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

Background: Shilajit is a historically valued natural substance with promising but still preliminary scientific support for urinary and diabetic health, yet its growing popularity risks exploitation and exaggerated claims without rigorous human clinical validation. This study investigates the therapeutic effects of Yemeni Shilajit sourced from Dhamar, Ma’rib, and Raymah on hemolytic anemia experimentally induced in rabbits using phenylhydrazine. Methods: Twelve male rabbits were divided into four groups: a control group and three treatment groups, each receiving Shilajit from one of the three regions. Anemia was induced via subcutaneous injection of phenylhydrazine hydrochloride, and treatment was administered orally at a dose of 125 to 250 mg/kg twice daily. Hematological parameters—including packed cell volume (PCV), hemoglobin concentration (Hb), red blood cell (RBC) count, and glucose-6- phosphate dehydrogenase (G-6-PD) activity—were evaluated at various intervals. Results: showed that Shilajit from Dhamar and Raymah significantly increased PCV, Hb, RBC count, and G-6-PD enzyme activity (p < 0.05), suggesting notable anti-anemic effects and potential for restoring hematological parameters to near-normal levels. In contrast, Ma’rib Shilajit exhibited limited efficacy, with significant improvement only in hemoglobin levels. Phytochemical analysis confirmed the presence of essential amino acids and bioactive compounds, such as fulvic acid and dibenzo-α-pyrones, which likely contribute to Shilajit’s therapeutic action. Conclusions: The study concludes that purified Shilajit from Dhamar and Raymah holds promise as a natural remedy for hemolytic anemia, supporting its traditional use and warranting further investigation for pharmacological applications.

Karishma

“Phyllanthus emblica” known to be amla has role in the skin aging influences the changes in skin, including skin dryness, wrinkle, and irregular pigmentation. Initially the 6 day observation has been taken for the ageing activity to be track to study the TREM2 pathway of “Phyllanthus emblica”. Cellular observation and pathway consideration: The environmental impact of pH, Temperature, Humidity and stability of amla fruits is important for the ageing of cells in neuronal cascade of TREM2 Pathway, while studying the fruits cell cycle. The melanin suppression through inhibition of tyrosinase and tyrosinase-related protein-2 activities, the strong antioxidant, and the potent matrix metalloproteinase-2 in cellular observation of tyrosinase pathway. The study aimed to evaluate the anti-skin aging efficacy of amla.

Dr. wahul umesh b

This dissertation aimed to critically investigate how UK manufacturing companies can employ 3PL services to enhance business profitability. A simple, cross-sectional sequential mixed methods research methodology was implemented with the qualitative phase being used to explain the findings of the quantitative phase, which was performed first. Data for the quantitative period were collected using an online questionnaire that was designed and administered through a Google survey (N= 416). At the same time, semi-structured interviews were performed via Zoom calls with senior executives and managers of UK manufacturing firms (N= 5). Descriptive statistics, a one-sample t-test, and stepwise regression were used for quantitative data analysis using SPSS while manual analysis of interview data was performed in Microsoft Excel. The results showed that transportation and fleet management were the services that UK manufacturing companies outsourced to the most significant extent while clearing and forward and inventory management were the services that were outsourced to the lowest degree. The reasons behind this trend included the level of risk involved in outsourcing a particular service, availability of 3PL providers offering the outsourcing service, and the cost involved. In terms of feasibility, all items were scored highly, although increased operational flexibility and significant reduction of operational costs ranked highest. Finally, the stepwise regression test revealed four statistically significant models with an overall prediction power of 20.1% on business profitability. The statistically significant predictor variables were a reduction of operational costs, increased operational flexibility, reduced fixed asset costs, and the gaining of external resources from 3PL service providers.

Mohamed sorogy

Dynamic capability has been used as the basis for organizations to build digital transformation to stay competitive in the market. This literature review aims to determine the significance of dynamic capability and digital transformation in family businesses. Using a systematic literature review methodology and utilizing the Dimensions database, three articles that met the criteria and fulfilled the goal of the review were selected. The findings indicate that family businesses have important dynamic capabilities that can aid their survival and expansion through digital transformation. Therefore, family business owners and managers should be able to identify and effectively use their dynamic capabilities to implement digital transformation in their business operations.

