Treatment adherence is a critical component of epilepsy management. Antiepileptic drug side effects affect adherence and may result in the discontinuation of medication. This study aimed to investigate the association between antiepileptic drug side effects and medication adherence among Libyan patients with epilepsy while identifying predictors of adherence. A cross-sectional study was conducted at Tripoli University Hospital involving 200 adult epilepsy patients. Adherence was assessed via a self-report tool dichotomized as adherent/ non-adherent if patients stopped medication due to side effects. Side effects were evaluated using the Side Effects of Antiepileptic Drugs questionnaire. Logistic regression analyzed predictors of adherence, including antiepileptic drug use, therapy regimen, and side-effect profiles, with p<0.05 declared association. The overall adherence rate was 87.0%. Higher adherence was observed in older age groups, 95.8% in patients aged 51-60, 89.4% in married patients, and 91.0% in university-educated patients. Patients on monotherapy and those seizure-free in the preceding month demonstrated better adherence (88.4% and 93.0%, respectively). Valproate users had notably low adherence (52.6%) while carbamazepine and phenytoin users showed higher adherence (89.7% and 91.7%, respectively). Cognitive complaints significantly reduced adherence (76.1% vs. 79.6%), as did aggressive behavior (58.3% adherence). Logistic regression identified two independent predictors: patients on old-generation antiepileptic drugs had 2.7 times higher adherence (AOR=2.702, 95% CI: 1.168-6.249; p=0.02) while cognitive side effects reduced adherence by 86.4% (AOR=0.136, 95% CI: 0.031-0.596; p=0.008). Cognitive side effects predict non-adherence, necessitating routine monitoring. Paradoxically, older antiepileptic drugs correlated with better adherence. Integrating patient-reported metrics and addressing cognitive impacts could optimize epilepsy care, highlighting gaps in side-effect management and advocating personalized strategies in clinical settings.

Mediterranean journal of pharmacy and pharmaceutical sciences

India’s economic system has undergone significant changes in recent years reflecting globalization and changes in national policies. This paper provides a comprehensive analysis of India’s economic growth, focusing on imports and exports. The study explores the key drivers of economic expansion, including trade liberalization, trade agreements, and technological advancement. It also explores the impact of international trade and geopolitical events on business models. It assesses the role of policy measures such as the Goods and Services Tax (GST), the Make in India initiative, and various free trade agreements in generating economic benefits. The paper also assesses the trade balance and its impact on India’s economic stability and growth. The paper concludes with recommendations for improving the market, including diversifying entrepreneurs, investing in infrastructure, and strengthening the domestic economy. The review provides insights to policymakers, businesses, and academics who want to understand and harness India’s economic potential in the global economy

Dr gedam kamalakar

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

Internship activities are carried out in universities to introduce the working world to students in the future. This is important to be examined, especially in terms of the effectiveness of the program that has been implemented. By conducting a survey of students who have undergone the internship process, a clearer picture can be obtained of overall student satisfaction in response to the placement process during the internship. There are five factors emerge from the data analysis, namely interpersonal skills, work environment, culture, challenges, and benefit.

L

Datura arborea Linn is a sacred plant known for over 3000 years to have been used for magical and curative purposes. It was shown to have a central nervous system depressant effect. The active substances identified were tropane alkaloids: atropine, scopolamine, and hyosine. Therefore, we aimed to find out whether the ethanol extract of Datura arborea Linn has sedative and hypnotic activity. The extract was subjected to a thiopental sodium-induced sleep test and diazepam was used as a standard drug. The plant possesses sedative-hypnotic qualities, the findings indicate that doses of 35 mg/kg (2.70.24 min), 70 mg/kg (3.80.19 min), and 140 mg/kg (4.30.20 min) decreased the control's (9.2 min) latency to fall asleep. In comparison to the control, the length of sleep was increased by 23.46 minutes for 35 mg/kg (99.002.99 min), 70 mg/kg (132.605.53 min), and 140 mg/kg (118.606.04 min), respectively. The present study established the acute toxicity of Datura arborea Linn to be less than 600 mg/kg in mice. This study indicated that the ethanol extract of Datura arborea Linn has a sedative-hypnotic activity in the diazepam-induced sleep test. It is safe to suggest that the extract acts via either β-receptor by causing hyperpolarization or a decrease in spike activity in the cell, leading to relaxation, but these effects were not blocked by β-antagonist or α2-receptor to decrease acetylcholine release, leading to relaxation of the smooth muscle.

