Knee osteoarthritis (KOA) is a chronic degenerative joint disorder that significantly impairs mobility and quality of life. While surgical interventions such as total knee arthroplasty (TKA) are effective in severe cases, conservative treatments are critical for early and intermediate disease management. This review evaluates the efficacy, safety, and clinical applications of both conservative and surgical treatment approaches, including lifestyle modifications, physical therapy, pharmacological interventions, regenerative medicine, and surgical procedures. The integration of a multidisciplinary approach is emphasized as a key strategy for optimizing clinical outcomes and tailoring interventions to disease severity.

Stigma surrounding drug addiction remains a critical barrier to effective treatment, significantly influencing healthcare access, patient engagement, and recovery outcomes. This study explores the multifaceted impact of stigma on individuals seeking help for substance use disorders (SUDs), with a focus on healthcare-related discrimination, internalized stigma, and structural barriers. Research indicates that negative perceptions among healthcare providers contribute to delayed treatment-seeking behaviors, reduced adherence to medication-assisted treatment (MAT), and increased relapse rates. Additionally, patients internalizing these societal judgments experience heightened psychological distress, social isolation, and decreased self-efficacy, further hindering their recovery process. To address these challenges, evidence-based strategies such as addiction medicine education, trauma-informed care, harm reduction approaches, and peer support models have been shown to effectively reduce stigma and improve treatment outcomes. Hospital administrators and nursing leaders play a critical role in fostering a culture of empathy, advocating for the reframing of addiction as a neuro-psycho-biological disease rather than a moral failing. Future research should explore digital mental health interventions, motivational interviewing techniques, and interdisciplinary collaboration to further dismantle stigma and enhance the effectiveness of addiction treatment programs. This study highlights the urgent need for systemic policy changes, targeted educational programs, and a shift in clinical attitudes to create a more inclusive and stigma-free healthcare environment. Through implementing these approaches, healthcare providers can ensure equitable access to treatment and improve long-term health outcomes for individuals with opioid use disorder (OUD) and other substance-related conditions.

Marcus Gunn syndrome or unilateral trigemino-oculomotor syncinesis is a very rare autosomal dominant genetic disorder characterised by a combination of congenital ptosis and mandibulopalpebral syncinesis during certain mandibular movements. We report a series of two cases of children with Marcus Gunn syndrome. Case 1: A 5-year-old boy with no previous pathological findings presented with unilateral ptosis of the left upper eyelid at the age of 4 months. His visual acuity was 10/10 in right eye on the right and 5/10 in left eye. Second case: a 7-year-old girl, brought in by her parents for a ptosis of the left eye noted at birth. This is a 7-year-old girl brought in by her parents for ptosis of the left eye, diagnosed at birth. She had no particular pathological antecedents. Her visual acuity was 10/10 in right occlusion and 3/10 in left occlusion. Both children had undergone sectioning of the superior levator muscle with frontal suspension using prolene sutures, with good progression, followed by total optical correction and treatment of the amblyopia.

Digital therapeutics (DTx) are emerging as a pivotal tool in promoting longevity by addressing non-communicable diseases (NCDs) such as diabetes, cardiovascular diseases, and mental health disorders. These software-driven interventions offer personalized, evidence-based treatments that can be accessed via digital devices, making healthcare more accessible and scalable. One of the key advancements in DTx is the integration of artificial intelligence (AI) and machine learning (ML) to tailor interventions based on individual health data. This personalization enhances the effectiveness of treatments and supports preventive care by identifying risk factors early. The need for digital therapeutics is underscored by the rising prevalence of NCDs, which are responsible for a significant portion of global mortality and healthcare costs. Traditional healthcare systems often struggle to provide timely and personalized care, especially in low-resource settings. DTx can bridge this gap by offering cost-effective solutions that are easily scalable. Moreover, digital therapeutics can address health inequities by providing low-cost interventions to underserved populations, thereby reducing the burden of NCDs and improving overall health outcomes. As technology continues to evolve, the potential for DTx to enhance longevity and quality of life becomes increasingly promising. Recent advancements in longevity medicine and technology have focused on extending both lifespan and healthspan, ensuring that people not only live longer but also maintain good health throughout their extended years. This review article highlights these advancements that are contributing to this compelling subject of Longevity.

Recent advancements in the screening, diagnosis, and management of obstructive sleep apnea (OSA) have significantly improved patient outcomes. For screening, the use of home sleep apnea testing (HSAT) has become more prevalent, offering a convenient and cost-effective alternative to traditional in-lab polysomnography. HSAT devices have shown good specificity and sensitivity, particularly in patients with a high pre-test probability of OSA. In terms of diagnosis, advancements in wearable technology and mobile health applications have enabled continuous monitoring of sleep patterns and respiratory parameters. These tools provide valuable data that can be used to identify OSA more accurately and promptly. Additionally, machine learning algorithms are being integrated into diagnostic processes to enhance the accuracy of OSA detection by analyzing large datasets and identifying patterns indicative of the condition. Management of OSA has also seen significant progress. Continuous positive airway pressure (CPAP) therapy remains the gold standard, but new developments include auto-adjusting CPAP devices that optimize pressure settings based on real-time feedback. Mandibular advancement devices and hypoglossal nerve stimulation are emerging as effective alternatives for patients who are CPAP-intolerant. Furthermore, lifestyle interventions such as weight management, positional therapy, and exercise have been shown to complement medical treatments, leading to better overall outcomes. This review article highlights these advancements that collectively contribute to improved patient adherence, reduced symptoms, and enhanced quality of life for individuals with OSA.

Digital therapeutics (DTx) play a transformative role in diabetes management by leveraging technology to provide personalized, data-driven medical interventions. These tools enhance self-management by offering continuous monitoring and real-time feedback on glucose levels, diet, and physical activity. This personalized approach helps patients adhere to treatment plans and make informed lifestyle changes, leading to improved clinical outcomes such as reduced HbA1c levels and better overall diabetes control. The importance of DTx lies in their ability to make diabetes care more accessible and convenient. Mobile apps and telemedicine platforms enable patients to receive support and guidance from anywhere, reducing the need for frequent in-person visits. Additionally, DTx often include behavioral support features like reminders, educational content, and motivational tools, which are crucial for maintaining healthy habits and managing stress. Currently, the dynamics of DTx in diabetes are rapidly evolving, with increasing integration of artificial intelligence and machine learning to further personalize and optimize care. As the adoption of these technologies grows, they hold the potential to significantly improve patient outcomes and revolutionize diabetes management on a global scale. This article will focus on the benefits of novel digital therapeutics for prevention and management of type II diabetes that are currently available in the market.

