Clinical microbiology serves as a partner to clinicians in the diagnosis and treatment of infectious diseases. Antibiotics are prescribed empirically before the availability of antimicrobial susceptibility testing data, especially when the patient's medical status could deteriorate by suspending the treatment. To investigate the impact of antimicrobial susceptibility testing on the management of outpatients with suspected bacterial infection in Libyan patients, a cross-sectional prospective study concluded on microbial microdroplet culture by including outpatients with suspected bacterial infection, who have done antimicrobial susceptibility testing. Thus, 53 Libyan patients with urinary tract infections and 14 Libyan patients with skin infections were included in this study. Before the availability of antimicrobial susceptibility testing data, 25 patients were appropriately treated while 42 patients were inappropriately treated. After the availability of antimicrobial susceptibility testing data, the number of appropriately treated patients increased to 57 patients. Thus, antimicrobial susceptibility testing improved the management of 41 patients by discontinuing an unnecessary antibiotic in four patients, starting necessary antibiotic therapy in 18 patients, and changing to more appropriate antibiotic in 19 patients. However, the antimicrobial susceptibility testing has no impact on the management of 24 patients and has led to the worsening of the management of two patients. The effect of antimicrobial susceptibility testing of antibiotic de-escalation was assessed in 35 patients; however, antibiotic de-escalation occurred in six patients. Thus, data of antimicrobial susceptibility testing has improved the management of Libyan outpatients with bacterial infection but their role in antibiotic de-escalation was slight

Mediterranean journal of pharmacy and pharmaceutical sciences

The adulteration and substitution of crude drugs is a burning problem. No doubt, substitution is helpful in places where the unavailability of particular oil drugs and or unwanted adverse effects of the desired crude drugs are there and have a choice of another drug with similar pharmacological effects and less unwanted aftereffects. However, in most cases, it is unacceptable because the conversion of authentic drugs into substandard medications may cause a variety of adverse effects, from mild and moderate to severe life-threatening reactions. So, understanding all the ways of adulteration and substitution is necessary to rectify this illegal act and maximize consumers' safety. At the end of this review, the Botanical Adulterant Program of the American Botanical Council is also highlighted.

Dr. salman ahmed

In this summary, the ideas used by the sales management to enhance the effective Selling of items to clients are addressed in detail. Overall, the report focuses on sales management, describing how the Marks and Spencer organisation's sales can be enhanced through the adoption of appropriate strategies and approaches that would aid in improving sales in the face of increasing market competition. The company modifies ongoing sales management techniques as well as sales organisation factors in an order to promote and retain competitiveness, highlight the significance of the sales organisation, and the necessity of such modifications appears to be stronger in the contemporary business environment.

Zamzam abdelazim

The aim of the study was to explore the inhibition and modulation of calcium oxalate monohydrate crystals into calcium oxalate dihydrate by phytic acid. The study was carried out on glass slides using phytic acid (1 - 5%) solutions. All tested solutions inhibited the growth and modulated calcium oxalate monohydrate crystals. Donuts, rosettes and X-shape crystals of calcium oxalate monohydrate along with their defected forms were observed. The presence of calcium oxalate dihydrate crystals as elongated rods and tetragonal bipyramidal crystals revealed the modulated forms of calcium oxalate monohydrate. Smaller zones of nucleation are declared as general patterns of growth inhibition. This study gives valuable information about calcium oxalate crystals' inhibition and modulation patterns. Further studies are required to confirm the results of the present study.

Dr. salman ahmed

Objective: This study fills an important research gap by focusing on the effectiveness of low-impact exercise in Parkinson's disease (PD), taking into account the different challenges faced by people with varying degrees of disease severity. Motivation: Unlike generic investigations into exercise and PD, our research prioritizes low-impact activities, considering safety concerns related to balance deficits and coordination challenges in the PD population. The study aligns with a patient-centred approach, aiming to provide a safer alternative to traditional exercise modalities. Approach: Conducting a comprehensive literature review, we conducted an online literature search on various databases, specifically investigating about low-impact exercises on both motor and non motor symptoms in PD individuals. Review process involved capturing diverse intervention types, durations, frequencies, and intensities. Findings: The amalgamation of diverse outcome measures, including UPDRS, Berg Balance Scale, TUG, 6MWT, and PDQ-39, showcased the multifaceted impact of low-impact exercises on both movement related and non-movement related symptoms. Notably, aerobic exercises being treadmill walking, cycling, and group sessions, emerged as pivotal interventions, demonstrating improvements in gait, balance, flexibility, and overall quality of life for PD individuals. Conclusion: While acknowledging limitations, such as potential publication bias and a focus on aerobic exercises, this study provides meaningful decision making information for clinicians and researchers. Future research should diversify interventions and methodologies to enhance the evidence base and address nuanced aspects of low-impact exercises in PD management. The results of this review contribute to the existing body of knowledge regarding the nuanced benefits of personalized low-impact exercise for Parkinson's disease.

