Telehealth is an increasingly growing practice among physicians to provide service and consultations to their patients and is the practice of utilizing telecommunications technology to give medical advice and check up on the patient. This paper reviews the current state of telehealth and the benefits and disadvantages with the practice, and how new technologies and practices associated with telehealth are progressing and improving the practice. The impact of these advancements in telehealth that are highlighted are the access of healthcare and delivery through telehealth, their potential to reduce geographical and financial barriers to receiving healthcare, increasing patient engagement, and reducing patient mortality.

Background: Septic states (sepsis and septic shock) remain serious because they are lead to high mortality. Digestive origins are the second cause of sepsis and septic shock in the world.

Aim: To describe the epidemiological, clinical and evolutionary profile of septic states during perioperative emergency digestive surgery at the CHU-JRA.

Method: In a retrospective study, over a period of 36 months (January 2019 to December 2021), all patients over the age of 18, undergoing emergency digestive surgery, presenting with a septic state (perioperatively) were included. Excel® v2211software was used for data processing.

Results: Seventy patients were included, aged 41 [18-80] years, mostly men (sex ratio 1,7). Acute intestinal obstruction represented 52% (n= 42). The qSOFA score was used. The time to progression of the disease (from the appearance of the first signs until the date of consultation and admission to the emergency room) was less than 7 days in 46 patients. Firty-four patients were operated in less than six hours. Sixty patients were treated with dual antibiotic therapy, and 44 patients benefited of norepinephrine (0,3 [0,1-0,5] µg/kg/min) for 2 [1-3] days. On leaving the surgical emergency unit, 21 patients (27%) died of a state of septic shock.

Conclusion: Septic states are frequent in the perioperative of emergency digestive surgeries. Early diagnosis as well as rapid management are the criteria for a good evolution. An improvement in the quality of care is therefore necessary.

Keywords: Digestive system surgical procedure; Mortality; Sepsis; Septic shock; q-SOFA

     Introduction It is estimated that the number of dementia (Alzheimer's disease) patients worldwide will reach 16.2 million by 2050, and urgent measures are required. Prevention of dementia must continue from childhood to old age, and behavioral changes in lifestyle are important.

     At present, there is no effective method for all stages of Alzheimer's disease from the pre-MCI stage to all stages of Alzheimer's disease. In this study, we focused on autologous tissue regeneration of adipocyte-derived stem cells to investigate an effective method for all stages of Alzheimer's disease from the pre-MCI stage.

     Adipocyte-derived stem cells have the ability to differentiate into various cell types and are expected to be applied to tissue regenerative medicine.

     Therefore, we investigated whether adipocyte-derived stem cells are effective for all brain atrophy.

     Methods 5-10 g of subcutaneous adipose tissue was collected from the abdomen of the subjects, and mesenchymal stem cells were isolated and cultured from the adipose tissue. The cultured autologous adipocyte-derived stem cells were administered intravenously to the subjects and evaluated by VSRAD until 1, 2, 3, 4, and 5 months after administration.

     Results Both subjects (n=2) showed a trend toward maintenance or improvement as analyzed by VSRAD.

    Conclusion In this study, except for the administration of adipocyte-derived stem cells, the subjects were only instructed to maintain their previous lifestyle, and the number of subjects was small, so it is not possible to determine the effect of the treatment.

     However, the fact that improvement in brain atrophy was observed is a new finding.

Keywords: Alzheimer's disease; mild cognitive impairment; VSRAD; Autologous adipocyte-derived stem cells; regenerative medicine

Introduction: Tuberculosis is an infection caused by Mycobacterium tuberculosis. Its extrapulmonary forms are numerous.

Method: This was a prospective descriptive study, lasting four years, from 1 February 2019 to 31 January 2023, carried out in the paediatric department of the CHU Donka. Our study variables were epidemiological, diagnostic and therapeutic.

Results: During our period, we counted 27 patients. The age group 11-15 years was most represented 40.74%, with an average age of 8.4 years. The male sex was the most represented 62.96% with a sex ratio of 1.7. Fever largely dominated the reasons for consultation, 70.37%. Eighteen (18) patients out of 25 had been vaccinated with BCG (66.67%). The TST and GeneXpert were very decisive in the diagnosis and meningeal tuberculosis dominated the picture (22.22%). Our patients were all treated with anti-tuberculosis drugs and the evolution was favourable (77.78%), 5 patients had died (18.52%).

Conclusion: Tuberculosis remains a significant pathology in our department despite BCG vaccination at birth.

Keywords: Extapulmonary tuberculosis; Pediatrics; CHU Donka; Guinea-Conakry

     Although largely confined to Western countries in the past, breast cancer incidence is increasing also in developing countries. Recent rise in Asia breast cancer has seemed weighted toward the both young and elderly. If caught in early stages, breast cancer can be treated effectively. If caught late, it is often fatal.

     Breast cancer can present with lump that feels different from the rest of the breast tissue, swelling of the breast, nipple discharge, rash on the nipple, and pain in the breast.

     Knowledge among the general public has not risen as fast as incidence in the developing areas. There are lack of health education and misunderstanding.

     Breast cancer often present in late stage in developing countries and causes stigma.

     Early diagnosis is important. If identified early, cancer is more likely to respond to effective treatment with greater probability of surviving, less morbidity, and less expensive treatment.

Kawasaki disease is an acute multisystemic vasculitis affecting the coronary arteries. It is the leading cause of acquired heart disease in children. It is more common in boys than in girls with a ratio of 1.6. Diagnosis is clinical and treatment is with immunoglobulins associated with aspirin. We report a case in our department and our objective was to help better identify cases during paediatric consultations in our health facilities.

Keywords: Kawasaki; Paediatrics; Donka

Background: In a developing country such as India, most of the 620 million rural Indians lack access to basic health care facilities. Additionally, according to research from the Indian Institute of Public Opinion, 89% of rural Indian patients must travel more than 8 kilometres to receive basic medical care, and the remaining patients must travel even farther. Nearly 75% of the population of India lives in rural areas. Aims: The study's objectives were to assess the level of knowledge regarding telemedicine among health care workers, evaluate effects of nurse led education programme on knowledge regarding telemedicine among health care. Methods: An evaluation method and a quasi-experimental one group pre-test post-test research design were used to perform the study. A non-probability convenient sampling technique was used to select 108 healthcare workers for the sample. Self-structured knowledge questionnaires were distributed to gauge the level of telemedicine knowledge before and after the introduction of the nurse-led educational programme. To analyse the collected data, descriptive and inferential statistics were health care workers. Result: The pre-test and post-test knowledge scores differed significantly, as shown by the paired t-test value of 37.50. Therefore, a nurse-led educational programme may be a helpful way to improve healthcare workers' understanding of telemedicine, according to statistical inference. Conclusion: The introduction of Nurse Led Educational Program, according to the study's results, significantly improved topic knowledge.

Keywords: Effects; knowledge; nurse led education programme; telemedicine; health care workers

Background: Pregnancy and child birth are special events in women`s life and indeed in the lives of their families. This can be a time of great hope and joyful anticipation. The primary aim of antenatal care is to achieve, at the end of pregnancy, a healthy mother and baby. The quality of care is more important. Pregnancy requires specialized care generally agreed to preventive activity.

Aim: To assess the knowledge regarding management of anaemia in pregnancy among antenatal women attending antenatal clinic at selected hospital of Jamuhar, Bihar.

Objectives: To assess the level of knowledge regarding anemia in pregnancy among antenatal women and to find the association between the level of knowledge about anemia in pregnancy among antenatal women.

Methods: 60 antenatal women attending the antenatal clinic of Narayan Medical College hospital, Jamuhar, Bihar were selected using non-probability purposive sampling technique and were given self- reported questionnaire to assess the knowledge about anaemia in pregnancy.

Results: The present study highlighted that among 60 antenatal women, majority 24(40%) of them had inadequate level of knowledge, 34(56.66%) of them had moderately adequate knowledge and 2(3.33%) of them had inadequate knowledge.

Conclusion: This study concluded that most of the antenatal women had moderate level of knowledge about prevention and management of anaemia which emphasises the need for creation of knowledge among antenatal women to bring forth better maternal and fetal outcomes.

Keywords: Anaemia; antenatal women; knowledge on anaemia

Since variations in cortisol hormone indicate the level of stress in humans, numerous studies are conducted to reduce or increase stress levels when necessary. There are 19 participants in this study. A sequence of a movie is present to the participant in three audio situations, the salivary cortisol test is perform after the end of each situation, and the results are record. Finally, it was found that cortisol could be adjusted with the movie soundtrack at each stage.

Keywords: Salivary Cortisol; listening Habit; Soundtrack; Hormone

Agriculture has been primarily on viewpoints of biology; plants, soils, fertilizer (involving agricultural medicals), bacteria, and weather sometimes. Meanwhile, medical doctors and biologists have discussed medicines regarding the human body organs and medical treatments. Here we propose handling agriculture and medicine in viewpoints of biological physics through an elementary particle of pico-sized water. As a result, reduction (deoxidation) occurs for both a plant and a human body besides the effects coming from the small size. We propose to improve human health by drinking Agaricus treated with the pico-sized water. Furthermore, people after drinking Agaricus and the water can recover from uterine cancer and brain tumor. Furthermore, we discuss the mechanism remedy of health by the water.

Chronic Lymphocytic Leukemia (CLL) is the most common type of blood cancer to be found in adults. It mostly arises when genetic/epigenetic abnormalities accumulate in those cells of the bone marrow that are destined to become B cells. Though this disease may start in bone marrow, at a later stage it moves to the blood. This disease is not often so lethal as the other types of cancers. Based on the aggressiveness of the disease, CLL patients may be classified into three types: little greater than 33% (of the patients) are non-aggressive (NA-CLL), little less than 57% are partly aggressive (PA-CLL), 10% are aggressive (A-CLL) [4]. A NA-CLL patient of a particular age lives so long as the healthy individual of same age. A PA-CLL patient develops the disease slowly over a period of 5-10 years, after which the PA-CLL patient transforms to the A-CLL patient. The A-CLL patient lives up to a maximum of 3 years. The pathogeneses of the disease and the transcriptional signatures of the CLL cells are different in different compartments [5]. The CLL cells have been found residing in the following three compartments: the bone marrow (BM), the peripheral blood (PB), and the lymph node (LN). This editorial is focused on the prognostic data of paper [5], in the context of CLL. The paper [5] has studied the transcriptional dissimilarities and similarities of CLL cells in only the two compartments, PB and LN.

The coenzyme Q-10 is possessing antioxidant property, high degree of hydrophobicity and occurrence in biological system, it plays an important role in cellular defense against oxidative damage. The coenzyme Q-10 is mainly present in brain, kidney, heart and liver and it is indicated in the treatment of cardiovascular disease, neurodegenerative disorders, cancer, diabetes mellitus, aging, alzheimer disease and kidney disease. Figure. 1

     Coenzyme Q-10 is a fat soluble vitamin like quinone commonly known as ubiquinone, CoQ, Vit Q 10. It is used in the treatment of a variety of disorders primarily related to suboptimal cellular energy metabolism and oxidative injury [1, 2]. Coenzyme Q-10 or ubiquinone is ubiquitous in nature and is widely distributed in plants, animals and micro-organisms. Coenzyme Q 10 was first isolated in 1957 in beef mitochondria and is found in highest concentrations in tissues with high energy turn over such heart, brain, liver and kidney [3, 4]. The primary role of coenzyme Q-10 is to facilitate the electron transfer between redox components of electron transport chain in order to create a proton gradient across the inner mitochondrial membrane thereby facilitating the ATP formation [5]. Additional biological functions maintenance of membrane fluidity, recycling of radicals forms of vitamin C and E [6, 7]. It is most importantly antioxidant protection against membrane lipid peroxidation [8]. It is the only endogenously occurring lipid soluble antioxidant among all the coenzymes ubiquitously synthesized [9, 10].

Public health refers to health care and health promotion that are aimed at the general public. It is combined role of individual, group, community as well as the government and non-government organisations to promote public health and awareness. Our goal is to make the population healthier overall so they can live life to the fullest and contribute to the development of the nation. This will lessen the burden of sickness in the community and reduce the treatment cost on the hospitals. It will also sensitise the population and encourage people to choose healthy lifestyle.

     According to WHO, health isn't only in terms of physical parameter but also includes mental, social, and emotional health and wellbeing. All of these are interconnected and interdependent. While discussing public health, the related issues for example life style, diet, family environment, immunity, home remedies etc. need to be addressed for achieving holistic aspect of public health.

Feticide refers to the intentional killing of a fetus, while abortion refers to the termination of a pregnancy before the fetus is able to survive outside the womb. Abortion is a legal and widely practiced medical procedure in many countries, while feticide is illegal and considered a form of homicide. Feticide may be committed in the context of a criminal act, such as in cases of domestic violence or as part of a forced abortion. It's important to note that the laws and ethical considerations surrounding abortion vary widely across different regions and cultures, and opinions on the matter can be highly polarized. Some people believe that abortion should be legal and accessible as a matter of reproductive rights and bodily autonomy, while others view it as a morally reprehensible act that amounts to the taking of innocent human life.

Feticide

     Feticide refers to the act of intentionally ending a pregnancy by causing the death of a fetus. This can be done through various methods, including abortion, but it can also occur as a result of other actions that harm the developing fetus, such as physical violence or drug abuse by the mother.

     The procedure for feticide depends on the stage of the pregnancy, the reason for termination, and the laws and regulations in the region. In general, a medical professional will first assess the health of the mother and fetus and provide counseling on the available options for termination. The medical professional will then determine the appropriate method for termination based on various factors. Some common methods of feticide include medication, surgical abortion, induced labour and physical trauma. In the early stages of pregnancy, medication can be used to terminate the pregnancy. Medication-induced abortion typically involves taking one or more pills that stop the growth of the fetus or cause it to detach from the uterine wall. This method is usually performed in an outpatient setting and does not require anesthesia. For later pregnancies, surgical abortion or induced labor are preferred. A surgical abortion involves the removal of the fetus and other contents of the uterus through surgical procedures such as dilation and curettage (D&C) or vacuum aspiration. In some cases, labor can be induced in order to deliver the fetus. This method may be used in situations where a pregnancy has to be terminated late in the pregnancy due to medical reasons. In rare cases, feticide can occur as a result of physical trauma to the mother, such as from a car accident or physical violence. Feticide is a serious matter and should only be undertaken with the guidance of trained medical professionals in accordance with local laws and regulations.

The metals content of water from Dadi Kowa river at Gombe state, Nigeria were analyzed using an atomic absorption spectrophotometer (AAS). The result shows the metal content of samples as follows, Fe (0.582±0.131 mg/L), Zn (0.467±0.095 mg/L), Cu(0.153± 0.018 mg/L), Cd, Cr and Pb were below the detection limit. The mean values for some physiochemical parameters of the water samples are; temperature (27.80±0.8 °C), pH (6.4±0.3), TS (332.28 ± 19.64 mg/L), TSS (76.28±10.96 mg/L), TDS (256.17±21.64 mg/L), the concentrations of heavy metals in water samples were less than the permissible limit set by WHO.

Keywords: Heavy Metals; Atomic Absorption Spectrophotometer; Water; River

Glomus tumour which arises from the neuromyorterial glomus, it is a normal arteriovenous shunt. It is supplied abundantly with the nerve fibres and its main function is regulation of the temperature. The commonest site of the presentation is the subungal region. In this study we present a case of 21 year old female who presented with swelling over the second interdigital space of the right hand for past 6 months. Excision biopsy revealed gloms tumour.
Keywords: Glomus tumour; subungal

Introduction: within the framework of relations with technical scientific development, teacher training is to form values in students, based on the identification of problems and the search for solutions that must be solved where work constitutes the core for the formation of multiple qualities of the individual. Objective: to characterize the process of training in values of teachers in the professional technical training of nursing in the Teaching Clinical Surgical Hospital "Joaquín Albarrán Domínguez" of Havana in the period 2019-2020. Methods: descriptive study, between December 2019 and December 2020. Theoretical and empirical methods such as historical-logical, systemic-structural, documentary review, survey and interview, respectively, were used. In addition, descriptive and inferential statistical methods, in a universe of teachers of the Teaching Surgical Clinical Hospital "Joaquín Albarrán Domínguez" of Havana. The sample consisted of 18 teachers, once the inclusion criteria were applied. The variable studied was the training in values of teachers for professional technical nursing training. Results: the need for specific training for teachers for training in values in technical professional nursing training was verified, based on the introduction in their practice of strategies such as professional guidance, group learning and the use of participatory methods to transform this reality.
Conclusions: the process of formation in values of teachers for professional technical nursing training, which all teachers must keep in mind before their own work, the inescapable need to form values, it is necessary to create new methods of thinking and a new scale of shared values on which to build their own life through essentialities of theoretical and practical knowledge and consequently efficient performance in professional activity.
Keywords: Teachers; Enfermía; Socialaspects; Vocational training; Havana

The sustainable energy sources provide an alternative for generation of power for the upcoming generations due to the problem of reduction of the fossil fuels. This paper upgrades the usage of sustainable power hotspots for everyday applications. It includes the model demonstrating of a power maker utilizing wind as a significant origin of energy and piezoelectric cells as an arbiter way between the oscillator and load for converting mechanical oscillations into power. Additionally, it shows the variety in the power creation when contrasted with the regular level horizontal turbine structure. The model has been tried with a particular application indicating the viable power creation with the oscillatory wind based framework. Additionally battery has been utilized as an energy storage device, which gives the vitality if there should arise an occurrence of breaks from the source. The proposed model has likewise been tried with various breeze speed conditions, various loads ON, OFF conditions.

Keywords: Oscillatory Power Producer; Piezoelectric Cells; Battery

     Viral infections are common diagnoses in dental and maxillofacial consultations, both in adult and pediatric patients. There are multiple infectious agents, which will vary their clinical characteristics on occasions, and on others it will be complex for the professional to carry out a differential diagnosis due to the similarity of the lesions.

     There are conditions that occur sporadically in certain geographical regions and seasons of the year. Treatments can be differentiated in certain situations, but in most cases these nosological entities are faced with antivirals in the prodromal periods and in most cases the therapy is symptomatic. At present, what I call a pandemic of antimicrobial resistance has been triggered, given by the erroneous prescriptions of antibiotics in cases where there was no justified scientific indication; this is the case of viral diseases.

