Journal of Medical & Clinical Nursing is an open access peer-reviewed journal from the publishers of Scientific Research and Community (SRC) which publishes articles in the form of written, video and power-point presentations from the arena of Medical & Clinical Nursing. The journal focuses to build up accessing the complete content of articles freely from online for reader’s perusal. Article acceptance will be in the form of Research, Review, Case Reports, Analysis, Magazines, Editorials, Opinion, Communications, Mini-Review, Short Communications, Picturized, Book Review, Video Type and Power Point Presentations (PPTS). Articles can be submitted through online from https://www.onlinescientificresearch.com/submit-online or can send through an Email with attachment for nursing@onlinescientificresearch.info
Humanitarian Crises, A Roadblock to Global Health Vaccinationand Immunisation Initiatives
Background: Humanitarian crises have a significant negative impact on global health initiatives. Humanitarian crises, driven by conflict and natural disasters, result in population displacement, and significantly affect healthcare and routine immunisation services. Problem: Vaccination and immunisation efforts in crisis-affected areas are hindered by broken logistics and supply chain systems, resulting in delayed deliveries, and weakened health infrastructure. Population displacement leads to overcrowding, and increased transmission of Vaccine-Preventable Diseases (VPDs). The resultant fragile governance limits coordination between government and humanitarian partners, leading to an increase in zero-dose and under-immunised children. Aim: This article analyses the mechanisms by which humanitarian crises disrupt vaccines supply chains and coverage, using the Cameroon conflict as a case study, and proposes integrated response strategies. Method: We conducted a narrative review of peer-reviewed and institutional literature published between 2015 and 2025 on vaccination in humanitarian and conflict-affected settings. We complemented this review with a qualitative case study using routine immunisation reports, outbreak investigation summaries, program monitoring data, and stakeholder field experiences from the Northwest and Southwest regions of Cameroon between 2019 and 2025. We synthesized findings thematically, focusing on health system disruptions, supply chain constraints, service delivery barriers, and surveillance breakdowns. Results: We observe broken health systems from armed conflict, leading to compromised delivery of health commodities, a preponderance in unimmunised and under immunised children in conflict laden areas of the world. The direct result is outbreaks, and increased under-5 morbidity and mortality. Impact: In Cameroon, VPDs have resurged over the past four years, including poliomyelitis, measles, yellow fever, and neonatal tetanus, especially in the crisis-hit regions, such as the Wabane and Eyumodjock health districts in the Southwest Region. This resurgence is not unique to Cameroon. Other conflictaffected countries report similar findings regarding VPDs. These trends illustrate how insecurity and logistical challenges compromise vaccine delivery and handling, as well as vaccination coverage, thereby threatening immunisation goals. Conclusion: The interplay between humanitarian crises and immunisation underscores the urgent need to integrate resilience and emergency response into vaccination strategies. Strengthening these systems is critical to improving coverage, protecting vulnerable populations, and advancing progress toward Sustainable Development Goal 3, with vaccination remaining central to health equity.
Copyright (c) 2026 Journal of Medical & Clinical Nursing
Mucormycosis (Black fungus): An Emerging Fatal Mycosis of21st Century- An Overview of History, Epidemiology, ClinicalSpectrum, Diagnostic Approaches and Treatment
Mucormycosis (zygomycosis, black fungus), is an emerging, noncontagious, opportunistic, life-threatening disease of sinuses, lungs, skin and brain of immunocompromised individuals, caused by the mucoraceous fungi. Friedrich Küchenmeister, a German physician, discovered the first case of mucormycosis in 1855. The fungal infections of humans, called mycoses, are a growing global health concern affecting more than one billion people causing over 3.75 million deaths each year. Due to the global surge in mucormycosis incidence with a marked increase in India and China especially among patients with uncontrolled diabetes mellitus (DM), it is designed as an emerging fatal mycosis of the 21st century. Globally, 39 fungal species belonging to 11 genera of Mucoromycetes (Mucoromycota) are involved in mucormycosis. Seventy-five percent incidences of mucormycosis are caused by the 3 genera Rhizopus, Mucor, Lichtheimia, and Rhizopus arrhizus (R. oryzae) alone is the main causative agent involved in 50 % of all cases of mucormycosis globally. The mortality rate is much higher in mucormycosis, considered to be an emerging mycosis, compared to aspergillosis and candidiasis, the two other fatal emerging mycoses. The infection mainly occurs when the fungal spores (sporangiospores) are inhaled by humans from the environment of the saprophytic mucoraceous fungi occurring in soil and decomposing plant residues. The inhalation is the most common mode of transmission compared to inoculation and ingestion. The epidemiology and mortality, despite antifungal therapy, has shown an exponential rise, the disease named as “black fungus” in 2021 following the second wave of COVID-19 pandemic. Prevalence of mucormycosis in India is nearly 80 times higher than global picture. Histopathological microscopic examination of stained biopsy samples for non-septate wide hyphae and identification of fungi based on fungal culturing are often used in diagnosing mucormycosis. Molecular (PCR- based fungal DNA), qPCR kits, protein homolog in spore coating, serology, and imaging techniques are the other diagnostic techniques. Early diagnosis and prompt initiation of antifungal therapy along with surgery and control of risk factors are needed for successful management of mucormycosis. Antifungal drugs to treat mucormycosis include: amphotericin B, Isavuconazole, posaconazole and itraconazole, the former two recommended by the USFDA for the primary therapy. Amphotericin B, preferably liposomal amphotericin B (L- AMB), is the drug of choice globally for managing mucormycosis of various types: rhino-orbital-cerebral, pulmonary, gastrointestinal, cutaneous, renal, disseminated and COVID-19-associated mucormycosis.
