Distributed Generators (DGs) are incorporated in the power distribution systems to develop green energies in microgrids. Islanding is a challenging task in a microgrid. Different types of islanding methods, e.g. local and remote methods, have been developed for handling this task, with local methods being easier to implement, while remote methods are communication-based and costly. The local methods are classified as passive, active, and hybrid, out of which the passive methods are more simple and economical. In this paper, a passive islanding detection method is proposed to detect single line to ground fault. This fault is considered to represent the 60 to 70% of the total un-intentional faults of this category. The available passive methods cannot detect islanding at lower power mismatches as the variations in voltage and frequency fall within thresholding values. In this method, the voltage signals are first retrieved at the targeted DG output and then the phase angle is estimated. Finally, the phase angle is differentiated to get Rate Of Change Of Voltage Phase Angle (ROCOVPA) to detect islanding, and then it is compared with the Rate Of Change Of Frequency (ROCOF) at zero percent power mismatch. Simulation results depict that the ROCOVPA is more effective than ROCOF. The proposed method not only reduces detection time and NonDetection Zone (NDZ) but is also stable during non-islanding cases like load connection and disconnection to avoid nuisance tripping.

Bangar raju lingampalli

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

Background In 2016, the Tanzanian government shifted the vaccine supply chain responsibilities from the Medical Store Department (MSD) to the Expanded Program on Immunization (EPI) to reduce costs. However, cost estimates that informed the decision were based on invoice value of vaccines and related supplies, rather than a proper economic evaluation study. Therefore, this study aims to compare the actual storage and distribution costs of vaccines and related supplies between MSD to EPI. Method Micro-costing approach was used to estimate resource use at MSD and EPI for the year 2018. Data were collected through a review of documents, warehouse databases, and interviews with key staff at MSD and EPI. We included both capital and recurrent costs. Microsoft Excel® was used for analysis with input data from the UNICEF forecasting tool, WHOs vaccine volume and capacity estimation tool, diesel generator calculator, and supply chain service fee estimator version 1.02. Results The total vaccine storage and distribution costs were estimated to be USD 1,996,286 at MSD and USD 543,648 at EPI. Distribution and program management costs represented 41% (USD 819,288) and 38% (USD 762,968) of the total costs at MSD, while storage and distribution costs represented 43% (USD 234,423) and 34% (USD 184,620) of the total costs at EPI, respectively. The cost drivers at MSD were fuel and transport (21%), receiving and dispatch (19%) and, program management personnel cost (14%), while at EPI were storage space (20%), program management personnel cost (18%) and fuel and transport (15%). Conclusion The storage and distribution of vaccines in Tanzania via the EPI reduced the vaccine supply chain cost to about 27% of the program costs at MSD.

Dr. omary swallehe

Epithelial cells, lining the skin and internal organs, play a crucial role as protective barriers and regulators of substance transport. Traditionally, these cells were not considered to employ electrical signaling for communication. However, recent investigations have unveiled that epithelial cells generate slow electrical signals, termed the "silent scream," in response to injury, thus challenging conventional views of intercellular communication. A recent experimental investigation provided compelling evidence for this phenomenon, demonstrating the ability of these cells to transmit electrical signals over considerable distances within the epithelium. The research utilized microelectrode array chips to precisely detect subtle electrical events in keratinocytes and Madin-Darby Canine Kidney (MDCK) cells, revealing spiking activity characterized by slow propagation speeds, distinct from the rapid action potentials of neurons. The mechanisms underlying this novel signaling are explored, focusing on the involvement of mechanosensitive ion channels, calcium signaling, and Adenosine triphosphate (ATP) release. Calcium ions, well-established intracellular messengers, appear to play a central role in this biological phenomenon. Integrating this newly discovered communication mode into the existing understanding of skin cell biology reveals a more intricate picture of how skin senses and responds to its environment. The implications of this finding extend to various facets of skin physiology and pathology, including wound healing, inflammation, and skin aging. In wound healing, where endogenous electric fields guide cell migration and promote repair, this unique type of electrical signaling potentially plays a crucial part. Furthermore, aberrant electrical signaling might contribute to chronic inflammatory conditions, and age-related changes in this signaling could underlie the functional decline observed in aged skin. The potential for other environmental stressors to trigger the epithelial-generated electric signals also warrants investigation. The exploration concludes by discussing potential technological applications, such as bioelectric sensors and enhanced wound healing therapies, and future research directions aimed at further elucidating the molecular mechanisms and functional roles of this non-excitable cell electrophysiology.

