Clinical microbiology serves as a partner to clinicians in the diagnosis and treatment of infectious diseases. Antibiotics are prescribed empirically before the availability of antimicrobial susceptibility testing data, especially when the patient's medical status could deteriorate by suspending the treatment. To investigate the impact of antimicrobial susceptibility testing on the management of outpatients with suspected bacterial infection in Libyan patients, a cross-sectional prospective study concluded on microbial microdroplet culture by including outpatients with suspected bacterial infection, who have done antimicrobial susceptibility testing. Thus, 53 Libyan patients with urinary tract infections and 14 Libyan patients with skin infections were included in this study. Before the availability of antimicrobial susceptibility testing data, 25 patients were appropriately treated while 42 patients were inappropriately treated. After the availability of antimicrobial susceptibility testing data, the number of appropriately treated patients increased to 57 patients. Thus, antimicrobial susceptibility testing improved the management of 41 patients by discontinuing an unnecessary antibiotic in four patients, starting necessary antibiotic therapy in 18 patients, and changing to more appropriate antibiotic in 19 patients. However, the antimicrobial susceptibility testing has no impact on the management of 24 patients and has led to the worsening of the management of two patients. The effect of antimicrobial susceptibility testing of antibiotic de-escalation was assessed in 35 patients; however, antibiotic de-escalation occurred in six patients. Thus, data of antimicrobial susceptibility testing has improved the management of Libyan outpatients with bacterial infection but their role in antibiotic de-escalation was slight

Mediterranean journal of pharmacy and pharmaceutical sciences

This brief inspects the situation with research in Indian advanced education and offers an outline of the idea of undergrad (UG) research as a method for change. The article endeavors a short survey of the public authority endeavors to further develop advanced education examination, and underlines the restrictions of their degree just as their ramifications. Through a sweeping audit of existing experimental and subjective investigations, this concise shows the advantages and effects of UG research on improvement of insightful characteristics in understudies also its impact on foundations. At last, it suggests methods of drafting this idea in the current arrangement of undergrad schooling in India, in view of remedies by the Chamber on Undergrad Exploration

Dr gedam kamalakar

On 18 March 2020, all South African universities and colleges were closed due to the COVID-19 virus. By early April, 10 universities announced that they were planning to resume teaching and learning online, including the University of the Witwatersrand (i.e., Wits University), Johannesburg, which is the joint highest ranked university in Africa. Therefore, the purpose of this editorial was to examine the perceptions and attitudes of these students regarding online learning in an era of disruption of COVID-19, uniquely using both multi-mixed methods research approaches (i.e., involving the partial integration of multiple methods research approaches and mixed methods research approaches) and meta-methods study approaches (i.e., involving the full[er] integration of multiple methods research approaches and mixed methods research approaches). A total of 4,419 Wits University students completed an online survey. A principal components analysis of one of survey’s scales, namely, the Attitude of Students Towards COVID-19 and its Impact on Higher Education scale, revealed 2 subscales, namely, Students’ Self-regulation Towards COVID-19-Based Higher Education and Attitudes Toward Teaching, Learning, and Assessment in COVID-19-Based Higher Education. Nonparametric analyses revealed that scores on these measures discriminated gender, age group, level of student (i.e., undergraduate vs. postgraduate), locality status (i.e., local vs. international student), and registration status (i.e., full-time vs. part-time). A multiple analysis of the open-ended responses by the VOSviewer 1.6.14 text mining software program led to the identification of 6 metathemes. Similarly, WordStat 8.0.29 topic modeling yielded 5 metathemes that mapped onto VOSviewer’s 6 metathemes, indicating triangulation of findings. A sentiment analysis revealed negative sentiments that identified not only the biggest challenges for students but also the characteristics of students who experience these challenges. Finally, a cluster analysis, combined with chi-square analyses, led to the identification of 4 clusters of students who differed with respect to their attitudes and online experiences. Implications of these findings are discussed.

