Drug Use and Abuse among Orthopedic Ward Patients—A Revolving Cycle of Menace in Atbuth, Bauchi

Background: The use of drugs for purposes other than those for which they are meant to be used or in excess amounts. Psychoactive drugs are some of the drugs more commonly abused, also, antibiotics and other medications too can be misused. Drug abuse and misuse can lead to serious social, medical and emotional harm to the patients, and antibiotic resistance that makes treatment harder are also likely complications. Method: Patients in both male and female wards of the Orthoepaedics Department of ATBUTH, Bauchi were interviewed using a structured questionnaire and their responses were recorded and data were analyzed using the SPSS version 29. Results: A total of 112 patients were interviewed, 76 males and 36 females. Thirty-two (28.6%) patients had taken various kinds of unprescribed medications while on admission: 9 patients had taken unprescribed tramadol, 4 patients had taken codeine, 6 Ampiclox, 5 flagyl and about 8 patients had taken different kinds of traditional medications while on admission. Among the 32 patients, 23 (72%) are aged less than 30 years, 5 (16%) are aged between 30 and 50 years and 4 (12%) are aged above 50 years. Sixteen (50%) had such medications brought to them by relatives or friends, 10 (30%) were given by other patients on admission, 5 (15%) brought or bought the drugs by themselves while 1 (5%) were given by a non-clinical staff of the hospital. Conclusion: Drug misuse and abuse is a very serious, deleterious practice with destructive consequences in its wake, such consequences as drug dependency with all its antecedent effects, antibiotic resistance and difficulties in controlling/managing infections are but a few. So, it’s very important to both educate patients about these terrible practices and cope with the spread of them in our wards and hospitals.

Survey Research into Cohesive Device Misuses in Business English Writing

Cohesive devices in students’business English writing are regarded as the object of the research.Based on Haliday and Hasan’s cohesion theory,this paper introduces commonly-used cohesive devices in English writing.With the method of quantitative data,use and misuse frequency of cohesive devices in students’writings can be known.The paper will also analyze why misuses happen through qualitative data analysis and explore right ways of using cohesive devices.

Intrusion Detection Algorithm Based on Model Checking Interval Temporal Logic

Model checking based on linear temporal logic reduces the false negative rate of misuse detection.However,linear temporal logic formulae cannot be used to describe concurrent attacks and piecewise attacks.So there is still a high rate of false negatives in detecting these complex attack patterns.To solve this problem,we use interval temporal logic formulae to describe concurrent attacks and piecewise attacks.On this basis,we formalize a novel algorithm for intrusion detection based on model checking interval temporal logic.Compared with the method based on model checking linear temporal logic,the new algorithm can find unknown succinct attacks.The simulation results show that the new method can effectively reduce the false negative rate of concurrent attacks and piecewise attacks.

Pain management in chronic pancreatitis incorporating safe opioid practices: Challenge accepted

Patients with chronic pancreatitis often experience severe,unrelenting abdominal pain,which can significantly impact their quality of life.Pain control,therefore,remains central to the overall management of chronic pancreatitis.Most of the strategies aimed at treating the pain of chronic pancreatitis are based on expert opinion and vary from one institution to another,as there are no uniform guidelines to direct a stepwise approach towards achieving this goal.In this editorial,we comment on best practice strategies targeted towards pain control in chronic pancreatitis,specifically highlighting the use of opioid medications in this patient population.We discuss various safe and efficacious prescription monitoring practices in this article.

CM-Droid: Secure Container for Android Password Misuse Vulnerability

Android applications are associated with a large amount of sensitive data,therefore application developers use encryption algorithms to provide user data encryption,authentication and data integrity protection.However,application developers do not have the knowledge of cryptography,thus the cryptographic algorithm may not be used correctly.As a result,security vulnerabilities are generated.Based on the previous studies,this paper summarizes the characteristics of password misuse vulnerability of Android application software,establishes an evaluation model to rate the security level of the risk of password misuse vulnerability and develops a repair strategy for password misuse vulnerability.And on this basis,this paper designs and implements a secure container for Android application software password misuse vulnerability:CM-Droid.

