The increasing incidence of mortality due to benign prostatic hyperplasia (BPH) in ageing men globally is of serious concern and needed collective efforts to arrest it. The benign prostatic hyperplasia result from excessive growth of the prostate gland due to proliferating cells which impairs urethral functions by compressing it. This present study evaluated the effect of methanol extract of Allium sativa (MEAS) on lipid profile, renal and hepatic function biomarkers of testosterone induced benign prostate hyperplasia in male rats. The study was done using 25 adult male albino rats, divided into 5 groups, which comprises of normal control, negative control, positive control, and BPH induced rats treated with 200 and 400 mg/kg /day of MEAS respectively. Hepatic and renal biomarkers (ALT, AST, ALP, Urea, Creatinine) and lipid profile (HDL, LDL, TAG, CHOL were evaluated. The BPH induction caused significant (p<0.05) increases in lipid profile with exception HDL; hepatic and renal biomarkers of the negative control when compared with the normal control. The MEAS treated BPH-induced rats had significant (p>0.05) reduction in the biochemical biomarkers with significant (p<0.05) increase HDL. The findings of this study indicated that BPH impairs cellular functionality and treatment of BPH with methanol extract of Allium sativa showed to be effective. Therefore, extract of Allium sativa is a potential agent for the treatment of benign prostatic hyperplasia.

Background and Objectives: Cardiac implantable electronic device (CIED) infections are increasing worldwide due to the increased use of implantable cardiac devices. (CIED) infection is a serious complication that is associated with increased mortality and morbidity as well as increased healthcare costs. However, risk factors for infection of implanted devices are poorly documented in Saudi Arabia. We aimed to determine risk factors for CIED infection in our region. Methods and Results: A retrospective study was carried out in cardiology departments at different centers in Saudi Arabia. Our population consisted of all patients with device-related infections over twenty years from January 2009 to December 2020 with one control case matched to each confirmed infection of the implanted device, resulting in 137 patients with device infection. The mean age was 58±16 years, where males constituted 75.2%. Most infections occurred in patients with the first implant. (63.5%) patients had chronic kidney disease, (59.9%) of patients had diabetes mellitus, (65%) of patients had hypertension, and (43.1%) of patients had coronary artery disease. Most of the patients had a pocket infection. Preop antibiotics were obtained in all patients before implanting. The median time from the last surgical intervention involving the device to infection symptoms was 730 days. The median length of hospitalization was 27±23 days. 130 patients survived at the time of discharge, resulting in an overall mortality rate of 5.1%. Using Multivariate analysis, we identified male gender (P = 0.000), hypertension HTN (P = 0.002), diabetes DM (P = 0.006), and presence of underlying heart disease CHD (P = 0.000) Type of the device (P = 0.000) as significantly associated with a higher risk of CIED infection. Conclusion: Our data show that gender, diabetes, hypertension, and heart disease are independent risk factors for infection after cardiac device implantation. As regards device characteristics, ICD device is associated with a higher infection rate compared to other devices.

