This study investigated the performance of Celtis zenkeri exudates in preventing galvanised steel exposed to acid concentrated water and soil. The study was performed in order to find an alternative coating substance that can reduce the corrosion of galvanised steel pipes exposed to corrosive water and soil media. Various steel specimens were cut into portions and coated with the exudates at 25 - 50µm thickness. To accelerate the rate of corrosion, 0.5M hydrochloric acid (HCl) was added to tap water in a container. Also, the same concentration of HCl was equally added to soil samples. Uncoated steel specimens were immersed in the acid concentrated water and soil, servicing as control sample. The rate of corrosion was monitored for 30 days (720 hours). The inhibition efficiency of the exudates for both corrosive media was compared. Results showed that the weight loss and corrosion rate of galvanised steel decreased with increase in coating thickness. Comparatively, the weight loss and corrosion rate in the uncoated specimens were higher than the coated specimens. With 25 - 50µm coating thickness, the decrease in corrosion rate ranged from 0.01272 to 0.0027mm/yr for specimens immersed in water and from 0.2226 to 0.0185mm/yr for specimens buried in soil, while for uncoated specimens, the corrosion rate was 0.2793mm/yr and 0.4150mm/yr for specimen immersed in water and soil respectively. The inhibition efficiency of Celtis zenkeri exudates increased with coating thickness, which ranged from 54.46 – 99.03% for specimens immersed in water and 46.36 – 95.54% for specimens buried in soil at 25µm – 50µm coating thickness. The results demonstrated that Celtis zenkeri exudates can be used as corrosion inhibitor for steel exposed to corrosive media.

Background: Polypharmacy, the concurrent use of multiple medications by an individual, presents challenges in medication management, patient safety, and healthcare outcomes, particularly among older adults. In Saudi Arabia, the prevalence of polypharmacy is increasing due to the aging population and the burden of chronic diseases. Understanding healthcare providers' awareness and practices regarding medication switching is crucial for optimizing medication use and improving patient outcomes. Study Aim: This systematic review aims to synthesize and analyze existing literature on healthcare providers' awareness of medication switching for polypharmacy patients in Saudi Arabia. The study focuses on pharmacists and physicians, exploring their knowledge, attitudes, and practices related to medication management, deprescribing, pharmacovigilance, and Medication Therapy Management (MTM) services. Methodology: A systematic search was conducted across major databases, including PubMed, Scopus, and Google Scholar, using predefined search terms related to polypharmacy, medication switching, healthcare providers' awareness, and Saudi Arabia. Eligible studies were selected based on inclusion criteria, including study design, setting, participants, and relevance to the study aim. Data extraction and synthesis were performed to analyze key findings and themes related to healthcare providers' awareness of medication switching. Results: Six eligible studies were included in the systematic review, encompassing survey-based investigations, cross-sectional studies, and qualitative studies conducted in various healthcare settings across Saudi Arabia. The findings revealed gaps in pharmacists' and physicians' knowledge regarding Potentially Inappropriate Medications (PIMs), Drug-Drug Interactions (DDIs), pharmacovigilance practices, and deprescribing strategies. Recommendations for improving pharmacists' education, enhancing pharmacovigilance practices, and promoting collaborative care models were highlighted. Conclusion: Healthcare providers in Saudi Arabia demonstrate varying levels of awareness and practices regarding medication switching for polypharmacy patients. There is a need for targeted educational interventions, standardized pharmacovigilance practices, and collaborative efforts among healthcare providers to optimize medication use, reduce polypharmacy-related risks, and improve patient outcomes.

