Tertiary institutions, both public and private, play a vital role in global socio-economic development through the production of human capacity. However, an area of research that has gotten relatively little academic attention in the Ghanaian higher education milieu is private universities' strategic responses to their financial sustainability. The purpose of this study, which used an exploratory research methodology, was to examine the various sources of income generation by private universities and strategic responses adopted to sustain their financing in Ghana. With an incorporated case study design, the study used a qualitative research methodology. The main findings, which were supported by data from semi-structured interviews conducted in five private universities and documentary evidence, showed that the primary source of pressure on private tertiary institutions comes from the limited funding that prevents them from achieving their missions. The findings also showed that private universities had taken certain strategic steps to counteract the effects of their restricted funding. The options highlighted included sustaining tuition fees through an aggressive admission strategy, income diversification strategy by expanding non-traditional sources of income, commercialising, and research. For the universities, cost-cutting through increased budgetary efficiency also represented a more important strategy. Although private universities in Ghana continue to haphazardly rely on inadequate funding, the survey found that they are actively engaged in numerous varied and alternative income-generating activities in order to survive.

The current study offers empirical evidence on the association that exists between the audit firm size and earnings management based on a sample of 64 manufacturing firms that are listed with the Amman Stock Exchange (ASE) from 2017 to 2021. From the results of the study, there is a significant negative association between the audit firm size and earnings management. These results have implications for policy makers and regulatory bodies in Jordan since they highlight the need to improve the good corporate governance practices and attempt to constrain the incidence of earnings management in Jordanian firms.

This study investigates whether earnings management is influenced by the audit committee characteristics. This study uses a secondary-data and the population study's consists of all industrial firms listed on Amman Stock Exchange (ASE) over the period 2009-2013. Using a random effect panel data model, the results reveal that audit committee independence and audit committee financial expertise are negatively associated with earnings management at significant level. Moreover, the results indicate that a significant relationship between audit committee size and earnings management but positive direction. These results have implications for policy makers and regulatory bodies in Jordan since they highlight the need to improve the good corporate governance practices and attempt to constrain the incidence of earnings management in Jordanian firms.

E-marketing is a tool that helps companies do business online. This is one of a number of strategic and operational tools that businesses have found to be beneficial. E-commerce has been effectively implemented in several industrialized nations for a long time. Electronic marketing is becoming a critical component in many western companies. penetration in underdeveloped nations like IRAQ is still trailing behind developed ones like the United States. E- marketing and telecommunications satisfaction research is lacking in the Arabic nations, and in Iraq in particular, according to the findings of the study. The goal of this empirical study is to examine Iraqi individuals' satisfaction with and their willingness to do transactions through this E- marketing and telecommunications. Based on this study's findings, the sample's perception of privacy is the most relevant factor. Iraq's E- marketing is nevertheless hampered by a slew of obstacles (including those related to e-payments, technology, law, culture, and trust, among others). Iraqi policymakers may use the findings of this study and other studies to better understand how E- marketing is spreading and being regulated in the country.

The Local Government Act 936 of 2016 and the Public Financial Management (PFM) Act 921 of 2016 enjoins district assemblies in Ghana to publish financial records by disclosing auditor general reports on their accounts and financial statement on various platforms accessible to the citizenry. The study examined the extent to which financial accountability and transparency levels within the Metropolitan, Municipal, and District Assemblies (MMDAs) in Ghana influence performance. SmartPLS 4.0 was used to test the research hypothesis. The results established the existence of positive influence between financial accountability and transparency on performance. The implication is that for the MMDAs to promote a higher performance, they must do well to entrench their accountability and transparency practices.

Covid-19 pandemic has affected the overall structure of the education system, it forced them to change the traditional methods we use for teaching and also the methods we use to analyze them i.e. offline exam. These changes are so sudden that we don’t have proper time to plan them; we have to act instantly and shift everything in online mode, even the paper exams. Due to this sudden transition not only colleges and schools have to face problems, students also have to face lots of problems. In this paper, we try to cover all the problems which are faced by the students and college administration during online exams by conducting a small survey. For conducting a survey we design certain fictional parameters like: Student Insight, Student’s educational attainment, Unfair Means, Staff Insights, Validation and Verification, Graphical User Interface Design, Technical Issues.

Introduction. One of the functions of the kidneys is as excretion function, especially electrolytes such as magnesium and chloride. Magnesium functions as a protein metabolism as well as the synthesis of mitochondrial ATP and has an important role in catalyzing more than 300 enzymatic reactions in the human body including protein synthesis, nerve and muscle transmission, and neuromuscular conduction. Chloride's function is currently unclear, but it can be identified that apart from being an acid-base balance and gastric acid, chloride is also important as a potential development of the membrane in muscle fibers. Regular hemodialysis patients always complain of muscle weakness which can be caused by muscle atrophy, muscle myopathy, reduced activity or a combination. Compared with normal patients muscle strength in regular hemodialysis patients can occur weakness Method. This study is analytical with a cross-sectional retrospective design. Data were analyzed after distribution test, then mean difference and correlation test was using the SPPS program where p <0.05 was considered statistically significant. Results. This study showed not significantly for Magnesium and Chloride with muscle strength in Patients with Regular Hemodialysis. Conclusion. Not significant association of changes Magnesium and Chloride levels to Muscle Strength for Pre and Post Regular Hemodialysis patients.