Objective: This study examines racial disparities in educational outcomes—including reading proficiency, grade point average (GPA), school discrimination, and school disciplinary actions—across regions with different levels of educational childhood opportunity index (COI). Our aim is to explore how these racial gaps between Black and White students vary in areas with differing educational opportunities. We hypothesize that higher COI is associated with smaller academic achievement gaps but may also correspond with greater racial bias in unfair school treatment. Methods: Data were drawn from the Adolescent Brain Cognitive Development (ABCD) study, which provides comprehensive measures of educational outcomes, cognitive performance, and COI. National COI rankings were used to classify regions into five categories: very high, high, average, low, and very low educational opportunity. We analyzed racial gaps in reading proficiency, and experiences of discrimination and suspension across these COI categories. Multi-group Structural Equation Models (SEM) were used to assess how the relationship between race and educational outcomes varies across COI levels. Results: Our findings confirmed that Black-White gaps in reading proficiency and cognitive test performance (Flanker task) were less pronounced in regions with higher COI. However, racial disparities in school disciplinary actions and experiences of discrimination were more pronounced in higher-opportunity areas. Specifically, the effect of Black race was stronger in regions with the highest COI, where Black students experienced a disproportionately higher rate of unfair school treatment, including both school discrimination and suspensions, compared to their White peers. Conclusion: This exploratory study supports that while higher educational opportunities are associated with smaller academic achievement gaps between Black and White students, they might be linked to increased racial bias in school disciplinary actions and discriminatory treatment. These findings underscore the complexity of educational equity, suggesting that improving access to quality education alone is insufficient to eliminate racial disparities in school experiences. Addressing school-based bias and discrimination must accompany efforts to enhance educational opportunities.

Drug shortages represent a significant and growing challenge within the pharmaceutical supply chain, with profound implications for patient care, public health, and healthcare costs. This manuscript provides a comprehensive examination of the causes and impacts of drug shortages, highlighting the multifaceted nature of this issue. Key factors contributing to shortages include manufacturing complications, limited availability of active pharmaceutical ingredients (APIs), market dynamics that discourage the production of less profitable medications, and regulatory challenges that slow down the approval process for new manufacturing capacities. The consequences of these shortages are far-reaching. Patients often face treatment delays, which can lead to adverse health outcomes, increased hospitalization rates, and even mortality. Healthcare providers experience heightened operational costs as they seek alternative therapies and manage complications resulting from inadequate treatment. Furthermore, the frequent occurrence of drug shortages erodes public trust in both the healthcare system and the pharmaceutical industry, leading to decreased patient adherence to prescribed therapies. To mitigate the impacts of drug shortages, this manuscript proposes several strategic solutions, including enhanced communication among stakeholders, diversification of supply sources, increased regulatory flexibility, and collaborative approaches between public and private sectors. Additionally, raising awareness among healthcare providers and patients regarding the causes and potential alternatives can empower stakeholders to navigate shortages effectively. Ultimately, addressing drug shortages necessitates a proactive and coordinated effort from all participants in the pharmaceutical supply chain. By implementing these strategies, stakeholders can enhance the resilience of the supply chain, ensuring that essential medications remain accessible and that patient care is not compromised. The findings of this manuscript underscore the urgent need for ongoing vigilance and collaborative action to tackle the challenges posed by drug shortages, safeguarding public health and improving healthcare outcomes globally.

Stroke and its disability have deserved the notoriety of a severe and potentially lethal condition, whose treatment is still challenging. The widely craved result of saving as much as possible from the neural tissue and eventually reviving what is thought to be in the ischemic penumbra – if not already dead and gone – is the outcome every clinician is dreaming of. There are several reviews on the issue, which have discussed several options of achieving neuroprotection in acute ischemic stroke. Of course, reviews are not and do not pretend to be exhaustive; new drugs enter repeatedly in the scene. We would limit our comments on some of the pharmacological agents, that although seem to be worldwide available, are still looking for obtaining the citizenship in the therapeutic armamentarium of acute ischemic stroke.

This case report describes a postoperative complication following laparoscopic lateral suspen-sion with mesh for the treatment of pelvic organ prolapse (POP) in a 67-year-old woman. The pa-tient initially presented with grade III anterior vaginal prolapse and grade IV apical uterine pro-lapse. A laparoscopic lateral suspension procedure was successfully performed, and the patient was discharged on postoperative day two without complications. However, two weeks later, she experienced pelvic discomfort, and examination revealed a recurrence of the prolapse due to the failure of the right lateral arm of the mesh. The mesh was successfully reattached via a second laparoscopic procedure, and the patient had an uneventful recovery. This case highlights the po-tential for mesh dislocation postoperatively, underscoring the importance of secure mesh attach-ment to prevent recurrence of prolapse.

The purpose of this study was to assess different periodontitis groups affected with mild, moderate and severe alveolar bone levels and treated using the Sandwich’s procedures. A total of 53 subjects, who had taken two sets of full-mouth standarized paralleling radiographs with mean observation time was 10.18±3.89 years and (ranges: 5.1 to 18.3 years) were collected for the past 20 years. The radiographic alveolar bone levels (RABL) at mesial and distal aspects of teeth were assessed by measuring the distance between cemento-enamel junction (CEJ) and the bone crest using an electronic digimatic caliper (EDC) under 7.5 magnified radiographs. The patients, who presented with SAP, were between 24 and 84 years of age, with a mean age of 54.8±10.2years. Although, the treatment of angular defects in molars with guided tissue regeneration, emdogain has been reported and has exhibited significant and predictable results, however, afforded very limited and less predictable results in the treatment of advanced class II and III maxillary furcation defects. The majority of root resection procedures are commonly recommended for treating advanced molar furcation, in particular located at molars with class III furcation involvement, there is still some controversy regarding the long-term prognosis after different treatment modalities. In general, the root resection procedure is a surgical approach for simultaneously performing a periodontal flap operation at first and followed by the amputation and/or resection of maxillary root(s). There are some complications and disadvantages, such as post-operative pain and bleeding, swelling, infection, etc. The present report is to describe the combination of therapeutic provisional prosthesis (TPP), fixed prosthesis, non-surgical procedure using root separation and/or resection (RSR) and for the treatment of advanced Class II and III furcation-Involved molars. In addition, evidenced-based clinical trials of retrospective and longitudinal data were also prescribed here. The purpose of this study was to present treatment procedures of Sandwich’s technique and retrospectively to evaluate the long-term clinical trials of this method in treating molar teeth with SAP and molar FI who were diagnosed as guarded and/or hopeless prognosis.