Karishma

Purpose: To assess incidence of demodex species, correlate ocular symptomatology, evaluate efficacy of coconut oil as treatment method in all types of blepharitis. Materials and Methods: 30 patients with anterior & mixed blepharitis, meibomian gland dysfunction & non-specific irritation were enrolled for study. History taken & examined clinically. 2 lashes/lid were sampled & mounted on slides with normal saline & observed under light microscope. Number of mites counted. Patients positive for demodex were treated with coconut oil application over lid margins & reviewed after 3 weeks. Results: Incidence of demodex was 40% & it increased with age. Demodex was commonly associated with meibomian gland dysfunction, non-specific irritation, madarosis, cloudy & toothpaste like meibum quality. Burning sensation and itching were common complaints. At 3rd week, all patients were symptom-free. Mite count dropped by 52.8% but were not eliminated. Conclusion: Demodex infestation is often overlooked but it is associated with about half of blepharitis cases. Hence further evaluation should be considered. Coconut oil is an easily available mode of treatment & helps reduce symptoms and mite counts.

Kamal singh

Background and objectives: Heavy menstrual bleeding (HMB) is the most common clinical presentation of abnormal uterine bleeding (AUB). The objective designed for the study was to evaluate the effect of a Unani formulation in HMB (Kaṭhrat-i-Tamṭh). Methods: An open observational single arm clinical study was carried out at the Department of Ilmul Qabalat wa Amraze Niswan, National Institute of Unani Medicine, Hospital, Bengaluru. Diagnosed cases (n=30) of HMB with pelvic pathology were included in the study. Unani formulation comprises of Khurma (Phoenix dactylifera Linn), Rasaut (Berberis aristata), Talmakhana (Asteracantha longifolia Linn), Lodh pathani (SymplocosracemosaRoxb) was administered orally in powder form in a dose of 3g with 2g sugar, twice daily for seven days/cycle for three consecutive cycles.Main outcome measures were clinical response of 30-50% in menstrual blood loss (MBL) assessed with pictorial blood loss assessment chart (PBAC) and duration of bleeding (DOB). Improvement in Hb% and quality of life (QOL) assessed with menorrhagia impact questionnaire (MIQ). Data were analyzed using paired Student ‘t’ test, Results: Clinical response of 30-50% in MBL and DOB was achieved in 86.7% (p< 0.001**) and 56.7% (p< 0.001**) patients respectively and improvement in Hb% and QOL was achieved in 16.7% (p=0.228) and 100% (p< 0.001**) patients respectively. Conclusion:Unani formulation had a significant effect in controlling the bleeding by reduction in MBL and DOB with improvement in QOL

Dr ismath shameem

Patients who are on regular hemodialysis and who have advanced renal failure but have not yet started on renal replacement therapy have a high risk of tendon rupture, although this is a rare situation. We reported a case of 55-year-old male patient who had been on regular hemodialysis for the past 10 years. He presented with a sudden onset of pain and swelling in the left posterior ankle while climbing stairs. Ultrasonography revealed a complete disruption of the Achilles tendon, which was surgically repaired. His medical history was remarkable for the right Achilles tendon rupture a year ago. Investigations revealed tertiary hyperparathyroidism with chronic metabolic acidosis and high β-2 macroglobulin. With surgical repair, physiotherapy, and parathyroidectomy, the patient regained full active mobility. This case emphasized the importance of high parathyroid hormone level, metabolic acidosis, and high β-2 macroglobulin in the pathogenesis of tendons ruptures.

