Background: The outpatient parenteral antibiotic therapy (OPAT) service is becoming increasingly popular worldwide due to its efficacy, safety, and cost-effectiveness. It is considered as an alternative to hospital treatment. However, these services have not yet become an integral part of the healthcare system in Saudi Arabia. The present study is intended to estimate the 30-day readmission rate of OPAT patients, estimate healthcare costs in OPAT services, evaluate patient and family satisfaction, and evaluate catheter-related complications. Methods: In this retrospective study, at the Prince Sultan Military Medical City (PSMMC), 80 patients aged ≥3 months to <14 years, stable and kept only for the completion of IV antibiotics were recruited between the period of November 2020 to October 2023. Data on demographic characteristics, antibiotics used, improvement rate, patient satisfaction and cost-effectiveness were collected. Results: Significant variations in medical cases are observed, with notable fluctuations in UTI cases and consistent reporting of other medical conditions across the years. Antibiotic usage patterns also vary, with some antibiotics increasing in usage over time. Cost-saving analyses reveal substantial saving associated with outpatient parenteral antibiotic therapy (OPAT) compared to inpatient care, highlighting OPAT's cost-effectiveness. Inferential findings confirm significant differences in the distribution of medical cases and antibiotic usage across the years. The study highlighted the importance of OPAT in providing patient-centered care and managing healthcare expenses efficiently. Conclusions: Our study demonstrates that OPAT is a reliable and cost-effective service. It can reduce the direct cost of life-threatening infections compared to completing the course as an in-patient case. We have saved 93.48% of the overall estimated hospital expense through providing OPAT service.

This study aimed at finding out whether chronic consumption of oxidized palm oil affects the expression and/or activity of the renal transport proteins involved in the transportation of the electrolytes and glucose. 20 male Wistar rats weighing 120-140gms at the beginning of the experiment were randomly divided into four groups namely: control group, fresh palm oil diet-fed group (FPO); photoxidized palm oil diet-fed group (PPO), and Thermoxidized palm oil diet-fed group (TPO). The control group received normal rat chow while the oil-fed groups received 15% of the respective palm oil diet regimen in addition to tap water for 90 days. After 90 days, the animals were sacrificed, and blood samples collected while the kidneys were excised for biochemical analyses. Results showed that aldosterone levels in the PPO and TPO were significantly (P<0.01 and P<0.001 respectively) higher than that of control with the levels in the TPO being significantly (P<0.001) higher than PPO. Na+/K+ATPase and H+/K+ATPase activities were significantly (P<0.01; P<0.001, P<0.001) higher in FPO, PPO and TPO compared with control; with the Na+/K+ATPase activities in TPO being significantly (P<0.001 and P<0.05) than FPO and PPO respectively; while K+/H+ATPase activities in TPO were significantly (P< 0.001; P<0.001) higher than FPO and PPO respectively. SGLUT2 concentration in PPO was significantly(P<0.001) lower than control and FPO; and significantly (P<0.001) lower in TPO when compared with control and PPO and FPO. Therefore, chronic consumption of photo-and thermoxidized palm oil diets increases Na+/K+ATPase, and H+/K+ATPase activities, aldosterone levels but lowers SGLUT2 levels in Wistar rats.

Background and Objectives: Our study aims to discover the relationship between forward head posture and to see the impact of increased levels of stress on performing activities of daily living. Material & Methods: 273 participants from Suresh Gyan Vihar University aged 20-45 years were included in this study using a convenient sampling method for data collection Three Outcome measures were used the ON protractor Smartphone Application to determine craniovertebral angle, Perceived stress scale for stress level and Northwick pain rating questionnaire for activities of daily living. Result: In this present study we have found that 86% of young adults both females and males are affected by forward positions working more than 3 hours on electronic gadgets or continuously working in a posture Our analysis shows a significant relationship between forward head posture and perceived stress with a p-value of (P 0.001). Conclusion: Our study confirms the relationship of Forward head posture with perceived stress and activity of daily living by promoting postural awareness we can prevent further postural deformities and improve their quality of life.

