Ulcerative colitis and Crohn's disease have an approximately 2-3-fold increased risk of colorectal cancers. The risk factors most frequently associated with the risk of these cancers in inflammatory bowel disease are those indicative of chronic inflammation, primary sclerosing cholangitis, previous dysplasia, and a family history of colorectal cancers. The pace of CRC surveillance in this population will be determined by the presence of these risk factors, and the surveillance modality is based on colonoscopy with chromoendoscopy and targeted biopsies. In the absence of staining, systematic biopsies can be performed.

The use of performance-enhancing substances (PES) among Mixed Martial Arts (MMA) athletes has been a growing concern in Kenya, driven by the desire to gain a competitive edge. This study explores the knowledge and attitudes associated with the use of PES, traditional herbs, and food supplements among Kenyan MMA athletes. The cross-sectional survey research design allowed for the collection of quantitative data to understand the athletes' perspectives. Participants in the study included MMA athletes from various regions across Kenya, with a target population of 4,000 athletes and a sample of 800 selected through Population Proportionate to Sample (PPS) technique. The research instruments used were questionnaires divided into two sections: Anti-Doping education and beliefs about PES, traditional herbs, and food supplements. Pre-testing ensured the reliability of the questionnaires. Data analysis utilized SPSS version 22, applying descriptive statistics and One and Two-Way Analysis of Variance to examine mean score differences at a 0.05 significance level. Results indicated that the majority of MMA athletes in Kenya are male (79.9%), with an age range of 18 to 54 years and a mean age of 26.8±4.1. Experience in years varied, with Wrestlers having the most years and Taekwondo athletes the least. Knowledge levels were generally low, with Bodybuilders scoring the lowest in a set of 16 Likert scale questions. Misconceptions about the safety of over-the-counter supplements were prevalent, with only 14.8% of athletes believing they were safe. Attitude scores showed that Bodybuilders and Weightlifters had a more favorable view of doping, while female athletes exhibited a significantly higher attitude score compared to males. The study concludes that there is a need for enhanced Anti-Doping education and awareness programs, particularly focusing on athletes with lower knowledge and attitude scores. Recommendations include implementing gender-specific education, promoting gender diversity in MMA, and strengthening collaboration with sports authorities and Anti-Doping agencies.

Introduction: Diabetes is a major cause of death and disability worldwide. It also represents a significant risk factor for stroke. The excess stroke risk associated with diabetes is significantly higher in women than in men, independent of sex differences observed for other major cardiovascular risk factors. Materials and Method: This retrospective descriptive study was carried out in the Internal Medicine department of Point G University Hospital from January 2008 to December 2012. Included in this work were all type 2 diabetic patients hospitalized in the department during the duration of the study, presenting clinical signs of sentivo-motor deficit with performance of a brain CT scan. Results: At the end of this work, 358 patients were hospitalized, among whom 19 cases of established stroke were recorded, i.e. a frequency of 5.3%. Dilated cardiomyopathy represented 36.8% of cases. LVH and repolarization disorders accounted for 21.1% each. Composite ischemic stroke represented 79% of cases followed by mixed stroke or 16% of cases. The evolution was marked by after-effects such as left hemiparesis 36.8%, right hemiplegia 10.5% and death in 5.3% of cases. Dyslipidemia 82%, hypertension 84.21% were the risk factors most associated with diabetes. Conclusion: Strokes are common in type 2 diabetic patients. Their prevention requires better management of diabetes and its associated risk factors.

Basic Education Curriculum Framework (BECF), emphasizes core values such as integrity, respect, and social justice. Despite this focus, there is a concern about the limited awareness and application of these values among learners, leading to a broader issue of inadequate value-based education. The objective of the study was to examine the knowledge and application of values among learners in primary and secondary schools in Kenya, focusing on the curriculum's role in nurturing ethical behavior and responsible citizenship. The study employed a mixed-method approach, incorporating both qualitative and quantitative methods. A cross-sectional survey design was used to collect data from schools across 24 counties, targeting school administrators, teachers, learners, and key informants. The sample included head teachers, teachers, learners, and stakeholders from various community sectors. Data collection instruments included questionnaires, interview schedules, and focus group discussions, with pre-testing to ensure reliability and validity. The main findings revealed that the majority of learners had limited awareness of core values, with integrity (39.9%) and respect (33.3%) being the most recognized. Despite this, learners identified several practical scenarios where they applied values, such as cleaning school compounds and respecting school rules. Teachers emerged as the most significant influencers of learners' values, followed by parents, while head teachers and relatives had a lesser impact. The study also noted that, while teachers and key informants generally agreed on the importance of nurturing values, there was uncertainty about the community's role in promoting them. In conclusion, the study indicates a need for a more integrated approach to value-based education. Recommendations include strengthening the curriculum to emphasize value-based learning, enhancing teacher training, fostering school-community partnerships, promoting consistent reinforcement of values, and implementing ongoing assessment and evaluation mechanisms.