Effects of intervention measures on irrational antibiotics/antibacterial drug use in developing countries: A systematic review

Irrational antibiotics/antibacterial (AB) drug use is a global problem, especially in developing countries. This results in an increased emergence of resistance to most common bacteria, higher cost of treatment, prolonged hospitalization and adverse drug reactions. Interventions measures have been instituted to avert the problem but it still persists. A systematic review was conducted to determine the effect of different interventions (education, managerial, diagnostic tests, regulatory, economic and multifaceted) on misuse of AB drugs in developing countries. A total of 722 articles were retrieved and 55 were reviewed. About 10.9% of the studies were from Africa, 63.6% from Asia, 9.1% from Latin America, and 16.4% from Southeastern Europe. A total of 52.7% of the studies were from hospital settings, 5.5% from outpatient departments, 21.8% were from public health care facilities, 12.7% from private pharmacies/drug stores, and 7.3% from the communities. Education intervention had 27.3% studies, managerial had 20%, managerial/education had 3.6%, regulatory had 9.1%, education/regulation had 9.1% and diagnostic had 3.6% studies. Multifaceted intervention had 27.3% studies, with 63% improvement in appropriate AB doses prescribed, 2.6% mean number of AB encounter reduction, 23% AB prescription reduction, 18.3% generic AB prescription improvement, 32.1% reduction in AB use, 89% reduction in AB use in acute respiratory infection, 82% in surgery, 62.7% mean reduction in deliveries, 39% in STDs, 36.3% mean reduction in diarrhea, 14.6% mean reduction AB use in malaria, and 6%-11% in the cost of treating bacteria-resistant organisms. Also noted was 6.3% reductions in mean AB encounters after 1 month of intervention, and then increased to 7.7% after 3 months thus lacking sustainability. Multifaceted interventions were effective in reducing irrational AB drug use in the various health facilities and communities as well as reduction in the emergence of resistance to the commonest bacteria in the developing countries though there was lack of sustainability or continuity of rational drug use over the time.

Misuse of the metabolic modulator meldonium in sports

1.Biochemical structure and molecular activity of meldonium Meldonium(commercial name Mildronate)was originally synthesized in the mid-1970s at the Institute of Organic Synthesis of the Latvian Soviet Socialist Republic Academy of Sciences.The chemical structure of this compound(3-(2,2,2-

A Corpus-Based Study of the Use of Verb DO in L2 Hong Kong University Students Writing

It is found in the study that there is a big difference concerning the overall frequency of Do with Hong Kong students using much more DO in their writings than native speakers.Besides,Hong Kong university students tend to overuse the verbal operator DO,which is contrary to Qi Yan's study(2006).At the same time,they also misuse Do;When Do is used as de-lexical verb,Hong Kong students share the same characteristics with the study of Fu zhuqin(2006),that is,they allow more freedom to collocate with more Nouns,some of which are inappropriate collocates in native English.The potential reasons for these problems might be illustrated as overgeneralization,mother-tongue interference,and lack of vocabulary etc.Based on the findings,the paper presents two pedagogical implications about vocabulary teaching and learning:the content of vocabulary teaching should be extended and enriched,and the corpus-based vocabulary teaching methodology should be integrated into class practices.

Alcohol and tobacco misuse: Reducing aerodigestive cancer risk

Significant concerns over the health,social and economic burdens of the two most common,and frequently co-misused drugs of abuse,alcohol and tobacco,has encouraged focused but separate health promotion and disease prevention policies.However,this separation of focus means that while individuals who present with alcohol-related problems are increasingly supported to attain and maintain abstinence from alcohol they are not routinely assisted to refrain from smoking.This is tragically inopportune as alcohol and tobacco have an established"synergistic"effect on aerodigestive cancer risk.Moreover,even when patients successfully tackle their alcohol problems they remain at increased risk for developing these cancers,especially if they continue to smoke.A case series is presented together with a discussion on how service provision for co-misuse could be improved to obviate aerodigestive cancer risk.Given the prevalence of alcohol and tobacco use in the United Kingdom,these observations may have far reaching implications for the individual,health provider(s)and wider society.

Study of Intrusion Detection Systems

Modern network systems have much trouble in security vulnerabilities such as buffer overflow, bugs in Microsoft Internet, sensor network routing protocol too simple, security flaws of applications, and operating systems. Moreover, wireless devices such as smart phones, personal digital assistants （PDAs）, and sensors have become economically feasible because of technological advances in wireless communication and manufacturing of small and low-cost sensors. There are typologies of vulnerabilities to be exploited in these devices. In order to improve securities, many mechanisms are adopted, including authentication, cryptography, access control, and intrusion detection systems （IDS）. In general, intrusion detection techniques can be categorized into two groups： misuse detection and anomaly detection. The misuse detection systems use patterns of weB-known attacks or weak spots of the systems to identify intrusions. The weakness of misuse detection systems is unable to detect any future （unknown） intrusion until corresponding attack signatures are intruded into the signature database. Anomaly detection methods try to determine whether the deviation is from the established normal usage patterns or not. The critical success of anomaly detection relies on the model of normal behaviors.

