Table of Contents: Volume 16; Issue 11; November 2024

A true experimental study to evaluate the effectiveness of lemon peel extract on knee pain among patients with Rheumatoid Arthritis in a village at Kanyakumari district. Aim: The aim of the study was to evaluate the effectiveness of lemon peel extract on knee pain among patients with Rheumatoid Arthritis. Materials and Methods: A true experimental pre-test post-test control group design was adopted for the study. Sample size was 60, calculated using Slovin’s formula and with the help of simple random sampling method 30 participants were allotted in study group and 30 participants in control group.Pre- intervention and post-intervention knee pain was assessed using Western Ontario And McMaster University Osteoarthritis Index (WOMAC) Scale. Lemon peel extract was applied for 20 minutes once a day for 15 days for the study group and control group had not received any intervention. Mean, standard deviation and paired and unpaired ‘t’ test was used to evaluate the effectiveness of lemon peel extract on knee pain. The comparison of post- intervention knee pain score between study group and control group was analysed by unpaired ‘t’ test. The comparison of pre-intervention and post-intervention pain score within the group was analysed using paired ‘t’ test. Chi-square test was used to find out the association between demographic variables and clinical variables of the participants with their pre-intervention knee pain score. Results: The study results showed that, in study group, the mean post-intervention score on knee pain (29.63) was lower than the mean pre-intervention score on knee pain (79.5), which showed that, there was a significant difference between the mean pre-intervention and post-intervention score on knee pain, in study group, whereas the mean post- intervention score on knee pain in study group (29.63) with the standard deviation of (9.73)was lower than the mean post- intervention score on knee painin control group (75.9) with the standard deviation of (10.998). Unpaired ‘t’ test value for knee pain was 18.259 which was significant at p≤0.05 and was highly significant at p≤0.01, p≤0.001. In study group the paired ‘t’ test value for knee pain was 11.411 which was significant at p≤0.05 and was highly significant at p≤0.01, p≤0.001, and in control group the paired ‘t’ test value for knee pain was 3.636 which was significant at p≤0.05 and was highly significant at p≤0.01, p≤0.001. This represents the effectiveness of lemon peel extract on knee pain. Conclusion: According to the results, application of lemon peel extract had considerably reduced the knee pain, which revealed that the lemon peel extract was one of the most important and effective intervention in reducing knee pain.

Le développement d’un pays dépend non seulement de sa richesse en ressources naturelles et minières mais aussi et surtout de son capital humain. L’homme est en amont et en aval de tout processus de développement, cette position charnière exige qu’il jouisse d’une bonne santé.Au Bénin, depuis le Renouveau démocratique, le secteur sanitaire est en proie à diverses difficultés dont les conséquences visiblesinterpellent le secours et l’action de la communauté internationale. L’objectif de cette recherche est d'apprécier l’impact des activités de l’USAID dans l’amélioration du système sanitaire béninois. La démarche méthodologique adoptée a consisté en une exploitation croisée de la documentation écrite et des témoignages oraux des acteurs du système.Les résultats montrent que pour aider le Bénin, l’USAID a soutenu plusieurs projets et programmes de santé de 1991 à 2011. Cette aide a apporté des changements significatifs à tous les niveaux de la pyramide sanitaire du pays.

