Clinical Audit (CA) is considered as one of the great tools of quality improvement in health care practice worldwide. Despite the fact that clinical audit concept has been implemented in several countries of the world, in Saudi Arabian context it is still not a well-performed practice. As such, many health professionals of Saudi Arabia including dental practitioners are still not aware of this concept though improving the quality of preventive and therapeutic health care services is one of the targets that has been set out by the National Transformation Program (NTP) based on 2030 vision of the Kingdom of Saudi Arabia (KSA). Hence, to improve the awareness, as well as, the knowledge of the positive implications and benefits of CA in practice, it is essential for dental professionals and other health practitioners to perceive the methodology of CA. In order to develop the quality of care and enhance evidence-based practice, activation of CA is of great importance. Hence, a clear view on the different stages in the implementation process of CA has been attempted to explain in this paper. Also, several study reports on the clinical audit in various dental specialities has been put forward in this review that may play an inspirational role for dental practitioners in grasping this procedure in providing a perfect dental health care.

Patients can undergo lower extremity surgery by using the lumbar plexus block (LPB) technique. However, compared with central block, LPB problems were complex. For lower limb procedures, psoas compartment block is a suitable regional anaesthesia approach in place of central neuraxial blockade. As a peripheral nerve block, it is considered less dangerous than a central neuraxial block. However, it might result in some severe issues. Here, we describe a rare side effect of total spinal anaesthesia following psoas compartment block guided by a peripheral nerve stimulator.

Introduction: Burns in pregnancy is common in Bangladesh. Burns are a major, global public health problem, resulting in an estimated 195,000 deaths annually. The majority of burns occur in low-and middle-income countries, with almost half occurring in the World Health Organization (WHO) South-East Asia Region. Objective: To assess the maternal and fetal outcome in second and third trimesters of pregnancy with burn. Methods: This is a retrospective study was conducted in Burn and plastic surgery unit Dhaka Medical College Hospital, Dhaka, Bangladesh from March to May 2022. Total 28 patients admitted were included. The data was collected on the basis of age, percentage of burn over the body surface, gestational age, maternal and foetal outcome. All admitted patients having burn with live pregnancy was included in the study and epidermal burn and burn with other severe co-morbidities were excluded from the study group. All patients were informed about the study. Then those patients willing to take part in the study were included. Results: Total 28 patients (3.1% of female burn patient of childbearing age), having burn with Pregnancy were included in this study fulfilling the inclusion and exclusion criteria. Among 28 patients, 10 (35.7%) patients were in age group 15-20 years followed by 11 (39.3%) in age group 21-25 years, 5 (17.8%) in age group 26-30 and 1 (3.6%) patient each was in age group 31-35 years and 41-45 years group. Age range was 16-45years. 96.4% burn Accidental and 3.6% burn Suicidal. Among 28 patients, 16 (57.1%) were survived after treatment and 12 (42.9%) patients died. The causes of death were septicemia and MODS in maximum cases. Fetal outcome shows, 16(57.1%) fetus were survived. Of them 8 pregnancy continued till discharge, 8 babies were delivered during treatment period (6 by normal vaginal delivery, 2 by caesarian section). 12 (42.9%) fetal death occurred. Among them 5 fetus died with maternal death, 1 intrauterine death follower by normal delivery and 1 still birth occurred. Conclusion: Most burns with pregnancy are in the 16-30 years age group and accident was the major cause of injury. Inhalation injury, burn related complications like burn shock, septicemia and infection are major factors responsible for maternal and fetal mortality. Early hospitalization, prompt and aggressive fluid management, proper management of suspected inhalation injury and early identification and management.

Background: Providing instant care for life-saving or rescuing the injured or sick people requires having a considerable amount of first aid (FA) knowledge and experience. The current work sheds some light on the current status of Saudi family members’ first aid knowledge and experience aiming at reaching a sustainable decrease in the number of deaths and unnecessary losses. Methodology: A questionnaire was used to collect (N=447) participants’ information 35.6% (159/447) males and 64.4% (288/447) females from a number of Saudi cities. The collected data were analyzed using IBM SPSS v 25. Results: The results showed that 48.3% (216/447) of the participants have good FA experience and only 7.2% (32/447) have excellent FA experience. The majority of the participants 65.3% (292/447) were not FA-certified, 22.8% (102/447) attended an FA course, and 11.9% (53/447) were certified first aiders. 93.7% (419/447) of the participants think that the community’s FA awareness is low. The results also reported statistically significant association between being related to health care sector and FA experience χ2(3) = 56.8, p = 0.000, witnessing accidents and gender v χ2(7) = 19.1, p = 0.008, and having got FA tools and FA experience χ2(3) = 28.5, p = 0.000. Conclusion: The current study’s results along with numerous similar research provoke a public outcry to take practical steps towards enhancing a sustainable community’s FA education through campaigns, workshops, and training courses.

