A Study of the Teaching-Learning Challenges of the 21st Century at University ELT Classroom

With the increased anticipation of a university degree as a requirement for workforce entry, the criticism of business leaders, and the general public, it becomes critical for institutions of higher education to know what they are offering students, especially the English language and how well this subject is being presented. Therefore engaging and preparing students for life after school is a great challenge to teachers and institutions. Through the implementation of new tools and practice, this study was designed to explore the teaching-learning challenges of the 21st century at the university ELT classroom. The researcher administered a questionnaire to 171 students and 40 faculty members from three universities in Erbil, Kurdistan Region of Iraq. Statistical Package analyzed the data for Social Science, including Descriptive statistical analyses such as the mean and standard deviation, also Pearson Correlation and ANOVA test to compare the groups' responses. The results showed that learning a second/foreign language collaboration skills while in the classroom inside universities is one of the suitable ways for learning in current time. Also, students in universities have been able to assess their collaboration skills when working via group effectively and positively effect their learning of the English language. Finally, the students have tried to develop their skills by using technology as a tool for learning; this is showing as finding in this study that the availability of tools or technology devices positively and effective factor for students to learn second/foreign language and skills in their universities

PROTON PUMP INHIBITORS AND THE RISK OF CHRONIC KIDNEY DISEASES: A CRITICAL REVIEW

Proton pump inhibitors (PPIs) are most widely used medications for acid related gastrointestinal disorders. Accessible evidence based studies suggest that the increased use of PPI is linked to a greater risk of developing kidney diseases. This review aims to determine the association of kidney disease with the use of proton pump inhibitor with various study designs. PubMed, Scopus and Google Scholar databases as well as a reference list of relevant articles were systematically searched for studies by using the following search terms; ‘proton pump inhibitors’, ‘acute kidney injury’, ‘chronic kidney disease’ and ‘end stage renal disease’. Both observational and randomized controlled trials (RCTs) exploring the association of PPI use with kidney disease were eligible for inclusion. A total of 8 articles, including 9 studies (n = 794,349 participants) were identified and included in the review. Majority of the studies showed a higher risk of kidney outcomes in patients taking PPIs, with effect higher of acute kidney injury (4-to 6-fold) compared with chronic kidney disease and end stage renal disease (1.5-to 2.5-fold). However, the studies suggest that the strength of evidence is weak and could not prove causation. The risk increased considerably with the use of high dose of PPIs and prolonged duration of exposure necessitates the monitoring of renal function. Exercising vigilance in PPI use and cessation of proton pump inhibitor when there is no clear indication may be a reasonable approach to reduce the population burden of kidney diseases

Medial epicondyle fractures in children: a study of functional outcome of surgical fixation

Background: Medial epicondyle fracture is a common elbow injury in children. It is associated with elbow dislocation in many cases. Treatment of displaced medial epicondyle fracture with and without elbow dislocation is a debated topic. Surgical and non surgical methods are practiced with variable results.Methods: Our study was a prospective study of medial epicondyle fractures treated by surgical fixation with k wires. We studied total of 24 cases out of which 15 had elbow dislocation. The study period was from 2012 to 2015 and indications for surgery were displacement more than 5 mm, elbow instability, incarceration of fragment, ulnar nerve irritation. Open reduction and internal fixation with K wire done. We used joystick method while reducing the fragment with k wire which was a great help. We assessed the cases using mayo elbow performance score.Results: Our study yielded excellent results in 92% of patients (mayo elbow performance score >90). There was no major difference in clinical outcome between two groups of patients. Complications like instability and non-union not seen following surgical fixation with K wires. The mean loss of flexion, extension, supination, and pronation was 4, 5, 3 and 2 degrees respectively with elbow dislocation group and 2, 3, 1, 1 in without dislocation group. Pre op instability seen in 54% patients was absent in follow up period. Stiffness was more in elbow dislocation group but overall performance was almost equal.Conclusions: Surgical fixation of medial epicondyle fractures yields excellent results and may be advisable when indicated

