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Modern World education pays more attention towards children where their perceptions, education, and reasoning got more prominent position. This 21st century’s educational system wanted emotionally and psychologically better and strong child that can only be achieved through better upbringing. Scholars defined term Upbringing as, the treatment and instruction received by a child from its parents throughout its childhood. In the whole process, educationists had adopted Children centric approach where their upbringing and socialization has more importance. But Islam as a religion got the child centric system much before where Prophet (ﷺ) trained child as a better citizen, problem solver, follower of moral values and also a better Muslim who can better serve society. Similarly, by taken various examples of upbringing of children by Prophet (ﷺ), one will be able to find out that, upbringing of children is also the duty of Parents as well as teachers as profession of teacher is also related to prophet hood. Therefore, teacher has a responsibility to play a role in inculcating high qualities in children. Similarly, the training of parents is very important for children’s upbringing. The article gives a research review of children’s upbringing in Islam by having precedents from life of Prophet (ﷺ). However, this research article also proposed that teachers and parents should play their constructive role in the development of positive behavior in children.

Objective: To analyze the frequency and nature of after-hours calls to endocrinology fellows and employ interventions to direct appropriate care to primary endocrinologists. Methods: The on-call fellows logged calls that came to them during the after-hours and marked them as urgent or nonurgent. We analyzed these calls and then implemented interventions to educate patients on calls that can wait until the next business day. We also trained providers to provide script refills during clinic visits and educated fellows on how to best manage and document these after-hours calls. Results: From July to August 2017, 100 calls were logged. The average number of calls per 24 hours was 1.61, and 47% were marked nonurgent. From January to March 2018, the fellows logged 0.64 calls per 24 hours, and 51% were logged as nonurgent. Most of these calls were for insulin and testing supply refills. Conclusion: Many after-hours calls to the fellows were nonurgent and could have waited until the next business day. Our continuing interventions aim at improving both physician and patient satisfaction, as well as patient care.

Introduction: Peri-operative glucose control improves patient outcomes. Most of the evidence for this stems from cardiac surgery where insulin management protocols are well developed. Guidelines for peri-operative insulin management in the ambulatory setting are fraught with significant variation in recommendations. Our study analyzes patterns of peri-operative insulin adjustment at our institution and attempts to identify predictors of hypo- and hyperglycemia. Methods: We identified patients with any form of diabetes on basal insulin, who underwent elective non-cardiac surgery over a 5 months period at our institution. Data regarding demographics, baseline diabetes control, peri-operative insulin changes, fingerstick glucose values on day of surgery and complications were abstracted through a chart review supplemented by a patient phone call. Primary outcome was glycemic control on day of surgery and secondary outcomes was self-reported complications postoperatively. Results:A total of 100 patients were included. Fasting hyperglycemia (Fingerstick glucose >140mg/dL) was noted in 42% of patients on day of surgery. Younger age (p=0.04) and longer duration of surgery (p=0.01) were found to predispose patients to hyperglycemia. Glycemic outcomes were also studied based on timing of basal dose, total daily insulin dose and pre-operative dose adjustment. The majority of patients who took an evening dose made no adjustments (73%) while those with morning dose typically held their dose on the day of surgery (77%). We found no statistically significant difference in risk of hypoglycemia or hyperglycemia attributable to pre-operative insulin adjustment. Severe fasting hyperglycemia (Fingerstick glucose >250mg/dL) was noted in 10% of patients, of which 50% required inpatient admission for glycemic management. The majority of the patients who had severe hyperglycemia had a hemoglobin A1c of more than 8.4%. Fasting hypoglycemia (Fingerstick glucose 8.4% could benefit from stricter control to minimize risk of severe hyperglycemia. Coordinated team efforts between endocrinology and anesthesiology during pre-surgical evaluations can benefit patients.

Pheochromocytomas are rare tumors that arise from the adrenal medulla, with an incidence of less than 1 per 100,000 person-years. These tumors are characterized by excess catecholamine secretion and classically present with the triad of headaches, palpitations, and sweating episodes. However, the clinical presentation can be quite variable. Herein, we present a patient who presented with persistent fevers. An adrenal mass was incidentally discovered during the extensive investigation for the fever of unknown origin. Consequently, blood and urine tests were done and found to be consistent with a pheochromocytoma. The resection of this pheochromocytoma resulted in resolution of fevers. It is hypothesized that fevers in patients with pheochromocytomas occur due to the excess catecholamine or possibly due to interleukins. This clinical presentation serves as a learning point that adrenal incidentalomas in the setting of fever of unknown origin should not be ignored. It also reminds clinicians that pheochromocytomas which present with fevers may have tumor necrosis and many such patients are at risk for multisystem crises.

Background. While 2% of all extranodal Non-Hodgkin Lymphomas present in the thyroid, there exists insufficient data to describe the incidence of mantle cell lymphoma in the thyroid. A case series of 1400 patients revealed that Patient Findings. A 65-year-old female was referred for a multinodular goiter. Multiple fine needle aspirations from the dominant right nodule were consistent with Hashimoto’s thyroiditis and flow cytometry was negative. Due to progressing dysphagia, she underwent total thyroidectomy.Summary. Pathology revealed MCL with mantle zone growth pattern in the right thyroid. Flow cytometry showed monoclonal B cells comprising 9% of total cells. The Ki-67 index was 10%. She was diagnosed as having stage IIE MCL and offered conservative management by medical oncology, given that she had no B symptoms.Conclusion. Though chemotherapy is the treatment of choice in MCL, a subset of patients with low-grade disease may be observed. As in our patient, mantle zone growth pattern and a Ki-67 index < 10% suggest a favorable prognosis. A diagnosis of primary MCL in the thyroid remains rare and staging modalities as well as treatment options continue to evolve.