Background: Methotrexate helps your immune system from assaulting your body's cells by calming it down. This helps to lessen the inflammation that causes rheumatoid arthritis's swollen and stiff joints, psoriasis' thickened skin, and Crohn's disease's gut damage. Because of its powerful effectiveness and safety, In the treatment of rheumatoid arthritis, methotrexate (MTX) is used as an anchor disease-modifying anti-rheumatic drug (DMARD) (RA).Although MTX aids a huge percentage of RA patients, it is not without adverse effects. When treating rheumatoid arthritis patients with the MTX, wide a variety of adverse effects, from minor to severe, can occur, leading to therapy termination. One putative harmful effect of methotrexate on the due to a local folate deficiency, there is a reduction in hepatic folate stores and toxicity. When MTX used with other medications, further research is needed to improve efficacy while reducing adverse effects. The management of MTX therapy is also reviewed, as well as options for dealing with adverse effects that may arise. Objective: The purpose of this study was to see how methotrexate affected individuals after 6 to 12 months of treatment for rheumatoid arthritis. Methods: Data was collected at the Shalamar hospital, Pakistan, between January 2021 and June 2022. Non-Probability Purposive Sample is the sampling strategy used in this investigation. Following the assignment of a study subject, the research took around 6 months to complete. After giving their informed consent, 120 patients between the ages of 30 and 50 were involved in this study. Data will be acquired using data collection technologies when an informed written permission form has been completed. Result: In this study 120 Rheumatoid Arthritis patients were studied, with 64 males (53.3%) and 56 women (46.7%) having an average age of 40 to 45 years and a range of 30 to 50 years. took part in the study, as shown in the graph (Table 3). In this study, 4 patients are 30 to 35 years old and have a percentage of (3.3%), 18 patients are 36 to 40 years old and have a percentage of (15%), another age group is 41 to 45 years old and has a percentage of (47.5%), and the last age group is 46 to 50 years old and has a percentage of (34.2%), as shown in the table (Table 2). The (Table 5) indicates the usual range of LFTs before Methotrexate, which is completely normal with no fluctuation in LFT parameters. As demonstrated in (Tables 6 and 8) where we examine the before and after effects of Methotrexate on the basis of patient immunity in 79 patients, the values of LFTs alter and become higher in comparison to normal, with a percentage of (65.8%). We compare the impact of Methotrexate on the basis of Gender using cross tabulation, which shows that LFTs were high in 41 males (67.1%) and 38 females (64.9%), as indicated in (Table 10). Finally, we compare the effect of Methotrexate on the basis of age factor as shown in (Table 11). After MTX therapy, RA patients experienced gastrointestinal side effects such as nausea, vomiting, and diarrhea, implying that MTX therapy will definitely affect the LFTs level and, most likely, according to the current study, will raise the LFTs level in blood, which will be treated promptly before further serious complications arise. A timely follow-up will be advised to all patients with consistently high LFTs levels. Conclusion: In this study, we discussed rheumatoid arthritis and the effects of methotrexate on rheumatoid arthritis patients' lives. It would appear that methotrexate is gaining popularity in the treatment of rheumatoid arthritis. Although there is risk of infection & probable cancer, the hazards are much outweighed by the potential therapeutic benefits. We also talked about R.A. diagnostic procedures. We covered the many characteristics of this autoimmune condition as well as several diagnostic approaches in this study.

Background: Co-curricular activities are engaging out-of-classroom learning activities that attract student’s participation. However, the risk and safety of the students become a concern since it is one of the activities that often cause injuries during the activities. Such activities require a needs analysis study to be conducted to ensure that the modules produced can meet the needs and specifications of co-curricular activities in schools. Objective: This study was conducted to identify the need for module content and module specifications based on the safety of students in school during co-curricular activities. Methodology: To construct a module that can meet the needs of students and teachers, a needs analysis was conducted on 40 teachers who specialized in uniformed units, sports and games and associations in the district of Kudat. Data collection was done through constructed questionnaires and simple and purposive random sampling techniques. Results: The needs analysis shows that the student safety management modules in out-of-classroom learning have significant needs to be developed. Conclusion: The needs analysis of the study found that it is important to construct safety management modules in out-of-classroom learning to overcome the problems faced by the co-curricular advisory teachers in schools. These findings will be used to design and develop the module in the next phase. These findings are expected to help produce teaching modules that can solve the problems of co-curricular advisors during co- curricular activities.