Methylphenidate Misuse in Adults: Survey of 414 Primary Care Physicians in Germany and Comparison with the Literature

Objectives: This paper deals with the methylphenidate (MPH) misuse by adults in Germany. Results of a survey among primary care physicians/internists have been supplemented by a comparison with the literature. Methods: In the period from October 5-20, 2015, a survey was sent to 414 primary care physicians/internists in four German cities (n = 10 were undeliverable). The response rate was 58% (n = 235). 34 original works on MPH abuse worldwide were found in the literature and are used in the analysis of the present data situation. The literature published before November 9, 2015 is considered in this paper. Results: 14% of the doctors who took part in the survey said that they had been asked for MPH prescriptions without any medical indication. The most frequent reason given for the request (42%) was adult attention deficit/hyperactivity disorder (ADHD) not verified by documents. According to the comparison with the literature, university students had a lifetime prevalence of MPH misuse ranging from 0.8% to 16.6% and school children had a misuse rate of 4.0%. In the civilian US population, the misuse rate was 4.2%. Among patients in possession of a current MPH prescription due to a diagnosis, the lifetime prevalence was 29% and among adolescents with suspected alcohol and/or drug problems 20%. Conclusions: MPH misuse is a major problem which has not been studied sufficiently. MPH misuse not only plays a role in the field of psychiatry, but also in other disciplines. Misuse particularly following a therapeutic prescription should be taken into account.

Opioid use and misuse in ulcerative colitis

BACKGROUND Patients with ulcerative colitis(UC) may be exposed to opioids over their disease duration. The use of such medications carries significant risk, including intestinal dysmotility and potential for addiction. However, the rates of narcotic use and misuse in patients with UC have not been studied extensively. Functional gastrointestinal disorders(FGID) are prevalent in patients with UC, and have been shown to increase the risk of narcotic use and misuse in patients with Crohn's disease. We hypothesized that patients with UC and a concurrent diagnosis of FGID would have increased rates of both opioid use and misuse in our patient cohort.AIM To evaluate the prevalence of chronic opioid use and misuse in UC.METHODS A retrospective chart review of UC patients seen at the University of Virginia Digestive Health Center was performed on all patients evaluated between 2006 and 2011. Patient demographics, medical, surgical, and medication histories were obtained from the electronic medical record. Concomitant diagnosis of FGID was also noted at the time. The electronic prescription monitoring program was accessed to obtain prescription opioid filling histories. Prescription opioid misuse was defined as opioid prescriptions filled from four or more prescribers and four or more different pharmacies in a 12-mo period.RESULTS A total of 497 patients with UC were included. Patients with UC and FGID were more likely to be female, but no other demographic variables were associated with FGID. Of the UC patients who had FGID, a greater proportion were found to be using opioids chronically(36% with FGID vs 9% without FGID, P < 0.0001)and were misusing prescription opioids(12.8% vs 1.3%, P < 0.001). Multivariate logistic regression demonstrated a significant association with FGID and chronic opioid use(OR = 4.50; 95%CI: 1.91-10.59) and opioid misuse(OR = 5.19; 95%CI1.04-25.76). Tobacco use(OR 2.53; 95%CI: 1.06-6.08) and anxiety(OR 3.17; 95%CI:1.08-9.26) were other variables associated with an increased risk of chronic narcotic use.CONCLUSION FGID was associated with a 4.5-fold increase in chronic opioid use and a 5-fold increased risk of opioid misuse in this patient cohort with UC.

Impact of alcohol consumption on treatment outcome of hepatocellular carcinoma patients with viral hepatitis who underwent transarterial chemoembolization

BACKGROUND Alcohol consumption increases the risk of hepatocellular carcinoma(HCC)in patients with pre-existing liver disease,including viral hepatitis.However,studies on the impact of alcohol consumption on the outcomes of HCC are limited.We hypothesized that alcohol had an additional effect with chronic viral hepatitis infection on treatment outcomes after transarterial chemoembolization(TACE)in patients with intermediate-stage HCC(Barcelona Clinical Liver Cancer[BCLC]-B).AIM To evaluate the additional effect of alcohol on treatment outcomes of TACE among HCC patients with viral hepatitis.METHODS This study,conducted at Hatyai Hospital in Thailand,included HCC patients over 18 years of age with chronic viral hepatitis.Records of HCC patients with viral hepatitis classified as BCLC-B who underwent TACE as the first treatment modality between 2014 and 2019 were retrospectively reviewed.Patients with chronic viral hepatitis only were categorized under group A,and those with chronic viral hepatitis and concurrent alcohol consumption were categorized under group B.Both groups were compared,and the Cox proportional-hazards model was used to identify the survival-influencing variables.RESULTS Of the 69 patients,53 were categorized in group A and 16 in group B.There were no statistically significant differences in tumor characteristics between the two patient groups.However,Group A had a statistically significantly higher proportion of complete response(24.5%vs 0%,P=0.030)and a higher median survival rate(26.2 mo vs 8.4 mo;log-rank P=0.012)compared to group B.Factors associated with decreased survival in the proportional-hazards model included alcohol consumption(hazards ratio[HR],2.377;95%confidence interval[CI],1.109-5.095;P=0.026),presence of portal hypertension(HR,2.578;95%CI,1.320–5.037;P=0.006),largest tumor size>5 cm(HR,3.558;95%CI,1.824-6.939;P<0.001),and serum alpha-fetoprotein level>100 ng/mL(HR,2.536;95%CI,1.377-4.670;P=0.003).CONCLUSION In HCC BCLC B patients with chronic viral hepatitis,alcohol consumption is an independent risk factor for increased mortality and decreases the rate of complete response and survival after TACE.

