Background and Aim: Ultrasound popliteal sciatic nerve block (UPSNB) is commonly performed in foot and ankle surgery. This study aims to assess the use of dexmedetomidine and dexamethasone as adjuvants in UPSNB for hallux valgus (HV) surgery, comparing their efficacy in producing motor and sensory block and controlling postoperative pain. The adverse event rate was also evaluated. Methods: This mono-centric retrospective study included 62 adult patients undergoing HV surgery: 30 patients received lidocaine 2% 200 mg, ropivacaine 0.5% 50 mg and dexamethasone 4 mg (Group 1), whereas 32 patients received lidocaine 2% 200 mg, ropivacaine 0.5% 50 mg, and dexmedetomidine 1 mcg/Kg (Group 2). At first, the visual analogue scale (VAS) was evaluated after 48 hours. The other outcomes were time to motor block regression, evaluation of the first analgesic drug intake, analgesic effect, adverse effects (hemodynamic disorders, postoperative nausea and vomiting (PONV)) and patient satisfaction. The continuous data were analyzed with student’s t-test and the continuous one with χ2. Statistical significance was set at a p-value lower than 0.05. Results: No significant difference was found in VAS after 48 hours (4.5 ± 1.6 vs 4.7 ± 1.7, p = 0.621) to motor block regression (18.9 ± 6.0 vs 18.7 ± 6, p = 0.922). The number of patients that took their first analgesic drug in the first 48 h (p = 0.947 at 6 hours; p = 0.421 at 12 hours; p = 0.122 at 24 hours and p = 0.333 at 48 hours) were not significant. A low and similar incidence of intraoperative hemodynamic disorders was recorded in both groups (hypotension p = 0.593; bradycardia p = 0.881). Neither PONV nor other complication was found. Patients in Group 1 reported a lower degree of interference with sleep (p = 0.001), less interference with daily activities (P = 0.002) and with the affective sphere (P = 0.015) along with a more satisfactory postoperative pain management (p < 0.001) as compared to Group 2. Conclusion: No significant differences were observed in the duration of motor and sensory blockade between patients in both groups. Additionally, both groups showed good pain control with a low rate of adverse effects, even if there was no clinical difference between the groups. However, patients who received dexamethasone reported experiencing less interference with their sleep, daily activities and overall emotional well-being, and overall pain control.

Dario cirillo

Medical research is defined as "all scholarly activities that deal with any of the areas of studies being conducted in the pre, para, and clinical areas being taught in a medical school". Such a definition is somewhat arbitrary, as medical research covers a much larger field and ultimately affects every individual. The results of research activities are directly translated into social action, such as pollution control, vaccinations, mass fluoridation and nutritional improvements. The eradication of diseases like smallpox, poliomyelitis and plague, the decline in the death rate from infectious and cardiovascular diseases, and the diagnosis of genetic disorders are some examples of how medical research helps to provide improved health care. Thus, the wealth of medical knowledge that grows through the process of discovery and research development becomes part of daily living. The aim of scientific research is always to extend the frontiers of knowledge and to discover rational correlations and principles [1, 2]. Medical research can be divided into biomedical (basic medical), clinical, and health science research. The areas overlap each other and health science research has a component of social research. Experimental research covers areas such as physiology, biochemistry, microbiology, pharmacology and pathology and is relatively easy to conduct. If adequate financial support is obtained, the necessary infrastructure for laboratory research could be built and experimental animals maintained in an animal house. For clinical research, the patients with a particular disease are the direct object of study. This type of research involves dealing with the clinical picture, diagnosis, therapy and prognosis of the disease. Dealing with human beings requires stringent regulations and precautions to be observed. It requires setting up a research team in the hospital to monitor and chart out guidelines involving the ethical dimension of the problem to be studied and maintain a systematic medical recording system. Moreover, it is through a prolonged study of a large number of cases of the same disease that clinical research learns to predict the likely prognosis and judge the efficacy of the treatment. This type of research activity has limitations in the form of having a restricted number of cases of the disease under investigation, a need to update one's knowledge concerning laboratory techniques from which he obtains his 'cues', and the longer time interval required to complete the work. Health science research is a recent development of medical research due to the demands placed on many health services. More often basic medical and clinical research go hand in hand and are inseparable. Furthermore, clinical research workers often conduct studies on experimental animals, due to either the limited number of human cases or for ethical considerations.