Background: Typhoid fever, caused by Salmonella typhi and Salmonella paratyphi, infects various organs after entering the bloodstream. It typically presents with headache, fever, splenomegaly, abdominal pain, and leucopenia, among other symptoms. Globally, it affects 11-21 million people annually, causing 120,000-160,000 deaths, with Southeast Asia being the most impacted region. Improved water, sanitation, and hygiene (WASH) practices are crucial for prevention, alongside targeted public health strategies in endemic regions like Bangladesh. Aim of the study: The study aims to identify demographic risk factors associated with typhoid fever in Bangladesh. Methods: This cross-sectional observational study was conducted at the Department of Medicine, North Bengal Medical College Hospital, Sirajganj, Bangladesh, over 12 months. We included 72 patients presenting with fever, headache, and abdominal pain, with positive blood culture reports for Salmonella typhi and Salmonella paratyphi, aged 18 years and above, who provided informed consent. Excluded were patients on antibiotics and those with multiple blood culture samples. A short questionnaire, validated through a pilot study, captured demographic and clinical data. Result: Mostly 76.39% of participants were aged 18-45. Males comprised 58.33% of participants, and females 41.67%. Occupationally, 48.61% were civil servants, 16.67% housewives, 13.89% students, 12.50% businessmen, and 8.33% farmers. Socio-economically, 16.67% were upper class, 37.50% middle class, and 45.83% lower class. Urban residents made up 40.28% and rural residents 59.72%. All participants had a fever, with other symptoms including headache (69.44%), abdominal pain (48.61%), vomiting (20.83%), coated tongue (27.78%), and constipation (61.11%). Conclusion: This study examines factors influencing enteric fever in Bangladesh, noting higher prevalence among males aged 18-45 due to occupational risks. Lower socio-economic status and rural living also increase risk, highlighting healthcare disparities. Common symptoms included fever, headache, and abdominal pain. Improving sanitation and targeting high-risk groups can reduce incidence.

We assessed the ameliorative effect of Virgin Coconut Oil (VCO) following atrazine-induced inflammation in rats. Adult male Wistar rats weighing 180 - 200 g body weight were separated into two major experimental groups. 35 rats in the test group were divided into five groups of 7 rats: Group 1,2 and 3 received 10 ml/kg body weight of distilled water, 10 ml/kg VCO and 123 mg/kg Atrazine (ATZ) respectively, group 4 was diabetic control and group 5 was diabetic group treated with 10 ml/kg of VCO for 2 weeks, after which the animals were sacrificed, and blood collected for analysis. 35 rats for the recovery group were also divided into 5 groups of 7 rats; group 1 and 2 received 10 ml/kg body weight of distilled water and 10 ml/kg of VCO; group 3,4 and 5 received 123 mg/kg of ATZ for 2 weeks. After the first 2 weeks, group 1,2,3 continued the initial treatment while the rats in group 4 and 5 were administered 10 ml/kg of VCO and 10 ml/kg of distilled water respectively. After 2 weeks all the animals were sacrificed and blood collected for analysis. C-reactive protein (CRP) and interleukin 6 (IL-6) were significantly (p<0.05) raised in VCO control, atrazine and diabetic untreated group when compared to normal control. Following recovery, CRP and IL-6 were significantly lowered in the VCO treated group when compared to ATZ group. ATZ toxicity resulted in increase in inflammatory markers but the withdrawal of ATZ significantly reversed some of these derangements; with more pronounced effect following VCO administration.

Extremely wide bony ridges require surgical procedures in order to insert dental implants. When less than 3 mm is present, different procedures are available, with ridge splitting being one of the most commonly used. The main limitation of this procedure is the angulation of the inserted implant. The two-stage split with transitional implants was created to overcome this drawback and achieve greater bone volume in the intervention area. This case series shows patients treated with this novel procedure. Material and Method: We retrospectively analysed patients who had undergone two-stage ridge expansion (using transitional implants) with at least 9 years of follow-up from the loading of the definitive implant, both in the maxilla and mandible. Data collection was performed by two independent examiners (different from those performing the prosthetic or surgical phase). All data were entered into a database which was managed by computer for the subsequent statistical analysis. The implant was the unit of analysis for descriptive statistics in terms of location, implant dimensions, and radiographic measurements. The primary variable was implant survival and as secondary variables mesial and distal bone loss and final bone crest width achieved after transitional implant integration, before replacement, were recorded. Results: Thirteen patients were recruited, and 30 transitional implants were inserted for width expansion in two surgical stages. These transitional implants were subsequently replaced by definitive implants at 5 months in the maxilla and at 3 months in the mandible. The mean initial ridge width of all two-stage split sites was 2.65 mm (+/- 0.63), range 1.32 to 3.70 mm. After placement of the transitional implants and bone healing, the final mean width of the specimen was 7.60 mm (+/- 0.26), range 4.31 to 12.20 mm. The mean mesial bone loss after loading of the final implant was 0.80 mm (+/- 0.26) and the mean distal bone loss was 0.85 mm (+/- 0.25). Conclusion: The two-stage split technique to achieve a gain in width of the residual bone crest is minimally invasive, predictable and the implants placed in the final (definitive) stage have a high survival rate, as we have seen in the present study with 9 years of follow-up.

