Articles

Background: Employee performance appraisal is essential for improving healthcare service delivery through systematic staff evaluation. In the health sector, effective appraisals support decision-making and professional development.Objective: This study aims to map and categorize existing employee performance appraisal methods in the health system using a scoping review approach.Methods: This scoping review was conducted using the JBI 2024 protocol. Articles published up to December 2024 were identified through four databases: PubMed, Scopus, Web of Science, and Google Scholar. The keywords used were “Personnel appraisal,” “Health workers,” and “Health workforce.” The inclusion criteria focused on studies assessing employee appraisal methods in health systems.Results: Of the 1,245 articles initially identified, 18 met the inclusion criteria. Appraisal methods were classified into traditional and modern categories. Traditional methods included ranking, critical incidents, and graphic rating scales. Modern approaches involved 360-degree feedback, Management by Objectives (MBO), and Behaviorally Anchored Rating Scales (BARS).Conclusion: No single appraisal method suits all healthcare environments. A hybrid approach tailored to organizational context and job roles is recommended. Emphasis should be placed on objective evaluation, customization, and the degree of scientific connection between the evaluator and the evaluated person to improve performance outcomes.

Depression, trauma, and anxiety disorders continue to be predominant causes of global disability, with typical therapies proving to be only marginally successful. Heart Rate Variability Biofeedback (HRVB) offers patients a self-regulation method that improves the flexibility of the autonomic nerve system via resonance breathing. Clinical research shows that training can significantly lower symptoms of sadness and PTSD, with improvements shown after 4 to 8 weeks. HRVB is inexpensive, non-invasive, and scalable, making it a promising supplementary therapy in psychiatry. Subsequent study ought to inform its incorporation into clinical protocols.

Prolactin (PRL), a hormone traditionally associated with lactation, has been increasingly recognized for its significant role in the immune system. This paper explores the multifaceted functions of PRL, particularly its contribution to immunosuppressive and corticosteroid drug unresponsiveness, commonly referred to as drug resistance. Hyperprolactinemia has been observed in various autoimmune diseases such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), systemic sclerosis (SSc), Sjögren’s syndrome (SS), and multiple sclerosis (MS). The association between PRL and these diseases is partly explained by the proximity of the PRL gene to the HLA-DBR1 region on chromosome 6, suggesting a genetic link to autoimmune pathogenesis. Furthermore, PRL’s interaction with immune cells, including T-cells, B-cells, and macrophages, as well as its production by these cells, underscores its role in modulating immune responses. This paper hypothesizes that hyperprolactinemia contributes significantly to the resistance to immunosuppressive and corticosteroid therapy frequently observed in autoimmune diseases. The mechanisms involve PRL’s interference with corticosteroid receptor signaling pathways, STAT5 pathways, and the IL-2 receptor pathways, leading to diminished anti-inflammatory effects. Furthermore, PRL is involved in PRL/JAK2 interactions, activation of the Ras/Raf/MAP kinase pathways, as well as the pathways involving the Src family of kinases (e.g, Fyn) and SHP2, IRS-1, and PI-3 kinase activation. In vitro and animal studies further support the immunomodulatory effects of PRL, demonstrating its ability to alter lymphocyte sensitivity to corticosteroids and immunosuppressive drugs. This comprehensive review aims to elucidate the complex interplay between PRL and the immune system, highlighting the potential for targeting PRL pathways in the treatment of autoimmune diseases and overcoming drug resistance.

Sagittal split osteotomy (SSO) of the mandible is still an important part of orthognathic surgery, but “bad split” fractures that happen during the surgery are still a big problem. This report describes a rare case of bilateral bad split associated with highly compact mandibular bone (D1–D2 type) in a 53-year-old male undergoing mandibular advancement. The bone was too hard for the piezoelectric and rotary tools to work, and there was very little bleeding. This caused fractures in the cortex and lingual. Postoperative computed tomography confirmed the presence of highly dense bone, correlated with delayed healing and recurrence. Consistent pre-surgical CT scanning for an assessment of the density of the mandibular bone can provide essential information about the potential risk of the osteotomy procedure in the patient. Performing a careful bone quality and density examination pre-operatively will allow the surgeons to select the most appropriate instruments and surgical techniques that will fit the patient’s individual anatomy. Such a point escalates to being very significant when dealing with the geriatric population, as bone density increase can not only alter the fracture behavior but also the recovery process during and after surgery. The inclusion of regular CT-based bone density evaluations into the preoperative routine not only facilitates the anticipation of surgical difficulties but also results in safer and more efficient osteotomies.