Nagarjuna narayanasetti

This study aims to creating an application in the widespread Excel spreadsheet program, using the common feed materials used in poultry rations include maize, wheat, barley, soybean meal, wheat bran, sunflower oil, protein concentrate, limestone, salt, diCalcium Phosphate, premix of vitamins and minerals, anti-coccidial, where the function property in Excel program, especially the sum - product function, can be used to create an application for formulating rations in a trial and error method until reaching the desired goal in terms of its nutrient content: (dry matter, crude protein, lysine, methionine, methionine and cysteine, calcium, available phosphorus, crude fiber, ether extract, linoleic acid, chlorine, sodium, arginine, phenylalanine, phenylalanine and tyrosine, threonine, tryptophan, leucine, Valine, histidine, glycine, glycine and Serine, as well as soluble carbohydrates, ash)%, in addition to estimate the cost of the ration

Rafea mohammedtaher khulel

The COVID-19 crisis has impacted all dimensions of our lives say it as the public health, the labour system, the social interaction, the political debate, the use of public spaces, the economy, the environment, and last but not the least it has proved to be a major contributor to the cultural value system of the individual living in society. This research paper is to analyse and understand the changes enforced by this pandemic on Indian culture and individual of the society. It also analyses the context of COVID-19 scenario with special reference to Indian culture and Hofstede’s theory of cultural dimension. This research paper is an attempt to emphasize the changes in culture and value system during the COVID-19 pandemic faced by India. India is enriched enough in cultural dimensions to combat COVID-19. The Hofstede’s model analysed in depth also leads to this finding that it also fits well in the present context. Thus, it is hereby summed up that as India is enriched in its cultural values it has posed itself as a fighter for this pandemic

Mamta gaur

Alternative Learning System (ALS) has been adopted in Philippine basic education, yet there is no academic institution in the region prepares ALS teachers in teaching life skills. ALS teachers graduated from different programs of teacher education for formal education. In response, an extension project was conceptualized and implemented to enhance the teaching capacity and effectiveness of ALS teachers. Case study was conducted to evaluate the effectiveness of the project. It explored the transfer of life skills among ALS teachers. Data were collected from multiple sources. Interview and written responses, and feedback were analyzed using thematic narrative analysis. Other data were analyzed using document and descriptive analyses. The project had achieved its objectives and rated best by participants. These indicate that the project was implemented effectively and successfully. ALS teachers have acquired life skills and transferred them to others. Thus, the project has made a difference in the lives of these teachers.

Manuel caingcoy

Efforts to understand the causes of poverty, how poverty is perceived have become important in the fight to mitigate poverty. In Vietnam, studies on the attitudes of poverty in specific populations, such as Vietnamese students, are rare. Thus, this dataset reports the results collected from 180 social work students and non-social work students of Ho Chi Minh City Open University through attitudes toward poverty and poor people in Vietnam. The Attitude toward Poverty Short Form 21-item scale, developed by Yun & Weaver, was used for the data collection. The survey results showed that when looking for causes of poverty, social work students and non-social work students put the most emphasis on structural factors of poverty. However, social work students, compared with non-social work students, consider personal deficiency and stigma more important. In future, this dataset can serve as a reference source for comparative studies on student’ attitudes toward poverty and impoverished persons and for social work education.

Le minh tien

For banking employees around the globe, stress on the job can be a challenge; stress can be sometimes positive and sometimes negative. Positive stress leads to productivity and negative stress leads to loss for the organization. There is already a certain level of stress in Banking employees work life and then encounter even more stress arising from the work pressure that Banking employees face on the job. Many employees cannot cope with such rapid changes taking place in the jobs. Role conflict, Service for customer, contribution, rapid technological change, lack of customer response is the great transaction of stress for the banking workers. The aim of this research is to understand roots and outcomes of job stress on the employee performance in banking sector.

