A growing body of research supports the significance of physician-nurse collaboration for the delivery of a quality patient care and positive outcomes. This study was undertaken to assess the attitudes toward collaboration between practicing physicians and nurses in three tertiary government hospitals in Riyadh, Kingdom of Saudi Arabia (KSA). A quantitative descriptive study was used to compare the difference in attitudes toward Physician-nurse collaboration between physicians and nurses. Attitudes toward collaboration as influenced by their age, gender, nationality, and number of years in practice was also explored. Data were obtained through distribution of survey questionnaire which is an adaptation of the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration (JSATPNC). Results showed a total mean scores on attitudes toward collaboration for physicians (n = 201) was 50.68 ± 8.31 and 53.59 ± 8.20 for nurses group (n=307). Mean scores were consistently higher in the 4 JSATPNC subscales of attitudes for nurses (p=0.007). Further analysis demonstrated that male physicians have statistically higher score than female physicians (p=0.043). Nurses who have more than 10 years hospital practice have higher score compared to those with 10 years and less of practice (p=0.048). Considering that physician-nurse collaboration is important in the promotion of a quality patient care and outcomes, healthcare institutions in KSA should give more focus on improving physician-nurse collaborative relationships.

Rheumatoid arthritis (RA) is a chronic, autoimmune, systemic disease, characterized by polyarthritis, erosive synovitis and sometimes shows multi system involvement. Oxidative damage induced by reactive species has been related to the pathophysiology of RA. The inflammation in the joints leads to joint damage and thus influences the quality of life in these patients. This work was undertaken to determine oxidative stress markers in patients with rheumatoid arthritis and to observe its correlation with inflammatory markers. Malondialdehyde (MAD) and Nitric oxide (NO) are estimated as the markers of oxidative stress and High sensitivity C-reactive protein (hsCRP) is measured as a marker of inflammation. A cross-sectional study in rheumatoid arthritis patients and healthy controls was done. We included 40 rheumatoid arthritis patients and 40 healthy controls. MDA, NO and hsCRP are measured in all the subjects. Statistical analyses were done using SPSS statistical software version 17.0. MDA, NO and hsCRP levels were increased in RA patients when compared to controls (p<0.001) and a positive correlation between the inflammatory marker and oxidative stress markers was also observed in these patients. The value of R is 0.7277 for MDA and hsCRP where as R value is 0.6153 for NO and hsCRP. The findings of present study support the concept of oxidative stress leading to tissue damage and inflammation. The positive correlation between inflammation and oxidative stress in these patients indicate the importance of correction of oxidative stress along with inflammation, further large and well controlled studies are needed to establish the role of anti oxidants in treatment protocols of RA patients.

A very simple, accurate, precise, robust, rugged and stability indicating method with gradient elution was developed for simultaneous estimation of Linagliptin and Empagliflozin in tablets. The developed method was rapid with a run time of 25 minutes eluting the peaks at 5.388 min (Linagliptin) and 8.390 min (Empagliflozin) and economic. The Chromatographic separation was achieved gradiently on a Hypersil ODS 3V, 250 x 4.6 mm.5.0µ. Column by using Potassium di-hydrogen phosphate (adjusted to pH 2.20 with ortho phosphoric acid) as mobile phase –A. Water: Acetonitrile (5:95) is used as mobile phase-B.. Flow rate of 1mL/min with UV detection at 225nm was used. The retention times of Linagliptin & Empagliflozin are 5.388 min and 8.390 min respectively. The developed method was specific and well separated from the impurities of both Linagliptin & Empagliflozin. The method is linear in a range of 40% to 160 % against the standard concentration for both Linagliptin & Empagliflozin. The correlation coefficient was found to be R2= 0.995 & 0.996 for Linagliptin & Empagliflozin respectively. Both standard and test solutions proved to be stable for up to 48 Hrs. Forced degradation study showed that the method is stability indicating. The developed method can be used for routine analysis of Linagliptin & Empagliflozin fixed dose combination.

Electrolyte abnormalities are common cause of morbidity and mortality in ICU patients. Quick and accurate results are required for immediate treatment. Conventionally these are measured in serum by electrolyte analyser but now point of care analysers are available to determine them in arterial blood by ABG. To measure electrolyte levels in venous and arterial samples and to evaluate the difference in them. The study was conducted in the department of biochemistry, GGS Medical College and Hospital, Faridkot. It was conducted on the total of 115 patients of either sex admitted in the intensive care unit (ICU). Arterial blood sample was collected for ABG and venous blood was processed in the electrolyte analyser. Results show that there is quite a difference between the mean values of these parameters in venous and arterial blood, with sodium having mean of 124.22 ± 9.18 in arterial blood and that of 137.09 ± 8.71 in venous blood. The mean value for potassium is 3.49 ± 1.28 in arterial blood and 4.21 ± 1.08 in venous blood. For chloride it is 108.54±9.9 in arterial blood and 101.77±7.2 in venous blood. The p values for all the parameters was <0.001. As we observed significant difference between electrolyte levels of venous blood done on electrolyte analyser and that of arterial blood done on ABG analyser so these cannot be used for in exchange for each other and so physicians should be cautious while reporting the results.

