Accreditation is one of the approaches to evaluate the quality of health care services, and it’s an essential requirement for the continuity of services. Nursing staff play a major role in the accreditation preparation, process and continuity. The study aimed to assess the nursing perception of the impact of accreditation on the quality of care and safety in a tertiary cardiac care center in the Eastern Province, Kingdome of Saudi Arabia. A cross-sectional descriptive research design was used. A convenient sample of 56 nursing staff was included. The study tool was a self-administered online questionnaire. It consisted of four major sections with 20 subscales rated from 1 to 5 on a Likert scale. Nursing documentation, patient medication information, healthcare-associated infection, leadership and support sections are all included. The study findings indicated that nurses have a 94.6% positive perception of the impact of accreditation on the patient’s safety. This perception was measured in accordance with the items related to international patients’ safety goals. Higher agreement was found on the items of nursing clinical documentation and medication safety process. The study findings support the overall positive impact of accreditation. The study further recommends exploring the nursing perception of accreditation impact in different settings.

Background: Cancer diagnosis can have an extensive impact on mental health and comfort. Depression and anxiety may hamper cancer treatment and recovery, as well as quality of life and survival. Cancer is an important incident in one's life which has substantial outcomes for patients and their families as well. The major psychological significance in cancer patients is depression that often takes less attention. Objective: The objective was to determine the prevalence of anxiety and depression among cancer patients and whether these conditions were associated with certain sociodemographic factors. Methods: It was a cross-sectional study. By convenient sampling technique, a total of 150 samples were selected. The patients were studied after histopathological confirmation of diagnosis of cancer. Sociodemographic and other data was collected by face-to-face interview using semi structured questionnaire. Data analysis was done by Statistical Package for Social Sciences (SPSS) version 26.0 and results were presented with appropriate graphs and texts. Results: The mean age was 46.5±9.5 years. 65.3% were male and 34.7% respondents were female. Male: female ratio 1.9:1. Moderate depression was higher in-service holder 53.8%. Among agriculture worker, 38.6% had mild depression symptom, within house wife 63.2% had mild to moderate depression symptom. No significant relation was found occupation with depression symptom (p>0.05). While moderate anxiety symptom was higher in-service holder 42.3%. Among agriculture worker, maximum 54.5% had moderate to severe anxiety symptom, within house wife 47.4% had moderate to severe anxiety symptom. No significant relation was found occupation with anxiety symptom also (p>0.05). Significant relation was found among income group with level of depression and anxiety symptom (p<0.05) as study showed both depression and anxiety were found more among higher income group population than lower income population. Conclusion: In this study both higher education and higher socioeconomic status were found to be predictors of depression and anxiety.

Background: White coat hypertension (WCH) is a condition in which people exhibit an elevation in blood pressure (BP) in a clinical setting, although they do not show such elevation in other settings. This study aims to provide new insight into determining the prevalence of WCH amongst patients with or without any cardiovascular risk. Method: This is a cross-sectional study of convenience sampling study design where 300 patients were involved based on their consultation to a Tertiary Healthcare Unit between November 2021 to March 2022 in Erbil city. Patients were classified according to the ESC into different categories of BP patterns by comparing the first BP reading that was taken at clinic with their average AMBP readings which were taken at home. Results: A total of 300 patients were included in the study where 58% of the population was male and 42% of the population was female. Of the population, 16% had WCH, 12.3% had sustained HTN, 59.3% were considered to be normotensive (NT), and 12.3% among them were categorized as masked hypertension. From the total of 47 patients that were diagnosed with WCH, 55.3% were male and 44.7% were female patients. The overall average Systolic Blood Pressure in WCH was 125.79±15.30 mmHg, and in Hypertensives it was 147.70±17.15 mm Hg with a P-value of <0.001. The Mean Arterial Pressure in WCH was 94.63±8.87 mmHg and in Hypertensives it was 112.16±13.62 mmHg with a P-value of <0.001. The average Pulse Pressure in WCH was 75.27±9.42 mmHg, and in Hypertensives it was 76.35±9.11 mmHg with a P-value of 0.001. Conclusion: WHC is significantly prevalent in Erbil city; therefore AMBP monitoring should be performed for those with certain indications to limit the prescription of unnecessary long-term medications with possibly significant side effects to patients with WHC.

