Occupational stress is a multidimensional phenomenon that manifests itself in physiological and psychological reactions to a difficult work situation. The development of stress factors is possible even in progressive, well-managed organizations, which is due not to structural and organizational characteristics, but also to the nature of work, personal relationships of employees, and their interaction. The article describes the history of development and the main forms of burnout syndrome. Article Details Issue

Rocky mountain spotted fever is a systemic inflammatory disease that occurs from April through September, even do, it may occur during other months like this case. In addition, it is presented in a rare context with cardiomyopathy and COVID-19.

The research is to process local-based product formulation into yogurt containing high Vitamin B6 and antioxidant by adding Purple Sweet Potato and Mung Bean Powder through a fermentation process and to find the suitable formulation of “Bio-Gurt”. Procedures were firstly done by formulating 3 treatments and 1 control. P0 (Treatment 0) as controlled variable, P1 as addition of 2% Sweet Purple Potato Powder and 4% Mung Bean Powder, P2 3% : 3%, and P3 4% : 2%. The results were determined by an organoleptic test and pH measurement. By all treatments, P3 suits the characteristic of yogurt texture. The limitations were due to the lack of effectiveness of the process. Bio-Gurt helps reduce the cytokine storm that occurs in the early stages of SARS-CoV2 infection. It also can reduce oxidative stress for the severity of COVID-19. Bio-Gurt becomes a healthy local snack containing vitamin B6 and antioxidants

Background & objectives: Early identification of bacterial infection in patients with fever is important for prompt and specific treatment. However, the available biomarkers such as C-reactive protein (CRP) and leukocyte counts are not specific to bacterial diagnosis. This study aimed to assess the diagnostic value of procalcitonin (PCT) over CRP and leukocyte counts for bacterial infection screening in febrile patients while awaiting their hemoculture results, which takes up to 7 Days before results are available though it is the gold standard for the diagnosis of bacterial infections. Methods: Blood samples were collected from febrile patients between January and July 2020 then processed for blood cultures. PCT, CRP and WBC levels were measured. The patients were divided into two groups according to the final diagnosis: bacterial infection group (group1) and non-bacterial infection group (group 2).SPSS version 20.0 software package was used for data analysis and normally distributed variables were calculated using mean, standard deviation and ANOVA test while median and range were used for variables without a normal distribution. Significance testing was done using Kruskal-Wallis h test and Wilcoxon two sample test and the diagnostic accuracy was assessed by calculating the area (AUC) under the receiver operating characteristic curve (ROC). Results: There were significant (P<0.05) difference in the levels of PCT, CRP and WBC among the two groups. The PCT levels of patients in the bacterial infections group were significantly higher than those in the nonbacterial infections group (27.9 vs., 11.7 P < 0.001). The best cut-off value to detect bacterial infections was 1.46 ng/ml for PCT. PCT, CRP and WBC had areas under the curve of 0.71, 0.66 and 0.45 respectively and sensitivity of 100%, 72.7% and 27.3% respectively. Interpretation & conclusions: Our results showed that PCT was a valuable marker for the early and rapid diagnosis of bacterial infections in febrile patients in our setting when compared to CRP and WBC. However, prospective and large scale studies are warranted to confirm these findings in Cameroon.

The Epidemiology Unit was established in 1959 with the assistance of the World Health Organization (WHO) to strengthen surveillance of communicable diseases. It is fully equipped with Epidemiologists who are qualified consultants in Community Medicine and Regional Epidemiologists (RE) deployed in all 26 RDHS divisions and Provincial Epidemiologists in Provinces. Epidemiology Unit carries out its functions, with the vision of “Healthy people in a healthy Sri Lanka” and the mission “To promote health and quality of life by preventing and controlling disease, injury and disability”.

