Insomnia disorder is very common in the older adults and tends to be accompanied with poor functioning during the day and likelihood of adverse outcomes. Hypnotics like benzodiazepines and Z-drugs are contraindicated because of their side effects on safety in older patients. This was a randomized, double-blind, placebo-controlled trial that compared the effectiveness and safety of a dual orexin receptor antagonist, lemborexant, in patients with insomnia disorder aged 55 years and above. One thousand one hundred subjects were randomized to get lemborexant 5 mg, lemborexant 10 mg, zolpidem extended-release 6.25 mg and placebo during 30 nights. There were subjective and polysomnographic outcomes of sleep. Both lemborexant doses showed a significant improvement in the sleep onset, sleep maintenance and sleep efficiency among the placebo and zolpidem in terms of effects lasting one month. The severity of insomnia and the functioning in the daytime were also improved significantly. There was an overall positive safety profile of lemborexant and it was generally well tolerated.
Over the years, men have mostly filled the ranks of practicing ophthalmologists. Even though the number of female medical students has gone up for many years, it is still not clear if this is visible in women joining ophthalmology residencies. Our main goal is to look at the trends in gender representation for ophthalmology residency applicants and compare these with those found in other surgical specialties over the past two decades. Counts of male and female applicants who listed ophthalmology as their number one specialty and those who were successfully placed, were found from data collected by a national residency matching service. We used data that is publicly available and completed a retrospective cross-sectional study. Afterward, trends for female ophthalmology applicants and female ophthalmologists were compared with what was happening in other surgical fields. During the study, a larger number of women applied for transplant and the rate of women who matched increased too. Nevertheless, the data indicated no clear rising trend in these later periods. No significant pattern in match rates was found for male and female applicants. The numbers of women in applicants and practicing ophthalmologists matched the proportions found in other surgical specialties. Female presence among ophthalmology applicants is higher than it was in the past, though the latest data point to a pause and indicate that gender parity continues to elude ophthalmology. More investigation is required to find out about the main reasons behind persistent gender biases.
The study was investigated the bacteriological contamination in Tigris River raw water and Tap water in Bagdad city from different area as Rashidiya, Kadhimiya, Shawaka and Salhia regions while the Tap water from Al-Hurriya region, the results showed The results were revealed the fecal coliform and members of the The Enterobacteriaceae was most prominent bacteria in the studied area and and gram positive bacteria as well While the results reported the isolated bacteria was less in Tap water also the current study isolated pathogenic bacteria as Aeromona hydrophila, Pseudomonas aeruginosa , salomenall spp, and some isolated that cause UTI as P.vulgaris and P. mirabilis. However, the results showed the bacteria count was higher in the areas compared in Tap water but the area 2 was recorded the highest count 952+0.432 With significant differences between other area at p ≤ 0.05 while in Tap water was 271+0.46. The study were revealed the fecal coliform and members of the The Enterobacteriaceae was most prominent bacteria in the studied area and and gram-positive bacteria which attributed to the factories and hospitals in the studied area are thrown into the Tigris River.
Background: Text Neck Syndrome (TNS) is a growing health concern related to the widespread use of smartphones, particularly among young adults. TNS is characterized by musculoskeletal discomfort in the neck, shoulders, and upper back, often caused by prolonged forward head posture during smartphone use. Objective: This study aimed to investigate the prevalence of TNS and its association with smartphone usage duration among young adults aged 18-30 years in Sabarkantha district, Gujarat, India. The study sought to assess the severity of musculoskeletal symptoms in relation to smartphone usage habits and posture. Methods: A cross-sectional survey was conducted with 500 participants randomly selected from both urban and rural areas of Sabarkantha. Participants completed a self-administered questionnaire that assessed their daily smartphone usage, types of activities performed, posture during use, and presence of musculoskeletal symptoms such as neck pain, shoulder discomfort, and headaches. Data were analyzed using SPSS, with chi-square tests and regression analysis to explore correlations between smartphone use and symptom severity. Results: The study found that 75% of participants reported experiencing symptoms of TNS, with 60% experiencing neck pain, 50% shoulder discomfort, and 55% headaches. Severity of symptoms was positively correlated with smartphone usage duration, with those using phones for more than 6 hours per day reporting more severe symptoms. Urban participants reported a higher prevalence of TNS compared to rural participants. Conclusions: TNS is prevalent among young adults, particularly those engaging in prolonged smartphone use. Public health campaigns should focus on ergonomic interventions, proper posture, and the importance of taking regular breaks to reduce the risk of TNS.
