The paper assessed 28 Value Engineering (VE) reports of studies conducted by third party VE consultants on Saudi Aramco capital projects from January 2020 to August 2022. The findings indicate that there is an inverse relationship between accepted number of VE proposals and the size of the workshop review team (the larger the team, the smaller percentage of accepted proposals). It, also, showed that accepted number of VE proposals is not influenced by the duration of VE workshops. The paper recommends the optimization of the size of VE teams and optimized workshop durations to be aligned to Saudi Aramco (SA) capital management system project classifications. The recommendations may result in increasing the number of quality accepted VE proposals while reducing the cost of VE workshops.

Background: One of the most serious complications of diabetes that places an enormous strain on the patient, the healthcare system, and the world economy is diabetic retinopathy (DR). It includes long-term exposure to the metabolic changes linked to diabetes, which cause damage to the retina's microvasculature. Objectives: The aim of the study was to assess the prevalence of diabetic retinopathy and associated risk factors among diabetic patients in a tertiary care hospital. Methods: This cross-section observational study was carried out in the Department of Ophthalmology, North Bengal medical College. Convenience sampling technique was followed. Face to face interview was done to collect data with a semi-structured questionnaire. After collection, the data were checked and cleaned, followed by editing, compiling, coding and categorizing according to the objectives and variable to detect errors and to maintain consistency, relevancy and quality control. Statistical evaluation of the results used to be obtained via the use of a window-based computer software program devised with Statistical Packages for Social Sciences (SPSS-24). The duration of the period from July 2018 to July 2022. A total of 120 patients were participate in the study. Results: About 58.33% respondents were male and 41.67% were female. Majority (33.33%) of the respondents were within the age group of 50-59. 33.33% were service holder, 41.67% were businessman, 12.5 were day labor, 6.67% were farmer. 75% were from urban area and 25% from rural area. The prevalence of DR in this study was 41.1%. About 90% had DM of <5 years, 55% had 6-10 years, 40% had 15-20 Years, 30% had 16-20 years and only 7% had >21 years. About 50% had normal grade of diabetic retinopathy in the worse eye, 15% had Mild NPDR, 8.33% had Moderate NPDR, 6.67% had Mild to moderate NPDR with non-CSME, 2.5% Moderate NPDR with CSME, Severe NPDR with non-CSME Severe NPDR with CSME and Advanced PDR respectively. Mean FBS (mg/dl) was 160.86±70.6, Total cholesterol (mg/dl) was 183.2 ± 2.1, Triglycerides (mg/dl) was 161.2 ± 2.6, Systolic BP was 130.56±15.7 and Diastolic BP was 80.86±13.4. Patients with baseline age of <60 years were three times (AOR = 3.2:95% CI: 1.19–8.63) more likely to develop DR. The odds of DR is about 3 times (AOR = 2.91:95% CI: 1.01–8.35) higher for patients with disease duration of ≥6 years as compared to disease duration of <6 years. Systolic blood pressure also had statistically significant association with patients having blood pressure of <140 mmHg being about 3.6 times (AOR = 0.28:95% CI: 0.09–0.82) less likely to have DR as compared to hypertensive patients with systolic blood pressure of ≥140 mmHg. The other cofactors, history of hypertension, and total cholesterol level were not independent significant factors for the development of DR in our study. Conclusion: Systolic hypertension, being on insulin alone or in combination with OHA, and having diabetes for a longer period of time were all independently linked to the occurrence of DR. The significant DR prevalence our study suggests that routine patient care, including treatment facilities, has to be improved. Healthcare practitioners must make a consistent effort to educate diabetic patients about the importance of blood sugar control and hypertension management in lowering the risk of the start and progression of DR. It is advised that diabetic patients get health education regarding the importance of routine eye exams for the early detection and treatment of diabetes-related eye problems.

