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Aim: We aimed this study to find the prevalence of depression among multi drug resistant (MDR) TB patients and its related determinants. Material and methods: An observational cross-sectional study was conducted at Jinnah Postgraduate Medical Center Karachi hospital, we enrolled 107 MDR-TB patients using non-probability consecutive sampling. Patients were evaluated for depression using Patient Health Questionnaire-9 (PHQ-9). Prevalence of depression along with its determinant were assessed. We used Chi Square test for association between depression and its determinants keeping P value < 0.05 was taken as statistically significant. Results: Patients’ mean age was 32.10±6.19, male patients were higher in number as compared to female patients. In our study we found that depression was present in 52 (48.6%) patients. Depression had significant association with financial issues, family problems, treatment duration and increasing age. Practical implication: Current study assess the determinants of depression in TB patients and spreads public awareness in community about Multidrug resistance in TB and ways to avoid TB in local population. Conclusion: From our study we conclude that 52 (48.6%) patients had depression in MDR-TB patients which is an alarming situation. Financial issues, family problems, treatment duration and increasing age were found to the determinants of depression in MDR-TB patients. Keywords: Tuberculosis, Multi Drug Resistance, Depression, Truenat, Xpert, Mental disorders, psychiatric comorbidity

Introduction: A thrombosis is a blood clot in an artery that can be highly harmful because it stops blood from reaching essential organs. Arteries are blood vessels that convey blood from the heart to the rest of the body and the heart muscle. Clinical Finding: pain in left lower abdomen and as well as thoracic region also and pain in lower limb extremities are also occurred, pulse is 78 beats/ min, and temperature is 98.6°F or 37°. Diagnostic Evaluation: Blood test:- Hb –14.3 gm%, total RBC count – 4.84 millions/cu mm, RDW – 13.3%, HCT -42.4%, total WBC count –7100/cu mm, monocytes – 03%, granulocyte –70%, lymphocyte – 25%. Peripheral Smear: RBC:- normocytic normochromic, Platelets:- adequate on smear, No hemiparasite seen Ultrasonography: There is no sonography report founded. Therapeutic intervention: Inj. Ceftraxine- 19 mg, inj. Hydrotrsol – 100 mg, inj. Heparin – 5000 IV –TDS , tab. Ecosprin – 100 mg –OD, tab. Clopitab- 75 mg – OD. Outcome: After treatment, the patient has improved his fever, pain in the chest, and lower extremities pain have all been reduced. Conclusion: Patient was admitted to cardiology ward in hospital with known case of arterial thrombosis and he had complain of fever chest pain and also pain in lower limb. After getting appropriate treatment his condition was improved. Smoking, overweight, and drinking are additional factors that promote intra-arterial thrombosis. After getting therapy, patient's condition significantly improved, and the treatment was continue until final day of care.

Introduction: Malaria is caused by the parasitic protozoan Plasmodium. It is a vector-borne disease which is transmitted from person to person via bites from infected mosquitoes. Following a mosquito bite the parasites multiply in the liver and subsequently infect red blood cells. It is a mosquito-borne illness. Fever or flu symptoms include shivering chills, headaches, and muscle pains. Anemia, jaundice, nausea, and diarrhea are some of the symptoms of malaria. Main Symptoms and Important Clinical Findings: A 24-year-old woman was admitted in. Acharya vinoba bhave rural hospital with chief complaint of stomach pain as her primary complaint. Then after several days Fever, pain, fatigue, headache occur. Several diagnostic evaluations done which shows total Red blood cells count: 4.8 million cu mm; white cell count: 11.810 cells mm3; lymphocytes: 11.2% platelets drop on smear, RBCs are moderated. The Main Diagnoses, Therapeutic Interventions, and Outcomes: 24 years old women admitted in Acharya vinoba bhave rural hospital with the chief complaint of stomach pain, fever, fatigue, headache and after all investigation she has diagnosed as malaria. Doctor manage with Iv fluids, cap. Doxycycline 100 mg, tab.dolo 650 mg, tab.larigo 650 mg, emset 4 mg injection Once a day, she was also given the Calcium Tab. Her condition has improved as a result of the treatment. The fever and agony had subsided. Conclusion: My patient was admitted to Acharya vinoba bhave rural hospital with a known case of malaria and a fever and discomfort complaint. Her condition improved after she received proper therapy.

