Acute cholangitis is defined by an infection of the bile ducts due to an obstacle preventing bile flow. It is a diagnostic and therapeutic emergency. Aim of the Study: Report epidemiological, etiological, therapeutic and evolutionary cholangitis. Materials: This is a descriptive prospective study, spanning a period from September 2020 to April 2023. Patients with acute cholangitis were included. Results: We collected 102 cases. The average age was 63 years old with a Sex ratio M/W: 1.37. 18 patients (17.6%) had a history of cholecystectomy. Abdominal ultrasound was sufficient to visualize the obstruction in 32 (32%) patients. The lithiasic origin was revealed in 54 (53%) cases, pancreatic head tumor in 16 (15.7%), cholangiocarcinoma in 17 (16.6%), ruptured hydatid cyst in the biliary tract in 7 (7%). 100 (98%) patients benefited from endoscopic treatment and 2 (2%) benefited from surgical treatment. Endoscopic biliary sphincterotomy was performed in 84 (84%) patients and sphincteroclasia in 9 (9%) patients. Extraction of the stones or hydatid membranes by balloon was performed in 55 (55%) cases. Mechanical lithotricy was necessary in 1 (1%) case. A biliary prosthesis was placed in 52 (52%) patients (Picture 3). The single-stage success rate was obtained in 91 (91%) cases, 8 patients (8%) required a second stage. The early complication rate after endoscopic managment was 10% (n=10) with a death rate of 5% (n=5). Conclusion: Acute cholangitis remains a severe condition requiring urgent treatment. The prognosis has clearly improved after the advent of interventional endoscopy giving satisfactory results. Our study had shown with a technical success rate of 92.7% and a general success rate of 95%.

Helicobacter pylori (HP) infection is one of the most prevalent infections worldwide, contributing to inflammation of the gastric mucosa which is of great interest given its involvement in many gastroduodenal pathologies and some extra-digestive diseases. Aim of the Study: Report the incidence of HP from the endoscopy and anatomopathology register. Methods: This is a descriptive retrospective study performed during a period from January 2019 to November 2022, based on data from the endoscopy and anatomopathology register. We included all patients over 16 years of age who underwent esophago-gastroduodenal fibroscopy (EGD) with gastric biopsies performed according to the Sydney protocol. Results: 903 patients were included in our study. The incidence of HP infection was 60% (n=541).The average age was 50 years [17-90], the Sex Ratio W/M: 1.3, the most frequent symptom was represented by epigastralgia. The esophago-gastroduodenal fibroscopy had objectified an erythemato-congestive gastric mucosa in 481 (89%) of the cases, erythemato-whitish in 27 (5%), nodular in 16 (3%) and it was normal in 16 (3%) of the cases. On anatomopathological study, the gastritis was antro-fundal, antral and fundal in respectively 487 (90%), 43 (8%) and 11 (2%) of the cases. The intensity of gastritis was mild in 6.8%, moderate in 92% and severe in 1.2% of patients. Gastritis activity was absent in 6 (1.1%), mild in 74 (13.8%), moderate in 455 (84.1%) and severe in 5 (1%) cases. The density of HP was mild in 75 (14%), moderate in 437 (80.8%), and severe in 28 (5.2%) cases. Intestinal metaplasia was observed in only 9 cases (1.7%), as for dysplasia, it was not identified in any of our patients. Adenocarcinoma was revealed in 9 (1.7%) patients. Conclusion: The results of our study indicate an incidence of 60% (n=541). The association of chronic gastritis was important. Its pathogenic role has been revealed in many gastroduodenal pathologies in particular gastric cancer objectified in our series in 1.7% of cases, hence the interest in researching HP infection and its eradication.

Aim: This study aimed to investigate the impact of different meal compositions on glycemic control in healthy adults in the University of Port Harcourt by examining the order and combination of carbohydrate and vegetable consumption. Method: A randomized crossover trial was conducted with 30 male and female participants. Three groups were formed, each consuming meals consisting of carbohydrates and vegetables in different sequences. Continuous glucose monitoring and postprandial glucose tests were employed to assess blood glucose levels. The glycemic index (GI) of the meals was also determined. Results: Participants who consumed vegetables before carbohydrates exhibited significantly lower mean glucose levels compared to the other groups. The Vegetable before Carbohydrate group demonstrated a lower overall glycemic response, as indicated by the lower GI values at various time intervals. Conclusion: The findings suggest that consuming vegetables before carbohydrates can lead to better glycemic control in healthy adults. The order of food consumption plays a role in regulating postprandial blood glucose levels. Including vegetables, which have a low glycemic index, in carbohydrate meals can mitigate rapid spikes in blood glucose levels.

