Health Sciences

Diabetes mellitus is a chronic metabolic syndrome characterized by hyperglycemia due to defective insulin secretion, insulin action or both. Nowadays massive developments in variety of synthetic modern medicines, alternative and traditional medicinal plants are still widely used for the management of diabetes mellitus. In this context when ethyl acetate fraction at the dose of 100 mg body weight/kg body weight was administered for 28 days, significant diminution in the STZ-induced hyperglycaemia was noticed. Plasma insulin and C-peptide levels as well as activities of antioxidant defense enzymes such as catalase (CAT), peroxidase (Px) and superoxide dismutase (SOD) in the hepatic tissue were found to be decreased in diabetic animals. This was corrected after the treatment of ethyl acetate fraction of hydro-methanolic extract of T. indica. Oral glucose tolerance test (OGTT) reveals that the fraction at the above said dose showed a remarkable decrease of blood glucose level in normal ...

Appropriate use of antibiotics remains critical for success in achieving MDG4. The aim of this study was to investigate antibiotics prescribing practices to febrile under-five children outpatients in urban public health services in a low income country. Methods: From March to April 2013, a cross-sectional epidemiological study of care facilities visit by under-five age, for febrile illness, was carried out in urban health services in Bobo-Dioulasso, Burkina Faso. Patient demographics, diagnoses and medications were recorded. We calculated for each diagnoses several indicators for antibiotics use. Results: Our study showed an over-prescription of antibiotics at the university teaching hospital (78.08%) and at the first level facilities (57.71%) for under-five outpatients for febrile illness. There was evidence of high antibiotic prescription in children with diarrhea (more than 9 on 10 at university teaching hospital of diarrhea cases and 60% at the first level facilities), in children with Upper respiratory tract infections (respectively 60% and 85.2% of cases at university teaching hospital and at the first level facilities) and in children with malaria (respectively 47.5% and 17.6% of cases at university teaching hospital and at the first level facilities). Overuse, misuse and inappropriately prescribed antibiotic coexisted in our results: at university teaching hospital 90.9% o f d iarrh ea cases, 60% o f URT I cases, 47.5% of malaria cases received antibiotic prescription; at first level heath care facilities 85.2% of URTI, 17.6% of malaria cases received an prescribed antibiotic and 11.8% of LRTI did not received a prescribed antibiotic. Developing countries have poor access to newer antibiotics and irrational antibiotics use remains a global problem. Overuse and misuse of antibiotics combat, rigorous infectious diseases diagnosis, antimicrobial resistance consequences education of users and health professional's prescribers, and improved surveillance of antimicrobial resistance, must be strengthened.

Ao meu Orientador, Dr. Joaquim Gonçalves, pela colaboração e compreensão, À minha família, pela paciência e pelo apoio incondicional, em especial à minha irmã e ao André Soares pela ajuda na revisão deste trabalho, Aos meus amigos, por partilharem comigo este percurso, Ao Pedro Nogueira e ao Luís Teófilo pela sua preciosa ajuda na revisão e formatação desta monografia, A todos, muito obrigada. Introdução | O parto pré-termo constitui um grave problema de saúde pública, com incidência crescente em países desenvolvidos, fruto da progressiva intervenção médica na reprodução humana. A prematuridade implica mortalidade e morbilidade neonatais assim como, encargos económicos. Com o intuito de prever o parto prematuro, diversos marcadores bioquímicos têm sido sugeridos na literatura, embora muitos não se apliquem na prática. Objectivo | Abordar a problemática do parto pré-termo e rever alguns dos seus marcadores bioquímicos de modo a comparar a sua eficácia em mulheres sintomáticas e assintomáticas. Métodos | Elaboração de um artigo de revisão bibliográfica baseado em literatura das últimas duas décadas, presente no arquivo científico biomédicopubmed. Desenvolvimento | Os marcadores de parto pré-termo apresentam diferentes desempenhos conforme são usados na predição de parto pré-termo em mulheres sintomáticas ou assimtomáticas. A fibronectina fetal, a proteína-1 fosforilada ligada ao fator de crescimento insulina-like assim como, as interleucinas são mais assertivas no diagnóstico a curto prazo nas mulheres sintomáticas. O estriol, a α-fetoproteína e a gonodotrofina coriónica humana β têm boa performance na avaliação de mulheres assintomáticas. Alguns dos marcadores apresentam melhores resultados quando estão associados ao comprimento do colo do útero ou quando são estudados em várias amostras sucessivas. Conclusão | Em mulheres sintomáticas, os marcadores bioquímicos com mais utilidade na prática clínica são, a fibronectina fetal, a proteína-1 fosforilada ligada ao fator de crescimento insulina-like e as interleucinas. Na avaliação de mulheres assintomáticas, a α-fetoproteína e a gonodotrofina coriónica humana β são marcadores amplamente associados a prematuridade. A proteína C reativa, obtida no segundo trimestre da gestação, e o estriol, também têm capacidade de rastrear estas mulheres. Os testes da fibronectina fetal revelaram ter uma boa relação custo-benefício quando os médicos têm em consideração os seus valores.

The medical education is shifting from teacher centric methods to student centric methods in these times. Nowadays more emphasis is given on learning component as compared to teaching component. Earlier, the large group teaching was considered as the principle method to deliver the content to the large number of students. But since few years, the small group teaching has over taken in imparting the knowledge as well as skills in medical students. The small group teaching plays a key role in developing confidence, self learning ability, critical thinking as well as problem solving skills, and leadership & team working capacity among the students. In this method, the educator plays a role of facilitator rather than lecturer, where the students are given problems or tasks instead of readymade solutions. It provides opportunity to the students for interactive discussion and masters them in communication skills also which is need of the time. Small group teaching demands time, resources,...

