Background: Although statins are considered safe, they do have side effects with a wide range of hepatic adverse effects. The present study aims to estimate the frequency of liver injury in patients treated with various statins and to describe their clinical characteristics and outcomes. Materials and Methods: We carried out a secondary post hoc analysis of collected data from our previous study entitled “Frequency of Rhabdomyolysis in Patients Treated with Statins in Hamad General Hospital, Qatar.” Results: We identified 10 cases (1.0%) of statin-induced liver injury during the study period. Their mean age was 62±10.09 years, with 6 (60%) males and 4 (40%) females. Of the 10 patients, six patients received rosuvastatin, two patients received atorvastatin, and other two cases received simvastatin. The mean duration between the initiation of statin and the development of liver injury (latency period) was 20.40±6.91 months. Five of our patients were asymptomatic, and liver injury was discovered incidentally during routine testing of the patients during routine follow-up, while four patients developed painless jaundice and one developed muscle pain attributed to rhabdomyolysis. Statins were stopped in all patients. Nine of them were managed on an outpatient basis, while one patient with rhabdomyolysis was admitted. In all patients, other statins were reintroduced after a mean time of 7.4±3 months without recurrence of liver injury. No mortality has been reported. Conclusion: Our study demonstrated that statin-induced liver injury is a rare clinical entity that occurs regardless of the dose and type of statin, with rosuvastatin being the most causative drug. Statin-induced liver injury was asymptomatic and was discovered incidentally in 50% of our cases during routine testing, underscoring the importance of routine follow-up of liver function tests in asymptomatic patients.

Karishma

Education is power. It constitutes the foundation of all the multidimensional socio-economic development of a country. In the present context, we need manpower or human capital for generating the growth and development in a country. The Government of India has taken several many initiatives for promoting education at all the stages i.e. Primary, Secondary and Higher. But still, we find such issues as a high dropout rate at all the stages of education, rural-urban disparity, gender disparity, interstate variations pose as some of the problems that impedes the development of human resources in our country. Even the work participation rate in India indicates the necessity of proper planning of skill training and employment opportunity. Most interestingly, the existing general and conventional higher educational institutions have not effectively been able to cope with the contemporary challenges and changes with the result that the nature of curriculum which is by and large in place tends to create only degree inflation in our country. So, we need such institutes and institutional arrangement that can cater to the contemporary challenges so as to upgrade the quality of education as well as to provide need based educational programmes that can develop human power in the society. Effective or quality education especially at higher level can play a vital role in bringing around multifaceted human resource development, enabling the learner’s absorption in the job market and selfemployment. This paper will discuss how the accessibility of education can be promoted to all through a convenient mode of education system and how the disparities in education can be minimized, and also focus on the various strategies for strengthening higher education system in the country.

Dr gedam kamalakar

The transportation problem is widely applied in the real world. This problem aims to minimize the total shipment cost from a number of sources to a number of destinations. This paper presents a new method named Dhouib-Matrix-TP1, which generates an initial basic feasible solution based on the standard deviation metric with a very reduced number of simple iterations. A comparative study is carried out in order to verify the performance of the proposed Dhouib-Matrix-TP1 heuristic.

Souhail dhouib

Cystic fibrosis is a challenging disease which creates many complications. The impact caused from cystic fibrosis on an adolescent is a challenging phase for their lives. Negative impacts like the society’s pressure, anxiety and depression are few common reasons that are being unspoken and ignored due to complexity of the disease. This study is aimed to identify the necessary gaps and educate the necessary policy makers and CF center health care team to have a better understanding about the context of the aftermath of cystic fibrosis and enhance better patient care. More over this systematic review also points out the main trends in this field of study. Qualitative study and quantitative are prominently used research methods to gain an understanding the about the gaps in the research. However, there is still a scarcity of quantitative and mixed research methods. Furthermore, limitations such as language, cultural influences were identified whilst going through the analysis. Overall through the information given in the following in this study more information regarding that warrants answers can be identified which will lead to proper care towards the teenagers who suffers from cystic fibrosis.