The aqueous and chloroform extracts of Acacia nilotica linn belonging to the family Fabaceae were evaluated for anthelmintic activity. The dried powder of Acacia nilotica bark was extracted and the activity was studied. Both aqueous and chloroform extract collected were tested for anthelmintic activity against Indian adult earthworm Pheretima posthuma (Annelida) and recorded the time taken for induction of paralysis and death. Two concentrations (25 mg/ml and 50 mg/ml) of aqueous and chloroform were evaluated in the bioassay involving determination of time of paralysis (P) and time of death (D) of the worms. Piperazine citrate (10 mg/ml) was used as reference standard and normal saline solution as a control. Comparative results of present study indicated that the aqueous and chloroform extracts of leaves of Acacia nilotica, linn shows significantly dose depending pharmacological activity on the earthworms.

Mentorship programs have been established in pharmacy education, both on the undergraduate and graduate levels. These programs are anticipated to improve the learning experience of mentees. The aim of this review was to assess the role and outcome of mentoring on pharmacy education. A systematic search of PubMed/Medline electronic database was conducted from 2000–2017, with relevant keywords (mentor OR mentorship) AND (pharmacy education OR pharmacy practice OR pharmacy training). Studies were screened by two independent reviewers for eligibility and data were extracted. This systematic review focused on the outcomes associated with application of mentorship programs in different educational settings. Our search retrieved 180 unique citations. Eight cross-sectional studies with a total of 662 pharmacy graduates were included. From included participants, there were 36 (5.4%) Masters, 58 (8.75%) pharmacy doctorates, 22 (3.3%) Baccalaureates, 60 (10%) assistant professors, and 20 (3%) PhD. All included studies reported that mentoring programs were successful, effective; and improved research skills, team working; and supported students' confidence. This study demonstrated that mentoring programs are effective, promising, and can be used as an adjunct to enhance student confidence, scientific, and professional efficiency. Outcomes of mentorship can be on organizational level, on mentees’ level, and on mentors' level. Thus, applying mentorship in pharmacy educational programs is expected to have significant results. We recommend further follow-up and research for the effectiveness of mentoring programs in all medical fields.

The Aim of this study was to compare the clinical efficacy and safety of non-fixed combination (NFC) of dorzolamide (2.0%)/timolol maleate (0.5%) versus NFC of latanoprost (0.005%)/timolol maleate (0.5%) regarding reduction of intra ocular pressure in patients with primary open angle glaucoma. This was a 12-week, randomized, open label, parallel group study with primary open angle glaucoma (IOP range: 24 – 36 mmhg), which included 40 subjects in dorzolamide/timolol group [dorzolamide (2.0%) instilled twice daily and timolol maleate (0.5%) twice daily] and 40 subjects in latanoprost/timolol group [latanoprost (0.005%) instilled once daily, timolol maleate (0.5%) twice daily]. IOP was measured at baseline, 4 and 12 weeks at 10 am. Adverse events were recorded at each visit. The difference in reduction of IOP in two treatment groups from baseline to 12 weeks was the main outcome measure. Mean IOP was similar at baseline for both groups. Absolute reduction in IOP from baseline to 12 weeks was 9.6 mmhg in dorzolamide/timolol group (P <0.001) and 9.7 mmhg in latanoprost/timolol group (P <0.001). No significant difference was found regarding reduction of IOP between the groups (P < 0.85). Both treatments were well tolerated. NFC of dorzolamide/timolol and latanoprost/timolol showed comparable efficacy in reducing IOP. They were also comparable regarding safety profile.

Complications involving the lungs as a sequela of a systemic disease process are not uncommon, and in fact, pulmonary involvement could be the first or even the only manifestation of systemic disease in a handful of clinical cases. Inflammatory bowel diseases are characterized by mucosal inflammation involving the GI tract that can follow a relapsing-remitting course. Respiratory tract diseases in the setting of IBD can be quite variable and warrants clinical recognition and proper treatment as it could have a significant impact on the patients' health. Here I summarize the potential pathological involvements of the respiratory system in the cohort of IBD patients and summarize the clinical assessment steps necessary to achieve the proper diagnosis.