The World Health Organization (WHO) defines Pharmacovigilance as the science & activities relating to detection, assessment, understanding and prevention of adverse effects or any other drug related problem. The National Pharmacovigilance Programme (NPVP) was launched in 2004 with World Bank funding till 2009, which was renamed as Pharmacovigilance Programme of India (PvPI). With advancement in the field of science and technology, India is emerging as a hub for clinical trials and new drug development, which challenges the monitoring of safety concerns in the use of new drugs. It has been difficult to identify or track the adverse drug reactions (ADRs) that occur in the patients due to polypharmacy, use of over the counter (OTC) preparations, change in physician etc. Hence the national programme has gained importance in our country off late. Yet it is observed that the importance of this programme is not realized by all health care professionals. Therefore, to support & strengthen t...

COVID-19 has occurred worldwide and left the detrimental effects affecting millions of people & caused deaths. It has affected almost every system of the body and left the survivors suffering with one or other complications. This review has studied and analyzed many articles published during and post COVDI period. The post COVID symptom varies from psychological to multiorgan involvement. This review was undertaken with the purpose of presenting a current scenario regarding the long term complications among the survivors from the various literatures. This may help the health care providers to be vigilant for observing and monitoring these symptoms in patients who suffered with COVID-19, which may help to provide better health care and improve their quality of life.

The World Health Organization (WHO) defines Pharmacovigilance as the science & activities relating to detection, assessment, understanding and prevention of adverse effects or any other drug related problem. The National Pharmacovigilance Programme (NPVP) was launched in 2004 with World Bank funding till 2009, which was renamed as Pharmacovigilance Programme of India (PvPI). With advancement in the field of science and technology, India is emerging as a hub for clinical trials and new drug development, which challenges the monitoring of safety concerns in the use of new drugs. It has been difficult to identify or track the adverse drug reactions (ADRs) that occur in the patients due to polypharmacy, use of over the counter (OTC) preparations, change in physician etc. Hence the national programme has gained importance in our country off late. Yet it is observed that the importance of this programme is not realized by all health care professionals. Therefore, to support & strengthen t...

Persons with pronated feet may be prone to more injuries than these with normal feet. As it disrupts the body’s natural alignment and causes increased impact when the foot strikes the ground. The purpose of the present study was to compare the effects of 4-week core stability training and foot intrinsic muscle training on foot posture in females. Twenty-six females with pronated feet were randomly divided into two groups. The group A performed the core stability training (n=13) and the group B performed the foot intrinsic muscle training (n=13) for four weeks with frequency of 5 sessions per week.  Foot Posture Index, McGill protocol, weight distribution and foot load response were assessed at the baseline and at the end of four weeks. Dependent t-test was used to check the differences within the group before and after the program. Independent t-test was used to compare the differences between groups after the intervention. 

Background: Although tobacco consumption in Iran has decreased in recent years, in 2010, the exposure to cigarette smoke was the fifth leading risk factor for death in Iran. This article is presenting the protocol for the prevention against tobacco dependence (PAD) project, an initiative planned and implemented by the Iranian Anti-Tobacco Association (IATA) of Iran in the city of Varamin. Methods: This project is carried out based on a participatory community-oriented approach and an action research method. It includes four inter-related, prospective studies phases; pilot, tobaccofree school (TFS), tobacco-free neighborhood (TFN), and tobacco-free city (TFS). The measuring tools for each phase were designed primarily using CDC and WHO guidelines and preliminary details were identified. Each phase is a combination of different methods (including systematic observation, questionnaire, heuristic interview, and structured interview). The studies will examine twelve goals and meet 9 project objectives in a comprehensive evaluation of ongoing progress with TFS, TFN, and TFC. Discussion: This project seeks to achieve indicators of tobacco-free schools, neighborhoods, and cities through direct and indirect education of all the target groups in the community. Participation of stakeholders and supporters in problem-solving can increase the effectiveness and influence of the project. The outcomes of the first two phases will be expanded to the wider settings.

Introduction: The aim of the study was determining the type of weapon and shooting distance depending on chemical analysis of inorganic gunshot residue from the skin gunshot wounds in experimental animals (pigs).Methods: Experimental study was conducted in order to determine components and their percentage in gunshot residue (GSR). In 60 samples, pig skin was shot by fi ring projectiles from four different weapons and from three different distances (contact wound and near contact wound from 5 cm and 10 cm). The methodology included determining the presence of inorganic material: antimony, barium, lead, nickel, zinc and copper in the skin and subcutaneous tissue using atomic absorption spectrophotometry (AAS).Results: Formula for determining weapon type was provided cutt-off points for different weapons, with 78.6% of original grouped cases being correctly classifi ed. Formula for determining weapon type was provided cutt-off points for different distances, with 58.9% of original gro...

Nanocarriers outperform traditional medication dosage forms in terms of efficacy, safety, and tolerability because of their small size, large surface area, and potential for precise targeting. More and more researchers are looking to produce nanocarriers that can be used to treat a variety of illnesses. Dendrimers, liposomal nanoparticles, polymersomes, polymer–drug conjugates and peptide nanoparticles are only some of the nanocarriers that have been developed for drug delivery. Other nanocarriers include carbon nanotubes, nanoshells and carbon dioxide nanoparticles. Nanocarriers have been characterised using a variety of approaches during the past few decades, both in vitro and in vivo. Most nanocarriers are characterised using fundamental in vitro, ex vivo, ex situ, and in situ techniques, which emphasise their advantages and limitations as well as regulatory and manufacturing issues that hinder the transfer of nanocarriers from laboratory to clinical use, as described in this rev...

