#opd: 2013

[lboogie1906]

Danielle Outlaw (born 1975) is an American law enforcement officer and police administrator. She was announced as the new Commissioner of the Philadelphia Police Department on December 30, 2019, and she started her role in February 2020. She served as chief of police for the Portland Police Bureau. She was the first African American woman to head the bureau in Portland and was appointed by Mayor Ted Wheeler. She worked for the Oakland Police Department, where she served as deputy chief from 2013 until 2017. Her parents worked with the California Department of Transportation and AT&T. She attended Holy Names High School in Oakland. She did not have a good perception of the Oakland police during her childhood. In high school, she visited the Oakland Police Department as part of a career exploration program, where she had the opportunity to patrol with officers. This caused her to change her perception of the police, and find out that many of those in the police force was just like her. She graduated from the University of San Francisco with a BA in Sociology, followed by an MBA from Pepperdine University. She entered the Pepperdine Grazio Business School to differentiate herself from people in her field. She was the recipient of the Oakland Black Officers' Association Trailblazer Award, the Holy Names High School Alumnae Association Citation for Service, and the 2015 Police Executive Research Forum, known as PERF, Gary P. Hayes Award. She began her law enforcement career with the OPD. Since she worked there, she rose her ranks to Deputy Chief, she worked in various assignments throughout the OPD, including Patrol, Community Services, the Office of Chief of Police, the Criminal Investigation Division, Internal Affairs, and the Office of Inspector General. During her time in Oakland, she thought the police should change their communication styles. She suggested that women's soft skills could help in communicating with other communities and avoid dangerous situations. #africanhistory365 #africanexcellence #alphakappaalpha #thelinks https://www.instagram.com/p/CmywZVJLBRm/?igshid=NGJjMDIxMWI=

[fancyranchskeletonpalace]

The Bashundhara Ad-din Medical College (BAMC)

The Bashundhara Ad-din Medical College (BAMC) is established in 2013 .The campus and hospital building are situated within the premises of Bashundhara Riverview Project, South Keranigonj, Dhaka. The academic building has been adequately equipped to accommodate Lecture galleries, Dissection hall, Laboratories and Museum. Each department has been provided with Computers and Internet facilities including access to Scanner, Multimedia and other audio-visual aids

Affiliation:

The college obtained-

Permission by the Ministry of Health and Family Welfare, Government of the People’s Republic of Bangladesh

affiliation by the University of Dhaka

recognition by the Bangladesh Medical and Dental Council – BM&DC

Hospital facilities

The hospitals have trained and dedicated professionals with ready access to state-of-the art ophthalmic infrastructure render high quality health care.They ensure consistent quality by earnestly following systems and procedures meticulously.

Specialists serve OPD directly

Consultant-Obs/Gynae available 24 hrs

14-hour OPD services from 8 AM to 10 PM

OPD remains open 365 days

Affordable cost

Publicized fee schedule for services

Provides department-wise patient’s card

General beds are free (213)

Complimentary food for all patients

Ensure safety net for poor patients

All Children assessed for Growth Monitoring

Free service for severely malnourished children

Free service for Obstetric Fistula repair

Highest immunization coverage

Women & baby friendly environment

With all those above feature they teaches there student the same thing to follow which is the best part about the college .The most important thing to check in the above list is that they provide the free services to poor and free bed also in there hospital which attract a huge patient flow everyday so the student get the best clinical training from the college .

Classrooms

The college has required number of lecture theatres, seminar rooms and demonstration rooms for each department. The rooms are well ventilated with proper lighting system, built-in and portable writing boards, equipped with LCD Projector, Overhead Projector, Computers with high wattage audio visual aids.

Library

The college library is well stocked with books on all branches of medicine, located in the college building. The library also subscribes national and foreign journals on medical and allied subjects. The library has wireless internet connectivity and there is a separate internet browsing room equipped with computers. The library also has facilities for video cassette and CDs. The library remains open from 7.45 a.m. to 4.00 p.m. The college library has a collection of adequate number of textbooks, references, monographs and current journals in various subjects. The reading rooms at the library can accommodate up to 50 students at a time.

Hostels

The hostel facilities of the college is very good boys hostel is just 5 mins from the college and they provide bus for the students to their hostels .The girls hostels is just beside the college campus they can walk and go to their hostel . For both hostel food facilities is very good of the college every meal veg or non-veg is provided by the canteen of the respective hostels.

Over all i can say as its a part of addin group they give a quality of education to their student which is required .

[baliportalnews]

Bupati Tabanan Mulang Dasar Pembangunan Patung Wisnu Murti

BALIPORTALNEWS.COM, TABANAN - Setelah melalui berbagai proses dan kajian yang mendasar, masyarakat Tabanan akan dipastikan kembali memiliki bangunan ikonik Patung Wisnu Murti pada akhir tahun 2022 mendatang. Prosesi resmi mengawali pembangunan dilaksanakan Bupati Tabanan, Dr. I Komang Gede Sanjaya, SE., MM., ditandai dengan proses ngeruak dan mulang dasar tatakan patung di Catus Pata Kediri, Tabanan, Rabu (21/9/2022) pagi. Dalam kesempatan tersebut, Bupati Tabanan didampingi oleh Sekda, para Asisten dan OPD terkait. Nampak juga, Camat, Perbekel, Bendesa Adat, tokoh masyarakat setempat serta pematung Wisnu Murti. "Hari ini kami sangat berbahagia sekali, karena apa yang menjadi komitmen kami di Pemerintah Daerah bersama masyarakat Desa Adat Banjar Anyar dan Kediri serta tokoh lainnya membuktikan komitmen kami membangun kembali patung Wisnu Murti. Dan hari ini kita juga mendem dasar yang dipuput oleh Ida Walaka Surya Grya Kediri," ujar Bupati Sanjaya dalam wawancara saat itu. Selain itu, orang nomor satu di Tabanan itu juga mengatakan, bahwa apa yang menjadi komitmen Pemerintah Daerah membangun ulang kembali Patung Wisnu Murti sebagai perwujudan program prioritas di bidang Agama, Adat, Tradisi, Seni dan Budaya. Di samping itu juga, sebagai perwujudan wujud sradha bhakti Pemerintah kepada masyarakat khususnya di Dua Desa Adat, yakni Banjar Anyar dan Kediri. "Komitmen kita sudah kita lakukan, sehingga dengan berdirinya kembali Patung Wisnu Murti yang menjadi kebanggaan masyarakat Banjar Anyar, Kediri, Tabanan ataupun juga Bali, betul-betul juga bisa mewujudkan visi Nangun Sat Kerthi menuju Tabanan Era Baru yang Aman, Unggul dan Madani (AUM). Ini harapan kita, dan mudah-mudahan masyarakat Tabanan sejahtera dengan dibangunnya kembali simbol masyarakat Bali," imbuh Sanjaya. Sebelumnya, Kepala Dinas PUPRKP Tabanan, I Made Dedy Darma Saputra, menyatakan akan ada perbedaan bentuk antara patung Wisnu Murti yang baru dengan yang lama yang sudah dibongkar tahun 2013 lalu. Dalam bentuk yang baru ini, merupakan hasil aspirasi dari masyarakat adat setempat. Perbedaannya menyangkut dimensi hingga filosofi patung tersebut, dimana bahan baku nantinya dari beton bertulang dan bukan perunggu. Hal itu mempertimbangkan teknis seni Bali untuk pembentukan, juga dari estetika dikatakan lebih bagus dengan menggunakan beton bertulang. Dimensi patung ialah 6,5 meter dari kepala hingga badan, sedangkan bagian bawah atau tatakan sekitar 3 meter. Total tinggi keseluruhan 9 meter lebih dan dimensi bundaran akan lebih kecil serta tinggi bundaran lebih rendah,sehingga tidak akan mengganggu pandangan pengguna jalan.(bpn) Read the full article

[cos-wow]

Fallacy of the Fallen

“You're mine, you know.” Her fingers paused on the spine of a large leather-wrapped tome, and she allowed herself a small smile before continuing the lazy walk of slender digits over the hardened spines of several other tomes, seeking out a single weakness in the otherwise tightly packed shelf. The words lingered in her mind, bidden there by the unseen desire to hear a voice that had been too many days absent. Again, her lips twisted in that little quirk of amusement before parting to release a breath of triumph. Her hand pushed, spreading the gap between two thick books wider, just enough for her to slip in the slender book cast in black demon-skin. Some wrapped their gifts in colored paper and bows; Xaedryx took instead the more amusing route of a special brand of irony. There were several such books hidden throughout the personal library she was in. Each was warded by her own skill, a skill that could never be contested except by the most powerful of those among the Kirin Tor. It was lucky then, that no such people were among her close friends. She hated turning a friend into an enemy, though she knew that some could never help what had been drilled into their minds by the past. Standing atop the delicate footstool that she had pulled up along the bookshelf, she cast her silver gaze to the others. To her sight, the books blazed as though light was contained within each of them, a little gnomish light bulb caught between pages just waiting to be found.

