Background and Objective: The COVID-19 pandemic affected medical care systems including stroke care, globally. In this study, we investigated the impact of the COVID-19 outbreak on stroke care in Hadramout, in terms of rate of admission, access to care, risk factors, clinical presentation, and outcome. Materials and Methods: A hospital-based cross-sectional study comparing all stroke patients admitted to Ibn-seena University Hospital (ISTH), Mukalla, Hadramout, during two periods, May 1–October 31, 2020, during the pandemic of COVID-19 (COVID-19 group), and from May 1 to October 31, 2019 (pre-COVID-19 group). Data collected from patients’ medical record files into a master sheet, and were processed by the Statistical Package for Social Sciences software. Results: There were 117 stroke patients admitted in COVID-19 pandemic in 2020, and 213 patients admitted in the same period in 2019. Stroke admission declined by 45.1% (Odds Ratio [OR]=0.30, 95% confidence interval [CI] [95% CI]: 0.22–0.42, p<0.0001) with no age and sex differences. Hypertension (HTN) and diabetes mellitus were more frequent in COVID-19 group than the pre-COVID-19 group (OR=1.74, 95% CI: 1.08–2.80, p=0.02) and (OR=1.81, 95% CI: 1.14–2, 88, p=0.01), respectively. No significant difference in other risk factors was found. Patients in COVID-19 group arrived the hospital more late than the patients in pre-COVID-19 group (OR=2.63, 95% CI: 1.64–4.21, p<0.0001). Dysphasia and altered consciousness including coma were more common in COVID-19 group compared with pre-COVID-19 group (OR=4.5, 95% CI: 2.18–9.08, p<0.0001) and (OR=3.2, 95% CI: 2.00–5.12, p<0.0001), respectively. Hospital stay was greatly reduced among COVID-19 group as compared with pre-COVID-19 group (02.9±0.31 days vs. 8.6±0.92 days, p<0.0001) Mortality rate was higher among COVID-19 group than the pre-COVID-19 group (41.9% vs. 27.2%, p=007). Conclusion: The number of stroke patients admitted during the COVID-19 pandemic decreased, they arrived late and spent shorter hospital stays while having higher rates of HTN, diabetes, and impaired consciousness with a high mortality rate.

Karishma

The Secret Language of Birthdays: Your Complete Personology Guide for Each Day of the Year by by Goldschneider, Gary, Elffers, Joost (Paperback) This The Secret Language of Birthdays: Your Complete Personology Guide for Each Day of the Year book is not really ordinary book, you have it then the world is in your hands. The benefit you get by reading this book is actually information inside this reserve incredible fresh, you will get information which is getting deeper an individual read a lot of information you will get. This kind of The Secret Language of Birthdays: Your Complete Personology Guide for Each Day of the Year without we recognize teach the one who looking at it become critical in imagining and analyzing. Don’t be worry The Secret Language of Birthdays: Your Complete Personology Guide for Each Day of the Year can bring any time you are and not make your tote space or bookshelves’ grow to be full because you can have it inside your lovely laptop even cell phone.

Kamal singh

Introduction: The right lung has two fissures, an oblique and a horizontal, dividing it into three lobes namely the upper, middle, and lower. The nature of the fissure is of great importance in planning operative strategy for thoracoscopic pulmonary resection where an the incomplete fissure may contribute to post-operative air leakage Aim: To assess the gross morphological features of the right lung with special emphasis on the completeness of horizontal fissure. Material & Method: Material for the present study comprised of right lungs obtained from 50 well-embalmed adult human cadavers of both the sexes dissected as a part of 1 MBBS curriculum in the Department of Anatomy, Govt. Medical College, Amritsar. Results: Horizontal fissure was found to be complete in only 10% of the lungs while in rest 90% it was either incomplete or absent. Conclusion: Inferable from the huge variation in nonappearance or partial appearance of horizontal fissure in the right lung and to the absence of an acceptable classification of fissures, an endeavor has been made to give one such classification. In like manner, the horizontal fissure is evaluated from Grade zero to IV contingent on its absence and profundity from coastal surface to the hilum. Each evaluation is additionally divided into 3 subgrades relying on the culmination or incompleteness of these fissures with respect to their length.

