Health care support workers have patient-facing roles within care teams but little autonomy; work is allocated. This study reports work stress experiences of Health Care Assistants (HCAs; UK support workers) in a dementia unit in 2018 towards the end of national austerity, a period of significant staff reduction in the UK National Health Service. HCAs (15; 40% of total) were individually interviewed, and in a focus group (6). Analysis revealed high job demands but low job resources. HCAs were altruistic regarding stressful dementia care but tension from the work environment was high. Difficulties directly or indirectly related to staff shortage: workload, inadequate staffing, and reliance on inexperienced temporary staff who required supervision, poor team skill mix, and poor shift patterns. Serious relationship issues for HCAs were exposed so post-hoc interviews with nurses (n=10) from the same unit were undertaken for further insight. HCAs considered nurses unsupportive, poor leaders and disrespectful of their experience. Nurses considered HCAs obstructive, compounded by failure to recognise nurses’ professional responsibilities. Coping by HCAs was mainly through short, time-out breaks but these were constrained by lack of staff cover. Tensions had been left to fester. Better awareness of managers is required that staffing impacts extend beyond workload.

After exposing the black mulberry juice to ultraviolet light with the intensity of 5, 10 and 20 kJ/m2, their quality analysis have been performed for 4 days at +4 °C and +25 °C. Within the current study the antioxidant activity, Total Phenolic Content (TPC), microbial charges and pH values of the samples have also been investigated. In the UV light exposed samples there existed no meaningful difference in the % DPPH radical scavenging activity level, a small amount of decrease has been detected in the TPC creation process. While the storage time worsens the DPPH activity, it affects the TPC positively. Microbial studies showed reduction in total mesophile aerobic microorganisms, yeasts and mould counts about by 1-log cycle on UV treatments. This is the first report on the effects of UV radiation on black mulberry.

Objectives: The aim of our study is to compare the outcomes in unilateral and bilateral cochlear implants in pediatric age and also between simultaneous and sequential surgery.

Material and Methods: This retrospective study was carried out with 83 children aged which included 41 children with bilateral Cochlear implants and 42 with unilateral implants. Out of these 41 children 21 were simultaneous and 20 were sequential. All children were operated at civil hospital Gandhinagar, Gujarat, India. SIRS, CAP scores, speech perception in quiet and noise, sound localization and comprehension were assessed at regular intervals over the period of 4 years. Also, drug administration time, surgical time, operating room time were assessed for simultaneous and sequential surgery.

Results: Children with bilateral implants fared significantly better with sound localization, speech comprehension and speech production tests, expressive language subscales than unilateral implants with a significant difference (p=0006) of means t tests between the two groups. Children with simultaneous bilateral implants achieved significantly higher scores in vocabulary outcomes and expressive language subscales than those with sequential bilateral implants. Simultaneous Surgery is associated with reduced surgical time, operating room time, it shortens the total in patient stay. There is less of drug administration and both ears get stimulated simultaneously.

Conclusion: Bilateral Cochlear implants are associated with better expressive language and receptive language when compared with unilateral implants, these differences were not statistically significant when simultaneous and sequential implants were compared but simultaneous surgery is better and safe option for pediatric cochlear implantation.

Purpose: Restless Legs Syndrome (RLS) is a motor and neurological disorder that is associated with a sense of urgency to move the legs. It is necessary to use
non-pharmacological treatments to reduce the symptoms of this syndrome.

Methods: The present study is a two-group clinical trial, in which transcutaneous electrical nerve stimulation (TENS) intervention was performed on 20
patients (10 patients in each group) for 3 sessions in 3 consecutive days. The aim of this research was to evaluate the effect of TENS on RLS in patients with
this complaint referring to a private medical center.

Results: The mean age of participants was 46.56 ± 9.16 years. There was a significant difference in RLS levels before and after the final intervention in
each group. There was no significant difference of RLS rate between the two groups after final intervention.

Conclusion: If future studies with a larger sample size confirm the results of the present study, patients can use a portable TENS according to the advice of
a physician at home to reduce nocturnal symptoms associated with RLS syndrome.

Atrial fibrillation increases with increased elderly population and it increases the risk of thromboembolism that may lead to stroke. Both CHADS2 and CHA2DS2 VAS scores are widely used to assess the stroke risk according to current international guidelines. The accuracy of both scores in predicting stroke risk is only modest. Some important clinical risk factors are missing of those scores such as chronic kidney disease, Body Mass Index BMI, echocardiographic abnormalities and other biomarkers. Assessment of bleeding risk using HEMORR2HAGES, HAS-BLED, and ATRIA scores are discussed in detail

Infiltration of sarcoid granuloma in old cutaneous scars is one of the uncommon cutaneous manifestations of sarcoidosis. Here, we report the case of a 32-year-old female who presented with pain and swelling in 9 month old appendicectomy scar. An incisional scar biopsy revealed granuloma. On query she had inflammatory polyarthritis and persistant dry cough for last 2 months. High-Resolution CT (HRCT) revealed right paratracheal, both hilar, paraaortic and subcarinal lymphadenopathy with pulmonary nodular densities in both lung fields. FNAC from mediastinal node revealed non caseating granuloma consistent with Sarcoidosis. Successful regression of cutaneous inflammation was achieved using a course of oral steroids, hydroxychloroquine and methotrxate. The onset of scar sarcoidosis is rare and, therefore, not well understood; however, inflammatory alterations in preexisting scars may be important indicators for disease onset.