A pharmacist in general and community pharmacist in specific is a key member of the “healthcare team” involved in achieving a common objective of better healthcare provision. The emergence of “community pharmacy” during post-world war-II era, with a known motto of “drug control” and “patient oriented practice” (POP) came in to existence. The modern pharmacy practices, are not devoid of obstacles and challenges specifically for “Newbie Community Pharmacist (NCP)”, who comes in to direct patient contact at root level, thus necessitates to strict to standards which will help not only in quality care provision but will enhance the abilities of the pharmacist to cope challenges facing at community level. Herein, we will discuss some of the concerns for NCP and their considerations to deal with.

Background: Numerous obligatory intracellular bacteria from the Alphaproteobacteria genus Rickettsia can cause rickettsial infection. The most prevalent newly emerging and reemerging diseases are rickettsial infections. Objectives: The aim of the study was diagnosis and management of rickettsial infections among febrile patients attending in inpatient and outpatient department in a district hospital in Bangladesh. Methods: This cross-section observational study was carried out in the 250 Beded District Hospital, Joypurhat. The duration of the period from March 2022 to February 2023. A total of 250 patients participated in the study. Both male and female with any age, patients with elevated body temperature, headache, malaise, rash, nausea, and vomiting and gave consent to be included in the study. Severely ill patients, not willing to participate were excluded from the study. Weil Felix test was used in this study and a titre of 1:80 was considered to be positive. Statistical evaluation of the results used to be obtained via the use of a window-based computer software program devised with Statistical Packages for Social Sciences (SPSS-24). Results: The mean age of the patients was 39 ± 1.9. 8% of the patients had ≤18 years of age. 16% were within the age group of 19-29 years, 28% were within the age group of 30-39 years, 24% were within the age group of 40-49 years, 14.4% were within the age group of 50-59 years and 9.6% were ≥60 years and 52% of the patients were male. 100% of the respondents had fever, 20% had generalized weakness, 15.2% had headache, 16% had cough and cold, 24% had body ache, 8% had vomiting and abdominal pain respectively, 4% had per nasal watery discharge, 36% had rash, 16% had nausea, 24% had anorexia and 4% had other symptoms. CBC & ESR and Weil Felix test were the most common (100%) investigation among the patients, Urine R/M/E in 68%, serum creatinine in 18%, USG of W/A in 15%, CRP in 18%, PBF in 7, Urine C/S in 10%, S. Electrolytes in 4% cases. We found 90 Rickettsial Infection positive patients. Doxycycline and Paracetamol and Esomeprazole were prescribed to all patients 90(100%) and followed by Linagliptin+Metformin to 20(22.22%), Glimipiride to 19(21.11%), Azithromycin to 18(20%) and Domperidon to 10(1.11%), Montelukast 9 (10%), Pantoprazole to 8(8.89%), Rupatadine to 7(7.77%), Ondansetron to 6(6.67%), Tiemonium to 5 5.57%), Fexofenadin to4(4.44%) and other treatment along with the prescribed medicines was given to 40(44.44%) patients. Authors studied the response of Doxycycline which showed 85(94.44%) cases improved within 48 hours of start of treatment. Remaining 5(5.55%) cases showed delayed response due to late presentation. Conclusion: Rickettsial illness is inextricably linked to the sociocultural life of the majority of metropolitan residents. However, a lack of medical facilities and qualified doctors makes it challenging to identify rickettsial disease in febrile patients. It's important to make an early diagnosis when treating rickettsial illness.

Despite the fact that the World Health Organization (WHO) had provided an average global reference data of Coagulation Properties (CP) of blood in the world, available statistics still suggest a significant discrepancy in CPs of blood among various age groups, socioeconomic classes and races in different locations of the world. Here in Port Harcourt Nigeria, absence of such local reference data had continued to pose over-reliance on the WHO global standards without recourse to our distinctive geospatial and socioeconomic peculiarities. As a result, this study therefore investigated coagulation properties of blood in healthy university students in Port Harcourt. A total of 157 participants were recruited into the study using Stratified Random Sampling techniques. They were administered well-structured questionnaires for an on-the-spot data collections. Thereafter, 5ml of venous blood were aspirated for various coagulation properties (Bleeding, clotting and Prothrombin times and Platelets Counts) investigation. Clotting and bleeding times were measured instantly using capillary and Ivy’s methods respectively. Results from the study revealed a significant (ρ≤0.05) coagulation difference between the WHO standards and both gender (male, 311032 ± 17300* and female, 293600 ± 12800*) for platelets counts. In the age groups, only ≥40 group were significant to all CP (10.30 ± 0.00* for BT, 10.00 ± 1.30* for CT, 10.22 ± 2.88* for PT and 190320.73 ± 1886.45* for PC). Similar significant result was also noted for Obese Class 2, morbid obesity and protein diet groups as compared with the Control. This study therefore concluded that CP significantly vary with the WHO standards, age, gender, BMI and nutritional background and recommended similar study be conducted in other locations in Nigeria and Africa.