Dr kulbir kaur

Bauhinia racemosa Lam. is a tall tree growing throughout Sri Lanka, China, India, and Pakistan. Various parts of the plant have great medicinal potential in folklore medicine and are used for diarrhoea, fever, skin diseases, cough, malaria, etc. Analgesic, anti-inflammatory, antipyretic, antispasmodic, antiulcer, cytotoxicity and hypotensive activities of Bauhinia racemosa have been reported. Different parts of this plant contain β-amyrin, β-sitosterol, kaempferol, quercetin, scopoletin, scopolin and tannins

Dr. salman ahmed

Elephantopus scaber L., a medicinal plant from Myanmar, was studied to evaluate its biological activity. The activity of antimicrobial assessment showed that ethyl acetate extract exhibited moderate activity in contrast to all six tested organisms. Using the 2,2-Diphenyl-1-picrylhydrazyl (DPPH) free radical scavenging assay with ascorbic acid as standard for antioxidant activity showed that ethyl acetate extract possessed 36.28 μg/mL. The in vivo antidiabetic activity with glipizide, as a standard hypoglycemic agent was employed to determine antidiabetic activity. The data parameter under observation for Elephantopus scaber L. reaches its peak at 135 min, with a 39.0% reduction. No toxic behavior was observed at the limited tested concentrations (2000 mg/kg and 5000 mg/kg) and it suggested a favorable safety profile.

Mediterranean journal of pharmacy and pharmaceutical sciences

Multiple choice questions (MCQs) and short essay questions (SEQs) are common methods of the assessment of medical students in courses of pharmacology. Poorly constructed test items (questions) are a widespread problem resulting in failure to assess learning objectives. It has been reported that there are 36.0% to 65.0% flawed test items in medical education assessment tools. Thus, the objective of this study was to evaluate MCQs by determining the item writing flaws (IWFs) and to evaluate the SEQs by determining the cognitive level of each item. Four pharmacology tests were administered to third-year pharmacy students at Department of Pharmacology, Faculty of Pharmacy, Omar Al-Mukhtar University, Bayda, Libya. These were evaluated by determining the IWFs and the level of the cognitive domains. Based on Buckwalter’s modification of Bloom’s taxonomy cognitive level, for the SEQs, 30.0% of the questions were attempted to check recall of information, 26.0% were attempted to evaluate understanding and interpretation of data and 43.0% of the questions were attempted to check the application of knowledge for solving a particular problem. For the MCQs, 94.6% of the questions were attempted to evaluate the understanding and interpretation of data. For the IWFs, there were more than 40.0% of flawed questions. The most common writing flaws were the negative stem (47.4%), unfocused item (16.0%), non-homogenous in grammar and contents (10.0%), all the above (10.0%) and clang association (05.0%). In a short essay, the SEQs were of excellent quality because they were equally distributed among the three levels of cognitive (level I, II and III). On the other hand, the most common mistakes IWFs of the MCQs were the negative stem (47.0%) and the idea was not clearly and concisely stated in the stem (16.0%). This study concludes that questions in SEQs are valid to measure the learning objective but MCQs were not in pharmacology courses in Libya.

Mediterranean journal of pharmacy and pharmaceutical sciences

Le discours du nouveau Président algérien, Monsieur Abdelmadjid Tebboune, se caractérise par une rhétorique différente de celle de ses prédécesseurs. Notre entreprise, dans le présent article, vise à rendre compte de cette spécificité discursive en interrogeant trois expressions ponctuant souvent son discours. Notre analyse se propose d’examiner des segments de discours collationnés à partir des différents entretiens périodiques accordés aux médias nationaux et internationaux ainsi que des allocutions du président lors des travaux réunissant le gouvernement et les walis. En guise de conclusion, nous déterminerons les motivations du choix de ces formules dans le discours présidentiel.