Cardiology at a Crossroads: From Volume to Value in the IndianContext
Cardiovascular disease remains the leading cause of death in India, despite major advances in cardiology. This editorial highlight the growing disconnect between technological progress and equitable, outcome-driven care. Key challenges include early-onset coronary artery disease, gaps between guidelines and real-world practice, limited emphasis on prevention, and variability in access to evidence-based therapies. The need for context-sensitive guidelines, indigenous research, ethical practice, and strengthened training is emphasized. The potential of digital health to reduce care disparities is discussed, alongside the importance of patient-centered, value-based cardiology. A balanced approach integrating innovation, affordability, and prevention is essential for improving cardiovascular outcomes in India.
Integrating Medical Outreach into Nurse Practitioner Education:Advancing Clinical Competence, Social Accountability, and HealthEquity
As healthcare systems confront widening health inequities, workforce shortages, and complex global health challenges, nurse practitioner (NP) education must evolve beyond traditional clinical training models. Medical outreach initiatives provide immersive, community-centered learning environments that align clinical skill development with social accountability and health equity. This article examines the importance of integrating structured medical outreach opportunities into NP curricula and training, emphasizing their role in enhancing clinical competence, cultural humility, interprofessional collaboration, and ethical practice. A narrative review of the literature was conducted, synthesizing evidence from global health education, service-learning, interprofessional practice, and competency-based NP education. A case exemplar from a long-standing academic community partnership is incorporated to illustrate best practices. Medical outreach experiences strengthen diagnostic reasoning, adaptability, leadership, and patient-centered care. When embedded longitudinally and ethically, outreach initiatives align with AACN Essentials, NP core competencies, and World Health Organization frameworks for social accountability and interprofessional education. Medical outreach is not supplemental but essential to preparing nurse practitioners capable of addressing health inequities in diverse settings. Academic leaders are encouraged to embed outreach within NP curricula through structured partnerships, reflective pedagogy, and competency-based assessment.
Treating Adolescent Sexual Victimization: A Concise Review ofEpidemiology, Neurobiological Consequences, and Evidence BasedInterventions
Sexual victimization of adolescents represents a critical public health concern with particularly elevated prevalence in low- and middle-income countries including Bangladesh. This narrative review synthesizes evidence on epidemiology, neurobiological mechanisms, and evidence-based treatments for adolescent sexual victimization. Global prevalence ranges from 3-41.5%, with girls disproportionately affected. The review covers Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) and Eye Movement Desensitization and Reprocessing (EMDR) as primary evidence-based psychotherapies, neurobiological changes in posttraumatic stress disorder (PTSD), and contextual factors unique to Bangladesh including legal gaps, stigma, and limitedservice infrastructure. Recommendations address legal reforms, institutional strengthening, and community awareness programs essential for effective response in resource-limited settings.
PTSD, Trauma- Focused Cognitive Behavioral Therapy
Copyright (c) 2025 Journal of Medical & Clinical Nursing
Sling Gauze Technique for the Positioning of RAE Tube in InfantsUndergoing Head and Neck Surgeries
In order to maintain anaesthesia with minimal complications, one of the vital steps is securing a stable oral endotracheal tube. The endotracheal tube may be displaced and become unstable due to suctioning, change in the position of the head and patient care. Poor fixation of the endotracheal tube is one of the leading causes of accidental extubation. The ideal endotracheal tube stabilisation method must allow changes in position of the infant during care while simultaneously minimising movement of the tube. The relatively short tracheal length in small children and infants is a major reason why placing the endotracheal tube (ETT) in the proper position may be difficult. The endotracheal tube may migrate cephalad with neck extension and caudally with neck flexion due to changes in the position of the head, such as extension or flexion of the neck. Sometimes, a well secured tube may also cause abnormalities in ventilation due to the dynamic positioning during surgeries on the cranium. Here, we present to you a technique where the oral endotracheal tube fixation at the lips, can be manoeuvred to change its depth of insertion by millimetres by a simple easily available device in the operation theatre.