Proximate analysis of fresh leaves of Polyalthia longifolia was carried out using gravimetric method of analysis. The analysis showed that percentages of total moisture, crude protein, crude fiber, ash content, total carbohydrate and the oil content were 51.12, 13.37, 25.20, 8.12, 22.97 and 11.34 present in the sample respectively. The results revealed that the fresh leaves could be a rich source of food and mineral nutrients which can be used for human nourishments and dietary supplements. It is also an implication that the leaves can be used in the medicinal, pharmacological and food industries for production of consumable supplements. The significant oil content is an indication of its ability to combat certain microorganisms that can cause disorders in human health, it can also be applied in the cosmetic industries for the production of a wide variety of cosmetics products it has been commonly found that the extract of the leaves can be used as curatives of haemorhoids, diabetes, fibroid. cancer and ulcer treatments because of the reasonable fibre content.

Today, it is common practice to employ computational software tools for investigating the structure, dynamics, surface characteristics, and thermodynamics of inorganic, biological, and polymeric systems. Computational software tools are a vital part of the guide for drug discovery. It is frequently employed in approaches for rational drug design and structure-based drug design. The process of drug design and discovery is essential in the invention of a new chemical entity. For this process, plenty of computational tools are available globally, Those computational software tools are fast, free, open online excess paid. Pharmaceutical software decreases human efforts, error, and time utilization in a particular task without compromising the quality of work with great accuracy and efficiency. This software is utilized by various institutes globally related to science and medicine. A computer program that transforms an input structure according toa library of medicinal chemical transformation rules before allowing evaluation of the output structures. High throughput screening is now widely accepted as a viable option that CADD supports. The development of top-notch datasets and design libraries that may be optimized for molecular diversity or similarity has resulted from the quest for novel molecular entities. On the other hand, breakthroughs in computing infrastructure and molecular docking methods are allowing screening throughput to increase quickly.

As the world continues to urbanize, the construction of transportation highway continuously requires quality pavement which made transportation engineers and experts focus on improving the performance and life of pavements, to which many studies had searched for better materials or modifications that could improve the properties of bitumen and reduce or even eliminate the development of asphalt pavement failures. To this end, the properties of bitumen modified with blend of PET + nanoclay was conducted. The bitumen was modified with PET (0.5 – 4.0% at 0.5% interval), and nanoclay (1.0 – 8.0% at 1% intervals), while the tests conducted on the materials were oxide composition test, Fourier Transform Infrared Spectroscopy (FTIR) test, penetration test, solubility test, ductility test, flash and fire point test, specific gravity test, softening point test, and viscosity test in accordance with codes and specification. Results from the findings showed that the unmodified bitumen and PET are hydrocarbon materials, while the nanoclay is an inorganic compound and a good reactive pozzolana. More results from the findings showed that the properties of bitumen was improved with addition of PET and nanoclay blend such that the penetration and solubility of bitumen decreases with increase in modifier content, and there was an increase in softening point, flash point, fire point, specific gravity, and viscosity of bitumen as replacement of PET and nanoclay blend increases. Hence, the modifiers (Nanoclay/PET blend) can be used to improve properties of bitumen since they fall within standard and code specification.