Introduction: Sjögren's syndrome (SS) is a systemic autoimmune disease whose target is the epithelium of the exocrine glands and in particular the salivary glands. SS affects women more often with a sex ratio of 9 women to 1 man and the peak frequency is around age 50. It is mainly described in Western literature where it seems to come second after RA. In Africa, it is mainly reported in the Maghreb. We report a case, revealed by pulmonary damage at the Nianankoro Fomba hospital in Ségou. Observation: This was a patient, aged 50, without any particular ATCD, who had consulted for chronic cough with mucco-purulent sputum and dyspnea, which had been present for more than four (4) months. Faced with the failure of a trial anti-tuberculosis treatment despite the negativity of the sputum testing for BARR in the Pneumophthisiology department, she decided to consult internal medicine. Clinical examination revealed NYHA stage III dyspnea. A chest CT concluded with bilateral pulmonary parenchymal interstitial syndrome associated with inflammatory bronchopathy with bronchiectasis. The immunological assessment revealed positive anti–SSA and anti–SSB Abs. Clinical improvement was obtained after initiation of corticosteroids and immunosuppressants. Conclusion: This observation illustrates the interest of looking for latent SS in the etiological assessment of a persistent cough.

Mixed Martial Arts (MMA) has seen a surge in popularity in Kenya, with athletes from various backgrounds participating in the sport. However, with this growth comes an increased risk of performance-enhancing substances (PES) use. The intense physical demands of MMA may drive athletes to seek an edge through these substances, leading to significant concerns about health risks and sports integrity. The aim of this study is to assess the practices and beliefs regarding PES, traditional herbs (TH), and food supplements (FS) among Kenyan MMA athletes. Additionally, the study explores the sources of PES, the factors motivating their use, and the efficacy of current Anti-Doping testing practices. To conduct the study, a cross-sectional survey design was employed, sampling 800 athletes from a target population of 4,000 across six MMA federations. Data were collected using structured questionnaires adapted from the World Anti-Doping Agency (WADA) and the Performance Enhancement Attitude Scale (PEAS), with pre-testing to ensure reliability. Data analysis involved descriptive statistics and One- and Two-Way Analysis of Variance (ANOVA) using SPSS version 22. The results indicate that the majority of MMA participants are male (79.9%), with a median age of 25 years and a mean age of 26.8±4.1 years. Over half of the athletes perceived PES as a problem, but less than one-third viewed traditional herbs as a concern. Food supplements were used by nearly a fifth of the athletes, with bodybuilders showing the highest usage rate (44.4%). Coaches, team doctors, and physiotherapists were primary sources of these substances, while some athletes reported chemists and medical practitioners as suppliers of PES. The study found that the primary reasons for using PES and FS were to boost economic status through prize money, with additional pressures from coaches, family, and colleagues. Anti-doping testing revealed that 20.6% of athletes had been tested out of competition, while 34.4% believed they could provide a sample that wasn't theirs. The study concludes that while many MMA athletes recognize the risks associated with PES, there is a lack of consistent understanding regarding traditional herbs and food supplements. This inconsistency, combined with external pressures, may lead to risky behavior, compromising the athletes' health and the sport's integrity. To address these issues, the study recommends implementing comprehensive education programs for MMA athletes, coaches, and support personnel to raise awareness of PES risks. Strengthening anti-doping regulations and monitoring sources of PES and FS is also crucial. Additionally, promoting ethical coaching practices and addressing external pressures can foster a safer environment and uphold the values of fair competition in Kenyan MMA.

