Hypertension is the disease with the highest prevalence in Indonesia. Prevalence of hypertension in the elderly aged 55-75 years and above, which is 62.63% of the overall percentage of people with hypertension. However, many elderly people are not aware and responsive to the treatment of hypertension. The use of anti-hypertensive drugs is often not taken with good procedures. The purpose of this study was to determine the effectiveness and side effects of anti-hypertensive drugs consumed by the elderly in Kalijaga. Sampling using purposive sampling technique with a sample of 30 respondents with blood pressure criteria ≥140/90 mm Hg. Data analysis used wilcoxon and chi-square tests. The results showed a significant effectiveness after the administration of anti-hypertensive drugs as shown by 26 people reaching the target blood pressure therapy. Many of the side effects felt were derived from the use of anti-hypertensive drugs.

Infertility has caused a lot of psychological traumas to married women who have not given birth to any child or those who could not give birth again after their first birth at their matrimonial home. Child bearing is the most important reason why most couples got married and if that sole aim is not achieved, it becomes a taboo in some culture in Africa. The aim of this study is to evaluate the Psychological Effects Arising from Infertility Amongst Married Women in South-South Nigeria. This was a cross-sectional study involving 350 married women who were within the age of 18 to 47 years. A well-structured questionnaire was administered to participants. Each participant had one questionnaire to fill appropriately and independently after instructions were given to them by the Research Assistants. The study lasted for a period of 3 months. Statistical analysis of data was done using SPSS Version 25 and P value < 0.05 was considered significant for data. The research findings revealed that the majority (71.4%) of the participants were between 28 – 32 years of age and 57 .1% had tertiary level of education. The study shows that 71.4% of the participants have not got pregnant, 28.6% have gotten their first pregnant, 42.5% had married for a period between 2-4years, 85.7% are eager to get a child, 71.4% do not have a child and 28.6% have only a child. The study also, shows that 85.7% of the participants were bordered and 91.4% were passing through several degree of psychosocial trauma. Again, the research revealed that 82.9% of the participants were passing through pressure or stress and 91.4% of the women have been abused for not conceiving. Also, 85.7% of the participants had increased in their blood pressure after undergoing medical check-up and 91.4% had depression. The study revealed that 71.3% of the women revealed that their husband is planning to take a new wife and 60.5% said their husband have already taken a new wife. The research findings revealed that 82.9% of the participants do not socialize, 74.3% said their husband do not love them again and 57.1% of the participants have pushed out of their matrimonial homes.

Sunscreen is a material that can absorb or reflect ultraviolet (UV) radiation to protect the skin from the negative impact. Sunscreen derived from synthetic compounds can cause long-term toxic side effects, so natural materials can be a safer alternative to sunscreen. Basil leaves (Ocimum basilicum L.), and jicama tubers (Pachyrhizus erosus L.) have sunscreen activity because they contain flavonoids that absorb UV. This study aims to compare the sunscreen activity of basil leaf extract cream with jicama tuber starch cream and determine the concentration of basil leaf extract or jicama tuber starch with the highest SPF value. Basil leaves were extracted by maceration using ethanol solvents, while jicama tubers were made into starch powder. Basil extract and jicama starch were formulated into a cream preparation. Then, an evaluation of the preparation was carried out. The SPF value was determined in vitro using a UV-Vis spectrophotometer instrument at a wavelength of 290 to 320 nm. The results of the evaluation of the cream preparation meet the requirements for the entire test. The results of measuring the SPF value of basil leaf extract sunscreen cream with concentrations of 15%, 20%, and 25% were 9.40 (maximum), 10.66 (maximum), and 15.41 (ultra). The results of measuring the SPF value of jicama tuber starch sunscreen cream with concentrations of 15%, 20%, and 25% were <2, so it is ineffective as a sunscreen. Basil leaf extract sunscreen cream with a concentration of 25% showed the best SPF value with an ultra sunscreen ability level.

Indonesian herbal heritage that still survives and continues to be preserved. Jamu that is very well known by the people of Indonesia is jamu gendong. Based on the Regulation of the Head of the Food and Drug Administration of the Republic of Indonesia number 12 of 2014 concerning traditional medicines that are prohibited from circulating, namely traditional medicines that do not meet the quality safety and usefulness requirements, one of which meets the TPC test requirements. The Total Plate Count (TPC) test is used to calculate the number of bacteria that grow and develop in a sample, as well as a reference for determining the quality and safety of simplisia. One of the regulations of the Food and Drug Supervisory Agency (BPOM) no 32 of 2019 concerning the safety and quality requirements of traditional medicines that in the process of making liquid preparations of internal medicine must meet the requirements of a total plate number value of r < 105 colonies / mL. The purpose of this study was to determine the TPC value before and after How to Make Good Fresh Herbal Medicine (CPJB) education and to determine the effect of CPJB education on jamu gendong rice kencur sellers in Kejaksan District and Kesambi District. Samples in this study were taken from 5 herbal medicine sellers. The results of this study showed the TPC value before CPJB education, sample 1 12 x 10-5, sample 2 1.4 x 10-4, sample 3 2.6 x 10-4, sample 4 3.6 x 10-4, sample 5 2.2 x 10-4. This study used leaflet media to conduct CPJB education. TPC value after CPJB education, in sample 1 amounted to 2.7 x 10-4. The conclusion of this study is that there is an effect of CPJB education on kencur rice herbal sellers, as evidenced by changes in TPC values before education and after education.