When ASHAs were introduced in NRHM in 2005, their primary aim was to visit homes of newborns as the first program in UP operated through the ASHAs was the Comprehensive Child Survival Program in 2008. Since then, tracking of all deliveries and all the newborns are an integral part of the work of ASHAs in all the primary health care programs operated by the NHM in UP (GOI, 2005, GOUP, 2013). The current article examines the role, work & approach of ASHAs through the feedback of the program managers at district & state level. Evaluation studies on the performance of ASHAs was done since 2011 as by then ASHAs had actually worked in the field for a minimum period of 5 years. It is to be noted that National Rural Health Mission was rolled out in April 2005 but it took about one to two years for the states to hire ASHAs and put things in place right from the state to the village level (GOUP, 2013). In this article, a comprehensive feedback is elicited from the program managers of newborn care program at the district & state level. The current study explores some of the crucial variables on the performance of ASHAs through the feedback of program mangers on the role of ASHAs in newborn & child health programs followed by their role in Home Based Newborn Care program. The article also includes the feedback of the program mangers on the work & approach of ASHAs. That’s how the perception of the program managers in the state of UP is included in this article. The program managers responded about the performance of ASHAs based upon their experience in the work by ASHAs on Janani Surakhya Yojana (JSY), New Born Care (NBC) & Routine Immunization (RI) as these are the frontline programs for the states. They were purposefully selected as respondents as they were the nodal persons for rolling out newborn care related programs. The relevance of the study assumes significance as data on the details of the program awareness of managers on child health & newborn are not included in many surveys. Further, feedback details on the health personnel’s performance is usually not collected from the nodal officers looking after the programs at district & state level. Such responses that collect feedback on the work & approach of ASHAs including the awareness of the program managers are not the focus in very large-scale health surveys. Such feedback on work & approach of ASHAs including the opinion & knowledge of program managers about the current implemented programs come under the ambit of social audits. The audits gain more teeth when the feedback is solicited from the people who manage the programs (GOI, 2016). It is important to note that social audit is an integral part of the National Health Mission document but it is not a priority activity of NHM. Usually, the responses, knowledge of trained health personnel are assessed in many studies while neglecting the response & perception of the program managers of the public health system. Here in this article, the managers talk about their own knowledge about the current programs, give feedback on the work & approach of ASHAs including the performance of ASHAs in the child health & newborn care programs. All these are trapped in 5 case studies of 5 stakeholders in 4 districts and one at state level. Here also it is seen that usually in social audits, the trained health personnel become the respondents as part of evaluation of their timely actions in many other studies. The uniqueness of the current study is that those who manage the programs are the respondents through their case studies. These managers become the pivot around which the contents of the current article revolve. A total of four districts of Uttar Pradesh were selected purposively for the study and the data collection was conducted among the program managers where one manager was purposefully selected in the respective districts & one at the state with the help of a pre-tested structured interview guide with only open-ended questions. These in-depth interview guide collected descriptive details as responded by managers. The qualitative data were conducted amongst the managers and a total of 5 respondents participated in the study through 5 case studies. The results reflected that among the operational programs, it was surprising to note that none of the policy makers in the four districts mentioned about the Facility Based Newborn Care programs. The state level manager gave the details about the child health & newborn care programs but hinted that Home-Based Newborn Care (HBNC) was recently at the forefront because of the emphasis on setting up Kangaroo Mother Care (KMC) centers at selected public health facilities. The knowledge of policy makers about the role of ASHAs in the roll out of newborn related program was poor across all the districts except the state level. Further, it was imperative that the management of program related information was not at all the priority of the program managers. ...............

Background: Plate fixation is the mainstay of care for distal forearm shaft fractures in adults. By and large, volar or dorsal plating is used for radial shaft fractures. The radius's lateral surface offers an equal and constantly curved region for inserting a plate. The radial bow may be readily evaluated and restored after surgery. A prospective investigation was performed to examine the result of lateral plating of radius shaft fractures. Objective: In this study our main goal is to evaluate the treatment outcome of fixation of fracture shaft of radius ulna. Method: The research was conducted at tertiary medical hospital and district general hospital, Dinajpur included 100 patients. Several of them had broken both of their forearm bones, while others had broken only the radial shaft. Within 36 hours of damage, all patients were fixed with a 3.5 mm restricted contact dynamic compression plate or locking compression plate on the lateral surface of the radius. Typical procedure was used to repair the ulna. Results: During the study, majority were belong to 32-40 years age group, 36%. Followed by 20% were belong to 41-50 years age group, 11% belong to 20-31 years age group. In addition to that, 80% were male. 75% had fractured both of their forearm bones. Followed by 70% had closed fractured type, 35% had motor vehicle accident and lastly 85% had middle third radial shaft. Union was assessed by gradual disappearance of the fracture line and/or development of bridging callus at the fracture site. After getting treatment, 89% patients had excellent results, 8% had satisfactory and 1% had unsatisfactory result. There was 1% failure (nonunion). Conclusion: As compared to conventional methods, radial lateral plating holds promise as a viable option. Longitudinal studies with larger patient groups and study criteria are needed to confirm the potential advantages and validate our results.

The odontoma is a benign tumor containing all the various component tissues of the teeth. It is the most common odontogenic tumor representing 67% of all odontogenic tumors. Odontomas are considered to be developmental anomalies (hamartomas) rather than true neoplasms. Based on the degree of morphodifferentiation or on the basis of their resemblance to normal teeth, they are divided into compound and complex odontomas. The compound odontoma is composed of multiple, small tooth-like structures. The complex odontoma consists of a conglomerate mass of enamel and dentin, which bears no anatomic resemblance to a tooth. They are usually diagnosed on routine radiological examinations in the second decade of life and are often slow growing and non-aggressive in nature. Here, we report a case of unusually, rare, compound odontoma, located in the left posterior mandible of a 17-year-old male patient.

