Background and Objective: The COVID-19 pandemic affected medical care systems including stroke care, globally. In this study, we investigated the impact of the COVID-19 outbreak on stroke care in Hadramout, in terms of rate of admission, access to care, risk factors, clinical presentation, and outcome. Materials and Methods: A hospital-based cross-sectional study comparing all stroke patients admitted to Ibn-seena University Hospital (ISTH), Mukalla, Hadramout, during two periods, May 1–October 31, 2020, during the pandemic of COVID-19 (COVID-19 group), and from May 1 to October 31, 2019 (pre-COVID-19 group). Data collected from patients’ medical record files into a master sheet, and were processed by the Statistical Package for Social Sciences software. Results: There were 117 stroke patients admitted in COVID-19 pandemic in 2020, and 213 patients admitted in the same period in 2019. Stroke admission declined by 45.1% (Odds Ratio [OR]=0.30, 95% confidence interval [CI] [95% CI]: 0.22–0.42, p<0.0001) with no age and sex differences. Hypertension (HTN) and diabetes mellitus were more frequent in COVID-19 group than the pre-COVID-19 group (OR=1.74, 95% CI: 1.08–2.80, p=0.02) and (OR=1.81, 95% CI: 1.14–2, 88, p=0.01), respectively. No significant difference in other risk factors was found. Patients in COVID-19 group arrived the hospital more late than the patients in pre-COVID-19 group (OR=2.63, 95% CI: 1.64–4.21, p<0.0001). Dysphasia and altered consciousness including coma were more common in COVID-19 group compared with pre-COVID-19 group (OR=4.5, 95% CI: 2.18–9.08, p<0.0001) and (OR=3.2, 95% CI: 2.00–5.12, p<0.0001), respectively. Hospital stay was greatly reduced among COVID-19 group as compared with pre-COVID-19 group (02.9±0.31 days vs. 8.6±0.92 days, p<0.0001) Mortality rate was higher among COVID-19 group than the pre-COVID-19 group (41.9% vs. 27.2%, p=007). Conclusion: The number of stroke patients admitted during the COVID-19 pandemic decreased, they arrived late and spent shorter hospital stays while having higher rates of HTN, diabetes, and impaired consciousness with a high mortality rate.

Karishma

Cardiovascular drugs constitute one of the largest and most widely used among other diseases and cardiovascular drug market has largely been exploded . Although these drugs have the potential to significantly improve the treatment of various cardiac diseases. They are potent agents with potential for serious adverse effects, toxicity and drug interactions. Newer agents are considerably costly than older drugs and, therefore, cost-effective strategies must be developed. Thrombolytics are pharmacological agents come from bacterial origin as streptokinase and staphylokinase or from human origin as urokinase or t-PA. Thrombolytics are used to restore blood flow to infracted artery quickly. Only streptokinase, alteplase, reteplase and tenecteplase are approved by US-FDA for treatment of ST-elevation myocardial infraction (ST-EMI) [3]. This reopens blood vessels after their occlusion and prevents tissue necrosis. Although, the safe and effective use of each of these drugs requires a thorough understanding of appropriate patient selection, drug timing, dosing regimens and monitoring parameters. The greatest benefit to risk ratio for specific drugs is seen in certain subsets of patients the complexities of cardiovascular drug therapy illustrate the need for an in depth current knowledge of clinical trial evidence.

