BACKGROUND: Acute exposure to hypobaric hypoxia can give rise to acute mountain sickness, and rarely, high altitude pulmonary edema, and high altitude cerebral edema. However, with gradual adaptation to “chronic hypoxia”, following the Adaptation to High Altitude Formula (Adaptation = time / altitudeΔ), the organism does remarkably well. High altitude residents are perfectly adapted to their environment. The cities of La Paz (3100–4100 m) and El Alto (4100 m) stand as living proof of this with 2.7 million inhabitants living perfectly normal lives, undisturbed by hypoxia and most even unaware of its existence. All the cells of the organism adapt to a lower arterial oxygen arterial partial pressure (PaO2) and likewise to a lower arterial partial pressure of carbon dioxide (PaCO2), an essential component that linked to an increased compensatory hemoglobin explain the paradox of increased “tolerance to hypoxia” at high altitude. METHODS: We reviewed the > 70 years old population historic records of the official Bolivian registration service SEGIP. Two groups were analyzed: those greater than 90 years of age, and those greater than 100 years of age according to the different altitude departments in Bolivia. RESULTS: As the altitude increases, the longevity increases. Santa Cruz at 416m and La Paz at 3800m (average), both with around 2.7 million inhabitants each, have 6 versus 48 centenarians respectively. CONCLUSIONS: Life under chronic hypoxia is not only tolerable, but also is, in fact, favorable to improve or treat many pathological conditions such as asthma, coronary artery disease, obesity and even giving rise to improved longevity. Sea level residents (when compared to high altitude residents) suffer a disability: poor tolerance to hypoxia.

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Background: Due to abuse and improper prescribing policy of antibiotics, the antibiotics resistance were remarkably increased in Pseudomonas aeruginosa, so there are urgently need to develop a new kind of antimicrobial to treat Pseudomonas aeruginosa infection. Biosynthesized silver nanoparticles (Ag NPs) have showed its interesting impact against bacterial infection drawn researchers to green nanotechnology. Aims: The study was conducted to evaluate the antibacterial activity of AgNPs against multi drug resistant P. aeruginosa isolated from urine sample of UTI patients. Methods: 126 UTI patent's urine samples were included in the study. P. aeruginosa strains were isolated, identify, antimicrobial susceptibility, drug resistance mechanisms were done as per routine laboratory protocol. The antimicrobial activity and mechanisms of the killing of Ag NPs were studied. Results: From this study, it was revealed that 25 (19.84%) isolates were multi drug resistant Pseudomonas aeruginosa. Green synthesized Ag NPs successfully destroyed the multi drug resistant strains via ROS generation and membrane damage. The prevalence of multidrug resistance is increased worldwide and there are urgently need another option to control the multidrug resistant strains. Conclusion: The findings of the study suggested that Ag NPs might be used to treat the multi drug resistant Pseudomonas aeruginosa.

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Objective: Early diagnosis and treatment decreases the mortality and morbidity of neonatal sepsis(NS). The aim of this study was to find out the level of different inflammatory markers in neonatal sepsis. Methods: Forty two term neonates with non-sepsis (n = 17), clinical (n = 10) and proven (n = 15) sepsis were evaluated. Blood cultures were obtained and ESR, CRP, procalcitonin, IL-6 levels were measured. Statistical analysis was performed to look for association between NS and different inflammatory markers and to compare the strength of association among the markers. Findings: Among the 42 neonates, CRP level was found to be elevated in 27 neonates, ESR in 22 neonates, both procalcitonoin and IL-6 in 24 neonates respectively. Both sensitivity and specificity of procalcitonin and IL-6 were high compare to CRP. Conclusions: Blood culture significantly increases the proven sepsis status among neonates with suspected sepsis. ESR is a poor predictor of NS. Newer inflammatory markers namely procalcitonin and IL-6 were found to have greater value than CRP, but not ESR.