Costus afer, a known medicinal plant used in the removal of total monocyclic aromatic hydrocarbon (TMAH) in crude oil-contaminated soil add to the list of plant that has the potential to restore the soil quality. This study investigated the potential of Costus afer plant at various ages (7, 14, 21, 28, 35, and 42 days old) to biodegrade crude oil-contaminated soil. The group-balanced block design (GBBD) was used in establishing the experiment. TMAH was quantified by the standard method, according to USEPA method using gas chromatography-mass spectrometry (GC-MS). The contamination of 48kg of sandy loam soil was simulated by mixing 0.5, 1.0, and 1.5L of Bonny-Light crude oil with the soil in three separate vessels to achieve conditions of low (C₁), medium(C₂), and high(C₃) contamination, respectively. An additional vessel with medium-level contaminated soil but no treatment (C₄) served as the control. The Costus afer plants were nursed and transplanted at the stated ages to each vessel except the control. Controlled irrigation was applied, and the setups were housed to shield them from rainfall. After 90 days of treatment, results showed that the 7 days old Costus afer plants produced the highest amount of TMAH reduction of 96.5, 39.8, and 32.1%, for C₁, C₂ and C₃, respectively, while the control (C₄) was 9.45%. Furthermore, the sequence of TMAH reduction by the plants was 7 days old, 14 days old, 21 days old, 28 days old, 35 days old, and 42 days old. Thus, in addition to its medicinal value, Costus afer plant also has the potential to biodegrade TMAH in crude oil-contaminated sandy loam soil.

Myeloproliferative neoplasms (MPNs) are hematological disorders affecting myeloid stem cells. They are classified as Philadelphia (Ph) chromosome positive-chronic myeloid leukemia, and Ph-negative polycythemia vera, essential thrombocythemia, primary myelofibrosis, chronic neutrophilic leukemia, chronic eosinophilic leukemia, juvenile myelomonocytic leukemia, and MPN unclassifiable. This review is mainly focused on the Ph-negative MPNs namely, PV, ET, and PMF. These affect both males and females with a slight male predominance, with patients mainly presenting in the seventh decade. Patients often present with thrombotic events resulting in complications that lower survival rates. The major driver mutations that have been identified in MPNs are JAK2 Exon 14, JAK2 Exon 12, MPL Exon 10, and CALR Exon 9. The importance of these driver mutations gives due recognition to their inclusion into the 2022 diagnostic criteria of the MPN WHO Classification. However, other non-driver mutations have also been reported, especially in triple-negative cases. These mutations lead to downstream constitutive activation of the JAK/STAT signaling pathway, as well as the MAPK, and PI3K/Akt pathways. Insights into the molecular pathogenesis of MPN and its association with JAK2, CALR, and MPL mutations have identified JAK2 as a rational therapeutic target. Thus, as an approach to MPN therapy, JAK2 inhibitors, such as ruxolitinib, have been shown to effectively inhibit JAK2, and are currently in clinical trials in combination with other drug classes. This review comprehensively examines the molecular markers of the main Ph-negative MPNs, as well as diagnosis and treatment options.

The aim of the present study was to assess the cumulative radiographic periodontal attachment loss (CRPAL) and annually radiographic periodontal attachment loss (ARPAL) of different disease groups over 5 years or more. A total of 53 subjects, who had taken two sets of full-mouth standarized paralleling radiographs with separated periods of 5 years or more in teaching hospital during 1981-2001, were collected for the past 20 years. The radiographic periodontal attachment levels at mesial and distal surfaces of teeth were assessed by measuring the distance between cement-enamel junction and the bone crest using an electronic digital caliper (EDC) under a 10X magnified radiographs. The results revealed that mean CRPAL was highest in the generalized aggressive periodontitis (GAgP) group (-5.523.27 mm), then the chronic periodontitis (CP) group (-4.823.47 mm), and the localized aggressive periodontitis (LAgP) group (-4.473.47 mm) followed, and lowest in the periodontal healthy (PH) group (-1.050.59 mm). The mean ARPAL was highest in the LAgP group (-0.260.25 mm/yr.), then the GAgP group (-0.200.13 mm/yr.), and the CP group (-0.120.09 mm/yr.) followed, and lowest in the periodontal healthy group (0.070.06 mm/yr.). Conclusions showed that mean CRPAL was highest in the generalized aggressive periodontitis group, then the CP group, and the LAgP group followed, and lowest in the periodontal healthy group. In addition, there existed a strong statistical significance (p<0.0001) in both CRPAL and ARPAL (mm) among individuals affected GAgP, LAgP, CP, and PH groups among mild, moderate, and severe periodontitis using paired t-test.

Delirium is a major complication most commonly observed in patients with advanced cancer. However, despite its prevalence, the early diagnosis, management, and prevention of this condition have not seen significant progress. Aim of this research is to provide insights into the prevalence of delirium, the optimization of interventions for managing delirium symptoms, their effectiveness and the impact of underlying factors on the reversibility of delirium in advanced cancer patients receiving palliative care. The review involved systematic searches of relevant databases including MEDLINE, CINAHL, ProQuest Nursing and Allied Health, and PsychInfo using refined search terms. Eight publications out of 614 studies originally searched were selected and critically reviewed. Their quality was assessed using Joanna Briggs Institute's Critical Appraisal Tool for Case Series. Data abstraction and content analysis were performed to synthesize the findings. Delirium is prevalent among advanced cancer patients in palliative care, with rates ranging from 10.3% to 24.1%. Pharmacotherapy and non-pharmacological interventions showed effectiveness in reducing delirium symptoms. Delirium was found to be reversible through palliative care interventions, antipsychotic medications, and exercise therapy. Effective delirium management is crucial in improving the quality of life of cancer patients. This review emphasizes the importance of subtype-specific treatments, standardized guidelines, and long-term follow-up studies. Implementing evidence-based individualized approaches to delirium management can optimize treatment efficacy and clinical outcomes in patients as well as improve the quality of care. Tailored interventions, standardized protocols, and further research are hereby recommended.

