Search results for: prescribed burns

Authors: Adaour Mohamed Amine, Bachene Mohamed Sadek, Fortassi Mosaab, Siouda Wafaa

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Foot infections are responsible for a significant number of hospitalizations and amputations in diabetic patients. The objective of our study is to analyze and evaluate the management of diabetic foot in a surgical setting. A retrospective study was conducted based on a selected case of suspected diabetic foot infections of osteitis treated at the Mohamed Boudiaf hospital in Medea. The case was reiterated as a therapeutic charge, consisting of treating first the infection of the soft tissues, then the osteitis: biopsy after at least 15 days of cessation of antibiotic therapy. Successful treatment of osteitis was defined at the end of a follow-up period of complete wound healing, lack of bone resection/amputation surgery at the initial bone site during follow-up , Instead, biopsies are prescribed in the treatment of soft tissue infection. The mean duration of treatment for soft tissue infection was 2-3 weeks, the duration of the antibiotic-free window of therapy prior to bone biopsy was 2-4 weeks. This patient received medical management without surgical resection. The success rate for treating osteitis at one year was 73% and healing at one year was 88%.It is often limited to a sausage of the foot at the cost of repeated amputations. The best management remains prevention, which necessarily involves setting up a specialized and adapted centre.

Keywords: osteitis, antibiotic therapy, bone biopsy, diabetic foot

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Authors: M. C. Venter, G. Hitge, S. C. Krygsman, J. Thiart

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For decades, South Africa has been planning transportation systems from a supply, rather than a demand side, perspective. In terms of parking, this relates to requiring the minimum parking provision that is enforced by city officials. Newer insight is starting to indicate that South Africa needs to re-think this philosophy in light of a new policy environment that desires a different outcome. Urban policies have shifted from reliance on the private car for access, to employing a wide range of alternative modes. Car dominated travel is influenced by various parameters, of which the availability and location of parking plays a significant role. The question is therefore, what is the right strategy to achieve the desired transport outcomes for SA. The focus of this paper is used to assess this issue with regard to parking provision, and specifically at a tertiary institution. A parking audit was conducted at the Stellenbosch campus of Stellenbosch University, monitoring occupancy at all 60 parking areas, every hour during business hours over a five-day period. The data from this survey was compared with the prescribed number of parking bays according to the Stellenbosch Municipality zoning scheme (requiring a minimum of 0.4 bays per student). The analysis shows that by providing 0.09 bays per student, the maximum total daily occupation of all the parking areas did not exceed an 80% occupation rate. It is concluded that the prevailing parking standards are not supportive of the new urban and transport policy environment, but that it is extremely conservative from a practical demand point of view.

Keywords: parking provision, parking requirements, travel behaviour, travel demand management

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Authors: Abdul Rahman Chamseddine

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The Companions of the Prophet Muhammad, the Sahaba, are regarded as the first link between him and later believers who did not know him or learn from him directly. This makes the Sahaba a link in the chain between God and the ummah (community). Apart from their role in spreading the Prophet’s teachings, they came to be regarded as role models, representing the Islamic ideal of life as prescribed by the Prophet himself. According to Hadith, the Prophet had promised some Sahaba unqualified admission to paradise. It is commonly agreed that the Sahaba have the following attributes in common: God is well pleased with them; they will surely go to paradise; they are perfectly trustworthy; and they are the authorities from whom Muslims can learn all matters related to their religion. No other generation of Muslims has received the attention received by the Companions of the Prophet. In spite of the importance of the Sahaba in Islam, we still know comparatively little about them. There are at least two reasons for this. First, there is the overall scarcity of information surviving from the early period. At the death of the Prophet, it is said, there were more than 100,000 Companions. As we shall see, this is a complex issue, involving the definition of the term Sahaba. However, only few Companions of the Prophet are known to us. Ibn Hajar al-‘Asqalani, who wrote in the fifteenth century A.D., was only able to collect facts about 11,000 of them (including those whose status as Sahaba was disputed). Ibn Sa‘d, Ibn ‘Abd al-Barr and Ibn al-Athir, all of whom lived earlier than Ibn Hajar, included in their respective works fewer lives of Sahaba than he did. If we consider Ibn Hajar’s Isaba as the most complete biographical account of the Sahaba that remains available, we have information, presumably, on approximately one tenth of them. The remaining nine tenths are apparently lost from the historical record. Second, discussion of the Sahaba tends to focus on those considered the most important among them such as ‘Uthman, ‘Ali and Mu‘awiya, while others, who together number in the thousands, are less well-known. This paper will try to study the origins of the term Sahaba that became exclusive to the Companions of the Prophet and not a synonym of the word companions in general.

Keywords: companions, Hadith, Islamic history, Muhammad, Sahaba, transmission

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Authors: D. S. Chakraborty, S. Ghosh, A. Hazra

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Objective: Medication errors are a reality in all settings where medicines are prescribed, dispensed and used. High Alert Medications (HAM) are those that bear a heightened risk of causing significant patient harm when used in error. We conducted a knowledge-attitude-practice survey, among residents working in a teaching hospital, to assess the ground situation with regard to the handling of HAM. Methods: We plan to approach 242 residents among the approximately 600 currently working in the hospital through purposive sampling. Residents in all disciplines (clinical, paraclinical and preclinical) are being targeted. A structured questionnaire that has been pretested on 5 volunteer residents is being used for data collection. The questionnaire is being administered to residents individually through face-to-face interview, by two raters, while they are on duty but not during rush hours. Results: Of the 156 residents approached so far, data from 140 have been analyzed, the rest having refused participation. Although background knowledge exists for the majority of respondents, awareness levels regarding HAM are moderate, and attitude is non-uniform. The number of respondents correctly able to identify most ( > 80%) HAM in three common settings– accident and emergency, obstetrics and intensive care unit are less than 70%. Several potential errors in practice have been identified. The study is ongoing. Conclusions: Situation requires corrective action. There is an urgent need for improving awareness regarding HAM for the sake of patient safety. The pharmacology department can take the lead in designing awareness campaign with support from the hospital administration.