Dansle bassin du lac Fitri, on observe la présence de plusieurs formations végétales très variées allant des forêts claires aux différents faciès de savanes et des champs. Pour ce faire, une étude a été menée dans le but de caractériser la flore et la végétation, d’évaluer l’impact de l’anthropisation et de déterminer les facteurs responsables de la dynamique du bassin du lac Fitri. La méthodologie utilisée a consisté à réaliser des enquêtes socioéconomiques, de déterminer la composition floristique et la structure du peuplement ligneux dans quatre types de formation végétale. Les inventaires floristiques ont permis de recenser 21 espèces, réparties en 14 genres et 10 familles. Cette richesse spécifique varie suivant les types de formations végétales définies. La richesse floristique a été relativement importante dans les savanes arbustives et dans les champs que dans les autres les unités de formation végétale. La flore ligneuse est dominée par les Mimosaceae et Balanitaceae. La densité des ligneux est de 128 ind. ha-1. La végétation de tous les types de formations végétales présente une structure verticale qui présente une répartition en classes de hauteur en forme de U renversé plus prononcé vers la gauche. On note un recouvrement moyen (49,37%) du couvert végétal et une difficulté de régénération des espèces. Les indices de diversité calculés indiquent une faible diversité des espèces dans les peuplements ligneux des différents types de formation végétale de la zone d’étude. Ces indices prouvent que même si la diversité floristique n’est pas assez forte, les espèces présentes sont distribuées de manière homogène et ont une répartition très irrégulière des effectifs entre ces espèces ou une répartition relative irrégulière des individus au sein des différents types de formation végétale. Ceci s’explique principalement par l’extension des zones agricoles et d’habitations avec la pression démographique, la recherche de fourrage à travers plusieurs méthodes dont l’élagage et le rabattage. Des stratégies de gestion durable sont donc nécessaires, cartographier et évaluer le taux de régénération des différentes espèces et procéder à la domestication de certaines essences prisées par les paysans qui pourront mieux produire, donner des produits de qualité, afin de contribuer à la diversification de la diète, tout en améliorant la résilience agroécosystémique et les intégrer dans des systèmes de production.

There are two types of odour tests that use 12 types of odours familiar to Japanese people in their daily lives as screening: odour sticks and open essence. In this study, we performed these two types of olfactory tests on the same male over 60 years old, and compared the results to clarify whether there were any differences. Twelvedifferent smells are India ink, wood, perfume, menthol, mandarin oranges, curry, household gas, roses, cypress, sweaty socks, condensed milk, friedgarlic. The participants were 59 male aged 60 years or older who received an explanation of the study and signed a subject consent form. Participants performed the open essence test, followed by a 10-minute break and then the odour stick test. In both tests, participants smelled the odour and then wrote the number they thought was correct from six options in the answer box. Options 1 through 4 were various specific odour names. Options 5 were for when there was an odour (detection) but it was unclear what it was, and option6 was for when there was no odour at all (odorless). The results of the two tests performed on the same subjects were compared statistically (chi-square test). The results showed that there was no statistically significant difference in the number of correct answers (P-0.579). However, when comparing each odour individually, there were statistically significant differences between the odours of India ink (P=0.009**), mandarin orange (p=0.002**), curry (P=0.012*), and fried garlic (P=0.008**). The results showed that the smells of India ink and curry were easier to identify using the open essence than using the odour stick, while the smells of mandarin oranges and fried garlic were easier to identify using the smelly stick than using the open essence. There were no statistically significant differences among the other eight odours. Even if the tests use the same 12 types of odours that are familiar to Japanese people, the results obtained will differ for each individual odour, so it can be said that the results cannot be combined or added together. A series of the studies must be conducted using the same method.

It is about a 45yearold malewho underwent urgently right thoracotomy for destroyed right upper lobe lung in sepsis. Patient underwent right upper lobectomy uneventfully.The pathology report showed pleomorphic carcinoma of the lung. Withina twenty day periodpost surgery patient developed local recurrence of the carcinoma involvingsuperiorly the lower right lobe. Redo right thoracotomy was decided and wedge resection of the tumor was uneventfully excised.Patient underwent immediately chemotherapy and twenty four months post therapy is asymptomatic and disease free. Protocols and guidelines really help to organize a strategic plan for effective therapy for patients with cancer. Perhaps we should keep in our mind that there not only diseases but also patients who respond differently to therapies. It is an interesting case report.

