In 2 to 3% of pregnancies, congenital malformations are diagnosed during pregnancy or shortly after birth. These abnormalities, with surpassing premature birth, are the most common cause of death in infants in the United States and account for 20% of these deaths (1). Preventive diagnosis, diagnosis of malformations, fractures, and chromosomal anomalies are some of the most important genetic syndromes in the fetus. Components included within the category of prenatal diagnosis include typical screening tests to find an aneuploidy and neural tube defects, invasive diagnostic tests such as percutaneous and amniocentesis sampling, screening and diagnostic tests suggested to individuals exposed to a specific genetic disorder, and the diagnosis of structural malformations with the help of specialized ultrasound and other methods of embryo imaging. The AFP screening of the mother's serum generally takes place between weeks 15 and 20. This should be done through the protocol, including quality control, consultation and follow- up. The amount of AFP is measured in nano-grams per milliliter and is reported by the median number (MoM) of the non-affected population. Converting outcomes to MoM standardizes AFP level distribution and allows comparison of results from different communities and labs percent reported.

To compare the sero-prevalence of HIV infection between nulliparous and parous women who attended the Sinawe Center following sexual abuse.

The use of hydrotherapy for healing has been practiced for centuries by the ancient Iranians, Greeks, Chinese and ancient Romans due to the unique properties of water. The use of hot springs was common among the people of that time to relieve and reduce all kinds of pain[1]. Today, different terms such as hydrotherapy (hydrotherapy), aqua-therapy, pool therapy, water sports, etc. are mentioned in different communities. Three important properties of water that cause the main difference between exercise in water and land: 1- Floating force, which causes weight loss in water. This weight loss can occur up to 90% (water depth to the neck), for example, a person who weighs 100 kg can lose up to 10 kg in water, which is the weight loss that causes the joints to overlap Reduce the pressure on them and relieve and reduce pain. 2- Viscosity or adhesion of water, this property of water, causes water resistance against body movements and strengthens various muscles. On the other hand, the force of water adhesion helps maintain balance and reduces falls in the elderly. Various studies have shown that one of the most important reasons for the inactivity of the elderly on land is the fear of falling and bone fractures, which makes water safe for the elderly to exercise safely without any injuries or falls. 3- Hydrostatic pressure: It is the pressure that water puts on different organs of the body simultaneously and causes the return of blood from the lower extremities to the heart to increase, and this improves the function of the heart and lungs, so exercising in water Due to its light weight, weight loss and easy and fast return of blood to the heart can be beneficial for cardiopulmonary patients[2].

Anti-COVID-19 policies follow the epidemiological traffic light that goes from red in total confinement to green in total deconfinement. In both scenarios, entrepreneurship is a response to the health and economic crisis. Based on distancing, confinement and immunization, the literature related to entrepreneurship configures a network structure that the present work set out to explain. A documentary, exploratory and cross-sectional work was carried out with a selection of findings published in journals indexed to Conacyt , Latindex and Redalyc. The information was selected considering the criteria of expert judges on the topics. A network was established from clustering and centrality coefficients. The results were discussed from the reviewed literature.

There is a documented increase in patient morbidity and mortality in the months where new interns start their training in the hospital. This is more commonly referred to as the ‘July effect’, as most institutions accept fresh medical graduates who have just completed their final examinations in the preceding spring months.
Donning the white coat for the first time as a doctor brings with it a sense of both accomplishment and apprehension. The responsibility that rests of a junior doctor’s shoulders is now far heavier than simply an impending exam. It is perhaps this feeling, in addition to the sudden increase in responsibilities and working hours in the hospital that may justify the reports favoring the matter 1, 2. There are, however, numerous publications that are contradictory to the idea of a July effect existing at all 3-6. This is reassuring to see that in some departments, the current level of training and vigilance is sufficient to overcome the potential vulnerability caused by the addition of the new members of staff.