L

Background and Objective: Health care workers (HCWs) are at the highest risk of contracting COVID-19, so their knowledge about the disease and their preventive attitude and practice toward COVID-19 are of concern. The present study aimed to assess the knowledge, attitudes, and practices of HCWs toward COVID-19 in Al-Thawra Hospital, Ibb Governorate, Yemen. Materials and Methods: We conducted a cross-sectional survey among HCWs in Al-Thawra Hospital, Ibb, Yemen, from January 1 to March 31, 2022. Results: Of the 80 participants, 50 (62.5%) were males and 30 (37.5%) were females with a mean age of 29.33±7.86 years. About 51.2% of respondents were aware that sneezing is a recognized symptom of COVID-19, while most were unaware of the extrarespiratory symptoms of the disease, such as diarrhea and confusion. About 28.7% of respondents believed that eating or contacting wild animals would result in infection by the COVID-19 virus, with the majority (71.3%) agreeing that wearing a well-fitting face mask effectively prevents COVID-19 infection. Approximately 48 respondents (60.0%) believed that washing hands could prevent contracting COVID-19, and only 31 (38.7%) agreed that if a patient shows signs and symptoms of COVID-19, they can confidently participate in that patient’s treatment. In response to avoid COVID-19, about 23 respondents (28.7%) had always gone to crowded places, and 35 (43.6%) had always worn face masks at every contact with patients, while only 14 (17.5%) of participants refrained from shaking hands and 37 (46.3%) always washed their hands before and after handling each patient. Conclusion: This study showed that most respondents have poor knowledge regarding the clinical picture of COVID-19 and its mode of transmission as most of them failed to detect an extrapulmonary manifestation of COVID-19 and were unaware of the possibility of transmission of the disease from wildlife. In addition, the attitude and preventive practice of the respondents were unsatisfactory in containing the transmission of the disease.

Karishma

Introduction: In recent years, the growing research towards new drugs has been targeted on plant-based drugs, and Neem (Azadirachta indica) is one of the plants that have been extensively researched for its diverse medicinal properties. The study aimed to determine the effects of neem on the hematological parameters (total white blood cells, neutrophil, monocyte and eosinophil counts) and histology of some organs of rats. Methods: Fifteen healthy male Wister rats divided into control (Nm0) and experimental groups (Nm11 and Nm22). Control group 1 (Nm0) was given 100mg/200g body weight of normal saline orally twice daily; experimental group 2 (Nm11), 100mg/200g body weight neem extract twice daily for 11 days and experimental group 3 (Nm22), 100mg/200g neem leaf extract twice daily for 22 days. Total number of white blood cells (WBC), lymphocytes, neutrophils, monocytes and eosinophils, packed cell volumes (PCV) and histological changes in the spleen, liver and kidneys were evaluated. Results: There were no significant differences in mean values of the hematological parameters (total WBC; PCV; neutrophils, lymphocytes, monocytes and eosinophils). We observed the central vacuolation and accumulation of lymphocytes in the spleen, hypertrophy of the central vein in the liver and shrinking of the glomeruli and accumulation of the lymphocytes in the kidney using hematoxylin and eosin staining following prolonged administration of neem extract (Nm22). Conclusion: Prolonged administration of neem affected the histology of some organs of the rats more than the hematological parameters

Emmanuel umegbolu

One of the unique features of Indian society is prevalence of caste system which was originated thousands of years back to demarcate the people engaged in different occupation or jobs. Initially it was not much rigid but gradually people belonging to upper castes for their own selfish means to maintain their monopoly made this arrangement hereditary and started treating people of lower castes disgracefully. For preservation of this system, people started controlling their women to prevent inter-caste marriages and the concept of endogamy came up. This robbed away many types of freedom from women. For women belonging to lower castes, this situation is worse as they are doubly subjugated on the basis on caste as well as gender. Men belonging to their own caste treat them as secondary beings. This paper throws light on this intersection. How intersection of these two kinds of inequalities place them at the lowest position in Indian society. Dr. B.R. Ambedkar rises as their leader who all his life worked for empowerment of downtrodden section of society. He argues that education is the primary tool for evading these differences among people. He further emphasizes to adopt the concept of exogamy to break the backbone of Indian caste system and to immediately leave a religion or culture which legitimizes such system of inequality among people of the same land.