Jute is highly flammable in character. Due to its high degree of flammability, the versatile use of this fibre is handicapped to some extent, particularly in some specific purpose where jute products with flame resistance finishes and demanded. Considering this disadvantage, a research project was undertaken to make this fibre flameproof and therefore safer in specialized textile uses. The study was performed using yarn and fabrics which were desized with diastase and lissapol-N. Yarn and fabrics were scoured with sodium carbonate, sodium hydroxide under some standard conditions. These pretreated yarns and fabrics were used in the whole experimental work. The treated yarns were tested for flame retardant by subjecting them to the luminous flame of Bunsen burner and by observing the time of flaming (after flame) and time of glowing (flameless combustion, after glow), if any Percentage losses of strength of the treated yarn and fabrics were also measured by standard method. Different solutions of fire resistant chemicals were prepared to change the chemical, concentration and pH ratio of the solution. Jute fabrics and yarns treated with 65% solution of urea and ammonium dihydrogen phosphate (the ratio of urea and ADP being 3:2) together with 2% Turpex NP and 3-6% perapret PE-40% were found durably flame retardant causing minimum loss of the strength. This research was focused on fire resistant treatment of jute yarn and fabrics with different chemicals to make jute products for diversified textile uses.

The study aims at: Preparing exercises using (S.A.Q) method and its impact on developing some physical fitness and skills abilities for youth handball players. Identifying the effect of (S.A.Q) exercises in developing some physical fitness abilities for youth handball players. It is hypothesized that: There are statistically significant differences between the two groups (experimental and control) for the pre and posttests in the development of some physical fitness and skill abilities for youth handball players. There are statistically significant differences between the two groups (experimental and control) for the post-test in the development of some physical fitness and skill abilities for youth handball players. The researchers have used the experimental method by designing the experimental and control groups with pre and post tests for its suitability and the nature of the current research problem. The research community is represented by the youth players of Salah El-Din Handball Club for the sports season 2020/2021 numbering to (22) players. A number of (4) players are excluded as follows (2) goalkeepers and (2) players, due to their participation in the pilot experiment. So, the number of sample members is (18) players constituting (81.8%) of the research community. Conclusions: The (S.A.Q) exercises have brought about a development in the studied fitness variables of quickness and agility. The exercises used have led to a development in the level of the offensive side, especially the skill of shooting, whether from the remote areas or those close to the goal.

Introduction: In realizing the promise of electronic health records, the needs to address the potential ethical issues are of paramount importance. Objectives: This research aims to determine the perception regarding the ethical issues in using the electronic health record among the medical staff of King Khalid General Hospital, Hafar Al-Batin, Saudi Arabia. Method: This research is quantitative-cross sectional approach. There are 43 medical record staffs who served as the participants. In determining the number of participants, the researcher used simple random sampling. A self-administered tool was used to collect the data. Ethical approval was obtained before data gathering. This research employed frequency and percentage for the demographic profile and weighted mean. In order to determine the differences, exist on the perception of the participants based on the tested variables, t-test was used for gender. Meanwhile, Analysis of Variance (ANOVA) was conducted to determine the differences in the department, level of education, and age. Results: The perception of the medical record staff about the ethical issues in the use of electronic health record is positive (x=3.68). Meanwhile, there is no significant difference on the department (Sig: 0.419; p-val. 0.5), age (Sig: 0.574; p-val. 0.5), level of education (Sig: 0.979; p-val. 0.5), and gender (Sig: 0.156; p-val. 0.5). Conclusion: The medical record staff in King Khalid General Hospital, Hafar Al-Batin, Saudi Arabia, have a positive perception regarding the ethical issues on electronic health records. As such, it can be used to improve more the practices in safeguarding the records. Moreover, this positive perception can address future ethical issues that may arise. Further, there are no significant differences in the department where these participants are deployed, the age, level of education, and gender.

As the allocated forestland for pulp and paper production in Bangladesh is very limited and a substantial amount of crops residues are generated each year, the latter can substitute for pulp and paper production. In this context, eight residues of crops produced in Bangladesh were evaluated. Final pulp yields were 40 -65% with the kappa number of 11-32% depending on crops residues. The experimental processes are outlined. The physico-mechanical properties of handmade papers are estimated by standard procedure. Gram per Square Metre (GSM), brightness percentage, thickness and tearing strength of different handmade paper sheets shows acceptable papermaking properties. FT-IR analysis were carried out for identifying types of chemicals bonds (functional groups).The study indicates that these hand-made papers can be used for making eco-friendly paper bags, packaging material which will be suitable alternative to the non-biodegradable plastic, a cause of ecological and environmental pollution.