Chanitha pemasena

Various quality control tests are employed for solid dosage forms such as uniformity, dissolution and drug contents in order to assess their pharmaceutical equivalence. The objective of the current study was to assess and contrast five distinct metformin hydrochloride brands that are offered for sale in the Libyan market. The physicochemical equivalence of the five brands of metformin hydrochloride tablets (500 mg) were determined through the evaluation of official and non-official standards according to the USP including uniformity of weight, friability, hardness, dissolution rate and drug content. All the examined brands available in the Libyan market passed the official weight variation, friability, dissolution and disintegration tests and were equivalent. The friability test was found within the specified limit. All the formulations were disintegrated within 09 - 15 min. The tested brands were non-equivalent to the innovator Glucophage® according to their dissolution evaluation. The percentage content of the active ingredient of five brands of metformin tablets showed values within the monograph specifications (95% - 105%). In conclusion, all the five brands available in the Libyan market which were evaluated in this study cannot be substituted with the innovator product in clinical practice.

Mediterranean journal of pharmacy and pharmaceutical sciences

Background: Salmonella typhi (S. typhi) antibodies may be considered as biomarkers of typhoid fever, a severe febrile systemic illness caused by an invasive Gram-negative Bacterium S. typhi. Worldwide, about 21-26.9 million cases of typhoid fever and 200 000-215 000 deaths, occur annually. Between 2003 and 2005, statistics have shown a rising trend in the incidence of typhoid fever in Abia and Enugu States. The aim of the study was to determine the sero-prevalence of S. typhi antibodies in some rural communities of Abia and Enugu States as proxy indicators of prevalence typhoid fever (TF) in the two states. Methods: This was a cross-sectional study of the sero-prevalence of S. typhi antibodies in ten rural communities of Umunneochi Local Government Area (LGA) of Abia State and Ezeagu LGA of Enugu State using 421 (200 in Abia and 221 in Enugu) blood samples for the Widal test to determine the titres of these antibodies. Results: In the Abia communities the mean sero-prevalence of S. typhi antibodies was 68.2%, while in Enugu it was 87.1%. Between the two states, difference in the sero-prevalence of S. typhi antibodies was significant (p=0.03). Conclusions: The sero-prevalence of S. typhi antibodies was higher (87.1%) in the Enugu communities, compared to the Abia communities (68.2%). To reduce the incidence and prevalence of TF in the communities, access to safe domestic water, improved sanitation and good food hygiene needs to be improved. Health-seeking behaviour also needs improvement.

Emmanuel umegbolu

Diabetes mellitus (DM) is a complex and chronic illness requiring continuous medical care. Type 2 diabetes (T2D) is commonly associated with obesity, hypertension, and a tendency to develop thrombosis, and an increase risk of cardiovascular diseases (CVD). Diabesity is a term used to indicate the coexistence of obesity and DM. Diabesity increases as obesity is an emerging epidemic in modern societies, the co-incidence with DM is also rising, so a joint plan of anti-obesity and anti-hyperglycemia for the management approaches. Therefore, this study aimed to identify the impact of glucagon-like peptide-1 receptor agonists (GLP-1RAs) on body weight and glycemic response in obese Libyan patients with T2D at the National Diabetes Centre in Tripoli, between July 2013 and May 2022. This prospective study included obese adults with T2D who were newly prescribed GLP-1RA therapy for six months with dulaglutide once weekly or liraglutide once daily. The study included 170 diabetic patients who were started on GLP1-RA as add on therapy to their treatment, with a regular follow-up with dietitian and their physicians to adjust their glucose-lowering medications, then comparing the effect of these agents on body weight and the level of glycated hemoglobin before and after 24 weeks of treatment. Most of the patients (n = 99, 58.23%) were in the age period from 54 to 74 years old and 101 of whom were female subjects (59.4%), with a mean duration of DM equal to 8.8 ± 7.3 years. The patients were divided randomly into two groups, the first group included 110 patients who received liraglutide pens showed a significant reduction in HbA1c from 9.6% (± 1.54) to 7.4% (± 1.03) by p < 0.001 and a significant weight loss from 88.3 kg (± 10.68) to 80.8 kg (± 11.83) by p < 0.001. The reported adverse events were in 23 cases of minor hypoglycemia due to gastrointestinal upset. The other group included 60 patients for dulaglutide pens and showed significant decrease in HbA1c = 9.6% (± 1.54) to 7.1% (± 1.2) by p < 0.05 and a significant reduction of bodyweight from 88.3 kg (± 10.68) to 83.8 kg (± 16.3) by p < 0.05. The reported adverse events were mild transient gastrointestinal distress for the initial week of a start and then subside with regular intake. Whereas, 115 patients (67.6%) with HbA1c above 10.0% before starting therapy, no patient with HbA1c above 10.0% after six months of both GLP-RA agents therapy. Thus, the uses of GLP-RA as add-on therapy for obese patients with T2D significantly improved glycaemic control with less hypoglycaemia, accordingly, reduce insulin requirement for blood glucose control and loss in body weight. It can thus be concluded that GLP-1RA therapy is an effective treatment option when used in obese patients with DM.

