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

The gold standard anesthesiologic procedure for urgent femur fracture surgery is Spinal Anesthesia. It is not always feasible because of patients' severe comorbidities and difficulties in optimizing drug therapy in the appropriate time frame such as discontinuation of anticoagulant drugs. The use of four peripheral nerve blocks (tetra-block) can be a winning weapon when all seems lost. We present, in this case series, three Caucasian adult femur fractures (an 83-year-old woman, a 73-year-old man, and a 68-year-old woman) with different and major comorbidities (cardiac or circulatory disorders on anticoagulants therapy that were not discontinued on time; breast cancer and others) underwent the same anesthesiologic approach in the urgent setting. Ultrasound peripheral nerve blocks, that is femoral, lateral femoral cutaneous, obturator, and sciatic with parasacral approach were successfully performed in all patients who underwent intramedullary nailing for intertrochanteric fracture. We evaluated the adequacy of the anesthesia plane, postoperative pain control with the VAS scale, and the incidence of postoperative side effects. Four peripheral nerve blocks (Tetra-block) can be alternative anesthesiologic management in urgent settings, in patients where drug therapy cannot be optimized, as in antiplatelet and anticoagulant therapy.

Dario cirillo

Metabolic dysfunction-associated fatty liver disease (MAFLD) and type 2 diabetes (T2D) are interconnected metabolic disorders with significant health implications. However, a comprehensive understanding of the extent of their co-occurrence in Africa is lacking. The aim of this review was to determine the prevalence of MAFLD and its association with glycemic control (HbA1c) in persons with T2D in Africa. A systematic search was conducted on PubMed, Medline, Embase, Scopus, Global Health, and Web of Science from their inception to December 6, 2023. Data on MAFLD prevalence and correlation coefficients regarding its association with glycemic control were pooled through random effect meta-analyses. Potential sources of heterogeneity were investigated using subgroup analysis and meta-regression. A total of 10 studies were included in the meta-analysis of MAFLD prevalence, while 2 were incorporated in the analysis of the association between MAFLD and glycemic control. The pooled prevalence of MAFLD in persons with T2D was 48.1% (95% CI: 36.1–60.3). The subgroup analysis revealed regional variations in MAFLD prevalence, with rates of 44.7% (95% CI: 28.7–62.0) in sub-Saharan Africa and 55.3% (95% CI: 36.2–73.0) in Northern Africa. Additionally, we observed an increasing trend in MAFLD prevalence, recording 55.1% (95% CI: 43.6–66.1) in the recent five years. There was a weak positive correlation between MAFLD and HbA1c (r = 0.33, 95% CI: 0.18–0.47). The findings of this study highlight a high prevalence of MAFLD in persons with T2D in Africa, with a suggested link between MAFLD and suboptimal glycemic control. Therefore, healthcare providers should prioritize the screening and management of MAFLD in individuals with T2D to enhance their metabolic health.

Emmanuel ekpor

Because of globalisation's intense change and competition pressure, businesses are driving from the company's dimension of individual management to collaborative cooperation approaches aided by the anticipated business strategy. A business strategy is a decision or action of a business or organisation to attract customers and achieve the organisation's objective. These strategies are the master plan for securing a competitive position of the firm market area of the competitors. Through business strategies, organisations will carry their business operations and fulfill the customers' desires and demands. Multination organisations and firms establishing subsidiaries and business entities in international markets or foreign countries must adopt different strategies during the integration process. The macro-economic and intercultural factors are the epicenter for change and must be considered in complex ventures. In the modern competitive market, multinational firms must collaborate and communicate with the partners, suppliers and customers through a complicated and temporary product supply chain. Business strategies involve complex processes requiring information on the diverse sources that need simultaneous changes by the managers of entrepreneurs. I this report, I choose Tesla Inc or Tesla Motors to explore the key strategies they have anticipated to inherit the global motor vehicle sector within the past few decades. The organisation was founded in 2003 by a group of various engineers. Tesla Motors deal in the automotive industry and has transformed its services to the global society.

Zamzam abdelazim

In this paper, we attempted to review the soil erosion studies conducted throughout the globe using Revised Universal Soil Loss Equation (RUSLE). We searched the SCI, Scopus, Web of Science, Google Scholar database and various theses for this study. Though RUSLE is the most widely used model for estimation of soil erosion, the factors, namely rainfall erosivity, soil erodibility, slope length and steepness, cover management and conservation practice; vary greatly over different climatic zones, soil properties, slope, land cover and crop phase, respectively. Depending upon those variations, researchers have developed various sets of equations for different factors of RUSLE. These equations can be useful to map soil loss for many places on this planet.