Pragmatic identity construction is conducive to achieving communicative purposes. And political discourse is an effective means of promoting international communication. While the construction of identity in the field of pragmatics is rarely discussed in political discourse. To better understand the political intention of speakers, the research explores how and what pragmatic identities are constructed in political discourse based on pragmatic identity theory, and takes the Keynote Speech by Xi Jinping at the Opening Ceremony of the Boao Forum for Asia Annual Conference 2022 as corpus. It is found that this speech included many derived identities from pragmatic identities. And President Xi Jinping chooses and exchanges his derived identities from various pragmatic identities by using the strategies of the personal pronoun and linguistic adaptation theory, which helps him better switch his pragmatic identity and achieve his interpersonal functions or political functions.

The prevalence of atopic dermatitis (AD), spanning across from childhood through adolescence is increasing in the Middle East region. Poor Quality of Life (QoL), excessive healthcare expenditure, loss of school and workdays are considered to be the significant burden of AD. Although, QoL data is available for children affected by AD in Saudi Arabia, there is limited data for adolescents and adults. Moreover, data on healthcare resource utilization (HCRU) in Saudi Arabia is lacking. The purpose of this review was to evaluate the association between AD severity and AD-related QoL and HCRU in adolescents and adults in Saudi Arabia. It also aimed to identify the gaps in literature on AD in the above two patient populations in Saudi Arabia and provide recommendations for better management of QoL and HCRU- related issues. Extensive literature search was carried out through various search engines, such as PubMed, MEDLINE, Web of Science, and Google Scholar using different keywords. This review highlighted the lack of literature from Saudi Arabia with respect to the effect of AD on QoL and HCRU in adult and adolescent populations. The gaps in data regarding patient perception, physician knowledge, family and caregiver burden, and QoL for better AD management related HRQoL and HCRU in Saudi Arabia were also identified and recommendations to bridge these gaps were provided.

Management of cervical fibroid which is one of the rare sites of uterine fibroid comes with challenges to gynaecologists especially in young nulliparous women where uterine conserving surgery is to be instituted. Cervical fibroid locations can be in the supravaginal or vaginal aspect of the cervix. It can also present as pedunculated fibroid or sessile fibroid from the cervical lip. The commonest presentations of cervical fibroid are pelvic pressure symptoms and menstrual irregularities. This is a case of a 24 year old nulliparous woman with recurrent pelvic pressure symptoms, heavy menstrual flow and vaginal discharge with diagnosis of cervical fibroid and vaginal fibroid polyp and was managed by uterine conserving surgery.

Tuberculosis (TB) is one of the leading causes of mortality in children worldwide, but there remain significant challenges in diagnosing and treating TB infection and disease. Tuberculous (TB) meningitis is the commonest infectious disease of the central nervous system in paediatric and geriatric cases. Childhood TB is an indication of failing TB control in the community. It allows disease persistence in the population. Tuberculosis can be prevented in children by diagnosing and treating cases of active TB amongst adults, as paediatric cases always acquire it passively from household contact of adults suffering from TB as disease in adults is multibacillary. Although significant data is available for the prevention of childhood extra-pulmonary and disseminated TB, offering Bacillus Calmette-Guerin (BCG) vaccination, it is still not routinely offered during vaccination. In this case report, a two-year child with a history of failure to thrive and constitutional symptoms diagnosed with disseminated extra-pulmonary TB presenting as TB meningitis with a history of contact with the mother suffering from active sputum positive pulmonary TB receiving anti-TB treatment. Child was evaluated with CT brain plain and contrast and documented meningeal enhancement. Cerebrospinal fluid analysis revealed tuberculous etiology in presence of lymphocytic predominance and raised ADA level in fluid. CSF fluid sent for cartridge based nucleic acid amplification test documented MTB genome with rifampicin sensitivity. We retrospectively analysed mothers’ sputum examination and observed higher grades of sputum AFB and her cartridge based nucleic acid amplification test revealed MTB genome with rifampicin sensitivity. Child and mother were treated with standard protocol recommended by NTEP (National Tuberculosis elimination program). In conclusion, we recommend BCG vaccination to all newborns, and tuberculin skin testing and isoniazid prophylaxis to the contact of adults with sputum positive pulmonary TB cases in India to prevent transmission of disease from mother to baby. A high index of suspicion is must while evaluating these cases and all possible measures should be taken to confirm tuberculosis to have successful treatment outcome.

