PriMera Scientific Medicine and Public Health (ISSN: 2833-5627)

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Generally, stillbirth is only experienced in about 1 out of every 200 pregnancies. Most stillbirths occur before delivery, however, up to 14% of all stillbirths do occur during the delivery period. Infection is an important cause of stillbirths worldwide: in low-income and middle-income countries, 50% of stillbirths or more are probably caused by infection. Infection may cause stillbirth by a number of mechanisms, including direct infection, placental damage, and severe maternal illness. A large variety of organisms have been associated with stillbirth, including many bacteria, viruses, and protozoa.

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The aim of the study - to investigate the influence of risk factors in the mother and morbidity in the neonatal period on the development of hypoxic-ischemic encephalopathy of newborns, depending on their gestational age, as well as to determine the effect of neuroprotection on the development of hypoxic brain lesions in premature infants. 
Materials and Methods At the first stage, a retrospective analysis of the course of pregnancy, child birth and the condition of newborns was carried out in 150 women whose children had suffered from hypoxic-ischemic brain damage. Group I (I G) consisted of 62 women who gave birth to full-term babies, Group II (II G) - 88 women who gave birth prematurely at 26+6 - 33+6 weeks of gestation. At the second stage, the level of neurospecific markers of nerve tissue damage (NSE and S100) was prospectively investigated in 60 preterm infants at gestational terms up to 32 weeks, which were divided in to two groups. The main group (MG) consisted of 30 preterm infants whose mothers were injected with magnesium sulfate for the purpose of neuroprotection, the comparison group (CG) - 30 preterm infants whose mothers did not receive neuroprotection for various reasons.
Results and Discussion The risk factors for the birth of children with HIE include extra genital pathology in the mother (OR 1090.818, 95% CI 64.501-18447.401), urogenital infections-chlamydia (OR 21.87, 95% CI 1.264 - 378.397), prematurity, low weight bodies at birth, PROM, chorionamnionitis (OR 17.6, 95% CI 2.288 - 135.407), Apgar score <7 points, morbidity in the neonatal period. Neurospecific enolase (NSE) was significantly higher in children with gestational age up to 32 weeks and an Apgar score of <6 points. The lower concentration of protein S 100 in
newborns of the main group can be explained by the protective effect of magnesium sulfate on the central nervous system of a premature new born.
Conclusions Risk factors for neurological disorders in newborns include extragenital pathology, urogenital infections of the mother, prematurity, premature rupture of the membranes, the development of chorionamnionitis, and fetal growth retardation. Conducting neuroprotection
with magnesium sulfate before delivery is an important measure to prevent hypoxic-ischemic brain damage to the fetus and premature newborn.
Keywords: hypoxic-ischemic encephalopathy; prematurity; preterm labor; chorionamnionitis; neuroprotection

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The answer posed by the title of this article may seem obvious: that pandemic policies are formulated as a crucial part of public health. However, a more in-depth exploration show that the situation is complex and one may not simply assume that all pandemic policies equate with good public health. To do so would imply that these policies override all other aspects of public health. Current debates among Western societies on this topic are highlighted, and discussed with respect to current pandemic policies in Hong Kong, where differences in culture and health and social systems exist. 

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Hand hygiene is fundamental to clinical practice and has been shown to reduce the risk of major diseases. School children and for that matter, primary school pupils are at higher risk the most because of the lack of paying special attention to a simple but very important personal hygiene behavior such as frequently washing hands with soap under running water and also due to insufficient knowledge on good hand washing with soap practice. Between November 2021 and March 2022, this study was conducted in Tehsil Lalian District Chiniot Pakistan. Data on hand washing practiced among primary school children were collected by using questionnaires. Ten students from each school were selected for the questionnaires and 20 schools in urban and 20 schools in rural areas were covered. The study helped us to check the current knowledge about hygiene and the availability of hand washing facilities in the school. Data were collected from above-mentioned schools by using questionnaires. Interviews were taken from the class students to check their knowledge about hygiene which they are given to the students to guide them about their hygiene and how they teach the students to keep them healthy. In rural schools, about 39% students were selected from class 3, 32% from class 4, and 29% students were selected from class 5, while in urban schools, about 35.5% students were taken from class 3, 36.5% from class 4 and 28% students from class 5 were selected. All schools (rural and urban) have the facility of hand washing points. About 96.75% schools have water supply within hand washing point while only 3.25 schools do not have a water supply. They have tissue papers facility instead of water. About 87.75% schools have sign boards of hand washing to guide the students while only 12.25% schools do not have sign boards on hand washing guide the students. About 71.5% students from rural schools wash their hands before eating food while 28.5% students wash their hands after eating. Further, 66.5% students from urban schools wash their hands before eating food while 32.5% students wash their hands after eating. About 74.5% students from rural schools, wash their hands after playing with friends while 25.5% students sometimes wash their hands. About 63.5% students from urban schools wash their hands after playing with friends while 36% students sometimes wash their hands and 0.5% never wash their hands after playing with friends. About 77% students know the importance to wash their hands with soap when in school and 23% students do not. About 42.75% students strongly agree that hand hygiene reduces the chances of spreading infections, 28% student only agree, 13% disagree, 12% don’t know while 4.25% strongly disagree. About 81% students think proper handwashing minimizes the risk of germ attack while 19% students do not think so. About 88.75% students know that if they fail to wash their hands properly, they will be exposed to the disease while 11.25% students do not think so. About 80.25% students think that poor hand washing can cause disease while 19.75% students do not think so.
Keywords: hand washing; disease prevalence; school children; washing practice; rural areas; urban areas

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This article is addressed to [1] All those who have been part of international development particularly in the healthcare sector long enough to be sick and tired of watching people die or suffer in outrageous numbers of preventable causes in more or less challenging environments, [2] Young professional who are witnessing unbearable facts (waste of minds, waste of resources, indifference, bias, etc.), and [3] Everyone who thinks the state of Global Health is disgraceful compared to what it could and should be and do not want to face any longer conditions included in the following loose and open-ended enumeration

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     Behavior and cognitive functions are results of a fine tuning of multiple neuronal synapsis and a myriad of biochemical reactions whose number, location, components, sequence, and logic are unknown.
     In entirely theoretical terms deleterious effects of reactive oxygen species (ROS) production during aerobic metabolism are neutralized by the antioxidant systems and in this manner the brain effectively regulates its oxygen consumption and redox generation capacity. 
     The knowledge about the metabolic processes of the CNS is so elementary, so theoretical, that only in the previous paragraph we find two notable errors: aerobic metabolism and oxygen consumption.
     The phrase aerobic metabolism refers to the fact that the oxygen contained in any tissue of the human organism, such as the CNS, comes from the air that surrounds us, since it is supposedly absorbed through the lungs and reaches the bloodstream to be distributed to all the cells of the organism.
     However, since 1850 researchers of the stature of Christian Bohr, Carl Ludwig, and Halender, published works in which, according to their experiments, the diffusion of atmospheric oxygen through the pulmonary alveoli could not explain the enormous difference between the concentration of atmospheric oxygen, which ranges between 19 and 21%, and the % SpO2 in the blood that reaches values of 98 and 99% [1].
     It was precisely the search for the mechanism that would explain such a difference between oxygen in the atmosphere and blood oxygen, which led these researchers to publish that there was no such thing, and that diffusion alone did not explain such a difference. 
     Unfortunately, at that time, the work of Krogh appeared [2] who, by means of a theoretical mathematical model, apparently simple, explained the unlikely passage of atmospheric oxygen to the bloodstream through the pulmonary alveoli. Krogh’s lung gas exchange model has been the foundation of respiratory physiology for the past 100 years even though the mathematical concepts it handles are so far-fetched that they cannot even be experimentally contrasted.
     Krogh’s original model has been modified and something like 100 equations have been added to try to explain the supposed passage of atmospheric oxygen to the bloodstream through the pulmonary alveoli, but even so, the experimental results do not
square with the predictions of such a model. So, research and care for patients during the past 100 years has been based on eminently theoretical models.
     So, returning to the phrase “aerobic metabolism of the CNS”, we have the surprise that it is wrong because the oxygen we have inside the body does not come from the air that surrounds us but from the water that contains inside each cell that conforms us.
Keywords: Oxygen; aerobic; Krogh´s model; energy; combustion; CSF

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At my practice, Shirodhara technique was tested on a group of 25 people who did not know what they were going to test. Each received a treatment of approximately 1 hour.
The following questions were asked before and after the session:
“If 0% is the minimum and 100% the maximum of physical and mental stress that you have experienced in your life, how much stress do you feel right now, for physical stress and mental stress?”

The novelty of this research consists in studying the psychological, physiological and ethno-cultural aspects of the use of the ancient Kazakh musical instrument kobyz for health purposes.

Due to the modern stressful rhythm of life, ecological, economic and social problems there is an alarming tendency of general growth of mental morbidity and psychological disorders [1]. Therefore the search for new non-drug methods of psychological correction and recovery is the most actual modern task. Recently the methods of music therapy have become more and more widespread.

Keywords: Bai Chay hospital; Quang Ninh; cancer patient; treatment at home; scientific technology

El-Kass et al (2021) stated Cancer is the leading cause of death in economically developed countries and is a threat to human lives. Cancer and chemotherapy side effects may affect the daily activity of cancer patients and their families on many levels confronted by changes in health status and lifestyles, leading to impaired self-care efficacy. Bai Chay Hospital in Quang Ninh province has been a pioneer in applying tech ology in medical services. Hospitals increase IT application, move towards paperless hospitals, and at the same time improve operating capacity and modernize. Our study shows that Home care service for cancer patients who want palliative care after cancer treatment or terminal cancer patients has been developed in big cities in Vietnam in order to solve one important thing is the psychological problem, when treating at home and reducing waiting time for cancer patients at hospitals.

1. UV Laser (Excimer).
2. Visible Laser (Argon).
3. IR Laser (Ionization Resonance).

The word LASER stands for Light Amplification by Stimulated Emission of Radiation. According to this abbreviation that summarizes the energy generation; it is the light that occurs when the crystal between two full and semi reflective mirrors is exposed to intensified energy amplification the type of laser is named with the substance in the liquid crystal [1, 2]. Laser was first applied in the musculoskeletal system w by Whipple in 1984 using C02 laser. Classification according to the laser optic parameters (wavelength, power and dose) was developed in clinical trials after that date [1, 3]. Laser is known to change cell proliferation, motility and secretion at different doses. Tissue interaction can occur in the form of destruction, liquification, heating and evaporation depending on dose. The type of laser commonly used for the musculoskeletal system is resonance type which can be classified as follows [2];

Keywords: semi-arid; overexploitation of aquifers; planning; crops

The overexploitation of water sources together with the lack of rain due to climate change that causes problems in the recharge of aquifers, this has led to the analysis of possible crops suitable for the current situation to ensure food self-sustainability in the future. Using a system of linear equations in an optimization model, emphasizing the water requirements to ensure the total development of the crop with new technologies, as well as the restriction to the availability of water for agricultural use in the region, feasible and substitutes crops were found. These crops maximize the value of production from the producer’s point of view and cross-price elasticities of supply. This tool will support decision-making in strategic planning in agribusiness and government policies.

On psychiatric consultation of 546 cancer patients there was revealed that 54% of the referrals were diagnosed as having adjustment disorders, 15% delirium and 9% major depression [1]. The results showed elevated risk of comorbid common mental health disorders among persons who at the time of the study were undergoing treatment for cancer across all countries studied compared with either cancer survivors or cancer-free respondents.

Cancer diseases affect approximately 10 million people only in Europe. As a result of the demographic development, their prevalence is expected to double during the next 10 years. Cancer accounted for nearly ten million deaths worldwide in 2020, or nearly 1 in 6 deaths. Meanwhile the number of survivors continues to grow, not just because of earlier detection and treatment, but also because of revolutionary new therapies. This changes the landscape from a terminal illness to more of a chronic illness. Such perspective on neoplasms has broadened the scope of care from treating the disease alone to managing cancer-related symptoms at different stages of the disease trajectory including mental disorders.

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Recently, in standard family conditions, unsocial humans with repetitive behaviors attracts increasing attention. Autism spectrum disorders (ASD) with all its behavioral disorders with deficit communication leading to lack in social interaction, obviously, induced central nervous system perturbations. Awareness of caregivers remains the most important factor facilitating the early diagnosis of autism in children. The educated level in some studies did not contribute for solving the problem of people-misunderstand completely, because their awareness depends on education field and their personality. We suggest that deletion of coding and non-coding genes transmitted from mother to son, resulted from oxidative stress due high anxiety levels, induced ASD. The neuroprotective effect of SNL in combination with MEM, DNP, CTP and ARP exhibited by the restoration levels of dopamine, acetylcholine, serotonin and glutamate. Modulations in neurotransmitters and pro-inflammatory cytokines succeed in adjusting stereotypes behaviors of VAP rats and mice.

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Harmine recently known by its multi-beneficial effects like neuroprotection, anti-diabetic and antitumor effect, but its impact upon animals and human during pregnancy remain pre-estimated with undesirable effects of Peganum harmala, as the plant usually used as an abortifacient by Middle Eastern population, morocco and many other countries. It took place an in depth debate due to its multiple uses and importance, the most abundant alkaloid in the parts of the plant is harmine that concentrated most in dry seeds and roots, but miss in flowers.

Keywords: regenerative medicine; stem cells; classification; differentiation; proliferation

This article is devoted to important issues of regenerative medicine and fetal stem cells administration as its valuable instrument. Herewith we will describe various types of stem cells, mechanisms of stem cells action and the spheres of their broad clinical application.

     The earliest land plants date back to around 3.70 Billion years before. Estimates on the number of Earth's current species range from 10 million to 14 million. They have major impact on Mankind. The impact of the Moon and its rotation around the Earth has many effects on life on the Earth and Mankind. Earth Science taught the Mankind, how to take care of the Nature and obtain the benefits of the atmosphere through plants so as to have a smooth life and healthy longevity.

     The burning of fossil fuels by humans is the largest source of emissions of carbon dioxide which is one of the greenhouse gases that allows radiative forcing and contributes to global warming. For that reason humans should use plant based foods for their overall health instead of animal based foods and plants as a medicines instead of Chemical Drugs.

     During the Nutrition month of September 2020, Government of India has taken a Plantation drive for Promotion of Kitchen Garden under “POSHAN KE LIYE PAUDHE ” (in Hindi language).

     Plants give us various types of seeds and dry fruits which in tern give us Vitamin E. This Vitamin E plays important role in human personality as well as in immune system as an antioxidant, preventing important molecules and structures in the cell from reacting to oxygen. When the delicate components of living protoplasm are attacked by oxygen they are often injured. If one wants to live longer, he/she has to be very friendly with vitamin E. It has now been found out that it has good role to play in many types of pains, not as a pain killer but a pain reliever. Vitamin E may help ease muscle aches after a tough workout, a new study suggests. Researchers believe that the antioxidant mops up the damaging by products created by a strenuous workout.

     Thus depending upon requirements of a person, various plants can be useful to maintain an overall health of a person so as to maintain his or her Healthy Longevity.

     In one study participants took a relatively high dose of vitamin E, the average person could probably get the same benefits from lower doses of between 200 to 400 IU per day.

     Thus the vitamin E which is a water soluble vitamin can be a good pain reliever as also immunity enhancer, if taken in proper proportion as also in proper Natural form.

     Our day-to-day eating habits provide many opportunities for us to support our immune system’s power to protect us. All these are from plant foods like….

    Black resins, dates & apple, provide us with Iron (Fe), Watermelon seeds give us Zn., Cereal sprouts give us Amino Acids. Gooseberry (Amala), Cranberry, Lime juice Sweet lime provide us vitamin C, Sunflower seeds give us Selenium. All these vitamins are plant sourced and are good for enhancing immunity but doses differs from person to person since unique physiological characteristics .Also it is important to know, how the nutrients are prepared & processed & what other substances accompany them into body. This is a Pharmacology of Nutrition. Further it considers alteration in food due to food processing, adulteration & contaminations. Hence food should be healthy & ideally suited to a particular person.

How can our diet affect immune health?

     Our body produces highly reactive molecules called free radicals as part of normal metabolic processes & in response to exposures like pollution & tobacco smoke. Immune cells produce them as a way to fight infections. High levels of free radicals trigger inflammation. Antioxidant nutrients consumed in excess may actually interfere with the body’s antioxidant defences. One has to be very careful while using any nutrient, including plant that high doses of one nutrient can create deficiencies of other nutrients, including those needed by the immune system.

     High-fibre diets can nurture gut microbes that provide anti-inflammatory protection. These microbes protect cells within the colon & seem likely to help protect against inflammation throughout the body. Now we are looking for plant based proteins and try avoid animal based proteins, so more of plant utilisation for our health.

     Make nutrient-dense foods the majority of our plate to provide the wide range of nutrients needed for immune system cells & function. This includes – but is not limited to – minerals like Zn, Se, Fe & Cu,omega-3 fats & protein.

A few more examples where plants can be of more beneficial are like…

     Lemon grass-Cloudy lemonade is served hot as a remedy for chest congestion. Ginger plant Juice-Contains gingerol, is very good muscle pain reliever. It is useful in cough and cold. Watermelon-Cucumber-Mint Juice This drink if taken during summer, it will have a soothing effect on hyperthermic body of a person. Cloves’ Powder and Honey.

     Cloves contain a natural compound eugenol which helps to stabilize blood sugar & has positive effect on artery clogging cholesterol. Carrot juice along with lemon juice works in case of Diabetic persons. Coriander, Basil, Pudina, Aloe vera, Moringa, Turmeric, Garlic and such other plants are good for Human health.

     The European Society of Clinical Nutrition and Metabolism guidelines on nutrition emphasize that their nutritional needs should be met through a balanced diet, adjusted as needed to meet each individual’s condition. But in general, the guidelines say that use of single high-dose micronutrients should be avoided.

In short, more is not always better.

     Free radicals are normal. They are important signals within cells & “turn on” body antioxidant defences but excessive levels of free radicals can damage cells & promote inflammation. Likewise, short-term inflammation is part of how the body clears an infection. If inflammation is out of control however, it can create cell & tissue damage that is difficult to reverse. Most us may be tempted to assume, “if some is good, more is better,” to fight these diseases. But that’s not what evidence shows.

     Pandemic Covid 19 has taught us many things during last two years. One of that is use of Plants for our health. Human body contents Plasma which carries substances like hormones, vitamins, amino acid & antibodies & also contains proteins called clotting factors that help the blood to coagulate. Balance of Saliva, Mucus & cerebrospinal fluids, is important for overall health of a person. Nature plays a major role in Human Health through various plants. Stress has been shown to increase clinical viral respiratory illness in humans. Immunity changes are associated with distress can contribute to the etiology and course of immunologically resisted diseases, such as infections, autoimmune diseases or cancer. So we will see how plants are associated with our health.

Keywords: Turmeric; In-vitro; Antioxidant; Ameliorative; Haemolysis; Radicals; Scavenging

Antioxidants are widely distributed in plants that are either used as food or medicine. These natural antioxidants, especially carotenoids, and polyphenols exhibit a wide range of biological effects which include; anti-inflammatory, anti-aging, anti-atherosclerosis and anticancer. Extraction and proper assessment of antioxidants from plants are crucial to explore the potential antioxidant sources and promote the application in functional foods, additives and pharmaceutical. The in-vitro antioxidant and ameliorating effect of butanol extract of Turmeric (C. longa) on osmotic-induced haemolysis was examined. Various experimental model including iron (III) reducing capacity, total antioxidant capacity, DPPH scavenging activity and in-vitro inhibition of osmotic-induced haemolysis were used for the characterization of antioxidant activity and ameliorating effect of the extract. The extract showed various degree of efficacy in each assay in dosed depended manner. In addition, at concentration of 1000µg/ml, the DPPH radical scavenging activity of the extract was found to compare well with that of the standard compound of ascorbic and gallic acids. From the obtained results, C. longa may be considered to be a source of antioxidant which can prevent oxidative stress.

     An important element to consider is that people with dementia may have limited access to information on COVID-19 and experience difficulties in applying safety strategies (social isolation, self-quarantine measures, wearing masks, and personal hygiene). Therefore, people with dementia may be more dependent on family members and social caregivers to support them [7] to live within government guidelines. This is further impounded by the provision of information through social media and the implementation of digital health technologies. Older people with dementia living in residential settings have not been able to engage with their family members due to the banning of visitors and with the cessation of group activities [8], older people, and those with dementia, are becoming further isolated [9].
     The consideration of the impact of COVID-19 on older people and those with dementia is essential due to the aging global population [10]. The global population of those over 65 years of age was estimated to be over 562 million in 2012, and the population of older adults rose by 55 million in 2015, which is projected to be double by 2050 [11]. Cognitive impairment is common in the older population, although is not a natural part of ageing [12]. The cognitive function of an individual may decrease with age, but mild cognitive impairment and dementia impacts on the person’s ability to independently complete their own activities of daily living, as well as impacting on their memory, language, and orientation. Recent studies showed that the use of computer helped in cognitive stimulation and improved cognitive function with mild cognitive impairment of elderly people [45]. The combined intervention of digital inclusion and physical exercise helped to prevent cognitive and functional loss with elderly [46]. Cognitive decline is a significant issue in aging and it is associated of dementia patients and increases independence, quality of life and falls. Thus, dementia can negatively impact on a person’s quality of life and life expectancy [13]. Dementia poses a challenge to the long-term financial sustainability of health systems worldwide [14]. Likewise, the number of people living with dementia in the developing countries will reach to 71% by 2040 [15] in developed countries such as Western Europe 9.9%, in North America 9.2%, and in America 9.1% of the population by 2040 [16] furthermore, older adults with dementia require further care services such as; care delivery, medication management, education and training for family members and informal caregivers, cognitive interventions, but also leisure activities to support a person with dementia to remain independent, all of which are currently extremely limited [17].
     Interventions to support people with dementia at home, have begun to use video telehealth, which has been found to be feasible to deliver cognitive rehabilitation [18] and improve cognitive performance [19, 20]. Face to face videoconference [21], pharmacological interventions [22], technology-based behavioral interventions [23] and cognitive assessments [24]. These approaches demonstrate that technology-based interventions for older people and those with dementia appears both affordable [25] and reliable [26]. COVID-19 has forced and enabled the adoption of technology in dementia support and care in the form of prevention, early detection, care, management and diagnosis [27]. The applications of these technologies could support older people and those living with dementia in rural areas, and those who have migrated and may have linguistically diverse languages. The COVID-19 crisis has provided the opportunity to embrace technology, to support older people, and those with dementia to maintain their connections with the outside world during self-isolation. Health policy makers, service providers and clinicians need to consider these innovative opportunities and support the technological transformation of dementia practice in the coming years [28].
     Digital health technologies can support a reduction in the provision of care in hospital settings, and support the management of infections [29]. Considering a significant contribution of digital technologies, the American Academy of Neurology has developed guidelines to implement telemedicine services for clinicians to assess and examine their patients, although some limitations have been acknowledged, such as the follow-up appointments [30]. However, this has not been converted into clinical practice as yet. COVID-19 has forced nations to consider the use of digital health, such as telehealth and e-health, which can contribute to the management of communicable diseases during the pandemic and possibly slow the infection rate of COVID-19 through supporting social distancing [31]. Digital health technologies provide and improve patients’ health, and reduces expenses and as well as the need for care facilities [32]. Telemedicine and mobile care tele-mentoring, tele critical care were significantly useful to offer care facilities during COVID-19 [33]. Within the specialist field of dementia memory screening tools, care, management of behavioral and psychological symptoms in dementia and consultations [34], have occurred through the use of remote technology. This approach has supported the difficult balance of maintaining social distancing and continuing to support people living with dementia, and those caring for them, but has also enable a significant cost reduction to the health system and decreased the risk of infections [35]. Furthermore, these processes have enabled clinical decisions, diagnoses and outcomes to be supported in a timelier manner, supporting earlier intervention opportunities [36] to support and improve mental health.
     Technology can also contribute to the reduction of the burden on healthcare institutions and professionals [37]. Technology has also been applied through satellite monitoring, health sensors and apps, Drones (drones were applied in carrying medicine), spraying disinfectants and 3D Printing which was deployed to mitigate shocks to the supply chain and export bans on personal protective equipment [38]. Digital health technologies have not only supported older people and those with dementia, through remote screening and the facilitation of care during a pandemic [39]. Telehealth played directly and indirectly in reducing the contamination by enabling physical distancing, tracking symptoms and detecting timely using interventions [40]. Further, telehealth supported to bring out put with patients’ safety, reliable and flexible regulatory [41]. Virtual care using technologies in home patients and out patients care in health institution, initial COVID-19 hospital surge, and post pandemic recovery was most effective for the care of the dementia patients [42].
     Emerging technologies are changing our daily lives under lockdown. The COVID-19 crisis has shown a further way that emerging technologies like the internet and artificial intelligence are not just tools, they are essential to the functioning of our society and economy in this 21st century. Thus, such digital tools must adapt as essential developmental procedure as the time progress. It is not only for COVID-19 issues but also should be implemented to make our daily life easiest than before to fight with communicable disease. Digital technology enables to educate from remote to health workers and populations to follow better care in limited resources and accurately using the Chatbots information getting update of current health systems and patients care home location of their activities and protect from the spread of the virus. Also, saved time, money and to all the sectors and will be cost effective [43].
     However, is still a gap in the research regarding how and which digital health (DH) technologies can be effective to support older people and those with dementia patients. But the reality is we are seeking more reliable proof to apply and implement the full potential of this growing area in health science [44]. Therefore, supporting older adults with dementia and maintaining their well-being during COVID-19 has become an urgent to apply digital health technology.

     COVID-19 is a global pandemic, with the highest rates in the US [1]. Many countries have enforced lockdown and social distancing as a process to control the epidemic [2]. Despite such stringent global efforts, the numbers of cases are again continuing to rise [3], and all aspects of society are being impacted [4]. The cases of COVID-19 in South Asian are comparatively less than developed countries, even though poor health care facilities are available [5]. Internationally, health authorities and governments are warning older people (those over 65 years old) of the high risk of negative outcomes associated with COVID?19 [6]. Older people and those with dementia are at high-risk of COVID-19 due to their age and multiple comorbidities.

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Keywords: Systematic literature review; systematic review; Meta analysis, protocols

     Evidence in clinical practice shows us various effects of improper communication on individuals; they range from minor to significant alteration of people’s health, according to the subject matter, transmission channel [oral, written format], interaction [face to face, virtual] type of communication [verbal, and nonverbal], time and exposure magnitude, dissemination area, environment characteristics, and sensitivity and vulnerability of intended recipient. Middle-aged people and the elderly are more sensitive to offensive attitudes and inappropriate words' energy transfer to them. Unskilful interactions imply the adrenergic pathway increasing activity determining changes in the blood volume flowing through the vessels, finally altering the cell’s functionality in the fragile area. Transitory and persistent unsafe communication increases blood pressure; it is another key for initiating, maintaining, and accelerating the evolution of arterial hypertension, affecting the heart and blood vessels. High blood pressure in arteries determines changes and adaptation of their structure and function in line with time action, forces, and individual susceptibility; it goes along with other risk factors for the building-up of atherosclerotic plaque. Atherosclerosis narrows blood vessels, disturbing the corresponding areas working. If nutrients and oxygen supply decrease by another medical condition interplay, the summative for possible exponential count effects increases. Atrial fibrillation, heart failure, stroke, peripheral arterial disease, chronic kidney disease, vision loss, or altered mind activity may be some effects of such disturbed blood volume flowing. Suggestive clinical signs and symptoms accompany the gradual or sudden loss of function of altered zones. Compiling all factors implying the functionality of the cardiovascular system, including communication skills, we have a general picture of its changing harmony and possible fissures; brain haemorrhage is an unwanted situation. The loss of proper control of the individual working appears under excessive nervous tension. Usually, forceful discussions between business partners, family, and community members may generate haemorrhage in fragile areas. Words’ battle forces exceeding limits lead to subsequent disorders in the easily broken zone. Other effects of inappropriate communication are initiation and advances of dyslipidaemia, altered blood sugar control, leads to depression, and generates people’s conflict ending in their separation or death by victim’s physical aggression or suicide. Concern about the wrong delivery of bad news in clinical practice is necessary since unskilful transmission of such info can lead to disaster in a person at risk. Improper communication affects an individual [intended recipient], but the effects extend to their dear ones, who will suffer for their distress. Finally, unsuitable communication alters individuals’ well-being.

     By contrast, the best communication skills delight people, amend the worsening of individual health, and improve life quality and expectancy. The right, kind words and attitudes act as medicines and must be considered in the personal therapeutic plan; they may resonate with a person, harmonizing his mind-sets. Practical, suitable terms and images created with the words assist the people passing trouble time for a better emotional state and enhance their ability to deal with dilemmas. Magnificent word composition energizes and inspires humans. Stars in this zone fascinate the individual since their words are a miracle in the body's functioning. The best words’ composition, products of divine inspiration, produces a good, bright effect.

     There are communications in front of indifference.

    Therefore the words represent a valuable communication channel for people’s collaboration; they inform us about the difference between individuals. Words influence the nervous system’s functioning through their energy and meaning. Appropriate word energy people use in interaction leads to effective clinical outcomes in practice. Unsuitable words’ energy and power alter their health and decrease work efficiency and social and professional life. For these reasons, communication skills represent a central theme for public health. In a family, there are differences between generations. The aspirations of older adults do not align with those of a young age, leading to conflict. Excessive debates and opinion differences generate nervous tension, leading to disaster for vulnerable people, as mentioned. Respect and appreciation for the parents’ input for their children’s professional, social, and cultural life formation are required. Over time the parents usually do not have a good memory or judgment. Their child has to impart compassion, be polite, and be attentive to them. Promoting good habits in doing well for other people, especially with the parents, is mandatory. Health promotion messages, such as ‘Be polite, and you’ll be rewarded,’ can effectively increase attentiveness and interest in communication. Encouragement and emotional support are essential for the elderly health improvement. We must advocate for the refinement into a partnership between the patient’s family, community members, and business partners. Professionalism in all domains is necessary. Unhealthy behavioural manifestations may originate in mental disorders, and we must identify and treat them. Modelling people's interaction adversities is a key to preventing and treating other disorders, including recuperating altered personality traits; social, professional, and culturally safe work is essential for society’s refinement and advancement. Artificial Intelligence supply offers another perspective for analysis, modelling, and applying the best communication skills in practice. Based on an analysis of ‘what happened?’ guided by AI experts, we can predict what will happen, and they can insert an influence mechanism as a solution and services for corrective actions to mitigate the harmful effects of an individual’s improper communication. Educational programs, hybrid models, IT devices, and artificial intelligence supply offer us the opportunity for instruction, modelling, and recovery in a short time, and that chance never existed before. They ensure human safety for a better life in an unceasingly changeable environment. The people must be aware, especially of words’ power to illuminate or destroy personal values. In this digital era of innovation, technological advances and discoveries allow us to use the words’ composition to our advantage, with cost and time saving, at our e-comfort, when and where necessary, for revitalization or peaceful moments. The ability to cope with harsh conditions makes us influential people in dilemmas. Improving our knowledge, communication skills in daily practice, customer centricity, increased revenue, and best interaction with other trades define us as professionals. Guidance in this direction assists us through excellence in the way of living, in the end, appreciation, and offerings abundantly supplying.

     People interact with their energy with or without words, attitudes, and images thinking of them. Their relationships vary individual emotional states, ways of thinking, and acting toward others. Unsafe interactions between them alter the personal equilibrium, and the best communication skills offer comfort and improve life quality and the person’s health. Genetic and environmental factors influence verbal and nonverbal communication styles. Well-educated behaviour elements ensure people effective collaboration. Instinctive and unskilful cooperation between them is in front of illusory health, deceptive clinical manifestations following.

Aim

     To highlight communication dimensions between generations and new choices for moral distress restoration in the digital era.

Material and Methods

     A qualitative study performed by the author in the community, 2008-2022, relating to communication value for people’s health. The effects of inappropriate communication were noticed and corrected when and where necessary and preventive actions were initiated.

Findings

     One day in the spring of 2021, a patient, 89, in interaction with a physician in public, used impolite attitudes and words, determining moral distress for the physician.

Patient medical history; widow: 1972; HTA: from 1972. Heart failure, NYHA class II, 2021; NYHA class III, 2022.

Patient family health history: brothers, sisters, parents: HTA.

Actions were taken

     The physician made no comment in public, but a few hours after that incident, when observed the patient alone, she went to her and compassionately scolded her. The patient commented: ‘I said it, and if I said it, what should I do now? Take a cake here from mine to pass you by! I am upset since my son-in-law passed away; he was diagnosed with COVID, and today is the funeral.’ The doctor was affected by the situation and expressed her condolences. To amend the moral distress generated by interaction with that patient, the physician listened to a selected classical music program and enjoyed chosen lectures.

Results

     No other offensive communications were noticed for that person.

Conclusion

     Grave life events and medical conditions make an older person less attentive in interaction with others in public. Supportive actions from the community can ameliorate their suffering. The digital era offers a new perspective on moral distress restoration.

Discussion/ Implications

     Older people were more affected by the pandemic COVID ID19; the loss of their dear ones makes them more vulnerable and sometimes unwise in interaction with others. That patient, in those moments, was probably furious with all physicians, considering the loss of her son-in-law. People must resonate with their suffering, understand their judgment impairment, and support them. Compassion, kind words, friendly attitudes, and encouragement are practical actions to ameliorate their distress. Moral distress restoration benefits in this era of technological advances; IT devices offer a new perspective that never existed before. The selection of the different programs according to individual preference, using the ‘watch on demand’ function, images from nature, reading stories of interest, and channels-mid conversation with dear ones are helpful instruments for restoration of moral distress. Digital products inspire, energize, and encourage us, even in difficult times. Walking in nature is another effective, cheaper technique for health improvement. Self-esteem in intersection with the principles for people’s collaboration in public may exceed the limits; the elderly often hurt us since time slowly undermine all.

     The people interact through their energy, with and without words, attitudes, sounds, and images, thinking of them. Individual behaviour reflects mind activity relating to others. A young person’s voice usually varies from that of an older individual; the elderly often share memory impairment and judgment differences; sometimes, reasoning deviance and unskilful transmission of their viewpoint in public are observed.

     The author of the article owns a series of publications highlighting the features of the pathogenesis of a new disease: "COVID - 19 - POSTCOVID SYNDROME", as well as a method of treatment and prevention of this disease based on the scientifically proven healing properties of Hirudo medicinalis medical leeches [3-13]. At the same time, the editors of three scientific medical journals have already adopted the author's concept of the name of the disease - "COVID - 19 - POST-COVID SYNDROME" [11-13], which reflects the understanding that this is a single disease that has two phases: the first phase is an acute process, which usually lasts 2-3 weeks - ("COVID - 19") and the next phase is the development of a chronic process - ("POSTCOVID]. The team of MGNOT doctors, represented by its Chairman - Professor A.P. Vorobyov, offers the following treatment for "Post-Covid syndrome": 1. Apply direct oral anticoagulants, twice a day; 2. Plasmapheresis - at least 900 ml, for 1 procedure, at least 5 procedures, daily, with plasma replacement with saline to reduce intoxication [6]. It should be noted that the use of direct anticoagulants has a number of limitations and significant complications with damage to the central nervous system, they can cause nasal, throat and renal bleeding. Plasmapheresis is applicable only if there is special equipment and trained personnel in the clinics. Given the huge masses of the population affected by the pandemic, the proposed treatment technology has no chance of large-scale application. SYNDROME"), which can last for 18-24 months.

     Such a definition of the new pandemic is important not only from a taxonomic point of view, but, above all, from a mental point of view, so it gives the doctor an understanding of the complexity of the course of the disease and requires monitoring patients during the entire specified period, for example, monitoring the dynamics: D-dimers, prothrombin time, platelet count and the level of fibrinogen in the blood of convalescents. These are the recommendations of the International Society on Thrombosis and Hemostasis (ISTH) [15]. Now these are the most informative markers of the danger of thrombosis. The term "Long COVID" does not reflect the essence of the disease process [13].

     It should be clearly distinguished that the cause of the disease is the virus "COVID-19" (Beta-coronavirus SARS-CoV-2), and the disease itself, for these reasons, should be called "COVID-19 - POSTCOVID SYNDROME".

     Analyzing the pathogenesis of this disease, we will dwell on the analysis of the pathogenesis and treatment offered by two scientific schools of Russia. One of them is the analysis and opinion of doctors united in the Moscow City Scientific Society of Therapists (MCSST) named after Professor S.P. Botkin. After examination and treatment of a significant number of patients (more than 2,000 people), with a confirmed diagnosis of “COVID-19”, during 2020-2021, the diagnosis of «POSTCOVID SYNDROME" was formulated. According to MCSST " POSTCOVID SYNDROME " is: “Chronically occurring thrombovasculitis with a predominant lesion of the nervous system (Central, autonomous and peripheral) and skin” [14].

     The team of MCSST doctors, represented by its Chairman - Professor A.P. Vorobyov, offers the following treatment for "POSTCOVID SYNDROME":

1. Apply direct oral anticoagulants, twice a day;
2. Plasmapheresis - at least 900 ml, for 1 procedure, at least 5 procedures, daily, with plasma replacement with saline to reduce intoxication [6].

     It should be noted that the use of direct anticoagulants has a number of limitations and significant complications with damage to the central nervous system; they can cause nasal, throat and renal bleeding. Plasmapheresis is applicable only if there is special equipment and trained personnel in the clinics.

     Given the huge masses of the population affected by the pandemic, the proposed treatment technology has no chance of large-scale application.

     Another clinical school, headed by academician Makatsaria A.D., believes that the leading pathological sign of this disease is the "Syndrome of disseminated intravascular coagulation - (DIC) syndrome [15]. The most unfavorable prognostic sign, according to the authors of this school, is coagulopathy.

     If the parameters of the main markers of coagulopathy (D-dimers, prothrombin platelet time, count and fibrinogen levels) worsen, more "aggressive" resuscitation care should be carried out: Low molecular weight heparin (LMWH) should be prescribed to all patients with diagnosed “COVID-19” infection (including non-critical patients) who require hospitalization, in the absence of contraindications to LMWH in these patients. The use of LMWH drugs by this school (Enaxiparin, Nadroparin, Dalteparin) in a prophylactic dose is also justified, which does not require special control. It is recommended to take these drugs to all patients, even with a mild course of the disease, excluding active bleeding, platelet count < 25x10⁹/l, intolerance to LMWH, severe renal failure.

      At the same time, it is not known how these drugs will behave with prolonged use, except for the above limitations for them.

     The author of this article spoke at the 11^th European Congress for Integrative Medicine in 2018 in Ljubljana (Slovenia) [1] and at the 5^th International Meeting on Traditional and Alternative Medicine in Rome (Italy) April 2019 with a report: "The Renaissance of hirudotherapy in Russia: The end of XX and the beginning XXI century [2]. These speeches and publications were positively received by the medical community, which served as an incentive for a more complete coverage of the topic of the current state of hirudotherapy in Russia [11-13].

     Without reducing the importance of the recommendations of the MCSST therapy of "POSTCOVID SYNDROME"), we offer an alternative way to solve the problem of reducing mortality from pneumonia and other complications caused by “COVID-19”. Previously, we expressed the same point of view in the treatment of elderly people with multi-organ pathology, namely, they become primarily victims of this pneumonia [4].

     This is the application of the "System Method of Leeching" (SML) - (hirudotherapy). The method is based on a combination of the principles of homeopathy and acupuncture (hirudopuncture, our definition). The proposed solution is based on the almost 30-year use of SML in elderly people with multi-organ pathology and children treated at the Academy of Hirudotherapy of St. - Petersburg [16]. The preventive and therapeutic plan for anticoagulant and antiplatelet therapy for the prevention of DIC- syndrome, distress syndrome is considered step by step from the standpoint of the “System Method of Leeching” (SML) in recent publications [4, 17].

     We remind readers about some unknown properties of leech.

     Over the past 30 years, the Academy of Hirudotherapy in St.- Petersburg has obtained a number of new fundamental facts when applying the “System Method of Leeching (SML), which can significantly enhance the clinical effect of its use, and will reduce the mortality of patients with pneumonia caused by the “COVID-19” virus.

In addition to the already known properties of hirudotherapy - antithrombic and thrombolytic, anti-inflammatory, countercurrent, new properties of medical leeches were discovered at the department:

• Discovery of the energy effect (information-entropic);
• Discovery of the neurostimulating effect of the medical leech;
• Discovery of the acoustic effect of leeching (hirudotherapy);
• Discovery of the detoxification effect of leeching (hirudotherapy);
• Discovery of the phenomenon of local hyperthermia in the body of a benign brain tumor - neurinoma;
• Discovery of the negentropic effect of leeching (hirudotherapy);
• The role of autohemogyrudotherapy in the formation of the immunomodulatory effect of leeching (hirudotherapy) is shown;
• Discovery of the aquastructuring effect of leeching (hirudotherapy);
• Discovery of the "Resonance-wave effect" of leech on the state of the human aquasystem.

     Descriptions of all these discoveries are detailed in the author's publications [3-13, 17].

     Therefore, as soon as the pandemic caused by the “COVID-19” virus was pumped up in Russia, our doctors, trained in the SML technology, began to actively apply this method in the treatment of the disease "COVID-19 - POST-COVID SYNDROME".

     At the same time, it was shown that SML is a pathogenetic method of treating this disease, including well-known signs of damage to the central and peripheral nervous system, (restoring smell, hearing and vision loss, manifesting antidepressant syndrome) preventing the development of DIC - syndrome.

     It should be noted that the use of SML has no restrictions on the timing of use, so a patient with a brain tumor - a neurinoma (schwanoma) received treatment for 23 years, demonstrating a positive result of treatment (Clinical case

described [18]).

     Why do we refer to hirudotherapy as a “Method of information medicine”?

      Not only because this method has about 20 types of therapeutic effect. But also because in the process of treatment with medical leeches, which is first shown in our studies, there is an impact on the information-entropy processes in the aqua system of patients, which leads to a process of harmony between the indicators of the chaos criterion (C_c) and the order criterion (C_o), with access to the harmony parameters - "Golden Proportion" or "Golden Ratio", which is characteristic of a high level of health [5, 19].

     Known for many centuries, the method of hirudotherapy, as part of Ayurveda or Ayurvedic medicine, is still revered and used in India and the countries of South-East Asia.

     At present, thanks to new knowledge in the field of hirudology and hirudotherapy, reflected in the "System Method of Hirudotherapy", the Ayurveda method has acquired a new image, content and capabilities.

Conclusion

     The SML method has no complications and can be used as monotherapy in both the acute and chronic stages of the disease "COVID - 19 - POSTCOVID SYNDROME".