     The professional must do everything necessary to reach a diagnosis as accurate as possible, rely on complementary studies, and be oriented towards the main clinical characteristics of these diseases. To avoid the unnecessary and iatrogenic prescription of drugs, just to avoid the so-called "superinfections". Of course in the medical sciences the words always and never are dangerous, since nothing is so absolute in living beings. There may be cases of patients who, due to their immunocompromised systemic state, or due to being decompensated from an underlying disease, have infected the lesions caused by the virus and to avoid other complications, it is decided to insert an antimicrobial into the drug treatment. These cases are not the ones that predominate and in most of the patients that are applied, it is that the initial phase has already passed where the antiviral had a true curative action.

     In this chapter we will address the main viral lesions that produce different damages to the oral and maxillofacial complex, emphasizing the main risks and complications that can occur.

Nano Biotechnology is a fast-developing budding science. How the individual molecules are moving under the mutual gravitation effect of all the molecules in a nano contaminated droplet is the hot topic. Let’s study a bit more deeply into this subject. Until now nobody attempted to find the basic nature of intermolecular attraction forces. All the earlier scientists worked on measurement of value of intermolecular attraction forces. SITA simulations find that Newtonian Gravitation is necessary, appropriate, and sufficient for explaining the basic nature of intermolecular attraction forces between other molecules and H₂O molecules as defined by Multi Molecule theory. Two different cases are possible, one I when earth’s gravity is considered, and other case being when earth’s gravity not considered. Both the cases were worked out.

     The human face presents great variability, resulting from evolution, which allows each individual to be unique and easily recognizable, thus becoming one of the most important and natural means of transmitting individual information. Several male and female craniofacial differences can be observed, in particular the anthropometric distances of the lower third, whose distance between the subnasal and the lower border of the upper lip is on average 20-22 mm in women and 22-24 mm in men, and when this distance is greater than 15 mm, the lip is considered to be long. During the transition process, transgender individuals can opt for facial aesthetic modifications, seeking to increase the characteristics corresponding to their gender, that is, trans women seek to increase the femininity of their traits. The "lip-lift" procedure consists of the surgical removal of a tissue strip with the aim of minimizing the nasolabial distance, evertting the upper lip, showing a greater portion of the red lip, and increasing the exposure of the upper central incisors, enhancing female characteristics. the face. This work aims to present a clinical case on the lip-lift technique in the facial feminization of a transgender patient.

Keywords: Feminization; lip-lift; trangender patient

The case consisted of septicemia due to Burkholderia cepacia during hemodialisis. We reported a case of a 76-year-old Malagasy man with stage V chronic kidney disease, hemodialysis-dependent, who was admitted to the hospital for fever and chills during hemodialysis. Blood cultures showed Burkholderia cepacia. From this case, B. cepacia consisted of the main differential diagnosis of severe sepsis in dialysis patient. Such identifcation is necessary to help in timely diagnosis of hospital acquired infections and to provide appropriate antimicrobial therapy.

Keywords: Burkholderia cepacian; Sepsis; Chronic kidney disease; Dialysis

     Some readers will think that studying these issues can be useful for stomatologists, but parasitic diseases play a preponderant role in the causes of global morbidity. As an important subgroup of these diseases, it is worth highlighting the tropical parasitosis.

     That, although they are not frequent, when they occur they make dental procedures very difficult.

     A series of important aspects have made it not strange to diagnose these diseases in several countries. Among these we highlight: for us health professionals, the increase in international contracts, the extension of migratory movements from countries with a tropical climate to Western countries, the growing number of these areas as tourist destinations for citizens of the so-called first Western world, the success and boom in the use of immunosuppressive substances and the spread of infection by the human immunodeficiency virus (HIV).

Hemorrhage is defined as a profuse escape of blood from a ruptured blood vessel. This term is often associated with physical trauma and is responsible for 30-40% of trauma-related deaths with 33-56% of these occurring in the prehospital setting. Hemorrhagic shock is the second leading cause of preventable early deaths in injured civilian patients, and it is the number one cause of preventable death on the battlefield. The solution to this issue is achieving hemostasis in a timely manner. Hemostasis is the process that prevents blood loss following an injury. This process has three characteristics, the first is vasoconstriction, and the second is plug formation, which involves the collection of platelets to act as a physical plug to prevent blood from flowing. Last is coagulation, which is a cascade where a fibrin network is formed to act as a glue in holding the platelet plug in place. When an injury occurs, especially in the prehospital setting, a wound dressing is used to achieve hemostasis until a higher-level intervention can occur at a hospital. Currently, no out of hospital treatments that resolve the hemorrhage in non-compressible areas of the human body. Nanofibers can be used to mitigate issues that present with current treatment guidelines for bleeding in non-compressible hemorrhage. Previous studies have tested individual novel treatments for non-compressible hemorrhage and have tested against a control. This study aims to test eight of the novel interventions developed based on nanotechnology. This review compares these nano fiber systems using a porcine model with a splenic laceration in order to determine which is more effective in the management of non-compressible hemorrhage as measured by the time taken to achieve hemostasis and survivability.

SARS-COV-2 was identified in Wuhan city of China in December 2019, a new strain of the coronavirus family. There are no specific drugs available in the market and trials regarding the treatment of the COVID-19. Therefore, in silico screening for natural compounds was required to evaluate their antiviral effect. Molecular docking is the most common type of in-silico study which enables the visualization of binding conformation of ligand to target and produce quantitative in the form of binding energy. Remdesivir is the drug that showed promising results in some COVID-19 patients used as the control in the study. Ten medicinal plant active compounds were used to test their binding affinity towards the main protease and the spike protein using molecular docking. The results from molecular docking indicate that Andrographolide, Ellagic acid and Quercetin were able to fit into the binding pocket of the main protease and the spike protein of COVID-19 with highest binding affinity. The analysis obtained from molecular surface supports the postulation above. In conclusion, Andrographolide, Ellagic acid and Quercetin are shown to be ideal inhibitors compounds for SARS-COV-2. The ligands identified showed a promising result as an effective antiviral for covid-19 and it required further investigation in vitro and in vivo.

Rectal prolapse long time considered a benign pathology is sometimes accompanied by rare complications to know its strangulation associated with hemorrhage and necosis. In addition to these complications mentioned above, the presence of a rectal tumor made this pathology exceptionally. The aim of our study was to report the management of a case of rectal prolapse associated with a rectal tumor. This was a 62 year old female patient who reportedly consulted in the emergency department for not reducing externalization of a necrotic rectal prolapse with presence of localized tumor. Outside from a clinical and biological anemia, the rest of the examination did not notice any particularities. The rectosigmoidal resection with colo-rectal anastomosis accoding to the Altemeier technique had occupied a large place in the management.

Currently, palliative care has become very important in terms of increasing the quality of life of patients , and palliative care based on the Bow Ttie model has become particularly important in recent years. The purpose is the investigate the impact of early palliative care based on the Bow-Tai model on the quality of life of chronic patients.

Papillary carcinoma thyroid has an aggressive form which is follicular variant [2]. More commonly it presents with regional lymphadenopathy and extrathyroidal extension [1]. A 24year old patient presented with chief complaints of swelling in front of the neck for the past 5 years, patient noticed the swelling in front of the neck, insidious in onset, gradually progressed to attain the current size.Not associated with any pain. FNAC showed papillary variant hence hemithyroidectomy was done which later proved to be FVPTC in HPE.

It is possible to detect possible changes in the differentiation steps of progenitor cell clones in hematopoiesis with a target protein. In our study, PinX1 (PIN2/TRF1-interacting telomerase inhibitor 1), nucleostemin (guanine nucleotide-binding protein-like 3) expressions were determined in erythroid (CD71⁺), myeloid (CD71^-) cell groups obtained from two different healthy donors prepared for transplantation, chronic myelogenous leukemia cell line; K562 and acute promyelocytic leukemia cell line; HL-60, along with TERT (Telomerase Reverse Transcriptase) levels were determined and their relationships with each other were investigated. According to RT-PCR and TERT concentration results; PinX1 and nucleostemin expression in K562 and HL-60 cell lines were shown to be significantly higher along with TERT concentration. In addition, PinX1, nucleostemin expression and TERT concentration were found to be higher in the erythroid (CD71⁺) group obtained from healthy donors than in the myeloid (CD71^-) group. The findings of this study showed that there may be a relationship between PinX1 and nucleostemin and that PinX1 and nucleostemin could be targets in leukemia patients in prospective drug studies.

Keywords: PinX1 (PIN2/TRF1-interacting telomerase inhibitor 1); nucleostemin (guanine nucleotide-binding protein-like 3); TERT (Telomerase Reverse Transcriptase); Chronic myelogenous leukemia; Acute promyelocytic leukemia

Acute abdomen necessitates immediate attention and treatment. Acute abdominal pain (AAP) is responsible for 7-10% of all ED visits. Nonetheless, the epidemiology of AAP in the ED is poorly understood. 1 The purpose of this study was to look into the epidemiology and consequences of AAP in an adult population referred to an urban emergency department. An institution-based, cross-sectional study was done among patients admitted with abdominal discomfort from January 1^st to January 31^st, 2022. This research concluded with. Gall bladder pathology was the most common cause of acute abdomen. It was present in 30% of cases, followed by gall bladder pathology, acute gastritis, pancreatitis, ureteric calculi, mesenteric lymphadenitis, acute appendicitis, and pelvic inflammatory disease.

Sarcopenia is a state outlined by loss of muscle strength, muscle quantity, or function. Sarcopenia is usually seen in the elderly population, persons following a sedentary lifestyle, and individuals with inappropriate nutritional intake or absorption; hence sarcopenia was interchangeably used with frailty syndrome. It is quite often seen in chronic ailments, such as chronic liver disease, accompanying with a greater possibility of unpleasant clinical outcomes. Nutritional assessment plays a pivotal role in treatment planning, more so in patients suffering from chronic ailments. The traditional methods of nutritional assessment and sarcopenia have been widely subjective, while the objective measurement techniques, especially using computed tomography (CT scan) has been in vogue lately. Imaging of lean body mass (LBM), skeletal muscle index, anthropometric measurements such as “mid upper arm circumference (MUAC), and muscle strength” measurements together mark the gold standard for assessing sarcopenia.

Keywords: Chronic liver disease; Frailty syndrome; Nutritional assessment; Sarcopenia; Skeletal muscle mass

Rheumatoid arthritis (RA) is triggered by a series of immune responses to an acute inflammation. The failure of the initial immune response to control the inflammation leads to a chronic inflammatory condition. In which case the loop of positive feedback of immune cells is triggered. This abnormal immune response leads to its classification as an autoimmune disease. Mesenchymal stem cells (MSC) are a self-regenerative, multilineage stem cells that have an immunosuppressive nature. These qualities make them a great candidate for the treatment of autoimmune disorders, specifically RA. RA is a genetically inherited marker that cannot be changed. However, studying the immune response to this inflammatory condition along with the influence of MSC on immune cells can direct us towards a new regenerative drug that can reverse or antagonize the damage caused in advanced cases of RA can help in the.

     This year, we reported the reasons for continuing Omicron to collect information on amino acids associated with Omicron. We found the relationship between the number of atoms (C, H, N, and O) in the amino acids to the Omicron's characteristics. Following it, we discuss the many variants of the present Omicrons to analyze more kinds of amino acids. We estimate the mix of the present Omicron and its effect on other diseases like diabetes rather than the respiratory system at the beginning time. Based on this analysis, we found the developed water will give a particular resolution.

Games have been used as a part of teaching learning process in the ancient time, since 3500 B.C. Till now gaming was not officially incorporated in nursing curriculum in India but after 1980’s in European countries has been included video games as a substitute to conventional lecture method.

     Adopting a new strategy in methods of teaching is not so easy and many of the nurse educators are typically slow to adopt new innovations in curriculum, even though game-based learning (GBL) is considered to be easy and convenient for enhancing learning skills, decision making and developing critical thinking skills. Research findings had showed that video games in nursing education had reported many potential benefits to nursing students to enhance academic growth. The main aim of this review is to identify the advantages of GBL in nursing curriculum and to check how educational games are useful in this current scenario.

Stomas have been created by surgeons as a diversion of feces since the early 1800s. Morbidity and mortality related to stoma creation has progressively decreased with the advancement of modern therapy. Morbidity related to stoma was estimated between 2.9% to 81.1% in India [1]. Stoma complications, including skin irritation and leakage, dehydration from high output stomas, bowel obstruction, prolapse, and parastomal hernia are common impediments to this life saving procedure. Parastomal hernias are of an interest as their further management needs surgical intervention.

Liver disease itself profoundly affects level of nutrition and malnutrition is commonly observed in ESLD patients awaiting liver transplantation (LT) [1]. Malabsorption renders the cirrhotic patient unable to utilize the food taken completely. Malnutrition is a considerable challenge to control efficiently in cirrhotic patients, specifically as the liver disorder advances [2]. Clinical nutrition was focused on nutritional support in order to meet the patient’s requirements and has been progressed to nutritional therapy planned as per the patient’s medical diagnosis. Recently, physicians and nutritionists are giving more importance to immunonutrition and pharmaconutrition [3].

Patients waiting for liver transplant are faced with a variety of nutritional deficiencies and as liver disease advances, they might present with severe malnutrition, which enhances morbidity, prolonged hospital stay, increased infectious complications and decreased clinical outcome. Due to various metabolic alterations occurs in patients with chronic liver disease (CLD), it is a challenge to manage and maintain nutritional requirements to improve their outcome and survival as they are prone for micronutrient deficiencies along with protein calorie deficiency. Hence, it is vital to do nutritional assessment during their visit to hepatology clinic and plan diet plan accordingly. In this review, we are addressing about the nutritional issues frequently observed among cirrhotics and the usual nutritional assessment tools.

The global spread of malaria is a serious public health concern. Parasites belonging to the genus Plasmodium are responsible for this condition. Plasmodium falciparum and Plasmodium vivax are responsible for the vast majority of human malaria cases, however the former is the more dangerous species. During their blood stages, Plasmodium falciparum and Plasmodium vivax cause similar anemia. Nearly a third of all malaria deaths are attributable to severe cases of malarial anemia induced by P falciparum. Multiple factors seem to contribute to malaria-related anemia. Red blood cell clearance increases and bone marrow erythropoiesis decreases characterize this condition. Still poorly understood at the molecular level are the mechanisms that cause malarial anemia. Malaria parasite ligands have been investigated for their potential roles in the destruction of adult erythrocytes and the remodeling of younger erythrocytes. The risk of developing severe malarial anemia has been linked to polymorphisms in cytokines. It is believed that the goal of these cytokines and the "toxins" generated by malaria is to interfere with erythropoiesis. The inflammation brought on by malaria is likely to be exacerbated by co-infections, making malarial anemia more likely to develop [1].

Lung cancer is one of the leading causes of death in the US and is caused mainly due to smoking. The number of patients that suffer from non-small cell lung cancer is around 85% of the total lung cancer population. Traditional treatment methods use radiation, chemotherapy, immunotherapy, surgery, and/or a combination to treat lung cancer. The issue with these traditional drugs is the non-specific toxicity caused at other healthy sites which causes side effects such as nausea, hair loss, etc. New advancements in science opened an avenue called nanodrug drug delivery system to make therapeutics 1-100 nm in size to increase bioavailability and specificity. In this review article, we discuss a promising nanodrug delivery system, liposomes, to target NSCLC for its treatment.

The current FDA model of drug approval relies on determining the direct effect of treatment on outcomes of interest, including an evaluation of patient experience. The Cures Act (among others) that amends the Federal Foods and Cosmetic Act defines patient experience data as:

Recent years have seen the emergence of nanocellulose (NC), or cellulose in the form of nanostructures, as one of the most significant green materials now accessible. Due to their enticing and extraordinary characteristics, such as their abundance, high aspect ratio, outstanding mechanical capabilities, renewability, and biocompatibility, NC materials have garnered increased interest. This Review paper provides in detail information about the production method of nanocellulose, such as chemical methods, mechanical techniques, and from Feedstock for nanocellulose production. Each section includes a summary of the theme's related field and the most recent work done by the entities mentioned. Currently, on an industrial scale at tonnes per day, nanocellulose can be used in a various application in our daily lives, including tissue engineering, water purification, food packaging, Drug delivery, environmental protection field, electronic sensors, batteries, as well as in paper, polymer, medical, food processing industry, and more.

Admixtures of two relatively distinct populations; as a result of clashing, mixing, and merging; can drastically affect its population genetics. Studies have suggested that admixed populations are instrumental in establishing novel populations. Computer simulations is a common method to study population admixtures. Although it is plausible to study the emergence of novel populations from simulated admixed populations, studies in this area have been sparse. Here, we attempt to demonstrate the emergence of novel populations from admixed populations using simulation. Our results show that all admixed populations have the potential to result in the emergence of novel populations despite large majority (up to 90%) of one of the two source populations. The null hypothesis of no significant allelic changes can be rejected with a p-value of 5.3E-05. Therefore, our simulation study supports current studies suggesting that admixed populations are instrumental in establishing novel populations.

“Concept of Therapeutic Drug Monitoring: Need of the Hour in Indian Healthcare System”.

     Therapeutic drug monitoring (TDM) is defined as “the clinical laboratory measurement of a chemical parameter that, with appropriate medical interpretation, will directly influence drug prescribing procedures”.It is the clinical practice of measuring specific drugs/medicines at selected intervals to maintain a constant concentration in a patient's bloodstream, thereby optimizing individualized dosage regimens. Generally, in TDM amount of drug concentration will be measured by using a suitable analytical method and the dose and therapeutic range adjusted accordingly [1].

     Natural Language Processing (NLP) is a branch of Machine Learning (ML) that primarily aims to reduce the distance between human and machine capabilities. We focus on designing and building applications and systems in a way that allows an easy intersection between computers and natural languages developed for human use. NLP has been used in several areas within artificial intelligence (AI) and data processing application such as social media, translation, summarization, and medical applications. In fact, in the last decades, it has been exhaustively used in current technology to support spam email privacy, personal voice assistants language, translation application, and big data management. Although the medical field is one of the richest in terms of big unstructured data it has not been well invested so far. The analysis of medical data such as patient reports, doctor notes, patient demography details, lab test results, and previous medical history can be effectively examined through NLP. It can improve the treatment and patient service within a reasonable cost and time. NLP helps to train a machine to convert unstructured data into structured and can suggest a decision in the diagnosis process [1].

