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Aim: To evaluate the outcome of Trabeculectomy in advanced glaucoma in a hospital in Rivers State, Nigeria. Methods: This was a non-randomized interventional study in which each patient served as its own control. Patients with advanced glaucoma and demonstrable field defects and Mean defect ≥-12 were included. The intervention employed was Trabeculectomy and IOP and visual acuity pre operative, as well as post op were collected and compared at pre- op, post -op day 1, one week, one month, 6 months. Data was analyzed using SPSS version 20. Results: Thirteen (13) eyes from ten (10) patients with advanced glaucoma were involved in the study. Mean age of study population was 53±19.62 years. Mean of mean defect was -19.05±5.23dB while mean of vertical cup disc ratio (VCDR) was 0.88±0.04. Mean of Pre- op Visual acuity (log MAR) was 0.46 and dropped to 0.72 first day post-op but improved over 6 months to 0.42. The mean of IOP pre-op was 24.15mmHg and dropped to 11.23mmHg (58.24%) over 6 months (p=0.001). Conclusion: Trabeculectomy still remains the gold standard surgical treatment for glaucoma. In our study it resulted in a 58.24% drop in IOP over 6 months with mean visual acuity maintained at pre-op levels after 6 months follow up. It therefore is effective and safe surgical intervention in advanced glaucoma.

The stem cell secretome is a collective mixture of soluble and insoluble factors released by stem cells during paracrine communication and/or autocrine signaling. In addition to intracellular communication, these paracrine factors play an integral role in tissue development and generation, acting as the primary driving force in the regenerative properties of stem cells. Despite such great potential of stem cell secretome in therapeutic applications, the lack of secretome-based treatments available for the public at the time of writing is odd and puzzling. Hence, this review aims to provide insights into recent advancements in understanding the stem cell secretome, as well as discuss future possibilities and current limitations that must be overcome for the proper development of secretome-based therapies. Through utilizing the MEDLINE database from the National Library of Medicine® (NLM), we found that while there is much evidence of the therapeutic effects of secretome-based therapy, flaws involving regulations and standardization hinder it from revolutionizing regenerative medicine at present. It is cardinal to emphasize that while secretome-based therapy may be the solution for many untreatable conditions, much research is still required before it is approved for clinical practice.

Dyspepsia refers to acute, chronic, or recurrent pain or discomfort centered in the upper abdomen. An international committee of clinical investigators (Rome III Committee) has defined Dyspepsia as Epigastric pain or Burning, early satiety, or postprandial fullness Dyspepsia occurs in 15 % of the Adult population and accounts for 3% of general medical office visits. The descriptive study was carried out in Eastern Afghanistan, Afghan Momand Medical Complex & Research Center, Department of Gastroenterology, during the years 2023-2024. To know the Clinico-Endoscopy of Dyspepsia, for patients who present with investigated Dyspepsia to Gastroenterological OPD & IPD. The study result showed, there were a total of patients 467, and of these patients 230 were Male and 237 were Female. According to the Age, 45 patients were under Age <20, 219 patients were between the ages 21-40 years, 130 patients were between ages 41-60 years and 73 patients were over 60 years of Age. However according to the presentation, 357 patients had Dyspepsia, 59 patients had Dysphagia, 13 patients had Chronic Liver Diseases & Screened for Varices, 3 patients presented after Acid ingestion, 2 patients had Anemia, 11 patients had persistent vomiting and 22 patients had suspected GI-Bleeding. Furthermore in Esophageal findings from a total of 467 patients 34 patients had Esophageal Candidacies, 6 patients had Esophageal Narrowing, 25 patients had Esophageal Growth, 71 patients had Hiatus Hernia, 180 patients had LA Grade A Esophagitis, 21 patients had LA Grade B Esophagitis, 6 patients had LA Grade C Esophagitis, 3 patient had LA Grade D Esophagitis. 16 patients had Lax Lower Esophageal Sphincter, 9 Patients had High-Risk Esophageal Varices, 3 patients had Small Esophageal Varices and 150 patients had Normal Esophagus and in Gastric findings from total all above patients, 4 patients had Antral Gastritis, 50 patients had Corpus Gastritis, 1 patient had Fundal Gastritis, 4 patients had Nodular Gastritis, 199 patients had Pan-Gastritis, 108 patients have Severe Pan Erosive Gastritis, 23 patient had Gastric Erosions, 6 patients had PHG (Portal Hypertensive Gastropathy), 3 Patients had Fundal Varices, 5 patients had Gastric Polyps, 5 patients had Gastric Growth, 2 patients had Pyloric Stenosis, 8 patients stomach not seen due to Esophageal Growth, 67 patients stomach were normal. In the present study there were Duodenal findings from a total of the above patients 48 had Duodenitis, 2 patients had Duodenal Polyps, 2 patients had duodenal ulcers, 1 patient had Duodenopathy, 2 patients had Duodenopathy, 2 patients Duodenum not seen due to Pyloric Stenosis and 413 patients Duodenum were normal. Regarding the habits in our study in which a total of 467 patients were examined 135 of the above patients had snuff habits, 103 patients had smoking habits, 2 patients were Heroin addicts and 227 of the total patients didn’t have any habits (the majority of them were using spicy food, overfeeding, drinking of nonalcoholic beverages, fatty foods, NSAIDs ...) and the higher incidence of Dyspepsia was in Female patients, Also with the age between 21-40 years (43%) patients, Also the higher incidence of Dysphagia 47% were in patients with Age >60 years, the Endoscopy showed that 83% patients had Gastritis also higher incidence regarding the habits 29% had snuff habit and 22% had a smoking habit.

