potassium is 3.49 ± 1.28 in arterial blood and 4.21 ± 1.08 in venous blood. For chloride it is 108.54±9.9 in arterial blood and 101.77±7.2 in venous blood. The p values for all the parameters was <0.001. As we observed significant difference between electrolyte levels of venous blood done on electrolyte analyser and that of arterial blood done on ABG analyser so these cannot be used for in exchange for each other and so physicians should be cautious while reporting the results.