Mediterranean journal of pharmacy and pharmaceutical sciences

The purpose of this study is to look at development trends and patterns of structural change in India's rural and labour markets. The rural labour strength have been moving from agricultural sector to non-agricultural sector for a living, after a long period of change (due to pain and growth-induced motives). Although the manufacturing sector lags, the building industry is a significant growing sector that employs rural people. Some improvements in rural areas have been made since the implementation of the MGNREGA rural employment development programme, but it has its own set of problems that experts are discussing. Furthermore, the rural labour market is plagued by high unemployment as a result of both the agricultural and non-farm sectors' failure to absorb rural employees. Nonetheless, the continuing COVID-19 epidemic has worsened its situation by causing a job-loss catastrophe. The rural labour market's future will become more unclear as a consequence of Covid pandemic-induced opposite migration of city workers to their villages, which has worsened food security and poverty issues in rural regions.

Dr. amarjeet singh

The COVID-19 pandemic and related lock downs have accelerated the need for online and remote teaching within university settings. However, due to the abrupt nature of the pandemic, many academic staff were not prepared for this forced transition. This study aimed to understand how the pandemic affected academics at a New Zealand university, with regards to their transition to emergency remote teaching. Specifically, it explores the challenges as well as benefits academics experienced during this transition. Recommendations for future online learning are also made. Academic staff (N 67) at a New Zealand University completed an anonymous online survey. Quantitative data were analyzed statistically using descriptive and inferential statistics, while qualitative data were analyzed thematically. Major challenges experienced included miscommunication from the university, concerns about student access to technology, finding a quiet space to work, lack of digital competence skills, too much screen-time, managing work hours, and work/ life balance. Benefits included enhanced flexibility, enhanced teacher creativity, increasing autonomy of learners, and reduced commute time. Looking forward, academic staff desired future teaching to include blended learning and virtual immersion. New strategies of working remotely are being explored to facilitate teaching and learning while catering to the preferences and skills of both educators and students. Our findings honor the considerable agility of academic staff who sought to sustain and enhance excellence in remote education. At an institutional level our findings point to the need for staff to be supported by their institutions as they further refine their work within new-found spaces

Gwen erlam

India is in the midst of a severe second wave of Covid-19. As per the Global Commission for Post-Pandemic Policy by mid-April of 2021, India had manufactured nearly 17 percent of all Covid-19 vaccine doses globally. It was the world’s fourth-largest producer, after China (about 36 percent), the United States (about 22 percent) and the European Union (more than 17 percent). Even so, following a shortage of vaccines and with insufficient local production, Government of India decided to import more foreign vaccines with quicker approval process for vaccines accepted in US/EU markets. India is currently using made-in-India vaccines, namely, Covishield manufactured by Serum Institute India and Covaxin of Bharat Biotech in its COVID-19 immunisation programme. The shortcoming in the production of vaccines and its dissemination within the country urges one to understand who the local producers are and how the market is playing out. This paper looks at the evolving market structure of vaccine production in India in the textbook framework of an oligopoly market. We use secondary data sources and daily newspaper briefs.