Background: The burgeoning issue of drug addiction, coupled with its intricate linkages to psychiatric aspects, necessitates innovative interventions. This research delves into the efficacy of awareness campaigns as a strategy for addressing the psychiatric dimensions of drug addiction, specifically within the confines of a tertiary level hospital in Bangladesh. Methods: This prospective study examined the impact of awareness campaigns on drug addiction's psychiatric dimensions. Using purposive sampling, 100 patients were selected from the Department of Psychiatry, Rajshahi Medical College, between January 2020 and December 2022. Quantitative surveys and qualitative interviews were conducted to measure changes in awareness, attitudes, and behaviors. Standardized scales gauged shifts over time. Ethical considerations were adhered to. Pre- and post-campaign comparisons facilitated longitudinal assessment. Results: Preliminary findings reveal a positive shift in participants' awareness of psychiatric aspects linked to drug addiction after exposure to awareness campaigns. Initial awareness levels of 25% concerning psychiatric dimensions rose significantly to 68% post-campaign. Moreover, willingness to seek comprehensive treatment increased from 32% before the campaign to 75% afterward. Actively seeking treatment information also saw a rise, climbing from 18% pre-campaign to 56% post-campaign. Qualitative insights highlighted that 83% of participants acknowledged the campaigns' role in enhancing understanding. Additionally, participants displayed improved attitudes towards seeking treatment for both addiction and concurrent psychiatric issues. These results collectively indicate the campaigns' efficacy in fostering heightened awareness, altering attitudes, and driving proactive behaviors. Conclusions: The initial results indicate that awareness campaigns hold promise as effective tools in addressing the psychiatric dimensions of drug addiction treatment. A comprehensive analysis of the complete dataset will provide deeper insights into the extent of these changes and their potential long-term implications for treatment outcomes.

The upshot of nonlinear thermal radiation of steady state MHD heat transfer of Jeffrey nanofluid together with prescribed boundary conditions of interest was studied. Essential fluid properties, dimensionless switch parameters with the assistance of the Lie group method were used to transform the convenient partial differential equations that describe the present model into a system of ordinary differential equations. The generalized flow of the present model incorporates Jeffrey parameters and nonlinear thermal radiation. The Mathematical model is first renovated into ordinary differential equations by Lie symmetry group alteration. The renovated equations were solved numerically using a bvp4c MATLAB solver. The Jeffrey parameter serves as a stabilizer on the velocity of the fluid while thermal radiation parameter and heat source-sink parameter improves the flow temperature. Lewis number, chemical reaction parameter diminished the mass transfer flow. Equally skin friction, Sherwood number and Nusselt number were expanded.

The center disclosures of this paper are that precludes maltreatment of kids; their abuse is rejected and youngster work is restricted. This work likewise features about Kid misuse, abuse, kid work, and trading youngsters for reason for prostitutions are restricted under the Bangladeshi regulations. The predominance of actual attack was a lot higher among more youthful youngsters albeit the likelihood of different sorts of misuse was higher among more established kids. Young men were more presented than young ladies to maltreatment of any sort. Destitution was additionally fundamentally connected with kid misuse. Multivariate examination proposed that the out-of-younger students and the offspring of ignorant, landless and incompetent workers were bound to be mishandled than others when age and sex of kids were controlled. The paper infers that bringing up open mindfulness against kid misuse and advancing preventive measures ought to be embraced to decrease kid maltreatment in Bangladesh.

Background: Blood flow pattern among various women in different location of the world had been noted to vary significantly with some anthropometric variations, geospatial locations, age, BMI and cardiovascular parameters. As a result, this study therefore investigated the flow properties of blood during menstrual cycle in female undergraduate students in Port Harcourt as a baseline study with a view of establishing local reference data for Port Harcourt, Nigeria. Materials and Methods: 125 volunteers were recruited into the study using stratified random sampling techniques and were administered well-structured questionnaires. Their blood samples were collected and haemorheological properties (Whole Blood Viscosity, Plasma Viscosity, ESR and haematocrits) were analysed against various phases of menstrual cycle namely: menstruation, follicular, ovulation and luteal phases among female undergraduate students in Port Harcourt. Results and Discussions: Result of the study when compared with the WHO standard references showed a significant (ρ≤0.05) difference in ESR, PV, WBV and ESR for menstruation and follicular phases while HCT was not significant with ovulation and luteal phases. Flow properties was also significant (ρ≤0.05) with ages (16-23, 24-30 and ≥31) years as compared with the WHO Control. BMI and blood pressure was also significant (ρ≤0.05) with Haemorrheological properties of blood. Conclusion: The study therefore concluded that there is a significant (ρ≤0.05) correlation between flow properties of blood and phases of menstrual cycle among university students in Port Harcourt, Nigeria as compared with the WHO standard values.

