Liver cancer is a global health concern with high morbidity and mortality. It remains the sixth most common cancer worldwide despite the preventable nature of its risk factors. Mouse double minute-2 (MDM2) is one of the candidate genes associated with liver cancer and an over expression of the gene may lead to liver cancer. This research was aimed at investigating the prevalence and frequency of risk factors in the MDM2 gene among liver cancer patients in the University of Calabar Teaching Hospital, Calabar. Forty five liver cancer patients and fifty controls were recruited for the study. Demographic information was collected from all the subjects using questionnaires and analyzed while blood samples were collected for molecular analysis. The result revealed a significant difference in the distribution of demographic variables in cases and controls (P<0.05). The overall frequency of mutations in MDM2 gene in the studied population in Calabar was 40%, odd ratio 1.25 and sex ratio 2.2:0.5.The major risk factors of liver cancer are hepatitis B virus (HBV) or hepatitis C virus (HCV) infection, heavy alcohol consumption, aflatoxin B1 ingestion, tobacco smoking and non-alcoholic fatty liver disease caused by obesity and insulin resistance.The risk factors associated with liver cancer cases revealed that Hepatitis C virus infection was detected in 11 patients (24.4%), Hepatitis B virus surface antigen positive (HBsAg+) was found in 27 patients (60%), co-infection was found in 11 patients (24.4%), 19(42.2%) were involved in alcoholism and chain smoking, alcoholic consumption was 41(91%), consumption of moldy groundnut soup was 43 (95.6%) and family history of the disease was 10 (22.2%).The results revealed that out of the 45 patients recruited for the study, 15.1% were HIV positive, 17.7% were diabetic, 31.1% had melanin stool 24.4% had ascitis and 17.7% had hepatic encephalopathy as shown in Table 3. The liver function test carried out on the patients revealed that the albumin was 43.58±9.42 g/dl, creatinine was 136.62±177.98µmol/l, urea was 4.20±1.88mmol/l, the platelet was 180.74±104.70 x109 l/cells, the haemoglobin was 11.01±3.36g/dl, the alpha-fetoprotein (AFP) present was 398.8±103.2ng/ml, the aspartate aminotransferase (AST) was 45.65±66.01μmol/l, alanine transaminase was 31.67±33.37μmol/l and the international normalized ratio (INR) was 6.4±23.04.The alpha-feto protein among patients was 398.8±103.2ng/ml and this showed a strong indicator of hepatocellular cancer.The study therefore recommends that people in the area should avoid predisposing and risk factors such as alcoholism, smoking and unhealthy lifestyle which promotes the spreading of liver cancer among genetically (MDM2) susceptible liver cancer patients in Calabar The findings serve as baseline information for further studies on the genetic etiology and therapeutic initiative for the disease.

In recent years, studies have placed a greater emphasis on the scientific evaluation of historical plant-based medications, as well as the examination of various plant parts for medicinal and pharmacological significance. In light of cultural histories and ancient medicine from previous decades, which have continued to promote the healing benefits of plants and their extracts, the medicinal values of plants cannot be overstated. Nutraceuticals are the use of therapeutic properties of plants or plant parts to prevent and control illness. The Zingiberaceae family includes Curcuma longa (Turmeric), which is one of the most innovative nutraceuticals. It is widely grown and consumed in India and Asian countries as a shelf-life enhancer and preservative, aromatic, and coloring ingredient. It possesses anti-glycemic, antioxidant, anti-inflammatory, anti-carcinogenic, and anti-viral properties, among other health advantages. For millennia, Curcuma longa has been regarded safe to use as a spice and seasoning.

Among the woody species found in Haiti, two are of primary importance: Ceiba pentandra, known in the region as mapou, and its counterpart, Ficus thonningii (or Figuier maudit). Both species are renowned in various places worldwide for their medicinal and pharmaceutical attributes. However, in Haiti, they are primarily associated with entrenched meanings related to the cultural beliefs and practices of native Haitians, who staunchly maintain the supernatural potentialities of these flora. Several researchers attest to their numerous healing benefits for the symptoms of many illnesses, but medical data have not been sufficiently compelling despite this pervasive belief system. Longitudinal inquiries could uncover a cultural motive for this fixation on unproven facts, at the risk of underestimating many other valuable attributes of the trees. In this study, general system theory was applied to analyze aspects of Haitian culture relative to individual beliefs about those species. The rationale of this phenomenon could be a case of communicative autopoiesis, whereby a system of operations creates a structure, thus establishing a network that continuously reproduces more operations within the system. Those traditional perceptions are trapped and buried, without the possibility of refinement or factual examination. The rigidity of those norms is so questionable that the presumption of a principle was essential. In the present study, it was assumed that those traditions derive from a series of linguistic operations that create a network wherein the process of autopoiesis occurs repeatedly in the system (L.O.A.S), as this network continues to replicate. The claim is that there is a method of communication that exists and maintains those trends. The assertion here is to cultivate an alternative to deep-rooted cultural views as much as to enlighten the locals with valuable knowledge and benefits regarding the flora under consideration.