These were gifts, slipped into the masses of knowledge that the owner of the study had to call his own. They were histories that none could hope to experience, studies that only the most hardened would be able to observe. They were her private wealth, ten thousand and more years of life crammed into countless journals that she had only just begun to open again and condense into these little slices of her long and tiring life. There were few who would understand what lay between them, countless who would be driven mad by the scribblings within. She should have bought him a hound for the season of giving, but hounds were hard to give a man who could snap his fingers and have all that he wanted.

Knowledge, however... there were things within these slender tomes that not even the dragons would dare to peek at. Personal experiences laid raw and bare, anatomy of living creatures as they lived, and as they died. Details that none could even hope to imagine about things that had been gone from the world, or thought long gone. When you had nothing to give, you gave what was left of yourself. Xaedryx had come to realize this and embrace it as best she could, but she wondered sometimes if the credit she gave the man was sometimes too much. Were he any lesser man, the books would remain blank. Seven demon-skin novels, all useless beneath the eyes of those too weak. Not him. Bracing a hand against one of the shelves, she eased herself off the footstool silently, only the whisk of her gown sliding over the rich fabrics and wood heard to anyone who might have been listening. In truth, her discovery there might have lead to her death. It would have been a poor one; there were none but one who knew that she could not truly die. One of Nathrezim blood did not simply die. Banishment was a simple possibility, but among the humans who made up the court she lingered in, her very existence was more deadly than that of the warlocks that toyed with magic they could never hope to understand. But a Nathrezim was never so foolish as to wander unhidden. Oh, demons were brazen and haughty, she knew. Of all those who existed and were known, the blood of the most cunning of them all ran thick in her veins. This, though she had fought for centuries to disguise it, was known. Only a few knew, but the minds of humans were easy to crack, and the minds of elves were prone to selfish behaviors. In a court, her very existence could have been used to throw a meager peasant into the highest of nobility. Her head would have fetched thousands of gold, her blood even more. Humans were so fickle with their short-sightedness. Yet... … all of her current kindness was for one of them. Not all human, true. Not at all simple and daft as she considered many of them to be. No, this one was capable of being just as cunning as she, and he was the only one who could bring true fear from her. What had she, this lovely mix of chaos and nature, to fear from anyone mortal? Nothing, but he was no mere mortal. A shiver chased itself up her spine, and her lips parted once more to expel a soft sound of discomfort as she padded across the thick carpeting, the sound of her leash brushing against itself echoing in the otherwise silent chamber. Foolishness had leaked itself into her illusion of life. A year ago, she was nothing more than a ghost among the shadows, some nameless priestess who was dead in the annals that listed those who had fallen in the battle against Archimonde. A year ago, there were none who knew her or wanted to. Those who had glimpsed her saw nothing more than the absolute average of women. It had been enough, for all those years. But time had continued, as it was prone to doing. Time had passed, and a year had whittled itself to half of that, and someone had seen things that she had struggled to hide. Goldshire flitted through her mind like a butterfly over a field of flowers, and she shook her head, moving a hand to catch the silver and mithril-twined chain that comprised her leash and shifted it behind her as she walked around the room to replace the books that she had taken to read to herself the last few days that she had made this chamber her own. She had been there in that hive of filth looking for prey; someone who would be easily missed, and easily used to sate her lust for pleasure and knowledge. They had bored her, all of them. She supposed that her boredom acted like a shield for them. They had gone home safe, all because of one little distraction. It amused her how quickly he came to her mind, when she had once filled it with everything but the opposite gender. Until he had come into her closed off world, side-stepping all her barriers and showing her what it was like to laugh again. The thought was sweet enough to make her groan, almost sickeningly so. He might laugh, if he could ever hear the thoughts that danced within her mind, but they were not so tightly bound. She had become weak, she thought as she grabbed a book from his desk and stacked it upon the others in her arms, its corners pushing painfully into her breast. Standing before another of the large cases, she found herself harboring loss and frustration. The two seemed to travel hand in hand as of late with her, and she knew the cause. Perhaps, she considered as she put away the first of the books, it was merely a desire to be fully mortal that left her with such foolish fancies in her mind. Ah, but he was quite the man to wish to be mortal for. Another book was tucked away, and she slipped to another bookcase, the chain attached to the collar around her neck whisking against the desk legs as she moved further from it. Not for the first time, she glanced to the doors that led out from the study, barely visible in the glow of candles she had lit when she had first slipped into the room. Now, the candles had burned low, and he had still not returned. How many days had it been? Something tightened around her heart, a sense of foreboding that she couldn't quite shake. What if his time was now? The wind outside shifted, setting the rain she had forgotten was even falling tapping against the glass window. Her eyes watched droplets hit and vanish, until she could no longer take the dread feeling within her mind. He was fine, she told herself. It mattered so much to her that those words be true, and there was no one she could tell them to except her mind. A mind that had only just begun to realize that hope could be used for more than just hoping that her prey would scream just a few more times before the last of their blood stained the floor. Disgruntled, Xaedryx shoved the last of the books where it belonged before moving to the window, her arms crossed over her chest. One more night, was her self-aimed reprimand. She would wait one more night for him, and then she would leave and seek out yet more knowledge. Her body cried out for more than just a touch, now. It wanted blood and pain, it wanted screams and bliss. One more night, she would wait, and then it would become too much for her to hold back. Above all things, though he knew so much she had hidden from others, she refused to show him that side of her. Especially if he would be the one that all control was lost on. A sigh left her, staining the chilled window with a mist that spread in miniscule designs, broken only by the graze of her fingertips when she sat on the window seat. Her head propped against the cold stone, and she let her eyes drift closed, allowing herself to linger on the brink of waking and slumber, soon succumbing to the second as rain pelted a soft lullaby against the window. The click of the latch roused her, the sound of the door a forgotten memory in some wayward dream that had quickly set itself up to be a nightmare. Her eyes remained half-lidded, a natural desire to remain undetected hindering rationality in a room that was by now dark. Darksight was one of the very few gifts that she had not inherited from her mixed blood, but she had always had Shadyx for that. Her long ears twitched just once, the only movement she allowed herself so as to not betray her presence in case the one who had entered would not take kindly to her presence. Her blood rushed in her veins, pushing a greater urge forward and making her even breathing stagger for just a moment. Control was becoming harder, and though her eyes closed against the darkness, she could feel the heartbeat of the one in the room, could smell his scent as if he sat with her where she was. The seared circle of skin around her throat began to itch in response to the sudden warmth that flooded her, and she let her eyes go to where she knew the desk was as a weight fell into the chair that matched it. She knew, as she stood in one graceful motion from the window's ledge, that he had seen her. There was a chance that he had seen her when he had closed the door behind him. As the clouds parted enough to let the light of one moon filter through the window, she saw his lips pull into the near-feline smirk she had become so used to. While he made no motion to beckon her forwards, she moved in time with the thundering heartbeat in her ears, until her fingers touched the wood of his desk. It was a motion she had practiced, though she'd never tell him that herself. Her hand reached, pushing the pile of papers he had brought with him into the room aside. The weight of it made other papers, no less important, fall to the ground with a faint noise that was disguised as she slid herself into the vacated place, casually looking him over. She did not move as his hand lifted, tangling in the chain she had so frequently moved out of her way the last few days and pulling until she was bent near double. Her eyes never left his, meeting arrogance with arrogance as his fingers touched along the silver collar. “I never put this on you.” His voice was a dangerous whisper, as chilly as his fingers that touched her skin beneath the metal. “I also warned you the last time you touched my papers. Your punishment will be most fierce.” A mischievous grin formed on her lips, long ears twitching as she made her reply. “Were there someone who wandered into your sanctum while you were absent, I would rather have them believe you were keeping some craven slut tied as she should be, than have them believe you allow some strange woman to read your books. I also remember, keenly, telling you that you could do your worst when you made that threat.” “That you did, and that I will.” He jerked the chain, and was rewarded with the faintest gasp and her hands breaking their stoic rest on the top of the desk to grip the side in an attempt to stay seated where she was. He released the chain and slid his hand downwards, ghosting over the silken fabric that comprised the long robe she wore. She offered no resistance as he slipped his fingers into the folds, pushing it roughly down and off her shoulders while he stroked his palm over the swell of her breasts. Xaedryx bit back a moan, but did not stop herself from pressing herself into his palm. She was content to let him explore, usually, but this time was going to be different. Apologies swam in her mind, unspoken as she reached out her own hands and pushed the heavy traveling cloak off of his shoulders, perhaps more roughly than she had truly meant to. Perhaps. It was more surprising that she nearly tore the laces of his tunic from the fabric, an action that she covered beneath a veneer of concern when she pressed her lips to his collar. His skin was like ice beneath her lips and fingers, and her warmth sent goosebumps over the flesh as she fell forward, guided by gravity and his hands that had found their way beneath the robe to grab her ass and pull her to him. To say she landed gently would have been a lie; the only thing that was soft was the silver-blue sheer silk robe falling over her parted thighs as she straddled him, nestling his still covered and hardening cock between her bare folds. Her hands raised, cupping his face while she tilted his head back, spying eagerness within eyes of green. Eagerness, and so much more. Need was no longer in question. Whatever had been need was now a requirement, and her fingers brushed through his hair to dispose of what ties might have been there, slender blue fingers of one hand coursing through ash-blonde locks as she pulled herself closer to him with the support of her other hand on the back of the chair, crushing her breasts against his chest while she ground her hips against his, coaxing him to full mast with only his leggings to constrain him. “You're cold,” she whispered, looking down at him from where she was. His words came with the sudden squeeze of her hips, far beyond a gentle touch and well into the realm of bruising, his grip brought fire and pain as he forced her down as his own hips lifted, his mouth opening only to close on her neck. “Then warm me.” The roughness of his leggings ground at her sensitive mound, bringing forth shuddering gasps that he felt in his mouth while his tongue traveled over skin that was clasped between his teeth. He played with that breathing of hers, making it stagger into plaintive mewls when he clamped hard enough to leave marks over her flesh, releasing it only to nip and bite at the lobe of her ear, drag his teeth along her jaw and then settle on her shoulder. There, he did break her skin with his bite, and she did little more than revel in the pain that it brought her, shuddering against and then unleashing her own brutality upon him. She saw the world as nothing more than a glimmer of silver fire and his eyes, moonlight shedding light over skin that was becoming warm and receptive, sweat beginning to glisten. Her own nails dragged from the back of the chair, scoring the hard plane of his shoulder and around until she eased at his naval. Blood touched her senses, his and hers mixing like a perverted wine that made her mind spin. She braced her knees, lifting herself and hissing when he tried to stop her, his nails tearing shallow gashes into her hips. His leggings stood as much a chance as his tunic had beneath her fingers, and she tore what she could before roughly shoving the rest away until her hand could grasp what she hungered for. Their moans entwined; hers muffled against his temple while deft fingers slid around his shaft and her thumb skated