The status of being an undocumented learner presents a myriad of learning challenges to the affected learners. Schools in South Africa, particularly in the rural areas and those areas along the borders with Mozambique and Zimbabwe, have over a million undocumented learners who are either children of South Africans or children born from non-South African parents. The purpose of this study is to explore the experiences of the undocumented learners, their parents, and the schools against the findings of the Phakamisa judgement of 2017, Case No.2480/2017 which was held in the Eastern Cape High Court in Grahamstown. The undocumented learners are children who join the schooling system; grow up being undocumented in the system, become teenagers or young adults in the system and end up exiting the system without anything to show for the number of years they stayed in the system. This paper explores the problem faced by undocumented learners and its implications to them in the classroom and beyond. This paper will, in concert with the findings of the Phakamisa judgement, implore the policy makers to move beyond compliance and put together policies that will protect the right of children through interdepartmental cooperation to fast track the documenting of learners at birth, irrespective of the status of their parents.

Sexual urge is a drive for sexual intercourse and orgasm is the peak at which the ladies involve in sexual intercourse intercourse attained and at this stage of orgasm, they are more receptive for sexual activity, more romance and show of enjoying the sexual activity through pronouncing different sounds. Recently, most women have lost sexual urge (drive) even when sex is preceded by sexual stimulation or sexual fondling or sexual caress by their male partners. And because sexual urge is lost, orgasm can not be attained. The aim of the study is to evaluate the Rising Trend of Lack of Sexual Urge and Orgasm Among Females in the Niger Delta. This was a cross-sectional study involving 250 married women who were within the age of 18 to 47 years. A well-structured questionnaire was administered to participants. Each participant had one questionnaire to fill appropriately and independently after instructions were given to them by the Research Assistants. The study lasted for a period of 3 months. Statistical analysis of data was done using SPSS Version 25 and P value < 0.05 was considered significant for data. The results’ shows the participants were between 18-22 and 43-47 years of age. Again, that 24.0% of the participants were single, 60.0%) were married, while 16.0% were divorced, 68.0% lack sexual urge, 40.0% have experienced it in 4 years, 68.0% have difficulty in reaching orgasm during sex, and 76.0% passed through stress.

Lipoma is a common benign tumor of soft tissues but rarely located in the hand or being responsible for neuropathy. A case of compressive lipoma of the Guyon canal with purely sensory disorders has been evolving for 04 years in a 56-year-old woman. The mass was removed without any damage to vascular, neural, or tendinous structures. Postoperative recovery was straightforward, and the patient regained good mobility in the hand and fingers.

Background: Prenatal care has proven to play an invaluable role in the reduction of maternal and perinatal mortality. The care provided to the parturient includes risk assessment, health promotion and education, and therapeutic intervention if need arises. The cardinal point of antenatal care is mainly but not limited to ensuring the delivery of a healthy newborn with minimal or no risk to the mother. The importance of prenatal care cannot be overemphasized especially in developing countries with high fertility rate, increased tendency to large family size and increased maternal mortality. Objectives: To determine the sociodemographic characteristics of booked and unbooked pregnant women and to ascertain any differences in maternal and perinatal outcome. Materials and Method: A retrospective cohort study at 68 Nigerian Army reference hospital from January 2020 to December 2023. All the antennal records of women booked in our facility within the period of study were retrieved. Maternity records that included all unbooked deliveries were all retrieved. The variables of interest were maternal age, parity, educational status, antenatal care (ANC) attendance, mode of delivery, obstetrics complications and pregnancy outcomes. Data was analysed using SPSS version 29. P<0.05 was considered significant. Results: A total number of 5032 patients were seen during the four-year period of review. Booked cases were 3572 (70.99%) while unbooked was 1460 (29.01%). Fetomaternal adverse outcome and complication were more in the unbooked category with high operative delivery 87.05% in the unbooked patients. Conclusion: The study showed that more adverse pregnancy outcomes occurs when women are unbooked during pregnancy. Continued utilisation of quality antenatal and delivery care services in our environment will significantly improve pregnancy outcome while reducing maternal and perinatal mortality and morbidity.