     Islet autoantibodies, Islet cell Ab, Islet cell cytoplasmic autoantibodies (ICA), insulin autoantibodies (IAA), glutamic acid decarboxylase autoantibodies (GADA/GAD), insulinoma-associated-2 autoantibodies (IA-2A), and zinc transporter 8 antibodies(ZnT8) are all considered to be diabetes-related autoantibodies to assist in the diagnosis of autoimmune type 1 diabetes and to forecast the onset of type 1 diabetes in close relatives of patients with the disease [1]. It is mainly utilsed when a patient is initially diagnosed with diabetes to help rule out autoimmune diabetes; when a person with non-insulin-treated diabetes has a lot of trouble maintaining glycaemic control (e.g., cannot maintain normal or near-normal blood sugar levels)[2].

WhatsAppitis, a condition caused by the excessive use of the popular instant messaging app, whatsappitis. It defines inflammation of the fluid-filled sheath that surrounds a tendon. Symptoms of tenosynovitis include pain, swelling and difficulty moving the particular joint where the inflammation occurs. Major clinical features are Pain at the radial side of the wrist, Spasms, Tenderness, occasional burning sensation in the hand, Swelling over the thumb side of the wrist, Difficulty gripping with the affected side of the hand, neck pain etc. Nursing fraternity must be made aware of the disease and nursing care that should be provided for the similar cases.

There is little research to improve and remedy of disease or sickness from the standpoints of biophysics. We report collaboration of oriental therapy of acupuncture and instrument using autonomic nervous system (Ryodoraku Autonomic Nervous System), and discuss the skin and figure pressure on tubo in viewpoint of electrodynamics leading to improve cerebral infarction. At the same time, we introduce water to the mechanisms of the electronic signals through skins and tubo, and water possesses the chemical-reducing ability with the pair of proton and electron. The patient of cerebral infarction has improved for walking without stick.

     The organism known as Mycobacterium tuberculosis, which was responsible for the development of tuberculosis was contagious through the air. Despite substantial efforts, tuberculosis continued to cause threat to the general public. The initial stage of tuberculosis called Latent tuberculosis could be prevented and controlled if being diagnosis early. Over the Years, Medical scientist, researchers and scholars have focused on the diagnosis and treatment of tuberculosis which has been the principal focused to prevent its spread. The disease have affected many countries including Saudi Arabia. Consequently, the implementation of comprehensive tuberculosis program that takes into account the management of latent tuberculosis infection illnesses among healthcare workers who have been reported to be at a higher risk for active tuberculosis than the general population would be important in curtaining the spread of the diseases. Therefore, the present research review the current diagnosis, treatment, prevention along with the negative medical and financial impact that the disease have on both the individuals and healthcare system. In addition to that, some suggestion and recommendation was provided as how the disease may be halted.

     This study aims to determine the factors associated with the presence of Aedes aegypti larvae in endemic and nonendemic areas of DHF in Biringkanaya District. The type of research used was observational with cross sectional design and through direct observation. The population is all houses in the Village of Pai and Kelurahan Daya. Determination of the sample was carried out by proportional simple random sampling method in order to obtain a sample of 100 houses each. Data analysis was carried out was univariate and bivariate with chi square test. The results showed that the related variables were the actions of PSN in endemic areas (p=0.025), water temperature (p=0.000), house humidity (p=0.000), container conditions (p=0.000) in endemic areas and (p=0.002) in nonendemic areas. Unrelated variables are knowledge (p=0.141) in endemic areas and (p=0.824) in nonendemic areas. The conclusion of this study is that there is a relationship between PSN action, water temperature, house humidity, and container conditions with the presence of larvae in endemic areas, but there is no relationship between respondents’ knowledge in the two regions and the actions of PSN in nonendemis areas.

     In order to find elucidations for intricate healthcare issues, artificial intelligence (AI) is nowadays becoming awidely recognized technique. This editorial focusing on the significance of AI in health care settings especially in nursing field [1]. Innovations in health care like launching of intelligent robots in patient care home settings have great impact in caring of patients. The definition of AI is “Artificial intelligence encompasses the techniques used to teach computers to learn, reason, perceive, infer, communicate, and make decisions similar to or better than humans” [2]. Everywhere, nurses are the major group of health professionals, accounting for approximately 40-50% of the health workforce.

Saudi Arabia has the second-highest rate of diabetes in the Middle East and the seventh-highest rate overall, according to the World Health Organization (WHO). As a result, Saudi Arabia is now ranked seventh in the world. Pre-diabetes affects an additional million Saudis, and it is believed that more than 7 million people worldwide actually have diabetes. It's arguably even more worrisome that diabetes has been on the rise in Saudi Arabia over the past few years. In fact, throughout the last three time periods, the rate of diabetes cases in Saudi Arabia has increased by a factor of about 10. Diabetes mellitus (DM) has been related to increased mortality, morbidity, vascular problems, poor overall health, and a lower quality of life. The prevalence of diabetes mellitus in Saudi Arabia is increasing at an alarming rate, making it a leading cause of several health problems and even death. The study, especially its incidence, prevalence, and socio-demographic factors, has been grossly inadequate compared to that conducted in industrialized nations. Without a comprehensive epidemic management program in place, with a strong focus on supporting a healthy diet, which includes exercise an active life, and weight control, the health burden caused by DM in Saudi Arabia is expected to increase to catastrophic proportions. A multidisciplinary strategy is required to properly manage diabetes in Saudi Arabia. Everything you need to know about DM in Saudi Arabia is included in this in-depth study. In this study, we examine the current diabetes epidemic and the detrimental consequences that diabetes complications have on both individuals and the healthcare system. In addition, the report suggests potential interventions to halt the pandemic.

     The anti-Bcl-2 therapy by the drugs like ABT‑263, ABT‑737, and ABT‑199 have been a hit in treating Leukemia. Similar success has also been reported for the treatment of Leukemia by monoclonal antibodies. Hence a certain study combined the anti-Bcl-2 therapy with antibody therapy in treating a particular Leukemia, the Double-hit Diffuse Large B-cell Lymphoma (DHL). The DHL cells overexpress Bcl-2 proteins. Hence the drug Venetoclax (ABT-199), which inhibits the anti-apoptotic activity of Bcl-2 proteins only, has been combined with either the Rituximab (anti-CD20 monoclonal antibody) or the Daratumumab (anti-CD38 monoclonal antibody) in treating the DHL cell lines CARNAVAL (CD20+) or WILL-2 (CD20-/CD38+). I analyze in depth the above work and draw fresh conclusions which the authors of the above work have not drawn themselves. Particularly I show in my work that it is the ABT-199/Bcl-2/Antibody/Antigen Complex which increases Antibody-dependent Cellular Phagocytosis in the combined ABT-199/Antibody therapy against DHL cells when compared with the Antibody-only therapy against DHL cells. This conclusion is currently of academic interest, but holds promise to improve treatments of B-cell malignancies with more fertile research in future.

Keywords: Apoptosis; Monoclonal Antibody; BH3 sub-structure; Bcl-2 protein; Rituximab; Daratumumab

Objective: Urinary incontinence (UI) is a common public health concern among women worldwide which can have an adverse effect on the quality of life (QoL). This study sought to explore the effectiveness of behavioral counseling in improving the QoL of Omani women with UI. Methods: This cross-sectional interventional study was performed between July 1st, 2019, and July 30th, 2020 at the Al Mabila Health Center, a primary health care (PHC) center in Muscat, Oman. A total of 20adult Omani women who screened positive for UI using a modified 4-item version of the Short-Form Urinary Distress Inventory were recruited. Four separate 40-60-minute counseling sessions were conducted over the 12-month study period, focusing on lifestyle modifications, bladder training, and Kegel exercises. A validated Arabic version of the 7-item Incontinence Impact Questionnaire was used to determine the pre-post intervention impact of UI on general QoL as well as four specific domains of living (ability to perform daily prayers, physical activities, social life, and mental health). Results: The behavioral counseling sessions had a significant positive impact on overall QoL (t19 = 12.03; p<0.001) as well as all four domains of living, including ability to perform daily prayers (t19 = 6.30; p<0.001), daily physical activities (t19=7.51; p<0.001), social life (t19=9.38; p<0.001), and mental health (t19= 18.38; p<0.001). Conclusions: This study provides evidence to support the impact of behavioral counseling in tackling UI as a public health concern in Oman. These findings may help to form the basis for implementing cost-effective health education and counseling programs at PHC centers in Oman in order to improve women’s QoL and other metrics of community health.

Posterior reversible encephalopathy syndrome (PRES) is a clinico-radiological syndrome characterized by a headache, seizures, altered mental status and visual loss and characterized by white matter vasogenic edema affecting the posterior occipital and parietal lobes of the brain predominantly [1].
We present here a young woman with altered sensorium, generalised tonic-clonic seizures in postpartum stage after massive blood transfusion. Reversibility of the symptoms and characteristic imaging findings led us to a diagnosis of PRES in our patient.

Forensic DNA analysis is frequently deployed in criminal investigations to discover illicit conduct. On the other hand, forensic DNA analysis is also utilized in civil procedures to determine the paternity of progeny over which there is a dispute. However, in addition to situations of inheritance, guardianship, maintenance, and validity, it may also be necessary to determine paternity in cases of adultery or fornication, as well as in cases of contested paternity arising out of divorce proceedings or questioned legality. Even if the child’s validity isn’t questioned, this is true. In a scenario in which the mother of the child feels that another person is to blame for her pregnancy, the objective of these investigations is to identify the guy who is the child’s biological father.

Biomedical waste (BMW) is a health and environmental problem. Also, a study was conducted to develop a biomedical waste management system whose implementation will improve public health, while respecting environmental, technical and socio-cultural concerns. This is a descriptive cross-sectional study which took place from January 16 to 31, 2021. Biomedical waste, in the same way as household or other type waste, is experiencing an ever-increasing production in all countries and their dangers increase in proportion to the quantity produced. Proper management of this type of waste, with a view to disposal that minimizes the risks to health and the environment, represents a high cost, which accentuates the problems in developing countries. However, the lack of means should not be used as an excuse for inaction and the health situation relating to biomedical waste could progress positively with a better awareness of local stakeholders and an improvement in their management. Indeed, hospital staff, patients and their families are likely to contract nosocomial diseases, while the general population is exposed to the dangers of DBM when consuming contaminated food, by inhalation, ingestion or through any type of direct or indirect contact with DBMs; this means that legal complaints about it are likely to increase over time.

The pancreas has two morphologically and functionally distinct compartments: one comprising the exocrine cells, and the othercomprising the endocrine cells [10]. The exocrine cells are the suppliers of various digestive enzymes to the upper small intestine through pancreatic duct, and the endocrine cells are the suppliers of various pancreatic hormones directly to the blood. Not surprisingly there are two broad divisions of Pancreatic Cancer (PC): the Exocrine Pancreatic Cancer, and the Neuroendocrine Pancreatic Cancer. The Exocrine Pancreatic Cancers are further divided into several sub-types that vary from each other histologically, and in symptoms and prognosis. Of these the Pancreatic Ductal Adenocarcinoma (PDAC), an Exocrine Pancreatic Cancer, is the most common amongst all the reported cases of PC. More than 90% of the PCs are found to be PDACs [12, 7]. From here on the term PC will be used to mean PDAC. PC is one of the deadliest cancers in the world because the PC is mostly detected when the tumor is not removable by surgery, and or the tumor has invaded the other organs of the body [9, 7, 3, 11].

Each drugs undergoes clinical trial phase before introducing into pharmaceutical market. Generally clinical trials involve a small number of patients who take the medicine for a short period. During this phase, patients are carefully selected and followed up very closely under controlled conditions. These initial trials will report only more common adverse drug effects. But the rare and long latency adverse drug effects can be reported only when the medicine is consumed by a large population [1]. In a real-life setting, a larger and more diverse group of patients will take the medicines. They may have co-morbidities and they may be taking other concomitant medicines also. Some less common or rare side effects may only occur once a medicine has been used for a long time or duration by many people. It is therefore vital that the safety of all medicines continues to be monitored while they are in commercial use. Information is continuously collected after the medicine is placed on the market to monitor real-life experiences with the product. The Commission on Human Medicines (CHM) and Medicines and Healthcare products Regulatory Agency (MHRA) encourage the reporting of all suspected reactions to newly introduced medicines to the market.

We think the disease not only aging, or gets worse during the aging process like degenerative diseases. Alzheimer’s is a typical one, and there are many diseases not known the causes, or not clear. We must consider not only instrument like X-ray and CT scanning, but also causative agents and its mechanism with biophysics. Here we discuss schizophrenia, clinical depression, and Alzheimer’s. In the viewpoint, we focus on the receptor and neurotransmitter. We regard the amino acids are arginine, dopamine, serotonin, and Gaba as the neurotransmitter and the cause. Furthermore, we propose the treatment of the disease from chemical bonding strength of the substances. The method is to use the water which can reduce the state of neurotransmitter and receptor with the pair of proton and electron in the hydrogen bond dissociated water.

Anaemia during pregnancy is a worldwide problem. Iron deficiency and folate deficiency are considered as two important causes for nutritional anaemia. During pregnancy there is an increase in the iron and folate requirements, therefore, the likelihood of presenting iron and folate deficiency is high, if there is no supplementation during pregnancy. The objective of this study was to evaluate the effectiveness of structured education with telephone support (SETS) on knowledge on anaemia among antenatal women. An Experimental pretest posttest control group design was used for this study in which 100 antenatal women of 20-30 weeks of gestation from antenatal outpatient department of tertiary care hospital were selected using consecutive sampling technique. A structured questionnaire to assess knowledge on anaemia was used. Structured education on first day followed by telephonic support once in 3 days for a period of 3 months for the study group and routine care for the control group was given. The study revealed around 50% of the antenatal women were anaemic and knowledge level improved after structured education with telephone support. Structured Education with Telephone Support had a positive effect on improving knowledge on anaemia among antenatal women. The nurses must conduct periodic analysis of antenatal women’s knowledge on anaemia and adherence to iron folate supplementation and educate them throughout their pregnancy period for their compliance with the medication.

Introduction: Stroke is a major public health problem in the world. In Madagascar, mortality from strokes is still relevant. Evaluating predictors of mortality would allow better treatment.
Methods: This is a retrospective, descriptive and analytical study of the records of patients admitted to the neurology department during the period January 2015 to December 2019. There have been 1,565 cases of stroke.
Results: The death rate from stroke ranges from 6% to 11%. Demographic characteristics are not predictors of mortality. Clinical features; especially the onset of complications are the predictors of death in stroke. Hemorrhagic stroke was a poor prognosis. Hospital stays of less than 10 days have been associated with mortality in patients with stroke. The NIHSS score has been a good prognostic tool for any type of stroke. For ischemic stroke, an ASPECTS score ≤ 7 was associated with mortality. For hemorrhagic stroke, the ICH score allows a good evaluation of the prognosis of these strokes.
Conclusion: The establishment of a neurovascular unit in the University Hospital JR of Befelatanana would help better manage patients with stroke and other cerebrovascular diseases. National stroke surveys are needed to better identify national priorities.

Paper deals with mental health of Children during lockdown where we are sharing our study-first author’s work, a voluntary organization working in Delhi, on the mental health issues of the school children and field work with school children on mental health narratives in pandemic. It finally concludes in discussion on the myths of our education system, digital divide in gender, DGs and EWS and camp model approach.

Introduction: Infant malnutrition is endemic in Chad. In 2018 in N’Djamena, the prevalence was 13.5%. This study aimed to identify factors influencing Severe Acute Malnutrition (SAM) in children under 59 months admitted to two Medical Feeding Centre in N’Djamena.
Patients and method: We conducted a cross-sectional, descriptive and analytical study of the files of children aged 6 to 59 months admitted for severe acute malnutrition in two feeding centre in N’Djamena, from September 2019 to February 2020. The files were selected randomly, and the study sample size was calculated using the Schwarz formula. Descriptive and analytical analysis was done using Chi-2 and binary logistic regression; a P value < 0.05 is considered statistically significant.
Results: Age 0-24 months (p = 0.001), breastfeeding mode (p = 0.027), early diarrhoea (p = 0.040), age of weaning (p = 0.013) and diversification (p = 0.034), self-medication (p = 0.047), and use of traditional care (p = 0.020) were significantly associated with SAM. The mother’s age and education level (p = 0.029) are also factors in the occurrence of SAM. Environmental hygiene and especially hand washing before feeding the child (p = 0.007) were significant for the occurrence of SAM.
Conclusion: Factors related to the mother, the child and the environment interact closely to lead to SAM in the child. Only concrete and multidisciplinary actions can overcome this problem.

Monkeypox is a zoonotic viral infection due to monkeypox virus, an enveloped double-stranded DNA virus, known as the very significant orthopox viral infection after the small pox is eradicated. The two distinct genetic clades of the monkeypox virus are the central African (Congo Basin) clade and the West African clade. The 2022 monkeypox outbreak in India is caused by the West African clade of the monkeypox virus [1]. The World Health Organization (WHO) announced it as a public health emergency on July 23 and it is clinically less severe than smallpox. The global cases of monkey pox reported in 2022 outbreak is 63,117 as on 14/09/2022 and in India 14 reported cases [2].

Despite serious safety concerns, Calotropisprocera is used for gastrointestinal disorders including constipation, diarrhea and stomach ulcers, even toothache, painful joint, cramps, joint pain and control parasitic infections like worms’ elephantiasis. The subterranean termites Odontotermesobesus is extremely invading wood pests that cause direct economic losses worth billions of dollars throughout the world particularly in humid and subtropic regions. Leaf extract of Calotropisprocera in two solvent hexane
and acetone, is used against workers of subterranean termites, mortality. LC50 and tunneling behavior of termites was observed at different concentration of 3%, 7% and 10% respectively and distilled water applied a control. Two solvent hexane and acetone is used for extraction. Data have been analyzed using software Minitab (version 16) at 5% level.

Research collaboration consists of researchers from various stature, funding status, nations and different organizations. Fundamentally, their collaboration provide mutual understanding, work towards mutually interesting and beneficial research. In today’s globalized environment, research collaboration is the foundation of the majority of studies. High research quality and fruitful collaboration go hand in hand. The foundation of collaborative research must be shared, up front expectations for the caliber of its outcomes. This is required to create a trustworthy research environment where everyone is willing to contribute and can benefit from the findings [1].