Introduction: Cellulitis is a bacterial infection that causes an inflammatory condition of the skin that affects the dermis and subcutaneous tissues. 2016 (Lee and Levell). Cellulitis of the lower limbs is a potentially dangerous condition (Halpern et al, 2008). Rubor or erythema, which is warm to the touch and often combined with a degree of localised oedema, is the most common symptom. However, because diagnosis is dependent exclusively on clinical data, it is commonly misdiagnosed [1]. There are a number of different illnesses that have symptoms that are similar to cellulitis. The purpose of this page is to provide information on the clinical symptoms of lower limb cellulitis as well as treatment options ensuring that practitioners are capable of making an accurate diagnosis and developing successful treatment programmes [2]. Clinical Findings: Fever, pain over right lower leg, wound present right dorsal foot, weariness, malaise, and swelling were the patient’s main complaints. Diagnostic Evaluation: Haemoglobin 14.7%,total RBC count 4.77, total WBC count 16100, platelet count 1.56, KFT – UREA -57 CREATININE -2.0 potassium- 4.6, LFT ALKALINE PHOSPHATE -105, ALBUMIN3- 0 TOTAL BILIRUBIN- 1.4 micro report is normal. His liver function and coagulation studies were normal. A diagnostic work-up that includes blood cultures, dengue, malaria smear, typhoid, and other tests. The following tests were sent: leptospirosis, monospot and stool investigations, and Clostridium difficile PCR [3]. Therapeutic Intervention: Four primary analgesic drugs, antibiotics drug in penicillin. Conclusion: My patient, a 65-year-old man, was hospitalised to the Hospital's medicine ward on June12, 2021.Fever, pain over right lower leg, wound present right dorsal foot, fatigue, malaise, and edema were among the symptoms that the patient had. His health improved when he received appropriate treatment. The patient was follow up after 1 weak [4].

Fractures of the femur are a common injury among the elderly. Understanding the pathogenesis as well as the appropriate treatment options can help to reduce the risk of mortality and morbidity associated with this condition injury. This activity focuses on the diagnosis and treatment of intertrochanteric femur fractures, emphasizing the importance of the In evaluating and treating people with this condition, an interprofessional team is used [1]. Clinical Findings: Pain in leg, swelling over the leg. Diagnosis Evaluation: Hb-11.3gm%, total WBC count- 1011/ cu.mm, total RBC count- 5.44 million/cu. mm, RDW- 14%,HCT-35.4%, Granulocytes-60%, Monocytes- 0.2%, Lymphocytes-36%, Basophils- 00%, Eosinophils- 0.2%, total platelet count - 3.16 lacs/cu.mm. Therapeutic Intervention: Inj.voveron- two time in a day. Tab. paracetomol- two time in a day. Tab. pantaprazole- two times in a day. Inj. tramdole- two times in a day. Outcome- After treatment, the patient show improvement. His pain is reduced. Conclusion: My patient age is 40 year old male. They are suffering from intertrochanteric fracture femur left side with same complaint. He is admitted in 8 -11-21.

Introduction: Cellulitis is a bacterial skin condition that is very frequent. In reality, cellulitis affects about 14 million people in the United States each year. If left untreated, the infection can spread to any part of the body and cause serious problems. Obesity and an inactive lifestyle are two of the most common causes of type 2 diabetes. Clinical Findings: Pain or tenderness in the leg, Skin redness or inflammation that gets bigger as the infection spreads, Skin sore or rash that starts suddenly, and grows quickly , Warm skin. Diagnostic Evaluation: Hb%- 10.7, MCHC- 33.4, MCV- 88.8, MCH- 29.8, Total RBC count- 3.6, Total WBC count- 7200, Total platelets count - 1.63, HCT- 37, Monocytes- 01, Granulocytes- 75, Lymphocytes - 20, RDW - 17.2, Eosinophils - 01. Therapeutic Interventions: Inj. Ceftriaxone 1mg x BD (IV), Inj. Pan 40 mg x OD (IV), Tab. Limcee 500 mg x OD, Tab. Pan 40 mg x OD, Protein powder 2 tsp x TDS, Inj. Insulin. Outcomes: A Male Patient of 88 year old was admitted in AVBRH with a chief Complaint of Cellulitis after getting treatment his condition is improving. Conclusion: Diabetic foot infections that aren't treated well or aren't treated at all result in lower-extremity amputation in about 10% of patients. Amputations of the lower extremities can be debilitating and have a significant impact on the patient's quality of life.