This study investigated the effect of Psycho-Educational Problem Therapy (PEPT) on the management of speaking phobia among English language students in senior secondary schools in North West Nigeria. The study utilized quasi-experimental research design which involved an experimental group exposed to PEPT and a control group that received conventional instruction. The objective of this study was to examine the effectiveness of Psycho-Educational Problem Therapy (PEPT) in managing speaking phobia among senior secondary school students learning English in North West Nigeria. Participants consisted of English language students from selected senior secondary schools in North West Nigeria. The sample is drawn using purposive and random sampling techniques to ensure appropriate representation. The experimental group received psycho-educational problem therapy sessions over a fixed period, while the control group received no such intervention. Data was collected using validated Speaking Phobia Assessment Scale (SPAS) and Speaking Performance Test (SPT) and analyzed using Analysis of Covariance (ANCOVA) to determine the treatment effects. The findings of the study revealed that Psycho-Educational Problem Therapy significantly reduced speaking phobia among students in the experimental group compared to those in the control group. The therapy also led to notable improvements in students’ English-speaking performance. Furthermore, students’ speaking phobia negatively influenced their speaking performance, significantly indicating that as students’ phobia decreased, their speaking performance increased. The study concluded that Psycho-Educational Problem Therapy is an effective intervention for managing speaking phobia and enhancing English-speaking performance among senior secondary school students.
Background & objectives: Although the known valuable of long-lasting insecticidal nets in providing safety against malaria. Just about 3149 LLINs were distributed in 2018 as an intervention implement against malaria spread in 8 villages under sub health centre Chiyadand, primary health centre Chirpani of Pandaria sub-district, Kabirdham district in Chhattisgarh, India. This present study assessed effect of positive cases at two different ecological parts (Hilly and Land) after LLIN distribution, IEC and explanation determinants. Methods: This study was done to become aware of high risk of malaria in Particularly Vulnerable Baiga Tribe and categorize the geographic risk factors. A cross-sectional village study was in 8 study villages of different locality compare between the years 2017 to 2019. Each village’s household surveyed where people suffer to fever using M1, interviewed with travel history of Positive cases using M3 and LLIN monitoring format structured according NVBDCP guidelines. Results: 738 households of Baiga tribes out of 1131 households were distributed LLIN in 8 villages. Total 65% baiga tribe is live at study villages. In 2017, 785 Malaria positive (499 in hilly villages and 286 in land villages) cases in the households during the survey and in sub health centre while In 2018, only 149 cases founded (43 in hilly villages and 106 in land villages) just about 81% positive cases decreased. In 2019, only 34 positive cases (19 in hilly villages and 15 in land villages) reported just 22.81% positive cases decreased after LLIN distribution. Interpretation & Conclusion: Health education campaigns and creating awareness about the benefit of sleeping under the LLINs in providing safety all the members of the family to have an epidemiological impact of this intervention at the community level.
Pilot in the study was an attempt to test the influence of magnesium (Mg) supplement on the accrual of bone mass in poor dieting adolescents on magnesium. The researchers selected premenarchal girls of ages 8-14 years old and assigned them to magnesium oxide (300mg/day) or placebo in a span of one year. Dual energy x-ray absorptiometry (DXA) was used to measure the bone mineral density (BMD) and bone mineral content (BMC) at baseline, after 6 months, and after 12 months. The increase in total hip BMC was also significantly greater in the Mg-treated group than a placebo group especially in the neck of the femur, total hip and Ward area. Whereas, the effect on the spinal BMC and BMD was comparatively small, the effect was positive in support of Mg group. Mg supplement was also safe and well tolerated and linked with a reasonable compliance. This paper has confirmed the possibilities of Mg supplement on bone health in early teens, and more studies are required on bigger populations.
