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Hepatobiliary ascariasis is found in subtropical or tropical countries and is prevalent geo-helminth infection.Ascariasis lumbricoides are found mainly in the small intestine. Rarely the worm may migrate to the pancreatic duct or common bile duct but rarely to the gallbladder due to cystic duct which is strait and tortuous. The gall bladder ascaris can cause obstructive features due to lithiasis or calcified worms. The management is usually conservative if the worm is alive or else it can be removed by surgery.

Eccrine spiradenoma is one of the rare, benign dermal neoplasm showing eccrine sweat gland differentiation. The literature search accounts for less than 100 reported cases of eccrine spiradenoma. Clinically, the lesion presents as solitary, intradermal, circumscribed, round or oval, firm, painful or tender nodule measuring from 0.3 - 5 cm in diameter. Rarely if ES, presents as multiple lesions, in combination with other types of adnexal tumors such as cylindromas & trichoepitheliomas, it can be considered as a part of the Brooke-Spiegler syndrome. Majority of these tumours appear on the head/face & upper trunk region of the body. Spiradenomas arise in early adulthood in most instances with few reports also of congenital cases and no sex predilection seen. The definitive diagnosis is made by excisional biopsy of the tumour. Complete tumor excision with clear surgical margins is considered the primary treatment for these cases. Here, we present a rare case report of a 58 years old male presenting with a soft, cystic lesion in the left lumbar region of the abdomen for past 2 years duration. Surgical excision of the tumour was done with clear margins and the specimen was sent for histopathological examination. Due to the overlapping histomorphological features, this tumour is often confused with cylindromas and trichoepitheliomas along with other vascular tumours. Eccrine Spiradenoma, although a benign tumour, but malignant transformation has been described especially in long-standing cases or multiple lesions. So, early diagnosis is very important to prevent recurrence and to identify any onset of malignant transformation.

Apprenticeship programs are considered as an effective learning method to improve the job skills of prospective workers. The Japanese apprenticeship program highlights 5 work principles consisting of Seiri, Seito, Seiso, Seiketsu, Shitsuke (5S). However, until now, the apprenticeship program's effectiveness in Japan to foster 5S work principles for students has not been much evaluated. The objectives of this study were (1) to describe the student's 5S performance profile; (2) factors affecting the implementation of student 5S performance in the apprenticeship program in Japan; (3) the benefits of the Japanese apprenticeship program. This study involved 69 students who were apprenticed in Japan. The data collection used a questionnaire, and the data were analyzed using descriptive analysis. The study results revealed that the student's 5S performance was considered good during the apprenticeship program in Japan. Besides, the study results also show that ten factors affect student performance when participating in an apprenticeship program, namely self-discipline, technology, equipment arrangement, workplace, job planning, worker characteristics, management support, work type, job characteristics, and the existence of training. . Finally, the apprenticeship program in Japan provides benefits to the development of student work competencies which include aspects of knowledge, attitudes, and skills. This study recommends the need to develop and strengthen apprenticeship programs with a positive work culture that can encourage student performance improvement.

To compare the outcome of patients undergoing conservative management versus ultrasound guided aspiration of small amoebic liver abscess (=

Within the scope of this paper, traditional estimation algorithms and supervised machine learning methods are used to estimate the manipulation of financial information. Traditional estimation algorithms, such as logit, and supervised machine learning methods, which are support vector machine (SVM), probabilistic neural network (PNN), k-nearest neighbor (KNN) and decision tree (DT) algorithms, are utilized. According to previous studies, support vector machine and probabilistic neural network algorithms perform higher than traditional estimation algorithms. Comparative analysis is made to decide better algorithm for classification by applying all algorithms separately to the data that is collected by skimming weekly bulletins of Capital Market Board of Turkey between 2009 and 2018. Thus, it is determined which algorithms perform better in financial information manipulation by looking at performance of classification accuracy, sensitivity and specificity statistics. The obtained results show that KNN and SVM have better performance than the other algorithms and all utilized algorithms have high performance compared to the previous literature’s results.