Background: Propofol is frequently associated with pain during intravenous injection ;which reported to occurs in 28-90% of patients , usage of ketamine as a pre-treatment with rubber tourniquet for one minute before propofol intravenous administration, significantly reduce the severity and incidence of propofol induced pain. Aims: first to evaluate the effect of pre-treatment with small dose of ketamine with venous occlusion on reducing the pain of propofol injection in adult patients, and second to find alternative to lidocaine pretreatment. Patients and methods: Informed consents were taken from ninety unpremeditated adult patients aged 20-60 years with ASA physical status classes 1 and 2; who were scheduled for elective surgery. Patients were assigned in to three equal groups each of 30 (1st Group -received intravenously 2mls normal saline, 2nd - 2mls of 1% I.V. lignocaine, 3rd - 2mls of ketamine 10 mg (i .v). Results: there was no significant differences in age ,sex or weight .The incidence of pain was 33.3% in the ketamine group as compared to 30% in the lidocaine group and 63.3% in the normal saline group , The difference between the two proportions is :63.3 - 30= 33.3 is significant because the difference is more than twice the SE ( P). (b)Saline Vs Ketamine: S E (P) = √ (63.3× 36.6)/30+ (33, 3× 66, 6)/30=12.3. The difference between two proportions =33.3 (Statistically significant) c) lidocaine Vs ketamine: S E (P) = √ (30× 70)/30+ (33, 3× 66, 6)/30 =12.00 Difference = 3.3 (no significant difference) There was no significant difference in pain score among lidocaine and ketamine groups. Although there was significant difference between group of normal saline other two groups The overall incidence and severity of pain during injection of propofol in the various groups    .The incidence of pain in saline group was 63.3% as compared to 30% and 33.3% in the lidocaine group and ketamine groups respectively. None of patients had any side effects like erythema, itching, and bradycardia. There is no significant difference in the incidence of pain between the lidocaine (30%) and ketamine (33.3%) groups. Severe pain occurred in two patients (6%) in the saline group as compared to (0 %) in both lidocaine and ketamine groups. No pain was 36.63%   in the saline group, 70% in the lidocaine group and 66.6 % in the ketamine group. Conclusion: the current study confirmed that pretreatment with intravenous 10mg ketamine with one minute venous occlusion by tourniquet reduced the incidence and severity of propofol (i.v) injection pain, and this can be an alternative for lidocaine.

Introduction: Internet addiction is one of the addictive behaviors and typically described as a state where an individual has lost control of the internet use and keeps using internet excessively to the point where he/she experiences problematic outcomes that negatively affects life. Objective: The aim of this study was to assess the magnitude and associated factor of internet addiction among regular under graduate students at Haramaya University, College of Health and Medical Science, from July1, 2021 to December 1, 2021. Method: Institutional based cross-sectional study was conducted in Haramaya University College of Health and Medical Sciences. The total of 216 under graduate students was enrolled in this study. The simple random sampling methods were employed to collect the representative samples. Internet Addiction was measured byYoung’s Internet Addiction test (YIAT). Logistic regression model were used to evaluate the association between IA and associated factors. P-value andadjusted odds ratio within 95 % level of confidence (CI) was used to interpret the results. Result from total of 216 study participants the overall magnitude of internet addiction among under graduate Haramaya University College of Health and Medical Sciences students was 57.9%. Factors such as current Khat use [AOR =1.94, 95% CI (1.05, 3.56)] and having psychological distress [AOR =1.15, 95% CI (1.032, 3.407)] were found to be significantly associated with magnitude of internet addiction. Conclusion The currentstudy shows that fifty seven percentof undergraduate students in Haramaya University were addicted to the internet. So internet addiction was associated with using current Khat user and having psychological. Therefore we recommended students need to be educated about safe, valuable, and healthy practice of internet use and better to counsel on substance use and its consequences to overcome the anticipated increase in internet addiction.

The strategy of price liberalisation and privatisation had been implemented in Sudan over the last decade, and has had a positive result on government deficit. The investment law approved recently has good statements and rules on the above strategy in particular to pharmacy regulations. Under the pressure of the new privatisation policy, the government introduced radical changes in the pharmacy regulations. To improve the effectiveness of the public pharmacy, resources should be switched towards areas of need, reducing inequalities and promoting better health conditions. Medicines are financed either through cost sharing or full private. The role of the private services is significant. A review of reform of financing medicines in Sudan is given in this article. Also, it highlights the current drug supply system in the public sector, which is currently responsibility of the Central Medical Supplies Public Corporation (CMS). In Sudan, the researchers did not identify any rigorous evaluations or quantitative studies about the impact of drug regulations on the quality of medicines and how to protect public health against counterfeit or low quality medicines, although it is practically possible. However, the regulations must be continually evaluated to ensure the public health is protected against by marketing high quality medicines rather than commercial interests, and the drug companies are held accountable for their conducts.

