Delirium is prevalent among critically ill patients and it is an independent risk factor for mortality. The audit aimed to determine the staff awareness of delirium screening and to establish whether we assess and document the cognitive state of our patients regularly in the course of intensive care admission. Furthermore, we aimed to review if the causes of delirium were considered and treated appropriately. A closed loop audit was conducted in the different intensive care units. The initial audit showed that Most of the nurses; 63 (97%) neither assessed the patients for delirium nor were aware of the delirium assessment checklist. There were 12(20%) patients out of 58 who had delirium during the audit with no documentation or treatment. The second audit cycle showed 86 (90.5%) of the staff were fully aware of the checklist and using it. We conclude that re-implementing the routine screening for delirium improved its evaluation and management.

This semi-systematic review aimed to quantitatively map and identify data gaps in patient journey touchpoints for chronic low back pain (CLBP) and osteoarthritis (OA) in Saudi Arabia. An evidence mapping approach was used to quantify the prevalence and distribution of different touch points including awareness, screening, diagnosis, treatment, adherence and control across CLBP and OA patient journeys. A systematic search of databases MEDLINE, Embase and BIOSIS was conducted using predefined inclusion criteria to identify relevant studies published in English between 01 January 2010 and 11 December 2019. A substantive unstructured literature search was also conducted on public or government websites with no date restriction. To address data gaps, anecdotal data were also considered for inclusion. Data combined from all sources was synthesized and presented as simple or weighted mean. Of the 47 records identified, five studies met the inclusion criteria. The overall prevalence of CLBP from three studies was estimated at 8%. The prevalence of OA as per anecdotal data was 30%. Awareness of OA, based on two published studies and anecdotal evidence was 48%. According to anecdotal evidence, screening and diagnosis of OA was 50% and 60%, respectively. The majority of patients with OA (80%) were treated, with higher adherence (90%), of which 60% of patients showed symptoms control. The study findings highlight the need for more evidence-based research related to common patient journey touchpoints, which in turn may aid in efficient resource utilization, innovative pain services and collaborative practices to improve patient outcomes at national level.

Mycetoma is a chronic, suppurative, granulomatous infection of subcutaneous tissue that eventually may involve bone. The Infection is caused by free living, exogenous, geophilic actinomycetes and fungi. It is characterized by a triad of localized swelling, underlying sinus tract and production of grains or granules. Approximately 40% of mycetomas worldwide are eumycotic and rest is actinomycotic [1]. Eumycetoma is most probably acquired by traumatic inoculation of certain fungi into subcutaneous tissue. Fungi are considered as an unusual cause of osteomyelitis of hand/palm. This paper describes a case of eumycetoma osteomyelitis of the hand. With clinical, radiological and pathological correlation we arrived at a final diagnosis.

Autophagy is a widely conserved catabolic process that is essential for maintaining cellular homeostasis under normal physiological conditions and driving the cell to switch back to this condition under times of starvation, hypoxia, and oxidative stress. The potential similarities and differences between basal autophagy and stimulus-induced autophagy are still largely unknown. Both act by clearing unusual or unnecessary cytoplasmic material, such as misfolded proteins, supernumerary and defective organelles. The relationship between reactive oxygen species (ROS) and autophagy is complex. Cellular ROS is predominantly derived from mitochondria. Autophagy is triggered by this event, and by clearing the defective organelles effectively, it lowers cellular ROS thereby restoring cellular homeostasis. However, if cellular homeostasis cannot be reached, the cells can switch back and choose a regulated cell death response. Intriguingly, the autophagic and cell death machines both respond to the same stresses and share key regulatory proteins, suggesting that the pathways are intricately connected. Here, the intersection between autophagy and apoptosis is discussed with a particular focus on the role ROS plays.

Skin Pigmentation is a phenomenon in which the accumulation of melanin occurs due to various factors and leads to skin tanning and other skin disorders. Now a day’s human beings are more conscious about quality of life and appearance. With this fascination towards various skin whitening or glowing agents is gaining more adherences. While synthetic chemicals approved as skin whitening agents have got the due recognition in market, the possible adverse effects on sensitive skin creates a question regarding their use. The natural plant extracts available as tyrosinase inhibitors are mostly phenolic entities. In this review the inhibitory effect of phenolic compound and flavonoids on tyrosinase enzyme using molecular simulations is studied. The insilico study of flavonoids helps to predict the mechanism of inhibition as well as identification of potential natural tyrosinase inhibitors. This review is oriented to understand the tyrosinase inhibitory activity of an array of phenolic compounds with emphasis on flavonoids to explain how position of the substituents and their interaction with the enzyme can be correlated for the efficacy against the tyrosinase activity.