Repetitive behavior is a common symptom in children and is characterised by sameness, rigidity and repetitiveness. These stereotypic and repetitive behaviors are seen in various psychiatric as well as neurological disorders. Till today, the focus of almost all studies was on repetitive behavior in ASD & OCD. The purpose of this study is to bring all the children presenting with repetitive behavior under the same roof, to investigate the patterns of repetitive behaviour in children associated with different childhood disorders and to study the distribution and severity of repetitive behaviors among childhood psychiatric disorders. A Cross-sectional observational study, for the duration of 1 year, was performed on 72 Children (0-12yr) with repetitive behaviour attending the child guidance clinic, who had given consent. Children were screened by using CBCL and diagnosed as per ICD-10 DCR. Severity of repetitive behaviors was assessed using the RBS-R scale & score of different subscale of each disorder were compared. Statistical analysis was done on SPSS version 23. Total 8 types of disorders were included in this study. Stereotyped behavior, Self-injurious behavior more in PDD than OCD, MR &TIC. Compulsive behavior more in OCD than PDD, TIC & MR. Ritualistic behavior, sameness behavior, restricted behavior and total score are more in OCD than tic disorder. Stereotyped behavior more in Tic disorder than OCD. Stereotyped behavior and self-injurious behavior more in MR than OCD. This research contributes to the literature looking at domains or specific groups of repetitive behavior within children with PDD, OCD, TIC and other disorders. As per our knowledge this is the first study in India on repetitive behavior in different childhood disorders.

The aim of the study is to determine the knowledge and practices of nurses towards postoperative pain management. The data collected from 92 participants were female nurses. In this study cross-sectional study design was used and self-administered structured questionnaire was conducted in government hospital Layyah Pakistan. Likert scale was used in this instrument. After data collection, it was analyzed by SPSS version 21. The results were analyzed in terms of descriptive statistics frequency, percentage for data analysis. A total of 100 questionnaire were returned from 120 questionnaires distributed to participant. Results of the study revealed that nurses have good knowledge about post –operative pain management but practices were not good Overall, study shows that knowledge of pain management of nurses statistically and significantly is good but practices were poor. In conclusion, patients are still hurting because of poor practices of nurses towards pain management thus the hospital management should focus on these factors to improve the nurse’s practices.

A holistic study of tinnitus to explore the etiology of tinnitus and to examine a successful alternative self-help approach, which combines the human voice (toning) with energy alignment. Four case studies of adults who suffered from tinnitus are used to illustrate the benefits of approach. Each adult sustained a three - week self-help programme of toning, colour and energetic alignment. The clinician researcher evaluates the methodology of the approach and cause of symptoms from a physiological and metaphysical perspective.

This study was designed to compare the properties, kinetics and stability of the immobilized lettuce protease with the free one. We also aimed to test the use of the immobilized lettuce protease for the production of novel bile binding and tyrosinase-inhibitory peptides from plant food processing wastes (cauliflower midrib and broad bean leaves). Immobilized lettuce protease was prepared previously from Lactuca sativa (lettuce) seeds. Free lettuce protease was immobilized on alginate-glutraldehyde beads by covalent bond at optimum conditions with high immobilization efficiency. In the present study, immobilized protease showed optimal activity 221.5 U/mg enzyme protein at pH 10 and 70°C, while the free one showed 22 U/mg enzyme protein at pH 7 and 60°C. Km values of the immobilized and free protease toward azocasein were 1.143 and 1.442 mg, and Vmax values were 142.9 and 24.6 U/mg enzyme protein, respectively. Immobilization of lettuce protease resulted in an increase of activation energy (Ea) for azocasein hydrolysis from 9.6 to 23 Kj/mol. Immobilization improved its turnover number Kcat (15.96 Kj/mol) and catalytic efficiency Kcat /Km (13.96 Kj/mol) compared to that of the free one (3.09 and 2.143 Kj/mol, respectively). Deactivation energy (Ed) values were 38.76 and 55.41 for the free and immobilized protease, respectively, confirming the enzyme stability by immobilization. Free protease could be stored for 70 days at 4°C with loss of only 20% of its initial activity, while the immobilized one could be stored for 23 and 46 days with retention of 114 and 74.5% of its initial activity at 9°C, respectively. CaCl2 increased the rigidity, stability and activity of the immobilized enzyme by 125%. Cauliflower peptides were enzymatically prepared from cauliflower protein. It had higher bile binding and tyrosinase inhibitor potency than the parent protein. Immobilized lettuce protease and cauliflower peptides could be applied in food and pharmaceutical industries.