Mediterranean journal of pharmacy and pharmaceutical sciences

Purpose Noise pollution is a common health hazard worldwide which is emitted along with chemical air pollutants, simultaneously from many sources. Some studies have been conducted to control these pollutants, simultaneously with promising results being achieved. Dielectric beads have been used in air pollution control technologies, successfully and probable effectiveness of them in noise reduction can be promising in dual use of them in the exhausts emitting noise and air pollution, simultaneously. Methods In order to investigate the effectiveness of dielectric beads in noise reduction, two types of them; namely glass and ceramic beads, were placed separately inside the connecting tube of a double-expansion chamber muffler. Then the transmission loss (TL) of muffler was examined using impedance tube. A factorial design was used to evaluate and optimize the effect of noise related parameters on TL of such a system. Results Results show that the presence of dielectric beads has significant effect on TL of muffler. The maximum TL was obtained as 74.76 dB for muffler with ceramic beads, under the optimal condition of 5250 Hz and 120 dB. Measurement of TL and sound absorption coefficient (SAC) of glass and ceramic beads showed that the noise reduction in muffler with ceramic and glass beads is probably due to SAC in ceramic beads and noise reflections in glass beads, respectively. Conclusion These results promise the dual use of dielectric beads in the exhausts emitting noise and air pollution simultaneously.

Niloofar

Breast cancer is the most prevalent invasive form of cancer in females and poses a significant challenge to overcoming the disease burden. The growth in global cancer deaths mandates the discovery of new efficacious natural anti-tumor treatments. In this regard, aquatic species offer a rich supply of possible drugs. Studies have shown that several marine peptides damage cancer cells by a broad range of pathways, including apoptosis, microtubule balance disturbances, and suppression of angiogenesis. Many side effects, including immune response suppression, characterise traditional chemotherapeutic agents. The discovery of novel putative anti-cancer peptides with lesser toxicity is therefore necessary and timely, especially those able to thwart multi-drug resistance (MDR). This review addresses marine anti-cancer peptides for the treatment of breast cancer.

Dr. salman ahmed

“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

Mobile pervasive environment interact with several devices at varying service ranges. The technical heterogeneity of pervasive environment is expected to increase the system flexibility and adaptability on modeling with context training phase. While working with context based training phase, time entity measure is considered as the significant issue. The evaluation of the services through numerous devices during training phase does not acquire an effective service monitoring on mobile pervasive environment. Mobile pervasive environment based information extraction fails to modify the patterns as activities change over time. To improve the flexibility of context training phase in mobile pervasive environment, an Active Context Source Discover Training Phase (ACSDTP) with Classifier Decision Tree Support (CDTS) mechanism is proposed in this paper. Our research work is to develop an effective modification (i.e., updation) of the pattern on training phase with real world context as per changes over time. Initially, the ACSDTP set up the available sensors in pervasive environment to work with the ever changing set of context users. The available sensors are maintained using the Active Discover process. Second, the CDTS mechanism is designed using weighted prediction for easy identification of context result on the training phase. Decision tree is operated separately using the learning techniques, where the identification is performed in a significant manner with minimal time factor. The learning process is performed to identify the inferred situations. Finally, the integration process is carried out to work with the complex association between the situations and sensor data in the mobile pervasive environment to achieve flexibility and adaptability factor. Experiment is conducted on factors such as time entity measure rate, precision ratio, and user context result determination level.

Dr h shaheen

The valuable effects of regular exercise for promotion of health and therapy of diseases were obviously evaluated. The notion that exercise can be considered as a medication has been hypothesized. The growing problems of obesity and non-communicable diseases have placed a great burden on public health experts to promote physical literacy and physical activity among the modern day population. Physical literacy and physical activity have become the cornerstones of women’s health. Women have certain special needs that includes reproductive health. Increased physical activity and maintaining normal body image and body weight will help a woman attain physical, mental and spiritual development. With the growing number of women with obesity and the implication of obesity as one of the main risk factors for non-communicable diseases like diabetes, hypertension, stroke and osteoarthritis, a knowledge and awareness about physical activity is essential. Thus, physical activity is a fundamental aspect of the improvement of motor skills and work performance, allowing a better healthy lifestyle. Physical exercise is effective to be measured as a drug, however, more care should be considered to the dosing and individual variations between genders.

Mediterranean journal of pharmacy and pharmaceutical sciences

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.Each WTO part that proposes to change its 'advanced education administrations' area to outline the 'responsibilities' by specifying certain conditions or restrictions with respect to its strategy on such progression. Contingent upon certain public or provincial targets and the states of interest and supply of advanced education, every part would set down various types of conditions while changing the area to unfamiliar instructive foundations. 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. The inquiry raised here is should WTO individuals from Pro training Services Liberalization permit Foreign Private Universities or Foreign Public Universities?