This study was aimed to modify some physiochemical properties of Gum Arabic and it's Emulsions by using laser irradiation. The sample of Acacia senegal Gum was collected in December 2018 from Aburai Area, Ghibaish Locality-West Kordofan State. The sample was shade dried and ground at Agricultural Research Corporation (ARC) in El-Obied. The aqueous solution of the sample was prepared with concentration 20% (w/v) and used as a test sample. Some of unirradiated aqueous solution was taken as control and the remaining portion was irradiated for different periods of time (5,10,15,20 and 25 minutes) by He-Ne Laser at 632.8nm wavelength and power 3mw using the pulse at Department of laser in Al-Neelain University – Khartoum. The irradiated samples were transported to analysis at Laboratories of Sudanese Petroleum Corporation (SPC). The results showed that there was no change in values of electrical conductivity and pH, whereas the value of the emulsifying stability and the viscosity offered by the emulsion were increased with increasing irradiation period comparing with the control. The Fourier Transform Infrared (FTIR) spectroscopy technique indicated that there was no change in some functional groups such as (O-H, C=O, C-O, and CH2) which were accompanied with absence of (C-X) at (10, 15, 20 and 25 minute) with formation of multiple bonding of nitrogen compounds at (10 and 15 minute) due to the effect of irradiation process. This study recommends that further work should be done to test other factors which may be had an effect on the emulsifying stability, also recommends to study the effect of He-Ne laser on Gum Arabic at another wavelength.

Mountaineering is a field that is easy to see but very difficult, those who adopt this field are well aware that one day they may not be able to see the next day’s sun. It is also very attractive in the background of how dangerous it looks. The beauty of the mountain valleys can only be appreciated by one who has seen it up close and Muhammad Ali Sadpara was one of those lucky people. He was the prince of the mountains who hoisted the flag of his nation on the highest peaks of the world. He climbed eight of 14 Eight-thousanders. His first climb was Gasherbrum II in Karakoram. In this review we tried to explore the life of a mountaineer who sacrificed his life just for the sake of his nation and country. We highlighted his achievements for Pakistan. February 4th 2021 he set out for the top of the K2 Mountain with two of his team members and got lost somewhere in the valley of the hill. A rescue mission with two army helicopters was organized but no trace of them has been found. We will not consider him past because he will live in our hearts forever and ever.

Oxygen is a unique element indispensable for life. Free radicals are forms as a consequence of ATP (adenosine triphosphate) production by the mitochondria in oxidative phosphorylation due to use of oxygen by cells to generate energy. Most of the by-products form as a result of this biochemical changes are reactive oxygen species (ROS) as well as reactive nitrogen species (RNS). Delicate balance between the two antagonistic effects is among the vital aspect of life ROS and RNS exert beneficial effects on cellular responses and immune function at low or moderate concentration. Therefore, the aim of this study is to evaluate the cholinesterase inhibitory effect of Cymbopogon citratus 80% (leaf) extract. The leaf was extracted with 80% methanol. A toxicity study was carried out on mice. Cholinesterase inhibitory activities were also evaluated on the same mice using Ellman’s method. Result revealed high cholinesterase inhibitory activities of the crude extract with high significant differences at P<0.001) between the group that were treated with crude extract only, group treated with crude extract and exposed to arsenic and group that were exposed to arsenic only as well as group that are maintained in complete media. It can be concluded that low toxicity and high cholinesterase inhibitory effect of the crude extract is responsible for it therapeutic effects of this crude extract. Toxicity screening of this crude extract on a mammal such as rat to reaffirm their toxicity profile are recommended. Antioxidant screening as well as isolation of bioactive compounds present in this plant part is strongly recommended.

In solve legal problems better by way of mediation so that the bias resolved in kinship if these efforts has been done has not been successful then the restriction of the efforts of the law through the mediation to ensure that the judicial process that is quick and cheap (so that the judiciary can be the choice of the people to resolve their disputes) as well as the anticipated increase in the number of cases which aims to reduce the accumulation of cases in the Supreme Court, especially at the level of Cassation. The increasing number of cases that enter, and decided in the district Court and the High Court, result in the amount of the verdict asked the efforts of law Appeal to the supreme court also increased and began to be a serious problem. Underlying it is necessary to do a study about the Role of the Judiciary in the Restriction of the Efforts of the Law in order to reduce the accumulation of cases in Court.

Pseudoangiomatous nodular stromal hyperplasia of the breast (PASH) is a benign lesion characterized by the presence of anastomotic clefts lined with flattened cells giving a pseudo-vascular appearance [1], it is a rare pathological entity that manifests itself most often in perimenopausal patients. It poses a differential diagnostic problem with fibroadenoma, phyllodes tumor or hamartoma and it is the histology that confirms the diagnosis. We describe through a series of studies and also through our case the clinical, histological and therapeutic particularity of these tumors.