Swati sharma

The Internal Medicine Residency Program at Hamad Medical Corporation (HMC) is accredited by the Accreditation Council for Graduate Medical Education–International (ACGME-I). Upon completion, residents are awarded both the Arab Board and Qatari Board certifications. This four-year program involves rotations across general internal medicine and its subspecialties in both inpatient and outpatient settings. This article aims to analyze the teaching theories and methods observed during internal medicine residency training. An essential benefit of learning theories is the ability to articulate educational plans and objectives more precisely. Furthermore, integrating theory into practice strengthens improvement programs and facilitates their evaluation. [1] The following sections describe and analyze the educational process as experienced throughout the residency program from resident perspective.

Karishma

ABSTRACT “Numbers are the highest degree of knowledge. It is knowledge itself.”- Plato “The world is built on the power of numbers.” Pythagoras “Everything around you is numbers.” Shakuntala Devi. The date, we were born on, was not an accident. Each number in our date of birth is connected with certain energies and vibrations. Similarly, each and every letter in our name (first as well as full name) also has particular frequency, energies and vibrations. The combined and correlated energies of numbers and letters of an individual reveal about the past, present and future. The careful study of these universal divine energies can reveal, who you are, why you are here, where are you going and how will you get there. In other words what is your personality, nature, thinking, and what is your future in terms of family career relationships and finances etc. In this study, an attempt has been made to analyze -How certain patterns of name numbers and date of birth related core numbers can emerge as a directional guide for an individual to choose any specific career/profession (by studying the patterns of over 1100+ date of births and names of the Engineers cum Arbitrators).

Jyotsnaa g bansal

In this research study, the mechanical properties of several Polymer matrix composites are investigated. These composites are multi-phase materials in which reinforcing materials are properly mixed with a polymer matrix. More precisely, Nylon 6 reinforced with 5, 15 and 25 wt. % of silicon carbide (SiC) and Nylon 6 reinforced with 5, 15 and 25 wt. % of boron carbide (B4C), prepared by means of an injection moulding process at three different injection pressures are considered. Specific attention is paid to the tensile and impact strength of these composites. The Taguchi technique is used to optimize the process parameters such as reinforcement material, its percentage and the injection pressure. It is observed that the specimens 5% SiC with 80 MPa injection pressure display a better tensile strength and similarly the specimen 5% B4C with 90 MPa injection pressure have a superior impact strength.

Boopathy govindarajan

This paper delves into the dynamic intersection of Artificial Intelligence (AI) and Remote Patient Monitoring (RPM), exploring how the integration of these technologies is reshaping the landscape of healthcare. By examining recent breakthroughs, practical implementations, and ethical considerations, the article elucidates the transformative potential of AI-enhanced RPM in providing personalized, proactive, and efficient healthcare solutions.

Dhruvitkumar talati

The microbiological quality of purified water is a crucial aspect in the healthcare industry to ensure safety for different applications and uses. Understanding the trend and forecasting would be of prime importance to take proactive control and protective measures before catastrophic excursions might occur leading financial and health casualties. This study analyzes microbial density, a key metric for monitoring water purification system efficacy in healthcare facilities. The objective was to transform irregular, cumulative data into a regular time series and identify the optimal ARIMA model for forecasting to support predictive maintenance and regulatory compliance. Preliminary modeling attempts were conducted using simpler approaches such as linear, exponential and Holt-Winters methods without showing promising outcomes. Descriptive statistics and distribution analysis, including the Johnson Transformation for normality, were performed. ARIMA models with differencing orders d=0, d=1, and d=2 were fitted to the Aggregated cumulative logarithmically transformed data series, with the best model at each order selected based on minimum AICc. Model adequacy was assessed through parameter significance and residual diagnostics (Ljung-Box test). Descriptive statistics showed the aggregated series non-normal (p<0 d=0) AICc=319.39) d=2) AICc=258.98)>0.5). The ARIMA(2, 1, 2) model (d=1) was optimal (AICc=256.91), with all significant parameters and white noise residuals (p>0.3), effectively addressing non-stationarity. Forecasts from ARIMA(2, 1, 2) predict stable future growth. The ARIMA(2, 1, 2) model with first-order differencing is the most appropriate and robust model for forecasting data trends. Its strong statistical fit and reliable residual properties make it a valuable tool for predictive maintenance, optimizing resources, and enhancing patient safety in healthcare water systems, provided model performance is continuously monitored. Addressing data limitations and processing requires monitoring and exploring alternative models for future improvement.