Hospitals plays an important role in providing health care facilities and are indispensable in supporting the public health services. The purpose of this study is to examine chief nurse leadership style, internal communication, incentive giving and work stress as well as the performance of nurses in the inpatient room of Hajj Hospital. This research used observational analytical methods with a cross sectional design approach that is research to find interest between variable. Questionnaires were in this study which consists of with closed statements. The data obtained is then collected and processed using SPSS. There were 96 respondents in this study consist of nurses in the Inpatient Unit Jakarta Hajj Hospital and 88 % female nurses who are above 30 years old with working experience of more than 5 years participated in this study. It was found that internal communication and incentive giving have the highest impact performance in hajj hospital. However, the findings of this study may differ with a larger samples taken for this study. Future research would suggest a mixed method study with a larger population across Indonesia.

Medicinal plants not only supplement or replace the frequently insufficiently available modern medical treatments but also improve the local population's health and security. As a result, these plants are essential to daily life and have strong ties to a wide range of social, cultural, and economic events related to birth, growth, aging, illness, and death. The formulation of Morinda citrifolia and Costus afer undergoing phytochemical screening in methanol extract. The phytoconstituents discovered in the formulation were tannin, terpenoid, flavonoid, alkaloid, cardiac glycoside, glycoside, saponins, etc. The therapeutic value of a medicinal plant is determined by its phytoconstituents, either singly or in combination. Some of the significant phytochemicals with various biological activities include alkaloids, flavonoids, phenolics, tannins, saponins, steroids, glycosides, terpenes, etc. The identification of the phytochemicals can be used to predict the pharmacological activity of a plant. The formulation used in literary works contains phytoconstituents that have been linked to a variety of pharmacological actions. Therefore, these plants may be exploited to create medications that are efficient against diabetes, heart attack, bacteria, and microorganisms as well as cancer cells.

This paper is a tentative endeavor to analyze the functions of interpersonal grammatical metaphor used in Biden’s 2022 State of the Union Address based on the theoretical framework which is composed of interpersonal grammatical metaphor theory and the theory of meta-functions within systematic functional grammar. The interpersonal grammatical metaphor used in this speech is examined from two aspects as metaphors of mood and modality. Quantitative analysis and qualitative analysis are both employed to reveal the linguistic characteristics as well as the interpersonal meaning hidden in the speech, aiming at explore the meta-functions of interpersonal grammatical metaphor so that the understanding of the speech content is deepened. The research has found out that metaphor of modality is the preferred type of interpersonal grammatical metaphor in the chosen linguistic text, which mostly serves to express the speaker’s evaluation of a proposition. The metaphor of mood accounts for a lower proportion, which is mainly used to express the address function. The functions of these two types of interpersonal grammatical metaphor are mainly within the scope of interpersonal meta-function, which relates to interact with others in order to establish and maintain the social relationship. This linguistic research proves the necessity and significance of the existence of grammatical metaphor theory and to some extent enriches the research of interpersonal grammatical metaphor in spoken discourse.

In the 1980s, the term "evidence-based practice" was developed to represent a process for selecting the best course of action based on available scientific data. The push for evidence-based practise started in England in the early 1990s. Making decisions about a patient's care using the best available evidence is known as evidence-based medicine (EBM) or evidence-based practise (EBP). Evidence-based practising is both a methodology and a way of thinking. The idea is founded on the moral precept that patients have a right to get the best interventions possible. Finding and putting into action those interventions is how we go about using the EBP methodology.

The primary objective of the school as an organization is to effect learning in the learners which they can demonstrate both in attitude and in their mental and adjustment behaviours. In Education, emphasis is laid on three domains of the educational objectives. These are cognitive (mental) domain, affective (behavioural) domain, and psychomotor (hand) domain. However, to achieve these three essential domains, the learner should respond to the three objectives under certain conditions. These conditions affect how the learner learns and also his willingness to learn. This paper therefore, examines the effects of the factors that affect the learner’s desire to learn and also proffers solution to the problems inhibiting the positive effects in teaching and learning under psycho-socio-physical parameters.

Pyogenic granuloma is a non-neoplastic reactive lesion that commonly occurs in gingiva. It is rarely found in extra gingival sites such as tongue, lip, palate and buccal mucosa. Lesions affecting the tongue are rarer and very few cases are reported. Unusual site of such lesions can be a diagnostic challenge. This case report describes an uncommon location of pyogenic granuloma occurring on the lateral border of tongue in a 60 -year-old male patient.