Background: SCI Action Canada partnered with researchers to adapt an evidence-based leisure-time physical activity (LPTA) counselling service (Get-in-Motion (GIM). A satellite GIM service called Passez à l’action was established within a French-speaking context for persons with physical disabilities. An understanding of the determinants that infl uenced the implementation and functioning of the GIM service within the Adaptavie context are required to maximize the potential of other community-based LTPA services being successfully introduced in similar organizations. Purpose: The case study objectives are to: 1) describe the characteristics and implementation contexts of two leisure-time physical activity counselling services for Canadians with a physical disability and the adoption process that took place when the protocol was translated to a new context, and 2) elucidate, from the point of view of the service providers, the organizational determinants that could have facilitated and/or hindered the implementation and functioning of these services. Methods: Guided by the Consolidated Framework for Implementation Research, focus groups were held with the directors and staff of each service. Mixed-content and thematic analyses were then used to determine overarching themes. Results: Findings suggest that the presence of service innovators fosters ownership of the service and facilitates ongoing staff training and support. A thoughtful implementation plan should be included as a component of translation between contexts. Conclusions: Lessons learned and recommendations for future translation of similar evidence-based services to additional contexts are discussed.

Kalanchoe pinnata is a widely recognized medicinal plant known for its antioxidant and anti-inflammatory properties. This study explores its in vitro antioxidant and anti-inflammatory activities, highlighting its potential for pharmaceutical and biomedical applications. The research innovatively assesses its bioactive components using DPPH radical scavenging, nitric oxide inhibition assays, and phenolic content analysis. Results demonstrated significant antioxidant activity with IC50 values comparable to ascorbic acid, along with notable anti-inflammatory effects via nitric oxide inhibition. These findings emphasize Kalanchoe pinnata’s potential as a source for developing antioxidant and anti-inflammatory therapeutics. Further investigation into bioactive compound isolation and mechanistic pathways is recommended to clarify its pharmacological efficacy.