Introduction: Foramen magnum meningiomas corresponds about 3 to 3.2% of all meningiomas. And 60 to 77% of all benign extramedullary tumors of the craniocervical junction. Due to its depth, these lesions and the delicate anatomical relationships, their resection demands detailed mastery and control of the complex anatomy of the region.Different approaches for resection of these lesions have been reported:suboccipital,transcondylar, transoral and retrosigmoid craniotomy.

Far lateral transcondylar approach have proved to be a safe, wide, sterile surgical access for the exposition of the ventral space to the central nervous system that allows good manipulation in a parallel plane. There are specific considerations according to the position and encasement of the vertebral artery, and the extension of the bone resection.

With the development of three-dimensional (3D) printing technology, more applications have been used in clinical settings for the planning and performance of surgical procedures, and neurosurgery is not the exception. 3D printed models are created through layer-by-layer deposition by high-precision 3D printers using reconstructed patient CT-scan images.

Materials and methods: The clinical case of a patient with a diagnosis of foramen magnum meningioma, pre-surgical planning with a 3D model, surgical resolution, and literature review are presented.

Results: Pre-surgical planning is performed on a 3D model, the patient undergoes surgical resolution without complications and she is discharged from the service due to improvement.

Conclusion: The use of current tools allows adequate and precise planning of neurosurgery procedures, as well as extensive explanation and taking individual anatomical considerations to reduce the risk of complications during surgery. 3D models represent a valuable surgical educational tool that improves the understanding of complex lesions of the skull base, for the neurosurgical residents

With no definite therapeutic or preventive drug against COVID-19 virus, vaccine is critical to disrupt the pandemic. Two vaccines have received emergency use authorization in America and Europe and two vaccine in India. Indian introduced COVID-19 vaccination on January 16, 2021. Despite severe disruption of the lifestyle, socioeconomic activities and ongoin restrictions, vaccine hesitancy is anticipated. While the vaccine introduction is in progress, the vaccine hesitancy needs to be considered based on the past experiences on pandemic and adult immunization drives. The initial experiences in India has been uneven with lower performance in some progressive states. Special targeted efforts are needed to tackle the vaccine hesitancy and improve public confidence for effective implementation

There are different methods to detect three-dimensional motions in biomechanical testing. Optical motion analysis or ultrasound-based systems seem to be the gold standard and have been described in previous studies. However, measuring the three-dimensional motion of a complex structure such as the lumbar spine is still challenging. With the current study, we introduce a new method to measure and at the same time to visualise the complex three-dimensional motion of the lumbar spine. It is a model-based tracking technique. We matched the three-dimensional motion of a lumbar spine with an optical motion analysis system. This was conducted in a spine testing machine with a 3D reconstruction from a CT scan. This method allows for visualization of the in vitro recorded motion of a lumbar spine using a normal CT dataset. Furthermore, the motion of the lumbar spine could be analysed in areas that were not seen by the two cameras of the optical motion tracking system. This method facilitates future research of the locomotor system using complex motion analysis in biomechanical testing.

Diabetes is chronic illness characterized by the body’s inability to produce sufficient quantities of insulin or an inability to use insulin effectively. The illness poses a major threat to public health. Biomedical advances have significantly helped to improve the quality of life of afflicted individuals, reducing morbidity and mortality rates. Diabetes is a multifaceted problem, characterized by wide-ranging biopsychosocial implications. It can cause considerable health complications if it remains untreated. The process of adjustment may be too overwhelming for some, resulting in anxiety and depression. A diabetes diagnosis may also affect family members who may be worried about potential health problems of their loved ones. Some individuals who are diagnosed with diabetes seem to go through stages of grief as they come to terms with their illness. This article discusses the broader biopsychosocial implications of diabetes and the importance of addressing the illness from a holistic perspective.

An effect of metformin on weight and biochemical parameter for 6 month or longer is extensively studied while the effect of only 3 months is not fully elaborated. In our retrospective study we collect and analyze data for the effect of metformin (3 months) on obese newly diagnosed diabetic on diet control (Mediterranean diet with reduce total calories intake) following a registered Nutritionist at Elkodes clinic. We include data of all overweight and obese newly diagnosed diabetics before and after 3 months period of starting metformin in addition to diet control. Patients on anti-lipid or weight reduction therapy and patient with known liver or renal disease were excluded. Paired T test was used. The mean weight, T cholesterol, Triglyceride, LDL-C and as expected HbA1c (72.04 Kg, 182.4 mg/dl, 135 mg/dl, 85.6 mg/dl, 6.1) was significantly lower after metformin compared to before therapy (83.6 Kg, 208.5 mg/dl, 169mg /dl, 113mg/dl, 7.9) respectively. Renal and liver functions were not statistically different. Our study shows that metformin can have significant favorable effect on weight and lipid profile even for (3 months) use without effect on liver function. Most previous evidence demonstrates the effect of metformin after 6 months or longer.