Dr manjunatha m k

The objective of this research was to investigate the effect of initial chick weight at the first day of the hatch on subsequent performance of Iraqi local chickens. 150 unsexed chicks of local chickens weighted at first day of hatch then divided to five groups (A, B, C, D, E) according to the initial weight (26.4, 31.89, 36.38, 41.09, 46.91) gm, the birds were reared in a wooden cage consist of individual compartments with dimensions (30×30×40) cm, The feed and water was available adlibitum, The birds and feed weighted weekly by sensitive balance. The result shows that initial weight had a significant effect on body weight, weight gain, feed and protein consumption, and growth rate but not significant on feed and protein conversion, where group E showed the best results, The relationship between initial body weight and productive traits were studied and the prediction equation of productive traits depending on initial weight shows highly significant

Rafea mohammedtaher khulel

Patients’ knowledge of hypertension and treatment has been found to affect health outcomes of hypertension. This study aimed to assess the impact of therapeutic patients’ education on knowledge of hypertension and lifestyle/dietary modification among hypertensive patients in Nigeria. The study was conducted among 317 hypertensive patients randomized into controlled and intervention groups (158 vs 159, respectively) between March 2021 and February 2022. Baseline knowledge of the patients was assessed and intervention was provided for the intervention group with a structured educational program at a baseline and six months. Descriptive data were presented with a frequency table in percentage while the chi-square test and univariate logistic regression were used to determine the association between categorical variables. Out of the total number of 318 patients, 275 completed the study (response rate: 86.8%) with 136 in the control group and 139 in the intervention group. The mean age of the patients was 59.5 (±12.5) and patients > 60 years (49.5%) were the most frequent age category. The baseline knowledge score of hypertension was 9.8 (±2.6) and 9.3 (±2.6) on a scale of 16 points in the control group and intervention group, respectively (P = 0.060) while at six months 11.9 (±2.3) vs 10.8 (±2.4) (P < 0.001) and 12 months 12.6 (±2.5) vs 9.5 (±2.0) (P < 0.001), respectively. Knowledge of lifestyle/dietary modification in the control group and intervention group at baseline was 7.0 (±2.1) and 6.6 (±2.0), respectively, while at six months 7.5 (±1.5) vs 9.9 (±1.3) (P < 0.001) and at 12 months 7.2 (±1.5) vs 10.4 (±1.2), respectively. Marital status, body mass index, and family history of hypertension were associated with knowledge of hypertension and lifestyle/dietary modification (P < 0.001). The educational intervention provided was found to be associated with a significant improvement in knowledge of hypertension and lifestyle/dietary modification. The marital status of the patients, body mass index and family history of hypertension influenced patients’ level of knowledge.

Mediterranean journal of pharmacy and pharmaceutical sciences

By January 2020, severe acute respiratory syndrome coronavirus-2 has spread internationally to a pandemic that mainly targets the respiratory system. The relevant infectious disease has been identified as coronavirus disease-2019 (COVID-19) by World Health Organization and declared as a global pandemic. In Libya, National Center for Disease Control reported the first case of coronavirus disease-2019 on 24th March, 2020. The authorities decided to close borders and activate designated treatment centers to deal with COVID-19 cases and contain the outbreak of SARS-COV-2. This study aimed to assess and evaluate the pharmaceutical situation of medications used in pharmacological management of hospitalized COVID-19 patients in Tripoli, Libya. Three WHO availability indicators were selected to be studied and reported. A comprehensive list of medicines used in the management of hospitalized COVID-19 patients was constructed after reviewing and comparing seven national and international pharmacological management protocols and guidelines for hospitalized COVID-19 patients. This comparison revealed that nearly 50 medications are intended for use in COVID-19 inpatient pharmacological management. They all agreed about the use of three medications, representing one from each main class. This list was used to cross check their availability at the chosen designated COVID-19 treatment center. This study proved that local treatment center’s protocol is more in line with international guidelines than the national treatment guideline. The later was issued on March 2020. The Libyan National Essential Medicines’ List contained 25 out of 50 medications of the comprehensive list based on the last update in April 2019. This study recommends that national treatment guidelines and National Essential Medicines’ list require updating. Not all medications used in COVID-19 inpatient management were available in local treatment centers, although, the Emergency Management Department of Ministry of Health in Libya is responsible for the supply of the required medical supplies and medications to the COVID-19 treatment centers.

