The second edition of “Short and OSCE Cases in Internal Medicine” [1] is a useful resource that enables candidates to learn the tricks of the clinical examination when preparing for higher specialist examinations such as MRCP (UK) PACES, MRCPI, Arab Board, and other clinical examinations which use the Objective Structured Clinical Examination (OSCE) format. As compared to the first edition [2], the number of photos and illustrations in the second edition has been considerably expanded to include about 150 photos to enhance the candidate’s learning experience. In addition, the author has revised and updated all sections based on new information and advancements in the medical field. Particular emphasis has been placed on a highly professional approach to the case, a competent, succinct, and relevant clinical examination techniques according to the examiner’sinstruction, and a concise, professional presentation by the candidate. Some mnemonics to help recall long lists also have been included as aide-mémoire.

Karishma

In the present study nanoparticles of lomustine were fabricated using chitosan polymer crosslinked with different crosslinking agents like sodium tripolyphosphate and sodium hexametaphosphate. Different formulations of nanoparticles were prepared using different concentrations of crosslinking agents and polyethylene glycol 6000. The average particle size ranged between 112 nm to 942 nm. Zeta potential of nanoparticles ranged between 29.0 mV up to 56.0 mV. Encapsulation efficiency was variable from 58%-96%. The nanoparticles were solid spherical. In vitro drug release study was carried out in phosphate buffered saline solution pH 7.4 for 10 h. The analysis of regression values of Higuchi plot suggested diffusional mechanism and follows Fick's law of diffusion. Drug polymer interaction was absent as evidenced by FT-IR spectra and DSC thermograms. With polyethylene glycol inclusion shows interaction between lomustine and PEG. Cell viability assay (MTT Assay) showed that the lomustine nanoparticles were able to reduce the tumour cell proliferation and increased cell viability significantly (p< 0.05) as compared to pure drug in L 132 human lung cancer cell line

Archana mehrotra

The transportation problem is widely applied in the real world. This problem aims to minimize the total shipment cost from a number of sources to a number of destinations. This paper presents a new method named Dhouib-Matrix-TP1, which generates an initial basic feasible solution based on the standard deviation metric with a very reduced number of simple iterations. A comparative study is carried out in order to verify the performance of the proposed Dhouib-Matrix-TP1 heuristic.

Souhail dhouib

Vigna trilobata (L.) VERDC. belongs to the family Papilionaceae, which is found throughout the tropical and warm temperate regions of the world. In folk medicine, it is used for arthritis, fever, cough, dysentery, and urinogenital disorders. Different secondary metabolites, such as alkaloids, glycosides, terpenoids, and flavonoids, have been reported in Vigna trilobata. It has antioxidant, antidiabetic, and anti-inflammatory activities.

Dr. salman ahmed

Avian influenza has impacted negatively on poultry production in Nigeria. The aim of this study was to determine the status of avian influenza virus (AIV) antibodies in wild birds to provide early warning of an outbreak. One hundred and forty-six sera from five different species of wild birds were tested for antibodies to avian influenza A viruses (H5 and H9) using enzyme linked immunosorbent assay and haemagglutination inhibition (HI) tests. An overall seroprevalence of 3.4% (5/146) was recorded in the study area. Seroprevalence of 6.67% (2/30) was recorded in speckled pigeons (Columba guinea) and Village weavers (Ploceus cucullatus) respectively and 3.33% (1/30) in Cattle egrets (Bubulcus ibis). No antibodies were detected in laughing doves (Spilolepia senegalensis) and African silver bill (Euodice cantans). The serological detection of AIV subtypes H5 and H9 by HI showed the exposure of these birds to the two subtypes. The result from this study indicates evidence of the presence of H5 and H9 AI viruses in wild birds in Zaria, Kaduna State. Therefore, comprehensive surveillance of influenza A involving wild birds’ population and H5 as well as H9 subtype is recommended. This is necessary in order to know the actual status of these strains in the poultry population in Nigeria in view of their zoonotic and economic importance.