Dr emmanuel ojo

Regularly used toothbrushes can be heavily contaminated with microorganisms, while inappropriate storage may increase the microbial load on these toothbrushes. Toothbrushes Microbial contamination can help to transmit many diseases, especially for people with mouth and/or Gum problems. This study aims to find the easiest and most available way to sterile toothbrushes at home. 24 adult volunteers were divided into four groups, the first three groups were asked to sterilize their toothbrushes with Dettol, water salt and hot water, while the fourth group toothbrushes were a positive control. Results showed that toothbrushes sterilized with Dettol gave the least contamination rate of 12.5%, toothbrushes sterilized with salt came next with 37.5%, while toothbrushes sterilized with hot tap water were the next with 50%. The toothbrushes of the fourth group which was used as the positive control were totally contaminated with different types of bacteria. Six bacterial agents were isolated; they are Staphylococcus Sp., Streptococcus sp., Bacillus Sp., E.coli, Pseudomonas Sp., and Salmonella sp. It was concluded that the use of Dettol was very effective in reducing the number of contamination of toothbrushes but its unacceptable flavour limiting its use. Other volunteers were comfortable with the use of salt and hot water as it was almost effective. The research suggests a group of recommendations to avoid the transmission of pathogens through toothbrushes and ensure healthy usage.

Kamal singh

Background and Aim: Ultrasound popliteal sciatic nerve block (UPSNB) is commonly performed in foot and ankle surgery. This study aims to assess the use of dexmedetomidine and dexamethasone as adjuvants in UPSNB for hallux valgus (HV) surgery, comparing their efficacy in producing motor and sensory block and controlling postoperative pain. The adverse event rate was also evaluated. Methods: This mono-centric retrospective study included 62 adult patients undergoing HV surgery: 30 patients received lidocaine 2% 200 mg, ropivacaine 0.5% 50 mg and dexamethasone 4 mg (Group 1), whereas 32 patients received lidocaine 2% 200 mg, ropivacaine 0.5% 50 mg, and dexmedetomidine 1 mcg/Kg (Group 2). At first, the visual analogue scale (VAS) was evaluated after 48 hours. The other outcomes were time to motor block regression, evaluation of the first analgesic drug intake, analgesic effect, adverse effects (hemodynamic disorders, postoperative nausea and vomiting (PONV)) and patient satisfaction. The continuous data were analyzed with student’s t-test and the continuous one with χ2. Statistical significance was set at a p-value lower than 0.05. Results: No significant difference was found in VAS after 48 hours (4.5 ± 1.6 vs 4.7 ± 1.7, p = 0.621) to motor block regression (18.9 ± 6.0 vs 18.7 ± 6, p = 0.922). The number of patients that took their first analgesic drug in the first 48 h (p = 0.947 at 6 hours; p = 0.421 at 12 hours; p = 0.122 at 24 hours and p = 0.333 at 48 hours) were not significant. A low and similar incidence of intraoperative hemodynamic disorders was recorded in both groups (hypotension p = 0.593; bradycardia p = 0.881). Neither PONV nor other complication was found. Patients in Group 1 reported a lower degree of interference with sleep (p = 0.001), less interference with daily activities (P = 0.002) and with the affective sphere (P = 0.015) along with a more satisfactory postoperative pain management (p < 0.001) as compared to Group 2. Conclusion: No significant differences were observed in the duration of motor and sensory blockade between patients in both groups. Additionally, both groups showed good pain control with a low rate of adverse effects, even if there was no clinical difference between the groups. However, patients who received dexamethasone reported experiencing less interference with their sleep, daily activities and overall emotional well-being, and overall pain control.

Dario cirillo

The blunted nose cone with and without a sharp aerospike and an aerodisk of various diameters and lengths are investigated numerically in detail in the current study at a hypersonic Mach number of 10. The aerodisk diameter is described as d/D ratios such as 0.2, 0.4 and 0.6, and the length of the aerospike is represented as the L/D ratio of 1, 1.5 and 2. The main objective of the research is to examine the aerodynamic properties of blunt noses with and without aerodisks and aerospikes, as well as the influence of shock production over the model. The design of blunted nose cones with aerodisk was made up using CATIA and numerical investigation was performed on the ANSYS Fluent. The turbulence model of SST k-omega was considered for study. The current study revealed that shock patterns drastically varied nearer to the nose cone model at L/D ratio 2 and variation of drag reduction occurred due to the increase in d/D ratio and aerospike and also flow pattern over the model was clearly investigated.

