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There is emerging evidence suggesting that vitamin D and fibrinogen play contrasting roles in ACS pathophysiology and their combined impact, expressed as the vitamin D/fibrinogen ratio, can be a potential biomarker for ACS severity. This study aimed to investigate the relationship between vitamin D, fibrinogen, and their ratio with ACS types, and assess their potential as risk stratification biomarkers. This multicenter observational study was conducted in tertiary care hospitals in Afghanistan, Egypt, and Pakistan, including 300 ACS patients. Serum vitamin D and fibrinogen levels were measured using electrochemiluminescence immunoassay and the Clauss method, respectively. Statistical analyses included ANOVA, Kruskal-Wallis, post-hoc Games-Howell tests, Spearman's correlation, Fisher's Z-test, and multivariable logistic regression. Vitamin D levels were significantly lower (p < 0.001) and fibrinogen levels significantly higher (p < 0.001) in STEMI patients compared to NSTEMI and UA. The vitamin D/fibrinogen ratio showed a stronger correlation with ACS severity (Spearman's rho = -0.45, p = 0.01) than vitamin D alone (-0.41, p = 0.01), but this difference was not statistically significant (Fisher Z = 0.34, p = 0.73). Logistic regression revealed that a 1 nmol/L increase in vitamin D reduced ACS severity by 7.1% (p = 0.043), while a unit increase in the vitamin D/fibrinogen ratio reduced severity by 6.2% (p = 0.048). The contrasting effects of vitamin D and fibrinogen can prove useful biomarkers and modifiable risk factors for ACS. The superiority of the vitamin D/fibrinogen ratio over vitamin D only, however, needs further validation in larger studies.

Background Hordeum vulgare L. (HV or barley) is used by traditional healers to treat various inflammatory and cardiovascular diseases, without the knowledge of pharmacologic rationale behind its actions. This study was designed to explore the potential scientific mechanism(s) that could explain the use of Hordeum vulgare in traditional medicine as a treatment for various inflammatory and cardiovascular diseases. Methods A crude extract and its three fractions were prepared from HV and screened for the inhibition of platelet aggregation and various metabolites of cyclooxygenase (COX), lipoxygenase (LOX) pathways of arachidonic acid (AA) metabolism as well as for its effects on certain antioxidant enzymes. Platelet aggregation was monitored using turbidometric principle, AA metabolism through radioimmunoassay and antioxidant enzymes by commercial kits using spectrophotometer. Results Results show that HV exhibited activities against all human platelet agonists used except adenine diphosphate, and inhibited both COX and LOX pathways of AA metabolism. It also elevated the activities of superoxide dismutase (SOD) and glutathione peroxidase (GPx). However, these activities were distributed in various fractions of HV. Aqueous fraction was most potent in elevating SOD activity; chloroform fraction had concentrated compounds responsible for COX inhibition while n-hexane seems to possess compounds responsible for LOX inhibition as well as the only fraction enhancing the activity of GPx. Conclusions These results suggest the likely mechanisms responsible for observed anti-inflammatory and cardiovascular effects of HV in traditional medicine.

The objective of this review is to analyze the hidden curriculum with respect to its potential as a curriculum promotor or inhibitor of medical curricula, and to review the strategies that can help make it one of the curriculum promotors. We searched PubMed, Cochrane Reviews, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) library, with Google Scholar for grey literature, using specified keywords with a time limit from January 2000 to December 2023. We included original articles, review articles and meta-analyses, book chapters, and books focusing on the hidden curriculum effects on curriculum. Three different reviewers independently searched the relevant literature. The Best Evidence Medical Education (BEME) quality criteria were used to assess the quality, the Critical Appraisal Skills Program (CASP) checklists for risk of bias assessment, and the GRADE-CERQual framework for confidence of evidence in each article. Findings were synthesized by using thematic synthesis to identify promotive and inhibitory effects along with recommended strategies. A total of 23 articles were selected for full review. These articles infer that the hidden curriculum can affect the medical curriculum in both negative and positive ways. A few of the curriculum-promoting effects of hidden curriculum are soft skills (interpersonal, communication, and professional behaviors often labelled as soft skills in the literature) and practical knowledge acquisition, cultural proficiency, moral growth, and professionalism. The negative or inhibitory effects include a detrimental learning environment, learning unprofessional and unethical practices, gender inequities, stress, and burnout. Strategies that should be adopted to overcome the inhibitory effects of the hidden curriculum include raising awareness among the stakeholders regarding the hidden curriculum, aligning the hidden curriculum with the intended curriculum, institutional and administrative policies, role modelling, and mentorship. Hidden Curriculum plays a very crucial role in medical education. By addressing its due importance, it can highly enhance the competence of future health professionals.

Purpose: Coronary artery disease (CAD), clinically manifested as coronary syndrome (CS), is the leading cause of death and a significant contributor to morbidity worldwide. Elevated serum homocysteine levels have been associated with an increased risk of cardiovascular diseases, including CAD. Despite extensive research, the relationship between serum homocysteine and coronary syndromes with related short-term mortality is still under-studied. The main objective of this study is to evaluate the correlation between serum homocysteine levels and various types of CS, as well as in-hospital mortality in these patients. Patients and Methods: This multicenter study included 381 CS patients from Afghanistan, Egypt, and Pakistan tertiary care hospitals. The relation of serum homocysteine levels with different types of CS as well as with in-hospital mortality was measured and analyzed using inferential statistics (ANOVA, Kruskal--Wallis test, Tukey's post-hoc, Pearson correlation, etc.) and regression analysis (Binary regression). Results: Among 381 patients from both genders, 160 were from Pakistan, 130 from Egypt, and 91 from Afghanistan. There was no significant difference in baseline characteristics, like age, gender, homocysteine level, CS type, and mortality, among the three countries (p > 0.05). The one-way ANOVA, the Kruskal Wallis Test, and Tukey's post hoc test showed a significant difference among different CS groups based on serum homocysteine levels, and Pearson correlation showed a strong correlation between serum homocysteine and CS (r = 0.4). Binary regression analysis showed a 10.5% increase in in-hospital mortality for each 1 [micro]mol/L increase in homocysteine levels. Conclusion: Serum homocysteine could serve as a valuable biomarker and mortality predictor in CS patients. Keywords: serum homocysteine, coronary artery disease (CAD), coronary syndromes (CS), cardiac biomarkers, risk factors of CAD

