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Probiotic gummy candy is an innovative food that can be used as a carrier to deliver probiotics. This study aimed to manufacture healthy gummy candy (HGC) as a carrier for probiotic capsules. The ingredients' effect on the viability of probiotic capsules and free cells was evaluated for 48 days under refrigerated conditions. Also, the textural properties, overall acceptability of products, and physicochemical properties were tested. The encapsulation probiotics in sodium alginate and chitosan provided a high efficiency of 88.16%. At the same time, the encapsulated cells-based HGC (HGC-C) had higher counts of probiotics than free cells-based HGC, and it remained above the 3 log CFU/g at the end of the 48-day storage period in HGC-C, while the free cells reached zero at 30 days. The HGC product showed a low hardness value and high antioxidant capacity as well as, and the colour coordinates for the product showed more yellow, with an intense red colour. Using mango pulp and probiotics in gummy candies is an innovative and viable alternative to the confectionery industry; therefore, combining fruits as a source of prebiotics and probiotic bacteria could be a promising formula for probiotics gummy supplement preparation.

Aims: The purpose of this research was to study the effects of preoperative training on static and dynamic balance among female athletes with injured ACLs. Methods: This semi-experimental study involved a 2-group pretest-post-test design. Subjects were 36 (19 control and 17 experimental) female athletes with injured ACLs, that were chosen with the available sampling method. The experimental group did the preoperative training in the eight weeks and the control group did not participate in any training program during this period. Static and dynamic balance and lower body muscle strength were measured. The paired sample T-test was used to compare pre and post-test results and the independent sample T-test achieved comparisons between the two groups. Results: The results indicated that static (with eyes opened and closed) dynamic balance and muscle strength were improved significantly (p < 0.05) in the exercise group, but no significant change (p > 0.05) was found in the control group. Also, significant differences were found in improvement changes results between the two groups (p < 0.05). Conclusion: Results of the study confirmed that preoperative training can have a beneficial effect on improving static and dynamic balance among female athletes with injured ACLs.

According to a 2022 systematic review on the prevalence of psychiatric disorders in general hospitals, it was estimated that approximately one-third of medical inpatients present with a coinciding psychiatric condition. However, other studies have reported that a low rate of patients actually obtain an inpatient psychiatric consult; and even fewer patients receive a consultation when it would not be traditionally indicated. Therefore, we have seen an emergence of the use of Proactive Consultation-Liaison (C-L) Psychiatry across many hospital settings. This model of care utilizes systematic screening for active mental health concerns, proactive interventions tailored to individual patients, team-based delivery, and care integration with primary services to provide psychiatric consultation earlier. This study conducted a focused PubMed search to review the research to date on proactive C-L psychiatry and its impact on hospital length of stay (LOS) in patients over 18 years old. Results show a consequential reduction in average hospital LOS when proactive C-L psychiatry services are used compared to reactive, on-request consultation services. A shortened LOS is seen with this practice when there is a quicker time for consultation or referral. Thus, there is evidence of proactive C-L psychiatry’s success in decreasing average hospital LOS and improving patient care. Additional studies are necessary to determine its significance, as little research to date has been completed on the topic. It is recommended to expand the scope of investigation to different patient populations, including but not limited to pediatrics and patients without an underlying mental health illness.

Usually affecting men in the sixth decade bladder cancer is generally revealed by hematuria or lower urinary tract symptoms. Cutaneous metastases are very rare in genitourinary tumors representing only 1.34% of cutaneous metastases of other neoplasms. The presence of cutaneous metastases is associated with a poor prognosis with a median survival of fewer than 12 months.We reported the case of a 65-year-old man current smoker who presented a cutaneous metastasis of urothelial bladder cancer confirmed after a cutaneous biopsy, palliative chemotherapy was initiated after multidisciplinary staff.

Background: We previously reported, for the first time, serum levels of the C-terminal fragment of fibroblast growth factor 23 (C-FGF23) in patients undergoing hemodialysis (HD). Most HD patients have undergone treatment with either recombinant erythropoietin (r-EPO) or hypoxia-inducible factor (HIF) proline hydroxylase domain (PHD) inhibitor, both of which stimulate FGF23 production and cleavage. Methods: This cross-sectional observational study involved analyzing measuring FGF-related parameters and comparing results for subgroups of patients who received either r-EPO and or a PHD inhibitor. Results: No significant difference was observed for iron-related parameters or serum hepcidin levels in both subgroups of patients. Significant differences were found for certain FGF-23-related parameters. Conclusion: Both FGF23 production and cleavage were stimulated more in patients treated with the PHD inhibitor than in patients treated with r-EPO.