Termites are causing drastic economical loss as they attack on building, crops and wooden products. The reason of study was to evaluate the effects of biflex, commonly used pesticides in Pakistan to control the termite’s population. A comprehensive survey of laboratory was conducted using biflex, commonly used pesticide to control termites. The results regarding barrier efficacy of biflex in different soil. The aim of this research was to see how effective Biflex (Bifenthrin) termiticides are against a common termite species in the lab. Soil was taken from various locations and after analysis classified as sandy loam soil (SL) or clay loamy soil (CL). In laboratory bioassays, mortality and LC₅₀ values in treated soil were determined after 8 hours and after one month, depending on soil type and the result showed that Sandy loam soil (SL) are more effective than clay loamy soil (CL). Biflex was shown to be more persistent in both soils. Based on these results and the benefits of specific chemical could be effectively used for effective control of termites.

     The coronavirus disease 2019 (COVID-19) pandemic caused and is still causing significant mortality and economic consequences all over the globe. Till date today, there are four U.S Food and Drug administration (FDA) approved vaccines, Pfizer-BioNTech, Moderna, Janssen and Novavax COVID-19 vaccines. Also, the antiviral drug remdesivir and two combinations of monoclonal antibody treatments are authorized for Emergency use (EUA) in certain patients. Furthermore, baricitinib- immune modulator was approved in Japan (April 23, 2021) for certain hospitalized adults with covid-19. Despite available vaccines and EUA, pharmacological therapy for the prevention and treatment of COVID-19 is still highly required. There are several ongoing clinical trials investigating the efficacy of clinically available drugs in treating COVID-19. In this review, latest novel pharmacological agents for the possible treatment of COVID-19 will be discussed.
     COVID-19 vaccine is the most promising strategy to end the current pandemic in addition to anti- viral agents. Design of novel anti-viral agents which are specific for SARS-CoV-2 will provide more effective therapy for COVID-19 patients. Development of effective vaccines and anti-viral drugs both needs multidisciplinary cooperation. Before effective antiviral drugs for COVID-19 are available, current treatment options will come from repurposing drugs. Thus, in this review we aim to highlight potential therapeutic strategies from the viewpoints of clinicians based on updated clinical evidences, and provide a basis for future researches of effective antiviral therapies. In the future, the development of new drugs and vaccines relies on multidisciplinary cooperation among structural biologists, chemists, and medical doctors. A knowledge gap of pharmacology for COVID-19 is expected to be filled up.

It is always said that our continent is never ready for public health events. We weren’t at the time of the last Ebola outbreak in West Africa [1], and we weren’t at the beginning of the COVID-19 outbreak as well [2]. Despite the events we have experienced, the means invested, we are in an endless restarting. However, we have an obligation to learn from this COVID-19 pandemic, in order to sustainably strengthen our health systems. It is certain that a next public health event will happen, the question is when? Would we be ready? To answer yes, each country will have to implement at least the following ten actions.

Raising the discussion to participate in the evolution of a healthcare system that reflects the complexity and diversity of the modern integrated healthcare system in alignment with the community is well-documented. However, in this precarious hierarchical environment, there are necessary areas for improvement with respect to progressing the medical professional and key stakeholders beyond a paternalistic or traditional-minded practice. Integral to a synergy that will fuel the U.S. and global healthcare markets, this article aims to raise awareness for the audience through evidence-based materials about a paradigm shift in the operative definition of healthcare providers (ie clinical doctors) that has evolved to embrace four instrumental degrees within their respective fields of expertise, the MD, DO, DMSc (PA), and DNP (NP). Essential systematic changes serve to create parity amongst the aforementioned healthcare providers to maximize workplace diversification, inclusion, collaborative care, and professional satisfaction. All of which may translate to improved team dynamics, offset social determinants of health, and ultimately provide greater access to innovative and affordable quality care.

Orthopedic surgery is a vastly evolving field with an increasing number of publications introducing new implants and innovations each year.
Systematic reviews and metanalysis are also booming as it is accepted as the highest level of evidence hierarchy in prestigious orthopedic journal.
Orthopedic surgeons have been challenged by this large number of new publications to appraise this expansion and the increasing number of surgeons depending on systematic reviews as their primary sources. This is not without problems due to the fact that many surgeons do not have formal training in advanced statistics to critically interpret these results. The quality of systematic reviews can only be as good as the primary studies included. There is an increasing concern regarding the low quality of orthopedic primary studies as they may not hold significant clinical applications, which in the end will affect the quality of their systematic reviews and
meta-analysis [1-4].

Background: Several studies have examined the association between physical activity and body size globally. However, few researches has focused on this aspect in Morocco. The objective of this study is therefore to explore the level of physical activity and its association with certain anthropometric indicators of corpulence among Moroccan schoolers of Marrakech city and in the province of Al-Haouz.
Methods: A retrospective survey was performed using a questionnaire to examine PA behavior in 1173 high school students, aged 15 to 19 years. Measurements of the respondents ‘height and weight and body fat percentages using an impedance meter. The PA level was estimated based on the participants’ total daily energy expenditure.
Results: The survey data show that students spend, on average, 4 hours per day in front of a screen and only 63 minutes in a sporting activity and that 25% of students are moderately active while 20% are considered to be sedentary active. Averages of body mass index (BMI) and body fat are much higher in the sedentary group compared to the moderately active group, with differences in mean BMI and body fat respectively of 1.24 kg / m2 (F = 4.8; p = 0.009) and 1.62% (F = 3.79; p = 0.023) in boys, and 1.33 kg / m2 (F = 6.21; p = 0.002) and 2.48 % (F = 3.54; p = 0.03) in girls.
Conclusion: The present study results reveal further evidence of the need to promote physical activity among high school students.

Objective: This study was conducted to assess knowledge and attitude of clinical undergraduate students of physiotherapy in Nigerian universities towards palliative care.
Materials Method: This was a cross sectional survey involving 281 (132 females and 149 males) clinical physiotherapy undergraduates from 10 purposively selected universities across Nigeria. Palliative care knowledge was assessed with a structured questionnaire on palliative care awareness while attitude was assessed using FROMMELT attitude towards care of the dying scale (FATCOD). Both questionnaires were administered online via Google forms. Socio-demographic data of each respondent was also collected. Data were analyzed using descriptive and inferential statistics. Level of significance was set at p<0.05.
Results: Majority of respondents were males (53%), at 400 level (4th year) of study (50.9%), aged 21-25 years (87.9%), Christians (73.7%) and from south-western Nigeria (61.9%). Over 40% are from Obafemi Awolowo University and had above average knowledge (62%). Almost all, (99.6%) of the respondents displayed favourable attitude. There were significant associations between knowledge and university of respondents (p=0.001), attitude and age of respondents (p=0.003), as well as attitude and geopolitical zone of origin of respondents (p=0.006). There was significant correlation between knowledge and attitude of
respondents (r =0.441, p =0.001).
Conclusion: Clinical physiotherapy undergraduates of Nigeria Universities demonstrated above average knowledge, and positive attitudes towards palliative care which indicates better than inadequate basic palliative care knowledge among healthcare undergraduates in other climes. This suggest that Nigeria trained physiotherapists may provide satisfactory palliative care which can be improved with moderate post qualification training on the job in any part of the world. However, the knowledge gaps signify an essential need for inclusion, reform or improvement in palliative care education in the curriculum of undergraduate physiotherapy training in Nigerian universities.

Presentation at the brige and root of nose sometimes be a nasal glioma. One such case is presented so as to make nasal surgeon, general surgeon aware of this neurosurgical intity.

Background: The COVID-19 pandemic continues to spread around the world. The African continent did not remain. Senegal is one of the most affected African countries and has demonstrated its capacity to manage this outbreak. Our aim is to share the epidemiological aspects of COVID-19 and the strategy put in place during the first 6 months of evolution.
Method: All patients tested COVID-19 positive by RT-PCR were recorded during the first six months of the epidemic: from March 2, 2020 (date of the first case) to September 2, 2020, across the entire national territory. An analysis of the epidemiological data was carried out.
Results: With 13,826 positive cases recorded in six months, the impact was less than expected, with mortality not exceeding 2.08%. All regions of Senegal are affected, with the epicenter in Dakar, the capital. Male predominance is noted in the number of positive cases and deaths. The young population was the most affected with an average age of 41 years. Those over 60 years of age were the most vulnerable, particularly with cardiovascular co-morbidities.

An ethnographic study of folk dentists was conducted in Delhi. Ten case studies of folk dentists and their patients were analysed for various domains of content analysis (CA). Data were collected through mixed method of data collection with some basic research questions guide for the folk dentists and patients during the COVID-19 partial lockdown period in Delhi. The CA for primary cases, secondary cases and for patients was analysed for various domains. Results reveal various aspects of their practices and issues on roadside assets in clinic, health and hygiene, family traditions, pride in work, income/economics, duration of their practices and uncertainties. Similarly, patients were analysed for their views on cheap services, health and hygiene, easily approachable folk experiences and quality of services. The researchers illuminated the policy issues of folk or traditional dentists practicing in a metropolitan city and their patients’ perspectives for their dental public health concerns and have made some recommendations to their salient voice.

Background: The level of satisfaction of students under the Tertiary Institution Social Health Insurance Program (TISHIP) is a measure of the success of such scheme. However, valid assessment of the success of TISHIP by students requires good knowledge of its operational guidelines. This study accessed the level of awareness and perceptions of TISHIP students’ enrollees of the Federal Colleges of Education in the North Central geopolitical zone of Nigeria.
Methods: The study was a descriptive cross sectional investigation in which 188 selected participants completed self-administered semi-structured questionnaires, Student TISHIP Awareness, Perception and Evaluation Questionnaire (STAPEQ). Data collated was analyzed using descriptive statistics of frequency and percentages and inferential statistics of chi-square and P < 0.05 was considered statistically significant. Two research questions and two research hypotheses were raised and formulated respectively to guide to the study.
Results: The results show that an average of 75.55% of the students was fully aware of TISHIP objectives, 62.74% were aware of the benefits, 41.0% were aware of their responsibility. Many of them (69.2%) were not aware of the procedures to seek for redress when dissatisfied with services they received from their healthcare providers. 73.4% believed their healthcare providers operate in clean environment, 70.21% felt that doctors and nurses were cordial and friendly, 62.7% claimed to have experienced long waiting period before doctors/nurses consultations. 63.83% of the respondents agreed to be satisfied with the quality of service rendered by their healthcare providers. There were no significant differences in level of awareness and perceptions of the two groups of students on TISHIP operation and service delivery respectively.
Conclusion: The study therefore recommended more enlightenment of students on TISHIP operational guidelines in order minimize the level of their misgivings about the scheme. Moreover, government should employ more medical personnel especially doctors in order to solve the challenge of long waiting period before medical consultations.

     Since the early 90s, there has been an increasing interest in incorporating clinical outcome assessment (COA) in clinical trials to measure how a patient feels or functions when describing the treatment benefit (both positive or negative) of an intervention. In 2009, the FDA issued the Patient Reported Outcome (PRO) Guidance which lays out the criteria for establishing the ‘fit for purpose’ of a COA, if that COA is to be used along the regulatory pathway (i.e., support approval or labeling). The principles elucidated in the PRO Guidance establish the gold standard for incorporating a COA, and provides the basis for the reliability, validity and interpretability of the COA data collected from a clinical trial on a registration path.

A 72-year-old with high cholesterol levels (Hypercholesteremia) was advised to take Atorvastatin 20 mg (Atorva-20 mg) which led to constipation and abdominal discomfort. As management, the Atorvastatin was discontinued and replaced with Rosuvastatin. The symptoms of constipation were reduced after cessation of the suspect drug Atorvastatin. The possible mechanisms for the event were unknown but has some proposed mechanisms like1. Levels of Nitric oxide 2. Inhibiting the production of melvonic acid 3. Decrease in coenzyme Q10.

Introduction: Child marriage is any legal or customary union involving a boy or girl under the age of 18. The study we conducted aimed to assess the knowledge and practices of parents with regard to early marriage. Method and materials: This was an action research study that took place in three phases, the first consisted of an initial assessment to take stock of knowledge on early marriages and the development of the plan. of action. The second phase was devoted to the implementation of the action plan for improving knowledge about these marriages through information, education and communication sessions. Finally, the third consisted of a final evaluation to observe the evolution after the action plan over a period of four months from April to July 2017 in the urban municipality of Koniakary/Region of Kayes. 99 people participated in this study during the evaluations. Results: The most represented age group was 41-45 years with 40.3% of cases. The primary evaluation made it possible to identify shortcomings and relative exact answers were provided. This led us to have a great progress in the secondary evaluation: the knowledge on the age of the marriage evolved favorably because 78.8% thought that it was less than 14 years for the age of marriage at the beginning of the study against 10.1% at the final evaluation. The main reasons for these early marriages mentioned were the eviction of illegitimate pregnancies in 58.6% of cases. The decision makers in these marriages were the father and the other men in the family in 62.6% of cases. Conclusion: The decision-makers of these early marriages were male adults who did not know the age of marriage according to the texts in Mali nor the dangers that young people faced in early marriages. Thus the action plan that we have implemented has improved the knowledge of those surveyed in relation to early marriage.

Arnold-Forster et al have recently pointed out their concern for the progressive deterioration of the mental health of doctors and for the neglect or ignorance that the medical health organizations in which they work have for their affective problems. They point out several causal factors, not only for the mental suffering of doctors, but also for the fact that the following is not taken into account: 1) the idea of the doctor as an exceptional being in society, 2) the social conviction that they must deny themselves and give themselves to others, 3) the dominant concept that their mental health and all their affective problems are their own responsibility, signs of disaffection, and are not the responsibility of the system in which they work. This brings us back to the topic of “discomfort in medicine” that we have addressed earlier. We propose to frame the affective disorders and discomfort of doctors and their causes in a larger psycho-social-professional framework, which is multicausal, currently dominates Western culture and which results in the deterioration of human behavior. In medicine, this results in the dehumanization of medical care, patient care and the health of doctors. They are not isolated events, but dependent on each other. Mutual causality includes the effects of the exponential increase in knowledge in science and technology, the accentuation of medical corporatism, the fragmentation of medical assistance, and the almost total loss of the holistic conception of the patient.

Brunneroma (Tumor of the Brunner’s gland) is an uncommon tumor of the duodenum. They are, probably, not true neoplasms but hamartomas arising from Brunner’s gland and may represent a protective phenomenon against gastric hypersecretion. It presents with non-specific symptoms such as abdominal pain, nausea and bloating or gastric outlet obstruction. Usually, they are treated with endoscopic resection, with some lesions requiring surgical intervention. We present here a case of pedunculated poly of first part of duodenum which was consistent with Brunneroma on histopathology. Tumor of Brunner gland is known as Brunner gland adenoma. They are also referred to as Brunneroma or polypoidal hamartoma. These lesions are usually benign with a low malignancy potential.

Background: In the United States over 500,000 episodes of alcohol withdrawal require pharmacological treatment each year [1]. The medications for withdrawal treatment in the U.S. are benzodiazepines and barbiturates. Studies suggest these treatments are equivocal, [2] however, studies comparing outcomes of the two medications have been limited.
Objective: The primary objective of this study is to compare alcohol withdrawal treatment with benzodiazepine and phenobarbital medication classes alone or in combination in hospitalized patients in a 8 hospital community-based healthcare system.
Methods: This is a retrospective review of 1,602 hospital encounters with a principal diagnosis of alcohol withdrawal from 01/01/2018 to 12/31/2019. Encounters were evaluated for type of pharmacologic treatment, 30-day readmission rate, ICU admission, and intubation rates.
Results: When comparing the treatment groups, patients in the phenobarbital treatment group compared to the benzodiazepine group had a statistically significant higher admission to ICU at 42% versus 28% respectively (p=0.0160). Phenobarbital and benzodiazepines were not statistically significantly different in intubation rate (p= 0.3690) or 30-day readmission rate (p=0.8626). Rates of 30-day readmission and intensive care (ICU) admission were statistically significant between the three pharmacologic treatment groups (p<0.001) with the combination of phenobarbital and benzodiazepines demonstrating the highest rates of both.
Conclusion: In other similar studies [8-11], there are varied outcomes in relation to ICU admission, intubation and 30-day readmission rates when comparing benzodiazepines and phenobarbital. This study further demonstrates variation in these outcomes. Due to these substantial differences in outcomes when comparing phenobarbital and benzodiazepines, higher level studies are needed to provide conclusive evidence that phenobarbital is equivocal or superior to use of benzodiazepines for the treatment of alcohol withdrawal.

Aim: The research study aims to determine whether the integration between Military Medicine and Space Medicine allows clinicians to improve their scope of practice, casualty variety, and confidence in unexpected situations that may influence other medical specialties over time through the development of Space Warfare Medicine.
Methods: Methods chosen facilitate the search for specific literature that applies to Space Medicine or Military Medicine while also observing perspectives from clinicians in the respective medical specialties.
Results: The integration of Space Medicine into Military Medicine is essential in the medical community as demands increase for clinicians trained in both Emergency Medicine and Space Medicine practices with the development of the USSF and commercialized space travel. Furthermore, Space Medicine is still very dangerous and proves to be far more complex than other specialties in which clinicians have limited time to adapt at the point of injury where unexpected events are likely to occur.
Conclusion: The significance of the ability to adapt to adverse conditions as the main connection between Military Medicine and Space Medicine justifies Space Medicine’s high affinity with Military Medicine that other specialties may not match.

We take care of the water daily life, but people are no worried about in daily life. There is a few of research on the water as basic science. We study the fundamental theme in water, not H₂O itself, which is the item that many people focus on it. Water forms a cluster of five or more with hydrogen bonds. However, we are perspective what happens if we dissociate the bonding. We find two points: a particle and wave in quantum physics of the water after dissociating hydrogen bonds. As a result, the water’s information transfers through space and affects other substances. Then, we employ some equipment to elucidate the characteristics indirectly since we cannot directly observe not only H₂O itself but also the hydrogen bond-dissociated particle with instruments. So, we use the research with optical, electricity, and magnetics associated with nuclear magnetic resonance, superconducting quantum interference, far-infrared optical spectroscopy, and laser flash.

CCL2 and CCL5 are the two chemokines plentifully expressed in Breast Cancer (BC). Close associations between CCL2 and CCL5 have been hypothesized; and both have been demonstrated to confer metastatic potential to the BC cells. Hence understanding the biology of either will shed light on the other. And in this paper I choose to investigate the source of CCL5 (in BC cells). Pin-pointing the source of CCL5 will lead to focused therapeutic intervention against BC metastasis. Through the analysis of connections between CCL5 and Interleukin 8 (IL8), I hypothesize that the CCL5 in BC is platelet CCL5. As a result of this hypothesis Aspirin seems to be the focused drug against BC metastasis. But there are challenges with using this drug in BC patient who is also simultaneously not suffering from any cardiovascular disorder.