Simulation of flow over stepped and traditional spillways

There are several challenges that are faced by these structures, such as cavitation and high speed of flow during the dissipation of flow energy. The spillway is one of the key basic elements of dams that are utilized to pass huge volumes of discharge. The current work used computational fluid dynamics (CFD) to numerically estimate the water surface flow and pressure distribution over stepped and traditional spillways. The numerical findings were compared with experimental data using the Renormalization group k- model. The numerical and experimental data have been compared, and it has been determined that there is an acceptable agreement between the two sets of findings

Paediatric forearm refractures- management and outcome: a prospective study

Background: Forearm fractures are one of the commonest injuries accounting for 40% of paediatric fractures with a refracture rate of nearly 5%. Forearm refractures are increasing probably due to poor bone mineralization as a result of decreased physical activity, Vitamin D deficiency. These are treated by conservative measures with closed reduction and casting or by surgical fixation with flexible nails or plates. There are no definitive guidelines for management of forearm refracture and implant removal.Methods: The study is aimed at the epidemiology, methods and difficulties of management and functional outcome of forearm refracture treatment. A prospective study of all the cases of forearm refracture who presented to our institution from 2010 to 2016 with refractures treated either by conservative methods or by IMN. All cases were followed up for 2 years and functional outcome was assessed serially according to price et-al criteria.Results: Our study contained 17 males and 8 females between 6 years and 14 years. 76% refractures occurred before 16 weeks and majority had only tricortical union at this time. 42% patients underwent surgical fixation following refracture. Price et al criteria showed excellent results in 72% of patients.Conclusions: Forearm refractures in children can be treated both conservatively and surgically like a primary fracture depending on the indications but needs 2 to 3 more weeks of immobilization. A good functional outcome was obtained in majority of the cases. We suggest using splints till quadricortical union is achieved to prevent chances of refracture

Outcomes of transnasal endoscopic repair of cerebrospinal fluid leaks: a prospective cohort study

Abstract Background Although cerebrospinal fluid (CSF) leak repair of the anterior and middle skull base defect by endonasal endoscopic surgery (EES) presents one of the more difficult challenges, it has shown high success rates with less morbidity. Our objective is to evaluate the outcomes of transnasal endoscopic repair of CSF leak regarding success rate, impact on olfaction, and sinonasal function. Methods A prospective cohort study was conducted to evaluate the CSF leak repair outcomes related to the site, size of the defect, surgical techniques, and the materials that been used through Smell Identification Test (SIT), 22-item Sino-Nasal Outcome Test (SNOT-22), Perioperative Sinus Endoscopy score (POSE), and Lund-MacKay Scoring (LM) of CT scan. Results Twenty-one patients were enrolled in the study; 12 out of 21 were females with a higher prevalence of traumatic causes of 61.9%. Different techniques and materials were used for the repair with a success rate recorded at 90.5% after the first closure attempt. The mean standard deviation (SD) scores postoperatively (after 6 months) was markedly decreased in SNOT 22 with mean (SD) 5.55 ± 3.6, slightly increase in POSE (mean ± SD = 0.43 ± 0.6), and slightly decrease in SIT (mean ± SD =10.31 ± 4.7) and LM (mean ± SD = 0.57 ± 0.7). Conclusion Transnasal endoscopic CSF leak repair is an effective technique for skull base defect closure with a high success rate and no valuable morbidity to sinonasal function other than mild hyposmia in patients where nasoseptal (NSF) and septal flap have been used. Trial registration The study was approved by the institutional review board and ethics committee of (The Arab Board of Health Specializations) with order no. (453) on 1April 2018

On Generalized Permuting Left 3-Derivations of Prime Rings

-Let R be an associative ring. Park and Jung introduced the concept of permuting 3-derivation and they are studied this concept as centralizing and commuting. The main intent of this work is to generalize Park and Jung's results by introducing the concept of generalized permuting left 3-derivation on Lie ideal