Mediterranean journal of pharmacy and pharmaceutical sciences

Eighteen chickpea (Cicer arietinum L.) genotypes were evaluated for yield and their susceptibility reaction against gram pod borer, Helicoverpa armigera Hub. for three consecutive years under natural field conditions during rabi 2010-11, 2011-12 and 2012-13 at Hisar. Among these, maximum grain yield was realized from the genotype H 04-28 (13.00 q/ha) during the season rabi 2010-11 and it was statistically at par with RSG 931 (12.45 q/ha), H 03-56 (11.73 q/ha) and RSG 963 (10.82 q/ha) during rabi 2011-12 and it was statistically at par with GNG 1488 (10.01 q/ha), CSJ 140 (9.07 q/ha) and H 03-56 (8.95 q/ha) during Rabi 2012-13 and it was statistically at par with RSG 888 (8.80 q/ha) and GNG 1591 (7.79 q/ha). However, on the basis of average of three years (2010-11 to 2012-13), the maximum yield was exhibited by the genotype GNG 1488 (9.36 q/ha) followed by RSG 931 (8.95 q/ha), H 04-28 (8.32 q/ha) and H 03-56 (8.20 q/ha). The genotype H 03-56 flowered earliest in 68-71 days and proved the best donor against gram pod borer with PSR 4.7. Minimum larval population was recorded in BG 256 (15.8 l/mrl) and it was followed by GL 25016 (17.5 l/mrl) and H 04-28 (18.5 l/mrl). Minimum per cent pod infestation by H. armigera was recorded in genotype H 01-27 (27.8%) and it was superior over all other genotypes. It was followed by H 03-56 (29.5%), CSJ 140 (30.9%) and GNG 1488 (31.3%). H 01-27 proved least susceptible genotype under natural field condition. The genotype H 03-56 flowered earliest and seemed to be the best as potential donor for pod borer’s tolerance under late sown condition. GNG 1488, RSG 931, H 04-28, H 03-56 and RSG 963 proved promising genotypes for yield and against H. armigera. These genotypes may further be utilized in breeding programmes to develop the high yielding and tolerant cultivars against gram pod borer.

Dr. babu lal jat

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

This study explores the influence of education, length of service, professionalism, and ethics on the professional values of public relations practitioners in Malaysia. A total of 427 questionnaires were distributed to public relations practitioners in Malaysia, and 322 questionnaires were returned. The study included 61% female respondents, and 39% male respondents. The study analyzed and identified the influence of professionalism and ethics on professional values of public relations practitioners. Additionally, the study examined whether education and experience influence professional values through professionalism, and code of ethics. Six hypotheses were tested to answer the research questions. The results from this study fully supported the hypotheses indicating that professionalism and ethics had an influence on professional values of public relations practitioners. The results also showed that education influenced both professionalism and ethics, and length of service influenced both professionalism and ethical practice.

Mohammed fadel arandas

Background: Although stroke is a major problem in Hadhramout Governorate, there is a scarcity of reliable information on risk factors of stroke and predictors of in-hospital mortality. The aim of this study was to explore the risk factors and outcomes of stroke patients admitted to Ibn Sina Hospital, Hadhramout, Yemen, and to identify the predictors of in-hospital mortality. Methods and Materials: This retrospective cross-sectional study was conducted in Ibn Sina Hospital in Mukalla district, Hadhramout Governorate, over a 4-month period (from January 1, 2021, to April 30, 2021). Results: During the study period, we recruited 100 cases of stroke, of whom 77 (77%) were male and 23 (23%) were female. Their mean age was 65.42±12.78 years. Hypertension was the most common risk factor, occurring in 81 (81%) patients, while no risk factors were identified in 5 (5%) cases (Cryptogenic). Ischemic stroke was found in 70 (70%) cases, and hemorrhagic stroke was noticed in 30 (30%) patients. The in-hospital mortality was 29 (29%), and the univariate analysis found male sex, hypertension, and hemorrhagic stroke as probable predictors of in-hospital mortality. Only hemorrhagic stroke (adjusted odds ratio [OR]=2.053 and 95% confidence interval [CI]=0.822–1.599; p<0.001) and hypertension (adjusted OR= 1.677; 95% CI=0.555–1.495; p=0.011) were found to be independent predictors of mortality by multivariate logistic regression analysis. Conclusion: Stroke is a major problem in Hadhramaut Governorate with ischemic stroke being more than hemorrhagic. Men were more likely to have a stroke than women and majority of cases were elderly. Hypertension, diabetes mellitus, smoking, and dyslipidemia were the most commonly identified risk factors that were significantly associated with stroke. Hemorrhagic stroke and presence of hypertension were found to be risk factors for in-hospital mortality; therefore, hypertension should be well-controlled to reduce in-hospital mortality.