Purpose: Hamstring extensibility is of functional significance in prevention of locomotion related injuries. stretching is a typical component of its rehabilitation programs. Recently evolved, matrix therapy promotes extracellular matrix clearance on a cellular level thereby normalizing tension of the musculature. Hence, this study was done to compare the immediate impact of stretching compare with matrix rhythm therapy on hamstring flexibility in normal healthy females. In this experimental study 40 female subjects aged between 18-25 were recruited. After their prior consent, selection criteria included screening and assessment of hamstring tightness by active knee extension test(p>0.05).Subjects fitting the study design were divided into 2 groups of 20 each who received either matrix therapy (Group A) or self stretching(Group B) for 3 times each within 3 weeks. On each leg matrix was given for 30 minutes whereas self stretching was repeated 6 times each with 30 secs hold. Pre and Post interventional ranges of both knee extension were measured after each session. Paired ‘t’ test was used to analyze within group difference while independent ‘t’ test was used for between group differences. Results: Significant improvement in hamstring flexibility was found post intervention compared to pre intervention in both the groups (p<0.001).However greater improvement in flexibility was seen in group A (Matrix rhythm) when compared to group B (self stretching). Conclusion: Based on the results, matrix therapy had an upper hand in improving hamstring flexibility than self stretching. matrix rhythm therapy can be used in the early rehabilitation of individuals with hamstring tightness.

Leukodystrophies are rare genetic disorders characterized by progressive damage to the white matter of the brain, manifesting with neurological and motor symptoms. In adults, the onset of leukodystrophy symptoms is typically delayed, with the disease being frequently misdiagnosed due to its broad symptomatology. This case report describes a unique presentation of early behavioral symptoms in an adult patient with leukodystrophy, emphasizing the importance of recognizing neuropsychiatric changes as potential early indicators. The patient, a previously healthy adult, presented initially with depressive and irritable behavior since 7 years, treated initially with antidepressants showing minimal improvement and later developed cognitive symptoms along with 1 manic episode 4 years back. Neuro-imaging and genetic testing ultimately confirmed the diagnosis, showing the utility of advanced diagnostic tools in cases of atypical leukodystrophy presentation. This case highlights the need for increased awareness of behavioral changes as possible early signs of leukodystrophy, which may facilitate earlier intervention and improved patient outcomes

Kidney stones have become increasingly common in contemporary society, affecting individuals across various age groups, with a higher prevalence in regions characterized by limited access to potable water. Composed primarily of calcium and phosphate, these rigid formations arise when substances like calcium oxalate and uric acid crystallize. While kidney stones can travels the urinary tract from the kidneys to the bladder, potentially causing severe pain, many individuals may experience resolution without permanent damage. This article explores various animal models and in vitro studies used to investigate urolithiasis, detailing the types of kidney stones, their symptoms, causes, risk factors, identification methods, treatment options, and preventive measures. The types of kidney stones include calcium, struvite, uric acid, and cystine stones, each with distinct etiologies and clinical presentations. Symptoms often escalate with stone size, ranging from severe abdominal pain to nausea and fever. Contributing factors include dehydration, dietary composition, genetic predisposition, certain medical conditions, and obesity. Key diagnostic tools include imaging techniques and urine analysis. Treatment approaches consist of non-invasive techniques like extracorporeal shock wave lithotripsy, minimally invasive procedures, and medication that alters urine chemistry. Prevention strategies focus on hydration, dietary modifications, and adherence to prescribed medications. Ultimately, management of kidney stones entails a holistic approach involving symptom awareness, lifestyle adjustments, and timely medical intervention to mitigate recurrence and promote kidney health.

