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THE EFFICACY AND SAFETY OF LEBRIKIZUMAB PLUS TOPICAL CORTICOSTEDOIDS IN MODERATETO SEVERE ATOPIC DERMATITIS.
Inflammatory and chronic skin conditions such as AD have a serious impact on patients' quality of life. A phase 3 randomised, placebo-controlled trial, ADhere (NCT04250337) examined the efficacy and safety of low-to-mid potency topical corticosteroids (TCSs) that contain IL-13 monoclonal antibody in moderate and severe AD, adolescents, and adults. Combining lebrikizumab and TCS was found to have tremendous effects on skin clearance and itch intensity, sleep disturbances, and quality of life in the trial. There has already been a statistically significant increase in EASI-75 week 4 and IGA (0,1) week 8 responses. Combination therapy was highly compliant and mild or moderate adverse events were reported mainly. In addition, these findings support the use of lebrikizumab and TCS as an effective method of managing moderate and severe AD.
Copyright (c) 2024 https://creativecommons.org/licenses/by/4.0/deed.en
EVALUATION OF TREATMENT EFFICACY AND COST-EFFECTIVENESS FOR WARTS IN PATIENTS WITH ADVANCED MALIGNANCIES
This research paper was to compare the clinical effectiveness and cost-effectiveness of different treatments of warts in 300 patients, considering the complete remission (CR) rates and the cost involved. Human papillomavirus (HPV) is the main cause of warts that can be seen in people of all ages and treated because of its painful and unattractive appearance. The methods of treatment evaluated in the study included four treatments: cryotherapy, topical imiquimod, surgical excision and combinations (cryotherapy and topical imiquimod). Age, gender, performance status, cancer stage (with cancer patients) and previous treatment history were identified as the baseline data. The outcomes indicated that 60 percent of patients attained CR with original warts and 73.3 percent with warts of any kind. The most prevalent modality was cryotherapy (50%), then topical imiquimod (38.9%), and surgical excision (11.1). The recurrence rates of original warts and warts in general were 22.2 and 22.7 respectively. The overall average cost per patient was 3250 that comprised both the direct and indirect cost. The economic model showed that combined therapy was the most affordable of the treatment generated and its cost was 2,450/CR. Cryotherapy and topical imiquimod were both effective and cost-effective and surgical excision was the least cost-effective intervention. These results indicate that cryotherapy and topical imiquimod are more appropriate because of their effectiveness and costs, especially when limited resources are used, and combined therapy may be the most appropriate with respect to the success of therapy and costs.
Patient Knowledge and Disease Activity in Rheumatoid Arthritis: Associations, Determinants, and Implications for Treat-to-Target Care
Background: Rheumatoid arthritis (RA) is a chronic, immune-mediated inflammatory disease characterized by persistent synovitis, progressive joint destruction, and significant functional impairment. Despite major therapeutic advances and the widespread adoption of treatto-target (T2T) strategies, a substantial proportion of patients fail to achieve sustained remission or low disease activity. Growing evidence suggests that patient-related factors, particularly disease-related
Patient Knowledge, Disease Activity, Rheumatoid Arthritis
Fadia Abd Allah Abd Alghany, Lobna Ismaeil Kotb , Eman Abdelsalam Mostafa Abdelkareem, Dina Sameh Mohamed El Rafey
Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0/deed.en
Executive Functions, Challenging Behaviors and Sleep Habits Among Children with Attention Deficit Hyperactivity Disorder
Background: Executive dysfunction is a major factor in the consequences of neurological developmental disorders including attention deficit hyperactivity disorder (ADHD), which causes challenging behavior and decreased social functioning. Additionally, higher sleep problems have been linked to lower executive skills in children with ADHD