Background: One of the most popular contrast agents is metrizamide which is also nonionic and the reason behind its high application in lumbar myelography is because of its high diagnostic quality as compared to the older contrast agents such as Pantopaque. But it has a range of side effects, especially gastrointestinal in nature, nausea, vomiting, headaches and others. Previous research has indicated that these side effects can be decreased by steroid treatments. The study was conducted to determine the effectiveness of oral dexamethasone in the management of gastrointestinal and other adverse effects that are prevalent with metrizamide lumbar myelography. Methods: It was a double-blinded placebo-controlled study together with 145 adult patients with either chronic low back and/or leg pain and underwent lumbar metrizamide myelography. At intervals, the participants were randomly grouped into dexamethasone (4 mg) and placebo before and after the procedure. The severity of the symptoms was evaluated by the use of a 24-item symptom checklist prior to the procedure and 24 hours post-procedure. Chi-square tests, correlation coefficients, and post hoc tests were the methods used to analyze the data to determine the relationship between treatment and changes in the symptoms. Results: The findings demonstrated that there was a statistically significant decrease in vomiting symptoms in the dexamethasone group whereby 10.5% patients in the placebo group reported increased vomiting symptoms as compared to 0 in the dexamethasone group ( 2 -test = 4.48, p = 0.034). The difference in other symptoms like headache and nausea was not statistically significant although there was a reduction. Pain in the legs and weakness in legs or feet were also significantly improved in the dexamethasone group, also not significantly. The results of the analysis also indicated a positive relationship between nausea and the scores on MMPI hysteria in the group of dexamethasone. Conclusion: In patients who underwent metrizamide lumbar myelography, oral dexamethasone was effective in the reduction of some gastrointestinal side effects especially vomiting. Even though the drug failed to alleviate all the side effects, its protective effects were specifically noticeable in the elderly patients. Personality traits also were recognized as having an impact on reporting of nausea and other symptoms in the study.
Sickle cell disease is an inherited structural disorder of hemoglobin and a major public health issue in the state of Chhattisgarh, India. Government of Chhattisgarh passed ‘Sickle cell bill’ in the Assembly looking to its previous impact on society. The present study was executed on sickle cell disease patients and controls. A cross-sectional study was done for screening of sickle cell hemoglobin with individual informed written consent, 90 subjects of Raipur & Durg districts, belonging to different caste category, ranging in age between 1.5year to 45 year were screened using 2% sodium meta bisulphate solution. Genotype of individuals with sickle cell hemoglobin as done by Allele specific polymerase chain reaction (ASPCR) analysis and normal individuals were treated as control. ERMA total blood cell counter machine (PCE-210) was used for the analysis of various hematological parameters. The study focused on two aspects. Firstly, mutant beta chain of HbSS was distinguished form normal beta chain of HbAA by using technique of PCR followed by gel electrophoresis. Secondly HbSS, HbAS & HbAA individuals correlated with various hematological indices. We found significant statistical difference for hematological indices – DLC, Leucocytes, bleeding time & clotting time between Sickle cell patients (HbSS & HbAS) & controls.
Psoriasis of the scalp is widespread, hard to treat, and commonly has poor adherence due to difficulty with topical application and impact of cosmetic acceptability on continued usage. A two-compound scalp formulation containing calcipotriol and betamethasone dipropionate was also designed at a fixed dose to enhance the convenience and tolerability in addition to long-term safety. Methods: This was a long-term randomized comparative safety study, in which 900 adults with a minimum scalp psoriasis of moderate level were randomly assigned to two scalp formulation groups consisting of two compounds and calcipotriol monotherapy (nor 450). Routine clinical practice was followed with regard to the use of treatments once per day, as necessary, and with a 12-month follow-up. The variables of safety were withdrawals, adverse events, adverse drug reactions (ADRs) and events that were potentially linked to long-term exposure to corticosteroids on the scalp. Findings Baseline characteristics did not differ between groups. The percentage of patients who withdrew was less with the two compound formulation compared to calcipotriol (21.3% vs 39.8%) and less patients would have not been withdrawn because of the unacceptable adverse events and inadequate efficacy. The incidence of ADRs in both the two-compound formulation and calcipotriol were lower (17.1% vs 29.6%), as well as pruritus and skin irritation. Such a positive tolerability profile was sustained in exposure (0 to 6 months and 0 to 12 months) in patients who had prolonged exposure to treatment. Judged events which could have been associated with long-term corticosteroid use were rare and had a similar frequency in the groups. Conclusion: Long-term as-needed and once-daily use of the two-compound calcipotriol/betamethasone scalp formulation had a good safety and tolerability profile, decreased withdrawal rates and reduced ADRs than calcipotriol monotherapy without any observed increment in corticosteroid-associated scalp adverse events.
Background: The antiresorptive therapy can only partially explain the reduction in the fracture risk by augmenting the bone mineral density (BMD). Structural geometry is also an important factor in bone strength and it cannot be sufficiently measured alone with BMD. Purpose: To assess the impact of alendronate (ALN), hormone replacement therapy (HRT) and a combination of the two on the hip structural geometry through hip structure analysis (HSA). Methods: HSA was reanalyzed (in 76 older women) with the use of the dual-energy X-ray absorptiometry scan in a randomized, double-blind, placebo controlled trial followed up over a 3 year period. The HSA measurements of the cross-sectional area, cortical thickness, section modulus, and BMD of the femur neck were evaluated. Findings: There were no differences in baseline characteristics. The active treatments yielded great improvements on majority of the structural indices as compared to placebo. Combination therapy showed the highest increases of cross-sectional area, cortical thickness, section modulus and BMD by HSA, intermediary effects of ALN and minor yet significant effects by HRT. Conclusion: Antiresorptive therapy, and specifically a combination therapy, has a significant improvement in the geometry of the hip structure indicating an improvement in mechanical strength going beyond simple alteration in the BMD.