Background: Acute Myocardial Infarction (AMI) is the most prevalent serious cause of morbidity and loss of quality of life worldwide despite current advances in primary preventive and state-of-the art interventional strategies for effective AMI treatment. Hypertension is the major contributor to atherosclerosis and which in turn leads to progression of AMI. Little is known about the prevalence of hypertension in AMI patients among Iraqi population. Objectives: The aim of this study was to assess the prevalence of Hypertension in AMI patients in relation to age and gender in Iraqi population. Methods: This study focused on 74 consecutive Iraqi patients diagnosed with AMI aged 22-85 years. Results: Findings of this study showed that hypertension was present in 74.3% of AMI patients. The prevalence of hypertension was significantly higher in females (46.7%) as compared to male patients (20.5%) at age group of 50-59 years. Furthermore, results showed that 37 hypertensive AMI patients (67.3%) had high-normal arterial hypertension, followed by 11 (20%) as isolated systolic arterial hypertension, 4 (7.3%) as Grade-1 arterial hypertension, 2 (3.6%) as Grade-2 arterial hypertension, and 1 (1.8%) as Grade-3 arterial hypertension level. Conclusions: These findings confirm that hypertension varied in age and gender in AMI patients among Iraqi Population. Hypertension was significantly more prevalent in older female patients with AMI when compared to male patients. The High normal of hypertension was the most prevalent type among AMI patients.

Victims of rape sometimes suffer from being blamed for their assault. The present study aimed to investigate whether hostile sexism, benevolent sexism influence acceptance of rape myths. The sample comprised of 240 university students recruited from Bahauddin Zakariya University, Multan. Demographic information sheet, Illinois Rape Myth Acceptance Scale (IRMA) [24], Ambivalent Sexism Inventory (ASI) [13] and scales were used for assessment. Results from Bivariate Correlation analysis showed that, Hostile sexism and subscales of benevolent sexist beliefs are positively correlated with rape myths. Subscales of Ambivalent Sexism (Hostile sexism, Paternalism, Heterosexuality and Gender differentiation) positively predicted subscales of Rape myths acceptance (she asked for it, it wasn’t really rape, he didn’t mean to and she lied). Results further showed that males had higher acceptance with Rape Myths and Ambivalent Sexism. Findings from the present study suggest that there is need to tackle negative stereotypes about rape victims and Interventions should focus more on the education on what rape and sexual assault are and what the health and legal consequences entail.

Background: A major challenge to antiretroviral therapy is poor adherence by the patients due to the multiplicity of drugs involved. For effective outcome of therapy, a 95% adherence is advocated in patients on ARV drugs. Objectives: Study sought to evaluate the factors that affect the adherence to their prescribed medications by people living with HIV (PLWHIV) in the capital city of Port Harcourt, South-South, Nigeria. Methods: A descriptive cross sectional study using pretested questionnaire was used to collect information on adherence among HIV adult patients. Socio-demographic factors were evaluated as possible factors associated with adherence. Reasons for missing medications were also obtained and described. Results: Participants comprised of 109 (31.8%) males and 231 (67.3%) females (mean age 37.3 ± 8.9) years. Study revealed a poor level (58%) of adherence among participants. Patient factors (forgetfulness, personal travels and work schedule), were major reasons given for missing their medications. Others are economic (lack of transport, poverty) and socio-cultural (stigma, spiritual) factors. Social support in the form of treatment supporter was found to be a significant (p<0.05) positive influencing factor to adherence by patients as well as disclosure of status to spouse. Conclusion: Strategies to improve adherence should be focused on the ways to address the negative influencing factors. Improved awareness in terms of counselling, education and orientation of the patients is strongly advocated. Social support systems (family, community, treatment supporter) and societal acceptance of PLWHIV should be put in place to encourage adherence.

Medicinal plants play a vital role to preserve human health. The genus Argemone consists of herbs, that are widespread in all over India and represents highly valuable plant species having therapeutic and nutraceutical importance. Genetic variation is essential for long term survival of species and it is a critical feature in conservation. Argemone mexicana (Papaveraceae) also known as Ghamoya. Traditionally the plants used the world for the treatment of several ailments including tumors, warts, skin diseases, inflammations, rheumatism, jaundice, leprosy, microbial infections, and malaria. It is an exotic weed indigenous to South America. In the present study an attempt has been made to assess the preliminary phytochemical screening and TLC profile of various leaves extract of A.mexicana.

Corona virus pandemic has certainly become one of the most challenging diseases ever to come to light in the history of humankind affecting from individual level to national level worldwide affecting every aspect of life. To decrease the mortality rate in coronavirus patients, the most significant role is played by early interventions when the virus is in its initial stages. To achieve this, various imaging techniques are employed out of which vascular ultrasonography is one of the most important ones. Although a little light has been shed so far on the mechanisms regarding the coagulopathies caused by Corona virus, it is without a doubt one of the hottest topics in the scientific community these days. The virus enters the body by interacting with angiotensin converting enzyme receptors which are present in different areas of the body like lungs, heart, arteries, and kidneys. The virus Interacts with endothelial cells becoming a cause for their activation and consequently initiating the coagulation system. Arterial thrombosis, deep venous thrombosis, acute respiratory distress syndrome, sepsis-induced coagulopathy, etc. are the complications caused by the virus and are the reason for mortality in severe cases of coronavirus. Vascular ultrasonography enables us to stop the virus in its tracks long before it can become fatal, ultimately helping us in decreasing the mortality rate significantly.