Aims: The study was conducted from January to June 2023 to observe the prevalence of repeat breeding syndrome in cows, to isolate and identify the bacteria with their molecular confirmation, and antibiotic sensitivity in Bangladesh. Study design & Place and duration of study: The study was conducted under the supervision of the Department of Medicine, Surgery, and Obstetrics, Hajee Mohammad Danesh Science and Technology University, Dinajpur-5200. Some laboratory work was performed at the Microbiology Department of Pathology and Parasitology laboratory, HSTU, from January to June 2023.Methodology: A questionnaire was used to identify repeat breeding syndrome. Bacteria were isolated and identified from the cervical mucus of affected cows. For confirmation of the detected bacteria, PCR was used. The agar disc diffusion method was utilized to investigate the antibiotic sensitivity of the detected isolates against widely used antibiotics in vitro. Results: The prevalence of Repeat Breeding (RB) was 41.33%. The prevalence of E. coli was 40%, Staphylococcus aureus 40% and Klebsiella spp. 10%. Molecular detection of E. coli and Staphylococcus aureus was confirmed by using Eco 223 (F), Eco 455 (R), Sau 234(F), and Sau 1501(R) primers. The target genes were 16S and 23S rRNA, and the size of the product amplified at 232 bp and 1267 bp, respectively. According to the antibiogram profile, E. coli was resistant to ciprofloxacin, penicillin, tetracycline, amoxicillin, and erythromycin, but sensitive to ceftriaxone and gentamicin. While Staphylococcus aureus was resistant to ampicillin and erythromycin, it was sensitive to ciprofloxacin, ceftriaxone, and levofloxacin. It was also intermediately resistant to vancomycin and amoxicillin. Klebsiella spp. Showed resistance to ceftriaxone, penicillin, and amoxicillin, while remaining sensitive to ciprofloxacin, tetracycline, and intermediate resistance to erythromycin and gentamicin. Conclusion: This study concluded that E. coli, Staphylococcus aureus, and Klebsiella spp. are the most common bacteria causing repeat breeding syndrome in cows.

Background: Atrophic scars following acne vulgaris are considered an aesthetic, psychological, and social problem for patients, and despite the existence of many treatment options, finding modern treatments is a necessity to reduce side effects associated with current therapies and reduce the financial burden on patients.Objectives: to evaluate the efficacy of punch elevation combined with dermapen in treating atrophic scars following acne vulgaris on the cheeks, and to evaluate patients' satisfaction with this procedure.Methods: This clinical trial involved 19 patients to evaluate the efficacy of punch elevation combined with dermapen in treating post-acne scars.Results: According to the Goodman and Baroon scale for acne scars, and after 6 months, the percentage of grade 4 decreased from 26.3% to 10.5%, grade 3 decreased from 73.7% to 31.6%, grade 2 increased from 0% to 52.6%, and grade 1 increased from 0% to 5.3%. p - value was less than 0.005, indicating a relationship between the degrees of atrophic scars on the Goodman-Baron qualitative scale after 6 months of treatment. According to the improvement scale, good improvement was 10.5%, acceptable improvement was 57.9% and no improvement was 31.6%. Patients were satisfied with the procedure after 3-6 months according to the modified Global Aesthetic Improvement Scale for Patient Evaluation.

With the rapid shift to telemedicine during the COVID-19 pandemic, clinicians have faced unprecedented demands in adapting to prolonged virtual consultations. This has given rise to “Zoom fatigue,” a form of mental and emotional exhaustion associated with extended video-based interactions. While the Zoom Exhaustion and Fatigue Scale (ZEFS) has been widely applied in studies involving students and office workers, there is limited research on its relevance to clinicians. Physicians, in particular, often conduct hours of uninterrupted virtual patient care, which can potentially lead to significant neurocognitive strain. This study explores the impact of prolonged virtual consultations on clinician well-being, employing ZEFS alongside the Depression, Anxiety, and Stress Scale (DASS-21) and Satisfaction with Life Scale (SWLS) to assess emotional and cognitive outcomes. Findings suggest that the increased cognitive load, reduced non-verbal communication, and digital interface stress contribute to higher levels of fatigue, anxiety, and dissatisfaction, highlighting the urgent need for systemic support and ergonomic telehealth practices.