Mostafa eissa

Lack of development of adequate social skills of special need students results in many disruptive behavior and poor academic gains. School setting is also an indicator of rise in academics and learning of social skills. The purpose of the current study was to investigate the social skills development and educational outcomes of special need students attending special and inclusive settings. Only 110 visually impaired students (60 from special and 50 form inclusive school setting) represent as special need children who participated as sample of the study. Data were collected from 5 Special Schools for Visually Impaired and 5 Inclusive Schools located in Delhi and NCR. Hindi Version of the Matson Evaluation of Social Skills with Youngsters: Self-rating form (MESSY) by Sharma (2000) was used to assess social skills development and to measure the educational outcome, aggregate percentage marks obtained by the students in their previous year‟s annual examination were collected from the records of the schools. Hypotheses formulated for this study were verified by applying appropriate statistical techniques- Mean, Standard Deviation and t-test. Significant differences found in the development of social skills and educational gains of the special need children in special vs. inclusive settings. Inclusive setting, to a great extent provides conducive learning environment and platform to develop social skills. Results of the study recommend implications for special and normal children, teachers and administrators.

Rubul kalita

The identification of isomorphism in epicyclic gear trains has been found a lot of attention by researchers for the last few years. Various methods have been suggested by different authors for the detection of isomorphism in planer kinematic chains and epicyclic gear trains (EGTs), but everyone has found some difficulties to address new issues. In this paper, a modified path matrix approach was presented in order to compare all the distinct geared kinematic mechanisms. A new method based on the matrix approach and corresponding train values is required to identify isomorphism among epicyclic gear trains and their mechanisms. The proposed method was examined on the basis of various examples from four-link, five-link, six links, and eight-link one-degree-of-freedom EGTs and six links two-degree-of-freedom EGTs. All the examples have been found satisfactory results with existing literature.

Jiyaul mustafa

Ayurvedic formulations are of three types, Herbal, Mineral and Herbo-Mineral. Of which, Herbomineral is prepared either by Khalweeya or by Bhasmeekarana procedures. The quality of Bhasma depends on the number of putas given. Rasa Bhasma is one such kind of a Herbo-mineral preparation which can be obtained by Puta procedure as described in texts of Rasa Shastra. Though there are different procedures mentioned for preparation of Rasa Bhasma, maarana done with Gorvara puta seems to be an apt way to obtain the final product. Puta is the generalised way of heat application used during the pharmaceutical procedures of Rasa dravyas, where the purified organic Metal/Mineral is converted completely into powder form which can be absorbed easily into the body without causing any ill effects. Different types of Puta have been explained for bhasmeekarana of different metals and minerals. Among them, certain putas have been mentioned where Mandaagni plays a crucial role in Maarana (Incineration). These Mandaagniputas are in use of preparing certain Bhasmas like ShilajitBhasma, HaratalaBhasma, GouripashanaBhasma, and PaaradaBhasma. As these drugs are having relatively low boiling and melting points when compared to other dravyas, and are easy to evaporate when exposed to high temperatures, they need a standardized quantum of heat by which they can be transformed into Bhasma. Gorvara puta is one such kind where agni plays a major role in the preparation of Bhasma. So, the present study A Comprehensive Study of Gorvara Puta in Preparation of Rasa Bhasmahas has been under taken.

Suri abhiram

Obesity is a complex and challenging global public health concern. It is a major disease involving excessive fat accumulation that may impair health. Obesity is dangerous and has been related to a range of long-term health issues that can impact adults and children. According to the World Health Organization, more than one billion people worldwide are obese as of March 2022. In the Libyan situation, the prevalence of obesity has increased among the public over the last decade. This cross-sectional survey-based study is conducted by using self-structured designed questionnaire to evaluate the use of anti-obesity drugs and herbal products among Libyan people. Additionally, considered as an indirect method, pharmacist performance in obesity management was also evaluated. The investigators collected interview data from three different cities in the Northwest of Libya over a period of five months, 2019. A total of 170 participants who use weight loss products were randomly selected to participate in the study after obtaining their verbal consent. The participants' experience with weight reduction agents revealed that more than half of the participants (52.3%) used herbal products while 32.0% of the participants have used drugs of chemical origin and 15.6% have used both (herbal and drugs). The majority of the participants (91.4%) used these products without medical consultation which in turn led to failure to lose and maintain weight with 74.2% gaining weight after stopping using these products. In conclusion, poor pharmacist intervention in obesity management was revealed where the majority of the participants reported that Libyan community pharmacists had not been offering weight management services, monitoring weight loss progress, or explaining the risks of being overweight or obese.