Nurses, especially ICU staff, complain of high level of stress regarding the workload. This can be related to many factors such as: nurse-patient ratio, doctor’s orders, timing, hospital environment to name a few. Nursing workload can be defined as all nursing work that must be carried out over a defined period of time. For example the effect of workload on covid-19 patients in intensive care units (ICUs) showed that higher RN staffing was associated with lower levels of hospital related mortality. Each additional full time equivalent RN per patient day corresponds to a 9% reduction in odds of death in ICUs. The aim of this study was to determine the extent of the effect of workload on nurses and other associated factors. A descriptive cross-sectional study was conducted in July to September 2020. 406 staff nurses were enrolled in the study. Instrument of the study was a questionnaire on the effect of workload on nursing staff who were taking care of covid-19 patients. Multiple logistic regression was utilized to identify the factors associated with high nursing workload of nurses. By using bivariate analysis; workload was found to be significantly associated with: nurse patient ratio, duty hours and type of department; the critical care units such as ICU, CCU and HD complained of higher workload (28.8, SD 3.7) than general units (20.7, SD 3.0) the P-value was 0.033. There was no significant difference between the workload and other demographic variables such as: environmental status, nationality, and type of hospital.

It is known that there is a strong link between social development and human resources policy. While the human resources policy covers the human resources of an organization in the micro sense, it covers the human resources of the nations in the macro sense. Achieving this goal will make it a center of attraction for qualified human resources; harmonious execution of growth, development, regional development and spatial development policies becomes more important than before. It is also aimed to strengthen the human resources management strategies and practices of administrations and organizations. Quantitative development will provide qualitative depth education; It is seen as a life-long process that accepts it as an investment in our future with a long-term perspective, improves the quality of life of our people, equips our country's human resources to compete with the contemporary world. In order to ensure that more qualified manpower comes to Turkey, new incentive mechanisms will be created and work permit processes are facilitated and accelerated. It is aimed to strengthen the human resources of the centers and schools to serve children better. Considering the power of human resources policy to realize social change, it is also important to consider what has been done in policy areas and future expectations.

Despite notable improvements in the understanding of the pathophysiology of sepsis, innovations in hemodynamic monitoring and methods of resuscitation, the cases of sepsis and septic shock still has a higher healthcare and economic burden and mortality. Yet, the significance of the nurses’ role is not explored and utilized enough in the fight against sepsis and septic shock. To give emphasis to the nurses’ role, this paper is a systematic review of existing reviews on sepsis following a research question: In patients with a suspected or confirmed sepsis, does specialized sepsis nursing assessment and intervention tool to standard nursing assessment tool improves management, outcome, and length of stay starting from the time of admission? This research question was formulated using the participant, intervention, (comparison), outcomes, and time frame (PICOT) formula. That is: (P) In patient with existing or confirmed sepsis, (I) does specialized nursing assessment and intervention tool (C) to standard nursing assessment tool only (O) improves management, outcome, and length of stay (T) starting from time of admission? Literature reviews and studies cited in this paper that explored sepsis recognizing the significance of the nurses’ role were published in either international or national journals and online databases including CINAHL Cochrane, Proquest, Medline, PubMed, and Google Scholars. The archives were searched using the following eligibility criteria: Nurses and Sepsis/Septic shock; Nurse Led Pathways and Sepsis/Septic Shock. Eligibility criteria of participants included suspected or confirmed blood infection. Out of 30 articles found, only 6 were included in the review based on the eligibility criteria set out. This paper found that nurse- led sepsis pathways played an important role in improving the management and outcome of sepsis. It also found a significant reduction of length of stay starting from the time of admission for those who are suspected or confirmed presence of blood infection. In its recommendation, the paper suggested the creation and implementation of a nurse-led pathway for use within the hospital initially and then throughout the catchment areas eventually.

Primary intestinal lymphangiectasia (PIL) is a rare disorder in children and it is more exceptional in adults. PIL is caused by a diffuse or localized dilatation and/or rupture of intestinal lymphatic vessels in the mucosa, submucosa, or subserosa due to high pressure in lymphatic vessels. The diagnosis is made on clinical grounds with the support of small bowel biopsies. The following report present a case of intestinal lymphangiectasia revealed by capsule endoscopy examination. This work shows that standard EGD and colonoscopy may miss characteristic lesions of PIL, and capsule endoscopy (or enteroscopy) may be required for the diagnosis because lesions are typically located in distal duodenum/jejunoileum.

