Background: The global healthcare system faces significant challenges, including workforce shortages, increasing demand for services, and rising costs. Strategic Human Resource Management (SHRM) is crucial in addressing these issues, as it ensures effective resource allocation and workforce optimization. Aim of the Study: To investigate the impact of strategic human resource management practices on the efficiency of healthcare service delivery. Methods: This cross-sectional observational study was conducted over 1.5 years (February 2023 to August 2024) at [Place of Study] in Saudi Arabia. A purposive sampling technique was used to select 230 healthcare professionals across various roles. Data were collected via structured questionnaires, checklists, and document analysis. Statistical analysis was performed using SPSS (version 26) to identify key trends and associations. Result: The study found that the majority of healthcare workers perceived the healthcare sector as adequately staffed and supported by effective HR strategies. However, concerns were raised regarding staff development programs, the availability of medical supplies, and the adequacy of timely promotions. Notably, 74.35% of respondents agreed that staffing was sufficient, while only 13.48% strongly agreed that development programs were available. Conclusion: Strategic HR management plays a critical role in enhancing healthcare service delivery efficiency by aligning workforce skills with organizational goals. However, gaps in staff development and resource availability highlight areas for improvement. Targeted HR interventions, including ongoing professional development and better resource management, are essential to improving healthcare service quality.

The Advanced Encryption Standard (AES) is widely regarded as a robust encryption algorithm, ensuring secure communication and data protection. However, physical vulnerabilities such as side-channel attacks (SCAs) pose a significant threat to its implementations. This paper investigates various types of SCAs, including power analysis and electromagnetic analysis, and explores countermeasures like masking techniques to enhance AES resilience. The study includes an implementation of AES in Vivado using Verilog and a detailed analysis of masked and unmasked designs to validate the effectiveness of proposed countermeasures.

Background: Displaced extra-articular tongue-type calcaneal body fractures are complex injuries that significantly impair foot function and quality of life. Traditional open surgical techniques pose risks such as wound infection and prolonged recovery, necessitating less invasive alternatives. Objective: This study aims to evaluate the efficacy, outcomes, and complications of managing these fractures with minimally invasive cortical compression screws, enhancing recovery and mobility. Methods: Between September 2015 and April 2016, 165 patients with displaced extra-articular tongue-type calcaneal fractures were randomly assigned to two treatment groups: the minimally invasive longitudinal approach (MILA) and the sinus tarsi approach (STA). Postoperative outcomes, including complication rates, functional assessments using AOFAS scores, and radiographic evaluations, were analyzed. Results: The MILA group demonstrated shorter operative times (45.9 minutes) and lower wound-healing complications (2.9%) compared to the STA group (61.9 minutes and 12.5%, respectively). Both groups had comparable functional outcomes for Type II and III fractures, but the STA group showed significantly better results for Type IV fractures (56.3% vs. 14.3%, P = 0.017). Conclusion: Both MILA and STA are effective for treating displaced extra-articular tongue-type calcaneal fractures, with MILA offering advantages in operative efficiency and lower complications for less severe fractures. However, STA is preferred for complex fractures due to superior anatomical reduction and functional outcomes. This supports a tailored approach in surgical technique selection based on fracture severity.

Calliandra portoricensis (CP) is used in ethnomedicine to manage breast inflammation. We investigated the anti-mammary tumour effects of fraction from CP in rat model of mammary tumorigenesis induced with N methyl N nitrosourea (NMU) and benzo (a)pyrene (BaP) and MCF-7 cells. In vivo, thirty-two female Wistar rats were assigned into four equal groups: Group 1 (control), group 2 received [NMU (50 mg/kg) +BaP (50 mg/kg)], group 3 received [NMU (50 mg/kg) +BaP (50 mg/kg) + CP (100 mg/kg)] and group 4 received [NMU (50 mg/kg) +BaP (50 mg/kg) + vincristine (VIN) (500 μg/kg)]. The NMU and BaP was injected intraperitoneally to rats at age 7, 10 and 13 weeks for twelve weeks. Thereafter, CP (orally) and vincristine (i.p) was administered for two weeks. In vitro, CP and VIN concentration-dependently inhibited the growth of MCF-7 cells by over 80% at 100 µg/mL. The CP and VIN elevated Bax by 4.2 and 1.5 folds, and decreased myeloperoxidase by 75% and 82%, respectively, while CP alone decreased interleukin-1β by 34% in vitro. In vivo, [NMU+BaP] increased weight and organo somatic weight of mammary gland by 3 and 2.9 folds; total bilirubin, nitric oxide and malondialdehyde by 23%, 51% and 52%, respectively. In [NMU+BaP] rats, weak expression of caspase-3, Bax, and strong expression of iNOS and NF-kB activities were observed, with histological alteration. The GC-MS fingerprint of CP fraction revealed the presence of hexadecanoic acid methyl ester as the most abundant constituent. Treatment with CP ameliorates mammary tumour through mechanisms that involve anti-inflammatory and pro-apoptotic reactions.