The article discusses the mechanism of the disease "COVID - 19 - POSTCOVID SYNDROME". The mechanisms of pathogenesis of this disease are affected. The most proven mechanisms of the pathogenesis of the disease and the most effective methods of treatment according to the literature are considered. In comparative terms, the advantage of the "System Method of Leeching" in comparison with the proposed methods of treatment is shown. The possibility of monotherapy with medical leeches (hirudotherapy) of this disease is shown, as an example of information medicine.

Keywords: Disease "COVID - 19 - POSTCOVID SYNDROME"; damage to the nervous system (central and peripheral); DIC- syndrome; “System Method of leeching” (SML) - hirudotherapy; new effects of hirudotherapy

Robotics in medicine is very innovative field of research and exploration recently. Recent advancements in different robotics technologies utilized in medical and personalized healthcare are in huge concerns both in academia and industry fields. Getting yourself to be familiar in the recent state-of-art in the different fields covering robotics in medicine is great step towards being professional in high demand for medical, personal healthcare, robotics and IT industries.

Topic Field-1: The board Spectrum of Robotics Applications in Medical and HealthCare Monitoring.

Topic Field-2: Recent Advancements of Medical Teleoperations.

Topic Field-3:  Medical Imaging and Image-guided Surgery.

Topic Field-4: Kinematics of Medical Robotics.

Topic Field-5:  Tracking & Surgical Navigation.

Topic Field-6: Surgical Collaborative Robots.

Topic Field-7: The Rise of Metaverse in Future Surgery.

Topic Field-8:  Towards Successful and Widely Adoption of Robotic Surgery in Common Surgical Procedures.

Topic Field-9: IoT and Digital Human-Body Twin for Precise and Reduced Cost Remote Robotic-Surgery.

Topic Field-10: The power of Artificial Intelligence in Personalized HealthCare and RoboticSurgery.

The section of robotics in medicine covers a wide spectrum of the recent advancements of connected modern technological infrastructure that allow collaborative and remotely precise surgical operations. The analysis of the potentials of the medical system under investigation in this book are hugely beneficial for researchers in the fields of personalized healthcare, remote precise surgical operation, modern image processing and visualization techniques and artificial intelligent automated services in medicine.

Public health medicine faces many obstacles and challenges, especially in developing countries. One of these challenges is that public health medicine is not given a high priority like other specialties of medicine. The reason is that health planners in these countries are focusing their efforts on secondary, tertiary, and advanced healthcare services and do not give the required support to public health medicine that considers effective wall to enhance the general health of the population, through the building of an integrated primary health care programs to detect and deal early with cases that may slip to higher levels of health care and cost healthcare systems a lot of money.

Governments and policymakers across the globe should give more attention to the public health medicine discipline as it is considered one of the pillars that enhance the health of societies and make them active and productive at the same time.

The health of the population is not the responsibility of the healthcare system, but of society as a whole. So, while public health may be within the health care system, it necessarily operates to a large extent beyond that system, at a community and societal level. Public health defines as the is the science and art of preventing disease, prolonging life, and promoting health through the organized efforts of society. On other hand, Public Health Medicine is one of the specialties of medicine that aims to promote health and prevent diseases and injuries (primordial and primary prevention), in contrast to the medical model of care, which focuses more on reacting to the illness through diagnosing and treating them after they occur (secondary and tertiary prevention). Public health medicine also focuses on assessing and measuring the health status of populations and developing effective interventions at the population level rather than individuals and creating the conditions that enable people to make healthy choices to improve their health.

   In fact, the feeding of human populations has gone from the collection of fresh vegetables in nature, to specialized production in large monoculture extensions, with high mechanization and use of agrochemicals; that is, from natural foods to those manipulated through different technological processes. The latter have become a few basic products, whose negative effects are well known, due to prolonged exposure over many generations to a low diversity of foods and their associated microbiota, which is why nutrition and immunity functions have been reduced naturally in the human microbiota (Vázquez 2022).

   Paradoxically, families from periurban communities, sometimes socially marginalized, are more likely to obtain food in small spaces, which provide them with a diversity of seminatural fresh products, because they are obtained with minimal physical interventions, not chemicals and very little manipulation, whose biotic direct interactions contacts with family members influence nutrition and health, facilitating a sustainable quality of life despite living with low income. In fact, these periurban communities constitute coinnovation niches that can serve as a reference for designing the food systems of the future.

Habitat and feeding

   An estimated 800 million city dwellers worldwide are involved in agriculture-related activities in cities and towns, where they produce food and generate income. A combination of data from national censuses, household surveys and research projects from various agencies indicate that up to two thirds of urban and periurban households are involved in agriculture, through local government, institutional, community and family programs (FAO 2010).

   It is interesting to observe that in the members of these families there are contrasts of origin, training and ages, which converge with a permacultural, organic or agroecological perception regarding family farming, mainly when elderly people of peasant or rural origin live together, who transmit their cultural traditions; also, people who have received training that allows them to understand the differences regarding feeding with products from conventional agriculture.

   Carrying out biodiversity management practices in small scale agricultural production systems, with social and environmental advantages in historical, socioeconomic, and geographical contexts in Latin America, has helped to maintain more sustainable agricultural systems than the technified ones (Mougeot 2006). These urban green spaces can provide vegetation structures and biodiversity for ecosystem functions and services, across fragmented habitats and spatial scales (Lin and Fuller 2013).

   Although urban agriculture alone will not solve the complex ecological and social problems of cities, given the multiplicity of factors that intervene in it. Agrocultural development in the city constitutes an effective strategy for the management, protection, and recovery of the urban environment from various spheres of action (Moreno 2007). In fact, small scale agricultures are those that produce around 70% of the food worldwide, using only 30% of the productive resources, while industrial agriculture produces 30% of the food in 70% of the surface (ETC 2017).

   Small scale food production in urban and periurban areas has become an important component in the design of feeding strategies in large cities of the developing world and is an agricultural production alternative with almost nonexistent negative environmental impacts (Morello 2000), experiences that justify the importance of integrating the habitat with the self management of food that can be considered as seminatural.

   In fact, human health is closely related to the environmental factors (Mejías 2013). The different existing models on health determinants contemplate the environment as an important factor to take into account (Evans et al 1996). Considering that the city is the main environment in which life takes place for a large part of the population and that, as has already been seen, it is possible that it will increasingly accommodate a greater number of people, it seems advisable to study how to make these ecosystems healthy spaces (Mejías 2013).

   Several studies indicate that contact with nature and the inclusion of green spaces in urban environments promote psychological wellbeing, stress reduction and improve the perception of health of its residents (Largo-Wight 2011).

   Given this need, agroecology emerges as a discipline that provides the basic ecological principles on how to study, design, and manage agroecosystems that are both productive and conserving natural resources, and that are also culturally sensitive and socioeconomically viable (Altieri 2010).

Food and health

   The modern diet is vastly different from that of our Paleolithic ancestors, who had an annual base of some 500 different plants, whereas ours has fewer than 50; they ate their food raw and often fermented, while we preserve, dry and cook our food, processes known to destroy many sensitive nutrients and antioxidants. This may be the reason why we are now seeing an increase in various atopic diseases, infections and so-called Western diseases (Bengmark 2001).

   Several leading authoritative reviews have shown that dietary diversity is associated with better health outcomes, and that a monotonous diet, even biofortified, is associated with nutritional deficiencies and high rates of chronic disease (Bélanger and Johns 2008). Another potential positive effect of participation in urban gardens is an improvement in nutritional habits there are studies that indicate that the consumption of fresh fruits and vegetables is higher among horticulturists than among those who are not (Alaimo et al. 2008).

   On the other hand, the postharvest rehandling of fresh agricultural products is a factor that can generate risks for healthy eating, mainly when good packaging, transportation and temporary storage practices are not guaranteed and the marketing circuits are long. This situation does not occur in family and community agriculture, where freshly harvested food is used or consumed in a short time, either by the family or community members.

   Through social practice, societies have developed experiences and systematized special ways of "know and to know" about health and disease, which have gradually shaped a set of notions and knowledge formed in people's daily and spontaneous common practice, until arriving at the empirical practice that concentrates and systematizes the experience of the community in a long time. This informal knowledge, of unquestionable cultural value, is considered by some health professionals as something that must be preserved or recovered due to its secular value (Silva 1997).

Sustainable quality of life

   The sustainable quality of life, although it is a highly complex socioeconomic challenge for health systems, can be considered as one of the priorities for the survival of human populations. It is a holistic approach to health conservation, which is particularly different in urban, periurban and rural systems, where factors that determine habitat quality, healthy eating and natural medication converge.

   People who have a working life in different occupations in society, find a moment to take care of plants and animals, which means a change of work that they do with pleasure, because it has the double function of contributing to the wellbeing of the family and their health, for being doing physical work. This is the integral health of the family, because they coexist in harmony with plants and animals that provide them with different benefits, be they food, nutrition, medicine and pleasure.

   Another problem is the social isolation suffered by a significant number of older people, which is an important risk factor for developing other disorders or pathologies (Kharicha et al 2007). It is mentioned that, for example, in Sri Lanka the shade, freshness and diversity of these orchards are considered essential for people's physical and mental wellbeing (Lok 1998).

   Although the current needs of human populations are diverse and of a high magnitude, integrating orchards into urban, periurban, and rural family homes has an invaluable contribution to sustainable quality of life, because it contributes to rediscovering habitat, food, and health.

   The original human populations lived in communities, where they coexisted in a feeding system integrated into the natural habitat. With social development, they were regrouped into urban (towns and cities), periurban and rural socioecosystems. These characteristics have contributed to the fact that today's society is made up of population conglomerates in anthropized habitats, where the quality of food and the state of health, which are still valued separately, have become important social problems, including in rural areas, where the influences of modernity have eroded traditional food culture and medication.

   Our world revolves around its advanced axis. Everything is progressive and innovative. Newer technology is on the horizon, and it has changed the spectrum of our world and transformed the way people live. This digital rise brought pros and cons to our scheme. This technological breakthrough contributed to different spheres of existence.

   The security of its citizens is the government's first priority. Since individuals are the most valuable resource the government has, improving medicine and medical procedures is essential if we want to win the public's trust. The delivery of public health is efficient if one medical practice is effective. We refer to this as the "parallel effect."

   Public health and medicine are intricately intertwined. The understanding of and contribution to public health made by medicine are changing along with the world. All facets are moving toward high definition and the internet of things as we reach the fourth industry. The cosmos is increasingly facing extreme climate change, which has negative effects on human health and the ecosystem. People are more involved in unrelated work, which increases the likelihood that health hazards will arise. Because of this, innovation in medicine and public health must coexist.

   By properly implementing various programs and curricula related to the effective use of medication as a therapy for any disease, public health is the process of creating a healthy environment for healthy people. The challenge here is how well public health professionals can treat everyone with inclusive medication in order to prevent any health complications. The 4^thIndustrial Revolution has profoundly changed the medical industry in many ways, so it is important to take that into account while promoting public health. Extensive learning is essential in order to practice advanced medicine.

   In a general sense, the primary goal of medicine and public health is to promote and improve the health of every individual and the whole population. This must include appropriate program implementation for the right people at the right time and in the right place. A comprehensive and thorough understanding of how to carry out this attempt in order to promote healthy well-being and a disease-free environment that is resilient throughout the seasons.

   The exceptional effect of COVID-19 disease greatly affects everything in the system. When it strikes, many lose their jobs and even their precious loved ones. Everything was on the brink of closure, and health is the major concern at this time. For the past two years of battling against COVID-19 disease, we have been in a health recovery as we face the so-called "new normal. Post-pandemic experiences improved the medical world's understanding of public health issues and concerns. Medicine, like technology, is evolving at a rapid pace today.

   Best practices of hospital, efficient leadership in healthcare, appropriate delivery of services to the patient at right time/ pace and empowered patient are the scenario of win-win. The grapes not only appear sour but also bitter!  Countries, companies and organisations are all striving to contain cost but the tug of war is highly imbalanced.

What is the solution?

   A techie / IT professional is much well paid, doctor is always on the receiving end, nurse is never polite and what not. Despite all Care of the infirm is a priority. Let us strive and make the system better. Pleasant interactions at a hospital are possible with these

• Patient centric management.
• Responsible reception desk.
• Well oriented progressive signages.
• Concerted team management of HR.
• Individualised billing priority.
• Incentivised feedback.
• Universal coverage. F.2

   To err is human, agreed. But amidst these humans exist the divine species of healthcare workers. Governments, policy makers and the general masses need to realise this and implement this in day to day lives.

   As per IMCA London, Cost Accounting is defined as “the process of accounting of cost from the point the expenditure is incurred or committed or committed to the establishment of its ultimate relationship with cost center & cost unit”. F.1

Three Kenya Medical Training college campuses were selected purposively, mainly, Bungoma in Bungoma County, Webuye in Bungoma County and Kakamega in Kakamega County. Across sectional analytical Study design was employed. A sample of 222 students and 12 key informants were included in the study. Systematic random sampling was used for selection of students. Structured questionnaires were used to collect data from students, Interview schedules used to collect data from Key Informants. Collected data was entered in the SPSS Version 21.0 and data analysed by descriptive statistics using percentages and means and inferential statistics of odds ratio used to test strength of association and 0.05 set as p value used to test the hypothesis in academic dishonesty. The response rate was (90.1%) n=202. The study findings revealed that out of 202, (47%) n=95 agreed to have been involved in some form of academic dishonesty; Most students, (40.1%), n=81 confessed to have received information on academic honesty through students’ hand book. The results revealed examination cheating as the main form of academic dishonesty (71.6%) n=145. The main contributing factor to academic dishonesty was lack of lecturers adhering to policies in administration of examinations and overcrowding (OR: 2.3; 95% CI: 1.2-4.5; p=0.01), students not aware of college rules (OR: 0.6; 95% CI: 0.3-1.0; p=0.07) followed by family pressure to score high 47.8% (n=97). Students reported that punishment, remedial teaching and ant plagiarism software detection strategies were explained to them at the beginning of the training (OR: 1.4; 95% CI: 0.7-2.7; p=0.03). Consequences for academic dishonesty differed from college to college (OR: 1.9; 95% CI: 0.9-4.0; p=0.04). The most employed strategy for addressing academic dishonesty was use of punishment. In conclusion, the study revealed that academic dishonesty was prevalent in the three colleges with cheating as the commonest form. Punishment was the commonest of all strategies used to deter students’ involvement in academic dishonesty. This study therefore recommends that lecturers should adhere to college policies particularly during invigilation of examinations and provision of enough spacing during examination to reduce examination malpractices and more current strategies like software plagiarism detection to be employed by the college administration in curbing academic dishonesty.

Globally, over 80 % (6.8 millions) of college students believe dishonesty in academics is a necessity to excel. On average, 70% of students confessed to having engaged in different forms of academic dishonesty. In Sub Saharan Africa approximately 50% (4.1 millions) students were involved in acts of academic dishonesty. In Kenya about 50% (70234) academic dishonesty occurs in most colleges in the Kenya Medical Training College with various forms being reported in the year 2012 and specific to western region, about 50% (20,243) of students in higher institutions of learning admitted to have engaged in different forms of academic dishonesty. A report by Kenya Medical Training College for the year 2015/2016 revealed an upsurge in academic dishonesty in most colleges nationwide. Contrary to the fact that Student are expected to be honest in their training as their future career revolved around taking care of people. Specific to Western region in Kenya, there has been limited documentation on academic dishonesty. Therefore, this study aimed at investigating academic dishonesty among nursing students in Kenya Medical Training Colleges in Western Kenya to specifically identify prevalence, factors contributing to academic dishonesty and strategies to prevent the same.

Keywords: Epidemiology; bacteriology; urinary tract infection; Sikasso; Mali

The objective of this work was to describe the epidemiological and bacteriological aspects of urinary tract infection in Sikasso hospital. This descriptive prospective cross-sectional study took place from February to August 2022 in the laboratory of Sikasso hospital. The identification of the bacteria was made from cultural, biochemical (Api 20E gallery) and antigenic characters. Antibiotic resistance was performed using the disc technique in agar medium and interpretation was made according to the recommendations of the antibiogram committee of the French microbiology society. We practiced 448 uine cytobacteriological examinations of which 61 met the urinary tract infection criteria, ie a prevalence of 13.62%. Gram-negative bacteria accounted for 98.36% of isolates with a predominance of E. coli 75.40%, followed by Klebsiella pneumonia 18.03%. The age group 60 and over in males was the most affected with 64.86% (p: 0.0001) of cases. A significant relationship was found for age (p: 0.0001), gender (p: 0.04) and the urinary tract infection. Concerning sensitivity to antibiotics E. coli opposed a resistance of 92.50% to aminopenicillins, 82.93% to cotrimoxazole, 76.09% to 3rd generation cephalosporins and 65.22% to ciprofloxacin. The resistance mechanism by extended-spectrum betalactamase production was observed in 47.83% of E. coli strains. At the end of this study, the hospital prevalence of urinary tract infection is estimated at 13.64% with Escherichia coli and Klebsiella pneumoniae as the majority microorganisms.

Clinical Presentation

     A 50 years old non diabetic, non-hypertensive male patient presented with acute onset fever for past 5 days and persistant hiccough and drowsiness for last 1 day. Fever was intermittent (twice daily), not associated with chill and rigor. It was associated with generalised weakness and myalgia. There was no history of cough and cold, dyspnea, abdominal pain, dysuria, headache, nausea, vomiting.

     On examination, patient was drowsy, GCS 14/15. Neck rigidity was absent. Chest examination revealed mild inspiratory crepitations over left lower zone.

Investigations

Complete hemogram shows Hb 11.5, TLC 3500 (N58L40E1M1), platelet 75000. LDH 780.
Liver function test showed total bilirubin 0.8, SGOT 170, SGPT 44, ALP 92, albumin 3.1, total protein 6.
Renal function test showed urea 51, creatinine 1.5, serum sodium 125, potassium 3.6.
C reactive Protein was 75.5.
Urine examination was normal.
Chest x ray was normal.

USG whole abdomen showed liver 14 cm, spleen 14 cm.
2 D echocardiography- Normal.
Malarial parasite and Dual antigen Negative.
Dengue IgM Negative, Typhidot IgM negative.
Leptospira IgM-positive (titre-1:80).
Scrub typhus IgM-positive (titre-1:80).

Clinical Course

Patient was managed conservatively with Ceftriaxone, Doxycycline and 3% Nacl, But didn't improve. He developed dyspnea and progressive drowsiness.

CSF analysis showed protein 72mg/dl, sugar 54mg/dl.cell count 3, all lymphocytes.

Further examination revealed Triglyceride was 613mg/dl, ferritin was 14540mg/dl.

Bone marrow examination revealed Haemophagocytes.

Management

     The patient was diagnosed with Macrophage Activation Syndrome secondary to Scrub typhus and Leptospirosis. He was treated with intravenous dexamethasone along with antibiotics. Patient improved dramatically from third day and he was discharged with oral antibiotic and oral steroid for total 14 days.

Learnings

     We have to keep Macrophage Activation Syndrome in our mind while treating a febrile patient who was not responding to antimicrobial therapies rather who was gradually deteriorating because antimicrobials without immunosuppresion in these cases can lead to fatal consequences.

Reference

1. Diwan AG., et al. “Triple trouble--macrophage activation syndrome in a case of severe leptospirosis and scrub typhus co-infection”. The Journal of the Association of Physicians of India 62.1 (2014): 58-61.

Acute onset febrile illness is one of the most challenging disease to physician. It can occur in various infective, inflammatory, neoplastic diseases. Sometimes it is very difficult to find the cause and sometimes it is also difficult to treat.

Keywords: Sepsis; Septic Shock; Biomarker; Presepsin; Procalcitonin; C-reactive Protein; Interleukin-6

The number of different biomarkers used in patients admitted in ICU for SIRS, sepsis and septic shock is extremely high, but no single one has high specificity and sensitivity so it has been suggested that combinations of several biomarkers may be more effective than single biomarkers. The aim of this study was to investigate the use of Presepsin, a soluble fragment of the cluster of differentiation marker protein 14 (CD14), involved in pathogen recognition by innate immunity. In selected ICU patients and cardiac surgery patients we tried to investigate the diagnostic and prognostic value of Presepsin (PSP) compared to Procalcitonin (PCT), C-reactive Protein (CRP), White blood cells (WBC) and IL6. The assay for biomarkers were performed on whole venous or arterial blood, on days 1, 2, 4, and 7 from admission of patients eligible for the study. The diagnostic accuracy of the biomarkers studied was evaluated using the areas under the curve (AUCs). The accuracy of all biomarkers decreases with time until they are no longer useful. The use of Presepsin (PSP) to early detect the presence of infection could improve patient survival and outcome in distinguishing sepsis from SIRS in intensive care unit.

Keywords: Autism Fetal stem cells Transplantation Cell therapy Biopharmacy

Autism spectrum disorders (ASDs) are heterogeneous complex neurodevelopmental pathologies defined by behavioral symptoms, but which have well-characterized genetic, immunological, and physiological comorbidities. Despite extensive research efforts, there are presently no agreed upon therapeutic approaches for either the core behaviors or the associated comorbidities. In particular, the known autoimmune disorders associated with autism are appealing targets for potential stem cell therapeutics. Of the various stem cell populations, fetal stem cells (FSCs) offer the potent immunoregulatory functions found in primordial mesenchymal stem cells, while exhibiting rapid expansion capacity and recognized plasticity. These properties enhance their potential for clinical use. Furthermore, FSCs are potent and implantable “biopharmacies” capable of delivering trophic signals to the host, which could influence brain development.

Keywords: Athlete; Semi-marathon; caffeine-based stimulant drink; acute dehydration; athlete's heart

Syncope is one of the rare but serious heart attacks occurring in an athlete during a semi-marathon race. The aim of this case report is to bring awareness of such accidents to the sports community in sub–Saharan Africa where little is published about syncope in athletes. We are reporting the case of a 31-year-old Cameroonian half-marathoner with no contributing past medical history, and whose Precompetition medical assessment (PCMA) performed 48 hours before the race was normal. The young man started the race at a favorable temperature of 26°C at 6 AM in Yaounde. An hour prior to the beginning of the race, the semi-marathoner drank without medical advice 66cl of a caffeine-based energy drink. After 17 kilometers of running without oral rehydration (out of medical advice), he abandoned the race, due to intense physical asthenia, constrictive pain under the diaphragmatic muscle, dizziness, palpitations, then fall from its height occurring 30 minutes after stopping the race with the spontaneous recovery of the state of consciousness a few minutes later during his medical transportation to the Emergency center of Yaounde were the early management showed a conscious, restless athlete with stable hemodynamic parameters: BP: 116/53mmhg, Regular and symmetric pulses at 63 pulsations/minute, Regular Respiratory Rate: 22 cycles per minute, the Body temperature of 37,8°C, Blood saturation (SaO2) of 94% in ambient air, Glycemia on the spot found at 1,03 g/l. The resting 12 leads Electrocardiography done at the emergency unit was like that of the PCMA excluding the absence of bradycardia. Doppler echocardiography is normal, as well as Troponin that was done 12 hours (H12) after the beginning of chest pain. So far, the working diagnosis was syncope due to a probable coronary Vaso spasm following the ingestion of a stimulant substance in the context of acute dehydration and intense physical exertion. The possibility of a paroxysmal rhythm disorder was still to be excluded.

Keywords: Deaths; cholera; conceptual mode; DRC

Context. In the Democratic Republic of Congo (DRC), the epidemiological profile is dominated by infectious diseases including cholera. It evolves in endemic and epidemic form depending on the province. Despite multisectoral and multidisciplinary interventions organized in the field, the number of deaths remains high, as some contributing factors remain unknown while interventions need to be directed towards these factors.

Objective. Develop and analyse the conceptual model of the factors underlying cholera deaths in the community and in cholera treatment centres (CTCs).

Methodology. A retrospective cross-sectional study, from 2000 to 2013, of descriptive and exploratory type was used. It used the Directorate of Disease Control (DLM) database of 500,670 cases and 11,560 deaths. Finally, the qualitative and prospective method was carried out from 16 September to 16 December 2016, multicentric and covering five cities: Kinshasa, Lubumbashi, Kisangani, Mbandaka and Kalemie. Focus group techniques with 50 community leaders, an in-depth semi-structured interview with 50 patients, 15 health experts and 25 cholera patients. And a structured face-to-face interview with 15 health workers assigned to the CTC was organized. The percentage (%) of respondents' responses was calculated. Content analysis and triangulation of information was performed. Some qualitative survey data was collected by telephone, for obvious reasons.

Results. Four main groups of factors: (i) Organization of services (training of providers, availability of inputs, principles of separation of treatment rooms, lack of working hours, poor management of inputs, lack of systematic follow-up and evaluation of patients, poor clinical evaluation of patients), (ii) Individual factors (physiological state, pathological state and immunological status), (iii) Cholera profile (endemic area, epidemic and virulence of Vibrio cholerae). (iv) Socio-community and anthropological factors (perception and representation of cholera on the one hand, and treatment on the other). These factors can be influenced by complex interrelations without linearity.

Conclusion. Our study, to the importance of developing a conceptual model of the factors of death due to cholera. Understanding the factors that influence and interact with death is the straight line on which efforts must be focused to effectively and significantly reduce mortality from this disease. This conceptual model was designed to develop and analyze more than 96% of these factors, with the exception of those related to the biology of Vibrio cholera, including virulence genes. An ongoing prospective analytical study will determine virulence gene characteristics and antibiotic susceptibility profiles of Vibrio cholerae O1 in clinical and environmental isolates in Lubumbashi, Democratic Republic of Congo.

Conclusion. Our study showed the importance of developing a new conceptual model of cholera death factors. Understanding the factors that influence and interact on death is the straight line on which efforts must be focused to effectively and significantly reduce mortality from this disease. In our view, actors targeting these factors would ipsofacto reduce cholera deaths in the Democratic Republic of Congo.

     Early diagnosis and management of COVID 19 improves prognosis. During the onset manifestation, the most common symptoms were fever (98%), cough (76%) and myalgia or fatigue (44%); less frequent symptoms were sputum production (28%), headache (8%), hemoptysis (5%) and diarrhea (3%) and more than half of the patients developed dyspnea [3]. At this stage, primary viral replication followed by cellular damage is presumed to occur in the mucous epithelium of the upper respiratory tract (nasal cavity and pharynx), with additional multiplication in the lower respiratory tract and the gastro-intestinal mucosa [4]. Activation of the immune system, which follows, is important. If this immunological response is adequate, the infection can be controlled and the patient remains asymptomatic. In contrast, it has been shown that SARS CoV 2 can block this antiviral immunity early, effectively and durably in the most serious cases [5]. Anticoronavirals should be helpful during this stage. It should be remdesivir (by antiviral activity against SARS-CoV-2), ritonavir boosted nirmatrelvir (SARS-CoV-2 main protease inhibitor and an HIV-1 protease inhibitor and CYP3A inhibitor), chloroquine and its derivative hydroxychloroquine (by a modification of an attachment protein on the head of the virus), baricitinib (by inhibiting cyclin G), among others. After this stage, major manifestations could be occurred.

     Major clinical manifestations linked to COVID 19 include digestive disorders, coagulation disorders, acute respiratory distress syndrome (ARDS), macrophagic activation syndrome, etc. These imply specific therapeutic approaches over anticoronaviral therapy.

Digestive disorders

     The digestive manifestations during COVID 19 are various: anorexia (83.8%), diarrhea (29.3%), vomiting (0.8%) and abdominal pain (0.4%) [6]. The interaction between SARS COV2 and intestinal microbiota on the one hand resulting a modification of microbiota, thus favoring the appearance of the cytokine storm and on the other hand interaction between SARS COV 2 and intestinal cells leads to their destruction [6]. Therefore, one of the therapeutic targets would be to add commensal bacteria to improve this modification. Another would also be to manage the cytokine storm. Some biological Disease-Modifying Antirheumatic Drugs (bDMARD) and targeted synthetic Disease-Modifying Antirheumatic Drugs (tsDMARDs) have given encouraging results in the cytokine storm management.

Coagulation disorders

     It manifests as thrombosis of small pulmonary vessels, pulmonary embolism, thrombosis of small skin vessels, deep vein thrombosis, hemorrhage of small vessels, disseminated intravascular circulation (DIC), etc. Activation of the coagulation system and fibrinolytic system result from systemic inflammation, endothelial dysfunction by interaction with SARS COV 2, severe hypoxemia and the production of antiphospholipid antibodies leading to clot formation. Anticoagulants are therefore essential in the management of these coagulation disorders. Heparin and direct oral anticoagulants can be used [7].

Acute respiratory distress syndrome (ARDS)

     It is characterized by acute onset of respiratory distress maked by dyspnea with hypoxia and hypocapnia; tachypnea; intercostal, sub sternal, supernal, supraclavicular pulling; crackling rales etc. The interaction between SARS COV 2 and red blood cells leads to a decrease in the capacity of hemoglobin to transport and efficiently exchange CO2 and O2 through the alveolo-capillary barrier which in the long term causes an alteration of the alveolo-capillary barrier, then can progress to pulmonary fibrosis. In addition, the interaction between SARS COV 2 and alveolar epithelial type II cells leads to the destruction of alveolar epithelial type II cells with production of hyaline membrane plus the alveolo-capillary barrier damage [2, 8]. A treatment based on hydroxychloroquine (by its action on the preservation of hemoglobin) allows to maintain the normal transport of oxygen (O2) and carbon dioxide (CO2) through the alveolo-capillary membrane. Certain bDMARDs can be used such as interleukin-6 (IL-6) blocker that seems to hold great promise for managing the massive cytokine storm associated with the development of typical lung damage and ARDS). tsDMARD can be also used (by interference with Janus kinase) in its management. Corticosteroids reduce excessive and harmful pulmonary inflammation, but they also inhibit the beneficial immune response which allows the patient to eliminate pathogens.

Macrophagic activation syndrome

     It manifests clinically by high fever, hepatosplenomegaly, lymphadenopathy among others and biologically by hyperferritinemia, hypofibrinogemia, pancytopenia, hepatocellular insufficiency etc. The interaction between SARS COV2 and cells having ACE 2 receptor induces an activation of the inflammatory process: vasodilation, vascular hyperpermeability, infiltration of inflammatory cells leading to the release of pyrogenic cytokines or even a cytokine storm (interleukin-6, interleukin-8, interleukin-10, tumor necrosis factor, etc) [2]. Therapies targeting the pro-inflammatory cytokines can improve macrophagic activation syndrome. Corticosteroid therapy and certain bDMARDS such as Anakinra (interleukin 1 receptor antagonist) have been discussed in management.

     So, what therapeutic strategy? The complexity of its pathophysiology, the multiple therapeutic targets and the absence of effective anticoronaviral monotherapy proven at the current state of knowledge are arguments to say that it is necessary to consider blocking several therapeutic targets in order to increase the anticoronaviral effectiveness. Hence the need to combine anticoronaviral therapeutic means taking into account the type of COVID 19 patient and in particular all the major clinical manifestations linked to COVID 19.

     Anticoronaviral multitherapy proposed by some authors may be the solution, if and only if, it can suppress viral replication and prevent the immune system from dysregulation. Indeed, clinical trial is underway to assess the efficacy and tolerance of the triple-drug therapy combining baricitinib, lopinavir / ritonavir and remdesivir [9]. The genetic susceptibility of COVID 19 patients to develop the severe form is not yet well established. Could anticoronaviral multitherapy prevent progression towards severe form? However, it has been shown that a reduced viremia does not prevent the immune system from racing and its progression towards the severe form [1]. Suppressing the virus does not seem to be enough. It would be better that all the management strategies are focused on the early diagnosis and adequate treatment of the type of COVID 19 patient and in particular all the major clinical manifestations linked to COVID 19. Anecdotally, we will say that no drug proposed is effective, all the drugs proposed are effective, it is a question of early diagnosis and adequate treatment of the types of patient and all the major clinical manifestations linked to COVID 19.

     This information will help to develop therapeutic strategies depending on the type of COVID 19 patient and in particular all the major clinical manifestations linked to COVID 19 instead to continuing to take account only an anticoronaviral monotherapy or anticoronaviral multitherapy, knowing well that the immune system dysregulation with its inflammatory corollary persists despite the decrease of viremia.

Competing interests

     Authors declare no competing interests.

Authors contributions

     Authors has read and agreed to the final manuscript.

References

1. Lescure F-X., et al. “Clinical and virological data of the first cases of COVID-19 in Europe: a case series”. The Lancet Infectious Diseases 20.6 (2020): 697-706.
2. Yuefei J., et al. “Virology, Epidemiology, Pathogenesis, and Control of COVID-19”. Viruses 12.4 (2020): 372.
3. Huang C., et al. “Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China”. Lancet 395.10223 (2020): 497-506.
4. Xiao F., et al. “Evidence for gastrointestinal infection of SARS-CoV-2”. medRxiv 158.6 (2020): 1831-1833.e3.
5. Meijuan Z., et al. “Functional exhaustion of antiviral lymphocytes in COVID-19 patients”. Cellular & Molecular Immunology 17.5 (2020): 533-535.
6. Lei P., et al. “Clinical characteristics of COVID-19 patients with digestive symptoms in Hubei, China: a descriptive, cross-sectional, multicenter study”. Am J Gastroenterol 115.5 (2020): 766-773.
7. McGonagle D., et al. “Immune mechanisms of pulmonary intravascular coagulopathy in COVID-19 pneumonia”. Lancet Rheumatol 2.7 (2020): e437-e445.
8. Wenzhong L and Hualan L. COVID-19: Attacks the 1-Beta Chain of Hemoglobin and Captures the Porphyrin to Inhibit Human Heme Metabolism (2020).
9. Stebbing J., et al. “COVID-19: combining antiviral and anti-inflammatory treatments”. Lancet Infect Dis 20.4 (2020): 400-402.

     The continuing spread of SARS-CoV-2 remains a Public Health Emergency of International Concern. World Health Organization (WHO) reported, globally, the number of new weekly cases (21 to 27 November 2022) was just fewer than 2.7 million new cases reported and the number of new weekly deaths with about 8400 fatalities. And, as of 27 November 2022, 637 million confirmed cases and 6.6 million deaths have been reported globally. Three types of COVID 19 patients are distinguished from the French study, (i) patients with few clinical signs but with a high nasal viral load and being highly contagious; (ii) patients with mild symptoms at the beginning but worsening towards the tenth day with the appearance of a severe acute respiratory syndrome despite a decreasing viral load; (iii) patients with a rapid worsening to an acute respiratory syndrome with persistence of a high viral load in the nose and throat and appearance of SARS-CoV-2 blood viremia causing multivisceral failure leading to death [1]. The major clinical manifestations linked to COVID 19 are numerous and diverse, among which there are digestive disorders, coagulation disorders, acute respiratory distress syndrome, macrophagic activation syndrome, myocarditis linked to SARS COV2, acute tubulopathy linked to SARS COV2, meningoencephalitis linked to SARS COV 2. These can be explained by the fact that the cellular tropism of SARS COV 2 is numerous as well as the physiopathogenic consequences. It concerns all cells with an angiotensin-converting enzyme 2 (ACE 2) receptor (example, alveolar epithelial type II cells, upper and stratified epithelial cells of the esophagus, absorbent enterocytes of the ileum and colon, pancreatic cells, glial cells, Sertoli cells) [2]. The interactions between SARS COV 2 and ACE2 cells lead to their internalization and massive viral replication with cellular damage, activation of the inflammatory process, activation of the immunological system, stimulation of the coagulation system, among others [2]. The various physiopathogenic consequences during COVID 19 largely explain its numerous therapeutic targets. What physicians need to know about physiopthothogeny with identified therapeutic targets, holistic diagnostic and therapeutic approach of Covid-19 is the subject of ongoing updates from experts at this Journal.

References

1. Ackoff RL. “The design of social research”. Chicago: University of Chicago Press (1953).
2. Alvi M. “A manual for selecting sampling techniques in research”. Munich Personal RePEc Archive (2016).
3. Best JW and Kahn JV. “Research in education”. Boston: Pearson Education Inc (2006).
4. Best J and Kahn J. Research in education (10th ed.). New Delhi: PHI Learning Pvt. Ltd (2010).
5. Bhardwaj P. “Types of sampling in research”. Journal of the Practice of Cardiovascular Sciences 5.3 (2019): 157-163.
6. Brick JM. “Explorations in non-probability sampling using the web”. Proceedings of Statistics Canada Symposium (2014).
7. Brown GH. “A comparison of sampling methods”. Journal of Marketing 6 (1947): 331-337.
8. Cochran WG. Sampling techniques (2nd ed.). New York.: John Wiley & Sons, Inc (1963).
9. Cohen L, Manion L and Morrison K. Research methods in education (8th ed.). New York: Routledge Palmer (2018).
10. Cresswell JW. Educational research: Planning, conducting, and evaluating quantitative and qualitative research (4th ed.). Noida: Pearson India Education Services Pvt. Ltd (2019).
11. Creswell J. Educational research: Planning, conducting, and evaluating quantitative and qualitative research (4th ed.). Boston: Pearson Publications (2012).
12. Davis D. “Business research for decision making”. Australia: Thomson South-Western (2005).
13. Dornyei Z. “Research methods in applied linguistics”. Shanghai: Oxford University Press (2007).
14. Fraenkel JR and Wallen NE. “How to design and evaluate research in education (7th ed.)”. New York: McGraw-Hill (1990).
15. Ghauri P and Gronhaug, K. “Research methods in business studies”. Harlow: Prentice Hall (2005).
16. Guthrie G. “Sampling in basic research methods: An entry to social science research”. Delhi: SAGE Publications India Pvt Ltd (2010).
17. Hansen MH, Hurwitz WN and Madow WG. “Sample survey methods and theory”. New York: Wiley 1 (1953).
18. Henry GT. Practical sampling. In L. Bickman, & J. D. Rog (Eds.), The SAGE handbook of applied social research methods. Delhi: SAGE Publications Ltd (2009): 29.
19. Kerlinger FN. “Foundations of behavioral research”. Delhi: Surjeet Publications (2011).
20. Kolb B. “Determining probability samples in marketing research”. Delhi: SAGE Publications (2011).
21. Kothari CR and Garg G. Researh methodology: Methods and technology (4th ed.). New Delhi: New Age International (P) Ltd (2019).
22. Kumar R. “Research methodology: A steo-by- step guide for beginners”. New Delhi: SAGE (2011).
23. Lohr S. “Sampling: design and analysis. Cengage Learning”. Boston: Cengage Learning (2009).
24. McCombes S. Sampling methods, types, techniques and examples (2022).
25. Nanda G and Khatoi P. “Fundamentals of educational research and statistics”. New Delhi: Kalyani Publishers. New Delhi: Kalyani Publishers (2005).
26. Raj D. The design of sample surveys. New York: McGraw-Hill Book Company (1972).
27. Ruane JM. “Essentials of research methods: A guide to social science research”. Maiden: Blackwell Publishing (2005).
28. Särndal C-E, Swensson B and Wretman J. “Model assisted survey sampling”. New York: Springe (1992).
29. Taherdoost H. “Sampling methods in research methodology: How to choose a sampling technique for research”. International Journal of Academic Research in Management 5.2 (2016): 1-10.
30. Taherdoost H. “Sampling methods in research methodology: How to choose a sampling technique for research”. International Journal of Academic Research in Management 5 (2020): 18-27.
31. Vogt WP, Gardner DC and Haeffele LM. “When to use what research design”. New York: The Guilford Press (2012).
32. Wilson J. “Essentials of business research: a guide to doing your research project”. SAGE Publication (2010).
33. Yamane T. “Elementary Sampling theory”. Englewood Cliffs: Prentice-Hall, Inc (1967).
34. Zikmund WG., et al. “Business research method: A south-Asian perspective”. Delhi: Cengage Learning India Pvt. Ltd (2010).

     Sampling design is one of the most recurrently conversed and discussed topics in research studies. Which sampling design is preferable and suitable in research primarily depends on the characteristics of a population through which we form a sample for the study. A sampling design is distinct plan for attaining a sample from the given population. The principal objective of this article is to choose the appropriate probability sampling designs in research studies. The present study is qualitative in nature and the data are collected from the secondary sources. This article will no doubt be beneficial to the persons who are engrossed in research studies as it provides them with a clear concept of types of the probability sampling designs so that they can cull an apt probability sampling design to carry out the research studies.

Keywords: Probability; research; sample; sampling design

References

1. Army Blood Transfusion Center. Blood product supplies. Paris: CTSA (2016).
2. MINSANTE Cameroon. Health Sector Strategy 2016-2027. Yaoundé: Sopecam- Cameroon (2017).
3. World Health Organization. Health Promotion - Ottawa Charter. Divisions of Health, Education and Communication for Health, Health Education and Health Promotion Unit. Geneva: WHO 1986. //WHO-(Regional Office for Europe). 1986. Health Promotion. Ottawa Charter (1986): 1.
4. WHO. World Blood Safety Database (GDBS) 2014 In Blood safety. Geneva: WHO (2014).
5. World Health Organization. Global status report on blood safety and availability 2016. Licence: CC BY-NC-SA 3.0 IGO. Geneva: OMS (2017).
6. See in article Afravih.
7. Hamel M., et al. The organization of front-line health services: a portrait of front-line medical services in Montreal and Montérégie. Montreal: Institut national de santé publique du Québec (2007).
8. Bitjoka I. “Cameroon-Public Health: Blood Banks in Cameroon Still Poor. Cameroonians implicated”. Cameroon-info.net. Yaoundé (2017): 29.
9. World Health Organization. Current status of blood safety and supply in the WHO African Region: Survey report 2013. Geneva: WHO; 2017.

Background: Cameroon faces security challenges that significantly impact the demand for blood and blood products in its care facilities, including military ones. The blood bank of the Military Hospital Region I Yaounde (MHRI) because of its human, material and managerial potential, and its situation provided the framework for analysing the communicational issues of the blood supply.

Methods: A descriptive qualitative-quantitative situational analysis of the military hospital's blood bank communication system, and its deployment in 2017 has been carried out. The 2014 Who Global Database on Blood Safety (OMS) collection and analysis tool used the bank's staff and routine documents.

Results: The bank registered 1101 candidates in the [18-27] bracket. There was no communication programme geared towards defence institutions, schools and university faculties. The staff's action, restricted but of good quality, was supported by financial and technical partners.

Conclusion: There are significant mobilization potentials at MHRI, and the value of setting up and supporting communication strategies to unite these dynamics for an efficient blood supply is needed.

Keywords: blood; communication; supply; MHRI

     Patients’ social behaviour toward the medical team mainly supposes appreciation and respect since there is a considerable investment in a medical carrier: long education period, financial resources, and emotional involvement. In medicine, responsibility is at the highest level; nothing can replace the loss of dear ones, and our mission is to improve and save life. To achieve these goals, a professional in the healthcare industry must have specific knowledge, quickly manage info and deliver medical services when and where necessary. The art of communication with patients and community members with different backgrounds helps us to attain the best results in clinical practice. To do that, theoretically, a medical team member must not be buried, not in his daily program or society. But in their daily routine, they can experience offensive comments or attitudes from persons with reasoning or communication problems.