This study examines the accommodation preferences and challenges of Dhaka’s urban residents, focusing on both public and private rental housing contexts. The city’s rapid expansion, driven by high in-migration and territorial development, has led to a severe housing shortage. Since the 1970s, multi-storied apartments have emerged as a key response to this shortage; however, significant challenges persist. As part of a mixed-methods approach, in-depth interviews and focus group discussions were combined with a structured survey of 180 respondents from key public and private rental clusters. The findings reveal that residents’ perceptions of various factors, including rental price, proximity to workplaces, utility and security services, structural integrity, availability of open space, and payment methods, differ significantly. While affordability and structural safety emerged as crucial baseline (hygiene) factors, security and payment flexibility were identified as key motivators influencing tenants’ decisions to stay or move. Despite the rise in high-rise apartment construction and increased private-sector investment, substantial gaps remain in providing safe, affordable, and equitable housing. The study further identifies systemic problems that exacerbate residents’ dissatisfaction, such as uneven rent regulation, poor utility management, and weak enforcement of building codes. These findings inform recommendations for integrated policy measures that balance the supply of public and private rental housing, improve infrastructure and service quality, strengthen regulatory frameworks, and align housing allocation with socioeconomic realities. By offering empirical evidence on tenant perspectives and decision-making processes, this study contributes to the broader discourse on sustainable urban housing. It also provides policymakers, urban planners, and other stakeholders with practical recommendations for enhancing living conditions in rapidly urbanizing cities like Dhaka.
The use of artificial intelligence (AI) in education is an interesting concept which is meant to revolutionize and improved capabilities of students and educators to carry out their responsibilities more effectively and efficiently. This study assesses the level of awareness, perceptions and use of AI for academic purposes among the students of the Faculty of Education, University of Nigeria, Nsukka. Four research questions and three hypotheses guided the study. Structured questionnaire was developed and administered to a total of 336 students randomly selected from the faculty while adopting cross-sectional survey design. The data were analyzed using frequencies, percentages, means, standard deviation for the research questions while ANOVA and t-test were employed as statistical test of significance for the hypotheses. The awareness of AI tools for education purposes is low among the students and generative AI like ChatGPT is the most used for academic purposes. The perception is positive but with reservations about the impact on the originality of academic outputs, transparency and ethical issues. At 0.05 level of significance, students’ perception and use of AI tools is not influenced by year of study while there is significant difference (p < 0.05) in AI awareness level due gender. The males have higher level of awareness than the females. Control and censorship structures is needed from educators and policy-makers for effective management of the use of AI for academic purposes.
The aim of this review is to provide a comprehensive evaluation of stevia in relation to diabetes, focusing on its mechanisms of action and therapeutic potential. Sugar, particularly sucrose, has long been a staple in human diets due to its sweetness and energy-providing properties. However, excessive consumption of sugar is strongly linked to obesity, type 2 diabetes, cardiovascular diseases, and metabolic syndrome. High intake of refined sugars can lead to hyperglycemia, insulin resistance, and chronic inflammation, creating a cascade of health complications. In recent years, attention has shifted toward natural sweeteners derived from plants, including stevia, monk fruit, and sugar alcohols (e.g., xylitol, erythritol). Among these, stevia (Stevia rebaudiana) stands out due to its rich content of bioactive compounds (phytochemicals) such as steviol, steviosides, and rebaudiosides, which exhibit strong anti-hyperglycemic activity. These compounds make stevia a safe and effective substitute for sucrose in diabetic patients.The active compounds in stevia not only lower blood sugar levels but also support pancreatic tissue health by enhancing insulin secretion and promoting anti-diabetic effects. Additionally, stevia contributes to maintaining normal glucose levels by reducing inflammation and oxidative stress, making it a highly effective natural sweetener for the growing demand in the herbal and natural food market.