Weight Loss with Acarbose and Metformin May be Curative in Early Phases of Diabetes Mellitus
Background: Atherosclerosis may be the main cause of diabetes mellitus (DM). Methods: All patients with sickle cell diseases (SCD) were included. Results: We studied 222 males and 212 females with similar ages (30.8 vs 30.3 years, p>0.05, respectively). Smoking (23.8% vs 6.1%, p<0.001), alcohol (4.9% vs 0.4%, p<0.001), transfused red blood cells (RBC) in their lives (48.1 vs 28.5 units, p=0.000), disseminated teeth losses (5.4% vs 1.4%, p<0.001), ileus (7.2% vs 1.4%, p<0.001), stroke (12.1% vs 7.5%, p<0.05), chronic renal disease (CRD) (9.9% vs 6.1%, p<0.05), cirrhosis (8.1% vs 1.8%, p<0.001), chronic obstructive pulmonary disease (25.2% vs 7.0%, p<0.001), coronary heart disease (18.0% vs 13.2%, p<0.05), leg ulcers (19.8% vs 7.0%, p<0.001), and clubbing (14.8% vs 6.6%, p<0.001) were all higher in males. Conclusion: As an accelerated atherosclerotic process, hardened RBC-induced capillary endothelial damage terminates with multiorgan insufficiencies in early decades in the SCD. Although atherosclerotic endpoints are common, we detected no case of DM probably due to lower body mass indexes. As the most common cause of CRD, DM may be an atherosclerotic endpoint, too. Increased blood and insulin needs of excess fat tissue in contrast to decreased blood supply of the excess tissue and pancreas both due to excess pressure on vasculature, externally and atherosclerosis, internally may be significant in the development of DM. Acarbose and metformin are safe, cheap, oral, long-term used, and effective drugs for loss of excess fat which may even be curative in early phases of DM before development of fibrotic changes on vasculature.
Variability, Severity, Preventability, and Outcomes of Adverse DrugReactions to HIF-PHIs in CKD Case Reports: A Systematic Review
Background: Underdiagnosed and undertreated renal anaemia remains an issue among individuals with chronic kidney disease (CKD). Hypoxiainducible factor prolyl-hydroxylase inhibitors (HIF-PHIs) offer significant options. However, there are unmapped areas regarding adverse drug reactions (ADRs) to HIF-PHIs. Thus, this systematic review aims to find ADRs to HIF-PHIs and analyse their variability, severity, preventability, and outcomes in individual CKD patients reported as case reports. Methods: A literature search of published case reports was conducted between 2018 and 2024 across various electronic sources. Of the total identified studies (N=2123), only 8 case reports (13 patients) were included after applying inclusion and exclusion criteria. Results: ADRs to roxadustat (8/13;61.5%) and daprodustat (5/13;38.5%) included retinal haemorrhage (7.7%), hypertension (15.4%), stroke (23.1%), hypothyroidism (7.7%), rhabdomyolysis (7.7%), and elevation of serum copper (38.4%). The mean ADRs time-to-onset was 6.5 months. Specific causality and non-preventability of ADRs to HIF-PHIs were confirmed in one report (1/8;12.5%), and definite probability and severity in two reports (2/8;25%) due to HIF-PHIs ADRs. Conclusion: This review suggests HIF-PHIs could be safe for patients to treat CKD anaemia. Thanks to personalised dosages that maintain the recommended Hb value and sufficient management of comorbidities, the probability and severity of ADRs could be decreased.
Copyright (c) 2024 Journal of Medical & Clinical Nursing
Predictive Values of CSF Ferritin in Cognitive Assessment ofPatients after Acute Central Nervous System Infections
CNS infections represent a unique challenge to clinicians due to significant morbidity and mortality. The role of ferritin as a reactant of various pathological conditions is currently being intensively investigated. The pathogenesis of cognitive impairment after acute neuroinfectious disease is not yet fully understood. It is believed to be a direct consequence of neuronal damage by the infection, but also by the activation of immunocompetent brain cells, with consequent disruption of signal conduction in a varying period of time after the infection has resolved. The aim of the study is to examine the prediction of ferritin on the degree of cognitive impairment in patients who have suffered from a CNS infection. The values of CSF ferritin were evaluated in three analyzed groups of subjects (bacterial, viral and group with normal CSF findings - meningism). The analyzed clinical data were correlated with the degree of neurocognitive impairment, and the relationship between CSF ferritin and the degree of cognitive impairment was analyzed. The conducted research is a retrospective-prospective analytical and clinical study that was conducted in the period from 01.01.2017 to 01.01.2020. The research includes 90 patients according to previously nominated criteria, divided into three groups, two “examined” and one “control”. The assessment of the cognitive status of the subjects was performed using the MMSE test. The SPSS for Windows software package (version 20.0, SPSS INC, Chicago, Illinois, USA) was used for statistical analysis of the obtained data. We confirmed that the CSF protein ferritin is a good predictor of distinguishing purulent from viral meningitis / meningoencephalitis. The obtained results did not confirm the hypothesis that elevated CSF ferritin values have a negative impact on cognition. Impairment of individual domains of cognition measured by MMSE I, such as “attention”, “calculation” and “memory” are more pronounced in purulent CNS infections. Impairment of individual domain MMSE II “calculation” is more pronounced in the purulent CNS infection category
Financing for Universal Health Coverage, A Myth or a Realityin Low- and Middle- Income Countries (LMICs): The Case ofCameroon