Mediterranean journal of pharmacy and pharmaceutical sciences

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

The purpose of this study was to determine the attitudes, expectations, experiences, and barriers that physicians in Tripoli hospitals experienced when working alongside Clinical Pharmacists (CPs). A descriptive self-administered questionnaire was used for the study, and participants were selected from several Tripoli hospitals. Most of the respondents agreed that CPs are an essential part of patient care teams and that they have the legal authority to review a patient's medication regimen and response. More than half of respondents believe CPs must be responsible for the medications they prescribe to patients. Half of the respondents agreed that CPs should be encouraged to play a more active role in hospitals and other healthcare facilities. The majority of participants agreed that CPs should participate in managing drug side effects and almost half agreed that CPs can contribute to decisions about drug interactions. By a low agreement rate, 42.7% of respondents thought CPs were specially qualified to counsel patients on drug therapy. A similar low trend was observed, with 40.9% agreeing to provide pharmacists with additional responsibility and authority in clinical departments, in contrast, 54.5% expressed their concern about the clinical responsibility of CPs in clinical practice. A minority of physicians agreed that Physicians should consult pharmacists in selecting the best pharmacological treatment. At the same time, the majority think that pharmacists lack clinical skills and 61.8% feel that physicians are unable to communicate effectively with CPs. 43.6% acknowledged that the traditional opposition between the two professions was a barrier to interprofessional collaboration while the absence of pharmacy space in clinical settings was cited by 39.1%. A majority of respondents agreed that physicians and pharmacists may improve their interprofessional collaboration by raising their awareness about it. A minority of respondents thought that laws and regulations governing physician collaboration should be put in place to promote effective collaboration between physicians and CPs. The study discovered that although most physicians endorse the introduction of clinical pharmacy services in hospitals and believe that physicians and pharmacists can collaborate on many tasks, respondents were not as impressed with the CPs' performance and believed that they lacked the professionalism required to carry out clinical responsibilities successfully. To facilitate the growth of clinical pharmacy services, laws and regulations must be put in place.

Mediterranean journal of pharmacy and pharmaceutical sciences

Herbal products are being paid particular attention by people around the world since they are natural, effective, and without side effects. In modern medicine, some drugs prescribed to the patients are derived from medicinal plants. Thus, the aim of this study is to investigate the central nervous effects of methanol extract of Ephedra altissima stems, in Albino mice. Doses of 500, 1500, and 3000 mg/kg of the methanol extract were administered in sub-acute doses (three doses), intraperitoneally at 24, 5.0, and 1.0 hours before scoring. General locomotor behavior profile, antidepressant activity, and anxiolytic activity were studied. The results revealed that the methanol extract of Ephedra altissima at 500, 1500, and 3000 mg/kg produced central nervous system depression, a remarkable decrease in the immobility time (forced swimming maze test), no anxiolytic-like effect by using elevated plus-maze model of anxiety. These results suggest that methanol extract of Ephedra altissima exhibits a central depressant activity, antidepressant-like activity, and mild antipsychotic activity without anxiolytic-like effect in tested experimental animal models with the doses used. Therefore, it can be concluded that Ephedra altissima extract may have a central depression, antidepressant-like activity with no effect as anxiolytic-like mood.

Mediterranean journal of pharmacy and pharmaceutical sciences

Hypertriglyceridemia-induced acute-pancreatitis (HTG-AP) is an important etiology of acute pancreatitis (AP). The treatment includes general management of AP with bowel rest, analgesia, and venous thromboembolism prophylaxis. Specific treatment of HTG-AP focuses on reducing serum triglyceride (TG) levels. Various modalities have been used, including heparin infusion, insulin infusion, plasmapheresis, and double filtration plasmapheresis (DFPP). However, the extent to which TG reduction translates into a clinical response remains unclear. This review highlights the emerging evidence on the management of HTG-AP. Insulin therapy and plasmapheresis remain treatment options to reduce TG. DFPP is an emerging treatment modality to reduce TG levels in patients with AP. However, to what extent this translates into a better clinical response is yet to be answered in large and prospective study designs.