Bitrus inuwa

Artificial Intelligence (AI) has emerged as a transformative force in the healthcare domain, revolutionizing various aspects of medical research, diagnostics, treatment, and patient care. This paper provides an overview of recent developments and applications of AI in healthcare, highlighting its potential to enhance efficiency, accuracy, and accessibility in medical practices. The integration of machine learning algorithms, natural language processing, and computer vision techniques has enabled AI systems to analyze vast amounts of medical data, support clinical decision-making, and personalize treatment plans. Additionally, AI-powered technologies play a crucial role in predictive analytics, early disease detection, and the optimization of healthcare workflows. Despite the promising advancements, challenges related to data privacy, ethical considerations, and regulatory frameworks need to be addressed to fully harness the benefits of AI in healthcare.

Dhruvitkumar talati

Lexical and structural levels of language abound ambiguities that are good source of humor. Consequently, violations of the maxims of conversation are leeway to induce humor in any type of discourse. Adding these two precepts and considering pragmatics as its foundation became the bases in analysing the top-grossing films of Vice Ganda. It sought to identify the verbal linguistic jokes and ambiguities present in the top-grossing films of Vice Ganda; determine on how these ambiguities create devaluation of Grice’s maxims of conversation; and determine on how the ambiguities in verbal linguistic jokes and devaluation of Grice’s maxims of conversation were used as ingredients in Vice Ganda’s top-grossing films. Discourse analysis was used in the study and the analytical framework to induce humor by Taghiyev (2018) was used in analysing the corpora. A priori coding was used to identify the recurring ambiguities and devaluation of maxims in the films. Findings show that lexical-semantic and structural-syntactic ambiguities were present in the films. It was intentionally used in order to create humorous effect in the dialogues of the films. Moreover, the devaluation of the maxims of conversation quietly and unostentatiously, opting out, coping with a clash between maxims, and flouting was deemed an effective ingredient to make the films become comical and appealing to the audience.

Darrel ocampo

The global endeavor to develop and deploy COVID-19 vaccines has underscored both significant scientific progress and enduring disparities in worldwide access. This analysis examines regional vaccine distribution patterns across World Health Organization (WHO) regions—Africa, the Americas, Eastern Mediterranean, Europe, and Western Pacific—revealing substantial variations in vaccine types and manufacturer contributions. Data indicate that the Americas and Europe demonstrate a broad vaccine portfolio, with prominent contributions from major international pharmaceutical companies alongside regionally developed vaccines. Conversely, African, Eastern Mediterranean, and Western Pacific regions show considerable reliance on vaccines from Asian (notably China and India) and Russian manufacturers, in addition to Western products. This distribution highlights the influence of geographical proximity to manufacturing centers, regional alliances, and local production capabilities (e.g., CIGB and Finlay in the Americas, COVIran Barakat in the Eastern Mediterranean, and various Chinese products in the Western Pacific) on vaccine availability. Predominant vaccines by country count include Pfizer-BioNTech's Comirnaty, AstraZeneca's Vaxzevria, Janssen's Ad26.COV2-S, Moderna's Spikevax, Beijing CNBG's BBIBP-CorV, and SII's Covishield. The observed regional variations in vaccine types and supply chains carry implications for comparative effectiveness research, the understanding of differential immune responses, and the evaluation of pandemic control strategies. Furthermore, inconsistencies in global data reporting and product nomenclature present challenges for comprehensive analysis. The findings emphasize the importance of diversified supply chains, the growing role of regional manufacturing in enhancing global health security, and the need for standardized global data for a more profound understanding of vaccine equity and efficacy to inform future pandemic responses.

Mostafa eissa

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

This abstract provides an overview of the critical role of academic leadership and governance in higher education institutions. As the landscape of higher education undergoes profound transformations, academic leaders and governance structures play a pivotal role in shaping the direction, quality, and effectiveness of educational institutions. This abstract highlights key themes, challenges, and considerations related to academic leadership and governance, emphasizing the need for adaptability, transparency, and inclusivity in the decision-making processes. The abstract begins by acknowledging the evolving nature of higher education and the increasing complexity of issues facing institutions, including technological advancements, changing student demographics, and shifting funding models. It underscores the central importance of academic leadership and governance in addressing these challenges and promoting institutional excellence.