The 17 Global Sustainable Development Goals were conceived and adopted by the United Nations in 2015, with an overall purpose to end poverty while protecting the planet and ensuring global peace and prosperity by 2030. One of the goals, Goal 3, directly relates to health by proclaiming good Health and wellbeing. Target 3.8 focuses on Universal Health Coverage (UHC). Universal Health Coverage is enshrined in the concept that all people have access to the full range of quality health services they need, when and where they need them, without suffering financial hardship. Therefore, UHC encourages financial risk protection including access to safe, effective, quality affordable essential medicines and vaccines to all. The achievement of target 3.8 of the Global Goals entails Government engagement and good political will in healthcare financing to limit out-of-pocket financing of healthcare. This can be achieved through dedicated government budgets to finance various aspects of the healthcare delivery system including essential medicines and health commodities, as well as health facilities within the rural communities. To realise this dedicated government funding, a structured questionnaire shall be administered to commercial directors of Brasseries du Cameroun, Guinness Cameroun, Kadji Beer Company, and Tobacco factories in Cameroon. The current rate of out-of-pocket financing of healthcare in Cameroon is approximately 70%. Thousands of families still suffer financial hardship. Besides, long travel distances to the nearest health facility, with no road networks are real obstacles to access to healthcare. This in turn affects targets 3.1 to 3.4 of the global goals. The current healthcare expenditure in Cameroon is 3.82% of GDP as of 2021, below the African average of 5.76%, the Sub-Saharan Africa average of 5.10% and the global average of 7.02% GDP. Considering the low political will, the low current healthcare spending, and the current crisis that are almost paralysing the economy, as recommendation, dedicated taxes on some commodities consumed within the country as source of finance to exclusively finance healthcare in enclaved areas of the country so that all people can indeed have access to the healthcare they need and where they need without suffering financial hardship.
A Complex Case of Febrile Illness in an Elderly Male withNeurological Symptoms and Negative Csf Cytopathology: ADiagnostic and Management Challenge
An elderly male in his eighties presented with persistent high-grade fever, altered mental status, and features suggesting central nervous system (CNS) involvement. The clinical picture was concerning for infectious or inflammatory encephalopathy. The diagnostic workup included cerebrospinal fluid (CSF) analysis, cartridge-based nucleic acid amplification test (CBNAAT), line probe assay (LPA), cytopathology, fungal microscopy, and aerobic culture. Despite significant systemic symptoms, CSF analyses returned negative for tuberculosis, fungal infection, and malignant cytology. MRI and MR spectroscopy findings revealed pontine hyperintensities and metabolic abnormalities suggestive of neuronal dysfunction. The imaging also showed decreased N-acetylaspartate (NAA) and elevated choline, with a lactate peak—findings supportive of encephalopathy or inflammatory pathology. Treatment was initiated empirically with broad-spectrum antibiotics, antifungals, and supportive neurological and systemic care. Electrolyte imbalance and hypertension were addressed promptly. Despite extensive diagnostics, no specific pathogen was identified, and the patient’s clinical course required close multidisciplinary monitoring. The case exemplifies the diagnostic and therapeutic challenges posed by febrile encephalopathy in the elderly, where overlapping features of metabolic, infectious, and vascular etiologies complicate definitive diagnosis. This report highlights the role of advanced imaging and CSF analysis in guiding management when primary infectious markers are inconclusive. Further follow-up, especially with culture data and clinical evolution, remains essential for ongoing care.
Novel Emerging Inflammatory Biomarkers Predict the Coronary Artery Diseases-Related Complications: An Integrative Review
This integrative Review aims to evaluate the utility of novel emerging inflammatory biomarkers in predicting major adverse cardiac events (MACEs) in patients with acute coronary artery disease (CAD). Cardiovascular diseases (CVDs), primarily driven by myocardial ischemia due to atherosclerosis, are the leading cause of global morbidity and mortality. Traditional biomarkers have offered mixed prognostic capabilities, necessitating the exploration of new markers that encompass complete blood count (CBC) parameters and CBC-derived indices. We conducted a comprehensive review, following PRISMA guidelines, and searched databases such as PubMed, Web of Science, ERIC, and Science Direct up to May 2023, focusing on inflammatory indices and their correlation with cardiovascular outcomes. The selected studies, published within the last five years and meeting our inclusion criteria, provided data on various biomarkers including Platelet Distribution Width (PDW), Mean Reticulocyte Volume, and systemic inflammatory indices such as Neutrophil-to- Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR). Emerging indices like the Systemic Inflammatory Index (SII) demonstrated significant predictive power for both short-term and long-term cardiovascular complications. Our findings suggest that these novel biomarkers, particularly CBCderived indices, offer valuable prognostic information that could enhance clinical decision-making in managing coronary artery disease. Further research and standardization are required to fully integrate these biomarkers into routine clinical practice.
Nursing informatics plays an essential role in modern healthcare by merging the disciplines of nursing, computer science, and information technology. It involves the use of technology to enhance nursing practice and improve patient care outcomes. This paper explores the evolving role of nursing informatics, particularly in the context of artificial intelligence, and highlights its significance in clinical decision-making. Additionally, it discusses the growing need for nursing informatics education and competencies to meet the demands of today’s healthcare systems. As healthcare becomes increasingly data-driven, the ability of nurses to effectively use technology and information systems is paramount. By integrating electronic health records (EHRs), decision support systems, and artificial intelligence, nursing informatics enables more efficient workflows, better clinical outcomes, and enhanced patient safety. The future of nursing is inextricably linked to the continued advancement and adoption of informatics tools that will help shape both patient care and the nursing profession itself.
