Background Type 2 diabetes and obesity are serious public health concerns globally and a growing burden in Africa. Both conditions have serious repercussions on health when they co-occur, yet the extent of their co-occurrence in Africa remains unknown. Therefore, this review aimed to identify the prevalence and associated factors of overweight and obesity among persons with type 2 diabetes in Africa. Method A systematic search was conducted on PubMed, MEDLINE, Embase, African Index Medicus (AIM), and African Journals Online (AJOL) for observational studies that reported the prevalence of overweight and/or obesity among type 2 diabetes patients in Africa. The prevalence data from individual studies were aggregated through a random-effects meta-analysis. The I2 statistic was used to evaluate between-studies heterogeneity, while subgroup analysis and mixed-effects meta-regression were performed to identify sources of heterogeneity. We assessed publication bias using funnel plots and Egger’s test. This review adhered to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Results Of 1753 records retrieved, 80 articles were eligible for this review, with 74 cross-sectional studies included in the meta-analysis. The pooled prevalence of overweight and obesity was 35.6% and 25.6% respectively, while the overall prevalence of both overweight and obesity was 61.4%. Also, the pooled prevalence of both overweight and obesity across the five geographical areas in Africa ranged from 56.9% in East Africa to 88.5% in Southern Africa. Nineteen factors were significantly associated with overweight and obesity among patients with type 2 diabetes. Conclusion The high prevalence of overweight and obesity among patients with type 2 diabetes is a significant public health concern that transcends geographical boundaries within Africa. The findings from this review highlight the need for innovative weight management interventions that are tailored to the cultural context of the African setting

Emmanuel ekpor

In the context of emerging sustainability challenges, demarketing has continued to draw the attention of academicians and practitioners globally over the past few years. It is interesting to note that demarketing is as old as marketing itself, yet its application and scope have grown from the past two decades only. Kotler and Levy, (1971) has defined demarketing as “that aspect of marketing which deals with discouraging customers in general or a certain class of customers in particular on a temporary or permanent basis”. This systematic literature review attempts to enrich the discussion on demarketing research through a systematic and comprehensive review of 64 articles published between 2000 and 2022. Using TCCM framework, we present relevant theories, research contexts, study characteristics, and methodologies used in demarketing research. Our review (1) Presents a systematic and comprehensive overview of the research in demarketing over the last two decades (2) Examines studies in demarketing within the framework of ‘triple bottom line’ approach for sustainability (3) Suggests a suitable definition of demarketing considering its exorbitant application within the sustainability context (4) Identify gaps and sets agenda for future research. Our systematic literature review found that research in demarketing has been growing considerably over the past two decades, twice as much in the last decade compared to the previous decade with spill-over to new sectors. The literature review, through the lens of ‘triple bottom line’ approach, is able to establish that demarketing can be employed to effectively address the sustainability challenges encountered by policymakers and practitioners.

Jeevan lawrence

This study examines the first occurrence of non-toxic dinoflagellate blooming of Gonyaulax polygramma and Chaetoceros sp in Ambon Bay that occurred for almost three weeks in January 2019 and it caused the watercolor became red brown. The objective of this study was to identified phytoplankton species and their abundance that cause red tide in the Inner Ambon bay. Phytoplankton samples were collected, temperature, salinity and Secchi depth were measured simultaneously on the 11th and 21st January 2019 (nortwest monsoon) at fifteen sampling stations in Inner Ambon Bay. The results show that the maximum abundance of G. polygramma, Chaetoceros affinis, C. danicus and C. decipiens were found in the greatest concentration up to 20×109, 9.0x106, 5.8x106 and 3.8x105 cells.L-1, respectively. They were found either in the form of a single cell or in chains. The very high abundance of cells of those species made the waters become red brown but there was no reports of fish killed during this red tide phenomena. This is the first time report of blooming phytoplankton Gonyaulax polygramma, Chaetoceros affinis, C. danicus and C. decipiens occurred in Ambon bay during the dry season where the recorded waters temperature and salinity ranged from 30-32ºC and 29-33 psu, respectively and the secchi depths ranged from 2 to 6m. These results show this is the first report of the red tide phenomena in the Inner Ambon bay during the dry season and it occurred for a long period caused by combination of the high abundance of G. polygramma Stein, Chaetoceros affinis, C. danicus and C. decipiens.