Background: Primary amenorrhea, defined as the absence of menarche by age 15 in the presence of secondary sexual characteristics or by age 13 without them, arises from various etiologic factors. Timely diagnosis and targeted interventions, including genetic counseling and reconstructive surgeries, are essential for effective management. Aim of the study: The aim of this study was to prevalence of etiologic causes of primary amenorrhea among women in a tertiary care center. Methods: This cross-sectional study was conducted in Department of Obstetrics and Gynaecology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, during the period from June 2023 to May 2024. Total 120 women presenting with primary amenorrhea during the study period were included. Result: The study involved participants with a mean age of 17.8 ± 3.2 years, with 58.3% aged 15-20. Most were from low-income backgrounds (62.5%), and 33.3% reported parental consanguinity. Hormonal causes (41.7%) predominated, followed by structural (33.3%) and genetic causes (16.7%). Hypogonadotropic hypogonadism (60.0%) and Müllerian agenesis (62.5%) were leading subtypes, while Turner syndrome accounted for 60.0% of genetic cases. Diagnostic findings included pelvic ultrasound abnormalities (45.8%, p <0.001) and karyotype abnormalities (16.7%). Hormonal imbalances were most common (58.3%), reflecting the diversity of etiologies and the importance of advanced diagnostics in identifying underlying causes. Socioeconomic status and parental consanguinity significantly influenced etiological patterns. Conclusion: This study highlights significant associations between socio-demographic factors, such as age, consanguinity, socioeconomic status, and etiological categories were observed. Diagnostic findings underscored the importance of pelvic ultrasound, karyotyping, and hormonal evaluation in accurate classification.

Early Childhood Caries (ECC) remains a global public health challenge, particularly in underserved populations where access to conventional dental care is limited. Silver Diamine Fluoride (SDF) has emerged as a transformative approach in the management of ECC, offering a minimally invasive, cost-effective solution to arrest caries progression and prevent new lesions. This review provides a comprehensive evaluation of SDF, focusing on its mechanism of action, clinical efficacy, advantages, and limitations in pediatric dentistry. Evidence from recent studies demonstrates that SDF is highly effective in halting caries progression, significantly reducing the need for more invasive treatments, particularly in young or uncooperative patients. However, aesthetic concerns, primarily the black staining of treated lesions, and the need for informed parental consent remain key barriers to its widespread adoption. The article also explores the integration of SDF into broader public health strategies for ECC prevention and treatment, emphasizing its role in resource-constrained settings. Ethical and legal considerations, along with future research directions, are discussed to address gaps in understanding its long-term safety and efficacy. By advancing the use of SDF, this review highlights its potential to revolutionize the management of ECC, aligning with global goals of equitable access to essential health care.

Data shows sudden cardiac arrest is still one of the leading causes of death in Europe and the United States (Berdowski et al., 2010). Healthcare professionals must provide immediate and proper resuscitation, which directly impacts the patient likelihood of survival. Mock code drills play a pivotal role in healthcare education and training, by enhancing the participants' confidence levels. This increased confidence, in turn, contributes to improved clinical performance and patient outcomes. Within the hospital setting, resources and personnel are readily available in the event of a medical emergency, however in the outpatient setting the stakes may be higher due to lessened resources and manpower (Urman, Punwani and Shapiro, 2012). To date, there is very little research surrounding medical emergencies in the outpatient settings, this highlights the need for further investigation as cardiac arrest is a high risk low volume emergency that many healthcare professionals feel unprepared and ill equipped for (Monachino et al., 2019). This Quality Improvement (QI) project explored the impact of mock code blue drills on healthcare professional’s confidence levels in the outpatient setting. Over three months, monthly code blue drills were conducted in two separate outpatient locations. Staff involved in this QI completed a pre and post drill survey consisting of nine statement with five-point Likert scaling assessing their confidence levels. Results in this QI showed an overall improvement in the confidence of clinical staff after taking part in mock code blue drills. There were limitations to this QI including a low response rate, small sample size, as well as external factors such as a faulty public announcement system impacting the drills. Future recommendations include increased frequency of drills, qualitative research to explore staff’s perceptions and high-quality simulation equipment. Code blue drills should be completed every three months to safeguard patient safety and promote staff responsiveness in a true cardiac arrest event.