Boopathy govindarajan

The significance of fermentation is gaining more relevance due to the need for better preparation of plants, the desire for better plant constituents, and the aim for the preservation of medicinal plants. Hence, this study sets out to determine and compare the pH, proximate composition, chemical constituents, antioxidant, and antimicrobial effects of 3-day and 7-day fermented seeds of Nigella sativa. The fermentation of the seed was done for 3 and 7 days using 2.5% sugar. The pH of the sample declined from 3.5 to 3.45 during the fermentation. The proximate composition (moisture, ash, lipid, protein, and carbohydrates) was higher for the 3-day fermented sample while fiber was higher for the 7-day sample. The phytochemical constituents (tannins, saponins, phenols, alkaloids, flavonoids, phytates, oxalates, terpenoids, steroids, and glycosides) were higher for the 3-day than the 7-day sample. The Gas Chromatography-Mass spectrometry technique showed peaks that were characterized as 17 and 20 constituents on days 3 and 7 of the sample, respectively. The antioxidant capacity (ranging from 35.50% to 82.69% for the 3-day and from 37.50% to 84.99% for the 7-day sample) varies by the increasing concentration (7.81 mg/mL to 1000 mg/mL) of the sample. The diameter of zones of inhibition tested at different concentrations (25 mg/mL, 50 mg/mL, and 100 mg/mL) showed varying degrees of activity against Proteus vulgaris and Staphylococcus aureus. The zones obtained were higher 8-10 mg/mL against Staphylococcus aureus and 10-12 mg/mL against Proteus vulgaris for the 7-day fermented sample while 8.0 to 9.0 mg/mL was obtained for the 3-day fermented against Staphylococcus aureus and 8.0 to 10.0 mg/mL against Proteus vulgaris. Overall, the results of this study indicated that fermentation contributed to enhancing the bioactive components and antioxidant capacity of the fermented seeds of N. sativa thereby supporting the use of fermentation in the production of value-added functional foods.

Mediterranean journal of pharmacy and pharmaceutical sciences

Social engineering is a method of information security that allows for system or network access. When victims are unaware of techniques, models, and frameworks to prevent them, social engineering attacks happen. In order to stop social engineering attacks, the current research describes user studies, constructs, assessment, concepts, frameworks, models, and techniques. Sadly, there isn't any specific prior research on mitigating social engineering attacks that thoroughly and efficiently analyzes it. Health campaigns, human security sensor frameworks, user-centric frameworks, and user vulnerability models are examples of current social engineering attack prevention techniques, models, and frameworks. Guidance is required to examine cybersecurity as super-recognizers, possibly acting as police for a secure system, for the human as a security sensor architecture. This research aims to critically and systematically analyze earlier material on social engineering attack prevention strategies, models, and frameworks. Based on Bryman & Bell's methodology for conducting literature reviews, we carried out a systematic review of the available research. Using a protocol, we discovered a novel strategy to stop social engineering assaults in addition to approaches, frameworks, models, and assessments, based on our review. We discovered that the protocol can successfully stop social engineering assaults, including health campaigns, the susceptibility of social engineering victims, and co-utile protocol, which can control information sharing on a social network. This comprehensive evaluation of the research is what we're presenting in order to suggest safeguards against social engineering assaults.

Mahesh donga

Mentoring relationships between a senior, experienced faculty member and a junior employee, between a faculty member and an undergraduate or graduate student, or between a senior and a junior student is essential in higher education. The current review aims to emphasize the necessity of establishing organized mentorship programs at national institutions to enhance academic performance, teaching/learning effectiveness, knowledge and skill development, growth and development, research productivity, and community engagement. The mentor and mentee both benefit from the mentoring relationship. Academic advising, preceptor supervision, and supervision of graduation projects are different from the mentoring relationship as they focus on only one aspect of the relationship, whether it is the study plan, the study session, or the project, respectively. Mentoring is a mutually beneficial relationship that calls for integrity, decency, self-assurance, trust, and respect. Educational institutes and colleges should set up a committee to establish a well-organized mentoring program with all the necessary templates for recruiting mentors and mentees, and also for annual evaluation and feedback from all parties involved.