Irma kesaulya

OBJECTIVE Study was designed to assess sexual experience, thoughts, and problems of women who have been treated with pelvic radiotherapy for cervical cancer. METHODS Seventeen sexually active patients who received minimum 3-month course of pelvic radiotherapy between March 20, 2014 and June 20, 2014 gave consent to participate in the study. Sexual life before cancer diagnosis and effects of treatment on sexual life were assessed with semi-configured score scale created by research group. RESULTS Main diagnostic finding was post-coital and post-menopausal bleeding, and vaginal stricture, vaginal dryness, and decreased sexual desire in partner or patient were primary sexual problems reported. CONCLUSION Health professionals should be aware of these effects and should encourage patients to express their problems and provide effective, individual counsel to each patient.

Reyhan aydin doğan

Lifelong learning is becoming part of the philosophy of professional education. Continuing medical education is the responsibility of all personnel who are responsible for the delivery of components of the health care delivery system. Continuing education is becoming increasingly obvious for medical universities, hospitals, and health care providers. Pharmacists who practice in a community pharmacy and hospital, and who are participating in residency recognize that the traditional role of the pharmacist is changing. Over the last decades, a host of new services have been identified as a function of the pharmacist [1]. A review of these services revealed a personal commitment to continuing education. It is the absolute need to develop a level of competence that will improve patient care. In Libya, pharmacists working in the community practice setting are pharmacists with a diploma of pharmacy or with a Bachelor of Pharmaceutical Science, Master of Science, and Doctor of Pharmacy (Pharm D). The main objective is that the graduates possess the knowledge and skills needed to perform optimally to man the pharmaceutical services [1, 2]. Patient's expectations from pharmacists are that the medicine should be effective, safe and affordable. Other expectations from Libyan pharmacists would be to dispense the drugs according to the rules with the right advice on how and when the medicines should be used, and what to do in the case of adverse drug reactions, and the provision of advice on common illnesses. Nevertheless, it is an undeniable fact that the pharmacist has failed to provide all these patient-oriented services [3]. It should be noted that the quality of pharmacy education and training can be improved through certain processes of accreditation.

Mediterranean journal of pharmacy and pharmaceutical sciences

In recent years, the educational landscape has changed drastically with increased connectivity and technology that promotes outside-the-box thinking and innovation. Classrooms at all levels are evolving to meet this "new normal" through virtual lessons, smart technology in schools and online access for students and parents an individual possession of knowledge, skills and experience through education certainly transforms the nature’s endowed resources as marketable products/services with ‘economic value’ is termed as human capital and knowledge economy. Enhance and enrich of human capital fillips nation’s sound and health economy is the rationale of education. Education thrives to (a) educate, enlighten and encourage teaching, (b) input of understanding and (c) spirit and urge true facts. Education policy needs a clear-cut and transparency to lead in commercialisation and determination of values and proactive to the market logic. The great challenges accompany have been thoroughly exposed in recent periods through Covid-19 crisis. Interaction and integration with the economy of the rest of Worlds Counties, has now become a new emerging facet to bring out a unifying roof of the whole-teaching contents and methodology to attain the socio-economic development. To become a world-class academic institute heavily depends upon the committed faculty, quality infrastructures, supportive administration, and learning environment. Last but not least is the hardworking and brilliance or vividness is the foremost factor of promising among the young students. The corporate philanthropy to higher education is the call of the day to ensure trueness of education system for urging the prime goal of socio-economic development. This study focuses on the emerging trends in Indian higher education.