Chorangioma is a placental lesion consisting of capillary proliferation in chorionic villi and typically presents as a nodule or as multiple nodules on the placenta. It is a rare abnormality of placental vascular development and its clinical characteristics depend on size of the lesion. Giant chorangioma is chorangioma with an average diameter greater than 5cm. It is associated with both maternal and foetal complications. This report documents our findings in a hysterectomy specimen removed from a 40-year old female, following emergency hysterectomy for intractable postpartum haemorrhage after an elective caesarean section for three previous sections. A giant chorangioma was discovered in association with both placenta praevia and placenta increta. The outcomes for both mother and child were good.

Growing demand of aluminium in domestic and international markets, forcing aluminium producers to modify their smelter to increase the production as well as to reduce the electricity consumption, though to build a new aluminium smelter plant is one of solution to meet this demand. This article is described modification one of the aluminium smelter plant in North Sumatera Province, Indonesia as a parts of aluminium smelter upgrading project to reach production up to 300,000 TPY.

To shed some light on the English translation of Song lyrics, this paper takes the English translation of allusions in Song lyrics by Xin Qiji as the research object, analyzes the role of the frame theory in the English translation of allusions in Song lyrics, and explores the strategies suitable for the translation of allusions from the frame theory perspective.

Covid 19 is the global pandemic that continues to surprise us day after day with its atypical clinical expressions, and its variable systemic damage from one patient to another. We report 3 clinical cases of patients with covid 19, in whom we diagnosed diabetes for the first time. The evolution of their diabetes towards remission marks its particularity. This so-called “covid” diabetes reminds us of transient neonatal diabetes.

Introduction: The purpose of the study was to investigate the effects of backpacks on body posture and spinal morphology in children and adolescents, and the relationship between them and back pain in adolescents, in order to provide a theoretical basis for further research in this area. Methods: The literature on backpacks, body posture, spinal morphology and back pain was searched and the results were analyzed. Results: The studies mainly focused on the effects of backpack type, weight and position on their muscle activity; and the main muscles studied were upper trapezius, erector spinae, and rectus abdominis, while the studies on other muscles were still insufficient. Conclusion: Backpack type and method, backpack weight, backpack strap design, backpack position, and backpack time all have different effects on muscle activity in various parts of the adolescent body, and these effects may lead to back pain, which is one of the factors affecting spinal health that cannot be ignored.

One of the government's efforts to realize the highest health status and goals, especially for people who cannot afford it, is regulated in Law Number 24 of 2011 concerning the Social Security Administering Body. However, in practice, several problems were found, such as a tendency for the public to assume that the Social Security Administering Body for the Health Sector bears all the financing for health services and there is no guarantee of comfort received by the participants of the Social Security Administering Body for Contribution Assistance. This shows that the enforcement of legal protection regarding the rights of the poor as participants in the Health Insurance Contribution Assistance has not been realized from the perspective of human rights. The purpose of this study is to identify and analyze legal protection and problems for participants of the National Health Insurance Contribution Assistance Recipients (PBI), to identify and analyze the legal factors that affect the implementation of the National Health Insurance system for Contribution Assistance Recipients and to identify and analyze the reconstruction of Article 11 Law on the Social Security Administering Body for participants in the National Health Insurance for Contribution Assistance Recipients based on the value of justice. This study uses a type of research and a Socio-Legal (socio-legal research). The paradigm used is the Constructivism Paradigm to understand that the existing reality cannot be generalized to a particular context at a specific time. The results of the study show that it can be seen clearly both from theoretical studies and empirical studies, including a review of the products of laws and regulations as well as government policies and institutions in the context of the Welfare States and the government's effort to provide social security and social services to all its people in an integrated manner. fair. Legal protection for patients participating in the National Health Insurance Contribution Assistance Recipients (PBI) is an important thing because this is closely related to the handling and health services that will be received by patients. The implementation of legal protection for people who cannot afford has been implemented but is not optimal. The legal factors that most influence the implementation of protection for poor people in hospitals today are community factors, namely not being aware of the law and or not obeying the law, so there is no effectiveness. In addition, there are still differences in the health services received by patients participating in the Health Social Security Administering Body for Contribution Assistance Recipients with patients from the Social Security Administering Body for Non-Contribution Assistance Recipients. The Ideal Construction of the National Social Security System in the Health Sector Based on Welfare Values can be realized by reconstructing the law against Article 11 of Law Number 24 of 2011 concerning the Social Security Administering Body by reconstructing 3 (three) components, namely strengthening the legal substance component, strengthening the legal structure component and strengthening the legal culture component.