Background: Benign paroxysmal positional vertigo (BPPV) is the most common vestibular disorder. Several studies have shown that comorbid hypertension can affect the prognosis of BPPV. This study aims to assess the comparison of clinical improvement in BPPV patients with and without hypertension. Method: This research is an analytical study with a cohort design. The research was conducted at the Neurology Polyclinic of RSUP Haji Adam Malik Medan for the period of October 1, 2019 to December 1, 2019. A total of 40 BPPV patients with and without hypertension were taken into the study sample, using consecutive sampling technique. For 7 days recurrence was recorded and on the 7th day, BPPV symptoms were reassessed with the Dix-Hallpike maneuver. Furthermore, statistical analysis was performed using the Mann Whitney U test and Kruskall Wallis test. Result: Of the 40 research subjects, there were 29 more women (72.5%) and the highest age was in the range> 40 - 60 years as many as 23 subjects (57.5%). It was found that 6 people (30.0%) BPPV patients with hypertension and 17 people (85.0%) BPPV patients without hypertension experienced positive clinical improvement, while 14 people (70.0%) BPPV patients with hypertension and 3 people (15 , 0%) BPPV patients without hypertension experienced negative clinical improvement (p = 0.001). Conclusion: There is a significant difference in clinical improvement between BPPV patients with and without hypertension.

Background: Inflammation plays a role in the pathophysiology of cerebral ischemic and also an initial response to brain injury. Inflammation involving Blood and Brain Barrier disturbance, leukocyte infiltration, endothelial cells activation, oxidant and inflammatory mediator buildups which can develop rapidly within hours and can cause secondary injury to brain tissues Objectives: To determine the correlation between Neutrophil-to-Lymphocyte Ratio (NLR) and High Sensitivity C Reactive Protein (hsCRP) with severity and outcome in acute ischemic stroke patients Methods: This study used a cross-sectional design approach. Sampling was done at H. Adam Malik General Hospital Medan and taken as many as 38 subjects. NLR and hsCRP were examined on the first day of admission. Severity was assessed by using the National Institutes of Health Stroke Scale and the outcome was assessed by using the Modified Ranking Scale on the first and fourteenth day of admission. The data analysis used the contingency coefficient correlation test and gamma test. Results: Demographic characteristics of the subjects are; the average age is 62 years old, the highest educational level is high school graduate, and the most occupation is unemployed. There is a positive, moderate, and significant correlation between NLR and severity of acute ischemic stroke (r=0.511; p=0.001). There is a positive, moderate, and significant correlation between NLR and the outcome of acute ischemic stroke (r=0.463; p=0.001). There is a positive, very strong, and significant correlation between hsCRP and severity of acute ischemic stroke (r=0.896; p=0.001). There is a positive, strong, and significant correlation between hsCRP and outcome of acute ischemic stroke (r=0.624; p=0.001) Conclusions: There is a positive and significant correlation between NLR and hsCRP with severity and outcome in acute ischemic stroke patients.

Introduction: xerosis cutis is a disorder of the skin surface due to reduced fluid or oil content in the skin that moisture on the surface of the skin layer decreases. Proteinuria is a risk factor for the progression of nephrotic syndrome. Nephrotic syndrome if there is proteinuria (≥40 mg / m2 / hour or protein / creatinine ratio ≥ 200 mg / mL or protein + 3 on urine dipstick test), hypoalbuminemia (<25 g / L) and edema. Objective: To determine the relationship between xerosis cutis and the degree of proteinuria in children with nephrotic syndrome. Subject and Method: This is is a cross-sectional analytic study, involving 50 subject xerosis cutis with nephrotic syndrome patients. Kruskal Wallis test is used to determine the relationship xerosis cutis with proteinuria degree in children with nephrotic syndrome. This study has been approved by the Health Research Ethics Commission of the Faculty of Medicine, Universitas Sumatera Utara/ H. Adam Malik General Hospital Medan. Result: Based on the characteristics of 50 research subjects, the age of all research subjects has a median value of 8 (3-16) years with the most age range at the age of 6-10 years, as many as 26 subjects (52%), male subjects as many as 34 subjects (68 %) and women as many as 16 subjects (32%). The duration of nephrotic syndrome has a median value of 2 (1-7) years. There was a significant skin dryness relationship based on the degree of proteinuria (p = 0.002). Thus it can be concluded that the higher the degree of proteinuria, the higher the level of dryness of the skin and the greater the degree of proteinuria in children with nephrotic syndrome, then indirectly describe the more protein that is wasted through urine. Conclusion: There is a significant xerosis cutis relationship based on the degree of proteinuria (p= 0,002).