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Encapsulating peritonitis (EP) is defined as diffuse peritoneal fibrosis which can progress to true sclerosis, sheathing the intestinal loops and forming the cocoon, its diagnosis is often intraoperatively during laparoscopies or laparotomies. It is a rare complication with an unfavorable prognosis. Its clinical presentation can range from an asymptomatic patient to an occlusion. It is often secondary to peritoneal dialysis, intraperitoneal chemotherapy or tuberculous peritoneal inflammation syndrome. Imaging makes it possible to approach the diagnosis, but surgical exploration provides diagnostic certainty and allows a therapeutic procedure, histological examination shows a deposit of fibrin. Medical treatment is often disappointing, and surgery which consists of enterolysis is indicated in complete bowel obstructions, repetitive subocclusions and urgent situations (perforations, necrosis, hemorrhages). In the absence of treatment, the outcome is fatal in the majority of cases. Despite current progress in the therapeutic management of encapsulating peritonitis, the prognosis remains relatively poor. We report this exceptional case of encapsulating peritonitis to educate the medical team about its rare occurrence, which will be of paramount importance, due to diagnostic difficulties and in order to improve the prognosis.

Erythema multiforme (EM) is an acute mucocutaneous disease which has been associated with herpes simplex virus (HSV) infection and drugs. This report presents a case of EM minor with a prompt diagnosis and appropriate treatment. A 19-year-old male, a military recruit, reported with a chief complaint of multiple, diffuse, painful oral ulcerations for more than 3 days. An intraoral examination showed multiple large ulcers on the bilateral lateral borders and ventral surface of the tongue, bilateral buccal mucosae, and gingivae. “Target” lesion was found on the skin surface of his body or extremities. The patient was treated with corticosteroids. A follow-up oral examination revealed that all oral ulcers had completely cleared up after the 7-day corticosteroid treatment. One year after treatment, the patient remained disease-free. We concluded that EM is a mucocutaneous disease that requires a prompt and precise diagnosis. Once the disease is confirmed by the clinical presentation, it usually dramatically responds to treatment with a medium or high dose of corticosteroids. Key words: erythema multiforme, target lesion, corticosteroids.

A comprehensive environmental assessment of the Arabian Gulf Coast in the State of Kuwait was carried out by assessing levels of heavy, toxic and rare mineral pollutants in coastal sediments, beach sand, shells and sea water collected from the coastline. By Using (Inductively coupled plasma - Mass spectrometry) ICP-MS technique, we analyzed (Al, Mn, Mg, Na, K, Ca, Zn, Ba, Sr, Co, Cu, Cd, Pb, Ag, Ni, Fe). The results of potential environmental risks indicated that the study area was heavily enriched with (Al, Mn, Mg, Na, K, Ca), moderately enriched with (Zn, Ba, Sr, Co), and low levels of (Cu, Cd, Pb, Ag, Ni, Fe). However, in general, these pollutant levels were not exceed the EPA and the Canadian ISQG values and still lower than some standardized reference values all over the world. Furthermore, the bioaccumulation index indicated that gastropod shells and pelecypod shells had greater ability to concentrate Fe, Na, K and Al, which may be attributable to the shape of them. Regarding the seawater samples, Na and K levels were higher than their average oceanic metal concentrations. Moreover, the average concentrations of heavy metals in the studied area, especially those of Pb, K, Fe, and Zn, were lower than the coasts of many countries all over the world. The moderate enrichment of some metals in the studied area could be partially attributed to anthropogenic activities, notably oil spills from oil tankers and exploration, transportation and from saline water desalination plants in Kuwait Coast, the nearby nuclear reactors overlooking the Arabian Gulf and other industrial activities in the region. Results were in accordance with recommended daily intake allowance by WHO/FAO. From this study, it was noticed that the concentrations of Heavy, Toxic and Trace Metals for Kuwaiti Environmental Marine Samples are lower than the worldwide average value. Results obtained are discussed and compared with the international recommended data.

This paper is aimed at evaluating the prospecting potential of the reservoir sands of D-field onshore Niger Delta located around 23km west of Uyo, Nigeria. The field covers an area of approximately 6.9km2, located around latitudes 6o 13’N and 6o 14’N and longitudes 7o18’E and 7o20’E. Well logs from eight wells were used – together with the seismic section, to evaluate these potentials from two reservoirs (D-A and D-B) in the field. D-A revealed average porosity and permeability of 0.22 and 7,390md respectively while D-B revealed average porosity and permeability of 0.21 and 3,714md respectively. D-A has 23MBO of oil while D-B has 80MBO. Both reservoirs will yield their oil at irreducible water saturation condition.