The torsional deformation behavior of an elastic bar with a circular cross-section was investigated by applying invariant dyadic analysis, where the small finite displacement functions advocated by Saint-Venant (1855) were fully employed. It was found that the previously overlooked circumferential shear force field generated by pure torsion on the side walls of a bar produces an unusual torque term induced by the skew-symmetric part of the deformation tensor and exhibits quadratic length dependence along the z-axis of the bar. The adaptation of this torque term for a helical conformation of α-peptides creates moments acting on the circular cross-sections and is directed along the surface normal of circular cross-sections, which coincides with the tangent vector of the helix. The projection of this torque along the z-axis of the helix varies quadratically with the azimuthal angle. The radial component of the unusual torque, which also lies along the principal normal vector of the helix, starts to perform a precession motion by tracking a spiral orbit around the z-axis, whereas its apex angle decreases asymptotically with the azimuthal angle and finally reaches a finite value depending on the height of the helix along the z-axis. The ordinary torque terms, which are also deduced from the self- and anti-self-conjugate parts of the deformation tensor, have magnitudes half that of the full torque term reported in the literature. The present results were applied to the helical conformation of α-peptides designated by {3.611} to show that the mechanical stability of strained open-ended helical conformations can be successfully achieved by spontaneous readjustments of the surface and bulk Helmholtz free energies under isothermal isochoric conditions. It has been demonstrated that the main contribution to the mechanical stability of α-peptide 3.611 cannot come alone from the electrostatic dipole-dipole interaction potential of the anti-align excess dipole pairs but also from the surface Helmholtz free energy, which is characterized by a binding free energy of -15.5 eV/molecule (-32.56 Kcal/mole) for an alpha-peptide composed of 11 amino acid residues with a critical arc length of approximately 10 nm, assuming that the shear modulus is G = 1GPa and the surface Helmholtz specific free energy density is fs = 800 erg/cm2. This result was in excellent agreement with the experimental observations of the AH-1 conformation of (Glu)n Cys at pH 8. The present theory indicates that only two excess permanent anti-align dipole pairs for one α-Helical peptide molecule is requirement to stabilize the whole secondary structure of the protein that is exposed to heavy torsional deformation during the folding processes which amounts to 7.75 eV/molecule stored electrostatic energy compared to the interfacial Helmholtz free energy of -23.25 eV/molecule, which is exposed to hydrophobic environments.

A recurrent miscarriage may be defined in the African context as the foetal demise of two or more successive pregnancies before the attainment of the age of viability. A literature review was done to assess the trend of recurrent miscarriage in sub-Saharan Africa. Identifying the main causes, considering the population at risk, and the availability of accurate diagnostic utilities to effectively ensure good management of recurrent miscarriage is an important gynaecologic issue. Over the years, studies have identified several etiologies and yet there’s been no tangible implementation of therapeutic strategies. Routine modifications should also be employed to develop new approaches to reproductive prognosis. There is notably scanty information on the cases of spontaneous abortion due to chromosomal abnormalities. Genetic and immunological factors should be considered in the work-up plan for women with RM. About 70% of the cases of RM are considered unexplained, and this may be due to limited resources. We concluded that there is relatively poor management of miscarriage and cases of missed and inaccurate diagnosis of the causes of spontaneous abortion in sub-Saharan Africa. More studies are needed in order to assess the extent of genetic induced miscarriage, where resources are limited, folic acid supplements should be provided for pregnant women.

A prospective cross-sectional study of diabetic patients registered at the Eye department of Tobruk Medical Center in Tobruk-Libya between (01.06.2023 to 29.02.2024). At the same time data was collected in the eye department in Alwahda Derna Teaching Hospital, Data was collected using the same administered questionnaire. Grading of DR was done by slit-lamp examination and Fundoscopy by an ophthalmologist. Descriptive analysis included percentage mean, median, and p - value by using SPSS 25. There were 185 diabetic patients, ages ranging between 30 and 90 years, with a mean of 58, the majority (97.6%) were of Libyan nationality. There were 86 males and 99 females. Patients with a duration of diabetes ranging between 11 and 15 years were at almost a five-fold risk of developing DR compared to those with a duration of < 10 years. Most of advanced complicated diabetic retinopathy cases had diabetes for more than fifteen years, and no advanced disease in the cases with a duration of less than 10 years.