The aim of this study is to determine the nutritional indices (Glucose, cholesterol, total protein and albumin) and body mass index of students attending public and private secondary schools in Igbanke. The study was conducted on 185 students comprising 95 students from public secondary schools (Igbanke mixed secondary and Igbanke grammar school) and 90 students from private secondary schools (Future hope secondary school and Wisdom comprehensive secondary school) in Igbanke. The research was designed to evaluate and compare the nutritional indices (Glucose, cholesterol, total protein and albumin) of students attending public and private secondary schools in Igbanke. The sample analysis was done at Diagnostic Laboratory, Department of Medical Laboratory Science, Ambrose Alli University, Ekpoma. This study was carried out within three (3) months. Our result shows that the mean values of body mass index (BMI) of students in public secondary school and private secondary school are 20.28±4.21kg/m2 and 21.74±4.14 kg/m2 respectively. There is no significant difference (p>0.05) in the values of BMI of students in public secondary school when compared with private secondary school. The mean levels of glucose (Glu) of students in public secondary school and private secondary school are 84.38±12.80mg/dl and 79.48±15.02mg/dl respectively. There was a significant increase (p<0.05) in the level of Glu of students in public secondary school when compared with private secondary school. The mean levels of total protein (TP) of students in public secondary school and private secondary school are 6.78±0.86mg/dl and 6.98±0.58mg/dl respectively. There was a significant decrease (p<0.05) in the level of TP of students in public secondary school when compared with private secondary school. The mean levels of albumin (Alb) of students in public secondary school and private secondary school are 3.73±0.61mg/dl and 4.01±0.48mg/dl respectively. There was a significant decrease (p<0.05) in the level of Alb of students in public secondary school when compared with private secondary school. The mean levels of cholesterol (Chol) of students in public secondary school and private secondary school are 154.62±30.94mg/dl and 168.30±14.88mg/dl respectively. There was significant increase (p<0.05) in the levels of cholesterol of students in private secondary school when compared with public secondary school. In conclusion, a poor diet can cause deficiency diseases such as blindness, anemia, scurvy, health-threatening conditions like obesity and metabolic syndrome and such common chronic systemic diseases as cardiovascular disease, diabetes and osteoporosis. The findings from this study have shown that there are differences in the nutritional indices of students in public secondary school and private secondary school with public secondary school having lower protein level and private secondary school high cholesterol level.

Introduction: Head and neck lesions are routinely encountered by the clinicians, irrespective of age, sex and demography. FNAC is a integral part of diagnosing these lesions as these lesions are quite accessible to aspiration. FNAC is easy OPD procedure with minimal complications and a good sensitivity and specificity. Aims: To assess the cytomorphological spectrum of various head and neck lesions diagnosed on FNAC according to site, age and sex in a peripheral hospital in north India where no previous such study has been done. Material and Methods: The present study is a retrospective study undertaken in the Department of Pathology, District hospital udhampur, a peripheral hospital in north India. Cases were studied from December 2020 to March 2021. Results: Out of 85 fine needle aspiration procedures 48.2% (40 cases) were of lymph node, 24.7%(21 cases) from skin and soft tissue swellings 17% (20 cases) were of thyroid, 7.05% from salivary gland(06 cases). The present study included 85 cases with the age ranging from 5 months to 72 years out of which 52(61.1%) were females and 33(38.8%) were males .Reactive lymphadenitis is the commonest inflammatory lesion. Colloid goitre is the commonest benign lesion. Conclusion: Skin and soft tissue lesions were second most common lesion in these areas as compared to other studies. No such previous study has been done in rural area. This will help us to know the trend of various head and neck lesions in these areas.

Introduction: In order to fight against preanalytical errors, a simulation workshop around the requirements of this phase was carried out by the team of the biochemistry laboratory of the university hospital of Tangier Tetouan Alhoceima. Newly recruited nurses in oncology, hematology and the sampling center benefited from this training. Material and Methods: The course of this workshop took place in the premises of the center of clinical simulation and educational innovation in health sciences of the faculty of medicine and pharmacy of Tangier (Tangier'Sim Center). The beneficiaries were 19 nurses divided into two groups. The practical part was performed on low-fidelity procedural dummies. Two questionnaires were completed pre and post training. Results and Discussion: Knowledge of the requirements and best practices of the pre-analytical phase improved significantly after this workshop, both in terms of preparing the patient and taking the sample. This approach is an original tool for training and familiarization with good practices for peripheral venous sampling, in particular the vacuum sampling system. And above all an opportunity to discuss the different requirements with a category of professionals very involved in their daily practice in the preanalytical phase. Conclusion: This experience resulted in the development of a leaflet on good practices for peripheral venous sampling which is part of the quality approach in the medical biology laboratory.