Nutritional value of space-controlled, fertilized and air-dried F1 Pennisetum purpureum as basal diet for lactating ruminants in the dry season was investigated. Established paddock of three blocks and four plots, each measuring 4m × 4m, with different spacing of 75cm and 100cm in a 2 x 2 factorial arrangement; using Randomized Complete Block Design (RCBD) was cut back to 20cm above ground level, using a metric tape. Urea fertilizer and Poultry manure analyzed for nitrogen was applied at the rate of 200kgN/ha each; to individual plot in the Experimental Layout labelled T1, T2, T3 and T4, respectively. The treatments were significantly different (p<0.05) across the layouts. Proximate composition, micro and macro minerals and microbial load varied among treatments. Crude protein (%) ranged from 12.90 (T1) to 13.31(T4), Ether extract(%); 1.93(T4) - 4.54(T2) and Ash(%); 10.62 (T4) - 12.54(T1). The macro mineral content were not significantly different (p>0.05) between TI and T2, likewise T3 and T4, respectively. Micro nutrients recorded significant (p<0.05) values ranges of Zinc (Zn) 56.84 Mg/g (T2) to 58.31Mg/g(T3), Manganese (Mn); 31.06 Mg/g (T1) to 34.14 Mg/g (T3), Iron (Fe) value was high in T4 with a record value of 124.18 Mg/g. There was no significant difference (P>0.05) in the value of Copper (Cu) for T1, T2 and T3. Total Bacteria, Total Fungal, Total Viral and Total coliform Counts were significantly different (p<0.05) among treatments. Space-controlled, fertilized and air-dried F1 pennisetum purpureum; based on findings from this study is adjudged nutritious and as such recommended as a basal diet for lactating ruminants during dry season.

The involvement of the community in sustainable forest management needs to be anchored on sound knowledge and vast understanding of forests, forest resources and their sustainable exploitation mechanisms. Humans encroachment into the Nandi Hills Forests, compounded by urban expansion, unsustainable timber harvesting and agricultural practices have over the years threatened to annihilate this catchment area. The study was undertaken in three districts; Nandi South, Nandi Hills and Nandi North Districts. A mixed methodological approach was used in this study, where concurrent triangulation and nested/embedded designs prevailed. The study reveals that environmental education has been institutionalized in the Nandi County and is yielding sustainable forest management. However, some institutional and capacity gaps do exist. Government agencies, international organizations and community-based organizations have been profiled as the predominant institutions that are involved in building the capacities of the locals through environmental education and forest conservation. Change detection, undertaken by way of GIS and remote sensing, has corroborated the perceptions and undertakings of the locals and institutions on forest management; exemplified by the level of awareness on the state of forest cover, and the ensuing consequences. The study proposes a heuristic for community environmental education centered on institutional arrangements, policy frameworks, formal and informal education approaches, GIS and remote sensing. Integrated community environmental education, epitomized in the heuristic, could be a robust tool for sustainable forest management once it is rolled out.

The evolution of doing business has drastically changed over the decades. The inclination of the organisation towards customer orientation has made the customers the prime focus of the 21st century marketing strategies. The concept is not limited to just selling but it has more to do with after sale performance. With the changing scenario of business, the concept of marketing has taken turn right from production concept to the very existing marketing concept. With the advent of digital era the offering style has changed and companies are ready to go extra miles to retain as well as gather new customer base.The study focuses on marketing strategies followed by different existing organisation in three different phases i.e. (1950-1970, 1971-2000, 2001-existing) to understand changing dynamics of market demands. The objective of the study is to find out the position of the organisation in the existing market through BCG and Pareto principle and also depicting the life cycle of the models of the cars. The study comprises of secondary research and also focuses on several marketing strategies i.e. BCG (Boston Consultancy Group), Pareto principle, PLC Graph. The study will help to evaluate the organisation’s position in the market through BCG and it will help in understanding the adaptability of the organisation. As a result, the study will give a broader view of the changing business scenario through a variety of factors.

A survey was conducted with students enrolled in the higher institutes and universities operating in the province of Tshuapa, in DRCongo, to collect their judgments and their expectations compared to the actors and practices around the elections of the governorsand vice-governors of provinces that were held from 2016 to 2019. In the same way, the respondents were questioned about the results and the electoral system in application for elections. Finally, the results of the investigation inform that these three elections were, mostly, inadequate with the expectations of the respondents. Indeed, the latter, in their majority, say they wanted to see other characters as governors and vice-governors that those who had won thanks to the voices of the provincial MPs (members of the provincial parliament). Similarly, investigations denounce and condemn several practices and behaviors found in these elections from actors acting both from the national level and those of the provincial one, while rejecting the large part of responsibilities on the provincial MPs who compose the electoral college of these ballots.

An increasing number of physicians departing from the healthcare profession due to disengagement could cause a significant healthcare crisis. Middle and senior-level healthcare managers often lack physician engagement strategies to help avoid physician burnout. Grounded in the transformational leadership theory, the purpose of this qualitative single case study was to explore the engagement strategies healthcare middle and senior-level managers have used to help avoid physician burnout. Participants comprised seven middle and senior-level healthcare managers, with a minimum of five years of employee management experience who effectively used physician engagement strategies to help avoid physician burnout at a Central Pacific United States healthcare organization. Data were collected using semistructured interviews via telephone, reflective journal, and publicly available media and organizational documents. Thematic analysis was undertaken to analyze the data. The major emergent theme of the importance of developing meaningful relationships is discussed in this paper. A key recommendation for middle and senior-level healthcare managers is to display diligence and empathy to understand the goals of each physician. The research knowledge and findings may hold positive implications for positive social change as physicians play a crucial role in healthcare, and in contributing to addressing socioeconomic disparities for patients within the community, from their focus on treatment and on improving the health of patients.

Two simple and sensitive extractive spectrophotometric methods (Method A and Method B) have been developed for the determination of Escitalopram in bulk and pharmaceutical preparation which are based on the formation of coloured complex of the drug with dyes namely bromothymol blue (BTB) and methyl orange (MO). The ion pair complexes formed was quantitatively extracted into chloroform under the experimental conditions. All the variables have been optimized and the concentration measurements are reproducible with a relative standard deviation of 1.98 and the recoveries are 99-100.7%.