Flexible magnifying endoscopy with narrow band imaging (ME-NBI) has outstanding diagnostic correctness for gastrointestinal metaplsia and is hope for to be highly useful for imaging stage cervixcal metaplsia beginning by imaging the first stage of metaplasia by imaging single layer of subcolmnar reserve cells reserve cells hyperplasia, the reserve cells are round to cuboid with large oval or round nuclei, seen below the surface columnar cells and the columnar

With the discovery by Calghatgi (2013) that three common antibiotics (Abs) increased mitochondrial reactive oxygen (ROS) and lipid peroxide (LP) and depleted their natural absorbant glutathione led me to investigate further the potential impacts of these genotoxic substances on carcinogenesis. The range of impacts on mitochondria and cellular DNA varied by antibiotic to those consistent with known prior contributions to carcinogenesis. Specific cancers probably increased by these changes were HCC, RCC (KCC), CRC, cancer of the esophagus. Tumor suppressor gene mutations resulting from LP were noteworthy in this regard and mutations induced in CRC were consistent with those found in carcinogenesis of CRC. In addition depression of short chain fatty acids in microbiomes were found which depress the immune system increasing risk of all cancers. Many cancers were increased according to epidemiological studies linking Abs with elevated odds ratios, with one concern in particular, fatal breast cancer. The impact of loss of functionality of the mitochondria was also linked to depression of the citric acid cycle and therefore ATP which deflected metabolism to glycolysis, the Warburg mechanism also increasing risk of all cancers, favoured by cancer cells. In conclusion, some portion of many cancer types are probably increased in likelihood by number, type and frequency of Abs treatment and chronic residue exposure which varies from individual to individual. This led me to propose a three pronged carcinogenesis mechanism for Abs. 1. Cancer critical mutations 2. Immune depression 3. loss of mitochondrial functionality leading to Warburg effects. Damage to mitochondria were also noted by common pesticides tested in China and cancer associations were also found for many pesticides supporting a similar contributory etiology. Heart health concerns were raised by these findings because of the myriad mitochondria in the heart and because of long term reliability needs. Studies suggesting hearts were affected by Abs and pesticide exposure were presented. Because of their geographical ubiquitousness and the huge range of diseases associated with mitochondrial dysfunction, antibiotics and pesticides and bacteriocidal biocides are of concern for biodiversity and life in general. I propose research steps to evaluate Abs safety and suggest directions for further research and make suggestions on ways to ameliorate Abs toxicity.

Ono S, Kondo S. Molecular Theory of Surface Tension in Liquids, in Structure of Liquids, series Encyclopedia of Physics, Springer, Berlin, Heidelberg. 1960; 3/10:134-280. Rowlinson JS, Widom B. Molecular Theory of Capillarity, Oxford University Press, Oxford. 1989. Jaycock MJ, Parfitt GD. Chemistry of Interfaces, Halstead Press, John Wiley & Sons, New York. 1981. Adamson AW, Gast AP. Physical Chemistry of Surfaces, Wiley-Interscience Publication, John Wiley & Sons. 1997. Rusanov AI, Prokhorov VA. Interfacial Tensiometry, Elsevier, Amsterdam. 1996. Baranov SA, Dikusar AI. Kinetics of Electrochemical Nanonucleation upon Induced Codeposition of Iron-Group Metals with Refractory Metals (W, Mo, Re). Surface Engineering and Applied Electrochemistry. 2022; 589(5):429-439. DOI: 3103/S1068375522050027. Baranov SA. Surface energy for nanowire. Annals of Mathematics and Physics. 2022; 81-86. DOI: 10.17352/amp.000043. Baranov SA. Surface Energy, and Production Micro-and Nanowire. Journal of Nanosciences Research & Reports 2022; 4(4):1-4. DOI: doi.org/10.47363/JNSRR/2022(4)142. Baranov SA, Rekhviashvili SSh, Sokurov AA. Some problems of simulation of the thermodynamic properties of droplets. Surface Engineering and Applied Electrochemistry. 2019; 55(3):286-193. DOI: 5281/zenodo.1228887. Sears GW. A grown mechanism for mercury whiskers. Acta metallurgical. 1955; 3(4):367-369. Cahn RW. Background to rapid solidification processing. Liebermann HH. (ed.) Rapidly Solidified Alloys, Materials Engineering Series. Dekker, Parsippany, NJ. 1993; 3:1-15. Khachaturyan AG. Theory of structural transformations in solids, Dover Publications, New York. 2008.

