The present study evaluates the efficacy of Vilanterol-Fluticasone Furoate (VI-FF) versus Formoterol-Budesonide (FM-BD) combination therapy in stable asthma. Both regimens led to significant improvements in asthma control, as evidenced by marked increases in FEV1 (% predicted) and ACT scores over time. The demographic characteristics, baseline respiratory symptoms, and treatment outcomes were similar between the groups, indicating that both strategies were equally effective for managing asthma. The findings indicate that both VI-FF once daily and FM-BD twice daily therapies enhance lung function and asthma control. Significant improvements in FEV1 (% predicted) and ACT scores were observed in both groups, as confirmed by intention-to-treat (ITT) and perprotocol (PPA) analyses. The equivalent efficacy of VI-FF and FM-BD, combined with the convenience of once-daily dosing, suggests that VI-FF may be preferable for patients who struggle with a twice-daily regimen. These findings highlight VI-FF as a convenient and reliable treatment, particularly can benefit patients with adherence challenges. In conclusion, our study's findings align well with other studies regarding demographic characteristics, baseline symptoms, exacerbation history, hospitalization history, and spirometry results. This consistency reinforces the validity and reliability of our results, suggesting that both VI-FF and FM-BD are effective options for stable asthma. The comparable efficacy supports flexibility in treatment choices, allowing for personalized asthma management. Future research should explore the long-term benefits and adherence patterns associated with these treatments to further optimize asthma management.

Dr k c yadav

The Internal Medicine Residency Program at Hamad Medical Corporation (HMC) is accredited by the Accreditation Council for Graduate Medical Education–International (ACGME-I). Upon completion, residents are awarded both the Arab Board and Qatari Board certifications. This four-year program involves rotations across general internal medicine and its subspecialties in both inpatient and outpatient settings. This article aims to analyze the teaching theories and methods observed during internal medicine residency training. An essential benefit of learning theories is the ability to articulate educational plans and objectives more precisely. Furthermore, integrating theory into practice strengthens improvement programs and facilitates their evaluation. [1] The following sections describe and analyze the educational process as experienced throughout the residency program from resident perspective.

Karishma

This study demonstrates main reasons for choosing The National University of Malaysia (UKM) by international students and their needs and expectations toward the University. The study also shows the obstacles faced by those students and their satisfaction towards UKM. A total of 108 questionnaires were distributed in the main campus to the respondents who came from ten diffident countries. The main reasons for choosing UKM were its high ranking, reasonable tuition fees, faculty, programmes, and lecturers respectively. The results revealed that the main obstacles faced international students were tough visa procedures, improper hostels, social isolation and discrimination, and bureaucracy. Both the facilities and services of UKM and the studying approach have met the expectations satisfaction of international students. Yet, both social relationship and participation in activities and living conditions in UKM hostels have disappointed international students and did not meet their satisfaction. This study suggested that UKM should establish counselling unit and organise regular meetings to listen to the problems and suggestions of those students. Volunteer and pre-enrolment activities should be organised to introduce the Malaysian culture and gather international students with their local peer. Moreover, international students should be provided upon their arrival to UKM by hostels that combine proper conditions of living at a reasonable price.

Mohammed fadel arandas

Background: Exposure to cigarette smoke has been associated with pulmonary and reproductive dysfunctions; inflammatory response, oxidative stress and oxidative DNA damage induced by polycyclic aromatic hydrocarbons (PAHs) present in cigarette smoke have been implicated in the pathogenesis of these disorders. The peak expiratory flow rate (PEFR), a biomarker of inflammation and oxidative DNA damage (8-hydroxy-2-deoxyguanosine (8-OHdG), tumor necrosis factor alpha (TNF-α)), reproductive hormones (testosterone (TST), luteinizing hormone (LH), follicle stimulating hormone (FSH)) cotinine and urinary PAH metabolite (1- hydroxypyrene (1-HOP)) were estimated in male active smokers. Methods: One hundred men aged 20-47 years, comprising 50 active male smokers and 50 non-smokers, were randomly recruited into this comparative cross-sectional study. The PEFR was measured using a peak flow meter, serum levels of cotinine, FSH, LH, TST, TNF-α, and urine 8-OHdG by enzyme-linked immunosorbent assay and 1-HOP by high-performance liquid chromatography. Data analysis was done using a t-test and correlation analysis at p≤0.05. Results: Smokers had significantly higher cotinine (49.73±31.76 versus 0.51±0.69 ng/ml, p≤0.001), 8-OHdG (16.34±12.10 versus 5.79±2.14 ng/ml, p≤0.001) and lower PEFR (309.20±56.05 versus 452.80±45.76 L/min, p≤0.001) and LH (5.75±2.06 versus 6.97±2.79 mIU/ml, p=0.015) compared to non-smokers. Duration of exposure to cigarette smoke correlated positively with cotinine (r=0.937, p≤0.001) and 1-HOP (r=0.813, p≤0.001) while cotinine correlated positively with 1-HOP (r=0.863, p≤0.001) only in smokers. Conclusion: Reduced lung function and luteinizing hormone and concurrent increase in oxidative DNA damage associated with exposure to cigarette smoke may suggest the involvement of PAH-induced DNA damage in the development of pulmonary and reproductive impairment in smokers.