Karishma

Systemic onset juvenile idiopathic arthritis (SoJIA) is a rare inflammatory disorder. It is the severest form of juvenile idiopathic arthritis, and complications occur most commonly in this type. Non-responsiveness to standard therapy with corticosteroids and disease-modifying antirheumatic drugs is not uncommon. Interleukin-1 beta (Il-1β) has been shown to be a main contributor to the pathogenesis of SoJIA. Anakinra, a recombinant Il-1β receptor antagonist, was shown to be effective in small cohorts of therapy-resistant adult and pediatric still's patients. This study aimed to evaluate the real-world efficacy, steroid-sparing effect, and safety profile of anakinra in patients with SoJIA at a tertiary care center in Libya. A retrospective case series was conducted on patients with SoJIA treated with anakinra at the Tripoli Children's Hospital between 2010 and 2017. Data on demographic characteristics, disease activity, corticosteroid dosage, concomitant medications, and adverse events were collected at baseline and at 1-, 3-, 6-, and 12-month post-treatment. 13 patients were treated with anakinra with a mean age of 9.4±4.6 years at anakinra initiation and a female-to-male ratio of 2: 1. All patients were on corticosteroids and 92.3% on methotrexate at treatment initiation. The proportion of patients achieving inactive disease (Jadas 10=0) increased over time. A marked steroid-sparing effect was observed: the number of patients requiring high-dose steroids (>0.5 mg/kg/day) decreased from 100% at baseline to 7.6% at 12 months, and 53.8% successfully discontinued corticosteroids entirely. All patients experienced injection site reaction, and macrophage activation syndrome occurred in 15.4% as a side effect after treatment initiation. But no severe infections or fatalities occurred. Reasons for discontinuation included remission (46.1%), drug unavailability (23.0%), inefficacy (15.3%), and side effects (15.3%). Anakinra demonstrated significant efficacy in inducing rapid disease control and reducing corticosteroid dependence in patients with refractory SoJIA, with a manageable safety profile

Mediterranean journal of pharmacy and pharmaceutical sciences

Noncommunicable diseases, also known as chronic diseases, tend to last long and result from genetic, physiological, environmental, and behavioural factors. Uric acid nephrolithiasis, arthritis and gout come under noncommunicable diseases related with Monosodium urate monohydrate (MSUM ) crystals. MSUM crystals are deposited in peripheral joints, causing gout and eliciting an intense localized inflammatory attack. In contrast, in collecting ducts and medullary interstitium, it is a urinary calculi which causes dysuria, nausea and hematuria. The study aims to explore the possible morphological features of monosodium urate monohydrate crystals. The study was carried out on a glass slide under a microscope to observe the growth patterns of MSUM crystals. For this purpose, a drop of gel medium (sodium meta silicate solution + 0.2M sodium hydroxide + 2N acetic acid) at pH 5.02 - 5.17 was placed in the middle of a glass slide and converted into a gel. A 0.07 M uric acid drop was added to the adequately formed gel. The glass slide was observed under a microscope till it was completely dried. Monosodium urate monohydrate was formed as spherical ring banded spherulites, dumbbell and composite spherulites. The current study provides different phases of MSUM crystallization on a glass slide for the first time. It may also be used as a model to evaluate prophylactic management against gouty and renal stones through in vitro assessment of crystal growth and aggregation inhibition and modulation of developing or developed crystals by using different natural products.

Dr. salman ahmed

In the last decade, we have observed the usage of artificial intelligence algorithms and machine learning models in industry, education, healthcare, entertainment, and several other areas. In this paper, we focus on using machine learning algorithms in the loan approval process of financial institutions. First, we briefly review some prior research papers that dealt with loan approval predictions using machine learning models. Next, we analyze the loan approval prediction dataset we downloaded from Kaggle, which was used in this paper to compare several machine learning classification models. During this analysis, we observed that credit scores and loan terms are the attributes that probably most affect the result. Next, we divided the dataset into a training set (80%) and a test set (20%). We trained 27 various machine learning models in MATLAB. Three models were optimized with Bayesian optimization to find the best hyperparameters with minimum error. We used 5-fold cross-validation for the validations to prevent overfitting during the training. In the following step, we used the test set on trained models to measure the models’ accuracy on unseen data. The result showed that the best accuracy both on validation and test data, more than 98%, was reached with neural networks and ensemble classification models.