Vegetables are a crucial part of the food chain. Vegetables are abundant sources of proteins, fats, minerals, carbohydrates, vitamins and antioxidants. The consumption of leafy vegetables is steadily rising in both urban and rural communities. The rising content of cadmium (Cd) in the food chain through the wastewater poses a significant threat to growth of plants and human health. Cadmium interferes with plant processes like transpiration, nitrogen assimilation, photosynthesis, and respiration. Main purpose of this experiment was to investigate the side effects of various exposure durations and various Cd concentrations on the physiology and growth of spinach. This research was conducted using a factorial design with five Cd doses and three exposure durations (25, 50, and 75 days), set up according to CRD and applying three replications. Results indicated that leaf area, root length and plant height were impacted by Cadmium concentrations up to 40 mg kg-1. Additionally, biochemical, and photosynthetic parameters were also affected. Spinach showed tolerance to various levels of cadmium. The highest tolerance index for spinach was observed at 10 mg Cd kg−1 soil after 50 DoE, while the lowest tolerance index was recorded at 40 mg Cd kg−1 soil after 75 DoE. Cd accumulation in the vegetables, daily intake via consumption poses significant health risks. The findings suggest that both the duration of exposure and Cd dosage are critical in determining Cd toxicity, as evidenced by significant reductions in spinach growth and physiological parameters. Consequently, the consumption of such Cd-contaminated vegetables could pose serious health risks to humans.

Aim- This study aimed to examine the usefulness of various mind-body interventions in physiotherapy rehabilitation. Methods- Through a comprehensive review of the literature on topics such as yoga, mind-body exercise, Tai Chi, pain neuroscience education, and mindfulness-based stress reduction, the researchers identified the potential benefits and drawbacks of incorporating these interventions into clinical practice. Result- These results indicate that combining mind-body therapies with physiotherapy rehabilitation may lead to positive outcomes for patients in terms of their recovery and overall well-being. Conclusion- The integration of mind-body techniques in physiotherapy rehabilitation holds significant promise for improving recovery and fostering general psychological well-being in individuals with musculoskeletal, neurological, and other conditions.

We describe a unique case of a 60-year-old asthmatic Saudi patient who developed acute respiratory distress syndrome (ARDS) and accelerated lung fibrosis after the administration of the second dose of the COVID-19 mRNA vaccine. This patient presented to the emergency room with a four-day history of fever, shortness of breath, and cough. His hospitalization was complicated by non-ST segment elevation myocardial infarction, non-sustained ventricular tachycardia, and a lowered Glasgow Coma Scale. He was intubated at a P/F ratio of 73 mmHg and a peak inspiratory pressure of 46 cmH2O. His antibiotics had to be modified, as he had QT prolongation. Additional anti-pseudomonal, anti-anaerobe, and anti-fungal coverings were empirically given, which were later switched to colistin based on the results of a sputum culture. On ICU day 17, the patient went into cardiac arrest due to severe ARDS and septic shock. Despite attempts at resuscitation, he was unable to be revived.

The over-the-top technique with lateral plasty is a technique that allows anterior cruciate ligament reconstruction and lateral plasty using a graft consisting of semitendinosus and gracilis that remain attached at the tibial level. This technique uses only the tibial tunnel without the femoral tunnel. We report on a series of 3 patients operated on for anterior knee instability following an anterior cruciate ligament injury in the orthopaedic department of the Delafontaine Hospital in Saint Denis, France, and discuss the results with a review of the literature.

Drug addiction is a one of the fast growing problem among the youth in the world and Bandipora District of Kashmir Valley is no exception due to prolonged turmoil, unemployment and economic uncertainty. The present study was conducted to know about the reasons of drug addiction, awareness among the people of Bandipora about drug abuse and the preventive measures adopted by the stake holders. 600 persons were selected at random from different areas of Bandipora. Among them 300 were male and 300 female. A questionnaire was circulated among them during the year 2023. The results obtained revealed a horrifying picture and a threat for entire society if the drug menace is not controlled.