Eworo raymond

Mano Matram Jagat; Mano Kalpitam Jagat - (“the world is as the mind sees and feels it; the world is as the mind thinks of it” (as qtd. by T.N.Sethumadhavan, 2010). So, our life is in the way we feel and perceive it. Humans are a mixture of emotions and reasons. Reasoning enables them to analyze and judge things with mathematical precision, while emotions help them to understand and empathize others that make them human. Traditionally, people with a high degree of logic and reasoning were believed to be intelligent and. The purpose of the IQ tests was designed to ascertain a person’s intelligence based on the reasoning and the logical aptitude of the person. IQ tests were found to be effective when a person is ‘not’ scared or angry or intrigue about specific things that aroused emotions. Emotions were considered disruptive in nature, which influences the process of thinking of a person (Woodworth, 1940). Mowrer (1960) opined that “emotions are of quite extraordinary importance in the total economy of living organisms and do not deserve being put into opposition with intelligence‟. The emotions are, it seems, themselves a higher order of intelligence.”

Aurora lyrics

When mental health experts provide information to courts on the results of a risk assessment conducted on a defendant or patient, they engage in “risk communication.” We examined the effects of four different forms of risk communication (prediction, categorical, risk factors/risk management, or hybrid) on judges’ (n = 253) perceptions of risk assessment evidence introduced in a case where they must decide whether to release from the hospital an individual found not guilty by reason of insanity. Judges who received information in the risk factors/risk management form were more likely to release the patient than were those who received prediction-based or categorical risk information. Judges with greater experience hearing cases involving risk assessment evidence were also more likely to release. Moreover, judges who had positive attitudes towards risk assessment and social science evidence in general, were more likely to find the risk assessment evidence introduced in the particular case to be understandable, relevant, and dispositive. Implications of the results for how mental health experts communicate risk information to the courts are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

John dolores

Objective: Pyrazolopyrimidines are heterocyclic molecules containing nitrogen as the main composition, and hence, they exhibit pharmacological efficacy. They are analogs of purines so that possessing wide applications in the field of medicinal chemistry. The main objective of this study is to synthesize different derivatives of pyrazole-pyrimidine classes by adopting simple methodology as well as by employing green chemistry. The purpose of the synthesis of these molecules is to study the antitumor activity against Ehrlich ascites carcinoma (EAC) cell lines. Methods: After literature studies, it makes us to involve in the research of synthetic organic chemistry, especially to synthesize new compounds of pyrazolopyrimidines. We are reported solvent-free synthesis of pyrazolo [3,4-d]-pyrimidine-thiones through ethyl acetoacetate, hydrazine hydrate, thiourea, and different benzaldehydes. An ionic liquid 2-methyl-imidazolium-oxalate catalyzed the reactions under ultrasonication bath. Both conventional and ultrasonic methods were employed and comparison studies have been made. It was found that ultrasonic method completed the reaction quicker than the conventional method. All the synthesized compounds were confirmed their structures by 1 HNMR, Fourier transform infrared, 13C-NMR, and elemental analysis spectra. The compounds were tested for in vitro anticancer activity against EAC cell lines. Most compounds revealed significant anticancer activity relative to doxorubicin as a positive control with inhibitory concentration (IC50) values. Results: Ultrasonication method is a simple method under which all the reactions were completed at faster time (<7 min) compared to the convention method. Among eight molecules, 8a and 8d completed the reactions at a faster rate. We reported IC50 values of all the molecules, in which 8e and 8g were exhibited excellent potency against EAC cell lines at different concentrations .

Dr ganesh n yallappa

Purpose: To study the outcome of therapeutic keratoplasty in severe microbial keratitis cases otherwise advised evisceration. Methods: A retrospective, single-center clinical audit included 28 patients with severe microbial keratitis presenting from April 2014 to April 2016. Patients with microbial keratitis either affecting more than 2 quadrants of the limbus and/or cases with infections involving more than 180 mm2 of the cornea who were advised evisceration by more than one ophthalmologist were included. Cases with endophthalmitis were excluded. At 3 months, the outcome was “success” if resolution of infection occurred without recurrence and evisceration was not required. Success was termed “complete” if best vision was 6/24 or better and “partial” other- wise. The outcome was termed a “failure” if infection recurred in the graft or the eye was eviscerated. Results: Mean age of the patients (male:female, 17:11) was 49.5 years, and the mean duration of symptoms before surgery was 28.6 days. Evisceration was required in 2/28 cases. The outcome was “success” in 22/28 cases (78.6%)—complete (10/22); partial (12/22) —and “failure” in 6/28 cases. The outcome was poorer in general in fungal keratitis (n = 16) than bacterial keratitis (n = 7). Conclusions: Primary evisceration is best avoided in infections limited to the anterior segment. Even in hopeless cases, every eye deserves a fair chance.