Mediterranean journal of pharmacy and pharmaceutical sciences

Salah satu mata pelajaran yang dianggap sulit oleh siswa adalah matematika. Sehingga pelajaran ini kurang diminati siswa. Permasalahan inilah yang menyebabkan banyak siswa mengalami kesulitan belajar matematika. Rumusan masalah dalam penelitian ini yaitu: Kesulitan Belajar Matematika Siswa MI Da’watul Falah Kecamatan Tegaldlimo Kabupaten Banyuwangi Tahun Pelajaran 2018/2019? Sedangkan tujuan penelitian ini adalah untuk mendeskripsikan kesulitan belajar matematika siswa MI Da’watul Falah Kecamatan Tegaldlimo Kabupaten Banyuwangi. Penelitian ini menggunakan pendekatan kualitatif dengan jenis penelitian fenomenologi. Subjek penelitian dalam penelitian ini menggunakan purposive sampling. Teknik pengumpulan data yang digunakan adalah observasi, wawancara, dan dokumentasi. Sedangkan analisis data menggunakan model analisis Miles, Huberman dan Saldana yaitu data Condensation, data Display, serta Conclusion drawing/verivication. Adapun pengecekan keabsahan data yang digunakan adalah triangulasi sumber dan triangulasi teknik. Hasil penelitian ini menunjukkan bahwa kesulitan belajar matematika siswa disebabkan salahnya mindset yang dibangun dari awal oleh siswa, sehingga mereka kesulitan dalam memahami materi yang diajarkan di kelas. Adapun faktor-faktor yang menyebabkan kesulitan belajar terdiri dari faktor internal dan faktor eksternal.

Educare: journal of primary education

Management accounting refers to the process of collecting, organising, and recording financial transactions with the aim of providing information for the management to make informed decisions about the operation of an organisation (Ameen, Ahmed, and Abd Hafez, 2018). Management accounting allows organisations to conform to the expectations of various financial agencies, such as tax agencies, by ensuring that all transactions that take place within an organisation are done correctly (Järvinen, 2016), thus enabling the organisation to meet its goals and objectives.

Zamzam abdelazim

How great would it be if you never forgot anything or never lost the ability to think and be creative? And just imagine how much more great it would be if your brain can be reconstructed so that it can stay young forever and be used to create wonders even after your death? It would be a great leap in the field of science if the brains of great minds like Steve Jobs or Albert Einstein can be recreated. That is exactly what the blue brain does. The blue brain project is an attempt to reconstruct the brain piece by piece and building a virtual brain in a supercomputer. It began in 2005 with an agreement between the EPFL and IBM, which supplied the Blue Gene/L supercomputer acquired by EPFL to build the virtual brain. The computing power needed is considerable. Each simulated neuron requires the equivalent of a laptop computer. A model of the whole brain would have billions. Supercomputing technology is rapidly approaching a level where simulating the whole brain becomes a concrete possibility. The main aim is to update the brain into a computer. As a first step, the project succeeded in simulating a rat cortical column. Efforts are now being made to simulate the human brain. In five years of work, Henry Mark ram’s team has perfected a facility that can create realistic models of one of the brains essential building blocks. This process is entirely data driven and essentially automatically executed on the supercomputer. This modeling will expand to all the areas of the brain and if successful, shed light on the relationships between genetic, molecular and cognitive functions of the brain. These models will be basic building blocks for larger scale models leading towards a complete virtual brain.

Dr h shaheen

Brushites are the most commonly found phosphate stones in the kidneys, ureters and urinary bladder. The study was conducted to observe the possible growth patterns of brushite crystals in the gel for 14 days. The crystal formation was observed as a bullet, needle, platy, columnar shaped and their aggregates. Magono and Lee's meteorological classification further explained these shapes. Besides the morphology, the average size, number and weight of crystals were also observed on the 7th and 14th days. Energy Dispersive X-ray, Fourier Transform Infra Red spectroscopy and Scanning Electron Microscopy were used to characterize the crystals. These results can help to determine the promotion, modulation and inhibition of the crystals, which will be helpful in evaluating the risk factors and prophylactic management of brushite-type urinary stones.

Dr. salman ahmed

Marketing refers to the actions that elevate customer value by motivating them to purchase the organisation's products or services (Kusumadewi, 2019). An organisation with strong capabilities must exhibit strong marketing capacities to effectively introduce its offerings to new markets (Lee and Falahat, 2019). Marketing strategies are part of an organisation's corporate strategy, which refers to the set of choices an organisation makes to develop and capture value across its business over time. As corporate strategy essentially drives financial performance (Sull et al., 2018), effective marketing strategies must be selected to ensure the organisation's attainment of objectives and long-term success.