The study integrates electrical resistivity tomography (ERT) and vertical electrical sounding (VES) methods for investigation of the groundwater potential of the study area. Five ERT was conducted to determine the variation in resistivity of the shallow subsurface rocks both vertically and laterally in order to infer aquifer zones therefrom while twenty-four VES was carried out to compliment the information obtained from the ERT, determine vertical variation in resistivity, infer lateral variation in resistivity, identify depth to aquifer and infer groundwater prospect of the area. Three geoelectric layers were obtained with layer resistivity and thickness increasing northwards with shallower depth to aquifer obtained at Kutigi. K (ρ1<ρ2>ρ3) and Q (ρ1>ρ2>ρ3) resistivity type curves constitute 75% of obtained curves signifying increasing groundwater saturation and salinity, and are indication of increasing aquifer prospect with depth. The groundwater prospects in the area is generally high with properly constructed boreholes in these areas will produce prolific groundwater at 40 meters with higher yield expected at the southern regions of the study area around Enagi.

Metacognitive knowledge, knowledge about knowledge, was found to have a positive effect on learners’ performance, self-regulation, and academic success (Hartman, 2001; Wenden, 2001 & McCormick, 2013). However, little research has been done about the use of metacognitive knowledge and strategies applied in EFL writing in a Saudi context. The present study investigated the university learners’ metacognitive abilities in relation to writing including other variables like learners’ educational background and years of studying English. The study examined the correlation between the learners’ metacognitive abilities and their writing performance affected by their metacognitive knowledge and its regulation. Data were collected using a modified version of the Metacognitive Components of Planning Writing Self-inventory developed by Escorcia and Gimenes (2020) to analyze the learners’ metacognitive writing strategies. The survey consisted of three factors, metacognitive conditional knowledge, covert self-regulation, and environmental self- regulation. Participants were 190 female learners, first-year students studying English in a comprehensive program including writing at the University of Jeddah. Learners were asked to complete the survey adapted by the end of their course. The level of metacognition was checked for its effect on learners’ writing through Linear Regression. Findings indicate a positive significant correlation between the learners’ metacognitive conditional knowledge and writing performance. Also, a significant impact was predicted on learners’ writing performance. However, findings also specify a negative correlation between environmental self-regulation and learners’ writing performance. Additionally, the ‘years of studying English’ highly correlate with the learners’ metacognitive abilities, unlike learners’ educational background.

Background: Ankylosing spondylitis (AS) is a common inflammatory rheumatic disease that affects the axial skeleton, causing inflammatory back pain and can lead to structural and functional impairments. On average, ankylosing spondylitis (AS) incidence rates range from 0.2% to 1% of the adult population. McKenzie exercise seems to be beneficial for those affected by AS, in particular when it is planned according to the needs of the individual aiming to maintain or improve the level of physical fitness. The prevalence of AS is generally believed to be between 0.1% and 1.4% globally. Aim of the study: The aim of this study was to evaluate the functional outcome of McKenzie exercise in patients with ankylosing spondylitis. Methods: This was a comparative experimental study which was conducted in the Department of Physical Medicine and Rehabilitation, BSMMU, Dhaka, Bangladesh from October 2019 September 2020. The study was approved by Institutional Review Board (IRB) of BSMMU on. A total of 112 patients with ankylosing spondylitis were selected who were divided into two groups. 56 patients were allotted in group A (NSAID group) and another 56 patients were allotted in group B (NSAID with McKenzie exercise). Collected data were processed, analyzed and disseminated by using MS Excel and SPSS version 23.0 program as per necessity. Results: The mean VAS score at baseline was 34.44 ±2.78 in group A and 34.03±2.23 in group B, at 4 weeks 28.89±3.67 in group A and 21.23 ±3.57 in group B, at 8 weeks 30.59 ±3.69 in group A and 16.95±3.62 in group B and at 12 weeks 28.08±3.34 in group A and 15.04 ±3.77 in group B. The mean BASFI at baseline was 3.19±0.15 in group A and 3.51±0.18 in group B, at 4 weeks 2.99±0.15 in group A and 2.15±0.05 in group B, at 8 weeks 1.99±0.09 in group A and 1.26±0.22 in group B and at 12 weeks 2.01±0.09 in group A and 1.25±0.2 in group B. The mean BASDAI at baseline was 5.01±0.39 in group A and 4.95±0.4 in group B, at 4 weeks 3.99±0.07 in group A and 3.43±0.09 in group B, at 8 weeks 3.97±0.09 in group A and 3.02±0.07 in group B and at 12 weeks 3.49±0.06 in group A and 1.98±0.09 in group B. The differences of VAS score, BASFI and BASDAI at 4, 8 and 12 weeks were statistically significant (p<0.05) between two groups. Conclusion: Ankylosing spondylitis (AS) causes pain and stiffness to affected joints and the spine and if the disease progresses, it can cause fusion of the joints, which can limit a person’s mobility and flexibility. In analyzing the outcomes of McKenzie exercise in patients with ankylosing spondylitis the differences of VAS score, BASFI and BASDAI at 4, 8 and 12 weeks were found as statistically significant (p<0.05) between NSAID group and NSAID with McKenzie exercise patient groups.