Sickle cell anemia is a kind of hemolytic anemia that is passed down in families. It is a kind of hemolytic anemia caused by inheriting the sickle hemoglobin gene. Africans, as well as individuals from the Middle East, the Mediterranean region, and India's aboriginal tribes, have a lower level of the sickle hemoglobin (HbS) gene. A kind of anemia that affects both children and adults is sickle cell anemia. Clinical Finding: Since 5 days, A 25-year-old man has been experiencing generalized bodily pain and anxiety. Examining the Problem: ALT (SGPT)- 97 U/L, AST (SGOT)- 56 U/L, total bilirubin – 5.4 mg percent, bilirubin conjugated – 1.7 mg percent, bilirubin unconjugated – 3.7 mg percent, total RBC count – 3.71 million/cu mm, total WBC count – 22100 cu mm, total platelets count – 6.46 lack/cu. Ultrasonography: Heterogeneous spleen. Therapeutic Intervention: Inj. Piptaz 4.5 gm TDS, inj. Levoflox 500 mg, tab. Hydroxyurea 500 mg, tab. Neurobion forte, inj. Pan 40 mg, inj. Tramadol 100 mg. Outcome: The client's condition has improved as a result of the treatment. He has no longer generalized bodily aches, and his anxiety levels have decreased. Conclusion: A 25-year-old man was admitted to Acharya Vinoba Bhave Hospital's Medicine ward with a history of sickle cell anaemia and complaints of nonspecific body aches and anxiousness. His condition improved after he received proper therapy.

Background: Smokeless tobacco consumption, which is widespread throughout the world, lead to oral sub mucous fibrosis (OSMF), which is a long-lasting and disturbing condition of the oral cavity with the potential for malignancy. Mainly focus on the consumption of smokeless tobacco, such as pan and ghutkha the role of these substances in the instruction of OSMF and ultimately oral cancer. It was established using the finding tools provide. The continuous chewing pan and swallowing of ghutkha cause progressive fibrosis in sub mucosal tissue. Generally, OSMF occurs due to multiple risk factors, especially smokeless tobacco and its mechanism, such as betel quid, Areca nuts, and slaked lime, which are used in pan and gutkha. The incidence of oral cancer is higher in women than in men in the South Asian country. Objective: 1 To assess the existing knowledge regarding health hazards of spitting in public places among the general population. 2. To develop Information booklet regarding health hazards of spitting in public places among the general population. Material and Method: Research Design: Pre experimental research design, Research Approach: Survey approach, Setting of Study: Rural population Sawangi (Meghe) Wardha district, Sample: The sample for the present study comprised of 100, Sample size: The sample size selected for this study was 100 sample, Sampling Technique: A convenience sampling technique. Result: After the complete analysis, this study lead to the following result that the mean knowledge score in pre-test was 6.61±2.30 and in post test it was 11.68±1.45 and mean percentage of knowledge score in pre test was 44.06±15.33 and in post test it was 77.86±9.70. Conclusion: After the conclusion of the study it is exposed that the most of the knowledge are gained by providing the booklet and it is most effective result are occurred to provide the same information about the splitting.

Introduction: Burkitt lymphoma is highly metastatic active malignant B- cell Non-Hodgkin’s Lymphoma characterized by translocation and deregulation of the d- MYC gene on chromosome no.8 on DNA strand. Background: Burkitt lymphoma (BL) accounts for 30–50% of all peadiatric lymphomas, and non-Hodgkin lymphoma (NHL) is the fourth most common malignant tumor in children. In the sex distribution, there was a male predominance, especially among children Case Presentation: A 12 year old female child was brought to Acharya Vinoba Bhave Rural Hospital, Sawangi (Meghe), Wardha, Maharashtra, India on date 12/01/2020 with complaints of breathlessness since 5 days, high grade fever since 10 days and retrosternal chest pain since 10- 15 days along with anorexia. The patient had a complete blood count, which revealed that his hemoglobin percent, total red blood count, hematocrit and Mean Corpuscular Hemoglobin were all low. Pleural Fluid cytology analysis, Virology investigation, CECT Chest and Cytopathological Examination (USG guided FNAC) done from left axillary lymph node were all performed for diagnostic purposes. The patient was diagnosed as Burkitt Lymphoma after comprehensive examinations. He was treated Tab. Tablet Augmentin, Tab. Pantoprazole, Tab. Prednisolone, Tab. Brufen, and Tab. Emset, Syrup Gelusil, Injection Cyclophosphamide and Injection Vincristine as well as nursing care was provided based on his needs. Conclusion: Patient showed spontaneous recovery.