The growing unconcern and poor attitude of some Ghanaians towards environmental protection and sanitation practices has become very endemic in Ghanaian Societies. Littering especially is considered a major environmental problem within the setting of this study. This study employed the mixed-method approach in integrating qualitative and quantitative research data. The study adopted a convergent parallel research design. The population for this study consisted of all teaching staff and students of Sefwi Wiawso Senior High Technical School and St. Joseph Catholic Senior High School in Sefwi Wiawso municipality in the Western North Region of Ghana. Purposive, simple random, and convenient sampling techniques were used to select the schools, teachers and students for the study. A sample size of one hundred and ninety-eight (198) consisting of one hundred eighty-eight (188) students and ten (10) teachers were selected for the study. The two main instruments used for data collection were questionnaires and interview guides. The quantitative data obtained from the questionnaire were coded with numerical values and keyed into the data view of the SPSS version 23. The qualitative data was analysed through content analysis and was further transcribed into themes for analysis with a side-by-side comparison with the quantitative data. The qualitative data gathered and presented, were organised and analysed manually using emerging themes. The study revealed that littering is currently caused by irresponsible behaviour among some staff and students coupled with other factors such as lazy attitudes among people, inadequate waste bins on campus, and more seriously, less sensitization of people on littering in the various senior high schools. The study also indicated that provisions of adequate waste bins at vantage points in the various campuses, awarding prizes to individual students and groups with good waste management practices on campus, implementing rules and regulations on littering, as well as educating, and sensitizing students and staff on littering on campuses formed the possibilities on how schools can shape up staff and student’s attitudes towards healthy environment by avoid littering. It is recommended that Students with good waste management practices should be rewarded to encourage others in Senior High Schools. It is also recommended that sustainable waste management practices (collection, transportation, and treatment) should be employed in all the Senior High Schools across the country.

The digital drug traceability systems ensure the patient-centric dose, dosage form, and strength delivered to the patient as intended in the supply chain. It helps the digital healthcare platforms securely establish drug information supplied to patients for potential treatments. Therefore, it is important for the global supply chain to explore the number of high-end digital health solutions and drug traceability to create an interactive loop on drug security for patients. This article provides an overview of advanced technologies for digital drug traceability, such as blockchain, that would establish a secure pharmaceutical supply chain for the digital world.

Thanks to their interesting mechanical properties, recyclability and low production costs, plant fiber-reinforced composites, derived from agricultural residues, are of particular interest to both manufacturers and scientists looking to incorporate new environmentally-friendly and biodegradable materials to replace synthetic fibers, particularly glass fibers. The growing use of these composites in fields such as the automotive, construction and building industries, and soon in aeronautics, raises concerns about the reliability of the structures with which they are manufactured. This reliability must be guaranteed at the design stage, by a good knowledge of the properties of the material used. In this case, for composites, it is necessary to know the mechanical properties of their constituents, fibers and matrix, etc. In this context, this paper focuses firstly on the economic and industrial recovery of Kenaf (K) and Date Palm (DP) fibers, and secondly on their incorporation as a reinforcing element in cementitious matrix composites, for subsequent use in non-structural applications. This research highlights the development of cementitious matrix bio-composites reinforced with this type of fiber, based on Taguchi's statistical methodology, in order to minimize the cost and number of tests. The bio-composites developed are then mechanically characterized under static loading in compression and 3-point bending after a 30-day drying period.

This experimental study was carried out to evaluate the effect of three selected pollinator-friendly practices on the African eggplant (Solanum aethiopicum) at Mankessim in the Central region of Ghana. The study focused on determining how the practices affect the production and yield of garden eggs. The three pollinator-friendly practices were the use of mulch, cassava hedgerow/marigold plants and controlled pesticide application in garden egg farms. Experimental-control group design was used. Mulching positively influenced the number of flowers, fruits and height of garden eggplants. Cassava hedgerow/marigold plants influenced the number of flowers, but had no significant effect on the number of fruits and plants’ height. There was no effect on the number of flowers, fruits, and height of garden eggplants when pesticide application was controlled or uncontrolled. No significant influence was observed in fruit weight in all treatment and control plots. The growth and yield trends observed in this research indicated that practicing the three pollinator-friendly practices may encourage flower visitors leading to effective pollination and increased yields. It is recommended that mulching be practised in garden egg farming to increase the growth and productivity of garden eggplants.

Calotropis procera, a medicinally important plant found in Asia, was explored for its anticancer and antibacterial properties in this study. The leaves of C. procera were extracted using methanol and FTIR and UV-VIS spectrophotometry were used to characterize them. Using the MTT assay and the disc diffusion test, the extract was examined for anticancer activity against the MCF7 breast cancer cell line and antibacterial activity against methicillin-resistant Staphylococcus aureus (MRSA). The methanolic fraction of C. procera was found to be efficient against the MCF7 cell line and dramatically suppressed MRSA growth. The metabolic fraction of C. procera leaves is important in suppressing the growth of the MCF7 cell line, and it has the potential to be an effective antibacterial agent, according to our findings. The implications of Calotropis procera for all healthcare professionals including oncologists, physicians, pharmacists, nurses, and nutritional therapists are significant. With the increasing incidence of cancer and antibiotic-resistant bacterial infections, there is a growing need for new, effective, and safer herbal treatments.