Background: End-stage heart failure patients awaiting heart transplant often require Ventricular Assisted Devices (VAD) to support systemic and pulmonary circulation and to improve ventricular function, symptoms, and Health-Related Quality of Life (HRQoL). This study evaluates the health-related quality of life in patients with VAD and was conducted at the Cardio Ventricular Assisted Devices Clinic at King Faisal Specialist Hospital and Research Centre, Riyadh. Methods: This retrospective cohort study design included all eligible VAD patients who were still attending the cardio ventricular assisted devices clinic at KFSHRC, Riyadh. Each study participant was assigned a detailed questionnaire to assess and evaluate HRQoL outcomes measured in physical limitations, emotional stress, sexual activity, and social function from the date of device insertion to the time of data collection. Data were analyzed using the Statistical Package for Social Studies (SPSS 22; IBM Corp., New York, NY, USA). Results: Between February 2016 until June 2020, 26 patients were eligible for the study. The patients' support scores were moderate to high, indicating a positive effect on their HRQoL, with a mean score of 57.69 in emotional activity, a mean score of 34.07 in physical activity, and a mean score of 83.17 in social activity. The study's results show that the level of HRQoL varies among patients with VADs. Conclusion: Participating patients with VAD reported excellent health-related quality of life in all domains, with moderate to high support scores indicating a positive effect on their HRQoL. There is currently a lack of study on HRQoL in patients with VADs in Saudi Arabia. Therefore, this study may provide a baseline understanding of current challenges in the care of heart failure patients with VAD awaiting a heart transplant.

Background: Desmoid fibromatosis is a locally aggressive benign fibroblastic soft tissue tumor representing nearly 0.03% of all neoplasms. They can be sporadic or may be associated with Familial Adenomatous Polyposis (FAP). Around 50% of fibromatosis are intrabdominal or arise in the abdominal wall. Rarely, these tumors can arise from the intestinal wall. Appendix and mesoappendix are extremely rare sites of presentation with only 3 reported cases. Case Presentation: A healthy 43-year-old male presented with abdomen distension. CECT scan showed a well-defined enhancing mass in the lower abdomen attached to the appendix with no surrounding infiltration, fat stranding, or evidence of distant metastasis. A wide resection was performed, and gross examination showed a well-circumscribed mass measuring 8 cm attached to the appendix. Histological examination revealed a well-circumscribed cellular spindle cell neoplasm with focal infiltrative borders. The tumor cells showed nuclear immunoreactivity for Beta-catenin and focally for Desmin, while they were negative for DOG1, CD117, CD34, STAT6, S100 & Pan Cytokeratin. The morphology and immunohistochemistry were compatible with Desmoid fibromatosis. CT scans were negative for recurrence or distant metastases after 8 months of follow-up. Conclusion: Appendix and mesoappendix desmoid fibromatosis are extremely rare and can present as an abdominal mass or features of acute appendicitis. Gastrointestinal stromal tumor (GIST) is an important differential diagnosis at this site and is crucial to differentiate from fibromatosis for patient management and follow-up. Identifying beta-Catenin (CTNNB1) mutation is a diagnostic criterion to differentiate from other spindle cell tumors, especially on small biopsies. Multi-disciplinary treatment approach is crucial for management.

Coccidiosis, a parasitic disease caused by protozoa of the genus Eimeria, poses significant challenges to poultry production worldwide due to its impact on productivity and economic costs. This review consolidates current findings on the epidemiology and genetic diversity of coccidiosis affecting chickens (Gallus gallus domesticus) and pigeons (Columba livia) in Chhatrapati Sambhajinagar, Maharashtra, India. By synthesizing existing literature and field study data, we provide an overview of prevalence rates, species diversity, and genetic characteristics of Eimeria spp. The role of environmental factors, host immunity, and management practices in shaping disease dynamics is also discussed. The review underscores the critical need for region-specific control measures and highlights potential future research avenues aimed at enhancing disease prevention and management strategies.