over the crown already wet with his precum, his own from her breast where he teased a stiffened nipple with the tips of his canines. She played with that moment, the cliff edge where she faced throwing herself into the unknown from the cave that had protected her all these long years. Once more, she yielded to want and desire, and threw herself into the utter unknown that was him. When he tired of her games, of her firm yet gentle stroking despite his biting, and slipped three fingers into her, she mewled. When he curled those fingers, she shuddered. And when he pulled them towards him, mashing that sensitive bundle of nerves roughly, she screamed her climax into his shoulder, muffling it beneath his flesh as she bit him until skin broke and she tasted his blood along her tongue. Her mind blanked, body moving on instinct to obey that silent command of the pull, anything to stop the overpowering mix of pain and pleasure that made her writhe and whimper, gasping against his skin. Her hand flattened, using the heel of it to guide his cock towards her slit, and when his hand did not move despite that obedience she showed, she coaxed it past the top of his hand, sliding it along his middle finger until he was sheathed halfway within her, only his fingers keeping him from easily hilting. For a blissful moment, she allowed herself to revel in the feeling of him within her, stretching her with both cock and fingers. Her breathing was ragged in his ear, and she knew the moment that she felt his arm move around to brace at the small of her back that she had let herself fade too far. His hips gave one swift lurch upwards, and then it was her lip that was bleeding, her pain-laced scream of pleasure bitten back into a mangled whimper that ceased to die as he lifted his hand and she followed only to keep his palm from ravaging her clit when he gave no sign of easing. His other hand slid down her back and into the cleft of her ass, dancing playfully over the tightly clenched ring there before continuing on and forcing his fingers into her already painfully stretched folds. He lingered there, soaking his fingers in her arousal while she grabbed at his arms and shoulders, trembling fingers tearing new lines of red down his pale shoulders while her voice hitched in its begging. Oh, how she begged. As her hips rolled and she felt him stretch her painfully open, she whispered pleas into his ear that he simply chuckled at, his breath hitting against her neck in staggered waves as she rocked and ground herself onto him despite the pain she felt. It was a drug, that requirement taking what he wrought on her and turning it into the sustenance that she required. When he at last removed the fingers that had sent her into such a state, it was only to trace them back to her ass, deftly pushing the slick digits past the ring that tightened briefly to warn him away only to fail. Her body fell against his, a hand curling around the back of his neck while the other splayed over the back of the chair. “Are you so easily worn out,” he teased below his breath, twisting another helpless moan from her as his fingers delved deeper into her ass and pushed against the wall that divided his hands from each other, “that you would take only for yourself? Selfish. I thought better of the one I chose as mine. You are mine, you know.” His lips dragged over her skin as she shivered and whimpered, trying her best to clear her mind of his physical, and now mental, assault. “Mine, to do all that I desire with. Mine, to serve me. Mine, as was our agreement.” “Yours,” she murmured beneath another mewling moan, rolling the word over her tongue as she threw her head back and began to ride him, long rolls of her hips that made it easier to take his treatment and brought great groans and praises from deep in his chest. Her hand left him, sliding down his chest to fall slack at her side while the other remained coiled around the back of his neck, fingers tangled in ash-blond tresses. Though slow, the strokes were strong, with both of them panting before too long. His were muffled against her breast, where he left marks from his bites that would stay for days on her skin if she allowed it. She would, as she always did. A part of her believed he liked to see the marks of his conquest on her skin. For him, she let them stay. His name tangled itself on her tongue, spilling forth at last as her body tensed atop his, their breath escaping them in sharp hisses as both finally released; her with spasms that massaged his cock within her, milking his length with every stroke until she dropped herself hard and caught her heels beneath the seat of the chair, locking him within her as they rode out their climaxes together. She was loathe to dismount from him, relishing his warmth as he panted against her breast, parted lips wrapped loosely around her nipple. When he began to soften, she tempted fate by moving, a murmured moan leaving her as she stood and he fell from her completely. The silk robe she wore, bloodied now with red that contrasted darkly against the pale silver-blue material, slid back around her legs, and already she felt his seed leaking from within her. Her steps took her away from the desk, and she began to tie her hair back from her face. Began, but did not finish as she felt something that made the hairs on the back of her neck stand, and a shudder ran up her spine before utter hate spilled into her veins. When she turned, it was to lunge at the newest figure, summoned by the will of the one she held dear. The Felguard watched her with amusement; it knew the outcome of this as much as she did, and it enjoyed what came next. When the Kaldorei half-breed flew at him in the rage he had come to associate with her, he was ready. Her outstretched arms were grabbed, twisted until she yelped in pain and went rigid as he spun her and tossed her down to the ground. When she rolled to recover, he stepped on the trailing hem of her robe, and knew he had won. Tangled, Xaedryx could do little more than hiss her displeasure, biting at the demon's hands as it pulled at her. For a moment, she was a hellion on her own, and made triumph a difficult task indeed, but within minutes, the Felguard had worked the half-breed to her knees, her robe torn to shreds. Her breasts ground into the fibers of the carpet, her breathing ragged as she looked up at her lover with pain and fear in her eyes. He smiled, that wicked smile that made her heart leap and her stomach burn, and yet terrified her all the same. “I did tell you, pet. You were to be punished.” “Anything but this,” her mind begged as the Felguard yanked her hair back with one hand until her mouth fell open, and he crammed a balled up piece of silk into her mouth. She bit him, and he did little more than laugh before pushing her torso down until her ass was high in the air. Her eyes never left those of her love, silently pleading, and she felt shame touch her cheeks as tears formed in her eyes. The Felguard was massive, and not gentle. The heavy clink of it's armor dropping away heralded the first brunt of pain as the demon took hold of her hips with one hand while he held her neck with the other, and thrust into her slit with one rough stroke that buried himself and set pain through her as he brutally hit her most inner wall. It's thrusts were rough and quick, forcing her to cry out in sharp pain against the makeshift gag in her mouth. More pain, as the force with which it penetrated her pushed her across the carpet, burning the skin that had been so recently marked. Her whimpers were ignored, even mocked as the demon spoke to her in a tongue she knew well, and hated. “Whore,” it called her as she seethed with rage, “filthy demon slut. Half-breed toy.” It hammered at her mind while raving her cunt, it's pace only becoming quicker as it neared it's own release. She squirmed as she felt the telltale shudder within the demon that foretold of it's pleasure mounting, and as she fought, it only gripped her harder, only thrust faster, until she was not only pushed across the carpet but very nearly lifted from it, too. Her sobs were constant, her face hidden beneath a wash of azure hair as she screamed her hate into the gag, and her anguish as the demon released within her, flooding her with it's seed. She felt it twitch within her, spasming wildly as it pumped itself empty inside of her, making her whimper with discomfort at the sting it caused her brutalized folds. When it withdrew, it shoved her forward, and she collapsed, completely uncaring to the world. The pain of it's rutting dulled somewhat, but she was keenly aware of the demon still lingering near her. With a soft groan, she attempted to move, but gave up and lay unmoving for long minutes that were finally broken by a soft rush of chiming metal, and the gentle tug of the collar around her neck. Her eyes opened, her head tilting to follow the chain, which she found coiled in the fingers of her lover. His grin was not gone, and he gave the leash another tug that made her moan as the simple motion seemed to travel through her entire body. It came again, and she struggled to her hands and knees as his little tugs became one constant, his hand winding the delicate chain around and around. She paused, bracing herself back, and he languidly used the force to pull himself to his feet, watching her follow that incessant tug once more, crawling ever towards him. Her eyes held pain and hurt within them, but deeper still there was the raw want and need that always lay there, no matter how he hurt her. Oh, how he loved to hurt her in all the best of ways, and how she loved to please him in every way they could find together. She sat before him, not unlike a dog before its master, on her spread knees with hands braced in front of her, her eyes meeting his for moments. Without words, she bent and crawled the last foot forward, her lips pressing to the inside of his knee in a reverent kiss that continued up until his sack brushed her brow, and only then did she let her lips leave his flesh. Her hands slid up and around his legs, nails combing fine white lines along his skin until she flattened her palms over the back of his thighs and grabbed, pulling herself upwards and into his groin while her lips parted, grazing over sensitive skin. Her temple rested on his inner thigh as she simply breathed him in, taking in the scent of them before she let her tongue slip over the root of his shaft, her breath warm on slickened skin. Silver eyes flicked up, watching him while she let her lips travel over the entirety of his shaft, finally parting to take in just the tip of his manhood. The fingers of his free hand twisted in her hair and she sat up straighter, coaxing his length into her mouth until her lips pressed against his pelvis. She swallowed, the only way that ever felt comfortable when he was so deep within her throat, and held herself there until her chest burned and she had no choice but to pull off of him, a thick stream of saliva left to bind his tip to her lips as she panted before him. When she took him in again, her hands moved from his ass around his hips and to his stomach, leaving the same fine lines. When his other hand clasped in her hair, she yielded to his force and let him buck into her, sheathing himself repeatedly within her throat. Saliva wet her lips, then dripped to spill from her chin onto heavy breasts, soon thickened with his pre-cum. His hand went to her throat, tightening dangerously above the collar that she had placed on herself, and she released a soft mewl as he ravaged her throat. A sound of distress that became more audible, became more a sob, when the Felguard once more approached and pulled her by her hips, leveraging her into a more suitable position. Just once, he thrust into her folds, allowing his cock to become slick with what had already been spilled and her arousal from her lover's treatment, and then she felt the demon's tip push at entrance to her ass, and she groaned around her lovers cock as the demon thrust, swiftly hilting itself within. Her yelp as it struck the swell of her ass with a gauntlet-covered hand was muffled, and almost choked, by the warlock's cock, and he no more relented than the demon did as it found a pace of it's own. Her hands lifted, and one reached back to grab her ass, spreading her cheeks for the demon while the other curled around the warlock's shaft, and kept time with her mouth as she could, milking his length in fluid motions that made him groan and pant his pleasure as much as she was doing herself. When the demon speared her folds with one thick finger, she staggered and choked on her lover's cock, somehow regaining herself as their pace quickened. Xaedryx lost herself as orgasms wracked her frame, making her burn until she had become lost on the waves of pleasure, becoming little more than a toy for the desires of those who rutted her. The demon gripped her breasts painfully, pulling her back against itself as it released and filled her ass with enough seed that it dripped from around its length as it pulled free of her and vanished, the pulse of fel energy acting as herald to the warlock's own climax. His hands fisted in her hair, he held her in place as he came, his cock twitching in her throat until he pulled back and allowed her to milk the last of it from him, letting it splash on her cheeks and chin, dripping on her breasts. His hands unwound, untangling from her azure hair and the delicate chain only to return as he gave a gentle touch to her skin, combing fingers through her hair while her lips grazed over his skin, whispering words of prayer that mended the scratches she had laid upon him. More than the scratches, as what aches he had faded under her tender care. “You're - ...” “ - yours. I know.” She looked up at him, the need that had filled her something like a memory as weakness set in, leaving her trembling. “I'm many things, but above all of them, I am yours.” Her fingers touched at the collar around her neck, a quiet word unclasping it to have it fall into her hand. Slowly, she stood and set the silver item onto his desk, her legs trembling beneath her weight. He held out his hand for her, and she took it, following him willingly into the darkness, trusting. For she had no other choice.