Keywords: high alert medication, medication error, questionnaire, resident

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Authors: Khairul Bariah Sulaiman, Tajul Aris Yang

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Malaysian dried cocoa beans have been reported to have low quality flavour and are often sold at discounted prices. Various efforts have been made to improve the Malaysian beans quality. Among these efforts is introduction of the shallow box fermentation technique and pulp preconditioned through pods storage. However, after nearly four decades of the effort was done, Malaysian cocoa farmers still received lower prices for their beans. So, this study was carried out in order to assess the flavour quality of dried cocoa beans produced by shallow box fermentation techniques, combination of shallow box fermentation with pods storage and compared to dried cocoa beans obtained from Ghana. A total of eight samples of dried cocoa was used in this study, which one of the samples was Ghanaian beans (coded with no.8), while the rest were Malaysian cocoa beans with different post-harvest processing (coded with no. 1, 2, 3, 4, 5, 6 and 7). Cocoa liquor was prepared from all samples in the prescribed techniques and sensory evaluation was carried out using Quantitative Descriptive Analysis (QDA) Method with 0-10 scale by Malaysian Cocoa Board trained panelist. Sensory evaluation showed that cocoa attributes for all cocoa liquors ranging from 3.5 to 5.3, whereas bitterness was ranging from 3.4 to 4.6 and astringent attribute ranging from 3.9 to 5.5, respectively. Meanwhile, all cocoa liquors were having acid or sourness attribute ranging from 1.6 to 3.6, respectively. In general cocoa liquor prepared from sample coded no 4 has almost similar flavour profile and no significantly different at p < 0.05 with Ghana, in term of most flavour attributes as compared to the other six samples.

Keywords: cocoa beans, flavour, fermentation, shallow box, pods storage

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Authors: Keshavamurthy Ganapathy Bhat, Manvinderpal Singh Marwaha

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Background: Coronary artery Disease (CAD) is a common cause of morbidity, mortality and reason for unfitness amongst aircrew. Coronary angioplasty and stenting are the standard of care for CAD. Antiplatelet drugs like Aspirin and Clopidogrel(Dual Antiplatelet therapy) are routinely prescribed post-stenting which are permitted for flying. However, in the recent past, Ticagrelor is being used in place of Clopidogrel as per ACC AHA and ESC guidelines. However Ticagrelor is not permitted for flying. Case Presentation: A 55-year-old pilot suffered Anterior Wall Myocardial Infarction. Angiography showed blockages in Left Anterior Descending Artery(LAD) and Right coronary artery (RCA). He underwent primary angioplasty and stenting LAD and subsequent stenting to RCA. Recovery was uneventful. One year later he was asymptomatic with normal Left ventricular function and no reversible perfusion defect on stress MPI. He had patent stents and coronaries on check angiogram. However, he was not allowed to fly since he was on Ticagrelor. He had to be switched over to Clopidogrel from Ticagrelor one year after stenting to permit him for flying. Similarly, switching had to be done in a 45-year-old pilot. Ticagrelor has been proven to be more effective than clopidogrel and as safe as Clopidogrel in preventing stent thrombosis. If Clopidogrel is being permitted, there is no need to restrict Ticagrelor. Hence "Policy" needs to be changed. Conclusions: Dual Antiplatelet therapy is the standard of care post coronary stenting which has been proved safe and effective. Policy needs to be changed to permit flying with Ticagrelor which is more effective than Clopidogrel and equally safe.

Keywords: antiplatelet drugs, coronary artery disease, stenting, ticagrelor

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Authors: Gela Gelashvili, David Gelenidze, Sulkhan Nanobashvili, Irakli Nanobashvili, George Tavkhelidze, Tsiuri Sitchinava

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Development of new highly efficient plasma arc combustion system of pulverized coal is presented. As it is well-known, coal is one of the main energy carriers by means of which electric and heat energy is produced in thermal power stations. The quality of the extracted coal decreases very rapidly. Therefore, the difficulties associated with its firing and complete combustion arise and thermo-chemical preparation of pulverized coal becomes necessary. Usually, other organic fuels (mazut-fuel oil or natural gas) are added to low-quality coal for this purpose. The fraction of additional organic fuels varies within 35-40% range. This decreases dramatically the economic efficiency of such systems. At the same time, emission of noxious substances in the environment increases. Because of all these, intense development of plasma combustion systems of pulverized coal takes place in whole world. These systems are equipped with Non-Transferred Plasma Arc Torches. They allow practically complete combustion of pulverized coal (without organic additives) in boilers, increase of energetic and financial efficiency. At the same time, emission of noxious substances in the environment decreases dramatically. But, the non-transferred plasma torches have numerous drawbacks, e.g. complicated construction, low service life (especially in the case of high power), instability of plasma arc and most important – up to 30% of energy loss due to anode cooling. Due to these reasons, intense development of new plasma technologies that are free from these shortcomings takes place. In our proposed system, pulverized coal-air mixture passes through plasma arc area that burns between to carbon electrodes directly in pulverized coal muffler burner. Consumption of the carbon electrodes is low and does not need a cooling system, but the main advantage of this method is that radiation of plasma arc directly impacts on coal-air mixture that accelerates the process of thermo-chemical preparation of coal to burn. To ensure the stability of the plasma arc in such difficult conditions, we have developed a power source that provides fixed current during fluctuations in the arc resistance automatically compensated by the voltage change as well as regulation of plasma arc length over a wide range. Our combustion system where plasma arc acts directly on pulverized coal-air mixture is simple. This should allow a significant improvement of pulverized coal combustion (especially low-quality coal) and its economic efficiency. Preliminary experiments demonstrated the successful functioning of the system.

Keywords: coal combustion, plasma arc, plasma torches, pulverized coal

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Authors: Trevor R. Higgins

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The aim of this study was to compare muscle activation of the latissimus dorsi between pin-loaded machine (Lat Pull Down), resistance band (Lat Pull Down) and body-weight (Chin Up) exercises. A convenient sample of male college students with >2 years resistance training experience volunteered for the study. A paired t-test with repeated measures designs was carried out on results from EMG analysis. EMG analysis was conducted with Trigno wireless sensors (Delsys) placed laterally on the latissimus dorsi (left and right) of each participant. By conventional criteria the two-tailed P value suggested that differences between pin-loaded and body-weight was not significantly different (p = 0.93) and differences between pin-loaded and resistance band was not significantly different (p = 0.17) in muscle activity. In relation to conventional criteria the two-tailed P value suggested differences between body-weight and resistance band was not quite significantly different (p = 0.06) in muscle activity. However, effect size trends indicated that both body-weight and pin-loaded exercises where more effective in stimulating muscle electrical activity than a resistance band with male college athletes with >2 years resistance training experience. Although, resistance bands have increased in popularity in health and fitness centres, that for well-trained participants, they may not be effective in stimulating muscles of the latissimus dorsi. Therefore, when considering equipment and exercise selection for experienced resistance training participants pin-loaded machines and body-weight should be prescribed.