Dr gedam kamalakar

A large number of people suffer from gallstones worldwide, and this problem is now increasing significantly due to malnutrition, changes in living lifestyle, lack of exercise and conditions, i.e. industrialization. Medicinal plants have been used for centuries due to their cultural acceptability, efficacy, safety and fewer side effects than modern synthetic medicines. This review aims to gather information on the plants utilized in various parts of society against gallstones. The information provided is beneficial for ordinary people and the scientific community for further phytochemical, toxicological and pharmacological studies, which may lead to the discovery of new, more effective and safer medicines for gallstones.

Dr. salman ahmed

Pada awal terjadinya pandemi COVID 19, telah terjadi banyak hal yang mengakibatkan perubahan di tengah masyarakat. Salah satunya adalah di kegiatan belajar mengajar. Berangkat dari hal tersebut maka pada pertengahan Agustus 2020 dimulailah satu kegiatan untuk membantu para guru yang ada di daerah untuk bisa beradaptasi dengan perubahan terkait kegiatan belajar mengajar pada masa pandemi. Kegiatan ini dilaksanakan dalam beberapa bulan dengan dua kegiatan utama dilaksanakan secara daring dan kegiatan pendampingan juga secara daring. Pada April 2021 didapatkanlah hasil dari kegiatan ini yang sebagian besar menilai kegiatan positif dan membantu dalam aplikasi kegiatan belajar mengajar. Hanya saja yang disayangkan kegiatan ini tidak menjangkau banyak peserta.

Lila maria kaban

Tuberculosis (TB) is an infectious disease caused by bacteria called Mycobacterium tuberculosis. The disease mainly affects lungs and causes pulmonary tuberculosis. It can also affect intestine, meninges, skin, bones and other tissues of the body. Although the drugs alone can cure TB, it still remains a major public health problem worldwide. The aim of the study was to assess the quality of life and medication adherence in TB patients. The Quality of life was assessed using SF-36 in patients receiving DOTS treatment in initial or continuous phase while the medication adherence was analyzed using Morisky Green Levine Scale. Subjects were also counselled about their disease during their first visit and a follow up was done after a month. A total of 152 subjects were enrolled in the study of which majority of the subjects had Pulmonary TB (55.26%). Diabetes was found to be the most common comorbidity followed by HTN. The average Physical Component Summary (PCS) and Mental component summary (MCS) were found to be 44.34 and 39.60 respectively. Females had a better quality of life scores compared to males. High adherence was seen in 32.24% of patients while 28.29% had low adherence. Follow up was done for 135 subjects. 15 subjects defaulted and 2 of them died. There was a significant increase in the QoL scores and medication adherence after one month. A significant association was found between the Physical functioning (p=0.001) and emotional wellbeing (p=0.01) with Duration of treatment indicating that subjects who had completed more than one month of their treatment had marked improvement in Physical functioning and emotional well-being scores

Dr mahendrakumar r

Object: In the competitive world of the market economy, every economic unit tries organizing everyday activities. Creating a set of suitable and cost-efficient organizational structures and making competitive products and services, top managers should find the mechanisms of building alternative ways of organizational structures. Methods: This paper presents the traditional and modern management structures, their historical steps, and developed methods. In this footfall of the market economy, companies in developing countries should build their management system’s organizational structure. They should advance a management system, managerial behaviours, and new management styles of developed ones. For this purpose in this research has learned organizational structures of developed companies. The investigation discusses the emergence, formation, and modern appearance of management structures that evaluate organizational structures’ importance in enterprises and companies’ activities, using vivid examples. Findings: Then, it has shown some forms of developed organizational structures of companies with the assessment of their highest role in management. In the conclusions and recommendations, we offer our approaches to solving existing organizational problems using the historical period of development to this day.

