To report a case of neurogenic stress cardiomyopathy post-trauma, managed using Non-Invasive Cardiac Output Monitor (NICOM)-guided conservative therapy. A middle-aged patient with traumatic subdural and subarachnoid hemorrhages developed hemodynamic instability. ECG showed QT prolongation; echocardiography revealed apical ballooning. We used NICOM which indicated low cardiac output (3.5 L/min). Fluids and inotropes were adjusted based on NICOM trends. The patient showed gradual hemodynamic and cardiac recovery. NICOM guided safe de-escalation of inotropes. Echocardiography normalized, and the patient was discharged. NICOM can be used for precise, non-invasive hemodynamic monitoring, aiding recovery in stress cardiomyopathy. Keywords: Traumatic brain injury, Takotsubo cardiomyopathy, Stress cardiomyopathy, Non-invasive cardiac output monitoring, Hemodynamic instability, Apical ballooning, Neurocritical care.

Journal of scientific innovations in anesthesiology

Carpal tunnel syndrome (CTS) is caused by the shortening of the median nerves in the wrist, resulting in hand pain and paralysis necessitating surgical operation for relief. Conventional open carpal tunnel release (CTR) procedures, involving long incisions, often lead to complications, delaying patients' recovery for weeks or months. Therefore, mini-incision surgery has emerged as a preferred option, offering reduced pain, smaller wounds, and improved appearance. This study aimed to compare the outcomes of modified mini-incision surgery for CTS before and after the operation. It was a retrospective study involving 80 patients, with data collected from medical records pre-and post-operation, specifically at the 2 nd week, 3 rd month, 6 th month, 12 th month, and 24 th month intervals. Variables included operation time, incision length, pinch strength, gripping strength, two-point discrimination (2-PD), visual analogue scale (VAS), Levine score, quick disabilities of the arm, shoulder and hand (Quick-DASH), wound pain, and pillar pain. Data were analyzed using descriptive statistics and logistic regression, with a significant level of 0.05. The mean incision length was 11.54 mm. At the 2-week post-operative mark, the pinch strength was 5.43, gripping strength was 14.96, 2-PD was 5.84, the VAS score was 2.86, the Levine symptom was 3.84, and the DASH score was 69.43. There was a relationship (p-value<0.05) between preoperative and postoperative measures for pinch strength, gripping strength, 2-PD, and Levine symptom condition. The study on 80 patients who underwent modified mini-incision surgery for CTS at Naresuan University Hospital in Phitsanulok, Thailand, found that these parameters showed significant improvement postoperatively. Patients demonstrated good recovery and condition 2 weeks after the mini-incision surgery for CTS.

Saran malisorn

This document will discuss some crucial operational aspect to the National Agricultural Development Company (NADEC) https://nadec.com.sa/ dairy Milk production company such as how well the inventories within the production system are currently managed, detailed illustration of the critical operations involved within NADEC production system presenting a logical operational flow, identify the two points where the organisation’s delivery system may fail to align its operational performance measures, how a lean approach could be utilised in the production system to reduce the failings potentially and the three key findings discussing the extent to which the lean approach may assist the production system with aligning its operational performance measures

Mohamed sorogy

This paper found that 35% of Adivasis have health problems, and 73% said that they are getting treatment with RMP. 87% have toilet facility and more than 12% still defecate openly. 18.3% said that they faced different problems at open defecation, and 50% of women not using sanitary napkins. Nearly 90% of respondents wash their hands after toilets and coming from outside of the home. Ten per cent of respondents said that they do not have an awareness of sanitation. Therefore, the study confirmed that the sanitation facilities considerably made the women's dignity and quality of life better in the study area. Moreover, four case studies also focused on open defecation problems in the study area.