Keywords: pin-loaded, resistance bands, body weight, EMG analysis

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Authors: Brittany Joi B. Kirsch

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Textbooks carry a crucial role in imparting ideologies that stimulate inclusivity and social diversity. In the Philippines, a law on inclusive education (IE) for differently-abled learners has recently been signed in order to ensure their rights to quality and IE are protected and upheld (Republic Act No. 11650, 2022). With the presence of ableism in textbooks, the promotion of IE may be challenged. A considerable amount of research has been done on disability representation and ableism in foreign countries; however, none, to the extent of the researcher’s knowledge, has been conducted on ableist ideologies in primary education English language textbooks in the Philippines. Hence, this paper aims to investigate the negotiation of ableist ideologies in primary education English language textbooks in the Philippines. Utilizing Fairclough’s (1995) three-dimensional model of critical discourse analysis (CDA) as the framework, six prescribed primary education English language textbooks from different grade levels were analyzed to examine instances of ableism in the texts. To further support the analysis of the study, supplemental data were gathered from the accounts of six public elementary school English language teachers. Findings reveal that the textbooks contain ableist ideologies with a limited representation of differently-abled people; by disclosing them as (1) invisible, (2) equipped with negative abilities, and (3) plagued with delicate health. By identifying ableist ideologies in textbooks, educational institutions and publishers may benefit in assessing and reforming instructional materials to resolve the presence of such ideologies, thereby abiding by the country’s law on IE and strengthening its overall implementation.

Keywords: textbooks, ideologies, inclusive education, critical discourse analysis, ableism

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Authors: Rohit Sane, Snehal Dongre, Pravin Ghadigaonkar, Rahul Mandole

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The present study was designed to evaluate efficacy of heart failure reversal therapy (HFRT) that uses herbal procedure (panchakarma) and allied therapies, in chronic heart failure (CHF) patients with low ejection fraction. Methods: This efficacy study was conducted in CHF patients (aged: 25-65 years, ejection fraction (EF) < 30%) wherein HFRT (60-75 minutes) consisting of snehana (external oleation), swedana (passive heat therapy), hrudaydhara(concoction dripping treatment) and basti(enema) was administered twice daily for 7 days. During this therapy and next 30 days, patients followed the study dinarcharya and were prescribed ARJ kadha in addition to their conventional treatment. The primary endpoint of this study was evaluation of maximum aerobic capacity uptake (MAC) as assessed by 6-minute walk distance (6MWD) using Cahalins equation from baseline, at end of 7 day treatment, follow-up after 30 days and 90 days. EF was assessed by 2D Echo at baseline and after 30 days of follow-up. Results: CHF patients with < 30% EF (N=52, mean [SD] age: 58.8 [10.8], 85% men) were enrolled in the study. There was a 100% compliance to study therapy. A significant improvement was observed in MAC levels (7.11%, p =0.029), at end of 7 day therapy as compared to baseline. This improvement was maintained at two follow-up visits. Moreover, ejection fraction was observed to be increased by 6.38%, p=0,012 as compared to baseline at day 7 of the therapy. Conclusions: This 90 day follow up study highlights benefit of HFRT, as a part of maintenance treatment for CHF patients with reduced ejection fraction.

Keywords: chronic heart failure, functional capacity, heart failure reversal therapy, oxygen uptake, panchakarma

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Authors: Mohamed Mamdouh Al-Banna, Warda Youssef Mohamed Morsy, Hanaa Ali El-Feky, Ashraf Hussein Abdelmohsen

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Background: The mechanically ventilated patients need a special nursing care with continuous closed observation. The patients’ body mass index may affect their prognosis or outcomes. Aim of the study: to investigate the relationship between BMI and selected outcomes of critically ill mechanically ventilated patients. Research Design: A descriptive correlational research design was utilized Research questions: a) what is the BMI profile of mechanically ventilated patients admitted to critical care units over a period of six months? b) What is the relationship between body mass index and frequency of organ dysfunction, length of ICU stay, weaning from mechanical ventilation, and the mortality rate among adult critically ill mechanically ventilated patients? Setting: different intensive care units of Cairo University Hospitals. Sample: A convenience sample of 30 mechanically ventilated patients for at least 72 hours. Tools of data collection: Three tools were utilized to collect data pertinent to the current study: tool 1: patients’ sociodemographic and medical data sheet, tool 2: BURNS Wean Assessment Program (BWAP) checklist, tool 3: Sequential organ failure assessment (SOFA score) sheet. Results: The majority of the studied sample (77%) was males, and (26.7 %) of the studied sample were in the age group of 18-28 years old, and (26.7 %) were in the age group of 40-50 years old. Moreover, two thirds (66.7%) of the studied sample were within normal BMI. No significant statistical relationship between BMI category and ICU length of stay or the mortality rate among the studied sample, (X² = 11.31, P value = 0.79), (X² = 0.15, P value = 0.928) respectively. No significant statistical relationship between BMI category and the weaning trials from mechanical ventilation among the studied sample, (X² = 0.15, P value = 0.928). No significant statistical relationship was found between BMI category and the occurrence of organ dysfunction among the studied sample, (X² = 2.54, P value = 0.637). Conclusion: No relationship between the BMI categories and the selected patients’ outcomes (weaning from MV, length of ICU stay, occurrence of organ dysfunction, mortality rate). Recommendations: Replication of this study on a larger sample from different geographical locations in Arab Republic of Egypt, conducting farther studies to assess the effect of the quality of nursing care on the mechanically ventilated patients’ outcomes.