OBJECTIVES: This study examined the prevalence, social correlates, and clustering of cardiovascular disease risk factors in a predominantly Black, poor, urban community. METHODS: Associations of risk factor prevalences with sociodemographic variables were examined in a population-based sample of 695 men and women aged 18 to 65 years living in Central Harlem. RESULTS: One third of the men and women were hypertensive, 48% of the men and 41% of the women were smokers, 25% of the men and 49% of the women were overweight, and 23% of the men and 35% of the women reported no leisure-time physical activity over the past month. More than 80% of the men and women had at least 1 of these risk factors, and 9% of the men and 19% of the women had 3 or more risk factors. Income and education were inversely related to hypertension, smoking, and physical inactivity. Having 3 or more risk factors was associated with low income and low education (extreme odds ratio [OR] = 10.2, 95% confidence interval...

teniendo en cuenta la carga de enfermedad que representan y que algunos trastornos mentales del adulto tienen su origen en la ni ñez o en la adolescencia, lo cual exige un mayor conocimiento del problema para dise ñar intervenciones oportunas y disminuir las complicaciones a largo plazo. Objetivo: Determinar la prevalencia y los factores asociados de los trastornos en los últimos 30 días y los últimos 12 meses. Métodos: Se aplicó la entrevista estructurada Diagnostic Interview Schedule for Children (DISC-P), que provee diagnósticos del DSM-IV a los cuidadores de ni ños no institucionalizados de 7-11 a ños. Se evaluaron los siguientes trastornos: depresión mayor, distimia, ansiedad generalizada, ansiedad de separación, déficit de atención e hiperactividad en sus tres presentaciones (mixto, inatento e hiperactivo), negativista desafiante y de conducta. El instrumento fue asistido por computador. Resultados: Se presentan las prevalencias de los trastornos tanto en los últimos 30 días como en los últimos 12 meses. En general se observa una prevalencia de cualquiera de los trastornos medidos del 3% (intervalo de confianza del 95% [IC95%], 2,2%-4,0%) en los últimos 30 días y del 4,7% (IC95%, 3,6%-6,2%) en los últimos 12 meses. Son más frecuentes en las mujeres. El trastorno por déficit de atención e hiperactividad es el más frecuente (el 2,3 y el 3,0%). Además, los trastornos de la conducta de inicio habitual en la infancia son los más frecuentes en este grupo etario, con prevalencias del 2,5% en los últimos 30 días y el 3,2% en el último a ño. Se presentan factores de riesgo asociados. Conclusiones: La ENSM de 2015 provee una información sobre la realidad de la situación mental de los ni ños de 7-11 a ños de Colombia que permitirá dise ñar estrategias de prevención, diagnóstico y tratamiento más apropiados y precisos.

Introduction: Diabetes Mellitus is a chronic metabolic disease wherein there is inadequate control of blood levels of glucose. Regardless of the specific type of diabetes, complications involve: microvascular, macrovascular, and neuropathic. Diabetic neuropathy leads to loss of sensation in their feet, burning or shooting pain in the lower extremity, sores, ulcers, and infections due to impaired sensations. Nerve damage also leads to increase problems with balance and coordination, leading to increased risk of fall. Method: In this study total 30 patients of diabetic neuropathy were selected and were trained with the task-oriented training protocol for 4 weeks. Pre and post activity specific balance, proprioception and lower limb function were assessed using Activity Specific Balance scale, Distal Proprioceptive Test and Lower Limb Function Scale. Results: Activity specific balance, Proprioception and lower limb function significantly improved (p <0.0001). Analysis showed that Ta...

Background: Hypertension has become an important public health challenge globally because of its high prevalence and concomitant increase in its risk for cardiovascular, cerebrovascular and renal diseases . A major characteristic of this disease is its insidious ons et and the inability of the affected individual to detect it on time until it has become complicated, for this reason, it is u sually referred to as a ‘silent killer’. Aims: This study was conducted in a University in the So uthwestern region of Nigeria. It assessed the preva lence of hypertension among the cleaners and their knowledge about it. It further examined the association betw een their educational status and knowledge of hypertension, r elationship between age, Body Mass Index and development of hypertension. Methodology: A non-experimental descriptive research design was adopted for the study. The Cluster Sampling Technique was employed to select a total of 228 res pondents. A self-developed, semi-structured a...

Când John Thomas şi-a început studiile despre tinereţea fără bătrâneţe, vârsta sa calendaristică era de numai 27 de ani, în timp ce vârsta reală, adică cea bioelectrică, era de 39 de ani. Astăzi, el are 53 de ani, conform calendarului, DAR vârsta sa bioelectrică s-a redus la numai 19 ani! Thomas este el însuşi cea mai bună dovadă a posibilităţii inversării procesului de îmbătrânire, pentru toţi cei care doresc să experimenteze personal acest lucru. John a fost puternic influenţat de vieţile exemplare trăite de Paul C. Bragg şi Jack LaLanne. Şi-a petrecut 26 de ani studiind fiecare aspect al procesului de îmbătrânire, refuzând dogmele unanim acceptate la ora actuală, deopotrivă ale medicinii convenţionale şi alternative. Thomas a descoperit faptul că "ştiinţa medicală" nu pune întrebările corecte, motiv pentru care nu găseşte răspunsurile cele mai bune, în timp ce "medicina alternativă" porneşte de la jumătăţi de adevăruri şi de la premise complet greşite, care nu conduc la rezultate pe termen lung.