Ladislav végh

Urolithiasis is a common worldwide problem with high recurrence. This review covers Convolvulaceae seven (07), Costaceae four (04), Ebenaceae four (04), Fagaceae six (06), Hypericaceae eight (08), Lauraceae nine (09), Liliaceae twelve (12) and Lythraceae three (03) plants used globally in different countries. Hopefully, this review will be helpful for the general public and attract the scientific world for antiurolithiatic drug discovery.

Dr. salman ahmed

Family businesses must harness the full potential of their human resources and maintain employee loyalty to achieve the companies’ objectives effectively. This study examines the influence of transformational leadership on employee commitment through work-life balance and workplace social support. The research was conducted from August to December 2023 using an online questionnaire distributed to employees in a family firm in Medan, Indonesia. The data were then analyzed using PLS-SEM. The results show that transformational leadership significantly effects employee commitment, work-life balance, and workplace social support. However, although workplace social support mediates the relationship between transformational leadership and employee commitment, work-life balance fails to do so. It was also found that work-life balance has no direct influence on employee commitment. Using an IPMA analysis, this study highlights the importance of transformational leadership and workplace social support in the family business environment. Transformational leadership has also been shown to have the best performance and effect on employee commitment. Managers should prioritize these aspects to reduce employees’ stress levels, improve psychological well-being, and increase job satisfaction, leading to a more committed, high-performance workforce.

L

Introduction: The university experience often brings various personal and academic challenges that can negatively impact students’ mental health. This research aimed to evaluate the effect of a mindfulness program on stress, anxiety, depression, sleep quality, social support, and life satisfaction among university students. Methods: A quasi-experimental study was conducted with 128 participants, divided into experimental and waiting list control groups. The experimental group participated in a mindfulness meditation program consisting of 12 weekly sessions. Pre-test and post-test measurements were performed using the Perceived Stress Scale (PSS-10), the Zung Self-Rating Anxiety Scale (SAS), the Zung Self-Rating Depression Scale (SDS), the Pittsburgh Sleep Quality Index (PSQI), the Medical Outcomes Study Social Support Survey (MOS-SS), and the Satisfaction with Life Scale (SWLS) to assess the variables. Results: The experimental group showed statistically significant differences between the study phases and the groups after the intervention for all the variables examined (p < 0.05). The effect sizes calculated using the HC3 model were stress (η2 = 0.376), anxiety (η2 = 0.538), depression (η2 = 0.091), sleep quality (η2 = 0.306), social support (η2 = 0.704), and life satisfaction (η2 = 0.510). The mindfulness program was shown to be effective in reducing levels of stress, anxiety, and depression while also improving sleep quality, social support, and life satisfaction in college students. Conclusion: These findings indicate that mindfulness meditation may be valuable for enhancing psychological well-being in educational settings.

Paul alan arkin alvarado-garcia

Oral cavity harbors a complex network of microorganisms which are in steady state of equilibrium with another microflora. Surgical removal of third molar is a very common procedure in oral surgery and suturing of surgical site is a crucial component determining success of wound healing. These suture materials sometime act a nidus of infection because of potential adherence of bacteria to its rough surfaces which may lead to surgical site infection. AIM- The aim of this study was to compare bacterial load on normal silk suture over antibacterial suture following third molar removal in 50 healthy individuals free of any systemic and local pathology. MATERIALS AND METHODS – A microbiological analysis using culture sensitivity test of distal most suture was evaluated after 7 days of procedure. RESULT - In relation to the colony count silk group showed higher number of colonization with a median of 80,000 cfu/ml. Relatively on the other side, antibacterial showed significant decrease in number of colonization with a median of 11,000 cfu/ml (p value < 0.0005). CONCLUSION – Antibacterial sutures group showed statistically significant reduction in bacterial count and can be possible alternative in patients who are unable to maintain good oral hygiene.