Keywords: mechanical ventilation, body mass index, outcomes of mechanically ventilated patient, organ failure

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Authors: Sait Ozsoy, Hacer Yasar Teke, Mustafa Dalgic, Cetin Ketenci, Ertugrul Gok, Kenan Karbeyaz, Azem Irez, Mesut Akyol

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Self-mutilating behavior or self-injury behavior (SIB) is defined as: intentional harm to one’s body without intends to commit suicide”. SIB cases are commonly seen in psychiatry and forensic medicine practices. Despite variety of SIB methods, cuts in the skin is the most common (70-97%) injury in this group of patients. Subjects with SIB have one or more other comorbidities which include depression, anxiety, depersonalization, and feeling of worthlessness, borderline personality disorder, antisocial behaviors, and histrionic personality. These individuals feel a high level of hostility towards themselves and their surroundings. Researches have also revealed a strong relationship between antisocial personality disorder, criminal behavior, and SIB. This study has retrospectively evaluated 6,599 autopsy cases performed at forensic medicine institutes of six major cities (Ankara, Izmir, Diyarbakir, Erzurum, Trabzon, Eskisehir) of Turkey in 2013. The study group consisted of all cases with SIB findings (psychopathic cuts, cigarette burns, scars, and etc.). The relationship between causes of death in the study group (SIB subjects) and the control group was investigated. The control group was created from subjects without signs of SIB. Mann-Whitney U test was used for age variables and Chi-square test for categorical variables. Multinomial logistic regression analysis was used in order to analyze group differences in respect to manner of death (natural, accident, homicide, suicide) and analysis of risk factors associated with each group was determined by the Binomial logistic regression analysis. This study used SPSS statistics 15.0 for all its statistical and calculation needs. The statistical significance was p <0.05. There was no significant difference between accidental and natural death among the groups (p=0.737). Also there was a unit increase in number of cuts in psychopathic group while number of accidental death decreased (95% CI: 0.941-0.993) by 0.967 times (p=0.015). In contrast, there was a significant difference between suicidal and natural death (p<0.001), and also between homicidal and natural death (p=0.025). SIB is often seen with borderline and antisocial personality disorder but may be associated with many psychiatric illnesses. Studies have shown a relationship between antisocial personality disorders with criminal behavior and SIB with suicidal behavior. In our study, rate of suicide, murder and intoxication was higher compared to the control group. It could be concluded that SIB can be used as a predictor of possibility of one’s harm to him/herself and other people.

Keywords: autopsy, cause of death, forensic science, self-injury behaviour

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Authors: Mike Omilusi

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Since the Buhari administration came to power, it has gained the people’s confidence with its anti-corruption efforts. Making culprits account for their past unlawful deeds, in a very determined and aggressive manner ever witnessed in the nation’s political history, generates different reactions among Nigerians. However, some questions remain pertinent to this study: Are Nigerians really advocating persecution or prosecution in respect of the graft suspects? Do they want conviction without being convinced? Is their outburst propelled by emotions and revengeful anticipation of having suspected looters of the nation’s commonwealth behind bars? Can the war be successfully fought without resorting to impunity? Relying extensively on secondary sources with the aid of descriptive and narrative tools, this study seeks to interrogate the claim of fundamental human rights in the face of wanton looting of the nation’s resources. If, as opined by President Buhari, corruption is a crime against humanity, then it is argued that those who commit such crime should be subjected to penalties prescribed by law. Such crime -as corruption in this study- deprives the citizens of welfare, social amenities and good things of life. In this instance, it also poses threats to national security, having misappropriated funds meant for the war against the Boko Haram terrorism as revealed by the anti-corruption agency in the country. A theoretically-driven investigation, this essay raises some expectations within the context of good governance-propelled anti-corruption crusade, making modest recommendations as to how corruption should be prevented and combated within the confine of rule of law.

Keywords: corruption, rule of law, human rights, prosecution, commonwealth

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Authors: Sara Ataei, Molouk Hadjibabaie, Shirinsadat Badri, Amirhossein Moslehi, Iman Karimzadeh, Ardeshir Ghavamzadeh

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Purpose: To assess the pattern and probable risk factors for moderate and major drug–drug interactions in a referral hematology-oncology ward in Iran. Methods: All patients admitted to hematology–oncology ward of Dr. Shariati Hospital during a 6-month period and received at least two anti-cancer or non-anti-cancer medications simultaneously were included. All being scheduled anti-cancer and non-anti-cancer medications both prescribed and administered during ward stay were considered for drug–drug interaction screening by Lexi-Interact On- Desktop software. Results: One hundred and eighty-five drug–drug interactions with moderate or major severity were detected from 83 patients. Most of drug–drug interactions (69.73 %) were classified as pharmacokinetics. Fluconazole (25.95 %) was the most commonly offending medication in drug–drug interactions. Interaction of sulfamethoxazole-trimethoprim with fluconazole was the most common drug–drug interaction (27.27 %). Vincristine with imatinib was the only identified interaction between two anti-cancer agents. The number of administered medications during ward stay was considered as an independent risk factor for developing a drug–drug interaction. Conclusions: Potential moderate or major drug–drug interactions occur frequently in patients with hematological malignancies or related diseases. Performing larger standard studies are required to assess the real clinical and economical effects of drug–drug interactions on patients with hematological and non-hematological malignancies.

Keywords: drug–drug interactions, hematology–oncology ward, hematological malignancies

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Authors: Vinod Nair, C. Sadasivan

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Beta-lactam antibiotics are the most frequently prescribed medications in modern medicine. The antibiotic resistance by the production of enzyme beta-lactamase is an important mechanism seen in microorganisms. Resistance to beta-lactams mediated by beta-lactamases can be overcome successfully with the use of beta-lactamase inhibitors. New generations of the antibiotics contain mostly synthetic compounds, and many side effects have been reported for them. Combinations of beta-lactam and beta-lactamase inhibitors have become one of the most successful antimicrobial strategies in the current scenario of bacterial infections. Plant-based drugs are very cheap and having lesser adverse effect than synthetic compounds. The synergistic effect of eugenol acetate with beta-lactams restores the activity of beta-lactams, allowing their continued clinical use. It is reported here the enhanced inhibitory effect of phytochemical, eugenol acetate, isolated from the plant Syzygium aromaticum with beta-lactams on beta-lactamase. The compound was found to have synergistic effect with the antibiotic amoxicillin against antibiotic-resistant strain of S.aureus. The enzyme was purified from the organism and incubated with the compound. The assay showed that the compound could inhibit the enzymatic activity of beta-lactamase. Modeling and molecular docking studies indicated that the compound can fit into the active site of beta-lactamase and can mask the important residue for hydrolysis of beta-lactams. The synergistic effects of eugenol acetate with beta-lactam antibiotics may justify, the use of these plant compounds for the preparation of β-lactamase inhibitors against β-lactam resistant S.aureus.