Down syndrome is the most common chromosomal pathology. It occurs when another chromosome appears in the 21st pair as a result of a random mutation. Often, children with Down syndrome (DS) and related disorders have some neurological problems, severe forms of stereotyped behavior. The purpose of this article was to study the neurological conditions of children with DS. Clinical, neurological, studies were performed in 120 children (75 boys, 45 girls) with DS. It was found that in children with trisomy, neurological deficits in the form of speech disorders, fine motor skills of the hand, disorders of the coordination sphere and autonomic dysregulation are more severe than in children with mosaic and translocation types.

The results of a comparative analysis of cases of incomplete asphyxia in children, adolescents and adults based on the materials of forensic medical examinations conducted in three regions of Uzbekistan in 2017-2020 are presented. It was found that children and adolescents accounted for 12.9% of all cases of post-asphytic conditions and in most cases they were associated with an attempted suicide by hanging. Among them, males prevailed significantly than among adults. The unconscious state in children and adolescents was more prolonged and various convulsions were observed more often than in adults. The incidence of deep coma as a result of impaired brain function is also high in them.

Quality Assurance (QA) in health care is to maintain a high quality health care services, through monitoring of its the effectiveness. The QA program of Divisional Hospitals, Primary Medical Care units and Medical Officer of Health (MOH) units are monitored at the RDHS level. Likewise, RDHS of Colombo district is responsible for all the above stated institutions in Colombo district. All the above institutions have started 5S concept upto a certain extent. Work performance, clinic services, disease surveillance, supply chain management, health information system, performance reviews of MOH Units are functioning very satisfactorily. Even though the Out patient services, emergency services, Inpatient services, Supply chain management, diagnostic services, waste management, utility services are functioning well, there are significant deficiencies in every aspect in curative care settings. I was satisfied about the achievements of preventive setting with regard to QA while I am not happy about the QA of curative care settings. QA of curative care institutions are not up to the expected standards. It is mainly due to poor leadership competencies and commitment of managers, mal - functioning of the Quality Management Unit of the RDHS office, inadequate supervision and performance reviews. Monitoring of curative care institutions by the directorate of Primary Care Services is also not satisfactory, while monitoring of preventive care institutions by National Programs is substantially high, which has resulted in high QA in preventive sector. It is recommended to strengthen the functions of the QMU of the RDHS unit; to introduce monthly institutional meetings; to perform quarterly review meetings at RDHS office, strengthening health information system, training of the staff, increase the number of supervisory visits by RDHS and performance appraisal and recognition of good work

Cotton (Gossypium spp.) is an arborous plant from the Malvaceae family. Cottonseed meal is a by-product of cotton that is used for animal feeding because it is rich in oil and proteins. However, gossypol toxicity limits cottonseed use in animal feed. Gossypol is a phenolic compound produced by pigment glands in cotton stems, leaves, seeds and flower buds. Cotton is a long duration crop and is attacked by a number of insect pests. Earlier, insecticide quantity applied on cotton was highest but with the advent of Bt cotton, there is a great reduction in insecticide and pesticide usage as majority of the bollworms are controlled by it. Bt cotton refers to transgenic cotton which contains endotoxin protein inducing gene from soil bacterium Bacillus thuringiensis. It was discovered by a Japanese scientist Ishiwata in 1901. B.thuringiensis strains produces 3 types of insecticidal toxins that are Crystal toxins (Cry), Cytolytic toxins (Cyt) and vegetatively expressed insecticidal proteins (vip). Bt-delta-endotoxins which functions as oral toxins are ingested by insect and protoxins are proteolytically activated to trypsin-resistant active core d- endotoxin in alkaline mid-gut. The active toxin binds to cadherin receptors present on the brush border membrane of the insect midgut. Cadherins process the toxins to form homo-oligomers, bind to specific receptors like alkaline phosphatases and aminopeptidases before causing pores in the epithelial membrane, resulting in osmotic lysis of the cells which results in cessation of feeding and finally mortality of the insect. Cry toxins have not been reported to be toxic to higher animals such as goats, sheep and cattle in any part of the world as scientific evidences indicate that the Cry toxins do not get activated under the acidic conditions of non-target animals such as goat, sheep and cattle. In one study of acute oral toxicity study in rats, Bt cotton seed material did not induce any treatment related observable toxic effects when compared with Non-Bt cottonseeds. Histological studies in another study revealed that there were no difference in cellular architecture in liver, heart, kidney and intestine of Bt and non-Bt diet fed rats. The Cry toxins Cry1Ac, Cry1Ab, Cry2Ab, Cry1F and Cry1C are considered to be safe to human beings. The stomach of humans, being the first organ of digestion which the Bt protein encounters, is acidic and contains proteases like pepsin which degrade the Bt protein. Thus, the alkaline conditions needed for pro-toxin solubilization and protease action required for toxin activation are absent in the stomach. More importantly, the human intestine lacks the specific receptors to which the activated Bt protein binds and initiates the physiological effect. However, there are several reports that Bt genes cause some serious problems to human health. Cry1Ac toxin at higher concentration have lethal cytotoxic and genotoxic effects on the human lymphocytes. The present review is an attempt to provide details from the available literature regarding uses of Bt cotton and its implications on animal and human health.