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Background: In iodine-replete basin of the river Ganga and the Bay of Bengal, we studied iodine nutritional status of school children by goiter prevalence and their urinary iodine (UI), iodine content in edible salt, and the bioavailability of iodine through water and its contribution to iodine nutrition. We also studied consumption pattern of common goitrogenic plants by measuring urinary thiocyanate (USCN), hardness of water (calcium and magnesium salt content) and assessed the effect of concomitant exposure of those environmental factors in goitrogenesis. Methods: 4603 children aged 6-12 years were examined for goiter by palpation, 520 urine samples were analyzed for UI and USCN; iodine content was estimated in 455 household salt and 130 water samples tested both for iodine and hardness. Results: The total goiter rate was 35.9%, median UI was 231 ΅g/l, mean USCN was 0.857 ± 0.48 mg/dl, iodine content in water was 44.7 ± 4.1 ΅g/l, 66.4% of salt samples contained iodine (15 ppm), and water was found to be hard. UI was correlated with both the drinking water iodine content and USCN and the degree of hardness in drinking water was associated with goiter prevalence. Conclusions: The studied population has endemic goitre despite iodine sufficiency. The concomitant exposure of a number of environmental factors, i.e., thiocyanate of cyanogenic plant food, hardness of drinking water, and excess iodine from environmental sources other than iodide salt are likely responsible for the causation and persistence of endemic goiter in the region.

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Background: Physical activity, health fitness, and academic results are very important goals in student life. However, success lies in academic subjects in educational establishments. Our background reveals the contradictions between two philosophers who approved the importance of physical education (PE) as a component of the curriculum and others who reiterated that PE and sports would never be a component of the curriculum as is the case in Algerian universities. Methods: The research samples were selected by the intentional manner which included sixty students, aged around 18 years. Twenty girls who will pass the baccalaureate, twenty girls of the 1 ^st year department languages, and twenty girls of the 1 ^st year PE and sports for the academic year 2014-2015 were included in the study. They were tested based on the field tests developed by the Canadian Society for Exercise Physiology. Results: Our results confirm that the absence of PE lessons and sport case department languages leads to loss of fitness in the opposite of high-school and students of the Institute of Sports, where the effects return to the absence of the session of physical education and sport. Conclusion: Physical activities are very important in the life of our scholar girls, where the sport practice is a physical as well as a mental effort which is the key to a healthier life.

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Context: Shelf life of the drug can be considered up to the period it gets deteriorated and does not get any alteration in its physicochemical state. Every product has definite shelf life, which depends on various physical, chemical, environmental, and biological factors. Ancient seers have clarified shelf life of various compound formulations. However, there is a need to revalidate and ascertain the shelf life of individual formulations by following parameters prevalent in respective scenario. Aim: To evaluate shelf life of Shirishavaleha prepared in the presence of water (SW) and Kanji (SK) as liquid media through accelerated stability study. Subjects and Methods: Physicochemical parameters were measured at 40°C ± 2°C temperature and 75% ±5% relative humidity. Analysis was repeated at intervals of 1, 3, and 6 months, and average 10% degradation of both the test drug samples was calculated and extrapolated to find the shelf life. Results: The sample prepared in the presence of Kanji (SK) showed more extractive values and sugar contents and found to have longer shelf life (2.6 years) than SW (1.4 years). Conclusion: Shirishavaleha prepared with Kanji (SK) is comparatively more stable than the sample prepared with water (SW).

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Psoriasis is a common inflammatory skin disorder characterized by itchy erythematous papules and plaques topped with silvery white scales. It has a chronic relapsing course and is associated with significant morbidity and reduction in the quality of life. Therapy of psoriasis is challenging. Topical therapy forms the first line of treatment for stable plaque psoriasis affecting a limited body surface area and in extensive disease systemic agents are indicated. All these drugs have inherent side effects, and none bring prolonged remission of the disease. The other therapeutic modality for psoriasis is phototherapy, but it is delivered through a specialized machine which can be available only at referral centers. Biologics have revolutionized the management of psoriasis as they can bring a remission of disease up to several years. Although limited availability and high cost prohibit their regular usage, Indian dermatologists are rapidly adopting biologics in the treatment of psoriasis.