ADHD, Challenging behaviours, Executive functions, Sleep Habits
Mai fawzi lotfi zaher , Radwa Ahmed Abdel Razek and Safia Ragab El Sebaie
Diagnostic Performance of Pulse Oximetry Waveform Analysis for Ambulatory Identification of Cardiac Arrhythmias
Background: Cardiac arrhythmias are a major cause of morbidity and mortality worldwide, with atrial fibrillation and other rhythm disturbances frequently remaining undiagnosed due to their intermittent and often asymptomatic nature. Conventional diagnostic strategies, including electrocardiography (ECG) and Holter monitoring, are limited by short monitoring durations, accessibility barriers, and patient adherence issues
Mohamed Salah Abdelbasit, Ahmed Magdi Hamed Mohamed Afify , Mohamad Hossam Eldeen Alshair, Shaimaa Wageeh Mohamed
Early Clinical Outcomes of Arthroscopic Treatment for Femoroacetabular Impingement: A Comprehensive Review
Background: Femoroacetabular impingement (FAI) has emerged as a major etiologic factor in the development of hip pain and early osteoarthritis among young and active individuals. The evolution of hip arthroscopy over the past two decades has provided a minimally invasive alternative to open surgical hip procedures, enabling precise correction of cam and pincer morphology, labral repair, and chondral management with reduced morbidity
Early Clinical Outcomes, Arthroscopic Treatment, Femoroacetabular Impingement
Mohammed Al-Ahmady Abdel-Rahim Ali , Mohammed Othman Mohammed Othman , Walid Ashraf Elnahal , Hany Mohammed Abdel-Fattah Bakr
Evaluation of the Toxic Effects of Dichloroacetic Acid on Hippocampus of Adult Male Albino Rats
Background: Dichloroacetic acid (DCAA) is a prevalent disinfection byproducts (DBPs) formed during the chlorination process of drinking water disinfection. Owing to its well-documented toxicological properties, DCAA has attracted substantial scientific attention. Extensive experimental studies in rodent models have demonstrated
Dichloroacetic acid, hippocampus, disinfection byproducts, neurotoxicity.
Basma Taher Megahed Ali , Sarah Elsayed Yousry El Refaey , Shaimaa Ali Abdelrahman , Eman El-Sayed Hassan Khayal , Nourhan Mohammed Hassan
Can Targeting Oxidative Stress and Inflammation with Lycopene Prevent Paclitaxel-Induced Spermatogenic Disruption?
Background: Paclitaxel is a widely used chemotherapeutic agent effective against various solid malignancies, including breast, ovarian, and lung cancers. Despite its therapeutic efficacy, accumulating experimental and clinical evidence indicates that paclitaxel exerts deleterious effects on the male reproductive system. Testicular tissue, characterized by rapid germ cell proliferation and high polyunsaturated fatty acid content, is particularly vulnerable to chemotherapeutic-induced
Paclitaxel; Lycopene; Testicular toxicity; Oxidative stress; Inflammation; Spermatogenesis; Reactive oxygen species; Chemotherapy-induced gonadotoxicity; Antioxidants; NF-κB.
Anogenital Distance as a Biomarker of Androgen Exposure and Female Sexual Function: Clinical Evidence and Mechanistic Links
Background: Anogenital distance (AGD) has emerged as a sexually dimorphic anthropometric measure reflecting prenatal androgen exposure. In females, AGD is increasingly investigated as a noninvasive biomarker of in utero androgenic programming, with potential implications extending into reproductive endocrinology and sexual medicine
Anogenital Distance, Androgen Exposure, Female Sexual Function
Ahmed Ismail Mohamed , Amal Mohamed El-anwar , Nourhan Essam Mohamed Mohamed Mounir , Abdallah Fekry Abdelmaksoud
Molecular Crosstalk Between Circulating miRNA-17-5p and Cyclin D1: Biochemical Insights into Acute Coronary Syndrome Diagnosis
Background: Acute coronary syndrome (ACS) represents a continuum of life-threatening ischemic cardiac events, encompassing unstable angina and myocardial infarction, which arise from atherosclerotic plaque rupture and subsequent coronary thrombosis. Despite advances in cardiac biomarkers such as troponins and natriuretic peptides, early and precise diagnosis remains challenging due to their limitedsensitivity during the initial ischemic phase. In recent years, circulating