Background: SARS-CoV-2 is increasingly recognized for its cardiovascular complications. To address the knowledge gap in our region, this study investigated the relationship between electrocardiographic (ECG) features and in-hospital mortality among COVID-19 patients.Methods: A prospective cohort study was conducted involving 140 RT-PCR-confirmed COVID-19 patients at Dhaka Medical College Hospital from August 2021 to July 2022. Patients were divided into two groups based on ECG findings: normal (Group A) and abnormal (Group B). Clinical data and ECG parameters were analyzed using SPSS 24.0.Results: Patients with abnormal ECGs were older, more likely male, and presented with higher rates of dyspnea and palpitations. They were also at increased risk of severe COVID-19 and had longer hospital stays. In-hospital mortality was significantly higher in Group B (21.4% vs.4.3%). ST-T changes and atrial fibrillation were associated with increased mortality. Independent predictors of in-hospital mortality included ECG abnormalities and admission SpO₂ < 90%.Conclusion: ECG abnormalities are significantly associated with adverse outcomes in COVID-19 patients. Further large-scale studies are warranted to strengthen these findings.

Insulin resistance, often referred to as impaired insulin sensitivity. This clinical case focusses on a woman with insulin resistance and a long-standing and recurring history of obesity to demonstrate how diet therapy can be applied in addition to standard medication therapy.

The aim of this work is to verify the pharmaceutical form in the galenic field of oral Budesonide compounded used in Crohn’s disease: capsules delay release or oral suspension. In particular ways the kinds of excipients or bases-vehicle used in the galenic pharmacy practice. The therapeutic need for Crohn’s disease requires a release of the API in delayed-release DR. The Budesonide molecule shows low systemic impacts due to its hepatic metabolism vs. a topical effect useful in this pathology. In this work, the oral pharmaceutical forms are analyzed: modified-release capsules and oral suspension with specific advantages for each one. Some formulations provided by various pharmacies are reported in this work as well as new technology like the 3D-PRINTING systems for colonic targeting tablets.

Background: The frequency of latex allergy is increasing, posing a major health problem. This increase is related to the widespread use of latex materials and cross-reactions between latex proteins and certain foods. This cross-reactivity makes latex avoidance difficult, and latex sensitization is likely to worsen atopic conditions. Objective: The authors evaluated the role of latex sensitization in the poor control of asthma and rhinitis. Methodology: An analytical cross-sectional study was conducted on 1860 patients of all ages and genders, followed up for allergic asthma and rhinitis since March 2012 in the Immuno-Allergology Unit of the Cocody University Hospital in Abidjan. Prick tests with native extracts and the European standard battery were performed to identify allergenic sensitization. The impact of latex sensitization on asthma and rhinitis control was assessed by calculating odds ratios. Results: A high frequency of latex sensitization was associated with asthma and rhinitis. The risks of poor control were related to monosensitization to latex and were even higher in the context of polysensitization. Conclusion: The impact of latex sensitization on the progression of asthma and rhinitis has been well demonstrated. It is recommended to integrate the latex sensitization status into the therapeutic management strategy of these two pathologies.

Venous Thromboembolism (VTE) is a major public health concern, affecting approximately 900,000 people annually in the United States. In rare cases, a Patent Foramen Ovale (PFO) may allow a venous thrombus to cross into the arterial circulation, causing a paradoxical embolism. This case report presents a 46-year-old male who developed left renal artery stenosis after a paradoxical embolism, likely triggered by a prolonged flight and binge alcohol consumption. The patient was found to have a moderate-sized PFO and renal infarction, confirmed by imaging studies. Despite initial anticoagulation therapy and a planned stenting procedure, intraoperative findings revealed only mild stenosis, leading to cancellation of the stent placement. The patient ultimately underwent PFO closure with an Amplatzer Talisman device. This case underscores the diagnostic challenges in managing paradoxical embolism and the need for individualized treatment, particularly concerning anticoagulation duration, the decision for PFO closure, and post-procedural antithrombotic therapy. Further research is required to establish optimal management strategies for cryptogenic embolic events.

Cutaneous Angioleiomyoma is a very rare benign tumour of which incidence is unknown. We report a case of a 42-year-old male patient who presented with a symptomless solitary nodule over the left nostril for one and a half years duration. Complete surgical excision of the tumour was done and the sample was sent for histopathological examination. Diagnosis of this tumour was done on the evidence of histopathological examination with haematoxylin and eosin mounts. Sometimes achieving the best aesthetically accepted results may be challenging due to the site of involvement. 