     How much must we tolerate facing daily work adversities from the patients or other individuals?

     Genetics, perception abnormalities, info-processing deficiency, reasoning nonconformity, and tolerance groups determine a patient’s social behaviour deviance. Medical conditions may affect them at various levels. Misinformation sources must be disapproved, detected, and punished when necessary. Broad-minded groups must be trained for multiple situations that are emerging offensive human actions. Identifying the origin of an individual’s wrong and cruel actions towards others and corrective actions are needed. An ethical, respectful approach to the problem must be considered.

     Patients’ intentions may differ from their actions’ end. Good intentions following the worst results reveal judgment impairment or misinformation processing; modelling such gaps helps us improve behaviour and joy in redressing individual misconduct in social interaction.

     Repetitive unpleasant people interactions must be stopped when necessary since improper people collaboration may lead to depression, hypertension, type 2 diabetes, or dyslipidaemia in vulnerable persons.

     So, making the individual aware of the consequences of his unconventional social behaviour is mandatory.

     The healthcare professionals offended by the patient may deny the further patient’s requests for healthcare services [except emergency care], The patient will be obliged to look after another healthcare provider, and that technique may initiate the patient’s reflection about his actions, consciousness’ activation and self-awareness for further interactions with professionals. Applying this possible convincing technique adds benefit to problem-solving mastery.

     Suppose the patient’s social behaviour deviance maintains after initial corrective actions. In that case, interdisciplinary collaboration, a multi-level intervention approach, and a corporate strategy for individual life quality and safety are required. Prompt and proper attitudes for social behaviour improvement can solve harsh work conditions.

     In this digital era, AI supply quickly detects and offers an ending to this problem with positive changes.

     Usually, medical conditions alter the individual judgment and actions toward others, especially for senior adults; we may tolerate their social behaviour deviance, but not in repetition and not too much, to protect ourselves.

      Time slowly undermines all, early enough for each one, and it is better not to get its work done in advance.

     Individual behaviour is how one acts or conducts oneself, especially toward others. Human conscious or subconscious response to various internal or external stimuli communicates to us about the person’s approach in different circumstances; it reflects the individual’s genetics, educational and relational development in a specific environment.

References

1. Alexis Kafando. “Evaluation of the introduction of the new A conjugate vaccine (MenAfrivac) at the national level on the epidemiology of bacterial meningitis in Burkina Faso”. University Diploma in Vaccinology, University of Bordeaux, Ecole Val de Grace (2011).
2. WHO: Weekly Epidemiological Record: Executive Brief: WHO Position on Meningococcal Vaccines, November (2011).
3. Yazi Mai Aiki Abdoul Aziz. “Clinical and paraclinical investigations of the probable sequelae of bacterial meningitis in Niger”. Medical Thesis No. 0 1935, Abdou Moumouni University of Niamey, (2011).
4. Adrien Deroubaix. “Impact of desert aerosols and climate on meningitis epidemics in the Sahel”. PhD thesis, Pierre and Marie Curie University. France (2013).
5. WHO/EMC/BAC/98.3: WHO practical guidance, Controlling meningococcal meningitis epidemics. www.who.int/emc.
6. WHO: Weekly Epidemiological Record: Executive Brief: WHO Position on Meningococcal Vaccines, November (2011).
7. Fati Sidikou., et al. Polymérase Chain Reaction Assay and Bacterial Meningitidis Surveillance in Remote Areas, Niger.
8. Frasch CE, Preziosi M-P and LaForce FM. “Development of a group A meningococcal conjugate vaccine, Men Afri Vac(TM)”. Hum Vaccin Immunother 8.6 (2012): 715-24.
9. Mamoudou Harouna Djingarey. Development and introduction of meningococcal A conjugate vaccine; Planning workshop for the introduction of the A conjugate vaccine (MenAfrivac) and operationalization of case-by-case surveillance in Burkina Faso; Bobo Dioulasso (2009).
10. SadouKalilou Moussa. “Evaluation of the response to the meningitis epidemic in the health district of Say, Niger, 2006”. Thesis for obtaining an interuniversity diploma, in Ouidah (2007).
11. WHO: Meningitis Weekly Epidemiological Bulletin 2010, week 48–52.
12. WHO: Meningitis Weekly Epidemiological Bulletin 2011, Week 48–52.
13. Sanon Adama. “Epidemiological, clinical, bacteriological and evolutionary aspects of bacterial meningitis about 179 cases at the Souro Sanou University Hospital in Bobo Dioulasso”. Thesis of Medicine, Burkina Faso (2004).
14. A Dembele. “Purulent meningitis in newborns from 0 to 60 days in the pediatric intensive care unit of the Gabriel Touré Hospital in Bamako”. Thesis of Medicine, University of Bamako (2001).
15. Towa Djeungoue Stéphanie Jackie. “Epidemiology of meningitis in Mali in 2007”. Thesis of Medicine, University of Bamako.
16. Abdoulkarim Sabo. Epidemiology and treatment of purulent meningitis at the infectious diseases clinic of the CHU de Fann in Dakar about 262 cases collected from 1994 to 1997, Thesis of pharmacy, Cheick AntaDiop University of Dakar (1998).
17. G Campagne., et al. Epidemiology of bacterial meningitis, Niamey (Niger), 1981-1996 Bulletin of World Health Organ 77.6 (1999): 499-506.
18. Amadou Oumarou. “Purulent meningitis in children (epidemiological, clinical, etiological, therapeutic and evolutionary aspects)”. Thèse de médecine, Niamey (Niger) (1898).
19. Barbach Youness. Management of meningitis in the emergency department of the Hassan II University Hospital – Fez (about 15 cases), Thesis of Medicine, Sidi Mohamed Ben Abdallah University of Fez, Morocco.
20. Julie Chaix. “Community-based purulent meningitis in children: a retrospective study from 1998 to 2003 of two cohorts in Dakar, Senegal and Nancy, France”. Life Sciences [q-bio]. FFHAL-01731977 (2006).
21. Taha MK. Meningococcal infections. EMC - Infectious Diseases 9.3 (2012): 1-17.
22. Syrogiannopoulos GA., et al. “Dexamethasone Therapy for Bacterial Meningitis in Children: 2- versus 4-Day Regimen”. The Journal of Infectious Diseases 169.4 (1994): 853-8.
23. Fabrice Bruneel and Michel Wolf. acute meningitis; Encyclopediamedico-surgical 17-160-C-10.
24. V des Portes. Sequelae of bacterial meningitis in children and adults; incidences, types, methods of evaluation; Medicine and infectious diseases 39.7-8 (2009): 572-580.
25. E Forestier. “Strategy for the management of presumed bacterial acute community-acquired meningitis in adults”. Medicine and Infectious Diseases 39.7-8 (2009): 606-614.
26. H Ben Hamouda., et al. “Clinical and evolutionary aspects of neonatal bacterial meningitis”. Pediatrics Archive 20 (2013): 938-944.

     The countries of the Peysonnia belt are paying a heavy price for bacterial meningitis. Morbidity and mortality of bacterial meningitis is linked to certain factors.

     It is a descriptive and analytical prospective study over a period of two months from April 15 to June 15, 2015 in subjects admitted for suspected meningitis at the National Hospital of Niamey. Identifying predictors of poor prognosis during this outbreak is our goal.

     One hundred and five patients were enrolled. The majority were young. Signs of severity were coma (22.9%), seizures (12.4%), signs of focus (9.5%), shock (7.5%). Delay in management and hyperproteinrachia have also been identified as poor prognostic factors. Sequelae were balance disorders (n=20; 19%), hearing loss (n=7; 6.6%), purpura fulminans (n=13; 12.4%). There were 12 deaths or 11.4% of which 11 comas (91.66%), 2 convulsions (16.66%), 1 purpura fulminans (8.3%), 6 shock (50%), 5 signs of focus (41.66%), 8 of these patients (66.66%) came 3 days after the onset of signs.

     Poor prognosis factors were related to brain damage, shock and delayed management. Improving Niger's health system will reduce them.

Keywords: bacterial meningitis; poor prognostic factors; Niamey; Niger

References

1. Amegbor K., et al. “Cancers in Togo from 1984 to 2008: Epidemiological and pathological aspects of 5251 cases”. J Cancer Epidemiol (2011) : 1-7.
2. Darre T., et al. “Descriptive Epidemiology of Cancers in Asian”. Pac J Cancer Prev 18.12 (2017): 3.
3. Walla A., et al. “Primitive bone tumors of the limbs at CHu Tokoin”. European Scientific Journal 11 (2015): 149-157.
4. Moore DD and Lu HH. Osteosarcoma. “Orthopedic Oncology: Primary and Metastatic Tumors of the Skeletal System”. Cham: Springer International Publishing; Cancer Treatment and Research (2014): 65?9.
5. Gnassingbe K., et al. “Cancer in the pediatric surgical setting in Togo”. The Pan African Medical Journal 17.209 (2014).
6. LA Omolade, CU Nwandinigwe and EC Onyegbule. “Pattern of bone tumors seen in a regional orthopedic hospital in Nigeria”. Niger J Med 23.1 (2014): 46-50.
7. Diop M. “The state of medical oncology in Senegal”. Cancer medical science 13 (2019): 941.
8. Rajani R and Gibbs CP. “Treatment of Bone Tumors”. Surg Pathol Clin 5.1 (2012): 3.
9. Thaler M and Khosravi I. “Therapeutic management in bone sarcoma”. memo 13.2 (2020): 1.
10. Sun J., et al. “Progress of Phototherapy Applications in the Treatment of Bone Cancer”. Int J Mol Sci 22.21 (2021): 11354.
11. Ambrosio L., et al. “Biomaterials for the Treatment of Bone Cancer”. Int J Mol Sci 22.15 (2021): 8.
12. Tapsoba TL., et al. “Contribution of bone scintigraphy in the assessment of extension of cancers at Yalgado Ouédraogo University Hospital Center (CHUYO): about 70 cases”. Nuclear Medicine 37.10 (2013): 466?71.
13. Kasongo MM., et al. “Multidisciplinary management of an osteosarcoma in a child in an underequipped environment: a clinical case”. African Annals of Medicine 12.4 (2019): e3473-e3478.
14. Ottaviani G and Jaffe N. “The epidemiology of osteosarcoma”. Cancer Treat Res 152 (2009): 3-13.
15. Errani C, Tsukamoto S and Mavrogenis AF. “Imaging Analyzes of Bone Tumors”. Rev. JBJS March 8 (2020): e0077.
16. Chelli Bouaziz M., et al. “The value of MRI in the diagnosis of joint involvement in malignant primitive tumors of the knee”. Bull Cancer 103.11 (2016): 911-920.
17. Choi JH and Ro JY. “The 2020 WHO Classification of Tumors of Bone: An Updated Review”. Advances in Anatomic Pathology 28.3 (2021): 119-138.
18. Serfaty A and Samim M. “Bone Tumors: Imaging Features of the Most Common Primary Osseous Malignancies”. North Am Radiol Clin 60.2 (2022): 221-238.
19. Biazzo A and De Paolis M. “Multidisciplinary approach to osteosarcoma”. Acta Orthop Belg 82.4 (2016): 690-698.
20. Voskuil R., et al. “Malignant Bone Tumors of the Knee: How to Identify and Treat”. J Knee Surg 32.4 (2019): 305-14.
21. Ban J., et al. “Mechanisms, Diagnosis and Treatment of Bone Metastases”. Cells 10.11 (2021): 2944.
22. Anract P. “Principles of surgical treatment of primitive malignant bone tumors”. Bulletin of the National Academy of Medicine 193.1 (2009): 107?2.
23. Garcia RA, Inwards and Unni KK. “Benign bone tumors--recent developments”. Semin Diagn Pathol 28.1 (2011): 73-85.
24. Steffner R. “Benign bone tumors”. Cancer Treat Res 162 (2014): 31-6.

Introduction: The objective of the study was to describe the epidemiological, diagnostic, therapeutic and evolutive aspects of long bones primary tumors at the Regional Hospital of Sokode.

Patients and Method: It was a prospective descriptive study of patients with long bone primary tumors for a period of 04 years from January 2019 to December 2022.

Results: Twenty-eight tumors were identified in 18 men and 10 women. The morphological assessment was standard radiography (n=28), CT scan was performed in 18% (n=05). These were osteolytic tumors (39.2%), osteocondensing tumors (21.4%), mixed tumors (25%) and mixed tumors with fracture (14.4%). Anatomopathology examination of 14 patients showed osteosarcoma (n=06), chondrosarcoma (n=03), Ewing's sarcoma (n=01) and an osteochondroma (n=04). Surgical treatment by transfemoral amputation was performed in 06 cases for malignant tumors. An excision biopsy was performed for the 04 lesions whose diagnosis was an osteochondroma.

Conclusion: Diagnosis and treatment of primary long bone tumors is difficult in isolated surgical areas. The subsidy of their treatment, the implementation of diagnostic and therapeutic tools could improve the vital prognosis of patients with malignant tumor.

Keywords: bone tumor; radiography; biopsy; treatment

     According to their disorder, middle-aged people and senior adults may experience difficulties in physical exercises; in that case, a remote job [virtual] or another job selection is recommended.

     Regular physical activity maintains and improves the well-being of people in good health. Daily fine-organized exercise program duration, frequency, and intensity ensure a better life, but excessive limits for physical exercise make an individual vulnerable.

     People at risk of various medical conditions, with specific demographic data, may carry out physical exercises well settled beyond hurt.

     For a weak individual, disproportionate physical activities can lead to disaster. In addition, the warm or cold season easily facilitates brain haemorrhage or myocardial infarction for these individuals doing excessive physical work.

     Generally, physical exercise, including walking in nature, is recommended to maintain and improve individual health. For young and middle age people with moral distress but a good heart activity, walking in nature is an effective remedy; fresh air, water flow sound, floral scent, and impressive or rousing trees have a positive impact on the respiratory system, blood flow and composition, and on mental functioning. It is a relatively inexpensive mode to attain expected clinical outcomes.

     Some senior adults may benefit from an accurate physical exercise program. Most old persons are registered with heart failure, respiratory diseases, and mobility problems. For this category, physical exercises may generate dyspnoea, fatigue, and pain with additional discomfort on relatives and social workers excessively implied in their care. Clinical practice evidence shows that even walking a short distance can be fatal for older adults with advanced heart disease. But in the digital era, they may use IT devices to admire nature’s splendor or paintings, watch on-demand musical programs and movies, update the information of interest, lecture, and communicate with their loved ones, and this option never existed.

     Physical exercise is a convenient remedy with a wide range of advice or limitation, adjusted to individual medical history and clinical and demographic data. Harm and benefit are two facets of the same method for dealing with problems for recovering and improving mental and physical health.

     There is a time to use or decline the physical exercises in the best interest of the individual health.

     The art of adjusting specific procedures to personal data to achieve the desired target return in the form of gratitude and admiration from the community we serve.

     Better to keep physical exercise limits on the way, and in the end, be able to open the door coming the night.

Work ennobles us and assures our dignity and prosperity in a never-ending natural world.

     ‘Those who do not work do not eat, except for individuals with serious illnesses’ - is a divine message.

     There is a hierarchy of work design, effecting, and monitoring; each individual has to be in a position according to his expertise and ability to play his role. Harmonic mental and physical activities ensure job performance.

     Job descriptions inform in some way prospective employees about their work-out to achieve better duties. A person’s good health facilitates job completion, but an altered physical activity declines a specified standing for an individual. Each selection compels work necessities and personal health, and individual medical conditions impose attention not to harm.

Introduction

     A significant global public health and economic concern was raised by the recent (COVID-19) outbreak brought on by (SARS-CoV-2). Every day, more information is learned about how the COVID-19 virus spreads. In order to open up society during the (COVID-19) crisis, many nations intend to make face masks compulsory. In order to avoid the transmission of (COVID-19) and other respiratory viral illnesses, it is recommended that people use masks as part of a comprehensive package of preventative and control measures.

     Face masks are the ubiquitous symbol of a pandemic that has sickened 35 million people and killed more than 1 million. In hospitals and other health-care facilities, the use of medical-grade masks clearly cuts down transmission of the (SARS-CoV-2) virus. But for the variety of masks in use by the public, the data are messy, disparate and often hastily assembled.

     Face masks are incredibly popular right now due to the corona virus outbreak. According to prior advice from the World Health Organization, healthy individuals should only use masks when caring for someone who may have (COVID-19) or when they are coughing or sneezing. However, using a mask alone is insufficient to provide an effective level of protection or source control; additional actions at the individual and community levels should be taken to prevent the spread of respiratory viruses. Whether or not masks are worn, adherence to hand cleanliness, physical segregation, and other infection prevention and control (IPC) measures is essential to preventing (COVID-19) transmission from person to person. The World Health Organization (WHO) has created particular advice on IPC strategies for healthcare settings [1], Long-Term Care Facilities (LTCF) [2] and home care [3].

     Face masks can help protect against many respiratory infections that are spread through the droplet route, and that includes coronavirus and the flu. Proper donning and doffing technique are also critical measure to prevent disease transmission. The (WHO) also cautions us that masks are only effective when they are worn in conjunction with regular, effective hand washing. Furthermore, if we choose to wear a mask, we must know how to utilize it and properly dispose of it out of an abundance of caution.

     WHO advises health professionals administering direct care to (COVID-19) patients to wear a medical mask in the absence of Aerosol Generating Procedures (AGPs) [4] (in addition to other PPE that are part of droplet and contact precautions). Activated carbon, spun bond, and melt blown materials are used to make facial masks (breathing masks). Combination masks with activated carbon can reduce hazardous pollution. Many diverse approaches exist for masks to protect both the wearer and others. Mechanical interception and inertial impaction are the two "intuitive methods" that masks filter bigger aerosols. A substance filters more effectively the denser its fibers are. Because of this, greater thread counts result in greater efficacy. Just more virus blockers are available. However, some masks (such those made of silk) also possess electrostatic qualities that can attract tiny particles and prevent them from passing through the mask as well. We can reduce our risk of contracting the corona virus by using one of two different types of face masks. The first of the two face masks is a surgical face and of the second type are also referred to as (N 95) masks.

     The general public does not need the (N 95) respirator. The (N 95) respirator filters at least 95% of airborne particles but is not resistant to oil [5]. Filtering face piece respirators, commonly referred to as (N 95) masks, are regulated by the National Institute for Occupational Safety and Health.

N: Respirator Rating Letter Class: This. It stands for ("Non-Oil,") indicating that you can use the mask in a work setting if there are no oil-based particulates present. Other mask classifications include R (eight hours of oil resistance) and P(oil proof).

95: Masks ending in a 95, have a 95 percent efficiency. and that is the same as a High Efficiency Particulate Air(HEPA) and Aerosol Generating Procedures (AGPs).

Microns: Dust, mist, and fume pollutants are filtered out by the masks. Large droplets and particles with a minimum size of.3 microns won't be able to cross past the barrier, according to the Centres for Disease Control and Prevention (CDC.)

Material: The filtration material on the mask is an electrostatic non-woven polypropylene fiber.

Valve: halation valves are available as an option with some disposable N95 masks. According to the (CDC), "having an expiration valve reduces exhalation resistance, which makes it simpler to breathe (exhale)".

     N 95 masks, which are worn by medical professionals and emergency personnel, offer superior shielding from corona virus particles than fabric or surgical masks. Protecting people who are most at risk of infection requires the use of N 95 respirators. The N 95 mask is designed for healthcare professionals, and the (WHO) states that it can be used for several patients with the same diagnosis for up to four hours. Gloves and labels should be applied to the N 95 masks before disposal. Used masks need to be destroyed or properly disposed of. Even though the majority of readily accessible N 95 pollution masks can be worn and used again, they do have a shelf life. When the mask wears out or the filter becomes clogged by pollutants, it loses its ability to effectively shield us from pollution. Masks contaminated with corona virus debris have recently emerged as a major global environmental issue. In one day, millions of masks are used and subsequently discarded globally. contrary to popular belief, the CO₂ footprint of the cotton face mask is 20% greater than that of the N 95 protective face mask. 850 tonnes of CO₂ are emitted by just 17 million of our protective N 95 masks. Imagine that a straightforward adjustment in the face masks' material may cut their impact by 20%. If 12 billion masks were used, 144.000 tonnes of CO₂ emissions would be avoided.

     N 99 masks, which are one of the best options for blocking the virus because they can reduce average risk by 94-99% for 20-minute and 30-second exposures, are more effective at filtering airborne particles than N 95 masks. However, they can be difficult to find, and there are ethical considerations such as leaving those available for medical professionals.

     From a purely medical perspective, the effectiveness of measures to contain the spread of the virus is independent of the geographic area where these measures are implemented. A well-fitting mask keeps the virus from reaching others. It can also protect the wearer from becoming infected.

     Masks should be worn anytime you are in public or people are nearby. Masks act as a physical barrier to protect you and others from viral and bacterial particulates. Many people unknowingly infect others by going out and spreading germs by coughing or touching other. Infections spread from person to person in the community, and it is essential to identify and implement measures to reduce transmission to slow down or even stop spread. Public officials and governments strongly encourage the use of wide spread face masks in public, including the use of appropriate regulation. Research on the efficacy of face shields, including in combination with masks, is needed, along with research into the efficacy of masks with transparent windows for the mouth. It is also important for health authorities to provide clear guidelines for the production, use, and sanitization or reuse of face masks, and consider their distribution as shortages allow.

Diagnosis

     Fever, exhaustion, dry cough, dyspnea, and other signs of an upper respiratory infection are also present in SARS-CoV-2 illness cases.

Conclusion

     In conclusion, masks and other Personal Protective Equipment (PPE) are essential for individuals battling the pandemic and are frequently utilised by the general people. Environmentalists worry, however, that the fight against mask pollution and adverse effects on animals would result from improper disposal of masks. In the future, we must ensure that we are prepared for pandemics like this one and that we are prepared to respond to them sustainably and one does not have to come at the expense of the other.

References

1. Infection prevention and control during health care when COVID-19 is suspected: interim guidance. Geneva: World Health Organization (2020).
2. Infection prevention and control for long-term care facilities in the context of COVID-19: interim guidance. Geneva: World Health Organization (2020).
3. Home care for patients with COVID-19 presenting with mild symptoms and management of contacts: interim guidance. Geneva: World Health Organization (2020).
4. The WHO list of Aerosol Generating Procedures (AGPs) includes: tracheal intubation, non-invasive ventilation, tracheotomy, cardiopulmonary resuscitation, manual ventilation before intubation, bronchoscopy, sputum induction induced by using nebulized hypertonic saline, and autopsy procedures.
5. NIOSH-approved N95 Particulate Filtering Facepiece Respirators.

One of the most harmful, communicable, and infectious diseases nowadays is COVID-19. The SARS-CoV-2-related illness COVID-19 is extremely contagious. Wuhan, China is where the corona virus first appeared, and it has since spread over the entire world. Common signs of this virus include headache, shortness of breath, fever, cough, cold, and sore throat. At this point, risk assessments and starting outbreak control efforts depend on readiness, openness, and information exchange. Face masks may become quite popular if a pandemic affecting the respiratory system breaks out. her individual and societal steps should be taken to prevent the spread of respiratory viruses because the wearing of a mask alone does not provide an appropriate level of protection or source control. Used masks need to be destroyed or properly disposed of.

Keywords: Covid-19; SARS-Cov-2; Face masks; N 95; respiratory viruses

Cloud and Edge Computing

     Many traditional healthcare and medical systems have faced a big problem of massive unstructured, diverse, and exponential-growing data collected from different sources, thus arising much more challenges to store and process data effectively and securely. To this end, the advanced techniques and high capacities of cloud computing allow analysing healthcare and medical big data. F

Immersive Technology

     Immersive technology, a term that refers to the technologies for reality extension using the neuroscience of the human brain, aims to create distinct experiences by merging the physical world with a digital or simulated reality.

Besides augmented reality (AR) and virtual reality (VR) as two primary types of immersive technologies, it includes ex- tended reality (XR), mixed reality (MR), holography, telepresence, digital twins, and first-person view (FPV) drone

flight. The above-mentioned immersive technologies can be briefly featured as follows:

• VR: a technology that allows the creation of a fully immersive digital environment, in which the physical or real-world environment is entirely suppressed.
• AR: a technology that enables the superposition of digital elements into the real-world environment, i.e., the composite view of physical and digital elements can be observed.
• MR: a technology that not only allows the superposition of digital elements being viewed in the real-world environment but also establishes their interaction.
• XR: an umbrella term that encompasses any types of technology that alters reality (e.g., adding digital/virtual elements to the physical environment at any level, thus nearly erasing the line between the digital world and the physical world). Indeed, XR includes AR, VR, MR, and other technologies.
• Holography: or hologram is a technology to product three-dimension image of an object with highest resolution of any imaging for device-free watching.
• Telepresence: a novel form of robotic remote control, in which a human operator can observe, feel, interact, and collaborate an object from distance.
• Digital twins: a virtual replication of real-world project, which is require for connecting the physical object for real-time data collection, processing, and response.
• FPV drone flight: a technology uses unmanned aerial vehicle (UAV) with a camera for transferring high- quality videos to goggles, headsets, and mobile devices or another screen, thus allowing users to enjoy environing- mental experience in the first-person view.
• Haptics: refers to a technology that uses tactile (touch) sensation to interact with the computer applications to uplift user experience.

Enabling Technologies of The Metaverse for Healthcare

     This section presents a detailed discussion of the enabling technologies of the Metaverse for healthcare, which includes extended reality, blockchain, artificial intelligence, IoT, 5G and beyond, digital twin, big data, quantum computing, human-computer interaction, computer vision, edge computing, and 3D modelling. The illustration of the above- mentioned enabling technologies of the Metaverse for health- care is depicted in the next Fig. F

A. Extended reality

     Extended reality includes technologies such as augmented reality (AR), virtual reality (VR), and mixed reality (MR), aided by artificial intelligence, computer vision, and connected devices like mobile phones, wearables, and head- mounted displays. By incorporating voice, gestures, motion tracking, vision, and haptics, this new technology is transforming the way services are delivered, improving the quality in various sectors.

B. Blockchain

     The foundation of blockchain emerged in a 2008 white paper written by Satoshi Nakamoto. A blockchain is a digital database of transactions that is duplicated and dispersed over the entire blockchain network. Each block in the chain contains several transactions, and whenever a new transaction occurs on the blockchain, a record of it is added to all participant’s ledgers.

C. Artificial Intelligence

     Artificial intelligence (AI), also known as machine intelligence, focuses on the development and management of technology that can autonomously learn to make decisions and carry out tasks on behalf of humans. AI is a collection of technologies that incorporates any software or hard-ware component that facilitates machine learning, computer vision, natural language understanding (NLU), and natural language processing. AI will help strengthen the Metaverse infrastructure, enhancing the 3D immersive experience, and boosting the virtual worlds’ built-in services. AI technology will also help in improving the quality of services and the Metaverse ecosystem.

      The health industry has recently begun utilizing revolutionary techniques such as XR and big data combined with AI in software and hardware to increase the efficacy of medical devices, reduce the cost of health services, enhance healthcare operations, and broaden access to medical.

D. Internet of Things

     The phrase "Internet of Things" (IoT) refers to the billions of devices that are currently connected to the Internet and exchanging data. Due to the introduction of low-cost computer chips and the broad availability of wireless net- works, everything from smartphones to intergalactic operations can now be connected to the IoT. Due to the incorporation of sensors and the capacity to communicate with one another, these devices can share real-time data without the need for a human supervisor.

E. 5G & Beyond

     The term "5G and beyond" refers to the fifth generation and beyond of wireless technology. It outperforms 4G LTE networks in terms of both speed and latency, and it has a higher capacity. In contrast to the maximum speed of 4G technology, which is only 1 Gbps, the maximum speed of 5G technology can exceed 20 Gbps. Additionally, delivers reduced latency, which has the potential to enhance the performance of commercial applications and other digital experiences.

F. Digital Twin

     A digital twin is a virtual representation that acts as the digital counterpart of a physical object or process in real-time. The first practical definition of a digital twin was proposed by NASA in 2010 to enhance the physical-model simulation of spacecraft.

G. Big Data

     Big data is defined as the "Information asset characterized by such a High Volume, Velocity and Variety to require specific Technology and Analytical Methods for its transformation into Value".

H. Quantum Computing

     Quantum computing is a form of computation whose activities can exploit quantum mechanical phenomena such as superposition, interference, and entanglement.

I. Human Computer Interaction

     Human-computer interaction (HCI) is a multidisciplinary topic of research that focuses on the design of computer technology and, specifically, the interaction of humans and computers. Voice, gesture, visual, and brain signal interaction have replaced textual or display-based control as the dominant paradigm in HCI. HCI, VR, AR, and the future of content creation and collaboration technologies will enable the creation of the Metaverse. The visual interactions in the Metaverse will be carried out by HCI technology which is called wearable consumer head-mounted displays (HMD). These HMDs will play a crucial role in the communication between the users and surroundings in the Metaverse.

J. Computer Vision

     Computer vision is the study of how computers visualize and interpret digital images and videos. Computer vision encompasses all activities done by biological vision systems, including perceiving a visual signal, interpreting what is being seen, and extracting complicated information in a form accessible by other processes.

K. Edge Computing

     Edge computing is a distributed computing paradigm that moves computation and data storage closer to the data sources. Edge computing will improve response times and conserves bandwidth.

L. 3D Modeling

     3D modelling is the process of producing a mathematical coordinate-based representation of any three-dimensional surface of an item using specific 3D modelling techniques. As a result of advancements in image processing, computer- aided design, and modelling techniques, it is now feasible to create extremely realistic and trustworthy 3D models. Multiple sectors, including cinema, animation, and gaming, as well as interior design and architecture, utilize 3D modelling.

     Medical diagnosis is the process of determining the medical condition of a patient based on the symptoms. Adoption of the Metaverse in healthcare significantly helps in efficient diagnosis of the medical conditions of a patient with the help of various advanced technologies such as AR and VR enabled MIoT models, extended digital twin, blockchain, 5G and so on. F

A. Medical Diagnosis

     Medical diagnosis is the process of determining the medical condition of a patient based on the symptoms.

B. Patient Monitoring

     The convergence of telepresence, digital twinning and blockchain will reap amazing benefits of the Metaverse in healthcare, especially in terms of patient monitoring.

C. Medical Education

     The Metaverse is a remarkable milestone in the field of medical education.

D. Surgeries

     The Metaverse is becoming an important technology in the medical industry, especially in surgery. Surgeons are currently using tools that range from VR headsets to haptic gloves to mimic surgical procedures, boosting prepared- ness and efficiency in the operating room.

E. Medical Therapeutics & Theranostics

     Medical therapeutics can be regarded as the branch of medicine that deals specifically with the treatment of diseases. Digital therapeutics (DTx) deliver evidence-based therapeutic interventions and can be considered as a class of digital medicine. Digital Therapeutics Alliance defines digital therapeutics as products that “deliver evidence-based therapeutic interventions to patients that are driven by high quality software programs to prevent, manage, or treat a medical disorder or disease”. F

Ongoing and Upcoming Projects

1. Healthify.
2. Dehealth.
3. Bump galaxy.
4. Accuvein.
5. Hintvr.
6. Healthblocks.

Challenges & Open Issues

• Data privacy concerns.
• Information Security Concerns.
• Interoperability Issues.
• High Cost of Technology.
• The Personal Touch is Lost.
• Legal and Regulatory Challenges.

References

1. J Thomason. “Big tech, big data and the new world of digital health”. Glob. Health J., in press.
2. World Economic Forum. “Building the healthcare system of the future”. (2016).
3. J Gaubert. “Seoul to become the first city to enter the Metaverse. What will it look like?”. Euronews.next (2021).
4. J Burke. “Reintroducing the open Metaverse OS paper”. Outlier Ventures (2021).
5. Feldman J. “Flickplay’s 3d social media platform presents as an industry first”. Influencive (2020).

     The rapid progress in digitalization and automation have led to an accelerated growth in healthcare, generating novel models that are creating new channels for rendering treatment with reduced cost. The Metaverse is an emerging technology in the digital space which has huge potential in healthcare, enabling realistic experiences to the patients as well as the medical practitioners. The Metaverse is a confluence of multiple enabling technologies such as artificial intelligence, virtual reality, augmented reality, internet of medical devices, robotics, quantum computing, etc. through which new directions for providing quality healthcare treatment and services can be explored. F

     The amalgamation of these technologies ensures immersive, intimate, and personalized patient care. It also provides adaptive intelligent solutions that eliminates the barriers between healthcare providers and receivers. Healthcare is one of the most significant determinants of ensuring general, physical, social and mental well-being of the entire human population.

     In the world. The primary objective of any healthcare system is to channelize its efforts towards activities that promotes, restores, maintains and improves healthcare services. The recent pandemic of COVID-19 have added enormous pressure to the global healthcare sector and related workforce, infrastructure and supply chain management. The COVID-19 has been the primary reason for accelerating rapid change across the healthcare ecosystem and have compelled the stake holders to pursue adaptation and innovation of all the technologies used in this sector. The need to deploy advanced digital tools and services has become a necessity to provide optimized This digital transformation has significantly impacted the healthcare ecosystem by improving their working capability, access to services, patient-clinician experience by using artificial intelligence, cloud computing, Augmented Reality (AR), Virtual Reality (VR) technologies]. The healthcare system in the Metaverse provides health-care service experience that is interactive, immersive and recreational customized to meet individual patient’s needs. The use of these technologies provides exposure towards new ways of delivering treatment in significantly lower cost thereby enhancing patient outcomes. The Metaverse technologies can help healthcare professionals in effective planning and diagnosis of diseases. The Metaverse environment enables enhanced surgical pre-operative planning by transforming CT scans into 3D reconstructions using headsets. This also helps the surgeons to specifically view, isolate and manipulate anatomical regions to perform critical surgeries. Plastic surgery is an extremely complex procedure which requires reconstruction of human body parts. In case of plastic surgeries, the use of VR in the Metaverse could play an important role wherein the virtual avatar could accurately predict the outcome of a plausible plastic surgery.

     The health data can be visualized by the patients on the virtual dashboard helping them to communicate with clinicians, researchers, nutritionists, and other stake holders for achieve individual care and treatment. The Metaverse has the potential to revolutionize medical education and training. The use of AR provides the conducive environment to explain practical procedures rather than disseminating theoretical knowledge.

     The Metaverse can provide 360 degrees visualization of the body ailments and can act as the most helpful surgical training tool fostering optimum level of cooperation and highest degree of immersion.

     The global statistics of the Metaverse reveal that the global healthcare market in the Metaverse holds a value of 5.06 billion Dollars in 2021 and is expected to reach 71.97 billion Dollars by 2030 with a compound annual growth rate (CAGR) of 34.8 percent during considered period of forecast.

Sensors

     The precision of personal healthcare analysis partly depends on the measurement of different physiological parameters using sensors. Recently, an innovative wearable temperature sensor technology which utilizes freestanding single reduction graphene oxide fibre was introduced and developed with many benefits, such as fast response, high stability and repeatability under mechanical deformation, and wearable comfort. Despite being readily available, medical equipment is costly and consumes a lot of power. With biomedical sensors, medical systems are flexible with machine-to-machine interactions, saving time of both patients and medical institutions, and offering treatment plans over tele diagnosis. Among various sensors, temperature, electrocardiogram (ECG), and pulse are the most important ones for health status evaluation besides blood pressure, accelerometers, and imaging sensors.

     The following part will discuss some relevant sensors commonly used in healthcare and medical systems.

In general, big data is currently characterized by seven Vs as follows: volume (a large amount of data), variety (including structured, semi-structured, and unstructured data with different formats), velocity (high rates of data inflow and real-time processing), veracity (detailed data accumulation), value (in-depth and meaningful information), variability (offering extensionality and scalability), and valence (data interconnection).

• Big data collection: Sqoop is an open-source framework for data import and export between Hadoop Distributed File System (HDFS).
• Big data processing: MapReduce is a programmable model that simplifies and accelerates a massive amount of data, featured by three main functions (e.g., mapping, sorting, and reducing)
• Big data storage: Hadoop performs the distributed system HDFS and the non-relational databased HBase for big data storage. HDFS, a primary component of a Hadoop cluster, provides high throughput access to application data and is suitable for high-volume data applications.

Artificial Intelligence

In the last decade, several modern technologies and tools based on distributed architectures, along with large memory and powerful computing units, have been introduced for big data processing in healthcare and medical domains:

     All in healthcare is an all-encompassing term used to describe the use of ML algorithms to mimic human cognition in presenting, analysing, understanding, and learning complex healthcare and medical data. In fundamental, most of the existing AI/ML algorithms can be grouped into two categories: traditional techniques and advanced techniques, which can solve three principal problems: clustering, classification, and regression. Conventional AI/ML algorithms usually performs four data-based learning types: supervised learning (i.e., learn the relation between input and output via a mapping function using labelled data and classify/predict the outcome for an unforeseen input sample using the trained model), unsupervised learning (i.e., involve the utilization of ML algorithms for unlabelled data analysis and clustering, and can find out data groups without the need for human intervention), semi-supervised learning (i.e., trained upon the combination of clustering similar data using an unsupervised learning algorithm and using the existing labelled data to label the remaining unlabelled data), and reinforcement learning (i.e., make a sequence of decisions, in which an agent learns to attain a goal in an uncertain and complex environment). Recently, deep learning (DL) is a subset of ML with advanced architectures, e.g., recurrent neural network, long short-term memory network, and convolutional neural network, relying on multi-layered artificial neural networks, to attain ground-breaking performance in many classification and regression tasks of healthcare and medical domains.

Wireless Communication Networks

     Many innovative communication technologies have been introduced in the last decade due to the explosion of IoT technologies with edge and mobile devices along with the diversity of applications and services, especially in the health- care and medical domains.

Cellular network: As so-called mobile network, a cell network is a radio network distributed over land areas called     cells. Each cell is served by at least one fixed-location transceiver, a.k.a., cell site or base station. Remarkably, cellular networks can enable a huge number of portable receivers to communicate with each other and other fixed transceivers via base stations.

Wi-Fi: is a wireless networking technology that allows diverse devices, such as computers (desktops, laptop, and tablets), mobile devices (smart phones, smart watches, and wearables) and others (printers, TVs, projectors, and video cameras) to connect the Internet.

References

1. Michael Ahdoot., et al. “MRI-Targeted, Systematic, and Combined Biopsy for Prostate Cancer Diagnosis”. N Engl J Med 382.10 (2020): 917-928.
2. Yasuhiro Y., et al. “Moving away from systematic biopsies: image-guided prostate biopsy (in-bore biopsy, cognitive fusion biopsy, MRUS fusion biopsy)-literature review”. World J Urol 39.3 (2021): 677-686.
3. Xiang Tu., et al. “Transperineal Magnetic Resonance Imaging-Targeted Biopsy May Pefrform Better Than Transrectal Route in the Detection of Clinically Significant Prostate Cancer: Systematic Review and Meta-analysis”. Clin Genitourin Cancer 17.5 (2019): e860-e870.
4. Marco R and Sebastiano DL. “Transperineal Freehand US/MRI Fusion Target Prostate Biopsy using the Esaote MylabTM9 System: A Step by Step Guide”. J Dise Dis Tre (2022).
5. Bass EJ., et al. Emberton M, Ahmed HU. “Magnetic resonance imaging targeted transperineal prostate biopsy: a local anaesthetic approach”. Prostate Cancer Prostatic Dis 20.3 (2017): 311- 317.
6. Smith CP and Tu?rkbey B. “PI-RADS v2: Current standing and future outlook”. Turk J Urol 44.3 (2018): 189-194.
7. EAU Guidelines on Prostate Cancer (2022).
8. Marco R et Sebastiano DL. “Are there Detection Rate Differences of Transperineal Freehand US/MRI Fusion Target Prostate Biopsy in Two Different Patient Settings: Under Local Anesthesia or Under Deep Sedation?”. Int J Clin Invest Case Rep (2022).
9. Stacy Loeb., et al. “Pathological characteristics of prostate cancer detected through prostate specific antigen based screening”. J Urol 175 (2006): 902-6.
10. Jerome P Richie., et al. “Effect of patient age on early detection of prostate cancer with serum prostate-specific antigen and digital rectal examination”. Urology 42.4 (1993): 365-74.
11. William J Catalona., et al. “Comparison of digital rectal examination and serum prostate specific antigen in the early detection of prostate cancer: results of a multicenter clinical trial of 6,630 men”. J Urol 197.2S (2017): S200-S207.
12. Smith CP and Tu?rkbey B. “PI-RADS v2: Current standing and future outlook”. Turk J Urol 44.3 (2018): 189-194.
13. Blake BA., et al. “Extraprostatic Extension Is Extremely Rare for Contemporary Gleason Score 6 Prostate Cancer”. Prostate Cancer 72.3 (2017): 455-460.

Introduction:  Currently prostatic biopsy on target found at the multiparametric MRI of the prostate is the best way to diagnose prostate cancer.

The European Association of Urology guidelines, updated to 2022, recommend to perform MRI-targeted prostate biopsy plus standard prostate biopsy when a PI-RADS 3 to 5 lesion is detected. 

The aim of the study is to establish if there is a real benefit of perfoming MRI-targeted prostate biopsy plus standard sampling when every PI-RADS 3 lesion is detected.

Case study: We performed a retrospective monocentric study at “San Pio” Hospital of Castellaneta, Italy.

76 patients underwent MRI-targeted prostatic biopsy with fusion or cognitive approach, associated with random sampling.

Results: Among the 124 biopsies on PI-RADS 3 lesions of our study only two PI-RADS 3 reported a positive outcome for not significant PCa detection.

Conclusion: Our results do not show a sure and real advantage in performing targeted prostate biopsy in all the patients with only PI-RADS 3 lesions and it may be appropriate to evaluate biopsy performance in these patients from case to case.

Keywords: Transperineal Prostate Biopsy; Fusion-Targeted Biopsy; Cognitive-targeted biopsy; Magnetic Resonance Imaging; PI-RADS 3; Prostate Cancer; Detection Rate

References

1. Andersson EK., et al. “Registered nurses’ descriptions of caring: a phenomenographic interview study”. BMC nursing 14 (2015): 16.
2. Nascimento KC and Erdmann AL. “Understanding the dimensions of intensive care: transpersonal caring and complexity theories”. Revista Latino-Americana de Enfermagem 17 (2009): 215-21.
3. Bridges J., et al. “Capacity for care: meta?ethnography of acute care nurses' experiences of the nurse?patient relationship”. Journal of advanced nursing 69.4 (2013): 760-72.
4. Carter C and Notter J. “Reorganization of critical care services”. Covid-19: An Open Access Critical Care Textbook 11 (2021): 41.
5. Kirchhoff KT and Kowalkowski JA. “Current practices for withdrawal of life support in intensive care units”. American Journal of Critical Care 19.6 (2010): 532-41.