Diabetes is becoming a major chronic disease burden all over the world. Little is known about the prevalence of intestinal parasitic infections in them. The aim of this study was to determine this prevalence in type 2 diabetes mellitus in Benghazi, Libya. A cross sectional case control study recruited two hundred type 2 diabetics from Benghazi diabetic center and one hundred non-diabetic individuals which served as control group was taken from Benghazi medical center and Elhiaa clinic .Their ages ranged between 18 to 55 years with and without diarrhea between January and December 2016. Socio demographic characteristics were taken during the interview. Fresh stool specimens were collected and processed, and data was analyzed. The prevalence of intestinal parasites was higher among diabetic patients (40.0%) than amongnon diabetic patients (16.0%).Specifically, the following intestinal parasites were highly prevalent in diabetic subjects Entamoeba coli (10.5%), Cryptosporidium parvum (8.5%), while in control group Entamoeba histolytica (10%), Ascaris Lumbricoides (3%) were the most isolated parasite. There was a significant relationship between prevalence of parasite and diarrhea (p=0.001), education (p=0.000), single and multiple infections (p=0.001). Relation was not significant between parasitic infections with sex and age in all sample (p=0.203, p=0.56) respectively .The present study emphasizes the necessity of increasing awareness among clinicians regarding the occurrence of intestinal parasites at higher prevalence in type 2 diabetic patients.

The study has been conducted for observing the dietary profile and prevalence of hypertension in NIDDM patients [1]. It is the study of patients out of 100 in which 50 were males and 50 females were selected to conduct the study. Hypertension (bp) is the very important risk factor for chronic disease burden in India. Studies of India have reported high prevalence of hypertension. The aim of this study was to examine, profile, nutritional content, education, food habits ,medicinal utilization of hypertension in NIDDM patients. Since food and dietary pattern of an individual have an important role to play in development, treatment or prevention of non-insulin dependent diabetes mellitus (NIDDM). The main criteria of the sample selection were non-insulin dependent diabetes mellitus male and female age group between 40-60 years of age. Few selected individuals had controlled diabetes. Their diabetes was controlled by the following:

• Limitation their food intake

• Morning and evening walk

• Do the exercise

• Yoga and meditation

• Avoiding of any stress

Figure 1: (a) Jamun seeds (b) Karela & Juice

Taking medicinal herbs like methi seeds, bitter gourd (in powder form) or jamun seeds besides their regular medicine [2] (Figure 1).

They got their urine and blood sugar levels checked regularly, every 15 days or after a month). Some diabetic subjects were dependent only on medication to control their blood glucose levels and did not regulate their dietary intake and physical activity.

Ketogenic diet is a high fat, moderate protein, low carbohydrate diet in which energy source is ketones instead of glucose, which was initially designed to treat epilepsy but it proved in delivering many other health benefits including weight loss, fat loss, improves glucose and insulin levels, sometimes it results in skin glow and many others health benefits. Intake of ketogenic diet will place your body into a state of “ketosis”. A process when human body becomes a fat burner rather than sugar burner. The present study includes brief description about ketogenic diet and its types, history, biochemistry, its benefits and their side-effects

The analysis presented here was to identify some responsible variables for the prevalence of diabetes for different duration in Bangladeshi adults. For this, 995 adults of ages 18 years and above whom visited different diagnostic centres in both urban and semi-urban areas were interviewed. Out of 995 respondents, 67.0% were diabetic patients and they were suffering for, on an average, 6.59 years with standard deviation of 4.06 years. The percentage of adults suffering for minimum 10 years was 17.1. The corresponding percentage was significantly higher for males (23.5%), single adults (27.5%0, elderly people (63.1%), farmers (22.1%) and business persons (20.1%), adults of families having medium income(17.9%), smokers (25.5%), adults involved in sedentary activity (23.3%), obese adults (30.3%) and hypertensive adults (64.4%).The risk of prevalence of diabetes for males was 14% more as it was for females. Similar higher risk was observed for single persons (43%), elderly people (36%), literate people (19%), businessmen ( 11%), obese adults ( 13%), smokers (10%), adults involved in sedentary activity ( 16%) and hypertensive adults ( 26%), The binary logistic regression analysis indicated that gender variation, marital status, age, occupation, body mass index, and blood pressure were the responsible variables for the prevalence of diabetes.

Percutaneous treatment of coronary bifurcation is a typical area where controversy regarding stenting techniques is still there. While provisional stenting (PS) of the side branch is a practical and effective technique, there is a number of cases where two stent techniques are needed. We present here a case of a 69-year-old gentleman presenting with Acute coronary syndrome (ACS) with ongoing chest pain was subsequently diagnosed to have right coronary artery (RCA) bifurcation lesion (Medina 0,1,1) where a change of stenting strategy from V-stenting to mini crush enabled us to tide over the complications.
A 69-year-old gentleman, non-diabetic, nonsmoker normal body mass index (BMI), with a past history of coronary artery disease (CAD), with ACS was transferred to our catheterization lab in view of recurrent chest pain and dynamic ST-T changes. Electrocardiogram (ECG) showed ST-T changes in inferior leads and Echocardiography (ECHO) showed regional wall motion abnormalities (RWMA) in RCA territory. A diagnosis of CAD, non-Q myocardial infarction (MI) was made. Coronary angiography (CAG) revealed triple vessel disease with culprit vessel was identified as distal RCA with bifurcation into posterior descending artery (PDA) and posterolateral vessel (PLV) with thrombolysis in myocardial infarction (TIMI) grade - 3 clot. Two stent strategy with V-stenting was contemplated due to ongoing chest pain and dynamic ST-T changes. Two Drug-eluting stents (DES) from distal RCA to PLV and PDA in a V fashion were implanted simultaneously. However, it resulted in edge dissection at the proximal edge of overlapping stents. Hence, another long stent 3 x 33mm DES was deployed from PLV to distal RCA crushing the PDA stent which was then recrossed and sequentially balloon dilated and final kissing balloon dilatation was performed with the excellent final result.
V-stenting can be an attractive two-stent strategy in patients of bifurcation where clinically there is an acute situation and PCI must be completed in the shortest possible time with minimal complicity. In case of complication of proximal edge dissection in V-stenting technique, the strategy can be changed to mini crush to bail out the complications.