Ikboljon odashev mashrabjonovich

Ageing is an inevitable phenomenon. Similar to other organs, skin is also subject to an intrinsic ageing process. Additionally, skin ageing is also influenced by various environmental factors. Existing conventional formulations have limited efficacy because skin serves as a rate limiting barrier for percutaneous absorption of drugs. This has led to the evolution of various novel drug delivery systems. Among these liposomes have received considerable attention due to the numerous advantages they offer. Liposomes, submicroscopic spherical vesicles, were discovered in 1960’s. Since then, they have gained popularity as potential carriers for drugs, diagnostics, nutrients, vaccines and other bioactive agents. Liposomes find applications in pharmaceutical, cosmetics and other industrial fields. Various topical actives that have been found to be efficacious in delaying the signs of ageing have been formulated as liposomes resulting in enhanced delivery, biocompatibility, and reduced toxicity. This review focusses on therapeutic use of liposomes in skin ageing.

Aparajita varshney

A simple one pot synthesis has been developed for the synthesis 1,4-dihydropyridine using an efficient and reusable silica supported MgO solid catalyst by condensation of dimedone, ethyl acetoacetate, aldehyde and ammonium acetate in methanol as a solvent at room temperature. The reactions could be carried out under mild reaction conditions with very good yield of polyhydroquinoline, up to 92%. This catalyst could be recycled very easily, which makes this methodology environmentally benign.

Shilpa sangle

The need for renewable energy sources in addressing global energy demands is growing, especially in Nigeria where electricity demand often exceeds supply. Solar photovoltaic (PV) systems have become a viable solution, with federal universities in Nigeria, as major electricity consumers, recognizing their potential. However, determining the right size of PV systems for individual faculties within these universities is a complex task. This study attempted to simplify this process by introducing an innovative approach to size PV systems in these faculties. The research method used the Extended Kalman Artificial Neural Network (EKF-ANN) and the Crow Search Algorithm (CSA) to enhance the accuracy of PV system sizing. Data was collected on the study site, load demand, weather conditions, system components, and operational control and systems models to establish sizing criteria. The study focused on the optimal size of a solar PV system at the Faculty of Law building, University of Port-Harcourt, and how to improve its accuracy. The results showed that using global solar insolation parameters, EKF-ANN predicted values for global temperature, flock size, and maximal iteration. This optimized system could generate surplus power for effective grid supply. The study found that the optimal size of the series-connected panels for the Faculty of Law building was 96, 83, 73, and 65 units, with corresponding insolation values ranging from 3.737 to 4.368 kW/m2. It was concluded that the combination of CSA and EKF-ANN in solar PV sizing is suitable for achieving optimal outcomes for energy storage and grid supply. Nonetheless, the study recommended additional investigation into real-time and grid-connected solutions to enhance the proposed approach's effectiveness.

Fxintegrity publishing

One of the unique features of Indian society is prevalence of caste system which was originated thousands of years back to demarcate the people engaged in different occupation or jobs. Initially it was not much rigid but gradually people belonging to upper castes for their own selfish means to maintain their monopoly made this arrangement hereditary and started treating people of lower castes disgracefully. For preservation of this system, people started controlling their women to prevent inter-caste marriages and the concept of endogamy came up. This robbed away many types of freedom from women. For women belonging to lower castes, this situation is worse as they are doubly subjugated on the basis on caste as well as gender. Men belonging to their own caste treat them as secondary beings. This paper throws light on this intersection. How intersection of these two kinds of inequalities place them at the lowest position in Indian society. Dr. B.R. Ambedkar rises as their leader who all his life worked for empowerment of downtrodden section of society. He argues that education is the primary tool for evading these differences among people. He further emphasizes to adopt the concept of exogamy to break the backbone of Indian caste system and to immediately leave a religion or culture which legitimizes such system of inequality among people of the same land.