The determination of fetal gender is done for various reasons, including medical reasons such as the diagnosis of sexually transmitted diseases or social causes such as purchases for each gender and the change in the place of residence of the parents. As some of the embryonic diseases are sexually related, the early detection of fetal sex allows parents to make appropriate genetic counselling. If one of the parents or both of them has a definite disease, they can have an early warning about the disease in their fetus, and thus they will be able to decide early on for that fetus. Clinical value is the determination of fetal sex in deciding whether or not to perform prenatal invasive tests (amniocentesis and patchy sampling), because invasive tests are required only in pregnancies that are fetal males. The studies that have been done so far confirm that the best results are obtained in diagnosing fetal sex after 12 weeks of gestation, as a result, invasive tests for the diagnosis of sexually transmitted diseases should only be performed after 12 weeks, because before that the diagnosis of fetal sex is unreliable.

Beside the gen hypothesis for the explanation of cancer there exists the metabolic hypothesis of Otto Warburg. It is explained with the result that the probability of its correctness is high. An effectful treatment can be concluded.

Introduction: Intussusception signifies the introduction of part of the intestine into adjacent lumen, resulting in intestinal obstruction. The disease has been reported in all ages and even during fetal development, which subsequently led to the absence of intestinal formation; however, it is the most common abdominal emergency and the second most common cause of intestinal obstruction in children under the age of two.

Introduction. Compartment syndrome is described as a pathological entity that owes its origin to several causes, where all of them lead to an increase in internal pressure of an injured limb that has muscle groups divided by septa and facial that are less compliant than by increasing pressure due to above 30 mmHg leads to deep nerve and vessel compression. Presentation of the patient. We present a case of incipient acute compartment syndrome of the lower limb in a patient who ruptured the gastrocnemius muscles at the knee after practicing sports. With the aim of testing the validity of preventive follow-up and conservative treatment through a protocol in four stages, lasting one week, it was possible to verify that as the treatment progressed in stages, the symptoms and signs disappeared until a total solution was reached. .after completion of the treatment, surgical intervention not being necessary in said patient. Conclusions. Acute compartment syndrome in the incipient phase can be resolved with conservative treatment, avoiding surgical intervention, provided that an adequate treatment protocol is applied.

Vinca alkaloids are a subset of drugs obtained from the periwinkle plant they are naturally extracted from the pink periwinkle plant (Catharanthus roseus), and they have been used to treat diabetes, high blood pressure and have been used as disinfectant. The vinca alkaloids are also important for being Cancer resistant there are four major vinca alkaloids in clinical use: Vinblastine (VBL), vinorelbine (VRL), vincristine (VCR) and vindesine (VDS). Vinca alkaloids are the second most used class of cancer drugs and will stay among the original cancer therapies. Catharanthus roseus is still source used for the powerful antitumor drugs. Callus culture had been done on MS-medium containing Different Concentrations from BA – 2,4-D – NAA – IAA. Where the different effects of growth regulators were studied when different parts of the plant have been cultured from leaves and stems this is to induce callus formation and encourage growth and the concentrations that were prepared: BA (0,1 – 0,3 – 1 – 2 mg/l) - NAA (0,1 – 1 mg/l) - IAA (0,1 mg/l) - 2,4-D (0,75 – 1 mg/l). And after culture the explants we transferred it to the growth room with a temperature ranging from 27 to 29 ° C relative humidity around 80% And in complete darkness. The results from HPLC analysis for the dry weight of callus were as follows ajmalicine (0.18 mg/g DW), catharanthine (0.07 mg/g DW), serpentine (0.37mg/g DW), vindoline (0.11 mg/g DW).

Lymphoma is a malignant proliferation of lymphatic system cells. Large B-cell lymphoma is one type of the large list of lymphomas. It could occur in the lymphatic system or other body organs outside it.The clinical expression of this kind of tumors can be really variable. Usely there are general signs such as fever, heavy sweating at night and losing of weight. In addition to symptoms related to the local development of the tumor. In this article, we are about to present a case of tonsillar lymphoma which clinical expression could be confused with any benign tonsillar lesion.