Noncommunicable diseases (NCD’s) such as type 2 diabetes and hypertension are increasing in Cambodia. Clinicians in Cambodia do not routinely offer behavioral interventions to address the lifestyle behaviors such as poor nutrition, lack of physical activity and tobacco smoking that contribute to poor outcomes for NCD’s. Behavioral conditions such as depression and substance use disorder that are frequently comorbid with NCD’s also contribute to poor clinical outcomes are also not routinely addressed in medical settings in Cambodia. Integrated healthcare is the systematic, team-based approach to delivering behavioral interventions to address lifestyle and behavioral conditions that underlie poor outcomes for NCD’s delivered by a Behavioral Health Consultant (BHC). Research on type 2 diabetes and hypertension risk factors such as nutrition, physical activity, tobacco smoking and alcohol misuse demonstrates the need for a new workforce of BHC’s to improve quality and outcomes. A model of integrated behavioral health designed by this research team uses a Health Risk Assessment, a social worker or community health worker in the BHC role,  and smartphone app platform for patient health self-management is recommended.

Background: Built-in bathroom facilities located within patients’ room were identified as a strategy to reduce inpatient falls. However, the relationship between having built-in bathrooms and falls incidence has not been examined. Purpose: To explore whether built-in bathrooms within an acute multi-bedded hospital room setting will reduce falls incidence among adult patients as compared to those sharing a separate bathroom situated outside their rooms. Method: A pre-and-post study involving a single group comparison of three-time phases was conducted. Results: Presence of built-in bathrooms in multi-bedded hospital room settings was not statistically significant in reducing falls, p>0.05. Conclusions: Built-in bathrooms had shortened the distance from the bathroom to patients’ bed, but it did not reduce falls incidence significantly. Other fall preventive measures such as reminding patients to seek assistance before ambulating and installation of handrails linking from the bed to the built-in bathrooms may be required in order to reduce fall incidence.

Aim: Undergraund Farmakology of Black Marked such as are Anabolic steroids wich are irational abused by young recreational bodybuilder are in hidden epidemic connection with fast muscle gain and increased cardiovascular risk. Many young recreational bodybuilders beisides syntetic testestorone derivats, different testosteron esters and supplements search for alternative methods to improve effectes of muscle gain. Effects of Hyperbaric Oxygen Therapy (HBOT) with connection of abuse of stacking anabolic steroids in recreational bodybuilders still stay generally and worldwide unexplored leaving lots of unfilled gaps.

Methodology: This study was conducted from beginning of May, 2018 till end of december 2018 at the Clinic of cardiovascular Surgery, department for vascular and endovascular surgery, Clinical Center University of Sarajevo, Special Hospital dr.Solakovic Department for Hyperbaric medicine (BIH) Head of Center for Hyperbaric medicine and chronic wound treatment Banja Luka (BIH), Private Hyperbaric and General Practice Therapy Centar Split and faculty Physical education and Sport Sarajevo included 72 subjects age 20-30 (36 of them went to hyperbaric chamber and used anabolic supplements while, 36 don’t went to hyperbaric chamber only used anabolic steroids). Potential Cardiovascular Side Effects are investigated For the testing of statistical significance of differences between the examined groups parameter tests were used. The difference at a level of p<0,05 was statistically significant.

Results: In all tested subjects we investigated increasing potential damage of cardiovascular parameters age 20-30 years after two years study. Analysis shows the no statistically significant influence of recoverry and strength improvment in (HBOT) Treat dacetate group, compared to non Trenbolone acetate abuser group (p<0,005).

Conclusion: Anabolic steroid stacking have generally efective potential abusing impact on skeletomuscular system it is unsignificant that oxgen therapy can provide such benefit in strength like anabolic steroids but certainly can improve recovery after hard working effort in a gym.

We report a case of a 47-year-old man with venous leg ulcers coexisting with liver cirrhosis and diabetes. The patient had received standard wound care for 12 weeks, but the leg ulcers were still worsening. Oral administration of fish compound peptides was used to reduce local protein catabolism and promote granulation tissue formation. The healthy granulation tissue was observed in the second week of nutritional intervention. The ulcers were constricted at the end of the third week. After eight weeks, the ulcers were completely healed. The case study demonstrated the positive impact of nutritional intervention with fish compound peptides in venous leg ulcers healing.