This study was conducted with beans to determine a protocol that will help reduce the cooking time of beans. It was carried out in the Foods laboratory at the University for Development Studies, Department of Family and Consumer Sciences. A quasi-experimental design was the design tool employed for this study to establish a cause-and-effect relationship between an independent and dependent variable where the independent variable is cooking time and dependent variable is softness of the beans. An experiment was carried out to text the effect of 2 different treatments given to beans during cooking to ascertain which treatment is best for reducing the cooking time for bean. The treatments meted out were addition of blended onion, crushed cassava and no additives. Addition of blended onion had a very significant effect in reducing cooking time with cooking time of 43minutes. Cooking beans with crushed cassava also saw some reduction in the cooking time for beans with 46 minutes. Cooking dry beans with no additive having the highest cooking time (47minutes). With quantity of water, the dry beans sample with crushed cassava used more quantity of water (3.4 liters). Cooking with blended onion and with no treatment both used 2.9 litres per 100grams beans each. The study therefore recommends that crushed onions are added to help reduce the cooking time of dry beans.

The present article seeks to provoke a discussion into how video games can be used in anxiety treatments and social stimulation tools among middle-year students and children of that same age. To do so, we initially start this article by reflecting on how the covid-19 pandemic disparate all anxiety alerts in our society including mental health issues such as depression and special anxiety disorders. Then we compare how the numbers of anxiety among children and young adults were already alarming before the lockdowns imposition and the social distance measures, especially in urban centers. This rising anxiety condition can be felt especially in the years that followed the social isolation of children especially because their social connection and recognition were just starting to grow and to establish important connections between their peers in-person and in virtual environments, throwing light on how to screen media and children`s homes are related with the anxiety increase and how we can investigate that phenomenon without succumbing to excessive positivism to today`s technology or to a deconstructive pessimism that leads us to distrust those media that are already in contact with middle-year students and children`s in that same age. To do so, we will resort to philosophical tools such as Edusemiotics and Cultural Studies to understand how games such as Minecraft and Roblox can be used in school environments to help students and teachers manage anxiety levels and surpass socialization issues past covid-19 lockdowns. To finish our reflection we also bring some data related to how those same media and games helped middle-year students to surpass social isolation and family disconnection during the pandemic while their kept exercising school content in those games, sharing and debating with their peers on virtual platforms.

As a result of the virus's global dissemination, novel COVID-19 infections have emerged as a significant obstacle for all healthcare professionals to overcome. Dental specialist plays an effective role in the prevention of coronavirus. Dental care units and settings face various problems relating to the transmission of disease during treatment and dental operations. Blood, saliva, and mixed water droplets possessing the virus cause contamination of equipment used for dental treatment. Both patients and workers may become transmitters and infectors of COVID-19 through direct contact during dental operations. Both dental workers and patients are likely to become infectors and transmitters of COVID-19. The dental care routine is very effective as we discussed below the prevention steps are very effective. All healthcare workers at the dentistry clinics, including nurses, should collaborate to prevent the spread of the COVID-19 virus among patients.

Background: Sexuality is considered to be one of the most significant markers of quality of life. This is due to the fact that sexuality is linked to ideas, feelings, behaviors, social integration, and therefore, a person's physical and mental health and well-being but with patients who have gynecologic cancers, there are significant challenges when it comes to matters of sexuality and intimacy. Aim: To find out how gynecological cancer affects women's sexual experiences and how they express sexuality in the context of their sickness Design: A qualitative synthesis, thematic approach Result: Nineteen (19) eligible studies centered with gynecologic cancers on sexual functioning were included with two (2) main themes emerged: (1) Issues with Sexual Experiences and (2) Physical and Emotional Burden. Many individuals were found to have one or more sexual dysfunctions, which commonly caused distress. Conclusion: Changes in the women’s quality of life in the sexual aspect due to their disease takes a toll not just on the physical but in other facets as well. Better knowledge and patient-centered approaches would improve gynecologic cancer patients' capacity to cope in terms of sexual functioning. Implications: Healthcare professionals such as oncology nurses and doctors should better understand ways to address the sexual problems of their patients following the myriad of events following their diagnosis and treatment of their gynecologic cancers.

Retinal detachments comprised of serious ocular conditions and can lead to permanent vision loss. When the retina, the neurosensory layer, detaches from the back of the eye, it loses its oxygen and nutrient supply leading to the death of the tissue. Immediate diagnosis and treatment are essential to avoid significant morbidity associated with this condition. In this mini review, we outline the evaluation and management of retinal detachments and highlights the role of the interprofessional team in evaluating and treating patients with this condition.

The study aimed at determination of the effect of intercropping maize and beans on the maize yields Isingiro Town Council, Isingiro District, South Western Uganda. The study used a randomized complete block (RCBD) experiment in which 8 treatments in 4 replicas of each to make a total of 32 sub-plots. Two rows of maize spaced at 4.5cm within rows and 90cm between rows were intercropped with two rows of velvet beans spaced at 30cm with rows and 90cm between rows. Two rows of NABE16 spaced at 4.5cm within rows and 75cm between rows were intercropped with maize a pacing of 5.5cm within rows and 75cm between rows. Rows of beans were separated from those of maize by 75cm in a 10m by 8m sub-plot. The experiment was conducted in two seasons (March to May 2020 and August to November 2021). Standard agronomical practices were followed from planting to harvesting, after which dry maize grain weight was taken and recorded. Data analysis was done using ONE WAY ANOVA in STATA version 13. Results show that the significant statistical difference in season one (p = 0.0000)** was higher than that in season two (p = 0.0211)*. The study concluded that unpredictable (too much or too little) rainfall negatively affects maize productivity. Early planting and application of organic fertilizers were recommended to improve maize productivity.

Background: Neck pain is one of the most common reasons patients seek treatment in the hospital. The causes of neck pain vary widely, trigger misdiagnosis, and often result in mistreatment. Misdiagnoses and mistreatment-related neck pain diagnoses are often associated with a diagnosis of cervical herniated disc. The implication of the misdiagnosis is the use of excessive investigations and inappropriate therapy. This review aims to determine the causes of neck pain often obtained in daily practice and how to diagnose and treat it. Method: Search relevant articles on clinical diagnosis of neck pain with the keywords neck pain diagnostic therapy using Medline and PubMed databases. Results: Neck pain can be in the form of axial pain, which is mostly related to disorders of the joints and muscles of the neck, or in the form of pain in the roots and spinal cord. Investigations and therapy must be related to the clinical diagnosis of neck pain experienced by patients with a history of neck pain. Conclusion: Neck pain is one of the most common complaints encountered in outpatient department settings, associated with reduced quality of life. Patients may come with differing degrees of pain, various symptoms, and aetiologies making it quite challenging to treat them into complete remission. Despite being frequently encountered, some patients with neck pain are underdiagnosed and undertreated due to failure to understand the clinical symptoms before deciding possible aetiologies.