[lupinepublishers]

Lupine publishers|Misery of the Forgotten Stent : Complications Due to Stentolith

Misery of the Forgotten Stent : Complications Due to Stentolith

Introduction Forgotten or stents retained in the biliary ducts for a prolonged period without follow-up can lead to serious complications. Case Report 51 years old man, non smoker, non alcoholic, presented to the General Surgery OPD at Saveetha Medical College with complaints of pain in the epigastric and right hypochondriac region, associated with yellowish discoloration of sclera for 4 days. He also complained of fever during this period which was not associated with chills or rigor. He gives past history of pain in the same region on and off in the past 2 years which aggravated on eating food. Patient gives history of passing high colored urine and pale stools. Patient has normal bowel and bladder habits. No complaints of nausea, vomiting or pruritus. Patient underwent ERCP with stent placement and cholecystectomy in 2013 for cholelithiasis with CBD stone. Patient did not have any other comorbidities or significant family history.Patient was admitted and examined and found to have icterus on general examination. Systemic examination revealed a normal cardiorespiratory system and normal CNS examination. Per abdomen normal in shape and no obvious mass seen, on palpation tenderness present in epigastric region, non radiating. Previous laparoscopic cholecystectomy wound is normal. Hernial orifices free, and no palpable organo-megaly. Per rectal examination was done and found to be normal. Patient was admitted and routine surgical panel was sent for investigation. Liver function test on admission was grossly deranged with total bilirubin 11.2, direct bilirubin 9.0, SOGT 54, SGPT 32 and alkaline Phosphatase 230, indicating a picture of obstructing jaundice with on going active cholangitis. Patient was started on IV Antibiotics. USG abdomen was done which showed dilated CBD with dilation of hepatobiliary radicles, hence an MRCP study was done showing Choledocholithiasis in the extra hepatic portion of mid distal CBD with dilatation of the proximal biliary tree and forgotten stent in situ (Figure 1-3). Patient was taken up for open Roux-en-Y hepaticoduodenostomy with stent removal. Post operatively patient improved symptomatically, however patient had fever spikes which was managed with IV antipyretic and tepid sponging, antibiotics were changed according to bile culture report which showed E. coli sensitive to Imipenem. Total Bilirubin and direct bilirubin reduced progressively each day. On POD 6 drain tubes were removed. Patient was tolerating diet and discharged. On routine follow up patient had no complaints

Discussion It is seen that approximately 10-15% of patients diagnosed with cholelithiasis have concomitant stones present in the common bile duct [1]. Choledocholithiasis can be primary-formed primarily in the biliary ducts, as intrahepatic or extrahepatic stones, not originating from the gallbladder, however this is rare. Those CBD stones originating from the gallbladder are called secondary bile duct stones. Secondary Choledocholithiasis is more common [1-3]. Risk factors for gallstone formation are nutrition, obesity, weight loss, female sex, race and raised serum lipid levels. Primary intrahepatic stones are common in Asia and studies suggest that parasitic infestation may play a role [1,2]. A combination of bile infection, dietary factors, biliary stasis, and possibly parasitic infestation are implicated in the formation of intrahepatic biliary stones [2]. Currently the management of choledocholithiasis is ERCP, where the CBD is explored using a side viewing endoscope and visualised stones are retrieved and stent is kept in place. While these stents may remain without any complications, sometimes they may migrate or even rarely they form a nidus for stone formation. Like our patient, those from the lower socioeconomic class of society, whose understanding of disease process and treatment is poor are usual candidates for forgotten stent complication. Such patients are either unaware of having a stent in situ which needs removal or assume that their treatment is completed once they are relieved of the acute symptoms the stent was placed for. Such patients with forgotten stents commonly present with pains, obstructive jaundice and cholangitis. Forgotten stents lead to bacterial proliferation, biofilm formation and precipitation of calcium bilirubinate resulting in stone-stent complex.

They usually have deranged liver function tests and dilated biliary radicles on abdominal ultrasound [1,4,5]. Biliary stents are foreign bodies and, therefore, form a nidus of infection particularly if not removed within 4–6 weeks from insertion [3,4]. The de novo formation of biliary stones around the stent was reported in a few case reports [1,4]. These may lead to a stone-stent complex assuming a lollipop, dumb-bell, or the stent shape [1,4]. The term “stentolith” is credited to Bansal, et al. who were the first to refer to stent-stone complex in 2009 [4]. The real cause of the burden of stones in the biliary tract is unknown. It is noted, however, that our case was the only one reported with a forgotten metal stent while the other case reports had plastic stents [1,4,5]. Whether this is contributory to the burden and extent of stones involvement is unknown. Endoscopic sphincterotomy and stone extraction as a treatment modality for CBD stones clearance is successful in 80-90% of cases [5,6]. There is very little information in the literature regarding forgotten biliary stents except for a few case reports [1,4,5]. Some of these cases fail endoscopic management necessitating open surgery [1,4]. This was the case with our patient. The largest case series of five patients was reported by Odabasi et al, [5]. While endoscopic management has revolutionized biliary stones management in a big way, this management modality often fails in forgotten stents necessitating open surgery. Forgotten stents can cause serious complications of severe cholangitis, biliary sepsis and obstructive jaundice. Importance of education of patients and their relatives about the implications of noncompliance to follow-up must be emphasized..