Purpose: To compare the outcome of corneal collagen crosslinking (CXL) in conjunction with antimicrobial agents (AMA) to antimicrobial agents alone in the treatment of infectious keratitis. Design: Prospective comparative clinical trial in a tertiary hospital in India. Participants: 40 patients with infectious keratitis randomised into two groups of 20 patients each- Group 1 and 2. Methods: Group 1 patients underwent CXL in addition to antimicrobial therapy. The patients in Group 2 received only antimicrobial therapy. The slit-lamp characteristics of the corneal ulceration, visual acuity, time taken for healing, and complications were documented in each group. The t-test was used for statistical analysis. P values less than 0.05 were considered statistically significant. Results: The mean time taken for healing in Group 1 was 44.5±11.2 days and in Group 2 was 27.65±7.79 days. Analysis of various parameters revealed that patients undergoing CXL showed slower healing duration (p=0.00). Conclusions: Use of CXL in conjunction with AMA lowers the risk of complications, but also slows the rate of healing of ulcers.

Severe acute respiratory syndrome coronavirus 2 that causes coronavirus disease 2019 (COVID-19) is changing at a rapid pace due to accumulated mutations in the viral genetic code over time. As new variants of the virus continue to emerge and replace previous versions of the variants, therapeutics and vaccines are being constantly monitored and reviewed for their efficacy against the new strains. With the surge in new omicron sub-variants across the nation, U.S. Food and Drug Administration issued emergency use authorization to a new monoclonal antibody therapy called bebtelovimab replacing the previous sotrovimab that was effective against Omicron BA.1. The main objective of the paper is to review the current treatment options available to treat non-hospitalized mild-to-moderate COVID-19 caused by the new omicron sub-variants BA.2, BA.4, and BA.5. Scientists, pharmaceutical companies, and researchers have been proactive in conducting randomized, double-blinded, placebo-controlled clinical trials to test the safety and efficacy of therapeutics in managing COVID-19 in addition to testing the vaccine efficacy against new strains. The paper focuses on reviewing the results of these randomized controlled trials. The oral antiviral options paxlovid and molnupiravir, and intravenous (IV) bebtelovimab continue to show their efficacy against the new sub-variants BA.4 and BA.5. It is important for everyone to stay well-informed of the new treatment options and only opt for those medications that are currently authorized for use in treating mild-to-moderate COVID-19.

PT. Tirta Investama – Subang Factory is an industrial company engaged in bottled drinking water, background of this research is significant increase in product returns of 5 gallons over five years (in 2016 - 2020) from AQUA Group. Purpose of this study was to analyze the cost of quality due to defective products and their impact on the company's performance. This study uses the quantitative destructive method with the seven tools analysis method. The results showed that the increase in conversion costs / industrial costs, especially quality costs, has an impact on the company's performance must be improved.

The ultrasonic scalers are today becoming the most chosen form of dental polishing and cleaning. With the various researchers and lab tests done on them, it is steered clear of any side effects or invasive methodologies that might harm the patient in any manner. It works both on the soft and hard oral tissues have become the most widely used cleaning instruments among dental practitioners. Ultrasonic scalers use its vibrating power to eradicate different forms of dental plague and foreign components from the teeth. Through various on-field experiments and lab tests, it was made sure that these ultrasonic scalers work much better than any other primitive method for the same task. And that’s the major reason why it is so much in demand, ultrasonic scaling has become widely used for professional tooth cleaning. The aim of the systematic review is to assess the role of ultrasonic scaling on dental restoration. A computerized literature search was performed in following database including: Pubmed, the Cochrane Library, Google Scholar and Scopus databases from 1st January 2000 till January 2022. Studies determining the impact of ultrasonic scaling on dental restorations including randomized controlled trials, prospective and retrospective studies, and cross-sectional studies were included. After an initial search a total of 570 articles were identified. Then, 44 studies which were full-text articles were critically reviewed by independently for eligibility. Finally, 10 studies which met all the inclusion criteria were included in the review. The findings showed that out of all of the elements used, we can observe that the glass ionomers have had the chances of greater impacts. Further studies should assess the method of polishing for the removal of discolorations from ceramic restorations after ultrasonic scaling procedures and the possible side effects of polishing.