Anomalies of the Paramesonephric duct is a group of congenital malformations that occur either from the failure to complete bilateral Mullerian duct elongation, fusion, duct canalization, or resorption of the septum. Septate uterus is the commonest of these anomalies and is associated with adverse pregnancy outcomes especially miscarriages. Metroplasty has been associated with improved pregnancy outcomes with hysteroscopic resection been the preferred approach currently. Open abdominal metroplasty is a useful alternative in low resource set-up or where facilities for hysteroscopy is not readily available or not affordable. The need for this case report is to document the case of a complete uterine septum in a 31-year-old woman with three previous miscarriages who had open abdominal metroplasty and subsequent pregnancy with good outcome.

Background: Gestational Trophoblastic Disease (GTD) encompasses a spectrum of pregnancy-related disorders, ranging from benign hydatidiform mole to malignant choriocarcinoma, and poses diagnostic and therapeutic challenges, particularly in resource-limited settings. The purpose of the study was to assess the clinical presentation and follow-up outcomes of patients diagnosed with Gestational Trophoblastic Disease (GTD). Aim of the study: The aim of the study was to evaluate the clinical presentation and follow-up outcomes of patients diagnosed with Gestational Trophoblastic Disease (GTD). Methods: This descriptive cross-sectional study, conducted at the Department of Obstetrics and Gynaecology, Sir Salimullah Medical College and Mitford Hospital, Dhaka, from November 2012 to November 2013, included 70 GTD patients. Data were collected using a structured questionnaire, analyzed via SPSS, and ethical approval was obtained with assurances of confidentiality and voluntary participation. Results: Among 70 patients with GTD, 55.71% were aged 21–30 years, and 91.43% came from below-average income groups. The most common symptom in molar pregnancies was per vaginal bleeding (55.56%), while persistent mole and choriocarcinoma patients frequently presented with bleeding and lower abdominal pain (52%). A large proportion (77.78%) of molar pregnancies had uterine sizes larger than the period of gestation. Regular follow-up was observed in 74% of patients, and 100% underwent serum β-hCG testing. Most hydatidiform mole patients (80%) achieved remission, while 10% of choriocarcinoma cases resulted in death. Conclusion: Consistent monitoring and early detection significantly improve the clinical outcomes of patients diagnosed with Gestational Trophoblastic Disease (GTD).

Background: Nurses play a vital role in caring for patients receiving extracorporeal membrane oxygenation (ECMO) for severe respiratory or cardiac failure. However, this area of nursing practice presents unique challenges. Accordingly, understanding these challenges is essential to improve patient care and support nurses' well-being. Aims: This study aimed to investigate and identify challenges nurses face in providing care to patients on ECMO. Method: A quantitative cross-sectional study of eligible nurses was conducted at King Faisal Specialist Hospital and Research Center in Riyadh City (KFSH&RC-R). A survey instrument developed by the principal investigators was used to collect data. A panel of ECMO specialists and clinical experts validated the survey content. Results: A total of 66 nurses (75.8% females, 60.6% aged 25–34 years, 33.3% with 1–5 years of nursing experience, and 87.9% holding a bachelor's degree in nursing) participated in the study. The identified challenges were managing complex equipment, maintaining stability, coordinating with multidisciplinary teams, addressing ethical dilemmas, managing high acuity, coping with stress, and prioritizing self-care. Conclusions: These findings highlight the multifaceted challenges nurses face in caring for patients on ECMO, which influence their well-being, job satisfaction, and the quality of care provided. Thus, interventional strategies to address these issues in this specialized area are urgently required.

This case study details a Dharma practitioner's journey in using spiritual practices to help her father overcome severe, long-term urticaria. Her father's condition, which began after killing and consuming live aquatic animals, gradually worsened despite extensive treatments with both Western and traditional Chinese medicine. When these interventions failed, the practitioner turned to the Guan Yin Citta Dharma Door, implementing the Three Golden Buddhist Practices. She dedicated herself to reciting Buddhist scriptures on her father's behalf, while he progressively adopted vegetarianism and Buddhist practices. Ultimately, he experienced a profound, lasting improvement in his skin condition, which doctors had previously deemed incurable. This case highlights the potential role of Dharma in addressing karmic illnesses and its significance in treating conditions viewed as spiritual or karmic in origin.