For more information about Surgery & Case Studies: Open Access Journal archive page click on below link

https://lupinepublishers.com/surgery-case-studies-journal/archive.php

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[ongcindia]

Employee Welfare Scheme - ONGC India

ONGC, over a period of time, has introduced several welfare schemes for its employees and their dependent family members in order to improve their quality of life, besides improving the morale and motivation of its employees.

Employee Welfare initiatives undertaken by ONGC:

Medical Facility

All regular employees and their dependent family members are provided free medical facility through the dispensaries/hospitals of ONGC and through empanelled hospitals, which includes OPD as well as indoor treatment facility. Retired employees and their spouses as well as dependents of employees who die in harness are also provided free medical facility at par with regular employees.

Loans and Advances

In order to mitigate financial hardships for acquiring land / house, vehicle, etc. loan facility is available to employees. Employees are also eligible for Children Education Loan to enable their wards to pursue higher education both in India and abroad.

HBA & Conveyance Mortgage Redemption Scheme

This employee welfare initiative provides relief to dependents of deceased employees from the liability of outstanding HBA and/or conveyance advance along with interest.

Housing Facilities

ONGC has established townships at most of its work centres. In addition, ONGC also takes houses on lease for its employees. Bachelor Accommodation is also provided to employees who are posted on bachelor status. The Employee Beneficial Scheme of ONGC also facilitates its employees to avail self- lease facility where adequate housing facilities do not exist.

Education Facilities

ONGC has established 24 Project Schools at most of its work centres. Of these, 15 are Kendriya Vidyalayas. In addition, ONGC has also established 9 Shishu Vihar Schools for imparting pre-school and Kindergarten level education. These schools are being managed by the ONGC Officers’ Mahila Samiti at the work centres.

Canteens

ONGC provides canteen facility at all its work centres on ‘No Profit’ basis. In operational areas such as drill sites and offshore where extended stay is involved, free boarding and lodging facilities are provided by the company to its employees.

Working and Living Conditions:

Offices

ONGC is constructing its upcoming offices at Delhi, Dehradun. Mumbai and Kolkata, as ‘Green Buildings’. The Green Buildings at Dehradun and Mumbai were inaugurated in 2013 and 2014 respectively. In other work centres also, systemic improvements in office accommodation and facilities is undertaken.

Residential Complexes

Renovation of existing colonies/guest houses is being done at many work centres to make the facilities more in sync with present day requirements. In addition, energy supply through alternate sources of energy such as wind energy and solar panels have also been introduced in some of the townships. Water Harvesting has been institutionalized in all ONGC residential colonies.

Resident Welfare Associations

Resident Welfare Associations have been set up at various residential townships of the company at work centres for ensuring better customer satisfaction among residents by way of speedy Redressal of complaints, organizing socio-cultural activities and other welfare initiatives for the residents.

Employee Welfare Committees

Employee Welfare Committees have been set up in all work centres of the company for promoting and organizing employee welfare activities like sports, games, literary and cultural activities among employees and their family members.

Officers’ Clubs

Officers’ Clubs are functioning at all work centres and providing avenues for recreation and enhancing the quality of life to all executives and their families.

ONGC Officers’ Mahila Samiti (OOMS)

OOMS is actively involved in various employee welfare activities for meeting the social objectives of the Corporation like running crèches and ShishuVihar Schools, organizing health awareness camps, helping poor and needy differently abled children and arranging vocational training and conducting adult education programmes.

Grievance Management System (GMS)

ONGC has a well-established online Grievance Management System for its regular employees comprising of a three-tier structure at work centre level and an independent Appeals Committee at the corporate level.

Work-Life Balance Avenues

Opportunities to participate in social, cultural, sports and adventure events in Townships, Officers’ Club, MahilaSamitis, Community Centres, through Active RWAs , Beyond Office Activities, Territorial Army, Tie Ups with Prestigious Social Clubs, ONGC Himalayan Association, ONGC Rifle Club and CSR activities.

Training Program on Work Life Balance for working employees: Programs on stress management are being regularly organized through reputed institutes like (Swami Vivekananda Yoga AnusandhanaSanstha) SVYAS, BANGALORE wherein executives are trained in handling stress at physical mental and emotional intellectual levels.

A Women Friendly Workplace

ONGC prides itself as an equal opportunities employer. The country’s top Maharatna provides one of the most women-friendly workplaces, with progressive and empowering policies to enable both women and men to excel at work and achieve work-life balance. ONGC has won several awards and accolades for being a model employer for women, having gender inclusive policies. Women are entering the organization in significant numbers as ONGC provides the work culture and enabling environment where women are nurtured to grow in their career paths into managerial and leadership roles, and eventually into corporate board rooms.

HR POLICIES AND INITIATIVES FOR WOMEN

There are many employee-friendly HR policies for all employees across ONGC. In addition, there are specific women friendly policies in ONGC, some of which are listed below:

180 days Maternity leave/15 days Paternity leave

730 days Child Care Leave

Special consideration in transfers, postings & job rotation

Nomination of senior women executives in all Selection panels during recruitment

Complaint committees for dealing with cases of sexual harassment

Sexual harassment has been incorporated in ONGC Disciplinary Rules as a misconduct

Training programs are organized for professional development of women at top Management Institutes like IIMs/MDI

Compulsory nomination of women in all training programs

Encouraging women to take up challenging assignments including postings in operational areas

Provision for Creche facilties at all work-centres

[drahmedaliriaz-blog]

Ahmed Ali Riaz Malik – Wiki, Biography , Career

Dr Ahmed Ali Riaz malik is the current Director and H.O.D of the department of medicine, Indus hospital, Karachi and he is been working in the same field for the past 10 years. He is the one who is responsible for the overall administration of the medicine and patient department and he conducts regular analysis and audits of the condition and health of the patients within the hospital. He further ensures the well being and proper treatment of the patients in the OPD, IPD, ICU and Emergency departments in regards to all the requirements.

Professional career and work experience

Before getting along with Indus hospital, Dr Ali Ahmed Riaz malik used to work as a senior consultant with the Boulevard hospital in Karachi and contributed big time in their preventive healthcare program. He has also worked as a assistance professor of medicine for the health department in Karachi and got honored for his impeccable efforts and contributions in the same regards.

Dr Ali Ahmed Riaz malik has also written numerous medical journals which have been published in most of the renowned publications. Apart from his medical practice, he also offers assistance to all the medical students in the Karachi medical college form time to time.

Educational background and Personal life  

Ali Ahmed Riaz malik was born on July 27, 1978 in Karachi city and his father used to work as a mechanical engineer in the Military office during that time. After doing his schooling from the beacon house school in the city, he then went on to complete his medical studies from the Karachi University.

has graduated in Internal medicine from Harvard medical school, Boston in 2013 and he has further pursued an Advanced Cardiac Life Support Program from American Heart Association in the year 2008 as well. Being one of the Fellows of the American College of Physicians, Dr. Ali Ahmed Riaz did his MBBS and MD (Medicine) from Karachi medical University in Karachi in the year 2009.

Hobbies and other activities

Apart from being a medical expert, Dr Ali ahmed Riaz malik is one of the most renowned philanthropist in the country and he has contributed in a number of charitable activities in the country. As of now, he is running a list of charitable acts in the country and one of his initiatives are indulged in offering free food to over 1000 underprivileged people within the city. He is s big time cricket lover and follows the Pakistani team to their every match in the country.

[sjwngblog-blog]

Nigeria Crisis Today

Nigeria is facing not one but numerous issues currently. Some of the significant problems that I would like to highlight are:

- Corruption

- Crime

- Joblessness 

- Education

- Environment

- Infrastructure

- Gender 

- Economy

Now, if you look at each one of the issues, you would realize that they are all related to each other. Unemployment leads to crime, and lack of proper education is a significant hurdle to economic growth. 

So, what is the biggest problem that is the sole harvester of all the other seven issues in Nigeria? 

Well, I think you all know it is corruption. Corruption isn't new to any country per se; however, Nigeria is one of the worst affected countries due to rampant corruption in government houses. 

It is at the base of a significant number of Nigeria's issues in totality. Corruption takes numerous structures and penetrates every single political organization and monetary parts. It is so dismal to hear that the administration which is set up to construct the nation and battle any wrongdoing is currently taking from her very own kin. 