The purpose of the study is to investigate the Parental Background influencing Primary School Pupils Academic Performance in Maru Local Government Education Authority Zamfara State-Nigeria. The objectives of the Study are therefore to establish the parental economic factors and parental educational background influencing academic performance in public primary schools in Maru Local Government Education Authority. A descriptive survey research design was used in the study. The target population was 148 public primary school of Maru Local Government. Ten 10 primary school were purposively selected from total population. Validity of the instrument: face and content validity were validated by some experts, including one in test and measurement all from the faculty of education and extension service Usmanu Danfodiyo University Sokoto. To ascertain the reliability of the instrument, a test and retest was carried out in 2 schools out of the sample with an intervals of two weeks after which the two scores was compared using Pearson product moment correlation formula and the reliability index of 0.824 was obtained which indicate the agreement of the 2 test was good enough for usage. Study, indicated that many parents do not play their roles in terms of their children’s education as evidenced by low motivation, and parentsalso do not follow their children’s academic success. It was recommended that parents should discourage absenteeism of pupils in the school. Parent should devote more of their time to the upbringing of their children by providing academic materials.

The compressive strength and optimization of concrete produced by replacing cement with CSA and GSA was conducted in this study. The materials used were cement, water, fine aggregate, coarse aggregate, CSA, and GSA. The CSA and GSA replaced cement at 5, 10, 15, 20, and 25% in combination, with a total of seventy two (72) cubes cast, while the concrete compressive strength was determined after curing by complete immersion in water at 7, 14, 21, and 28 days. The modeling and optimization was done with the aid of design expert (version 13) software, while the Analysis of Variance (ANOVA) was done using SPSS (Statistical Package for Social Sciences) version 23 and adopting the Least Square Difference (LSD) method. Results from the findings showed that the CSA used in the study is a good reactive pozzolana, and the GSA is not a reactive pozzolana. Also, the increase in CSA and GSA content in concrete reduces its workability, and concrete compressive strength. However, cement replaced with 5%CSA-0%GSA gave the optimum 28 days compressive strength which is not statistically significantly from the control concrete and can be used to produce concrete of compressive strength close to the control. Further findings from the regression model showed that CSA-GSA concrete compressive strength significantly fits a linear model and can be used to predict the 7, 14, 21, and 28 days compressive strength of CSA-GSA concrete, while the optimized result showed that CSA and GSA replacement of cement at 3.29% and 4.45% respectively yielded an optimum compressive strength of approximately 22.31N/mm2.

The rapid development of Shi’a movement around the world involving several crisis in the Middle East become a major influencer on the Muslims in Malaysia. Though, its teachings and influence growth, but it was contradict with the Ahlul Sunnah Waljamaah (Sunni) teachings practice in this country. This development have become a serious problem when they dare to protest against the fatwa on banning Shi’a. Therefore, the purpose of this paper is to discuss the Shi’a deviance and the strategies to fight against its propaganda in Malaysia. The findings in this paper shows the Shiites deviation is from faith and practices aspects. At the same time, this paper found some of the key element regarding the Shiites propaganda among the people in Malaysia. Then, the paper concludes that the banned on Shiites movement in Malaysia is due to its extreme doctrine or teaching that effect the Islamic faith. Thus, the Shiites in Malaysia is not only seen as heresy, but it consider as a threat to the national security. Shiites dispersion is contagious in the country and need to eradicated as well as possible. This is because it’s a threat that able to clash the unity of Ummah and religious integrity as well as dividing the unity of the Muslims in this country.