Designing Intrusion Detection System for Web Documents Using Neural Network

Cryptographic systems are the most widely used techniques for information security. These systems however have their own pitfalls as they rely on prevention as their sole means of defense. That is why most of the organizations are attracted to the intrusion detection systems. The intrusion detection systems can be broadly categorized into two types, Anomaly and Misuse Detection systems. An anomaly-based system detects com-puter intrusions and misuse by monitoring system activity and classifying it as either normal or anomalous. Misuse detection systems can detect almost all known attack patterns;they however are hardly of any use to de-tect yet unknown attacks. In this paper, we use Neural Networks for detecting intrusive web documents avail-able on Internet. For this purpose Back Propagation Neural (BPN) Network architecture is applied that is one of the most popular network architectures for supervised learning. Analysis is carried out on Internet Security and Acceleration (ISA) server 2000 log for finding out the web documents that should not be accessed by the unau-thorized persons in an organization. There are lots of web documents available online on Internet that may be harmful for an organization. Most of these documents are blocked for use, but still users of the organization try to access these documents and may cause problem in the organization network.

Chronic pain, posttraumatic stress disorder, and opioid intake: A systematic review

BACKGROUND The literature suggests that there is a high degree of co-occurrence between chronic pain and posttraumatic stress disorder(PTSD). An association has been found between PTSD and substance abuse. PTSD is a severe disorder that should be taken into account when opioids are prescribed. It has been found that the prevalence of opioid use disorder(OUD) in chronic pain patients is higher among those with PTSD than those without this disorder.AIM To perform a systematic review on the association between PTSD, chronic noncancer pain(CNCP), and opioid intake(i.e., prescription, misuse, and abuse).METHODS We conducted a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The Patient, Intervention,Comparator, and Outcomes(PICOS) criteria were formulated a priori in the protocol of the systematic review. A search was conducted of the PROSPERO database. In March 2019, searches were also conducted of 5 other databases:Pub Med, MEDLINE, Psyc INFO, Web of Science, and PILOTS. The Scottish Intercollegiate Guidelines Network checklist for cohort studies was used to assess the selected studies for their methodological quality and risk of bias. Each study was evaluated according to its internal validity, participant sampling,confounding variables, and the statistical analysis.RESULTS A total of 151 potentially eligible studies were identified of which 17 were retained for analysis. Only 10 met the selection criteria. All the studies were published between 2008 and 2018 and were conducted in the United States. The eligible studies included a total of 1622785 unique participants. Of these, 196516 had comorbid CNCP and PTSD and were consuming opiates. The participants had a cross-study mean age of 35.2 years. The majority of participants were men(81.6%). The most common chronic pain condition was musculoskeletal pain:back pain(47.14% across studies;range: 16%-60.6%), arthritis and joint pain(31.1%;range: 18%-67.5%), and neck pain(28.7%;range: 3.6%-63%). In total,42.4% of the participants across studies had a diagnosis of PTSD(range: 4.7%-95%). In relation to opioid intake, we identified 2 different outcomes: opioid prescription and OUD. All the studies reported evidence of a greater prevalence of PTSD in CNCP patients who were receiving prescribed opioids and that PTSD was associated with OUD in CNCP patients.CONCLUSION Opioid analgesic prescription as the treatment of choice for CNCP patients should include screening for baseline PTSD to ensure that these drugs are safely consumed.

Emergency DepartmentmProblem Solving Approach

Emergency Department （ED） suffers from one or more of these problems. Some are resistant to treatment, to become a chronic problem represented in resistant overcrowded ED, and it is a syndrome that needs a holistic view of the problem, then to have a holistic solution, and this needs teamwork to be achieved, so the authors have to consider all these problems and solutions together; and may be more solutions are needed. The author＇s goal is to reach to effectively running ED, structurally and functionally, locally and internationally.