     Quality assured patient care is expected by nurses all over the world. Caring has been acknowledged as the inner and essence of nursing. For a critical care nurse, caring for a patient implies saving life. While working in an intensive care unit, learning about various life saving procedures such as Cardio pulmonary resuscitation, endotracheal intubation. inserting a central venous catheter is a wonderful experience. Postings in different intensive care units gives worthwhile experiences in different specialties. However, when providing reassurance to patient about their wellbeing, they taught us how to fight with life. Apart from providing care to the patients, critical care nurse acts as a communicator, a liasor between patient, relatives and health care team. The demand of critical care nurses is in increasing trend all over the world. One should not think twice before choosing critical care as a speciality. From creating a spark of hope in patient’s eyes to provide them care at the end of life, critical acre nurses acts as a sole support for the patients and family.

Keywords: critical care nurse; perspective of critical care nurse

References

1. Andreoli SP, Mallett and Bergstein JM. “Role of glutathione in protecting endothelial cells against hydrogen peroxide oxidant injury”. J. Lab. Clin. Med 108 (1986): 190-198.
2. Artur Y., et al. “Age-related variations of enzymatic defenses against free radicals and peroxides”. EXS 62 (1992): 359-367.
3. Blankenberg S., et al. “Glutathione peroxidase 1 activity and cardiovascular events in patients with coronary artery disease”. N Engl J Med 349 (2003): 1605-1613.
4. Burton GJ and Jauniaux E. “Placental oxidative stress: from miscarriage to preeclampsia”. J. Soc. Gynaecol. Invest 11 (2010): 342-352.
5. Bergmeyer HU and Bernt E. Glutamate-oxaloacetate transaminase in Method of enzymatic analysis (ed) H U Bergmeyer (New York Academic Press) (1974): 727-733.
6. Beutler E, West C and Blume KGJ. “The removal of leucocytes and platelets from whole blood”. Lab Cin Med 88 (1976): 328-333.
7. Beutler E. Method in Hematology (Beautler, E. Ed. Longman, U.K 16 (1986): 52-72.
8. Cohen G and Hochstein P. “Glutathione peroxidase: the primary agent for the elimination of hydrogen peroxide in erythrocytes”. Biochemistry 2 (1963): 1420-1428.
9. Combs GF Jr. “Status of selenium in prostate cancer prevention”. Br J Cancer 91 (2004): 195-199.
10. Copeland PR and Driscoll DM. “Purification, redox sensitivity, and RNA binding properties of SECIS-binding protein 2, a protein involved in selenoprotein biosynthesis”. J Biol Chem 274 (1999): 25447-25454.
11. Deponte M. “Glutathione catalysis and the reaction mechanisms of glutathione dependent enzymes”. Biochemica et Biophysica Acta 1830 (2013): 3217-3266.
12. Erden M and Bor NM. “Change of reduced glutathione, glutathione reductase, and glutathione preoxidase after radiation in guinea pigs”. Biochm Med 31.2 (1984): 217-27.
13. Gleason DM., et al. “Removal of hypernephroma and inferior vena cava: right artical tumor thrombus”. Arch Surg 105.5 (1972): 795-7.
14. Griffith OW. “Determination of glutathione and glutathione disulfide using glutathione reductase and 2-vinylpyridine”. Anal Biochem 107 (1980): 207-212.
15. Gupta BL and Baquer NZ. “Hexokinase, G-6PDH and antioxidant enzymes in diabetic reticulocytes: Role of insulin and vanadate”. Biochem. Mol. Biol. Int 48 (1998): 1145-1152.
16. Gupta BL, Preet A and Baquer NZ. “Protective effects of sodium orthovanadate in diabetic reticulocytes and ageing red blood cells of Wistar rats”. J Biosci 29 (2004): 73-79.
17. Hughes S, Higgs NB and Turnberg LA. “Loperamide has antisecretory activity in the human jejunum in vivo”. Gut 25 (1984): 931-935.
18. Johanson JF, Sonnenberg A and Koch TR. “Clinical epidemiology of chronic constipation”. J Clin Gastroenterol 11.5 (1989): 525-536.
19. McCrea GL., et al. “A review of the literature on gender and age differences in the prevalence and characteristics of constipation in North America”. J Pain Symptom Manage 37.4 (2009): 737-745.
20. Mullineaux P and Creissen GP. “Glutathione reductase: regulation and role in oxidative stress Oxidative stress and the molecular biology of antioxidant defenses”. Cold Spring Harbor Laboratory Press (1997).
21. Rao SS. Constipation: evaluation and treatment of colonic and anorectal motility disorders. Gastroenterol Clin North Am 36.3 (2007): 687-711.
22. Seybold U., et al. “Senna-induced hepatitis in a poor metabolizer”. Ann Intern Med 141 (2004): 650-651.
23. Siegers CP and Younes M. “Clinical significance of the glutathione-conjugating system”. Pharmacol Res Commun 15.1 (1983): 1-13.
24. Spiller HA., et al. “Skin breakdown and blisters from Senna-containing laxatives in young children”. Ann Pharmacother 37 (2003): 636-639.
25. Talley N J., et al. “Risk factors for chronic constipation based on a general practice sample”. Am J Gastroenterol 98.5 (2003): 1107-1111.
26. Trevisan M., et al. “Correlates of markers of oxidative status in the general population”. Am J Epidemiol 154 (2001): 348-356.
27. Upadhayay A., et al. “Sennoside contents in Senna (Cassia angustifolis Vahl.) as influenced by date of leaf picking, packaging material and storage period”. J Stored Prod Postharv Res 2 (2011): 97-103.
28. Wald A, Hinds JP and Caruana BJ. “Psychological and physiological characteristics of patients with severe idiopathic constipation”. Gastroenterology 97.4 (1989): 932-937.
29. Yamada E., et al. “Clinical factors associated with the symptoms of constipation in patients with diabetes mellitus: a multicenter study”. J Gastroenterol Hepatol 33 (2017): 863-868.
30. Yu BP and Chung HY. “Adaptive mechanisms to oxidative stress during aging”. Mech Ageing Dev 127 (2006): 436-443.
31. Younes M and Siegers CP. “Interrelation between lipid peroxidation and other hepatotoxic events”. Biochem. Pharmacol 33 (1984): 2001-2003.

     The defensive enzymes like glutathione preoxidase, glutathione reductase and catalase along with the defensive metabolites like reduced glutathione and oxidised glutathione were measured in red blood cells of acute constipated rats also along with sanay treated constipated rats. It was observed a decrease in GPx activity in both sexes of rats i.e., males and females. The GR activity in constipated rats was shown to be increased by more than GPx activity. The catalase activity has been observed to be increased insignificantly in acute condition. However, the GSH levels were found to be decreased in acute constipated rats but GSSG levels enhanced in acute condition. The sanay leaves treatment to acute condition rats restored the changed enzymes activities and metabolites levels.

     The liver function test carried out by the two enzymes namely GOT & GPT which increased in constipated rats. It shows that the enhanced GOT & GPT activities caused dysfunction of liver and invite kinds of liver diseases. The creatinine levels in red blood cells showed insignificant changes in both acute constipated rats and its treated condition with sanay leaves. It may be concluded that sanay treatment restores the low defense system found in constipated rats as well as the liver function which is slightly changed during constipation.

     H. pylori could migrate or get forced to migrate to the colon under the influence of antibiotics where it will continue to produce ammonia for a reason or no reason leading to accumulation of profuse amounts of ammonia un-opposed or buffered by any acidity. Accumulation of profuse amounts of ammonia in the colon is toxic and could constitute a biological stress to the body causing toxic pancreatitis that could lead to potential stress diabetes in predisposed children. The spread of H. pylori-induced childhood diabetes could constitute more than 90% of the world’s burden of childhood diabetes during the latest three decades specifically since the implementation of the triple anti-H. pylori antibiotic eradication strategy in 1986 [7-10].

     The concept of the biological toxic stress leading to an onset of H. pylori-induced childhood diabetes is not just hypothetical or scientific fantasy as upon the basis of this concept the newly-discovered childhood diabetic condition has been readily and adequately corrected in many children; around 89% of cases in some recent studies [10].

     Colon clear with the senna leaves extract purge and vinegar-mixed food therapy have been recently demonstrated to effectively deal with the challenge of H. pylori including eradication of colonic and abnormal-behavior gastric H. pylori strains in addition to prevention of recurrence [8, 9].

Therefore; countries should follow a characteristic strategy towards H. pylori dyspepsia and H. pylori-related dysglycemia:

• Any newly discovered childhood diabetes should be first considered a potential condition not an established illness and should be treated as stress diabetes. Children should be immediately investigated for existence of colonic H. pylori strains and immediate employment of colon clear with the senna leaves purge once followed by vinegar mixed salad or yogurt with principal meals once or twice daily for one week. Patients with inadequate response to colon care and colon clear by vinegar and the senna could do revision of the senna purge twice with one-month space between them. Patients who remain hyperglycemic in spite of these measures should be given one-week physical rest together with physiological rest of the pancreas by administration of fractionated regular insulin doses for one week. Children who do not recover after that could be considered established diabetics and could receive the anti-diabetic medication appropriate to their condition.
• Children who recover a potential diabetic condition should practice extreme carefulness towards out-side home meals and should return to colon care and colon clear either on regular basis or at least whenever they develop colonic troubles. They should care from gastric recurrence by regular dental hygiene and cleaning of dental plaques as being possible reservoirs for H. pylori or children can just employ mouth wash with diluted dietary vinegar as tolerated once or twice weekly together with washing hands with vinegar and water after washing with soap in order to avoid fecal-oral recurrence as soap alone does kill H. pylori [8].
• The antibiotic aggression towards H. pylori should be re-discussed in details and gastric sedatives including anti-urease activity should be subjected to severe revision and accurate re-determination.
• The world should stop searching/re-searching after H. pylori; save these funds and direct them towards raising the life and water supply standards in poor and developing countries as the matter of H. pylori is essentially a sanitary conflict before it is a medical challenge and rich people tour in poor countries while poor people travel to work as food handlers in rich countries; that is how abnormal H. pylori strains travel from stomach to stomach via meals and navigate all over the world [8].
• Patients and families should be educated as concerns misbehavior in food habits and antibiotic use.
• Orientation of primary health care units as concerns natural measures towards H. pylori dyspepsia.
• Dyspeptic mothers should investigate for existence of colonic H. pylori strains and deal with them via employing natural measures (colon care and colon clear) but not antibiotics in order to avoid transmitting H. pylori to their kids. Mothers preparing food for their kids particularly if dyspeptic should usually wash hands with vinegar then water after washing with soap.
• Pregnant mothers should not feel lazy to cook and should not love the fast food for themselves and their kids during pregnancy.
• Food handlers should strictly and frequently disinfect hands with vinegar and travelers should make vinegar a friend to their meals while touring.

References

1. Habib HS. “Frequency and clinical presentation of ketoacidosisat onset of childhood type 1 diabetes mellitus in Northwest Saudi Arabia”. Saudi Med J 26.12 (2005): 1936-9.
2. Sabin MA and Shield JP. “Childhood obesity”. Front Home Res 36 (2008): 85-96.
3. De Ferranti SD and Osganian SK. “Epidemiology of pediatric metabolic syndrome and type 2 diabetes mellitus”. Diab Vasc Dis Res 4.4 (2007): 285-96.
4. Al-Nozha MM., et al. “Diabetes mellitus in Saudi Arabia”. Saudi Med J 25.11 (2004): 1603-10.
5. Salardi S., et al. “Helicobacter pylori and type 1 diabetes mellitus in children”. J Pediatr Gastroenterol Nutr 28.3 (1999): 307-9.
6. Dore MP., et al. “Diabetes mellitus and Helicobacter pylori infection”. Nutrition 16.6 (2000): 407-10.
7. Farinha P and Gascoyne RD. “Helicobacter pylori and MALT Lymphoma”. Gastroenterology 128.6 (2005): 1579-605
8. Nasrat AM., et al. “Misconception and misbehavior towards Helicobacter pylori is leading to major spread of illness”. General Med S1 (2015): 002.
9. Nasrat SAM., et al. “The dramatic spread of diabetes mellitus worldwide and influence of Helicobacter pylori”. General Med 3.1 (2015): 159-62.
10. Nasrat AM., et al. “The challenge of childhood diabetes”. General Med 3.4 (2015): 193.

     The frequency of ketoacidosis at onset of childhood in the world particularly in developing countries is significant. Prevention of diabetic ketoacidosis and control of its rising frequency should be a healthcare target [1]. The epidemic of childhood diabetes is a worldwide challenge that could be directly related to the whole world challenging epidemic of childhood obesity or it is simply part of the dramatic spread of adulthood diabetes worldwide [2-4].

     Similar to the spread of adult DM, Helicobacter pylori could arise as a major environmental reason that could be directly related to the flaring challenge of childhood diabetes. A possible link between H. pylori and diabetes mellitus in children has been mentioned in some studies while this relation has been denied by other reports [5, 6].

References

1. Helvaci MR, Aydin Y and Gundogdu M. “Smoking induced atherosclerosis in cancers”. HealthMED 6.11 (2012): 3744-9.
2. Helvaci MR., et al. “Metformin and parameters of physical health”. Intern Med 47.8 (2008): 697-703.
3. Helvaci MR., et al. “Physical inactivity or an excessive eating habit”. Middle East J Nursing 12.1 (2018): 14-8.
4. Eckel RH, Grundy SM and Zimmet PZ. “The metabolic syndrome”. Lancet 365.9468 (2005): 1415-28.
5. Helvaci MR., et al. “Aging syndrome”. World Family Med 15.3 (2017): 39-42.
6. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation 106.25 (2002): 3143-421.
7. Juel K. “Life expectancy and mortality in Denmark compared to Sweden”. What is the effect of smoking and alcohol? Ugeskr Laeger 170.33 (2008): 2423-7.
8. Helvaci MR., et al. “The most desired values of high and low density lipoproteins and triglycerides in the plasma”. World Family Med 18.8 (2020): 21-7.
9. Calle EE., et al. “Body-mass index and mortality in a prospective cohort of U.S. adults”. N Engl J Med 341.15 (1999): 1097-105.
10. Helvaci MR., et al. “Prevalence of white coat hypertension in underweight and overweight subjects”. Int Heart J 48.5 (2007): 605-13.
11. Azadbakht L., et al. “Beneficial effects of a Dietary Approaches to Stop Hypertension eating plan on features of the metabolic syndrome”. Diabetes Care 28.12 (2005): 2823-31.
12. Helvaci MR., et al. “Body mass and blood pressure”. World Family Med 17.1 (2019): 36-40.
13. Funahashi T., et al. “Role of adipocytokines on the pathogenesis of atherosclerosis in visceral obesity”. Intern Med 38.2 (1999): 202-6.
14. Fodor JG., et al. “Do we diagnose and treat coronary heart disease differently in men and women?”. Wien Med Wochenschr 154.17-18 (2004): 423-5.
15. Grunberg NE., et al. “National working conference on smoking and body weight. Task Force 1: Mechanisms relevant to the relations between cigarette smoking and body weight”. Health Psychol 11 (1992): 4-9.
16. Walker JF., et al. “The effect of smoking on energy expenditure and plasma catecholamine and nicotine levels during light physical activity”. Nicotine Tob Res 1.4 (1999): 365-70.
17. Hughes JR and Hatsukami DK. “Effects of three doses of transdermal nicotine on post-cessation eating, hunger and weight”. J Subst Abuse 9 (1997): 151-9.
18. Miyata G., et al. “Nicotine alters the usual reciprocity between meal size and meal number in female rat”. Physiol Behav 74.1-2 (2001): 169-76.
19. Laaksonen M, Rahkonen O and Prattala R. “Smoking status and relative weight by educational level in Finland, 1978-1995”. Prev Med 27.3 (1998): 431-7.
20. Froom P, Melamed S and Benbassat J. “Smoking cessation and weight gain”. J Fam Pract 46.6 (1998): 460-4.
21. Helvaci MR, Kaya H and Gundogdu M. “Gender differences in coronary heart disease in Turkey”. Pak J Med Sci 28.1 (2012): 40-4.
22. Prescott E., et al. “Smoking and risk of myocardial infarction in women and men: longitudinal population study”. BMJ 316.7137 (1998): 1043-7.
23. Helvaci MR., et al. “Smoking may even cause irritable bowel syndrome”. World Family Med 17.3 (2019): 28-33.
24. Helvaci MR, Kabay S, Gulcan E. “A physiologic events’ cascade, irritable bowel syndrome, may even terminate with urolithiasis”. J Health Sci 52.4 (2006): 478-81.
25. Helvaci MR, Algin MC and Kaya H. “Irritable bowel syndrome and chronic gastritis, hemorrhoid, urolithiasis”. Eurasian J Med 41.3 (2009): 158-61.
26. Rehm J. “Alcohol and mortality”. Alcohol Res 35.2 (2014): 174-83.
27. Westman J., et al. “Mortality and life expectancy of people with alcohol use disorder in Denmark, Finland, and Sweden”. Acta Psychiatr Scand 131.4 (2015): 297-306.
28. Roerecke M and Rehm J. “Alcohol use disorders and mortality: a systematic review and meta-analysis”. Addiction 108.9 (2013): 1562-78.
29. Gabay C and Kushner I. “Acute-phase proteins and other systemic responses to inflammation”. N Engl J Med 340.6 (1999): 448-54.
30. Wool GD and Reardon CA. “The influence of acute phase proteins on murine atherosclerosis”. Curr Drug Targets 8.11 (2007): 1203-14.
31. Helvaci MR, Abyad A and Pocock L. “High and low density lipoproteins may be negative acute phase proteins of the metabolic syndrome”. Middle East J Nursing 14.1 (2020): 10-6.
32. Pirillo A, Catapano AL and Norata GD. “HDL in infectious diseases and sepsis”. Handb Exp Pharmacol 224 (2015): 483-508.
33. Ma C., et al. “Low-density lipoprotein cholesterol and risk of hemorrhagic stroke: a systematic review and dose-response meta-analysis of prospective studies”. Curr Atheroscler Rep 21.12 (2019): 52.
34. Helvaci MR, Abyad A and Pocock L. “The safest values of low density lipoproteins in the plasma”. World Family Med 18.4 (2020): 18-24.
35. Toth PP. “Cardiology patient page. The "good cholesterol": high-density lipoprotein”. Circulation 111.5 (2005): 89-91.
36. Ertek S. “High-density lipoprotein (HDL) dysfunction and the future of HDL”. Curr Vasc Pharmacol 16.5 (2018): 490-8.
37. Femlak M., et al. “The role and function of HDL in patients with diabetes mellitus and the related cardiovascular risk”. Lipids Health Dis 16.1 (2017): 207.
38. Keene D., et al. “Effect on cardiovascular risk of high density lipoprotein targeted drug treatments niacin, fibrates, and CETP inhibitors: meta-analysis of randomised controlled trials including 117,411 patients”. BMJ 349 (2014): 4379.
39. Helvaci MR, Abyad A and Pocock L. “What a low prevalence of diabetes mellitus between the most desired values of high density lipoproteins in the plasma”. World Family Med 18.7 (2020): 25-31.
40. Helvaci MR., et al. “Positive and negative acute phase reactants in sickle cell diseases”. World Family Med 20.3 (2022): 36-42.
41. Helvaci MR, Kaya H and Gundogdu M. “Association of increased triglyceride levels in metabolic syndrome with coronary artery disease”. Pak J Med Sci 26.3 (2010): 667-72.
42. Helvaci MR., et al. “The safest value of plasma triglycerides”. World Family Med 17.7 (2019): 22-7.
43. Helvaci MR, Abyad A and Pocock L. “The lowest is the safest value of plasma triglycerides”. World Family Med 17.10 (2019): 10-5.
44. Helvaci MR, Abyad A and Pocock L. “The safest upper limit of triglycerides in the plasma”. World Family Med 18.1 (2020): 16-22.
45. National Cholesterol Education Program. Second Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel II). Circulation 89.3 (1994): 1333-445.
46. World Health Organization. Definition, Diagnosis and Classification of Diabetes Mellitus and its Complications. Report of a WHO consultation (1999).
47. Helvaci MR., et al. “Cholesterol may be a negative whereas triglycerides positive acute phase reactants in the plasma”. Asclepius Med Res Rev 4.1 (2021): 1-8.
48. Helvaci MR., et al. “What is the relationship between hypertriglyceridemia and smoking?”. Middle East J Age and Ageing 8.6 (2011).

Background: There may be some significant relationships between smoking and triglycerides and low density lipoproteins (LDL) in the plasma.

Methods: Consecutive daily smokers at least for a period of six months and age and sex-matched non-smokers were included into the study. Cases with regular alcohol consumption (one drink a day) and patients with inflammatory, infectious, or devastating disorders including eating disorders, malignancies, acute or chronic renal failure, cirrhosis, chronic obstructive pulmonary disease, hyper- or hypothyroidism, or heart failure were excluded from the study.

Results: The study included 150 smokers (99 males) and 162 non-smokers. The mean age of smokers was 45.9 years, and 66.0% of them were male. Although the mean body weight, body mass index, systolic and diastolic blood pressures, and hematocrit values were similar in both groups, triglycerides (163.3 versus 151.8 mg/dL, p<0.05) and LDL (126.1 versus 117.4 mg/dL, p<0.05) were higher in the smokers, significantly. Similarly, erythrocyte sedimentation rate (ESR) (10.8 versus 9.4 mm/h, p<0.05) and C-reactive protein (CRP) (2.5 versus 2.1 mg/L, p<0.05) values were also higher in the smokers. On the other hand, high density lipoproteins (HDL) (41.1 versus 44.0 mg/dL, p<0.05) and fasting plasma glucose (FPG) (101.9 versus 111.9 mg/dL, p<0.01) values were lower in the smokers, significantly.

Conclusion: Smoking causes a low-grade systemic inflammation on vascular endothelium terminating with an accelerated atherosclerosis-induced end-organ insufficiencies all over the body. As significant indicators of the systemic inflammation, smoking increases triglycerides and LDL, parallel to ESR and CRP, whereas decreases HDL and FPG in the body.

Keywords: Smoking, triglycerides, low density lipoproteins, high density lipoproteins, fasting plasma glucose, erythrocyte sedimentation rate, C-reactive protein

     Among the commensal community, mucosa associated commensal species such as segmented filamentous bacteria (SFB) are a minority regulating strongly the host immune response. Autoimmune diseases, especially RA, are involved in such modulation by gut microbiota. SFB drive autoimmune arthritis in the K/BxN mouse model of arthritis by triggering signals that instruct gut T helper 17 (Th17) cells to differentiate and help in autoantibody production.

     T follicular helper (Tfh) cells contribute in the production of high-titer antibodies (Abs) through helping B cells to produce high affinity Abs and long-lived plasma cells by inducing somatic hypermutation and class switching.

     The frequency of Tfh cells significantly increased in RA peripheral blood and this was accompanied by increased level of anti-citrullinated protein autoantibodies (ACPAs) indicating the possible involvement of Tfh cells in development of RA.

     In a K/BxN RA mouse model, SFB interfered with Tfh differentiation in Peyer’s Patches and supported antigen specific Tfh dissemination at systemic sites which could also support the contribution of both SFB and Tfh in RA pathogenesis.

     The effects of long-term antibiotics on the microbiota are not yet understood and the emergence of resistance due to genetic alteration in microbiota, still to be investigated.

     In conclusion, the crucial role of the microbiota in health and disease is well firmly established. Studies must be undertaken to better understand human microbiome in terms of composition, metabolic pathways and its role in RA. There is evidence that targeted modulation of the microbiota may improve clinical outcome in RA suggesting that personalized treatment strategies based on patient microbiome profiles may increase drug efficacy, safety, and prognosis. This might benefit in establishing a highly individualized management for each RA patient.

Background

     Rheumatoid arthritis (RA) is a chronic autoimmune disorder where genetic and environmental factors contribute to the pathogenesis of disease.

     RA leads to functional disability; it was found that 30% of patients are unable to work after 3 years of disease. The gut contains about 29% of all micro-organisms that live in and on the human body. Their function is to help in digestion, nutrition, energy production and vitamin synthesis. Gut microbiota are an environmental factor that regulate the immune system thus providing health benefits to their host.

References

1. Brown TA and Rosellini AJ. “The direct and interactive effects of neuroticism and life stress on the severity and longitudinal course of depressive symptoms”. Journal of Abnormal Psychology 120.4 (2011): 844-56.
2. Khan A and Murphy A. “Updates on therapies for chronic prostatitis/chronic pelvic pain syndrome”. World Journal of Pharmacology 4.1 (2015): 1-16.
3. Nickel JC. “Understanding chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)”. World Journal of Urology 31.4 (2013): 709-710.
4. Shoskes DA and Nickel JC. “Classification and treatment of men with chronic prostatitis/chronic pelvic pain syndrome using the UPOINT system”. World Journal of Urology 31.4 (2013): 755-760.
5. Potente C., et al. “Evaluation of the effectiveness of rehabilitation treatment in patients with chronic pelvic pain: a systematic review”. Pelviperineology 38 (2019): 70-77.
6. Nickel JC, Shoskes DA and Wagenlehner FM. “Management of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS): the studies, the evidence, and the impact”. World Journal of Urology 31.4 (2013): 747-753.
7. Tripp DA., et al. “Predictors of quality of life and pain in chronic prostatitis/chronic pelvic pain syndrome: findings from the National Institutes of Health Chronic Prostatitis Cohort Study”. BJU international 94.9 (2009): 1279-1282.
8. Doiron RC, Shoskes DA and Nickel JC. “Male CP/CPPS: where do we stand?”. World Journal of Urology 37.6 (2019): 1015-1022.
9. Nickel JC., et al. “Psychosocial variables affect the quality of life of men diagnosed with chronic prostatitis/chronic pelvic pain syndrome”. BJU international 101.1 (2008): 59-64.
10. Chung SD, Huang CC and Lin HC. “Chronic prostatitis and depressive disorder: a three-year population-based study”. Journal of Affective Disorders 134.1-3 (2011): 404-409.
11. Ahn SG., et al. “Depression, anxiety, stress perception, and coping strategies in Korean military patients with chronic prostatitis/chronic pelvic pain syndrome”. Korean journal of urology 53 (2012): 643-658.
12. Anderson RU., et al. “Psychometric profiles and hypothalamic-pituitary-adrenal axis function in men with chronic prostatitis/chronic pelvic pain syndrome”. Journal of Urology 179 (2008): 956-960.
13. Melekhin AI. “Gynecological and urological chronic pelvic pain: tactics of cognitive-behavioral psychotherapy”. neurodynamics. Journal of Clinical Psychology and Psychiatry 4 (2019): 47-63.
14. Egan JK and Krieger JN. “Psychological problems in chronic prostatitis patients with pain”. The Clinical Journal of Pain 10.3 (1994): 218-226.
15. Kwon JK and Chang IH. “Pain, catastrophizing, and depression in chronic prostatitis/chronic pelvic pain syndrome”. International neurourology journal 17.2 (2013): 48-58.
16. Mehik A., et al. “Fears, sexual disturbances and personality features in men with prostatitis: a population-based cross- sectional study in Finland”. BJU international 88.1 (2001): 35-38.
17. Koh JS., et al. “The association of personality trait on treatment outcomes in patients with chronic prostatitis/chronic pelvic pain syndrome: an exploratory study”. Journal of Psychosomatic Research 76.2 (2014): 127-133.
18. Leue C., et al. “Functional urological disorders: a sensitized defence response in the bladder-gut-brain axis”. Nature Reviews Urology 14.3 (2017): 153-163.
19. Berghuis J.P., et al. “Psychological and physical factors involved in chronic idiopathic prostatitis”. Journal of Psychosomatic Research 41.4 (1996): 313-325.
20. Ullrich PM., et al. “Stress is associated with subsequent pain and disability among men with nonbacterial prostatitis/pelvic pain”. Annals of Behavioral Medicine 30.2 (2005): 112-118.
21. Sullivan MJ., et al. “Theoretical perspectives on the relation between catastrophizing and pain”. The Clinical Journal of Pain 17.1 (2001): 52-64.
22. Potente C., et al. “Evaluation of the effectiveness of rehabilitation treatment in patients with chronic pelvic pain: a systematic review”. Pelviperineology 38 (2019): 70-77.
23. Pirola GM., et al. “Chronic prostatitis: current treatment options”. Research and reports in urology 11 (2019): 165-174.
24. Shoskes DA and Nickel JC. “Classification and treatment of men with chronic prostatitis/chronic pelvic pain syndrome using the UPOINT system”. World Journal of Urology 31.4 (2013): 755-760.
25. Seung Wook Lee. “Recent trend of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) management”. Hanyang Medical Reviews 37.1 (2017): 40-46.
26. Nickel JC, Mullins C and Tripp DA. “Development of an evidence-based cognitive behavioral treatment program for men with chronic prostatitis/chronic pelvic pain syndrome”. World Journal of Urology 26 (2008): 167-72.
27. Nickel JC and Shoskes DA. “Phenotypic approach to the management of the chronic prostatitis/chronic pelvic pain syndrome”. BJU International 106.9 (2010): 1252-1263.
28. Allsop SA., et al. “The DABBEC phenotyping system: towards a mechanistic understanding of CP/CPPS”. Nature Reviews Urology 8 (2011): 107-11.
29. Melehin AI. “Cognitive behavioral therapy in the complex treatment of chronic prostatitis and pelvic pain syndrome”. Digest of Urology 5 (2019): 26-32.
30. Melehin AI. “Cognitive-behavioral psychotherapy of chronic pelvic pain syndrome: specifics of its implementation and effectiveness”. Experimental and clinical urology 1 (2020): 80-96.
31. Miller HC. Stress prostatitis. Urology 32.6 (1988): 507-510.
32. Keltikangas-Jaervinen L., Ruokolainen J and Lehtonen T. “Personality pathology underlying chronic prostatitis”. Psychotherapy and Psychosomatics 37 (1982): 87-95.
33. Naliboff BD., et al. “Clinical and psychosocial predictors of urological chronic pelvic pain symptom change in 1 year: a prospective study from the MAPP Research Network”. The journal of urology 198 (2017): 848-857.
34. Daskalakis NP., et al. “The three-hit concept of vulnerability and resilience: toward understanding adaptation to early-life adversity outcome”. Psychoneuroendocrinology 38.9 (2013): 1858-1873.
35. Brown TA and Rosellini AJ. “The direct and interactive effects of neuroticism and life stress on the severity and longitudinal course of depressive symptoms”. Journal of Abnormal Psychology 120.4 (2011): 844-56.
36. Tripp DA., et al. “Catastrophizing and pain-contingent rest predict patient adjustment in men with chronic prostatitis/chronic pelvic pain syndrome”. The Journal of Pain 7.10 (2006): 697-708.
37. Moussas G., et al. “Alexithymia association with chronic prostatitis”. European Psychiatry 24 (2009): 19-28.
38. Sousa N. “The dynamics of the stress neuromatrix”. Molecular psychiatry 21 (2016): 302-312.
39. Tripp DA. “Managing psychosocial correlates of urologic chronic pelvic pain syndromes: Advice from a urology pain psychologist”. Canadian Urological Association Journal 12.6 (2018): 175-177.
40. Brünahl CA., et al. “Combined Cognitive-Behavioural and Physiotherapeutic Therapy for Patients with Chronic Pelvic Pain Syndrome (COMBI-CPPS): study protocol for a controlled feasibility trial”. Trials 19.1 (2018): 20-29.
41. Clemens JQ., et al. “Urologic chronic pelvic pain syndrome: insights from the MAPP Research Network”. Nature Reviews Urology 16.3 (2019): 187-200.

Using the example of modern biopsychosocial urological models, the article shows that the syndrome of chronic urological pelvic pain has a multi-factorial Genesis and requires an integrative, multidisciplinary approach (urologist, neurologist, and clinical psychologist).In this regard, the identification of individual urological clinical phenotypes of patients allows us to identify predisposing, provoking and supporting factors that determine the course of the disease and the response to therapy. The phenotypic urological systems are described: Marr, UPOINT, and DABBEC. The specifics of mental comorbidity (depression, panic disorder, borderline personality disorder, etc.) in this group of urological patients are detailed. The Association of symptoms of depression and changes in sexual functioning with urological chronic pelvic pain syndrome is shown. For the first time, the models of urinary-bladder-bowel-brain by L. Karsten are described; accumulated stress and falsification of anxiety, loss of control in patients with urological pelvic pain by D. Dasalakis and models of the influence of the patient's mental state on muscle-tonic manifestations in the urological clinic of Yaong Ki. Personal characteristics of patients with urological pelvic pain neuroticism, compliance, openness, conscientiousness, conscientiousness, changes in masculine identity, alexithymia, catastrophization) are systematized and described. The tactics of conducting a full and rapid comprehensive psychological assessment of a urological patient are presented.

Keywords: chronic prostatitis; chronic pelvic pain syndrome; prostatitis; biopsychosocial approach; catastrophization, neuroticism; depression

References

1. Aghajanyan NA, Bayevsky RM and Berseneva AP. “Problems of adaptation and the doctrine of health: studies”. manual. M (2006): 284.
2. Amosov NM. “Thoughts about health”. M.: AST, Donetsk: Stalker (2005): 287.
3. Ananyev BG. “Man as a subject of knowledge”. St. Petersburg.: Peter (2002): 288.
4. Ananyev VA. “Fundamentals of psychology health”. Book 1. Conceptual foundations of health psychology. St. Petersburg: Speech (2006): 384.
5. Ananyev VA. “Psychology of health - a new direction of medical psychology”. Psychological and psychiatric problems of clinical medicine. Collection of scientific papers dedicated to the 100th anniversary of the Department of Psychiatry and Narcology of St. Petersburg State University named after Academician I. P. Pavlov. St. Petersburg: Publishing House of St. Petersburg State University (2000): 191-194.
6. Belikova TA and Zhivaikina AA. “Consumer society: progress or degradation”. Bulletin of medical Internet conferences 5.12 (2015): 1787.
7. Bovina IB. “Social psychology of health and disease: monograph”. M.: Aspect Press (2008): 264.
8. Diseases in spite of: 10 celebrities who have defeated deadly diseases / Arguments of the Week [Electronic resource] (2020).
9. Brekhman II. “Valeology - the science of health”. M.: Physical culture and sport (1990): 206.
10. Vasiliev OS and Filatov FR. “Health as a subject of interdisciplinary research: approaches and problems”. Applied Psychology 5 (2001): 65-80.
11. Vasilyeva OS. Psychology of health. The phenomenon of health in culture, psychological science and everyday consciousness”. Rostov n/D: Mini Type (2005): 480.
12. Vasilyeva OS. “Psychology and health culture. Basic concepts, concepts and approaches”. Rostov n/D: Southern Federal University (2011): 176.
13. Vetrov II. “Fundamentals of Ayurvedic medicine”. St. Petersburg: "Svyatoslav". (2004): 353.
14. Giddens E and Sutton F. “Basic concepts in sociology”. M.: Publishing House of the Higher School of Economics, (2018): 336.
15. Goransky IV. “The life and death of Manoel dos Santos Garrinchi”. M.: Physical culture and Sport (1988): 158.
16. Gurvich IN. “Social psychology of health”. St. Petersburg: Publishing House of St. Petersburg State University, (1999): 1023.
17. Davidenko DN, Shchedrin YuN and Shchegolev VA. “Health and lifestyle of students”. St. Petersburg: SPb GUITMO (2005): 124.
18. Dubrovina IV. “Mental and psychological health in the context of psychological culture of personality”. Bulletin of Practical Psychology of Education. M, No 3.20 (2009): 17-21.
19. Dubrovsky VI. “Sports medicine: Textbook for students. higher. studies. Establishments”. 2nd ed., add. M.: Humanit. ed. center VLADOS (2002): 512.
20. Zhuravleva IV. “Attitude to the health of the individual and society”. Institute of Sociology of the Russian Academy of Sciences, M (2006): 238.
21. Healthy personality: materials of the international scientific and practical conference on June 21-22. (2012). St. Petersburg: St. Petersburg State Institute of Psychology and Social Work (2012): 167.
22. Healthy personality. edited by G.S. Nikiforov. St. Petersburg: Speech (2013): 400.
23. Islamov RE. Definition of the concept of "health" in the theoretical and legal aspect [Electronic resource] (2022).
24. Kalyu PI. The essential characteristic of the concept of "health" and some issues of healthcare restructuring: overview information. M (1988): 33-35.
25. Coronovirus COVID-19 today. Online statistics on the incidence of coronavirus in the world [Electronic resource] (2022).
26. Kotsan IYa, Lozhkin GV and Mushkevich MI. “Psychology of healthy people”. Lutsk: RVV Vezha (2011): 430.
27. Kulikov LV. “Personality psychology: basic concepts and problems: textbook”. St. Petersburg: Publishing House of St. Petersburg State University (2000): 144.
28. Lisitsyn YuP. “Public health and healthcare: textbook”. 2nd ed. M (2010): 512.
29. Lisitsyn YuP. “Human health is a social value”. Moscow: Mysl (2007): 265.
30. Litnitskaya EV. “The problem of personal health in psychology of the XIX-XX century”. Yaroslavl Pedagogical Bulletin 2.11 (2012): 268-274.
31. Medvedko LI. Russia, the West, Islam: "clash of civilizations"? Worlds in world and "other" wars at the break of epochs. Moscow: Kuchkovo Field (2003): 420-434.
32. Official Documents of the World Health Organization, Nº 2, p. 100, April 7, 1948 [Electronic resource] (2022).
33. Petlenko VP. Human valeology: health - love - beauty. St. Petersburg: PETROC, Book 1 1,2,3 (1998): 718.
34. Petryuk PT and Yakushchenko IA. “Psychosomatic disorders: issues of definition and classification”. Bulletin of the Association of Psychiatrists of Ukraine 3-4 (2003): 133-140.
35. Psychology of health. Kyiv.: Limited Liability Company "Financial Rada of Ukraine". (2017): 100.
36. Psychology of health: electronic textbook. E.A. Denisova et al. Togliatti: Publishing House of TSU, 1 optical disc.
37. Psychology of occupational health: textbook. edited by G.S. Nikiforov. SPb.: Speech (2006): 480.
38. Mental health. WHO [Electronic resource] (2022).
39. Psychological dictionary. Under the general Ed. of Yu.L. Neymer. Rostov n/D: Phoenix (2003): 640.
40. Reshetnikov AV. Health as a subject of study in the sociology of medicine. Grif UMO on medical education. M.: GEOTAR-Media (2008): 446.
41. Sekach MF. “Psychology of health: a textbook for higher education”. M.: Academic Project (2015): 192.
42. Spencer G and Tsigen T. Assosiativnaya psychology. Osnovaniya psychologii. Physiologicheskaya psychology v 14 lecture. The series "classic zarubejnoy psychologii". Location: AST (1998): 560.
43. Titshenka PD. O filosofskom smisle fenomenov zdorovya I bolezni. Location: Academy (2006): 275.
44. Tyumaseva ZI. Osnovi valeologii (V frame professionalnoy podgotovki Master po napravleniyu pedagogicheskogo obrazovaniya): uchebno-metodicheskoe posobie. Yuzhno - Uralsky gosudarstvenniy humanitarno-Pedagogical University. Chelyabinsk: Yuzhno-Uralsky nauchny Centre Rao (2020): 239.
45. Frolova YuG. Psychology zdorovya. Minsk: scale of Vissaya (2014): 256.
46. Khrustalev YuV. “Human health as a problem of philosophy”. Health economics 8 (2003): 5-12.
47. Shantyr EE. “Unification of the concept of personality as a basic term of practical psychology”. Psychology and socionics of interpersonal relations. K 4.148 (2015): 50-52.
48. Shantyr EE. “Integrative theory of personality: concept and practical implementation”. Scientific and methodological journal "Problems of modern science and education". 27.109 (2017): 102-111.
49. Shetelov A. The T. Philosopher zdorovya. Directmedia (2013): 242.
50. Elliatt S Decher. “Zdorove Kak tselostnost. Put K chelovecheskomu prosvetaniyu”. Location: IG" VES" (2010): 224.
51. Fromm E. I for himself. Translation E.M. Spira. M., (2018): 349.
52. Barling J and Griffiths A. “A history of occupational health psychology”. Handbook of occupational health psychology. Washington, DC: APA Books (2010): 21-34.
53. Belav B., Sergeeva M and Tarasova G. “Vaccination in rheumatology: Evolution of views on the problem”. Terapevticheskii arkhiv 89.5 (2017): 83-89.
54. Csikszentmihalyi M. “The Promise of Positive Psychology”. Psychological Topics 18.2 (2009): 203-211.

The paper conducts an analytical review of the history of understanding the phenomenon of health, reveals all the diversity in approaches and judgments about this conceptual category. It is emphasized that the interpretation of the concept of health is important not only the medical and scientific aspect, but also has a key socio-psychological significance for the development of modern society and the formation of a person's personality. On the example of coronavirus infection, the article provides a justification for the relevance of the semantic content of this conceptual category now. The scientific novelty of this work lies in the analytical studies of the concept of health as a basic socio-psychological conceptual category and the development on this basis of new theoretical approaches and corresponding definitions of the concept of health and its main derivatives. The proposed interpretations, according to the author, have a more pronounced social and psychological determinant for the formation in modern society of a new worldview regarding the concept of health and its derivatives. Because of new conceptual priorities, as shown in the work, it is possible to significantly strengthen the health of the population, increase the individual, herd level of immunity, and improve, ultimately, the quality of the very realization of a person in all spheres of his life.

Keywords: psychology; social psychology; practical psychology; health; mental health; physical health; reproductive health; sexual health; terms and concepts

References

1. Schilder H. “Cleaning and shaping the root canal”. Dent Clin North Am 18 (1974): 269-96.
2. Imura N., et al. “The outcome of endodontic treatment: a retrospective study of 2000 cases performed by a specialist”. J Endod 33 (2007): 1278-82.
3. Gorni GM and Gagliani MM. “The outcome of endodontic retreatment: A 2-yr follow-up”. J Endod 30 (2000): 1-4.
4. Pineda F and Kuttler Y. “Mesiodistal and buccolingual roentgenographic investigation of 7,275 root canals”. Oral Surg Oral Med Oral Pathol 33 (1972): 101-10.
5. Schafer E., et al. “Roentgenographic investigation of frequency and degree of canal curvatures in human permanent teeth”. J Endod 28 (2002): 211-6.
6. Wildey WL, Senia ES and Montgomery S. “Another look at root canal instrumentation”. Oral Surg Oral Med Oral Pathol 74 (1992): 499-507.
7. Peters OA. “Current challenges and concepts in the preparation of root canal systems: A review”. J Endod 30 (2004): 559-67.
8. Lertchirakam V, Palamara JE and Messer HH. “Patterns of vertical root fracture: factors affecting stress distribution in the root canal”. J Endod 29 (2003): 523-8.
9. Hulsmann M, Heckendorff M and Lennon A. “Chelating agents in root canal treatment: mode of action and indications for their use”. Int Endod J 36 (2003): 810-30.
10. Calt S and Serper A. “Time-dependent effects of EDTA on dentin structures”. J Endod 28 (2002): 17-9.
11. Yamada RS., et al. “A scanning electron microscopic comparison of a high volume final flush with several irrigating solutions: part 3”. J Endod 9 (1983): 137-42.
12. Bramante CM and Betti LV. “Comparative analysis of curved root canal preparation using nickeltitanium instruments with or without EDTA”. J Endod 26 (2000): 278-80.
13. Peters OA., et al. “Changes in root canal geometry after preparation assessed by high-resolution computed tomography”. J Endod 27 (2001): 1-6.
14. Villas-Boas MH., et al. “Micro-computed tomography study of the internal anatomy of mesial root canals of mandibular molars”. J Endod 37 (2011): 1682-6.
15. Peters OA., et al. “ProTaper rotary root canal preparation: effects of canal anatomy on final shape analysed by micro CT”. Int Endod J 36 (2003): 86-92.