The Challenge of Post-Acute Compliance with Infection Preventionand Control
Healthcare-acquired infections (HAIs), also known as nosocomial infections, are infections that patients acquire while receiving treatment for other conditions within a healthcare setting. These infections pose a significant challenge to healthcare systems worldwide, affecting millions of patients each year and leading to substantial economic burdens and adverse health outcomes.
Tension and Pulse at Intubation before and after 5 Minutes onNeurology Patients with General Anaesthesia: An ObservationalStudy
Background: General anesthesia is still the best choice for neurosurgery, even it must be maintained so that the airway remains open. Airway management measures that can be carried out in several ways include intubation using laryngoscopy. There may be an increase in the hemodynamic response, namely blood pressure and pulse rate starting from 5 seconds after intubation. However, it is still being debated by experts. The aim of this study was to determine blood pressure and pulse frequency after being given Fentanyl and after the 5th minute of intubation in neurosurgical patients under general anesthesia. Method: An observational research design, 30 neurosurgical patients using fentanyl 2 mcg/kg BW and intubation techniques. The variables measured were blood pressure and pulse frequency after being given Fentanyl and after 5 minutes of intubation. The instruments used were an intra-anesthetic Hemodynamic Observation Sheet, a watch, and a bedside monitor. Data was analyzed using the independent T-test with a level of confidence 95%. Results: The results showed that there was an increase in the average Systolic blood pressure (p value 0.009) and pulse frequency (before intubation) and after intubation at the 5th minute (p value 0,000). Conclusion: The study can trigger anesthesia experts to look forward to this problem appropriately.
Menstrual Hygiene Management Practice and Associated Factorsamong Urban and Rural Primary School Adolescent Girls inGondar City Administration and Gondar Zuriya District NorthwestEthiopia, 2021
Background: Menstrual hygiene management is the practice done by girls or women through; using a clean material, changing a private way body using water with soap,and having disposal facilities. It is insufficiently acknowledged among adolescent school girls in Ethiopia. Therefore, understanding the level of hygiene management practice and identifying determinant factors is a crucial first step to taking appropriate interventions. Method: An -institution-based cross-sectional study design was employed among 335 urban adolescent girls from March to April 2021.Study participants were selected by using a multistage stratified sampling technique. Aninterviewer-administered structured questionnaire was used for data collection. The data were entered by using EPI INFO version 7.2 and analyzed by using STATA version 14.1 software. Bivariate and multivariable logistic regression analysis with a 95% confidence interval was employed. A P-value< 0.05 was considered as statistically significant and AOR with a 95% confidence interval was considered to show the strength of the association. Result: Overall, prevalence of menstrual hygiene practice among adolescents’ girls were 66.0% (95% CI: 60.7, 70.9) among urban school girls. urban residence [AOR= 3.41(95% CI: 1.1, 10.58), media exposure for SNP advertisement [AOR=2.43 (95%CI; 1.08, 5.48)], good menstrual knowledge [AOR=3.68 (95% CI: 1.76, 7.69)], female toilet inside locked [AOR=2.66 (95%CI; 1.1, 6.45)], girls who have private room at home [AOR=3.53(95% CI: 1.46, 8.5)], good water accessibility (AOR=3.35(95% CI:(1.62,6.95), gain information from friends [AOR=3.35(95%CI:1.04,10.77)] were found to be significantly associated with good MHP among overall school adolescent girls. Conclusion: Though the overall prevalence of the study was low.it was relatively better among urban school girls. It shows a significant variation between the urban and rural study groups. Therefore, Implementation of girl friendly WASH services in all schools should be applied, health education should be strengthened, WASH facilities constructed at school levels, free discussion with parents and teachers in order to practice safe MHM.
The nursery medical services and knowledge is attracting un-precedent attentions. Nursery knowledge and education in areas of healthcare and medical fields change a lot. However, sustainable supporting in funding, position and technology can be further improving. The different pressures and personal condition of nurses may be eased in the clinic. This editorial discusses these medical translations for nursery services and knowledge in details.