Emergency medicine providers＇ opioid prescribing practices stratified by gender, age, and years in practice

BACKGROUND: Emergency medicine providers(EMPs) prescribe about 25% of opioids, but the effect of EMP risk perception on decisions to prescribe opioids is unknown. This study was undertaken to identify factors that infl uence EMP risk and opioid prescribing practices.METHODS: We distributed an anonymous questionnaire to EMPs at a military trauma and referral center. Response frequencies and distributions were assessed for independence using the Chi-square test.RESULTS: Eighty-nine EMPs completed the questionnaire(100% response). Respondents were primarily younger male physicians(80%) in practice under fi ve years(55%). Male EMPs were more likely to prescribe more opioid tablets than female ones both when and when not concerned for opioid misuse(P<0.001, P<0.007, respectively). Of the providers, 70% stated that patient age would inf luence their prescribing decisions. Hydrocodone and oxycodone were the opioids prescribed most frequently. About 60% of the providers reported changing their prescribing behavior would not prevent opioid misuse. Additionally, 40% of the providers believed at least 10% of patients seen at this military ED misused opioids.CONCLUSION: Female EM providers reported prescribing fewer opioid tablets. Patient age infl uenced prescribing behavior, but the effect is unknown. Finally, EM providers reported that altering their prescribing behavior would not prevent prescription opioid misuse.

Opioid misuse in Canada and critical appraisal of aberrant behavior screening tools

The incidence of prescription opioid misuse in Canada is increasing. Initiatives for safe prescribing practices for opioid medications include risk assessment for current and future opioid misuse. A clinical screening tool that can be universally applied to all patient populations is currently not available. Our objective was to provide a brief narrative review on opioid misuse from a Canadian perspective as well as a critical appraisal of the available clinical screening tools for detecting aberrant behaviors associated with opioid misuse. The Drug Abuse Screening Test, Addiction Behaviors Checklist, Diagnosis, Intractability, Risk and Efficacy Inventory, Pain Assessment and Documentation Tool, Prescription Drug Use Questionnaire, Prescription Opioid therapy Questionnaire, Screener and Opioid Assessment for Patients with Pain(SOAPP), Revised SOAPP, Pain Medication Questionnaire, Opioid Risk Tool and Current Opioid Misuse Measure were included in the following review. Overall, a wide variability in quality, sensitivity and specificity was observed between screening tools. There is an overall lack of applicability to diverse patient populations as the majority of screening tools have been validated in pain clinic populations only. To conclude, there is a great need for a validated and convenient aberrant behaviors risk assessment tool that can be applied to a diverse patient population in a clinical setting.

Refining Use/Misuse/Mitigation Use Cases for Security Requirements

We investigate security at the same time as the functional requirements by refining and integrating use, misuse, and mitigation use cases. Security requirements rely on the interactions among normal system execution (use cases), attacks (misuse cases), and necessary security strategies (mitigation use cases), but previous approaches only use a high-level of abstraction. We use refinement to uncover details of each case and the relationships among them before integrating them. We identify and model “includes” and “extends” relationships within each refined case type, and use a condition-driven process that maintains these relationships as refinement continues. We then systematically identify and model “threatens” and “mitigates” relationships to integrate the cases at a detailed level.

An Analysis of the Misuse of Definite Article THE of English Majors

The acquisition and usage of definite article THE has always gained attention from scholars from domestic and overseas due to its difficulty of learning and mastering. As a result, the relative study of definite article THE acquisition has been one of the the most significant tasks of second language acquisition all the time. For English majors, the acquisition of definite articles THE runs through the whole process of language learning and application. Learner＇ s version of foreign language, known as interlanguage, is a kind of language that exists between the mother tongue （Chinese） and the target language （English）. Interlanguage is a systematic unit which changes and develops constantly. Since definite article THE has rather complex and frequently altered usage, it is inevitable that there are a throng of misuse and problems for English majors when they are using definite article THE. This paper intends to do a survey focusing on English majors＇ application situation of definite article THE. Through analyzing the common misuse and mistakes appeared when English majors are using definite article THE, this paper aims to summerize the FAQ （frequently asked questions） and causes of those misuses. At the same time, the 100 experimental subjects of this survey are equally and randomly chosen from freshmen and third year students of foreign languages college, OUC （Ocean University of China）. By comparing the experimental results of two different grade English major students, this paper aims to demonstrate the influence of different grades on the mastering of definite articles THE of English majors.