Nandini

The present study evaluates the efficacy of Vilanterol-Fluticasone Furoate (VI-FF) versus Formoterol-Budesonide (FM-BD) combination therapy in stable asthma. Both regimens led to significant improvements in asthma control, as evidenced by marked increases in FEV1 (% predicted) and ACT scores over time. The demographic characteristics, baseline respiratory symptoms, and treatment outcomes were similar between the groups, indicating that both strategies were equally effective for managing asthma. The findings indicate that both VI-FF once daily and FM-BD twice daily therapies enhance lung function and asthma control. Significant improvements in FEV1 (% predicted) and ACT scores were observed in both groups, as confirmed by intention-to-treat (ITT) and perprotocol (PPA) analyses. The equivalent efficacy of VI-FF and FM-BD, combined with the convenience of once-daily dosing, suggests that VI-FF may be preferable for patients who struggle with a twice-daily regimen. These findings highlight VI-FF as a convenient and reliable treatment, particularly can benefit patients with adherence challenges. In conclusion, our study's findings align well with other studies regarding demographic characteristics, baseline symptoms, exacerbation history, hospitalization history, and spirometry results. This consistency reinforces the validity and reliability of our results, suggesting that both VI-FF and FM-BD are effective options for stable asthma. The comparable efficacy supports flexibility in treatment choices, allowing for personalized asthma management. Future research should explore the long-term benefits and adherence patterns associated with these treatments to further optimize asthma management.

Dr k c yadav

Strain improvement studies were conducted for the production of L-asparaginase from a marine fungus Beauveriabassiana SS18/14 by employing physical and chemical mutagens, in a systemic manner to obtain mutants that have higher L-asparaginase production. The wild strain produced 6.32 IU/mL of L-asparaginase activity while the UV mutant UVF-4 yielded 8.34 IU/mL and nitrous acid mutant UVF4-N-2 exhibited 10.44 IU/mL enzyme activity. The overall strain improvement programme increased L-asparaginase activity 1.65 times with respect to the parent wild strain

Dr.p.v.kamala kumari

A huge number of embedded devices offer their services to the end users in pervasive environments. Context-aware discovery is a rich and very dynamic system extensively applied for combining the different mobile devices, sensors, actuators and software functions. Existing knowledge-based system using the Common KADS (CKADS) system represent contextual information but algorithm are not effective in predicting the user behavior. Current Location-aware Private Service Discovery (LPSD) considers the discovery path for reducing the distributed topology and flooding operations. LPSD in pervasive environment is not effective in accurately locating the required service by searching method. To present an architecture principle for accurately predicting the user behavior in mobile-pervasive computing environment, Affluent Context Aware Systems based on the User Behavior (ACAS-UB) is proposed in this paper. ACAS-UB mechanism contains the class of mobile devices that can sense (i.e.,) search the physical pervasive environment. Affluent means effectively engaged mobile devices in ACAS-UB mechanism which uses the context information. The ACAS-UB context information contains the judgment of the similar users and also the response from the other users for improving the effectiveness in pervasive environment user behavior prediction. Master-slave concept is used in the ACAS-UB mechanism for the easy collection of response information from the different users. ACAS-UB mechanism construct the user profile initially from the context information, then performs the similarity measure and finally work is to predict the user behavior. ACAS-UB mechanism provides the hints which are necessary to explore different options, rather than just limiting the options in mobile-pervasive computing environment. ACASUB mechanism is experimented on the factors such as message overhead in pervasive environment, scalability and approximately 10 % lesser processing time.