During instrumentation of a root canal, ethylenediaminetetraacetic acid (EDTA) as a chelating agents may be used during cleaning and shaping. EDTA demineralizes dentin and may inadvertently contribute to root canal transportation. The purpose of this study was to evaluate the effect of chelating agents used in moderately curved canals during instrumentation using micro-computed tomography (µCT) and imaging/modelling technology.

Methods: Moderately curved root canals of 36 identified mandibular premolars were standardized in length and divided into 3 groups (n=12). Initial scans were taken using µCT. All canals were instrumented with Profile^® DENTSPLY0.06 taper NiTi rotary instruments using saline, 17% EDTA (Pulpdent Corp., Watertown, MA) or RC Prep™(Premier). After instrumentation, lengths were re-measured and all the teeth were re-scanned. Using computer software, 3-dimensional models were created from the pre and post-instrumentation scans. Models were compared for changes in volume and transportation.

Results: There was no statistically significant difference between the groups for any of the variables evaluated: working length, volume and transportation. Conclusion: Under the conditions of this study, the use of chelating agents during instrumentation did not affect the size or position of the root canals.

Keywords: EDTA; chelating agents; root canal preparation; transportation; micro-computed tomography

Reference

1. Keech C., et al. “Phase 1-2 trial of a SARS-CoV-2 recombinant spike protein nanoparticle vaccine”. N Engl J Med 383.24 (2020): 2320-2332.
2. Hall VG., et al. “Randomized trial of a third dose of mRNA-1273 vaccine in transplant recipients”. N Engl J Med 385 (2021): 1244-1246.
3. Kamar N., et al. “Three doses of an mRNA COVID-19 vaccine in solid-organ transplant recipients”. N Engl J Med 385 (2021): 661-662.
4. Benotmane I., et al. “Antibody response after a third dose of the mRNA-1273 SARS-CoV-2 vaccine in kidney-transplant recipients with minimal serologic response to 2 doses”. JAMA 326 (2021): 1063-1065.
5. Saiag E., et al. “The effect of a third-dose BNT162b2 vaccine on anti-SARS-CoV-2 antibody levels in immunosuppressed patients”. Clin Microbiol Infect 28 (2022): 735.e5-735.e8.
6. Aikawa NE., et al. “Increment of immunogenicity after third dose of a homologous inactivated SARS-CoV-2 vaccine in a large population of patients with autoimmune rheumatic diseases”. Ann Rheum Dis 81 (2022): 1036-1043.
7. Azzolini E., et al. “mRNA COVID-19 vaccine booster fosters B- and T-cell responses in immunocompromised patients”. Life Sci Alliance 5 (2022): e202201381.
8. Tenforde MW., et al. “Effectiveness of a third dose of Pfizer-BioNTech and Moderna vaccines in preventing COVID-19 hospitalization among immunocompetent and immunocompromised adults-United States, August-December 2021”. MMWR Morb Mortal Wkly Rep 71 (2021): 118-124.
9. Yue L., et al. “Antibody response elicited by a third boost dose of inactivated SARS-CoV-2 vaccine can neutralize SARS-CoV-2 variants of concern”. Emerg Microbes Infect 10 (2021): 2125-2127.
10. Schmiedeberg K., et al. “Efficacy and tolerability of a third dose of an mRNA anti-SARS-CoV-2 vaccine in patients with rheumatoid arthritis with absent or minimal serological response to two previous doses”. Lancet Rheumatol 4 (2022): e11-e13.
11. Karaba All., et al. “A third dose of SARS-CoV-2 vaccine increases neutralizing antibodies against variants of concern in solid-organ transplant recipients”. medRxiv (2021).
12. Bar-On YM., et al. “Protection of BNT162b2 vaccine booster against COVID-19 in Israel”. N Engl J Med 385 (2021): 1393-1400.
13. Bensouna I., et al. “SARS-CoV-2 antibody response after a third dose of the BNT162b2 vaccine in patients receiving maintenance hemodialysis or peritoneal dialysis”. American Journal of Kidney Diseases 79 (2022): 185-192.
14. Bertrand D., et al. “Antibody and T-cell response to a third dose of SARS-CoV-2 mRNA BNT162b2 vaccine in kidney-transplant recipients”. Kidney Int 100 (2021): 1337-1340.
15. Le Bougeois A., et al. “Interest of a third dose of BNT162b2 anti—SARS-CoV-2 messenger-RNA vaccine after allotransplant”. Br J Haematol 196 (2022): e38-e40.
16. Marlet J., et al. “Antibody responses after a third dose of COVID-19 vaccine in kidney-transplant recipients and patients treated for chronic lymphocytic leukemia”. Vaccines 9 (2021): 1055.
17. Reindl-Schwaighofer R., et al. “Comparison of SARS-CoV-2 antibody response 4 weeks after homologous vs heterologous third vaccine dose in kidney-transplant recipients: a randomized clinical trial”. JAMA Intern Med 182 (2022): 165-171.
18. Mair MJ., et al. “Third dose of SARS-CoV-2 vaccination in hemato-oncological patients and healthcare workers: immune responses and adverse events-a retrospective cohort study”. Eur J Cancer 165 (2022): 184-194.
19. Kartnig F., et al. “Safety and immunogenicity of a third COVID-19 vaccination in patients with immune-mediated inflammatory diseases compared with healthy controls”. Ann Rheum Dis 82 (2023): 292-300.
20. Kulkarni PS., et al. “Safety and immunogenicity of SII-NVX-CoV2373 (COVID-19 vaccine) in adults in a phase 2/3, observer-blind, randomized controlled study”. The Lancet 10 (2023): 100139.
21. Kang L., et al. “Immunogenicity and safety of COVID-19 vaccines among people living with HIV: a systematic review and meta-analysis”. Vaccines 10 (2022): 1569.
22. Hibino M., et al. “Safety and immunogenicity of mRNA vaccines against severe acute respiratory syndrome coronavirus 2 in patients with lung cancer receiving immune checkpoint inhibitors: a multicenter observational study in Japan”. Journal of Thoracic Oncology 17.8 (2022): 1002-1013.
23. Xia S., et al. “Safety and immunogenicity of an inactivated COVID-19 vaccine, WIBP-CorV, in healthy children: interim analysis of a randomized, double-blind, controlled, phase ½ trial”. Frontiers in Immunology 13 (2022): 898151.
24. Huang R., et al. “Safety and immunogenicity of inactivated SARS_CoV-2 vaccine (BBIBP-CorV) in hypertensive and/or diabetic people aged over 60 years: a prospective open-label study”. Diabetes Ther 14 (2023): 139-151.
25. Yang B., et al. “Immunogenicity, efficacy, and safety of SARS-CoV-2 vaccine dose fractionation: a systematic review and meta-analysis”. BMC Medicine 20 (2022): 409.
26. Li C., et al. “Retrospective study of the CoronaVac SARS-CoV-2 vaccine in people with underlying medical conditions”. Communications Medicine 2.1 (2022): 151.
27. Song J-W., et al. “Safety and immunogenicity of COVID-19 vaccination in immunocompromised patients”. Chinese Medical Journal 135.22 (2022): 2656-2666.
28. Zakarya K., et al. “Safety and immunogenicity of a QazCovid-in® inactivated whole-virion vaccine against COVID-19 in healthy adults: a single-centre, randomized, single-blind, placebo-controlled phase 1 and open-label phase 2 clinical trials with a 6 months follow-up in Kazakhstan”. EClinical Medicine 39 (2021): 101078.
29. French RWJr., et al. “Safety, immunogenicity, and efficacy of the BNT162b2 COVID-19 vaccine in adolescents”. N Engl J Med 385.3 (2021): 239-250.
30. Munro APS., et al. “Safety and immunogenicity of seven COVID-19 vaccines as a third dose (booster) following two doses of ChAdOx1 nCoV-19 or BNT162b2 in the UK (COV-BOOST): a blinded, multicentre, randomized, controlled, phase 2 trial”. Lancet 398 (2021): 2258-2276.
31. Xia S., et al. “Effect of an inactivated vaccine against SARS-CoV-2 on safety and immunogenicity outcomes: interim analysis of 2 randomized clinical trials”. JAMA 324.10 (2020): 951-960.
32. Walsh EE., et al. “Safety and immunogenicity of two RNA-based COVID-19 vaccine candidates”. N Engl J Med 383 (2020): 2439-2450.

A comprehensive search was carried out in mainstream bibliographic databases or Medical Subject Headings, including ScienDirect, PubMed, Scopus, and ISI Web of Science. The search was applied to the articles that were published between January 2020 and early 2023 With strict literature search and screening processes, it yielded 14 articles from 373 articles of initial literature database. Among 14 study results, there was acceptable for immunogenicity, both humoral and cellular immune responses in 11 studies (78.57 %), whereas acceptable potent immunogenicity was found in patients aged more than 40 years with chronic diseases, particularly, chronic respiratory diseases and coronary artery diseases. Only potent T-cell response was identified in one study. No significant difference in vaccine safety compared with healthy subjects and effective neutralizing antibodies (two doses completion) against SARS-CoV-2 (COVID-19) in patients older than 60 years with diabetes and/or hypertension were demonstrated after completion of COVID-19 vaccination. Immunogenicity and safety in aged people and individuals living with various chronic diseases (both infectious and non-infectious) is highlighted in this study. In conclusion, specified local and systemic AEs and unsolicited AEs, AESI, and SAEs after each vaccination and after the second dose should be monitored. Recording the adverse events of special interest (AESI) and serious adverse events (SAEs) throughout the patients’ vaccination course should be performed and can decrease COVID-19 vaccination hesitancy in these persons.

Keywords: adverse reactions; COVID-19; immunogenicity; neutralizing antibody; safety; vaccine

Historical Background

     Before 1967, abortion was generally illegal in the United States of America except to save the patient’s life [1]. From 1967 to 1973, some states like New York, Washington, Alaska, Hawaii and California liberalized abortion laws. The landmark US Supreme Court judgement of Roe and Wade in Jan 1973 legalized abortion nationwide [1] Despite this, opposition across the US led to the camps of abortionists and the Pro–life. This had a great impact on the political dynamics of the country and also globally. The abortionist camp through advocacy, sponsorship, education and NGOs campaign against unsafe abortion and its implications led to the adoption of abortion laws or modified forms in different counties.

     Despite the obvious positive effects of Abortion laws in reducing maternal mortality and morbidity, the Pro-life in the US continued its efforts to repeal the laws through legislation and the Courts. In 1992 the Supreme Court almost overturned the Roe decision, (Planned Parenthood of Southeastern Pennsylvania v Casey, 505 US 833) [1].

      About fifty years after the Roe decision that legalized abortion was overturned on June 2022 by the US Supreme Court and individual states in the US were empowered to decide the legal parameters for abortion [2]. The effects of this decision will not only affect women in the US but globally, considering the global impact of US policies. The US is the leading donor globally to family planning and abortion care and has a rule that prohibits the use of its funds for a program that conflicts with its policies. The “global gag rule” will affect reproductive rights services in other countries especially the Sub –Saharan Africa which depends heavily on donor-funded program [2].

Unsafe Abortion and abortion laws in Sub-Saharan Africa

     Globally there were about 6.8 million unsafe abortions annually with the majority occurring in sub-Saharan Africa. Evidence has shown that the incidence of abortions is the same worldwide whether abortion law is liberalized or restricted. Thirty-five per cent of abortions are unsafe in regions where the abortion laws are restrictive while only 1% of abortions are unsafe in counties where the abortion laws have been liberalized [3]. In Sub-Saharan Africa, 77% of abortions are unsafe due to restrictive laws on abortions [3].

     According to 2019 figures, sub-Saharan Africa has the highest case fatality of 185/100,000 unsafe abortions resulting in over 15,000 avoidable deaths [3]. This was a remarkable improvement from the 2000 figure of 315 / 100,000 which was due to the availability of abortion care / post-abortion care services and the improvement of abortion law in the region [3].

     Extensive work was done on unsafe abortions and abortion laws in the last two–three decades by Bankole et al of the Guttmacher Institute and published in 2020 titled “From unsafe to safe abortion in Sub-Saharan Africa: Slow but steady progress”. From the study, great progress has been made. The African Union Maputo agreement of 2003 stipulated the legal criteria of allowing abortion when the woman’s life or physical or mental health is threatened and in cases of rape, incest and grave fetal anomaly. Some countries have gone beyond the Maputo agreement and have liberalized abortion laws (Category 6) including South Africa, Cape Verde, Guinea-Bissau, and Sao Tome & Principe. Zambia also has broadly liberalized abortion law - Category 5. Twenty-seven of the 48 – sub-Saharan African countries have moderately restrictive abortion laws (abortions to save the woman’s life and to preserve her physical or mental health).

     The majority of the countries in the Sub-African have either liberalized or moderately restrictive laws on abortion. Despite the above statement majority of the populace live within the highly restrictive due to the high population of countries like Nigeria in this category.

     Other countries in the region have highly restrictive abortion laws which are to save the life of the mother (Category 2) except for six with total restriction on abortion – Category 1(Madagascar, Angola, DRC, Mauritania, Seria-Leone & Senegal).

     Most of the progress in ensuring safe abortions in this region through legal and political means was hinged on the Roe and Wade case, the global funding for safe abortion and NGO partnership. The question of whether this overturning will have effects on reproductive rights and the safety of our women in the reproductive age is not in doubt.

The effects and the way forward

     The effect of restrictive abortion laws is not limited to the termination of unwanted pregnancy but may affect adequate post-abortion care after miscarriages, and those with a significant maternal or fetal condition that requires interventions [2]. All these will hinder the achievement of the United Nations Sustainable Development goals of reducing maternal mortality to 70 per 100,000 live births by 2030.

     One of the main drives to liberalize abortion law in this region was the US bio-political pressure emanating from Roe and Wade’s decision for the last half a century [2]. Reversal of this decision and the anti–abortion policy at the Federal level, may lead to counter bio-political pressure in the opposite direction.

     Most of the abortion care and family planning materials were donor-driven and subsidized. This reversal may lead to reduced funding and an increase in cost even when available, coupled with the current economic downturn worldwide will harm SDG -Goal 3 3.

     The decision to restrict abortion at the federal level in the US may resonate in African countries with more countries becoming more restrictive too. As it had been shown restrictive abortion law does not reduce the incidence of abortion but rather increases the incidence of unsafe abortions [1.3]. This will further increase the maternal mortality rate thereby making SDG 2030 unrealistic.

     This decision will also have negative implications for medical education funding in abortion care and will influence the knowledge, skills, and quality of care provided by medical practitioners as documented by Traub and co-workers. This will be more pronounced since most funds for reproductive health education and training were from International NGOs and Partners of which the US accounts for the bulk of the donation

Conclusion

     There is no doubt the Overturning Roe and Wade decision will adversely affect the African policy on Safe abortion practices and with the likelihood of increased unsafe abortion with associated mortality and morbidity.

     Africans need to meet to take their destiny into their hand by ensuring local funding for reproductive health services and post–abortion care to manage complications from unsafe abortions.

References

1. Levine PB., et al. “Roe v Wade and American fertility”. American Journal of Public Health 89.2 (1999): 199-203.
2. Coen-Sanchez K., et al. “Repercussions of overturning Roe v. Wade for women across systems and beyond borders”. Reproductive Health 19.1 (2022): 1-5.
3. Bankole A., et al. “From unsafe to safe abortion in Sub-Saharan Africa: Slow but steady progress”. New York: Guttmacher Institute (2020).
4. Traub AM., et al. “The implications of overturning Roe v. Wade on medical education and future physicians”. The Lancet Regional Health–Americas (2022): 100334.

     Unsafe abortion and its complications remain a major contributor to maternal mortality which is still very high worldwide, especially in the sub-Saharan. The legalization of abortion remains the most impactful way of minimizing the mortality and morbidity from unsafe abortion and its complications.

     The legalization of abortion remains one of the most contentious issues in modern medicine with great emotional, religious, cultural, legal, political and medical discourse.

Reference

1. Agur AM and Dalley AF. “Moore's essential clinical anatomy”. Lippincott Williams & Wilkins (2018).
2. McCue FC, Alexander EJ and Baumgarten TE. “Median nerve entrapment at the elbow in athletes”. Operative Techniques in Sports Medicine 4.1 (1996): 21-27.
3. Schickendantz MS and Yalcin S. “Conditions and Injuries Affecting the Nerves Around the Elbow”. Clinics in Sports Medicine 39.3 (2020): 597-621.
4. Bamac B., et al. “Evaluation of nerve conduction velocities of the median, ulnar and radial nerves of basketball players: Original research article”. International SportMed Journal 15.1 (2014): 1-12.
5. Salerno DF., et al. “Median and ulnar nerve conduction studies among workers: Normative values”. Muscle & Nerve 21.8 (1998): 999-1005.
6. Simon NG and Walker S. “The role of limb position in the interpretation of nerve conduction studies: The Role of Limb Position in The Interpretation of Nerve Conduction Studies”. Muscle & Nerve 56.3 (2017): 353-354.
7. Ross A, Leveritt M and Riek S. “Neural influences on sprint running: Training adaptations and acute responses”. Sports Medicine (Auckland, N.Z.) 31.6 (2001): 409-425.
8. Revathy G and Krishnan A. “Comparison of Motor Nerve Conduction Velocity between Football Players and Sedentary Individuals: A Cross-sectional Study”. Journal of Clinical and Diagnostic Research 16.7 (2022).
9. Bera K, Shukla A and Bapi RS. “Cognitive and Motor Learning in Internally-Guided Motor Skills”. Frontiers in Psychology 12 (2021): 604323.
10. Vernon PA and Mori M. “Intelligence, reaction times, and peripheral nerve conduction velocity”. Intelligence 16.3 (1992): 273-288.
11. Halar EM, Hammond MC and Dirks S. “Physical activity: Its influence on nerve conduction velocity”. Archives of Physical Medicine and Rehabilitation 66.9 (1985): 605-609.
12. Li J. “Molecular regulators of nerve conduction—Lessons from inherited neuropathies and rodent genetic models”. Experimental Neurology 267 (2015): 209-218.
13. Desai CB., et al. “Effect of sensory nerve conduction studies of median and ulnar nerve: Height and body mass index”. National Journal of Physiology, Pharmacy and Pharmacology 11.3 (2021): 331-336.
14. Sleivert GG, Backus RD and Wenger HA. “Neuromuscular differences between volleyball players, middle distance runners and untrained controls”. International Journal of Sports Medicine 16.6 (1995): 390-398.
15. Patel NR., et al. “To Study Nerve Conduction Velocity of Median Nerve in Mobile Phone Users-A Cross Sectional Study”. National Journal of Integrated Research in Medicine 8.3 (2017).
16. Pawlak M and Kaczmarek D. “Field hockey players have different values of ulnar and tibial motor nerve conduction velocity than soccer and tennis players”. Archives Italiennes de Biologie 148.4 (2010): 377-388.
17. Manual of Nerve Conduction Studies Second Edition. by Ralph M. Buschbacher, MD and Nathan D. Prahlow, MD (2006): 84-86.
18. Kleinrensink G., et al. “Mechanical tension in the median nerve”. The effects of joint positions. Clinical Biomechanics 10.5 (1995): 240-244.
19. Rayan GM. “Archery-Related Injuries of the Hand, Forearm, and Elbow”. Southern Medical Journal 85.10 (1992): 961-964.
20. Häger-Ross C and Schieber MH. “Quantifying the independence of human finger movements: Comparisons of digits, hands, and movement frequencies”. The Journal of Neuroscience: The Official Journal of the Society for Neuroscience 20.22 (2000): 8542-8550.
21. Rossini PM and Rossi S. “Clinical applications of motor evoked potentials”. Electroencephalography and Clinical Neurophysiology 106.3 (1998): 180-194.
22. Spitzer H, Desimone R and Moran J. “Increased attention enhances both behavioral and neuronal performance”. Science (New York, N.Y.) 240.4850 (1988): 338-340.

Background: Engaging in athletic training not only improves cardiovascular, pulmonary, and musculoskeletal function but also has been shown to enhance neural capabilities.

Purpose: The purpose of this study is to examine how the positioning of the forearm and elbow joint affects median nerve conduction velocity (NCV) among three groups: throwers, archers, and non-athletes.

Method: This study included a total of 34 subjects of both genders, with body mass indices (BMI) ranging from 18.5 to 24.9 Kg/m². To measure median nerve conduction velocity (NCV) across the elbow joint at various angles (0° elbow extension, 45°, 90°, and 120° elbow flexion) and different forearm positions, NeuroStim NS2 EMG/NCV/EP System was used.

Result: Repeated Measure Analysis of Variance (RMANOVA) demonstrated a statistically significant difference in the mean values of median NCV across different angles, forearm positions, and groups (p<0.05).

Conclusion: The positioning of the forearm and elbow joint can significantly impact median nerve conduction velocity, particularly among athletes who engage in repetitive upper limb motions. Study showed that the archers had significantly faster NCV than throwers and non-athletes at 0° of elbow flexion.

Keywords: Angles; Joints; Motor; Peripheral nerve

     Unintentional errors necessitate moderation in spreading data, compassion, and even forgiveness.

     Minor to moderate unintentional errors may benefit from the community's emotional support; frequently, they explore the problem and consider the individual's past performance and successful activities completed before the error happens. Their actions during his troubled time express their inner voice toward him.

     If this doesn't happen, he must reflect on his past acts to be sure if there are some possible gaps in effecting job requirements or relational problems; these potential breaches must be detected and corrected accordingly.

     Their attitude of criticism or a lack of interest in him in troubled times will determine a similar response from him when they are in need.

     Intentional errors must be identified and punished; minor to significant corrective and curative actions, according to error, will be used to avoid other misconduct with more people suffering.

     Consciousness and more reflection on mistakes following undesired effects on the individual and community level are necessary. Through the power of a negative example, remediation is possible only using the image of such action, without any words or aggression.

     Individuals with genetic abnormalities facilitating disapproval behaviour should be re-educated for improvement since each individual has an ineffable spark.

     The people responsible for spreading misinformation must be punished, paying for moral distress to the intended recipient.

     In this digital era, spreading bad news about an individual alters his credibility. Honour is essential for practical, successful work, and its alteration by lousy information shared wide affects personal health.

     If an untruth is applied rapidly, a disaster could follow since affected personality traits for an innocent, not guilty person exponentially amplify his distress, leading to significant mental and physical disorders.

     Verification for honest info before spreading prevents possible disasters.

     Sometimes, envy subtly controls the envisioned steps to attain the intended goal. Such encounters are better to be identified and exposed to the public so as not to fall again someone.

     The world includes a variety of individuals, and not all are gentle, honest people. Selective relationships for life quality improvement define us, ensuring ill prediction, termination, and rehabilitation of the individual.

     People's successful relationships suppose truth, respect, and consideration. To work in dignity is a requirement, and the individual good morality and integrity assure esteem in the community.

     Lack of respect and admiration from our community alters mind functioning and job performance and declines perspective.

     Error is usual, but not exceeding limits for survival.

     Disgrace means the loss of people’s respect as a response to the individual’s misconduct.

     Personal acting up has various effects on the community and determines feedback; the error in practice outlines humiliation.

     In the digital era, good and bad news rapidly spreads. Usually, people are curious and quickly respond to new info. The data spread about someone may be correct or false, including intentional or unintentional errors. The fast distribution of inaccurate data dangerously works on the equilibrium of the receiver, sender, and producer.

     In the healthcare industry, individual medical errors rapidly circulate by media, commonly generating people to disapprove and censure the following behaviour. People's criticism increases the suffering in the heart and mind of an individual making mistakes; prolonged suffering can lead to disaster since the mind's activity influences bodily function, and fragile areas can decline their activities under excessive distress. Therefore, reputation must be ameliorated and recuperated quickly, whenever possible. Proper actions to rapidly establish the truth and collective support for health improvement may ease the torment.

References

1. Bogoch A., et al. “Pneumonia of unknown etiology in wuhan, China: potential for international spread via commercial air travel”. J. Trav. Med 27.2 (2020).
2. Lu H, Stratton CW and Tang YW. “Outbreak of pneumonia of unknown etiology in wuhan China: the mystery and the miracle”. J. Med. Virol 92.4 (2020): 401-402.
3. S Zhao., et al. “Preliminary estimation of the basic reproduction number of novel coronavirus (2019-nCoV): in China, from 2019 to 2020: a data-driven analysis in the early phase of the outbreak”. Int. J. Infect. Dis.: IJID : Off. Publ. Int. Soc. Infect. Dis 92 (2020): 214-217.
4. Du Toit. “Outbreak of a novel coronavirus”. Nat. Rev. Microbiol 18 (2020): 123.
5. LL Ren., et al. “Identification of a novel coronavirus causing severe pneumonia in human: a descriptive study”. Chinese Med J (2020).
6. C Huang., et al. “Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China”. Lancet 395.10223 (2020): 497-506.
7. H Lu. “Drug treatment options for the 2019-new coronavirus (2019-nCoV)”. Biosci. Trends (2020).
8. W Wang, J Tang and F Wei. “Updated understanding of the outbreak of 2019 novel coronavirus (2019-nCoV): in Wuhan, China”. J. Med. Virol 92.4 (2020): 441-447.
9. H Nishiura., et al. “The extent of transmission of novel coronavirus in wuhan”. China, 2020, J. Clin. Med 9 (2020).
10. M Bassetti, A Vena and D Roberto Giacobbe. “The Novel Chinese Coronavirus (2019-nCoV): Infections: challenges for fighting the storm”. Eur. J. Clin. Invest (2020): e13209.
11. ML Holshue., et al. “First case of 2019 novel coronavirus in the United States”. N. Engl. J. Med (2020).
12. Q Li., et al. “Early transmission dynamics in wuhan, China, of novel coronavirus-infected pneumonia”. N. Engl. J. Med (2020).
13. WG Carlos., et al. “Novel wuhan (2019-nCoV): coronavirus”. Am. J. Respir. Crit. Care Med 201.4 (2020): 7-8.
14. J Lei., et al. “CT imaging of the 2019 novel coronavirus (2019-nCoV): pneumonia”. Radiology (2020).
15. Assiri JA., et al. “Epidemiological, demographic, and clinical characteristics of 47 cases of Middle East respiratory syndrome coronavirus disease from Saudi Arabia: a descriptive study”. Lancet Infect. Dis 13 (2013): 752-761.
16. N Lee., et al. “A major outbreak of severe acute respiratory syndrome in Hong Kong”. N. Engl. J. Med 348 (2003): 1986-1994.
17. LT Phan., et al. “Importation and human-to-human transmission of a novel coronavirus in Vietnam”. N. Engl. J. Med (2020).
18. W Ji., et al. “Homologous recombination within the spike glycoprotein of the newly identified coronavirus may boost cross-species transmission from snake to human”. J. Med. Virol 92.4 (2020): 433-440.
19. R Lu., et al. “Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding”. Lancet 395.10224 (2020): 565-574.
20. Y Wan., et al. “Receptor recognition by novel coronavirus from Wuhan: an analysis based on decade-long structural studies of SARS”. J. Virol (2020).
21. P Wu., et al. “Real-time tentative assessment of the epidemiological characteristics of novel coronavirus infections in Wuhan, China”. as at 22 January 2020 Euro Surveill 25 (2020).
22. JA Jaimes., et al. “Whittaker, A tale of two viruses: the distinct spike glycoproteins of feline coronaviruses”. Viruses 12 (2020).
23. DS Hui., et al. “The continuing 2019-nCoV epidemic threat of novel coronaviruses to global health - the latest 2019 novel coronavirus outbreak in Wuhan, China”. Int. J. Infect. Dis 91 (2020): 264-266.
24. J Cui, F Li and ZL Shi. “Origin and evolution of pathogenic coronaviruses”. Nat. Rev. Microbiol 17 (2019): 181-192.
25. N Zhu., et al. “A novel coronavirus from patients with pneumonia in China”. N. Engl. J. Med 382 (2019): 727-733.
26. P Zhou., et al. “A pneumonia outbreak associated with a new coronavirus of probable bat origin”. Nature (2020).
27. E de Wit., et al. “SARS and MERS: recent insights into emerging coronaviruses”. Nat. Rev. Microbiol 14 (2016): 523-534.
28. JT Wu, K Leung and GM Leung. “Nowcasting and forecasting the potential domestic and international spread of the 2019-nCoV outbreak originating in Wuhan, China: a modelling study”. Lancet (2020).
29. S Su., et al. “Epidemiology, Genetic recombination, and pathogenesis of coronaviruses”. Trends Microbiol 24 (2016): 490-502.
30. S Perlman and J Netland. “Coronaviruses post-SARS: update on replication and pathogenesis”. Nat. Rev. Microbiol 7 (2009): 439-450.
31. R Lu., et al. “Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding”. Lancet (2020).
32. AR Fehr and S Perlman. “Coronaviruses: an overview of their replication and pathogenesis”. Methods Mol. Biol 1282 (2015): 1-23.
33. PS Masters. “The molecular biology of coronaviruses”. Adv. Virus Res 66 (2006): 193-292.
34. K Knoops., et al. “SARS-coronavirus replication is supported by a reticulovesicular network of modified endoplasmic reticulum”. PLoS Biol 6 (2008).
35. W Li., et al. “Angiotensin-converting enzyme 2 is a functional receptor for the SARS coronavirus”. Nature 426 (2003): 450-454.
36. XY Ge., et al. “Isolation and characterization of a bat SARS-like coronavirus that uses the ACE2 receptor”. Nature 503 (2013): 535-538.
37. Chinese SARS Molecular Epidemiology Consortium, Chinese Molecular evolution of the SARS coronavirus during the course of the SARS epidemic in China, Science 303 (2004): 1666-1669.
38. VS Raj., et al. “Dipeptidyl peptidase 4 is a functional receptor for the emerging human coronavirus-EMC”. Nature 495 (2013): 251-254.
39. Barlan J Zhao., et al. “Receptor variation and susceptibility to Middle East respiratory syndrome coronavirus infection”. J. Virol 88 (2014): 4953-4961.
40. C Huang., et al. “Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China”. Lancet (2020).
41. JS Peiris, Y Guan and KY Yuen. “Severe acute respiratory syndrome”. Nat. Med 10 (2004): S88-S97.
42. F Wu., et al. “A new coronavirus associated with human respiratory diseases in China”. Nature (2020).
43. SA Jeffers., et al. “CD209L (L-SIGN): is a receptor for severe acute respiratory syndrome coronavirus”. Proc. Natl. Acad. Sci. U.S.A 101 (2004): 15748-15753.
44. G Simmons., et al. “Characterization of severe acute respiratory syndrome-associated coronavirus (SARS-CoV): spike glycoprotein-mediated viral entry”. Proc. Natl. Acad. Sci. U.S.A 101 (2004): 4240-4245.
45. S Belouzard, VC Chu and GR Whittaker. “Activation of the SARS coronavirus spike protein via sequential proteolytic cleavage at two distinct sites”. Proc. Natl. Acad. Sci. U.S.A 106 (2009): 5871-5876.
46. JK Millet and GR Whittaker. “Host cell entry of Middle East respiratory syndrome coronavirus after two-step, furin-mediated activation of the spike protein”. Proc. Natl. Acad. Sci. U.S.A 111 (2014): 15214-15219.
47. H Wang., et al. “SARS coronavirus entry into host cells through a novel clathrin- and caveolae-independent endocytic pathway”. Cell Res 18 (2008): 290-301.
48. K Kuba., et al. “Trilogy of ACE2: a peptidase in therenin-angiotensin system, a SARS receptor, and a partner for amino acid transporters”. Pharmacol. Ther 128 (2010): 119-128.
49. J Liu., et al. “Novel immunodominant peptide presentation strategy: a featured HLA-A*2402-restricted cytotoxic T-lymphocyte epitope stabilized by intrachain hydrogen bonds from severe acute respiratory syndrome coronavirus nucleocapsid protein”. J. Virol 84 (2010): 11849-11857.
50. N Keicho., et al. “Association of human leukocyte antigen class II alleles with severe acute respiratory syndrome in the Vietnamese population”. Hum. Immunol 70 (2009): 527-531.
51. YM Chen., et al. “Epidemiological and genetic correlates of severe acute respiratory syndrome coronavirus infection in the hospital with the highest nosocomial infection rate in Taiwan in 2003”. J. Clin. Microbiol 44 (2006): 359-365.
52. SF Wang., et al. “Human-leukocyte antigen class I Cw 1502 and class II DR 0301 genotypes are associated with resistance to severe acute respiratory syndrome (SARS): infection”. Viral Immunol 24 (2011): 421-426.
53. AH Hajeer., et al. “Association of human leukocyte antigen class II alleles with severe Middle East respiratory syndrome-coronavirus infection”. Ann. Thorac. Med 11 (2016): 211-213.
54. X Tu., et al. “Functional polymorphisms of the CCL2 and MBL genes cumulatively increase susceptibility to severe acute respiratory syndrome coronavirus infection”. J. Infect 71 (2015): 101-109.
55. G Li, X Chen and A Xu. “Profile of specific antibodies to the SARS-associated coronavirus”. N. Engl. J. Med 349 (2003): 508-509.
56. Z Xu., et al. “Pathological findings of COVID-19 associated with acute respiratory distress syndrome”. Lancet Resp. Med (2020).
57. YY Fan., et al. “Characterization of SARS-CoV-specific memory T cells from recovered individuals 4 years after infection”. Arch. Virol 154 (2009): 1093-1099.
58. F Tang., et al. “Lack of peripheral memory B cell responses in recovered patients with severe acute respiratory syndrome: a six-year follow up follow up study”. J. Immunol 186 (2011): 7264-7268.
59. J Zhao., et al. “Rapid generation of a mouse model for Middle East respiratory syndrome”. Proc. Natl. Acad. Sci. U.S.A 111 (2014): 4970-4975.
60. AE Williams and RC Chambers. “The mercurial nature of neutrophils: still an enigma in ARDS?”. Am. J. Physiol. Lung Cell Mol. Physiol 306 (2014): L217-L230.
61. R Channappanavar and S Perlman. “Pathogenic human coronavirus infections: causes and consequences of cytokine storm and immunopathology”. Semin. Immunopathol 39 (2017): 529-539.
62. MJ Cameron., et al. “Human immunopathogenesis of severe acute respiratory syndrome (SARS)”. Virus Res 133 (2008)13-19.
63. CK Min., et al. “Comparative and kinetic analysis of viral shedding and immunological responses in MERS patients representing a broad spectrum of disease severity”. Sci. Rep 6 (2016): 25359.
64. EJ Snijder., et al. “Ultrastructure and origin of membrane vesicles associated with the severe acute respiratory syndrome coronavirus replication complex”. J. Virol 80 (2006): 5927-5940.
65. R Channappanavar., et al. “Dysregulated type I interferon and inflammatory monocyte-macrophage responses cause lethal pneumonia in SARS-CoV-infected mice”. Cell Host Microbe 19 (2016): 181-193.
66. R Channappanavar., et al. “IFN-I response timing relative to virus replication determines MERS coronavirus infection outcomes”. J. Clin. Invest 130 (2019): 3625-3639.
67. D Niemeyer., et al. “Middle East respiratory syndrome coronavirus accessory protein 4a is a type I interferon antagonist”. J. Virol 87 (2013): 12489-12495.
68. Y Yang., et al. “The structural and accessory proteins M, ORF 4a, ORF 4b, and ORF 5 of Middle East respiratory syndrome coronavirus (MERS-CoV): are potent interferon antagonists”. Protein Cell 4 (2013): 951-961.
69. VD Menachery., et al. “MERS-CoV and H5N1 influenza virus antagonize antigen presentation by altering the epigenetic landscape”. Proc. Natl. Acad. Sci. U.S.A 115 (2018): E1012-E1021.
70. M Corman., et al. “Detection of 2019 novel coronavirus (2019-nCoV): by real-time RT-PCR”. Euro Surveill 25 (2020).
71. H Lu, CW Stratton and Y Tang. “Outbreak of pneumonia of unknown etiology in wuhan China: the mystery and the miracle”. J. Med. Virol (2020).
72. World Health Organization, WHO Director-General’s Remarks at the Media Briefingon 2019-nCoV (2020).
73. N Chen., et al. “Epidemiological and clinical characteristics of 99cases of 2019 novel coronavirus pneumonia in Wuhan”. China: a descriptive study,Lancet (2020).
74. D Wang., et al. “Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in wuhan, China”. J. Am. Med.Assoc (2020).
75. World Health Organization, Novel Coronavirus (2019-nCoV), Situation Report – 12 (2020).
76. Wellcome, Sharing Research Data and Findings Relevant to the Novel Coronavirus(nCoV): Outbreak (2020).
77. European Commission, Coronavirus: EU Mobilises €10 Million for Research (2020).
78. Verdict Medical Devices, Co-Diagnostics Launches RUO Test for New Coronavirus (2020).
79. Verdict Medical Devices, Primerdesign Launches Molecular Test for NewCoronavirus (2020).
80. BBC, Coronavirus: UK Donates £20m to Speed up Vaccine (2020).
81. The White House, Proclamation on Suspension of Entry as Immigrants and Nonimmigrants of Persons Who Pose a Risk of Transmitting 2019 NovelCoronavirus (2020).
82. BBC, Coronavirus: Hong Kong Hospital Staff Strike to Demand Closure of China Border (2020).
83. BBC, Coronavirus: China to Pump Billions into Economy amid Growth Fears (2020).
84. Bloomberg Businessweek Coronavirus Is More Dangerous for the Global Economy than SARS (2020).
85. Reuters Instant View: China's Economic Growth Slows to 6.1% in 2019, Near 30-year Low (2020).
86. As Wuhan Coronavirus Drags on Chinese Markets, the World Economy Braces for a Slowdown (2020).
87. Brookings Global Manufacturing Scorecard: How the US Compares to 18 Other Nations (2018).
88. China's Oil Imports Are Most World's Ever Seen and Still Growing Financial Times China’s Xi Jinping knew of coronavirus earlier than first thought (2020).

In the month of December 2019, Wuhan which is a city of Hubei, state of China suffered an unusual outburst of pneumonia of unclear origin. The causative agent was described as a novel coronavirus, which the WHO (World Health Organization) designated as COVID-19. Coronavirus-19 is initiated by a β-coronavirus called SARS-Covid-2 that presents itself as pneumonia and disturbs the lower respiratory tract in individuals. It's related to SARS and MERS. Covid-19 continues to spread amid worldwide isolation and quarantine attempts. We summaries the existing state of awareness concerning COVID-19 as a response to this global outbreak.

Keywords: Coronavirus (COVID-19); Pathogenesis; Global Outbreak

References

1. Aju. Covid-19 (2020).
2. Jyothi. Consumer Behaviour: Impact of COVID-19 (2021).
3. Changotra R., et al. “Largest democracy in the world crippled by COVID-19: Current perspective and experience from India”. Environment, development and sustainability 23.5 (2021): 6623-6641.
4. Chen Q and Wang Y. “Key-performance-indicator-related state monitoring based on kernel canonical correlation analysis”. Control Engineering Practice 107 (2021): 104692.
5. Dani MT, Singh AG and Chaturvedi P. “COVID-19 vaccine hesitancy in India”. Cancer Research, Statistics, and Treatment 4.3 (2021): 437.
6. Duan, W., et al. “Evaluating model uncertainty of an in situ state parameter-based simplified method for reliability analysis of liquefaction potential”. Computers and Geotechnics 151 (2022): 104957.
7. Eger L., et al. “The effect of COVID-19 on consumer shopping behaviour: Generational cohort perspective”. Journal of Retailing and Consumer Services 61 (2021): 102542.
8. Goswami B, Mandal R and Nath HK. “Covid-19 pandemic and economic performances of the states in India”. Economic Analysis and Policy 69 (2021): 461-479.
9. Hupert N., et al. “Heterologous vaccination interventions to reduce pandemic morbidity and mortality: Modeling the US winter 2020 COVID-19 wave”. Proceedings of the National Academy of Sciences 119.3 (2022): e2025448119.
10. Ijsem. Inventory Management Practices in Manufacturing Industries during the COVID 19: A review (2022).
11. Jessica. Building Better amidst the Coronavirus Disease (COVID-19): Pandemic: An Analysis of Critical Success Factors within Resilience to Natural Hazards and COVID-19 (2022).
12. Madan A, Bindal S and Gupta AK. “Social distancing as risk reduction strategy during COVID-19 pandemic: A study of Delhi-NCT, India”. International Journal of Disaster Risk Reduction 63 (2021): 102468.
13. Mahmoudi MR and Abbasalizadeh A. “How statistics and text mining can be applied to literary studies?”. Digital Scholarship in the Humanities 34.3 (2019): 536-541.
14. Manish. Managing Global Management Teams in COVID and Post Lockdown Period (2022).
15. Asenahabi BM. “Basics of research design: A guide to selecting appropriate research design”. International Journal of Contemporary Applied Researches 6.5 (2019): 76-89.
16. Mazhar SA., et al. “Methods of data collection: A fundamental tool of research”. Journal of Integrated Community Health 10.1 (2021): 6-10.
17. Nimavat N., et al. “Online medical education in India–different challenges and probable solutions in the age of COVID-19”. Advances in Medical Education and Practice 12 (2021): 237-243.
18. Reiter PL, Pennell ML and Katz ML. “Acceptability of a COVID-19 vaccine among adults in the United States: How many people would get vaccinated?”. Vaccine 38.42 (2020): 6500-6507.
19. Sharmin A., et al. “Addressing critical success factors for improving concurrent emergency management: lessons learned from the COVID-19 pandemic”. Annals of Operations Research (2021): 1-35.
20. Vu TTN. “Understanding validity and reliability from qualitative and quantitative research traditions”. VNU Journal of Foreign Studies 37.3 (2021).
21. Yang L., et al. “COVID-19: immunopathogenesis and Immunotherapeutics”. Signal transduction and targeted therapy 5.1 (2020): 128.