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The Ziziphus jujuba tree is one of the major sources of betulinic acid (BA). After isolation, the bulk structure of the compound was converted to a self-assembled nanofibers (SA-BA) configuration which showed better anti-leukemic efficacy than its bulk form. After internalization in leukemic cells, SA-BA elevated reactive oxygen species (ROS) and pro-inflammatory cytokine secretion which ultimately activated apoptosis pathway. The SA-BA showed potent ameliorative role against acute chemotherapeutic toxicity induced by doxorubicin in human peripheral blood lymphocytes through the mechanism totally opposite to said pathway. Thus, SA-BA showed cell specific distinct effects. It was also revealed that the SA-BA had potent immunomodulatory affected on T cells and macrophages by polarizing the cytokine balance toward Th1 at a slightly higher dose. SA-BA arrested the growth of in vivo cancer by increasing the CD4 ⁺ cells in associated with increased cytotoxic T-cell response. SA-BA was also selectively internalized in folate receptor overexpressing leukemic cells. For this purpose, folic acid (FA) and polyethylene glycol (PEG) were conjugated on the nanostructured of SA-BA. After internalization, the conjugate (FA-PEG-SA-BA) diminished the cellular redox system and generated an excess amount of ROS which induced tumor necrosis factor-alpha-mediated cell death through activation of caspase 8 and 3 cascade system. Throughout all these studies, no toxic effects of the conjugates toward normal cells were observed. Thus, the whole study enlightens the multifunctional role of SA-BA in different aspects of anti-leukemic therapy which may be useful in future treatment policies.

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Objective: Tongue cancer (TC) is one of the most common oral cancers. Prognostic evaluation of this tumor includes histologic grade and TNM stage. In this study, we evaluated the expression of p53, Ki-67, epidermal growth factor receptor (EGFR), and sex-determining region Y-box 2 (SOX2) and correlated it with the clinicopathologic variables to assess their potential for use as prognostic markers. We compared the p53 positive and negative group. Design: A retrospective and prospective study with 45 cases of biopsy proven TC which were studied for the expression of p53, Ki-67, EGFR, and SOX2. The results were correlated with known clinicopathologic variables using Chi-square test. The p53 positive and negative groups were compared. Materials and Methods: Archieved blocks of biopsy proven TC were retrieved. Using 4 micron sections of the blockes immunostaining for p53, Ki67, EGFR and SOX2 was done. Results: P53 expression was 68.9%, Ki-67 was 88.9%, EGFR was 48.9%, and SOX2 was 35.6%. Expression of p53 and Ki-67 did not show any correlation with any of the clinicopathologic variables. There was a statistically significant association between EGFR expression and lymph node (LN) positivity (P = 0.001). Stage of tumor and SOX2 positivity showed a significant correlation (P = 0.03). The comparison of p53 positive and negative groups did not reveal a significant difference. Conclusion: p53-negative TC is not significantly different from the p53-positive TC at presentation. The absence of mutant p53 in more than 30% TC points toward the possible etiological role of human papillomavirus in TC. Larger studies are needed to evaluate the possible use of EGFR for prediction of LN metastasis and SOX2 as a prognostic marker.

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Thalassemia is an autosomal recessive disorder characterized by the reduction or absence in the synthesis of the globin chains of hemoglobin. Worldwide, approximately 15 million people are estimated to suffer from this disease and 300 million carriers born every year. The carrier rate for β-thalassemia varies from 1% to 17% in India. The prevalence is very high among certain communities and is emerging as a major public health problem in India but received little attention. Due to the chronic nature of the disease, thalassemic children need long-term treatments such as blood transfusions and chelation therapy. Hence, these children need repeated hospitalization, forgo schooling, and cannot perform day-to-day activities including play. This may affect the quality of life (QoL) in these children. The nursing strategies for enhancing QoL include providing a network of care, supportive strategies, positive coping mechanism, ongoing assessment, prevention of complications, and empowering the children with thalassemia and their parents. The future hopes are unrelated cord blood stem cells, gene therapy. To conclude, a comprehensive approach toward the care of children with thalassemia can increase the level of QoL among these children. The review search was done through Google engine, PubMed as well as scholarly articles from printed journals, and books.

