Introduction: The incidence of pancreatic cancer has increased in recent years. Pancreatic cancer accounts for 2.9% of all cancers in our registry. Biliary drainage is frequently required and is mainly indicated in cases of cholangitis and/or hyperbilirubinemia. Our work aimed to evaluate the efficacy of endoscopic biliary drainage in pancreatic adenocarcinoma. Materials and Methods: A cross-sectional study was conducted between May 2019 and October2021 and included all patients with pancreatic adenocarcinoma, who underwent endoscopic biliary drainage. Results: Forty-five patients were enrolled, including 23 males and 22 females with a sex ratio of 1.04. The average age was 61 ± 10.9 years. Seven patients (16%) had a history of diabetes, 7 patients (16%) had a history of smoking, 4 patients (9%) had a history of alcoholism, 27 patients had no history. All patients were presented with cholestatic jaundice and 17 patients (37.7%) with abdominal pain. After morphological evaluation, only 11% of our patients had a resect able tumor and 89% of the patients had an unresectable tumor. Thirty-eight patients (84%) had a metallic biliary stent and seven patients (16%) had a plastic biliary stent. Biliary drainage associated with antibiotic therapy allowed controlling cholangitis in 98% of cases, only one patient (2%) died after drainage from sepsis. The average total bilirubin level before biliary drainage was 19.7 mg/dl and 4.8 mg/dl 2 weeks after drainage (P = 0.51), representing a decrease of 76%. Conclusion: Endoscopic biliary drainage is the gold standard for relieving the obstruction in pancreatic adenocarcinoma. Most of our patients (89%) had an unresectable pancreatic tumor. Drainage was ensured respectively by the metallic stent and plastic stent in 84% and 16% of patients and provided very sufficient biliary drainage with a decrease of 76% of bilirubinemia at 2 weeks post drainage.

The research study analyzes multidimensional poverty in seven states of India, namely Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, Odisha, Rajasthan, and Uttar Pradesh. The study focuses on three key dimensions of poverty: infant mortality rate, birth rate, and educational dropout rates at both primary and upper primary levels. Additionally, the study examines the availability of basic amenities such as clean cooking fuel, improved sanitation facilities, and safe drinking water. By calculating the Multidimensional Poverty Index (MPI), the study ranks the states based on their performance in these dimensions. Madhya Pradesh emerges as the top-performing state with the lowest MPI score of 0.310745, followed by Uttar Pradesh, Rajasthan, Chhattisgarh, Odisha, Bihar, and Jharkhand. The study reveals that despite having relatively low MPI scores, Madhya Pradesh and Uttar Pradesh still struggle with high infant mortality rates and birth rates. This indicates the need for targeted interventions to improve healthcare and family planning services in these states. Additionally, the study highlights the importance of education in poverty reduction. It identifies Jharkhand and Chhattisgarh as states with the highest primary and upper primary education dropout rates. This emphasizes the need for improving the quality of education and implementing strategies to encourage school completion. It also states the importance of addressing issues related to healthcare, education, and basic amenities in order to reduce poverty and improve overall well-being. The normalized index approach used in this study provides a comprehensive and objective measure of poverty, enabling policymakers and stakeholders to make informed decisions and allocate resources effectively.

Introduction: Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia and is associated with various complications if not properly managed. Aloe vera, a medicinal plant with diverse pharmacological properties, has shown promise as a potential therapeutic intervention for diabetes. This study aimed to investigate the antihyperglycemic and histological effects of Aloe vera in an alloxan-induced diabetic Wistar rat model. Method: Forty-eight Wistar rats were divided into six groups and treated with different regimens of Aloe vera and metformin, a standard antidiabetic drug. The effects of the treatments on blood glucose levels and histology of the pancreas, liver, and kidney were evaluated. Result: The results of the study revealed that alloxan injection induced hyperglycemia and pathological changes in the pancreas, liver and kidney of Wistar rats. The treatment with 100mg/kg, 200mg/kg and 400mg/kg of Aloe vera significantly reduced blood glucose levels in a dose-dependent manner. Additionally, Aloe vera administration preserved the histological integrity of the pancreas, liver, and kidney in diabetic rats. This preservation of organ histology can be attributed to the antioxidant, anti-inflammatory, and tissue-protective properties of Aloe vera. Conclusion: Aloe vera demonstrated antihyperglycemic effects and preserved organ histology in an alloxan-induced diabetic Wistar rat model. The bioactive compounds present in Aloe vera are believed to contribute to these effects. Aloe vera holds potential as an alternative or adjunctive therapy for diabetes management, but its clinical efficacy and safety need to be further explored.