The present study deals with identifying the impact of COVID-19 pandemic and vaccination in context of India. The impact of pandemic on the organization, management, and Health of people of India has been thoroughly described. Several strategies have been taken by management and Indian government in order to control the pandemic situation. The strategies and the importance of vaccination has been discussed in the study. Vaccination can be seen as an important part for mitigating health issue and control the risk of spreading the virus. This study focusing on discussing the vaccination process and how the vaccination helps the country to improve its condition and mitigate the pandemic risk. Quantitative research strategy has been employed in the study in order to collect data and achieve get an outcome of the research. Primary data has been collected from 51 participants and statistical analysis has been done on the collected data. According to the analysis of the data it can be stated that, Covid-19 pandemic reduces movement of the people that are forced to stop production of several organization. Moreover, vaccination method was more seen to be helpful for different management and organisation to mitigate issues and reboot financial activities.

References

1. Amitiza R. Soft gelatin capsules [prescribing information] Bethesda, Md: Sucampo Pharmaceuticals, Inc. (2006).
2. Bergmeyer HU and Bernt E. Glutamate-oxaloacetate transaminase in Method of enzymatic analysis (ed) H U Bergmeyer (New York Academic Press) (1974): 727-733.
3. Beutler E, West C and Blume KGJ. ‘The removal of leucocytes and platelets from whole blood”. Lab Cin Med 88 (1976): 328-333.
4. Beutler E. Method in Hematology (Beautler, E.Ed, Longman, UK 16 (1986): 52-72.
5. Crowell MD. “The role of serotonin in the pathophysiology of irritable bowel syndrome”. Am. J. Manag. Care 78 Supp l (2001): S252-S260.
6. Cho I and Blaser M. “The human microbiome: at the interface of health and disease”. Nat Rev Genet 13 (2012): 260-270.
7. Cummings JH. “Laxative abuse”. Gut 15.9 (1974): 758-766.
8. Dalvi SM, Patil VW and Ramraje NN. “The roles of glutathione, glutathione peroxidase, glutathione reductase and the carbonyl protein in pulmonary and extra pulmonary tuberculosis”. J Clin Diagn Res 9 (2012): 1462-5.
9. De Lillo AR and Rose S. “Functional bowel disorders in the geriatric patient: constipation, fecal impaction, and fecal incontinence”. Am J Gastroenterol 95.4 (2000): 901-905.
10. Deponte M. “Glutathione catalysis and the reaction mechanisms of glutathione dependent enzymes”. Biochemica et Biophysica Acta 1830 (2013): 3217-3266.
11. Erden M and Bor NM. Change of reduced glutathione, glutathione reductase, and glutathione preoxidase after radiation in guinea pigs Biochm Med. 312 (1984): 217-27.
12. Everhart JE and Ruhl CE. “Burden of digestive diseases in the United States part II: lower gastrointestinal diseases”. Gastroenterology 136 (2009): 741-54.
13. Feldman M., et al. Intestinal gas. In: Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 10th Ed. Philadelphia, Pa.: Saunders Elsevier (2016).
14. Frier BM and Scott RD. “Osteomalacia and arthropathy associated with prolonged abuse of purgatives”. Br J Clin Pract 31.1-3 (1977): 17-19.
15. Griffith OW. “Determination of glutathione and glutathione disulfide using glutathione reductase and 2-vinylpyridine”. Anal Biochem 107 (1980): 207-212.
16. Guinane CM and Cotter PD. “Role of the gut microbiota in health and chronic gastrointestinal disease: understanding a hidden metabolic organ”. Therap Adv Gastroenterol 4 (2013): 295-308.
17. Gupta BL and Baquer NZ. “Hexokinase, G-6PDH and antioxidant enzyme in diabetic reticulocytes: Role of insulin and vanadate”. Biochem. Mol.Biol. Int 48 (1998): 1145-1152.
18. Gupta BL, Preet A and Baquer NZ. “Protective effects of sodium orthovanadate in diabetic reticulocytes and ageing red blood cells of Wistar rats”. J Biosci 29 (2004): 73-79.
19. Hallmann F. “Toxicity of commonly used laxatives”. Med Sci Monit 3 (2000): 618-28.
20. Higgins PD and Johanson JF. “Epidemiology of constipation in North America: a systematic review”. Am J Gastroenterol 99(4) (2004): 750-759.
21. Hughes S, Higgs NB and Turnberg LA. “Loperamide has antisecretory activity in the human jejunum in vivo”. Gut 25 (1984): 931-935.
22. Johanson JF, Sonnenberg, A, and Koch TR. “Clinical epidemiology of chronic constipation”. J Clin Gastroenterol 11.5 (1989): 525-536.
23. Lembo A and Camilleri M. “Chronic constipation”. N Engl J Med 349.14 (2003): 1360-1368.
24. Maqbool A and Liacouras CA. “Major symptoms and sign of digestive tract disorders”. In Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21 st ed. Philadelphia, PA: Elsevier (2020).
25. McCrea GL., et al. “A review of the literature on gender and age differences in the prevalence and characteristics of constipation in North America”. J Pain Symptom Manage 37.4 (2009): 737-745.
26. Mete R., et al. “The role of oxidants and reactive nitrogen species in irritable bowel syndrome: a potential etiological explanation”. Med Sci Monit 19 (2013): 762-6.
27. Nascimento MNG., et al. “Antimicrobial and cytotoxic activities of Senna and Cassia species (Fabaceae) extracts”. Industrial Crop and Products 148 (2020): 1120-81.
28. Parkman HP., et al. “Neurotrophin-3 improves functional constipation”. Am J Gastroenterol 98 (2003): 1338-1347.
29. Talley NJ., et. al. “Constipation in an elderly community: a study of prevalence and potential risk factors”. Am J Gastroenterol 91.1 (1996): 19-25.
30. Taneja V. “Sex Hormones Determine Immune Response”. Front Immunol 9 (2018): 1931.
31. Vanderperren B., et al. “Acute liver failure with renal impairment related to the abuse of senna anthraquinone glycosides”. Annals of Pharmacotherapy 39.7-8 (2005): 1353-1357.
32. Wald A., et al. “The burden of constipation on quality of life: results of a multinational survey”. Aliment Pharmacol Ther 26 (2007): 227-36.

Chronic constipation developed by loperamide in Wistar rats were subjected to experimentation and their treatments with senna leaves extracts. It was observed that there was an increase of body weight, swollen stomach and belly size. The stools were hard and less in amount in constipated rats which all they got normalized with sanay treatments.

In chronic constipation the glutathione peroxidase activity was observed to be decreased by 18% approximately in case of male and 16% approximately in case of female. The glutathione reductase activity also increased by 22% in male and 25% in female rats red blood cells. The catalase activity has shown an increase of 14% in males and 32% approximately in female rats red blood cells. The GOT activity increased by 54% in males and 48% in females. The GPT activity in red blood cells was observed to be increased by 36% approximately in case of male and 44% in female. The catalase activity was found to be increased by 14% in male and 32% in female rats red blood cells. All these enzymes activities normalized after sanay leaves extract treatments to chronic constipated rats.

The metabolites levels of GSH also decreased by 25% in both male and female rats and the GSSG levels increased by 77% in male and 66% in female. The sanay treatments to both male and female rats normalized the metabolites levels.

In chronic constipation the creatinine levels were observed to be increased by 8% approximately in case of male and 13% in case of female. This metabolits level was observed to be normalized after sanay leaves extracts treatments to chronic constipated rats.

It may be concluded that the female rats suffer the most biochemical dysfunction in comparison to male in chronic constipation.

References

1. Aihie ON. “Perceived parenting styles as correlates of self-esteem among adolescents in secondary schools”. International Journal of Educational Benchmark 4.1 (2016): 96-106.
2. Alliance CTS. “Youth sports national report card”. Strategies 19.3 (2005): 26-28.
3. Ampofo?Boateng K., et al. “The motives young malaysians assign for participating in tennis”. Annals of Leisure Research 10.2 (2007): 196-214.
4. Anderson JC., et al. “Parental support and pressure and children's extracurricular activities: Relationships with amount of involvement and affective experience of participation”. Journal of Applied Developmental Psychology 24.2 (2003): 241-257.
5. Bremer KL. “Parental involvement, pressure, and support in youth sport: A narrative literature review”. Journal of Family Theory & Review 4.3 (2012): 235-248.
6. Brustad RJ. “Affective outcomes in competitive youth sport: The influence of intrapersonal and socialization factors”. Journal of Sport and Exercise Psychology 10.3 (1988): 307-321.
7. Donnelly P. “Problems associated with youth involvement in high-performance sport”. In B. R. Cahill & A. J. Pearl (Eds.), Intensive participation in children’s sports, Champaign, IL: Human Kinetics (1993): 95-126.
8. Ede S., et al. “Youth Hockey Athletes’ Perceptions of Parental Involvement: Thy Want More”. Journal of Sport Behavior 35.1 (2012): 3-18.
9. Edwardson CL and Gorely T. “Activity-related parenting practices and children’s objectively measured physical activity”. Pediatric Exercise Science 22.1 (2010): 105-113.
10. Feeley BT, Agel J and Laprade RF. “When is it too early for single sport specialization?”. The American Journal of Sports Medicine 44.1 (2016): 234-241.
11. Fredricks J and Eccles JS. “Family socialization, gender, and sport motivation and involvement”. Journal of Sport and Exercise Psychology 27.1 (2005): 3-31.
12. Gardner LA, Magee CA and Vella SA. “Social climate profiles in adolescent sports: Associations with enjoyment and intention to continue”. Journal of Adolescence 52 (2016): 112-123.
13. Gecas V and Schwalbe ML. “Parental behavior and adolescent self-esteem”. Journal of Marriage and the Family 48.1 (1986): 37-46.
14. Gould D. “The professionalization of youth sports: It's time to act!”. Clinical Journal of Sport Medicine 19.2 (2009): 81-82.
15. Gould D., et al. “Understanding the role parents play in tennis success: A national survey of junior tennis coaches”. British Journal of Sports Medicine 40.7 (2006): 632-636.
16. Gould D., et al. “The role of parents in tennis success: Focus group interviews with junior coaches”. The Sport Psychologist 22.1 (2008): 18-37.
17. Harwood C and Swain A. “The development and activation of achievement goals within tennis: Ii. A player, parent, and coach intervention”. The Sport Psychologist 16.2 (2002): 111-137.
18. Hollins DK. “When enough is enough: The impact of parental involvement in children's participation in organized sports”. Portland State University (2016).
19. Hoyle RH and Leff SS. “The role of parental involvement in youth sport participation and performance”. Adolescence 32.125 (1997): 233-243.
20. Jowett S and Lavallee D. “Social psychology in sport”. United States: Human Kinetics 10 (2007).
21. Knight CJ, Boden CM and Holt NL. “Junior tennis players’ preferences for parental behaviors”. Journal of Applied Sport Psychology 22.4 (2010): 377-391.
22. Knight CJ., et al. “Influences on parental involvement in youth sport”. Sport, Exercise, and Performance Psychology 5.2 (2016): 161.
23. Koehn R. “The association of parental involvement and youth athletes’ self-esteem”. (Master of Education), Goucher College (2017).
24. Krejcie RV and Morgan DW. “Determining sample size for research activities”. Educational and Psychological Measurement 30.3 (1970): 607-610.
25. Kushwah GS. “An investigation of Junior Tennis Players on Self Esteem and Competitive Advantage”. Proceedings of National Seminar on Fitness and Wellness, Gwalior, Madhya Pradesh (2014).
26. Lawn Tennis Association of Malaysia. News & ranks (2019).
27. Lee M and Maclean S. “Sources of parental pressure among age group swimmers”. European Journal of Physical Education 2.2 (1997): 167-177.
28. Lee YC. “A study of relationship between parenting styles and self-esteem: Self-esteem's indicator-parenting styles”. (Bachelor of Social Science (Hons) Psychology), UTAR (2011).
29. Leff SS and Hoyle RH. “Young athletes' perceptions of parental support and pressure”. Journal of Youth and Adolescence 24.2 (1995): 187-203.
30. McElroy M. “Consequences of perceived parental pressure on the self-esteem of youth sport participants”. American Corrective Therapy Journal 36.6 (1982): 164-167.
31. Qurban H., et al. “The mediating role of parental support: The relation between sports participation, self-esteem, and motivation for sports among chinese students”. Current Psychology 38.2 (2019): 308-319.
32. Ridley MJ. “Parental perceptions of their sport involvement with late adolescent student athletes”. (Masters of Arts), Ball State University (2013).
33. Rosenberg M. “Conceiving the self (reprint edition)”. Melbourne, FL: Krieger (1979).
34. Sánchez-Miguel PA., et al. “The importance of parents’ behavior in their children’s enjoyment and amotivation in sports”. Journal of Human Kinetics 36.1 (2013): 169-177.
35. Scanlan TK and Lewthwaite R. “Social psychological aspects of competition for male youth sport participants: Iv. Predictors of enjoyment”. Journal of Sport Psychology 8.1 (1986): 25-35.
36. Schwebel FJ, Smith RE and Smoll FL. “Measurement of perceived parental success standards in sport and relations with athletes’ self-esteem, performance anxiety, and achievement goal orientation: Comparing parental and coach influences”. Child Development Research (2016): 1-13.
37. Strandbu Å., et al. “Young people’s experiences of parental involvement in youth sport”. Sport, Education and Society 24.1 (2019): 66-77.
38. Stroebel LCE. “Parental involvement in sport: Perceptions of competitive adolescent swimmers”. (Master of Arts), University of the Free State (2006):.
39. Udry E., et al. “People helping people? Examining the social ties of athletes coping with burnout and injury stress”. Journal of Sport & Exercise Psychology 19.4 (1997): 368-395.
40. Wilson KS, Spink KS and Whittaker C. “Parental response to lapses in child's physical activity: To control or not to control”. Journal of Sport & Exercise Psychology 29 (2007).
41. Wuerth S, Lee M and Alfermann D. “Parental involvement and athletes’ career in youth sport”. Psychology of Sports and Exercise 5.1 (2004): 21-33.
42. Wylleman P., et al. “Talented athletes' perceptions of the athlete-coach-parents relationships”. Kinesiologia Slovenica 8.2 (2003): 59-69.

Participation of young tennis athletes can be highly influenced by parents. There are times when the parents are over-involved in their children’s sports career when their eagerness turns into obsession, especially among junior tennis athletes, in which may influence the psychological development of the athlete. This paper describes the relationship between parental involvement and their self-esteem as perceived by Malaysian junior tennis athletes. The Parental Involvement in Sports Questionnaire (PISQ) and the Rosenberg Self-Esteem (RSE) scale were used and filled by a total of 169 Malaysian junior tennis athletes aged between 11 to 16 years old. The participants were also categorized by age group of 11 to 12 years old, 13 to 14 years old, 15 to 16 years old. It was revealed that a significant difference between the component of the athlete-perceived parental involvement in sports on the combined dependent variable of the four components of Directive Behaviour, Praise and Understanding, Acting Involvement and Pressure among the three age groups. ANOVA test also indicated a statistically significant difference in the self-esteem scores for the three age groups. Correlation analysis showed a small but positive correlation between the Praise and Understanding component and the self-esteem. It can be concluded that age groups does significantly differ in both components of parental involvement and self-esteem among Malaysia junior tennis athletes. Praise and Understanding is also the only component of Parental Involvement that is positively related to the self-esteem of the Malaysian junior tennis athletes. The practical implications of these findings could serve to improve the experience of participants in youth sport.

Keywords: parent; praise: understanding; juniors; participation

References

1. BE Smith., et al. “Incidence and prevalence of patellofemoral pain: A systematic review and meta-analysis”. PLoS One 13.1 (2018).
2. RW Willy., et al. “Patellofemoral pain clinical practice guidelines linked to the international classification of functioning, disability and health from the academy of orthopaedic physical therapy of the American physical therapy association”. J. Orthop. Sports Phys. Ther 49.9 (2019): CPG1-CPG95.
3. S Kobayashi., et al. “The prevalence of patellofemoral osteoarthritis: a systematic review and meta-analysis”. Osteoarthr. Cartil 24.10 (2016): 1697-1707.
4. M Boling., et al. “Gender differences in the incidence and prevalence of patellofemoral pain syndrome”. Scand. J. Med. Sci. Sports 20.5 (2010): 725-730.
5. KM Crossley., et al. “2016 Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester. Part 1: Terminology, definitions, clinical examination, natural history, patellofemoral osteoarthritis and patient-reported outcome m”. Br. J. Sports Med 50.14 (2016): 839-843.
6. BS Neal., et al. “Risk factors for patellofemoral pain: A systematic review and meta-analysis”. Br. J. Sports Med 53.5 (2019): 270-281.
7. RV Briani., et al. “Knee flexor strength and rate of torque development deficits in women with patellofemoral pain are related to poor objective function”. Gait Posture 83 (2021): 100-106.
8. H Guney., et al. “Correlation between quadriceps to hamstring ratio and functional outcomes in patellofemoral pain”. Knee 23.4 (2016): 610-615.
9. RV Briani., et al. “Lower Trunk Muscle Thickness Is Associated with Pain in Women With Patellofemoral Pain”. J. Ultrasound Med 38.10 (2019): 2685-2693.
10. A Motealleh., et al. “Trunk postural control during unstable sitting differs between patients with patellofemoral pain syndrome and healthy people: A cross-sectional study”. Knee 26.1 (2019): 26-32.
11. TH Nakagawa, CD Maciel and FV Serrão. “Trunk biomechanics and its association with hip and knee kinematics in patients with and without patellofemoral pain”. Man. Ther 20.1 (2015): 189-193.
12. U Röijezon, NC Clark and J Treleaven. “Proprioception in musculoskeletal rehabilitation: Part 1: Basic science and principles of assessment and clinical interventions”. Man. Ther 20.3 (2015): 368-377.
13. NC Silva., et al. “Adding neuromuscular training to a strengthening program did not produce additional improvement in clinical or kinematic outcomes in women with patellofemoral pain: A blinded randomised controlled trial”. Musculoskelet. Sci. Pract (2023): 102720.
14. MF Chevidikunnan., et al. “Effectiveness of core muscle strengthening for improving pain and dynamic balance among female patients with patellofemoral pain syndrome”. J. Phys. Ther. Sci 28.5 (2016): 1518-1523.
15. MV Nascimento-Ferreira., et al. “Reliability and Validity of a Questionnaire for Physical Activity Assessment in South American Children and Adolescents: The SAYCARE Study”. Obes. (Silver Spring) 26.Suppl 1 (2018): S23-S30.
16. R Ferber., et al. “Strengthening of the hip and core versus knee muscles for the treatment of patellofemoral pain: A multicenter randomized controlled trial”. J. Athl. Train 50.4 (2015): 366-377.
17. KD Pompeo., et al. “Can we replace exercises targeted on core/hip muscles by exercises targeted on leg/foot muscles in women with patellofemoral pain? A randomized controlled trial”. Phys. Ther. Sport 58 (2018): 1-7.
18. JKW Chiu., et al. “The effects of quadriceps strengthening on pain, function, and patellofemoral joint contact area in persons with patellofemoral pain”. Am. J. Phys. Med. Rehabil 91.2 (2012): 98-106.
19. MHM Ducatti., et al. “Knee flexor strength, rate of torque development and flexibility in women and men with patellofemoral pain: Relationship with pain and the performance in the single leg bridge test”. Phys. Ther. Sport 50 (2021): 166-172.
20. NR Glaviano., et al. “Improvements in lower-extremity function following a rehabilitation program with patterned electrical neuromuscular stimulation in females with patellofemoral pain: A randomized controlled trial”. J. Sport Rehabil 29.8 (2020): 1075-1085.
21. JD Willson and IS Davis. “Lower extremity mechanics of females with and without patellofemoral pain across activities with progressively greater task demands”. Clin. Biomech 23.2 (2008): 203-211.
22. ES Di Filippo., et al. “Neuromuscular electrical stimulation improves skeletal muscle regeneration through satellite cell fusion with myofibers in healthy elderly subjects”. J. Appl. Physiol 123.3 (2017): 501-512.
23. LD Hamilton., et al. “Electrical nerve stimulation modulates motor unit activity in contralateral biceps brachii during steady isometric contractions”. J. Neurophysiol 120.5 (2018): 2603-2613.
24. J Gondin, PJ Cozzone and D Bendahan. “Is high-frequency neuromuscular electrical stimulation a suitable tool for muscle performance improvement in both healthy humans and athletes?”. Eur. J. Appl. Physiol 111.10 (2011): 2473-2487.
25. DF Collins, D Burke and SC Gandevia. “Sustained contractions produced by plateau-like behaviour in human motoneurones”. J. Physiol 538.1 (2002): 289-301.
26. AJ Bergquist, JM Clair and DF Collins. “Motor unit recruitment when neuromuscular electrical stimulation is applied over a nerve trunk compared with a muscle belly: Triceps surae”. J. Appl. Physiol 110.3 (2011): 627-637.
27. JE Stevens-Lapsley., et al. “Early Neuromuscular Electrical Stimulation to Improve Quadriceps Muscle Strength After Total Knee Arthroplasty: A Randomized Controlled Trial”. Phys. Ther 92.2 (2012): 210-226.
28. P Banerjee., et al. “Prolonged electrical muscle stimulation exercise improves strength and aerobic capacity in healthy sedentary adults”. J. Appl. Physiol 99.6 (2005): 2307-2311.
29. RM Enoka, IG Amiridis and J Duchateau. “Electrical stimulation of muscle: Electrophysiology and rehabilitation”. Physiology 35.1 (2020): 40-56.
30. C Papadopoulos., et al. “Greek cultural adaption and validation of the Kujala anterior knee pain scale in patients with patellofemoral pain syndrome”. Disabil. Rehabil 39.7 (2017): 704-708.
31. L Kooiker., et al. “Effects of physical therapist-guided quadriceps-strengthening exercises for the treatment of patellofemoral pain syndrome: A systematic review”. J. Orthop. Sports Phys. Ther 44.6 (2014): 391-402.
32. TY Fukuda., et al. “Short-term effects of hip abductors and lateral rotators strengthening in females with patellofemoral pain syndrome: A randomized controlled clinical trial”. J. Orthop. Sports Phys. Ther 40.11 (2010): 736-742.
33. GPLA Almeida., et al. “Anteromedial versus posterolateral hip musculature strengthening with dose-controlled in women with patellofemoral pain: A randomized controlled trial”. Phys. Ther. Sport 49 (2021): 149-156.
34. J Duchateau., et al. “Strength Training: In Search of Optimal Strategies to Maximize Neuromuscular Performance”. Exerc. Sport Sci. Rev 49.1 (2021): 2-14.
35. MV da Silva Boitrago., et al. “Effects of proprioceptive exercises and strengthening on pain and functionality for patellofemoral pain syndrome in women: A randomized controlled trial”. J. Clin. Orthop. Trauma 18 (2021): 94-99.
36. D Mani., et al. “Neuromuscular electrical stimulation can improve mobility in older adults but the time course varies across tasks: Double-blind, randomized trial”. Exp. Gerontol 108 (2018): 269-275.
37. AM Almuklass., et al. “Pulse width does not influence the gains achieved with neuromuscular electrical stimulation in people with multiple sclerosis: double-blind, randomized trial”. Neurorehabil. Neural Repair 32.1 (2018): 84-93.

Background: Patellofemoral pain (PFP) is a chronic condition that usually results in long-term functional impairments both in adults and adolescents PFP has been found to decrease activity levels in individuals.

Purpose: The purpose of the present study was to investigate whether the additional use of electrical stimulation to an intervention program could result in greater improvements in the knee function and the level of pain compared with the intervention program itself.

Material and Methods: 22 women reported anterior knee pain symptoms clinically allocated in the patellofemoral region and confirmed through the patellar position, analyzed by magnetic resonance imaging (MRI). They randomly assigned into two groups with the same strengthening program. The experimental group used electrical stimulation combined with knee extensors and flexors strengthening exercises. The main outcome of the study was the visual analogue scale (VAS) in order to assess pain and the Anterior Knee Pain Scale (AKPS) to evaluate the functionality of the knee joint. All the outcomes were analyzed and compared pre and post a 6-weeks intervention period.

Results: Statistically significant differences were found between the two rehabilitation groups at the end of the intervention period both in VAS (F1,20 = 44.083, p < 0.001) and functional assessment (F1,20 = 35.687, p < 0,001), suggesting that the conventional intervention program with the use of electrical stimulation is more effective regarding the pain degrees and the knee function.

Conclusion: The use of electrical stimulation, combined with conventional strengthening program, could provide greater beneficial effects on PFP female individuals compared to the strengthening program itself.

Keywords: Anterior knee pain; conventional training; electromyostimulation; pain; functionality

References

1. Akimova LN. “Psychology of sexuality”. Odessa: SMIL (2005): 198.
2. Alexandrov AA. “Integrative psychotherapy”. SPb: Piter (2009): 352.
3. Abnormal sexual behavior. Ed. A. A. Tkachenko and G. E. Vvedensky. SPb: Publishing house "Legal Center Press". (2003): 657.
4. Bantskhaf Kh, Teler B and Til N. Man and Woman. Secrets of reciprocity in astrology and psychology. Astrology of intimacy, sexuality and relationships. Insights, leading to integrity. M. IG "Ves" (2018): 510.
5. Badoo glorifies the heroes of masturbation in a new advertisement. Stav. ua electronic resource (2022).
6. Bendas TV. Gender Psychology: A Textbook. SPb. Piter (2005): 431.
7. Bern E. Sex in human love. Per. with M. P. Papusha. M. Izd-vo EKSMO-Press (2000): 384.
8. Giddens E. Transformation of intimacy. Sexuality, love and eroticism in modern societies. Per. with English by V. Anurina. SPb. Piter (2004): 208.
9. Giddens E. Foucault on sexuality. Sociology of sexuality. SPb: Institut sotsiologii RAN (1997): 20-29.
10. D?denko SL. The psychology of hollowness and hollowness. Kyiv: Aristey (2003): 312.
11. Deryagin GB. Criminal sexology: a course of lectures. M. Shchit-M (2008): 552.
12. Davidson Richard. The Flames of Yahweh. Sexuality in the Bible. Per. with G. Yastrebova. M. Izdatelstvo: "Eksmo" (2015): 1270.
13. Giddens E and Sutton F. Basic concepts in sociology. M. Izd. House of the Higher School of Economics (2018): 336.
14. Ivanova NY. Psychological aspects of "sexuality". Bulletin of Tomsk State Pedagogical University (Tomsk State Pedagogical University Bulletin) 11.139 (2013): 81-86.
15. Ilyin EP. Differential psychophysiology of men and women. SPb. Piter (2003): 544.
16. The Story of Sexuality-III: Self-Care. Per. with fr. T. N. Titovoy and O. I. Khomy pod obshch. red. A. B. Mokrousova. M. Refl-buk (1998): 288.
17. Zberovsky AV. Men's sexual fears, tricks and tricks. Psychology of love behavior. Moscow: Mir (2018): 416.
18. Zdravomyslov VI, Anisimova ZE and Libih SS. Functional female sexopathology. Perm', M. Mir (1998): 692.
19. What is the attitude towards LGBT people in the world and in Russia?. news. myseldon.com [Electronic resource] (2022).
20. Caprio F. Manifold of sexual behavior. M. Artania (1995): 352.
21. Klein LS. Other Love: Human Nature and Homosexuality. SPb. Folio-Press (2000): 864.
22. Kon IS. Adolescent sexuality on the threshold of the 21st century. M: Phoenix (2001): 147.
23. Kocharyan AS. Personality and sexual role. Khar'kov: «Osnova» (1996): 127.
24. Crooks R and Baur K. Sexuality. SPb: Prime-Evreznak, (2005): 480.
25. Obukhovskii K. Psychology of human inclusion. M Progress (2012): 248.
26. Will Europe remain itself? Opinions of the clergy [Electronic resource] (2022).
27. Psychology of sexuality. Textbook for the course "Psychological counseling in sexology". Ed. Kashchenko E. A. M. Ridero (2019): 554.
28. Sexology. Ed. by D. N. Isaev. SPb. Piter (2001): 512.
29. List of sexual deviations. Wikipedia. Free Encyclopedia. wikipedia.org [Electronic resource] (2022).
30. List of countries in the world in relation to the legality of homosexual contacts. Wikipedia. Free Encyclopedia. wikipedia.org ;Electronic resource] (2022).
31. Starovich Z. Forensic sexology. Per. with Polish. M. Yurid. lit (1991): 336.
32. Tkachenko AA. Boundaries of the sexual norm and modern classifications of violations of psychosexual orientations. Abnormal sexual behavior. M. RIO GNTS SiSP im. V. P. Serbskogo (1997): 6-31.
33. Tkachenko AA. Sexual perversions – paraphilias. M. Triada-Kh (1999): 461.
34. Top-10 countries of the world by the number of homosexuals. top10a. ru [Electronic resource] (2022).
35. Tennehill R. Sex in History. M. Kron-Press (1995): 400.
36. Freud Z. Essays on the psychology of sexuality. M. Eksmo (2017): 533.
37. Freud Z. "Psychology of Sexuality". Khar'kov: Folio (2007): 288.
38. Foucault M. Will to Truth: Beyond Knowledge, Power and Sexuality. Works of different years. Per. from French M. Castal (1996): 448.
39. Shantyr EE. “Socio-psychological concept of the foundations of lawmaking in the field of family and marriage relations”. Psychologist (2017): 68-89.
40. Erickson E. Identity: youth, crisis. Per. from English. M: Progress (1996): 342.
41. Andersen M. Thinking about women. Sociological Perspectives on Sex and Gender. Boston: Allyn and Bacon (1997): 78-79.
42. Baker Robin R. Human sperm competition: Ejaculate adjustment by males and the function of masturbation”. Animal Behavior 46.5 (1993): 861.
43. Brian Y Park., et zl. “Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports”.  Behav Sci (Basel).6.3 (2016): 17.
44. Foucault M. History of sexuality, t. II: The use of pleasures, t. III: The concern for oneself, Paris, Gallimard (1984): 285.
45. Fromm E. Man for himself. Translation from English E. Spirova (2018): 349.
46. Giles GG., et al. “Sexual factors and prostate cancer”. BJU International 92.3 (2003): 211-216.
47. S Seidman, N Fischer and C Meeks. Introducing the New Sexuality Studies. 2nd edn. L. N. Y. Rout-ledge (2011): 571.

This article is devoted to sexuality as a fundamental socio-psychological conceptual category. The paper provides an analytical review of the history of understanding sexuality as a construct of socio-political relations and the formation of state power, reveals all the diversity in approaches and judgments about this conceptual category. The paper shows that the interpretation of sexuality as a concept is not only an important general scientific aspect, but also has a key socio-psychological significance for the development of modern society and the formation of a person as a person by gender. Using the example of various sexual transformations, the article substantiates the relevance of the formation of the semantic content of this conceptual category in our time, when sexuality can no longer be considered separately from the state of the human psyche and those negative trends and various deformations of social consciousness that inevitably affect both the reproductive function of a person and the whole way of family and marriage relations in the modern world. It is possible to change the situation for the better in this area only by forming fundamentally new ideological priorities in the public consciousness. The scientific novelty of this work consists in analytical studies of the concept of sexuality as a fundamental socio-psychological conceptual category and the development on this basis of new theoretical approaches and corresponding definitions of the concept of sexuality and related conceptual categories. The proposed interpretations, according to the author, have a more pronounced social and psychological determinant for the formation of a new worldview in modern society regarding the development of a person, taking into account gender, which will ultimately lead to the improvement of reproductive function, improvement of demographic indicators and, in general, will contribute to improving the quality of life of a modern person in his social and physical realization.

Keywords: psychology; social psychology; practical psychology; medical psychology; sexuality; sex; asexuality; asex; sexual health; terms and concepts

References

1. Aleksandrov AA. “Integrative psychotherapy”. St. Petersburg: Peter (2009): 352.
2. Ananiev BG. “Man as a subject of knowledge”. St. Petersburg: Piter (2001): 228. (in Russian).
3. Vekker LM. “Psyche and reality: a unified theory of psychic Processes”. Moscow: Smysl (1998): 670. (in Russian).
4. Types of psychological problems. Psikhologos. Encyclopedia of Practical Psychology.
5. Voynivska OO. “Actual psychological problems of religious appeal of personality in modern society”. Science and education 4-5 (2004): 14-17.
6. Eliseev OP. “Practicum on the psychology of personality”. St. Petersburg: Peter (2001): 560.
7. Zhdan AN. History of psychology. From Antiquity to the present day: Textbook for universities. 5th ed., rev. and add. M.: Akademicheskii Project (2004): 576. (in Russian).
8. Caprara J and Servon D. “Psychology of personality”. SPb.: Piter (2003): 640. (in Russian).
9. Cloninger S. “Theories of personality: cognition of a person”. SPb.: Piter (2003): 718.
10. Kozlov NI. “Personality”. Psikhologos. Encyclopedia of Practical Psychology.
11. Kozlov NI. “Personality in psychology”. Psikhologos. Encyclopedia of Practical Psychology.
12. Kulikov LV. “Psychology of personality in the works of domestic psychologists”. Anthology, 2nd ed. Isravl. and add-e. St. Petersburg: Peter (2009): 464.
13. Leontiev AA. “Activity, consciousness, personality”. M.: Smysl (2005): 431.
14. Martsinkovskaya TD. “History of psychology”. Moscow: Akademiya (2001): 538. (in Russian).
15. Nemov RS. Psychology. Kn. 1. General foundations of psychology. 4th ed. M.: Gumanit. Ed. VLADOS Center (2003): 688. (in Russian).
16. Papucha MV. “The inner world of man and his formation”. Dis. doct. psychol. Sciences. K.: Institute of Psychology. G.S. Kostyuk (2013): 400.
17. Pervin L and John O. “Psychology of personality: Theory and research”. Moscow: Aspect Press (2001): 607. (in Russian).
18. Platonov KK. “Structure and development of personality”. Moscow: Nauka (1986): 56-57.
19. Psychiatric states/Comp. and the general edition of L.V. Kulikov. SPb.: Piter (2000): 512. (in Russian).
20. Psychology of personality in the works of foreign psychologists. Comp. and the general edition of A.A. Rean. SPb.: Piter (2000): 320.
21. Psychology of personality: Collection of articles. A.B. Orlov. Moscow: Voprosy psikhologii (2001): 192. (in Russian).
22. Human psychology from birth to death. Ed. by A.A. Rean. SPb (2002): 656. (in Russian).
23. Psychology of self-awareness. Reader. Edited by Raigorodsky D.Y. Samara: "Bahrakh-M" (2003): 672. (in Russian).
24. Salvatore Maddi. “Theories of personality: a comparative analysis”. St. Petersburg: Rech (2002): 539. (in Russian).
25. Fernheim A and Haven P. “Personality and social behavior”. SPb.: Piter (2001): 358. (in Russian).
26. Frager R and Feydimen D. “Big book of psychology. Personality. Theories, exercises, experiments”. SPb.: Prime-Evroznak (2008): 704. (in Russian).
27. Hegglund B. “History of theology”. SPb.: Svetoch (2001): 370. (in Russian).
28. Kjell L and Ziegler D. “Theories of personality (Basic provisions, research and application)”. St. Petersburg: Piter Press (2003): 608. (in Russian).
29. Shantyr EE. “Interpretation of professions and issues of training in the field of psychological services”. Psychology and Psychotechnics 9 (2015): 942-950.
30. Shantyr EE. “Unification of basic concepts and practical terms Psychology”. Psychologist 2 (2015): 99-117.
31. Shekhovtsova LF. “Worldview foundations of humanistic and transpersonal psychology”. Shekhovtsova L. F. Khristianskoe worldview as the basis of psychological counseling and Psychotherapy. St. Petersburg: Society of Orthodox Psychologists of St. Petersburg Petersburg (2009): 24-32.
32. Shcherbak TI. “Development of the image of the self in the period of representation of intelligence Personality”. Dis. Cand. psychol. Sci.Odesa: Ministry of Education and Science of Ukraine DZ "South Ukrainian National. ped. Univ. them. K.D. Ushinsky (2013): 200.
33. Jung KG. Human. Moscow: AST-Press (2007): 470. (in Russian).

     One of the main socio-psychological conceptual categories is the concept of personality, while there is no generally accepted interpretation of this term. The basis of scientific ideas about the personality of a person at the moment is a number of theories and ideas, which are characterized by different scientific approaches, diverse semantic content and ambiguous interpretation.

     At the same time, the problems of modern society urgently require the development of a fundamentally new theory of personality, which, by analogy with integrative psychology, would act as a unifying principle of all paradigms of psychological thought in the context of interpreting the concept of personality and would contribute to a unified approach to understanding this basic conceptual category in other social and philosophical sciences.

     This article consistently outlines a new theory of personality, which is based on the main provisions of integrative psychology and, accordingly, is called the Integrative theory of personality. According to the author, this theory can act as a consolidating principle, both in the scientific worldview and in practical implementation. On the basis of analytical research, the paper shows the main approaches to understanding the content of personality theory, gives a definition of the concept of personality, describes the structure of personality as the basis of human behavioral manifestations, and also shows and discloses the basic terminological concepts that the Integrative Personality Theory operates on. Based on its main provisions, the author of the article interprets the key issues that are most often discussed in scientific and popular science literature regarding the conceptual category of a person's personality.

Keywords: psychology; sociology; social psychology; practical psychology; integrative psychology; personality; personality theory; personality structure; terms and concepts

     The use of radiation in diagnosis and therapy is common but not without fear of detrimental risks and a general feeling of uneasiness. Effects of LDR have not been adequately elucidated and more research is needed to unravel the underlying mechanisms. However, LDR is known to cause stimulations in a variety of cellular processes resulting in beneficial effects which offer new opportunities to harness the protection to normal cells and therapeutic outcomes through toxic effects. It is pertinent to recall that billions of years ago the living organisms from bacteria to humans evolved in high ionizing radiation background and they armed themselves with complex protective machineries for survival against external stressors. In the present time, average annual natural environmental radiation is estimated ~2.4 mSv which, of course, varies at various locations on the earth ranging from about 1 mSv in Japan to 260 mSv in Iran. Most interestingly, it is found that people residing in such natural high background radiation (HBR) areas live a normal life and there are no reported significant health issues.

     The living organisms exhibit adaptation offering protection against radiation exposure and learn to live below certain threshold dose. Furthermore, a low radiation dose causes stress to cells which turn on genes at specific threshold of radiation dose. The radiation activated genes up-regulate the protection systems which produce enhanced positive effects e.g. prevention of cancer, risk prediction and suppression of diabetes etc. Presumably, the LDR induced positive effects arise due to intracellular production of reactive oxygen species (ROS) which initiate production of endogenous antioxidants for its neutralization and signaling processes. More importantly, LDR activate repair of the damaged DNA, induce the mechanism of apoptosis causing the self-destruction of cancerous cells. LDR could modulate excessive inflammatory responses, regulating lymphocyte counts, and controlling bacterial co-infections in patients with COVID-19. Also, it is known to boost immunity which can annihilate cancer cells as well as reduce or counter virus assaults. Overall, LDR initiates recruitment and rescue operation in the injured cell which results in protection against radiation in normal cells or to the pathogenic agents including COVID-19 virus attack. On the other hand, a higher dose of ionizing radiation overstresses the organisms and the genes are turned on/off at specific radiation doses. It is known that different genes are activated by high and low doses. Thus, the built in protection system in cells is overtaken at higher doses and harmful effects are observed. That is to say, the low dose induced beneficial effects are generally marred by high dose radiation exposures. Another important finding in radiobiology is the observation of damage to non-irradiated cells called bystander effect. The DNA damage, apoptosis and other effects in non-irradiated cells show different patterns. It remains to be seen how bystander effect will modify cancer therapy outcome, risk estimates(carcinogenesis) and protection against radiation. Evidently, the promise of LDR in therapy of cancer and other diseases (e.g.cardiovascular) needs to be isolated, identified and tested in clinic. More importantly, a new opportunity is in the sight to optimize a window of LDR doses, say between 10 mSv to 200 mSv, that needs to be tested and optimized in the therapy of chosen lung cancers and novel COVID -19 infection which locates in the lower respiratory system and causes pneumonia symptoms leading to breath deterioration and eventually death.

     In the evolution of life, organisms have harnessed the low dose stimulation to their survival advantage. It is no surprise that extensive LDR research in environmental ranges at molecular, cellular, and animal level has shown no adverse or detrimental effects. Thus, the concern for likely safety of health issue is critical. In fact, the safety concerns of scientists from LDR therapy seem to entail from the Reports of International Commission for Radiation Protection (ICRP) which believes in Linear-No- Threshold (LNT) model which is based on the assumption that no dose is safe however small. The ICRP prefers to ignore biological fact of intrinsic cellular repair machinery and hence believes in no threshold. Radiobiological studies on the surviving population from Hiroshima and Nagasaki atom bomb have shown that the cancer rate increases in proportion to the amount of exposure to radiation at acute high doses. However, there is no convincing data that shows the increase in cancer rate with a low level of exposure. On the contrary, there are even reports indicating that the cancer rate declines in high background radiation studies in China, India Brazil and Iran. The observed adaptability and the built in intrinsic protection system in living organisms against radiation are ignored for establishing the regulation and standards for radioprotection. In this context, the observed threshold of LDR dose at which genes are turned on and the dose at which they are turned off are important transition from beneficial to harmful effects of radiation. Of course, the dose thresholds and the amounts of benefit and harm observed are the characteristics for each organism. But, the remarkable demarcation of response of organisms from a LDR to acute radiation dose (ARD) is frequently observed which needs re-examination for the validity of LNT model.

     In summary, the studies on low dose radiation effects on living organisms needs re-focus and role of LDR therapy in fighting cancer merits re-examination, a fresh look at carcinogenic risk evaluation/prediction (in view of Adaptive response and bystander effects) and developing novel tools for treating COVID-19 appear highly urgent and it’s use in therapy deserves re-evaluation and rigorous analysis of the clinical data. International scientific community is divided on the carcinogenic risk of LDR but recent surge in publications on evaluation of low dose therapy in the treatment of pneumonia caused by the novel COVID-19 and cancer re-emphasizes the need for technical developments and brings new hope for saving human life.

