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Stevia is a natural sweetener that has gained attention as a potential sugar substitute for glycemic control and weight management. Extensive research has shown that high sugar consumption is linked to obesity, dental caries, and other health issues. Stevia, derived from the Stevia rebaudiana plant, offers sweetness without calories and has a favorable glycemic profile. Studies have demonstrated its effectiveness in regulating blood glucose levels and reducing overall sugar and caloric intake. Consumer attitudes suggest a positive reception of Stevia as a sugar substitute among health-conscious individuals. However, further research is needed to understand its long-term effects and consumer sentiments. Future investigations should prioritize human clinical trials, targeted studies in diabetic populations, and exploration of Stevia’s interaction with gut microbiota, among other aspects. Stevia shows promise as a health-conscious alternative in glycemic control and weight management.

A critical component of the radiation regimen for treating cancer patients is the precise dose delivery to the treatment organ while minimizing the dose to the healthy tissue. This study aims to evaluate in-field organ dose and dose distribution outside the target organs to estimate the excess lifetime risk of second cancer. The study was carried out with a male Alderson Rando Phantom. 20 sets of thermoluminescence dosimeters (MTS-100) were used in this study. The in-field organs absorbed dose was measured by inserting TLDs at different geometrical depths of the left lung, right lung, and stomach, and for peripheral organs skin dose TLDs were placed at the surface of the corresponding organs. Target organs were irradiated at 100 cGy and 200 cGy by a 60Co teletherapy unit, and irradiated TLDs were read out by a RE-2000 TLD reader. For precise dose delivery to the cancerous organs by 60Co teletherapy, the depth dose correction factor for lung cancer treatment is 0.8667 ± 0.01, and for the stomach is 0.7856 ± 0.017. In the case of the treatment for the lung and stomach, the closest organs received significant doses compared to the other distant organs. Thus, the risk of second cancer due to the peripheral dose is obtained. The stomach is at the highest risk when the lung is the target and the liver is at the highest risk when the stomach is the targeted organ.

Anal melanoma is a rare and highly aggressive mucosal melanocytic malignancy. It is the third most common after melanomas of the skin and retina. The peak incidence in seen in the sixth and seventh decades. The clinical symptoms are pain, anal mass, bleeding per rectum, tenesmus or change in the bowel habits. It affects anal canal, rectum or both with a tendency to spread along submucosal planes. It is mostly beyond complete resection at the time of diagnosis and majority of patients die of metastasis. MR imaging significantly increases the diagnosis of anal melanoma in its early stages.

Background: Patients with chronic kidney disease (CKD) are at the risk of increase hospital admission as compared to the general population, due to various reasons. They have increased vulnerability to cardiovascular diseases (CVD) as well as infections, therefore they usually got admit in health care units due to various reasons. The causes of hospitalization in CKD patients in this part of the world are not studied well. Methods: This cross sectional study was conducted in The Kidney Centre Post Graduate Training Institute (TKC-PGTI) of Karachi. Variables included in the study were age, gender, are of residence, ethnicity, smoking status and level of education. Comorbid conditions like causes of CKD and causes of hospitalization. Data analysis performed by using software IBM SPSS 21. Results: Total of 269 patients were enrolled in our study. The male 148(55%), mean age was 55 years. The most common cause of hospitalization in our population was infection148 (55%) and urinary tract infection (UTI) was the most common site of infection 55 (20%) followed by sepsis of unknown origin 29(10.8%). Cardiovascular events like volume overload 32 (11.4%) and acute coronary syndrome 20(7.4%) were the second most important cause of hospitalization. Conclusion: Hospitalization of CKD patients is high, and in our population infection is found to be the leading cause of hospital admission. Infection originating from urinary tract is more common in all stages of CKD patients, while blood born infection originating from double lumen (DL) dialysis catheter or arteriovenous fistula (AVF) cannulation is more common in dialysis population. Cardiovascular events, both acute coronary syndrome and pulmonary edema due to volume overload followed the infections.

Background: Early and effective identification of childhood neurodevelopmental disorders remains a critical task of all pediatric healthcare professionals, which is critical to the well-being of children and their families. Methods: A retrospective review of medical records of all preschool children referred to a Child Development Centre (CDC) in North-West England, over a six-month period between Sept 2014 and Feb 2015 was conducted. The local multi-professional approach to the clinical assessment and management of preschool children was described and the published literature on this topic was reviewed. Results: Twenty four different categories of professionals spanning the whole range of primary, secondary, and tertiary healthcare, social care and educational services were involved in the management of the patients. The largest group of professionals was the primary healthcare specialists. The ten different primary care professionals managed an average of 42% of the patients. The secondary healthcare providers were involved in the care of an average of 17%, tertiary care providers 10%, educational specialists 25% and social care professionals were involved with 5% of all the patients. The commonest diagnostic disorders were Speech/Language delay (56%), Global developmental delay (33%), Behavior difficulties (26%), Social communication concerns (21%) and Autistic spectrum disorder (19%). Conclusion: The high number and specialties of various healthcare professionals at all levels of care indicates the high social and economic investment required in managing the affected preschool children in the region. Childhood neurodevelopmental disorders in the preschool age represents a high level of public health significance.