Assanvo

Background Osteoarthritis (OA) is a significant global health concern and is characterized by the degeneration of joint structures, leading to pain, stiffness, and functional limitations It is estimated that 654.1 million individuals are affected by osteoarthritis worldwide, with females, especially those older than 60 years of age, being the population most impacted. However, there remains a gap in understanding the awareness of knee osteoarthritis among specific populations, such as the Palestinian community in the West Bank, thus, highlighting the need for targeted research to address this health disparity. Methods A cross-sectional survey was conducted in the West Bank from August to September 2024. Participants were recruited from 11 cities and a validated questionnaire adapted from a previous study was used to collect the data. The reliability of the questionnaire was assessed using Cronbach’s alpha, yielding a value of standard alpha = 0.71, which is an acceptable value. The survey collected demographic data, clinical characteristics, knowledge of osteoarthritis risk factors, symptoms, and attitudes towards treatment options. R Statistical Software was used for data analysis, which included descriptive statistics, chi-square tests, and logistic regression to explore the relationships between demographic factors and osteoarthritis knowledge, whereby a p-value of ≤ 0.05 was set up as a significance level. Results A total of 725 valid responses were included in our study. Among the participants, 569 were female, predominantly aged 25 or younger (66%, n = 479), and 62% (n = 450) were single. Knowledge assessment revealed that 80% (n = 580) recognized knee osteoarthritis as a chronic disease, while only 51% (n = 369) understood its impact on joint involvement. The majority identified high BMI (87%, n = 632), advancing age (94%, n = 683), and previous knee injury (72%, n = 520) as risk factors, although only 42% (n = 306) acknowledged genetics as one. Most participants were aware of the management strategies, including analgesics (70%, n = 510) and physiotherapy (80%, n = 579). However, 66% (n = 478) scored low for overall knowledge regarding knee osteoarthritis. Conclusion This study emphasizes the critical importance of raising awareness and knowledge about osteoarthritis within the Palestinian community. Despite being widely known as a long-term issue, there are still noticeable gaps in the understanding of the joint impact, potential risks, and effective treatment methods for osteoarthritis. The use of informal sources highlights the importance of specific educational programs by healthcare providers.

Mohamad banat

Service quality is a key factor for success in any hotel. Many researchers have conducted studies on service quality, but only a few studies have been conducted on internal service quality (ISQ) in general, and in the hotel industry in particular. Since there is no general agreement among researchers on the measurement of ISQ, many studies have used SERVQUAL instrument to measure the employees’ perceptions of ISQ. The purpose of this study is to explore the influence of ISQ on employee’s job satisfaction in five-star hotels in Jordan. The current study was carried out by measuring the data gathered through a seven-point Likert scale. The quantitative survey method was applied, and therefore the SERVQUAL instrument was used to measure ISQ, and the Job Satisfaction Survey (JSS) was used to measure job satisfaction. Data obtained from a sample of 238 respondents drawn from 14 five-star hotels in Jordan were analysed with the SPSS software based on descriptive statistics. The study’s findings indicated that the ISQ of five-star hotels in Jordan has a significantly positive influence on an employee’s job satisfaction. These findings support the hypothesis that there is a positive relationship between ISQ in the hotel industry and industry employees’ job satisfaction.