References

1. BIER VII: Health Risks from Exposure to Low Levels of Ionizing.
2. Augusto Giussani and Francesca Ballarini. Risk at Low Doses: Scientific Knowledge, Uncertainties and Management, University of Milan, Italy (2002).
3. UNSCEAR. (2000) Sources and Effects of Ionizing Radiation: United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) 2000 Report to the General Assembly with Scientific Annexes. United Nations Publications Sales No. E.00.IX.6, New York Wolff S (1998).
4. Wolff S. “The adaptive response in radiobiology: evolving insights and implications”. Environ. Health Perspect 108 (1998): 277-83.
5. Cuttler JM, Pollycove M and Welsh JS. “Application of low doses of radiation for curing cancer”. J.Am.Physic Surg 8.4 (2003): 108 -111.
6. Clarke RH. “Radiological protection phylosophy for the 21st century”. Workshop on internal dosimetry of radionuclides Occupational, public and medical exposure. Oxford (UK) (2003).
7. Ishii K., et al. “Decreased incidence of thymic lymphoma in AKR mice as a result of chronic, fractionated low-dose total-body X irradiation”. Radiat. Res 146.5 (1996): 582-5.
8. Calabrese EJ and Baldwin LA. “Toxicology rethinks its central belief”. Nature 421 (2003): 691-692.
9. Feinendegen LE, Pollycove M. “Biologic responses to low doses of ionizing radiation: detriment versus hormesis, part 1: dose responses of cells and tissues”. J.Nucl Med 42.7 (2001): 18N-27N.
10. Shu Zeng Liu. “Cancer control related to stimulation of immunity by low dose radiation”. Dose-Response 5 (2007): 39-47.
11. Feinendegen LE. “The role of adaptive responses following exposure to ionizing radiation”. Hum. Exp.Toxicol 18 (1999): 426-32.
12. Mishra KP. “Cellular sensitivity to low dose ionizing radiation”. J Radiat Cancer Res 12 (2021): 91-95.
13. Mishra K. “Low?dose radiobiology: Opportunities for new research and technology for anticancer and anti?COVID?19 strategies”. J Radiat Cancer Res 11 (2020): 73.
14. Seyed Mohammad Javad Mortazavi, Amirhosein Kefayat and Jing Cai. “Point/Counterpoint. Low-dose radiation as a treatment for COVID-19 pneumonia: A threat or real opportunity?”. Med Phys 47.9 (2020): 3773-3776.

     Research on the low dose radiation (LDR) effects on living systems especially the doses in environmental ranges (< 200 mSV) has evinced increasing interest to meet the new health care challenges in present time. Low dose exposure situation is witnessed in diagnostic and therapeutic applications and in cases of mine workers, watch dial painters. In recent years, there have been increasing incidences of cancer globally after high dose radiation exposure endangering human health and causing deaths. Moreover, at this point of time, the world has faced a grave health danger due to novel CORONA-19 virus pandemic posing serious threat to human health and resulting in millions of deaths globally. It is fairly well known from cellular and animal researches that low dose irradiations suppress the incidence of cancer by subsequent acute radiation dose exposures (~ 1000 mSv), a phenomenon called adaptive response (AR) or hormesis. It is also widely accepted that LDR exposures stimulate immune responses offering protection from radiation and disease-causing pathogenic stress. Therefore, it seems reasonable to apply LDR in fighting cancer, evaluation of risk and COVID-19 virus onslaught on the vulnerable human population. The advantage can be derived from the externally applied radiation and other stressors induced anti-inflammatory cytokine storm in human body’s immune system which goes into an overdrive to fight an infection or other forms of trauma.

References

1. A Cui., et al. “Global, regional prevalence, incidence and risk factors of knee osteoarthritis in population-based studies”. EClinicalMedicine 29-30 (2020): 100587.
2. M Runa, E Lau and RD Altman. “Cost-of-illness of knee osteoarthritis: potential cost savings by not undergoing arthroplasty within the first 2 years”. Clin. Outcomes Res 11 (2019): 245-255.
3. MD Kohn, AA Sassoon and ND Fernando. “Classifications in Brief Kellgren-Lawrence Classification of Osteoarthritis”. Clin. Orthop. Relat. Res 474.8 (2016): 1886-1893.
4. A Askin., et al. “Quality of life and functional capacity are adversely affected in osteoarthritis patients with neuropathic pain”. Kaohsiung J. Med. Sci 33 (2017): 152-158.
5. JA Gustafson., et al. “Dynamic Knee Joint Stiffness and Contralateral Knee Joint Loading during Prolonged Walking in Patients with Unilateral Knee Osteoarthritis”. Gait Posture 68 (2020): 44-49.
6. MA Clynes., et al. “Impact of osteoarthritis on activities of daily living: does joint site matter? are the fourth leading cause of morbidity in older people”. Aging Clin. Exp. Res 31.8 (2019): 1049-1056.
7. A Hislop., et al. “Hip strength, quadriceps strength and dynamic balance are lower in people with unilateral knee osteoarthritis compared to their non-affected limb and asymptomatic controls”. Brazilian J. Phys. Ther 26.6 (2022): 100467.
8. G Bouchouras., et al. “Women with knee osteoarthritis increase knee muscle co-contraction to perform stand to sit”. Aging Clin. Exp. Res 32.4 (2020): 655-662.
9. M Anan., et al. “Gait & Posture Do patients with knee osteoarthritis perform sit-to-stand motion efficiently?”. Gait Posture 41.2 (2015): 488-492.
10. T Bieler., et al. “Effectiveness of promotion and support for physical activity maintenance post total hip arthroplasty — study protocol for a pragmatic, assessor ? blinded, randomized controlled trial (the PANORAMA trial)”. Trials 23.1 (2022): 647.
11. SL Kolasinski., et al. “2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee”. Arthritis Care Res 72.2 (2020): 149-162.
12. TC Rocha, AG Dias and EA Martins. “The Effects of Physical Exercise on Pain Management in Patients with Knee Osteoarthritis: A Systematic Review with Metanalysis”. Rev. Bras. Ortop 5.55 (2020): 509-517.
13. TK Colak., et al. “The effects of therapeutic exercises on pain, muscle strength, functional capacity, balance and hemodynamic parameters in knee osteoarthritis patients: a randomized controlled study of supervised versus home exercises”. Reumatol. Int 37.3 (2017): 399-407.
14. AB Kuntz., et al. “Efficacy of a biomechanically-based yoga exercise program in knee osteoarthritis: A randomized controlled trial”. PLoS One 13.4 (2018): e0195653.
15. S Deepeshwar., et al. “Effect of yoga based lifestyle intervention on patients with knee osteoarthritis: A randomized controlled trial”. Front. Psychiatry 9 (2018): 180.
16. N Pirayeh., et al. “The Effect of Balance Training on Functional Outcomes in Patients with Knee Osteoarthritis: A Systematic Review”. Med. J. Islam. Repub. Iran 17 (2022): 107.
17. CD Lima., et al. “Acute Effects of Stretching on Flexibility and Performance: A Narrative Review”. J. Sci. Sport Exerc 1.1 (2019): 29-37.
18. N Guissard and J Duchateau. “Neural aspects of muscle stretching”. Exerc. Sport Sci. Rev 34.4 (2006): 154-158.
19. L Luan., et al. “Knee osteoarthritis pain and stretching exercises: a systematic review and meta-analysis”. Physiotherapy 114 (2022): 16-29.
20. H Chen., et al. “The effects of a home-based exercise intervention on elderly patients with knee osteoarthritis: a quasi-experimental study”. BMC Musculoskelet. Disord 20.1 (2019): 160.
21. MH Elgendy., et al. “Efficacy of rectus femoris stretching on pain, range of motion and spatiotemporal gait parameters in patients with knee osteoarthritis: a randomised controlled trial”. BMJ Open Sport Exerc. Med 8.4 (2022): e001459.
22. DA Reid and PJ McNair. “Effects of an acute hamstring stretch in people with and without osteoarthritis of the knee”. Physiotherapy 96.1 (2010): 14-21.
23. M Nakamura., et al. “Time course of changes in passive properties of the gastrocnemius muscle-tendon unit during 5 min of static stretching”. Man Ther 18.3 (2013): 211-215.
24. M Nakamura., et al. “The Comparison of Different Stretching Intensities on the Range of Motion and Muscle Stiffness of the Quadriceps Muscles”. Front. Physiol 11 (2021): 628870.
25. MJ Thomas., et al. “Acute flares of knee osteoarthritis in primary care: a feasibility and pilot case- crossover study”. Pilot Feasibility Stud 4 (2018): 167.
26. T-S Lee., et al. “Balance factors affecting the quality of life in patients with knee osteoarthritis”. South african J. Physiother 78.1 (2005): 1628.
27. JH Park., et al. “Effects of knee osteoarthritis severity on inter ? joint coordination and gait variability as measured by hip ? knee cyclograms”. Sci. Rep (2021): 1-9.
28. J Afonso., et al. “Strength Training versus Stretching for Improving Range of Motion: A Systematic Review and Meta-Analysis”. Healthc 9.4 (2021): 427.
29. SB Al-Mhanna., et al. “Effects of Circuit Training on Patients with Knee Osteoarthritis: A Systematic Effects of Circuit Training on Patients with Knee Osteoarthritis: A Systematic Review and Meta-Analysis”. Healthc 10.10 (2022): 2041.
30. F Arab., et al. “Association of eccentric quadriceps torque with pain, physical function, and extension lag in women with grade ≤ II knee osteoarthritis”. Medicine (Baltimore) 101.31 (2022): e29923.
31. H Chaabene., et al. “Acute Effects of Static Stretching on Muscle Strength and Power: An Attempt to Clarify Previous Caveats”. Front. Physiol 10 (2019): 1468.
32. J Palmer., et al. “Surgical interventions for symptomatic mild to moderate knee osteoarthritis (Review)”. Conhane Database Syst. Rev 7.7 (2019).
33. DG Behm., et al. “Acute effects of muscle stretching on physical performance, range of motion, and injury incidence in healthy active individuals: A systematic review”. Appl. Physiol. Nutr. Metab 41.1 (2015): 1-11.
34. S Stafilidis and M Tilp. “Effects of short duration static stretching on jump performance, maximum voluntary contraction, and various mechanical and morphological parameters of the muscle-tendon unit of the lower extremities”. Eur. J. Appl. Physiol 115.3 (2015): 607-617.
35. D Cannavan, DR Coleman and AJ Blazevich. “Lack of effect of moderate-duration static stretching on plantar flexor force production and series compliance”. Clin. Biomech 27.3 (2012): 306-312.
36. SR Freitas, ANZ Milanovic and B Mendes. “Can chronic stretching change the muscle- ­ tendon mechanical properties?? A review”. (2018): 794-806.

Background: Knee osteoarthritis (KOA) is a degenerative disease with over 600 million people suffering worldwide. KOA is considered a major burden for the health systems as the annual healthcare expenses are to be calculated at over 27$ billion only in the USA.

Purpose: The purpose of the present study was to investigate the acute effects of a stretching intervention program in KRoM and knee stiffness in patients with KOA.

Material and Methods: Twenty female selected patients with diagnosed KOA were recruited and randomly assigned into the two groups. The intervention group performed a stretching protocol on an isokinetic dynamometer. The intervention consisted of three times of 60sec. All the measurements were performed on an isokinetic dynamometer. The main outcomes of the present study were the range of motion (KRoM), the maximum torque, and the joint stiffness of the knee joint to assess the joint's functionality. All the parameters were analyzed and compared pre and post-the stretching protocol.

Results: Statistically significant differences were found between the two groups right after the stretching intervention in all outcomes, suggesting that the passive stretching stimulus could be effective regarding KRoM (F1,18 = 8.352, p < .001) and the joint stiffness (F1,18= 6.384, p = .021).

Conclusion: Passive stretching could provide immediate benefits to KOA female individuals, possibly leading to better knee functionality during activities of daily living.

Keywords: Range of motion; Joint stiffness; passive torque; osteoarthritis; activities of daily living; knee functionality

References

1. Centre for Equity Studies (CES). Lives and Livelihoods: A Rapid Assessment of the Impact of COVID-19 on Workers in the Informal Economy in India (2020).
2. Debnath M and Banerjee S. “Social determinants of health and its effects on COVID-19 pandemic in India: a narrative review”. J Educ Health Promot 10 (2021): 61.
3. Indian Council of Social Science Research (ICSSR). Impact of COVID-19 on Education in Rural India (2020).
4. International Labour Organization (ILO). COVID-19 and the World of Work: Impact and Policy Responses (2020).
5. Karmakar K., et al. “Impact of COVID-19 pandemic on socioeconomic and environmental determinants of health in India: A systematic review”. Int J Environ Res Public Health 18.6 (2021): 3177.
6. Mohanty SK and Mishra SK. “Health inequalities during COVID-19 pandemic: A study of social determinants affecting the urban slum dwellers in India”. Int J Health Plann Manage 36.3 (2021): 862-875.
7. Panchal S., et al. “Effect of social determinants of health on COVID-19 incidence in India: A comprehensive study”. Int J Community Med Public Health 7.9 (2020): 3615-3620.
8. Public Health Foundation of India (PHFI). Disruptions in Routine Healthcare Services during COVID-19 Pandemic in India (2020).
9. Samanta S and Biswas T. “Social determinants of COVID-19 and their influence on health disparities in India”. Clin Epidemiol Glob Health 11 (2021): 100749.
10. Singh AK., et al. “Diabetes in COVID-19: Prevalence, pathophysiology, prognosis and practical considerations”. Diabetes Metab Syndr 14.4 (2020): 303-310.

The global spread of the COVID-19 pandemic has highlighted existing social determinants of health (SDH) that have contributed to health disparities and inequities in India. In this study, we aimed to track the SDH during the COVID-19 pandemic in India using close-ended surveys. Our findings suggest that vulnerable populations, such as those with lower income and education levels and poor housing conditions, are at heightened risk of the pandemic infection and poorer mental health outcomes. Access to healthcare is also a concern for vulnerable populations during the pandemic. These findings have important implications for policy and practice, highlighting the need to address SDH and health inequities to ensure equitable health outcomes during the COVID-19 pandemic in India.

Keywords: SDH; Covid-19; India; Survey; Health Outcomes; Food Security; Health Outcomes; Mental Health; Access to Healthcare; Policy

References

1. Aburukba Raafat., et al. “Configurable ZigBee-based control system for people with multiple disabilities in smart homes”. IEEE (2016): 1-5.
2. Aslam F., et al. “Innovation in the era of IoT and industry 5.0: Absolute innovation management (AIM) framework”. Information 11.2 (2020): 124.
3. Bisht D., et al. “Imperative Role of Integrating Digitalization in the Firms Finance: A Technological Perspective”. Electronics 11.19 (2022): 3252.
4. Cerchione R., et al. “Blockchain’s coming to hospital to digitalize healthcare services: Designing a distributed electronic health record ecosystem”. Technovation 120 (2023): 102480.
5. Chehbi-Gamoura S., et al. “Insights from big Data Analytics in supply chain management: an all-inclusive literature review using the SCOR model”. Production Planning & Control 31.5 (2020): 355-382.
6. Cong LW, Li B and Zhang QT. “Internet of Things: Business Economics and Applications”. Review of business 41.1 (2021).
7. Dang LM., et al. “A survey on internet of things and cloud computing for healthcare”. Electronics 8.7 (2019): 768.
8. Demiris G and Hensel K. “Technologies for an Aging Society: A Systematic Review of 'Smart Home' Applications”. IMIA Yearbook of Medical Informatics 17 (2008): 33-40.
9. Gheorghiu RA, Iordache V and Cormo? AC. “Analysis of the possibility to detect road vehicles via Bluetooth technology”. Sensors 21.21 (2021): 7281.
10. Haghnegahdar L, Joshi SS and Dahotre NB. “From IoT-based cloud manufacturing approach to intelligent additive manufacturing: Industrial Internet of Things - An overview”. The International Journal of Advanced Manufacturing Technology (2022): 1-18.
11. Khatoon N, Roy S and Pranav P. “A survey on Applications of Internet of Things in Healthcare”. Internet of Things and Big Data Applications: Recent Advances and Challenges (2020): 89-106.
12. Khurshid A and Gadnis A. “Using blockchain to create transaction identity for persons experiencing homelessness in America: policy proposal”. JMIR research protocols 8.3 (2019): e10654.
13. Kumar A, Pujari P and Gupta N. “Artificial Intelligence: Technology 4.0 as a solution for healthcare workers during COVID-19 pandemic”. Acta Universitatis Bohemiae Meridionalis 24.1 (2021): 19-35.
14. Lee D and Yoon SN. “Application of artificial intelligence-based technologies in the healthcare industry: Opportunities and challenges”. International Journal of Environmental Research and Public Health 18.1 (2021): 271.
15. Li KHC., et al. “The current state of mobile phone apps for monitoring heart rate, heart rate variability, and atrial fibrillation: narrative review”. JMIR mHealth and uHealth 7.2 (2019): e11606.
16. Maneejuk P and Yamaka W. “The impact of higher education on economic growth in ASEAN-5 countries”. Sustainability 13.2 (2021): 520.
17. Mogaji E and Nguyen NP. “Managers' understanding of artificial intelligence in relation to marketing financial services: insights from a cross-country study”. International Journal of Bank Marketing 40.6 (2022): 1272-1298.
18. Mohamed E. “The relation of artificial intelligence with internet of things: A survey”. Journal of Cybersecurity and Information Management 1.1 (2020): 30-24.
19. Ndiaye M., et al. “IoT in the wake of COVID-19: A survey on contributions, challenges and evolution”. IEEE Access 8 (2020): 186821-186839.
20. Nosratabadi S., et al. “Data science in economics: comprehensive review of advanced machine learning and deep learning methods”. Mathematics 8.10 (2020): 1799.
21. Parida V, Sjödin D and Reim W. “Reviewing literature on digitalization, business model innovation, and sustainable industry: Past achievements and future promises”. Sustainability 11.2 (2019): 391.
22. Picache JA., et al. “Collision cross section compendium to annotate and predict multi-omic compound identities”. Chemical science 10.4 (2019): 983-993.
23. Ruggiano N and Perry TE. “Conducting secondary analysis of qualitative data: Should we, can we, and how?”. Qualitative Social Work 18.1 (2019): 81-97.
24. Statista Research Department. “Internet of Things (IoT) connected devices installed base worldwide from 2015 to 2025”. Statista (2023).
25. Stewart C. “AI in healthcare market size worldwide 2021-2030”. Statista (2023).
26. Thormundsson B. “Artificial intelligence software market revenue worldwide 2018-2025”. Statista (2022).
27. Ushakov D., et al. “The Internet of Things impact on smart public transportation”. Transportation Research Procedia 63 (2022): 2392-2400.
28. Vermeer Y, Higgs P and Charlesworth G. “What do we require from surveillance technology? A review of the needs of people with dementia and informal caregivers”. Journal of rehabilitation and assistive technologies engineering 6 (2019): 2055668319869517.

The study has depicted the usages of IoT (Internet of things), AI (Artificial intelligence), and big data, which are mainly integrated health, financial and transportation system. IoT assist in establishing advanced connection between one device to another with the specific region with an application of sensor or wireless connection. The IoT in the healthcare help to create connection between doctors system to patient’s system for mentoring the patients. This application in financial sector helps to transact confidential information, which specifically happened with block chain technology. In the transportation, the sensor or wireless connection help to develop a connection thorough airspace and this also create a better connection with land to understand the direction. Similarly, the application of AI and Big Data can help gather accurate and insightful information that can help take better decisions in each of sectors for future growth and development. To evaluate and investigate the application of artificial intelligence, the internet of things (IoT), and big data in healthcare, finance, and transportation. The paper has used secondary data to provide the required insights on the topic and address its purpose. It is quite evident from the conducted research that the application of these technologies is only going to increase in the mentioned sectors considering their positive impact on growth and development of the respective sectors.

Keywords: IoT (Internet of things); AI (Artificial intelligence); big data; technological advancement; connection; healthcare; financial sector

References

1. Mlenzana NB., et al. “Barriers to and facilitators of rehabilitation services for people with physical disabilities: A systematic review”. African Journal of Disabilities 1.22 (2013).
2. IWBF Player Classification Commission. “IWBF Official Classification Manual, IWBF – OCM”. Version #1 2018, © Copyright: IWBF.
3. IWBF Executive Council. “Official Wheelchair Basketball Rules 2018”. Hamburg, Germany (2018).
4. Jaarsma E., et al. “Sports Participation and Physical Disabilities: Taking a Hurdle”. Scandinavian Journal of Medicine and Science in Sports, Chapter 3 (2014).
5. Jaarsma E., et al. “Barriers and Facilitators of sports in Dutch Paralympic athletes: An explorative study”. Scandinavian Journal of Medicine and Science in Sports (2014).
6. Kean B and Driver C. “Environmental Factors Influencing Early Participation in Para-Sport”. in the Book Human Factors and Ergonomics in Sport (2020).
7. Khumalo B., et al. “An investigation into participation trends by wheelchair basketball players at the Zimbabwe Paralympic games: A case study of Bulawayo”. International Journal of Human Movement and Sports Sciences 1.1 (2013): 1-12.
8. Khumalo B, Heerden J and Skalko T. “State and status of wheelchair basketball facilities in Zimbabwe”. in The Routledge Handbook of Disability in Southern Africa, Edited by: Tsitsi Chataika (2018): 278-289.
9. Marques MP and Alves AC. de Jesus Investigating environmental factors and paralympic sports: an analytical study (2021): 414-419.
10. National survey on disability and health (2013).
11. Phiri P. Wheelchair basketball provincial team selected (2013).
12. Wiggill W. Wheelchair Basketball and community reintegration of people with a spinal cord injury (2016).
13. World Health Organization (WHO). “International classification of functioning, disability and health: children & youth version: ICF-CY”., © World Health Organization (2007): 38-48.
14. World Health Organization (WHO) World Disability Report, WHO, Geneva (2011).
15. Zimbabwe population census (2012).

The objective of this study was to determine the influence of personal and environmental factors that affect the participation likelihood of athletes in wheelchair basketball. Convenient sampling was used. The Participation Likelihood Assessment Tool for Wheelchair Basketball (PLAT-WB), developed by Khumalo B, Van Heerden J, and Skalko T. was used to collect data. Data was analysed through the method prescribed for scoring the questionnaire. The T-test (SPSS version 20) was used to find the significance difference of how the influential factors affect males and females. A total of 38 questionnaires, of which 18 from women and 20 from men, were correctly completed. The results showed that there is a 92.11% moderate likelihood to participate, 2.63% very low likelihood to participate in wheelchair basketball. Males have 5% low likelihood, 90% moderate likelihood and 5% high likelihood to participate in wheelchair basketball. Females showed a 5.6% low likelihood, 0% low likelihood, 94.4% of moderate likelihood and 0% of high likelihood to participate in wheelchair basketball. There is no significant difference (p = 0.215) between men and women participation likelihood as affected by environmental factors and no significant difference (p= 0.918) by personal factors. Generally, men (92.11%) and women (92.11%) with a moderate participation likelihood are quite likely to play WB. The study revealed that the personal and environmental factors have the same influence in the participation likelihood levels for both males and females. Thus, the barriers that hinder the possible WB to participate affect both males and females in a similar way.

Keywords: Perception; Participation; Restrictions; Environmental Factors; Personal Factors

References

1. Bukhari MH, M Syed and S Zain. “The Differences between Traditional Vaccines and RNA Vaccines: Safety, Efficacy, Reliability and Future of COVID-19 Vaccines”. Annals of King Edward Medical University 27.2 (2021).
2. Zheng H and JJ Cao. “ACE gene polymorphism and severe lung injury in patients with COVID-19”. The American journal of pathology (2020).
3. Dai L and GF Gao. “Viral targets for vaccines against COVID-19”. Nature Reviews Immunology 21.2 (2021): 73-82.
4. Lipworth B, C Kuo and R Chan. “Emerging pharmacotherapy for COVID-19”. Journal of the Royal College of Physicians of Edinburgh 50.2 (2020): 133-137.
5. Cheng H, Y Wang and GQ Wang. “Organ‐protective effect of angiotensin‐converting enzyme 2 and its effect on the prognosis of COVID‐19”. Journal of medical virology 92.7 (2020): 726-730.
6. Pillaiyar T, S Meenakshisundaram, and M Manickam. “Recent discovery and development of inhibitors targeting coronaviruses”. Drug discovery today 25.4 (2020): 668-688.
7. Dhama K., et al. “COVID-19, an emerging coronavirus infection: advances and prospects in designing and developing vaccines, immunotherapeutics, and therapeutics”. Human vaccines & immunotherapeutics 16.6 (2020): 1232-1238.
8. Deb B, H Shah and S Goel. “Current global vaccine and drug efforts against COVID-19: Pros and cons of bypassing animal trials”. Journal of biosciences 45.1 (2020): 1-10.
9. Le TT., et al. “Evolution of the COVID-19 vaccine development landscape”. Nat Rev Drug Discov 19.10 (2020): 667-668.
10. Basavaraja CK., et al. “Adverse events following COVID-19 vaccination: first 90 days of experience from a tertiary care teaching hospital in South India”. Therapeutic Advances in Vaccines and Immunotherapy 9 (2021): 25151355211055833.
11. Shahzamani K., et al. “Vaccine design and delivery approaches for COVID-19”. International Immunopharmacology 100 (2021): 108086.
12. Uttarilli A., et al. “Super-rapid race for saving lives by developing COVID-19 vaccines”. Journal of Integrative Bioinformatics 18.1 (2021): 27-43.
13. Callway E. “Oxford covid vaccine results puzzle scientists”. Nature 588 (2020): 16-18.
14. Mascellino MT., et al. “Overview of the Main Anti-SARS-CoV-2 vaccines: mechanism of action, efficacy and safety”. Infection and drug resistance 14 (2021): 3459.
15. Garofalo M., et al. “Prospects of replication-deficient adenovirus based vaccine development against SARS-CoV-2”. Vaccines 8.2 (2020): 293.
16. Kurup D and MJ Schnell. “SARS-CoV-2 vaccines–The biggest medical research project of the 21st century”. Current Opinion in Virology (2021).
17. Angeli F., et al. “SARS-CoV-2 vaccines: Lights and shadows”. European Journal of Internal Medicine (2021).
18. Miller JM., et al. “Guidelines for safe work practices in human and animal medical diagnostic laboratories”. MMWR Surveill Summ 6.61 (2012): 1-102.
19. Nikhra V. Evolving COVID-19 Pandemic: The Lurking Dangers and Pillars of Hope.
20. Zahid A. Johnson & Johnson Vaccine Update.
21. Huang KY., et al. “Humanized COVID‐19 decoy antibody effectively blocks viral entry and prevents SARS‐CoV‐2 infection”. EMBO molecular medicine 13.1 (2021): e12828.
22. Shrestha Y., et al. “Covid-19 Vaccine Authorized in India-A Mini Review”. (2021).
23. Voysey M., et al. “Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK”. The Lancet 397.10269 (2021):  99-111.
24. Analytica O. “India’s vaccine roll-out faces key obstacles”. Expert Briefings (2021).
25. Darbar S, S Agarwal and S Saha. “COVID19 Vaccine: COVAXIN®-India’s First Indigenous Effective Weapon to Fight against Coronavirus (A Review)”. Parana Journal of Science and Education 7.3 (2021): 1-9.
26. Srivastava R, P Ish and S COVID. “The initial experience of COVID-19 vaccination from a tertiary care centre of India”. Monaldi Archives for Chest Disease (2021).
27. Majumdar S., et al. “Perspectives about modulating host immune system in targeting SARS-CoV-2 in India”. Frontiers in genetics 12 (2021): 125.
28. Wani R, PH Manihar and VJ Wani. “Covid-19 Vaccination: Part Played in Pregnancy”. The Indian Practitioner 74.3 (2021): 7-10.
29. Sharma P and G Pardeshi. “COVID-19 vaccination in India: An ethical perspective”. Diabetes & Metabolic Syndrome: Clinical Research & Reviews 15.6 (2021): 102314.
30. Abdulla ZA., et al. “A Summary of the SARS-CoV-2 Vaccines and Technologies Available or under Development”. Pathogens 10.7 (2021): 788.
31. Kumar M., et al. “A Comprehensive Overview on the Production of Vaccines in Plant-Based Expression Systems and the Scope of Plant Biotechnology to Combat against SARS-CoV-2 Virus Pandemics”. Plants 10.6 (2021): 1213.
32. Gharate JS, SA Daitkar and KA Aher. Approved Covid 19 Vaccines: A Review (2021).
33. Abduljaleel Z, FA Al-Allaf and SA Aziz. “Peptides-based vaccine against SARS-n CoV-2 antigenic fragmented synthetic epitopes recognized by T cell and β-cell initiation of specific antibodies to fight the infection”. Bio-design and Manufacturing (2021): 490-505.
34. Sapkal GN., et al. “Inactivated COVID-19 vaccine BBV152/COVAXIN effectively neutralizes recently emerged B. 1.1. 7 variant of SARS-CoV-2”. Journal of Travel Medicine 28.4 (2021): taab051.
35. Singh AK., et al. “Antibody Response after First-dose of ChAdOx1-nCOV (Covishield) and BBV-152 (Covaxin) amongst Health Care Workers in India: Preliminary Results of Cross-sectional Coronavirus Vaccine-induced Antibody Titre (COVAT) study”. medRxiv (2021).
36. Sharma R, S Tiwari and A Dixit. “Covaxin: An overview of its immunogenicity and safety trials in India”. Bioinformation (2021): 840-840.
37. Nikhra V. “Stages in COVID-19 vaccine development: The Nemesis, the Hubris, and the Elpis”. Int J Clin Virol 4 (2020): 126-135.
38. Cohen J. “Doses of reality”. American Association for the Advancement of Science (2021).
39. Sharma M. “Story of the biggest vaccination drive in the world so far”. Journal of pharmacovigilance and drug research 2.2 (2021): 1-2.
40. Zare H., et al. “Prevalence of COVID-19 vaccines (Sputnik V, AZD-1222, and Covaxin) side effects among healthcare workers in Birjand city, Iran”. International immunopharmacology 101 (2021): 108351.
41. Ella R., et al. “Efficacy, safety, and lot to lot immunogenicity of an inactivated SARS-CoV-2 vaccine (BBV152): a double-blind, randomised, controlled phase 3 trial”. MedRxiv (2021).
42. Dar MA., et al. “Safety, efficacy, and immunogenicity of COVAXIN: A review”. Journal of Applied Pharmaceutical Science 11.11 (2021): 018-025.
43. Rotbi MF, S Motahhir and AE Ghzizal. “Blockchain technology for a Safe and Transparent Covid-19 Vaccination”. arXiv preprint arXiv:2104.05428 (2021).
44. Bobdey S, S Kaushik and A Menon. “The conundrum of two-dose interval of ChAdOx1 nCOV-19 corona virus vaccine: Way ahead”. Medical Journal, Armed Forces India 77 (2021): S250.

Since the pandemic began, India has confirmed more than 35 million cases and 50 lakh deaths (COVID19). The country has the second-highest number of Covid-19 infections in the world. As a result, vaccines that are both safe and effective required. The most widely used vaccinations in India are CoviShield and Covaxin. While the Serum Institute of India in Pune produces CoviShield, Covaxin is wholly designed, developed, and manufactured in India. CoviShield, a viral vector vaccine developed, it delivers spike proteins and mounts a tolerable immune response to a live virus using an adenovirus discovered in chimps, ChAD0x1. Covaxin is an inactivated coronavirus vaccine. India has reached the milestone of more than 1 billion vaccination doses. In addition, India achieves a world record by administering 2.5 million vaccines in a single day. The major goal of this research is to distinguish between the two most often used vaccinations in India, CoviShield and Covaxin. Also everyone in the public is aware of how it works, safe, effective and harmful it is. As a result of these vaccines, India plays a critical role in halting the coronavirus in the present and near future, perhaps saving millions of lives.

Keywords: CoviShield; Covaxin; Vaccine; Covid-19; India; Virus

     Healthy relationships always suppose trust, respect, and appreciation between interest groups; sicknesses play down these fundamental components, annoying the beneficiaries.

     Prosperous affairs or weak spots going down them continuously appear, soothing or distressing the individuals. Younger individuals are more candid, genuine, heartfelt, and open to challenging situations. Still, they have less life experience than adults or seniors. Old individuals are frequently registered with many diseases, including arterial hypertension and type 2 diabetes shading their performance. For all categories, illnesses get in the way of thinking and acting and may cause disruptions in interpersonal relationships. An unfair manifestation of judgment makes partners terminate the connection, amplifying mental suffering in the sick individual.

     Rational thinking and performing duties gratifies people working and attract individuals, but imbalanced actions can harm their other relationships. People look for another collaborator when they are disappointed by unsafe collaboration. They usually need to prepare for such turning effects and want a more direct and effective way of interaction.

     Persistent bad feelings disturb the human equilibrium, primarily affecting lipid profile and glycaemic control that alter cell functioning.

     Therefore, people’s health ensures a prosperous social, professional, cultural, and emotional life. A deep look through the factors implying the appearance and evolution of various illnesses is necessary. A medical team’s mission is to identify all risk factors connected with the clinical manifestations of multiple diseases that affect reasoning and measures to attenuate or eliminate them when possible.

     Disorder management has a different approach in this century. Person-centricity leads to a better- understanding of diseases, moving to their origin, and considering human life evolving and undergoing rational transformation.

     People’s complex connectivity infers numerous parts that vary by age, instruction, setting, surroundings, and circumstances. The inability to select the most advantageous factors for enhancing professional and social life needs improvement.

     Occasionally dire conditions cannot be avoided, and the individual must be prepared to deal with dilemmas. Successfully coping with unexpected problems defines the capacity to beat barriers, or if an inevitable fall occurs, rising above is preferable. The excellent position gained after falling depicts the victory against overcoming adversities, illuminating a path for restorative health and optimistic well-being improvement.

     Sometimes illogical actions originate in intentional immoral thinking, finally repulsing, revolting, or shocking the recipients. Corrective and informative actions are indispensable to going back to normality. The artificial Intelligence supply and instruction hybrid model add benefit for remodelling unhealthy behaviour.

     Acting as professionals, we gain recognition from the community we serve.

     And so, mental activity may also be evaluated by the effectiveness of connections between individuals with various backgrounds and demographic data.

     Individual reasoning change over time is expected. It should be better to have its improvement, but if decline appears, it has to be eased, and it is preferable not to fall again. Rising once more for the beauty of life in this natural and perceptible world that will end up sooner or later for each one is wanted.

     Humans share various communication styles in the community according to their culture, education, genetics, and medical conditions.

     As individuals evolve, their reasoning transforms through experiences, training, and possible disorders.

     Affairs ground society’s evolution, promoting sustainable production of goods and services. The human virtual or physical connection and a chain of command for doing that may be effective or ineffective, in line with individual expertise, available technologies advancement, and refinement in collaboration with other parties implied more or less in the creation process.

References

1. Kaur A, Singh M and Jasuja OP. “Inter-script comparison of handwriting features leading to their identification and authorship”. Nowa kodyfiacja prawa karnego 45 (2017): 15-26.
2. Cha SH and Srihari SH. “Writer Identification: Statistical Analysis and Dichotomizer”. Proc. SS & SPR 2000 LNCS-Advances in Pattern Recognition (2000): 123-132
3. Lee S, S-H Cha and Srihari SH. “Combining macro and micro features for writer identification”. Proceedings of SPIE (2002).
4. Mathur S and Choudhary SK. “Examination of handwritten documents of unfamiliar scripts: A forensic viewpoint on various Indian languages”. International Journal of Research in Applied, Natural and Social Sciences (IMPACT: IJRANSS) 2.4 (2014): 137-144.
5. Niels RMJ, Grootjen FA and Vuurpijl LG. “Writer identification through information retrieval: the allograph weight vector”. In 11th International Conference on the Frontiers of Handwriting Recognition (ICFHR.2008) (2008):  481-486
6. Obaidullah SM, Das SK and Roy K. “A System for Handwritten Script Identification from Indian Document”. In Journal of Pattern Recognition Research 8.1 (2013): 1-12.
7. Roy S., et al. “Handwritten isolated Bangla compound character recognition: A new benchmark using a novel deep learning approach”. Pattern Recognition Letters 90 (2017): 15-21.
8. Sorate P, Kanwal NK and Malhotra M. “Comparison of various writing characteristics of Hindi and Marathi languages of Devanagari origin” Int. Journal of Innovative Science, Engineering & Technology 4.1 (2017).

Learning to write by hand begins with copybook models, which gradually evolve into individual features as writers acquire their own traits over time. In this paper, two separate scripts were used, and commonalities between the two scripts were found based on the way the two scripts formed letters that looked similar to one another. Nine distinct lookalike letters were noted and investigated. 200 handwriting samples from 100 people were gathered (50 each from familiar and non-familiar writers). These observations have been compared using a graph. The t-test, a statistical tool, was used to examine the significance of the overall hypothesis. 4.5547 was the t-test value at 5% significance, which is significant at df 16.

Keywords: Inter-script; Comparison; Lookalike alphabets; Stylistics

References

1. Chauhan N. After Covid-19 lockdown, plan to unlock India in phases. Hindustan Times (2020).
2. Goel A., et al. “Health benefits due to reduction in respirable particulates during COVID-19 lockdown in India”. Aerosol and Air Quality Research 21.5 (2021): 200460.
3. Gopal A Sharma, AJ and Subramanyam MA. “Dynamics of psychological responses to COVID-19 in India: A longitudinal study”. PloS one 15.10 (2020): e0240650.
4. Gupta H., et al. “Data analytics and mathematical modeling for simulating the dynamics of COVID-19 epidemic - a case study of India”. Electronics 10.2 (2021): 127.
5. Gupta V., et al. “Changing dynamics and travel evading: a case of Indian tourists amidst the COVID 19 pandemic”. Journal of Tourism Futures 9.1 (2023): 84-100.
6. Laxminarayan R, Jameel S and Sarkar S. “India’s battle against COVID-19: progress and challenges”. The American journal of tropical medicine and hygiene 103.4 (2020): 1343-1347.
7. Laxminarayan R., et al. “Epidemiology and transmission dynamics of COVID-19 in two Indian states”. Science 370.6517 (2020): 691-697.
8. Mandal M., et al. “A model based study on the dynamics of COVID-19: Prediction and control”. Chaos, Solitons & Fractals 136 (2020): 109889.
9. Muniyandi M., et al. “COVID-19 in India: Moving towards a post-pandemic future”. Indian Journal of Medical Microbiology 39.1 (2021): 1-6.
10. Pai C, Bhaskar A and Rawoot V. “Investigating the dynamics of COVID-19 pandemic in India under lockdown”. Chaos, Solitons & Fractals 138 (2020): 109988.
11. Rai B, Shukla A and Dwivedi LK. “Dynamics of COVID-19 in India: A review of different phases of lockdown”. Population Medicine (2020).
12. Samui P, Mondal J and Khajanchi S. “A mathematical model for COVID-19 transmission dynamics with a case study of India”. Chaos, Solitons & Fractals 140 (2020): 110173.
13. Saxena SK and Arora VK. “COVID-19 in India: Lessons from the second wave”. Diabetes and Metabolic Syndrome: Clinical Research and Reviews 15.5 (2021): 1029-1031.
14. Shaikh AS, Shaikh IN and Nisar KS. “A mathematical model of COVID-19 using fractional derivative: outbreak in India with dynamics of transmission and control”. Advances in Difference Equations 1 (2020): 373.
15. Sharma S., et al. “COVID-19 in India: Current status, challenges, and the way forward”. Journal of Family Medicine and Primary Care 10.4 (2021): 1437-1442.
16. Singh A, Prasad G and Hussain A. “COVID-19 in India: an overview of the current situation”. Journal of Health Management 23.1 (2021): 1-10.
17. Singh S, Singh A and Singh SP. “COVID-19 in India: challenges and opportunities”. Journal of Community Health 45.4 (2020): 729-732.
18. Srivastav AK., et al. “A mathematical model for the impacts of face mask, hospitalization and quarantine on the dynamics of COVID-19 in India: deterministic vs. stochastic”. Mathematical Biosciences and Engineering 18.1 (2021): 182-213.

Introduction: The term pandemic is considered to be the most dangerous thing that the world witnessed, however Covid-19 is considered to be the scariest thing till date. It damaged many things in the Nation, people lost life, their closed ones, earning sources and mental peace. The effect of Covid -19 is not over yet, however the seriousness of the virus is under control with proper vaccination and guidelines followed in India.

Objective: The objective of this research was to understand the dynamics of Covid -19, discussing the measures taken by the Government and challenges faced during its implementation and lockdown scenarios implemented in the nation in different phases. The paper also discusses the proactive role of the Indian Government and the risk management journey of the nation as a whole.

Methodology: The paper used secondary for studying the dynamics. The information was taken from authentic sources, online database; government reports, print media articles and different journals and research papers. The researcher used exploratory research design and secondary research approach to meet the research objectives.

Results: The article reports there was positive as well as negative effects of the lockdown in India.

Keywords: Pandemic; Lockdown; Covid- 19 in India; SARS Cov-19

References

1. Ansari SH and Ali M. “Hair care and herbal drug”. Indian J Nat Prod 13.1 (1997): 3-5.
2. Rathi V., et al. “Plants used for hair growth promotion: A review”. Phcog Rev 2.3 (2008): 165-167.
3. Begum R and Begum A. “Preparation and evaluation of herbal hair oil”. Int J of Res and Anal Reviews 6.1 (2019): 266-9.
4. Rathi V., et al. “Plants used for hair growth promotion: A Review”. Phcog Rev 2.3 (2008): 165-167.
5. Price VH. “Treatment of hair loss”. N Eng. J Med 341.13 (1999): 964-973.
6. Sinclair R. “Male pattern androgenetic alopecia”. BMJ 317.7162 (1998): 865-869.
7. Orasan MS., et al. “Hair loss and regeneration performed on animal models”. Clujul Med 89.3 (2016): 327.
8. Abell E. “Embryology and anatomy of the hair follicle”. Dis Hair Growth (1993): 1-19.
9. Kirsten Nunez. Hair Serum Benefits and How to Use (2020).
10. Elea Carey. How to Use Olive Oil for Hair Care (2019).
11. Rogers NE and Avram MR. “Medical treatments for male and female Pattern hair loss”. J Am Acad Dermatol 59.4 (2008): 547-566.
12. Ali BH and Blunden G. “Pharmacological and toxicological properties of Nigella sativa”. Phytother Res 17.4 (2003): 299-305.
13. Majdalawieh AF, Fayyad MW and Nasrallah GK. “Anti-cancer properties and mechanisms of action of Thymoquinone, the major active ingredient of Nigella sativa”. Crit Rev Food SciNutr 57.18 (2017): 3911-28.
14. Yousefi M., et al. “Comparison of therapeutic effect of topical Nigella with Betamethasone and Eucerin in hand eczema”. J Eur Acad Dermatol Venereol 27.12 (2013): 1498-504.
15. Halligudi N. “Pharmacological properties of Flax seed: A Review”. Hygeia J D Med 4.2 (2012): 70-7.
16. Manjula D., et al. “Formulation and evaluation of flaxseed hair gel: A natural hair Tamer”. Int J Res Pharm Chem 8.3 (2018): 487-91.
17. Saleem U, Sabir S and Ahmad B. “Protective role of Nigella sativa in chemotherapy induced alopecia”. Bangladesh J Pharmacol 12 (2017): 455-62.
18. Zhang Q. “Development of citrus peel ethanolic extract shampoo”. IOP ConfSer: Mater SciEng (2019): 1-6.
19. Erukainure OL., et al. “Orange peel extracts: Chemical characterization, Antioxidant, antioxidative burst and phytotoxic activities”. J Diet Suppl 13.5 (2016): 585-94.
20. Zhang Q. “Development of citrus peel ethanolic extract shampoo”. IOP Conf Ser: Mater SciEng (2019): 1-6.