This research addresses the significant challenge of unreliable wireless communication, which hinders the performance of ZigBee-based wireless sensor networks (WSNs) in precision agriculture. A dual-slope log-distance path loss model was developed to accurately predict signal propagation complexities in dense vegetative environments for improved wireless communication. The study was conducted on a cassava farm in Ondo State, Nigeria, characterized by vegetation heights of 1.8 meters, making it an ideal site for investigation. A systematic methodology was employed, incorporating radio frequency measurements in both line-of-sight and non-line-of-sight conditions. This involved deploying two XBee S2C modules operating at 2.4 GHz, with one designated as a coordinator and the other as a router. The collection of Received Signal Strength Indicator (RSSI) and throughput data occurred at 5 meter intervals, with variations in the router's orientation. Results revealed a maximum communication range of 70 meters under non-line-of-sight conditions, compared to 140 meters in line-of-sight scenarios, where the path loss exponent was determined to be 1.78. The path loss exponents for the cassava fields were found to be 2.55 and 4.25. The developed dual-slope path loss model showed a strong fit to additional empirical data from a separate cassava farm location, achieving a Mean Absolute Percentage Error (MAPE) of 3.30 % and an R-squared value of 0.94. Hence, this model offers a comprehensive framework for characterizing radio wave propagation in agricultural environments, enhancing data transmission reliability and energy efficiency in smart farming applications.

Pesticides are commonly used in agriculture soils to distroy various pathogens. During the late 1950s and early 1960s, the media in Western Europe and North America extensively covered the issue of birds on agricultural land being poisoned by aldrin, dieldrin, and heptachlor, which were commonly used as seed dressings. To highlight this issue, an experiment was performed to examine the effects of sodium fluoride on Japanes quail growth, biochemical and histology of kidney. In the present work, forty-eight sexually male Japanese quail, weighing 105gm, were used, divided in 4 equal groups as A, B, C & D having 12 quails in every group. Quails were acclimatized for two weeks. After acclimatization experimental treatments were applied to their respective groups. Duration of experiment was 30 days. Sodium fluoride was given to quails orally with the help of gavage on daily basis. Quails in group C handled with 3.75mg/kg dose and group D handled with 5.0mg/kg dose showed significant changes in physical, biochemical and renal parameters as compared to control group. These treatments also cause significant reduction in final weight of birds. Birds in groups B with 2.5 mg/kg dose showed non-significant results. On 3.75mg/kg exposure, the highest accretion of fluoride occurred in the kidney. Sodium fluoride exposure significantly increased the kidney injury and other renal biomarkers. The histopathological variations such as necrosis of parenchymal cells, congestion and hemorrhage varied in dose dependent manner of sodium fluoride.

Objective: Hepatitis B and C viruses (HBV, HCV), as well as the Human Immunodeficiency Virus (HIV), are capable of replicating in lymphoid tissues. These infections can lead to chronic antigenic stimulation, which may be linked to the development of lymphoproliferative disorders. This study aims to explore the serological status of Hepatitis B, C, and HIV in lymphoma patients. Methods: In this study, medical records of lymphoma patients diagnosed between 2022 and 2024 were reviewed to record parameters such as HBsAg, Anti-HBs, Anti-HBc IgG, Anti-HCV, Anti-HIV. Results: The average age of the 59 patients was 60.6 ± 15.3 years, and 37.3% were women. Of the 59 patients, 41(69.5%) were treated with chemotherapy including Rituximab (rtx). Among the patients, 6 (10.1%) were HBsAg positive, 22 (37.2%) were HBsAg negative with Anti-HBc (+) detected. Of the 28 patients with HBsAg (+) and/or Anti-HBc IgG (+), 24 had received rtx treatment, and antiviral therapy was administered to 20 of them. One of these patients experienced HBV reactivation during follow-up. A false positive result for Anti-HCV was observed in one patient (1.7%). HIV positivity was detected in 3 patients (5%). Conclusıon: These findings indicate that the seroprevalence of Hepatitis B and HIV in lymphoma patients in our center is higher than in the general population. Therefore, HBV and HIV tests should be performed before initiating treatment in lymphoma patients. These patients should be evaluated for the risk of HBV reactivation, and appropriate prophylaxis should be planned.

The purpose of this research was to assess the challenges facing students when using the school library in Zanzibar. The study was conducted in Zanzibar West “A” District, Unguja. It involved three public secondary schools. This study used a qualitative method and employing a descriptive case study design. The objective of the study was to assess the challenges students face when using the school library. Data was collected through interviews, focus group discussions, and observations from 48 respondents selected from schools in the West “A” District in Zanzibar. The findings of the study revealed the usage of school libraries was low due to the various challenges facing students in using school libraries in Zanzibar, including shortage of resources, insufficient reading space, shortage of facilities in reading rooms, limited designated time for library usage, poor customer service from librarians, limited library hours, and shortage of librarians. The study recommends that schools be supported in establishing well-equipped, furnished, and resource-rich libraries to encourage students to enjoy visiting and utilizing these spaces for reading books and accessing informational materials.