Ethmoturbinates, nasoturbinates, and maxilloturbinates are well developed in the narial tract of land‐dwelling artiodactyls ancestral to whales, but these are greatly reduced or lost entirely in modern whales. Aegyptocetus tarfa is a semiaquatic protocetid from the middle Eocene of Egypt. Computed axial tomography scans of the skull show that A. tarfa retained all three sets of turbinates like a land mammal. It is intermediate between terrestrial artiodactyls and aquatic whales in reduction of the turbinates. Ethmoturbinates in A. tarfa have 26% of the surface area expected for an artiodactyl. These have an olfactory function and indicate that early whales retained a sense of smell in the transition from land to sea. Maxilloturbinates in A. tarfa have 6% of the surface area expected for an artiodactyl. These have a respiratory function and their markedly reduced size suggests that rapid inhalation and exhalation was already more important than warming and humidifying air, in contras...

recently described the synthesis of optically pure enantiomers of (+)-trans-3 ,488). In the present study we examined the in vitro opioid receptor selectivity of (-)-(1S,2S)-U50,488, (+)-(1R,2R)-U50,488 and (___)-cis-3,4-dichloro-N-methyl-N-[2-(1-pyrrolidinyl)-cyclohexyl]benzeneacetamide (the cis diasteromers of U50,488), as well as their pharmacological activities in rhesus monkeys. Using ) to label K binding sites of guinea pig membranes, the apparent dissociation constants of the enantiomers of U50,488 were 0.89 and 299 nM, for the (S,S) and (R,R) enantiomers, respectively. The (-)-cis and (+)-cis diastereomers had apparent KdS of 167 and 2715 nM, respectively. Binding surface analysis of the interaction of (-)-(1S,2S)-U50,488 with x binding sites labeled by [3H]bremazocine resolved two binding sites at which (-)-(1S,2S)-U50,488 had KdS of 30 and 10485 nM, respectively. The (+)-cis, (-)-cis and (+)-cis diastereomers of U50,488 (1 /~M) did not inhibit [3H]bremazocine binding. Rhesus monkeys were trained to discriminate ethylketocyclazocine (EKC) and saline. All compounds tested substituted completely for EKC. The order of potency was (-)-(1S,2S)-U50,488 > (+)-U50,488 > (___)-cis diastereomer of U50,488 > (+)-(1R,2R)-U50,488. In tests of analgesia, (-)-(1S,2S)-U50,488 was 2-4 times more potent than (+)-U50,488, while (+)-cis diastereomer of U50,488 and (+)-(1R,2R)-U50,488 were inactive at the highest doses tested (32 mg/kg). Taken collectively, these data indicate that the pharmacologically active enantiomer of U50,488 is (-)-(1S,2S)-U50,488, and provide preliminary evidence for three subtypes of x binding sites in guinea pig brain.

The concept of a good death is crucial in palliative care, but its relationship with attitudes toward death and feelings of interconnectedness needs to be further deepened. The first aim of this study was to explore the concept of good death, attitudes toward death, and feelings of interconnectedness among family caregivers (FCs) and health-care providers (HCPs) of terminally ill patients with cancer. The second aim was to analyze associations of good death concept with attitudes toward death and feelings of interconnectedness. Participants were asked to assess the importance of features that characterize a good death. To explore each person’s attitude toward death and feelings of interconnectedness, 3 open questions were used. The sample consisted of 49 participants: 24 (48.98%) FCs and 25 (51.02%) HCPs. Nine good death features were considered essential by more than 70% of participants. These referred to the physical (eg, symptoms control), social (eg, loved ones’ presence), emoti...

Incorporating of silica nanoparticles with crown ethers is of interest regarding the excellent stability of these inorganic polymers against various acidic and basic conditions. The attachments of silica nanoparticles to macrocycles are involved many reactions to attach the active site of crown ether with modified silica nanoparticles. To achieve the goal, the selection of 3,5-dihydroxybenzolic acid as a model for the synthesis of macrocycle base the reaction of esterification of acid residue followed by etherification with propargyl chloride and finally the cyclization reaction with di azide residue to form macrocycle 4. From the other side, the silica nanoparticle both magnetic and mesoporous were prepared in different size and properties according to the literature. The final step involving the attachment of macrocycle to the silica nanoparticles of different type, two methods are used. First method was included the crafting of macrocycle with the ready synthesized nanoparticles under basic medium. Second method is the one-pot synthesis of nanoparticles and adding the macrocycle 4, directly before finish the reaction. All the compounds have been characterized by the instrumental techniques include FT-IR, 1H NMR, 13C NMR, EXD, XRD, FESEM, TEM and BET.

Incorporating of silica nanoparticles with crown ethers is of interest regarding the excellent stability of these inorganic polymers against various acidic and basic conditions. The attachments of silica nanoparticles to macrocycles are involved many reactions to attach the active site of crown ether with modified silica nanoparticles. To achieve the goal, the selection of 3,5-dihydroxybenzolic acid as a model for the synthesis of macrocycle base the reaction of esterification of acid residue followed by etherification with propargyl chloride and finally the cyclization reaction with di azide residue to form macrocycle 4. From the other side, the silica nanoparticle both magnetic and mesoporous were prepared in different size and properties according to the literature. The final step involving the attachment of macrocycle to the silica nanoparticles of different type, two methods are used. First method was included the crafting of macrocycle with the ready synthesized nanoparticles ...

