Polycystic ovary syndrome (PCOS) is a very common, complex, and heterogeneous endocrine disorder of women that involves a combination of environmental and genetic factors. PCOS affects women of growing age particularly at the early to late reproductive stage (15–35 years). Currently, PCOS affects 1 in every 10 women worldwide. It is characterized majorly by a raised level of androgens such as testosterone and a large number of ovarian cysts (more than 10) that cause anovulation, infertility, and irregular menstrual cycle. PCOS is also related to other endocrine and metabolic abnormalities, such as obesity, hirsutism, acne, diabetes, insulin resistance, and glucose impairment. PCOS can be treated with allopathic, ayurvedic, and natural or herbal medications along with lifestyle modifications. Herbal medicines remained in demand for numerous reasons such as high cost and side effects associated with the use of allopathic medicine and our traditional norms, which have helped humans to use more herbal products for their health benefits. Estrogenic and nonestrogenic phytochemicals present in various plant species such as Glycyrrhiza glabra L. [Fabaceae], Aloe vera (L.) Burm. f. [Asphodelaceae], Silybum marianum (L.). Gaertn. [Asteraceae], Serenoa repens (W.Bartram) Small [Arecaceae], Actaea racemosa L. [Ranunculaceae], and Angelica sinensis (Oliv.) Diels [Apiaceae] are effective and harmless. Herbal medicines are found to be cost-effective, efficacious, and a highly esteemed source of management/treatment for PCOS than allopathic medicines. In this literature review, diagnosis, signs, and symptoms of PCOS; causes of hormonal imbalance; and risk factors associated with PCOS and their management are discussed briefly, and the focus was to find out the role of herbal remedies in PCOS management.

To overcome the issue of multidrug resistant (MDR) microbes, the exploration of ways to improve the antimicrobial efficiency of existing antibiotics is one of the promising approaches. In search of synthons with higher efficiency, in current investigations, cocrystal and amorphous salt of levofloxacin hemihydrate (LEV) were developed with phthalimide (PTH) and caffeic acid (CFA). New materials were characterized with the help of FT-IR, Raman spectroscopy, powder X-ray diffraction (PXRD), differential scanning calorimetry (DSC) and thermogravimetric analysis (TGA). Shifting, attenuation, appearance/disappearance and broadening of bands were observed in the FT-IR and Raman spectra of the materials as evidence of the required product. The PXRD diffraction pattern observed for LEV-PTH indicated cocrystal while halo diffractogram of LEV-CFA revealed amorphous nature. DSC/TG analysis confirmed the hydrated nature of the cocrystal/salt. The dissolution rate and antimicrobial activity against selected strains, K.pneumonia, E. coli and S. typhi of parent drug and the new material were compared. The zone of inhibition (ZI) observed for 5 µg LEV-PTH was 30.4 + 0.36 (K. pneumonia), 26.33 + 0.35 (E. coli) and 30.03 + 0.25 mm (S. typhi) while LEV-CFA salt (5 µg) against the same strains inhibited 33.96 ± 0.25, 31.66 ± 0.35 and 27.93 ± 0.40 mm, respectively. These novel formulations enhance the dissolution rate as well as antibacterial efficiency and are expected to be potent against MDR bacterial strains.

Aims: assess nurses’ knowledge and performance-related safe administration of oxygen (O2) therapy; apply an intervention program for nurses about standardized protocol for oxygen; and evaluate the effectiveness of standardized protocol for oxygen in improving nurses’ performance and patients’ health outcomes. Design: a quasi-experimental study was used. Setting: the current study was conducted at three hospitals in Sakaka City with totally different medical aid units (ICUs), CCUs, emergency care departments (ED), medical and surgical wards, pediatric care units (PICUs), neonatal intensive care units (NICUs), pediatric emergency care departments (PED) and pediatric inpatient\outpatient departments. Subjects: a convenience sample of 105 nurses and 105 patients was divided into 55 patients in the control group who received routine care and 50 patients in the study group who received intervention. Findings: 34.3% of studied nurses had poor knowledge pre-intervention compared with 17% post-intervention. Moreover, 33.3% of them had satisfactory knowledge pre-intervention versus 21% post-intervention. Only 5.7% of them had excellent knowledge pre-intervention, compared with 34.4% post-intervention. Concerning the complications of oxygen therapy, only 10.5% did not have complications in the control group versus 62.9% in the study group, 33.3% of the control group had cyanotic lips and fingernails pre-intervention, versus 7.6% in the study group; 10.5% had oxygen toxicity in the control group, versus 7.6% in the study group, with a highly statistically significant difference at p 0.001 for all. Conclusion: the current results of this study concluded that there was improvement in nurses’ knowledge and practice related to oxygen therapy post-intervention. Moreover, when the standard protocol for safe oxygen therapy was used in a positive way, it led to better health for patients and fewer problems with oxygen therapy.