Dr gedam kamalakar

Furosemide is a widely potent diuretic drug used in the management of edema and hypertension. Various brands of furosemide are available in the Libyan market and should be subjected to different quality control tests to assess their pharmaceutical equivalence. This study aimed to assess and compare the quality and the pharmaceutical equivalence of some generic brands of furosemide 40 mg tablets marketed in Libya. The pharmaceutical quality of four brands of furosemide tablets was investigated using official and unofficial compendia standards including uniformity of weight, friability, thickness, hardness, drug content and dissolution rate. The results obtained showed acceptable external features as well as the thickness, diameter and uniformity of weight for all the furosemide tablets. The tested brands complied with the official specifications of friability, hardness and drug content. In conclusion, all four brands can be considered as bioequivalence and thus can be pharmaceutically substituted in clinical practice.

Mediterranean journal of pharmacy and pharmaceutical sciences

Digital data is growing enormously as the year passes and therefore there is a need of mechanism to protect the digital contents. Image watermarking is one of the important tools for the human to provide copyright protection and authorship. For achieving the ideal balance between imperceptibility and robustness, a robust blind color image watermarking employing deep artificial neural networks (DANN), LWT and the YIQ color model has been presented. In the suggested watermarking method, an original 512-bit watermark is applied for testing and a randomly generated watermark of the same length is used for training. PCA is used to extract 10 statistical features with significant values out of 18 statistical features, and binary classification is used to extract watermarks here. For the four images Lena, Peppers, Mandril, and Jet, it displays an average imperceptibility of 52.48 dB. For the threshold value of 0.3, it does an excellent job of achieving good balance between robustness and imperceptibility. Except for the gaussian noise, rotation, and average filtering attacks, it also demonstrates good robustness against common image attacks. The results of the experiment demonstrate that the suggested watermarking method outperforms competing methods.

Manoj kumar pandey

Metamizole or Novalgin® is a widely used well tolerated analgesic drug which is however compromised by agranulocytosis as adverse effect. Subsequent to nonenzymatic hydrolysis, the primary metabolic step is N-demethylation of 4-methylaminoantipyrine (4-MAA) to 4-aminoantipyrine (4-AA). The aim of the present study was to identify the human cytochrome P-450 enzyme (CYP) mediating this reaction. This study identified the relevant CYP using virus expressed isolated human CYP, human liver microsomes and rat liver microsomes with chemical inhibition studies. The substrate of 4-methylaminantipyrine was employed at six different concentrations (25, 50, 100, 400, 800 and 1200 µmol per l) with varying concentrations of selective inhibitors of CYP1A2 (furafylline, fluvoxamine), CYP3A4 (ketoconazole), CYP2A6 (coumarin), CYP2D6 (quinidine), CYP2C19 (omeprazole, fluvoxamine, tranylcypromine), CYP2C9 (sulphaphenazole) and CYP1A1 (alpha-naphthoflavone). 4-MAA and 4-AA were analyzed by HPLC and enzyme kinetic parameters (Km and Vmax) were determined by regression (Sigma plot 9.0). The N-demethylation of 4-MAA by microsomes prepared from baculovirus expressing human CYP was pronounced with CYP2C19. Intrinsic clearance of the most active enzymes were 0.092, 0.027 and 0.026 for the CYP enzymes 2C19, 2D6 and 1A2, respectively. Metabolism by human liver microsomes was strongly inhibited by fluvoxamin, omeprazole and tranylcypromine (IC50 of 0.07, 0.07 and 0.18, respectively) but with coumarin, sulphaphenazole, ketoconazole, moclobemid, quinidine alpha-naphthoflavone and furafylline were 0.79, 1.20, 1.36, 1.44, 3.46, 4.68 and 8.41, respectively. The enzyme CYP2C19 apparently has an important role in N-demethylation of 4-methylaminoantipyrine which should be further analyzed in clinical studies and which may also be interesting concerning the agranulocytosis.