Introduction: in hemodialysis patients. Osteoporosis associated with kidney disease chronic is a complex entity with significant morbidity and mortality relative to risk of fracture. Its prevalence is high, but the incrimination of clinical and biological factors remains poorly identified. The purpose of our study is to determine the prevalence and factors associated with osteoporosis. Methods: A cross-sectional study included 40 chronic hemodialysis patients for at least 6 months. All subjects underwent a bone mineral density (BMD) assay with dual-energy x-rays absorptiometry (DXA) at the lumbar spine (LS) and femoral neck (FN). Data were statistically analyzed by means of descriptive analysis. Patients were divided into 2 groups based on the T-score to define the osteoporotic (t score≤-2.5) and the no-osteoporotic (t score>-2.5). The search for the risk factors studied [age, duration of hemodialysis, parathyroid hormone (PTH), alkaline phosphatases (ALP), and calcification of the abdominal aorta (AAC)] has been carried out by logistic regression. Results: The average age was 59 ± 16 years, 47% were women, and the median of hemodialysis duration was 54 months. The prevalence of osteoporosis at the lumbar spine was 27.5% and at the femoral neck was 32.5%. Regarding risk factors, at the LS, the factors associated with osteoporosis retained in the univariate analysis were age (p=0.034), PTH (p=0.024), AAC (p=0.024), ALP (p=0.027) and in the multivariate analysis, only PTH was significantly associated (p=0.019). At the FN; The factors associated with osteoporosis retained in analysis univariate were age (p = 0.03), AAC (p = 0.01), ALP (p=0.04) and in analysis multivariate was the APL (p= 0.035). Conclusion: Osteoporosis is associated with turnover abnormalities. We suggest that regular screening for fracture risk using DXA and early correction of the disorders.

Polycystic ovarian syndrome (PCOS) is a complex endocrine disorder characterized by hormonal dysregulation, metabolic disturbances, and reproductive abnormalities. Probiotics are the gut bacteria which helps in digestion and possess several functionalities positively in body like immunomodulation, hormonal balancing, antihypertensive etc. There are evidences pointing for preventive as well as therapeutic results from the PCOS symptoms by administrating probiotics to the adolescent women. Some triggers causing implications of gut microbiota alterations in PCOS, including modulation of host metabolism, inflammation, insulin resistance, and reproductive function. Present paper reviews the mechanism through which these outcomes are achieved.

The article discusses the concept of universal jurisdiction and its implementation in international law. It explores the relationship between universal jurisdiction and treaty law, as well as customary international law. The author emphasizes the importance of universal jurisdiction in holding individuals accountable for serious international crimes, even when they flee to another country. The article also discusses the concept of hot pursuit and its connection to universal jurisdiction. Real-life geopolitical events are presented to illustrate the complexities and challenges of implementing universal jurisdiction. The author argues that universal jurisdiction can contribute to peace and security by redefining international relations and moving away from traditional approaches. The article draws on various primary and secondary sources to support its arguments.

Background: The study of free radical chemistry has received a considerable lot of attention recently. Our bodies produce reactive oxygen and nitrogen species and free radicals as a result of a variety of endogenous processes, exposure to various physiochemical situations, or pathological conditions. For optimum physiological function, free radicals and antioxidants must coexist in balance. Oxidative stress results when the body's defences against free radicals are overpowered. As a result, free radicals damage lipids, proteins, and DNA and cause a variety of human disorders. Therefore, using antioxidants from an external source can help to manage this oxidative damage. In contrast to synthetic antioxidants, which are either added to food to increase its shelf-life or are synthesised by plants and found in the foods we consume, natural antioxidants are produced by plants (for example, vitamins and other naturally-occurring substances in our food) (e.g. BHT). Annona squamosa. (Annonaceae, Family). Hindi-speaking locals refer to it as "Sitaphal." Insecticidal, purgative, laxative, astringent, anti-inflammatory, antidiabetic, anti-ulcer, anti-oxidant, antimalarial, and antibacterial are only a few of the pharmacological effects of the plant. Method: In current study HO-1 protein selected as target protein. The Auto Dock software used a grid-based docking algorithm to determine the bond. Using the Merck Molecular Force Field, 2D structures of compounds were created, transformed to 3D, and then energetically decreased up to an arms gradient of 0.01. (MMFF). Result: Flavonoids of A.squamosa found to be effective antioxidant component and effectively binds to be target protein HO-1 with binding energy -6.18 & -5.26 kcalmol-1for quercetin and rutin respectively. Conclusion: The finding of the in-silico molecular docking showed that both lead compound is effective binds & inhibitory action on target protein. The molecular docking of ligands like quercetin and rutin with human HO-1 receptor revealed that it has exhibited the chemical interaction with the amino acids in the active pockets.