Dr gedam kamalakar

Lycium schweinfurthii is a shrub belonging to the Solanaceae family which widely grows in North Africa and Mediterranean regions. The plant leaves have traditionally been used for gastrointestinal diseases as peptic ulcer in Libya. This study aimed to investigate the effect of Lycium schweinfurthii extract on the central nervous system in mice including anticonvulsant, antidepressant and muscle relaxant activities. The methanolic extract was prepared by fractionation technique. Albino male mice weighing 22 ± 2.0 gm were used and equally divided into equal number and weight for each experiment (n = 6). The best effective pharmacologically dose of 400 mg/kg, i.p. of the methanolic extract was selected to explore the anticonvulsant activity for picrotoxin-induced convulsion in mice (5.0 mg/kg), antidepressant activity of forced swimming test of depression and muscle relaxant action by motor coordination test of hanging wire. Fluoxetine (10.0 mg/kg), imipramine (15.0 mg/kg) and diazepam (5.0 mg/kg) were used as reference compounds. Lycium schweinfurthii extract exhibited a significant prolonged delay in the onset time of induced convulsion and significant decrease in the frequency of convulsion as well as a significant decrease in the duration time of attacks. Pretreatment with flumazenil (2.0 mg/kg) was found to increase the frequency and duration of convulsions without profound change in the onset time produced by Lycium schweinfurthii. For antidepressant activity, the plant leave extract significantly decreased immobility time duration without a muscle relaxant effect. The results suggest that the methanolic extract of Lycium schweinfurthii leave has anticonvulsant and antidepressant-like activities without any muscle relaxant effect in mice. Thus, Lycium schweinfurthii may have a neuropharmacological potential use in human.

Mediterranean journal of pharmacy and pharmaceutical sciences

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

Every religion includes a whole series of beliefs and practices and we should start by concentrating our attention on religious practices to understand a religion. This paper intended to clarify the religious practices of Vietnamese Catholic Youth. Based on the theory of Glock and Stark and by using survey method, descriptive statistics, this is the first study to demonstrate the religious practices of youths in a diocese of Vietnam. This issue considered as an interesting research topic in the context of Vietnamese research because it explores youths lives from a different perspective by focusing on the micro level of analysis. The respondents in this study were total of 388 young adults between 18 and 30 years of ages from 24 parishes who were randomly selected through Probability Proportional to size sampling method. The findings of the research indicate that the ritualistic dimension of religiosity among Vietnamese Catholic youth is still so high in the context of change in Vietnam

Le minh tien

The study identified the level of competencies and the extent of professional development needs of kindergarten teachers in the Sultan Kudarat Division, during the school year 2019 - 2020. The study employed a descriptive method. The study involved 54 kindergarten teachers in the division in accomplishing the 12-item self-assessment instrument. Data were analyzed using descriptive statistics. The results revealed that kindergarten teachers have a high level of competencies in content knowledge and pedagogy, learning environment and diversity of learners, curriculum and planning, and assessment and reporting. These indicate that they possess almost all of the competencies of efficient teachers. Results further revealed a very high extent of professional needs in content knowledge and pedagogy and the learning environment and diversity of learners, while they had a high extent of professional needs in the remaining domains. Since they reported very high priorities in content knowledge and pedagogy and the learning environment and diversity of learners, these areas would be the main considerations in the crafting of a professional development plan.