In developed countries, universities are reputed as hub of innovation, contrarily to developing countries, universities are intermediary platforms for the diffusion of technology from large manufacturing companies to the value chain. The Malaysian Government through its blueprints emphasize that public universities have an important role in supporting innovation and technology commercialization. Despite myriad initiatives created and executed to help universities in improving their ability to innovate, the outcomes have yet to meet national expectations. This suggests a lack of awareness on the influence of universities especially in University Industry Collaboration (UIC) towards sustainable development in the innovation ecosystem. On that grounds, it is important to address this research gap, for it will provide insights to manufacturing companies and help universities themselves in being instrumental towards the intensification of UIC. The intent of this paper is to determine the role of public universities in UIC within the Malaysian manufacturing landscape. This paper is based on findings of a quantitative approach through survey questionnaire. A total of 20 public universities and 40 large manufacturing companies were surveyed and analysed using Descriptive statistics and Pearson’s correlation coefficient. For further evidence, registered intellectual property was analysed using One sample T-test. The percentage of expenditure of R&D per export value by large manufacturing companies in Malaysia was used as test value to determine the current role of public universities within the Malaysian manufacturing landscape. The findings reveal, public universities in Malaysia remain as intermediary platforms for large manufacturing companies to share their technology with the value chain. As intermediaries, public universities fortify knowledge and product development for large manufacturing companies. The findings further reveal, registered intellectual property by large manufacturing companies is a significant indicator of UIC outcomes through R&D processes. The findings of this paper add to the dimensions of empirical research on the significance of public universities in intensifying UIC. The importance of public universities in creating relevant and sustainable technology is paramount. Only when universities are solicited as hub of innovation by the manufacturing landscape, Malaysia will move up the value chain in manufacturing.

Innovation has been the key pillar of success for economic growth especially for developing countries. Malaysia is one resorting to both universities and industries to collaborate in a more engaging and concentrated fashion to accelerate innovation growth especially in the manufacturing sector. Despite the high number of university industry collaborations, the return rate of investments is low. This suggest a mismatch between the demands of both the university and industry. On that grounds, it is important to address this research gap, for it will provide insights to help industries and universities understand how academic collaborations can be intensified to spur innovation. The aim of this paper is to establish Technology Sharing as a conduit in University Industry Collaboration to intensifying innovation within the Malaysian Manufacturing Landscape. The paper is based on findings of a quantitative approach through survey questionnaire to determine a strong relationship on Technology Sharing through University Industry Collaboration as a source of innovation in the manufacturing industry. A total of 120 companies within the manufacturing landscape were survey and analysed using paired sample T-test. The mean scores were translated into percentages to amplify the magnitude of knowledge improvement and product development with Technology Sharing in manufacturing against the Business expenditure on R&D (BERD). The findings reveal, Technology Sharing through University Industry Collaboration improves knowledge within the company significantly. This generation of new knowledge is a source of innovation in product development to enhance the product/process/technology of the manufacturing companies in Malaysia. The findings also show that with Technology Sharing, companies’ absorptive capacity of new product development is significant. Improvement of knowledge translates into product development and augments innovation. This further ascertains the relationship of Technology Sharing in intensifying University Industry Collaboration to the growth of innovation within the Malaysian Manufacturing landscape.

A series of 1,2,4-triazole hydrazones 1–25 has been synthesized and characterized using different spectroscopic techniques including FT-IR, 1H-NMR, and ESI MS spectrometry. The synthetic derivatives were evaluated for their β-glucuronidase enzyme inhibition properties. Among them, 17 compounds demonstrated potential inhibitory activity towards β-glucuronidase with IC50 values ranging between 2.50 and 53.70 µM. Compounds 1 having IC50 = 2.50 ± 0.01 µM was found to be the most active compound of the series and showed remarkable activity and found to be far more potent than the standard d-saccharic acid 1,4-lactone (IC50 = 48.4 ± 1.25 µM). Furthermore, the possible binding interaction of active compounds was explored by in silico studies. These compounds can be used for anti-diabetic drug development process.