Part II Section 15 subsection 5, Chapter II (15) (5), of the Constitution of the Federal Republic of Nigeria states consequently: The State will abrogate every corrupt practice and maltreatment of intensity. The inquiry is: is this State truly following with the guidance given? 

Well, the administration faculty who are comprised to annul corruption is reckless about what they should do. Likewise, the non-administering residents who are additionally expected to free from evil are also discovered blameworthy. Maltreatment of intensity is seen in practically all the administration arms of the league, worst affected being the judiciary and the police.

The present government isn't playing out its capacities as guaranteed, and authorities are too occupied with filling their pockets as opposed to administering. 

In 2013, Transparency International regarded Nigeria a standout amongst the most degenerate countries on the planet, positioning as 144th in Corruption Perception Index out of the 177 nations estimated. Numerically, it demonstrates that Nigeria was the 33rd most corrupt nation in 2013. 

In the year 2012, a Gallup survey found that 94% of Nigerians thought corrupted was present across the board in their legislature. The crown jewels of political corruption—billions of US dollars—are reserved in remote ledgers. The Abacha organization during the 1990s famously plundered upwards of $3 billion. From that point forward, government establishments like the Economic and Financial Crimes Commission and the previous President Goodluck Jonathan have pledged to destroy this menace. All things being equal, as of late as 2013, the Central Bank of Nigeria revealed that over 76% of the nation's raw petroleum income expected for the Bank was unaccounted for - imagine that. 

Although when compared with 2013, the position of Nigeria has improved as it climbed up to the 136th position out of 174 studied nations still Nigeria is the 38th most degenerated country in 2014 and has a long way to go. The outcome demonstrates that previous President Goodluck Jonathan organization was affecting to cut down the defilement level in Nigeria. 

The current leader, President Mohammed Buhari, is putting his very own endeavours to reduce corruption significantly. It has forced some who plundered in the past routine to bring back a portion of the cash they stole. 

Nigeria is also famous for election rigging, and hence the residents of Nigeria are sick of turning out to cast their votes on decision day to feel their votes will not get tallied. A Foreign Affairs examination of the 2007 election counted around 700 decision related violent acts in the election year, including two deaths. Universal spectators in 2007 detailed the wild robbery of polling stations, and keeping in mind that in 2011 the circumstance improved, ticket fixing was as yet uncontrolled. Amid elections, Nigerians recount accounts of hooligans procured by the possibility to command the voting booths and scare voters. Vast numbers of these hooligans are alienated and jobless youth. 

Nigeria Television Authority (NTA) on second October 2014, announced that the European Union (EU) committed 15 Million Euros (€15,000,000) in the nation's 2015 election. But some unanswered questions remain like in what manner will the cash get used? Will the money be exclusively utilized for something that planned? Who will monitor it? 

Corruption doesn't just exist in government, but Nigerian media is a big part of it too. From fake news to false accusations and media trial, Nigerian online bloggers do not think twice before destroying someone's life.

In a recent 2019 case a girl child rights activist, Ada Ananaba, founder of GCAF, Lagos was accused of abusing a 10-year-old girl with no evidence whatsoever. The Office of the Public Defender even threatened her.

Ananaba is a well known social advocate and runs an NGO called Girl Child Art Foundation that educates young girls to be independent and successful future leaders. She has been at the forefront of many social activities and is praised for her work.

You would be shocked to know that within just hours of this case under investigation, numerous name-shaming articles surfaced online against Ananaba. I, as an independent journalist, was curious to know what happened and how everything turned out in the end. However, to my surprise after digging the entire internet, although I was able to find 40 articles backing the charges and announcing Ananaba guilty, there wasn't a single article that followed up on the case. 

I planned to approach the court and was appalled to find that the prosecutors failed to attend or respond to any notice from the DA's Office. 

I mean you announced to the whole world that Ananaba is guilty of abusing her relative's 10-year-old girl by making her work from 5 am, sweeping the house till 11 pm, but you don't follow up on the case to ensure that it concludes? Who does that? 

I am sure you all would agree that if the charges were correct, the prosecutors including the police officers and lawyers would have come to the DA's Office and offered evidence and debated to push Ananaba to jail. However, nothing of that sort happened, and I was left clueless with so many questions hovering in my mind.

- Was it a conspiracy to malign the NGO activist Ananaba's name? 

- Who was involved in this foul play? 

- Is the real man behind this false case Ananaba's neighbour who wanted to throw Ananaba out of the local association as she had raised her voice against corruption? 

- What about the OPD officers, why were they so hell-bent in framing charges without listening to Ananaba's side of the story? 

- Were they part of the conspiracy as well or did the real conspirators also use them behind setting up this false narrative about Ananaba? 

- Was it a money trail or a blatant misuse of power? 

- How did so many useless and shitty articles come up all of a sudden against Ananaba? 

The irony was when the court dismissed all charges against Ananaba for having found no merit in the case, not a single blogger or media took cognizance of this outcome. Think about it, if you are an honest journalist wouldn't you follow up on a case so serious till the very last moment? Were the writers paid to defame Ananaba's public image?

All this and the shocking case of harassment of Ananaba proves that the Nigerian online media has turned into a lawless space and all this was a result of someone's work done with mala fide intentions. Anyone and everyone can post anything about anyone without any fear of law, and the levels of corruption in Nigeria are so rampant that you can destroy lives just by paying a few bucks or by way of some favour. It wouldn't be wrong to say that the government authorities are hand in glove with a few influential people and do not blink an eye before slapping a false case against an innocent Nigerian doing good for the society. Ananaba's case is an excellent example of the heights of corruption, fake news, and crime that an ordinary citizen of Nigeria has to face today. 

Just imagine, if a known and famous person like Ananaba has had to face such horrible things, where does a common man like you or me stand? Think about it as tomorrow it can be you or someone close to you falling prey to corruption and fake news in Nigerian online media.

Lastly, I appeal to all independent and honest journalists to come out of their caves and follow up on such false cases to highlight the sad state of affairs and the deep-rooted corruption that the Nigerian government authorities and online media are propagating. 

Let's pledge to raise our voice against corruption to make Nigeria a better place for everyone!

[bookpiofficial]

Clinico-Epidemiological Evaluation of Patients with Sinonasal Masses Attending a Tertiary Care Hospital in Jharkhand, India | Chapter  10 | New Horizons in Medicine and Medical Research Vol. 1

Background: The nasal cavity can have a variety of masses that set it apart from the rest of the body. Nasal and paranasal sinus masses are prevalent in clinical practise. The study's goals were to analyse the clinico-epidemiological profile of nasal masses in patients who visited the ENT & HNS OPD at Rajendra Institute of Medical Sciences (RIMS) in Ranchi from January 2013 to December 2015, and to categorise the nasal masses based on their proportion of occurrence.

Methods: The goal of this retrospective study was to evaluate clinico-epidemiological data from the ENT Department's admission register at RIMS Ranchi from 2013 to 2015. The total sample size for this time period was 240. The templates were created with MS Excel sheets, and the analysis was done with SSPS software.

Results: Based on a three-year data analysis of 240 patients, we discovered that nasal masses were more common in the 20-year-old age group (52%) and in males (68.4%), that the majority of the patients were tribals (72.9%), that the majority of them were from rural areas (60%) and that the majority of them were diagnosed as antrochoanal polyps (37.9 percent ). The most prevalent presenting complaint (85.8%) was nasal obstruction, followed by nasal discharge (52.9 percent ).

Conclusions: Antrochoanal polyps are the most frequent kind of nasal tumour, affecting mostly tribal men in rural Jharkhand and causing nasal obstruction. For benign lesions, surgery is the therapy of choice. Certain benign tumours have a high risk of malignancy, whereas others can have locally damaging characteristics and malformations. Author(S) Details Ranbir Kumar Pandey Department of ENT, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India. Dheeraj Kumar Department of ENT, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India. Nisha Shrivastava Department of ENT, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India. Nishant Kumar Department of ENT, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India. View Book:- https://stm.bookpi.org/NHMMR-V1/article/view/6175

[borobudurnews]

Anggota Komisi IV DPD RI Temui Ganjar Pranowo, Ini yang Dibahas

Anggota Komisi IV DPD RI Temui Ganjar Pranowo, Ini yang Dibahas

BNews– JATENG– Sejumlah anggota Komisi IV Dewan Perwakilan Daerah (DPD) RI berkunjung ke Jawa Tengah, Senin (7/2). Kunjungan dilakukan terkait rencana perubahan undang-undang nomor 1 tahun 2013 tentang Lembaga Keuangan Mikro (LKM). Rombongan dipimpin oleh Wakil Ketua Komite IV DPD RI, Casytha A Kathmandu. Pertemuan juga dihadiri Kepala OJK Jateng, jajaran OPD Pemprov Jateng dan perwakilan LKM di…

[phgq]