Keywords: betalactamase, eugenol acetate, synergistic effect, molecular modeling

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Authors: Nicholas Agyepong, Paul Gyan

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Inappropriate prescribing of antibiotic is a common healthcare concern globally resulted in an increased risk of adverse reactions and the emergence of antimicrobial resistance. The wrong antibiotic prescribing habits may lead to ineffective and unsafe treatment, worsening of disease condition, and thus increase in health care costs. The study was to examine the antibiotic prescribing pattern and associated risk factors at Regional Hospital in the Bono region of Ghana. A retrospective cross-sectional study was conducted to describe the current prescribing practices at the Hospital from January 2014 to December, 2021. A systematic random sampling method was used to select the participants for the study. STATA version 16 software was used for data management and analysis. Descriptive statistics and logistic regression analysis were used to analyze the data. Statistical significance set at p<0.05. Antibiotic consumption was equivalent to 11 per 1000 inhabitants consuming 1 DDD per day. Most common prescribed antibiotic was amoxicillin/clavulanic acid (14.39%) followed by erythromycin (11.44%), and ciprofloxacin (11.36%). Antibiotics prescription have been steadily increased over the past eight years (2014: n=59,280 to 2021: n=190,320). Prescribers above the age of 35 were more likely to prescribe antibiotics than those between the ages of 20 and 25 (COR=21.00; 95% CI: 1.78 – 48.10; p=0.016). Prescribers with at least 6 years of experience were also significantly more likely to prescribe antibiotics than those with at most 5 years of experience (COR=14.17; 95% CI: 2.39 – 84.07; p=0.004). Thus, the establishment of an antibiotic stewardship program in the hospitals is imperative, and further studies need to be conducted in other facilities to establish the national antibiotic prescription guideline.

Keywords: antibiotic, antimicrobial resistance, prescription, prescribers

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Authors: Nicholas Agyepong, Paul Gyan

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Inappropriate prescribing of antibiotic is a common healthcare concern globally resulted in an increased risk of adverse reactions and the emergence of antimicrobial resistance. The wrong antibiotic prescribing habits may lead to ineffective and unsafe treatment, worsening of disease condition, and thus increase in health care costs. The study was to examine the antibiotic prescribing pattern and associated risk factors at Regional Hospital in the Bono region of Ghana. A retrospective cross-sectional study was conducted to describe the current prescribing practices at the Hospital from January 2014 to December, 2021. A systematic random sampling method was used to select the participants for the study. STATA version 16 software was used for data management and analysis. Descriptive statistics and logistic regression analysis were used to analyze the data. Statistical significance set at p<0.05. Antibiotic consumption was equivalent to 11 per 1000 inhabitants consuming 1 DDD per day. Most common prescribed antibiotic was amoxicillin/clavulanic acid (14.39%) followed by erythromycin (11.44%), and ciprofloxacin (11.36%). Antibiotics prescription have been steadily increased over the past eight years (2014: n=59,280 to 2021: n=190,320). Prescribers above the age of 35 were more likely to prescribe antibiotics than those between the ages of 20 and 25 (COR=21.00; 95% CI: 1.78 – 48.10; p=0.016). Prescribers with at least 6 years of experience were also significantly more likely to prescribe antibiotics than those with at most 5 years of experience (COR=14.17; 95% CI: 2.39 – 84.07; p=0.004). Thus, the establishment of an antibiotic stewardship program in the hospitals is imperative, and further studies need to be conducted in other facilities to establish the national antibiotic prescription guideline.

Keywords: antibiotic, antimicrobial resistance, prescription, prescribers

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Authors: Murali Munisamy, Gauthaman Karunakaran, Mubarak Al-Gahtany, Vivekanandhan Subbiah, M. Manjari Tripati

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Background: Sodium valproate is a widely prescribed broad-spectrum anti-epileptic drug. It shows high inter-individual variability in pharmacokinetics and pharmacodynamics and has a narrow therapeutic range. We evaluated the effects of polymorphic uridine diphosphate glucuronosyltransferase (UGT1A9) metabolizing enzyme on the pharmacokinetics of sodium valproate in the patients with epilepsy who showed toxicity to therapy. Methods: Genotype analysis of the patients was made with polymerase chain–restriction fragment length polymorphism (RFLP) with sequencing. Plasma drug concentrations were measured with reversed phase high-performance liquid chromatography (HPLC) and concentration–time data were analyzed by using a non-compartmental approach. Results: The results of this study suggested a significant genotypic as well as allelic association with valproic acid toxicity for UGT1A9 polymorphic enzymes. The elimination half-life (t 1/2=40.2 h) of valproic acid was longer and the clearance rate (CL=937 ml/h) was lower in the poor metabolizers group of UGT1A9 polymorphism who showed toxicity than in the intermediate metabolizers group (t1/2=35.5 h, CL=1042 ml/h) or the extensive metabolizers group (t1/2=26. h, CL=1,302 ml/h). Conclusion: Our findings suggest that the UGT1A9 genetic polymorphism plays a significant role in the steady state concentration of sodium valproate, and it thereby has an impact on the toxicity of the sodium valproate used in the patients with epilepsy.