Small and Medium Enterprises (SMEs) represent a very large percentage in the Malaysian economy landscape and has a huge impact on University Industry Collaborations (UIC). In many developed and developing countries, UIC have clearly benefited both the industry and university on a large scale. However, Malaysia faces a different set of challenges to overcome in establishing intensified UIC. The representation of SMEs must be considered and amplified in a collaboration between industries and universities to ensure sustainability in the collaboration and continuous innovative development of both the industry and university. Herein, this paper explores the prominence of SMEs within the Malaysian economic landscape. It further examines the differences in policy direction and supply chain management for SMEs by developed economies. Based on that parameters, this paper also discusses the imprint SMEs has on UIC.

Background: The Immunization Programme was started in India in 1978 with the objective of reducing the morbidity and mortality due to vaccine preventable diseases. Universal Immunization Programme against six preventable diseases, namely, diphtheria, pertusis, childhood tuberculosis, poliomyelitis, measles and neonatal tetanus was introduced in the country in a phased manner in 1985, which covered the whole of India by 1990.1 Objectives: 1. To assess the knowledge of mothers of under five children regarding immunization schedule and vaccine preventable diseases.2. To associate the finding with selected demographic variables. Method: In this study the structure questionnaire used regarding immunization schedule and vaccine preventable diseases. Result: The Study shows that due to mass media communication no mother of rural area is having poor level of knowledge score, 39(65%) of mother of rural area having average level of knowledge score, 21(35%) of mother of rural area having good level of knowledge score, and no mother of rural area had excellent knowledge score. The minimum score was 11 and the maximum score was 20, the mean score was 15.48 ± 2.40 with a mean percentage score of 48.38 ± 7.51. Conclusion: There was significant increase in the knowledge scores of the study participants. This shows that, all mothers had good knowledge regarding immunization schedule and vaccine preventable diseases.

Background: Developmental milestone are a set of functional skills or age-specific tasks that most children can do at a certain age range. Child development refers to how a child becomes able to do more complex things as they get older. Growth refers to the child's development: Although each milestone has an age level, the actual age when a normally developing child reaches that milestone can vary quite a bit. Hence it would be possible the parents must educated regarding developmental milestones especially in rural communities. Objectives: 1. To assess the existing knowledge of the mothers regarding developmental milestones in infants. 2. To find the effectiveness of structured teaching programme on mothers' knowledge regarding developmental milestones. 3. To find an association between knowledge and demographic variable. Materials and Methods: present study conducted in rural areas of Wardha district 60 subjects recruited based on inclusion criteria, and utilized the technique of Non probability convenience sampling. Pre experimental one group pre test post test without control group used, the instruments were structured questionnaires and the planned teaching was given after the pre test. Results: The study findings were in pre test knowledge score were seen into 4 categories, poor, average, good, and excellent. 8.33% of the mothers of infant had poor, 71.67% had average and 20% of them had good level of pre test knowledge score. Mean knowledge score was 6.93±1.83. in post test knowledge score were 26.67% of the mothers of infants had good and 73.33% had excellent level of post test knowledge score. Mean knowledge score was 13.35±1.41. Hence it is interpreted most of the parents understood about developmental milestones and its importance to find out the growth and developmental abnormalities easily. Conclusion: developmental milestones is most neglected aspect so the study was to assess the effectiveness of planned teaching on knowledge regarding developmental milestones among mothers of infants in rural area of wardha, where there is a vulnerable groups and underprivileged population.

Background : In a recent study of outpatient nurses, participants reported significant unintended skin and eye exposure to chemotherapy (Friese, et al., 2011). In this study, the author concludes that the overall rate of exposure decreases when nurses report adequate staffing and resources (2011). This implies that nurse-patient ratios and workplace demands contribute to the problem of mishandling chemotherapy. Therefore, these results implicate the need for adequate staffing and resources as well as increased staff compliance to established practice standards in order to better protect oncology nurses. Other contributing factors identified in system failures that result in an unsafe work environment include lack of awareness of personal and public risks of exposure, poor communication, and direct interruptions and/or distractions while preparing to administer medications (Ashley, et al., 2011). Objectives : To assess the practice regarding safety measures used by nurses while handling chemotherapy drugs. Method : In this Study the structured checklist was used to see the practice regarding safety measures used by nurses while handling chemotherapy drugs. Result : Assessment of nurses practice while handling chemotherapy drug shows that Majority of samples 56 (56%) were having poor practice while handling chemotherapy drugs and 44% of nurses were having good practice while handling chemotherapy drugs, Maximum score was 6 and minimum score was 1. Conclusion : After the detailed analysis, this study leads to the following conclusion that assessment of nurses' practice while handling chemotherapy drug. Majority of samples were having poor practice while handling chemotherapy drugs.