Cebu City public hospital starts receiving out-patients

#PHnews: Cebu City public hospital starts receiving out-patients

CEBU CITY – The Out-Patient Department (OPD) of the new building that houses the Cebu City Medical Center (CCMC) is now operating in full swing and already accepting patients who are seeking medical consultations. Mayor Edgardo Labella said via social media on Friday that Cebuanos will start enjoying the amenities of the OPD with much ease and convenience after years of making do with the temporary facility of CCMC inside the Bureau of Fire Protection compound in this city,   “While we are working very hard to complete the facility, the city government is making sure that we can already accommodate more patients and provide them with the much-needed medical services,” Labella said. He said that consultation services offered in the OPD include internal medicine, general surgery, pediatrics, obstetrics and gynecology, and general dentistry. It is open from Mondays through Fridays from 8 a.m. to 5 p.m. He reminded patients seeking OPD services to observe the minimum health protocols such as wearing of face mask and face shield and physical distancing.  Situated at the ground floor of the just recently inaugurated hospital edifice, the new OPD boasts of a spacious reception area that ensures adherence to Covid-19 (coronavirus disease 2019) physical distancing protocol in the middle of a continuous flow and outflow of people. A triage section greets healthcare seekers to assist them in determining the right kind of services they need.  Patients’ personal details are electronically processed and stored in the registration room. The new building was constructed after its original structure with a 300-bed capacity was damaged by the 7.2 magnitude earthquake in October 2013. (PNA)

***

References:

* Philippine News Agency. "Cebu City public hospital starts receiving out-patients." Philippine News Agency. https://www.pna.gov.ph/articles/1129775 (accessed February 06, 2021 at 02:17AM UTC+14).

* Philippine News Agency. "Cebu City public hospital starts receiving out-patients." Archive Today. https://archive.ph/?run=1&url=https://www.pna.gov.ph/articles/1129775 (archived).

[intervantional]

Non Surgical Treatment in India

Non Surgical Treatment in India

Dr. Ajit Yadav

MBBS, DNB, FVIR, EBIR, Consultant, Department of Interventional Radiology, Secretary, ISVIR; President Elect, IRIA Delhi

Dr. Ajit K Yadav is a consultant at the Department of Interventional Radiology, Sir Gangaram Hospital, New Delhi. After receiving a medical degree at the Pt BDS PGIMS, Rohtak, he served as a medical officer at a rural government hospital for 6 months. He completed residency training in radiodiagnosis at Sir Gangaram Hospital. He was nationally board-certified in 2011 and went on to complete a fellowship in Interventional Radiology at GRIPMER, Delhi. He also visited MD Anderson cancer center, in Houston, Texas, USA for a short-term fellowship in 2013. He attended a short training program on TACE at Seoul National University Hospital, South Korea in 2014. Dr. Yadav’s clinical interests include uterine artery embolization for minimally invasive treatment of uterine fibroids and post-partum hemorrhage, prostatic artery embolization for BPH, Bronchial artery embolization for hemoptysis, minimally invasive oncologic interventions (including transarterial chemoembolization, radioembolization, and radiofrequency tumor ablation), ablation for thyroid nodules, and lymphatic interventions. In addition, he offers minimally invasive procedures for various diseases like Varicose veins, Liver diseases, and traumatic bleeding.

His research interests include the interventional treatment of liver malignancy, a topic on which he has written peer-reviewed publications, Non Surgical Treatment in India. He has authored more than 30 papers in the field of Interventional Radiology. He has also presented his work at numerous national and International meetings. In addition to clinical activities, he is an active teacher of residents including Interventional Radiology fellows.

He is a member of several professional organizations, Indian Radiological and Imaging Association (IRIA), the Indian Society of Vascular and Interventional Radiology (ISVIR), and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE). Currently, he is the secretary of ISVIR and President Elect of IRIA Delhi.

Who We Are ( Interventional Radiologist )?

Interventional Radiology utilizes minimally invasive procedures that are image-guided, to diagnose as well as treat patients in nearly every organ system. These procedures have less pain, minimal complication rate and less recovery time in comparison to open surgery.

The Department of Interventional Radiology was established in 2006, at Sir Ganga Ram Hospital by Dr. Arun Gupta. Our department is well developed with our own IR OPD and IR Angio-Suite(Cath Lab). All in-patients who undergo any kind of IR procedure are monitored daily, during morning and evening rounds, Non Surgical Treatment in India.

Innumerable non-vascular procedures including FNACs, Biopsies, Percutaneous drainages (PCD) are carried out both on OPD and on in-patient basis. In addition, PTBD (Percutaneous Trans hepatic Biliary Drainage), Biliary Stenting, stone removal (Hepaticolith), PCN (Percutaneous nephrostomy) and Ureteral Stenting are also performed commonly under local anesthesiaor sedation.

As far as vascular procedures are concerned, all kinds of Embolization: BAE (Bronchial Artery Embolization for hemoptysis (coughing of blood), Renal Bleed Embolization & GI (gastro intestinal) bleed embolization are performed commonly. Basically, these are the procedures to stop/control bleeding from the concerned site and are thus carried out on emergency as well as elective basis.

We are also one of the very few centers that perform lymphangiography and thoracic duct embolization for lymphatic leaks.

Stenting for bowel ischemia, peripheral arterial & venous disease and TIPSS (Trans jugular intrahepatic portosystemic shunt) for recurrent and non-resolving ascites orhematemesis (vomiting of blood) are also carried out commonly by our team.

Obstetric & gynecological procedures including UAE (Uterine Artery Embolization) for Fibroids / adenomyosis and PPH (excessive bleeding after delivery) are also performed by our team. We also offer treatment options for infertility including Fallopian tube sclerotherapy for hydrosalpinx before IVF and varicocele embolization.

Oncological Interventions are an important part of our department. We perform pre-operative embolization for a variety of tumors along with Trans-arterial chemo and radioembolization (TACE/TARE) for liver tumors- HCC and hepatic metastasis. Percutaneous ablation of liver tumors, bone tumors and thyroid nodules is also performed routinely, using MWA (microwave ablation) and RFA (radio-frequency ablation).

Other procedures performed in our department include PAE (prostatic artery embolization) for BPH (benign prostatic hyperplasia) and GAE (genicular artery embolization) for pain due to osteo-arthritis and ablation for thyroid nodules.

In addition, we also perform musculoskeletal (MSK) interventions including pain management and minimally invasive interventions for sports injury. These include interventions for spinal pain (disc prolapse, facet arthropathy), vertebroplasty for vertebral collapse, joint and soft tissue injections (including PRP) for common diseases like osteoarthritis, Rotator Cuff tear/tendinopathy, Lateral epicondylitis (Tennis Elbow), Carpal Tunnel Syndrome, tendon tears, Achilles tendinopathy and plantar fasciitis. We also perform image guided nerve blocks, treatment for headache and cancer related chronic pain.

Training (fellowship) of interventional radiology residents had been started in our department in 2013. In addition, DNB super-specialization (DNB-SS) in IR (Interventional Radiology) was started for the first time in Gangaram Hospital in our department, from 2019.

Our team consists of renowned,dedicated & well-traineddoctors including Dr. Arun Gupta – Chairperson & senior consultant, Dr. Ajit Yadav – Consultant and Dr. Raghav Seth – Associate Consultant, along with Fellows, DNB registrars and Senior Residents. Regular academic sessions including seminars, journal clubs & case discussions are carried out in the department (thrice a week).

Our department is also involved in academic research & we have multiple publications in national & international journals, Non Surgical Treatment in India. IR procedures have become an integral part of medical care with IR Physicians increasingly taking on a clinical role. We hope to expand & develop the department further.

To schedule an appointment with Dr. Ajit Yadav, please contact:

Name: Interventional Radiology India

Address: Sir Ganga Ram Hospital, Old Rajendra Nagar, Delhi - 110060 India

Phone: 011 42251897, +91 - 9958474870

Website: www.interventionalradiologyindia.com

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Charlie's Animal Rescue Centre (CARE) https://charlies-care.com/ WELCOME TO CHARLIE’S ANIMAL RESCUE CENTRE Charlies Animal Rescue Centre – CARE established in January 2013, initially on half an acre of land adjacent to the picturesque Jakkur Lake, later moved to a larger place at Mitteganahalli, Yelahanka. The inspiration behind the trust, is 15 year old Charlie, a differently abled, 3 legged Indian Dog who was an established figure in the field of canine therapy since 2005. Charlie passed away in March, 2017, but has left behind a legacy that the CARE shelter aims to live up to through rescue and rehabilitation of animals in need. The Care Shelter is also home to animals of all kinds which includes dogs, cats, guinea pigs, rabbits, pigs, ducks and a calf. These animals are permanent residents of CARE due to their varying needs and special conditions – blindness, differently abled, paraplegic,serious ailments, aged and who require constant care, medical attention and love. These animals will live at CARE for the rest of their lives. CARE Shelter Facilities Helpline & Ambulance service for animals in distress from 9am to 5pm. Inpatient facility for sick and injured animals A fully equipped medical unit with OPD, Operation Theatre, X Ray, Scanning facility and Laser Machine. Housing, rehabilitation and re-homing of abandoned animals Adoption of pups, kittens, dogs, cats, rabbits & guinea pigs. An exclusive Cattery with a separate Cat treatment unit and kitten nursery. Holiday Boarding facility for dogs and cats. Visit Us Take a tour of the shelter and spend time with our permanent residents. Request a visit form for corporates, groups and schools Hours Monday – Saturday, 11:00am – 4:00pm Sundays 11:00am – 3:00pm Address Charlies Animal Rescue Centre – CARE Survey No. 124, Mitteganahalli Cross, Kogilu Village, Yelahanka Hobli, Bangalore North, 560064 #adoptnobuy #refugioanimal #adoptar #adopta #dog #cat #animalsanctuary #animalshelter #donate #adoption #adoptions #puppies #kitties #adoptme #animallivesmatters https://www.instagram.com/p/B_s2e6aHF-Y/?igshid=1qc2xlq49ipjs

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Medicare for All? For More? Here is How Medicare Works?