miRNA-17-5p,Cyclin D1, Acute Coronary Syndrome
Haidy Essam Eldin Ahmed Zidan, Alaa El-Sayed Mohamed Abdullah Salama, Salma Emad Gharib Abdullah , Asmaa Atef Ahmed Ali Ibrahim
Beyond Ejection Fraction: How High-Burden PVCs Reshape Left and Right Ventricular Mechanics on Advanced Echocardiography
Background: Frequent premature ventricular complexes (PVCs) are commonly encountered in clinical cardiology and have traditionally been regarded as benign in patients without overt structural heart disease. Accumulating clinical and imaging evidence, however, indicates that a sustained high PVC burden may exert significant adverse
Ejection Fraction, PVCs Reshape , Advanced Echocardiography
Radwa Muhammad Abdullah , Ahmed Fathy Ahmed Elsayed , Mohammad Abdalla Eltahlawi , Omar Ayman Abdelbaset Elshaarawy
BIOTECHNOLOGY SOLUTIONS FOR SOIL HEALTH MANAGEMENT
Abstract: Soil health represents a critical determinant of agricultural productivity, ecosystem stability, and sustainable development. The increased agricultural practices, the over usage of chemicals coupled with the change in climatic conditions have contributed to massive soil erosion that includes the loss of rejuvenation of the nutrients, anaerobicity
Soil health, biotechnology, biofertilizers, microbial inoculants, sustainable agriculture, rhizosphere, mycorrhiza, soil microbiome, nutrient cycling, bioremediation
THE EVOLVING LANDSCAPE OF FEMALE REPRESENTATION IN OPHTHALMOLOGY RESIDENCY AND CLINICAL PRACTICE
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.
Copyright (c) 2023 https://creativecommons.org/licenses/by/4.0/deed.en
Serum Sirtuin-1 Level in Systemic Lupus Erythematosus and its Relation to Disease Activity and Metabolic Syndrome
Background: Background: Systemic lupus erythematosus is a chronic autoimmune disease characterized by immune dysregulation, multisystem involvement, and increased cardiovascular risk. Sirtuin-1 is a regulatory
Sirtuin-1, Systemic Lupus Erythematosus , Disease Activity, Metabolic Syndrome
Asmaa Abdelhady Wafa, Amany Mostafa Abou Elsoud, Nahlah Ibrahim El-attar, Amina Mohamed Hussini
EFFECT OF PSYCHO-EDUCATIONAL PROBLEM THERAPY ON SPEAKING PHOBIA MANAGEMENT AMONG ENGLISH LANGUAGE STUDENTS IN SENIOR SECONDARY SCHOOLS IN NORTH WEST, NIGERIA
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.
Copyright (c) 2025 https://creativecommons.org/licenses/by/4.0/deed.en
EFFICACY AND SAFETY OF LEMBOREXANT IN ELDERLY PATIENTS WITH INSOMNIA DISORDER: A RANDOMIZED CONTROLLED STUDY
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.
EFFICACY AND SAFETY OF ESKETAMINE NASAL SPRAY IN PATIENTS WITH MAJOR DEPRESSIVE DISORDER AND ACTIVE SUICIDAL IDEATION: RESULTS FROM A RANDOMIZED DOUBLE-BLIND STUDY
Major depressive disorder and the presence of active suicidal ideation is a psychiatric emergency that must be treated swiftly and efficiently. The traditional antidepressants have the disadvantage of slow action that causes an unmet clinical need in acute suicidal crisis. It was a randomized, placebo-controlled, double-blind study, which compared the effectiveness and safety of the esketamine nasal spray in patients with major depressive disorder and intent-to-committ suicide thoughts. One hundred and sixty (160) patients were randomly assigned to take esketamine 84 mg and the standard-of-care or placebo and standard-of-care. The main outcome measure was Montgomery-Aseberg Depression Rating Scale (MADRS) total score at 24 hours of first dose. The secondary endpoints were modifications to the severity of suicidality and safety outcomes. Esketamine was shown to respond with rapid response in the depressive symptoms than that of placebo, with a statistically significant response in terms of suicidality measures. Adverse events emerging during the treatment were high in the esketamine group yet were mostly mild to moderate and temporary. These results justify the use of esketamine as a suitable and convenient rapid-acting intervention, in high-risk patients with depression.