Background: The clinical manifestations of Corona Virus Disease of 2019 (COVID-19) varied from patient to patient with evidence of multi-organ involvement. Many patients continue to have a wide range of symptoms for variable periods of time. The long-term effects of COVID-19 infection (post-COVID-19 illness or syndrome) are not yet been fully explored.This study aims to highlight the clinical manifestations of the acute COVID-19 infection and the longer-term manifestations of the disease among the attendants to a private GP clinic in the Urban Amman Area, Jordan.Methods: A clinical case-series study was conducted on a sample of 300 COVID-19-positive cases among patients attending my private GP clinic in the Urban Amman Area, Jordan. We used the structured questionnaire based mainly on World Health Organization (WHO) Case Report Form (CRF) verified tool for post-COVID-19. All patients with COVID-19 were included in the study. Data collection was conducted through phone calls and analyzed using the Statistical Package for Social Sciences (SPSS) software. Results: The incidence of COVID-19 among patients attending the clinic during the period of this study was 25%. Females were 135 (45%) of the study population and males were 165 (55%). The mean (SD) of age was 34.2 (5.0) years. Most of the infected staff (90%) were symptomatic and developed acute COVID-19 symptoms. Fever, Cough, Fatigue, joint pain and loss of smell and taste were the most common symptoms. 72% of the study population had fully recovered from the infection, while 28% of them continued to suffer from many long symptoms. Fatigue (28%), shortness of breath on activity (18%), Social withdrawal (18%), anxiety (17%), forgetfulness (16%), trouble concentrating (15) and depressed mood (14%) were the most frequently reported long symptoms.Conclusion: The prevalence of Post COVID-19 illness was 28% with a high public health burden calling for the public health system to address the medical and psychological needs of affected persons. Mental health and psychosocial support are recommended elements for the management of patients.

Aims and objectives: By reporting the use of therapeutic nursing interventions to facilitate the process of change in a depressive elderly caregiver, this paper seeks to underline the importance of fitting interventions to individual clients. Background: In assisting families of chronic illness sufferers, it must be remembered that the perceptions and functions of both clients and families are determined by family members, and that changes, if any, are made by those clients and families, rather than by nurses. However, nurses do play an important role in facilitating the process of change. Design: This is a case report. Methods: A case study of a depressive elderly caregiver is used to examine the use of therapeutic nursing interventions to facilitate the process of change with problem analysis, case conceptualisation and specific skills employed documented. Results: The change from one therapeutic approach (Cognitive-behavioural therapy) to another (Narrative Therapy) facilitates enlisting the caregiver’s unique strengths, resources and competence to overcome the difficulties and challenges identified during the process of change. In dealing with depression in family caregivers, nurses should not only be flexible but also remain sceptical in using different approaches, with heightened awareness of the client’s circumstances.