Increasingly expanding various actions that have been categorised as contempt of court, which threaten the authority of the court, it is necessary to regulate. The research method used is the normative legal method using statute, case, and conceptual approaches. This research is a legal study based on norms in force related to the contempt of court in existing regulations. The results show that all forms of actions that, in principle, disrupt safety, psychological and physical calm both inside and outside the trial, can be categorized as contempt of court. Although contempt of court has not been regulated clearly and firmly in statutory regulation many events can be classified as contempt of court. The scope of contempt of court in the justice system in Indonesia is very broad. The weighting of criminal sanctions is imposed based on the category of the seriousness of the crime committed by the defendant. Criminal weighting can be given if a crime fulfils special elements. Considering that the criminal justice process takes much time or is complex contempt of court can be used as a factor in increasing criminal sanction by the defendant so that there is no need for a new or separate criminal justice process to be held.

Background: One of the most effective instances of readily detected biomarkers diagnosing a very big health concern is the measuring of proteins in blood to represent heart damage. The idea of utilizing a blood test to reflect organ or cell harm necessitates a chemical that is plentiful in the target cell, can reach blood, has a suitable half-life in blood, and is preferably in a particular form that only reflects the target cell in tissue. Because contraction is the primary function of the myocyte, proteins involved in contraction or the energy required to sustain it should be suitable potential indicators. The work on diagnostic tests for myofibrillar proteins begins in 1978. Different key pieces of evidence fueled in the research. In Ist-year outcomes were identical in chest pain patients whose acute myocardial infarction (AMI) was ruled out by electrocardiography and cardiac enzymes, demonstrating that the existing diagnostic tools were not beneficial for risk prediction and treatment recommendations. Second, CK and lactate dehydrogenase isoenzymes were brought into clinical practice and demonstrated to have higher specificity and sensitivity than traditional tests. All of the biomarkers used to diagnose cardiac injury are involved in contraction or energy metabolism, but the markers evolved via trial and error, beginning with transaminases in the 1950s and ending with troponins in the 1990s. This background is discussed, along with observations on my experiences establishing CK-MB and Troponin I assays. Methods: 140 individuals with AMI are included who are diagnosed using WHO criteria. A cross-sectional study with purposive sampling technique is conducted in wazirabad institute of Cardiology. This research is last around 6 months. Before the examinations, blood samples are obtained from patients by vein puncture using syringes and preserved in clot tubes. The research includes patients experiencing chest pressure, tightness, or discomfort, shortness of breath, and irregular cardiac rhythms on ECG. Patients having a normal ECG are not included in the study. Different equipments are utilized to assess appropriate heart function and to obtain serum for the identification of various cardiac biomarkers. Result: The sensitivities of all biochemical markers change depending on the time of infarction, as previously demonstrated and expected from a patho-physiologic standpoint, the blood sample of all the patients was collected and used for further investigation in the Lab. In the current study, 140 patients are enrolled, and all of the patients who had a single episode of AMI had their ECGs taken. All of the patients' ECGs are abnormal. In compared to other Bio-Cardiac Markers, the Troponin –I has a higher ratio of patients, according to the present findings. When a person undergoes AMI, the first protein that is released is troponin-I. When these tests are conducted over a period of time, they provide us with a quick assessment of the severity of AMI. As a result of the current findings, patients have a higher level of Trop-I in their blood when they experience their first episode of AMI. In this situation, the patient should go to the nearest health care center's emergency room as quickly as feasible. Conclusion: The traditional enzymatic assays of creatine kinase (CK), CK-MB (activity), and lactate dehydrogenase are rapidly being replaced by mass measurements of myoglobin, CKMB, and troponin T and troponin I (Tnl) 1 " to achieve high diagnostic sensitivity and specificity within a few hours from the onset of tissue necrosis; the ultimate goal is the early and appropriate management of patients' conditions. We compared the diagnostic sensitivity and specificity obtained by measuring various biochemical markers, some of which are widely used, and concluded that Troponin I is the first cardiac marker that releases simultaneously after the first episode of AMI when performed as single tests and in parallel and serial modes.

Accreditation is one of the approaches to evaluate the quality of health care services, and it’s an essential requirement for the continuity of services. Nursing staff play a major role in the accreditation preparation, process and continuity. The study aimed to assess the nursing perception of the impact of accreditation on the quality of care and safety in a tertiary cardiac care center in the Eastern Province, Kingdome of Saudi Arabia. A cross-sectional descriptive research design was used. A convenient sample of 56 nursing staff was included. The study tool was a self-administered online questionnaire. It consisted of four major sections with 20 subscales rated from 1 to 5 on a Likert scale. Nursing documentation, patient medication information, healthcare-associated infection, leadership and support sections are all included. The study findings indicated that nurses have a 94.6% positive perception of the impact of accreditation on the patient’s safety. This perception was measured in accordance with the items related to international patients’ safety goals. Higher agreement was found on the items of nursing clinical documentation and medication safety process. The study findings support the overall positive impact of accreditation. The study further recommends exploring the nursing perception of accreditation impact in different settings.