Mediterranean journal of pharmacy and pharmaceutical sciences

Good prescription writing is essential for dispensing the right drug formulation and dose. When prescriptions are not legible, inaccurate and do not include complete information, there is a possibility of prescribing errors occurring, which leads to adverse events. Poor handwriting is another important issue that makes the information unclear; especially look-alike drug names that may be confused by the pharmacist. World Health Organization has issued a practical manual for Good Prescribing that includes the essential information that should be included in a prescription. In this study, we attempt to investigate the problem of bad prescribing habits in out-patient prescriptions in Benghazi, Libya. Two hundred seventy-five out-patient prescriptions were collected from two private pharmacies on four consecutive days. These prescriptions were scanned for any errors or missing information depending on the standard criteria established by World Health Organization in its practical manual "Guide to Good prescribing". The collected data were processed and statistically analyzed by using SSPSS to calculate the percentage of missing information. Eleven percent (11.0%) of the prescriptions had no address or name of the prescriber on them while 58.0% had no date written on them and in 21.0% the prescriber did not sign the prescription. The age of the patient was only written on 38.0% of the prescriptions. The name of the medication was not clearly written in 18.0% of the prescriptions, while the dosage form of the medication was not written at all in 18.0% and not clearly written in 20.0% of the prescriptions. The total amount of the prescribed drug was not written in 30.0% of the prescriptions. It is to conclude that prescribers included in this study wrote prescriptions with a lot of missing and unclear information as per WHO guidelines for a good prescribing. This shows the weak attitude of Libyan prescribers toward the different aspects of “Good Prescribing”.

Mediterranean journal of pharmacy and pharmaceutical sciences

Background: Perforation is the most serious surgical complication of peptic ulcer disease due to its attendant high morbidity and mortality. Hypovolemia, a consequence of gastro-duodenal perforation, is considered to be a cause of renal hypo perfusion with accompanied decreased clearance of urea and creatinine. The aim of this study was to determine the preoperative baseline serum urea and creatinine profile among patients with perforated peptic ulcer disease and the relationship of serum urea and creatinine with the outcome of care. Methods: A retrospective study of patients who had operation for perforated peptic ulcer disease over a 5-year period at Dalhatu Araf Specialist Hospital, lafia, North-central Nigeria was conducted. Results: Sixty-four patients were studied with a mean age of 36.6 ± 12.3 years. Majority of the patients were males, 59 (92.2%). While 38 (59.3%) patients had elevated preoperative baseline urea levels, 37 (57.8%) patients had elevated creatinine levels. Out of 29 patients who had surgical site infection, 16 (55.2%) had elevated serum urea (p = 0.535) while 19 (65.2 %) had elevated serum creatinine (p = 0.579). An overall in-hospital mortality rate of 14.1% was recorded. There was statistically significant relationship between elevated serum urea and inhospital mortality (p = 0.007). Conclusion: This result showed that preoperative baseline serum urea and creatinine levels were elevated in majority of the patients. In addition, the result of this study suggests that elevated baseline serum urea level has considerable relationship with in-hospital mortality

Karishma

Physically unclonable function (PUF) is a hardware security module preferred for hardware feature based random number and secret key generation. Security of a cryptographic system relies on the quality of the challenge-response pair, it is necessary that the key generation mechanism must unpredictable and its response should constant under different operating condition. Metastable state in CMOS latch is undesirable since it response becomes unpredictable, this feature used in this work to generate a unique response. A feedback mechanism is developed which forces the latch into the metastable region; after metastable state, latch settle to high or state depends on circuit internal condition and noise which cannot be predicted. Obtained inter hamming variation for 8 PUF is 51% and average intra hamming distance is 99.76% with supply voltage variation and 96.22% with temperature variation.

Abhishek kumar