Guillain–Barré Syndrome (GBS) is an acute immune-mediated neuropathy that leads to rapidly progressive weakness, sensory loss, and reduced functional independence, significantly affecting quality of life. Despite advances in acute treatment, many survivors experience persistent motor deficits, fatigue, and psychosocial challenges, especially in low-resource settings. Rehabilitation plays a critical role in recovery; however, evidence remains limited regarding the comparative effectiveness of high- versus low-intensity nurse-led rehabilitation programs. Nurses are central to patient assessment, monitoring, and individualized rehabilitation planning, yet the optimal intensity of such interventions is not clearly established. This study aims to evaluate the effects of high- and low-intensity nursing rehabilitation on the quality of life of GBS patients, with the goal of providing evidence-based guidance to improve functional recovery, emotional well-being, and daily living outcomes. Objective: To determine the effects of the Nurse- led high & low intensity rehabilitation on quality of life among Guilin -Barre syndrome patients. Methodology: A quasi-experimental pre- and post-study design was used to evaluate the effects of nurse-led high- and low-intensity rehabilitation on the quality of life of Guillain–Barré Syndrome (GBS) patients. A total of 40 confirmed GBS patients were selected through convenience sampling at Lahore General Hospital (PINS) from June to December 2025. Data were collected using a structured demographic form and the validated WHOQOL-BREF scale, which measured physical, psychological, social, and environmental domains. The intervention was delivered in two phases, beginning with low-intensity rehabilitation followed by high-intensity nursing-led exercises and psychosocial support. Pre- and post-intervention quality-of-life scores were compared using nonparametric tests in SPSS version 22, with statistical significance set at p < 0.05. This methodological approach ensured a systematic assessment of the impact of rehabilitation intensity on patient outcomes. Results: A total of 40 participants were included, most of whom were aged 35–45 years (60%) and female (60%). Normality testing using the Shapiro–Wilk test showed that both pre- and post-intervention QOL scores were not normally distributed (p < 0.001), leading to the use of non-parametric analysis. Following the nurse-led rehabilitation program, categorical QOL levels improved markedly, with poor QOL decreasing from 42.5% to 5%, and good QOL increasing from 0% to 7.5%. The Mann–Whitney U test revealed a significant improvement in overall QOL, with the post-intervention mean rank (48.86) higher than the pre-intervention mean rank (32.14) (U = 465.500, p < 0.001), demonstrating the effectiveness of both high- and low-intensity nurse-led rehabilitation in enhancing quality of life among GBS patients. Conclusion: he study concludes that the WHO-based nursing intervention significantly enhanced patients’ daily functioning, reduced pain, and improved overall quality of life following hip surgery. These findings highlight the importance of structured rehabilitation and nurse-led guidance in promoting faster recovery and better postoperative outcomes. The intervention model can be effectively integrated into routine clinical practice to strengthen patient-centered care.
This article explores the intricate power dynamics and acts of resistance portrayed in the select works of J.M. Coetzee, focusing on Disgrace, Waiting for the Barbarians, and Life & Times of Michael K. Coetzee’s narratives delve deeply into the interplay of authority, oppression, and individual agency within contexts marked by colonialism, systemic inequality, and ethical dilemmas.
Background and purpose: Stroke is a leading cause of long-term disability worldwide, with a profound impact on individuals functioning abilities and quality of life. Among the evidence-based therapies, repetitive task training has emerged as a promising approach in neuro rehabilitation following stroke, aiming to improve the performance of everyday activities that are essential for independent living and is highly effective in promoting motor learning and functional improvement by engaging patients in meaningful and purposeful activities. This study aims to determine the effect of repetitive task training to improve upper limb functions and activities of daily living in persons with hemiplegia.
Background: Piroxicam, a nonsteroidal anti-inflammatory drug (NSAID), has poor solubility and bioavailability, limiting its therapeutic effectiveness. This study aimed to develop and optimize Piroxicam-loaded nanoparticles using the solvent evaporation method to enhance drug encapsulation and achieve sustained release.
Prediction of significant wave height (Swh) and Wind stress (WS) were carried out spatially and temporally for a period of nine years (2015-2023) in the Bay of Bengal (BOB) region using a combination of empirical orthogonal function (EOF) analysis. In the present work, WAM-4C model is performed to generate spatially gridded swh data for nine years (2015-23). Six hourly NCEP blended winds have been applied to force the model. The wind stress, is estimated from wind speed using a drag coefficient.
Betulinic Acid, a bioactive compound with significant anticancer potential, suffers from poor solubility and low bioavailability, limiting its therapeutic efficacy. This study aimed to develop Betulinic Acid-loaded lipid nanocarriers (BALNCs) to enhance drug solubility, bioaccessibility, and controlled release. With particle diameters between 42 and 44 nm, a polydispersity index (PDI) of approximately 0.26, and a zeta potential of approximately 20 mV, the nanocarriers were effectively synthesised and characterised, guaranteeing stability.