Soil salinity poses a significant constraint on plant growth and productivity of maize. Salinity causes reduction in water content in plant tissues, ultimately reducing the photosynthetic capacity and resulting in decreased productivity. Normally in saline soils, chloride ions (Cl−) are particularly considered toxic to certain crops, but in case of maize, sodium ion (Na+) is the main ion responsible for toxicity due to its competition with K+ for binding sites at the plasma membrane. Mycorrhizoremediation which is an enhanced form of phytoremediation is one of the key players in remediation saline soils. Inoculation of these beneficial arbuscular mycorrhizae fungi can alleviate growth inhibition and the adverse effects of salinity in both halophytes and glycophytes by establishing symbiotic relationships with plants. AM fungi colonize the roots of maize plants, perform a crucial role in nutrient cycles in terrestrial ecosystems and own highly efficient and various mitigation mechanisms. Under saline conditions, AM fungi restrict the absorption and translocation of Na+ to shoot tissues and enhance the uptake of K+ in plants. An experiment aiming to enhance salt tolerance in maize through AMF symbiosis was conducted. In this experiment three AMF were evaluated at two salinity levels 66 mM and 100 mM. analysis of data revealed that AMF Ri collect showed showed highest percentage of root colonization at all salinity levels. While plants inoculated with AMF Ce CdG showed highest shoot and root biomass. Furthermore, plants inoculated with Sc CdG and Ce CdG showed a significant reduction in Na+ accumulation and enhance K+ accumulation in shoot and root tissues as compared to non-mycorrhizal plants.

Introduction: Immunotherapy is a form of oncologic treatment directed towards enhancing the host immune system against cancer. Immunotherapeutic agents were significantly associated with a higher risk of developing adverse effects in cancer patients. Bevacizumab was significantly associated with higher risk of developing venous thromboembolism, GI perforation such as bleeding and leukopenia in cancer patients. Trastuzumab has led to a significant improvement in the treatment of both advanced and early breast cancer by over expressing HER-2 receptors. It was associated with an important adverse effect, cardiotoxicity. Cetuximab and Panitumumab are monoclonal antibodies targeting the endothelial growth factor receptors (EGFR) currently used for systemic treatment of metastatic colorectal cancer in combination or alone have been reported to be able to induce skin toxicities. Nausea, diarrhea and rash were the most common adverse effects in Pertuzumab alone and Pertuzumab – based therapies. Pertuzumab also increases the risk of clinical heart failure, but not asymptomatic/minimally symptomatic left ventricular systolic dysfunction, in HER2-positive cancer patients. Materials and Methods: An ambispective observational single center study was conducted by collecting details of patients prescribed with Trastuzumab, Bevacizumab Pertuzumab, cetuximab and panitumumab. Retrospective study period of 5 years (2017 November to 2022 November) and Prospective study period of 6 months were conducted (December 2022 to May 2023). Patients of all age groups prescribed with immunotherapeutic agents other than immune checkpoint inhibitors was included and patients who were discharged against medical advice and incomplete data was excluded. Results: Majority of patients in our study were in age groups of 56-65 years with 38.5%. Among 65 patients, 4 of them reported with trastuzumab induced cardiotoxicity and 3 of the patients taking trastuzumab along with pertuzumab also reported with cardiotoxicity. Among 30 patients who were taking bevacizumab, one patient was reported with pneumonitis. We conducted a correlation analysis using chi-square test between study considered drugs and the reported adverse reactions. All of the patients prescribed with Trastuzumab + Pertuzumab were having ADR. Also, majority of the patients prescribed with Bevacizumab were not having ADR. Since the p-value of chi-square test was found to be <0.001 so there exist a significant relation between drugs prescribed and ADR. Conclusion: We assessed the safety profile of immunotherapeutic agents other than immune check point inhibitors in cancer patients. We also correlated the study considered drugs and adverse drug reaction occurrence, there existed a significant correlation.