Coronary artery disease (CAD), clinically manifested as coronary syndrome (CS), is the leading cause of death and a significant contributor to morbidity worldwide. Elevated serum homocysteine levels have been associated with an increased risk of cardiovascular diseases, including CAD. Despite extensive research, the relationship between serum homocysteine and coronary syndromes with related short-term mortality is still under-studied. The main objective of this study is to evaluate the correlation between serum homocysteine levels and various types of CS, as well as in-hospital mortality in these patients. This multicenter study included 381 CS patients from Afghanistan, Egypt, and Pakistan tertiary care hospitals. The relation of serum homocysteine levels with different types of CS as well as with in-hospital mortality was measured and analyzed using inferential statistics (ANOVA, Kruskal-Wallis test, Tukey's post-hoc, Pearson correlation, etc.) and regression analysis (Binary regression). Among 381 patients from both genders, 160 were from Pakistan, 130 from Egypt, and 91 from Afghanistan. There was no significant difference in baseline characteristics, like age, gender, homocysteine level, CS type, and mortality, among the three countries ( > 0.05). The one-way ANOVA, the Kruskal Wallis Test, and Tukey's post hoc test showed a significant difference among different CS groups based on serum homocysteine levels, and Pearson correlation showed a strong correlation between serum homocysteine and CS (r = 0.4). Binary regression analysis showed a 10.5% increase in in-hospital mortality for each 1 µmol/L increase in homocysteine levels. Serum homocysteine could serve as a valuable biomarker and mortality predictor in CS patients.

Kota Kinabalu (KK) is one of the pilot cities to implement smart city infrastructure in Malaysia. Given this privilege, lots of apps are needed to enable the city folks taking advantage of the highspeed bandwidth infrastructure. One of it is moving towards smart environment and smart government through supporting the green environment and cashless payment system for parking purposes. This paper describes the effort on the development of an apps, JumPark Bah! as an alternative to the current coupon-based parking system handled by the local authorities, Kota Kinabalu City Hall (KKCH). The current approach is quite cumbersome for KK city folks as they need to have a valid parking coupon displayed on the dashboard to park their car around KK city area. They must be able to correctly estimate the parking time or else summon will be issued if the parking time is exceeded. As for the KKCH, they need to assign many parking attendants for checking and validating the parking session. Thus, JumPark Bah! has been proposed as an alternative solution for KKCH by utilizing the concept of cashless payment parking system and is able to minimize the above-mentioned issues. The apps consist of a mobile application (for citizen and parking attendant) and the web-based system (for admin, i.e., KKCH). The web-based system allows the authority to monitor the fees, generate a report and even updates the user through announcement and news functionality. Based on the user evaluation using System Usability Scale (SUS), it has been found that JumPark Bah! has achieved 71.06% score which exceed the 68% score for good usability target.

Herein, a series of pH-responsive composite hydrogels based on carrageenan (CG) and synthetic polymer poly (N-vinyl-2-pyrrolidone) (PVP) was developed by using 3-aminopropyl triethoxysilane (APTES) as cross-linker. The formation of the hydrogel was confirmed with the help of Fourier-transform infrared spectroscopy (FTIR). The FTIR spectra revealed the presence of all functionalities at their specific wavenumbers. The thermal stability of the as prepared composite hydrogels and pristine carrageenan and PVP was evaluated with the help of thermogravimetric analysis (TGA). The obtained thermo-grams portrays that the composite hydrogels are thermally more stable as compared to the pristine hydrogels. Furthermore, antibacterial investigations exhibit good activities against S. aureus a gram-positive strain indicating that the as prepared hydrogels can be employed for the biological applications. Additionally, the time-dependent sustainability of the composite hydrogels was confirmed by biodegradation analysis. The results obtained are in well agreement with the reported results. Also, the swelling behavior of the hydrogels was examined against different media using different concentrations of the APTES. The percentage of swelling in water for hydrogel samples was increased with the quantity of APTES. The different pH of the same solutions explains the swelling behavior in dependable way as hydrogels exhibit inverse relation of swelling with pH; in acidic medium, i.e., at low pH, maximum swelling was observed and vice versa. This idiosyncratic behavior of these synthesized hydrogels and its sustainability favors their use for control release of fertilizers. The release pattern was studied by spectrophotometer using indophenol blue at 640 nm showed 86.82% of fertilizer release over a period of 216 h in a phosphate buffer saline (PBS) in a controlled manner.

One of the important applications of polyurethanes is polyurethane foam. Flexible type of polyurethane foam is divided into many types and one of them is visco-elastic foam. Visco-elastic foam is unique foam showing both viscous and elastic behavior at same time. Visco-elastic foam covers major applications of flexible polyurethane foam. Visco-elastic foam samples were synthesized on lab scale by cup foaming. All samples were characterized, by finding density of each sample. Cream time, gel time and rise time were also estimated for each sample. The chemical compositions of all polyurethane foam samples were characterized by FTIR analysis.