Challenges and difficulties of Nursing Students, at the Universityof Gjakova, in Relation to Work and Employment Models
Migration is a very complex and challenging factor in Kosovo, whose trends continue to play an extraordinary role in the economic and political developments in the country. Historically, Kosovo has faced the departure of citizens towards developed western countries, whose main destinations have been Germany, Switzerland and Austria. Despite the fact that the majority of the Kosovar diaspora lives in Germany, the migration reforms, driven mainly as a result of the labor shortage in Germany, continue to attract Kosovars, influencing that the trend of emigration still continues to a large extent. Only in 2021, 21,487 people entered Germany from Kosovo, and 4,323 people originating from Kosovo left Germany, where the net migration in this year was 17,164 people. Human capital and a qualified workforce that can satisfy the labor market’s needs for skills and drive innovation are essential for increasing competitiveness, attracting investment and the ecological and digital transition of the region. They are also the main pillars of an economy’s resilience and prosperity, which is particularly important in a changing international environment and its consequences covid-19 pandemic. The continued high levels of labor force emigration, especially of young talents, constitute a serious development challenge for the region. While they relieve pressure from the labor market and reduce unemployment levels, they also promote and accentuate the region’s apparent skills mismatches and shortages; they, in turn, reduce the growth potential of local companies and may prevent potential investors from finding adequate skills. Creating the right conditions for attracting investment and creating new jobs by stimulating career prospects – while producing skills that match the needs of the labor market – is a prerequisite for building a resilient economy and retaining or attracting of talents. Globalization and the increased interconnection of economies, societies and cultures also extends to higher education and academic life. The internationalization of higher education serves as a context, at the same time it is driven by the mobility of students between countries and institutions in different parts of the world. In addition to the physical movement of students, there are other initiatives that globalize education such as international research networks, harmonization of curricula, online courses, university branches in different countries, bilateral and multilateral schemes for the exchange of students and staff, and the prevalence of English as a global academic language. Chamber of Nurses of Kosovo (OIK), reports that during 2023, the Chamber has issued 713 licenses for nurses, certificates that serve them for employment abroad. “According to the statistics, the year 2021 has seen a decline, of course, based on the analysis, the pandemic is also the cause. The increase was in 2022, which started significantly, and 543 nurses from all over Kosovo applied for non-plasticizing licenses. While in 2023 this number has increased, it means that by the 25th of December they requested 713 non-plasticized licenses, which means that they are looking for these licenses to migrate to the countries of the region and to develop the profession further “.
Hyper-Stimulation of the Endometrial Thickness and Egg Relaeseof Women between the Ages of 18-46 years in Imo State, Nigeria
The uterus is a dynamic tissue under the control of ovarian steroids, estrogen and progesterone, it comprises of endometrial layer of the uterus which undergoes proliferation, secretion and menstrual cycle to reach the receptive state in the implantation of the embryo. Endometrial thickness and growth during ovarian stimulation is a possible predator of implantation in invitro fertilization. Objective: To ascertain the endometrial thickness and number of ovulation egg released by hyper-stimulation. Research Design: The study population contains 10 women aged 18-46 years. Groups were randomly selected from clients that came to seek for medical help in vaden specialist clinic, Owerri, Imo State Nigeria. Result: The age group 18-25 had the highest thickness of endometrium (45MM thick) while the age group 36-40 had the least thickness of endometrium (7MM thick). The age group 20-25 produced the greatest quantity of eggs (53.8%) while the age group 36-40 produced the least quantity of eggs (0.77%). Summary: This study has shown that Endometrial thickness increases under hormonal influence which affect the egg release from the ovaries.
Effective Strategies for Managing Substance Use Disorders in OlderAdults in Nursing Homes
Substance use disorder is very prevalent in nursing home (NH) residents due to aging, the number of prescription drugs that are being used to manage their physical and psychological pain, and several discharges with the diagnosis of substance use disorder from hospitals to NH for aftercare support. However, many nursing homes are not equipped to provide adequate care for residents with a diagnosis of substance use. The staff is not well-trained to care for this type of population, which is becoming a challenge for the staff to manage residents in-house, leading to overdose, recurrent hospitalization, and unsuccessful discharges to communities due to relapses and an increase in the number of frequent flyers. Substance use disorder has become a significant public health concern in the United States, especially in the older population from the past couple of decades, which tends to increase. Discharging older adults with substance use disorders into nursing homes without ensuring established resources in the long-term care setting raises safety and quality concerns, emphasizing a pressing need for innovative preventive and management approaches for substance use disorders to meet unique needs of older adults in nursing homes. Purpose: The purpose of the study is to explore and identify the interventions, treatments and care models to effectively manage substance use disorders in older residents who are living in nursing homes. The study further focuses on the unique challenges that are faced by older adults and staff in nursing homes to understand the need for integrating addiction treatments in Long-term care settings to assess the need to enhance care strategies to improve resident outcomes, which includes handling overdose emergencies, prevention, rehabilitation and relapse management of substance use disorders (SUDs). Scope: Provides valuable insights for future researchers and points out the need for collaborative models among the rehabilitation, addiction centers, and LTC and the need for virtual health platforms to improve access to care, interdisciplinary approaches, and policy innovation on resident retention and optimum resource allocation to reduce the health care cost of frequent flyers or unnecessary hospitalizations, therefore, improve patient outcomes.
Cardiac Auscultation: A Practical Method for Instruction andLearning
In response to the worldwide deficiency in the use of standard acoustic stethoscopes for the analysis of cardiac disorders, we have developed a cost-free platform for learning and teaching of cardiac auscultation by combining graphic images with actual patient recordings.