Introduction: Nurses worldwide are facing hardships during the COVID-19 pandemic.
Aims: To examine the impact of work environment, workplace support and individual-related factors on burnout during the COVID-19 pandemic.
Methods: This was an analytical cross-sectional study conducted in a hospital in Singapore that nursed confirmed and suspected COVID-19 patients between 12
March and 25 May 2020. An email invitation was sent to all nurses to participate in an online survey. Multivariable logistic regression analysis was conducted
to examine associations between burnout and work environment, workplace support and individual-related factors.
Results: 855 nurses responded to the survey. Compared to nurses working in low-risk areas, nurses in high-risk areas had 1.6 times higher risk of burnout (95%
CI: 1.072 – 2.454; p=0.022). Perceiving lack of teamwork (OR = 1.630, 95% CI: 1.067– 2.492, p=0.024), not feeling appreciated (OR = 14.811, 95% CI:
3.520 – 62.328, p<.001) and poor self-rated health (OR=0.348, 95% CI: 0.264-0.460, p<.001) were associated with burnout.
Discussion: Nurses working in high-risk areas, such as wards are designated for acute respiratory infections patients, are at higher risk of experiencing burnout.
Implications for practice: Nurses in high-risk areas would benefit from interventions that build physical health and esprit de corps to prevent burnout.

Humans were formed when their brains changed. They gained technical skills and lost communication skills. The result was violence far in excess of all other creatures and damage has been inflicted on everything from our planet to ourselves. At last, mass communication by technology may compensate for inherent inadequacy if we learn to manage ourselves.

Despite numerous advances in coronary intervention techniques, in-stent restenosis (ISR) remains the Achilles heel of interventional cardiology. The incidence of ISR varies from 10-50% and depends on the absence or presence of several risk factors such as small vessel size, longer lesions, and diabetes. Drug-eluting stents (DES) have dramatically reduced the rates of restenosis and target vessel revascularization in a wide spectrum of patients with varying lesion morphologies. The interventionists must do a strategic evaluation of their patient before doing angioplasty to prevent ISR. Intracoronary imaging might help to understand the mechanism and to decide the management. In this article, we describe and compare the contemporary treatment modalities in patients who develop ISR. We also describe the role of imaging in the evaluation and characterization of in-stent restenosis. Various modalities of treatment like balloon angioplasty, cutting and scoring balloon, rotational atherectomy, excimer laser coronary angioplasty (ELCA), drug coated balloons, drug-eluting stents, brachytherapy, and the role of coronary artery bypass grafting (CABG) have been discussed.

The paper dealt with analytical results of data collected from 995 adults of 18 years and above living in rural and urban areas of Bangladesh. The analysis was done to identify some socioeconomic variables which were responsible for the prevalence of hypertension in adults of 18 years and above. The prevalence rate was observed among 5.9% adults. The rate was significantly higher than the overall prevalence rate among non-Muslims, elderly people, retired persons, smokers, and process food consumers, adults involved in sedentary activities, obese adults, and diabetic adults suffering for a longer duration. The risk of prevalence was more among urban people, males, single adults, lower educated adults, and adults of economically affluent families. However, the most responsible variable for the prevalence of hypertension was age followed by the duration of diabetes, process food consumption, sedentary activity, body mass index, smoking habit. These variables were identified in discriminating hypertensive and non-hypertensive adults.

The brain is a multilayered and multicompartment system structured for accomplishing robust behaviours which leads to cognitive and physiological functioning of the human system [1]. The total volume of the human brain is 1450cm3 on an average. It comprises of innumerable neurons and glial cells which make up the building blocks of the brain [2]. Scientists have been trying to understand the brain and unfold it’s mysteries for many decades. Inspite of taking avid interest in this field the information gathered does not provide a complete comprehensive perception of the brain [3, 4]. The effort to comprehend the brain has evolved over the years [5]. Machine learning techniques are being widely used to make relevant outcomes for neuro imaging. The advent of imaging technologies has helped to facilitate our understanding of the brain and its complexities [6-8]. Brain imaging technologies provide an unprecedented tool to analyse the changes in the central nervous system (CNS). These technologies have bought with them higher resolution and deeper penetration into the brain thus exposing newer functionalities of it. Exploring the brain to absorb its secrets and unravel its enigma is one of the most promising and rewarding applications of biomedical brain imaging technologies. Brain imaging technologies provide non invasive techniques of viewing the brain and its activities [9]. Doctors and researchers can monitor the brain without having to intrude into it via painful and risk staking neurosurgeries. This is one of the biggest advantages of the emerging and ever evolving brain imaging technologies. Today, a number of these techniques are being put to practical application to save innumerable patients around the globe. The current brain imaging technologies include Functional magnetic resonance imaging (fMRI), Computed tomography (CT), Positron Emission Tomography (PET), Electroencephalography (EEG), Magnetoencephalography (MEG), Near infrared spectroscopy, Two Photon Microscopy and Photoacoustic tomography (PAT). Of these fMRI and PAT are the recent imaging tools of particular interest.