Breast cancer is the most commonly diagnosed form of cancer in women. Several studies have shown the benefits of physical activity (PA) before and after treatment on the physical and psychological components of patients. Almost all of the studies mentioned are carried out on non-African patients over the age of 40. And no experimental studies have been carried out in young patients undergoing treatment for breast cancer. This is how we asked ourselves the question of whether a physical exercise program carried out on young Beninese women under the age of 30 undergoing treatment for breast cancer at the Saint Nicolas clinic in Porto-Novo could it have the same effects on their physical and psychological components? Our objective through this research is to study the potential effect of a physical activity program on the physical and psychological state in women under 30 years old (27±5.8 years) undergoing treatment for a breast cancer at the Saint Nicolas clinic in Porto-Novo. An experimental study was then carried out with 13 patients (very low rate of women in this section suffering from breast cancer) undergoing treatment throughout 2022 at the Saint Nicolas clinic in Porto-Novo. The experimental group followed a physical activity program consisting of aerobic and muscular exercises; over a period of 8 weeks. According to the data collected and the feedback from the patients, the physical activity program seems to have been beneficial for most of them. There is an improvement in the quality of life and the physical condition of the patients. In addition, the management of physical fatigue and psychological fatigue also seem to improve. There was also a marked improvement in the ability to concentrate and self-esteem. The physical activity program has improved the physical and psychological state of Beninese women with breast cancer

Even patients from developed nations have trouble staying on top of their drug compliance. When it comes to improper medicine use, there is an odd parallel between underdeveloped, emerging nations and the so-called developed world in the West. The key factor influencing whether patients stick to their treatment plan is their understanding and perception of the disease.

Objective: The study investigated the impacts of third molar (M3) extraction on periodontal status of adjacent second molar (M2) and oral health-related Quality of life (QoL). Methods: 272 cases with M3 were randomly divided into treatment group and control group, each of 136 cases. Questionnaire survey evaluated demographic features of the subjects. Gingival index (GI), plaque index (PLI) and conscious symptoms of adjacent teeth of the M3 were detected in both groups at baseline (T0), 1 week (T1), 1 month (T2) and 6 months (T3) after treatment. The impacts of QoL were evaluated using OHIP-14 to measure total scores and various items of OHIP-14 at different observation point. Results: The percentage of swelling and toothache in the treatment group was significantly lower than that in the control group at T1, T2 and T3. Significant differences could be seen in GI and PLI between the treatment and control groups at T2 and T3. The total score of OHIP-14 in T2 and T3 was significantly lower than that in T0 and T1 in the treatment group. The 14 items scores and the percentage of positive reaction in the treatment group were significantly lower than those in the control group at T2 and T3. Conclusion: M3 extraction had significant impacts on the periodontal status of the second molar and quality of life. This study would provide an important basis for the prophylactic removal of M3 in clinical work.

The liver is critical organ for metabolic homeostasis and toxic substance clearance and plays an important role in the systemic response to critical illness. Acute panreatitis (AP) progresses with a local production of inflammatory mediators, eventually leading to systemic inflammatory response syndrome. Knowing that almost all pancreatic mediators released from the pancreas to the blood stream may pass through the liver before their dilution in the systemic circulation, it would be reasonable to assume a determinant role of this organ in development of the inflammatory response associated with acute pancreatitis. Objectives: The study aimed to investigate the time courses of the effects of the exogenous glucocorticoids agonist dexamethasone on microscopical changes occurring in the liver of rats used as a model of AP induced by L-Arginine. Materials and Methods: 60 adult male albino rats weighing 150-200 gm were used. They were divided into 3 groups: Control group: Which is also divided into 2 subgroups (a & b) each of animals of the first were IM injected with 0.5ml/100gm B.W saline and those of second were injected by 0.5mg/100gm B.W dexamethasone. L-Arginine group: which received L-Arginine to induce AP. The animals of this group were divided into 3 subgroups a, b and c the animals of which were sacrificed 3 days, 2 weeks and 1 month after L-Arginine injection respectively. Dexamethasone and L-Arginine group: in which the animals were injected with both L-Arginine and dexamethasone. They were also divided into 3 subgroups a, b and c, the animals of which were sacrificed 3 days. 2 weeks, one month after the injection of the drugs. The liver of the scarified animals were dissected out and prepared for microscopical examination. Results: The histopathological changes that occurred in the livers of acute pancreatitis (AP) model animals started in the periphery of the classic hepatic lobules and progressively extended in a centripetal manner to involve all the cells of the lobules in the late period of the experiment. These changes were in the form of ballooning of the hepatocytes, progressive vacuolation of their cytoplasm most propably with fat globules and depletion of the PAS+ve glycogen granules. Injection of dexamethasone in AP model animals did not improve the case, but on the contrary it made the changes more intense, severe, and rapid. One month after injection of L-Arginine and dexamethasone, the hepatocytes all over the hepatic lobules were severely affected. They were markedly ballooned with severely vacuolated cytoplasm which was completely depleted from its PAS +ve glycogen granules, indicating severe fatty degeneration of the liver. Conclusion: From the previous data, it can be concluded that treatment of AP with dexamethasone is caused a late bad effect on the liver, where it causes its late fatty liver changes.

In this review proteins associated with tight junctions (TJs) is described with an emphasis on prostate cancer. Overall tight junctional proteins do not seem to play a decisive role in prostate carcinoma pathogenesis. Of TJ proteins, expression of some claudins show an association with clinical behaviour of the tumors. Claudin 1 expression appears to be related to a better prognosis partly due to its involvement in EMT abrogation. Claudin 3 and 4 are highly expressed in prostate cancer and their expression is associated with aggressive behaviour. Inhibition of claudin 8 promotes prostate carcinoma invasion and spread but studies are few. CPE has been known to bind to especially claudins 3 and 4 and cause cell lysis. Several experiments with modified CPE have been made in prostate cancer cell lines. Regardless of this effective CPE based human treatment for prostate cancer have not yet been developed.

