Introduction: Currently drug use is as a major problem of global public health, given the diversity of aspects involved in drug abuse, psychoactive substances exert impacts on users, families and community, contributing to damage to the physical and mental health, as well as the socio-economic vulnerability and legal problems. Objective: Analyze the degree of cocaine / crack users behavior in Cozy Communities and the Reference Center for Population Homeless (POP Center) located in Arapiraca city in Alagoas. Methodology: This is a research with a quantitative approach, performed in Cozy Communities and POP Center, which are distributed in the city of Arapiraca. The instrument used for the production of data was made by means of structured interviews conducted in the period May to July 2018, in its physical space of the institutions, listing the sociodemographic profile and Impulsiveness Scale – BIS 11. For impulsive behavior grade analysis was used to impulsiveness scale – 11 BIS, based on “Ernst Barratt model, which is considered as one of the most important in impulsive behavior explanation”. Results: The results obtained, the overall score obtained an average of 2.38 were found for each partial average score of the three subdomains impulsiveness, the resulting average motor impulsivity: 2.24 to attentional impulsivity: 2.51 and impulsivity not planning: 2.34. Conclusion: This study shows the importance of impulsivity associated with the pattern of use of psychoactive substances.
Assessment of Nurses’ Knowledge and Utilization of Evidence Based Practice and its Associated Factors
Background: Evidence based practice is conscientious, clear and judicious use of current best evidence in making decisions about the care of patient. It is becoming a worldwide concern for nurses, doctors and administrators at various level of health care settings considered as critical element to improve quality of health care services. Currently one of the major barriers to utilize Evidence-based practice is knowledge deficit especially in developing countries like Ethiopia. Objective: the aim of this study was to assess nurses’ knowledge and utilization of evidence-based practice and its associated factors in selected hospitals of three zones of SNNPR, South Ethiopia. Methods: setting: the study was carried out in a sample of three zonal and secondary hospitals because evidence based practice are more implemented at hospital settings. Study design and period: Facility-based descriptive cross-sectional study design was conducted among nurses working in selected hospitals of three zones of south region from March 30 to May 1, 2017. A total of 208 nurses answered a self-reported questionnaire and selected by using convenient sampling technique. Descriptive statistics, Bi-variate and multivariate logistic regression were used to analyze the data. A statistical significance was declared at p value
Amebiasis affects around 500 million people in the world. Clinical manifestations of intestinal amebiasis can overlap with symptoms of the inflammatory bowel disease (IBD). Many studies evaluated the relationship of IBD patients during exacerbation periods and amoebic colitis as it is important to rule out the infection before starting steroids and/or immunosuppressive treatment. This mini-review focused on the best strategy to diagnose the infection in this specific population, using classical stool analysis for ova and parasites, serology, investigations by PCR and colonoscopy according to the degree of clinical suspicion. It also suggested an algorithm for management approach where patients were divided into asymptomatic carriers vs. symptomatic patients under 5 ASA or immunosuppressive therapy having either a vegetative or cystic form of the infection. All these patients were treated accordingly by intraluminal agents, and nitroimidazole was added in the vegetative form. 5-ASA was not a contraindication for treatment, while immunosuppression is forbidden until after eradiation of EH. Amoebic infection should always be ruled out before starting treatment with steroid or immunosuppressive medications, in order to minimize its deleterious outcomes on IBD patients.
The Upgrading of Foreign Trade Industry in Jiangsu Province- Based on the Perspective of Global Value Chain
Based on the global value chain perspective, this study carried out a comprehensive analysis of foreign trade industry in Jiangsu province from four dimensions, including contribution rate of foreign trade industry to GDP, value chain division, value chain dependency and value chain links. Research showed that the four types of industry upgrades (processes, products, functions, chains) could be realized by integrating “Internet +” from the perspective of value chain. Therefore, we planned three proposals to promote the upgrading of Jiangsu foreign trade industry: Integrate and promote the value chain, merge the internet technology; extend the value chain, build Internet platform; reconstruct the value chain and optimize the trade process.
Study of the effect of sofosbuvir and daklatasivir on respiratory system in patients with chronic hepatitis C
Back ground: The aim is to study effect of sofosbuvir and daklatasivir on respiratory system. Patient and methods : A randomized study was done after all patients gave an informed consent before the start. The study population consists of 21 patients receiving treatment of HCV coming to the outpatient clinic of beni suef university hospital. Results : There is no major adverse effect of sofosbuvir and daklatasivir on respiratory system as proved by assessment of pulmonary function and Computed tomography before and after treatment.
Reform in the public sector organizations starts with reforming the accounting information system. The idea of reform boosted the attempts of certain countries to take steps toward developing the accounting systems in their managements in order to improve their efficiency and to cope with the fast political and economic changes in addition to satisfying the public opinion about getting better services. International organizations, including the International Monetary Fund (IMF) have realized the importance of improving the efficiency of the public sector to improve development rates in developing countries and to get international grants and loans. Thus, a unified way to communicate among countries was needed. This study investigates the impact and impediments of implementing International Public Sector Accounting Standards (IPSAS) in Lebanon. The researchers adopted the analytical descriptive approach utilizing an empirical study. A questionnaire was constructed and distributed among a sample of Lebanese certified public accountants. The research yielded some important findings mainly that adopting and implementing IPSAS lead to the advancement in the qualitative characteristics of financial statements in public organizations in Lebanon. It also concluded that there are some obstacles in adopting and implementing IPSAS in public organizations in Lebanon.