B suresh lal

This research is the result of research that describes the implementation of the Take and Give learning model in the fifth grade social studies subject at MI Ar-Rahim, Arjasa, Jember. The learning process includes 3 stages, namely the planning, implementation, and evaluation stages. This research aims to answer. Based on the background described above, the formulation of the problems in this study are: 1. How is the preparation in implementing the Take and learning model for class V social studies subjects at MI Ar-Rahim, Arjasa District, Jember Regency? 2. What is the process of implementing the Take and Give learning model for the fifth grade social studies subject at MI Ar-Rahim, Arjasa District, Jember Regency? 3. How is the evaluation in implementing the Take and Give learning model for the fifth grade social studies subject at MI Ar-Rahim, Arjasa District, Jember Regency? The research method used is descriptive qualitative with data collection techniques using observation, interviews and documentation. The data sources in this study were the Principal, Teachers and Grade V Students of Class V Social Studies at MI Ar-Rahim, and other supporting documents. The results of this study indicate: 1. The implementation of the Take and Give learning model in the preparation stage has fulfilled all preparations well. 2. The process of implementing learning in class makes the learning atmosphere fun and students become more active. 3. At the evaluation stage all students have reached the assessment criteria in 3 aspects of the assessment, namely attitudes, knowledge and skills Penelitian ini adalah hasil penelitian yang menggambarkan tentang implementasi model pembelajaran Take and Give pada mata pelajaran IPS kelas V di MI Ar-Rahim Kecamatan Arjasa Kabupaten Jember. Proses pembelajaran tersebut meliputi 3 tahap, yaitu tahap perencanaan, pelaksanaan, dan evaluasi. Adapun penelitian ini bertujuan untuk menjawab Berdasarkan latar belakang yang telah dipaparkan di atas, maka rumusan masalah dalam penelitian ini adalah: 1. Bagaimana persiapan dalam mengimplementasikan model pembelajaran Take and mata pelajaran IPS kelas V di MI Ar-Rahim Kecamatan Arjasa Kabupaten Jember? 2. Bagaimana proses dalam implementasi model pembelajaran Take and Givemata pelajaran IPS kelas V di MI Ar-Rahim Kecamatan Arjasa Kabupaten Jember? 3. Bagaimana evaluasi dalam mengimplementasikan model pembelajaran Take and Givemata pelajaran IPS kelas V di MI Ar-Rahim Kecamatan Arjasa Kabupaten Jember? Metode penelitian yang digunakan adalah kualitatif deskriptif dengan teknik pengumpulan data menggunakan observasi, wawancara dan dokumentasi. Adapun sumber data dalam penelitian ini adalah Kepala Sekolah, Guru dan Peserta didik kelas V mata pelajaran IPS kelas V di MI Ar-Rahim, dan dokumen penunjang lainnya. Hasil penelitian inimenunjukkan: 1. Implementasi model pembelajaran Take and Give pada tahap persiapan sudah memenuhi segala persiapan dengan baik. 2. Proses pelaksanaan pembelajaran dikelas membuat suasana belajar menjadi menyenangkan dan peserta didik menjadi lebih aktif. 3. Pada tahap evaluasi semua peserta didik telah mencapai kriteria penilaian dalam 3 aspek penilaian yaitu sikap, pengetahuan dan keterampilan.

Educare: journal of primary education

It is with more sorrow and tremendous sadness we remember the death of our colleague the Libyan pharmacist, professor Mokhtar Ramadan Haman, at his home in Tripoli, Libya after long-suffering from brain cancer. He died on 02, February 2017 and his immaculate corpse was buried on the following day at the Souk-Al-Ahad cemetery, Bin Ghashir Palace. Professor Haman, was born in Tripoli, Libya, on January 1, 1957. He obtained his Bachelor of Pharmaceutical Sciences in 1981 at the University of Tripoli and his Ph.D. in Pharmacognosy in 1989 at Cardiff University, UK.

Mediterranean journal of pharmacy and pharmaceutical sciences

The strategy is a means of establishing the organisation's purpose in terms of priorities for resource allocation, action programs and long term objectives (Grant 2005). Chandler (1962) defines strategy as determining the primary long-term goals of an organisation, the adoption of courses of action, and the allocation of necessary resources. Besides, the strategy also focuses on allocating resources in relation to the organisation and its environment (Schendel & Hatten 1972). The strategy also pertains to the top management's decisions pertaining to its scope and the future direction. Such strategy covers an action plan on the organisation's future, commitments to specific products, services, and the markets.