Background: Antibiotics are medicines that fight bacterial infections. If they are used probably, they can save lives. Still there is a growing problem of antibiotic resistance. It happens when bacteria undergo some mutation and become able to resist the effect of an antibiotic. Objectives: This cross sectional study was to determine the prevalence of antibiotics resistance among group of patients and to know the causes that lead to antibiotic resistance crisis to compare the results with previous studies concerning this subject in order to identify the risks of antibiotic resistance to offer some solutions (if any) that can minimize this problem at Iraqi hospitals. Methodology: This cross sectional study was conducted from May to October 2019. The sample was 128 patients (their specimens were cultured and antibiotic sensitivity was tested) especially toward a group of antibiotic. Results: At the end of this study the result showed that a higher group of resistance especially to penicillin group and a lower rate to azithromycin, another finding was the bacteria which infect (admitted in patients) were resistant to multiple drugs than those which infect (out patients). Conclusion: A high resistance to penicillin group, Staphylococcus aureus was found to be the most resistant microorganism as culture results showed.

This study investigated constraints to environmental hygiene practices among boarding students in Awka-South L.G.A of Anambra State. Three research questions and two hypotheses guided the study which adopted descriptive e survey research design. The population for this study consisted of the 5336 boarding students (2,348 male and 2,988 female) in the 10 secondary schools in Awka-south Local Government Area of Anambra State. A multi-stage sampling procedure was adopted to draw the sample size of 800 boarding students. A questionnaire designed by the researcher entitled: “Constraints to Environment Hygiene Practices among Boarding Students Questionnaire (CEHPABSQ)” was used for data collection. The instrument was properly validated and a reliability index of 0.76 was obtained using Cronbach Alpha. Data generated were analysed with mean and standard deviation to answer the research questions while z-test was used to test the hypotheses at 0.05 level of significance. Results of the study revealed that constraints to environmental hygiene practices to include inadequate provision and maintenance of sanitary facilities by school authorities with aggregate mean scores of 2.90 > 2.5 criterion mean. Based on these findings, it was concluded that school authorities and parents should address environmental constraint without any compromise for promotion of good health of the students. Based on the conclusion the following recommendations were proffered; school authorities should ensure that there is constant water supply in their schools for good environmental hygiene practices.

Background: There is no known study on the sole dermatoglyphic pattern of the Elele people that could serve as their baseline data; hence, this study was done to provide baseline data for the sole dermatoglyphic patterns of the Elele people of the Ikwerre ethnic group in Rivers State, Nigeria. Material and methods: A Non-experimental analytical and cross-sectional study. 200 subjects [males 107, females 93] pure-breed indigenes of Elele extraction were purposively sampled, on the basis of both parents and grandparents to the fourth generation being natives of Elele. Participants who had distortions and malformations of the sole were excluded from the study. The parameters studied includes: the dermatoglyphic patterns on the soles and toes participants in Elele, Rivers State, Nigeria. The patterns on the sols and toes were observed and classified following the standard procedure. Result and Discussions: The study also showed the following distribution on the toe for the males [arch 253 (47.5%), whorl 134(25.2%), loop 145(27.3%)]; the females on the other hand had [arch 383(40.9%), whorl 289(30.9%), loop 264(28.2%)]. The arch pattern was most frequent in both genders. And the total distribution showed thus: arch 636(43.3%), whorl 423(28.8%), loop 409(27.9%). Dankmeijer’s index [male 1.32, female 1.880, total 1.50]; Pattern Intensity Index [male 84.2, female 41.3, total 125.5]. The results show that the pattern intensity index is greater in females than in males. While the Dankmeijer’s index was higher in males than females. Conclusion: The study showed that the loop pattern was most frequent on area I and II in both genders, whorl pattern was most frequent on area I and II in the males and area I and IV in the females, and the arch pattern was most frequent on area I and II in both genders. The absence of whorl on the toes of males was seen as a characteristic pattern for the males in Elele.