Fibrous Dysplasia in the head neck region generally have a predilection for the maxilla and the mandible. Presentation of FD as a paranasal sinus lesion is very rarely reported in literature. We present such a case of paranasal sinus FD discovered incidentally during the ENT examination in a patient presenting with mucosal disease of the middle ear.

Objective: This study was conducted to prospectively analyze the clinical features of hospitalized patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD), sputum culture and drug susceptibility results, and the use and efficacy of antimicrobial to guide the pathogens of AECOPD hospitalized patients. Learning judgment and choice of antimicrobial drugs.
Materials and Methods: A total of 327 patients with acute exacerbation of chronic obstructive pulmonary disease admitted to the Department of Respiratory Medicine, Jingzhou Central Hospital from January 1, 2018 to December 31, 2018 were enrolled. Among them, 46 patients were positive for sputum microbial culture, and 48 positive sputum culture results were obtained. The demographic characteristics (age, gender, BMI index), smoking history, acute exacerbation/year, mMRC score were statistically analyzed. CAT score, lung function index, presence or absence of respiratory failure, sputum culture type and drug sensitivity, antibacterial drug selection. All data were tabulated and divided into 2 groups according to the presence or absence of respiratory failure. The clinical data and etiology differences of the 2 groups were counted. According to the sputum culture, G-negative bacilli or fungi were divided into two groups, and the clinical data of the two groups were counted. The measurement data were mean±standard error, and the percentage was used. The statistical analysis was performed by Fisher’s exact test. The measurement data were analyzed by independent sample t test. The count data were analyzed by chi-square test. The P value was less than 0.05, which was statistically significant.
Results: A total of 327 cases were involved in the study, of which 48 were positive for sputum culture (46 patients). In the positive patients, 41 males (89.10%) and 5 females (10.4%) showed that males had higher prevalence than females. The most common age group is mostly 70-79 years old, with an average age of 73.08 years. During the follow-up, 8 people died in first year (58-83 years old, average 70.1 years old), and the mortality rate was 17.39%. Among the 46 patients, the available data were analyzed, BMI: 22.68 ± 0.67 (N = 28), AE / year: 1.82 ± 0.12 (N = 46), age (years): 73.52 ± 1.22 (N = 46), mMRC: 2.82±0.20 (N=28), CAT: 23.55±1.43 (N=27), FEV1:1.05±0.08 (N=28), FEV1%: 45.21%±3.29% (N=28), FVC: 2.25±0.11 (N=28), FVC%: 75.07% ± 3.4% (N=28). The most common microorganism in sputum culture was Candida albicans (50%), a total of 24 cases. There were 14 cases (30%) of bacterial infections and 34 cases (70%) of fungal infections. The most commonly used antibiotics for AECOPD patients are fluoroquinolones, followed by ceftazidime, followed by carbomycins, and antifungal drugs are most commonly fluconazole, followed by voriconazole. There was a statistically significant difference in the composition ratio between bacteriaand fungi between the first sputum culture and the non-first sputum culture (P=0.018), suggesting that the late stage of hospitalization was fungal infection. FEV1 and FVC between the respiratory failure group (14 cases) and the non-respiratory failure group (34 cases). AE/year was statistically significant (P<0.05), 2 groups. Candida albicans is the main pathogen in the patients. According to the pathogen, G-negative bacilli and fungi were divided into two groups. There was no significant difference in age, BMI, mMRC, CAT, AE times/year, FEV1 and FVC between the two groups.  
Conclusion: G-negative bacilli and fungal infections were the most common in male, elderly, and recurrent AECOPD hospitalized patients, with the highest incidence of Candida albicans infection. Fungi was main source of infection in the late stay after 5 to 7 days of hospitalization. Candida albicans is most common positive pathogen in hospitalized patients regardless of whether it is associated with respiratory failure. This suggests that our combination of antibacterial and antifungal drugs in clinical treatment, especially in the late hospital stay can benefit these patients.

Road safety is both a health and development issue of concern. Road traffic injuries are one of the leading causes of deaths, disabilities and hospitalizations with severe socioeconomic costs across the world and India in particular. As per the ‘Road Accidents in India 2020’, there were 3,66,138 unfortunate road accidents during 2020, which claimed 1,31,714 lives and caused injuries to 3,48,279 persons [1]. As per the World Health Organization, at least one out of 10 persons killed on roads across the world is from India and India positions first in the number of road accident deaths worldwide. The youth are particularly vulnerable on the world’s roads, and road traffic injuries are the leading cause of death for children and young adults aged 5-29 years [2]. The Ministry of Road Transport and Highways (MORTH) has considered road safety an issue of paramount importance. It has been taking proactive steps to address it by a technique called 4Es, Education, Engineering (of both roads and vehicles), Enforcement and Emergency care. Hence instruction and education to the adolescent and youth are of utmost importance to prevent road traffic accidents [1].

Various views on climate change exist. Many proposals to combat it also exist. Since I hold an unconventional view about the origin of life and the earth [1] some may wonder if I also hold an unconventional view about how to preserve the planet. My view on climate change and how to stop it is:

1.Cellular dust created the universe, the earth and the climate thereof

2.If scientists acknowledge the existence of the microzymas and learn to manipulate them we can terraform the planet to our liking

3.Since microzymas never die, if scientists fail to do the above earth could be ruined-however the microzymas will probably create another earth with new flora, fauna and man.

A documentary study was carried out with a non-probabilistic selection of sources indexed in international repositories, considering the year of publication and the relationship between the concepts of organization and human capital. The empirical test of the null hypothesis suggests the non-rejection of a significant difference between the findings reported in the literature with respect to the observations and analyzes carried out in the present work. It is concluded that the observed sample can anticipate a scenario of convergence between labor stigma and talents in their modality of human, intellectual and intangible capital in the organizations that were studied during the pandemic period from December 2019 to April 2022.

The paralysis of the foot elevators is a common condition with a variety of etiologies. The transfer of the posterior tibialis on the lateral cuneiform constitutes the surgical gesture of reference to compensate for the deficit of the elevators of the foot.
Objective
The aim of this work was to evaluate the result of the transfer of the posterior tibialis on the lateral cuneiform. 
Patients and Method
This was a descriptive retrospective study from January 2006 to December 2021. During the study period, we operated on 07 patients with paralysis of the foot elevators at the Regional Hospital of Kayes and at the University Hospital of Kati. The results were assessed according to the raising and maintenance of the plantigrade position of the foot.
Results
The use of the aforementioned judgment criteria allowed us to classify our Patients into four very good results, two good results and one poor result. The only bad result was hind foot varus with posterior tibialis side 4.
Conclusion
The transfer of the posterior tibialis on the lateral cuneiform ensures the effective raising of the foot. Postoperative rehabilitation is an integral part of the therapeutic protocol to restore the transferred muscle to its initial strength.

     Acute cholecystitis can now have an impact worthy of interest in black Africa, although it was considered rare in the past. Several surgical works currently published in Africa have demonstrated this.
     The objective of this work was therefore to determine the hospital frequency in the department of general surgery of acute lithiasic cholecystitis, to describe the diagnostic and therapeutic aspects, to describe the surgical follow-up and to evaluate the cost of management.
     This was a retrospective and prospective study that was carried out from 1 January 2016 to 31 December 2018 in the general surgery department of the Sominé Dolo Hospital in Mopti. It involved 46 patients including 16 men and 30 women with an average age of 50.64 years ± 14.97 and sex-ratio of 0.54, having been operated by intraoperatively confirmed acute cholecystitis laparotomy.
     The annual frequency was 15.33 cases/year. The defense sign in right hypochondrium was found in all our patients. Cholecystectomy was the rule of surgical treatment in the absence of the laparoscopy spine, and non-training of surgeons in coeliosurgery, all our patients were operated by conventional surgery. Antibiotic prophylaxis and antibiotic therapy were performed in all our patients. Vesicular bed drainage 45(97.8%) was the main surgical procedure associated with cholecystectomy Operative soot was simple in 84.8% of our patients. The morbidity rate was 13.04%; the mortality rate was 2.17%.
     The average cost of care was 129,800 FCFA (±9650 FCFA) ie 197.66 ± 14.69 euros.

Smoking has an adverse impact on several female reproductive life aspects, like oviducts function, uterus impairment, menstrual function disturbance. Moreover, smoking during pregnancy is a fundamental cause of health problems for both mother and fetus. It raises embryo implantation complexities associated with health conditions such as heart and cardiovascular diseases, pulmonary diseases, and hypertension. Smoking has an adverse impact on several female reproductive life aspects, like oviducts function, uterus impairment, menstrual function disturbance. Moreover, smoking during pregnancy is a fundamental cause of health problems for both mother and fetus. It raises embryo implantation complexities associated with health conditions such as heart and cardiovascular diseases, pulmonary diseases, and hypertension. Furthermore, several cigarette smoke compounds have toxic impacts on clinical IVF/ICSI treatment.

     Often is the case that researchers rely on just the statistical significance of the result in question to convey the study results to a broader audience, whether that is a publication or a presentation at a medical meeting. Ignored are the interpretation from the clinical perspective and the magnitude of the statistic in question.
     A noticeable misstep is the interpretation of the correlation coefficient, often times the researcher interprets the p-value and leaves it at that. Not discussed is the degree of association, whether there is no, weak, moderate, or strong correlation.
     The correlation coefficient measures the strength of association between two variables, or a single variable across time. There are many different ways to calculate the correlation coefficient depending on the distribution of the variables or the type of variable being analyzed. For example, the pearson correlation coefficient is calculated when the data are normal or the use of polychoric correlation to measure the strength of association between two ordinal variables.
     The statistic generally ranges from -1 to 1 with the sign indicating the direction of the association. While there are many different ways that one can interpret the magnitude of the relationship, in general, a coefficient that is equal to 0 indicates no relationship, and a coefficient of 1 indicates a perfect relationship-that is the two variables in question are redundant, and if both are included in the analyses will introduce multicollearnity. The absolute value of the correlation coefficient indicates the strength of the relationship, with the following gradient: |0| = none; |0.1-0.3| is weak, |0.3-0.5| is moderate, |0.5-0.7| is strong and |0.7-1.0| is very strong. The endpoints of each range are open, 0.299 will be considered as weak, and 0.30 would be considered moderate.
     It is important when conveying the results of the study that both the magnitude and statistical significance is presented. The magnitude and statistical significance has an important place in understanding the clinical value of the relationship.
     Another area where researchers often present just the statistical results is when presenting data on the minimum clinical important difference (also known as the minimum clinical threshold). This concept is important when presenting the results of any clinical outcome assessment (COA). COAs are defined as either CLINROS (a scale completed by the health-care provider after observing the patient); PROs (a measure about the patients’ health status completed by the patient without any interpretation by others); PerFos (a measurement based on an standardized task and evaluated by a trained personnel) and an ObsRo (a measurement based on observable signs, events or behaviors related to the patients’ health status). Caregivers usually provide such information. In trials of MDD, the FDA acknowledges the importance of PRO measures, suggesting that such information is useful in assessing benefits of treatment.

Introduction: Pregnancy is a time of many physical and physiological changes. Increased ligamentous laxity and hormonal changes leads to significant postural deviations and musculoskeletal changes. In addition, increased body weight of pregnancy, fluid retention lowers the arches of the foot, further adding to foot’s length and width.
Objective: The purpose of the study was to find and compare the dimensional changes of feet during pregnancy in nulliparous (Group-A) primiparous (Group-B) and multiparous (Group-C) women.
Methods: A cross- sectional study involved a sample of 90 participants (30 in each group), in the age group of 18 – 35 years with gestational age of 32- 36weeks were measured for Foot arch index (FAI) and Navicular drop Test (NDT). Baseline characteristics were recorded, and BMI was calculated.
Results: Results showed a statistically significant difference in dimensions of foot markedly in group-B (P-value 0.00001) and group-C (P-value 0.0008) as compared to group-A. However, no significant difference was found between the trimester and total foot length in all the groups. There was significant change in Width of the foot (P- value 0.0018) markedly in group-B (P-value 0.0127) and group-C (P- value 0.0005). The Foot arch Index was positively correlated with Navicular Drop test, but negatively
correlated with total length and width of foot.
Conclusion: The study concluded that there are dimensional changes of foot that occurs during pregnancy more in multipara than primipara irrespective of the trimester.

Water studies are widespread globally, and the methods are various kinds of technology. Some researchers study soft X-ray emission spectrometer [1], neutron diffraction [2], Raman scattering spectroscopy [3], Fourier transfer infrared spectra (FTIR) [4]. Those studies are mostly on H₂O or any substance’s compound with water. The contents are a structure like an angle of the O-H bond in the water molecule. Some interesting issues include hydrogen cation [5], Rydberg, and valence-shell character in H₂ [6].

Our health on the earth has been threatened since the middle of the 1990s. Mostly, Flood and droughts due to climate change also affect the food supply in agriculture. We need healthy soils, clean water, and sunlight as well known. On the other hand, they want enough harvest and efficiency in plant growth. However, they are also a necessary theme for everybody globally, and they fertilize and spray pesticides containing various chemical medicine. As a result, we may damage, and the risk will be spread because of scattering from the air. Therefore, what we take the balance of these themes must be an increasingly imminent issue. Therefore, the purpose of the article is to inform why we use SIGN water so that we can achieve decrease of the damages with agricultural chemicals, and good harvest to use it. Here, we propose the usage of pesticides as little as possible so that we reduce the effects on crops and soils with our pico-sized water.

The Personality pattern and coping skill both are very important aspects for a dancer because these characteristics support them to resolve the stress of stage performance in front of the audience or if doing any mistakes in the dance. The main aim of the present study is to analyze and compare the personality pattern, coping strategies of Indian classical dancers (Bharatnatyam Dancers) and Contemporary dancers. The sample size was 90, divided into 3 groups, i.e., Indian classical Dance Group (Bharatnatyam Dancers), Contemporary Dance Group, and Control group (non-dancer). Each group consisted of 30 female participants, age ranging between 19 to 22 years, selected from different established dance institutes across Kolkata. The NEO Five factor Inventory- Revised (Costa, Robert & Mc.Crae, 1991) and Coping Checklist II (Rao, Subbakrishna, and Prabhu,1989) were administered to the participants. For data analysis, descriptive statistics (mean, SD), Inferential Statistics (ANOVA one way and Post Hoc- Turkey Tests) and product moment correlation were applied. Results – 1) Indian classical dance Group (Bhartanatyam Dancers) is using a significantly greater amount of agreeableness, conscientiousness, religion & faith coping strategies, and social support seeking coping strategies. 2) Contemporary Dance Group is using a significantly greater amount of extraversion, openness and acceptance coping strategies.

Centella asiatica (L.) is a perennial, climbing plant, barely fragrant and an expensive therapeutic herb worldwide. It is commonly disseminated all the way through humid and subtropical provinces. The appliance of Centella in foodstuff and beverages has improved in modern era due to its favourable functional properties. The plant and its synthetic constituents are recurrently utilized for the therapy of several nootropic disorders, cognitive disorder, platelets conglomeration, burn wounds, hypertonic scars, insomnia, psoriasis, skin cell reconstruction and curing. Centella determines the greater part of its pharmacological actions from four foremost bioactive triterpene glycosides specifically, asiatic acid, asiaticoside, madecassoside and madecassic acid (termed as centellosides). This current search have another look at focuses to impart inclusive information on pharmacology, various preclinical and clinical studies, safety precautions, mechanisms of action and present research scenario of the herb.

The Covid 19 pandemic has affected every aspect of our lives and changed the way the world works, and also changed people’s perspective on health systems so far. Patients stay away from hospitals, hinder their checkups during this time, and cause significant diagnosis or treatment delays [1]. People who do not know how to deal with such a shocking disaster and seek alternative solutions were easy prey for pseudo-scientists. Who uses the reputation and power of medical science and thus gains trust, serves their own personal interests and disregards public health by trying to sell some herbal mixtures and homeopathic pseudo-drugs. Thus, modern and accurate health care was blocked or delayed more in many scenarios; the problems caused by the pandemic have deepened, and inequalities in health have increased more and more. As this whole process and short-term results show, the most critical way to deal with all developments in life is to be on the path of science. Because even against a virus effective enough to affect the world and cause a pandemic, four different vaccines were developed for coronavirus, a little more than a year after the first case of COVID-19 was identified [2]. This alone is a glorious victory for the medical and scientific community worldwide.

Is important to bear in mind that the company may be within of a market with the different product and service, need to know, which is what the consumer wants or what you are looking wing when purchasing a product or service, these, which must have strategies to fully satisfy customer needs and achieve the objectives and targets in the company. The service sector is of great importance in the global economy, because the services are found in all parties, is for a medical consultation, restaurant, travel, daily transportation, school or university, at the supermarket or market. From there, the importance of knowing a little about the marketing of services.
Use the marketing services to increase sales and must be designed and offered in such a way that meets customer needs.

The aim of this study is to assess the risk of car passengers in Dual Energy X-ray inspection devices and to determine the maximum number of passes through the system in a given amount of time. The MCNPX code was used to simulate a newly fabricated dual-energy X-ray car inspection device, which included an X-ray tube, detector arrays, and a rando phantom, to their exact specifications. A Rando phantom was placed in a car and TLD dosimeters were placed within different sections of the phantom for experimental dosimetry. The maximum equivalent dose was absorbed in the gastric, breast, and lungs in experimental results, while simulation results showed that this quantity belongs to bone surfaces and gastric. Based on simulation results and experimental dosimetry, the total equivalent dose of 155 kVp is 0.256 and 0.276 Sv, respectively, with a difference of 7%. The results showed that the MCNPX is suitable for dosimetry in this case. The system falls into the category of devices of limited utility, according to the ANSI standard. Anyone can move through this machine a maximum of 806, 66, and 15 times in a year, month, and week.

Objectives: Depression is the second leading cause of disability among elderly patients and negatively affects quality of life. This study aimed to explore the impact of a behavioural counselling intervention on elderly patients with depression in Oman. The hypothesis was that, as engagement with social support and activities increased, depression score would decline. Methods: This observational cross-sectional study included 16 elderly patients attending the elderly outpatient clinic of Al Ghubra Health Centre, a primary health care (PHC) institution in Muscat, Oman. All patients had been diagnosed with depression using the 15-item Geriatric Depression Scale (GDS-15). Each patient underwent short weekly behavioural counselling sessions involving cognitive behavioural therapy, problem-solving therapy and interpersonal therapy over a period of four months. Pre-and post-intervention GDS-15 scores were compared to assess the impact of the intervention using a paired sample t-test. Results: There was a significant reduction in mean GDS-15 score following the intervention (mean score: 8.63 ± 3.18 versus 6.00 ± 3.69; P <0.001). Moreover, the mean number of weekly social activities increased from 0.75 ± 0.93 to 5.50 ± 2.92. Conclusion: The findings of this study support the implementation of brief, cost-effective behavioural counselling interventions at PHC institutions in Oman in order to prevent or reduce depression among the elderly.