Zamzam abdelazim

A performance analysis on a vapour compression refrigeration system with various refrigerants mixture of R152a, RE170, R600a, and R290 were done for various mixture ratios and their results were compared with R134a as possible alternative replacement. The results showed that all of the alternative refrigerants investigated in the analysis except R431A, [R 152a (29%), R290 (71%)] have a slightly higher performance coefficient (COP) than R134a for the condensation temperature of 500C and evaporating temperatures ranging between -300C and 100C.Refrigerant blend of R152a/RE170 (20/80 by wt%) instead of R134a was found to be a replacement refrigerant among other alternatives. The effects of the main parameters of performance analysis such as refrigerant type, degree of sub cooling and super heating on the refrigerating effect, coefficient of performance and volumetric refrigeration capacity were also investigated for various evaporating temperatures.

Baskaran

Plants, the beauty of nature, have been the basis For treating human ailments. The current accepted modern medicine has gradually developed over the years and is undoubtedly the gift of God in the sense of traditional knowledge about different medicinal plants. However, what is needed are rapid screening techniques, structure base design and combinatorial chemistry for drug development under innovations, which will share the profit of products derived from indigenous plants. There is less known information about Ficus exasperata Vahl., and Cleome ciliata Schmach and Thonn. However, the author of this book presents comprehensive information about traditional uses and the biological and phytochemical investigation of Ficus exasperata Vahl. and Cleome ciliata Schmach and Thonn.

Dr. salman ahmed

Diabetes is a global issue, the diabetes epidemic is expected to continue, and the burden of diabetes causes catastrophic expenditure for healthcare system. The current study aimed to determine the presentation, the clinical feature and cardio-vascular risk factors in patients with diabetes. A retrospective observational study had been conducted in out-patients department at Almustaqpal Almosherq Centre during September, 2013 till September, 2020, the total number of attended out-patients department were 1 024, 820 patients who were selected for this study. A special perform was completed for every patient, which included details about patient’s demographics, points in clinical history, relevant investigations and clinical examinations were recorded. The study reported that out of 820 patients, 66% (n = 538) was female and their age range was between 14 - 87 years with a mean age of 56.53 ± 13.49 years, 96% (n = 791) were clinically diagnosed as type II diabetes, 07% of the patients were diagnosed as pre-diabetes, the duration of diabetes ranged from newly diagnosed to more than 10 years, with 46% (n = 379) of the studied population were more than 10 years diabetes duration, 70% (581) were presented with classical symptoms of diabetes. Initial treatment for diabetes also different in the studied sample, were absent of anti-diabetic medications in 30% (n = 248) of the patients, they refused to start glucose lowering drugs, 34.6% (n = 284) of them have morbid obesity (body mass index is more than 40), 80% (n = 662) have high HBA1c (more than 8 g%), 40.3% (n = 240/596) were uncontrolled hypertension on anti-hypertension drugs, 95.6% (n = 682/713) were controlled on treatment of lipid lowering drugs. This study showing the presentation of diabetes were the common, type II diabetes, at age group between 41 - 66 years about 65%, female sex, with high body mass index, high glycated hemglobulin and uncontrolled hypertension. There is concern that diabetic patients were occurring at a high frequency in younger adults, where longer duration of illness could increase the risk of developing more complications in later life. The rate of coexist cardiovascular risk factors (hypertension, dyslipidaemia and obesity) in Libyan patients with diabetes is highlighted.

Mediterranean journal of pharmacy and pharmaceutical sciences

Urolithiasis is a common worldwide problem with high recurrence. This review covers thirteen (13) antiurolithiatic plants of the family Boraginaceae, twenty (20) from Brassicaceae, twenty-three (23) from Malvaceae and twenty-four (24) from Poaceae used globally in different countries. Hopefully, this review will be helpful for the general public and attract the scientific world for antiurolithiatic drug discovery.

Dr. salman ahmed

As one of the flow-based passive sorting, the hydrodynamic filtration using a microfluidic-chip has shown to effectively separate into different sizes of subpopulations from cell or particle suspensions. Its model framework involving two-phase Newtonian or generalized Newtonian fluid (GNF) was developed, by performing the complete analysis of laminar flow and complicated networks of main and multiple branch channels. To predict rigorously what occurs in flow fields, we estimated pressure drop, velocity profile, and the ratio of the flow fraction at each branch point, in which the analytical model was validated with numerical flow simulations. As a model fluid of the GNF, polysaccharide solution based on Carreau type was examined. The objective parameters aiming practical channel design include the number of the branches and the length of narrow section of each branch for arbitrary conditions. The flow fraction and the number of branches are distinctly affected by the viscosity ratio between feed and side flows. As the side flow becomes more viscous, the flow fraction increases but the number of branches decreases, which enables a compact chip designed with fewer branches being operated under the same throughput. Hence, our rational design analysis indicates the significance of constitutive properties of each stream.