Keywords: UGT1A9, sodium valporate, pharmacogenetics, polymorphism

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Authors: Anahit Khananyan

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The results of the long-term Jungian analysis with female clients from Eastern and Asian countries, which belong to collectivist cultures, are summarised in the article. The goal of the paper is to describe the cultural complex, which was found by the author in the analysis of women of collectivistic culture. It was named “the repression of Animus”. Generally, C.G.Jung himself and the Post-Jungians studied conditions caused by the possession by Animus. The conditions and cases of the repressed Animus, depending on the type of culture and cultural complexes, as we know, were not widely disseminated. C.G. Jung discovered and recognized the Animus as the second component of a pair of opposites of the psyche of women – femininity and Animus. In the way of individuation, an awareness of manifestations of Animus plays an important role: understanding the differences between negative and positive Animus as well as the Animus and the Shadow, then standing the tension of the presence of a pair of opposites - femininity and Animus, acceptance of the tension of them, finding the balance between them and reconciliation of this opposites. All of the above are steps towards the realization of the Animus, its release Animua, and the healing of the psyche. In the paper, the author will share her experience of analyzing the women of different collectivist cultures and her experience of recognizing the repressed Animus during the analysis. Also, she will describe some peculiarities of upbringing and cultural traditions, which reflected the cultural complex of repression of Animus. This complex is manifested in the traditions of girls' upbringing in accordance with which an image of a woman with overly developed femininity and an absence or underdeveloped Animus is idealized and encouraged as well as an evaluating attitude towards females who have to correspond to this image and fulfill the role prescribed in this way in the family and society.

Keywords: analysis, cultural complex, animus, manifestation, culture

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Authors: Nazari Maryam, Gorji Saman

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For most competitions, athletes usually engage in a process called rapid weight loss (RWL) and subsequent rapid weight gain (RWG) in the days preceding the event. Besides the perfection of performance, weight regulation mediates a self-image of being “a real athlete” which is mentally important as a part of the pre-competition preparation. This feeling enhances the focus and commitment of the athlete. There is a large body of evidence that weight loss, particularly in combat sports, results in several health benefits. However, intentional weight loss beyond normal levels might have unknown negative special effects on the immune system. As the results show, a high prevalence (50%) of RWL is happening among combat athletes. It seems that energy deprivation and intense exercise to reach RWL results in altered blood cell distribution through modification of body composition that, in turn, changes B and T-Lymphocyte and/or CD4 T-Helper response. Moreover, it may diminish IgG antibody levels and modulate IgG glycosylation after this course. On the other hand, some studies show suppression of signaling and regulation of IgE antibody and chemokine production are responsible for immunodeficiency following a period of low-energy availability. Some researchers hypothesize that severe glutamine depletion, which occurs during exercise and calorie restriction, is responsible for this immune system weakness. However, supplementation by this amino acid is not prescribed yet. Therefore, weight loss is achieved not only through chronic strategies (body fat losses) but also through acute manipulations prior to competition should be supervised by a sports nutritionist to minimize side effects on the immune system and other body systems.

Keywords: athletes, immune system, rapid weight loss, weight loss strategies

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Authors: Kristopher A. Pruitt, Justin M. Hill

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The purpose of this research is to determine the pacing and nutrition strategies which minimize completion time and carbohydrate intake for athletes competing in ultramarathon races. The model formulation consists of a two-phase optimization. The first-phase mixed-integer nonlinear program (MINLP) determines the minimum completion time subject to the altitude, terrain, and distance of the race, as well as the mass and cardiovascular fitness of the athlete. The second-phase MINLP determines the minimum total carbohydrate intake required for the athlete to achieve the completion time prescribed by the first phase, subject to the flow of carbohydrates through the stomach, liver, and muscles. Consequently, the second phase model provides the optimal pacing and nutrition strategies for a particular athlete for each kilometer of a particular race. Validation of the model results over a wide range of athlete parameters against completion times for real competitive events suggests strong agreement. Additionally, the kilometer-by-kilometer pacing and nutrition strategies, the model prescribes for a particular athlete suggest unconventional approaches could result in lower completion times. Thus, the MINLP provides prescriptive guidance that athletes can leverage when developing pacing and nutrition strategies prior to competing in ultramarathon races. Given the highly-variable topographical characteristics common to many ultramarathon courses and the potential inexperience of many athletes with such courses, the model provides valuable insight to competitors who might otherwise fail to complete the event due to exhaustion or carbohydrate depletion.

Keywords: nutrition, optimization, pacing, ultramarathons

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Authors: Hamza Shams, Sajid Saleem, Bilal A. Siddiqui

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This paper investigates the coefficient of friction at nano-levels of commercially available superhydrophobic/oleophobic coatings when applied over 316L SS. 316L Stainless Steel or Marine Stainless Steel has been selected for its widespread uses in structures, marine and biomedical applications. The coatings were investigated in harsh sand-storm and sea water environments. The particle size of the sand during the procedure was carefully selected to simulate sand-storm conditions. Sand speed during the procedure was carefully modulated to simulate actual wind speed during a sand-storm. Sample preparation was carried out using prescribed methodology by the coating manufacturer. The coating’s adhesion and thickness was verified before and after the experiment with the use of Scanning Electron Microscopy (SEM). The value for nano-level coefficient of friction has been determined using Lateral Force Microscopy (LFM). The analysis has been used to formulate a value of friction coefficient which in turn is associative of the amount of wear the coating can bear before the exposure of the base substrate to the harsh environment. The analysis aims to validate the coefficient of friction value as marketed by the coating manufacturers and more importantly test the coating in real-life applications to justify its use. It is expected that the coating would resist exposure to the harsh environment for a considerable amount of time. Further, it would prevent the sample from getting corroded in the process.

Keywords: 316L SS, scanning electron microscopy, lateral force microscopy, marine stainless steel, oleophobic coating, superhydrophobic coating

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Authors: Yasir Karabacak

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Objective: The aim of periodontal therapy is to control and eliminate inflammation in order halt disease progression. The initial periodontal therapy (IPT) including scaling and root planing (SRP) can control periodontal disease in most cases of periodontitis; also maintaining good oral hygiene by the patient is fundamental. The aim of this case report is to present IPT and to present 3-month follow-up results in a patient with periodontitis. Materials and Methods IPT of a 63-year-old non-smoker male with generalized periodontitis is presented. The patient had no history of systemic disease. The intraoral examination reveals marked gingival inflammation as well as plaque accumulation and significant calculus deposits. On radiographic examination, severe bone loss was evident. The patient was diagnosed with generalized advanced periodontitis. Initial periodontal therapy including oral hygiene instructions and quadrant-based SRP under local anesthesia was performed using hand and ultrasonic instruments. No antibiotics were prescribed. The patient was recalled 4 weeks after IPT. Results Favorable clinical improvement was obtained. Gingival inflammation was resolved significantly. A reduction of the mean probing depth from 2.4 mm at baseline to 1.9 mm was observed. The patient presented with a good standard of oral hygiene. The plaque scores decreased from 54.0% at baseline to 17.0%. In addition, the percentage of sites with bleeding on probing decreased from 80.0% at baseline to 44.0%. The patient was scheduled for maintenance therapy every three months. Conclusion: The level of oral hygiene has a great impact on periodontal treatment outcome and supports periodontal therapy properly.