Mediterranean journal of pharmacy and pharmaceutical sciences

Around the world, several oral health measures have been implemented. The most popular method is to use a toothpaste. However, chewing sticks are still used in many cultures around the world in a conventional manner. Chewing sticks have a mechanical cleansing action similar to a toothbrush in addition to their antimicrobial effect. The purpose of this study is to evaluate the effect of Miswak on the growth of Candida species and to compare it to that of toothpaste. A cross-sectional study was carried out on 120 selected randomly volunteers from January to April, 2022. Two groups of participants were used for two weeks. The participants were separated into a group used Miswak and a group use ordinary toothpaste. Samples were collected before and after two weeks in these two groups. Samples were immediately processed for microbiological phenotypic conventional methods and in vitro susceptibility testing of the microbial isolates to antimicrobial. The findings show that a significant effect of Miswak against an oral cavity candida species. Total candida count was 27.5 ± 18.48, P = 0.001 (Mean ± SD) from Miswak group and 247.0 ± 90.14, P = 0.979 (Mean ± SD) in toothpaste group. The most frequent Candida isolates organisms were C. albicans: 22 (36.67%) in the Miswak group and 24 (40.0%) in the toothpaste group, the second isolate was C. dubliniensis: 04 (6.69%) in the Miswak group and 12 (20.0%) in toothpaste group followed by C. glabrata: 02 (3.33%) in Miswak group. In conclusion, Miswak has a considerable antifungal impact immediately and after two weeks of use.

Mediterranean journal of pharmacy and pharmaceutical sciences

Viral hepatitis is one of the main public health concerns around the world. Even though infection management techniques have been implemented over the last few decades, eradication or significant reduction has remained a mystery. The purpose of this study is to look into the prevalence of acute infectious hepatitis in the East of Libya and how the type of virus, age, gender, clinical manifestations, and outcome are related. This is a hospital-based retrospective study. The data on the frequency and distribution of viral hepatitis based on age, gender, seasonal, clinical, and ultrasound findings, and the outcomes during a period of two years from January 2020 to December 2021 were collected and analyzed. Of the 0.39% (72 cases) of total hospital admissions (18340) under the age of 15 years old for acute infectious hepatitis patients, the most common age group was 5-12 years (79.6%). Winter accounted for 41.6% of all the cases. Females made up 65.3% of the cases. Jaundice was the most prevalent presentation (87.5%). Hepatomegaly was seen in 83.3% of the patients. Most of the cases have mild hyperbilirubinemia (5-9 mg/dL, 75.0%). Approximately 1/5th of the patients' serum glutamic-oxaloacetic transaminase (SGPT), and nearly 1/3rd of the patients' SGPT levels were in the range of 1000-2000. One patient's hepatitis C was positive, one patient's hepatitis B was positive, and 97.2% were positive for hepatitis A. 88.8% of the individuals recovered without complications, whereas 11.1% showed symptoms of hepatic failure but recovered. The present study indicates that acute hepatitis A is more prevalent, especially in the winter. Those who are females and 5-12 years of age were more affected by acute viral hepatitis in Libya.

Mediterranean journal of pharmacy and pharmaceutical sciences

The aim of this study was to evaluate the knowledge, attitude, and practice of pharmacovigilance by healthcare professionals in Benghazi. A structured questionnaire adapted from a previous validated study. One hundred questionnaires were distributed in August 2019 and filled by healthcare providers working at different hospitals in Benghazi, Libya. Participants were 57% physicians and 43% pharmacists (age average 31-40 years). 47% had correctly defined Pharmacovigilance while 19% know what is meant by adverse drug reactions. Moreover, 61% of the participants did not share information about raising adverse drug reactions in some patients with other healthcare professionals. 35% of them did not know about the adverse drug reactions reporting system in Libya. Whereas, 42% have strongly agreed that reporting adverse drug reactions is essential. 41% and 45% of participants believed that reporting adverse drug reactions is not time-consuming and increases patient safety, respectively. In conclusion, educational programs and training courses about the importance of Pharmacovigilance for physicians and pharmacists in Benghazi are needed.