Poor sterilizing is led to transfer of so many human diseases such as dysentery, cholera, hepatitis A and cholera. In this review, the important of sanitization to the human diseases is explained and the dynamical relationship between them is illustrated. Sterilizing and hygiene are very important to defeat diseases by washing hands and using alcohol sanitizer to clean floor, stairs offices and indoors. In addition, many types of sterilizers that used to clean are introduced with their components. The risk of using alcohol a lot is discussed also it is compared with normal washing with soaps and non-alcohol materials use. Moreover, the important relation between sterilizing and recent disease such as MARS and Covid-19 is covered in details. Eventually, the antimicrobial resistance that produced from the overuse of the sanitizers is discussed with the aim of covid-19 pandemic.

Scholars have divergent views on the classifications of Hausa dialects. Their classifications were based on the Hausa dialects' linguistic features and the geographical locations of the dialects in the Hausa land. Bargery (1934) was the first scholar who classifies the Hausa dialects into two broad divisions of Eastern and Western Hausa dialects in the introduction of his famous dictionary. He made the classification based on their common linguistic features and their regional or geographical locations. Most of the subsequent research of scholars conducted after Bargery’s 1934 dictionary followed the same footsteps of the Eastern and Western dialects classifications, though some scholars had different views on the individual dialects constituting the earlier two broad divisions. Some of the works of these scholars include; Jaggar (1945), Muhammad (1978), Abubakar (1982), Amfani (1993), Bello (1992), Musa (1995), Fagge (2002), Sani (2003), Yakasai (2006), Muhammad (2010), Bello (2015), Musa (2015) and Bello (2016). However, the research works of Ahmed and Daura (1970), Malka (1978), Wurma (2005), and Zulyadaini (2005) on the other hand classified Hausa dialects on the basis of major and minor dialects. They argued that the dialects are supposed to be classified and studied based on popularity and populations of speakers. In essence, the population of speakers of a dialect determines its status of being either a major or a minor Hausa dialect. This paper attempts to make a critical review of the scholars' classifications of Hausa regional dialects of Eastern and Western Hausa dialect divisions with a view to highlighting some of the neglected Western Hausa dialects found in Nigeria today that were not earlier considered in the scholars' two broad divisions. The data of this research was sourced mostly from the Hausa dialect works conducted by scholars and researchers. The research discovered that the earlier classification of individual Western Hausa dialects made by scholars was too narrow, which resulted in merging a number of independent Hausa Western dialects into one, instead of classifying the dialects and studying each dialect independently and broadly.

Many individuals are exposed to bacteria especially those who are raising pets. This interaction between household pets such as cats and dogs and human gives the chance for bacteria to transmit easily. Thereby, these bacteria could transfer from pet’s food and scratching to the owners. In this review, a bacteria gene transmission between pets and human is introduced and discussed. This transmission is happened due to the raising and owning these small animals. In addition, studies on Zoonotic diseases transfer between humans and animals especially pets are presented. Furthermore, the risk of pet ownership by people is reviewed and how should they interact with each other. Also, researches on how Antimicrobial-resistant pathogenic bacteria transmitting between human and pets are discussed. Eventually, gene transfer types between human and pet are explained with their consequences.

Introduction: The dilation of the bile ducts which the obstacle could not be visualized by conventional imaging, constitutes a daily challenge in our medical practice. This work aims to evaluate the frequency and the role of biliopancreatic echo-endoscopy in the etiological diagnosis of bile duct dilatation. Material and methods: This is a descriptive and monocentric retrospective study conducted within the department of 'Digestive Functional Explorations and Hepato-gastro-enterology' at the Ibn Sina Hospital in Rabat, from September 2015 to April 2023. It includes 115 patients admitted for dilation of the common bile duct with no visible obstacle to conventional imaging and who underwent a bilio-pancreatic echo-endoscopy. Results: Our study included 81 patients, whose mean age was 61.2 years with a clear female predominance. Echo-endoscopy confirmed the presence of bile duct dilation in 67% of cases. It established an etiological diagnosis in 82% of cases. Lithiasis of the common bile duct was found in 42,9% of cases, followed by cystic dilation in 12,9% of cases and chronic pancreatitis in 5.2% of cases. A pancreatic tumor has been revealed in 3,8% of cases as well as an ampulloma in 3,8% of cases. Conclusion: Our study, despite its limitations, highlight the role and performance of biliopancreatic echoendoscopy in the etiological diagnosis of bile duct dilatation without any visible obstacle to conventional imaging.