Mediterranean journal of pharmacy and pharmaceutical sciences

Background: Quality of life (QOL) is an important determinant in assessing the health status. It includes physical, psychological, and social well being. The aim of this research was to identify the intrinsic and extrinsic factors of QOL; and the association of QOL with socio-demographic, anthropometric variables and lifestyle variables. Methods: This cross sectional study was conducted in Tamil Nadu among 327 adults during July 2020 through online using standardized WHOQOL-BREF tool to assess the quality of life along with socio-demographic variables, anthropometric variables and lifestyle variables. Principal component analysis method was used to identify the factors which influence the QOL of adults. The association between socio-demographic variables, anthropometric variables and lifestyle variables with quality of life was also assessed. Among the selected samples 165 were female and 162 were male. The structured questionnaire included Section A- socio-demographic variables such as age, gender, occupation, educational qualification, place of residence, marital status; Section B - anthropometric variables such as height, weight and BMI; Section C lifestyle variables such as type of diet and physical activity pattern; and Section D -consisted of Standardized WHO-BREF tool to assess the quality of life. Results: The identified intrinsic factors include Life style approach, Emotional stability and Health status; Safety & accomplishment, Financial support with societal information were identified as extrinsic factors. These factors played an influential role in QOL of the adults during pandemic crisis. The association between the type of residence (p=0.001), occupation (p=0.000) and marital status (p=0.022) with QOL was highly significant at 1 % and 5 % respectively. Conclusion: The identified factors during covid-19 pandemic had influenced the quality of life domains namely physical health, psychological, social relationship and environment. Intrinsic factors were dependent on individual’s perception towards accepting the new normal during the pandemic. Whereas, extrinsic factors were greatly influenced by the environment and society in which the study participants were exposed. One of the identified extrinsic factors (residence), showed high significant association with QOL.

Athina deepa prasanna

This study ascertained availability of disaster preparedness and digitization in archives preservation in public libraries in Rivers state. Two objectives and its corresponding research questions and hypotheses guided this study. The descriptive survey design was adopted for this study. The target population of this study comprised 514 library staff drawn from Rivers state library board and staff from Jubilee library Port Harcourt. The sample size for this study was 399 library staff comprising of 227 staff from Rivers state library board and 172 library staff from Jubilee library Port Harcourt. The sample size was determined by Taro Yamane sample size determination formula while a two-stage sampling technique of stratified and simple random sampling techniques was used to select the sample size. A self-structured questionnaire titled availability of disaster preparedness and digitization in archives preservation questionnaire was used as the instrument for data collection. Face and content validation was ensured by three experts. The instrument yielded reliability coefficients of 0.79 with the use of Cronbach Alpha reliability method. Meanand Standard Deviation was used in answering research questions while z-test was used for the inferential statistics. The findings revealed that disaster preparedness and digitization in the preservation of archives are supported and available in public libraries in Rivers state, Nigeria. Based on the findings, it can be concluded that there are significant differences in the responses of Rivers state library board staff and Jubilee library Port Harcourt staff on the terms of the availability of the disaster preparedness and digitization in archive preservation in the public libraries. It was therefore recommended that more librarians should be employed by the Rivers state government so as to make the process of archive preservation in the State’s public libraries through disaster preparedness and digitization less rigorous and efficient.

Fxintegrity publishing

Hydatid disease or hydatidosis is a worldwide zoonosis disease caused by the tapeworm of Echinococcus granulosus and still widely endemic in Tunisia especially in rural areas where the sheep-dog cycle is dominant. It is an important public health problem in the pediatric age group causing significant morbidity and mortality. We report a case of primary hydatid cyst of the small intestine in a child and we want to highlight the difficulty that we meet in the diagnosis despite the contribution of imaging.

Sameh

This paper aims to investigate the trend of human resource disclosure (HRD) quality based on publicly disclosed annual reports of 235 Malaysian listed companies. The data was collected through content analysis method using HRD index. The results reveal that there is an increasing trend of HRD quality from 2010 to 2014. However the significant increase is only between 2012 and 2013. This study provides empirical support for Institutional theory’s coercive isomorphism, through its findings on quality of HRD. This is because, the related disclosure regulations and the Malaysian government policy through Malaysia Plan may have significantly influenced firms to increase HRD quality in their annual reports.