Rosai Dorfman disease (RDD) is rare histiocytic disease with unknown etiology that typically presents with painless cervical lymphadenopathy. The disease is also known as sinus histiocystosis with massive lymphadenopathy (SHML). The normal functioning of lymph glands is disturbed due to significant enlargement of the lymphatic sinuses. Sinus hystiocytes contain cytoplasmic fat and strongly positive S100 protein CD68 and CD14 can be positive. Forty percent of patients have extra nodal involvement. The prognosis of the disease is usually good. However, if accompanied by immunologic abnormalities young age, extra nodal involvement (especially in the kidney or, liver), and the prognosis is poor. Regarding treatment, the disease often has spontaneous remission; therefore, observation is essential. No treatment modalities are superior to over another. In this article, we present a male patient who was diagnosed as having extra nodal RDD with skin and soft tissue involvement, who was followed up for four years.

Introduction. AI is often being touted as the means to bring about the fourth Industrial Revolution and its role in almost all sectors of our society is almost certain. This brings about an urgent need for evaluating benefits and limitations of AI and Machine Learning across various sectors. Pharmaceutical industry has pioneered in embracing the use of AI in all of its core areas but the success as of yet seems very limited. The major advantage of AI is that it reduces the time that is needed for drug development and, in turn, it reduces the costs that are associated with drug development, enhances the returns on investment and may even cause a decrease in cost for the end user along with improved drug safety. So in this article we will review the scope and limitations of AI in the Pharmaceutical industry.

Ultrasound (Sonography) uses high-frequency sound waves; these waves are produced and transmitted to the body by a device placed on the abdomen. A softener gel is applied to the body for a more complete wave transfer to the body. The waves pass through the tissues after entering the body and travel from one organ to another and then are bounced off to the body surface. Ultrasound device receives these waves which are used to take images of internal organs. Movement observation is also possible in ultrasound, so fetal movements or its internal organs can be detected and examined. In weeks 5 to 6 of pregnancy, fetal heart rate is visible as well. Pregnancy ultrasound is used to diagnose the health of the fetus in the mother’s uterus and is normally performed four times as recommended by a gynecologist. All these measurements are carried out to determine the exact age of the fetus and the risk of disease which must be reported by an accurate ultrasound. According to specialists, women are better to have an ultrasound of the uterus and ovaries prior to planning to conceive to get informed about their fertility status. Ultrasound helps the physician to know about the health of the uterus (in terms of size or presence of abnormalities), the presence of apolipo fibroids or ovarian cyst, and many other uterine problems; however, in case of the need for treatment and follow up measures, the patient receives necessary instructions from her doctor.

Bepotastine besilate is a selective histamine H1-receptor antagonist and a second-generation non-sedating antihistamine approved for relief from pruritis in various dermatological disorders.
Aim: To study the real world efficacy and tolerance of bepotastine in cutaneous disorders associated with pruritus and other symptoms (redness, wheal and angioedema), by assessing patient’s perceived symptomatic improvement.
Methodology: Adult patients presenting clinically with any of the symptoms: pruritis, redness, wheal or angioedema, associated with skin conditions, were evaluated to record patient’s end of treatment perception of improvement in the presenting symptoms, as well as tolerance to treatment, in response to bepotastine 10mg twice a day. Adverse events if any were recorded, assessed and managed.
Results: Overall for each symptom, complete or significant relief was obtained by >80% patients (P<0.001). Average treatment duration was 21 days or less in 80% patients. Patients achieving complete relief was maximum between 14-21 days. The adverse event rate was low at 0.3%.
Conclusion: Bepotastine 20mg/day, is an effective and well tolerated treatment for improving pruritis and other symptoms: erythema, wheal and angioedema, associated with cutaneous disorders, with an optimum treatment duration of 14-21 days.

Surgery is a very stressful situation for humans, resulting in various psychiatric problems. Fear of the operation process, fear of the unknown, death anxiety along with changes in primary personal, family and professional roles, cause the manifestation of problems from the mental realm. The effects of psychiatric disorders can have a profound effect on both the mental and physical health of the patient. Aim: The aim of this study is to present psychiatric disorders during the perioperative period. Material and method: The method used to write this study is the literature review. The writing was done by studying books, scientific articles and internet search. Results: Psychiatric problems such as anxiety, depression, delirium at their onset, affect the preoperative and postoperative condition of the patient. Conclusions: The evaluation of psychiatric disorders experienced by patients should be an integral part of perioperative care. Early diagnosis and early treatment are associated with the avoidance of chronicity and serious complications.