Efforts to improve prevention and cure are commendable. Many concepts have been introduced and implemented for this purpose. However, improving the effectiveness of existing medicines remains a challenge for research. Permissible medicine “Halalopathy” offers a new perspective to prevent disease by controlling the entropic state and/or facilitating cure by implementing the concept of permissible medicine. The entropic state is controlled by enriching the state of “no fear, no grief”, while permissible medicine establishes a compatible relationship between therapeutic medicines and people’s lifestyle. The healing power of each effect contributes to the healing process and enhances the overall effect of the medicine.

We report various researches on minimal catalyst (MICA) water and spin information gauge network (SIGN) water from 2009 to the present. The theme is our body, besides plants, animals, and substances like vinyl bags, fiber and LED light even atmosphere. Furthermore, we also reported the change of atoms from radioactive cesium to stable barium after the Fukushima accident in 2011. Our water science and technology are relevant to dissociating hydrogen bonds in water. We fabricated SIGN water under the pressure of more than 100MPa rather than 3MPA for MICA water. The difference may be the abundance rate of the elementary-like particle (infoton) after hydrogen bond dissociation; namely, we assume three times in SIGN water than MICA water, although it is the same works, and both emit far-infrared through terahertz. Here, we focus on SIGN water and present recent research of oxidation-reduction potential and blood tests involving diabetes besides user’s comments after using the water and the activated LED light to the affected parts of our body.

During the 20th century, the sociocultural paradigm of the West underwent a significant change, imposing antihuman values. This metamorphosis (individualism, the desire for power and wealth prevailed over brotherhood and compassion) was coincided with extraordinary scientific and technical development. The new paradigm colonized the minds of physicians and medical training curricula. Medicine became self-centered, cold, fragmented, and practically ignored affectivity. The reaction to this spiritual degradation of medicine was the humanist movement in medicine that originated in the twentieth century but has been developed more in the XXI century, spreading through many countries in the West and also in the East. Currently in the curricula of many schools we find the area of “Humanization of medicine”. In the Faculty of Medicine of the CLAEH University of Uruguay “Humanismo Medico” (HM) is a compulsory subject that is taken during 3 clinical years (70 hours per year) and its practice is experiential. Likewise, we have found it of great interest to know the perceptions, reflections and feelings (self-declared) of the students about their own changes at the end of all the training cycles of HM. Based on 77 opinions (out of 111 issued) of 20 4th year students, we were able to verify that taking HM had caused very important changes in them towards a more humanistic identity. They state that they perceived; 1) a deep inner rational and affective transformation and they observed an increase in their introspection, critical thinking, self-analysis, empathy and emotional balance, 2) greater capacity to plan a professional life with greater well-being, 3) improvement of group interrelationship, which has been more open, sincere and fraternal; 4) ability to share reflections and anguish and 5) acquisition of a holistic view of sick people and better skills to listen and accompany them, and relate to their families.

Home health care management for dwellers and the elderly is much of a desire than a real time opportunity for most. The future points to homes having a room designated for health care just as a kitchen, bathroom or dining room form essential rooms in a house. This choice of location however must be outfitted with equipment capable of monitoring health, logging and retrieving data for remote communication to those involved in virtual medicine, for diagnosis.

Early detection of any type of cancer, especially lung cancer, one of the world’s worst diseases, can save a lot of lives. By using the early forecast, we will be able to increase life expectancy and decrease death. While there are other approaches for detecting lung cancer cells, such as X-rays and CT scans, CT pictures were found to be more preferred. CT scans, for example, use 2D images to get more accurate results. The proposed approach here will cover how to interpret CT pictures from a Computer Tomography (CT) Scan with the Confusion Matrix for Mining Heterogeneous Lung Cancer. This study will look at how image conversion may be performed using various image processing approaches to get better outcomes from CT images. The Confusion Matrix is a tool for calculating inequality in an image pattern. Following Confusion Matrix’s examination of the processed images, a final accuracy of 93 percent is attained.
Keywords: Computer Tomography (CT); Mining; Confusion Matrix; Lung Cancer

Seasonal greeting to the editorial staffers, staff, and readers of MCMS globally. In the 20th and now 21si centuries, exponential uses and applications of medicinal plants, and herbs from different sources, in diverse forms, had become the basic fundamental norm in the health sector of the global population. In accordance to WHO findings, about 80% of the world population use one form of medicinal plants or herbs at their homes for prevention, and curing different types of diseases that have bedeviled humans in the 21st century largely due to our lifestyles-food materials that we eat, numerous different drinks either soda or alcohol or otherwise that most cases if not check are inimical to our health at a long run; smoke pluming into the air, and find their ways into our lungs with lots of chemical compositions that are often lethal to the hosts in no time.

Curing diseases and achieving complete recovery is challenging particularly with complex diseases such as cancer, where complete remission is most likely the preferred option that can be achieved. The hope for a complete recovery is inspired by cancer patients who have successfully beaten cancer and achieved a complete recovery. Despite physicians referring to these stories as “miraculous” recoveries, nevertheless, they reveal that victory over cancer can be achieved. According to Halalopathy, a key role in complete recovery is played by setting up the favourable circumstances for the cure, a process that can be achieved by involving the patient in the therapeutic process. Entropy and potential energy are inversely proportional, and both are key elements in the process of prevention and cure. The catabolic reaction is driven by entropy, while the anabolic reaction is driven by potential energy. The stimulation of potential energy and the reduction of entropy contribute greatly to the activation of the immune system and thereby create the necessary circumstances required for effective prevention and therapy. 
Keywords: Cancer; miraculous cure; potential energy; entropy; immune system

NMSOD is an inflammatory disease affecting the optic nerves and spinal cord. It is an uncommon disease but is a differential that presents similarly to a few common diseases. Misdiagnosing NMOSD for multiple sclerosis might result in severe health consequences and the rapid deterioration of the patient if they are treated with disease modifying agents like interferon beta, fingolimod or natalizumab. It is noted that this disease affects females predominantly.

Background: The aim of the present study was conducted to assess the level of knowledge and attitude regarding crisis management of natural disaster among people of selected rural community at Kannur district.
Objectives: Assess the knowledge and attitude about the crisis management in natural disaster among local people. Find out the association between knowledge and attitude of people with selected demographic variables. Find out the correlation between knowledge and attitude regarding crisis management in natural disaster.
Setting and Sample: Study was conducted in 250 families at pattuvam Gram Panchayath, Taliparamba, Kannur, Kerala. 
Materials & Methods: Quantitative descriptive approach and cross-sectional design were used for this study and sample selected by convenient sampling technique. A self-structured knowledge questionnaire and attitude scale comprised of 10 items and 15 statements respectively.
Results: The study result shows that majority of samples were very good knowledge (81%) and positive attitude towards crisis
management on natural disaster.
Keywords: Knowledge; Attitude; Crisis management; Natural disaster

There is 4 to 7 percent of the population who have palpable thyroid nodules; nevertheless, there is 19 to 67 percent of the population who have nodules identified accidentally on ultrasonography. The great majority of thyroid nodules do not manifest themselves with symptoms. As malignant nodules account for around 5% of all palpable nodules, the major purpose of investigating thyroid nodules is to rule out the presence of cancer. One of the tests that may be used to differentiate between a thyrotoxic nodule and a euthyroid nodule is the thyroid-stimulating hormone test. Thyroid nodules should be fine-needled aspirated in individuals who are otherwise healthy but have a thyroid nodule, and radionuclide scanning should be reserved for patients with equivocal thyroid cytology or thyrotoxic endocrine disease (thyrotoxicosis). Using ultrasonic guidance during fine-needle aspiration, the frequency of inadequate specimens from fine-needle extraction is reduced. Operation is the most common treatment for malignant lesions, and the amount of the surgery is decided by the severity and kind of the sickness. Postoperative radioactive iodine ablation is done on high-risk patients who have cancer that has spread or that has returned after treatment. However, thyroxine suppression therapy is often employed surgically to treat malignant lesions. 
Keywords: Thyroid thyroid nodules; Epidemiologic presentation; Lymphocytic thyroiditis; Diagnosis; Treatment

Alzheimer’s disease is the most common type of neurological disorder called dementia and, it affects people from every gender, region, culture, ethnicity, religion, and sexual orientation. Research shows that in 2021, approximately 6 million seniors in the U.S. suffered from Alzheimer’s [1, 2].

Aim: To evaluate the level of exposure to benzene and the state of health of the workers of “ORYX-BENIN SA”. It is a descriptive and analytical cross-sectional study aimed at evaluating the level of exposure to benzene in 18 workers of ‘’ ORYX- BENIN SA ‘’. 
Materials and Methods: It was carried out with their informed consent and after they had completed a questionnaire. The data collection was carried out by questionnaire, a direct observation grid, a summary clinical examination of the workers and a composite biological assessment: Blood count and leucocyte count by the Culter method and the determination of urinary phenol by the nitro-4-aniline spectrophotometric method.
Results: 55.55% of the workers are between 26 and 40 years old. They are all male. 61.11% of the workers have less than one year of experience and 22.22% have at least three years of experience. All the workers, grouped in three shifts, work 8 hours a day. None of the workers wear a mask while working. The only means of protection used by all workers are gloves, gowns and safety shoes. No agent of this company works with his back to the wind. The clinical manifestations recorded during the survey are 50% nausea, 38.89% asthenia and 16.16% eye irritation. A total of three chargers show hematological signs of benzene intoxication. The rate of urinary phenol is largely higher than 250 mg/g. of creatinine at the end of the shift.
Conclusion: It is observed that the inversion of the leucocyte formula is moderate in only one charger while it is severe in five and very severe in six. All of the loaders involved in this study were exposed to benzene at more than 25 ppm per working day.
Keywords: benzene; urinary phenol; exposure level; loading activity

Introduction: Urinary tract infections (UTIs) are the second most common infectious disease in humans after respiratory diseases [1]. In pregnant women, any UTI is by definition at risk of complication [1]. Urinary tract infection (UTI) can have harmful consequences for the mother and the fetus. It can manifest itself in three forms: gravidic urinary tract colonization, acute gravidic cystitis and acute gravidic pyelonephritis (AP). The urine cytobacteriological examination (UCE) is the only way to confirm the diagnosis and to guide the treatment. It is also by far the most frequently requested examination from a microbiology laboratory [2].
Objectives: The aim of our study is to establish the bacteriological profile of germs involved in urinary tract infections in pregnant women at the Departmental Hospital Center of Atacora, Northwestern BENIN from March to October 2021.
Methods: This is a prospective, descriptive, cross-sectional study with an analytical focus that included 192 ECBU samples collected from pregnant women in prenatal consultation at the Departmental Hospital Center of ATACORA. On these samples we performed the following examinations: ECBU followed by antibiogram.
Results: The study revealed that out of 192 ECBU 19 were positive, i.e. a frequency of 9.9%. This result was confirmed by [3] and [4] who found 10% and 9.9% respectively. The most frequent germ was Escherichia coli (68.4%) followed by Staphylococcus aureus (21.1%) and finally Klebsiella pneumoniae (10.5%). However, we found a resistance to (90.1%) ampicillin and a sensitivity to (100%) ceftriaxone in Gram-negative bacteria, in Gram-positive bacteria we noted an effective activity of third generation cephalosporins, fluoroquinolones.
Conclusion: The results of this study allow us to highlight the problem of treatment of urinary tract infections in pregnant women. In the absence of bacterial identification and antibiogram, the problem of the choice of antibiotics arises. One possibility is to choose the less expensive aminopenicillins, knowing that very few of the isolated strains are sensitive to amoxicillin and that the combination of amoxicillin and clavulanic acid is only active on a small proportion of the isolated strains. The choice of other more active antibiotics is limited, either by the numerous contraindications (quinolones), or by their high cost, especially the third generation cephalosporins
Keywords: Urinary tract infection, Bacteria; Asymptomatic bacteriuria; Acute gravid cystitis; Acute gravid pyelonephritis

Objective: The overall objective of the study was to evaluate the relationship between C-reactive protein (CRP) and prostate specific antigen (PSA).
Material and Methods: This is a cross-sectional and descriptive study that took place from April 2019 to September 2019 in the Biomedical Analysis Laboratory (SPACE-LABM). The CRP was determined by the agglutination technique on 85 samples of which 30 were PSA negative and 55 PSA positive.
Results: In PSA (-) subjects, we have 5 cases of positive CRP for a frequency of 17%. In PSA (+) subjects, we have 34 cases of positive CRP for a frequency of 62%. PSA (+) subjects are more likely to have a CRP (+) than PSA (-) subjects. There is a positive correlation (r = 0.38) between CRP and PSA.
Conclusion: At the end of our study, we observed a positive correlation between CRP and PSA in patients with positive PSA.
Keywords: Prostate Specific Antigen (PSA); C Reactive Protein (CRP); correlation; prostatitis

The objective of this study is to determine serum and urinary creatinine levels, hematies leukocytes per minute and the albuminuria/urinary creatinine ratio in tuberculosis patients at the National Hospital Center for Pneumo-phtisiology (CNHPP) in Cotonou. This is a prospective, descriptive and analytical study that included 42 patients over 15 years of age followed for 6 months at the National Center for Pneumo-Phtisiology (CNHPP) in Cotonou. Serum creatinine and urinary albumin levels were determined by the enzymatic method. The count of red and white blood cells in the urine was done under the microscope on Malassez cells. The results show that out of 29% of men and 71% of women, the majority age group is between 39 and 58 years old. The weight of the tuberculosis subjects according to the treatment at the beginning of the treatment is around 52.5Kg and at the end of the treatment is around 57.5Kg. White blood cell counts/min in TB patients on treatment at the end of the intensive phase (p<0.03) and at the end of treatment (p<0.01) were significantly lower compared to TB patients not yet on treatment. Urinary creatinine levels increased significantly in TB patients at the end of treatment (p<0.05) compared to TB patients not yet on treatment and at the end of the intensive phase. From these results, it is important to note that anti-TB drugs must be used with great care to ensure the proper functioning of the vital organ that is the kidneys. The impact of these antituberculosis drugs, which does not appear to be significant, can become so very quickly with the use of other molecules and in the worst case lead to dialysis.
Keywords: Tuberculosis; hematuria; creatinine; renal clearance; renal failure

This work addresses the concepts that surround what comprises healing modalities in these days and times. The concepts discussed do not involve those of surgery. There are three major thrusts in the origin of healing concepts that have been developed over the ages. The more advanced Eastern concepts first originated in the sub-continent of India and were later transferred to the area that is now known as China. All Eastern concepts began development some 4000 years ago and eventually yielded a comprehensive treatment system that lasted into modern times. The Western concepts originated in Europe and progressed much more slowly than those in the East. In all cases, most of what would be known as medicines were for the most part derived from herbal sources with a minority from mineral of animal sources.

Background: Breast cancer remains the most commonly diagnosed cancer in women accounting for about 11% of all cancer types diagnosed globally annually and one of the leading causes of women mortality in spite of significant improvements in treatment. Treatment of breast cancer in Nigeria is based of expression pattern of ER, PR and HER2 using targeted therapies.
Methods: Two hundred and seventy three (273) archived paraffin wax processed breast tissue samples were sorted and selected from the histopathology laboratories and museums of the facility. Data were realized from clinical records, operation notes and histopathology results of the patients involved. HER2, ER and PR expressions were assessed by immunohistochemistry (Avidin-biotin complex method). Expression patterns were scored based on proportion and intensity of immune-labeling using semi-quantitative method.
Results: The age of patients ranged from 30 to 75 years with greater population falling between 30-45 years. Numerically, breast cancer cases seen increased progressively from 2015 to 2019. Most breast cancer tissues were ER positive 146 (53.5%) while 65 (23.8%) samples were HER2 positive. A greater percentage of the samples assessed were ER/PR/HER positive (Triple positive) while ER negative/PR positive accounted for the least case.
Conclusion: The present study revealed a progressive increase of breast cancer incidence from the year 2015 to 2019 in the centre studied with ER/PR positive cancers being the most prevalent followed by triple negative cancers. More awareness to breast cancer risk factors, prevention, screening and early presentation to hospitals should be intensified with emphasis on early detection and targeted and personalized management.

Keywords: Breast Cancer; ER; PR; HER2

Abstract
Aims and objectives: Covid 19 pandemic brought a host of symptoms in the last 2 years. Amongst these anosmia or loss of smell and taste were some of the striking though less common symptoms. Significant rise in Anosmia with or without onset of upper respiratory tract infection prompted a study in which patients with loss of smell were screened over a period of one year to study the nature of this symptom.
Materials and Methiods: A questionnaire had to be filled by patients visiting in our clinics or through online consultations. 53 patients were selected.
Observations: Our observations showed that in 86.8% of patients, anosmia was the only symptom and 73.6% required no specific treatment. In 89.3% anosmia resolved within 3 months.
Conclusion: Hence it is concluded that anosmia can be used as a marker for COVID 19 testing. It appears to be a transient symptom which resolves spontaneously.

Keywords: Anosmia; loss of smell; COVID 19; SARS-CoV-2; Olfactory dysfunction

Application of Neuro-physiological monitoring (IONPM)
Application of neurophysiological monitoring during surgery (IOM) in intra operative Neurospinal surgery, cases reduces the chances of neuro-spinal surgery complications at all neurological level. Many techniques are available and motor and SSEP (evoked potentials somatosensory) are thought to be essential for better results of IONPM. Spinal cord - evoked potentials (SEP) are observed and recorded over cord where stimulation by electrical means is given on directly over the spinal cord (posterior column) by an epidural stimulation by electrodes. SSEP (somatosensory evoked potentials) provide the functional and anatomical continuity of sensory tracts .starting from peripheral most nerve and posterior column to the sensory cortex.