Telehealth is increasingly used to manage many long-term conditions including ones which affect physical and mental health. The range of methods of delivering telehealth is increasing as technology, and the internet, develop and become increasingly ubiquitous. The various means of delivering telehealth includes the use of computers, smart phones, mobile phones and landlines. As the means of communicating remotely increase, so do the range of ways in which telehealth can be used to both monitor long-term conditions and aid in the delivery of self-care. This paper reviews various applications of telehealth as they are applied to the management of type II diabetes. It examines the role of the different forms of technology in monitoring the disease remotely, in prompting episodes of self-care and in the delivery of proactive education. The review identifies sixteen randomised controlled trials which all use telehealth, in at least one of its forms, to deliver monitoring, disease management prompts and proactive education (or any combination of the three) remotely. The quality of the evidence uncovered is variable, with the long-term utility of many of the approaches remaining largely unproven because of the time limited nature of the research available. The least equivocal findings are from the studies which take a three pronged approach to the delivery of telehealth – monitoring, prompting and educating – which all showed measurable benefit in terms of the management of blood glucose levels. This improvement also held true for the studies which employed both monitoring and real time disease management prompts alone. The evidence suggests therefore, that attempts to use telehealth to improve the management of type II need to include, at the very least, an element of remote monitoring and real-time disease management prompts. Whether the benefits which accrue from these approaches have any long-term value needs to be further researched.

Focal dermal hypoplasia (FDH) or Goltz syndrome is a rare genetic skin disorder; characterized by abnormalities of both ectodermal and mesodermal structures. We report the case of a girl of 8 years of Moroccan origin, second of a fratery of two, resulting from a non-consanguineous marriage and without any particular family history. Examination at admission notes that the patient presents with an overall hypotrophy, right facial asymmetry with low-set protruding ear, narrow nasal bridge. The examination of the oral cavity notes: Arborescent papillomas of the oral mucosa, hypertrophy gingival, abnormous tooth form, ectopic extensive dental caries eruption. Skeletal abnormalities: Ectrodactyly ("lobsterclaw" hand deformity) of the right hand, Syndactyly bilateral second and third toes. Hypopigmentation of the abdomen skin, microphthalmia of the right eye. The rest of the clinical examination is without particularity. The genetic study confirmed the diagnosis of FDH by highlighting a mutation of the PORCN gene.

The accurate morphological identification of the cells is a diagnostic problem in conventional smears. By using 10% alcohol formalin as a fixative and obtaining cell block gives effective diagnosis regarding cellular morphology in serous effusions. This study was carried out to evaluate cell block technique as a diagnostic tool for serous effusions. It is expected that cell block technique will give better morphological details and thereby improve the sensitivity of the diagnosis in comparison with conventional smears. This retrospective study was conducted in cytology section in a tertiary care hospital,46 fluid samples were subjected to diagnostic evaluation over a period of 10months.The cell blocks were prepared by using 10% alcohol-formalin as a fixing agent along with the conventional smears. The nucleo-cytoplasmic details were evaluated as benign, suspicious for malignancy and malignancy in both conventional smears and cell block method. Out of 46cases only 3/46cases (6.53%) found to be malignant in conventional smearsand using cell block technique 6/46cases (13.043%) were positive for malignancy. Cell block technique is a useful adjuvant evaluating fluid cytology for the more presumptive diagnosis, when combined with conventional smear method. Cell blocks can be stored for a longer period for further evaluation and can be used for special stains, Immunohistochemistry and molecular diagnosis in order to obtain specific diagnosis.

The objective of this study is to evaluate the antioxidant and anti-inflammatory activity of the aqueous extract of Arthrospira platensis var. Lake Chad, also call spirulina. A phytochemical screening of the aqueous extract was done for the characterization of the secondary metabolites. The microbiological quality was estimated and essays of acute toxicity were made. The anti-inflammatory activity was determined by the method of the oedema led by carrageenan; total phenols were determined and the antioxidizing activity was estimated by the method of trapping of the radicals free of the DPPH. The phytochemical test showed the presence of tannins, flavonoids, sterols, saponosides and alkaloids. Subsequently, during the microbiological quality control, no presence of total coliforms, fecal coliforms, molds and salmonella was observed.

The objective of the study was to evaluate the aphrodisiac property of the aqueous extract of Panax ginseng C.A. Meyer rhizomes (Zngiberaceae) in albino and normal male rats of the Wistar strain. Colorimetric and precipitation methods were used to highlight secondary metabolites of the plant. The acute toxicity test was conducted according to OCDE guideline 423. Four lots of 6 animals were used to evaluate the aphrodisiac property of P. africana. The positive control received sildenafil citrate (5 mg/Kg) and the negative control, distilled water. The test lots received the extract at 500 and 2000 mg/Kg for 8 days. The copulatory parameters were observed on days 1, 4 and 8. The phytochemical screening revealed the presence of ginsenosids, alkaloids, tannins, saponosides and tri terpenes in the extract. No changes in the general appearance of the rats and no mortality were recorded during the toxicity test, highlighting that P. africana is non-toxic. The extract significantly increased the sex parameters of the tested rats. This aphrodisiac effect of P. africana attributed to identify secondary metabolites justifies its use in traditional medicine as a sexual stimulant.