Cirrhosis is characterised by the formation of regenerative nodules in liver parenchyma surrounded by fibrous septa due to chronic liver injury. It occurs due to necrosis of liver cells followed by fibrosis and nodule formation. Cirrhosis is the final stage of chronic liver disease and has many causes including viral hepatitis, excessive alcohol intake and non alcoholic steatohepatitis. Liver cirrhosis effects the quality of life and patient survival. Cirrhotic patients are in need of early diagnosis and careful follow up to prevent further complications.This review article covers the clinical aspects of cirrhosis and its management strategies.

Background: Obstructive sleep apnea (OSA) is a prevalent and potentially serious condition in children, with significant implications for health and development. Limited data exists on the prevalence and management of OSA in Saudi Arabian children. Objective: To study the prevalence and management of OSA in children residing in Saudi Arabia. Methods: An extensive search of PubMed, Web of Science, Scopus, and Science Direct was performed to locate relevant material. Rayyan QRCI was used to select the eligible articles. Results: Our data includes eight articles with 2619 children, 1254 (47.8%) of whom were males. The prevalence of OSA in Saudi children ranged from 6.6% in school children to 50% in children with SCD, with a total prevalence of 208 (9.9%). Adenotonsillectomy (AT) successfully and effectively managed OSA and lifestyle modifications improved the outcomes of AT. Anti-inflammatory therapy with a combination of nasal steroids and anti-leukotriene significantly lowers the adenectomy rate. Some orthodontic evaluation and orofacial morphology were significantly associated with a higher incidence of OSA. Conclusion: The prevalence of OSA in Saudi children is generally low but rising among children with SCD. AT and lifestyle modifications can reduce the severity and symptoms of sleep apnea in Saudi children with OSA. Anti-inflammatory and steroid therapy was reported to decrease the rate of implementing AT. Certain craniofacial traits were more common, but not consistently, in a subset of juvenile OSA patients. Effective care necessitates a comprehensive approach that includes early detection, surgical and non-surgical procedures, and addressing underlying risk factors like obesity and allergies. By addressing current hurdles and utilizing future research, Saudi Arabia's healthcare system may enhance the quality of life for children with OSA.

Objectives: To assess the effectiveness of different types of physical activities (e.g., weight-bearing exercises, resistance training, aerobic exercises) in preventing osteoporosis in postmenopausal women. Methods: A comprehensive computerized search of pertinent databases was conducted in order to find studies that satisfied the inclusion requirements. To find pertinent information, a thorough search of PubMed, SCOPUS, Science Direct, and Web of Science was conducted. Results: Our data included seven trials with 30,728 women. Each study included a different exercise program, such as walking impulse, general regular exercise, aerobic exercise, and multipurpose exercise. Frequent regular exercise for a longer duration (>1 h) had considerably stronger preventative benefits for postmenopausal osteoporosis. The multifunctional exercise regimen described here had a positive impact on specific musculoskeletal, BMD, body composition, and cardiometabolic endpoints. After a meal, 45 minutes of suprathreshold speed-enhanced accelerated walking on level ground can prevent or mitigate postmenopausal osteoporosis in stationary women. Hormone replacement therapy and aerobic exercise can raise vertebral bone mineral density. Conclusion: For postmenopausal women, physical activity is a crucial non-pharmacological intervention in preventing osteoporosis. Personalized exercise prescriptions are necessary, nevertheless, as evidenced by the variation in the efficacy of various exercise regimens. Subsequent studies have to persist in refining our comprehension of the ideal workout plans for averting osteoporosis and tackling the obstacles associated with consistency and durability.

International Medical School (IMS), Management and Science University, Malaysia Pregnant mothers with uncompleted pregnancies should be encouraged to perform physical exercises. Aerobic and muscle strengthening exercises are beneficial in pregnancy [1].