Karishma

Inflammation is said to be a healthy component of the body immune system's reaction. Inflammation is characterised by four key symptoms: pain, redness, heat or warmth and swelling. As secondary metabolites, plants may produce a wide range of phytochemical compounds, which possess anti-inflammatory characteristics. Herbal remedies are important therapies for a wide range of ailments all over the world. There are around 7 500 species of medicinal plants, including representatives from over 17 000 flowering plant species. Even when synthetic chemistry has developed out their expectations, the use of natural ingredients in the manufacture of drugs used in contemporary medicine is unparalleled. By interfering with the biology of inflammation, anti-inflammatory medications may assist to minimise tissue damaging and increase patient’s comfort. Because of the bulky figure of species reachable for study, the effective development of novel naturally taking place anti-inflammatory drugs is mostly dependent on a multidisciplinary approach to discovering new chemicals. Despite the statistic that many review papers have been produced in this field, the conventional of them simply examined the issue from an area perspective. Several non-steroidal anti-inflammatory drugs have been shown to reduce inflammation and pain by decreasing the isoform of the cyclooxygenase enzyme's digestion of arachidonic acid, hence lowering prostaglandin production. Non-steroidal anti-inflammatory drugs have a host of harmful effects. There are, however, medicinal herbs with anti-inflammatory pharmacological properties that have few or no negative effects.

Mediterranean journal of pharmacy and pharmaceutical sciences

To report a case of neurogenic stress cardiomyopathy post-trauma, managed using Non-Invasive Cardiac Output Monitor (NICOM)-guided conservative therapy. A middle-aged patient with traumatic subdural and subarachnoid hemorrhages developed hemodynamic instability. ECG showed QT prolongation; echocardiography revealed apical ballooning. We used NICOM which indicated low cardiac output (3.5 L/min). Fluids and inotropes were adjusted based on NICOM trends. The patient showed gradual hemodynamic and cardiac recovery. NICOM guided safe de-escalation of inotropes. Echocardiography normalized, and the patient was discharged. NICOM can be used for precise, non-invasive hemodynamic monitoring, aiding recovery in stress cardiomyopathy. Keywords: Traumatic brain injury, Takotsubo cardiomyopathy, Stress cardiomyopathy, Non-invasive cardiac output monitoring, Hemodynamic instability, Apical ballooning, Neurocritical care.

Journal of scientific innovations in anesthesiology

Nowadays, the Internet of Things (IoT) has been used widely in our daily day to day life, starting from health care devices, hospital management appliances to a smart city. Most of the IoT devices have limited resources and limited storing capability. All the sensed information must have to be transmitted and to store in the cloud. To make a decision and for making analysis all the data stored in the cloud has to be retrieved. Making certain the credibility and security of the sensed information are much necessary and very important for the use of IoT devices. We tend to examine the proposed technique to be much secure than the existing one. In IoT, if the security is not ensured, then it may result in a variety of unsought issues. This survey resembles the overall safety aspects of IoT and debates the overall issues in the security of IoT.

Jebin bose s

Abstract Higher education in India is always a socio-political way and a powerful engine of social mobility. It adds to the benefits to society as more people earning Higher Education credentials. It is proven that college graduates earn more. They are less likely to be unemployed. They are more likely to vote, more likely to volunteer, and more likely to maintain good health. India as a Globalised and developing nation has been little systematically progressing on the educational front since its independence. The government is making progress in reaching out to all the classes of its society. The improvement in the country’s economic front has resulted in the upscaling of communication technology. The advent of the internet, have vastly leveraged the promotion of education across all verticals. But at the same time, the idea of Equity and Equality needs to be redefined in the present context of the newly established notion of ‘Inclusivity’. This paper deliberates on the various ideas and approaches of Higher Education in India on ‘Inclusivity’ in general and Equity and Equality in particular.