The phenomenon of suicide is a significant concern for public health globally, as it ranks among the top causes of mortality in different age demographics. The objective of this analysis is to offer a thorough examination of existing strategies for preventing suicide, which include psychological, medical, and community-based approaches. Through evaluating the efficacy of diverse interventions and pinpointing areas that require enhancement, this article aims to contribute to the creation of more comprehensive and all-encompassing frameworks for suicide prevention. The analysis emphasizes the significance of early identification, availability of mental healthcare, and the influence of societal support in reducing the risks associated with suicide.

Enhancing aesthetics, occlusion and functions is a primary motivation for individuals with open-bite malocclusion seeking orthodontic treatment. Open-bite malocclusion, characterized by a lack of vertical overlap of the anterior teeth, can be effectively treated using anterior vertical elastics. It’s a common, non-surgical orthodontic approach to correct open-bite issues. In this case report, we present the treatment of a male patient with anterior open-bite malocclusion. Initially, the patient underwent a lingual frenectomy followed by an active and passive phase of swallowing rehabilitation by wearing a nocturnal lingual envelope (NLE). Subsequently, a fixed orthodontic appliance was bonded to achieve well-aligned arches, normalize the overjet and overbite with the use of anterior vertical elastics (AVE) and enhance both aesthetics and functions.

This study aims to evaluate the effectiveness of applying measures to improve students' positivity during Vovinam lessons at FPT University Ho Chi Minh City (FPT University). Thereby, it serves as a basis for monitoring, adjusting, and changing the content of Vovinam subjects to suit the students being trained in the school. We conducted indirect interviews with research subjects using a questionnaire on a Likert scale (5 levels) to identify difficulties and obstacles while teaching and learning Vovinam. After interviews, 10 possible solutions were selected to put into practice. At the same time, conduct a reality check to understand the change in students' positivity after applying measures to enhance positivity during Vovinam lessons. After the experimental period, it was shown that the positivity (including intellectual positivity; cognitive positivity; learning positivity) of students in the experimental group (experimental group) and the control group (control group) both increased. However, the growth of the experimental group was clearly and statistically significantly higher (with P<0.05) than that of the control group’s.

Black humor emerged as a distinctive fictional genre in the United States in the 1960s. In the creative process, novelists tend to emphasize the unique charm of this genre through the portrayal of anti-heroes. Thomas Pynchon is a forerunner in American black humor novels during the 1960s and 1970s, and his masterpiece Gravity’s Rainbow is an outstanding example of this genre. This article focuses on two representative anti-heroes in Gravity’s Rainbow, Tyrone Slothrop and Roger Mexico. Through a thorough analysis of Pynchon’s humorous descriptions of the difficulties faced by these two characters, the black humor characteristics of this novel are interpreted, and readers can gain a deeper understanding of Pynchon’s creative style and the essence and appeal of black humor.

Introduction: The femoral nerve is one of the vital nerves of the thigh region, which has importance in various fields of clinical areas, as well as in the field of Anatomy and the research areas. Femoral nerve blockade plays an important role in surgical interventions of the anterior thigh. Although the femoral nerve is superficial and easier to identify, a profound knowledge regarding the dimensions of the nerve is inevitable to perform successful surgeries and blockades. Objective: The describing study was an attempt to analyze the different dimensions of the femoral nerve in the thigh region of the Malaysian cadavers with relevant clinical implications, as there is a paucity of these studies involving Malaysian cadavers has been reported. Methods: This study had been conducted with the involvement of 78 adult lower limb specimens (cadaveric and disarticulated) of both genders and different ethnicity. Result: The average length of the femoral nerve from the inguinal ligament (IL) till its division and the width at the IL resembled the previous studies conducted on other geographical locations. The width at the division was similar to that of the IL level. The thickness at the IL was 1.32 ± 0.21 (right) and 1.29 ± 0.17 (left); and at the division was 1.50 ± 0.196 (right) and 1.43 ± 0.16 (left). The circumference of the nerve at the IL was 25.44 ± 1.26 (right) and 25.98 ± 0.89 (left); and that at the division was 25.65 ± 1.32 (right) and 25.66 ± 1.25 (left). Conclusion: The knowledge of the morphometric anatomy of the femoral nerve in the thigh region will not only assist neurologists and future researchers but also facilitate clinicians to prevent misdiagnoses and iatrogenic neurological damage.