Myung-suk chun

Beetroot is vegetable containing phytochemical ingredients with potent antioxidant, hypoglycaemic and anti-inflammatory properties. It is key drivers in the pathophysiology of some metabolic syndromes. Its effect on the progress of induced metabolic syndrome has, however, hardly been investigated. Thus, this study aims to determine the effect of beetroot extract on various biophysical components of metabolic syndrome in rat. Following ethical approval, 50 Wister albino rats were used in this study and divided into three groups: Group A: rats were put on a high-fat-high-fructose (HFHF) diet; Group B: rats were put on an HFHF + fresh beetroot extract while group C: rats were the control group and were given a normal diet. The animals’ body weights and fasting blood sugar were taken fortnightly. Five rats from each group were then sacrificed at weeks 4, 8, 12 and 16 and the following parameters were measured: liver volume, fasting lipid profile, hepatic transaminases and blood platelet level. Compared to the HFHF group, beetroot supplementation resulted in a significant attenuation of overall weight gain (56.91% vs. 34.51%; p < 0> 0.05). Beetroot supplementation further ameliorated the thrombocytopenia caused by an HFHF. Beetroot juice supplementation attenuated the attendant effects of induced metabolic syndrome which might contribute towards averting the consequential cardiovascular sequel. Thus, lifestyle modification comprising beetroot intake as a dietary supplementation may alleviate metabolic syndrome and may offer a potential non-medical adjunct in the routine management of metabolic syndrome.

Mediterranean journal of pharmacy and pharmaceutical sciences

Penelitian ini bertujuan untuk melihat seberapa besar dampak kualitas produk, persepsi konsumen dan brand image terhadap keputusan pembelian produk endorsement pada masyarakat di Medan dengan menggunakan word of mouth sebagai variabel moderasi. Sampel penelitian ini adalah sebesar 100 orang responden dengan teknik analisis data menggunakan analisis jalur (path analysis). Hasil dari penelitian ini menunjukkan kualitas produk, persepsi konsumen dan brand image berpengaruh terhadap keputusan pembelian produk endorsement pada masyarakat di Medan. Lebih lanjut, word of mouth tidak memoderasi kualitas produk terhadap keputusan pembelian dan juga tidak memoderasi persepsi konsumen terhadap keputusan pembelian namun word of mouth memoderasi brand image terhadap keputusan pembelian produk endorsement bagi masyarakat di Medan.

L

This study examined work-life balance and teacher engagement in private secondary schools in Rivers State. Three research questions and three hypotheses guided the study. The study adopted a correlation research design with a population of 7,143 teachers (2,676 males and 4,467 females) in all the 275 private secondary schools in Rivers State. The sample size of 714 teachers was drawn through a proportionate stratified random sampling technique, which represents 10% of the population. Two self-designed instruments entitled: “Work-life Balance Questionnaire (WLBQ)” and “Teacher Engagement Questionnaire (TEQ)” were used for data collection. The instruments were in two sections –A and B. Section A consisted of the demographic factors while Section B contained the variables that were used to elicit information from the respondents. Section B contained 20 items on Work-life Balance and 15 items on Teacher Engagement respectively. Face and content validities were ensured by experts in the relevant areas. The Cronbach’s Alpha reliability method was used to establish the internal consistency, and indexes of .79 for WLBQ and .83 for TEQ were established respectively. Research questions 1 and 2 were answered using simple regression while research question 3 was answered using multiple regression. Hypotheses 1 and 2 were tested with a t-test associated with simple regression while hypothesis 3 was tested using ANOVA associated with multiple regression at 0.05 alpha level. The findings of the study revealed, among others, that work-life balance significantly and jointly predicted teacher engagement to a very low extent in secondary schools in Rivers State. Based on the findings, it was recommended, among others, that both employers and school managers should create flexible work environments that promote work-life balance for teachers so as to motivate them to perform optimally for the attainment of educational goals.