Swati sharma

The 2019 coronavirus disease (COVID-19) was declared by the World Health Organization as a pandemic on 11th March, 2020 which spread rapidly all over the world. COVID-19 disease has different clinical presentations, ranging from asymptomatic to severe symptoms. Laboratory findings are important in determining which therapeutic strategies to seek and to identify severe cases initially. In this study, we compared the results of C-reactive protein, D-dimer, blood electrolytes and mean corpuscular hemoglobin concentration between survivors and non-survivors of 22 Libyan patients with COVID-19 present in the intensive care unit at Maitika Isolation Center (Tripoli, Libya) in the period of January to June 2021. We could not detect any significant difference in C-reactive protein between survivors and non-survivors but a significant difference in D-dimer level was observed. Non-survivor COVID-19 patients have a higher level of D-dimer. Moreover, a statistical significant difference in chloride and sodium levels but not in potassium level were detected. A marked lower of mean corpuscular hemoglobin in non-survivor than survivor COVID-19 patients was shown. Thus, these parameters could act as biomarkers for COVID-19 patients.

Mediterranean journal of pharmacy and pharmaceutical sciences

Tracing graduates has become an imperative for higher education institutions much more during the pandemic. This tracer determined the employment and employability status of the 2019 BSE graduates and identified the competencies they adequately acquired and deemed vital for work. It used descriptive design, and data were collected from the 103 graduates through a Google form with open and closed-ended questions administered between November and December 2020. Results revealed that most of the graduates had been employed in teaching and teaching-related jobs but mostly in contractual arrangements within the first and second six months after graduation. Many had their first jobs with meager salaries from the private sector. Communication, pedagogy, information communication technology, time management, and flexibility were the top competencies they adequately acquired and were beneficial in work. The study concluded that these graduates had acquired 21st-century skills in their respective degree programs. These results have corresponding implications for future research in confirming the most employable skills in secondary teaching. As recommended, classroom instruction might emphasize the development of these skills. Eventually, these become the competitive advantage and employability capitals of future graduates. Administering the licensure examination and the release of its results can be done within the first three months after graduation to lessen the cost of waiting.

Manuel caingcoy

Pelvic inϑlammatory disease (Waram al-Rahim)is one of the most serious gynaecological infections of the upper female genital tract with the worldwide annual rate of 10-20/1000 women of reproductive age. The objective planned for the study was to evaluate the effect of Sharbat-e-Deenar in uncomplicated Pelvic Inϑlammatory Disease (uPID). A pre and post observational single group clinical study was carried out in the Department of IlmulQabalatwaAmrazeNiswan, National Institute of Unani Medicine, Hospital, Bengaluru. Diagnosed cases (n=30) of uPID were included in the study. Patients with complicated PID, history of antibiotic therapy within seven days of recruitment; delivery, abortion or gynecologic surgery within the last 30 days, systemic diseases, malignancies, pregnancy & lactation were excluded. Sharbate-Deenarconsists of Poste baikhekasniandTukhmekasni(Cichorium intybus Linn.), Gulesurkh (Rosa damascene mill.), Tukhmekasoos(Cuscutare৒lexaRoxb.) and Rewandchini (Rheum emodiWall. ex Meissn) were administered orally in a dose of 20 ml twice daily for 14 days. Outcome measures were 30-70% clinical improvement in Visual Analogue Scale (VAS) score for lower abdominal pain and McCormack Pain Scale (McPS) score for abdominopelvic tenderness and White Blood Cells (WBCs) count <10 on saline microscopy of discharge. Data were analyzed using paired Student ‘t’ test, Wilcoxon Signed rank test and Paired Proportion test.Clinical improvement of 30-70% in McPS and VAS score was achieved in 96.7% (p<0.001**) and 93.3% (p<0.001**) patients respectively. WBCs count <10 on saline microscopy of discharge was achieved in 70% patients (p<0.001**).Sharbat-e-Deenarwas effective in improving the sign & symptoms of PID due to its anti-microbial, anti-inϑlammatory, antispasmodic and anti-oxidant properties. No adverse effect of the research drug was encountered during the study. Hence, Sharbat-e-Deenar serves as an effective alternative in patients with PID, proving the research hypothesis.