Medicare for All? For More? Here's How Medicare Works As Democrats grasp growing the government medical coverage program, we took a gander at what it takes care of and costs. It's a long way from "free." Medicare, the government medical coverage program for individuals who are 65 or more established, has moved toward becoming something of a panacea in the Democratic presidential race. A few competitors, including Senators Bernie Sanders and Elizabeth Warren, need to offer it to everybody and even grow its advantages. Others, similar to previous Representative Beto O'Rourke, need to give it naturally to individuals who don't have other medical coverage. Many, including previous Vice President Joseph R. Biden, need to give individuals the privilege to get tied up with a Medicare-like general health care coverage program. Whatever their positions, Medicare is the thing that the vast majority of the up-and-comers are holding up as a model for all inclusive inclusion, an objective they all grasp. Medicare is well known among its 60 million recipients. However the program likewise has confinements. It is surely not "free." Co-installments can be high for certain individuals. Particularly for long haul hospitalization and a few drugs. Some Democratic recommendations, including those from Mr. Sanders and Ms. Warren, would change. That by taking out premiums and deductibles. And pay for the program rather with higher assessments. As the extension of Medicare turns into a battle season encouraging cry. We investigated what it resembles to be on Medicare now. Here are a few responses to essential inquiries. What precisely does Medicare spread? Are the advantages great? The advantages are thorough, however not comprehensive. A few proposition would grow them, yet Medicare partitions benefits into classes. One, Part A, covers inpatient care at emergency clinics and — with certain points of confinement — gifted nursing offices, where individuals frequently go to recuperate from damage or sickness. It likewise covers hospice care and, in certain conditions, home medicinal services. Another classification, Part B, covers regular checkups, outpatient methodology, and tests, some psychological well-being administrations, just as wheelchairs, walkers and other gear. Part D covers Physician recommended medications. Part C is a secretly run overseen care alternative called Medicare Advantage. What doesn't Medicare spread? Medicare does not cover glasses, essential eye tests, listening devices and most dental consideration. Baffling exclusions for some recipients; Who are at an age when they are bound to require these administrations. It likewise won't pay for consideration got outside the United States. In any case, by a long shot the most costly thing Medicare doesn't pay for is long haul care in nursing homes. Helped living offices or at home. A few people purchase long haul care protection or spend down their resources for meet all requirements for Medicaid. That covers nursing home consideration. A private room in a nursing home cost a normal of $100,375 a year ago; as per Genworth, a monetary organization. What amount does it cost? Section A normally has no month to month premiums; (like Social Security, it's financed by finance charges all laborers pay). Yet it has a deductible of $1,364 per "scene of sickness". In addition to a fixed sum — as high as $682 every day; in the event that you go through over 60 days in the medical clinic. For Part B — specialist's visits and outpatient care — premiums depend on pay. The standard premium this year is $135.50 per month, yet money related assistance is accessible for individuals with low wages who don't fit the bill for Medicaid, the administration wellbeing program for poor people, which covers pretty much everything. More extravagant Medicare recipients — people with yearly salaries over $500,000 — pay $460.50 per month. Premiums are normally deducted from individuals' Social Security checks. Part B likewise has a deductible of $185 every year, and co-installments of 20 percent after you arrive at your deductible. Numerous individuals purchase supplemental "Medigap" protection to cover Medicare's out-of-pocket costs. Not at all like the Affordable Care Act plans, Medicare has no top on out-of-pocket spending, so the expense can climb very high for wiped out individuals. An examination by the unprejudiced Kaiser Family Foundation found that Medicare enrollees in reasonable or weakness spent a normal of $6,128 in 2013 or 47 percent of normal Social Security salary. Physician recommended medication expenses can likewise be high in Medicare, and they speak to one of the most unpredictable, befuddling portions of the program. Medicare Part D plans are controlled by private safety net providers. And the premiums cost $40 every month by and large this year, as per Kaiser. There are likewise yearly deductibles before inclusion kicks in. They are topped at $415 this year. In addition to copayments and coinsurance. However, on the off chance that your pay is low enough, you may meet all requirements for additional assistance paying for medications, and now and again, owe no premiums or out-of-pocket costs. More Information At that point, there is the feared "donut opening" — a hole wherein the Medicare medication plans don't pay for patients' drugs after they have spent a specific sum — this year, $3,820. By then, enrollees need to pay 25 percent of the expense of brand-name drugs, and 37 percent of the expense of nonexclusive medications, until their aggregate out-of-pocket spending has come to $5,100. When they hit that, they fit the bill for "disastrous inclusion," and just pay a little copayment for secured drugs for the remainder of the year. Kaiser as of late discovered that one million Medicare recipients had out-of-pocket spending over the disastrous edge in 2017, averaging $3,214. Currently, an Indian Healthcare company (Root India Healthcare) is working for OPD Health care for all program. Wherein a patient can get wide coverage of out-of-pocket expense in OPD treatment. You will be wondering, since it covers doctors fee, medicine and investigation too. What is Medicare Advantage? Medicare Advantage is an inexorably prominent option in contrast to customary Medicare. Favorable position plans are offered by private safety net providers. That have contracts with Medicare. These plans have no different advantages as customary Medicare, and regularly increasingly, for example, dental consideration or fitness center participations. Co-pays and deductibles shift contingent upon the arrangement. In contrast to conventional Medicare, all Medicare Advantage plans have limits — $6,700 this year by and large — on out-of-pocket spending. Medicare pays Advantage designs a fixed month to month total for every recipient. While in conventional Medicare; suppliers are paid for each administration dependent on a yearly expense plan. Thus, Advantage plans will in general use devices like pre-approval necessities and severe supplier systems to control costs. Those limitations can be a side road to individuals with a ton of therapeutic needs. A few information recommends individuals with Medicare Advantage will in general be more beneficial yet less rich than those with conventional Medicare. One thing is sure: the private plans are developing in prevalence. Around 33% of Medicare beneficiaries, or 22 million individuals, presently have them, up from 6,000,000 out of 2005. Could individuals pick any specialist they need? This depends generally on whether they have customary Medicare or a Medicare Advantage plan. Customary Medicare enables recipients to look for consideration from any specialist or emergency clinic in the United States. That acknowledges it and does not expect referrals to masters or earlier approval for administrations. Be that as it may, Medicare Advantage designs ordinarily have severe systems of restorative suppliers. That recipients need to utilize except if they are eager to pay more. Some Advantage plans may cover care outside the system; as per the Center for Medicare Advocacy, yet the out-of-pocket expenses; are commonly higher than for in-arrange care. Bit of leeway plans do cover crisis care outside their system. In the event that you are voyaging locally, for instance yet nothing else. Does each specialist and clinic acknowledge Medicare? No, yet generally do. As indicated by the government Centers for Medicare and Medicaid, 2,752 specialists and different suppliers quit Medicare in 2018 — a moment number considering there are more than one million rehearsing specialists alone. Therapists are the greatest classification of specialists who quit, as indicated by Kaiser. A little portion of specialists; Who acknowledge Medicare is designated "nonparticipating suppliers,". Which means they can charge Medicare patients higher expenses, up to a specific breaking point. The patients are in charge of paying everything past what Medicare pays — a training called parity charging. It is even rarer for an emergency clinic not to acknowledge Medicare, albeit some private mental or other strength medical clinics that oblige the affluent may not. Would you be able to advance a choice if Medicare will not cover an administration? Truly, albeit few individuals make this stride. At any rate as indicated by a report a year ago by the reviewer general at the Department of Health and Human Services. The report found that recipients and suppliers requested in excess of 863,000 refusals from 2014 through 2016. Just around 1 percent of the all out number of dissents during that period. In any case, their prosperity rate was high. About 70 percent of the interests were completely fruitful at the principal level. (there are five potential levels to continue engaging). As indicated by the report. Most were from suppliers with respect to installments that had been denied. No patients in regards to administrations that had been denied.   Read the full article