Fxintegrity publishing

Effect of germination and fermentation on the nutrient contents, functional and antioxidant activities of pigeon pea (Cajanus cajan) flour were investigated. The pigeon pea seeds were sorted, cleaned and processed into germinated, fermented and raw flours. The flour samples obtained were analyzed for proximate composition, mineral contents, antinutrient contents, functional properties and antioxidant/free radical scavenging properties using standard methods. The results of the proximate composition showed that the moisture content within the range of 9.62±0.02-9.96±0.01, crude protein content 16.63±0.01-24.17±0.01, crude fibre content 1.41±0.01-2.59±0.01, lipid 4.33±0.01-5.61±0.01, ash content 1.62±0.01-2.17±0.01, carbohydrate 56.80±0.02 - 62.47±0.01 and energy values 366.91 - 374.40kcal/100g. The result of elemental mineral analysis showed magnesium as the major mineral element in the sample (91.32±0.02 to 123.75±0.04mg/g), calcium (96.02 ± 0.02 - 110.14 ± 0.003mg/g), phosphorus (39.11 ± 0.02 - 46.12 ± 0.03mg/g), sodium (8.63 ± 0.02 - 12.61 ± 0.001mg/g), Iron (3.08 ± 0.02 - 4.11 ± 0.001mg/g) and zinc (2.04 ± 0.01 - 3.17mg/g) respectively. The result of the functional properties showed optimal gelatinization temperature ranged from 73.610C - 89.410C, emulsion capacity, 11.88 - 43.42%, foam stability,28.22 to 65.81%, foaming capacity,15.83 to 21.11%, bulk density,0.53 - 0.71g/ml, water absorption capacity, 1.11 and 1.51ml/g while oil absorption capacity,0.84 - 1.14ml/g. The sensory properties of the moi-moi from the processed flours showed that the colour test, (6.33 -7.53), flavour (7.63 to 7.75), taste (5.13 to 5.53), mouth-feel (7.25 to 7.36), overall acceptability (6.93±0.04 - 8.83±0.04). The results of the phenolic content ranged from 20.13mg\GAE, 53.43mg\GAE and 42.64mg\GAE for raw processed, malted and fermented samples respectively. The results of the 1,1-diphenyl-2-picrylhydrazyl (DPPH) antioxidant activity of ethanolic extracts showed IC50values of 0.810, 1.177 and 1.014mg\ml for the raw, malted and fermented seed extracts respectively. The moisture, crude protein and fibre contents was significantly increased (p>0.05) during germination and fermentation whereas lipid, carbohydrate, ash and energy values were significantly (p<0>0.05) increased the % scavenging properties of pigeon pea extract though that of germination was higher. Malting and fermentation significantly (p<0.05) decreased the sensory properties of moi-moi produced. Based on the result obtained, regular consumption of pigeon pea will be a proactive measure against heart diseases and other related disorders in the human body.

Okechukwu obed chukwuemeka

Giving stimulus from educators in the form of giving appreciation and punishment will greatly affect the way of thinking and behavior of students in achieving the goals of character education that have been set. This study aims to describe the implementation of reward and punishment in shaping the character of students' discipline. This research uses a qualitative approach with the type of case study. Methods of data collection using interviews, observation and documentation. The validity of the data used source triangulation and technical triangulation. The results of this study indicate: (1) The implementation of rewards in shaping the discipline character of students is done by giving rewards in the form of praise and giving appreciation in the form of gifts. (2) The implementation of punishment in shaping the disciplinary character of students is carried out by giving gradual warnings, giving spontaneous warnings and written warning letters. (3) Evaluation of the implementation of rewards and punishments in shaping the character of students' discipline is using process evaluation, which is an assessment carried out during the learning process by observing the attitudes of students everyday when they are in the madrasa environment.. Pemberian stimulus dari pendidik berupa pemberian apresiasi dan hukuman akan sangat mempengaruhi cara berpikir dan tingkah laku peserta didik dalam mencapai tujuan pendidikan karakter yang sudah ditetapkan. Penelitian ini bertujuan untuk mendeskripsikan implementasi reward dan punishment dalam membentuk karakter disiplin peserta didik. Penelitian ini menggunakan pendekatan kualitatif dengan jenis studi kasus. Metode pengumpulan data menggunakan wawancara, observasi dan dokumentasi. Keabsahan data menggunakan triangulasi sumber dan triangulasi tehnik. Hasil penelitian ini menunjukkan: (1) Implementasi reward dalam membentuk karakter kedisiplinan peserta didik dilakukan dengan memberikan reward dalam bentuk pujian serta memberikan apresiasi dalam bentuk hadiah. (2) Implementasi punishment dalam membentuk karakter kedisiplinan peserta didik dilakukan dengan cara memberi peringatan secara bertahap, memberi teguran spontan dan surat peringatan tertulis. (3) Evaluasi implementasi reward dan punishment dalam membentuk karakter kedisiplinan peserta didik adalah menggunakan evaluasi proses, yaitu penilaian yang dilakukan di saat proses pembelajaran berlangsung dengan mengamati dari sikap peserta didik sehari-hari ketika berada di lingkungan madrasah.