Kaushik ghosal

Financial Inclusion is emerging as a new paradigm of economic growth that plays major role in driving away the poverty from the country. It refers to delivery of banking services to masses including privileged and disadvantaged people at an affordable terms and conditions. Financial inclusion is important priority of the country in terms of economic growth and advances of society. It enables to reduce the gap between rich and poor population. In the current scenario financial institutions are the robust pillars of progress, economic growth and development of the economy. When and where all citizens are participated in financial system, the economy and system will become very strong. In this regard the research article was focuses on customer perceptions towards inclusive banking practices.

Dr tatayya bommali

Background: Although geriatric depression is widespread in primary health care (PHC), local studies on the prevalence of depression in elderly PHC patients appear to be scarce. This study aimed to determine the prevalence of depressive symptoms and some of the associated risk factors among elderly PHC patients. Methods: A cross-sectional study recruiting elderly people (60 years or older) from five PHC centers in Port Said Governorate was conducted. All participants had a structured interview. The long version of the geriatric depression Scale (cut-off point ≥10) was used in elders with a Mini-Mental State Examination ≥24. Results: About two-thirds of the total sample (65.7%) was female. The total prevalence of depressive symptoms was 49.4% of all subjects, more commonly in women (58.1% vs. 32.8%). Multiple regression analysis shows that female gender, high education, unemployment, low income, lonely life, loss of a close person, chronic diseases, tumor, iatrogenic medications, and depression history were the significant associated risk factors of depression in the studied elders after adjusting all previous variables in addition to age and marital status. Conclusion: Depressive symptoms constitute a significant health problem among older PHC patients in the Port Said governorate. Routine screening for depression of every elderly PHC patient is recommended for early detection.

Karishma

Assessing students' progress in introductory programming courses is crucial for identifying learning gaps and improving teaching methods. This study evaluates the effectiveness of Moodle-based tests with randomized questions in monitoring student progress in C programming courses at J. Selye University during the 2023/24 academic year. A series of ten tests were administered across two courses, covering essential programming topics such as data types, variables, conditional statements, loops, two-and three-dimensional arrays, recursion, and sorting algorithms. The results revealed significant variations in student performance, with recursion and the pretest/posttest loops presenting the greatest challenges. The correlation analysis of test scores showed strong relationships among related topics, confirming the structured progression of the curriculum. These findings suggest that Moodle-based assessments offer valuable insights into students' learning trajectories, enabling educators to adapt their instructional strategies accordingly. Such insights can help optimize introductory programming curricula, enhancing student engagement and understanding.

Ladislav végh

Objective: To determine the association between oral health literacy, oral hygiene and gingival health status. Methods: This cross-sectional study was conducted among patients attending University of Benin Teaching Hospital, Benin City. Data were collected through interviewer-administered questionnaires. Index used in this study for estimating oral health literacy levels was Rapid Estimate of Adult Literacy in Dentistry- 30 (REALD-30). The participant’s oral hygiene status was assessed using the Simplified Oral Hygiene Index while gingival health was assessed using the Gingival Index. Results: Two hundred and eight participants with 130 (62.5%) males and 78 (37.5%) females formed the population of the study and their mean age was 28.32 ± 10.5 years. The prevalence of low oral health literacy was 86 (41.3%). The oral hygiene status of most of the participants 100 (48.1) was fair. The prevalence of gingivitis was 58.2%. Oral health literacy had significant statistical negative correlation with age, oral hygiene and gingival health status. Oral health literacy consistently emerged as a predictor of oral hygiene and gingival health status. Conclusion: Majority of the participants with low oral health literacy had fair/poor oral hygiene status (p = 0.000, OR= 17.870, 95% CI = 7.320-43.627) and gingivitis (p = 0.000, OR= 7.054, 95% CI = 3.514-14.164).

Hope inegbenosun

Glioblastoma multiforme (GBM) is the most common primary malignant brain tumor in humans. It is characterized by excessive cell growth, accelerated intrusion of normal brain tissue, and a poor prognosis. The current standard of treatment, including surgical removal, radiation therapy, and chemotherapy, is largely ineffective, with high mortality and recurrence rates. As a result, traditional approaches have evolved to include new alternative remedies, such as natural compounds. Aquatic species provide a rich supply of possible drugs. The physiological effects of marine peptides in glioblastoma are mediated by a range of pathways, including apoptosis, microtubule balance disturbances, suppression of angiogenesis, cell migration/invasion, and cell viability; autophagy and metabolic enzymes downregulation. Herein, we address the efficacy of marine peptides as putative safe therapeutic agents for glioblastoma coupled with detailed molecular mechanisms.