Asyraf afthanorhan

This research assessed the nutritional composition, microbiological and sensory attributes of maize-based fortified food with peanut and carrot blends. A total of six composite flour samples were formulated using varying ratios of maize, peanut, and carrot: (MPC1) 100% maize flour (control), (MPC2) 90% maize, 5% peanut, and 5% carrot, (MPC3) 80% maize, 15% peanut, and 5% carrot, (MPC4) 70% maize, 20% peanut, and 10% carrot, (MPC5) 60% maize, 25% peanut, and 15% carrot, and (MPC6) 50% maize, 30% peanut, and 20% carrot. The proximate, mineral, vitamin, antinutrient, and functional properties of these fortified food samples were assessed using established methodologies. The proximate analysis revealed a significant increase (p<0.05) in moisture, crude protein, fat, crude fibre, ash, and energy content of the fortified samples, with values ranging from 1.63% to 3.80%; 3.08% to 44.43%; 2.39% to 15.16%; 3.58% to 7.04%; 2.34% to 3.80%; and 381.75 to 432.52 KJ/100g, respectively, as the supplementation of peanut and carrot flours increased. Conversely, the carbohydrate content decreased from 86.98% to 27.64%. The mineral content of the fortified samples also showed a significant increase (p<0.05) with higher levels of peanut and carrot flour supplementation. The findings of this study indicated a statistically reduction (p<0.05) in the antinutrient profiles of the fortified food samples. Additionally, the vitamin content significantly increased (p<0.05) with the addition of peanut and carrot flours. The overall viable counts were significantly low, and there were no detectable coliform or fungal counts. Although, the result of sensory evaluation indicated that the control sample was more organoleptically acceptable than the substituted samples, incorporating these nutrient-rich and functional ingredients in the production of maize-based cereals may broaden the application of peanut and carrot flours in the creation of various cereal types and other cereal-based food items.

Okechukwu obed chukwuemeka

In this report, Abacus Ltd employee will offer his client guidelines, another organisation trying to comprehend risk management. Abacus gives a scope of business consultancy administrations to their clients which assist them with developing their business. Abacus's new client wants all individuals from the senior group to comprehend risk management in business and the various kinds of danger (Aven and Renn, 2010).

Zamzam abdelazim

Children's vaccinations play a significant role in public health efforts, particularly in reducing morbidity and mortality rates among children worldwide. However, challenges such as the accessibility of healthcare facilities, misinformation, and perceptions continue to affect the achievement of immunization goals in Tanzania and other developing countries. Based on the need to protect the community from diseases that can be prevented by vaccination, this study aimed to assess vaccination coverage and timeliness among children aged 12-23 months who attended postnatal immunization clinics in the Kongwa district located in the Dodoma region, Tanzania. A quantitative cross-sectional study was employed, involving 200 children who visited vaccination clinics along with their caregivers. Data were obtained through a questionnaire prepared and vaccination cards. This current study revealed that 96.0% were fully vaccinated, with 4.0% partially vaccinated, while no children were found to be totally unvaccinated. Timeliness varied across vaccines assed vaccines: 75.0% of Bacillus Calmette-Guérin vaccinated on time, four doses of Oral Polio Vaccine ranged from 74.0-87.0% of on time vaccination. Three doses of the Pentavalent Vaccine and Pneumococcal Conjugate Vaccine had on-time vaccination rates ranging from 79.5% to 86.0%. Two doses of the Rotavirus Vaccine reached on-time rates of 84.5% to 86.0%. 60.5% of people received the Measles and Rubella vaccine, with 35.5% experiencing delays and 4.0% remaining unvaccinated. This study revealed that, despite the national efforts to improve vaccination rates for children, issues such as delays and incomplete immunizations persist. Strategies like community engagement, continuous training for healthcare professionals, and improving healthcare accessibility in remote areas should be reinforced to improve vaccination uptake in Tanzania.

Mediterranean journal of pharmacy and pharmaceutical sciences