Laparoscopy Supports Implementation of Primary Infertility Diagnosis and Treatment: Case Reports
Background: Infertility is defined as conception failure in couples who have had sexual activity without regular contraception for one year and are still not pregnant. Abnormalities in the fallopian tube have the highest percentage of 30-45% as a cause of infertility. Hydrosalping is a condition where one or both fallopian tubes have fluid-containing clots and is the cause of 25–30% of all infertility cases. The condition of the fallopian tube and its patency can be detected with a hysterosalpingogram (HSG). Although a HSG examination can give a picture of the uterine cavity and tubes, other abnormalities such as adhesion and endometriosis are sometimes not detected. So, laparoscopy can be used to solve this problem. Results: We reported that a 27-year-old woman, Para 0, Abortus 0, came to the gynecology department with a major complaint of infertility. At the HSG examination, an unpatented right fallopian tube was found. So, the patient underwent laparoscopy, but both fallopian tubes were found in a patent state, and there was a tubal attachment on the omentum and a paratuba cyst, so adhesionolysis and cystectomy were performed. It can be concluded that tubal abnormalities can be detected more clearly with laparoscopy than with HSG. Conclusions: Laparoscopic is more recommended in cases of primary infertility, but further research to compare or combine these two modalities is still imperative.
Some contemporary organizations are going through a state of administrative corruption, which is represented by the organization’s leadership dismissing distinguished employees, either for the purposes of preserving the job position, or for the purposes of revenge for personal goals, or because it is convinced of the necessity of introducing new blood into the organization and replacing it with old blood.
Hybrid Prisms: Transforming Medical Imaging Technology
This research article delves into the groundbreaking use of hybrid prisms in X-ray imaging devices, emphasizing their role in enhancing the precision and efficiency of imaging systems. A hybrid prism, which integrates the functions of a lens and a reflective prism, is a versatile optical component capable of manipulating electromagnetic waves across a spectrum of wavelengths, including visible light and X-rays. This technology significantly improves the focusing and imaging capabilities of X-ray devices, making it indispensable in fields such as medical diagnostics.
Organoleptic Quality and Chemical Quality of Fish Meatspogo(Aluterus Monoceros) with Substitution Moringa Leaf (MoringaOleifera Lam)
Introduction: Meatballs are one of the most popular products by consumers. Until now, the meatballs have a standard taste so that it has the potential to be developed, one of which is being developed by adding new innovations to the pogo fish ball product with the addition of Moringa leaves. Pogo fish (aluterus monoceros) is a fish that is easy to find in coastal areas with cheap and affordable prices, this fish should be consumed by coastal communities because it can improve the nutritional status of children during growth. Moringa (Moringa oleifera) is a plant that is widely available in the surrounding environment and has leaves that contain vitamin A, tannins, steroids, flavonoids and other compounds that are beneficial to the body. This study aims to determine the acceptability and chemical analysis of the nutritional content of pogo fish balls with the addition of Moringa leaves. Method: The type of research used is descriptive. The panelists in this study were as many as 25 people who were selected from level II and III students of the D-IV Nutrition Study Program. Panelists are required to be healthy, not sick, not smoking, not color blind, not hungry and willing. The data collection technique carried out an acceptance test in the taste test laboratory, majoring in nutrition, and a chemistry test at the laboratory of the Faculty of Mathematics and Natural Sciences (FMIPA) at Haluoleo University in 2022. Results: The research shows that the panelists’ acceptance is the taste received by the panelists, namely the X1 treatment. The aroma received by the panelists was in the X1 treatment. The color received by the panelists is in the X2 treatment. The texture received by the panelists is in the X1 treatment. The highest chemical quality was obtained by product X3 protein 16.76%, fat 4.76%, carbohydrates 10.80%, water 32.86% and iron (Fe) 21.04 mg/100g. Conclusion: Acceptance of pogo fish balls with Moringa leaf substitution in terms of taste, aroma, color and texture, namely the taste received by the panelists, namely in the X1 treatment. The aroma received by the panelists was in the X0 treatment. The color received by the panelists is in the X0 treatment. The texture received by the panelists was in the X1 treatment. The highest chemical quality of pogo fish balls was obtained by X3 treatment of 16.76% protein, 4.76% fat, 10.80% carbohydrates, 32.86% water and 21 iron (Fe) 04mg/100g Keywords: Pogo Fish, Moringa Leaves, Meatballs, Acceptance Test, Chemical Quality.
Developing a Mind-Set Framework for Understanding the Way in which Diversity Contributes to Quality in Peri-Operative Care
This paper delves into the significance of patient diversity as a factor to improving peri-operative care. The focus is on diversity of mind-sets, ways of dealing with patients who have different needs and ways of thinking regarding issues surrounding their operation. We introduce the concept of AIgenerated mind-sets and AI-synthesized stages of a journey. We focus on what can be understood by knowing the patient mind-set and the stage in the journey. The objective is to open a new area of understanding patients. The paper introduces two assessment tools, the interview guide and the mind-set questionnaire. The objective is to create a systematic framework which comprehends the needs of individual patients, leading to recommendations for personalized care.