Dr. salman ahmed

Background: Ending open defecation has been identified as a top priority for reducing global inequalities in water and sanitation (WASH). It is explicitly referenced in sustainable development goals (SDGs) target 6.2 and closely associated with more comprehensive efforts to end extreme poverty by 2030. Since 2000, the global rate of open defecation has decreased from 21% to 9% (0.7 percentage points per year). However, the 673 million people still practicing open defecation in 2017 were increasingly concentrated in a small number of countries, and these will need to be the primary focus of efforts to end open defecation by 2030. Objectives: To study the socio-economic background of Adivasis, to study the status of sanitation in rural areas, to examine whether economic conditions affect open defecation, to examine whether better sanitation facilities improve health conditions and to examine whether improved sanitation facilities impact the quality of life and thereby dignity of tribal women. Methods: Essentially it is an empirical study and a multi-stage random sample design was adopted. Data were collected from 120 sample households from two villages, i.e., Bandarigudem and Nadikudi of Khammam districts in Telangana State through a structured questionnaire. Statistical tools like frequency distribution, percentages, cross-tabulation with Chi-Square test, and a case study method were used. Results & Discussion: 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

The purpose of this study is to explore the belief of teacher educators about the relationship between teaching and research. Keeping in view the role of the teacher educators, a survey was done. The beliefs of teacher educators were explored with the help of an opinionaire. The collected data were analyzed through qualitative method of analysis. It was found that the secondary teacher educators were positive about the need of research with a little dilemma between teaching and research.

Rupal mankad

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

CoronaVirus’ is a hard hit on both Millennial consumers and marketers. It forced consumers and marketers to do the usual activities of buying and selling differently. Panic buying and herd mentality was widely noticed among millennials. Their unusual buying behavior which reflects behavior during a crisis is highly influenced by environmental stimuli. From this study, it is found that there has been a significant buying behavioral shift of global millennials in emerging markets (BRIC – Brazil, Russia, India, China; CIVETS – Columbia, Indonesia, Vietnam, Egypt, Turkey, South Africa). It is evident that the initial marketing attempts of marketers failed during COVID-19 due to the lack of understanding of the significance of environmental and marketing stimuli in consumers’ purchase decisions. This study brings out the various positive substantial changes brought about through internetization in marketing goods and services to millennial customers during the pandemic. The pandemic enabled a rapid digital revolution in buying and selling using digital/online platforms. The study suggests the application of the Black Box Model by marketers in marketing and selling decisions. The Internet has been the most important tool used by customers and sellers to access what they need. This study is useful to marketers and upcoming entrepreneurs to understand that it is the consumer’s buying behavior that triggers and pushes marketers to sell differently.

Sridevi

Regularly used toothbrushes can be heavily contaminated with microorganisms, while inappropriate storage may increase the microbial load on these toothbrushes. Toothbrushes Microbial contamination can help to transmit many diseases, especially for people with mouth and/or Gum problems. This study aims to find the easiest and most available way to sterile toothbrushes at home. 24 adult volunteers were divided into four groups, the first three groups were asked to sterilize their toothbrushes with Dettol, water salt and hot water, while the fourth group toothbrushes were a positive control. Results showed that toothbrushes sterilized with Dettol gave the least contamination rate of 12.5%, toothbrushes sterilized with salt came next with 37.5%, while toothbrushes sterilized with hot tap water were the next with 50%. The toothbrushes of the fourth group which was used as the positive control were totally contaminated with different types of bacteria. Six bacterial agents were isolated; they are Staphylococcus Sp., Streptococcus sp., Bacillus Sp., E.coli, Pseudomonas Sp., and Salmonella sp. It was concluded that the use of Dettol was very effective in reducing the number of contamination of toothbrushes but its unacceptable flavour limiting its use. Other volunteers were comfortable with the use of salt and hot water as it was almost effective. The research suggests a group of recommendations to avoid the transmission of pathogens through toothbrushes and ensure healthy usage.

Kamal singh

During the 16th century, firearms played a transformative role in Indian warfare, considerably enhancing the effectiveness of the Mughal army. The introduction of muskets and artillery by Babur in 1526 revolutionized military strategies, giving the Mughals a decisive advantage in battles and sieges. The Mughal army’s structure, particularly under Akbar’s Mansabdari system, centralized control and ensured a loyal, efficient military force. This technological and organizational superiority enabled the Mughals to consolidate power over diverse regions through a combination of military might and diplomacy. By the 17th century, there was a significant change in rebellions as firearms started being used by peasants. This shift in weaponry fundamentally altered the nature of these uprisings, empowering the peasantry in new ways to resist authority. Multiethnic regional powers also recognized the importance of firearms, acquiring them from the Mughals or Europeans, and employing them effectively in battles. In the mid-18th century, the Marathas and later the Mysore Sultanate took a notable step by establishing arms factories and engaging European experts to produce advanced firearms. This marked a departure from the past, where regional powers typically relied on the Mughals or European companies for firearm procurement. This shift toward domestic arms production signaled a move toward greater self-sufficiency and the development of advanced firepower. By the 18th century, the Mughal Empire was in decline, and multiethnic regional powers and European colonial forces, equipped with advanced firearms, challenged and eventually overshadowed Mughal dominance.