Within the scope of this paper, traditional estimation algorithms and supervised machine learning methods are used to estimate the manipulation of financial information. Traditional estimation algorithms, such as logit, and supervised machine learning methods, which are support vector machine (SVM), probabilistic neural network (PNN), k-nearest neighbor (KNN) and decision tree (DT) algorithms, are utilized. According to previous studies, support vector machine and probabilistic neural network algorithms perform higher than traditional estimation algorithms. Comparative analysis is made to decide better algorithm for classification by applying all algorithms separately to the data that is collected by skimming weekly bulletins of Capital Market Board of Turkey between 2009 and 2018. Thus, it is determined which algorithms perform better in financial information manipulation by looking at performance of classification accuracy, sensitivity and specificity statistics. The obtained results show that KNN and SVM have better performance than the other algorithms and all utilized algorithms have high performance compared to the previous literature’s results., Bu çalışma kapsamında, finansal bilgi manipülasyonunu tahmin etmek için geleneksel tahmin algoritmaları ve denetimli makine öğrenmesi yöntemleri kullanılmaktadır. Geleneksel tahmin algoritması olarak logit kullanılırken, denetimli makine öğrenmesi yöntemlerinden destek vektör makinesi (SVM), olasılıksal sinir ağı (PNN), k-en yakın komşu (KNN) ve karar ağacı (DT) algoritmaları kullanılmıştır. Önceki çalışmalara göre, destek vektör makinesi ve olasılıksal sinir ağı algoritmaları geleneksel tahmin algoritmalarından daha yüksek performans göstermektedir. 2009-2018 yılları arasında Sermaye Piyasası Kurulu'nun haftalık bültenlerini gözden geçirerek toplanan verilere tüm algoritmalar ayrı ayrı uygulanmıştır. Hangi algoritmanın finansal bilgi manipülasyonunu tespitinde daha başarılı olduğuna karar vermek amacıyla karşılaştırmalı analiz yapılmıştır. Karşılaştırmalı analizde, algoritmaların duyarlılık ve özgünlük istatistiklerinin performansına bakılmıştır. Elde edilen sonuçlar, KNN ve SVM’nin diğer algoritmalardan daha iyi performansa sahip olduğunu ve kullanılan tüm algoritmaların önceki literatürün sonuçlarına kıyasla yüksek performansa sahip olduğunu göstermektedir.

Background The COVID-19 vaccination in Sudan launched in March 2021 but the extent of its acceptance has not been formally studied. This study aimed to determine the acceptance and hesitancy of the COVID-19 vaccine and associated factors among medical students in Sudan. Methods A descriptive cross-sectional study was conducted using an online self-administered questionnaire designed on Google Form and sent to randomly-selected medical students via their Telegram accounts from 30th June to 11th July 2021. Data were analyzed using Statistical Package for Social Sciences software. Chi-square or Fisher’s exact test and logistic regression were used to assess the association between vaccine acceptance and demographic as well as non-demographic factors. Results Out of the 281 students who received the questionnaire, 220 (78%) responded, of whom 217 consented and completed the form. Males accounted for 46. 1%. Vaccine acceptance was 55. 8% (n = 121), and vaccine hesitancy was 44. 2% (n = 96). The commonly cited reasons for accepting the vaccine were to protect themselves and others from getting COVID-19. Concerns about vaccine safety and effectiveness were the main reasons reported by those who were hesitant. Factors associated with vaccine acceptance were history of COVID-19 infection (adjusted odds ratio (aOR) = 2. 2, 95% CI 1. 0–4.7, p = 0. 040), belief that vaccines are generally safe (aOR = 2.3, 95% CI 1. 2–4.5, p = 0.020), confidence that the vaccine can end the pandemic (aOR = 7.5, 95% CI 2. 5–22. 0, pp = 0.031). No demographic association was found with the acceptance of the vaccine. Conclusions This study has revealed a high level of COVID-19 vaccine hesitancy among medical students. Efforts to provide accurate information on COVID-19 vaccine safety and effectiveness are highly recommended.

TB in India is extremely common especially in young and adults as compare to other age groups. It is more common in the female population in India where women remain poor and neglected. We present the case of a 35-year-old male who presented with a thyroid lump. On examination, there was a solitary, non-tender, and firm swelling on the left midline neck with no evidence of lymphadenopathy. Ultrasound of thyroid revealed multinodular goiter with the largest nodule (3.5 × 2 cm) in the right lobe of the thyroid. Ultrasound-guided FNAC revealed follicular cells on a background of lymphocytes making a diagnosis of thyroiditis and underwent hemithyroidectomy for the same.