Intermittent fasting (IF) is currently one of the world’s most popular health and fitness trends. Several IF patterns have been studied. Not all were shown to be equally effective. Also, each person’s experience of intermittent fasting is individual, and different styles will suit different people. The potential health benefit list of IF is long: accelerated weight loss, reduced inflammation, lower cholesterol, longer lifespan, blood sugar stabilization, and prevention of type 2 diabetes. Emerging research suggests IF may also lead to a healthier brain, longer life, and even aid cancer treatment. Placing time restrictions on feeding has been shown to have broad systemic effects and trigger similar biological pathways as caloric restriction. One key mechanism responsible for many of these beneficial effects appears to be “flipping” of the metabolic switch. The metabolic switch typically occurs in the third phase of fasting when glycogen stores in hepatocytes are depleted and accelerated adipose tissue lipolysis produces increased fatty acids and glycerol. Just changing the timing of meals, by eating earlier in the day and extending the overnight fast, significantly benefited metabolism even in people who didn’t lose a single pound.
The skin aging process, which is prompted by environmental variables, is named untimely or extrinsic skin aging process and can be recognized from the sequentially (intrinsic) skin aging process by trademark skin aging signs. Albeit human skin goes about as a biological shield against pro-oxidative chemicals and physical air pollutants, prolonged or tedious presentation to abnormal amounts of these pollutants may have profound negative impacts on the skin. Sexual orientation contrasts in toxicity have been accounted for some substances. Youngsters are known to be increasingly defenseless against the antagonistic health impacts of air pollution. Environmental pollution by traffic is additionally connected with the event of indications of extrinsic skin aging. Heavy metals, for example, cadmium, lead and mercury are regular air pollutants that posture health hazards because of bioaccumulation. Ozone in the stratosphere has protective impacts by sifting solar UVR; be that as it may, in the troposphere ozone has toxic implications for skin. Because of scarcity of logical proof, there are no settled rules as of now accessible for protecting the skin against air pollution. Beside lessening presentation, potential protection techniques should concentrate on fixing the skin barrier, renewing antioxidant save, and diminishing inflammation brought about via air pollutants.
Liver cirrhosis with high IgG4 in a patient with, diabetes mellitus, ulcerative colitis with papillary thyroid cancer, is it all related ? which one to blame& is it time to raise awareness about IGG4 and hepatobiliary diseases
Back ground: There is possible etiological relation between high IgG4 in a patient with liver cirrhosis, ulcerative colitis, diabetes mellitus , prostatitis ,venous thrombosis and thyroid cancers and the use of immunosuppressive & biologic agents. Method: a study of patient with multiple organ involvement with persistently elevated IgG4. A 56 years old male with persistently elevated IgG4 over 2.5 times normal level, diabetic on insulin, ulcerative colitis on azathioprin & adalimumab developed deep skin pigmentation and liver enzymes elevation with portal hypertension and liver cirrhosis, azathioprine & adalimumab were stopped and golimumab started, after 3 infusions of golimumab papillary thyroid cancer developed .Total thyroidectomy followed by radio iodine after which severe sialo adenitis developed which responded to steroids. His ulcerative colitis was treated with vedolizumab with good response. liver cirrhosis progressed with bleeding varices and portal vein thrombosis with factor Leiden V mutation. Results and conclusions: High IgG4 can be related to many organs including pancreas,liver,thyroid ,small and large bowel,parotid glands ,in this patients all these were affected resulting in colitis,diabetes,liver cirrhosis and thyroid cancer and sialo adenitis. Awareness is needed on the associations with high IgG4. Conclusion: A patient with elevated IgG4 , liver cirrhosis , diabetes mellitus, ulcerative colitis developed skin pigmentation, and papillary thyroid cancer associated with persistently elevated IgG4.
This article covers the epidemiology, pathophysiology/complications and management of diabetic gastroparesis (DGP), and more broadly diabetic gastroenteropathy, which encompasses all the gastrointestinal manifestations of diabetes mellitus (DM). Hyperglycemia, autonomic neuropathy, and enteric neuromuscular inflammation and injury are implicated in the pathogenesis of delayed gastric emptying (GE). Initial options include dietary modifications, supplemental oral nutrition, and antiemetic and prokinetic medications. Patients with more severe symptoms may require a venting gastrostomy or jejunostomy and/or gastric electrical stimulation (GES). To date, few population-based studies have estimated the true prevalence and incidence of gastroparesis. Nonetheless, its prevalence appears to be rising, as does its incidence among minority populations, documented via hospitalizations, which can impose significant economic burdens on patients.