Background: Rheumatoid arthritis (RA) is characterized as a symmetric, inflammatory, peripheral polyarthritis, arising from an autoimmune response primarily affecting women. Synovial hypoxia is characterized by a reduced oxygen partial pressure (pO2), involved in RA pathophysiology. Hypoxia leads to the induction of angiogenesis, inflammation, apoptosis, cartilage erosion, abnormal energy metabolism, and oxidative damage. Objective: The objective of the study is to examine the contemporary understanding of hyperbaric oxygen therapy (HBOT) as a treatment modality for rheumatoid arthritis. HBOT is a non-invasive medical procedure wherein patients inhale nearly 100% oxygen within a hyperbaric chamber that is pressurized to levels exceeding those of sea level pressure (1 atmosphere absolute or ATA). Results: The study indicates that HBOT offers advantages for patients with RA, including alleviation of pain, reduction of inflammatory responses, and enhancement of physical activity. Further research is required to establish the efficacy of HBOT in the context of RA.

Aim: To use image analysis to compare the pre and post treatment photographs and measure the incidence and severity of white spot lesions in patients who underwent fixed orthodontic treatment. Materials and Methods: The orthodontic pre treatment and post treatment intra oral (frontal view) digital photographs taken immediately after debonding are analysed by using Image J software version 1.50i. The facial surfaces of the anterior 6 maxillary teeth (canine to canine) are evaluated for WSLs. Teeth identified as having WSLs had their total facial surfaces and the lesion areas outlined with the free hand tool in the Image J 1.50i software and the respective areas are calculated using the same software. The area of the WSL was divided by the area of the total facial surface of the tooth to calculate the percentage of the facial surface affected. Teeth without WSLs are recorded as a zero percentage. The percentage of WSL per total facial tooth surface provided a relative value that controlled for differences in magnification of the digital photos. Results: Comparison of WSLs in pre and post treatment photographs showed incidence of WSLs were more in right canine. The decreasing order of incidence of WSLs (comparison between WSLs in pre and post group) was right canine, left canine, right lateral, left central, left lateral, right central. The decreasing order of severity of WSLs in pre treatment group was right lateral right canine, left canine, left lateral, left central and right central. In post treatment group was left lateral, right lateral, left central, right canine, left canine and right central. The WSLs were developed more in lateral incisor (24%) when compared with other teeth. Among all the patients 73% developed WSLs on the labiogingival areas of the teeth included in this study. On average 54.5% develop WSLs and 45.5% did not develop WSLs. Among 20 patients 51% of patients develop WSLs on right canine, 46% on right lateral, 55.6% on right central, 42.4% on left central, 49.2% on left lateral, 40.1% on left canine. Conclusion: Comparison between pre and post treatment photographs showed more incidence of WSLs on right canine. In post treatment group the increase in WSLs was highest in lateral incisors. 73% of patients develop WSLs on the labio gingival areas of the teeth.

This review article is all about the Punicagranatum Pomegranate possessing the phytochemicals, their activity and effect in terms of benefits and uses. Although pomegranate has already been proven containing therapeutically active ingredients collectively called as antioxidants, the fruit holds great importance in many mythologies and cultures starting from Middle East to all over the world. This article is also about the myths and facts about the fruit. The facts coming out of scientific studies carried out before are also discussed in the article. However along with factual data the article is focused on phytoconstituents of Punicagranatum and their activity determination. Mainly the active ingredients present in Punicagranatum such as flavonoids, vitamins, punicalagins and minerals are discussed.