Mukhles m. al-ababneh

Objective As technology continues to improve, it plays an increasingly vital role in the practice of medicine. This study aimed to assess the feasibility of the implementation of virtual reality (VR) in a rheumatology clinic as a platform to administer guided meditation and biofeedback as a means of reducing chronic pain. Methods Twenty participants were recruited from a rheumatology clinic. These participants included adults with physician-diagnosed autoimmune disorders who were on a stable regimen of medication and had a score of at least 5 on the pain Visual Analog Scale (VAS) for a minimum of 4 days during the prior 30 days. VAS, part of most composite outcome measurements in rheumatology, is an instrument used to assess pain that consists of a straight line with the endpoints ranging from “no pain at all” and “pain as bad as it could be.” Patients were randomized into two groups that differed in the order in which they experienced the two VR modules. One module consisted of a guided meditation (GM) environment, whereas the other module consisted of a respiratory biofeedback (BFD) environment. Data on pain and anxiety levels were gathered before, during, and after the two modules. Results The three most common diagnoses among participants were rheumatoid arthiritis (RA), lupus, and fibromyalgia. There was a significant reduction in VAS scores after BFD and GM (P values = 0.01 and 0.04, respectively). There was a significant reduction in Facial Anxiety Scale after the GM compared with the BFD (P values = 0.02 and 0.08, respectively). Conclusion This novel study demonstrated that VR could be a feasible solution for the management of pain and anxiety in rheumatology patients. Further trials with varying treatment exposures and durations are required to solidify the viability of VR as a treatment option in rheumatology clinics

Ben spielberg

If you already have a research project in mind, the research planning phase must be completed with the formulation of a wellstructured research proposal that must be submitted to an ethics committee for approval before your project can start. Generally, a research proposal contains the following elements: Title, abstract, introduction, objectives, methodology, timeline and milestones, ethical considerations, budget, appendices, and references. Whether you are a medical student or a researcher, knowing how to write a research proposal is an important skill to start any research project. This guide will give you the skills to write a successful research proposal.

Karishma

Lateral epicondylitis, commonly known as Tennis Elbow, affects approximately 1-3% of the population. Despite the absence of histological evidence of inflammation in the affected tissue, the term “epicondylitis” implies inflammation. The Extensor Carpi Radialis Brevis (ECRB) muscle is primarily affected, and the condition is attributed to excessive use of this muscle. Non surgical treatment options, such as rest, physiotherapy, cortisone injection, platelet-based therapies, and restricted movements, are recommended. Surgical intervention is suggested for cases involving physical impairment or chronic pain. This review aims to provide healthcare professionals with an understanding of the condition, including its causes, symptoms, diagnosis, and treatment planning options.

Saran malisorn

Unmanned aerial vehicles (UAVs) are aerial systems controlled remotely or autonomously by astronauts. Massive advancements in electronics and information technology have prompted the popularity and growth of UAVs. As a result of the huge advances made in electronics and information technology, civilian tasks can now be accomplished with UAV in a more effective, efficient, and secure way. Known as a drone, UAVs are developed and operated using a variety of technologies such as machine learning, computer vision, artificial intelligence, and collision avoidance. Having become more affordable and accessible, drone technology has become more popular among civilians. Therefore, this technology is constantly evolving and can be used across a variety of fields. The application of drones makes a huge difference in the most demanding and complex industrial environments such as those in the mining industry, maritime, oil, gas, and seaports. The usage of drones is increasing among industrialists to improve and optimize processes, as well as to enhance operational efficiency in industrial process. This chapter discusses UAVs on a wide range of topics, including evolution and historical perspectives of UAV, taxonomy of UAV, significance of UAV to society and industry, and industrial and academic perspectives on UAV.

Dr h shaheen

The blunted nose cone with and without a sharp aerospike and an aerodisk of various diameters and lengths are investigated numerically in detail in the current study at a hypersonic Mach number of 10. The aerodisk diameter is described as d/D ratios such as 0.2, 0.4 and 0.6, and the length of the aerospike is represented as the L/D ratio of 1, 1.5 and 2. The main objective of the research is to examine the aerodynamic properties of blunt noses with and without aerodisks and aerospikes, as well as the influence of shock production over the model. The design of blunted nose cones with aerodisk was made up using CATIA and numerical investigation was performed on the ANSYS Fluent. The turbulence model of SST k-omega was considered for study. The current study revealed that shock patterns drastically varied nearer to the nose cone model at L/D ratio 2 and variation of drag reduction occurred due to the increase in d/D ratio and aerospike and also flow pattern over the model was clearly investigated.