Obesity is a major health hazard not only for developed countries but also for Bangladesh and it is an established risk factor of breast cancer. In our country there is a scarcity of studies on the associations of BMI and different features of breast tumour. This study was aimed to evaluate the associations of BMI with molecular sub-types, clinical and pathological characteristics of breast cancer in Bangladeshi women. This cross sectional descriptive type of observational study was conducted in National Institute of Cancer Research and Hospital (NICRH), Mohakhali, Dhaka from September, 2019 to August, 2020. A total of 90 patients with breast cancer were selected purposively according to inclusion and exclusion criteria. An informed consent was sought from the patient to take part is this study. Detail history taking thorough physical examination was done along with relevant investigations. Data were collected by semi structured questionnaire and analysis was done with the help of Statistical Package for Social Science (SPSS), version 21.0. Mean age of the respondents was 41.17 years with a standard deviation of ±8.79 and a range of 24-65 years. Of all, ninety percent patients were housewives and 52.2% belonged to upper middle socio-economic class. About 66.7% patients were pre-menopausal and 33.3% were post-menopausal. The mean BMI of respondents was 25.89(±4.67) kg/m2 and among them 51.1% were obese, 23.3% were overweight and 20.0% had normal weight. No association between BMI and vii molecular subtypes of breast cancer were noted (p>0.05). No association between BMI and hormone receptor status of breast cancer was found. Association with tumor size, axillary lymph nodes, tumor grade and lymphovascular space invasion were also not significant (p>0.05). No association between BMI and molecular subtypes, clinical and pathological features of breast cancer were noted both in pre and post-menopausal groups. This study found no association between BMI and different features of tumor, which could be attributed to small sample size, absence of control and a single centered study. However, further extensive study is recommended.

Background: Premature rupture of membrane (PROM) is linked to significant fetal and maternal morbidity and mortalities. The maternal and fetal outcomes in PROM are very important to decrease maternal and child mortality and for better management and prevention of complications. Objective: To find out maternal & fetal outcomes of preterm premature rupture of the membranes. Methods and Material: This is a cross-sectional observational study carried out in the Department of Obstetrics & Gynaecology, 250 Beded District Hospital, Chapainawabganj, Rajshahi, Bangladesh from January 2016 to July 2016. 50 pregnant women with preterm premature rupture of the membranes. Result: The majority of patients with preterm PROM (30%) belong to the age group 31-35 years. The mean age of the patients and SD were 26.4±6.58. 60% of respondents were multipara and 40% primipara. Most of the patients had irregular antenatal checkups (56%), 24% had regular antenatal checkups, and 20% had no antenatal checkups. Twenty percent of patients developed labor pain within 15 hours of rupture of membrane, 24% within 16-30 hours, 56% within 31-45 hours, 10% within 46-60 hours, and 12% without the onset of labour pain. 37 (74%) patients with preterm PROM had a normal vaginal delivery, and 13(26%) delivered by caesarian Section. Forty-three percent of patients delivered within 24 hours of the ruptured membrane, followed by 24% of patients within 24-48 hours, and 28% of patients within more than 48 hours. Among 50 patients, 12 (24.0%) had a previous history of abortion, 24 (48%) had H/O preterm delivery due to PROM, 2 (4.0%) had H/O MR, and 6 (12.0%) had H/O D & C. Among 50 respondents with PPORM 4 (8.0%) had diabetes mellitus, (12.0%) had HTN, 15 (2.0%) had urinary tract infection and 10 (20.0%) had lower genital tract infection. In this study, the total number of the alive baby was 42, and the stillborn baby was 2. Out of 42 alive babies, 18(42.86%) were affected by the consequence of preterm PROM and the birth process. Among 48 alive babies, 6(12.50%) developed birth asphyxia, 5(10.42%) developed jaundice, 3(6.25%) developed neonatal sepsis, and 4 (8.33%) developed respiratory distress syndrome. Maternal morbidity were chorioamnionitis 4(8%) puerperal sepsis 5(10%), postpartum endometritis 2(4%), abruptio placenta 1(2%) and wound infection 2(4%). Conclusion: The incidence of preterm PROM was more in multipara. The majority of the patients were from lower- and middle-class families. This study found some factors, e.g., Coitus, the recent history of abortion, M.R., D & C, and previous history of PROM. The study was done with a small population, but it introduces us to certain risk factors that can be prevented. Proper health education, patient motivation, improved health hygiene, and adequate maternity and childcare services are needed to reduce morbidity and mortality.