Cydonia oblonga is a medicinal plant that is used to treat a number of health complications in traditional medication systems. The objective of this study was to evaluate the phytochemical composition, and antibacterial, antioxidant, and ant-diabetic potentials of methanolic extracts of Cydonia oblonga bark. The Cydonia oblonga bark extraction was fractionated through HPLC and seven purified fractions labeled as F1, F2, F3, F4, F5, F6, and F7 were obtained. The HPLC-UV analysis of methanolic extract showed the presence of a number of possible compounds. The GC-MS and HPLC analysis confirmed the presence of the following bioactive compounds in the crude extract and purified fractions: malic acid, mandelic acid, quercetin, caffeic acid, catechin hydrate, as morin (HPLC analysis), BIS-(2-ethylhexyl)phthalate and diisooctyl phthalate (F1), carbamide (F2, used as fertilizer), octasiloxane and dimethylsiloxanecyclictrimer (F3), silicic acid and cyclotrisiloxane (F4), 6-AH-cAMP, 4H-cyclopropa[5′,6′]benz[1′,2′,7,8]azule, and 4-(4-chlorophenyl)-3-morpholinepyrol-2-yl)-butenedioic acid (F5), isopropyamine (F6), and 1-propylhydrazine (F7). The extract and purified fractions were then tested for biological activities. All the purified fractions and methanolic extract showed effective antibacterial activity; however, the highest activity was recorded for methanolic extract against Staphylococcus aureus and Streptococcus pneumonia. Antioxidant evaluation of methanolic extract and purified fractions against DPPH showed strong % inhibition of the synthetic free radical. The methanolic extract exhibited 87.41 ± 0.54% inhibition whereas fractions showed: F1, 85.45 ± 0.85; F2, 65.78 ± 0.68; F3, 58.61 ± 0.58; F4, 80.76 ± 0.59; F5, 571.29 ± 0.49; F6, 85.28 ± 0.94; and F7, 48.45 ± 0.62% inhibition. Ascorbic acid (standard) was used as a control with 94.88 ± 0.56% inhibition at a maximum concentration of 1000 µg/mL. The α-glucosidase inhibition assay of methanolic extract and purified fractions at a maximum concentration of 1000 µg/mL showed activities as: methanolic extract, 78.21 ± 0.67; F1, 55.01 ± 0.29; F2, 56.10 ± 0.24; F3, 62.44 ± 1.03; F4, 70.52 ± 0.15; F5, 62.18 ± 0.92; F6, 72.68 ± 0.2; and F7, 57.33 ± 0.05% inhibition. α-Amylase % inhibition of methanolic extract and purified fractions were noted as: methanolic extract, 77.98 ± 0.57; F1, 79.72 ± 0.02; F2, 79.72 ± 0.02; F3, 82.16 ± 0.48; F4, 77.37 ± 0.28; F5, 72.14 ± 0.30; F6, 74.24 ± 0.29; and F7, 56.58 ± 0.10 at the highest concentration of 1000 µg/mL. Acarbose (standard) showed 87.65 ± 0.71% inhibition of α-glucosidase and 85.99 ± 0.44% inhibition of α-amylase at the highest concentration of 1000 µg/mL. It was found that all biological activities of methanolic extract and purified fractions might be attributed to the fact that they are rich sources of phenolic and flavonoids along with other bioactive compounds. The total phenolic and flavonoid contents of methanolic extract were recorded higher as compared to purified fractions (TPC = 70% and TFC = 69%). Amongst the purified fractions, fraction 6 exhibited the highest TPC value (64%), and purified fraction 1 exhibited the highest value of TFC (58%). Recent research demonstrated that Cydonia oblonga may be considered an antibacterial medicinal plant. The result of the present study revealed that it might be utilized for the isolation of bioactive phytochemicals that can lead to new opportunities in the discovery of new antibiotics.

Purpose The health-care services in Iraq currently face many challenges. The most noted is the lack of effective nursing leaders to meet the growing needs of the health-care services. Effective nursing leadership is critical to the health-care system, affecting work performance, quality of care and staff satisfaction. The literature suggests that nursing leaders in Iraq are not adequately trained to provide leadership to improve the nursing profession and have limited involvement in decision-making. The purpose of this study is to explore the views of nurses on what they believe constitutes effective leadership in Iraq. Design/methodology/approach A qualitative methods approach is used involving 20 semi-structured interviews of senior nurses. The sample of nurses came from two large general hospitals in Iraq. The qualitative data was thematically analyzed and interpreted. Findings The study results indicated that there were factors that influence the performance of nurse leader, namely, excessive workload, personal relationship with nursing staff, professional recognition of nursing and selection criteria of leaders. Test results show that there were significant differences in views of the nurses toward nurse leaders’ performance. This research concludes that the nurse leader performance in developing countries is affected by excessive workload, personal relationship with nursing staff, professional recognition of nursing and selection criteria of leaders. Originality/value The relevance of the study stems from the scarcity of research on the leader performance in developing countries, while studies on the factors influencing the innovative performance of leaders in nurses’ professional are significantly limited. This study is one of the earliest studies that investigate these factors influencing the nurse leader’s performance.