Dr h shaheen

Diabetes is a global issue, the diabetes epidemic is expected to continue, and the burden of diabetes causes catastrophic expenditure for healthcare system. The current study aimed to determine the presentation, the clinical feature and cardio-vascular risk factors in patients with diabetes. A retrospective observational study had been conducted in out-patients department at Almustaqpal Almosherq Centre during September, 2013 till September, 2020, the total number of attended out-patients department were 1 024, 820 patients who were selected for this study. A special perform was completed for every patient, which included details about patient’s demographics, points in clinical history, relevant investigations and clinical examinations were recorded. The study reported that out of 820 patients, 66% (n = 538) was female and their age range was between 14 - 87 years with a mean age of 56.53 ± 13.49 years, 96% (n = 791) were clinically diagnosed as type II diabetes, 07% of the patients were diagnosed as pre-diabetes, the duration of diabetes ranged from newly diagnosed to more than 10 years, with 46% (n = 379) of the studied population were more than 10 years diabetes duration, 70% (581) were presented with classical symptoms of diabetes. Initial treatment for diabetes also different in the studied sample, were absent of anti-diabetic medications in 30% (n = 248) of the patients, they refused to start glucose lowering drugs, 34.6% (n = 284) of them have morbid obesity (body mass index is more than 40), 80% (n = 662) have high HBA1c (more than 8 g%), 40.3% (n = 240/596) were uncontrolled hypertension on anti-hypertension drugs, 95.6% (n = 682/713) were controlled on treatment of lipid lowering drugs. This study showing the presentation of diabetes were the common, type II diabetes, at age group between 41 - 66 years about 65%, female sex, with high body mass index, high glycated hemglobulin and uncontrolled hypertension. There is concern that diabetic patients were occurring at a high frequency in younger adults, where longer duration of illness could increase the risk of developing more complications in later life. The rate of coexist cardiovascular risk factors (hypertension, dyslipidaemia and obesity) in Libyan patients with diabetes is highlighted.

Mediterranean journal of pharmacy and pharmaceutical sciences

Background and Objective: Health care workers (HCWs) are at the highest risk of contracting COVID-19, so their knowledge about the disease and their preventive attitude and practice toward COVID-19 are of concern. The present study aimed to assess the knowledge, attitudes, and practices of HCWs toward COVID-19 in Al-Thawra Hospital, Ibb Governorate, Yemen. Materials and Methods: We conducted a cross-sectional survey among HCWs in Al-Thawra Hospital, Ibb, Yemen, from January 1 to March 31, 2022. Results: Of the 80 participants, 50 (62.5%) were males and 30 (37.5%) were females with a mean age of 29.33±7.86 years. About 51.2% of respondents were aware that sneezing is a recognized symptom of COVID-19, while most were unaware of the extrarespiratory symptoms of the disease, such as diarrhea and confusion. About 28.7% of respondents believed that eating or contacting wild animals would result in infection by the COVID-19 virus, with the majority (71.3%) agreeing that wearing a well-fitting face mask effectively prevents COVID-19 infection. Approximately 48 respondents (60.0%) believed that washing hands could prevent contracting COVID-19, and only 31 (38.7%) agreed that if a patient shows signs and symptoms of COVID-19, they can confidently participate in that patient’s treatment. In response to avoid COVID-19, about 23 respondents (28.7%) had always gone to crowded places, and 35 (43.6%) had always worn face masks at every contact with patients, while only 14 (17.5%) of participants refrained from shaking hands and 37 (46.3%) always washed their hands before and after handling each patient. Conclusion: This study showed that most respondents have poor knowledge regarding the clinical picture of COVID-19 and its mode of transmission as most of them failed to detect an extrapulmonary manifestation of COVID-19 and were unaware of the possibility of transmission of the disease from wildlife. In addition, the attitude and preventive practice of the respondents were unsatisfactory in containing the transmission of the disease.

Karishma

The Performance Management System is considered as most important system in organization. HR Analytics in Performance Management helps to understand better what is required among their Employees to increase Productivity and ultimately improves the employee Performance. HR Analytics is a method used to measure and organize information related to employee that give clean insights about the performance and productivity of an employee. It also helps the Organisations to maintain record and analyse information of specific employee with specific skill sets, this helps in cost reduction, optimizing recruitment and improving talent quality. For every organization, their employees are very precious asset. Thus, it is extremely essential to analyse, assess, and predict employee requirements. In this Modern Era measuring the performance of employees in IT Companies is a great task. This paper highlights the importance of Performance management in organisation and its influence on employee’s better performance, job achievement and work life balance.