Flooding is a significant natural hazard impacting societies worldwide, with increasing severity in urbanized regions. This paper presents a case study of Lagos, Nigeria, examining flood risk management efforts in the city. The purpose is to evaluate the effectiveness of current strategies and suggest improvements for reducing the impacts of flooding. Findings highlight the roles of government and private stakeholders, as well as policy challenges. Recommendations for sustainable flood management practices are provided, with implications for other high-risk areas. 

Previable Preterm Premature Rupture of Membranes (PPROM) before 24 weeks of gestation in dichorionic diamniotic (DCDA) twin pregnancies is a rare and challenging obstetric complication. Three cases are presented in this case series, all involving prolonged latency periods of 74, 98, and 158 days following membrane rupture. The management strategy employed was expectant, utilizing antibiotic prophylaxis and close monitoring to prevent infection. Neonatal outcomes varied, with pulmonary hypoplasia and respiratory distress observed in some cases. One twin from Case 2 died due to sepsis, while the remaining twins in all three instances survived after extended neonatal intensive care. This series highlights the potential for extended latency and favorable outcomes in select cases, though neonatal morbidity remains a significant risk, underscoring the need for individualized counseling and vigilant care.

This paper examines the effects of globalization on nations, focusing on economic, social, and cultural dimensions. It analyzes the roles of protectionism and globalization in shaping consumer welfare and producer earnings through qualitative methods and the Customs Union theory framework. The study discusses the benefits and drawbacks of globalization in the context of World Trade Organization (WTO) regulations. The findings indicate that globalization has intensified financial flows between countries, which can exacerbate economic crises. Countries with abundant human resources can capitalize on the international division of labor to specialize in high-value sectors, while those with limited resources risk falling behind in the digital landscape. This division of labor fosters specialization and improves production efficiency through targeted education. However, multinational corporations often impede cost-effective production in developing nations, underscoring the necessity to restructure research and development to facilitate technology adoption in underdeveloped areas. This restructuring can help close the technological gap and encourage equitable participation in the global economy. Jel code Classification: D6: Welfare economics, Fo1 Global outlook, F40: General F4: Macroeconomics aspects of international trade and finance

Pneumomediastinum (mediastinal emphysema) is an uncommon condition characterized by the accumulation of air or gas in the mediastinum. Here is a case of a 16-year-old female known to have depression who presented to the emergency department with complaints of shortness of breath, restlessness, chest discomfort, and hoarseness of voice for 2 days. She was initially diagnosed with panic attack, and later on clinical examination, surgical emphysema over the right supraclavicular area was noticed. Chest X-ray was found to be normal, and further imaging with high-resolution computed tomography (HRCT) of the thorax showed pneumomediastinum. In this report, the clinical presentations, radiological features, and management of pneumomediastinum will be discussed.

Many studies from the early 20th century on the significance of the pores of Kohn were assessed based on the pathogenesis and pathology of pneumococci pneumonia occurring in man. The pneumococci were carried in the edema fluid directly from alveolus to alveolus through the pores of Kohn and from bronchiole to bronchiole as a result of repeated aspirations, aided by breathing, coughing, and gravity. With the emerging minimally invasive and non-invasive techniques experimentations and the current medications; tackling exacerbations and improving the pulmonary function in various lung diseases remains a dilemma for clinicians and researchers. In this article, we aim to review specifically the pores of Kohn as this is the portal for the spread of infection but also lung recruitment during breathing.

Background: One of the problems in vitro fertilization (IVF) treatment for infertility is the high frequency of embryo developmental arrest in the preimplantation stages. Arrested embryos were not selected for transfer and were usually discarded. Case report: We present a case of clinical pregnancy and live birth following IVF treatment and transfer of one arrested embryo. A 31-year-old woman with unexplained infertility underwent IVF treatment. Using the IVF procedure, 7 embryos were produced which were frozen on day 3. In order to embryo transfer in the blastocyst stage, two embryos were thawed and cultured for 2 days. After thawing, one of them was not suitable for transfer and another embryo was arrested at the 10-12 cell stage. Discussion: The Clinical pregnancy and live birth happened after the transfer of an arrested embryo on day 5.Conclusion: This case showed that arrested embryos may resume growth after the transfer to the uterus and result in a successful pregnancy and live birth.