Dr ismath shameem

The experiments were conducted at CCS HAU, Hisar (Haryana) to study the morpho physico-chemical components of resistance to pod borer, Helicoverpa armigera in pigeonpea with different sowing dates. In different four sowing dates, the minimum pod infestation (1.70%) was recorded in (D4) 3rd week of July sown crop, whereas, it was observed maximum (4.54%) in (D2) 1st week of July sown crop. In different pigeonpea varieties, the minimum mean pod infestation (2.45%) was recorded in AL-201, whereas, the maximum mean pod infestation (3.72%) was recorded in Pusa-992. The glandular (type A) and non-glandular (type B) trichomes on pods of top and middle canopy of the plant and pod wall thickness were associated with resistance to H. armigera, whereas, the non-glandular lengthy (type C) trichomes and pod length were associated with susceptibility to this insect. The expression of resistance to H. armigera was also associated with the high amount of fat, phenol and tannin content. Crude protein and total soluble sugar content were responsible for higher pod infestation.

Dr. babu lal jat

This study's objective was to determine the distribution of allele frequencies of CYP2C9 and CYP2C19 gene polymorphisms among the Papuan population, known as the second-largest ethnic group in Indonesia. According to recent research, there is a decrease in CYP2C9 and CYP2C19 produced by humans globally, including in Indonesia. These gene polymorphisms aid in the transmission of various endogenous and exogenous drugs in the human body. Material and Methods: A sum of 99 subjects, comprising 73 male and 26 female subjects aged 20-30 years, were used for this research. PCR-RFLP (polymerase chain reaction-restriction fragment length polymorphism) analysis using AvaII, NsiI, and SfaNI enzymes tested for the genotypes CYP2C9 and CYP2C19 administered. The distribution of genotypes was calculated in the population (P<0.05) using the Hardy-Weinberg equilibrium. The Faculty of Medicine Gadjah Mada University's Medical and Health Research Ethics Committee (MHREC) accepted this research with written consent. The results revealed that in Papua subjects, CYP2C9*2 (rs1799853) and CYP2C19*17 (rs12248560) alleles were absent while in 17 percent of the population CYP2C9*3 (rs1057910) allele frequency was. In conclusion, CYP2C9*3 has the highest polymorphism rate in Indonesia, with the absence of CYP2C9*2 and CYP2C19*17. Therefore, genetic drift can occur within this ethnic group.

Syahrul tuba

Marketing has now adopted technologies in the attempt to increase brand recognition. Due to the COVID-19 pandemic, many companies suffer, yet many even reap more profits, such as e-commerce. The purpose of this research is to figure out whether Celebrity Endorsement, Advertising Appeal, and Electronic Word of Mouth have influence towards customer’s Purchase Decision in one of popular e-commerce in Indonesia called Bukalapak. Through the non-probability sampling type, particularly purposive sampling approach, one hundred respondents are taken as samples. The method in this research is descriptive and causal, and the research type is quantitative research. The data analysis methods used are descriptive statistics, coefficient of correlation, coefficient of determination, linear regression analysis and hypothesis testing through T-Test and F-Test. The T-test shows that Celebrity Endorsement, Advertising Appeal, and Electronic Word of Mouth partially influence the Purchase Decision. The F-Test result shows that all independent variables simultaneously influence Purchase Decision. Out of all, Celebrity Endorsement has the biggest influence on Purchase Decision. The value of coefficient of determination obtained is as much as 80.6% indicating that the customer’s Purchase Decision in Bukalapak is explained by Celebrity Endorsement, Advertising Appeal, and Electronic Word of Mouth. The recommendation given is to ensure the company uses talented and well-known celebrity endorsers, design attractive and unique advertisement, and maintain satisfactory performance to encourage complimentary reviews on its platform.

Lila maria kaban