Js

Tuberculosis (TB) is an infectious disease caused by bacteria called Mycobacterium tuberculosis. The disease mainly affects lungs and causes pulmonary tuberculosis. It can also affect intestine, meninges, skin, bones and other tissues of the body. Although the drugs alone can cure TB, it still remains a major public health problem worldwide. The aim of the study was to assess the quality of life and medication adherence in TB patients. The Quality of life was assessed using SF-36 in patients receiving DOTS treatment in initial or continuous phase while the medication adherence was analyzed using Morisky Green Levine Scale. Subjects were also counselled about their disease during their first visit and a follow up was done after a month. A total of 152 subjects were enrolled in the study of which majority of the subjects had Pulmonary TB (55.26%). Diabetes was found to be the most common comorbidity followed by HTN. The average Physical Component Summary (PCS) and Mental component summary (MCS) were found to be 44.34 and 39.60 respectively. Females had a better quality of life scores compared to males. High adherence was seen in 32.24% of patients while 28.29% had low adherence. Follow up was done for 135 subjects. 15 subjects defaulted and 2 of them died. There was a significant increase in the QoL scores and medication adherence after one month. A significant association was found between the Physical functioning (p=0.001) and emotional wellbeing (p=0.01) with Duration of treatment indicating that subjects who had completed more than one month of their treatment had marked improvement in Physical functioning and emotional well-being scores

Dr mahendrakumar r

In the world of yoga there are ―Eight limbs path‖ which helps in different aspects like coordination of body and mind and helps to create positivity of mind and help the body healthy and fit by which the functioning of the body improves. In today‘s modern life various type of disease and deformity takes place most of the things takes place due to unbalanced food, & other. The mind is always wondering and being rebellious, never focusing on the moment. It is the mind job to think, it is relentlessly interpreting everything. That is seen, perceived and experienced and this pattern of habit goes through change to behavior and attitude. Many people who practice yoga do so to maintain their health and well-being, improve physical fitness, relieve stress, and enhance quality of life. In addition, they may be addressing specific health conditions, such as back pain, neck pain, arthritis, and anxiety. Basically yoga has been more effective than control and waitlist control conditions, although not always more effective than treatment comparison groups such as other forms of exercise. More randomized controlled studies are needed in which yoga is compared to active exercise groups. Having established the physical and mental health benefits of yoga makes it ethically questionable to assign participants to inactive control groups. Shorter sessions should be investigated for cost-effectiveness and for daily practice.

Yatendra sharma

The soil samples were collected from Melia dubia plantations in two different locations in Tamil Nadu. A total of twenty five actinomycetes isolates were isolated and they were screened for melanin pigment production using different culture media. Only two isolates were able to produce melanin pigment under in vitro study and one isolate showed positive reaction to L-tyrosine substrate. Based on morphological and bio-chemical characters the isolate was identified as Streptomyces sp. The DNA of the isolate was isolated and its 16S rDNA gene was amplified and sequenced. The phylogenetic analysis of Streptomyces puniciscabiei was carried out.

Dr. saranya devi k

The construct of Leadership entails the process of influencing other people to accomplish specific objectives. However, like love, the construct of Leadership is a universal desire that is virtually difficult to define explicitly (Klingborg, Moore and Varea-Hammond, 2006, p.280). It is characterised by the idea of an individual charisma capable of recruiting followers towards his or her path, promoting team-based problem-solving. Conversely, the concept of Leadership is based on many factors such as; "leaders are made not born", "he was a leader since he was a kid" and "if you have the will power, you can become an effective leader" (Klingborg, Moore and Varea-Hammond, 2006, p.280). However, scholars and organisations tend to focus on Leadership and how leaders impact an organisation. The leadership process entails how an individual influences other(s) to achieve a common goal or mission.

Zamzam abdelazim