Ventilators induced pneumonias are usually associated with some predisposing risk factors. Predisposing factor which were taken into account during this study were prior antacids, prior aspiration, alcoholism, smoking, prior hospital stay and underlying diseases which includes chronic lung disease, diabetes mellitus, neoplasia and heart insufficiency, antibiotic therapy. 50 such case undergone neurosurgeries were studied and detailed analysis is presented.
Keywords: Pneumonia; Ventilator; Consolidation; Hospital acquired infection; Hospital associated infection; Kerby-Bauer method

This thesis mainly studies the social environment of pharmaceutical industry development in China and the United States in the early days of the founding of the People’s Republic of China. By analyzing various factors of social development, this paper points out that historical factors greatly affect the development mode of national industry on the basis of combining industrial characteristics.
Keywords: Pharmaceutical industry; Historical factors; Industry characteristics

Rising interest in a single-payer healthcare system known as Medicare for All (MFA) has reached the support of nearly 55% of physicians and two-thirds of Americans polled [1]. This comes at a time when nearly 29 million Americans remain uninsured in the setting of a 4.6% increase in healthcare spending in 2019 totaling $3.8 trillion in expenditures, despite the implementation of the multitude of insurance options within the Affordable Care Act (ACA) of 2010 [2]. Presently, there are two bills in the legislature being considered to address this matter with the Medicare for All Act of 2019. Lobbyists are considering a government- funded healthcare system that would serve to reduce burdensome administrative and health-related costs and simplify an already multiplex insurance-laden system. 
Keywords: Medicare programs; Fee-for-service; Private insurance; Selection bias; Drug costs; Medicare reimburse

Introduction: Common periodontitis that attacks the human population is periodontitis induced by plaque. Periodontitis begins with the ordering of plaque that adheres to the tooth surface. Dental plaque is a thin layer of multi-species biofilm containing colonization of bacteria, bacterial products, and food debrish. The dental plaque that causes periodontitis is usually located in the subgingival area, then extends apical to the tooth, causing inflammation of the periodontal tissue. The causes of periodontitis in general are bacterial species found in dental plaque, and about 10 species have been identified as pathogens in periodontal disease, especially gram-negative stem bacteria, including Porphyromonas gingivalis, Prevotella intermedia, Actinomyces viscosus, Bacteroides forsythus, Campylobacter rectus, Treponema denticola, and Fusobacterium nucleatum.Apart from plaque factors, periodontitis can also be caused by systemic factors, genetic disorders as well as environmental and risk factors. Studies show that people with diabetes mellitus and smokers suffer from periodontitis a lot. Whereas in patients with periodontitis due to genetic disorders caused by damage to the periodontal tissue by macrophages that respond to IL-1 excessively. ROS, also plays role in pathophysiology in periodontitis.
Discussion: Chronic periodontitis is a chronic infectious disease with a complex etiology. The main etiology is bacteria and is exacerbated by various other factors. In this case, excessive production of ROS and changes in state can lead to abnormal activation of apoptosis, approaches important factors involved in the production of periodontitis extensions and various clinical features of periodontitis. Several studies have demonstrated a role for ROS in the deregulation of apoptosis. Between ROS and the body can produce neo-epitopes which then stimulate a broad spectrum associated with tissue damage and breakdown of the periodontium. Studies in periodontitis patients and involves oxidative stress in disease pathogenesis. Polymorphism genes coding for superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx) and the gene encoding NADPH oxidase NCF2 have been identified in many ways with a risk of periodontitis. All biomolecules (lipids, proteins and DNA) can be damaged by the overproduction of ROS. 
Conclusion: During infection, immune system produce reactive oxygen species (ROS) which are released into the extracellular environment. The ROS does not have a specific target that could damage tissue especially in periodontitis.

Keywords: ROS; Pathophysiology; Periodontitis

There are many kinds of research about water in various fields such as agriculture, chemistry, biology, medicine, and physics. The targets of water research are these in daily life, the ocean, in the air and the substances. Moreover, there is the theoretical study of water (H₂O) itself. They have reported Ab initio calculation, and the density-functional theory have on the hydrogen bond of water molecules and interaction between monomers, which research issue is associated with the water molecule itself. Here we present the theoretical concept to protect us from any virus involved in COVID-19.The mechanism based on amino acid reaction with water involved a proton and electron are essential to our body. Due to pressurization (more than 100 MPa) applied to ordinary water, hydrogen bond dissociation can work for various functions. Besides smallness, proton and electron may play a role passing an electric current to protect viruses and germs through the water in a body. The information of the water is supposed to be “momentum” (spin, mass, and velocity) may protect us from any virus and germ due to chemical reduction by proton and electron in the water.

Keywords: Weak energy water; Proton & electron; Hydrogen bond; Amino acid; Electrical current

Health Science is one of the multidisciplinary sciences that aims to publicize information, grant experience in education, practice and research between health status and quality of live for all society’s categories including individuals, families and communities. Nowadays, Health Science considered as an emerging field. The aspects of health science contribution in the scientific research include factors that nations, developing and developed, can be evaluated via the advancement of its health science.

At present the interest inidentify and satisfy consumer needs for this companies use various techniques such as the study of market, conducting surveys, product testing by mention a few, nowadays to get a better result precise techniques and tools have evolved a lot. Neuromarketing is one of those advances, which helps us to determine with greater accuracy and depth the preferences of the consumer. Focus on knowing conscious behavior, while the consumer buying behavior is fundamentally  unconscious. Today with the help of new technologies more interest has developed in applying the methods of neurology in various areas other than medicine, that are related to human behavior, being the Neuromarketing one of the ways to investigate and know consumer behavior and decision-making purchase, thus supporting us to better understand the psychological behavior and dictate more precise actions to marketing based on the knowledge of the reactions cerebral.

Keyword: Neuromarketing; Emotion; Neuroscience; Neuron; Neural network

The ongoing COVID-19, caused by the new coronavirus, SARS-CoV-2, after originating from the Wuhan City of China, was declared a “pandemic” on 11 March 2020 by the World Health Organization (WHO). Availability of a number of vaccines against COVID-19 may prove a game-changer. However, in the absence of an acceptable specific antiviral agent, therapeutic approaches in an overwhelming majority of the cases are a cocktail of symptomatic/supportive measures, immunity boosters, immunomodulators, immunotherapy, steroids and antimicrobials. In life-threatening situations in hospitalized patients, critical care measures are adopted. In deference to the recommendations of the WHO, antibiotics such as azithromycin and doxycycline continue to be consumed irrationally in a large proportion of the patients even in absence of a bacterial coinfection, especially in the resource-limited countries. The widespread misuse of antibiotics is likely to have worsened the already existing problem of antimicrobial resistance (AMR). The endeavors aimed at controlling the COVID-19 pandemic (that has been causing huge morbidity and mortality worldwide and adversely impacting economy), need to be complemented with spirited and restrengthened campaign against irrational antibiotic use that is augmenting the AMR. Also, there is a need for promoting antibiotic prudency through alternative and complementary therapies. Most importantly, developing the new antibiotics from new classes should be a top priority.

Keywords: Antibiotic prudency; Antimicrobial resistance; Multidrug resistance; New antibiotics; Superbugs

Bullying”, a neglected psychological factor that has encouraged cultism in the society. Looking at the society in all its different units, every unit of the society has a major role influencing the growth of a particular pattern either negative or positive and this has influenced the society so much that it is no longer a thing of supernatural forces but a thing of manmade inventions. Man influences his society either positively or negatively consciously or unconsciously. How about the introduction of ignorance, till the root of the problem is tackled, man will keep adding to his problem even as he is providing solutions to his problem. The smallest unit of the society is Family and this has shaped a lot of individuals into what they are today. The mind of the man is a Tabula Rusa as the psychologists describes it. It is plain and filled with experiences and information acquired daily. When a child is born, the first place of imprinting new information is the family he finds himself. From the language, smell, taste of food, music heard and other behaviors exhibited by his family members. The school is only a place where behaviors and morals are shaped generally unlike the family where only your
family pattern or style is tolerated.

Mrs. XYZ36-year-old lady recently consulted me for severe acid reflux, migraine headache and indigestion since past 9 months. She tried various conventional treatment without relief. Finally decided to try homeopathy and our holistic treatment.

It was 1938 and China was in dire need of healthcare workers during the Sino Japanese war when Japan attacked China and China turned to India for help.

Dr. Dwarkanath Shantaram Kotnis was an Indian Doctor who volunteered to go to China as a part of a medical assistance team sent by India. He was born in Solapur District in the state of Maharashtra on 10^th October 1910 and went to medical school at Seth GS Medical College in Mumbai and was preparing for Post-Graduation.

Abstract
According to tremendous translational researchers, biomarkers as a part of the ligand-receptor tandems have induced an impulse to prompt the evolution of an upgraded concept of the targeted therapy. It is health indicators that justifying the necessity to create targeted drug of the next-step generation to be implemented at the clinical and sub-clinical key stages of the disease process and to get involved into a multi-stage process to get the shifts appeared modified.

There is an evident-based outcome of the latest studies in multiple sclerosis (MS) related fields that illustrates the proved targeted activity of Ab-proteases. High impact of Ab-proteases can be used to monitor both clinical and subclinical courses of chronic autoimmune inflammation (MS) to predict stepwise transformations of the course and to prognosticate the clinical illness  finally. In this sense, Ab-proteases can be programmed and reprogrammed to suit the requests and standards of regenerative medicine and re-myelination, in particular. This data makes it possible to design the algorithms for combinatorial (preventive, prophylactic, therapeutic and rehabilitative) treatment, whilst developing unique tools for individually therapy, especially, for autoimmune diseases which holds a particular position.

There have been published many researches about water in the various fields such as agriculture, chemistry, biology, medicine and physics. The targets of water research are these in daily life, ocean and in the air besides in the substances. Moreover, there are the theoretical study of water (H₂O) itself. Ab initio calculation and the density-functional theory have been reported on the hydrogen bond of water molecules and interaction between monomers, which research issue is associates with the water molecule itself. Here we present the theoretical concept to protect any virus involving in COVID-19, and the mechanism based on the reaction of amino acids with water involving a proton and electron which are essential to our body. It has been performed with the dissociation of hydrogen bond due to pressurization (more than 200 MPa) applied to ordinary water. Besides the smallness, the proton and electron may play a role to pass an electric current to protect a virus and a germ through the water in the body. The information of the water is supposed to be “momentum” (spin, mass and velocity) may protect any virus and germ due to chemical reduction by proton and electron in the water.

Keywords: Weak energy water; Proton & electron; Hydrogen bond; COVID-19, Amino acid

Children are the gift given by God to humanity. Sexual abuse of Children is one of the most heinous crimes. CSA (child sexual abuse) and SA (Sexual Assault) is the most reported crime against children across worldwide. It affects not only physically but also mentally it may lead to death. Both girls and boys in India face severely assault like early marriage, domestic violence, bullying, child labor, and many more children can be sexually assaulted in any place like home, streets, schools, workplaces, prisons, orphans. It affects the overall development of the children. According to NCRB 109 children face any form of CSA every day in India. Keeping in view the alarming situation of sexual crime against children. Indian government passed a law against the crime against women in 2018 and the crime against children in 2012. In 2012, the amendment of the POCSO (Protection of children from sexual offenses) act in sections 4, 5, 6, 9, 14, 15 and 42 is made to save the children from sexual assaults. 

The objective of our study is to describe the overall crime rate of DELHI NCR on child abuse and sexual assaults in the year 2019, March 2019 to June 2021, under IPC 376, 377, 354, POCSO Act 2012, etc. Forensic Laboratory receives 5-10 cases of child sexual abuse every month. In most cases, the criminal is known and/or unknown to the victim. In this study, we also try to create awareness towards the Sexual Assault and the POCSO Act.

The plant genus Cuscuta, belongs to the family Cuscutaceae, has been traditionally used as therapeutic treasure against various metabolic and neurological diseases such as mental abstraction, headache, spleen disease, jaundice, diabetes mellitus and hypertension. There are numerous secondary metabolites have been identified that are considered as phytochemical constituents, such as alkaloids, flavonoids, lignins, steroids, phenolic acids, fatty acids, glycosides and polysaccharides. Due to the presence of these bioactive ingredients, various ethnopharmacological actions including anticancer, antiviral, antisapasmodic, antihypertensive, antibacterial, antioxidant, diuretic, antihypertensive were explored. This review brings eyesight for the explorations of novel therapeutic agents for the various ailments of mankind. 
Keywords: Therapeutic treasure; Phytoconstituents; Pharmacological activity

This proposed commercial model is based on deep Long Short-Term Memory Network (LSTM), used because of its ability to learn long term dependencies, in taking the concatenated function and market data as input, while integrating Smart Data encapsulations, retrieving information by combining various search results (all the Web). It provides some good ideas for that we have extended to improve Corporate Marketing and Business Strategies. We show that the proposed model learns to both localize and recognize their different aspects. We evaluate it on the challenging task of detecting Fraud in Financial Services and Financial Time Series Forecasting and show that it is both more accurate than the state-of-the-art of other neural networks and uses fewer parameters and less computation.

Keywords: Awareness; Business; Education; LSTM; Smart Data

Sustainable manufacturing is the demand of time. Due to limited availability of natural resources, there is constant demand to reduce consumption [1]. Manufacturers are seeing the carbon footprint associated with the process. Mass manufacturing has given rise to newer techniques of manufacturing which are highly advanced techniques and the energy consumption of such processes is very high. For example CNC (Computer and Numerically controlled) machining centers consumes a lot of energy [2] and are associated with enhanced carbon footprints.

This research work was undertaken to explore the neuroprotective potential of Sargassum wightii against scopolamine-induced dementia in rats. Progressive loss of memory is a most prominent symptom in neurodegenerative diseases. Five groups of animal were used for this experiment and scopolamine (16 mg/kg body weight/ i.p.) was administered to induced dementia like symptoms. Behavioral study was performed by Morris Water Maze test (MWM) to assess learning and memory, biochemical parameter such as acetylcholinesterase enzyme (AChE) activity was measured to analyze cholinergic activity in brain, the oxidative biomarker enzyme status was estimated by analysis of malondialdehyde (MDA), GSH and histopathological assessed were then performed. Scopolamine 16 mg/kg body weight significantly impaired acquisition and memory in Morris water maze test. Pretreatment with Sargassum wightii (methanolic extract) both the doses 200mg/kg and 400mg/kg showed significant improvement in MWM performance and learning memory deficit. Scopolamine also enhanced brain acetylcholinesterase activity, MDA level and decreased in GSH level. Sargassum wightii extract reversed the change in AChE activity, brain oxidative stress and histopathological changes in a significant level. The conclusion of this study suggested that the neuroprotective activity of Sargassum wightii against scopolamine-induced dementia like symptom probably through enhancement of cholinergic activity and reduced oxidative stress action.

Keywords: Neurodegenerative; Scopolamine; Sargassum wightii; Morris water maze; Acetylcholinesterase

Anemia is widely spread nutritional problem in world. Low BMI value (Underweight condition) and anemia are associated and together it’s a big problem in developing countries like India. Anemia among adolescent girls is problem not limited to any region, and caste but a problem faced across the world. By the help of present study we tried to investigate and understand about the prevalence of Anemia among adolescent students especially in females.

Keywords: Anemia; BMI; Adolescent; Females; Underweight

Colchicine is an active alkaloid that is commonly used for treatment of multiple diseases including gout, primary biliary cirrhosis and familial Mediterranean fever. Less commonly, it has been implicated in cases of fatal overdose owning to its narrow therapeutic index. Clinical presentation of colchicine poisoning follows a well described but swift course with gastrointestinal symptoms being the earliest manifestation. Death usually occurs either directly due to multiorgan failure or indirectly due to secondary sepsis. We report an extreme case of colchicine ingestion by a 22 years old female who intentionally ingested 45 to 50mg of colchicine. Six hours later she presented in local hospital where gastric lavage was performed. Four days later, on continual deterioration of her condition, she presented with poor prognosis in the tertiary care emergency. She exhibited symptoms of coagulopathy, respiratory distress, multiple organ failure and eventually suffered fatal cardiopulmonary collapse approximately 14 hours after admission. Use of Colchicine specific Fab fragments have been shown to reverse symptoms of Colchicine poisoning in experimental settings however they are not available for general use. Currently treatment options are limited to specific supportive measures.

Keywords: Colchicines; Poisoning; Multiple organ failure; Cardiopulmonary resuscitation; Respiratory distress syndrome

When we hear the word gluten we usually associate it with the fad diet either as a gluten-free diet (GFD) or a healthy diet.

What is Gluten?
It is a storage protein found in grass-related grains like barley, rye, oats, wheat (BROW). It nourishes the seeds during flowering and germination.

Gluten itself is a complex mixture of proteins. In wheat, rye, barley, oats this storage protein exists as gliadin, secalin, hordein and avenins respectively. All these proteins are collectively referred to as gluten. Gliadin has many peptide sequences which are resistant to our gastrointestinal enzymes.

In the last decade great strides have been made towards the discovery of molecules whose aberrant functioning has been held responsible for the genesis and progression of Non-Small Cell Lung Cancer (NSCLC). Broadly speaking there are two types of lung cancers: NSCLC, and Small Cell Lung Cancer (SCLC). The majority of lung cancers are of the type NSCLC. In this paper the therapeutic molecular targeting of aberrantly functioning molecule has been dealt with in the context of NSCLC, but, however, the conclusions derived in this paper hold for any molecular targeted therapy for any cancer. Different molecules are functioning aberrantly in different NSCLC patients, some of them being Mesenchymal–epithelial transition factor (MET), Kirsten Rat Sarcoma (KRAS), Epidermal Growth Factor Receptor (EGFR), etc. The paper analyzes the limited success of molecular targeted therapies in NSCLC in the context of MET inhibitors, and generalizes the results of analysis for any molecular targeted therapy against any cancer. The paper ends with the suggestion that the targeted molecular therapy in NSCLC be combined with the depressants of the Pentose Phosphate Pathway to improve patient response to the therapy.

Keywords: Clinical trial; Clinical success; Inhibitors; Proliferation; Apoptosis

The objective of this project was to build a system software that could assist any first responder irrespective of their background in first-aid. It employed a combination of Internet of Things (IoT) technologies to dial for emergency medical assistance and make a diagnosis of the treatment needed. An Image Recognition (IR) service was trained using IBM Watson to assess the casualty’s primary condition. Training phrases were fed into Dialogflow to construct a voice and text-based conversational interface for Google Assistant’s Artificial Intelligence (AI) to give a secondary diagnosis. Vuforia’s Augmented Reality (AR) engine in Unity was then enlisted via Target Detection to display a virtual assistant applying first-aid on the casualty. The components were amalgamated using the AI’s autonomous control over the IR and AR applications to create the end-to-end system software. Lastly, XCode, an app-building engine, developed the components into prototype mobile applications. Future prototyping could assist first responders during an actual emergency and complement the Singapore Civil Defence Force’s efforts of promoting high
standards of first-aid.

