The objective of this project is to implement a VPA that meets the minimum characteristics for quality distance education according to experts. To this end, the validation methodology of experts was used in order to achieve the objective of the investigation. The benefits of this project will be: a growth of the institution, have a greater number of enrolled and will provide education opportunity to more population.

Antibiotics can enhance human lives by treating or preventing diseases. The prodigious, indiscriminate and improper use of antibiotics has played a substantial role in the outspread/emergence of antibiotic resistance bacteria. In the current scenario, a major public-health threat is the resistance to antibiotics. In addressing the problem on antibiotic resistance, the use of probiotics in lieu of antibiotics for treating certain diseases of host organisms has been investigated. Probiotics play a preventive role rather than a therapeutic role and is, thus, considered the opponents to antibiotics. Probiotics are live microorganisms which when administered in adequate amounts confer a health benefit on the host. Most probiotics are common members of the human intestinal tract, and they are ingested in large amounts in functional foods. This review emphasizes on how antibiotics and probiotics face each other pertaining to antimicrobial resistance

The objective of this study is to identify the factors that intervene in the choice of university among upper secondary students. A 95% reliability was used for the investigation. Students from the National College of Technical Professional Education (CONALEP) were asked. The results obtained were the geographical location of the IES and the prestige of the academic program with 68.8%, then the facilities dimension with 60.33%, followed by the recommendation dimension towards the IES with 55.2%. The dimension that scored the least was the Prestige dimension of the IES with 32.2%.

This before-and-after study (without controls) with educational intervention was conducted at a municipal medical college to evaluate the effect of experiential learning in medical students by using narratives that focus on the affective domain. Medical students aged 18+ years, of either gender, were explained about the study. The participants took a pre-test, which was designed to seek the response of participants to ten bioethics-related narratives. Subsequently, the students were exposed to bioethics training wherein the narratives were discussed and a post-test, identical to the pre-test, was administered. A total of 120 students (53.33% females; 46.67% males) participated in the study. The gender differences in the pre- and post-test responses were not statistically significant. The difference was not statistically significant in pre- and post-test responses to questions in two narratives – surrogacy by childless couple and medical termination of pregnancy in case of congenital anomaly. The significant improvement in the post-test scores of participating students implied that they have inculcated the values learnt in their training. Narratives can simulate real-life situations and discussion on these narratives can help students in internalizing theoretical ethical concepts, improve moral reasoning and facilitate in handling certain ethical dilemmas that can improve doctor-patient relationship

The aim of study is to analyze how does the political leadership of the two candidates is being represented on Twitter?; To what extent does the topic mapping of online-news coverage could affect Jokowi's electability and Prabowo's electability?; To what extent does black campaign on Twitter could affect Jokowi's electability and Prabowo's electability? Method of this research using quantitative content analysis. Data were gathered by using crawling technique. This technique uses the help of the Drone Emprit engine to capture all topic maps from online news coverage and Twitter conversations during the period 1 September 2018 at 12.00 AM Western Indonesia Time (GMT+7) until 31 December 2018 at 11:59 PM Western Indonesia Time (GMT+7) is amounting to 7,876,727 mentions with the following details: 257,819 articles from online news and 7,618,908 conversations on Twitter. Based on the Drone Emprit analysis, negative sentiments related to news and discussion about Jokowi and Prabowo did not dominate the conversation. Jokowi gets more negative sentiments in the form of SARA attacks, defamation, bodyshaming, Propaganda, hoaxes, fakenews, negative campaign, and black campaign with a comparison ratio of 9:1 to Prabowo. Interpretatively, it can be said that the supporters of the opposition have done more than black campaigns and negative campaigns rather than carrying out rational political ideas.

This complete-enumeration, before-and-after type of study (without controls), was conducted to determine the effectiveness of communication skills training for first-year MBBS students in improving their knowledge and awareness regarding communication skills. The participants (60 first-year MBBS students, aged 18 years and above, of either gender) were briefed about the study and written informed consent was obtained. The students took a pre-test containing 10 multiple choice questions (one mark each, total 10 marks) pertaining to communication in various situations. Subsequently, these students were trained in communication skills using lecture, case scenarios and role play and a post-test was administered. The questions in the post-test were identical to that in the pre-test. The difference in the overall pre- and post-test scores was significant (Z=2.811; p=0.00494) but the gender differences in the scores were not significant. This study identified vital areas to be focused upon while imparting communication skills training to medical students. The participants favourably rated the training on communication skills. Teaching communication skills to first-year MBBS students will improve their attitude towards and communication with peers and staff members and also help overcome socio-cultural barriers between students