Artikel ini mengupas tentang kedudukan al-Sunnah dalam syariat Islam danhubungannya dengan Al-Quran dan bagaimana mengamalkan sunnah Nabi. Adapun hasildari penelitian ini adalah: 1). Keyakinan akan kebutuhan al-Sunnah dalam syariat Islam, yangditunjukkan oleh ayat-ayat al-Qur’an, teks-teks al-hadis, kesepakatan umat Islam, dan pemikiranyang sehat. 2). al-Sunnah adalah sumber kedua setelah kitab Allah, dan hal ini sudahditetapkan oleh ayat-ayat al-Qur’an dan teks-teks Sunnah, ijma’ umat, serta logika dan akalsehat. 3). Melekatnya al-Sunnah dan Al-Qur’an, tidak bisa dipisahkan satu sama lain, karenaAl-Quran sepenuhnya aturan syariat, dan al-Sunnah merupakan penjelas, perinci, danpenerang dari al-Qur’an. 4). Sebagai peringatan, bahwa tidak semua yang datang dari NabiMuhammad Saw berlaku sebagai syraiat, karena syariat harus dengan konsep yang jelas. 5).Apa yang datang dari Nabi Muhammad Saw sebagai syariat tidak hanya dalam satu tingkatanamal, karena itu suatu keharusan.Kata kunci: al-Sunnah; syariat Islam; al-Quran; pengamalan.الخلاصة: هذه المقالة تبيّن عن مكانة السنة في التشريع الإسلامي وعلاقتها بالقران الكريم وكيف نتعامل مع السنة المطهر. وأما النتائج في هذه المقالة: أولا. تأكيد حجية السنة النبوية في التشريع الإسلامي والتي دلت عليها آيات القرآن الكريم ونصوص الأحاديث الصحيحة وإجماع الأمة المسلمة والعقول السليمة. ثانيا. إن السنة النبوية هي المصدر الثاني المعصوم بعد كتاب الله، وهذه المرتبة حددتها آيات القرآن الكريم، ونصوص السنة، وإجماع الأمة، وكذلك المنطق المعقول. ثالثا. إن السنة النبوية ملازمة للقرآن الكريم، ولا يمكن فَصْلُ أحدهما عن الآخر، لأن القرآن كليٌّ هذه الشريعة، والسنة بيان وتفصيل لمجمله، وتوضيح لمبهمه. رابعا. التنبيه على أنه ليس كل ماصدر من الرسول صلى الله عليه وسلم يعد تشريعاً؛ لأن الصادر منه تشريعاً لابد أن ينضبط بضوابط معينة. خامساً: إن الصادر من الرسول صلى الله عليه وسلم تشريعاً ليس على درجة واحدة في العمل، لأن منه الواجب، والمندوب ومنه ما هو للتأسي فقط.الكلمات المفتاحية: السنة، التشريع الإسلامي، القران الكريم، التعامل

Introduction: An anal fissure is defined as a split in the mucosa extending from the anal verge towards the dentate line and most common proctologic symptom. The management of anal fissures is diverse and range from non-operative techniques like dietary changes, topical ointments (2% diltiazem, 0.2% glyceryl trinitrate), botulinum toxin injections and sitz baths to surgical intervention. Aim: To evaluate and compare the efficiency of Topical Glycerine Nitrate (0.2%) with Topical Diltiazem (2%) in patients with anal fissures. Materials and Methods: Out of 100 patients of anal fissure, 50 were selected for treatment with topical application of 2% Diltiazem and were classified as Group I while rest 50 selected for topical application of 0.2% Glyceryl trinitrate and were classified as Group II. Patients were followed for a period of six weeks (weekly follow-up) to evaluate the healing effect of above two topical ointments. Results: On follow-up at week six, patients relieved of all the complaints were assessed as fully cured and patients still having any of the complaints were assessed as partially cured. Full cure was observed in significantly higher proportion of cases of Group I as compared to Group II (88.0% vs. 68.0%), rest of the patients of both the groups had partial cure. Majority of the patients of both the groups did not observe any side effects (Group I-94.0% and Group II-84.0%), remaining patients of Group I reported side effects of Itching (6.0%) while remaining patients of Group II reported headache as side effect (16.0%). Difference in side effects of patients of above two groups was found statistically significant. Conclusion: Findings of the present study indicated that topical diltiazem (2%) was more effective as compared to glyceryl trinitrate (0.2%) for conservative treatment of anal fissure. Diltiazem was capable to provide full relief of complaints within six weeks to majority of the cases (88.0%).