Introduction: Cardiothoracic ratio and vertical height are important indicators of cardiac size. The chest radiograph provides excellent contrast between the air-filled, cardiac, and aortic outlines. Aim of the study: This study was aimed at determining the cardiothoracic ratio, vertical height, transverse dimension of the trachea of Nigerians resident in Port Harcourt. Materials and Methods: This was a retrospective descriptive study carried out in the Radiology Department of the University of Port Harcourt Teaching Hospital, Rivers State. The study duration was 8 months (January–September, 2021), which involved four hundred and forty-eight (216 males and 232 females) normal chest radiographs of adult Rivers aged between 18 and above. The radiographs were found to be normal by a qualified radiologist in the department. Random sampling was used to determine the sample size for the study. Results and Discussions: Males [VH(cm) 1.49±0.40; TDT(cm) 20.20±2.81; ACR(cm) 0.46±0.068]; females [VH(cm) 19.08±2.58; ACR(cm) 0.48±0.06; CTR (cm) 41.44±3.40]. The males had repeatedly higher values vertical height and cardiothoracic ratio than the females, while the females had a higher value for aorto-cardiac ratio. Conclusions: The values of vertical height, cardiothoracic ratio, transverse dimension of trachea, and aorto-cardiac ratio demonstrated sexual dimorphism, the males had consistently higher values than the females except for aorto-cardiac ratio.

Forests ecosystem englobes abundant natural resources in which the world population highly depends on for their existence. Internationally, the 1992 Rio Declaration and the 1992 Convention on Biological Diversity amongst others, has categorically prescribed universal legal standards for the protection of the rights of forests communities. In Cameroon, forests with its natural resource endowments (timbers and non-timbers) has been considered by many as the cultural heritage of most local communities and a source of government revenue. Without mincing words, the forestry law and other related laws have given local communities bundles of rights to sustainably use and manage forest resources. However, these rights remain wanting due to ineffective implementation. As a result, local communities are prone to abject poverty, misery and paradox of plenty or rather put it “Tragedy of the Commons”. In this vein, the paper therefore, seeks to address the following worries: What type of rights do these forests communities exercise? Are the provisions of the law with regard to local communities’ rights and interests in the sustainable management of industrial forestry respected and if so, to what extent? What difficulties do local communities encounter in exercising these bundles of rights? Legally, the methodology employed in this article is purely doctrinal which is based on both primary and secondary data. The paper therefore, concludes with some robust recommendations which if effectively implemented and enforced will go a long way to guaranteed the rights of forest communities and thus, enhance sustainable industrial forestry management.

Background: The aim of this paper is to illustrate the expansion of mandibular arch using Transforce appliance. Case Report: Use of Transforce appliance for arch expansion for severely constricted mandibular arch. The patient is successfully treated with arch expansion. Conclusion: Transforce appliance is a good choice for mandibular arch expansion. Since mandible lacks sutures to open up, light force is required for arch development and Transforce appliance is capable of producing light forces.

Fenugreek seed mucilage (FSM) is isolated from the seeds of Trigonella Foenum-graecum, commonly known as Fenugreek, which is herbaceous plant. Fenugreek seeds contain high percentage of mucilage, which does not dissolve in water, but swell up and become slick when exposed to fluids. Atorvastatin is one of the HMG-CoA reductase inhibitors (statins), which are lipid-lowering medications used in the primary and secondary prevention of coronary heart disease. Atorvastatin is poorly absorbed orally, its oral bioavailability is very low (about14%) because it is very slightly soluble in distilled water and pH 7.4 phosphate buffer, which would limit its clinical application. The objective of this study is to enhance atorvastatin solubility in order to increase its bioavailability by the formulation of solid dispersion using fenugreek seed mucilage. Mucilage was extracted from the seed and evaluated for flow properties, pH value, FTIR spectroscopy and percentage practical yield. Then solid dispersions with different drug to polymer ratios were prepared from fenugreek mucilage and hydroxy propyl methyl cellulose (HPMC), after that saturation solubility was tested for fenugreek seed mucilage solid dispersion (FSMSD), hydroxxy propyle methyl cellulose solid dispersion (HPMCSD) and pure drug. Tablets were prepared from solid dispersion with the highest saturation solubility, then tablets were tested and evaluated. The tablets showed satisfactory physicochemical properties as 1.77%RSD in tablet weight variation, 1 min disintegration time, 5.24±0.457 Hardness and 89% drug release in 45 min. it is concluded that FSM is a promising excipient that can be used in dosage forms formulation to enhance solubility of low soluble drugs.