Background: Through surgery, a colostomy is a method of redirecting the flow of stool from the colon to a stoma by making an incision in the abdominal wall. The mothers who care for children with colostomies may experience physical, social, and psychological health problems as a result of providing high-quality care. Numerous stressors that moms face have an impact on their daily lives. Therefore, this study aimed to determine the effect of educational guidelines on stress and coping strategies among mothers having children with colostomy. Method: Design: This study employed a quasi-experimental research design. Sample: comprising fifty mothers who care for children with colostomy. Setting: The investigation was conducted at Sohag University Hospital (MUCH) in the pediatric surgery unit. The tools of data collection were; a structured questionnaire sheet, Parenting Stress Index-Short Form, and Coping Health Inventory for parents. Results: The study found that before educational recommendations, mothers' overall mean stress level was high; however, following educational guidelines, this score decreased. In addition, the overall mean score of mothers' coping strategies was low before educational guidelines but increased following them. Additionally, there was a statistically significant difference between the stress levels of mothers before and after the educational guidance, as well as between the coping strategies they used to lessen their stress. Additionally, it was shown that higher levels of coping strategies were associated with higher levels of parenting stress via positive correlations between parenting stress and coping strategies. Conclusion: Educational guidelines are useful in reducing mothers' stress levels and increasing the coping strategies employed by moms of children with colostomy. Recommendations: Mothers should be taught and advised on a variety of coping strategies and parenting techniques to reduce their stress levels. Additionally, nurses should be heavily involved in health education and counseling mothers regarding all facets of caring for their children who have colostomies as well as strategies for managing the stress that comes with this care.

Diabetes mellitus is a disease that affects millions around the globe. It also comes with a major complication, diabetic foot ulcers. Lower extremities having little to no vascularity in diabetic people leads to wounds that are unable to heal on their own. These wounds later become infected and cause osteomyelitis, a condition in which the infection in soft tissues of the lower extremities spread to the bones of the foot. Charcot arthropathy is one of the more serious foot issues that can arise from diabetic neuropathy. The soft tissues, joints, and bones of the foot or ankle are all impacted by Charcot. The joints in the foot or ankle might dislocate when the bones deteriorate and become brittle. Diabetes patients who have their soft tissues and bones infected might even have to get their extremities amputated if not managed right on time. We describe the case of a 66-year-old man with type 1 diabetes mellitus who presented to the emergency department with increasing pain in the right foot. There was a hyperemic discharge coming out of his wound which increased gradually over time. The patient's been using Lantus and Novorapid and his blood glucose measurement at the time of admission was 466. Our patient said that he was hospitalized in the intensive care unit due to diabetic ketoacidosis 20 days before he applied to our emergency department, and his wounds, discharge, pain, and redness increased after this incident. We requested his anteroposterior and lateral radiographs of the right foot and a lower extremity CT. The scans were examined carefully and at last, amputation was recommended for the patient. The patient did decline our offer and wanted to go home with a dressing. Ampicillin/sulbactam and ciprofloxacin were started. We also recommended he see infectious diseases and plastic surgery consultants in the following days.

The goal is to find the risk of colorectal cancer after an episode of acute diverticulitis in conservatively treated patients. Secondly, to determine the benefit of colonoscopy in these patients. Background: In the Netherlands, it is a common practice to routinely perform a colonoscopy after an episode of conservatively treated diverticulitis to exclude a malignancy. Yet according to the Dutch guidelines, these patients should not undergo a colonoscopy on a routine basis. The aim of this study is to determine the benefit of a colonoscopy in patients who have been treated for diverticulitis conservatively. Study: This retrospective study includes patients who were diagnosed with acute diverticulitis (Hinchey 0 and I) and were treated conservatively, with or without antibiotics. Only patients who underwent colonoscopy were included for analysis. In addition, the outcome (yes or no colorectal cancer) of colonoscopy was analyzed according to patients' presentation of alarm symptoms for colorectal cancer. Results: Between January 2008 and June 2013, 977 patients were treated conservatively for an episode of acute diverticulitis. Of those, 645 underwent colonoscopy during follow-up. Alarm symptoms for colorectal cancer were present in 205 patients. Nine of them were diagnosed with colorectal cancer (4.4%) versus 1 patient (0.2%, P = 0.0002) in the group without alarm symptoms (N = 440). Conclusions: This study confirms that routine colonoscopy is not indicated after acute diverticulitis which has been treated conservatively in a large series. Only in case of alarm symptoms a colonoscopy is mandatory, but even then the actual finding of a colorectal cancer is rare.

This study aims to examine the influence of admission glycaemia and glycosylated haemoglobin (HbA1C) levels on the length of hospitalization and its outcome in insulin-independent diabetes mellitus (DM) patients suffering from ST-Segment Elevation Myocardial Infarction (STEMI)/Non-STEMI (NSTEMI). This cross-sectional study included 103 subjects with a history of insulin-independent DM, currently hospitalized due to acute myocardial infarction (AMI). Out of 103 subjects, 59 (57%) were men and 66 (64.1%) of them suffered from STEMI. Mean age of study population was 67±9 years. The following parameters were monitored: demographic, coronary, cardiovascular and DM risk factors history, as well as laboratory, clinical, echocardiography and angiography parameters. DM mean duration was 7 (1-30) months, and it influenced the length of hospitalization (r=0.232, p<0.05), but not the outcome (r=0.174, p>0.05). Mean length of hospitalization was 8 and 8.5 days in STEMI and NSTEMI patients ...

Corporate Governance is the set of policies that are created for deciding a company's performance and direction. It is an overview of rules and regulations for the people in-charge of an incorporated firm. They are the ones who agree to take responsibility towards the shareholders. Corporate governance is a broad term is today's business environment. The legal outfits of corporate governance can be customized to fit the meticulous choice of each wearer. The present wok is aimed to discuss corporate governance from India's point of view. In the conclusion, the paper gives a summary of how corporate governance is influencing the present economic condition of India.