This study examined the relationship between supplier relationship management and the effectiveness of firm's supply chain of selected manufacturing in Port Harcourt. Correlational survey research design was adopted for this study as this study seek to determine the relationship between the two variables. The population of this study is thirty-two (32) manufacturing companies in Rivers State which are registered with the Rivers State branch of Manufacturers Association of Nigeria (MAN). There are only 32 registered firms with MAN in the State. With regard to the respondents of the study given the strategic nature of the study, three key managers (production manager, marketing manager and logistics manager) were chosen as respondents from each using simple random sampling of the thirty-two firms constitute the study subject. This gave us a total of ninety-two (92) for the study. Structured questionnaire instrument title” Supplier relationship management and effectiveness questionnaire was developed on five-point likert scale. The result of the Cronbach's Alpha reliability test indicates .800 which is above .70 which implies that the items are reliable. Pearson product moment correlation was used to test the hypotheses using SPSS (statistical package social sciences). The study revealed that there is a significant relationship between Collaborative Supplier Relationship Management and Effectiveness of Firm's Supply Chain of selected manufacturing firms in Port Harcourt. There is a significant relationship between Transactional Supplier Relationship Management and Effectiveness of Firm's Supply Chain of selected manufacturing firms in Port Harcourt. There is a significant relationship between Strategic Supplier Relationship Management and Effectiveness of Firm's Supply Chain of selected manufacturing firms in Port Harcourt. The study concluded that Supplier Relationship Management (SRM) plays a crucial role in enhancing the effectiveness of a firm’s supply chain, particularly in the manufacturing industry. In Port Harcourt, Nigeria. The study recommended that manufacturing firms should focus on building long-term strategic partnerships with key suppliers based on trust, mutual benefit, and shared goals. This can help in aligning interests, fostering innovation, and creating a competitive advantage.

The past ten years have seen significant expansion in the aviation sector, which during the previous five years has steadily pushed emerging countries closer to economic independence. It is crucial to accurately forecast the potential demand for air travel to make long-term financial plans. To forecast market demand for low-cost passenger carriers, this study suggests working with low-cost airlines, airports, consultancies, and governmental institutions' strategic planning divisions. The study aims to develop an artificial intelligence-based methods, notably fuzzy inference systems (FIS), to determine the most accurate forecasting technique for domestic low-cost carrier demand in Bangladesh. To give end users real-world applications, the study includes nine variables, two sub-FIS, and one final Mamdani Fuzzy Inference System utilizing a Graphical User Interface (GUI) made with the app designer tool. The evaluation criteria used in this inquiry included mean square error (MSE), accuracy, precision, sensitivity, and specificity. The effectiveness of the developed Air Passenger Demand Prediction FIS is assessed using 240 data sets, and the accuracy, precision, sensitivity, specificity, and MSE values are 90.83%, 91.09%, 90.77%, and 2.09%, respectively.

Myocardial infarction resulting from coronary embolism is a rare type of acute coronary syndrome, often going unnoticed. Distinguishing it from acute coronary syndromes arising from atherosclerosis is important, as it significantly influences the treatment approach. It is frequently associated with conditions that increase the risk of thromboembolism, such as infective endocarditis, atrial fibrillation, mitral valve disease, neoplasia and cardiac surgeries. We would like to present a case of coronary embolism involving a 42-year-old male with a history of rheumatic valve disease and atrial fibrillation who was admitted for acute chest pain. The diagnosis was confirmed through coronary angiography.

Introduction: Acute pancreatitis is an acute inflammatory condition of the pancreas involving varying degrees of regional tissues and distant organ systems. This study aims to investigate the clinical presentations and risk factors associated with acute pancreatitis to enhance understanding and guide more effective management strategies. Aim of the study: The aim of this study was to evaluate the clinical presentation and risk factors associated with acute pancreatitis. Methods: This retrospective study was conducted at Holy Family Red Crescent Medical College Hospital, Dhaka, from July 1, 2021, to December 31, 2023, spanning 2.6 years. The study included 42 consecutive patients diagnosed with acute pancreatitis. Data were collected by reviewing patient records for demographic details, clinical presentations, etiological factors, complications, and outcomes. Statistical analyses were conducted using SPSS version 23, with categorical variables expressed as numbers and percentages. Result: The majority of the 42 patients included in the study were within the age group of 20-39 years, 24 (57.14%) patients The most common clinical presentation was abdominal pain, reported by 40 (95.24%) patients. Biliary causes, including gallstones and common bile duct stones, were identified as the predominant etiology in 27 (64.29%) patients. Complications included necrotizing pancreatitis in 4 (9.52%) patients. Regarding outcomes, 27 (64.29%) patients recovered and were discharged. Conclusion: Effective management, emphasizing early diagnosis and treatment, is crucial for reducing the morbidity and mortality associated with acute pancreatitis.