Bidyut patar

Community acquired pneumonia is a prevalent disease in the Emergency Department (ED). The literature reveals that clinical practice could not be related with guidelines recommendations. The aim of this study is to determine the impact of the implementation of the recommendations of the Spanish society of Emergency Medicine in the Hospital Clínico Universitario Lozano Blesa (Zaragoza) ED in the management of community acquired pneumonia. Use of Pneumonia Severity Index (PSI) estimation was used to assess the adherence. This study was carried out from December, 2014 to February, 2015. Data was compared with the previous two months. The indicators management (discharge or admission decision, adequacy and anti-biotherapy) as well as the incidence of PSI estimation before and after the intervention in these parameters were evaluated. 209 patients were included, 97 before the intervention and 112 after the intervention. No significant differences were observed in the calculation of PSI. A significant decrease of admissions was observed after the intervention in the patients in whom the PSI was calculated (68.8% vs. 45.0%, p < 0.05). A greater use of the Observation Room was aimed at those patients in whom the PSI was calculated (06.3% vs. 17.5%, p < 0.05). PSI calculation significantly increased antibiotic prescription adherence (88.9% vs. 75.2%, p < 0.05). There were no modifications in the prescription after the intervention. In conclusion, PSI is a useful and effective measure to achieve a greater adherence to the recommendations. However, despite the positive trend in the use of the PSI and its interpretation, a low-intensity intervention is not sufficient to generalize its use.

Mediterranean journal of pharmacy and pharmaceutical sciences

Vitamin E is extensively available in the natural world and is produced by prototrophs such as plants, algae, and blue-green algae. Vitamin E is used as a dietary supplement, an antioxidant food stabilizer, a pharmaceutical additive, and a preservative in livestock feed. Several types of vitamin E can be differentiated by the position and number of the methyl functional group, and each form has a unique biological role. The function of antioxidants such as vitamin E is to defend cells from the effects of oxidative stress. Vitamin E is a free radical scavenger converted to vitamin E radical, then converted back to vitamin E by ascorbic acid. Vitamin E was discovered by Evans and Bishop in 1922; it has proved to be an effective nutrient for reproduction. It is also possible for vitamin E to act by a mechanism not directly linked to the inhibition of oxidation. Such non-antioxidant actions of vitamin E may result from gene regulation and specific cell signalling. The function of vitamin E in cellular signalling, especially its biological impact, is undoubtedly an imperative subject for future studies. The explicit roles of the several isomers and esters of vitamin E analogues should also be the subjects of future studies.

Dr. salman ahmed

Rasa aushadhis are known for their uniqueness in curing the diseases with a very low dosage. These formulations are divided into two types based on their mode of preparation i.e., Single drug and Compound drug formulations. Based on their origin, the drugs are divided into three types, Herbal, Mineral and Animal. Any of these two or three together is combined to make a compound formulation. Apart from these, the other major factor which is needed for a formulation is the Rasa Panchaka of a Drug. Many of the formulations are being prepared based on their availability, keeping their Rasa Panchaka and Samprapti vighatana in mind. These formulations are designed in such a way that two or more drugs will be having one common quality, or Opposite Qualities or an Antidote of a particular Vishadravya, which can help in curing the disease. So an attempt is made to Review Tribhuvanakeerti Rasa with its Probable mode of action.

Suri abhiram

Production process in the manufacturing industries has proven wasteful of the resources in the production process over time. integrating of lean principles in the manufacturing activities has brought notable success in a complex and slow production process in an industry. This study aims at integrating of lean principles to a product development process to eliminate break down cases as it makes the process easy as well as speeding up the product development in an automotive industry. Three major phases are applied in product development namely; the early concept phase, middle core design and the launch phase. An exceptional definition of products development of lean principles are applied to come up with an analysis framework. Through interviews, observations, documentation and experience barriers that causes large number of wastes can be established. Lean principles will then be applied to eliminate such causes in the product development and then derive conclusion that shows the industry the process of lean in product development in the entire process

Levi p. cheworei