Dr. ashwani kumar ghai

Pain according to WHO has been one of the greatest issues to plague man, in the bid to handle this issue of pain, man has sought to look for other means to reduce pain to its bare minimum. This study is aimed at investigating the analgesic activity of the methanolic extract of the African weaver ant using acetic acid-induced writhing, hot plate method, and formalin-induced pain models in Swiss mice. In the acetic acid test, the methanolic extract of Oecophylla longinoda (OL) was administered orally at 200 and 400 mg/kg body weight while aspirin was administered at 100 mg/kg and tween 80 served as standards. In the hot plate and formalin models, the extract was administered orally at two doses of 200 and 400 mg/kg while pentazocine at 10 mg/kg and tween 80 at 10 mg/kg served as standards. The methanolic extract of OL exhibited significant analgesic activity in all the models, with none less than the standard significant difference (p < 0.05) by increasing the reaction time of the mice after treatment in comparison to the control. The 400 mg/kg extract in the acetic acid-induced writhing response has a percentage inhibition of 52.7%, which shows how well the extract inhibits pain in mice. The methanolic extract significantly reduced pain response in mice, with a p-value of 0.03, 0.02, and 0.001 in all the test models, respectively. OL increased the pain threshold over time and significantly reduced the writhing response that mice experience from acetic acid. Furthermore, pretreatment with OL significantly and dose-dependently decreased the early and late phases of formalin-induced pain in mice. Thus, these findings suggest that the methanolic extract of OL acts on central and peripheral pain pathways.

Mediterranean journal of pharmacy and pharmaceutical sciences

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

In these researched analyses of different forging product for controlling the forging waste in forging process. In forging process forging waste are carry with forging operation which identify by parting line of products. Parting which defines the product upper and lower die meshing area. Those extra material are used in forging operation which goes to out side of die that material is called as waste of forging. The foraging waste are not use for further any product manufacturing process for their hardness. There for such waste are to controlled for increasing the product utilization any minimising the production cost. In that paper we concentrate to minimizing waste of forging by amylases of different products.

Vijay jadhav

A novel, simple, accurate, sensitive, reproducible, economical and less time consuming spectroscopic method was developed and validated for determination of cefixime. The solvent used was 0.1 N HCL and the absorbance maxima or the λmax was found to be 283.0 nm and 303nm for zero order and first order derivative respectively. This method obeyes Beer’s Law for the concentration range of 8–16 µg/ml for cefixime. The proposed method was been validated statistically as per the ICH guidelines for linearity, accuracy, precision, specificity, LOD and LOQ. The method developed and validated successfully for the quantitative analysis of cefixime in bulk and dosage form.

Prasanna pradhan

Analgesic activity on two Cleome scaposa and Cleome brachycarpa by applying pressure-induced pain model

Dr. salman ahmed

Our research is a contribution to the analysis of emergent practices in the mediatization of the Gospel. It mobilizes an intercultural approach of the appropriation of the TIC by social actors at ends of proselytism and propaganda. The mobilized problem is that of the seduction in the media revival of the neo-pentecostal leaders. By supporting us on an observation of the practices of the TVevangelism in Cameroon, we analyze the emergent social uses of the audio-usual mediums at ends of proselytism and propaganda. Our research reveals the interest to go beyond the deterministic analyses of the development of the TIC to propose an intercultural analysis which underlines the sociocultural contingency of the movement of emergence and development of the TIC. The aim is to propose an intercultural analysis which underlines the sociocultural contingency of the movement of emergence and development of the TIC in Africa.

Tedongmo teko

We reported a case of cyclophosphamide (CYP)-induced posterior reversible encephalopathy syndrome (PRES) in a 26-year-old previously healthy male patient who was presented to the emergency department with a history of fever, shortness of breath, and hemoptysis. After extensive investigations, including bronchoscopy and autoimmune screening, he was diagnosed with renalpulmonary syndrome. The diagnosis of CYP-related PRES was based on the development of neurological clinical picture supported by magnetic resonance imaging findings. The dose of CYP was decreased to 75 mg/day, and the patient’s symptoms improved after 3 days.