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Realgar has been not only well-known poisons but also used as healing agent. Realgar has long been used in traditional medicines for different diseases; so far arsenic can be extremely toxic and carcinogenic. In Ayurvedic and Chinese traditional medicines arsenic usually comes from conscious addition for healing purposes, mostly in the form of mineral arsenicals with orpiment (As₂S₃), realgar (As₄S₄), and arsenic trioxide (As₂O₃). Pharmacological studies revealed that realgar is effective against in different cancer cell line. However, it has been critically limited clinical applications because of its many disadvantages, for example, low solubility in water, high toxicity, poor gastrointestinal absorption, and bioavailability. This review evaluates the toxicology, bioaccessibility, and pharmacology of the realgar used in Ayurvedic and Chinese traditional medicines. In recent times, numerous types of realgar nanoparticles (NPs) have been developed due to insolubility of realgar in water and different media. Most of the NPs of realgar possess the exclusive optical qualities of quantum dots. The pharmacological activities and bioavailability of realgar NPs are much more partial by their sizes, building realgar an exciting biomedical and pharmaceutical research applicant.

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Introduction: Liver is termed as Yakrut in ayurvedic classical literature, is one of the major organs for maintaining homeostasis, and is involved more or less with all the biochemical pathways in the body. Arogyavardhini Rasa (AVR) is one of the widely practicing ayurvedic herbo-mineral formulations in liver disorders. It has been used for the management of diverse types of Jvara (fever), Kushtha (skin disorders), Medoroga (altered lipid profiles associated with obesity), and other Yakrit vikara (liver disorders). In this study, AVR was prepared as per the 13^th-century classical text Rasaratna Samuchaya. On the other hand, heavy metals causing toxicity, especially mercury present in this formulation, are an issue of concern. Aim of the Study: Hepatoprotective effects of formulation were evaluated by paracetamol (PCM)-induced liver damage in rats to substantiate the role of metal mineral in the classical AVR formulation. Materials and Methods: Effects of formulation were assessed on serum and liver tissue biochemical parameters and histopathological studies. Results: PCM produced significantly impaired the liver and kidney functions as assessed through an increase in liver and kidney marker enzymes. Arogyavardhini-treated group significantly (P = 0.05) prevented this hepatotoxicity and strongly supported by histopathological examinations that revealed AVR shows the protection of liver tissue from PCM-induced hepatotoxicity. Conclusion: The observation of the present study has stalwartly supported the hepatoprotective action of AVR against PCM-induced hepatotoxicity in rats.

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Arsenic, a sulfhydryl reactive metalloid, found primarily in two forms: arsenite and arsenate, causing several human health problems, is considered as a dreaded agent against public health. It mainly spreads through groundwater contamination and affects human mainly through drinking water. Arsenic contaminated groundwater is now a major threat in some parts of India (the river basin of Ganga and Brahmaputra) and Bangladesh. The current authors belong to the region where arsenic poisoning and its consequences are spreading in an uncontrolled way. We are helpless to stop the spreading of geogenic groundwater arsenic contamination at present. Although most of the research on arsenic removal from drinking water and on toxicity profile has been carried out, very few preventive measures have been reported till date to balance the arsenic-induced cellular energy deficiency and oxidative stress-mediated cell death and cellular senescence. And, therefore, we need to think about alternative remedial to address such problems, which propel us to propose the current hypothesis that the adverse effects of energy imbalance due to arsenic toxicity in cells could be dodged by intake of moderate amount of alcohol. While pyruvate dehydrogenase complex is blocked by arsenic, glucose cannot be utilized through Kreb's cycle. However, alcohol can produce energy by bypassing the aerobic adenosine triphosphate (ATP) production machinery. In addition, arsenic poisoning incurs cellular oxidative stress which needs to be scavenged further. So to meet this secondary problem, we also suggest consuming red grape juice (a potent antioxidant and cytoprotective agent) in addition to alcohol (as per International Center for Alcohol Policies (ICAP) Drinking Guidelines) in our second part of the hypothesis. In conclusion, it can be suggested that the red wine which contains moderate amount of alcohol and high levels of red grape polyphenols, galic acid, resveratrol, and other antioxidants could be the best alternative to tackle the arsenic-induced cellular aging, senescence, and death.