Copyright (c) 2024 Dr. Vidhya Joth N (Author) https://creativecommons.org/licenses/by/4.0/deed.en
Recalcitrant Alopecia Areata: Pathogenesis, Predictive Biomarkers, and Emerging Therapeutic Strategies
Background: Alopecia areata (AA) is a common autoimmune hair loss disorder driven by loss of hair follicle immune privilege and cytotoxic T-cell–mediated inflammation. While many patients experience spontaneous remission or respond to topical/intralesional corticosteroids, a clinically important subset develops recalcitrant AA—persistent, relapsing, or progressive disease despite appropriate therapyoften associated with extensive scalp involvement
Recalcitrant Alopecia Areata, Pathogenesis, Therapeutic Strategies
Mahmoud Yousry AbdelMawla, Fathia Mohamed Khattab, Eman Hassan Abdelbary , Menna Allah Hamed Abdel Aziz
Minimally Invasive Management of Displaced Intra-Articular Calcaneal Fractures: Functional and Radiological Outcomes
Background: Displaced intra-articular calcaneal fractures (DIACFs) represent one of the most complex injuries in foot and ankle trauma, often resulting from high-energy mechanisms and associated with substantial morbidity. Traditional open reduction and internal fixation (ORIF) via extensile lateral approaches has been considered the gold standard for restoring calcaneal anatomy and subtalarcongruity. However, this technique is associated with high rates of wound complications
Minimally Invasive, Displaced Intra-Articular Calcaneal Fractures
Mohamed Ismail Abdelrahman Kotb , Ahmed Hashem Amin, Mahmoud Mohamed Farag Mohamed , Ahmed Mohamed El-shaer
Outcomes After Stapled and Hand-sewn Intestinal Anastomosis in Emergency General Surgery: A Narrative Review with Practical Recommendations
Background: Emergency general surgery accounts for a substantial proportion of surgical morbidity and mortality worldwide, with emergency laparotomy representing one of the highest-risk procedures. Intestinal resection with primary anastomosis is frequently required in this setting for indications such as bowel obstruction, ischemia, perforation, trauma, and complicated colorectal pathology. However, the hostile physiologic environment of emergency surgery
Stapled, Hand-sewn Intestinal Anastomosis
Tamer.A.A.M.Habeeb, Walid Abdelmawla Elsayed Ali, Reham Zakaria Mohamed , Ahmed Hassan Soliman Yhya
REAL TIME EFFICIENT VEHICLE SPEED MONITORING AND TRAFFIC SURVEILLANCE SYSTEM USING DEEP LEARNING
Real-time vehicle speed monitoring and traffic surveillance are critical for reducing urban accidents, yet existing deep learning systems struggle with low-resolution CCTV, occlusions, and variable frame rates in diverse Indian traffic. This paper introduces the Uncertainty-Guided Hybrid YOLOv10-Transformer (UGHYT) framework, which fuses optical flow transformers for robust detection/tracking, evidential deep learning for probabilistic speed regression, and federated edge distillation for deployment on resource-constrained CCTV nodes. Evaluated on MITS dataset (94.1% mAP) and custom 50-hour Bhopal CCTV corpus (3.8 km/h RMSE, 35 ms latency), UGHYT outperforms YOLOv8/9 baselines by 35% in speed accuracy under 70% occlusion and 480p conditions.​ UGHYT enables scalable IoT-edge integration for smart cities, supporting anomaly alerts and adaptive signals. Future federated learning across regions promises cross-domain robustness for safer transportation.