Nanomedicine is an increasing science area concerned with the development and fabrication of nanometer-scale structures for improved cancer care, detection, and imaging. Most cancer treatment options available in the clinic currently limit their usages with limited solubility and off-target side effects. Nanomaterials improve the bioavailability, solubility, selective organ distribution, and therapeutic effect of several biomolecules. Gene therapy using free nucleic acids can deal with vital candidate genes of cancer. However, their effect is delayed due to poor cell uptake and instability in circulation. Recently, Short interfering RNA (siRNA), highly capable of knockdown of specific genes, has emerged as a promising molecular therapeutic tool in targeted cancer treatment. Using liposomes, polymers, and dendrimers nanoparticles to deliver cancer drugs and siRNAs have been successful in recent preclinical studies. However, improving the tumor specificity of therapeutic cargo remains a major challenge. Therefore, the development of a novel tumor-targeted drug/gene delivery platform is urgently needed. Numerous novel drug delivery devices for siRNA distribution were being created to address the main challenges preventing siRNA's therapeutic potential. In the present review, we summarise the recent advancements in the nano-based drug delivery systems for siRNA delivery. Additionally, the innovative nanomedicines used for cancer therapy would be addressed. This study comprises a vast variety of siRNA drug delivery systems established in vitro and in vivo for improved intracellular delivery and selective gene regulation and addresses their features and possibilities for functional siRNA medical applications.

We have earlier reviewed both etiopathogenesis along with therapy of both type1 diabetes mellitus (DM) (T1D) as well as (T2D) thoroughly along with advances in therapy. Despite that, there is no permanent cure and with the growing epidemic of obesity and thus the parallel enhancement of worldwide prevalence. Extracellular vesicles(ECV) by definition are physiologically bilayer vesicles that carry bioactive receptors, lipids, proteins as well as nucleic acids which cross-react with target cells, driving the modification of target cells. Maximum cells liberate ECV as well as recently have been shown to not only work as promising biomarkers for the disease but work as therapeutic agents for some diseases. ECV represent a heterogeneous population of small membrane vesicles (30-2000nm) liberated from various types of activated or apoptotic cells. In view of their ability of carrying out cell-cell communication , lot of significance has been given to them regarding their role as biomarkers or as utilization for therapy by trying to overtake cell-based therapy. DM T1D or T2D both if uncontrolled for long have the potential of causing a lot of complications like kidneys, cardiac, neuronal, eyes, feet problems ending with chronic end-stage kidney disease, blindness, stroke, myocardial infarction (MI) , erectile dysfunction, diabetic foot ulcers and gangrene , hence some permanent methods are sought to cure these. Here we conducted a systematic review utilizing the MeSH terms; Type1Diabetes mellitus; T2D; stem cells sources for DM therapy; exosomes; Extracellular vesicles; treatment potential in DM by utilizing the search engine Pubmed, Google Scholar, Web of science, Embase, Cochrane review library from 2000 to 2020. We found a total of 550 articles out of which we selected 128 articles for this review. No meta-analysis was carried out. Here we have tried to discuss the details of what are EVs, how they can be obtained, their contents, mechanism of actions in curing diabetes along with its complications like diabetic wound healing, diabetic retinopathy, diabetic nephropathy, stroke, diabetic peripheral neuropathy along with diabetic foot ulcers, erectile dysfunctions. Further the place clinically in trials we have reached in utilizing clinically as well as challenges faced in translation as well as bulk generation, methods utilized for their preservation. Hopefully, these will be overcome gradually and soon can get translated into clinical medicine.

Non-steroidal anti-inflammatory drugs (NSAIDs) disrupts mucosal defense through inhibition of cyclooxygenase (COX) and depletion of endogenous prostaglandins, thus exerts its adverse effects. Tea flavonoids; catechins and its derivatives, in particular, are known to prevent various systemic diseases like ulcer, cancer, atherosclerosis, hypertension, and diabetes that occur due to oxidative stress. Green tea is the most abundant source of catechins and its derivatives. In the present study, we aimed to determine the dose dependent toxicity of conventional NSAIDs, indomethacin on cultured AGS cells using MTT assay and morphological deformities by DAPI and acridine orange/ethidium bromide (AO/EtBr) fluorescence staining where aqueous extract of green tea (aGTE) provided significant protection. In the future, aGTE will be useful in designing and development of a novel protective supplement against NSAIDs that have reduced gastrointestinal toxicity while maintaining their essential therapeutic efficacy to inhibit pain and inflammation.

This paper explores how nonverbal cues can be utilized to maximize health communication among the youth in Zimbabwe. This study concludes that non-verbal cues are essential part of health information dissemination on behavioral change among the society at large. They complement verbal communication, allow easy presentation of information create an attractive presentation through the use of gestures and facial expressions that make the presentation more interesting as well as making the message easy to understand. Health communicators have a unique opportunity to provide meaningful input in improving and saving lives in the wake of such life threatening diseases such as HIV/AIDS and Covid 19 health pandemic in public health campaigns. Including how people think about and respond to health issues such as HIV and AIDS. The ways in which health communication can be effected in the public health sector are so many in such a way that this paper will not suffice to give justice to all of them. It will mainly focus on how non-verbal communication can be utilized in health practices for higher returns and favorable health outcomes. Research findings show that it is an important source of self- motivation and concentration for health officers and their clients as well as a tool for maintaining attention within the public. This shows that the issues of non-verbal communication go beyond being simple a means of communication to being a more complicated tool to that can be used to help disseminate essential health information. The study is qualitative in nature and used the interview and observation research instruments to solicit data from research participants. The research participants were purposively selected.