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BACKGROUND: Nowadays, one of the most common vulnerable sites of extrapulmonary tuberculosis is female genital tract tuberculosis (FGTB) leading to infertility. As FGTB produce clinical symptom quite late, its detection is very difficult to the health-care providers and according to some experts in this field; FGTB has no confirmatory investigation procedure. FGTB can cause other form of reproductive failure through ectopic pregnancy, tubal block, and implantation failure. Their presence may alter the cytokines level in endometrium. METHODS: A total of 300 cases in our clinic had undergone polymerase chain reaction (PCR) for detection of tubercle bacillus (TB-PCR). Among of them, 91 individuals fulfilling all inclusion and exclusion criteria were included in this study. In our study, we measured cytokines, two from pro-inflammatory group (interleukin-6 [IL-6] and IL-10) and three from inflammatory group (IL-2, interferon gamma [IFNγ], and tumor necrosis factor alpha [TNFα]). RESULTS: Out of 91 participants, 45 (49.46%) cases were TB-PCR positive, and 46 (50.55%) cases were TB-PCR negative. It has been observed that the value of IL-10 and TNFα did not fit any statistical parameter. The result showed that pro-inflammatory indicators IL-6 and inflammatory indicators IL-2 and IFNγ had significant different values between TB-PCR- positive and TB-PCR-negative groups. P value of this cytokines has statistically significant. CONCLUSION: From our study, we conclude that cytokine study was undertaken, of which IFNγ showed a possibility to become an important clinical indicator of endometrial hostility followed by IL-2.

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OBJECTIVES: The aim of this study is to compare the role of Kabat rehabilitation and facial exercise techniques with nerve stimulation common in both for Bell's palsy treatment and its effectiveness in improving physical and social function. MATERIALS AND METHODS: A randomized control trial conducted at the Department of Physiotherapy, Mayo Hospital, Lahore. Two equal Groups (A and B) consist of 26 patients each. Patients were employed Kabat rehabilitation technique in GroupA and with facial exercise in Group-B. Patients in both treatment groups were followed until 3 weeks and improvement in Sunnybrook facial grading scale (SFGS) and facial disability index (FDI) scale were recorded at the end of treatment. RESULTS: In this study, 52 patients were enrolled into the study. At the end of 3 weeks, more improvement was seen in SFGS in Group-A (81.58 + 11.321) versus Group-B (63.77 + 21.645). Similarly, the improvement in physical and social function on FDI in Group-A was more than Group-B (>0.05). CONCLUSION: Kabat technique is more effective as compared to facial exercise technique in improving physical and social function.

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BACKGROUND: Exercise plays an essential role in managing cardiovascular disorders, and high-intensity training (HIT) exercise is a potential, time-effective alternative to traditional aerobic exercise. OBJECTIVES: The objective of this study was to evaluate the effect of HIT program on the time and frequency domains of heart rate variability (HRV) in sports professionals and healthy young adults (18–30 years of age) through a systematic review. METHODS: Physiotherapy Evidence Database (PEDro), PubMed, ScienceDirect, Taylor and Francis Online, and Google Scholar were searched for relevant studies. PEDro scale was used to assess internal validity, exclude risk bias, and assess the methodological quality of studies. RESULTS: A total of 4430 search results were obtained by searching for specific keywords, out of which, only 7 studies met the inclusion criteria after removing all the duplicate articles. Our results showed that HIT programs have significant effect on HRV (root mean square of successive difference [RMSSD], mean difference [MD] =13.35, 95% confidence interval [CI] =1.73, 24.97), high-frequency (HF, MD = 381.7, 95% CI = 321.54, 441.86) power, and low- to high-frequency power (MD = -0.10, CI = -0.73, 0.53) ratio in young adult athletes and healthy young adults. No significant difference was found in other HRV variables. CONCLUSION: HIT is an effective exercise program that can cause improvement in parasympathetic and sympathetic cardiac modulation depending on the duration of the HIT program. HIT program can be given for 2–4 weeks to improve HRV in young adults.