Educare: journal of primary education

A survey was conducted to screen the presences of antibiotic-resistant Salmonella from broiler chicken meat brought from local retail shops situated at Kozhinjampara, Palakkad, Kerala. Based on the morphological and biochemical characterization, a total of 15 Salmonella sp were isolated. Among 15 isolates, five (S7, S8, S10, S12, S14) isolates exhibited 100% resistance to all tested antibiotics and only one isolate S9 shows sensitivity to maximum antibiotics tested. In the study, garlic extract was tested against antibiotic-resistant isolates and it exhibited maximum inhibition against S12 isolate (30mm) and minimum inhibition against S8 isolate (22mm). The analyses of the garlic extract by GC-MS confirmed that the major components of garlic having antimicrobial activity. The result specified that garlic extract was found to be effective in controlling antibiotic resistance Salmonella species from broiler chicken meat. Therefore, incorporating garlic products in poultry feeds will help reduce antibiotic-resistant pathogenic microbes which causes drastic infections in human beings.

Dr. saranya devi k

This Experiment was conducted on 120 day old unsexed Ross broiler chicks to study the effect of added methionine to soybean meal as substitute for protein concentrate in the starter ration on some productive traits . The chicks were raised on floor were distributed to three treatments with four replicates each ( 10 birds) . The three experimental starter rations (1-28) day contained 2800 kcal/kg ME and 22% cp . The first supplemented with 5% protein concentrate , while the second and third were with out protein concentrate but supplemented with 0.1 and 0.2% methionine respectively . The Finisher ration (29-49) day contained 3047 kcal/kg ME and 19.19% cp. At 49 day of age 2 birds from each replicate were slaughtered for carcass traits . Statistic analysis of data showed a significant increase (P ≤ 0.05) in body weight , weight gain , feed and protein efficiency ratio for third treatment during (1-28) day , No significant difference in all studied traits during (29-49)day, and the third treatment showed best economic efficiency .

Rafea mohammedtaher khulel

Turcicum leaf blight (TLB) and Polysora rust diseases are taking heavy shiver in all maize growing regions of Karnataka. Several new fungicides are used to control the diseases, among them strobilurin group fungicides in combination with triazolefungicides are found effective in management of diseases. A mixture of Trifloxystrobin 50 WG + Tebuconazole 250 EC and mixture of Azoxystrobin 25 SC + Difenoconazole 25 EC were used in this study to manage the TLB and Polysora rust. The two combination fungicides were evaluated in different days against TLB and Polysora rust on two susceptible varieties namely 219J and CM 202. Results revealed that mixture of Trifloxystrobin 50 WG + Tebuconazole 250 EC @ 0.7 g/lit and mixture of Azoxystrobin 25 SC + Difenoconazole 25 EC @ 2.5 ml/litwere found effective in the management of TLB (15.0 % and 11.0 % respectively) and mixture of Trifloxystrobin 50 WG + Tebuconazole 250 EC @ 0.7 g/lit were found effective in controlling Polysora rust (13.2 %). Allied to yield, more significant increase in yield was recorded in treatment Trifloxystrobin 50 WG + Tebuconazole 250 EC @ 0.7 g/lit (5131.1kgs/ha). While, mixtures of Azoxystrobin 25 SC + Difenoconazole 25 EC @ 2.5 ml/lit recorded yield of 5913.0 kgs/ha, this was significantly superior with respect to disease control and yield aspects.

Veerabhadraswamy al