Air pollution is one of the main environmental problems in Tehran capital of Iran. Every day, a huge volume of exotic and destroying gases and different kinds of dangerous pollutants are added to the city air by cars, heavy vehicles, motorcycles, small workshops activities and garbage burners of hospitals. A hazardous complex is made by different types of carbon and nitrogen monoxides, sulfurs and solid particles of lead create such a harmful complex which is able to expose civilian’s lungs, eyes, skin to kill poisonous compounds made by the secondary and primary reactions. In fact, there is an exceeding number of those suffering from cancer, eyes, skin and pulmonary diseases. Carbon monoxide, nitrogen and sulfur oxides, ozone, and floating solar particles were studied as a monthly average within 12 months of a five- year statistical period. For each month the amount of the correlation the coefficient the hazardous pollutions with monthly average the number of pulmonary patients in Imam Hussein Hospital located in the east of Tehran has been determined in the same five- year- statistical period. Neural network models have been applied to predict the pollutants concentration for the next months. Since the correlation coefficients were in the best conditions, regressive relationships have been applied to predict the number of patients in Tehran and estimated the rate of the environmental destructive effects.

Depression is largely experienced in our societies. It is costly and highly prevalent medical condition having a lifetime prevalence of around 16% in US adults. Around 13.5 million adults got major depressive disorder in the last year and 34 million will get it at some point. Women experience it more likely about 1.5 to 3 times greater than men. Anyone can experience it at any age but most people experiences first episode in their early thirties. This review represents different factors that are associated with depression

Transseptal access from right atrium to left atrium through the fossa ovalis using transseptal puncture and patent fossa ovalis repair are widely used cardiac techniques. These techniques require through knowledge of the cardiac anatomy especially of the fossa ovalis .Evaluation of the various morphological parameters of the fossa ovalis forms an important prerequisite before undertaking any surgical procedure in this region. This study was conducted on 60 cadaveric hearts from the department of Anatomy, Government medical college, Nagpur. The right atrium was opened and the fossa ovalis was studied for its shape, size, floor and the prominence and extent of the limbus fossa ovalis was noted. The fossa ovalis was observed for the presence of any patent foramen ovale or probe patency. In majority of the cases the shape of fossa ovalis was found to be oval 66.7% cases, the average craniocaudal diameter was found to be 15.03mm, and average anteroposterior diameter was found to be 14.44mm. Limbus fossa ovalis was found to be raised in 83.33% cases and flat in 16.66% cases. Probe patency of foramen ovale was found in 15% cases but no case of patent foramen ovale was found. The floor of fossa ovalis was found to be flat in 65% cases and aneurysmal in 35% cases. In 10% cases membranous structure with multiple fenestrations or fine strand like structures were seen attached to the lower part of fossa ovalis. The findings of the present work are of immense value to interventionists and cardiologists

Objective: The point of this examination was to assess the criticalness of the fetal kidney length (FKL) for the estimation of gestational age. Method: A cross sectional study was carried out on 399 pregnant women with singleton pregnancies having no complications at Baloch Hospital Lalian. Pregnant women with single fetuses underwent standard ultrasound fetal biometry. The fetal kidney length measurements were performed from 20th weeks to 38th weeks of gestation. These measurements were used to date the pregnencies. Results: A positive linear relationship was found between gestational age (measured by femur length) and length of left kidney. G.A in weeks (measured by femur length) = 25.430+1.912 (Left Kidney in cm) with R2=0.939 and p value=0.000<0.05. Another statistically significant positive linear relationship was found between gestational age (measured by femur length) and length of right kidney.G.A in weeks (measured by femur length) =13.496+5.727(Right Kidney in cm) with R2=0.939 and p value=0.000<0.05. Conclusion: FKL is easy to identify and measure. It is most accurate single parameter for estimating GA than other biometric indices especially in cases when the other parameters like BPD, FL, AC and HC are not reliable for assessing GA in the 2nd and 3rd trimester of pregnancy

Gall Bladder Carcinoma (GBC) is the most aggressive and most common malignancy of the biliary tract in the world. GBC is common in India and shows rising trend with 10 times more incidence in northern and north eastern region than Southern region. As most of the patients are diagnosed in the advanced stage of cancer, prognosis is dismally poor and early diagnosis is essential. We aim to study the importance of Ultrasound (US) guided Fine Needle Aspiration Cytology (FNAC) in the early detection and diagnosis of gall bladder malignancy in the suspicious cases of gall bladder lesions. A prospective cytomorphologic analysis of total 580 cases of suspected gall bladder lesions was conducted in the Department of Pathology, SMS Medical College, Jaipur, Rajasthan over a period of 2 years. US guided FNAC of the suspicious lesion was done and diagnosis was made on the basis of their cytomorphological features. The mean age of presentation was 54 years with male: female ratio of 1:2. The most common site for GBC was found to be Fossa (97.4%). According to nature of the smears, 73% were malignant, 18% unsatisfactory, 7% benign and 2% were suspicious. On cytomorphological diagnosis, Adenocarcinoma was found to be the most common of all malignant neoplasm (42%), followed by cholangiocarcinoma (9%), MEN (8%), metastatic (05%), adenosquamous (3%) and squamous cell carcinoma (1.5%). We concluded that US guided FNA is safe, quick and reliable procedure for an early diagnosis and pre therapeutic workup for gall bladder lesions.