Keywords: Internet of Things; Augmented Reality; Artificial Intelligence; Deep machine learning; First-aid

Anesthesiologist plays a role in the recovery of the patient without any risk with the ideal anesthesia management, under the responsibility that the science of anesthesiology is not a preventive, protective, therapeutic method alone.

The practice of anesthesia requires a high level of medical expertise as well as significant practical skill, and most importantly, anesthesia is a team effort. In many cases, the responsibility of not only the expert but also the departments and regulatory authorities that set up the system should be considered. Therefore, the appropriate method for patient safety should often be the systems approach. However, this does not remove the responsibility that each doctor should strive for quality, safe approach and excellence in his work for his patient [1].

For boosting the immune system, to promote optimum health & to reduce the complications or risks of the disease, kitchens ingredients play a significant role. The objective of this study was to find out the popular home remedies for common cold and to modify them for better results. Survey and interview method helped in collecting the field information from the sample of hundred respondents. The most popular remedies were identified and modified by addition of any three more ingredients from the kitchen shelf. The modified recipes were subjected on the sample of twenty-five adults suffering with common cold. Their experiences showed reduced recovery time and better response in improving their general health condition.

Keywords: Common cold; Home remedies; Kitchen ingredients

Medical design may intervene to improve, prolong and save lives. Many health critical problems can be addressed thanks to the power of design, which solutions, developed in academic and business settings, can answer in an innovative way to the needs of patients. It is in this context that is located the ongoing research presented, which is based on the integration between parametric design and data visualization, whose convergence leads to the realisation of medical devices customized on specific morphologies and needs of users and, as well, - thanks to the integration of IoT - capable to record and return data related to the course of the therapeutic advancements, made readable for both patients and doctors. As highlighted by the most recent scientific literature, the development of technological medical devices, able to reduce steps and simplify the doctor/patient relationship, is becoming an important field of research, most of all if we consider the condition of endemic fragility that characterises the contemporary society. In this perspective, the aim of the paper is to introduce the concept and design of orthopedic devices, through the description of the methodology and approaches applied and of the protocol outlined during the research.

Keywords: Medical Design; Parametric Design; Information Design; E-health; Personalized medicine

Objective: Smile plays a vital role in facial appearance. The current study was performed to evaluate the smile parameter variations between Class I and Class III male subjects aiming to obtain a full understanding to smile features serving in diagnosis and treatment planning for highest patient satisfaction.
Materials and Methods: This study was performed on 30 skeletal Class III and Class I males. Two frontal digital photographs were taken for each subject, one at rest and the other in the posed smile position. Photographs were uploaded on Photoshop software for standardization and then uploaded on the Digital Smile Design software (DSD) where the actual incisogingival height of the central incisor was used for automatic calibration.
Results: At rest, there was no significant difference for all soft tissue measurements of Class I and Class III males, while on smiling, Class III males tended to have wider smile widths, less incisor display, wider smile width and a higher percentage of non-consonant and flat smile arcs than normal Class I subjects.
Conclusions: The maxillary incisor display for Class I was found to be significantly greater than that for Class III. The smile width and smile height for Class III was found to be significantly greater than that of Class I.

Keywords: Class III males; Esthetics; Malocclusion; Smile

Brain gate is an electrode chip that’s implemented in the cortex of the brain. It is a system developed by cyberkinetics, a biotech company in the year 2003 in connection with neuroscience department at Brown University. It helps to exchange the electrical signals between brain and the electrical gadgets. The principle behind this brain implant system is with normal brain functions, brain signals are been generated, but they can’t be sent to arms, hands or legs, these signals are understood and translated to cursor movements, which helps the individual to regulate the computer by his or her thoughts. Special software carries all the signaling processes.

Keywords: Brain gate; Electoral signals; Cursor movements

A study to assess the knowledge, opinion of faculty and post graduate students of nursing regarding translational Research in nursing in Tirupathi was conducted on 50 nursing faculty and 50 nursing post graduate students in Tirupathi, with the objectives to find out 1. Knowledge regarding translational Research 2. Opinion regarding translational research. Method and Material It was an incidental study conducted by the investigator when nearly 500 nursing personnel came to participate in the national workshop organised by Sri Padmavathi Mahila Visva vidyalayam in Tirupathi. The study comprised of survey questionnaire of multiple choice type to elicit the information and an opinion check list. The sample of study is selected randomly from 2 groups comprised of faculty and post graduate students. The data was collected before starting of the Workshop when participants assembled for registration. Results showed that the knowledge score’s levels of nursing faculty was almost the same as that of post graduate nursing students. However, both groups showed slightly different responses on opinionnaire regarding translational research. Conclusion Translational research in nursing is not a myth and distance dream but can be a realty.

Keywords: Nursing; Evidence Based Practice; Nursing Education; Nursing Research; Translational Research; Knowledge and Opinion

Neurological and neurodegenerative diseases have become a major social and economic burden worldwide with more individuals predicted to be affected in coming decade. Therefore, understanding the neuropathological mechanism and identifying the promising target for intervention has become an active area of research in neurodegeneration. The chronic neuroinflammation has considered to be fundamental mechanism causing progressive loss of dopaminergic neurons as observed in clinical course of various neurodegenerative diseases. Microglial proliferation and activation are the hallmarks of several neurological disorders.

Human Brain is made up of interconnected cells called neurons. The connection between these neurons is called neural network.Thoughts are created by interconnected brain cells called neural network. It is the result of hidden data and input data. If suffering, then it is because there is something wrong in your hidden data. Take good input data that will override the hidden data to create good thoughts. Artificial neural network is the pattern to work like the human neural network.

Background: Due to the ongoing pandemic of Covid-19 almost all the sectors in the world left the traditional ways behind and the educational sector was no exception. Nowadays the school children are able to pursue their education remotely inside their most familiar physical setup, their home, with the help of information technology. This study aimed to find out the impact of this ‘online learning’ among school children. Methods: A quantitative approach which adopted a descriptive survey design was used for this study among 30 school going children from selected schools in Kerala. These 06-18 years aged children were selected using convenient sampling technique and data collection was done through a structure checklist. The collected data was analyzed using descriptive and inferential statistics using Minitab Version 16. Results: The impact of online learning was graded in to positive and negative for analysis and interpretation of the data. The findings showed that majority of the school children (63.33%) were positive impacted from online learning and there was no association found between online learning and demographic variables at 5% confidence level (p<0.05). Discussion: Even though the online learning had a positive impact on school children, to get most out of the online learning, the teachers must have to adjust the materials and methods used for remote teaching to make them more interesting for the learners.

     We performed in 1975, the first heterotransplantation of invertebrate A.O in nude mouse, then a double heterotransplantation of human tumor and axial organ next to this last one, always in nude mouse: The human tumor was rejected in 50% of observed cases. Some years later, we found that A.O cells exerted an induced and spontaneous cytotoxicity against SP2 and MBL2 mouse tumoral cells. Recently, we discovered a sea star Igkappa gene with immune properties. This gene was inserted in a CMV (cytomegalovirus) and finally in a plasmid called « young » plasmid.

     The induced « young » protein exerted a spontaneous cytotoxicity against osteosarcom cells (U2oS cells) against A-375 melanome cells and Hela cells.

Background: Pregnancy involves many maternal physiological and psychological changes both of which has implications on sleep. During the first trimester, sleep is disturbed by the hormonal changes and in the last trimester the grown up fetus and the anxiety regarding delivery disturbs the sleep. Objectives: This study was done to evaluate the Sleep Disturbances during Pregnancy among Pregnant Women, in a tertiary Hospital at Puducherry. Methods: 238 pregnant women were interviewed using modified Pittsburgh Sleep Quality Index (PSQI) to evaluate the Disturbances in sleep during Pregnancy. Results: The findings of the study showed that that almost all the subjects (87.3%) had poor sleep in their pregnancy. Only 12.7% had good sleep quality. The mean Pittsburgh Sleep Quality Index Score was 7.60 (SD - 1.83), which shows poor sleep during pregnancy. No significant relationship was identified between sleep quality with selected socio demographic and clinical variables. Conclusion: Sufficient good sleep during pregnancy is important to improve the pregnancy outcomes. It can be conluded that there is a great need to sensitize antenatal women on this issues appropriately.

Key words: sleep quality; pregnant women

     World Health Organization and United Nations Children’s Fund in 1980 has stated that if the baby does not get his/her own mother’s milk, the best food for that baby is Human breast milk from another lactating mother. Donor milk has a broad range of therapeutic uses. Common reasons for prescribing donor milk are prematurity, allergies, feeding formula intolerance, immunologic deficiencies, etc. Breastfeeding is not recommended for mothers who have specific health problems. In the absence of the infant’s mother’s milk, donor milk offers the benefits of human milk for the infant, including optimal nutrition, easy digestibility, and immunological protection against many organisms. Human milk also contains growth factors that can protect immature tissue, promote maturation, particularly in the gastrointestinal tract, and promote the healing of tissue damaged by infection.

     A human breast milk bank is a service that collects, screens, processes, and dispenses by prescription. Human milk is donated by nursing mothers who are biologically not related to the recipient infant. The optimum nutrition for newborn is breastfeeding, if possible for the first year.

     Human milk is recognized for its numerous benefits, including tolerance to allergens, providing passive immunization, improving lipid profile, and controlling blood pressure. In studies conducted in the neonatal unit, infants fed human breast milk had fewer severe infections, less necrotizing enterocolitis, and less colonization by pathogenic organisms. The majority of mothers are encouraged to breastfeed their babies. However, breastfeeding arises when the baby is sick or admitted to the hospital, particularly in premature infants. Also, the mothers may be unable to provide an entire volume of milk due to numerous physical and emotional behaviors to breastfeeding. So, the pasteurized donor milk from a healthy mother should be the first consideration for supplementation. In such cases, the role of breast milk banks becomes crucial as these are the place where the donor milk is stored and is made available for use in vulnerable populations. India is a developing country where neonatal mortality is  very alarming. Breast milk banks are essential for the control of cases of neonatal mortality and malnutrition.

Methodology-This cross-sectional study aimed to assess the level of knowledge of nursing officers regarding the human breast milk banks and to identify service-related factors associated with the level of knowledge on human breast milk banks among nursing officers. One hundred seventy-six participants were selected for the studies who fulfil the inclusion criteria of the study. A structured questionnaire was used to assess the knowledge level among the nursing officers. Both inferential statistics and descriptive statistics were used in this study.

Results-A total of 176 nursing officers were analyzed. Findings revealed that most nursing officers had inadequate knowledge (93.18%) regarding the human breast milk bank.

Conclusion-Most of the nursing officers are having inadequate knowledge regarding the breast milk bank. The study also reveals the clinical experience; the area of posting has a significant correlation in the knowledge level of the participants so that the institute can plan for in-service education programs to update the staff’s knowledge.

Keywords: Human breast milk bank; Preterm neonates; Nursing officers; Nutrition

      In a study looking at potential impact to respiratory health of quarry workers exposed to airborne respirable crystalline silica (RCS) in Queensland, Australia, respirable dust exposure sampling was undertaken using the method specified in AS 2985-2009. Analysis of the collected samples for alpha quartz was carried out using infrared spectroscopy. Lung function tests for the exposed workers at each quarry were conducted using an Easyone® spirometer. The aim of this study was to determine whether increased RCS exposure is associated with a reduction in lung function. Personal RCS exposures were pooled into similar exposure groups (SEGs), minimum variance unbiased estimates (MVUE), were plotted against the forced expiratory volumes in one second (FEV1) % of predicted for corresponding SEGs. Non-linear correlations were observed including natural log and polynomial function. Estimated (full shift) exposures pooled for each Similar Exposure Group (SEG) correlated with lung function measured as FEV1 % of predicted (p<0.05) as confirmed by the Kolmogorov goodness of fit test. Furthermore a trend test using SAS 9.4 resulted in p = 0.0013. A major finding for those workers exposed to RCS at 0.1 mg/m3 was loss of lung function greater than 20%. The increased loss of lung function was positively correlated with jobs associated with increased RCS exposure. When similar exposure groups were combined into three RCS exposure ranges categorised as high (≥ 0.09 - ≤ 0.20 mg/m3), medium (≥ 0.04 - ≤ 0.08 mg/m3) and low (< 0.04 mg/m3), analysis of variance (ANOVA) confirmed that the loss of lung function below the lower limit of normal (LLN) at 0.1mg/m3 TWA-8hrs, is significant (p < 0.05). 

      A major finding from this study predicts that an abnormal loss of lung function may occur even when workers are exposed to RCS where the occupational exposure limit (TWA) is 0.1 mg/m3 or greater which is the case in many jurisdictions.
Keywords: Respirable Crystalline Silica; lung function; quarries

The use of illegal drugs, excessive consumption of drugs with or without prescription, alcohol, and marijuana is known as substance abuse. There can be both physical or psychological dependence [2]. Substance abuse is one of the main problems among medical students. The reason behind substance abuse among medical students is the stress of the study, the curiosity of how it tastes, party and occasion celebrations. Medical students were getting those substances through their friends [9]. Risk factors for substance abuse disorder are family history of substance abuse, peer pressure, mental health disorder, use of abusive substances at an early age, and lack of support from the family. Different types of substance abuse disorders are Opioid Use Disorder., Marijuana Use Disorder. Alcohol Use Disorder. Sedative Use Disorder., Nicotine Use Disorder. Stimulant Use Disorder. Hallucinogen Use Disorder [2].

Pedophilic disorder is characterized by recurring, intense sexually arousing fantasies, urges, or behavior involving children (usually 13 years old or younger). In some undeveloped countries, a lot of sensitizations hasn’t been done yet to defend pedophilia as a maladaptive condition and even give room for treatment of pedophiles.

Neutrophilic urticarial dermatosis is a rarely discovered entity manifesting as a maculopapular, barely pruritic or non-pruritic, fleeting erythema with a specific histological appearance showing a perivascular infiltrate of unaltered neutrophils without associated vasculitis. This entity is associated with certain systemic diseases such as Still’s disease, Gougerot-Sjögren syndrome and Schnitzler syndrome. We report the case of a patient who presented with neutrophilic urticarial dermatosis (NUD) associated with systemic lupus erythematosus (SLE) with extracutaneous renal involvement.
Keywords: Neutrophilic urticarial dermatosis; lupus nephropathy

Food hygiene practices to human existence cannot be over-emphasized. It bring about good health, growth and development of the people when it is properly maintained, while improper handling of hygiene practices could lead to illness and diseases, poor health, increased medical bills and reduced productivity. This study work on the state of hygiene practices and its important in promoting good health and development of human growth in Ekiti State. The aim is to foster proper hygiene practices among people in the State. The research will shows among others that the campaign for good hygiene alone does not assure quality and safety hygienic practice, that high premium must be placed on ascertaining compliance with proper hygiene Practice by people, food manufacturers and food agencies. Its suggested that citizens, food handlers and manufacturers should maintain high level of personal hygienic practices, and health practices in line with regulatory standards.
Keyword: Food Hygiene; Hospitality Industry

Data collection process has witnessed explosive growth that could even outsmart the measurable gains in the field of power of computation as speculated by Moore’s Law. However, scientists spread over various domain are smearing victory through network models to denote their data. Graph- algorithms come in handy to investigate the topological structure and bring out the hidden relationships and attributes among variables. But the task of finding dense subgraphs, are still hard to negotiate from a computational viewpoint. So, it is stimulating to find new algorithmic methods in the probe of graphs derived from huge data sources that are complex. We provide a bird’s eye view of application of graph theoretic tools crisply for the probe of complex networks based on gene expression signatures and to find exact and effective solutions to hard combinatorial tasks such as epigenetic biomarker detection. To make an efficient design which is algorithm based, a probe of two core components of fixed parameter tractability namely branching and kernelization is suggested for parallel imposition of vertex cover. We have also discussed the concept of Para clique and domination concept to better handle gene expression networks.
Keywords: Genes; Genetic Networks; Data Types; Graphs; Clique Domination

Corona virus disease 2019 (COVID 19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [1]. It is transmitted chiefly by contact within factious material (such as respiratory droplets) or with objects or surfaces contaminated by the causative virus and is characterized especially by fever, cough, shortness of breath and may progress to pneumonia and respiratory failure. The present study was a descriptive study to assess the lifestyle changes adopted during covid-19 among young adults residing in selected districts, kerala. The research approach was quantitative, and the research design adopted was descriptive survey design. 100 samples were selected by purposive sampling technique. An informed consent was obtained from the study subjects. The study was done using online structured questionnaires. Data was analyzed using descriptive and inferential statistics. The result revealed that majority of samples 62% have changes in dietary habits and 69% preferred indoor activities during this pandemic. Among samples 33% gained weight, 41% had mild anxiety during this period and 46% preferred cooking as most common leisure activity during this time. There is a greater elevation in social media usage. There was a significant association between lifestyle changes and selected demographic variables. The various changes that have become a part in our lives during this pandemic tragedy. The way forward must also be to learn the art of living with corona. And this cannot be without some changes to our lives.
Keywords: Covid-19; Lifestyle changes

Microvita are the smallest living entities, the concept which was first propounded by Shrii P. R. Sarkar in 1986. The science of Microvitology has categorized the microvita depending on their subtlety and field of activity. Positive microvita are conducive for human psycho-spiritual progress while negative microvita are detrimental for physico-psychic health. All the viral diseases are in fact negative microvita diseases affecting both physical (Microvitopathy) and psychic structures (Microvitopsychopathy) and the world has faced many epidemics of such diseases. According to Microvitotherapeutics, negative microvita could be destroyed only by increasing the number of positive microvita. For this purpose, sentient diet and environment, adopting moral cardinal principles along with regular practice of psycho-spiritual meditation are mandatory pre-requisites. In this context, the science of microvita should be thoroughly explored in physical and mental laboratories to combat with such negative microvita diseases.
Keywords: Microvita; Microvitotherapeutics; Virus; COVID-19

In traditional Chinese medicine (TCM) philosophy, we believe that Human body are holist, it is a small universe. We also believe the corresponding relationship between five Yin organs, six Yang organ, five tissues, five sense organs with five directions, four seasons and five tastes in the nature. It unify the human body and nature environment together, reflecting the mutual acceptances of the human body and universe, which just reflects the concept of harmony between human and nature.