This research aims to examine and analyze standard peer-to-peer lending contract agreements with exoneration clauses that are not based on the value of justice. To study and analyze the weaknesses that arise in implementing peer-to-peer lending Financial Technology agreements at this time. To study and analyze the reconstruction of standard agreements with exoneration clauses on peer-to-peer lending Financial Technology based on the value of justice. The method used in this research is sociological juridical. The paradigm in this research is constructivism. The theory used in this study is the Pancasila legal theory of justice as a grand theory, the working theory of law as a middle ranged theory, and the progressive theory as an applied theory. Based on the research conducted, it was found that standard peer-to-peer lending contract agreements with exoneration clauses that are not based on the value of justice are due to overlapping rules, the lack of reach of law enforcement in standard contracts made by Financial Technology institutions, and the influence of globalization which has resulted in the growth of financial institutions. technology is getting out of control. So it is necessary to amend the provisions of the Financial Services Authority Circular Letter Number 13/Seojk.07/2014 in which the financial services business actors are not only entitled to make procedures regarding standard agreements, but it is necessary to regulate the position of Financial Technology institutions in the Republic of Indonesia Financial Services Authority Regulation Indonesia Number 10/Pojk.05/2022 concerning Information Technology-Based Joint Funding Services is clear. It is necessary to regulate information on the process of public complaints against the OJK, especially in the case of Financial Technology institutions. It is also necessary to control sanctions related to Financial Technology that violates the law, especially in standard agreements with exoneration clauses.

The objective of this research was to assess the predictive potential of Semaphorin 5A in comparison to Anti-Cyclic Citrullinated Peptide antibodies for forecasting disease progression and treatment responses among Iraqi patients with Rheumatoid Arthritis (RA). Conducted as a case-control study, the investigation encompassed a total of 150 participants, comprising 100 RA patients and 50 healthy individuals. The study took place at Baghdad Teaching Hospital over the period from November 2021 to February 2022. Enrolled participants were selected based on the 2010 criteria established by the American College of Rheumatology. The levels of biomarkers were assessed using the enzyme-linked immunosorbent assay (ELISA) method. The findings demonstrated a noteworthy elevation in the levels of both ACCP and Semaphorin 5A among RA patients compared to the control group (p<0.001). Furthermore, these levels were found to be higher in individuals with active disease as opposed to those with inactive disease. In both active and inactive disease states, the levels of both ACCP and Semaphorin 5A remained considerably higher compared to the levels observed in the healthy control group (p<0.001). In patients who had not undergone treatment, the levels of both ACCP and Semaphorin 5A exhibited considerably greater significance compared to those who received Methotrexate or etanercept (p<0.001). A noteworthy and positive correlation was observed between ACCP and Semaphorin 5A, with a correlation coefficient of 0.476 (p<0.001). The sensitivity for ACCP and Semaphorin 5A was determined to be 72% and 83% respectively, while the specificity values were 98% and 76%. The study's conclusion highlighted the promising prognostic potential of both ACCP and Semaphorin 5A, establishing them as potential biomarkers for distinguishing between Rheumatoid Arthritis patients and healthy individuals. Predict disease activity and response to methotrexate or etanercept. Active disease patients and without treatments patients ACCP and Semaphorin5A levels were higher than inactive and received treatments (methotrexate or etanercept).