Background: Acute kidney injury (AKI) is a frequent and serious clinical complication in patients with severe malaria. The purpose of this study was to assess the incidence of AKI in a large population of hospitalized patients with a primary admission diagnosis of malaria, and to investigate the robustness of the KDIGO criteria for predicting the need for dialysis, length of hospital stay and hospital mortality. Results: We studied 695 consecutive patients admitted with primary diagnoses of malaria, in a 6 months period. AKI occurred in 86 (12.4%) patients (Stage 1 in 30.2%, Stage 2 in 23.3% and Stage 3 in 46.5%), and 19 (22.1%) patients required hemodialysis. No patient in the no-AKI or AKI Stage 1 groups (admission or maximum AKI Stage) required hemodialysis, and the requirement of hemodialysis was higher in patients with AKI Stage 2 (23.1%) and Stage 3 (42.4%). The length of hospital stay was longer (7.3±7.4 days vs 5.1±3.0 days; t=4.996, p<0.0001), and mortality was higher in patients who developed AKI than in those who did not (22,5% vs 2,5%; χ2=79.52; p<0.0001). Patients with AKI Stage 1, 2 and 3 had significantly higher hospital mortality (11%, 23% and 30%, respectively), compared with 2.5% for patients without AKI [odds ratio 5.2 (1.40-19.11, p=0.0331), 13.2 (4.24-41.06, p=0.0002), and 16.9 (7.26-36.65, p<0.0001)], respectively. Conclusion: In a relatively large cohort of patients with falciparum malaria infection, the KDIGO criteria identified 12.4% with a diagnosis of AKI. The KDIGO classification was robust in this population for predicting the need for dialysis, length of hospital stay and hospital mortality. The results support the utilization of the KDIGO criteria in diagnosis and to predicting outcomes for patients with malarial AKI.

Intravenous iron is used in combination with erythropoi esis-stimulating agents to treat the anemia of hemodialysis patients, however, there is variety in the dose and the frequency. So we compare bolus intravenous iron administration protocol vs an intermittent intravenous iron infusion protocol for 3 months in a single blinded design that was conducted on 30 patients randomized into 2 matching groups. Iron parameter, hemoglobin level, and CRP were monitored before and at the end of study. Patients with end stage renal disease on regular hemodialysis with iron deficiency anemia can be treated with intravenous iron administration either by the protocol of divided doses of IV iron through the sessions of hemodialysis or by giving the total dose of iron needed as a single large dose on only one session of hemodialysis, obtaining the same outcome in correction of iron parameters in treatment of iron deficiency anemia.

Endothelial dysfunction and inflammation play a key role in the pathophysiology of diabetic nephropathy; Tetrahydrobiopterin (BH4) is an essential cofactor for nitric oxide synthase, when BH4 is reduced to dihydrobiopterin (BH2), endothelial dysfunction is induced. Purpose: The aim of this study is to evaluate the relationship between the levels of biopterins with albuminuria in type-2 diabetic hypertensive patients. Methods: We studied 30 hypertensive type-2 diabetic patients in whom biopterins levels were measured by reverse phase high performance liquid chromatography with fluorescence detection. Additionally, 24 h urinary albumin excretion was also measured (nephelometry). The levels of biopterins and albuminuria were correlated with the Pearson correlation coefficient. Results: We did not find a significantly correlation between biopterins levels and albuminuria, However, we found a significantly inverse correlation (R= -0.498, p<0.005) between the BH4/BH2 ratio and albuminuria. Conclusion: Our results suggest that the BH4/BH2 ratio instead of biopterins levels may be a marker of nephropathy in hypertensive type-2 diabetic patients.

A Gamma Ionization Chamber was developed for the purpose of high gamma radiation detection during accident conditions in a Light Water reactor. The pre-eminence of the detector is that it was designed and developed to monitor gamma exposure rates in the wide range of 100 mR/hr to 107 R/hr. The detector has an overall diameter of 90 mm with a length of 400 mm. The response of the detector is accurate and the sensitivity is within ± 6% over gamma energies ranging from 660 KeV to 1.25 MeV. The detector operates with a DC voltage of 500V. The V0.9 voltage is about 250V for 107 R/hr. The estimated operation life of the detector is about 20 years. 

Posterior reversible encephalopathy syndrome (PRES) is a neurological syndrome with clinical features of altered sensorium, headaches, visual problems and seizures. It has been associated with uncontrolled hypertension (HTN), thrombotic thrombocytopenic purpura (TTP) and immunosuppressive drugs. Rituximab has also been implicated as a cause of PRES that usually occurs after the first dose. We report a case of PRES that occurred after the second dose of Rituximab. A twenty three years old female known case of resistant TTP treated with multiple courses of steroids and plasmapharesis was admitted with renal failure, severe volume overload ad lower respiratory tract infection. She was treated with hemodialysis, intravenous antibiotics, steroids and plasma exchange (PEX).