High blood pressure or hypertension in pregnant women can cause low birth weight baby. Based on the results of previous studies, provision of avocados can stabilize blood pressure become, gradually decrease and can be used as an alternative to non-pharmacological drugs. Local honey is also used because it has many health benefits and as a natural sweetener. The purpose of the study was to analyze the effect of avocados and local honey provision on hypertension in pregnancy at the Gorontalo City Health Center. This type of research is quantitative with pseudo-experimental methods with a one group pretest and posttest design approach. Avocados were given as much as 100 grams and local honey as much as 20 ml, avocado fruit is stirred together with local honey, then consumed after meals in the morning or evening. The sampling technique used is purposive sampling. Wilcoxon's test results showed 29 respondents experienced a systolic decrease and 10 respondents experienced a diastolic ...

Pregnancy is a happy thing for every husband and wife but sometimes complaints arise during pregnancy, one of them that is very annoying is back pain problems when pregnant. Back pain when pregnant is usually experienced by women in certain time of the pregnancy, usually happens often in trimester 3 pregnancy. The purpose of this research is to know the difference of pregnancy exercise effectiveness with endhorpin message to decrease in lower back pain in trimester III pregnancy at Sipatana Public Health Center. This research type was quasi experiment by using the method of pre and post test with two group design. The total samples were 30 people. The result of bivariate analysis was pregnancy exercise (p = 0.000) and endhorpin message (p = 0.000) which (p<0.05), so that there was an effect of doing pregnancy exercise and endhorpin message to decrease in lower back pain in Trimester III pregnancy. The difference of effectiveness between pregnancy exercise and endhorpin massage is (p = 0.042), so that there is a significant difference between doing pregnancy exercise and back massage to decrease in lower back pain in trimester III pregnancy at working area of Sipatana Public Health Center. It is expected that Trimester III pregnant women can apply pregnancy exersice and back massage in order to be healthy especially decrease lower back pain in pregnancy.

BACKGROUND: The high rate of stunting cases is a serious nutritious problem that still persists in Indonesia. The problem is potentially impactful on the quality of the country’s human resources. AIM: This present study aimed to analyze the determinant factors of stunting cases in 24–59-month-old children in the working area of Puskesmas or Community Health Center in Kota Tengah, Gorontalo. METHOD: The case-control survey analytical research involved a case population of 34 people and a control population of 34 people. All the participants were 24–59 months old. All case populations were treated as the research subject, while the control population was calculated based on the formula. A simple random sampling technique was employed to acquire the sample in the control group. The study involved independent variables of birth length, birth weight, provision of exclusive breastfeeding, and the number of siblings. Meanwhile, the dependent variable was the stunting cases in 24–59-month-o...

Recent studies show that, Inflammation plays an important role in the initiation and progression of atherosclerosis and in the pathogenesis of acute cardiovascular events. There is a possible association between ventricular dysfunction following acute myocardial infarction and high Sensitivity C-reactive protein (HS-CRP) and uric acid. In this study we assessed the relationship between HS-CRP and uric acid with LVEF and Killip Class in patients with acute myocardial infarction (AMI). In a cross sectional study, 188 patients (63 females and 125 males) with AMI (STEMI) who were admitted in CCU ward in Emam Khomeini Hospital, Tehran/Iran, were entered. Uric acid and HS-CRP were measured within first day of admission. We measured ejection fraction (LVEF) and used Killip classification system. The mean age of patients was 60.4±9.2 years. The mean of uric acid was 5.9±1.6, 6.6±2.1, 7.1±2.1 and 9.4±1.3 in patients with Killip Class I, II, III and IV, respectively (P=0.005). The mean of HS-CRP was 1.9±1.4, 14.2±10.9, 12.2±10.9 and 15.7±6.7 in patients with Killip Class I, II, III and IV, respectively (P=0.005). There was a relationship between HS-CRP and LVEF (Correlation coefficient= -0.788, P<0.001), but there was not between uric acid and LVEF (Correlation coefficient= -0.111, P=0.129), The plasma concentration of C-reactive protein correlated with LVEF and Killip Class in patients with AMI but serum uric acid was just correlated with Killip Class IV. It seems that plasma concentrations of HS-CRP and uric acid are useful for prediction of development of heart failure in AMI patients. More future studies are necessary for final judgment.

On May 19, 2016, the US Food and Drug Administration (FDA) hosted a public workshop, entitled ''Mechanistic Oral Absorption Modeling and Simulation for Formulation Development and Bioequivalence Evaluation.'' 1 The topic of mechanistic oral absorption modeling, which is one of the major applications of physiologically based pharmacokinetic (PBPK) modeling and simulation, focuses on predicting oral absorption by mechanistically integrating gastrointestinal transit, dissolution, and permeation processes, incorporating systems, active pharmaceutical ingredient (API), and the drug product information, into a systemic mathematical whole-body framework. 2

Background: The lack of knowledge of the biochemical processes in the treatment process of Lutuku constitutes a real problem. The study compares the enzymatic activity of transaminases in consumers of native Lutuku alcohol and non-consumers. Methods: This is a case-control study involving 40 Lutuku-consuming and healthy subjects. The enzymatic activities of GOT and GTP were performed using standard clinical chemical methods developed by BIOLAB. Results: The rate of TGO and TGP are 4 to 5 times higher in consumers of Lutuku than in healthy subjects. In the control group, the median TGO/TGP serum ratio was more pronounced in women (0.9667 U/l) than in men (0.88 U/l). Female alcoholics had a serum TGO/TGP ratio of 1, while males had a median ratio of 1.0275. Serum GOT/GTP ratios were correlated with serum GOT in both sex with respectively (r = 0.268 , p < 0.01) in men and (r= 0.499, p < 0.05) in women; and GTP (r = 0.236 , p < 0.01 ) only in men. Conclusion: Consumption of Lutuku induced four to ve times more transaminase activities (TGO and TGP) compared to those observed in healthy.