This study examines the relationship between parental influences and a young person's job decision, particularly in the context of choosing courses before enrolling in higher education institutions like Vocational Training Centres (VTCs). The research aims to understand how trainees' perceptions of parental influential factors predict their career choice intention in Taita Taveta County, Kenya. The study analysed data from 2,386 trainees and 29 principal managers in Taita Taveta County VTCs in 2022 using a descriptive survey design. Data was collected using structured interviews and questionnaires. Male trainees comprising 63.1%) were more than female participants 261 (36.9%) (χ2= 6.76, d.f.=1, p = 0.0093). In 2022, 21-year-old trainees in Taita Taveta County VTCs enrolled in car repair, with 18.9% choosing this course, while 0.1% chose agriculture. Parents were the most influential factor, with 58.50% of trainees agreeing with this statement (35.70%) (χ2= 139.95, d.f.=4, p< 0.0001). When asked if other family members had the most impact on their decision to enrol in a course, the majority of respondents 351 (49.60%) agreed with the statement (χ2= 93.53, d.f.=4, p< 0.0001). In relation to opinion that counsellors had greatest influence in their course choice, majority of the respondents agreed 384(54.30%) while the rest disagreed (χ2= 93.53, d.f.=4, p< 0.0001). Also, when the trainees in the VTCs were asked whether the teachers had influence in their course choice, most of them 405(57.1%) agreed, with a significant difference (χ2= 122.93, d.f.=4, p< 0.0001). Parents’ expectations significantly predicted course choice, F 0.05 (1,706) = 6.381, p< 0.05, which indicates that parents’ expectations play a significant role in shaping the course choice (b= 0.599, p < 0.05). The study found trainees' course selections influenced by parents, relatives, counsellors, and instructors, but their personalities, intellectual capacities, and practical and theoretical skills limited their participation. Parents, family members, counsellors, and trainers should influence trainees' course selections based on personalities, intellectual prowess, KUCCPS needs, and course management capacity, ensuring beneficial outcomes.

Introduction: Oral candidiasis is a common fungal infection caused by various yeast species, including Candida albicans, Candida krusei, Candida parapsilosis, Candida tropicalis, and Candida glabrata. Clove, a well-known plant in traditional medicine, has been used as an antiseptic remedy for diverse infections, including those affecting the oral cavity induced by yeasts and bacteria. The emergence of resistance to numerous antifungal agents among Candida species necessitates exploring alternative treatments. Hence, this study aims to evaluate the antimicrobial activities of clove extract and develop a suitable pharmaceutical formulation containing clove extract for managing oral candidiasis. Method: The antimicrobial culture and sensitivity test were conducted using the agar-well diffusion assay, evaluating different concentrations of clove extract against Candida albicans. The minimum effective concentration was then formulated into a gel dosage form, and its antimicrobial activity was assessed, comparing it with miconazole oral gel. Result: The results showed that the prepared clove extract gel had antifungal effects on Candida albicans that were similar to those of the miconazole oral gel. The zone of inhibition for the clove extract gel was measured at 25 mm, while the miconazole gel showed a zone of inhibition of 27 mm. Conclusion: The results of this study show that clove extract gel may be an effective antifungal agent, especially against Candida albicans. This suggests that it may be a promising herbal alternative to conventional medicines for treating oral candidiasis.

Objective: Ovarian cancer is a leading cause of gynecological cancer death among women worldwide. Silent growth of the tumor and challenges associated with preoperative evaluation of an ovarian mass are responsible for late presentation. The aim of this study was to evaluate the association between preoperative neutrophil to lymphocyte ratio (NLR) and epithelial ovarian tumor. Methods: A total of 60 patients diagnosed with ovarian tumor who fulfilled the selection criteria were recruited as study population. The ovarian tumor was subsequently diagnosed by histopathological analysis as either malignant epithelial ovarian tumor or benign epithelial ovarian tumor. Preoperative demographic and laboratory variables are reviewed in all patients. Association of preoperative NLR was assessed in benign and malignant epithelial ovarian tumor using unpaired t test. Receiver operating characteristics curve was used to calculate optimal cut off value for NLR to predict ovarian cancer preoperatively. A p-value of <0.05 was considered to indicate statistically significant differences. Results: There was statistically significant difference between the groups in terms of age, menopausal status, and NLR (all p=0.001, except for menopausal status p=0.007). NLR value was significantly higher (3.47±1.52) in patients with malignant ovarian tumor (p=0.001) than that of benign ovarian tumor. Higher NLR value predicted ovarian cancer at the cut-off value of 2.78, with 75.6% sensitivity and 78.9% specificity (95% CI, 0.97-1.0). Conclusion: Malignant epithelial ovarian tumor is associated with higher NLR. Preoperative NLR may be helpful for prediction of malignant ovarian tumor.