For many years medical community has attempted to standardize its approach to the assessment of patients. The vital signs are a valuable parameter with which to assess and monitor a patient's response to supportive treatment and antidote therapy. Vital signs play an important role in the practice of medical toxicology beyond evaluating and monitoring a patient's overall status as they are frequently valuable physiological clues to toxicology and disease gravity. In 1970’s two paediatric physicians Howard C Mortenson and Joseph Greensher, coined a term “Toxidromes” which is a combination word of toxic syndromes. They have quoted “Some common combination of manifestation which we have termed toxidromes can give a clue to the drug involved” in an article “The unknown Poison”. Aim: This paper aims to provide an understanding on the various vital signs and symptoms which is observed during poison treatment. Methodology: An extensive review of literature was carried out to elicit information on various vital signs and toxic syndromes. Results: The study revealed that the health care professionals on understanding various toxidromes can help them to identify the type of poison, its antidote and the can provide a better treatment. Conclusion: The healthcare professionals has to undergo training on toxidromes. Which can improve the treatment and outcome in any poisoning case

The year 2009 witnessed emergence of novel H1N1 subtype of influenza A virus. This novel strain rapidly spread across the world and caused pandemic. In 2010, WHO declared pandemic to have crossed its peak and also warned that it will continue as seasonal influenza outbreaks in winter seasons. Several aspects of the epidemiology of influenza A H1N1/2009 strain have not been accurately determined. We sought to study whether the age & gender affects susceptibility to influenza. During the study period of one month, patients categorised as category C under national influenza guidelines and admitted to isolation ward were screened for influenza. Real-time reverse transcriptase PCR (rRT-PCR) was used for detection of influenza viral RNA. For PCR setup, WHO & CDC guidelines were followed. The result given was either Influenza A/H1N1/2009pdm strain positive or negative. Out of 75 samples received in the laboratory, 32 samples were positive (positivity rate of 42.66%). Positivity rate for females (46.51%) was higher than males (37.50%). Positivity rate was maximum in 70-79 years age group (100%) followed by 30-39 years age group (46.15%) and 20-29 years age group (44.44%). None of the patient was positive in 10-19 years age group (Positivity rate of 0%). The influenza (H1N1/2009) virus is still active several years after the 2009 pandemic in the various parts of the world. The incidence of H1N1 influenza is higher in old individuals. This emphasizes importance of vaccination especially in high risk group before the start of the flu season.

Objective: To determine students perspectives about effectiveness of teaching learning strategies used by nurse educators. Study Design: A cross- sectional study. Place and Duration: Isra College of Nursing Islamabad from June 2017 to September 2018. Methodology: A Structured questionnaire, including demographic information and questions regarding use of teaching learning strategies, was used. To assess the students perspectives about the effectiveness of these strategies five-point likert scale was used which include from marking point 1 for not effective to 5 for very effective. Data was analyzed using SPSS version 22. Results: Mean age and standard deviation of the participants was 28.5 ± 4.7 years respectively. In total, 36 students participated out of which 11 (30.5%) were male, whereas 25 (69.5%) were female. The most effective teaching learning strategy student perceived was case scenario and 77.8% found it very effective followed by group teaching which was found very effective by 47.2% of students, However the least effective strategy was cooperative teaching because only 11% of the students established it as effective. Conclusion: This study concluded that student perceived case based teaching as most effective teaching learning strategy than other educational methods, however students also forechoose the use of multiple teaching learning strategies for overall group learning

Background: Dengue fever (DF) and dengue hemorrhagic fever (DHF) are important arthropod borne viral diseases. Dengue is emerging as major public health concern in India and spreading with increased morbidity. Objective: This study was carried out to determine the seroprevalence of Dengue infection among patients attending in Gandhinagar civil hospital attached with medical college during the period of January 2018 to December 2018. Methods: A total of 2545 blood samples received in the department of microbiology, were tested for the confirmation of suspected cases of dengue. Dengue NS1 antigen and Dengue IgM antibody ELISA tests was performed for the confirmation of dengue cases. We estimated the incidence by applying age, sex and season adjusted dengue positivity. Results: Out of 2545 samples tested, 639were positive for dengue infection, among the positive cases 503 were NS1 antigen ELISA positive and136 were IgM ELISA positive. Higher incidence in male patients was noted. Number of positive cases was increased in rainy season. Conclusion: Virus activity is high during monsoon and post monsoon period which coincides with increased vector breeding. This study thus emphasizes the need for continuous sero epidemiological surveillance for the timely formulation and implementation of effective dengue control programme.