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Road infrastructure serves as the primary medium of economic and agricultural transportation in developing countries. Afghanistan’s district roads play a critical role in connecting rural production centers to markets; however, systematic maintenance is often hindered by inadequate funding, lack of structural monitoring, and climatic deterioration. This research develops pavement condition assessment and deterioration prediction models using Pavement Condition Index (PCI), pavement age, characteristic rebound deflection (Dc), and Average Annual Daily Traffic (AADT). Multiple regression models were generated based on recorded field data across six district road sections in Herat Province. Regression coefficients demonstrated high goodness of fit (R² = 0.964 – 0.992), indicating reliable predictive capability. Based on PCI-based prioritization, maintenance strategies were ranked and scheduled under budget constraints. Results indicate that Sections D01 and D02 urgently require rehabilitation due to structural fatigue and distress propagation, while other sections can be preserved through preventive maintenance. This study provides a scientifically supported PMS framework for Afghan district roads, enabling optimized resource allocation, deterioration forecasting, and long-term serviceability planning.

The effect of the novel coronavirus (SARS-CoV-2) pandemic has produced significant health concerns negatively impacting individuals. As the ongoing and constantly changing nature of SARS-CoV-2 continues, the unique characteristics of this pandemic trend toward anxiety and loneliness as significant behavioral health outcomes. Furthermore, the SARS-CoV-2 pandemic has significantly impacted the utilization of social media platforms such as Twitter. Utilizing over 1.6 million tweets from approximately 988,760 Twitter users geolocated in Washington state from the University of Pennsylvania’s publicly available Twitter database (from March 2020 to March 2021), this study evaluated the impact of SARS-CoV-2 by using expressions of loneliness and anxiety to predict mental and physical symptoms. Bivariate correlations revealed expressions of loneliness were correlated to trouble breathing while expressions of anxiety were correlated to skin lesions, body aches, flu-like, seasonal cold, trouble breathing, nausea or diarrhea, fever, chills, and cough. Multiple multivariate linear regressions were completed, and a significant regression equation was found in predicting trouble breathing symptoms on expressions of loneliness and anxiety, however, the proportion of variance was 8% of the observed variation in the model. Further implications revealed the importance of understanding mental and physical well-being during a public health crisis as well as the use of social media platforms as primary and supplementary stimuli.

Background: The main cause of adrenal insufficiency (AI) in paediatric patients is prolonged treatment with corticosteroids. Determination of plasma cortisol (PC) during ACTH test is the most used adrenal function indicator in clinical practice. However, determination of salivary cortisol (SC), a simple test especially useful in children in order to avoid invasive procedures, can be used as an alternative technique for the diagnosis of adrenal disease. Methods: A two-year prospective study (January 2014-January 2016) in paediatric patients (2-18 years of age) treated with corticosteroids for more than fifteen days, who were investigated for suspected AI. Low-dose ACTH test was used to determine adrenal function and samples for SC and PC were obtained simultaneously in basal situation and during the test (at 30, 60 and 90 minutes). Results: 230 samples (118 PC-112 SC) of 30 studies belonging to 20 patients (4 males), mean age 10.93 years ± 3.69 SD. Pearson’s correlation coefficient showed a positive correlation between PC and SC (r = 0.618, p < 0.001). All the studies with some determination of PC higher than 18 μg/dL (n = 8) had a SC peak higher than 0.61 μg/dL with a specificity of 66.67% and a sensitivity of 93.94% (ROC analysis). Conclusion: Measurement of SC is a less invasive, easier and quicker test than PC to measure plasma free cortisol levels. In our study, a SC peak in low-dose ACTH test higher than 0.61 μg/dL was able to discriminate patients without AI, and proved to be a useful tool in the initial evaluation of children with suspected AI.Introduction The activation of the hypothalamic-pituitary-adrenal axis in response to critical illness and the resulting release of cortisol from the adrenal cortex are essential to stress adaptation. Adrenal insufficiency (AI) is described as the inability of adrenal glands to produce an appropriate hormonal secretion not only under stress but also in basal situation. Therefore, a low baseline plasma cortisol (PC) (< 5 μg/dL) and a poor cortisol response to stimulation with exogenous adrenocorticotropic hormone (peak < 18 μg/dL) are some of the defining criteria of this condition [1,2]. It is well known that the main cause of AI in paediatric patients is prolonged treatment with exogenous corticosteroids, which is an iatrogenic cause derived from the increasing complexity of paediatric pathologies and the increased use of prolonged high-dose corticosteroid therapy. In clinical practice, adrenal function is usually assessed by the total PC (determined by low-dose ACTH test). This implies the placement of a vascular access which is often a traumatic experience for children. PC includes protein-bound fraction and serum-free cortisol. The latter constitutes the biologically active form of the hormone and is responsible for glucocorticoid activity on peripheral organs. Most of the circulating cortisol is bound to plasma proteins (over 90%), such as cortisol-binding globulin (CBG) and albumin, whereas only about 10% of circulating cortisol is free. Hence, the measurement of plasma-free cortisol level has been considered more representative of adrenal function (especially in critically ill adults and children) [1,2], because some conditions, such as hypoalbuminaemia or hypoproteinaemia (frequent in critically ill patients or in patients with cirrhosis), may lead to misinterpretation of adrenal function with an overestimation of the prevalence of AI. But the direct measurement of free PC is a laboratory-dependent and time-consuming procedure that is not available for routine use. Salivary cortisol (SC) is one of the several indirect methods available to determine free PC [3], as SC levels accurately reflect free PC [4] even in cases of hypoalbuminaemia or CBG abnormality [1,5]. For this reason, in the last years, this technique (SC) has been introduced as a non-invasive tool in the diagnosis of adrenal cortical disorders, for its simplicity and applicability in the paediatric population. However, few studies to date have evaluated the usefulness of SC as a diagnostic method in children with AI. No interactions between exogenous corticoids and SC have been described [6]. The aim of the present study was to assess the usefulness of determining salivary cortisol levels as a diagnostic tool in children with suspected secondary iatrogenic AI. 