Dr. preeti oza

Innovations to enrich mathematics learning resources can be expressed in the form of culture-based or ethnomatematic learning. The purpose of this study was to analyze the ethnomatematic content of Selogending Temple in Kandangan as mathematics teaching material for grade 4 elementary school students. This type of research uses qualitative research. Sources of research data are Selogending Temple and resource persons related to the Selogending Temple site. This study uses data collection methods in the form of observation, interviews, and documentation. Qualitative data analysis techniques used are reduction and data exposure, and drawing conclusions. Based on the results of the study, it can be concluded that there are mathematical elements in Selogending Temple including plane geometry, spatial geometry and reflection. The Selogending Temple building which has ethnomatic content is the Entrance Gate, Mbah Tejo Kusumo Petilasan, Mbah Pukulun Petilasan, Patrapan Hall, shrine, Padma, Wadung Prabu, Linggasiwa, and Mbah Raden Selogending Petilasan. Inovasi untuk memperkaya sumber belajar matematika dapat dituangkan dalam bentuk pembelajaran berbasis kebudayaan atau etnomatematika. Tujuan penelitian ini adalah menganalisis muatan etnomatematika pada Candi Selogending di Kandangan, Kabupaten Lumajang, Provinsi Jawa Timur sebagai bahan ajar matematika kelas 4 SD. Jenis penelitian ini menggunakan penelitian kualitatif. Sumber data penelitian adalah Candi Selogending dan narasumber terkait situs Candi Selogending. Penelitian ini menggunakan metode pengumpulan data berupa observasi, wawancara, dan dokumentasi. Teknik analisis data kualitatif yang digunakan yaitu reduksi dan pemaparan data, serta penarikan kesimpulan. Berdasarkan hasil penelitian dapat disimpulkan bahwa terdapat unsur matematika pada Candi Selogending meliputi bangun geometri bidang, geometri ruang dan pencerminan. Bangunan Candi Selogending memiliki yang memiliki muatan etnomatematika adalah Gapura Pintu Masuk, Petilasan Mbah Tejo Kusumo, Petilasan Mbah Pukulun, Balai Patrapan, tempat pemujaan, Padma, Wadung Prabu, Linggasiwa, dan Petilasan Mbah Raden Selogending.

Educare: journal of primary education

Self-medication with antibiotics is becoming a trend that threats the health systems worldwide through developing bacterial resistance which is associated with high health care costs and increased rate of morbidity and mortality. The main objective of this study is to assess antibiotic self-medication practice among Libyan university pharmacy students. This is a cross-sectional study conducted among pharmacy students at Sabratha University in the western region of Libya. A validated questionnaire was used to collect relevant data which were statistically analyzed. A total of 170 undergraduate Pharmacy students participated in the study during spring 2021. About 80% of the participants reported the use of antibiotics without consulting a physician. The major reason for using antibiotics was to get a quick relief of emergency conditions which was reported by 35% of the students. About 25% of the students used antibiotics to relieve their pains and aches. The most commonly used antibiotic was amoxicillin (55%). Most antibiotics were obtained over the counter from community pharmacies (85%). Half of the participants were not sure if they can advise patients to use antibiotics without a prescription, although 60% of them believed that it was good practice. In conclusion, prevalence of antibiotic self-medication among university pharmacy undergraduate students is high. Thus, serious interventions are required to ensure safe and effective use of antibiotics among the population in Libya.

Mediterranean journal of pharmacy and pharmaceutical sciences

The Group of Twenty (G20) has emerged as a pivotal forum for international cooperation, bringing together leaders from the world's major economies to address pressing global challenges. In this paper, we analyse the priorities of G20 leadership in fostering consensus and advancing collective action on key issues facing the global community. Drawing upon recent declarations, communiqués, and policy statements, we identify and examine the core areas of focus for G20 members, exploring both common ground and divergent perspectives. Our analysis reveals several recurring themes that underscore the G20's commitment to promoting economic stability, sustainable development, and inclusive growth. Addressing climate change and environmental sustainability emerges as a top priority, reflecting growing recognition of the urgent need for concerted action to mitigate the impacts of climate change and transition to a low-carbon economy. Additionally, enhancing global health resilience and strengthening pandemic preparedness feature prominently on the agenda, as demonstrated by recent efforts to coordinate responses to the COVID-19 crisis and bolster health systems worldwide. Furthermore, the G20 remains committed to advancing trade and investment liberalization, promoting financial regulatory reform, and fostering innovation and digital transformation to drive economic recovery and prosperity. However, divergent views on issues such as trade imbalances, protectionism, and technology governance persist, posing challenges to consensus building and cooperation among member states.