Neuroscience is not a stand-alone discipline. The brain interacts with outside environment at different depths of nature. Neuroscience is embedded in cognitive science, which in turn is embedded in cosmology and astrophysics. Science of various information-states is the key to go about their operation. Five different areas have been specified with innovative ideas and review of presently available knowledge in the literature namely, cognition, behavior, dark energy, consciousness and layers between signal and consciousness. On the basis of these ideas several research questions and research statements have been made. What is in demand is innovative technology in addition to existing neuroimaging techniques and computational neuroscience; for example, new clinical skill for cognitive analysis, brain inter-netting, a kind of mechanization mimicking ‘psyche’ that runs by not force, energy or field, but by means of ‘will’ and intention, a technology that could harness dark energy as visible energy and another new technology that could help healing. All said and done, this is the time to change the way we look into the brain and penetrate into the depth of neuroscience to analyze the brain, cognition and behavior in the context of the multiversal whole.

Background: Metabolic syndrome (MetS) is a combination of risk indicators that appear to promote the development of chronic diseases. It is also described as a group of risk factors that increase the chance of having heart disease, diabetes and stroke.

Purpose: The purpose of this study was to compare the consequences of MetS among adult Whites, African Americans and Hispanics aged 40 years or more.

Methods: The proposed study used data abstracted from the National Health and Nutrition Examination Survey (NHANES) 2015-2016. The following variables were utilized: sociodemographic data (age, gender, marital status, educational level and household income); the criteria for MetS diagnosis (levels of blood pressure, fasting plasma blood glucose, blood triglyceride, HDL-cholesterol, and waist circumference); and the consequences of MetS (coronary heart disease, heart attack, stroke, breast cancer, prostate cancer, diabetes and prediabetes, overweight and obesity). The data were analyzed using SUDAAN software (RTI international, INC., Research Triangle Park, North Carolina). The relationship of MetS and its individual components to the consequences of MetS was compared among the three ethnic groups using chi-square and t-tests. The level of significance was 5%.

Results: The findings demonstrated that participants who were diagnosed with MetS criteria are more likely to have higher risk of the following consequences: Diabetes and prediabetes, overweight and obesity. The findings show that of all the ethnic groups evaluated, those who had high blood glucose levels were significantly more likely to be diagnosed at risk of diabetes and obesity.

Conclusions: Diabetes/Prediabeteswere found (considering the sentence-has a high association with high waist among Whites, African Americans and Hispanics. There is an assassination between high waist circumference levels and overweight/obese among all ethnic groups.

Granthi is term christened for benign lesions by Sushruta in his treatise, various types of Granthi can be cited in the text. Among them, raktajagranthi is a form which is congenital form of swelling wherein vascular malformation is the cause. A case of raktajagranthi which can be correlated to Haemangioma is being discussed in this article

Curcumin, the polyphenolic pigment from turmeric has excellent therapeutic potential but due to poor aqueous solubility and metabolic instability, it has not yet been possible to use it as a drug. Structural studies have revealed that depending upon ambient pH, curcumin can remain in keto- enol tautomeric forms. The keto form is generated at acidic pH and due to the presence of the β-diketone motif in the molecule, the methylene group gets activated and can donate a hydrogen atom to reactive oxygen species which is responsible for its anti-oxidative properties. The enol form of curcumin which is present at alkaline pH becomes a planar molecule due to extensive delocalization of electrons from one aromatic ring to the other through the pi orbital of C=C bonds in the heptadione linkage. At alkaline pH, curcumin gets degraded to smaller molecules which have interestingly been shown to have therapeutic activity. Molecular interaction studies have identified the methylene group in the β-diketone domain and the methoxy as well as the phenoxy group on the aromatic rings of curcumin molecule to be the contact points with enzymes and signaling molecules and may be involved in inactivating them. The bioavailable forms of curcumin cited in this review have been formulated using curcumin entrapped or bound to polymeric nanoparticles, liposomes, phospholipid complexes,nanoemulsions, or polymeric micelles and have been tested against chronic inflammatory conditions in animal models or cell lines.

NadiVrana is a condition analogous to sinus which usually develops due to inappropriate or incomplete care of an abscess leading to track formation. In this case, we present Iatrogenic sinus not just single but multiple born out of the incomplete drainage of gluteal abscess which was resultant of a complication of intramuscular injection. Sushruta was the foremost author who scripted the details of this condition in his treatise narrating the various etiological factors and also its Therapeutical modalities.

Forensic nursing is being practised in many countries of the world and with the pandemic of COVID-19 like other branches in the medical field forensic nursing practice is also being affected by this pandemic due to the fear of getting this disease. Clients of forensic nurses are too afraid of coming to the health facilities to avoid getting the infection by SARS-CoV-2. In this paper effects of this pandemic on the trends of forensic nursing practice in this COVID-19 era are being discussed along with the measures which should be taken so that there is no reduction in the clients seeking forensic nursing care. How forensic nursing education is changing in the era of COVID-19 pandemic and how forensic nursing education is coping up to keep the education process intact so that forensic nursing education is not affected or least affected by this pandemic is also being highlighted.