Manish anand

Plants have been used as medicine for the treatment of diseases for thousands of years. These herbal remedies, although natural, can cause some serious damaging effects on the vital organs of the body due to inadequacy in standardization and safety regulations. Mucuna pruriens Linn. belongs to the family Fabaceae and is used traditionally in various ailments. The present study reports the acute systematic toxicity and topical toxicity of methanolic extract of Mucuna pruriens (seeds) on albino mice and rabbits respectively. The test solution was injected intravenously into the tail as 1ml/20gm of the mice body weight. The observation was made immediately and after 1/2, 1, 4, 24, 48 and 72hours of drug administration. Mice showed normal activity till 72hours. The intracutaneous test is designed to evaluate local responses to the extracts of materials under test following intracutaneous injection into rabbits. The toxicological investigations of Mucuna pruriens with particular reference to intracutaneous toxicity in experimental animals displayed that it showed slight edema.

Dr. salman ahmed

Women are multi taskers in their lives- mother, wife, daughter, sister and a lot more. And hence are exposed to a lot of emotions. A working woman is exposed to many other more roles- boss, subordinates. A working woman has to develop skills of self awareness, self management, be motivated, feelings of optimism, positivity and internality, empathy and social skills (collectively called as emotional intelligence) to perform her multiple roles, both at home and at, work place efficiently so as to meet the expectations of both the family members and their organization. Current study focuses on investigating the influence of demographic factors on the level of emotional intelligence among the respondents in Coimbatore city. These factors tested against being determined by their age, job profile, marital status.

Nandini

This paper attempts to review the status of law in the context of the UK. The critical areas reviewed in the study included the nature of the legal systems within the UK, focusing on the role played by law within the community and the sources of law. In the second task, the connection between law and the business world is established, trying to ascertain the role of company law, employment laws, the law of contract, and the intellectual property to the businesses. Task three assessed the existing laws regarding the different types of business organizations created in the country, concentrating on the legal requirements for establishing the same. The last task focused on the recommendation that the study makes in conclusion regarding the dispute resolution processes available in the current business world.

Zamzam abdelazim

Field studies were carried out in wet seasons of 2014 and 2015 in rice fields of College Farm, Rajendranagar, Hyderabad to understand the abundance and biodiversity of spiders in varied rice cultivation systems. Design of the experiment was split plot with three main modules, viz., transplanted, broadcasted and drum sown rice and subtreatments under each main module included three plant protection methods viz., organic protection, farmers’ practices and ‘no protection’ practices. Results showed that predator numbers in ‘no protection’ and organic protection plots of all main treatments were more than in farmers’ practices indicating the impact of the chemical pesticides. A total of 22 genera of spiders belonging to 12 families were recorded which comprised of seven guilds based on their hunting strategies and microhabitats. Shannon diversity index ranged between 1.83 and 2.26 and Pielou’s evenness index was 0.59-0.72 in two years of study indicating a stable ecosystem and even species distribution in rice crop at Rajendranagar. Study of the guild assemblage indicated that orb-weavers constituted 28.1% of the population, ground runners 23.51%, space web builders 18.38%, sheet-web builders 13.12%, stalkers 8.04% and ambushers made upto 0.38% of the spider population. Understanding the vertical stratification of various spider genera on the plant gave further insight into the prey preferences of these predators.

Gorthi anitha

The study of molluscan animals is called Malacology and the study of molluscan shell is called as conchology. The scaling of metabolic rates with body mass is one of the best known and most studied characteristics of aquatic animals. We studied here how body size is related to rate of oxygen consumption, ammonia excretion and O: N ratio in Freshwater Bivalve Mollusc Lamellidens marginalis species in an attempt to know how body size specific changes affect their metabolism. The freshwater bivalve molluscs with specific body size i.e. small (76-79 mm in shell-length) and large (90-94 mm in shell-length) were chosen for experimental work from Bhima River at Siddhatek on April and May during summer. The adult bivalve molluscs with small body size reported high value in rate of oxygen consumption and O: N ratio but rate of ammonia excretion was low value in small body sized bivalves compared to large ones. The results are discussed in the flush of metabolic processes in fresh-water bivalve molluscs.