Dr gedam kamalakar

Tracing graduates has become an imperative for higher education institutions much more during the pandemic. This tracer determined the employment and employability status of the 2019 BSE graduates and identified the competencies they adequately acquired and deemed vital for work. It used descriptive design, and data were collected from the 103 graduates through a Google form with open and closed-ended questions administered between November and December 2020. Results revealed that most of the graduates had been employed in teaching and teaching-related jobs but mostly in contractual arrangements within the first and second six months after graduation. Many had their first jobs with meager salaries from the private sector. Communication, pedagogy, information communication technology, time management, and flexibility were the top competencies they adequately acquired and were beneficial in work. The study concluded that these graduates had acquired 21st-century skills in their respective degree programs. These results have corresponding implications for future research in confirming the most employable skills in secondary teaching. As recommended, classroom instruction might emphasize the development of these skills. Eventually, these become the competitive advantage and employability capitals of future graduates. Administering the licensure examination and the release of its results can be done within the first three months after graduation to lessen the cost of waiting.

Manuel caingcoy

Long periods of free-movement Restrictions may negatively affect Cardio-Pulmonary fitness and health. As, the COVID-19 virus primarily affects Respiratory system, and also associated with cardiovascular disease, can induce the following complications like thrombosis, myocardities, Interstitial pulmonary fibrosis, diffuse alveolar damage and persistent decline in lung function, as the lung capacity decreases it may results in decrease in Cardio Pulmonary endurance. The Present study investigated changes after the COVID-19 confinement in total distance covered in 6 minutes by patients and correlation between 6 minutes walk test vs. oxygen saturation; Results suggest that the Mean ± SD of age is 43.4 ± 10.8years. Male: Female 1:0.5.Mean ± SD of total distance walked in 6 minutes by patients is 443.5 ± 55 compared with Hypothetical mean (normative value) is 571 ± 90.Correlation between Total distance walked in 6 minutes vs. oxygen saturation is r = 0.055.

Nagarjuna narayanasetti

Youth entrepreneurship contributes to the social, cultural, and economic development of society, especially in many developing countries. The idea of encouraging young people to start businesses for a variety of reasons is now widely encouraged. However, there are many challenges and doubts faced in starting a business particularly after the Covid-19 is over. Therefore, the community service was carried out by lecturers at Business School, Universitas Pelita Harapan Medan Campus, providing the onsite seminar and training to 70 high school students at Santo Nicholas School in February 2023. The purpose of the community service was to encourage the students to plan their business projects by presenting data and information on the latest trends and issues in entrepreneurship and finance, as well as conducting one-to-one sessions with the students. Most of the students were enthusiastic throughout the activities resulting in several business plans and proposals being created at the end of the community service. It is implied that young people are indeed motivated to begin their entrepreneurship journey and school is the right place for them to acquire the necessary knowledge and skills. Teachers and parents are suggested to continue to assist the students by providing the commitment and funding required to begin and sustain the business.

L

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

Vallecular cysts, although infrequent in adults, pose a challenge for anesthesiologists in view of the risk of airway obstruction at anesthesia induction or aspiration in case of cyst rupture. The present case is of a 35-year-old male patient who was scheduled for excision of a vallecular cyst. An awake technique was initially decided for nasotracheal intubation using a flexible videolaryngoscope, AmbuscopeTM, after complete topicalization of the airway with local anesthesia. However, anticipating the need for a tracheostomy, the surgical team was prepared, and this was timely chosen as the only viable option following failure to visualize the glottis despite negotiating every possible way around the cyst. This case highlights the successful management of a large vallecular cyst in an adult patient, where failed awake nasotracheal intubation despite optimal preparation necessitated an early, planned tracheostomy. This reiterates the fact that the surgical airway may not be always chosen as the last resort in crisis but also as a timely intervention to prevent an airway catastrophe.

Journal of scientific innovations in anesthesiology

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