Background: There is paucity in studies reporting long-term results following anterior cruciate ligament (ACL) rupture. A UK national ligament registry (NLR) designed to collect demographic, clinical and outcome data on patients undergoing ACL reconstruction was launched in 2013. There was therefore an emergent question on the role of such registry as an additional source of evidence. Study aims: A framework analysis aimed to provide a basis for the evaluation of outcomes following ACL management and formulate a structure of the evidence, which can be derived from the registry. Methods: A systematic approach was adopted to select relevant studies. Qualitative thematic and meta-narrative analyses were conducted. Level-1 registry data were recorded for all primary ACL reconstruction procedures from January to June 2016. Registry data content and validity were evaluated. Results: Seven studies were suitable for analyses yet none defined the pattern of meniscal injury following initial treatment. When reported the incidence varied markedly between 23% and 80%. There was evidence of collection of at least one principal outcome measure in at least 85% of participants across all studies. Thematic analysis identified four key domains of outcome measures (1) intervention selection, (2) Knee stability evaluation, (3) Patient reported outcomes, (4) Radiographic evaluation and risk of secondary osteoarthritis. Graft choice, rate of meniscal and chondral injuries and cumulative risk of revision surgery had incomplete and inconsistent reports. Comparison of demographic and clinical data with the first registry report demonstrated: predominately younger patient population; older female patients at time of intervention; and higher incidence of meniscal tears. Conclusions: Registry data driven quality and research improvement open a new paradigm in ACL reconstruction evidence base and future practice. Early observations have consolidated the importance of associated meniscal injuries in the management of ACL rupture. Further work is needed to improve registry data completeness, accuracy and validity. A proposed data migration process using available technologies can help harmonise data collection without the added burden on clinical services.

The psychological burden of physicians has been the focus of many researchers since the 1950s, and some papers have found a high prevalence of anxiety and depressive disorders among medical staff. Recent studies have shown that the coronavirus pandemic didn’t go easy on healthcare workers. The fact that it has been three years since the outbreak, has motivated our study. Which aims to evaluate the intensity of anxiety among medical personnel and the risk factors that could be incriminated post-COVID pandemic and if the level of anxiety is back to normal. This is a cross-sectional study, carried out with a survey split into 2 parts sociodemographic and work-related data, and the French version of the Hamilton anxiety scale, Statistical analysis was performed using Jamovi et Microsoft Excel. About half of the 116 physicians in our study had no anxiety (55.2%), while 21.6% had mild anxiety, 10.3% had moderate anxiety, and 12.9% had severe anxiety. The identified risk factors for anxiety were female gender, personal and family history of anxiety disorder, doing night shifts, and being a general practitioner. The anxiety rate of physicians is back to normal post-COVID pandemic. But we shouldn’t stop there. The mental health status of medical personnel depends on several of the factors listed above. Determining them would imply a call for the implementation of preventive measures for anxiety and depressive disorders among physicians. Because taking care of physicians is taking care of patients.

When I asked the students in my general Chemistry class whether grade is more important than knowledge, a majority of them opted for grades over knowledge and this answer did not surprise me a bit as the smart phones are available for them to think while their brains are corrupted or unused for most of the time. This brings one to the Einstein’s prediction that technology will develop to the point where there is no human interaction, which will be the day a new generation of idiots will emerge, and we are witnessing everywhere, including in the classrooms all over the world.

The topic of this paper is to describe the 3-D current density in the windings of a 3-D coil, which fills the volume between two coaxial cylinders at a precisely defined distance from each other, and which serves to generate a magnetic field gradient in the center of the cylinder axis. The 3-D current density is considered an unknown input quantity, which is calculated from the known gradient magnetic field output. It is an inverse problem in mathematics, where the direct problems are the calculation of unknown output quantities based on known input quantities. Fourier series expansion methods in the context of cylindrical coordinates were used to describe the 3-D current density. In that case, Bessel functions are used as development components. The current densities, at each point in space, were lined up to represent current lines. Each power line is associated with a coil winding through which a current of a certain strength flows. After that, the principle of discretization of coil windings was applied. Each winding is divided into a large number of elementary segments that were considered as current elements, which create, based on Bio-Savar's law, an elementary magnetic field. In this way, the total, continuous magnetic field is broken into many elementary components, which come from different current elements. An important result of this process is that each current element can be controlled independently by a current source. This means that the output magnetic field of the gradient can be controlled by current sources, which are the input sizes, and this is what is at the core of the topic of this paper.

Everyone can be placed somewhere on an exercise continuum with the idle at one end and the hyperactive at the other. At both extremes, health suffers. Exercise is essential to health and managing it is the responsibility of individuals but few know what they should do. Doctors seldom teach how to be healthy and act only when repair is needed.