Dr. pritesh ramanlal gugale

Background: This manuscript presents an audit focused on assessing the extent of drug wastage and associated costs linked to the disposal of unused intravenous agents within the operating theatres of a tertiary care hospital. The study aims to carefully look at drug wastage, figure out why it happens, and propose strategies for optimizing resource utilization and cost-efficiency in clinical settings. Materials and Methods: This audit is a prospective observational study carried out in a tertiary care hospital. The amount of drug loaded preoperatively, the amount of drug utilized, the amount of drug unutilized and discarded, the total quantity of drug wasted, and the cost related to the wastage were calculated in percentage. Results: The maximum wastage of loaded drugs was seen with atropine (100%), followed by ephedrine (93.6%), propofol (52.5%), phenylephrine (35.2%), atracurium (28.6%), dexmedetomidine (27.8%), fentanyl (16.8%), vecuronium (16.2%) and morphine (6.4%). The cost analysis revealed that 36.3% of the total loaded drugs were wasted amounting to Rs.46903.54. The cost of wastage of propofol was maximum with Rs.14006 which is 29.8% of total cost wastage followed by atracurium 21%(Rs.9856), dexmedetomidine 18.4%(Rs.8687.5), ephedrine 14.7%(Rs.6919), phenylephrine 10.4%(Rs.4910), fentanyl 3.7%(Rs.1780), atropine 1.9% (Rs.906), vecuronium 1.2% (Rs.563.76), Morphine 0.18% (Rs.85.28). Conclusion: In our audit, the maximum drug wastage was observed with atropine (100%) amounting to Rs.906, and the cost of wastage was maximum with propofol amounting to Rs.14006 which was 29.8% of the total cost of wastage. Our audit underscores the importance of proactive management of drug wastage and disposal costs in healthcare settings, particularly within operating theatres where intravenous agents play a crucial role in patient treatment. By conducting a comprehensive audit and proposing targeted interventions, healthcare institutions can optimize resource utilization, enhance sustainability, and ultimately improve patient outcomes.

Kamal singh

Background: There is a lack of adequate data about the prevalence and types of tuberculosis (TB) disease in Hadramout Al-Sahel, Yemen. Hence, this study aimed to investigate the prevalence, types, and outcomes of TB disease in Hadramout Al-Sahel, Yemen. Materials and Methods: This cross-sectional study was conducted at the National TB Program (NTP) center in the city of Al Mukalla, Hadramout, Yemen. The study enrolled TB patients from different districts of Hadramout Al-Sahel who had registered at the NTP center between January 1 and December 31, 2021. Results: A total of 127 new active TB cases were recruited, including 102 (80.3%) with pulmonary TB (PTB) and 25 (19.7%) with extra PTB (EPTB). The overall prevalence of TB disease in 2021 was 12.7 new TB cases per 100,000 population, while the median age of the study population was 38 years. The majority of cases (23.6%) belonged to the age group of 35–44 years. There were 85 (66.9%) males, and most patients (74; 58.3%) were identified in Al Mukalla City. EPTB was detected in 25 (19.7%) patients, with pleural effusion being the most frequent manifestation, found in 12 (48.0%) patients. All patients received 4-agent anti-TB therapies; 99 (77.9%) patients received anti-TB therapy for 6 months; 9 (7.1%) patients received anti-TB therapy for 9–12 months; 8 (6.3%) patients died during treatment; and 11 (8.7%) patients were lost during follow-up. The majority of patients (108; 85%) were cured on completion of treatment. Conclusion: The prevalence of TB in Hadramout Al -Sahel was 12.7 cases per 100,000 population. Males were affected more than females; the pleura was the most commonly affected extrapulmonary site; and 85% of cases were cured. The results indicated the need to support the Al Mukalla NTP center, by providing more resources for improved TB reporting and for conduct of surveillance to detect new TB cases among high risk groups. Health authorities are also urged to provide state hospitals with the equipment needed for TB diagnosis.

Karishma