Copyright (c) 2024 Mohit Tiwari, Dr. Vikas Sakalle (Author) https://creativecommons.org/licenses/by/4.0/deed.en
Iron Oxide Nanoparticles: Physicochemical Determinants, Multifunctional Applications, and Toxicological Implications Across Biological Systems
Background: Iron oxide nanoparticles (IONPs) have emerged as one of the most extensively investigated nanomaterials owing to their unique magnetic properties, versatile surface chemistry, and broad applicability across biomedical, industrial, food, environmental, and agricultural sectors. Their increasing integration into clinical imaging, drug delivery, food additives, cosmetics, and environmental remediation has markedly expanded the potential for human exposure, raising
Iron Oxide Nanoparticles, Toxicological Implications, Biological Systems
Mie Mohammed Samir Gomaa, Nashwa Mohamad Mohamad Shalaby, Mohamed Abdelrahman Ghoneim Shaheen, Hoda Gamal Ghonemy Ibrahim
EFFICACY OF TWO MODES OF PROJECT-BASED TEACHING METHODS ON STUDENTS’ INTEREST IN BASIC SCIENCE AND TECHNOLOGY: IMPLICATIONS FOR SCIENCE TEACHERS, EDUCATIONAL AND BUSINESS MANAGERS
This study examined the efficacy of two modes of project-based teaching methods (grouped and individualized) on students’ interest in Basic Science and Technology, with gender as a moderating variable. The study was motivated by the persistent low interest and engagement of students in Basic Science, which is critical for scientific literacy and national development. A quasi-experimental design was employed, involving 76 secondary school students (34 males and 42 females) from selected schools. The Basic Science Interest Scale (BSIS) was used to collect pre-test and post-test data. Reliability of the instrument was established using Cronbach Alpha, which gave reliability coefficient of 0.84. Descriptive statistics of mean and standard deviation and analysis of covariance (ANCOVA) were used to analyze the data. Findings revealed that students taught using the Group Project-Based Teaching Method recorded significantly higher interest scores than those taught using the Individualized Project-Based Teaching Method; there was no significant difference in the mean interest scores of male and female students in Basic Science, although male students recorded slightly higher interest ratings than their female counterparts; the interaction effect of gender and teaching methods on students’ interest in Basic Science was not significant. It recommends that science teachers adopt these methods, while educational and business managers provide resources and support to facilitate their implementation.
Copyright (c) 2025 Chisom Precious Anyigor, Chiamaka Nneka Oguejiofor, Nneka Charity Emeasoba, Samson Abayomi Ojo, Michael Eze Odo, Nkeiru Catherine Enyi, Alieze Sunday Ekpa, Damian Kanayochukwu Ogbu, Chinyere Maryrose Nwachukwu, Chinwe Nene Nwatarali (Author) https://creativecommons.org/licenses/by/4.0/deed.en
Fiscal Imbalances and Debt Sustainability in India: The Role of Growth, Unemployment, and Interest Burden
The dynamics in the post-reform period of the Indian public debt are not only characterised by the presence of fiscal imbalances but also by the interplay between deficit financing, employment pressures, growth performance and increasing interest commitments. Although traditional methods of debt sustainability tend to use the traditional focus on fiscal discipline, the experience in India has indicated that structural labor market factors
Public debt; fiscal deficit; unemployment; economic growth; fiscal responsibility; India
AZITHROMYCIN AND CO-AMOXICLAV AT DIFFERENT DOSAGES HAVE BEEN PROMOTED FOR TREATING CHILDREN WITH LOWER RESPIRATORY TRACT INFECTIONS
The effectiveness of azithromycin in treating acute lower respiratory tract infections (LRTI) was evaluated through a comparison study with co-amoxiclav. Depending on their weight, the children received either azithromycin (10 mg/kg/day) or co-amoxiclav (45/11.25 mg/kg/day). Co-amoxiclav treatment cured 87 percent, whereas azithromycin treatment cured 91 percent. In view of P=0.55, we conclude that there are no statistically significant differences between the two groups. The drug, however, caused significantly fewer adverse reactions in patients, most of which occurred in the gastrointestinal system. Patients who received azithromycin and co-amoxiclav between 25 and 30 days after treatment showed improvement by their third visit. The benefits of azithromycin are greater for children with LRTI than those of coamoxiclav because it is safe, effective, and convenient.
ZONISAMIDE: EFFECTIVENESS AND SAFETY IN CHILDREN WITH EPILEPSY: A POSTMARKETING STUDY IN INTELLECTUALLY NORMAL AND DISABLED CHILDREN
An analysis was done to determine zonisamide's long-term efficacy and safety in the treatment of childhood epilepsy, comparing its outcomes for intellectually normal and intellectually disabled children. Among the 349 subjects, all were younger than 15 years of age; they were divided into two groups based on their intellectual abilities: the intellectually normal group (n=184) and the intellectually disabled group (n=165). It was found that 62 percent of subjects improved on seizure control over the previous month, with 78 percent of subjects responding better than 45 percent of subjects with intellectual disabilities. There is some evidence that zonisamide is not only effective in partial and generalized seizures, but it is also superior in this case when applied to people who are intellectually normal. There were 24 percent of patients who reported having adverse effects that were more severe when monotherapy was used compared to combination therapy. It is clear that zonisamide may be useful in treating partial and generalized seizures in children, but adverse events should be monitored, especially when used in combination with other medications.