Keywords: initial periodontal, therapy and follow-up in a periodontitis, patient, a case report

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Authors: Michael A. Ifarajimi

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The transition from being a graduate teacher to a highly accomplished teacher has been widely portrayed in literature as challenging. Pre-service teachers are troubled with complex issues such as implementing, assessment, meeting prescribed learning outcomes, taking risks, supporting eco sustainability, etc. This list is not exhaustive as they are further complicated when the concerns extend beyond the classroom into the broader school setting and community. Meanwhile, the pre-service teacher education programme as is currently run in Nigeria, cannot adequately prepare newly trained teachers for the realities of classroom teaching. And there appears to be no formal structure in place for mentoring such teachers by the more seasoned teachers in schools. The central research question of the study, therefore, is which institutional framework can be distinguished for enactment in mentoring practices in teacher education? The study was conducted in five colleges of education in South-West Nigeria, and a sample of 1000 pre-service teachers on their final year practicum was randomly selected from the colleges of education. A pre-service teacher mentorship programme (PTMP) framework was designed and implemented, with a focus on the impact of transformative inquiry on the pre-service teacher support system. The study discovered a significant impact of mentoring on pre-service teacher’s professional transformation. The study concluded that institutionalizing mentorship through transformative inquiry is a means to sustainable teacher education, professional growth, and effective classroom practice. The study recommended that the government should enact policies that will promote mentoring in teacher education and establish a framework for the implementation of mentoring practices in the colleges of education in Nigeria.

Keywords: institutionalization, mentoring, pre-service teachers teacher education, transformative inquiry

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Authors: Mahsa Taghavi

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In the treatment of breast cancer, tamoxifen is a regularly prescribed medication. The effect of tamoxifen on breast cancer patients' EMT pathways was studied. In this study to see if it had any effect on the cancer cells' resistance to tamoxifen and to look for specific miRNAs associated with EMT. In this work, we used continuous and integrated bioinformatics analysis to choose the optimal GEO datasets. Once we had sorted the gene expression profile, we looked at the mechanism of signaling, the ontology of genes, and the protein interaction of each gene. In the end, we used the GEPIA database to confirm the candidate genes. after that, I investigated critical miRNAs related to candidate genes. There were two gene expression profiles that were categorized into two distinct groups. Using the expression profile of genes that were lowered in the EMT pathway, the first group was examined. The second group represented the polar opposite of the first. A total of 253 genes from the first group and 302 genes from the second group were found to be common. Several genes in the first category were linked to cell death, focal adhesion, and cellular aging. Two genes in the second group were linked to cell death, focal adhesion, and cellular aging. distinct cell cycle stages were observed. Finally, proteins such as MYLK, SOCS3, and STAT5B from the first group and BIRC5, PLK1, and RAPGAP1 from the second group were selected as potential candidates linked to tamoxifen's influence on the EMT pathway. hsa-miR-1204 and hsa-miR-639 have a very close relationship with the candidates genes according to the node degrees and betweenness index. With this, the action of tamoxifen on the EMT pathway was better understood. It's important to learn more about how tamoxifen's target genes and proteins work so that we can better understand the drug.

Keywords: tamoxifen, breast cancer, bioinformatics analysis, EMT, miRNAs

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Authors: Leili Nekounazar

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Since 2009, when the Green movement, Iran’s most significant political uprising in post-Islamic revolution materialized, the term 'soft war' has become an integral part of the Iranian regime’s lexicon when addressing the media propaganda waged by the west and the regime’s so-called 'enemies'. Iran’s authorities describe soft war as a western campaign aiming at undermining the revolutionary values by covert activities, deploying cultural tools and purposeful dissemination of information. With this respect, Internet and in particular, the social media networks, and oppositional radio-television broadcasts have been considered as the west’s soft war conduits. With the rising of the underground fashion industry in the past couple of years that does not conform to the compulsory dress codes prescribed by the state, the Islamic regime expands the soft war narrative to include any undesired fashion-related activities and frames the rising fashion industry as a cultural war intoxicating the Iranian-Islamic identity. Accordingly, fashion products created by the Iranian fashion intermediators have been attributed to the westerners and outsiders and are regarded as the matter of national security. This study examines the reactive and proactive measures deployed by the Iranian regime to control the rise of fashion industry. It further puts under the scrutiny how the state as a part of its proactive measure shapes the narrative of 'soft war' in relation to fashion in Iran and explores how the notion of soft war has been articulated in relation to the modeling and fashion in the state’s political rhetoric. Through conducting a content analysis of the authorities’ statements, it describes how the narrative of soft war assists the state policing the fashion industry.