Background: Cancer diagnosis can have an extensive impact on mental health and comfort. Depression and anxiety may hamper cancer treatment and recovery, as well as quality of life and survival. Cancer is an important incident in one's life which has substantial outcomes for patients and their families as well. The major psychological significance in cancer patients is depression that often takes less attention. Objective: The objective was to determine the prevalence of anxiety and depression among cancer patients and whether these conditions were associated with certain sociodemographic factors. Methods: It was a cross-sectional study. By convenient sampling technique, a total of 150 samples were selected. The patients were studied after histopathological confirmation of diagnosis of cancer. Sociodemographic and other data was collected by face-to-face interview using semi structured questionnaire. Data analysis was done by Statistical Package for Social Sciences (SPSS) version 26.0 and results were presented with appropriate graphs and texts. Results: The mean age was 46.5±9.5 years. 65.3% were male and 34.7% respondents were female. Male: female ratio 1.9:1. Moderate depression was higher in-service holder 53.8%. Among agriculture worker, 38.6% had mild depression symptom, within house wife 63.2% had mild to moderate depression symptom. No significant relation was found occupation with depression symptom (p>0.05). While moderate anxiety symptom was higher in-service holder 42.3%. Among agriculture worker, maximum 54.5% had moderate to severe anxiety symptom, within house wife 47.4% had moderate to severe anxiety symptom. No significant relation was found occupation with anxiety symptom also (p>0.05). Significant relation was found among income group with level of depression and anxiety symptom (p<0.05) as study showed both depression and anxiety were found more among higher income group population than lower income population. Conclusion: In this study both higher education and higher socioeconomic status were found to be predictors of depression and anxiety.

Background: White coat hypertension (WCH) is a condition in which people exhibit an elevation in blood pressure (BP) in a clinical setting, although they do not show such elevation in other settings. This study aims to provide new insight into determining the prevalence of WCH amongst patients with or without any cardiovascular risk. Method: This is a cross-sectional study of convenience sampling study design where 300 patients were involved based on their consultation to a Tertiary Healthcare Unit between November 2021 to March 2022 in Erbil city. Patients were classified according to the ESC into different categories of BP patterns by comparing the first BP reading that was taken at clinic with their average AMBP readings which were taken at home. Results: A total of 300 patients were included in the study where 58% of the population was male and 42% of the population was female. Of the population, 16% had WCH, 12.3% had sustained HTN, 59.3% were considered to be normotensive (NT), and 12.3% among them were categorized as masked hypertension. From the total of 47 patients that were diagnosed with WCH, 55.3% were male and 44.7% were female patients. The overall average Systolic Blood Pressure in WCH was 125.79±15.30 mmHg, and in Hypertensives it was 147.70±17.15 mm Hg with a P-value of <0.001. The Mean Arterial Pressure in WCH was 94.63±8.87 mmHg and in Hypertensives it was 112.16±13.62 mmHg with a P-value of <0.001. The average Pulse Pressure in WCH was 75.27±9.42 mmHg, and in Hypertensives it was 76.35±9.11 mmHg with a P-value of 0.001. Conclusion: WHC is significantly prevalent in Erbil city; therefore AMBP monitoring should be performed for those with certain indications to limit the prescription of unnecessary long-term medications with possibly significant side effects to patients with WHC.

Purpose: To compare the outcome of corneal collagen crosslinking (CXL) in conjunction with antimicrobial agents (AMA) to antimicrobial agents alone in the treatment of infectious keratitis. Design: Prospective comparative clinical trial in a tertiary hospital in India. Participants: 40 patients with infectious keratitis randomised into two groups of 20 patients each- Group 1 and 2. Methods: Group 1 patients underwent CXL in addition to antimicrobial therapy. The patients in Group 2 received only antimicrobial therapy. The slit-lamp characteristics of the corneal ulceration, visual acuity, time taken for healing, and complications were documented in each group. The t-test was used for statistical analysis. P values less than 0.05 were considered statistically significant. Results: The mean time taken for healing in Group 1 was 44.5±11.2 days and in Group 2 was 27.65±7.79 days. Analysis of various parameters revealed that patients undergoing CXL showed slower healing duration (p=0.00). Conclusions: Use of CXL in conjunction with AMA lowers the risk of complications, but also slows the rate of healing of ulcers.