Recently, the concept of smart contract has come to existence as an alternative for a more technologically sophisticated digital contract. Smart contract operates based on the blockchain technology, does not involve a third party and has self-executing ability; allowing an implementation of a contract with zero risk of failure. In regards to this, HARA, an agriculture start-up company, created a self-titled platform that focuses on data exchange in the decentralized agriculture sector in order to provide consumers with the access to data. Some of the data provided by HARA include farmer identifications; cultivation data; specific location data; ecology data; market information and transaction data which are collected from various sources. However, an in-depth study is required to better understand smart contract and its contract law application. This study is normative legal research and used the conceptual and statutory approaches. Smart contract and its self-executing or self-enforcing ability does not render a revision or renewal of the contract by the contracting parties impossible. In this case, the responsibility of the platform provider to meet the terms of the contract can still be requested. The concept of smart contract, which is also categorized as an electronic agent, has met the Indonesian requirements for contract validity. The distinct feature of a smart contract is its self-executing/self-enforcing ability. Furthermore, there are five legal relationships that exist among the users of the HARA application.

Indigenous Indonesians have practiced restorative justice for centuries, particularly in Papua, Bali, Toraja, Minangkabau, and other traditional groups that retain their culture tenaciously. Indigenous tribes manage problems locally, without contacting state authorities. The standard of justice is not retributive justice in the form of punishment or vengeance, but conviction and forgiveness. The notion of Indonesian customary law as a venue for customary justice institutions also includes a concept that is the origin of restorative justice. The current method of resolving criminal matters outside of court is either the outcome of a lengthy voyage of study and examples or experimental programs, or it is a social tradition. The fundamental ideas of restorative justice are still present in current practices. Victim-Offender Mediation, Conferencing/Family Group Conferencing, Circele, and Reparative Board/Youth Panel are the four practices that pioneered the application of Restorative Justice.

This work is an attempt to understand the effect of climate in an environment, therefore the effect of driving rain on buildings and on monuments is considered a case study. The study area is Port Harcourt Metropolis, a subequatorial climate environment, located in southern part of Nigeria. The study made use of questionnaire, and response were analyse using a descriptive statistical tool (simple percentage and pie chart). The study observed among other things that driving rain defaces buildings and monuments. Furthermore majority of those interviewed are of the opinion that driving rain has made them spend more money in building and monument maintenance as the case may be. It was also observed that driving rain contributes to rill erosion within and around buildings and monuments. The study also finds out that driving rain affects the strength of buildings negatively, and that electrical appliance can also be affected. This work suggests among other things, that water resistance paints and material should be used on buildings and monuments. The windward side of buildings should be designed in a way that the effect of driving rain should be minimal on the wall or windows. Furthermore, materials like books, cloths and other weather sensitive materials should be kept away from the damp windward side of the rooms. This implies that wardrobes should not be fixed or constructed in the windward side of the building. The study suggested that strong materials and standard specification of concrete mixture and standard original materials should be used in building construction especially in a humid environment like Port Harcourt metropolis. Finally, geographical factors need to be considered before building construction and professionals should be engaged in the business of building of houses and monuments construction to avoid collapse and damages.

The industrial revolution 4.0 with its rapid development speed and far-reaching impacts on the development of each country, if being left behind of this revolution, the lags behind the development is also inevitable. On the contrary, if making good use of the advantages of this revolution, the opportunities are huge. Industry 4.0 is based on people, in which high-quality human resources are the core for development. This is also the development direction that each country needs to prepare for incessant changes in the future. This article will present the issue of "Vietnam's higher education in the era of Industrial Revolution 4.0: Opportunities, challenges, and innovations”

The management of student archives is an important factor to measure the quality of education and teaching in a university, which is of great significance to the reform and innovative development of colleges and universities. There are still many deficiencies in the traditional management of students' archives adopted by today's universities, and it is difficult to adapt to the development needs of modern college education. Therefore, it is necessary to make certain changes and updates to the traditional management mode of student archives. This paper first discusses the essential attributes and characteristics of student archives, and expounds the value of student archives under the "three complete education". Then, according to the problems retained in the development of student archives, corresponding solutions are put forward to ensure the effective work affairs of the management of student archives, so that the university can better transport talents for the society.

Fanconi Anemia (FA) is an extremely rare autosomal recessive disorder characterized by chromosomal break up that induces congenital abnormalities. FA results from a mutation in one of the 15 genes involved in the DNA repair pathway that is essential for the proper development of white blood cells, red blood cells, and platelets (Dental Perspective of Rare Disease of Fanconi Anemia (2). Some signs made up of a short stature, hyperpigmentation and bone marrow failure should suggest the diagnosis. In this paper we report two case reports of FA of in different ages who were followed in our Paediatric Dentistry Department in la Rabta Hospital and in which various classical signs were present. Comparing the different symptoms, we noticed that developmental and physical abnormalities are in common such as hyperpigmentation, short stature, skeletal abnormalities and some oral manifestations such as microdontia, periodontitis, and dental caries. Due to an increased risk of malignancies in this population, we have given emphasis on oral manifestations and the role of pediatric dentist in making early diagnosis and ensuring the maintenance of oral health for these patients.