Zamzam abdelazim

Venous thromboembolism (VTE) is a serious medical condition that has a high clinical burden on both the mother and fetus, despite having a low incidence during pregnancy and the postpartum period. VTE is a leading cause of death among pregnant women and new mothers worldwide, and its severity cannot be underestimated. The development of VTE is influenced by a combination of genetic and environmental factors, as well as acquired conditions. Pregnancy-related changes, such as increased levels of coagulation factors and diminished fibrinolysis, can increase the risk of VTE. Additionally, older mothers, those who are obese, multiparous, or have undergone cesarean delivery, are at a higher risk of developing VTE. Owing to the lack of standardized guidelines and reliable data on VTE prevention, diagnosis, and treatment, authorities have developed risk scores that allow for a personalized assessment of the risk of thrombosis during pregnancy and postpartum, enabling a tailored approach to prevent thrombosis. Managing VTE during pregnancy poses significant challenges because the benefits and risks of anticoagulant treatment for both the mother and fetus must be carefully balanced. An interdisciplinary approach that includes obstetricians, neonatologists, physicians, and hematologists is essential to achieving optimal outcomes. This review explored the VTE updates in pathogenesis, presentation, complications, treatment options, and research gaps with proposal strategies to improve VTE outcomes and suggest further research.

Karishma

Indian Banking industry has witnessed a tremendous developments due to sweeping changes that are taking place in the information technology. Electroic banking has emerged from such an innovative development. Many developments in Tele-communication technology and electronic data processing in recent years have contributed to remarkable changes in the banking sectors. The application of modern information technology has radically altered the traditional way of doing banking business. Availability of ATMs and plastic money (i.e., credit and debit cards) has helped customers avoid going to bank premises for cash. Bank customers can view their bank accounts; get statements of accounts, purchase drafts and transfer funds through their personal computers. Another development viz., Electronic Data Interchange (EDI) has contributed to effective working of banks. The computer networks have helped to automate the funds transfer, contributing to more effeicient systems of payments. All these developments in banking sectors in recent years have given birth to a new concept called E-Banking. Hence this study is undertaken in order to know the customer preference towards E-banking services with special reference to private sector banks.

Dr.n.s.lissy

Background: The rising global DM epidemic is driving the problem of TB control. This research determined glycemic control in TB only infected and DM-TB comorbidity and the consequence of the double burden on treatment outcome. Methods: fifty M. TB infected subjects and fifty control subjects were enrolled into the study, all the participants gave consents. FPG and HbA1c were determined by Colorimetry. Data were analyzed using SPSS version 20.0 statistical package, differences between groups and variation among groups were determined by Student’s t-test and ANOVA respectively while the association between variables by Pearson’s correlation. Differences were considered statistically significant at p<0.05. Results: The mean FPG and HbA1c levels of TB subjects were significantly (P<0.05) higher than those of the control. The mean BMI of the TB infected subjects was significantly lower (p=0.001) than that of the controls. The mean age, FPG and HbA1c of TB subjects at the beginning phase of treatment were significantly lower (p<0.05) than those of subjects at the continuation phase of treatment. The mean age, FPG and HbA1c of subjects with DM-M.TB coexistence were significantly (p<0.05) higher than those of the M.TB only infected subjects. BMI of the DM-M.TB comorbidity subjects was lower than that of the M.TB only infected subjects (p=0.109). A significant positive correlation was obtained between HbA1C and FPG in M.tb infected subjects. (r=0.910, p=0.001). A negative correlation obtained between HbA1C and BMI in M.tb infected subjects. (r=0.267, p=0.061). Conclusion: Infection with mycobacterium tuberculosis poses a risk to DM and vice versa, which may adversely affect treatment outcome and control of both diseases. Firm efforts to control DM may likely have a significant valuable effect on TB treatment outcome.