Manuel caingcoy

Background General Government Health Expenditure (GGHE) in Mauritius accounted for only 10% of General Government Expenditure for the fiscal year 2018. This is less than the pledge taken under the Abuja 2001 Declaration to allocate at least 15% of national budget to the health sector. The latest National Health Accounts also urged for an expansion in the fiscal space for health. As public hospitals in Mauritius absorb 70% of GGHE, maximising returns of hospitals is essential to achieve Universal Health Coverage. More so, as Mauritius is bracing for its worst recession in 40 years in the aftermath of the COVID-19 pandemic public health financing will be heavily impacted. A thorough assessment of hospital efficiency and its implications on effective public health financing and fiscal space creation is, therefore, vital to inform ongoing health reform agenda. Objectives This paper aims to examine the trend in hospital technical efficiency over the period 2001–2017, to measure the elasticity of hospital output to changes in inputs variables and to assess the impact of improved hospital technical efficiency in terms of fiscal space creation. Methods Annual health statistics released by the Ministry of Health and Wellness and national budget of the Ministry of Finance, Economic Planning and Development were the principal sources of data. Applying Stochastic Frontier Analysis, technical efficiency of public regional hospitals was estimated under Cobb–Douglas, Translog and Multi-output distance functions, using STATA 11. Hospital beds, doctors, nurses and non-medical staff were used as input variables. Output variable combined inpatients and outpatients seen at Accident Emergency, Sorted and Unsorted departments. Efficiency scores were used to determine potential efficiency savings and fiscal space creation. Findings Mean technical efficiency scores, using the Cobb Douglas, Translog and Multi-output functions, were estimated at 0.83, 0.84 and 0.89, respectively. Nurses and beds are the most important factors in hospital production, as a 1% increase in the number of beds and nurses, result in an increase in hospital outputs by 0.73 and 0.51%, respectively. If hospitals are to increase their inputs by 1%, their outputs will increase by 1.16%. Hospital output process has an increasing return to scale. With technical efficiencies improving to scores of 0.95 and 1.0 in 2021–2022, potential savings and fiscal space creation at hospital level, would amount to MUR 633 million (US$ 16.2 million) and MUR 1161 million (US$ 29.6 million), respectively. Conclusion Fiscal space creation through full technical efficiency, is estimated to represent 8.9 and 9.2% of GGHE in fiscal year 2021–2022 and 2022–2023, respectively. This will allow without any restrictions the funding of the national response for HIV, vaccine preventable diseases as well as building a resilient health system to mitigate impact of emerging infectious diseases as experienced with COVID-19.

Ajoy nundoochan

In the last decade, we have observed the usage of artificial intelligence algorithms and machine learning models in industry, education, healthcare, entertainment, and several other areas. In this paper, we focus on using machine learning algorithms in the loan approval process of financial institutions. First, we briefly review some prior research papers that dealt with loan approval predictions using machine learning models. Next, we analyze the loan approval prediction dataset we downloaded from Kaggle, which was used in this paper to compare several machine learning classification models. During this analysis, we observed that credit scores and loan terms are the attributes that probably most affect the result. Next, we divided the dataset into a training set (80%) and a test set (20%). We trained 27 various machine learning models in MATLAB. Three models were optimized with Bayesian optimization to find the best hyperparameters with minimum error. We used 5-fold cross-validation for the validations to prevent overfitting during the training. In the following step, we used the test set on trained models to measure the models' accuracy on unseen data. The result showed that the best accuracy both on validation and test data, more than 98%, was reached with neural networks and ensemble classification models.

Ladislav végh

Colon is part of the digestive system in the human body responsible for absorbing water and nutrients from food residues. There are many problems affecting the colon including irritable bowel syndrome, constipation, hemorrhoids, anal fissures, abscess, colitis and colon cancer which considered one of the most common diseases among the Libyan community. The aim of this study was to search the presence of colonic disease and the tendency of those diseases to transform into colonic cancer at Benghazi medical center in Benghazi-Libya. A survey was comprised of 15 questions concerning colon diseases, proper diagnosis and treatment type. The survey was distributed to the physician specialized in medicine at Benghazi medical center and they fill it voluntary. The initial part of the questionnaire designed to obtain demographic data concerning the physicians who diagnose the colon illness. The rest part of the questionnaire was concerning special questions to define frequency of the diagnosed disease. There were 20 participants at this study. The response to all questionnaires were collected and analyzed for drug use, patients and disease distribution. In conclusion, this study demonstrates that the correct diagnosis, prescribing the appropriate treatment for the colon disease and using the medicine properly is one of the most important things that help in treating the disease and reducing its exacerbation. In some cases, eradication procedures may be required if the medicine is not sufficient to treat the disease without the need for operations

Mediterranean journal of pharmacy and pharmaceutical sciences

The city that never sleeps, a vibrant tapestry of dense neighborhoods and relentless energy, has long grappled with the pervasive challenge of air pollution. The very dynamism that defines the city – its traffic, buildings, and industry – contributes to ambient concentrations of fine particulate matter (PM2.5) and ground-level ozone (O3), pollutants known to exact a heavy toll on public health. [1-3] An extended analysis of environmental health data from 2005 to 2019, meticulously compiled by the town Department of Health and Mental Hygiene (DOHMH), offers a crucial lens through which to view the city's journey: a narrative marked by significant public health victories interwoven with stark, persistent environmental injustices. [4] This fifteen-year period reveals not just the efficacy of targeted interventions but also the deeply entrenched disparities that continue to leave vulnerable communities uneasy. Thus, the aforementioned challenge provides a very important lesson to address similar problems around the globe, especially in the crowded urban areas.