Karishma

Introduction: During the COVID-19 pandemic, most educational institutions have opted for online education rather than traditional modes of education to protect their employees and students. Online education has been gaining momentum in almost all countries around the world. This coincides with the recently introduced competency-based medical education in India which has embraced online education. This poses a new challenge for the institutions involved, the instructors or teachers, and the students since they must adapt quickly to the new mode of learning. Online education requires teachers to improve their competency in three major areas; pedagogy, technology, and content knowledge. Some of the challenges include; lack of technological skill, poor time management and lack of infrastructure. As technology rapidly advances, health care education systems must also advance in tandem. To implement the new competency-based system and online education, the institutions and the individuals must realize the importance of online education, identify the barriers and quickly work on solutions for success. Methods: This review was conducted based on various research papers on the topic of online medical education, the challenges faced by faculty members, and the opinion of students on this dilemma. Search terms included online medical education, COVID19, competency-based medical education. Conclusion: This review identified various challenges posed by online education on the current medical curriculum, faced by both faculty members and students, especially under the light of the Competency-Based Undergraduate Curriculum for Indian Graduates. Different solutions were proposed to overcome these challenges.

Nirav

Background: Malaria in pregnancy (MiP) remains a critical public health concern in Nigeria, with significant implications for maternal and fetal health. Despite national policy guidelines advocating the use of Intermittent Preventive Treatment in pregnancy using Sulphadoxine- Pyrimethamine (IPTp-SP), its uptake remains suboptimal in many rural communities. This study aimed to assess the factors influencing IPTp-SP utilization among pregnant women attending antenatal clinics (ANCs) in rural areas of Abia State. Methods: A descriptive cross-sectional study design was adopted, involving 422 pregnant women selected through a multistage sampling technique across three predominantly rural Local Government Areas (LGAs): Ugwunagbo, Isiala Ngwa South, and Ukwa East. Data were collected using a structured, interviewer-administered questionnaire and analyzed using SPSS version 25. Descriptive statistics, chi-square tests, and Pearson correlation analyses were employed to examine associations between socio-demographic variables, accessibility, beliefs, health system factors, and IPTp uptake. Statistical significance was set at p < 0.05. Results: The majority of respondents were married (82.0%), aged between 25 and 34 years (46.9%), and had attained at least secondary education (71.1%). Key barriers to IPTp uptake included drug unavailability (30.6%), long waiting times (28.9%), fear of side effects (19.4%), and cultural beliefs (23.0%). Notably, only 24.6% reported consistent IPTp-SP availability during ANC visits, and 46.4% had to purchase the drugs outside the clinic. Correlation analysis revealed significant associations between IPTp uptake and distance to clinic (r = -0.412, p = 0.001), health education (r = 0.562, p < 0.001), drug availability (r = 0.489, p = 0.002), and cultural beliefs (r = -0.297, p = 0.012). Chi-square analysis confirmed significant relationships between IPTp uptake and education level (χ² = 19.438, p = 0.001), awareness (χ² = 24.511, p < 0.001), and satisfaction with ANC services (χ² = 14.257, p = 0.003). Conclusion: The study highlights multifaceted determinants affecting IPTp-SP uptake among pregnant women in rural Abia State. These include socio-demographic factors, health system challenges, cultural beliefs, and availability of services. Interventions aimed at increasing awareness, ensuring consistent drug availability, and improving ANC service delivery are critical to enhancing IPTp coverage in rural Nigeria.

Karishma

Dietary supplements are extensively consumed, but irrational use is a health hazard. Pharmacy students, being future healthcare providers, can facilitate rational use. The present study evaluated the knowledge, attitudes, and practices of pharmacy students at Srinivas College of Pharmacy, Mangalore, about dietary supplements and their role as an advocate, in addition to mental health correlations. 250 students selected through stratified random sampling took part in a cross-sectional mixed-methods study. A 30-question instrument (Cronbach's alpha=0.85) measured demographics, dietary supplement usage, knowledge, attitude, practices, and mental health was evaluated with the depression, anxiety, and stress Scale-21 (DASS-21). The data were collected during January-March 2025 and were analyzed with the chi-square test, logistic regression, and Pearson correlation tests. 35.0% (n=88) used dietary supplements regularly, with a preference for multivitamins (50%) and protein supplements (30%). Knowledge was moderate (60% risk aware), attitudes favorable (70% in favor of counseling), but practice restricted (25% informed peers). Everyday use of dietary supplements escalated stress probability (OR=2.5, 95% CI: 1.8-3.4, p<0.001), with correlation (r=0.38, p<0.01). In conclusion, students have promise as dietary supplement champions but require additional training to close knowledge-practice gaps and mitigate mental health risks. Curriculum and policy interventions are needed to enhance students' abilities in encouraging rational dietary supplement use and identifying potential mental health effects.

Mediterranean journal of pharmacy and pharmaceutical sciences