Les événements climatiques à l’origine des catastrophes climatiques, touchent la vie des communautés. Les populations des Communes des 2KP disposent des connaissances endogènes four faire face auxdits évènements climatiques. L’objectif de cette recherche est d’analyser les perceptions des acteurs du système pastoral sur les vulnérabilités des parcours de transhumance face aux risques climatiques dans les 2KP. L’approche méthodologique adoptée s’articule autour de la collecte des données climatologiques, démographiques et socio-anthropologique, du traitement des données et l’analyse des résultats. Les techniques de collecte utilisées concernent essentiellement la recherche documentaire et les investigations en milieu réel afin de recueillir toutes les données et informations nécessaires à la réalisation de cette étude. L’analyse en composante principale, la statistique descriptive et les graphiques ont servi pour étudier les perceptions des agropasteurs et des éleveurs. Les résultats obtenus montrent que, le début tardif de saison de pluie (93,7 %), la baisse de pluviométrie (71,3 %) la fin précoce de saison de pluie (63,1 %) et la hausse de température (55,7%), l’harmattan rude (50,7 %), les poches de sécheresse prolongée (47,3 %), les fortes pluies (45 %), les vents forts et violents (76,8 %) sont les facteurs de vulnérabilité les plus fréquentes selon la perception des éleveurs. Par conséquent, l’insécurité alimentaire ou manque de fourrage (61 %), l’exaspération de la pauvreté (53 %), les conflits et migrations accrus (48 %), la baisse de rendement et de motivation (45 %), le changement d’activité ou reconversion (18 %), la rupture de la solidarité (22 %) etc. sont les effets majeurs de la variabilité climatique sur le quotidien des agriculteurs et éleveurs de bovins. Il ressort également que selon la perception des éleveurs, le troupeau (bovins, ovins, caprins etc.) est très vulnérable, suivi des ressources pastorales (fourrage, herbe, végétaux et eau) et des communautés pastorales (bergers, femmes, propriétaires d’animaux).

This study discusses the system of relations between Palestinian children's literature in Israel and the war. The study firstexamines the concept of war in the world literature provided to children. Then, the study moves to Palestinian children's literature and the war and is concerned with giving models that illustrate the interaction of this literature with the Arab-Jewish conflict, the impact of this conflict on aspects of life, and how the war affected the psychology of its contemporary. The study gives a portion of its pages to show the features of this impact on people and indicates that the Palestinian is a political object; either he remembers the effects of the war, lives it, or fears its coming and bitterness, and no matter how this literature tries to separate from its reality or is forced by circumstances to do so, it eventually fuses with this reality in different ways.

Purpose： Eradicating corruption is a long process that requires not only the improvement of institutional norms but also the development of soft power to constrain corruption. Education can mould an individual's personality, attitude, and character, thus inhibiting corruption. Therefore, through school education, integrating anti-corruption theories, integrity culture and institutional norms, cultivating the values of integrity, making students aware of corruption, and shaping anti-corruption and integrity character become the necessary content of anti-corruption and integrity education. Research Methodology：This study utilised the textual analysis method and questionnaire survey to analyse the implementation of anti-corruption and integrity education at various education stages in China. Finding：The study found that the objectives and contents of the current anti-corruption and integrity education have been incorporated into the ideological and political education curriculum. The method of integrity education is mainly used to guide students to form an integrity character. Still, there is insufficient emphasis on anti-corruption education, such as corruption, its causes, manifestations and hazards, the relationship between corruption and integrity, the current anti-corruption and integrity legal system, and initiatives related to the fight against corruption. Implications： In the future, educators could construct anti-corruption and integrity teaching modules, use a variety of teaching methods, integrate anti-corruption and integrity education in political and ideological education curricula, and create an integrity campus atmosphere to form a character of integrity at the individual level, guide students to understand corruption, the history of anti-corruption, anti-corruption measures and responsibilities, and cultivate integrity and incorruptible citizen.

In modern practice Democracy is a system of government in which the citizen’s use power directly by electing representatives to form a government and now we call it parliamentary system of government. Democracy is referred as ‘rule of the majority’. The word Democracy is originally begins in classical Greece, where political representatives were elected by a jury amongst the male citizens; rich and poor. The English word dates to the 16th century, from the older middle French and Middle Latin equivalents. Democratic government is deference from the forms of government where power is either held by an individual, as in an absolute monarchy, or where power is held by a small number of individuals, as in an oligarchy. Karl Popper defined democracy in contrast to dictatorship or tyranny, thus focusing on opportunities for the people control their leaders and to oust them without the need for a revolution. In this context the study on Indian Democracy is very relevant and this paper is mainly a theoretical study on Issues, concerns and challenges to Indian Democracy.