Glomus tumors are rare, usually benign, lesions that arise most often in the extremities. They are derived from the glomus body and have a propensity to be found in the fingers and toes, and often in the subungual area [1]. They typically demonstrate pinprick sensitivity, cold hypersensitivity and paroxysmal pain [2]. Only two glomus tumors of the scrotum have been reported and we report a third case of this rare tumor.

The discipline of Hassidic Philosophy, which emanates from a particular movement in Orthodox Judaism called Hassidism, begins with the premise that all of creation is a dichotomous world of opposites with both sides in a perpetual conflict with one another. The human construct is therefore a dichotomous spiritual entity manifested in the physical world through a mind-body. One side of this soul is the Godly intellect giving rise to the human identity or self-awareness and the other side is the animal soul whose purpose is to galvanize the body. Having learned that this discipline provides its followers with tools for behavioral transformation through inner conflict resolution, I find that it offers a clearer understanding of the spiritual component of holistic health and nursing theory as well as a tool for behavioral transformation that has practical application in nursing practice. Therefore, the purpose of this paper is to present the basic constructs of Hassidism as it pertains to human behavior, demonstrate its compatibility with existing nursing theory and offer a new methodology for advanced practice nurses (APN’s) to assist their clients in achieving behavioral transformation through inner conflict resolution.

A new technique for the use of Artificial Neural Networks (ANN) for the generalization and visual presentation of the results of experimental studies is proposed. The possibility of using ANN for cases for which their use was previously considered impossible is shown. ANN calculators have been created that summarize the results of experimental studies on the effect of trans-polynorbornene and basalt fiber on the characteristics of a rubber compound based on general-purpose rubbers (isoprene SKI-3, butadiene-methylstyrene SKMS-30ARK and butadiene SKD), which also contained vulcanizing agents (N, N′-dithiodimorpholine, thiuram D), vulcanization accelerators (sulfenamide C, 2-mercapto-benzothiazole), vulcanization activators (zinc white, stearic acid), emollients (industrial oil I-12A, rosin) and antioxidants (acetonanil H, diaphene FP). The rubber mixture was prepared on laboratory rollers LB 320 160/160. Subsequently, the rubber mixture was vulcanized in a P-V-100-3RT-2-PCD press. For the resulting vulcanizates, the physical and mechanical properties and their changes were determined after daily exposure to air and in a standard SZhR-1 hydrocarbon liquid at a temperature of 100 °C. We also studied the change in the mass of vulcanizates after exposure to industrial oil I-20A and water. The dynamic parameters (modulus of elasticity and mechanical loss tangent) of vulcanizates, which characterize their noise and vibration-absorbing properties, were studied on a Metravib VHF 104 dynamic mechanical analyzer. The created ANN calculators allow solving a direct problem - interpolating the dependences of all rubber characteristics on the content of basalt fiber, as well as solving inverse problems - to determine the required content of basalt fiber to create rubber with the required performance properties. The autonomous executable modules of the calculators developed by ANN were made and can be passed to everyone.

Background: In health care systems nursing care documentation is a vital and powerful tool that ensures continuity of care and communication between health personnel for better patient outcomes. Knowledge, attitude and practice of nurses’ towards nursing care documentation affect the quality and coordination of patients’ care. Hence, this study aimed to assess knowledge, attitude, practice and associated factors towards nursing care documentation among nurses in West Gojjam Zone public hospitals, Amhara Ethiopia. Method: Institutional based cross sectional study was conducted among 246 nurses in West Gojjam Zone public hospitals from February to March 8, 2018. The study participants were selected by simple random sampling technique. Data were collected by using pre-tested and validated self-administered structured questionnaire with internal reliability of Cronbach’s Alpha values 0.912, 0.784 and 0.713 for knowledge, attitude and practice questions respectively. Epi data version 3.1 and SPSS version 20 was used for data entry and analysis respectively. Descriptive statistics and binary logistic regression model were used. Result: The overall response rate was 97.56%. Among 240 respondents 54.6% of them had good knowledge, 50% of study participants had favorable attitude and 47.5% of study participants had good nursing care documentation practice. Sex and monthly salary were found to be statistically significant with knowledge of nurses. Work setting, work experiences and knowledge of nurses had significant association with nurses’ attitude towards nursing care documentation. Availability of operational standards, knowledge and attitude of nurses had significant association with nursing care documentation practice. Conclusions and Recommendation: Results of this study showed that knowledge, attitude and practice of West Gojjam zone public hospital nurses on nursing care documentation were poor. Therefore; in order to solve this problem each hospital should recruit nurses until hospitals are saturated enough. It is recommended to avail nursing care documentation standards/guidelines in each hospital and to give training about it and also it is recommended to conduct multisite studies especially qualitative type to increase its quality.

Fox, et al. [1] reported on the relevant cardiopulmonary findings in a series of autopsies of patients deceased from SARS-CoV-2 infection. In particular, regarding the histologic examination of the lungs, they observed bilateral diffuse alveolar damage with a lymphocytic infiltrate, thickened alveolar capillaries, fibrin thrombi within the capillaries and small vessels, and entrapment of neutrophils, without any significant neutrophilic, infiltrate within airways or the interstitium.