Intellectually disabled children and Adverse effects
TOPIRAMATE FOR REFRACTORY EPILEPSY IN PEDIATRIC PATIENTS: A MULTI-CENTER TRIAL ON CLINICAL OUTCOMES AND SIDE EFFECTS
This paper compared the efficacy and safety of topiramate in young children and infants with refractory epilepsy. A total of 24 children, aged 6 to 60 months, diagnosed with refractory epilepsy were included in the study. Three tertiary hospitals were used to recruit these children and the study protocol was accepted by the ethical committees of all the participating institutions. The first endpoint was the change of seizure frequency, with therapeutic responses categorized as satisfactory (seizure-free or >50% reduction) or unsatisfactory (≤50% reduction or worsening). The study also monitored side effects, including cognitive and physical symptoms, as well as changes in concomitant antiepileptic drug levels, liver function, and overall health. The results showed that 50% of the participants had a satisfactory response, with 21% achieving complete seizure freedom. The highest efficacy was observed in children with Lennox-Gastaut syndrome, followed by those with cryptogenic epilepsy. Common side effects included somnolence, poor appetite, irritability, and fatigue, all of which were generally mild and transient. Severe side effects, such as worsened seizures and hypothyroidism, were rare. Despite some limitations, including the absence of blood level monitoring for topiramate and a short follow-up period, the study supports topiramate as a viable treatment for refractory epilepsy in pediatric patients, particularly in cases where other AEDs have failed.
Building Climate Capability: Green HRM and Emissions-Linked Rewards in Bangladesh
Corporations are increasingly adopting climate objectives; yet, many find it challenging to integrate these goals into daily operations and achieve quantifiable carbon reductions. This paper hypothesizes and examines how Green Human Resource Management (GHRM) and emissions-linked incentives (ELR) together develop climate capabilities, which are characterized as the routines, skills, and governance practices that facilitate Scope 1–3 abatement. Utilizing strategic human capital and dynamic capabilities, we assert that (i) GHRM directly improves employees’ climate knowledge, motivation, and opportunities for action; (ii) ELR reinforces the instrumental pathway by linking rewards to validated emissions performance; and (iii) climate capabilities mediate the effects on pro-environmental behavior (PEB) and emissions performance. We estimate a structural equation model using a multi-firm, multi-respondent survey including managers and staff, alongside organization-level emissions KPIs. Results demonstrate that GHRM (β≈0.41, p<.001) and ELR (β≈0.27, p<.01) are both predictors of climate capacities, exhibiting a positive interaction (β≈0.12, p<.05). Capabilities subsequently predicted PEB (β≈0.48, p<.001) and enhancements in emissions intensity (β≈0.22, p<.05). We examine the consequences of implementation: integrate climate responsibilities into roles, certify training, accurately assess abatement, and incentivize teams based on confirmed reductions.
Copyright (c) 2024 Dr. Mohamed Kaisarul Haq, Dr. Farzana Nazera, Mohammad Shah Alam Chowdhury (Author) https://creativecommons.org/licenses/by/4.0/deed.en
THE ORAL DEXAMETHASONE EFFECTIVENESS IN REDUCING GASTROINTESTINAL AND NEUROLOGICAL SIDE EFFECTS OF METRIZAMIDE LUMBAR MYELOGRAPHY: A DOUBLE-BLIND, PLACEBO-CONTROLLED STUDY
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.
EFFECTS OF ALENDRONATE, HORMONE REPLACEMENT THERAPY AND COMBINATION TREATMENT ON HIP STRUCTURAL GEOMETRY IN OLDER WOMEN: A HIP STRUCTURE ANALYSIS- BASED RANDOMIZED CONTROLLED TRIAL
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.