Mediterranean journal of pharmacy and pharmaceutical sciences

Vehicular adhoc structures (VANETs) handle the Public Key Infrastructure (PKI) and Certificate Revocation Lists (CRLs) for their security. In any PKI structure, the check of a got message is performed by checking if the check of the sender is joined into the current CRL, Verifying the reliability of the certification and standard for the sender. In this paper, it has been propose a Vehicular Digital Hash Gen show up (VDHG) for VANETs, which replaces the dull CRL checking process by a profitable revoking checking process. The renouncing check process in VDHG uses a Private Key Infrastructure (PKI), where the key used in finding the VDHG is shared particularly between On-Board Units (OBUs). In like manner, VDHG uses a novel probabilistic key stream, which extras with OBUs to trade and revive an issue key. VDHG can on a very basic level lessen the data torment in light of the message declaration deferral pulled back and the standard assistance structures using CRL

Dr h shaheen

The Construction Industry is one of the industries contributing highest GDP in Indian economy. The material that is most chosen in construction Industry is concrete. Concrete is a material made with Cement, Fine aggregate in the form of sand, Coarse aggregate in the form of gravel and water. With increasing scarcity of sand, construction works are coming to jolt and thereby increasing the need for choosing an alternative material. Vermiculite is a material which after exfoliation can be used as a filler material replacing sand partially without affecting strength much. One more material Granite (by product which is a waste is causing lot of environmental Issues), produced from granite industry, is available in India in several million tons. Coarse aggregate generally used is a crushed aggregate obtained from rocks like granite, basalt and soon. Recycled aggregate is an aggregate which is obtained after demolishing of an existing building, which is a waste causing economical in balance and which if put into use can not only decrease the construction cost but also make this waste into a better use. In the present study, for a M35 grade of concrete, Vermiculite (0, 5%, 10% and 15% of weight of sand) and granite powder (fixed at 10% of weight of sand used) is used to replace sand partially and in the place of normal coarse aggregate, recycled aggregate is used which is 20 mm passing and 12 mm retained After preparation of Mix-Design(1:1.83:2.69 with w/c ratio of 0.38) the concrete cubes are casted to test for compressive strength after curing for 28 days, 56 days and 90 days. Forsec brand super plasticizer is used to take care of workability requirements. Durability test in the form of resistance to attack of sulphuric acid was conducted along with compressive strength. The test results were promising at 10% replacement levels of Vermiculite.

Kiran kumar narasimhan

Background: Emerging data found that Type 2 diabetes mellitus (T2DM) is associated with Vitamin D deficiency at various frequencies. This study aims to estimate the prevalence of Vitamin D deficiency in T2DM patients in Qatar and the correlation between Vitamin D deficiency and other variables such as dyslipidemia, glycemic control, and microalbuminuria. Methods: This retrospective cross-sectional analytical study was conducted in the medical outpatient clinic at Hamad General Hospital. The study involved adult patients (≥18 years) with T2DM. The study covered patients admitted between January 1, 2018, and July 31, 2018. Ethical approval was obtained from the Medical Research Committee. Results: We recruited 400 subjects with T2DM. Their mean age was 58.97±10.32 years, and the majority were women (52.0%) and Arabs (69.5%). The mean duration of Type 2 diabetes diagnosis was 14.94±8.99 years. The prevalence of Vitamin D deficiency was 29.5%. A comparison between Vitamin D deficiency and non-vitamin D deficiency groups showed a statistically significant difference in terms of fasting blood (FB) sugar (p<0.001), random blood (RB) sugar (p<0.001), hemoglobin A1c (HBA1c) (p<0.001), total cholesterol (P = 0.001), low-density lipoprotein cholesterol (LDL [C]) (p=0.004), high-density lipoprotein cholesterol (HDL [C]) (p<0.001), triglyceride (p<0.001), and urinary albumin excretion rate (UAER) (p=0.007). Data analysis showed that a significant negative correlation was found between Vitamin D level and FB sugar (r=−0.208, p<0.001), RB sugar (r=−0.20, p<0.001), HBA1c (r=−0.260, p<0.001), total cholesterol (r=−0.218, p<0.001), LDL (C) (r=−0.176, p=0.004), triglyceride (r=−0.342, p<0.001), and UAER (r=−0.184, p=0.007). Conclusion: Our study showed a significant correlation between Vitamin D deficiency and the poor control of T2DM, dyslipidemia, and microalbuminuria. The results emphasize the importance of monitoring Vitamin D status in high-risk populations.