Boopathy govindarajan

The cross line movement according to the two labor and products is the thing to take care of in the present worldwide economy. Worldwide exchange labor and products has for some time been a standard, for different advantages that gather from it. There have been numerous respective and multilateral arrangements comparable to cross line exchange dealings. The development of administrations area that decidedly influences the everyday daily routine and guidelines of experiencing or personal satisfaction. The World Trade Organization (WTO), of which in excess of 156 nations are individuals, has an understanding according to global administrations exchange. The General Agreement on Trade in Services (GATS) is the WTO's arrangement that administers exchange 12 sorts of administrations, including 'instruction administrations'. One of the basic inquiries or issues in such manner would be corresponding to the sort of college to be permitted to set up its grounds or branch or in any case offer training administrations. This paper would endeavor to give some potential experiences into this issue. Internationalization and globalization are the two Global ideas terms conversely utilized as far as higher education. Most impressively, the test to set up colleges will come from the worldwide monsters of the interchanges, data innovation and mixed media ventures worldwide suppliers, packed with capital, ready to get to remarkable global researchers and educators, talented in giving in situ understudy support at the same time in numerous nations, and equipped for expediting proficient accreditation and acknowledgment all throughout the planet. Quality in the subsequent 'worldwide virtual colleges' will be high, normalization will make cost structures that are powerfully serious, brand acknowledgment will be acquired, maybe by accepting one of the incomparable Ivy League organizations as an accomplice, or on the other hand by moving into advanced education a prevailing brand from the correspondences or processing ventures.

Dr gedam kamalakar

Background: Uterine leiomyoma is the most common benign smooth muscle tumor of unknown aetiology. Progesterone may contribute to leiomyoma growth through the induction of B-cell lymphoma-2 (BCL-2) protein in leiomyoma cells. This study aims to determine the patterns of Bcell lymphoma-2 (BCL-2) and progesterone receptor (PR) expression in uterine leiomyomas seen at LTH, Ogbomoso, over a five-year period using immunohistochemical techniques.Methods: This was a hospital-based retrospective study of histologically diagnosed leiomyomas in the histopathology department of a teaching hospital between January 2012 and December 2016. A total of 141 cases of uterine leiomyomas were semi-quantitatively analysed immunohistochemically for PR and BCL-2 antigens. Results: Immunohistochemical analysis showed that out of 141 cases studied, 74 (52.5%) and 118 (83.7%) were positive for BCL-2 and PR, respectively. Among the 141 cases, 23 (16.3%) were negative for both PR and BCL-2. There was a moderate positive correlation between the immunohistochemical expression of BCL-2 and PR antigens, with a p-value < 0.001 (Pearson correlation = 0.563). Conclusion: This study showed that the majority of women with leiomyomas expressed both progesterone receptor and B-cell lymphoma-2 antigens. Therefore, selective women with leiomyomas could benefit from progesterone receptor modulators instead of undergoing invasive procedures such as myomectomy or hysterectomy.

Karishma

Hemodialysis patients suffer from poor health-related quality of life which results in a higher risk of hospitalization and mortality. This study investigates the importance of pharmaceutical care and role of pharmacist for hemodialysis patients to optimize drug therapy, minimize drug related problems and thereby improving their health-related quality of life. The study was conducted to evaluate the impact of pharmaceutical care interventions on health-related quality of life of hemodialysis patients in Benghazi, Libya. Randomized control study was carried out after getting an ethical approval from the committee of the hospital. Health-related quality of life was assessed using SF-36 instrument for all the patients (n = 80). Among them, 40 patients were received the normal care along with brief medication review and counselled by pharmacists for two months. Then, health-related quality of life was assessed again for those 40 patients who received the pharmaceutical care. Data was analyzed using an appropriate methods. The results showed that the quality of life for hemodialysis patients was poor in both physical and emotional aspects. After implementation of appropriate pharmaceutical care to the patients, their quality of life improved significantly. Health-related quality of life is an important determinant of treatment effectiveness in dialysis patients