Keywords: censorship, fashion, Iran, soft war

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Authors: Sushil Kumar Singh, Ashok Kumar, Ankit Ganeshpurkar, Ravi Singh, Devendra Kumar

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In spectrum of neurodegenerative diseases, Alzheimer’s disease (AD) is characterized by the presence of amyloid β plaques and neurofibrillary tangles in the brain. It results in cognitive and memory impairment due to loss of cholinergic neurons, which is considered to be one of the contributing factors. Donepezil, an acetylcholinesterase (AChE) inhibitor which also inhibits butyrylcholinesterase (BuChE) and improves the memory and brain’s cognitive functions, is the most successful and prescribed drug to treat the symptoms of AD. The present work is based on designing of the selective BuChE inhibitors using computational techniques. In this work, machine learning models were trained using classification algorithms followed by screening of diverse chemical library of compounds. The various molecular modelling and simulation techniques were used to obtain the virtual hits. The amide derivatives of 4-(phenylsulfonamido) benzoic acid were synthesized and characterized using 1H & 13C NMR, FTIR and mass spectrometry. The enzyme inhibition assays were performed on equine plasma BuChE and electric eel’s AChE by method developed by Ellman et al. Compounds 31, 34, 37, 42, 49, 52 and 54 were found to be active against equine BuChE. N-(2-chlorophenyl)-4-(phenylsulfonamido)benzamide and N-(2-bromophenyl)-4-(phenylsulfonamido)benzamide (compounds 34 and 37) displayed IC50 of 61.32 ± 7.21 and 42.64 ± 2.17 nM against equine plasma BuChE. Ortho-substituted derivatives were more active against BuChE. Further, the ortho-halogen and ortho-alkyl substituted derivatives were found to be most active among all with minimal AChE inhibition. The compounds were selective toward BuChE.

Keywords: Alzheimer disease, butyrylcholinesterase, machine learning, sulfonamides

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Authors: Boshra Mozaffar, Iskandar Idris

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Taste change is a common complication after Bariatric surgery (BS). However, the cause of this is still not clear. Since zinc is important fortaste perception, zinc deficiency, which is common after BS, may play an important role for taste change after BS. In this review, we aimto collate evidence relating to taste change and zinc deficiencyin relation to BS; effects of zinc replacement on taste perception in general and thereafter discuss the possible role of zinc deficiency to induce taste change after BS. A literature search was conducted, using four electronic bibliographical databases—EMBASE, PubMed, AMED and MEDLINE. We identified all available and relevant articles published before 30th February 2021.In total, 33 studies were included. The total number of participants analysed was N= 3264. We showed that taste change is a frequent complication after BS, especially after Roux-en-Y gastric bypass RYGBP comparing to other types of procedures. Patients' taste sensitivity differs among studies, but the most important decline in taste preference was observed for sweet food. Twelve studies investigating zinc deficiency following BS showed a significant decrease in zinc levels at six months after surgery. Supplementation with 45–50 mg of zinc sulphate was effective in improving taste, except in cancer patients, who showed no improvement in taste following zinc supplementation. Zinc deficiency appears to be associated with taste change after BS. Supplementation with much higher levels of zinc, at 45–50 mg, was effective in taste change treatment for many cases of taste disorder. The currently recommended levels of zinc replacements currently prescribed to patients following BS were not effective for avoiding zinc deficiency after BS—and thus not effective for averting taste change. It is therefore suggested that taste change following BS is closely related to zinc deficiency induced by the surgery.

Keywords: taste change, taste disorder, bariatric surgery, zinc, zinc sulphate or Zn, deficiency, supplementation, and micro-nutrient deficiencies

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Authors: S. Jurado, E. Pazmino

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Determination of the medial axis of a porous media sample is a non-trivial problem of interest for several disciplines, e.g., hydrology, fluid dynamics, contaminant transport, filtration, oil extraction, etc. However, the computational tools available for researchers are limited and restricted. The primary aim of this work was to develop a series of algorithms to extract porosity, medial axis structure, and pore-throat size distributions from porous media domains. A complementary objective was to provide the algorithms as free computational software available to the academic community comprising researchers and students interested in 3D data processing. The burn algorithm was tested on porous media data obtained from High-Resolution X-Ray Microtomography (HRXMT) and idealized computer-generated domains. The real data and idealized domains were discretized in voxels domains of 550³ elements and binarized to denote solid and void regions to determine porosity. Subsequently, the algorithm identifies the layer of void voxels next to the solid boundaries. An iterative process removes or 'burns' void voxels in sequence of layer by layer until all the void space is characterized. Multiples strategies were tested to optimize the execution time and use of computer memory, i.e., segmentation of the overall domain in subdomains, vectorization of operations, and extraction of single burn layer data during the iterative process. The medial axis determination was conducted identifying regions where burnt layers collide. The final medial axis structure was refined to avoid concave-grain effects and utilized to determine the pore throat size distribution. A graphic user interface software was developed to encompass all these algorithms, including the generation of idealized porous media domains. The software allows input of HRXMT data to calculate porosity, medial axis, and pore-throat size distribution and provide output in tabular and graphical formats. Preliminary tests of the software developed during this study achieved medial axis, pore-throat size distribution and porosity determination of 100³, 320³ and 550³ voxel porous media domains in 2, 22, and 45 minutes, respectively in a personal computer (Intel i7 processor, 16Gb RAM). These results indicate that the software is a practical and accessible tool in postprocessing HRXMT data for the academic community.

Keywords: medial axis, pore-throat distribution, porosity, porous media

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Authors: Katharina Schuck

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For a long time, luxury hotels devoted little effort to sustainability, and also scientists were fairly attracted to this subject. While some luxury hotels are now increasingly showing engagement in sustainability, the extent of their commitment varies greatly, which makes the whole industry quite intransparent when it comes to sustainable practices. In general, each hotel companyand each individual hotel can decide for themselves to what extent they commit to sustainability as long as there are no legally prescribed minimum requirements in the respective countries. Despite pleading and compelling calls from industry experts and representatives of relevant sustainability institutions, this is still reality – although climate change and environmental disasters as well as poor treatment of workers and the local population are also issues in progressive and hotel-dense European cities. This paper therefore deals with the question which sustainability activities (environmental and social) have been established by European luxury hotels so far and to what extent these activities are rather a way to differentiate in the market or are simply evaluated as part of a necessary adaptation of the luxury hotel industry. For this purpose, interviews were conducted with both industry experts and hotel representatives in order to obtain a diverse picture of the current status. The studyrevealed that a clear agenda is missing so far, which takes luxury hotels by the handand supports them in the process towards more sustainable hotel management. While a large part of the luxury hotels addressed have already established initiatives and activities regarding sustainability, they are extremely diverse, and range from recyclable toiletries use to comprehensive concepts for energy generation. The study's findings provide insights for both practitioners who seek to implement sustainability in a luxury hotel setting as well as offer an extension of the existing research base on sustainability in hospitality.

Keywords: luxury hospitality, qualitative research methods, sustainability, sustainable hotels

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