Karishma

Education in India is losing its relevance. This seems much more applicable to the situation in the present day of legal education. This essay aims to focus on two aspects of legal education. Whilst, on one hand, it aims to provide details of the existing legal education system on the other, it aims to drive more attention to the various improvements and developments that are needed. The essay firstly shall describe the existing legal education system. It shall analyze and assess the curricula that are available for the various undergraduate law degrees available in India. It aims to provide an understanding of the perceived distinctions between the three-year law degree and the five-year law degree. As a second aspect, the essay aims to explore options to further the quality of legal education in India by considering examples of various law schools or colleges of law across the world that have consistently proven themselves as a cut-above not legal education and research in their global scale. Also, from the learnings of the gaps in the curricula of the law degrees as discussed previously, the essay shall provide suggestions on the various plausible collaborations with foreign law schools and universities for the benefit of the Indian law schools and colleges of law. As a third and final aspect, as a measure to curb fake or bogus law schools or colleges of law within India and to enhance the employability of law graduates in India at par with those across the globe, the essay aims to provide suggestions applicable for the present-day legal education scenario.

Hari hara sudhan r

This study aims to see and determine the effect of transformational leadership and competence of PT Waruna Shipyard Indonesia on employee performance through job satisfaction as intervening variable. This research was conducted at PT. Waruna Shipyard Indonesia, located on Bagan Deli Street, Medan Belawan District, North Sumatra. This research was conducted of the month of August 2019-January 2020. The data analysis tool by structural equation modeling (SEM) with smartpls program. The population is employees at PT. Waruna Shipyard Indonesia in 2019, namely as many as 134 employees. This study used slovin formula for the sampling, calculations sample were respondents is 100 permanent employees of PT. Waruna Shipyard Indonesia. Thus taken 30 respondents outside of the sample to validity and reliability test instrument for testing questionnaires. Based on structural equation modeling (SEM) analysis, transformational leadership and competence have positive and significant effect on employee performance with job satisfaction as intervening variable at PT. Waruna Shipyard Indonesia. The contribution of transformational leadership, competence, and job satisfaction explains the employee performance variable of 0.724 or 72.40%. The remaining 0.276 or 27.60% is effect by other independent variables not examined in this study.

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Medicinal plants and herbal drugs have widely been used in several diseases which contain highly active pharmacological agents. Several previous studies have mounted about the hepatotoxicity of these remedies which ranges from mild enzyme alterations to liver failure in humans and animals. This study aimed to evaluate the toxicity profile of the crude methanolic seed extract of Calliandra surinamensis on rat liver functions. An acute toxicity study was carried out using modified Lorke’s method and sub-chronic toxicity was done following the Organisation for Economic Cooperative and Development guidelines with testing chemicals 423 and 407 to assess the effect of the seed extract on liver function alongside histopathology assessment of the liver. The haematological indices revealed no significant change in red blood cells and other haematological parameters. The average organ weight of the tested rats showed no significant differences. The histopathological examinations of the rat liver revealed no observable toxic injury to the tissue after treatment with the seed extract across all concentrations. There were desirable morphological vasoactive changes of dilatation and active congestion in the organ across all the concentrations which were dose-dependent. There was induced activation of the sinusoidal kupffer cells, which signified a boost to the local immune system of the liver. The nucleoli in the hepatocyte nuclei were remarkably conspicuous which implied an increase in the production of ribonucleic acid that is deployed in protein synthesis.

Mediterranean journal of pharmacy and pharmaceutical sciences

In the running of the Internet world, Ecommerce industry has its own benchmark in terms of its rapid growth and has made itself an established sector that is indispensable for every industry to trade and do transactions online. As the world is rushing in a rapid manner, India is slogging in the improvisation of the online market, leading to the lack of customized needs of the customers. Bigger companies are trying to put in a different strategic approach taking that into consideration an approach of blended emining along with ecommerce has been devised. It would be a design of the semanticand neuralbased page ranking algorithm [2]. This tool upon launching would be a welldefined approach for ecommerce website ranking [1]. It would also facilitate the customers to find the relevant websites on the top of the page during their search for any particular product orbusiness. It would be further customized with all the relevant comparison of the other websites in terms of the product quality and price.