Stroke is an acute violation of cerebral circulation, which is one of the main causes of disability and mortality in the population. In addition to its unconditional medical and social significance, a stroke also brings colossal economic damage. For example, in the United States, costs associated with the treatment and rehabilitation of patients with stroke, as well as economic losses associated with disability, amount to 6.5-11.2 billion dollars per year. The problem of stroke is especially urgent in the Russian Federation, where 450 thousand cases of strokes are registered annually and for every 100 thousand of the population there are 600 patients with the consequences of stroke, of which 60% remain disabled [2, 9].

Trigeminal neuralgia (TN) is characterized by sudden, severe, brief, and stabbing recurrent episodes of facial pain in one or more branches of the trigeminal nerve. The right side of the face (60%) is affected more than the left side. Bilateral simultaneous pain in TN is rare (1.7%–5%) and more often these patients experience side-alternating unilateral pain paroxysms. The pain of TN most frequently affects the distribution of the maxillary (V2) and mandibular (V3) divisions of the trigeminal nerve, though approximately a quarter of the cases have ophthalmic (V1) division involvement. The results of the study are presented and the frequency of damage to the branches of the trigeminal nerve, the most common etiological factors in the development of TN in the examined patients, the frequency of damage to the branches of the trigeminal nerve depending on the duration of the disease, the clinical semiology of the trigeminal nerve depending on the duration of the disease, the score of pain in TN in depending on the duration of the disease, clinical and vegetative indicators depending on the duration of TN.

Objective of the article is to present more extensive data of manifestations of neurological disorders in patients with Covid 19. Method. We gathered data from Pubmed, based on the words such as Covid 19, neurological disorder, neurological manifestation, complication, acute and long-term consequences, neurorehabilitation. Results. The growing interest in the topic of Covid-19 is due to its systemic inflammation, multiple symptoms, course and consequences and increased risk of neurological disorders. Effects of coronavirus on the central nerve system are of concern. Covid 19 RNA was detected in spinal fluid that is a testament of the theory of its neurotrophic involvement. Conclusion. Neurological clinical symptoms of Covid-19 are summarized as possible mechanism of coronavirus involvement in the brain.

This article discusses the features of epilepsy in the mountainous desert areas of Surkhandarya region and how it occurs. Epilepsy is a chronic polyetiological neuropsychiatric disorder that often begins in childhood and adolescence and is characterized by paroxysmal disorders, personality changes in the emotional sphere. Therefore, the prevention of epilepsy begins in childhood, and the disease is not only a medical but also an important social problem. Knowing the clinic of epilepsy, especially to determine the extent of its onset, is necessary for general practitioners, as patients with epilepsy often consult these physicians when their initial symptoms appear. The article also describes what disease epilepsy is and the condition of the patient with it