Eworo raymond

Streptococcus bovis/gallolyticus was considered as lower grade pathogen involved in endocarditis. Recent accumulating evidence has suggested that Streptococcus bovis/gallolyticus plays an important role in the initiation and development of colorectal cancer. This study was aimed to address the association between Streptococcus bovis/gallolyticus and colorectal cancer among Libyan patients, to determine the dominant biotype of Streptococcus bovis/gallolyticus associated with colorectal cancer patients and to evaluate the antibiotic susceptibly patterns of isolated strains. The study involved 20 colorectal cancer patients, 20 patients with large adenomas polyp and 20 people with healthy colonic mucosa as a control group. All the candidates were subjected to colonoscopy and histopathological examinations and conformation. The suspected and normal cases were then diagnosed according to the protocol used by the medicine specialist and grouped in accord with the study aim. All biopsies were handled and treated to isolate the suspected positive colonies of Streptococcus bovis/gallolyticus. Of the 20 colorectal cancer patients, seven patients (35%) were found to be Streptococcus bovis/gallolyticus carriers, (95% CI 1.22 - 1.72, p < 0.05). Nine patients (45%) were diagnosed colorectal cancer positive at age above 60 years old, eight patients (40%) at age 40 - 60 years old and three patients (15%) at age bellow 40 years old. Also, nine out of 20 patients (45%) with large adenomas polyp were found to be Streptococcus bovis/gallolyticus carriers, (95% CI 2.16 - 2.71, p < 0.05). Of the 20 healthy people with colonic mucosa, Streptococcus bovis/gallolyticus never been isolated. Streptococcus. bovis biotype II/I and Streptococcus. equinis were both susceptible to the above mentioned antibiotic classes, although Streptococcus bovis biotype I was highly resistance to most clinically used antibiotics. However, there was strong relationship between Streptococcus bovis/gallolyticus and colorectal cancer or large polyp formation. However, it is not well understood whether the bacterium has a pathogenic role in the initiation and progression of neoplasia or just an epiphenomenon of colorectal neoplasms.

Mediterranean journal of pharmacy and pharmaceutical sciences

Introduction/aims: Maturity-Onset Diabetes of the Young (MODY) is a monogenic non-autoimmune diabetes with 14 different genetic forms. MODY-related mutations are rarely found in the Tunisian population. Here, we explored MODY related genes sequences among seventeen unrelated Tunisian probands qualifying the MODY clinical criteria. Materials and methods: The GCK and HNF1A genes were systematically analyzed by direct sequencing in all probands. Then, clinical exome sequencing of 4,813 genes was performed on three unrelated patients. Among them, 130 genes have been reported to be involved in the regulation of glucose metabolism, β-cell development, differentiation and function. All identified variants were analyzed according to their frequencies in the GnomAD database and validated by direct sequencing. Results: We identified the previously reported GCK mutation (rs1085307455) in one patient. The clinical features of the MODY2 proband were similar to previous reports. In this study, we revealed rare and novel alterations in GCK (rs780806456) and ABCC8 (rs201499958) genes with uncertain significance. We also found two likely benign alterations in HNF1A (rs1800574) and KLF11 (rs35927125) genes with minor allele frequencies similar to those depicted in public databases. No pathogenic variants have been identified through clinical exome analysis. Conclusions: The most appropriate patients were selected, following a strict clinical screening approach, for genetic testing. However, the known MODY1-13 genes could not explain most of the Tunisian MODY cases, suggesting the involvement of unidentified genes in the majority of Tunisian affected families.

Mariam moalla

Objective: This study was conducted to investigate traditional beliefs and practices of women regarding care of the mother and the infant during pregnancy, in childbirth, and in the postpartum period. Methods: This was a descriptive, cross-sectional study conducted at a public hospital in Istanbul. The data collected consisted of socio-demographic and obstetric characteristics, and responses to questions about some traditional customs regarding pregnancy, delivery, and the postpartum period. Results: In our research, some non-harmful cultural practices were found, such as the belief that to have a clever and beautiful baby the mother should eat fruit; that to have a healthy and peaceful pregnancy, the mother should not look upon ugly things; the mother should indulge her food cravings; and to have an easy birth, the mother should walk and focus on prayers. On the other hand, we also found beliefs that could be harmful, such as wiping the mouth of a baby with a date before breastfeeding, and practices believed to be protective that could cause harm, such as putting a knife under the baby’s bed, fastening a safety pin to the baby’s clothes, and for the mother and child to remain at home for 40 days. Conclusion: While non-harmful and beneficial practices related to maternal and infant health should be accepted and supported as a part of our cultural richness, practices that could be harmful should be prevented in pregnancy classes or with training upon hospital discharge

Reyhan aydin doğan