Regulations on religious freedom vary widely from country to country. Several factors, including country history, culture, and religious demographics, can influence these different approaches to religious freedom. Considering all these aspects, this paper explores the differences in regulating freedom of religion between Indonesia and Canada by applying normative legal research methods. The studies concluded that the difference in regulating religious freedom between Indonesia and Canada lies in how they officially recognize religion, restrict the construction of places of worship, provide legal protection, prohibit discrimination, and approach multiculturalism. Although Indonesia recognizes several official religions, its legal application and protection may need to be clarified and more potent than in Canada, which has a more comprehensive and robust legal framework protecting religious freedom and respecting religious diversity.

Background: Worldwide, diabetes mellitus (DM) is a leading cause of death and disability. Iron overload is increasingly being connected to insulin resistance in patients with type 2 diabetes mellitus (T2DM). Free iron causes the assembly of reactive oxygen species that invariably steer the body’s homeostasis toward oxidative stress-mediated diabetic complications. We have very limited research-based data regarding the total iron binding capacities in type 2 diabetes mellitus patients. Aim of the study: The aim of the study was to compare the total iron binding capacities (TIBC) between type 2 diabetes mellitus patients and healthy individuals. Methods: This cross-sectional study was conducted in the Department of Biochemistry, Dhaka Medical College (DMC), Dhaka, Bangladesh from July 2015 to June 2016. In total 100 participants were enrolled in 2 groups as the study subjects. In group A, in total 50 diagnosed patients with type 2 diabetes mellitus (T2DM) were included. On the other hand, in group B, 50 age and sex-matched healthy individuals were included. Properly written consent was taken from all the participants before data collection. All the demographic and clinical information of the participants was recorded. All data were processed, analyzed and disseminated by using MS Excel and SPSS version 23.0 program as per necessity. Results: In this study, the mean serum iron in group A and group B were 112.7 μg/dl and 87.6 μg/dl respectively. The mean serum ferritin concentration in group A and group B were 199.3 μg/dl and 107.0 μg/dl respectively. There was a statistically significant increase in serum iron and serum ferritin concentrations in group A compared to group B. Both serum ferritin and serum iron levels showed strong positive correlations with HbA1C ((r=0.724, p<0.001, r=0.724, p<0.001) and FPG (r=0.724, p<0.001, r= 0.724, p<0.001). The mean TIBC level was found 184 μg/dl in group A and 318.8 μg/dl in group B. In analyzing the total iron binding capacities (TIBC) between the groups we observe that the TIBC (µg/dl) levels in group A and group B were 184.0±79.5 and 318.8 ± 14.0 µg/dl respectively. The TIBC levels were significantly lower in group A than in group B (<0.001). Conclusion: The total iron binding capacity level is significantly lower in type 2 diabetes mellitus (T2DM) patients than that in healthy individuals. Routine screening for iron status along with glycemic control in diabetic patients might help prevent complications in such patients.

Enhancing facial aesthetics is a primary motivation for individuals with class II division 1 malocclusion seeking orthodontic treatment. Among the different techniques available to treat Class II malocclusions, a two-phase approach involving functional jaw orthopedics and fixed orthodontic treatment is commonly employed. In this case report, we present the treatment of a young male patient with a Class II Division 1 malocclusion. In the initial phase, the patient underwent growth modification and correction of overjet, overbite, and profile using the Andresen activator. Subsequently, a fixed orthodontic appliance was utilized in the second phase to achieve well-aligned arches and enhance both aesthetics and functionality.

The continuing spread of drug-resistant tuberculosis (TB) is one of the most urgent and difficult challenges facing global TB control. Patients who are infected with strains resistant to isoniazid and rifampicin, called multidrug-resistant (MDR) TB, are practically incurable by standard first-line treatment. In 2012, there were approximately 450,000 new cases and 170,000 deaths because of MDR-TB. Extensively drug-resistant (XDR) TB refers to MDR-TB strains that are resistant to fluoroquinolones and second-line injectable drugs. The main causes of the spread of resistant TB are weak medical systems, amplification of resistance patterns through incorrect treatment, and transmission in communities and facilities. Although patients harboring MDR and XDR strains present a formidable challenge for treatment, cure is often possible with early identification of resistance and use of a properly designed regimen.