Mediterranean journal of pharmacy and pharmaceutical sciences

Background: Cubital tunnel syndrome (CuTS) is the second most common nerve entrapment syndrome of the upper extremity after carpal tunnel syndrome. In situ decompression (ISD) and ulnar nerve transposition (UNT) are the major surgery methods in practice for the treatment of CuTS. However, controversies exist over the efficacy and safety of these methods. Aim: The objective of the study was to compare the short- and long-term clinical outcomes in patients treated with ISD and UNT surgery. Method: This was a retrospective study comprising 56 patients who underwent either ISD or UNT at Naresuan University Hospital between January 2013 and December 2022. Data on age, sex, hand involved, duration of the surgery, duration of the symptoms including the clinical outcomes such as elbow range of motion (ROM), quick disabilities of the arm, shoulder, and hand (QuickDASH), McGowan grade (MGG), Visual Analog Scale (VAS) for pain scores, motor and sensory conduction velocity (MCV1, MCV2, and SCV), and Tinel's sign were collected during the two-week, one-month, three-month, and six-month follow-ups post-surgery. Results: Of the 56 patients in the study, 62.5% were female. The number of patients aged <60 years was higher in both groups. The mean age of patients in the ISD group was 49.07±6.13 years, while in the UNT group, it was 51.5±7.04 years. After one month, 53.57% and 32.14% of the patients recovered to MGG 1 in the ISD and UNT groups, respectively. The majority of the patients had MGG 1 six months after the surgery. The QuickDASH score and pain scores of the patients improved during all follow-ups, but no statistical significance was revealed when the two techniques were compared. Conclusion: The study found that both the ISD and UNT were efficient and safe in treating CuTS. Further study with the inclusion of parameters such as revision surgery and complications would be vital.

Saran malisorn

The kidney stones are one of the most widely spreading disorders in the world. The present study was undertaken to evaluate the efficacy of ethanolic extract of Didymocarpuspedicellata and Ashwagandha for its antiurolithiatic activity in rats. Urolithiasis was induced in adult male albino wistar rats by 0.75% of ethylene glycol for 28 days. The effect of the oral administration of the ethanolicextracts has been studied and is compared with the effect of oral administration of Cystone(Himalaya) as a standard on Wistar rat. Ethylene glycol feeding resulted in hyperoxaluria as well as increased renal excretion of calciumand phosphate. Supplementation with ethanolic extract of the plants significantly reduced the elevated urinary oxalate, showing a regulatory action on endogenous oxalate synthesis. Both the plant extract showed significant antiurolithiatic activity

Zeenath banu

Background: Epilepsy and cerebral palsy (CP) are reported as the two most common indications for electroencephalogram (EEG) requests in children in Nigeria. Although several studies have examined epilepsy and EEG findings in the country, most have not documented the conditions under which EEG recordings were performed—whether during wakefulness, natural sleep, sleep deprivation, or drug-induced sleep. This study aimed to compare the effectiveness of sleep deprivation and the use of melatonin in achieving sleep EEG recordings in children with epilepsy and CP versus those with epilepsy without CP, at the Pediatric Neurology Clinic of Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria. Methods: This was a cross-sectional comparative study involving children aged 6 months to 15 years, conducted between March 2022 and February 2023. A total of 121 subjects with epilepsy associated with CP (Group 1) and 124 subjects with epilepsy not associated with CP (Group 2) were consecutively recruited. Conventional inter-ictal sleep EEG recordings were performed using an EEG machine (Model: Satellite P200-132, Toshiba Europe GmbH, DC 19V, 3.4A). Data were analyzed using SPSS version 25.0, and a p-value of <0.05 was considered statistically significant. Results: Of the subjects with epilepsy and CP (Group 1), 67 (55.4%) achieved sleep EEG recordings following sleep deprivation, while 54 (44.6%) required sleep induction with melatonin. Among subjects with epilepsy without CP, 107 (86.3%) attained sleep EEG recordings after sleep deprivation, whereas 17 (13.7%) required melatonin-induced sleep. The difference between the two groups regarding the need for melatonin to induce sleep was statistically significant (p < 0.001). Conclusions: Sleep deprivation was more effective in achieving sleep EEG recordings in children with epilepsy who did not have CP.

Karishma