The hair follicle is known to be the most important organ in the mammalian system, determining appearance, gender difference, providing severe temperature protection, and playing a part in self-defense. Many lifestyle-related changes, such as fatigue, anxiety, junk food consumption, and the use of various hairstyling/coloring methods, have caused serious hair loss difficulties in the younger generations. The thinning of one's hair In most situations, it is not transient, but it causes alopecia. Due to excessive anxiety and tension, many people suffering from hair loss seek different remedies, ranging from mythology to conventional and therapeutic healing to the use of minoxidil and finasteride. Hair root activation is necessary to improve hair development and prevent hair loss.

Keywords: Hair stimulant; Hair loss; serum

References

1. Soresen LT, Karlsmark T and Gottrup F. “Abstinence from smoking reduces incisional wound infection: a randomized controlled trial”. Annals of surgery 238.1 (2003):1-5.
2. Farhan S, Zeeshan S, Moshin Z and Shahzad A. “Frequency of Post-operative Surgical Site Infections in a Tertiary Care Hospital”. Journal of Dental and Medical Sciences 7.11 (2019): 42-43.
3. Shrestha A and Sharma VK. “Bacteriological study of wound infection and antibiotic susceptibility pattern of the isolates”. Nepal Journal of Science and Technological 14.2 (2013): 143-150.
4. Church D. “Burn Wound Infections”. Clinical Microbiology Review 19.2 (2006): 403-434.
5. Manikandan C and Amsath A. “Antibiotic susceptible of bacterial strains isolated from wound infection patients in Pattukkottai, Tamilnadu, India”. International Journal Current Microbiology Applied Science 2 (2013): 195-203.
6. Anguzu JR and Olila D. “Drug Sensitivity Patterns of Bacterial Isolates from Septic Post-operative Wounds in a Regional Referral Hospital in Uganda”. Africa Health Sciences 7 (2007): 148-154.
7. CDC Guideline for the Prevention of Surgical Site Infection 152.8 (2017): 784-791.
8. Owens CD and Stoessel K. Surgical site infections: epidemiology, microbiology and prevention”. J Hosp Infect 2 (2008): 3-10.
9. Horan TC, Gaynes RP, Martone WJ, Jarvis WR and Emori TG. “CDC definitions of nosocomial surgical site Infections: A modification of CDC Definitions of nosocomial Surgical Site Infections: A modification of CDC definitions of Surgical Wound Infections”. Infection Control Hospital Epidermiology 13.10 (1992): 606-608.
10. Altemeier WA. “Sepsis in Surgery. Presidential address”. Arch Surg 117.2 (1982): 107-112.
11. Garner JS, Javis WR, Emori TG, Horan TC and Hughes JM. “CDC definitions for nosocomial infection”. American Journal of Infection Control 16 (1988): 128-40.
12. Cantlon CA, Stemper ME and Schwan WR. “Significant Pathogens isolated from surgical site infections at a community hospital in the Midwest”. America Journal of Infection Control 34.25 (2006): 526-529.
13. Barie PS and Wilson SE. “Impact of evolving epidemiology on treatments for complicated skin and skin structure infections: The surgical perspective”. Journal of America College Surgery 220.1 (2015): 105-106.
14. Anderson DJ. “Surgical site infections”. Infectious diseases and Clinic of North America 25.1 (2011): 135-153.
15. Stevens DL, Bisno AL, Chambers HF, Dellinger EP, Goldstein EJ, Gorbach SL and Wade JC. “Practice guidelines for the diagnosis and management of skin and soft tissue infections: Update by the infectious Diseases Society of America”. Clinical Infectious Disease 2 (2014): 10-52.
16. Lawson EH, Hall BL and Ko CY. “Risk factors for superficial vs deep/organ-space surgical site infections: implications for quality improvement initiatives”. Jamaica Surgery 148.9 (2013): 849-858.
17. Malik A, Mohammad Z and Ahmad J. “The diabetic foot infections: biofilms and antimicrobial resistance. Diabetes and Metabolic Syndrome”. Clinical Research and Reviews 7.2 (2013): 101-107.
18. Cheesbrough M. “Medical Laboratory Manual for Tropical Countries”. Microbiology. Butterworth and Co. Ltd 3 (2007): 258-270.
19. Clinical Laboratory Standards Institute (CLSI). Performance standards for antimicrobial susceptibility testing. Twenty second informational supplement. Wayne, PA, USA: CLSI (2012): M100-S22.
20. Kirby QMM. and Bauer AW. “Antibiotic susceptibility testing by a standardized single disc method”. Am. J. Clin. Path 45 (1966): 493-6.
21. PY Liu, YJ Lau, BS Hu, JM Shyr, ZY Shi, WS Tsai, YH Lin and CY Tseng. “Analysis of clonal relationships among isolates of Shigella sonnei by different molecular typing methods”. Journal of Clinical Microbiology 33 (1995): 1779-1783.
22. Olufunmilola BM, Olugbenga AO and Folasoge AA. “Bacterial Agents of Surgical Site Infections in South-Western Nigeria”. American. Journal of Biomedical Sciences 5 (2010): 217-225.
23. Bibi SGA, Channa TR, Siddiqui and Ahmed W. “Pattern of bacteria pathogens in postoperative wounds and their sensitivity patterns in Karachi, Pakistan”. Journal of Surgery Pakistan 17.4 (2012): 164-167.
24. Bisi-Johnson MA and Olowe OA. “Studies on bacteria agents of surgical site infection in Osogbo, South Western Nigeria”. International Journal of Infectious Diseases 1.21 (2014): 346.
25. Giacometti A, Cirioni O, Schimizzi AM, Del Prete MS, Barchiesi F and D’errico MM. “Epidemiology and microbiology of surgical wound infections”. Journal of Clinical Microbiology 38.2 (2000): 918-922.
26. Kemebradikumo P, Fente BG and Oladapo O. “Current microbial isolates from wound swabs. Their culture and sensitivity pattern at the Niger Delta University Teaching Hospital, Okolobiri, Nigeria”. Tropical Medical Health. 41.2 (2013): 49-53.
27. Pradeep M and Rao KVV. “A study on surgical site infections, their bacteriological profile and antimicrobial susceptibility pattern”. International Journal of Medical Microbiology Tropical Disease 5.1 (2019): 9-13.

Surgical site infections [SSIs] remain a common postoperative complication despite the use of prophylactic antibiotics and other preventive measures, mainly due to increasing antimicrobial resistance. SSIs increase postoperative morbidity and mortality and may require hospital admission, intravenous antibiotics and even surgical re-intervention. A hospital based descriptive study was conducted on 100 consented postoperative patients with clinical SSIs. Data on patients was obtained using structured data collection form. Swab samples were collected aseptically from each patients. Bacteriological culture examination and identification was done following standard microbiological techniques. Antibiotics sensitivity test was done by Kirby-Bauer disc diffusion method. Ninety (90%) bacterial isolates were recovered from surgical site infection. Gram negative bacteria (GNB) were predominant (83.3%) with the dominant being Escherichia coli (27.78%) and Staphylococus aureus (16.67%). All the isolates were highly resistant to amoxicillin/clavunalate, ceftazidime, cefuroxime, levofloxacin and all the isolates were resistant to metronidazole but susceptible to imipenem, polymycin B and amikacin. The plasmid analysis in this study revealed that out of the 40 (44.4%) multi-drug resistance isolates, 35 (87.5%) of which were Gram-negative bacteria had 9 (22.5%) detectable plasmid pattern with the molecular weight of between 2027kbp to 23120kbp while the remaining 26 (74.6%) had no plasmid bands. The remaining 5 (12.3%) which was Staphylococcus aureus isolates had 2 (40%) detectable plasmid pattern with the molecular weight of between 23130kbp and 6557 while the remaining 3 (60%) had no plasmid bands. Imipenem is the drug of choice in the treatment of surgical site infections in this study area These findings necessitates judicious antibiotic use and calls for surveillance of SSIs periodically as well as strict adherence to good sanitation practice to reduce spread of drug-resistant pathogens.

Keywords: Surgical Site Infections; Antimicrobial susceptibility; Gram negative; Bacteria; Gram positive; Plasmid Profile; Clinicians; Operating Room

     Among these, newer possibilities are being searched which could fulfil the purpose. One of these is Fish Protein Hydrolysate produced from the visceral waste of fish, which is an excellent nutritional supplements and most researched fishery product in last decade. It bears bioactive properties and get absorbed easily in diverse metabolic operations. The abundance of amino acids, PUFAs, antioxidant peptides and low fat content makes it an attractive option of nutraceutical. Besides, it exhibits antimicrobial, immunomodulatory, anticancerous, anti-coagulant, anti-obesity and anti-tumorous activity. It is being commonly marketed as nutraceutical in some countries. Noteworthy among those are PROTIZEN®, AMIZET®, Nutripeptin®, Seacure®, Vasotensin®, LIQUAMEN®, Stabilium®200, etc.

      However, the functional properties of the hydrolysate depend upon source of the viscera and the hydrolysis method. Fish protein hydrolysate, on the other hand is considered as best way to combat underutilized or by-catch fish as it minimises the perishable article and gives away a useful product. Operators of food businesses should generally assure product safety. Before a food ingredient is made available on the market, its safety requirements must be documented. When protein hydrolysates are made with proteases of food grade and are synthesised from proteins that have a history of being safe for consumption, protein hydrolysates can be regarded as safe. The manufacturing should assess the safety of fractions and bioactive peptides produced from safe hydrolysates before introducing them to the market. Moreover, the utilisation of fish waste may not be acceptable to certain regions of globe due to religious issues but it can be overcome by creating awareness and emphasising global waste problem.

     Both humans and animals can benefit from medicines in the treatment and prevention of disease. However, due to the nature of medicines, they may also have unintended effects on animals and environmental microorganisms. The potential environmental effects of the manufacture and use of medications are less well understood and have only lately emerged as a topic of study interest, despite the fact that the side effects on human and animal health are typically explored in depth safety and toxicity studies. In every region of the world, antibiotic resistance is increasing to dangerously high levels. Our ability to cure widespread infectious diseases is being threatened by the emergence and global dissemination of new resistance mechanisms. As antibiotics lose their effectiveness, a growing number of infections, including gonorrhoea, blood poisoning, pneumonia, and tuberculosis, are getting harder to treat and occasionally becoming incurable. The COVID-19 epidemic that is currently threatening the health of the entire world's population has halted activities in a number of important economic sectors. This is adding to the pressure placed on dietary supplements and nutraceuticals.

     Individual working reflects genetics, education, social connection, and environmental characteristics. It is advisable to maintain an equilibrium between intellectual activity and physical exercises. Moreover, intellect work can relax in the digital age, along with a personal choice from diverse virtual offerings aiding in recharging, ensuring a harmonious state of being.

     People’s data fast circulates by media, helping individuals to better decide on their collaborators. Personal reputation, appreciation, trust, and respect are fundamental for long-lasting relationships. Good partnership work ensures a prosperous social, cultural, professional, and emotional life. Unsafe people interactions have detrimental effects on their health and, consequently, decline work efficiency and well-being. IT advancement facilitates blocking collaboration with dishonest or uneducated people.

     The medical team’s mission is to detect the negative impact of unhealthy behaviour on individuals’ well-being and provide timely solutions for that, utilizing information technology resources for a swift recovery.

Immoral conduct in daily work is easily identified by using specialized electronic tools for monitoring; applying reasonable measures for remediation makes possible fast restoration of bad habits and ameliorates offensive people collaboration. Nowadays, corrective actions for harmful human behaviour are used more gently and with more permission, exploring self-reflection value for improvement.

     AI-powered tools can assist in restoring health, expanding knowledge, and enhancing the overall quality of life, finally leading to increased life expectancy.

     The latest technological advancement in healthcare delivery is used in clinical diagnosis, which may be established using only virtual patient data. Various IT devices are available for both rich and poor people in need. But just using a modest mobile phone makes the connection between the physician, nurse, and patient possible; online voice analysis combined with breath characteristics and face and hands info enables a rapid clinical diagnosis with no more time-consuming. This new practice model is more facile and accessible, gaining benefits for all parties implied in dealing with medical conditions: health professionals, patients, their families, pharmaceutical departments, and representatives of other trades connected for social support.

     Recording people’s physical or online interactions allows us to revisit communication for analysis; this helps detect possible gaps, correct them, and improve business or corporate performance.

     Customer experience reflects the professionalism of individuals collaboratively working and offering their products; the client’s knowledge, involvement, skills, emotional state, and proficiency are examined by gathering data from various touch-points and other communication channels. Consumer satisfaction ensures increased revenues, improved practice efficiency, and societal progress.

     People’s interaction with robots replacing their labour is a new, more accurate, rapid, and cost-saving alternative in service mode.

     As for each fact, there are two opposite facets of the advancement of technologies these days. The optimistic attributes of IT may fascinate us but are easily eclipsed by other elements with detrimental effects on individual health: more absorbed time to navigate them, a decreased program for physical activities or relaxation in nature, less time interacting in person, and disturbed slipping rhythm. These factors, if unbalanced, can lead to increased body mass index and brain disorders; sleep disruption represents a point start of other medical conditions. Ingenuity for an educational platform focussing on people’s health in the digital age is imperative.

     A fair digital program for an individual ensures a healthy life expedition, attaining excellence in living in the natural and perceptible - audible and visible world.

     People’s interaction has changed over time. Traditional face-to-face interaction is frequently replaced with virtual interaction, offering communication comfort without walking or traveling at a low cost. Reduction of time-consuming for that, saving money, and the opportunity to arrange exchanges with selected people according to personal interests and preferences means lifestyle change influences public health.

     Using IT devices for quick communication, immediate info available if necessary, and even acquiring expertise in one’s chosen domain by accessing on-demand educational programs and online certification represent a more convenient way of instruction and living.

References

1. “Coronavirus duseases (COVID-19) pandemic”. World Health Organisation (2023).
2. Akil L and HA Ahmad. “Socioeconomic impacts of COVID-19 pandemic on foodborne illnesses in the United States”. Eur J Env Public Health 7.2 (2023): em0128.
3. Davidescu Adriana Ana Maria, Simona-Andreea Apostu and Liviu Adrian Stoica. "Socioeconomic Effects of COVID-19 Pandemic: Exploring Uncertainty in the Forecast of the Romanian Unemployment Rate for the Period 2020–2023". Sustainability 13.13 (2021): 7078.
4. Ramaci Tiziana., et al. "Social stigma during COVID-19 and its impact on HCWs outcomes". Sustainability 12.9 (2020): 3834.
5. Allam Zaheer and David S Jones. "Pandemic stricken cities on lockdown. Where are our planning and design professionals [now, then and into the future]?". Land use policy 97 (2020): 104805.
6. Tambunan Tulus. "Recent evidence of the development of micro, small and medium enterprises in Indonesia". Journal of Global Entrepreneurship Research 9.1 (2019): 18.
7. Strijker Dirk, Gary Bosworth and Gosse Bouter. "Research methods in rural studies: Qualitative, quantitative and mixed methods". Journal of Rural Studies 78 (2020): 262-270.
8. Kabir Radifah. “Is A Fourth Wave of Covid-19 Possible? Should India Be Worried? Here’s What Experts Say”. abp Live (2023).
9. Wang Zeyu., et al. "Business Innovation based on artificial intelligence and Blockchain technology". Information Processing & Management 59.1 (2022): 102759.
10. “Summary: India Coronavirus COVID-19 Cases”. Trading Economics (2023).
11. “COVID-19 India as on”. Ministry of Health and Family Welfare (2023).
12. Kanwal Sanyukta, “COVID-19 vaccine doses administered in India March 2023”. Statista (2023).
13. Kanwal Sanyukta. “COVID-19 cases in Indian states 2023, by type”. Statista (2023).
14. Kourula Arno., et al. "New roles of government in the governance of business conduct: Implications for management and organizational research". Organization Studies 40.8 (2019): 1101-1123.
15. Writter entertainment. “India Unemployment Rate 2023 [7.45] – State Wise, India Vs World”. TEQIP (2023).
16. “State of the Economy 01 2022-23: Recovery Complete”. India budget (2023).
17. “Economic Survey 2022-23: India's GDP growth estimated at 6.5% in FY24, to remain fastest-growing economy”. India Today (2023).
18. Hayashi Teruaki., et al. "Actual conditions of person-to-object contact and a proposal for prevention measures during the COVID-19 pandemic". Scientific Reports 12.1 (2022): 18092.
19. Mital Anshu. “Trends of Indian education in 2023”. TOI (2023).
20. Ng Davy Tsz Kit., et al. "Teachers’ AI digital competencies and twenty-first century skills in the post-pandemic world". Educational technology research and development (2023): 137-161.
21. “Coronavirus: Janata curfew on March 22 between 7 am and 9 pm, says Modi”. The Hindu (2020).

The main purpose of the study is to evaluate the case of COVID-19 pandemic situation in 2023 in context of India. The recent scenario has highlighted the appearing of new wave of corona virus, which has hit the nation at a highest rate in which Maharashtra has seen many cases that are more active rather that other state. The vaccination has also been done to prevent this unpredictable case. The secondary qualitative and quantitative study has assisted in gathering of much useful information about the pandemic. The political and social condition has drastically been affected due to new wave of this virus that is affecting many people. On the other hands, the careless nature of many people has resulted as highest chance to increase the rate of pandemic situation. The threat of the pandemic is yet not over for India in 2023 and this in turn has various implications for the economic policies of the nation. Hence, a complete survey of the scenario in India in 2023 has been provided in the article with the help of secondary sources.

Keywords: COVID-19; corona virus; pandemic; economy political

Reference

1. Barratt E. “Impulsiveness and aggression”. Chicago: University of Chicago (1994): 61-79.
2. Bauer LO. “Neural Responses to Signals for Behavior Change: Greater Within-Person Variability is Associated with Risk Factors for Substance Dependence”. Alcoholism, clinical and experimental research 44.9 (2020): 1783-1790.
3. Brennan GM and Baskin-Sommers AR. “Brain-behavior relationships in externalizing: P3 amplitude reduction reflects deficient inhibitory control”. Behavioral brain research 337 (2018): 70-79.
4. Carlson SR and Thái S. “ERPs on a continuous performance task and self-reported psychopathic traits: P3 and CNV augmentation are associated with Fearless Dominance”. Biological psychology 85.2 (2010): 318-330.
5. Chamberlain SR and Sahakian BJ. “The neuropsychiatry of impulsivity”. Current Opinion in Psychiatry 20.3 (2007): 255-261.
6. Chen AC., et al. “Reduced frontal lobe activity in subjects with high impulsivity and alcoholism”. Alcoholism, clinical and experimental research 31.1 (2007): 156-165.
7. Chudasama Y. “Animal models of prefrontal-executive function”. Behavioral Neuroscience 125.3 (2011): 327-343.
8. Dayan-Riva A, Berger A and Anholt GE. “Early cognitive processes in OCD: An ERP study”. Journal of affective disorders 246 (2019): 429-436.
9. Dimoska A and Johnstone SJ. “Neural mechanisms underlying trait impulsivity in non-clinical adults: stop-signal performance and event-related potentials”. Progress in neuro-psychopharmacology & biological psychiatry 31.2 (2007): 443-454.
10. Dong G, Zhou H and Zhao X. “Impulse inhibition in people with Internet addiction disorder: electrophysiological evidence from a Go/NoGo study”. Neuroscience letters 485.2 (2010): 138-142.
11. Drislane LE, Vaidyanathan U and Patrick CJ. “Reduced cortical call to arms differentiates psychopathy from antisocial personality disorder”. Psychological medicine 43.4 (2013): 825-835.
12. Duven EC., et al. “Altered reward processing in pathological computer gamers—ERP results from a semi-natural gaming design”. Brain and behavior 5.1 (2015): 13-23.
13. Fein G and Cardenas VA. “P3b amplitude is not reduced in abstinent alcoholics with a current MDD”. Alcohol (Fayetteville, N.Y.) 63 (2017): 33-42.
14. Hoptman MJ., et al. “Sensory and cross-network contributions to response inhibition in patients with schizophrenia. NeuroImage”. Clinical 18 (2018): 31-39.
15. Ibanez A., et al. “The neural basis of decision-making and reward processing in adults with euthymic bipolar disorder or attention-deficit/hyperactivity disorder (ADHD)”. PloS one 7.5 (2012): e37306.
16. Kam JW, Dominelli R and Carlson SR. “Differential relationships between sub-traits of BIS-11 impulsivity and executive processes: an ERP study”. International journal of psychophysiology: official journal of the International Organization of Psychophysiology 85.2 (2012): 174-187.
17. Kamarajan C., et al. “Theta oscillations during the processing of monetary loss and gain: a perspective on gender and impulsivity”. Brain research 1235 (2008): 45-62.
18. Kim JS., et al. “Auditory evoked potential could reflect emotional sensitivity and impulsivity”. Scientific reports 6 (2016): 37683.
19. Kim M., et al. “Neurophysiological correlates of altered response inhibition in internet gaming disorder and obsessive-compulsive disorder: Perspectives from impulsivity and compulsivity”. Scientific reports 7 (2017): 41742.
20. Kim YY and Jung YS. “Reduced frontal activity during response inhibition in individuals with psychopathic traits: an sLORETA study”. Biological psychology 97 (2014): 49-59.
21. Koelsch S. “P3a and mismatch negativity in individuals with moderate Intermittent Explosive Disorder”. Neuroscience letters 460.1 (2009): 21-26.
22. Krakowski MI., et al. “Disturbances in Response Inhibition and Emotional Processing as Potential Pathways to Violence in Schizophrenia: A High-Density Event-Related Potential Study”. Schizophrenia bulletin 42.4 (2016): 963-974.
23. Kreusch F., et al. “Alcohol abuse and ERP components in Go/No-go tasks using alcohol-related stimuli: impact of alcohol avoidance”. International journal of psychophysiology: official journal of the International Organization of Psychophysiology 94.1 (2014): 92-99.
24. Lole L, Gonsalvez CJ and Barry RJ. “Reward and punishment hyposensitivity in problem gamblers: A study of event-related potentials using a principal components analysis”. Clinical neurophysiology: official journal of the International Federation of Clinical Neurophysiology 126.7 (2015): 1295-1309.
25. Merlotti E., et al. “Impulsiveness in patients with bulimia nervosa: electrophysiological evidence of reduced inhibitory control”. Neuropsychobiology 68.2 (2013): 116-123.
26. Morie KP., et al. “Intact inhibitory control processes in abstinent drug abusers (II): a high-density electrical mapping study in former cocaine and heroin addicts”. Neuropharmacology 82 (2014): 151-160.
27. Munro GE., et al. “Response inhibition in psychopathy: the frontal N2 and P3”. Neuroscience letters 418.2 (2007): 149-153.
28. Oberg SA, Christie GJ and Tata MS. “Problem gamblers exhibit reward hypersensitivity in medial frontal cortex during gambling”. Neuropsychologia 49.13 (2011): 3768-3775.
29. Park M., et al. “Differential neurophysiological correlates of information processing in Internet gaming disorder and alcohol use disorder measured by event-related potentials”. Scientific reports 7.1 (2017): 9062.
30. Park M., et al. “Sustained dysfunctional information processing in patients with Internet gaming disorder: 6-month follow-up ERP study”. Medicine 96.36 (2017): e7995.
31. Ribordy Lambert F., et al. “Acute alcohol intoxication and expectations reshape the spatiotemporal functional architecture of executive control”. NeuroImage 215 (2020): 116811.
32. Rosburg T., et al. “Inhibition and attentional control in pedophilic child sexual offenders - An event-related potential study”. Clinical neurophysiology: official journal of the International Federation of Clinical Neurophysiology 129.9 (2018): 990-1998.
33. Sandy. P300. NeuRA Library (2020).
34. Schmüser L., et al. “Data-driven analysis of simultaneous EEG/fMRI reveals neurophysiological phenotypes of impulse control”. Human brain mapping 37.9 (2016): 3114-3136.
35. Schuermann B., et al. “Impaired decision making and feedback evaluation in borderline personality disorder”. Psychological medicine 41.9 (2011): 1917-1927.
36. Sehrig S., et al. “Decision- and feedback-related brain potentials reveal risk processing mechanisms in patients with alcohol use disorder”. Psychophysiology 56.12 (2019): e13450.
37. Steele VR., et al. “Brain potentials measured during a Go/NoGo task predict completion of substance abuse treatment”. Biological psychiatry 76.1 (2014): 75-83.
38. Sumich A., et al. “Neurophysiological correlates of excitement in schizophrenia”. Progress in neuro-psychopharmacology & biological psychiatry 46 (2013): 132-138.
39. The impulsive client: Theory, research, and treatment (1993).
40. Venables NC., et al. “Factors of psychopathy and electrocortical response to emotional pictures: Further evidence for a two-process theory”. Journal of abnormal psychology 124.2 (2015): 319-328.
41. Verona E, Sprague J and Sadeh N. “Inhibitory control and negative emotional processing in psychopathy and antisocial personality disorder”. Journal of abnormal psychology 121.2 (2012): 498-510.
42. Watson TD, Sweeney JF and Louis H. “Neurocognitive, psychological and behavioral correlates of binge drinking and use of alcohol with caffeinated beverages in college-aged adults”. The American journal of drug and alcohol abuse 40.1 (2014): 58-66.
43. Wei S., et al. “Enhanced neural responses to monetary rewards in methamphetamine use disordered individuals compared to healthy controls”. Physiology & behavior 195 (2018): 118-127.
44. Yau YH., et al. “Blunted feedback processing during risk-taking in adolescents with features of problematic Internet use”. Addictive behaviors 45 (2015): 156-163.

Impulsivity has been conceptualized as a predictive factor among various problem behaviours of people who are clinically diagnosed with psychiatric disorders. In recent decades, there has been an attempt to understand impulsivity in terms of brain activities. The trait impulsivity is measured through P3a and P3b amplitudes to understand how they might change in pathological populations. Altered P300 is a biomarker for psychotic disorders, neurotic disorders, and various disorders related to addiction. Overall, P300 can be associated with impulsivity and inhibitory control. However, in different psychiatric disorders, the nature of changes in P300 indicated different types of underlying processing in decision-making and response inhibition.

Keywords: Impulsivity; P300; Psychopathology; Addiction; Psychosis

References

1. World Health Organisation. Antimicrobial resistance: Global Report on Surveillance 2014. Geneva: WHO (2014).
2. Hassaine H and Boulanoir M. “Antibiotic resistance of Escherichia coli isolated from urinary tract infections at Tizi Ouzou hospital”. Akli Mohand Oulhadj-Bouira University, Morocco (2019): 74.
3. Ouedraogo AS., et al. “Emergence and spread of antibiotic resistance in West Africa: enabling factors and threat assessment”. Tropical Health Medicine 27 (2017): 147-154.
4. Toudji AG., et al. “Prevalence of extended-spectrum beta-lactamase-producing enterobacteriaceae strains isolated in Togo and their susceptibility to antibiotics”. International Journal of Biological Chemical Sciences 11.3 (2017): 1165-1177.
5. Kalambry AC., et al. “Beta-lactam resistance profile of enterobacteriaceae isolated from urine samples at the Mali Hospital”. Malian Journal of Infectiology and Microbiology 14 (2019): 6-13.
6. Rakotovao-Ravahatra ZD., et al. “Phenotypes of resistance of Escherichia coli strains responsible for urinary tract infection in the laboratory of the University Hospital Center of Befelatanana Antananarivo”. Pan Afr Med J 26 (2017): 166.
7. French Society of Microbiology Enterobacteriaceae. In: CASFM / EUCAST: French Society of Microbiology Ed (2019): 1-45.
8. Romli A., et al. “ESBL Enterobacteriaceae for urinary tract infections: epidemiology and resistance”. MOROCCO MEDICAL 33.1 (2011): 12-17.
9. Hailaji NS, Ould Salem ML and Ghaber SM. “Antibiotic susceptibility of uropathogenic bacteria in the city of Nouakchott – Mauritania”. Prog Urol 26.6 (2016): 346-52.
10. Sissoko T. “Urinary tract infections in Bamako: epidemiological and bacteriological aspects”. University of Bamako, Mali (2006): 103.
11. Sbiti M, Lahmadi K and Louzi L. “Epidemiological profile of uropathogenic enterobacteriaceae producing extended-spectrum beta-lactamases”. Pan African Medical Journal 28.29 (2017): 1-8.
12. El Bouamri MC., et al. “Current antibiotic resistance profile of uropathogenic Escherichia coli strains and therapeutic consequences”. Advances in Urology 16 (2014): 1058-62.
13. Elhani D. “Extended-spectrum beta-lactamases: the challenge is increasing”. Ann Biol Clin 70.2 (2012): 117-40.
14. Gonsu Kamga H., et al. “Resistance phenotypes of Escherichia coli strains responsible for community-acquired urinary tract infections in the city of Yaoundé, Cameroon”. African Journal of Pathology and Microbiology 3 (2014): 1-4.
15. Nguyen JC and Lambert T. “Phenotypic interpretation of antibiogram vis-à-vis aminoglycosides”. Francophone Journals Laboratories 445 (2012): 75-7.
16. Batard E., et al. “From antibiotic consumption to bacterial resistance: the example of Escherichia coli resistance to quinolones”. Therapeutic medicine 17.4 (2011): 294-301.
17. Tagajdid MR., et al. “Study of the resistance of Escherichia coli strains isolated in urine to fluoroquinolones and third-generation cephalosporins”. Medicine and infectious diseases 40.2 (2010): 70-3.

Introduction: In order to guide antibiotic therapy, most often probabilistic this study aimed to characterize the different phenotypes of antibiotic resistance of E. coli strains responsible for urinary tract infections. Materials and methods: This was a prospective cross-sectional study with descriptive purposes that took place from January to December 2020 at the medical biology laboratory of Niamakoro FOMBA Hospital in Ségou. Uriselect 4 Agar was used for urine culture followed by biochemical identification by API 20E gallery. The antibiogram was then performed by the disc method according to the 2019 recommendations of the antibiogram committee of the French Society of Microbiology. Results: During this study, 56 enterobacteriaceae were isolated and identified in urinary tract infections, including 43 strains of E. coli or 76.79%. Regarding resistance patterns, the ESBL phenotype was the most observed with 46.51% for the beta-lactam class. Aminoglycoside resistance affected 41.46% of strains resistant to all aminoglycosides tested. Quinolone resistance was identified with 88.10% of strains resistant to all quinolones. ESBL profiles were associated with resistance to aminoglycosides, fluoroquinolones and sulfamethoxazole + trimethoprim in 13.95% of cases. Conclusion: The present study on resistance phenotypes in E. coli isolates reports worrisome results for the main classes of antibiotics.

Keywords: Antibiotics; E. coli; urinary tract infection; resistance phenotypes

Reference

1. Gahlawat DK, Jakhar S and Dahiya P. “Murraya koenigii (L.) Spreng: an ethnobotanical, phytochemical and pharmacological review”. Journal of Pharmacognosy and Phytochemistry 3.3 (2014): 109-119.
2. Sangam S., et al. International Journal of Health Sciences and Research 5.1 (2015): 156-164.
3. Singh AP., et al. “LC-MS-MS characterisation of curry leaf flavonols and antioxidant activity”. Food Chemistry 127.1 (2011) 80-85.
4. Henry AB Trimen. “A hand-book to the flora of Ceylon”. Dulau and Co (2015): 1-1893.
5. Kumar S, Loveleena D and Godwin S. “Medicinal property of Murraya koenigii-A Review”. International Research Journal of Biological Sciences 2.9 (2013): 80-83.
6. AG Atanasov., et al. “Discovery and resupply of pharmacologically active plant-derived natural products: a review”. Biotechnology Advances 33.8 (2015): 1582-1614.
7. H Yuan., et al. “The traditional medicine and modern medicine from natural products”. Molecules 21.5 (2016): 559.
8. Narasimhan NS., et al. “Murraya koinigi, structures of mahanimbine,koenimbine, mahanine, koinine, koenigine and koenidine”. Indian J Chem 13 (1975): 993-995.
9. Rastogi RP and Mehrotra BN. “Compendium of Indian medicinal Plants”. Volume 2, Central Drug Research Institute, Lucknow and National Institute of Science Communication, New Delhi, 486-489 (1980-1984).
10. Math MV and Kattinaw YR. ------------- Br J. oral maxilloFac. Surg 59.4 (2021): 497-498.
11. Mandal S., et al. “Fitoterapia Antidiarrhocal activity of carbozole alkaloids form Murraya koenigii spreng (Rutaceae) seeds”. Fitoterapia 81.1 (2010): 72-74.
12. Mishra RK. Curry Leaves (Murraya koenigii spreng) (2018): 23-28.
13. Patil Rupali Arun. Mukund Langade Padmaya Babarao Dighade Pramod and Hiray Ashok Yogesh (2012).
14. Rupali Arun Patil., et al. “Antinociceptive acute and chronic administration of Murraya koenigii L. Leaves in exmerimental animal modes”. Indian J Pharmacol 44.1 (2012): 15-19.
15. Jaysinghe AN Sandamali., et al. “Cardioprotective Potential of Murraya koenigii (L.) sperm Leaf extract against Doxorubicin Induced cardiotoxicity in Rats”. Evid Based Complement Alternat Med (2020): 6023737.
16. Verma Nidhi and Kumari Dharmashila. “Amoliorating effect of Muraraya koenigii leaves (curry leaves) against paracetamol induced genotoxicity in mice sperm cells”. IJIRMF 6 (2020): 12.
17. Ningappa MB, Dinesha R and Srinivas L. “Antioxidant and free radical scavenging achivies of polyphenol-oriched curry leaf (Murraya koenigii L.,) extracts”. Food chemistry 106.2 (2008): 720-728.
18. Bhandari P. “Curry Leaf (Murraya koenigii) or cure leaf: Review of its curative propertics”. Journal of Medical Nutrition and nutraceuticals 1.2 (2012): 92.
19. Ghosh D., et al. “Protective effect of aqueous leaf extract of Murraya koenigii against leaf induced oxidative stress in rat liver, heart and kidney: A dose response study”. Asian journal of Pharmaceutical and Clinic research 5.4 (2012): 54-58.
20. Arulselvan P and Subramanian S. “Effect of Murraya koenigii Leaf extract on carbohydrate metabolism studied in streptozotocin induced diabetic rats”. Int JBiol chem 1.1 (2007): 21-28.
21. Nishan M and Subramaniam P. “Murraya koenigii (curry leaves). a review on its potential”. international journal of pharm Tech Research 7.4 (2015): 566-572.

Curry Leaf (Murraya koenigii) is a South Asian native that is used in a variety of cuisines for its flavour and smell. Herbal drugs, which are relatively affordable and have few side effects, have long been used to treat a wide range of ailments. Curry Leaf is commonly utilised in traditional Ayurvedic medicine. Small deciduous shrub having medicinal and nutritional properties that could make it a future industrial crop. Murraya koenigii contains antibacterial, antifungal, and antiprotozoal effects, according to the literature, particularly in the leaf, stem, bark, and oil. The herb as a whole is used as a tonic and stomachic. The purpose of this research is to look at the classification, origin, physical properties, and traditional usage of curry leaf around the world.

Keywords: Extracts; Leaves

References

1. Zelkowitz P. “Prematurity and its impact on psychosocial and emotional development in children”. Encyclopedia of Early Childhood Development (2017): 1-3.
2. Singer L., et al. “A longitudinal study of developmental outcome of infants with bronchopulmonary dysplasia and very low birth weight”. Pediatrics 100.6 (1997): 987-93.
3. Platt MJ. “Outcomes in preterm infants”. Public health 128.5 (2014): 399-403.
4. World Health Organization. WHO recommendations on interventions to improve preterm birth outcomes.
5. Goldenberg RL and Culhane JF. “Low birth weight in the United States”. The American journal of clinical nutrition 85.2 (2007): 584S-90S.
6. Behrman RE and Butler AS. Preterm birth: causes, consequences, and prevention.
7. Johnson TJ., et al. “Economic benefits and costs of human milk feedings: a strategy to reduce the risk of prematurity-related morbidities in very-low-birth-weight infants”. Advances in nutrition 5.2 (2014): 207-12.
8. Tucker J and McGuire W. “Epidemiology of preterm birth”. Bmj 329.7467 (2004): 675- 8.
9. Purisch SE and Gyamfi-Bannerman C. “Epidemiology of preterm birth”. InSeminars in perinatology 41.7 (2017): 387-391.
10. Cutland CL., et al. “Low birth weight: Case definition & guidelines for data collection, analysis, and presentation of maternal immunization safety data”. Vaccine 35.48 (2017): 6492-6500.
11. Quinn JA., et al. “Preterm birth: Case definition & guidelines for data collection, analysis, and presentation of immunisation safety data”. Vaccine 34.49 (2016): 6047-56.
12. McCarthy R., et al. “Mouse models of preterm birth: suggested assessment and reporting guidelines”. Biology of reproduction 99.5 (2018): 922-37.
13. Seidel HM., et al. “Mosby's Guide to Physical Examination-E-Book”. Elsevier Health Sciences (2010).
14. Tunon K., et al. “Gestational age in pregnancies conceived after in vitro fertilization: a comparison between age assessed from oocyte retrieval, crown‐rump length and biparietal diameter”. Ultrasound in Obstetrics and Gynecology 15.1 (2000): 41-6.
15. Cech DJ and Martin ST. “Functional Movement Development Across the Life Span-E-Book”. Elsevier Health Sciences (2011).
16. Adolph KE and Berger SE. “Motor development”. Handbook of child psychology 2 (2007): 39
17. Cui LR., et al. “Physical and occupational therapy utilization in a pediatric intensive care unit”. Journal of critical care 40 (2017): 15-20.
18. Marks K., et al. “The thorny nature of predictive validity studies on screening tests for developmental-behavioral problems”. Pediatrics 122.4 (2008): 866-8.
19. Shapiro-Mendoza CK and Lackritz EM. “Epidemiology of late and moderate preterm birth”. InSeminars in Fetal and Neonatal Medicine 17.3 (2012): 120-125.
20. Stoinska B and Gadzinowski J. “Neurological and developmental disabilities in ELBW and VLBW: follow-up at 2 years of age”. Journal of Perinatology 31.2 (2011): 137-42.
21. Rebage V., et al. “Neurological newborn in our center and follow-up”. Revista de neurologia 47 (2008): S1-13.
22. Newborn A. “Hospital discharge of the high-risk neonate”. Pediatrics 122.5 (2008): 1119-26.
23. Amorim RC., et al. “Family health program: proposal to identify risk factors for neuropsychomotor development”. Brazilian Journal of Physical Therapy 13 (2009): 506-13.
24. Kayenne Martins Roberto Formiga C, Linhares MB. “Motor development curve from 0 to 12 months in infants born preterm”. Acta Paediatrica 100.3 (2011): 379-84.
25. Celik HI., et al. “Investigation of the relationship between sensory processing and motor development in preterm infants”. American Journal of Occupational Therapy 72.1 (2018): 7201195020p1-7.
26. Malina RM. “Motor development during infancy and early childhood: Overview and suggested directions for research”. International journal of sport and health science 2 (2004): 50-66.
27. Adolph KE and Berger SE. “Motor development”. Handbook of child psychology (2007).
28. de Kieviet JF., et al. “Motor development in very preterm and very low-birth-weight children from birth to adolescence: a meta-analysis”. Jama 302.20 (2009): 2235-42.
29. van Vliet EO., et al. “Perinatal infections and neurodevelopmental outcome in very preterm and very low-birth-weight infants: a metaanalysis”. JAMA pediatrics 167.7 (2013): 662-8.
30. Wallois F, Routier L and Bourel-Ponchel E. “Impact of prematurity on neurodevelopment”. InHandbook of clinical neurology 173 (2020): 341-375.
31. Walhovd KB., et al. “Long-term influence of normal variation in neonatal characteristics on human brain development”. Proceedings of the National Academy of Sciences 109.49 (2012): 20089-94.
32. Valentini NC., et al. “Motor trajectories of preterm and full‐term infants in the first year of life”. Pediatrics International 61.10 (2019): 967-77.
33. YH Jeng SF., et al. “Gross motor trajectories during the first year of life for preterm infants with very low birth weight”. Physical therapy 97.3 (2017): 365-73.
34. Piper MC., et al. “Construction and validation of the Alberta Infant Motor Scale (AIMS)”. Canadian journal of public health= Revue canadienne de sante publique 83 (1992): S46-50.
35. Jeng SF., et al. “Alberta infant motor scale: reliability and validity when used on preterm infants in Taiwan”. Physical therapy 80.2 (2000): 168-78.
36. Restiffe AP and Gherpelli JL. “Comparison of chronological and corrected ages in the gross motor assessment of low-risk preterm infants during the first year of life”. Arquivos de neuro-psiquiatria 64 (2006): 418-25.
37. Van Haastert IC., et al. “Gross motor functional abilities in preterm‐born children with cerebral palsy due to periventricular leukomalacia”. Developmental Medicine & Child Neurology 50.9 (2008): 684-9.
38. De Kieviet JF., et al. “Motor development in very preterm and very low-birth-weight children from birth to adolescence: a meta-analysis”. Jama 302.20 (2009): 2235-42.
39. Månsson J, Fellman V and Stjernqvist K. Express Study Group (authors). “Extremely preterm birth affects boys more and socio‐economic and neonatal variables pose sex‐ specific risks”. Acta paediatric 104.5 (2015): 514-21.
40. Inder TE., et al. “Defining the nature of the cerebral abnormalities in the premature infant: a qualitative magnetic resonance imaging study”. The Journal of pediatrics 143.2 (2003): 171-9.
41. Goyen TA., et al. “Eye–hand coordination skills in very preterm infants< 29 weeks gestation at 3 years: effects of preterm birth and retinopathy of prematurity”. Early human development 82.11 (2006): 739-45.
42. O’Shea TM., et al. “Intraventricular hemorrhage and developmental outcomes at 24 months of age in extremely preterm infants”. Journal of child neurology 27.1 (2012): 22-9.
43. Beligere N., et al. “Neurodevelopmental Disabilities in Children with Retinopathy of Prematurity: A Report from India”. Int J Ophthalmol Clin Res 7 (2020): 114.
44. Stylianou-Riga P., et al. “Maternal socioeconomic factors and the risk of premature birth and low birth weight in Cyprus: a case–control study”. Reproductive health 15.1 (2018): 157.
45. Kepenek-Varol B., et al. “Assessment of motor development using the Alberta Infant Motor Scale in full-term infants”. Turk J Pediatr 62.1 (2020): 94-102.