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CONTEXT: Iron-folic acid deficiency is the leading nutritional deficiency globally, affecting the lives of >2 billion people, accounting over 30% of the world's population. Provision of iron-folic acid supplement to all pregnant women, is among the very critical interventions to reduce the burden of anemia. Even though the service is free in Ethiopia, the prevalence of anemia is slowly increased in the country. AIM: The aim is to assess adherence to iron-folic acid supplementation and associated factors among pregnant women attending governmental health center in Yeka sub city, Addis Ababa, Ethiopia, from November 1 to 30, 2019. METHODOLOGY: An institutional-based quantitative cross-sectional study was used to conduct the study. Systematic sampling system was used to select 408 study populations. Data were collected through interview using structured questionnaire. Bivariate and multivariable logistic regressions were employed to identify the predictor variables. Statistical significance was considered at P < 0.05 with adjusted odds ratio (AOR) calculated at 95% confidence interval (CI). RESULTS: A total of 408 pregnant women attending anti-natal care (ANC) were participated in this study, with response rate of 100%. The overall adherence rate was found to be 71.3%. Women whose family income >1500 Ethiopian Birr (ETB) (AOR [95% of CI]) = 3.77 (0.58–24.38)], having secondary or higher educational level (AOR [95% of CI]) = 1.48 (0.90–2.43), having history abortion (AOR [95% of CI] = 6.99 (1.11–44.19), starting ANC visit in first trimester (AOR [95% of CI] = 3.0 (0.24–37.18) were significantly associated with iron-folic acid supplementation. CONCLUSION: According to this study, adherence to iron-folic acid supplementation was relatively high. Empowering women in economy and education are very important. Proper counseling and health promotion about iron-folic acid supplementation, promoting the benefits of early and frequent ANC visit are very important to increase adhere to iron-folic acid supplementation.

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BACKGROUND: Air pollution is associated with a broad spectrum of an environmental health problem, caused by increased urbanization and population, globally. Emission of pollutants was strongly implicated in acute morbidity and mortality associated with severe pollution. Traffic cops are most vulnerable due to the nature of their job, continuously exposed to toxic pollutants. AIM OF STUDY: The study aimed to assess the physical and respiratory morbidities of traffic cops due to the effect of environmental pollutants. METHODOLOGY: Air quality data were collected by the Central Pollution Control Board. Traffic cops were selected from three traffic zones of the city. Anthropometric data were collected by anthropometric instruments. Health assessment was performed via the questionnaire method. Pulmonary function parameters were recorded via digital spirometer. STATISTICAL ANALYSIS: Collected data were analyzed statistically via SPSS (V-16.0). RESULTS: Particulate matter 2.5 (PM 2.5) and PM 10 found to be dominant pollutants in three zones of Kolkata. Air Quality Index values are high in winter. Any type of respiratory symptom is highest in the north, followed by the south and central zones. In the central zone, forced expiratory volume in 1 second and forced expiratory flow from 25% to 75% values significantly changed with work exposure. The habit of smoking also showed a significant effect on pulmonary function test (PFT) parameters. The difference of the change in PFT among the three zones was found significant. CONCLUSION: The result of the study indicates that outdoor environmental exposure creates detrimental effects on lung function parameters of traffic cops among the three zones of Kolkata. Use of mask, healthy food intake, performing exercise, and regular medical check are suggested to prevent respiratory damages of police personnel.