Background: Multiple epiphyseal dysplasia (MED) a rare form of skeletal dysplasia with early-onset osteoarthritis affecting the hip and knee joints. There is paucity of evidence regarding the long term outcomes of arthroplasty in this patient cohort. This is the first study to describe the outcomes of bilateral arthroplasty of the hip and knee in patients with MED. Methods: A prospective study of patients with MED who underwent bilateral staged total hip arthroplasty (THA) and bilateral simultaneous total knee arthroplasty (TKA) between July 2013 to April 2014. Preoperative and postoperative clinical and radiographic assessment including functional outcomes namely Merle d’aubigne score, Harris hip score (HHS), Knee society score (KSS) and numeric rating scale (NRS) for pain were recorded in prospective database and evaluated. Results: 3 patients (female - 1 / male - 2) with MED who underwent bilateral lower limb arthroplasty of the hip and knee were reviewed periodically with an average followup of 7.31 years. Mean preoperative Merle d'Aubigné score (6.33 ± 0.58), HHS (31.83 ± 5.31) and KSS (28.67 ± 7.97) increased following bilateral lower limb arthroplasty with mean postoperative Merle d'Aubigné score (16.33 ± 0.58), HHS (84.33 ± 5.99) and KSS (86.33 ± 7.09) (P<0.001). Mean NRS decreased from 7.33 ± 0.58 in the preoperative period to 0.67 ± 0.58 at the most recent followup (P<0.001). One patient had heterotrophic ossification following THA. There were no revisions. Conclusions: Bilateral lower limb arthroplasty of the hip and knee is a good treatment option to restore function and mobility in MED patients with advanced degenerative arthritis. Careful preoperative planning, meticulous surgical techniques, patient focussed postoperative rehabilitation with multidisciplinary team approach are vital to ensure good functional outcomes and implant survivorship.

The therapeutic effect of Cyclophosphamide (CPA) is thus attributed to phosphoramide mustard and acrolein leads to the formation of high levels of reactive oxygen species (ROS), which results in decreased antioxidant activity. Excessive production of ROS could also culminate in oxidative stress. Objectives: This study aims to evaluate the effect of sub-lethal dose of the cyclophosphamide, 5-FU, combination of 5-FU, and CPA on testicular antioxidant status, and oxidative stress in male albino rats. Materials and Methods: Twenty-eight male adult rats were grouped randomly into four groups (n=5 each group). Group I (control): Rats were injected with saline intraperitoneally and at a dose of 1.0 ml/kg b.w. for 14 days. Group II cyclophosphamide (CPA): Cyclophosphamide at a dose of 10 mg/kg day by day through i.p. to rats for 14 days. Group III Fluorouracil (5-FU): 5-Fluorouracil at a dose of 10 mg/kg day by day in saline was given through i.p. to rats for 14 days. Group IV (CPA+5-FU): Rats were given CPA followed by 5-FU at a dose of 10 mg/kg per day (day by day) through i.p. to rats for 14 days. At the end of the experimental period, rats were anesthetized using light ether. Blood and testes tissue samples were taken and prepared for biochemical measurements. Biochemical parameters in rat serum and tissues were evaluated. Results: Individual injection of CPA and 5-FU to rats were reduced testes TAC, GSH concentration, GR, and CAT activities compared to control. However, the combination treatment of rats with 5-FU and CPA increased the levels of these non-enzymatic and enzymatic antioxidant compared with those treated with CPA alone. Also, results showed significantly increased TBARS and NO concentration in the testes of CPA treated rats when compared to normal ones, while 5-FU increased NO only compared with the control. Conclusion: It can be concluded that treatment of rats with CPA is associated with the production of free radicals that leads to hazardous alterations in certain non-enzymatic, and enzymatic functions. The increase in lipid peroxidation probably leads to the intracellular accumulation of ROS with the subsequent development of testes tissue injury. However, 5-FU and CPA combination could produce a significant amelioration in most cases for these changes, and it may be considered as a potentially useful candidate in the combination chemotherapy with CPA to combat oxidative stress mediated non target organs injury even if it was not a complete protection. Future work should consider combined chemotherapy regimens, as two or more mechanisms of action of chemotherapeutic drugs could be more powerful than one mechanism.

Background: Oral health plays an important role in maintaining life functions and quality of life. Periodontal disease can vary with respect to bacterial etiology, host response, and clinical disease progression. A key role of genetic effects has suggested distribution of lesions and severity of destruction in each individual. Many diseases, particularly digestive disorders, cancer, and infection, show preferences among the ABO blood types. Knowledge of blood groups and their association with oral diseases is very important, as it may help in early diagnosis and treatment strategies‏. Objectives: The study aimed to investigate the distribution of patients with oral and dental health problems according to age, regions, Socio-demographic Variables, and blood groups in the Tripoli region. Material and Methods: The present study was conducted on 200 patients with oral and dental health problems attending six medical centers in Tripoli region from the 01^st March 2022 to the 01^st June 2022. Also, 100 healthy individuals without any oral and dental health problems or any other diseases were recruited as a control group. This study was approved by the Research and Ethical Committee of the medical centers and Libyan Academy of graduate studies. One ml of venous blood was withdrawn from each participant in the study for determination of blood groups. The data were compared using Chi-Square using SPSS Statistics for Windows, Version 25. Results: The results showed that the mean age of the patients was 43.03±13.82 years. The higher distribution of patients was 58 patients (29%) in the age group (26-35) years while the lower distribution was 10 patients (5%) in the age group (66-75) years. The distribution of patients according to the region were 81.5%, 13%, 4%, and 1.5% in Tripoli, South Tripoli, West Tripoli, and East Tripoli, respectively. The Distribution of patients according to occupation were 4.5% Students, 30% Housewives, 10.5% Employers, 12.5% Teachers, 14% Nurses, 7.5% Doctors, 12.5% Laboratory Technicians and 8.5% Freelance workers. The distribution of patients according to levels of education were 23.5% Pre-Secondary, 19% Secondary, 46% Bachelor's or equivalent, and 11.5% Master's or equivalent. The distribution of patients according to marital status were 26% single and 74% married. The distribution of patients according to oral and dental problems were 5% with bridge, 8% with missing teeth, 86% with dental caries, 63.5% with bleeding of gum, and 25.5% with swelling of gum. The degrees of gingival erythema among patients were 36.5% mild, 38% moderate, and 25.5% severe. The degrees of gingival inflammation among patients were 36% mild, 38.5% moderate, and 25.5% severe. The distribution of A, B, AB, and O blood groups showed a significant (P=0.000) difference between healthy individuals and oral and dental health problems among patients that, were 54%, 12%, 4%& 30%, and 21.5%, 9%, 3.5% & 66%, respectively. Also, the distribution of A⁺, A^-, B⁺, B^-, AB⁺, O⁺, and O^- blood groups showed a significant (P=0.000) difference between healthy individuals and patients with oral and dental health problems that, were 49%, 5%, 10%, 2%, 4%, 25%, & 5%, and 18%, 3.5%, 8%, 1%, 3.5%, 60%& 6%, respectively. But, the distribution of Rh⁺ and Rh^- blood groups showed a non-significant (P=0.695) difference between healthy individuals and patients that, were 88% & 12%, and 89.5%& 10.5%, respectively. Conclusion: It can be concluded that the mean age of the patients with oral and dental health problems was 43.03 years and the higher distribution of patients was in the age group (26-35) years. The higher distribution of ABO blood groups was O blood group among patients especially O⁺ blood groups. The distribution of Rh+ and Rh- blood groups were showed a non-significant difference between healthy individuals and patients with oral and dental health problems. Further studies are needed to confirm these results.