The global climate continues to deteriorate, resulting in excessive carbon emissions, heavy metal pollution possesses serious threats to human life and modern civilization. The concentration of Zn, Fe, Cr, Pb, Cu and Cd in soil and rice grown in two locations (A and B) AROUND Edozhigi river were determined using standard methods og analysis. Results obtained for location A, indicate high concentration of Zn 9.75±0.55, 9.61±0.54, 1.03±0.58 and 1.69±0.66 mg/kg in soil, root, stem and seed of rice plant respectively. The order of Zn concentration of Zn metal in location B is 2.07±0.55 (soil) > 1.70±0.54 (root) > 1.67±0.58 (stem) > 1.27±0.66 (seed). Concentration of Fe (mg/kg) in soil (25.50±0.00) and root (26.32±0.00) from location B were significantly higher than those of stem (8.46±0.00 mg/kg) and seed (6.98±0.00 mg/kg) respectively. Concentration of Cu (mg/kg) in soil, root, stem and seed from location A and B were between 0.00±0.00 - 0.03±0.40 mg/kg respectively. The low concentration of these metals in soil around Edozhigi river makes the soil fit for growing crops.

The civil service played a critical role in fostering socio-economic development, particularly in developing countries like Nigeria. This paper examined the role of the civil service in driving socio-economic progress, with a focus on Akwa Ibom State. The study assessed how civil service structures and policies influenced key areas such as employment generation, economic growth, infrastructure development, and public service delivery. To achieve the study objectives, the researcher utilized both descriptive and ex post facto research designs to analyze civil service operations and their impact on socio-economic development. The descriptive design provided a detailed overview of the current state of civil service practices, while the ex post facto design allowed for the examination of past policies and their outcomes without manipulating variables. Data were collected from a variety of secondary sources, including textbooks that offered foundational knowledge, journals with empirical studies, civil service information handbooks detailing regulations, and government bulletins providing insights on policies and challenges. The findings revealed that inadequate allocation of resources; bureaucratic delays, corruption, and ineffective human resource management were major factors that hindered the civil service's ability to achieve socio-economic development. The paper concluded with recommendations for enhancing the efficiency of the civil service, including policy reforms, capacity building, and strategic leadership, to better align with national development goals in Akwa Ibom State.

Background: Management of IUFD has immense significance in today’s obstetric practice. To summarize, dinoprostone gel, misoprostol and intra cervical catheter can be used for induction of labour in second and third trimester IUFD. Mechanical methods, i.e. the use of Foley’s catheter balloon, though effective have not gained much popularity because of the fear of infection. Objective: To observed the complications of induction of labor with Foley's catheter in patients with a previous cesarean section. Materials and Methods: The observational study was carried out in the Department of Obstetrics & Gynecology, Dhaka Medical College Hospital. Dhaka, Bangladesh. Total 52 patients with singleton pregnancy with IUFD, at ≥28 weeks of gestation was attending in the Department of Obstetrics & Gynae were included in this study. Details of history, general physical and systemic examination, ultrasonography, basic laboratory investigations like haemoglobin level, and DIC profile were recorded. Results: Forty three (82.7%) received augmentation with oxytocin, 3(5.8%) developed scar tenderness and 8(15.4%) had failed induction. Failed ICC was found 8 cases, among them 5(62.5%) had dinoprostone gel used followed by vaginal birth, 2(25.0%) had LUCS and 1(12.5%) had laparotomy. Induction delivery interval was found 16.3±5.5 hours. Regarding maternal outcome 49(94.2%) patients had normal vaginal delivery, 4(7.7%) had PPH, 3(5.8%) had fever, 2(3.8%) were ICU admission, 1(1.9%) had laparotomy and 1(1.9%) had rupture uterus. Conclusion: Common maternal complications were PPH, fever, ICU admission, laparotomy and rupture uterus. Induction can be done safely in carefully selected cases of previous LSCS with Foley’s Balloon.

The halal lifestyle is now widely adopted in Muslims' lives, including medical practice. The study aims to determine the level and correlation of knowledge, perception, and attitude of doctors toward readiness to enter the era of mandatory halal certification of drugs and the demographic factors that influence it. A cross-sectional study was conducted online using a questionnaire validated by experts and previous validation and reliability tests. This study was attended by 400 respondents from five provinces in Java, using purposive sampling. The results of the study showed that doctors had sufficient knowledge (mean 38.50 ± 2.293), sufficient perception (mean 40.92 ± 5.076), and sufficient attitude (mean 39.14 ± 4.523) towards halal drugs. There is a weak correlation between knowledge perception (r=0.306, p<0.05), a very weak correlation between knowledge attitude (r=0.297, p<0.05), and a robust correlation between perception attitude (r=0.828, p<0.05). Doctors' knowledge, perception, and attitudes about halal medicine influence each other (p value<0.05). Factors such as workplace, position, and length of service influence knowledge (p value<0.05), and age, workplace, position, and length of service influence perception and attitude (p value<0.05.) of doctors about halal medicine. It is concluded that doctors have sufficient knowledge, perception, and attitude and influence each other; the correlation between knowledge-perception is weak, knowledge-attitude is very weak, and perception-attitude is very strong. Age has a relationship with knowledge, perception, and attitude, education has a relationship with knowledge, and the workplace has a relationship with doctors' perception of halal medicine.