All parts of Mucuna poggei and Justicia carnea have been known to possess valuable medicinal properties. This calls for the need to determine the effect of combined methanol extract of mucuna poggei and justicia carnea leaves on hematological and biochemical indices of phenylhydrazine induced anaemic albino rats. The study was done using 60 male albino rats. The rats were divided into five groups of five (5) rats each. Group 1 (non-anaemic) was administered water and feed only which served as Normal control. Group 2 was administered Phenylhydrazine only which served as negative control. Group 3 through 5 were Phenylhydrazine induced anaemia treated with combined extract (1:1) at 200 mg/kg, 400 mg/kg and 600 mg/kg respectively. The results showed a significant (p<0.05) increase in Hepatic and renal biomarkers (ALT, AST, ALP, Urea, Creatinine) of the anaemic (negative) control. The combined extract significantly restored the alteration through significant (p<0.05) dose dependent decrease in the assayed hepatic and renal function biomarkers. The hematological indices of the treated rats were maintained compared to the anaemic control. The study showed great potential of combined methanol extract of Mucuna poggei and Justicia carnea leaves capable of ameliorating anaemia.

Background: EHRs have the potential to improve patient healthcare by providing real-time access to patient information, improving communication between healthcare providers, and reducing medication errors. However, the evidence on the impact of EHRs on clinical outcomes is mixed. Objective: To review the literature on the impact of EHRs on clinical outcomes and to provide recommendations for improving the use of EHRs to improve patient healthcare. Methods: A literature review was conducted to identify studies on the impact of EHRs on clinical outcomes. The search was limited to English-language studies published in peer-reviewed journals. Results: The literature review found that EHRs have the potential to improve clinical outcomes, such as mortality, morbidity, hospital readmission rates, and bed utilization. EHRs can also help to reduce medication errors and improve patient safety. However, the impact of EHRs depends on a number of factors, such as the quality of the EHR system, the way it is implemented, and the training of healthcare providers. Recommendations: For improving the use of EHRs to improve patient healthcare include: Developing high-quality EHR systems that are easy to use and can integrate with other systems, Providing adequate training for healthcare providers on how to use EHRs effectively, Encouraging interoperability between EHR systems from different vendors, Addressing privacy and security concerns, Reducing user resistance to EHRs. Conclusion: EHRs have the potential to improve patient healthcare by providing real-time access to patient information, improving communication between healthcare providers, and reducing medication errors. However, the impact of EHRs depends on a number of factors, such as the quality of the EHR system, the way it is implemented, and the training of healthcare providers. By following the recommendations above, we can make EHRs a more effective tool for improving patient healthcare.

Background: The contamination of patient files is a serious problem that can have a negative impact on the health of patients and staff. Bacteria, viruses, fungi, and parasites can all contaminate medical files, which can lead to nosocomial infections. Methods: This study reviewed the literature on the contamination of patient files in hospitals. The study identified a number of factors that can contribute to contamination, including the handling of medical files by healthcare workers who are not properly washing their hands, the placement of medical files in areas where there is a lot of traffic, and the condition of medical files. Results: The study found that the contamination of medical files is associated with a number of risks, including the risk of nosocomial infections, the risk of cross-contamination between patients, and the risk of damage to medical records. Conclusion: The study concludes that it is important to take steps to prevent the contamination of medical files. These steps include educating healthcare workers on the importance of proper handwashing, developing and implementing policies and procedures for the handling of medical files, regularly inspecting medical files for signs of contamination, cleaning and disinfecting medical files that are contaminated, and using EHRs instead of paper records.