Rehabilitation is important, as are other facets of universal health coverage such efficient illness prevention, treatment, and palliative care. A person who has undergone rehabilitation can participate in school, job, recreation, and important life responsibilities including caring for family members. Rehabilitation enables a child, adult, or senior to be as independent as possible in daily activities. A health issue that could be treated by rehabilitation affects an estimated 2.4 billion individuals worldwide. The need for rehabilitation services is anticipated to increase globally as a result of changes in population health and features. People are living longer but with more chronic illness and incapacity, for instance. Rehabilitation needs are now mostly unmet. More than half of the population does not obtain the necessary rehabilitation services in several low- and middle-income nations. Rehabilitation and other healthcare programs have been severely impacted by the COVID-19 pandemic.

The modern education system of the teacher training college shapes responsible enlightened citizens and qualified experts without whom no nation can progress socio-economically, culturally, and politically. Since society is becoming knowledge-based it is higher education that is contributing to a cultural socio-economic and environmentally sustainable improvement of the individual, organization, community, and nation. The Indian education system can neither compete nationally nor globally without a systematic and well-planned curriculum for the betterment of the trainee teachers’. Yogic practice in scientific ways daily basis is known as an influential factor on many physiological parameters of them. Studies have identified that yogic practice affects working efficiency. This study aimed to identify the effect of yogic practice on physiological parameters. College settings had been full of stressors that negatively influence pupils' mental health and academic performance. For solving trainee teacher s' academic performance issues, the yogic practice has been used to improve their academic outcomes. These findings further the knowledge of the role played by yogic practice interventions in reducing pupils' burnout symptoms and cultivating their ability and well-being, in promoting a nurturing classroom climate, and also in promoting the ability and well-being of Trainee teacher s. This study applied information process theory to demonstrate the internal mechanism between yogic practice and academic performance in three pathways with three major sections. This study benefited from the summary of the mechanism of yogic practice and academic performance, promoting the development of yogic practice-related activities and applications, and improving trainee teachers' participation in yogic practice interventions, thereby improving their academic performance. The findings suggest that yogic practice can improve the total personality of an individual. These results suggest that mindfulness-based yoga can be a positive tool for the classroom to reduce trainee teacher s’ anxiety, stress, and depression. Benefiting from the summary of the mechanism of yogic practice and academic performance, promoting the development of yogic practice-related activities and applications, and improving trainee teachers' participation in yogic practice interventions, thereby improving their academic performance.

Sarcocephalus latifolius and Cnestis ferruginea are shrubs with heights of 5 to 8 m and 3 to 3.6 m, respectively, and are known to be powerful aphrodisiacs. Our aim was to evaluate the effect of aqueous extracts of their leaves on the body weight and relative weight of some androgen- dependent sex organs of male rats. For this purpose, the rats were subjected to an 8-day treatment. These extracts had no significant effect on either the body weight or the relative weight of the androgen-dependent secondary sex organs of the rats compared to the control over the 8-day treatment period. The leaves of Sarcocephalus latifolius and Cnestis ferruginea did not have any detectable androgenic properties during this period.

The purpose of this study is to analyze the UTAUT2 model of interest in using accounting software in MSMEs by using accounting knowledge as a moderating variable. The data collection technique uses simple random sampling through Google Forms in the form of a questionnaire. This study has a total sample of 164 respondents with the criteria of MSME owners. The data processing method in this study is to use smartPLS with the aim of testing the hypothesis. The results of this study indicate that performance expectations, hedonic motivation, and social influence have a positive and significant effect on the intention to use accounting software while accounting knowledge cannot moderately and negatively influence the UTAUT 2 model on interest in using accounting software. The results of this study recommend that to increase interest in using accounting software for MSMEs, it is necessary to socialize the meaning of accounting and procedures for using accounting software for MSMEs in order to improve the management of financial reports.