Objective study this is for analyze effect of KEMP VINCENT Training on consistency groundstrokes in athletes tennis. Janis research use method experiment. Method study validating with test influence One or more variable than other variables. Study implemented in the field Yogyakarta State University Tennis. Implementation of 16 meetings, with frequency of 4 meetings in One Sunday. Taking sample using purposive sampling. Criteria sample includes; [1]. Players who are still active follow practice [2]. Willing follow all over training given [3]. No in circumstances Sick. Amount population of 20 athletes tennis field selalabora. Instruments / tests use forehand groundstroke test and backhand groundstroke test. The results of the validity and reliability of the backhand groundstroke are 0.895 and 0.925. Value data normality test results significance 5% or 0.05 normally distributed data. Homogeneity test obtained mark significance of 0.694 and 0.617 ≥ 0.05, population own similarity variant or homogeneous. And percentages increase in ability consistency with hasi; 18.3%. So that method Kemp Vincet Rally Tennis training matches for enhancement consistency groundstrokes, there are average increase of the player 's forehand groundstroke and backhand groundstroke scores tennis field selalabora.

Background: A needle stick injury is a serious occupational health hazard in health care settings. Health care workers are at risk of bloodborne diseases and the psychological consequences of these injuries. Objectives: we aimed in this study to assess the prevalence of NSI among health care workers in King Saud Medical City and to assess their knowledge, attitude and practices regarding needle stick injuries. Methods: A cross-sectional study was conducted from 17th August 2022 until 30th November 2023. A structured questionnaire from Saudi Ministry of Health guidelines was used to collect the data. The content validity was evaluated by four academics from King Khalid University in Abha, and some minor changes were made. Results: As regard the prevalence of NSI, out of 220 participants, 132 individuals did not report any needle-stick injuries (NSI). While 92.3% of participants accurately defined NSI and acknowledged blood-borne disease transmission risks, only 39.1% followed preventive measures like recapping needles and proper disposal. There were knowledge gaps observed, with varying awareness levels on Hepatitis B and C prevention. Participants demonstrated awareness of post-exposure guidelines but lacked knowledge on immediate actions to take post-injury. Attitudes towards NSI varied, with a significant percentage 44.1% prioritizing patient care over healthcare worker safety. Interestingly, significant support was shown for immediate reporting of sharp injuries and the belief that NSIs are preventable. In terms of practice, adherence to safe needle practices varied, with the majority 90.9% using assigned disposal containers and being vaccinated against Hepatitis B, but not all receiving recent training on safe devices. Conclusion: This study revealed that NSIs remain a prevalent occupational health hazard among healthcare workers. Although a significant number of participants demonstrated adequate knowledge and awareness of NSIs and bloodborne disease transmission risks, there were noticeable gaps in their implementation of preventive measures and immediate post-injury actions. Attitudes towards NSIs varied, with some prioritizing patient care over healthcare worker safety. However, there was strong support for the immediate reporting of sharp injuries and belief in the preventability of NSIs.

This work was initiated with an objective that would screen for bioactive specifically antibacterial molecules secreted by actinomycetes growing in fresh water pond soil. Actinomycetes being treasure trove of thousands of bioactive molecules. It is recommended that either novel or present day bio molecule derivatives should be detected and pertinent drug development process be carried out with this background this study was proceeded to identify strains of Microbacterium barkeri (LMA4), Corynebacterium argetoratense (LMA5) and Streptomyces shenzhenensis (LMA6) form the local marshy pond soil. The actinomycetes was with Arial mycelia was gram positive with profuse branching. In a test considering MDR strain of Escherichia coli (BME4) and Staphylococcus aureus (BMS4) as test bacteria. The 16s rRNA sequences and the BLASTn analysis helped out to predict the sequence identification as the actinomycetes isolates.