Dr h shaheen

Purpose: Congenital hypogonadotropic hypogonadism (CHH) is a rare genetic disorder mostly characterized by gonadotropins release and/or action deficiencies. Both isolated (idiopathic hypogonadotropic hypogonadism) and syndromic (Kallmann) forms are identified depending on the olfactory ability. Clinical and genetic heterogeneities of CHH have been widely explored, thus improving our understanding of the disease's pathophysiology. This work aims to (1) provide a detailed clinical and hormonal description of normosmic CHH patients and (2) identify the mutation linked to the studied phenotype. Participants and methods: We investigated three affected patients with normosmic CHH, belonging to a consanguineous Tunisian family. Patients underwent an insulin-induced hypoglycemia test. We performed whole exome sequencing to identify the causal mutation. Results: At first diagnosis, a total gonadotropic deficiency was identified in all patients. The insulin-induced hypoglycemia test has also revealed a reduced cortisol secretion and complete growth hormone deficiency. At 20.8 years, one female exhibited a spontaneous recovery of the hypothalamic-pituitary-adrenal axis function, unlike her affected siblings who still depend on corticosteroid replacement therapy. Herein, we identified a novel homozygous nonstop mutation (c.1195T>C) in KISS1R gene in all affected subjects. This mutation led to the substitution of the physiologic stop codon by an arginine (p.X399R). Conclusions: Our study highlights the importance of the KISS1R signaling, in gonadotropin-releasing hormone neurons, in the control of reproductive function. Additionally, our data suggests a complex central and peripheral metabolic control of puberty, through the hypothalamic KISS1R signaling. We suggest a mutual link between the hypothalamic-pituitary-gonadal, -adrenal, and -somatotropic axes.

Mariam moalla

Background: Pre-eclampsia remains a significant contributor to maternal and perinatal morbidity and mortality. Research into changes associated with the disease offers some hope into identifying predictive and prognostic factors. In recent times, serum leptin has attracted interest as a possible marker for the disease. The aim of this study was to determine and compare the serum leptin levels in normotensive and pre-eclamptic pregnant women attending antenatal clinic at the Delta State University Teaching Hospital, Oghara, Delta State, Nigeria. Methods: This was a prospective case-control study design at the Delta State University Teaching Hospital, Oghara, Nigeria in which sixty three pregnant women who received antenatal care and developed pre-eclampsia were recruited into the study. For each selected pre-eclamptic, a matched normotensive was selected as control. Serum leptin level was measured by radioimmunoassay (RIA) ELISA. Results: There was a statistically significant difference in mean serum leptin levels between the normotensive and pre-eclamptic pregnant patients 15.11±4.81 ng/dl vs 38.98±8.66 ng/dl; p<0.001. Furthermore, there was a statistically significant difference in mean leptin levels between mild and severe pre-eclampsia; 16.49±8.22 ng/dl vs 39.03±8.58 ng/dl;p<0.001.Conclusion: This study revealed an association between serum leptin level and pre-eclampsia. Serum leptin may be a potential marker for pre-eclampsia and deserves further investigation.

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

2-Azetidinone shows biological activities like anti-bacterial, anti-microbial activity, anti-tubercular activity, and anti-cancer activity. 2-azetdinone derivatives were synthesized by simple procedures. The first step is synthesis of benzohydrazide through nucleophilic substitution reaction between methyl benzoate and hydrazine hydrate. The above formed compound is then treated with substituted aromatic aldehydes in the presence of catalytic amount of concentrated hydrochloric acid with stirring for one hour to give benzohydrazone which results in the formation of Schiff bases.Schiff bases undergone cyclisation in the presence of chloroacetylchloride and diethylenediamine by using ethanol as a solvent upon stirring for 4 hour’s yielded 2-azetidinone derivatives. The in-silico anti-leukemic activity was determined by using the computational tools i.e. “PASS Online”, “AutoDock4.2” and “ADMET” properties by online software’s. Among these six derivatives compounds (AZT-6) was shown more activity when compared with the other five compounds.

M. yaswanth

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