A 3-year-old non-lactating pet goat was referred to our clinic due to advanced ocular lesions and blindness of the left eye (Figure 1). According to the case history, two weeks ago, a grass awn penetrated and injured the eye. The awn was removed by the owner immediately. The following day, the goat had serous ocular discharge and photophobia and was referred to a private veterinarian. The veterinarian did not find any remaining piece of the awn and prescribed tetracaine eye drops to be administered twice a day for the next 4 days. The treatment was not successful and the eye’s condition deteriorated the following days.

Summary: Exercise is recommended for the treatment and prevention of type 2 diabetes. Also, to control and reduce glucose fluctuations in people with type 1 diabetes. However, the most appropriate time and the most effective intensity of exercise is still unknown, and various studies provide different results and different recommendations, and none of the studies provide a comprehensive and practical result. We conducted our studies to examine the results and determine the effect of time and intensity of exercise on blood sugar control and glucose fluctuations during the day. Methods: search in PubMed and Google Scholar with keywords morning, evening, type 1 and 2 diabetes, exercise, interval, periodic, aerobic, and glucose and blood sugar fluctuations were performed. A total of 31 articles were reviewed and finally, 10 articles that were most related to each other or had complementary information were selected. Conclusion: HIIT exercises are useful for type 2 diabetes, but they are recommended for type 1 diabetes with less pressure. Morning exercise increases glucose and evening exercise is applicable for type 1 and 2 diabetes.

A 79 years old woman presented with one-day history of pain, redness, pain and swelling without discharge in her left ear, later her right ear started with the same symptoms as in her contralateral ear spreading around the scalp and the forehead (Figure 1), she denied fever, or other constitutional symptoms. 

Acute pulmonary damage and vascular coagulopathy appear to be frequent in patients with SARS-CoV-2 infection relation to corona-virus. The inflammatory process accompanying the infection and excessive coagulation state is one of the most important causes of patient loss.

Background: Dipylidium caninum, a zoonotic cyclophyllidean tapeworm, mainly infects dogs, cats, and occasionally humans as well. Here, we present D. caninum infection in a domestic cat. A cat of about one year of age with a history of intermittent diarrhea and shedding stool containing whitish cooked rice like soft particles. Methods: The case was identified by thorough clinical, coprological, and parasitological examinations, and treated accordingly.Results: During the physical examination, the cat was found to be infested with flea, and coprological investigation revealed the presence of gravid segments of cestodes. By preparing a permanent slide, we conducted a microscopic examination, and the cestode was confirmed as D. caninum. The cat was treated with albendazole and levamisole, which were ineffective; additionally, levamisole showed toxicity. Then, we administered niclosamide which completely cured the animal. On re-examination after a week, feces were found negative for eggs/gravid segments of any cestode. Conclusion: Niclosamide was found effective against dipylidiasis and can be treated similar infections in pets.

There are a number of key issues that matter to patients and General Physicians (GPs) in the primary care treatment system for severe depression. Patient and doctor narratives can contribute by highlighting these key issues. Various systems are employed in treating severe depression. However, there needs to be an investigation using systems failure methodology and how this methodology is applied which can help identify how and why the NHS treatment system for severe depression can fail patients in terms of provision of effective care.

Introduction: Temporomandibular joint (TMJ) ankylosis is one of the most disruptive anomaly that affects the masticatory system and is referred as permanent movement disfunction of the mandible caused by bilateral or unilateral fibrous or bony adhesions and create problems. The etiology is congenital or idiopathic and include trauma, arthritis, infection, previous TMJ surgery etc. Management requires extensive resection of the ankylotic mass and reconstruction of the ramus-condyle unit with autogenous or alloplastic grafts. Most of the time, combination of surgical treatment with physiotherapy is needed in order to achieve maximum rehabilitation and functionality of the mandible. Purpose: The aim of this study is to present the surgical management of an unusual case of unilateral TMJ ankylosis and recent of literature review. Case report: A thirty-seven-year old patient reported unable moving his lower jaw. Clinical examination revealed unilateral TMJ ankylosis of congenital cause and the lateral movement of the mandible was impossible. The patient surgical treatment included resection of the newly formed bone mass, replacement of the condyle with costo-chondral graft and replaced of articular disc with the temporal fascia. Since and for ten years after surgery the patient shows no signs of relapse. Conclusion: The development of TMJ ankylosis may be congenital or acquired etiology. In order to manage it required a comprehensive clinical and radiographic examination. Surgical resection of the bone and coronoid process on the entire side is necessary and a graft that mimics the articular disc is placed, while it is necessary the immediate postoperative kinesiotherapy.