Karishma

Behavioral finance theory highlights how psychological factors can lead to poor investment decisions, which may threaten investors' trust in the stock market, discourage investments, and hinder economic growth. This study aims to examine how behavioral finance factors, particularly herding bias and overconfidence bias, influence investment decision on the Indonesia Stock Exchange through risk perception. The research was conducted using an online questionnaire distributed to 120 Gen Z stock investors and analyzed using PLS-SEM. The results show that herding and overconfidence biases have a significant positive influence on risk perception. Both herding and overconfidence biases have indirect positive influences on investment decision through risk perception. Although overconfidence bias and risk perception can directly affect investment decision, herding bias fails to do so. These findings highlight the importance of considering an individual's behavioral biases and risk perception, while policymakers should devise strategies to mitigate their impacts; so that investors can benefit from investing, which may eventually lead to the growth of the national economy.

L

The mechanical heart valve prosthesis with a caged ball has been around for 60 years. It has since experienced changes and adjustments. The Starr–Edwards (SE) valve was a pioneer and was taken out of clinical use in the late 2000s. SE is reportedly close to or has reached the age of 50, according to numerous sources from around the globe. The author’s observations and review of the literature about thrombogenicity, pannus formation, left ventricular outflow tract obstructions, and infective endocarditis in the SE valves, which were reportedly higher before its clinical ending, were only an overestimation and were not supported by scientific data. However, it was less discussed in the article, along with potential benefits. The main reasons for its demise were its obtrusive size and unattractive shape. There have been several successful implantations of these valves in Asian nations and reports of fewer primary failures and unexpected cardiac fatalities. Therefore, there is a need for extensive data gathering, documentation, and more recent studies on these valves to prepare for a prospective revival of use with newer research, mainly when long-term durability is considered.

Karishma

Background: Pulses are well known richest source of vegetable protein and is known as poor man’s food because of its essential component in diet. The frontline demonstrations of pulses were carried out on 311.8 ha area with 694 demonstrations in different clusters of Nagaur district of Rajasthan. Methods: Front line demonstrations on chickpea, mung bean and moth bean crop were conducted by Krishi Vigyan Kendra, Nagaur-I, Agriculture University, Jodhpur during rabi and Kharif season of 2011-12 to 2019-20. Result: In demonstrations up to 29.43%, 30.29% and 35.22% yield increase of chickpea, mungbean and moth bean crop was observed over the farmer’s practices in the year 2011-12, 2017 and 2016. The yield gap between improved technology and conventional farmer’s practices was ranging from 1.98 to 4.54 q/ha, 0.61 to 2.55 q/ha and 0.6 to 1.68 q/ha, respectively. Whereas, the highest net returns of ` 71,881 ha-1 , ` 45,884 ha-1 and ` 14,315 ha-1 was observed in the year 2019-20, 2014 and 2016, respectively with the highest incremental cost benefit ratio of 1:3.71, 1:3.95 and 1:1.97 under demonstrations practices.

Dr. babu lal jat

The application of clinical pharmacokinetic is the responsibility of all pharmacists providing pharmaceutical care. An appropriately applied clinical pharmacokinetic is expected to result in improved patient outcomes: decreased mortality, reduced length of treatment, reduced length of hospital stays and cost-savings. Data on the extend of pharmacokinetic application in Libyan hospitals remain scarce but available subjective evidence suggests that services related to clinical pharmacokinetic are mostly provided and performed by professionals other than clinical pharmacists. To explore the training background and perceptions of pharmacists on the pharmacokinetic course contents they received during their undergraduate pharmacy programs. Also, to determine the attitudes and barriers experienced by the pharmacists when applying pharmacokinetic principles in their current practice. This is a cross-sectional, descriptive study that was conducted between July 2018 and November 2019 using a self-administered survey. The study targeted hospital pharmacists practicing in different hospitals in Libya. A total of 104 pharmacists completed the questionnaire and submitted it back. The majority of participants learned pharmacokinetic courses as a mandatory course during undergraduate courses 81.0% with 37.0% selecting that course was taught as a separate course or courses. Around 80.0% of the participants agreed or strongly agreed that pharmacokinetic courses received in undergraduate studies are useful in pharmacy practice with over 75.0% of the participants agreeing or strongly agreeing on relevance of those course to their current clinical practice. About 40.0% of the participants described their current skills in allowing optimal patient care as can be better. Different barriers were highlighted by the participants to allow sufficient clinical pharmacokinetic practice including lack of sufficient information, lack of awareness of pharmacists’ role and skills in applying clinical pharmacokinetic by other pharmacists and by other health care providers. Thus, this study shows that most practicing pharmacists showed a positive attitude of current pharmacokinetic practice and to the impact of their undergraduate studies on their successful practice. However, they have clearly addressed the room for improvement.

Mediterranean journal of pharmacy and pharmaceutical sciences

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