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Uncivil behavior in the classroom threatens the teaching-learning process. Research to date has focused on nursing student incivility in academia with little research examining the faculty role associated with incivility. Due to the lack of research examining faculty incivility toward nursing students, additional research in this area is indicated. The purpose of this study was to examine the effects of faculty incivility on nursing students' satisfaction with their Bachelor of Science Nursing (BSN) nursing program in a rural Southeastern state. Quantitative data was collected via surveys. Research questions included: (1) What percentage of senior nursing students report experiencing faculty incivility? (2) What is the relationship between faculty incivility and nursing students' ratings of program satisfaction? (3) In what educational settings does perceived incivility toward nursing students occur? (4) How do nursing students respond to perceived faculty incivility? The results of this survey revealed that 35.3% of students had at least one nursing instructor that put them down or was condescending toward them during their educational experience. Furthermore, 20.7% reported that two or more faculty put them down or were condescending toward them. Collectively, the pilot study revealed that over half of the participants reported faculty behaving in a way that was perceived as uncivil. Incivility in the nursing profession has been an on-going problem. The high number (over half) of participating students reporting that they perceived that at least one nursing instructor had put them down or was condescending toward them during their educational experience raises additional concerns for the level of civility in nursing programs and the role modeling that is presented to students. It is imperative that nursing faculty and students interact professionally and establish effective communication patterns.

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Background: If the impression thickness is uniform, stock trays can also give a better result when compared to custom trays. Purpose: This study aimed to obtain a uniform thickness impression with a modified putty-wash two-step technique. Materials and Methods: A chairside method of putty-wash two-step impression in a stock tray was made utilizing a wax spacer. Results: A uniform thickness impression was obtained in stock tray in quick time. Conclusion: The current article has given the options of using wax as spacer for making putty wash two step impressions for the fabrication of tooth-supported fixed restorations. Further research is required to find whether there is any dimensional inaccuracy caused in restorations due to usage of wax as a spacer.

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Aims: We have seen middle-aged and elderly patients with lower urinary tract symptoms (LUTS) or retention of urine in our hospital. Digital rectal examination (DRE) and prostate-specific antigen (PSA) were done for workup. Prostate biopsy (PB) was done whenever indicated. We wanted analysis of PB in our rural setup. Materials and Methods: The study period includes from January 2008 to May 2012 and January 2015 to May 2016. Any patient aged 45 years or more presenting with LUTS or retention of urine was included in the study. PSA and DRE were done in all patients. Inclusion criteria were abnormal DRE or PSA ≥4 ng/ml. Exclusion criteria were immunocompromised status, coagulopathy, urinary tract infection, acute prostatitis or abscess, uncontrolled diabetes mellitus, or previous biopsy. Histopathology report was noted. Statistical Analysis: No special software was used. Author used his arithmetical skill learned in school days to do analysis. Results: One hundred and thirty-four patients were included in the study. Average age was 69 years. PSA ranged from 1 to 1700, average being 65.3 ng/ml. Prostate cancers (PCs) was found in 65 cases. Adenocarcinoma of prostate was found in 54 cases, average PSA being 110.8 ng/ml. Small cell PC (SCPC) found in 11 cases, average PSA being 55 ng/ml. Prostatic intraepithelial neoplasia was found in six cases, average PSA being 18.8 ng/ml. Conclusion: PC is not uncommon in India. Patients present in advanced stages and with high PSA values. Transrectal ultrasound-guided 12-core systematic PB is the standard to confirm diagnosis of PC. Incidence of SCPC is high in our series. They presented with high PSA values. This need further study.

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The passive case-finding approach of Revised National Tuberculosis (TB) Control Programme in India strongly affects the health-seeking behavior of TB patients, the timing of help seeking as well as the subsequent delays associated with the same. Studies carried out in different parts of India reveal a host of several factors for delay in seeking help and the reasons for not seeking help at all. Important reasons for delayed health-seeking behavior include financial constraint, symptoms are not severe (as perceived by the patients), work pressure, lack of awareness, first consulted nonpublic sector, inaccessibility to health facility, home remedy, social stigma, self-medication, transport problem, and dissatisfaction with health facility. Similarly, the median patient delay ranged from 7 to 56 days as reported by various studies. Health-seeking behavior and related delays are of utmost importance in TB care from two important perspectives; first, TB requires timely treatment, and second, it requires protracted treatment. Required level of knowledge and a positive health behavior helps the patients in taking timely help from an appropriate health facility. Moreover, timely help-seeking prevents further spread of the disease and helps in establishing a TB-free society.

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