Karishma

Urolithiasis is a common worldwide problem with high recurrence. This review covers Convolvulaceae seven (07), Costaceae four (04), Ebenaceae four (04), Fagaceae six (06), Hypericaceae eight (08), Lauraceae nine (09), Liliaceae twelve (12) and Lythraceae three (03) plants 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

The current study was designed to explore the analgesic effects of methanol extracts from the leaves of Samanea saman Merr. and Prosopis cineraria Druce., using tail immersion test. Thermal stimuli produced painful reactions in mice by dipping the tail tips of the mice into hot water. Methanol extracts of the leaves of Samanea saman Merr. and Prosopis cineraria Druce. were administered intraperitoneally at the dose of 100mg /kg body weight. Pethidine 50mg/Kg intraperitoneally was used as a standard analgesic drug. The tail-flick latency delay was measured at 0.5, 1.0, 1.5, 2.0, 2.5 and 3.0 hours after the intraperitoneal administration. Both extracts produce analgesic effects when compared with pethidine.

Dr. salman ahmed

Cyperus esculentus (tiger nut) seed is the parent of many products like flour, milk, starch, and oil. All these share similar and sometimes better properties when compared to similar products obtained from other sources. This study aimed to produce and characterize a cream made from oil extracted from tiger nuts. The proximate analysis was tested by the established methods and data obtained show that tiger nut powder has a moisture content (14.50%), an ash (1.98%), a fat (51.27%), a protein (8.47%), fiber (13.94%) and carbohydrate (9.98%). The oil from the tiger nut was extracted using the hot press method, the tiger nut oil had an 8.00% yield. The oil was used to produce a body cream which was characterized and tested for its antibacterial activity. Its antibacterial activity showed inhibition against Klebsiella pneumoniae, Escherichia coli, Staphylococcus aureus, and Pseudomona aeruginosa. The characterization tests gave results of 1735.80 cP for viscosity, moisture content (1.07%), pH of 6.10, ash (5.11%), volatile matter (94.89%), electrical conductivity (390 µS/cm), spreadability at 30oC was 145.28 g.cm/s, at 35oC was 149.41 g.cm/s and 152.25 g.cm/s at 40oC. The cream was checked for stability and found to be stable at different temperatures. It was checked for allergens and it exhibited some level of allergic reactions. Physicochemical analysis of the golden-brown oil indicated the specific gravity (0.98), density (0.98 g/ml), acid value (1.82 mg/KOH/g), iodine (37.75 mg), peroxide (2.00 meq/kg), saponification (236.32 mg/KOH/g), free fatty acid (0.91%) and refractive index (1.46). The GC-MS analysis identified a total of 22 compounds. Oil, with the major constituents being palmitic acid (13.70%), oleic acid (18.50%), oleamide (31.25%), acexamic acid (4.68%), stearic acid (2.99%), squalene (2.87%) by composition. The study reveals that oil from tiger nut seed is useful when applied in the production of body creams and has possible uses in the production of antibacterial ointments.

Mediterranean journal of pharmacy and pharmaceutical sciences

Ketorolac tromethamine, the non-steroidal anti-inflammatory drug, was formulated into mucoadhesive films to overcome the limitations in the currently available dosage and routes of administration which in sequence will increase patients’ compliance. Films were cast from organic and aqueous solvents using various bioadhesive polymers namely: HPMC E-15, Eudragit RLPO, Eudragit RSPO, Carbopol 934P. The prepared films were subjected to investigation for their physical and mechanical properties, swelling behaviors, in vitro bioadhesion, drug permeation via bovine buccal mucosa, and in vitro drug release. These properties were found to vary significantly depending on the preparation methods, the type of the polymers, and the ratio of addition of both plasticizers (i.e. polyethylene glycol and film forming agent. Formulation F4 is selected for best formulation because it shows the 98.85% drug release at time 6 hr. In addition, this film was subjected to in vitro and in vivo release. The obtained results indicate that the concentration of ketorolac in the oral cavity was maintained above 4.0 µg/ml for a period of at least 6 h. This film shows promising results for using the ketorolac mucoadhesive route of administration topically and systemically, and thus it will be subjected to clinical evaluation in future work.

Kuldeep vinchurkar