Introduction: My acquaintance from college married her fellow citizen, and after a few years gave birth to a healthy and beautiful baby. She had no sexual adventures in her marriage, but the baby was black, even though her husband was fair-skinned, which later led to many disagreements, divorces and the breakup of the family. The goal of the work is to enable the wider, and not only narrow scientific public, to learn about telegony and its positive or negative consequences for an individual, family or social community. The methodology of the work is based on research and study of knowledge obtained from available literature, as well as own experience. The results of the work confirm not only the scientific, but also the practical possibility of recording a wave genetic record and recording it in an intimate partner during sexual intercourse for an unlimited time. The recorded wave genetic record can be woven into the offspring after many years, not only in physical but also in spiritual traits, even though the woman has not had sexual relations with former partners for many years, and her child inherits the traits of the former or former sexual partners. This is how it happens that a white-skinned woman, who was once in a relationship with a black man and had sexual relations, after several years marries a white-skinned person and gives birth to a black child. A child born can inherit not only physical, but also mental characteristics of former sexual partners. These possibilities are confirmed by a scientific discipline called telegony. To conclude that telegony is not an everyday visible phenomenon in physical features, i.e. that white married pastners have a black child, but is often manifested in weaker or stronger noticeable physical and spiritual characteristics of former sexual partners. Sometimes in our life, we have probably heard Introduction: My acquaintance from college married her fellow citizen, and after a few years gave birth to a healthy and beautiful baby. She had no sexual adventures in her marriage, but the baby was black, even though her husband was fair-skinned, which later led to many disagreements, divorces and the breakup of the family. The goal of the work is to enable the wider, and not only narrow scientific public, to learn about telegony and its positive or negative consequences for an individual, family or social community. The methodology of the work is based on research and study of knowledge obtained from available literature, as well as own experience. The results of the work confirm not only the scientific, but also the practical possibility of recording a wave genetic record and recording it in an intimate partner during sexual intercourse for an unlimited time. The recorded wave genetic record can be woven into the offspring after many years, not only in physical but also in spiritual traits, even though the woman has not had sexual relations with former partners for many years, and her child inherits the traits of the former or former sexual partners. This is how it happens that a white-skinned woman, who was once in a relationship with a black man and had sexual relations, after several years marries a white-skinned person and gives birth to a black child. A child born can inherit not only physical, but also mental characteristics of former sexual partners. These possibilities are confirmed by a scientific discipline called telegony. To conclude that telegony is not an everyday visible phenomenon in physical features, i.e. that white married pastners have a black child, but is often manifested in weaker or stronger noticeable physical and spiritual characteristics of former sexual partners. Sometimes in our life, we have probably heard the words that someone’s child looks a lot like a neighbor.the words that someone’s child looks a lot like a neighbor.
Introduction: Pulmonary fibrosis is a progressive, incurable disease with a lower survival rate than most cancers. Due to the rapid increase in deaths following SARS-CoV-2 infection, evidence of a link between viral infection and the development of pulmonary fibrosis in patients with Covid-19 present with degrees of fibrotic change ranging from fibrosis, to disseminated fibrotic disease after severe acute lung injury. Objective: The purpose of the study is the management of patients with post-Covid-19 pulmonary fibrosis, with the aim of early treatment of these complications, so that patients can return to their previous lives. Materials and Methods: This is an observational study. Data were collected from the medical records of 60 patients hospitalized in “Shefqet Ndroqi” hospital, Tirana, in the internal pathology ward, where post-Covid 19 patients are treated, were reviewed. Their demographic, clinical, physiological, laboratory and imaging data were collected. These patients were followed in the period, March 2022-June 2022. Results: From the 60 patients who were clinically followed for 10 weeks, it was found that at the end of the 10th week, 25.6% of the patients had a significant improvement, 64% of the patients had a slight improvement, and 10.4% of these patients had no improvement. no improvement, compared to their previous condition. Conclusion: The elderly and those with severe symptoms during the acute phase are at greater risk of moderate and severe sequelae, which require multidisciplinary management, according to the patient’s condition.
A Rare Case of Autosomal Recessive GLS-Related Epileptic Encephalopathy and Respiratory Failure
The student said, “Oh, that is why we learned that!”. The student that sparked this research admitted that as she went through the program she often thought, “why are we learning this? I cannot see utilizing this in my everyday job.” In academia today, we often treat the clinical or practicum experience as a separate component of the learning. Some schools even front load the content so they do all of the experiential learning after the classroom portion is over. Experiential learning works best when the learner can connect what they see and hear in the classroom to what they are actually seeing and doing in the field. There are a number of ways to bring the two worlds together. One program did just that and based on findings, the students felt better prepared for the job after graduation. The element of the unknow was removed. Students reported feeling more prepared for their new career and were able to fully grow during the orientation.
Beyond the Challenges: An Optimistic Perspective on Nursing asa Career
The nursing shortages in the United States are well documented in the literature, with COVID-19 further escalating the workforce shortage and exposing the drawbacks in the healthcare systems, such as unsafe work conditions, high levels of burnout, and long-standing neglected issues in the health care system, lead nurses to leave the profession. Studies have estimated that more than 100,000 Rn’s left the profession during 2021, which is a significant drop, unlike in the past 40 years [1]. While these problems are substantial and discussed in previous literature beyond the challenges in the nursing profession, this paper focuses on an optimistic perspective on nursing as a career.