Background: The lack of knowledge of the biochemical processes in the treatment process of Lutuku constitutes a real problem. The study compares the enzymatic activity of transaminases in consumers of native Lutuku alcohol and non-consumers.Methods: This is a case-control study involving 40 Lutuku-consuming and healthy subjects. The enzymatic activities of GOT and GTP were performed using standard clinical chemical methods developed by BIOLAB.Results: The rate of TGO and TGP are 4 to 5 times higher in consumers of Lutuku than in healthy subjects. In the control group, the median TGO/TGP serum ratio was more pronounced in women (0.9667 U/l) than in men (0.88 U/l). Female alcoholics had a serum TGO/TGP ratio of 1, while males had a median ratio of 1.0275. Serum GOT/GTP ratios were correlated with serum GOT in both sex with respectively (r = 0.268 , p &lt; 0.01) in men and (r= 0.499, p &lt; 0.05) in women; and GTP (r = 0.236 , p &lt; 0.01 ) only in men.Conclusion: Consumption of Lutuku...

Background and Aims: Mother-to-child transmission (MTCT) of HIV remains a significant global health challenge, particularly in resource-limited settings. The virus disrupts maternal-fetal immunity through immune dysregulation, placental barrier impairment, and altered antibody transfer, thereby increasing the risk of vertical transmission. Methods and Results: This narrative review synthesizes current evidence on the immunological and clinical factors influencing MTCT. It highlights how maternal immune exhaustion, placental inflammation, and suboptimal ART timing contribute to transmission. While widespread use of ART has reduced MTCT rates, persistent challenges include late ART initiation, HIV drug resistance, co-infections, and transmission through breastfeeding. Emerging strategies-such as maternal immune modulation, monoclonal antibody therapies, and tailored ART regimens-show potential for further risk reduction. Conclusion: To effectively minimize MTCT, comprehensive prevention approaches are essential. These should combine medical interventions with maternal nutrition support, co-infection management, and safe breastfeeding practices under ART coverage. A multifaceted strategy is key to protecting both maternal and infant health. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Although Tahfiz students’ Islamic knowledge is generally accorded privilege, Tahfiz students’ English language proficiency is considered weak and insubstantial. The advent of technology and the 21st century reveal the centrality of English proficiency as it is still the most spoken language in the world. As such, to become global Da’ie, Tahfiz students might better possess English language proficiency commensurate with the global demands. Based on Dornyei’s (2005) L2MSS, a new L2 motivational model for Tahfiz students has been proposed. In this paper, the authors describe one specific factor in the new model, namely the Islamic Drive which contains five items extracted via the Exploratory Factor Analysis. The element of Islamic Drive used singly is useful because it substantiates a unique aspect of motivation for Tahfiz students. In essence, the Islamic Drive suggests that Tahfiz students’ motivation is closely associated with their spiritual vision; to use English mainly as a means...

Aberration in social behaviour seems to provide the theoretical ground to understand social relations. This is because the aberration foregrounds the underbelly of social relations. It is in and through aberration, that one can properly analyze the basis for sociality. Knowledge of 'insanity' is not new to the natives of Malabar. However, there are many contradicting conceptions and heterogeneous healing practices around insanity within the community. There have been studies on the treatment method of madness and its evolution from traditional to modern medical sciences in Kerala. This paper attempts to take the study further to concentrate on the social awareness of madness in the cultural context of Malabar, Kerala and an attempt to engage with the role of neighbourhood in understanding aberrance.

Aberration in social behaviour seems to provide the theoretical ground to understand social relations. This is because the aberration foregrounds the underbelly of social relations. It is in and through aberration, that one can properly analyze the basis for sociality. Knowledge of ‘insanity’ is not new to the natives of Malabar. However, there are many contradicting conceptions and heterogeneous healing practices around insanity within the community. There have been studies on the treatment method of madness and its evolution from traditional to modern medical sciences in Kerala. This paper attempts to take the study further to concentrate on the social awareness of madness in the cultural context of Malabar, Kerala and an attempt to engage with the role of neighbourhood in understanding aberrance.

O NT-proBNP é um fragmento inativo do pró-hormónio BNP (peptídeo natriurético do tipo B), produzido pelos miócitos ventriculares em resposta a estiramento ou sobrecarga de volume/pressão. O BNP ativo promove natriurese, vasodilatação e redução da pressão arterial. Situações em que se usa o NT-proBNP em cães:

Readmissions after hospitalization for acute myocardial infarction (AMI) are common. However, the few currently available AMI readmission risk prediction models have poor-to-modest predictive ability and are not readily actionable in real time. We sought to develop an actionable and accurate AMI readmission risk prediction model to identify high-risk patients as early as possible during hospitalization. We used electronic health record data from consecutive AMI hospitalizations from 6 hospitals in north Texas from 2009 to 2010 to derive and validate models predicting all-cause nonelective 30-day readmissions, using stepwise backward selection and 5-fold cross-validation. Of 826 patients hospitalized with AMI, 13% had a 30-day readmission. The first-day AMI model (the AMI &quot;READMITS&quot; score) included 7 predictors: renal function, elevated brain natriuretic peptide, age, diabetes mellitus, nonmale sex, intervention with timely percutaneous coronary intervention, and low systol...