Giant cell arteritis (GCA) with ocular involvement is an emergency condition, and treatment with glucocorticoids should be provided immediately upon clinical suspicion of GCA to prevent potential blindness. In this case report, we discuss a case of a 70-years-old Caucasian male presented to the emergency department with one day sudden onset of double vision. This is a teaching case report aimed to discuss the management options, potential complications and visual prognosis of this particular case.

Many attempts have been made to repurpose existing and approved drugs for the treatment of COVID-19 infection. This involves anti-malarial drugs such as hydroxychloroquine and chloroquine, which have been shown to be less successful than initially believed, with a substantial risk of often fatal complications and interactions. This also involves Remdesivir, which has been shown to decrease recovery time significantly in hospitalized patients. However, for patients who are not yet hospitalized, there is no currently accepted treatment. Treating patients before they need to be admitted or even prophylactically could greatly decrease the load on hospitals, protect healthcare workers and reduce the spread of COVID-19. An in-vitro study indicated that Ivermectin was dynamic against COVID-19-infected cell. Ivermectin has antimicrobial, antiviral, and anticancer, immunomodulatory properties. This drug could reduce the viral load in COVID-9 infected patients, with potential effect on disease progression and spread. Therefore, Ivermectin may be a therapeutic choice for treatment of COVID-19, however, there is still a lack of evidence-based studies to support ivermectin treatment of patients with COVID-19.

Background: Cyclophosphamide (CPA) induces acute inflammation of the urinary bladder, renal damage, and liver damage, thereby limiting its therapeutic use. Objectives: The present study aimed to evaluate the hepatorenal toxicity induced by cyclophosphamide and amelioration by 5-fluorouracil in male albino rats. Materials and Methods: Twenty-eight male adult rats were grouped randomly into four groups (n=5 for each group). Group I (control): Rats were injected with saline intraperitoneally and at a dose of 1.0 ml/kg b.w. for 14 days. Group II cyclophosphamide (CPA): Cyclophosphamide at a dose of 10 mg/kg day by day through i.p. to rats for 14 days. Group III Fluorouracil (5-FU): 5-Fluorouracil at a dose of 10 mg/kg day by day in saline was given through i.p. to rats for 14 days. Group IV (CPA+5-FU): Rats were given CPA followed by 5-FU at a dose of 10 mg/kg per day (day by day) through i.p. to rats for 14 days. At the end of the experimental period, rats were anesthetized using light ether. Blood samples were taken and prepared for biochemical measurements. Results: Serum total protein, albumin, and globulin concentration significantly reduced in animal groups that received cyclophosphamide. 5-FU and CPA combination reduced the changes in total protein, albumin, and globulin compared to CPA treated group. A significant increase in LDH serum concentration was found in CPA, 5-FU, and their combination-treated animals. The mean values of the combination of chemotherapy were above that in CPA followed by 5-FU treatment. Administration of CPA, 5-FU resulted in a significant increase in serum AST, ALT, ALP, and bilirubin compared to the control. Co-treatment 5-FU with CPA significantly attenuated the increase in serum AST, ALT, ALP, and bilirubin when compared to CPA – treated rats. Compared to controls, urea and creatinine levels were increased in CPA-treated rats, while uric acid was reduced in CPA, 5-FU, and their combination. The changes in urea and creatinine produced by the chemotherapy were restored when rats received CPA in combination with 5-FU. Conclusion: It could be concluded that the treatment of mammals with chemotherapy is associated with the production of free radicals that lead to hazardous alterations in biochemical parameters. However, 5-FU and CPA combination could produce a significant amelioration in most cases for these changes, and it may be considered as a potentially useful candidate in the combination chemotherapy with CPA to combat oxidative stress-mediated non-target organ injury even if it was not complete protection. Future work should consider combined chemotherapy regimens, as two or more mechanisms of action of chemotherapeutic drugs could be more powerful than one mechanism. Toxicological studies must be performed before using drugs as a combination before application. Further research is required on the toxicological impacts of drugs and pollutants mixtures.

Alpha emitters in internal contamination are the main cause of homosexuality. There is a pattern that can be identified and described precisely as a hormone cloning process, after initial loss from alpha emitters of testosterone, and development of a painkilling effect through steroid accumulation with sodomy feeding development of steroidogenic cells. This altogether explains how homosexuality becomes a self-refeeding bubble. A treatment method is proposed at the end to break the cycle and help the subject return into heterosexuality.

For the adequate treatment of bone fractures, it is necessary to have knowledge about mechanical concepts as the interaction of implants and bone. The understanding of the concept of stress riser must be clear for surgeon for adequate surgical planning, thus preventing refracture due to incorrect application of implants. This article presents the concept of stress riser applied to orthopedics and briefly discussion.