Excipients are fundamental components of galenic formulations, critically influencing the safety and efficacy of the final medicinal product. This is of paramount importance in neonatal and pediatric populations, where physiological immaturity results in significant differences in pharmacokinetics and pharmacodynamics compared to adults. This work provides a comprehensive overview of excipients and vehicles used in galenic preparations for these vulnerable groups. It highlights specific excipients known to be dangerous, detailing their mechanisms of toxicity, and suggests safer alternatives. The discussion covers formulations for oral solutions, suspensions, and topical dermatological use, including ready-to-use vehicles. The role of the prescribing physician and the verifying pharmacist is emphasized, underscoring the necessity of checking for efficacy, safety, incompatibilities, and microbiological compatibility. The results of a practical five-year local experience with an observational analysis are provided.Furthermore, innovative technologies such as 3D printing for pediatric dosage forms are discussed. The conclusion asserts that a rigorous, risk-based assessment of excipients is essential in neonatal and pediatric galenic practice to ensure patient safety.

Fungus is a gathering of eukaryotic life forms that include microorganisms. As of late, the fungus has assumed a part in criminological science and has been utilized in criminal examination as a source of information. As organisms show both sexual and agamic reproduction in their life cycle, they are utilized as a scattering specialist. The investigation of growths is called mycology. Legal mycology is the part of science that portrays the types of growth. Utilizing the limit of the study of fungus distinguishing proof, which step by step opens its place as a device to recognizing tests and investigations in mycology, showed that certain chemoecological gatherings of organisms can go about as over the ground grave markers, in contrast to plants. Organisms can likewise develop on, for instance, stone, block, tiles, wood, and so on. The principal agent tracked down the primary key of contagious gathering in determining the time of body passing. The scientific mycology structures the contagious local area, they give the date after death and post entombment spans. The microbial clock has been created utilizing society-free high-throughput sequencing in a model framework. The extension to issues worried about common examination where there are clinical ramifications. Organisms were cultured from the mucosal swabs, skin scratching, hair, and lung biopsies. The organisms exist in numerous climates. The parasitic spores are created in huge amounts and spread without any problem. Which can frequently track down the person in question. (Garments, hair, or skin). As a follow-up, proof is searched for, and shape spores are tracked down in paleontological readiness. Spores are utilized for ordered qualities and the identification of species-level. The environmental and palynological data showed proof of a connection between the suspect and where the body was kept. During the examination of the parasite, we can recognize the reason for death, the season of death, find a covered carcass, and so on. As per the going timeframe, specific growth shows specific qualities at specific climate.

Introduction: Forensic odontology is a specialized field at the crossroads of dentistry and law, focusing on the analysis of dental evidence in legal investigations. Due to their resistance to decay and environmental degradation, teeth serve as a vital resource in age estimation and gender determination. Various techniques, including microscopic examination of the incremental lines in enamel and cementum, neonatal lines, and dentin translucency, are commonly employed for forensic analysis. To enhance the accuracy and ease of examination, there is an increasing demand for high-quality, non-demineralized tooth sections that are durable, easy to handle, and maintain uniform thickness. Aims and objectives: 1. Evaluate the effectiveness of the Rosin stain in identifying incremental lines in hard dental tissues. 2. Compare Rosin stain with Haematoxylin and Eosin stain as well as with unstained sections. Materials and methods: Sixty sound teeth were included in the study. Thin longitudinal sections of 2 mm were prepared using a diamond disc, and ground sections of 25 µm were prepared on Arkansas stone. The sections were divided into three groups: (A) sections stained with Rosin, (B) sections stained with H&E, and (C) unstained sections. The longitudinal ground sections were examined under both the Light Microscope and the Phase Contrast Microscope. The Microstructures of the teeth, such as incremental lines of enamel, dentin, and cementum, were assessed.Result  and conclusion: Rosin-stained ground sections observed under phase contrast microscopy provided better visualisation of dental microstructures than unstained or H&E-stained ground sections, suggesting Rosin enhances the identification of incremental lines in forensic dental analysis.