BackgroundHomologous recombination repair (HRR) accurately repairs the DNA double-strand breaks (DSBs) and is crucial for genome stability. Genetic polymorphisms in crucial HRR pathway genes might affect genome stability and promote tumorigenesis. Up to our knowledge, the present study is the first to investigate the impact of HRR gene polymorphisms on BC development in South Indian women. The present population-based case-control study investigated the association of polymorphisms in three key HRR genes (XRCC2-Arg188His,XRCC3-Thr241Met andRAD51-G135C) with BC risk.Materials and methodsPolymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method was used for genotyping the HRR variants in 491 BC cases and 493 healthy women.ResultsWe observed that theXRCC3Met allele was significantly associated with BC risk [OR:1.27 (95% CI: 1.02–1.60); p = 0.035]. In addition, the homozygous mutant (C/C) genotype ofRAD51G135C variant conferred 2.19 fold elevated risk of BC [O...

with innumerable health problems. Most of the diseases have direct or indirect link with the type of food we consume, our food habits, and lifestyle. 80% of the top ten killing diseases of the world are due to wrong food habits. In the society, due to improper Ahara (diet) and Vihara (lifestyle), incidences of diseases are increasing in day-to-day life. If proper dietary pattern is not followed by the patient, nobody can cure these diseases. Main causes for the disease are improper diet, habits, stress, not following Ahara Vidhi Visheshayatana, etc., Viruddhahara, Asatmya Ahara, stale food, spicy irritant food, oily foods, bakery products, some fast foods, excess consumption of tea and coffee, excess food intake, drinking excess water after meals, freezed products, wine, cigarette smoking during meal, chemical medicines during meal, etc. Chronic diet-related diseases are on rise around the world due to new lifestyles and eating habits. Gastrointestinal disturbances are increasing and India is no exception to this. Among them, non-ulcer dyspepsia, a gastrointestinal tract (GIT) disorder, acquires majority of the share.

Background: Patient education is the physical therapist's key in guiding patients to a healthier future. When considering patient education, it is important to note that barriers such as limited health literacy can alter the effectiveness of teaching strategies. Health literacy is the ability to comprehend health information and use that information to make informed decisions about one's health and medical care, thus giving individuals the knowledge and skills to optimally function and navigate in the health care environment. While millions of Americans have marginalized literacy skills, older adults aged 65 years and older represent the largest group with compromised general literacy skills in the United States, which significantly contribute to limited health literacy skills. Limited health literacy can have negative consequences on health outcomes due to a lack of knowledge of healthy lifestyle choices, preventative services, disease etiology and management, being able to locate and access appropriate health care services, and carrying out self-care tasks. In addition, limited health literacy increases the risk of hospitalization, the overall cost of health care, and mortality rates. Purpose: This article includes (1) the definition of health literacy, (2) the prevalence and consequences of limited health literacy, (3) signs of limited health literacy, (4) health literacy screening and assessment tools, (5) intervention strategies, and ( ) implications for physical therapist education. Methods: PubMed, MEDLINE, CINAHL, and EBSCOHost were searched for articles published from 1990 to 2010 with the descriptors: health literacy, older adults, patient education, functional health literacy, health literacy outcomes, health literacy assessment, and health literacy interventions. Conclusion: Limited health literacy affects millions of Americans and plays a significant role in reduced health outcomes for patients. Through patient education and targeted intervention strategies, physical therapists can assist patients in overcoming limitations and enhancing the quality of their health and medical care.

Patient education is the physical therapist&#39;s key in guiding patients to a healthier future. When considering patient education, it is important to note that barriers such as limited health literacy can alter the effectiveness of teaching strategies. Health literacy is the ability to comprehend health information and use that information to make informed decisions about one&#39;s health and medical care, thus giving individuals the knowledge and skills to optimally function and navigate in the health care environment. While millions of Americans have marginalized literacy skills, older adults aged 65 years and older represent the largest group with compromised general literacy skills in the United States, which significantly contribute to limited health literacy skills. Limited health literacy can have negative consequences on health outcomes due to a lack of knowledge of healthy lifestyle choices, preventative services, disease etiology and management, being able to locate and ...

To describe the effects of vagus nerve stimulation (VNS) on sleep-related breathing in a sample of 16 epilepsy patients. Methods: Sixteen adults with medically refractory epilepsy (nine men, seven women, ages 21-58 years) underwent baseline polysomnograms (PSGs). Three months after VNS therapy was initiated, PSGs were repeated. In addition, patient 7 had a study with esophageal pressure monitoring, and patient 1 had a continuous positive airway pressure (CPAP) trial. Results: Baseline PSGs: One of 16 patients had an apneahypopnea index (AHI) >5 (6.8). Treatment PSGs: Five of 16 patients had treatment AHIs >5. Respiratory events were more frequent during periods with VNS activation (on-time) than with-out VNS activation (off-time; p = 0.016). Follow-up studies: Esophageal pressure monitoring in patient 7 showed crescendos in esophageal pressure during VNS activation, supporting an obstructive pattern. The CPAP trial of patient 1 showed that all respiratory events were associated with VNS stimulation at low CPAP levels. They were resolved at higher CPAP levels. Conclusions: Treatment with VNS affects respiration during sleep and should be used with care, particularly in patients with preexisting obstructive sleep apnea. The AHI after VNS treatment remained <5 in the majority of patients and was only mildly elevated (<12) in five patients. In one patient, CPAP resolved VNS-related respiratory events.