Purpose: This study highlights the clinical and radiological challenges in distinguishing ovarian malignancy from pelvic tuberculosis (TB), underscoring the need for precise diagnosis and appropriate treatment. Background: Pelvic TB, a rare extrapulmonary form of tuberculosis, presents diagnostic challenges, particularly in developed countries where it is less prevalent. Its symptoms, including chronic pelvic pain, menstrual irregularities, and adnexal masses, can mimic those of ovarian cancer, leading to potential misdiagnosis. Although TB is uncommon in developed nations, it remains a significant global health issue, particularly affecting individuals from endemic regions. Pelvic TB typically spreads to reproductive organs through lymphatic dissemination, direct extension, or hematogenous routes. Case Presentation: A 46-year-old woman presented with abdominal pain, abnormal vaginal bleeding, breathlessness, weight loss, and night sweats. She had a history of lung sarcoidosis, recurrent chest infections, and prior TB exposure. Initial imaging suggested advanced ovarian malignancy, but an omental biopsy revealed granulomas consistent with sarcoidosis. Further tests confirmed disseminated TB, and the patient underwent a 9-month course of anti-tuberculous therapy, which resolved most disseminated TB lesions. However, a persistent complex pelvic cyst required conservative follow-up. Conclusion: Although pelvic TB is rare in developed countries, it should be considered in the differential diagnosis of pelvic masses with ascites and elevated CA 125, especially in patients with recurrent chest infections and TB exposure.

In the context of the energy transition, optimizing photovoltaic solar systems with charge controllers plays a crucial role in managing the energy produced by solar panels and its storage in batteries. Two dominant technologies are used in this field: MPPT (Maximum Power Point Tracking) and PWM (Pulse Width Modulation). This paper presents an in-depth comparative study of these two technologies, focusing on their efficiency, cost, and suitability for small-scale solar installations, particularly in rural African contexts where budget constraints are significant. The study begins with a detailed literature review, analyzing the operating principles of MPPT and PWM controllers, their respective advantages and disadvantages, and performance under various environmental conditions. Previous studies are examined to identify the conditions under which each type of controller offers the best performance. Empirical data and existing case studies are reviewed to establish a solid comparison base. This analysis is accompanied by tables and graphs illustrating the performance of both types of controllers. Based on the results of this analysis, the paper proposes the design of a PWM charge controller suitable for small solar installations in rural areas with budget constraints. This solution aims to promote energy accessibility while minimizing costs, offering a viable alternative for rural communities with limited resources.

The remarkable progress in nanotechnology in the last several decades has drawn attention to nanoparticles (NPs) and their characterization, synthesis, and applications. This phenomenon is caused by changes in the mechanical, chemical, and physical properties of the materials on this scale, including their optical properties, thermal conductivity, and melting point. Since many procedures for producing metal nanoparticles need high temperatures and harsh chemical conditions, scaling them up for large-scale manufacture can be challenging. Generally, there are two primary methods for synthesizing nanomaterials: the bottom-up method and the top-down method. A spinning disc reactor (SDR) is used in the spinning-assisted production of nanoparticles. Carbon fullerenes are spherical cages that contain anything from 28 to over 100 carbon atoms. Because of the way they interact with carbon to generate hexagons and pentagons, which result in hollow balls, they resemble soccer balls. The chemical or elemental makeup of nanoparticles directly affects their purity and functionality. The efficiency of the nanoparticle may decline if there is a rise in secondary or undesired materials present, since this might also result in secondary reactions and contamination throughout the process. Although they are commonly supplied as dispersions in different media, including glasses or liquid solvents, they may also be produced in the gas phase to create aerosols. When gold nanoparticles are exposed to a particular wavelength of light, the light's oscillating electromagnetic field causes the free electrons to collectively oscillate coherently. The nanoadsorbents are particularly effective in reducing pollutants, and very little nanoadsorbent is needed to absorb the pollutants' components.

This research examined the impact of students' characteristics and their perceptions about learning environment on mathematics and science achievement. It specifically aimed to demystify the effect of gender, economic, social and cultural status, immigrant background, teacher feedback, teacher support, exposure to bullying, and disciplinary climate on on mathematics and science achievement. Furthermore, it reanalyzed the results of the 2018 PISA-Saudi Arabia. Economic Social and Cultural Status, Gender, Teacher Support, and Immigrant Background found to have an influence on mathematics and science achievement. The study recommended that educational institutions in Saudi Arabia should pay attention to gender differences and the economic, social and cultural status, and immigrant backgrounds of students.