Nowadays if we notice to our human world, we find that most of our social instability and insecurity is caused by our own members of Homo sapiens species; especially our young generation is engaging themselves in many unethical activities, violence and juvenile crimes forgetting their morality as well as identity based rules and regulations. It is going to be a matter of concern as well as an alarming matter all over the world. Like other countries Bangladesh is also facing this kind of challenges. According to the FBI statistics, most crimes are committed by adolescents. The rate of this involvement is alarming in Bangladesh; especially in Dhaka city. Now the question is what the causes behind this youth degradation are? If we notice deeply we will find that, the root cause of all unethical behaviors and activities of a human being is mainly caused by their identical instability or crisis, which invokes them to engage with inappropriate activities with their identity. In this article, we discussed about this important issue and tried to establish the root cause of youth degradation with explaining necessary terms, causes, providing real scenario of this crisis in young generation of Bangladesh and exploring overcoming strategies.

In sickle cell anaemia (SCA), continuous activation of the vascular endothelium by inflammatory cytokines leads to increased elaboration and secretion of von Willebrand Factor (vWF), a potent mediator of adhesive interactions involving the endothelium and circulating blood cells. Non-O blood groups are associated with the elevation of vWF concentration. Thus, SCA and non – O blood groups are determinants of increased levels of vWF, which plays a pivotal role in the pathophysiology of vaso-occlusive crisis (VOC). To determine the influence of plasma vWF:Ag levels, ABO and Rh (D) blood groups on the risk of occurrence of sickle cell vaso-occlusive crisis. We conducted a prospective study of frequencies of VOC with respect to plasma vWF:Ag levels, ABO and Rh (D) blood groups of 50 SCA patients. In comparison with blood group O, patients with non – O blood groups had significantly higher mean vWF concentration (4.17+3.16 IU/l vs 3.46+3.69 IU/l, p< 0.001), with a significantly higher mean number of VOC episodes per patient (3.2 vs 1.3, p<0.001). The relative risk of VOC for patients with non- O blood groups was 1.87 (95% confidence interval 1.5 - 2.2, p<0.001). However, the association of Rh (D) blood group of the patients and their plasma vWF:Ag levels on the risk of occurrence and frequency of VOC was not statistically significant (P = 0.155). SCA patients with non – O blood groups had more episodes and higher risk of VOC that were likely due to the effect of higher plasma vWF concentration. These results indicate that the non- O blood group is a risk factor for frequent VOC and an unfavourable prognostic marker in SCA. We hereby recommend that a large multicentre prospective study be carried out to definitely determine the impact of ABO, Rh and other blood groups on the overall clinical course of SCA.

Introduction: The changes of the operative program lead to inefficient use of available operating ranges, and waste of resources. Objective: This study was conducted to evaluate the incidence, causes in the changes of the operating program and any consequences in order to find appropriate solutions for better patient management. Materials and Methods: It was of a study conducted in the potential services of anesthesiology of the Mohammed V military hospital in Rabat. Was included in the study changes the operating program (refusal, addition). Were excluded all the changes in the other operating sites. For any changes was completed farm return. The collected parameters were: age, sex, ASA, categories, the service concerns by adaptations, causes, the timing of the change and patient’s outcomes. Results: From November 2020 to May 2021; 3620 were scheduled for elective surgical operations. Of these, 320 (8, 8 %) patient’s operations were cancelled and 252 (7%) were added. The Urology department had the highest rate of cancellations (23, 4%). Causes related to patients represented 50 % of cancellation’s rate, followed by causes related to the surgery 40% and finally those related to anesthesia in 10% of all cancellations. The absence of the patient during the intervention was the most common patient-related reason for cancellation (78.1 %), the most common surgery reason was not a sufficient time frame (55.5 %) and finally the non-availability of blood and up ICU (25% each), were those related to anesthesia. Conclusion: Changes in the operating program rate were high in comparison with reported rate worldwide. Efforts should be made for planning, programming and coordination between the different actors involved in the operational planning.