Role of cancer stem cells in the esophageal carcinogenesis is not clear.To assess the expression of CD44 and CD133 cancer stem cell markers in esophageal squamous cell carcinoma (ESCC) and its predisposing lesions by immunohistochemistry.Prospective study as a part of an intramural research project.Tissues samples were obtained with endoscopic biopsy and from surgically resected esophageal specimens. Fifty cases each of histopathologically diagnosed cases of esophageal squamous cell carcinoma and its predisposing lesions (mild, moderate, and severe dysplasia and esophagitis) were evaluated for stem cell marker CD44 and C133 by immunohistochemistry using a scoring system.Chi-square test, analysis of variance (ANOVA), post-hoc tests (Tukey-HSD) were used as appropriate for data analysis. Two sided P0.05 was considered as significant.CD44 expression was significantly higher in ESCC as compared to dysplasia and esophagitis (mean IS 7.92 ± 1.45 vs. 6.34 ± 0.80 vs 5.15 ± 0.86 respectively, P0.001). CD133 expression was also significantly higher in ESCC as compared to dysplasia (mean IS 6.82 ± 1.57 vs. 1.00 ± 0.00 respectively, P0.001) while esophagitis showed no expression. CD44 and CD133 expressions were significantly higher in poorly differentiated ESCC than moderately differentiated and well differentiated lesions (CD44 mean IS 6.94 ± 1.44 vs 8.17 ± 1.38 vs. 8.63 ± 1.02 respectively, P0.001 and CD 133 mean IRS 5.63 ± 0.81 vs 6.00 ± 00 vs. 9.0 ± 00 respectively, P0.001).Significantly higher expression of CD44 and CD133 cancer stem cell markers in ESCC as compared to its predisposing lesions (esophagitis and dysplasia) suggests its role in esophageal carcinogenesis.

Bu tez kapsamında finansal tablolardaki bilgilerin çarpıtılması olarak tanımlanabilecek finansal bilgi manipülasyonunu tahmin etmek için denetimli makina öğrenmesi yöntemleri kullanılmıştır. Geleneksel tahmin algoritmalarına göre daha yüksek performans gösteren destek vektör makinesi (SVM), olasılıksal sinir ağı (PNN), k-en yakın komşu (KNN) ve karar ağacı (DT) algoritmalarından yararlanılmıştır. Sermaye Piyasası Kurumundan elde edilen verilere ayrı ayrı tüm algoritmalarda uygulanarak daha önce benzer çalışmalarda başarısını kanıtlamış destek vektör makinesi ve olasılıksal sinir ağı yöntemlerinin güncel olarak kullanılan k-en yakın komşu ve karar ağacı algoritmalarıyla karşılaştırılmalı analizi yapılmıştır. Böylece finansal bilgi manipülasyonunda hangi algoritmaların daha iyi performans gösterdiği kullanılan yöntemlerin sınıflandırma performansı özgünlük, duyarlılık ve toplam sınıflandırma doğruluğu istatistiklerine bakılarak tespit edilmiştir. Yapılan çalışmalar sonucunda SVM ve PNN'in üstün performans gösterdiği görülmüştür. Bu nedenle, bu algoritmaların manipülasyonları otomatik olarak tespit etmek için kullanılabileceği söylenebilir., Within the scope of this thesis, traditional estimation algorithms and supervised machine learning methods are used to estimate the manipulation of financial information, which can be defined as distorting information in financial statements. Traditional estimation algorithms, such as logit, and supervised machine learning methods, which are support vector machine (SVM), probabilistic neural network (PNN), k-nearest neighbor (KNN) and decision tree (DT) algorithms, are utilized. According to the previous studies, support vector machine and probabilistic neural network algorithms perform higher than traditional estimation algorithms. Comparative analysis is made to decide better algorithm for classification by applying all algorithms separately to the data obtained from the Capital Market Board. Thus, it is determined which algorithms perform better in financial information manipulation by looking at performance of classification accuracy, sensitivity and specificity statistics. SVM and PNN have shown superior performance. So that it can be said that these algorithms can be used to detect manipulation in automated manner.

We reported a case of a 12-year-old girl child with an uncommon intracranial metallic foreign body who was hit by her younger sister with sickle that got stuck to skull. Patient presented to us with stuck sickle in her head and was fully conscious with complaint of headache. She was very much afraid of her injury and was screaming with pain and fear. There was no neurological weakness. Computed tomography scan revealed that metallic foreign body was located adjacent to the confluence of major sinuses posteriorly on her skull. The location and position of foreign body suggested that it was of low velocity, and was hit from pointed end of sickle. It was taken out after doing craniectomy all around the sickle point and dural tear was repaired with pericranium. The postoperative course was uneventful.