Methotrexate (MTX) is used as a DMARDs for some autoimmune illnesses, inclusive of rheumatoid arthritis, juvenile dermatomyositis, psoriasis, psoriatic arthritis and plenty of sorts of vacuities. Low-dose, weekly MTX (10 to 25 mg/week) used as both monotherapy or in mixture with other drugs, has an advanced efficacy profile as defined in placebo-managed trials and comparable efficacy to different medicines which include anti-TNF remedy. Patients suffering from rheumatoid arthritis (RA) may have some comorbid conditions that require a combination of a lot of medicinal drugs. For these comorbidities, prescription show polypharmacy and these medicines may additionally regulate the efficacy or growth of the toxicity of methotrexate (MTX). Interactions among drugs (DDIs) among the prescribed drugs are the reason behind the ADRs and these adverse effects are commonly seen in the aged patients (above 65) due to poly-pharmacy in prescription. In truth, poly-therapy boom the complexity of the therapeutic management and thereby the risk of a clinically applicable drug interaction. In this review, we report the interactions between MTX and the other tablets commonly used in the control of rheumatoid arthritis. The usage of google scholar, PubMed, PCM, NCBI website and reference lists. we studied the study material posted until 2019 and file the most common drugdrug interaction founds in the prescription of RA patients treating with MTX. In the context of a cure for MTX and NSAIDs like COX-1, COX-2 inhibitor, and among glucocorticoids or immunosuppressive medicinal products e.g., azathioprine, and cyclosporine, clinically important DDIs are identified. DDIs play a major role in both the production of ADRs and therapeutic failure in the treatment of MTX and specific medications

Bee venom is commonly used for treating ailment including pain and tumor. There are various investigations concerning melittin in terms of tumors treatment or antitumor activity. Melittin consists of 26 amino acid residues, mostly with hydrophobic or at least uncharged side chains, except for the C-terminal region, and the principal function of melittin as a component of bee venom is to cause pain and destruction of the tissue of intruders that threaten a beehive. There are various shreds of evidence regarding the effect of melittin on cancer or tumor cells. The aim of this review study was to investigate the effects of melittin on breast cancer. Studies with inclusion criteria from 2016 were included in this study. The second reason for death in women is breast cancer. The development of breast cancer is a multi-step process involving multiple cell types, and its prevention remains challenging in the world. By various biochemical and molecular mechanisms, Melittin could lead to a reduction of tumor size, prevention of metastasis, and in some cases cancer treatment. It was particularly significant cytotoxicity on damaging breast cancer cells. Some pieces of evidence also suggested that for diminishing the hemolytic and allergic reactions and fulfilling the efficacy of treatment outcome combine melittin with nanoparticles or chemotherapeutic agents. Melittin has positive effects on several types of cancer, such as renal, lung, liver, prostate, bladder, breast, thyroid, and melanoma. However, it should not be underestimated that most studies are in vitro and in vivo; therefore, more randomized control trials are required.

SARS-CoV-2 which is the causative agent of COVID-19 is a single-stranded RNA virus, commonly spread by respiratory droplets and human-to-human contact. The COVID-19 pandemic has compromised the eating habits of individuals making them vulnerable to food insecurity and triggering eating disorders in individuals at risk of these disorders causing severity or relapse.Extreme quarantine measures because of the COVID-19 pandemic have also contributed to the increase in the severity of eating disorders and altered eating habits. Thus, we review the implications of COVID-19 on eating habits. This study would serve as a foundation for further research on Covid-19 and its implications on healthy eating habits.

Previously published study has demonstrated that stress in the plasma membrane can contribute to the mechanical activation of mechanosensitive channels (e.g. BK_Ca), though the possibility for the involvement of ancillary proteins in the activation cannot be ruled out. However, the activation of BK_Ca channel is unclear. The reviews have provided an important mechanism.

The aim of this paper was to observe the influencing socioeconomic variables in enhancing the obesity and heart disease simultaneously among Bangladeshi adults of 18 years and above. The adults were interviewed from different urban and semi-urban diagnostic clinics by some nurses with the help of medical assistants working in the clinics when the adults were visiting the clinics for suggested blood test. The number of investigated adults was 995, out of which 51.1% were males. The percentage of obese adults was 30.2 and heart problem was prevailed among 21.7% of them. These latter groups of adults were classified by levels of different socioeconomic variables to observe the association of the variables with the prevalence of obesity-heart disease. The risk ratio for this prevalence for a particular level of socioeconomic variable was calculated along with confidence interval of risk ratio. The influencing variable for the prevalence of obesity-heart problem was detected by logistic regression analysis. The responsible variables were residence, gender, age, family income, smoking habit, sedentary activities and blood pressure. However, non-involvement in physical labour, habit of taking process food and family expenditure were significantly associated with prevalence of obesity-heart disease. The higher risk of prevalence of obesity –heart disease was noted among urban residents, housewives, adults of ages 40-60 years, smokers, process food consumers and among hypertensive adults.

Coronavirus disease (COVID-19), the infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has generated a public health crisis all over the world. The sequels this pathologies cause need considerations and Physiotherapy treatments have shown to be effective. Although there is not a gold standard treatment, Physiotherapy should be included into the multidisciplinary medical team for the restoration of these patients.