Background and Objectives: The rates of Cardiac implantable electronic device (CIED) infections are increasing worldwide due to the increased use of these devices. (CIED) infection is a serious complication that is associated with increased mortality, morbidity and healthcare costs. There is a need to investigate data on the microbiology of CIED infections since it is poorly documented in Saudi Arabia. We aimed to determine microbiological findings of CIED infections in our region. Methods and Results: The study was carried out in cardiology departments at different centers in Saudi Arabia. Our population consisted of all patients with device-related infections over a period of eleven years from January 2009 to December 2020. It was resulting in 137 patients with device infection. Blood cultures and device material swabs were obtained. Staphylococcus aureus was the most common isolated pathogen (37.2%). particularly, coagulase-negative Staphylococcus aureus in 15.3% of cases, Methicillin-susceptible Staphylococcus aureus (MSSA) in 13.9% of cases and Methicillin-resistant Staphylococcus aureus (MRSA) in 8% of cases. Brucella accounted for 9.5% of cases. Negative cultures of CIED infections seemed to be a critical issue over the studied years. Conclusion: Staphylococcus aureus was the most frequently isolated pathogen and Brucella is a considerable pathogen for CIED infections in our country.

In Sour Sweet, Timothy Mo tells a story about a Chinese family’s struggle in the UK. After experiencing a serious of cultural conflicts, among the three family members Chen, Lily and Mui, only Lily achieves a delicate balance. After defining the process of establishing oneself in a new environment as a kind of translation, this paper applies André Lefevere’s thoughts to study the three characters’ different responses to the cultural conflicts, analyzes how different strategies adopted affect each character’s translation, and explains why does or doesn’t he/she translates himself/herself successfully.

This study aims to investigate the problems and challenges which is usually experienced by English learner's students in the Saudi universities when trying to speak English. It also checks at the problems that students face when learning English language in Saudi universities and try to find remedies to this problem. The research uses a questionnaire, interviews, and descriptive methods in the collection of data about fluency in English language in universities in KSU as an example. The data was then statistically analyzed using the SPSS program. The results showed that there are various problems which hinder fluency of English learning in the universities and among them include: under-qualified teachers, unsuitable teaching materials and the methods used in teaching are also poor. The other problem is the psychological factor which makes student lack motivation while learning English. The study also contains ways in which these problems can be handled to bring efficiency in learning and teaching English in Saudi universities.

Introduction: Oligohydramnios is a pregnancy disorder characterized by a shortage of amniotic fluid volume. It is a rather common obstetric complication that has severe effects on the health of both the mother and the fetus. Early identification is essential for prompt diagnosis and therapy because the clinical appearance of oligohydramnios can vary greatly. This study aimed to investigate the various modes of presentation of oligohydramnios in patients admitted to Bangabandhu Sheikh Mujib Medical University (BSMMU), a tertiary care hospital in Bangladesh. Methods: This prospective observational study was carried out on the admitted patients at the Department of Gynaecology and Obstetrics in Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from February to July 2008 (6 months). A total of fifty women (N=50) having Oligohydramnios in pregnancy were included in the study. Completed data forms were reviewed, edited, and processed for computer data entry. The data analysis was performed using Statistical Package for Social Sciences (SPSS) Version 25.0.The ethical clearance of this study was obtained from the Institutional Review Board (IRB) of BSMMU, Dhaka, Bangladesh. Results: The mean age of the mothers was 25.8 years and two-fifths of the mothers (20, 40.0%) belonged to 21-25 years old. Twenty-three mothers (23, 46.0%) were nulliparous. Of fifty mothers (N=50), eighteen (18, 36.0%) had borderline oligohydramnios and thirty-two (32, 64.0%) had severe oligohydramnios. Normal CTG tracing was found in eighteen patients (18, 36.0%) and abnormal CTG was found in thirty-two patients (32, 64%) (p < 0.01) which was statistically significant. Among the alive babies after initial resuscitation, twenty-three babies (23, 50.0%) were required to get admitted. Twelve admitted babies (12,52.2%) stayed in the neonatal ward for <7 days and among them one baby (1,8.3%) died, nine babies (9,39.1%) were treated for 7—21 days, among them two babies (2,22.2%) could not survive and two babies were treated for more than 21 days but could not survive. Conclusion: According to the findings, severe oligohydramnios was linked to a higher risk of cesarean delivery, higher APGAR ratings, and probable issues that would necessitate neonatal admission and care.