Intracranial aneurysms, abnormal dilations of blood vessels in the brain, pose significant health risks, especially when ruptured, leading to conditions such as subarachnoid hemorrhage and stroke. The primary objective of this study is to evaluate the diagnostic accuracy of different computed tomography angiography (CTA) protocols for detecting intracranial aneurysms and to identify methods for optimizing scanning parameters to reduce radiation exposure while ensuring high image quality. Results from the analysis of various CTA protocols revealed that lowering tube voltages (80-120 kV) and milliampere seconds (mAs) effectively reduced radiation exposure without compromising the quality of images. Additionally, the use of advanced reconstruction algorithms, including deep learning techniques, significantly improved the visualization of small vascular structures, thereby enhancing diagnostic accuracy. These findings provide valuable insights for enhancing clinical practices in the fields of neurology and radiology.

Renal carcinoma associated with Xp11.2 translocations and TFE3 fusions (Xp 11.2 RCC) form a new and little known entity of the WHO classification. It accounts for at least one-third of pediatric RCCs and 15% of RCCs in patients <45 years of age. Renal carcinoma associated with Xp11.2 translocations and TFE3 fusions (Xp 11.2 RCC) is a rare pediatric renal carcinoma diagnosed by fluorescence in situ hybridization (FISH). We report a case of Xp 11.2 RCC in a 13 year old girl, presented with hematuria. Mass was detected on CECT. She underwent nephrectomy and histopathological examination confirmed renal cell carcinoma. Type was confirmed by FISH. Renal cell carcinoma in pediatric age with characteristic morphology need to be subcategorized using ancillary methods. The most sensitive and specific immunohistochemical markers for these neoplasms are TFE3 protein and cathepsin-K3. Complete surgical removal of the tumour mass including the kidney is the preferred therapy in patients with lower stage ...........

Artificial Intelligence (AI) expeditiously transmutes from a specialized area of study to a key component of contemporary technology, propelling breakthroughs in a wide range of industries. AI Unleashed, Pioneering Trends and Future Directions in Artificial Intelligence is a study examining the current developments influencing the field's progress and future course. This study explores essential fields, including autonomous systems, machine learning, and natural language processing, showcasing new developments and present uses. It also considers AI's ethical and societal ramifications, including issues with prejudice, privacy, and the necessity of robust governance systems. Exploring the confluence of artificial intelligence (AI) with other cutting-edge technologies, such as quantum computing and the Internet of Things (IoT), highlights the potential for unparalleled capabilities. With a perspective beyond the future, this overview highlights the significant obstacles and possibilities that will shape artificial intelligence (AI), from improving human-machine interaction to expanding general intelligence. This assessment offers insights into the cutting-edge trends propelling AI forward and the future paths that will mold the next wave of AI innovation through an extensive examination.

Background: Malaria is a major public health problem in Sudan. Severe malaria, due in majority of cases to P. falciparum, poses a real burden on hospitals. This study aims to describe the prescribing pattern of intravenous artesunate (IV-AS) for severe malaria and compliance with national malaria treatment protocol in Gezira State, Sudan. Methods: The study enrolled severe malaria patients who were admitted to the Wad Madani Teaching Hospital during June – August 2022. Patients were verbally consented and followed at hospital level till discharge. Data was recorded on data collection sheet and analyzed using SPSS version 20. Results: Over three months period, 500 patients were diagnosed as having severe malaria based on clinical criteria and the results of thick blood film. The majority were from rural areas and most of them were male. IV-AS was administered for all patients and 71% of patients discharged after administering three doses of artesunate with no serious adverse effects. In 96.4% of patients, the prescription followed the right dosage schedule. The source of the drug was health insurance fund and private sector in 78.4% and 21.6% respectively. The study investigates the prescribing patterns of intravenous artesunate (IV-AS) for severe malaria and compliance with the national malaria treatment protocol in Gezira State, Sudan. A Chi-Square Test of Independence was used to explore associations between gender and the number of IV-AS doses received, as well as between residence (rural vs. urban) and compliance with the dosage schedule. The results showed no significant association between gender and the number of IV-AS doses received (p = 0.915), and no significant association between residence and compliance with the dosage schedule (p = 0.925). These findings suggest that the prescribing patterns and compliance with the treatment protocol are consistent across different genders and between rural and urban patients. Conclusion: Severe malaria patients were treated with IV-AS according to national malaria treatment guidelines with few exceptions. Most patients discharged after administering three doses of artesunate with no serious adverse side effects. Efforts to establish quality assured microscopy and to maintain the current prescription pattern is highly needed.

Background: Hepatic damage is a major cause of poor quality of living and mortality worldwide. This study investigates the hepatoprotective effects of cocoa seed extract against reserpine-induced hepatotoxicity in male Wistar rats. Methods: Thirty adult male Wistar rats were divided into six groups for a 28-day study: Group A (control), Group B (0.5 mg/kg/B.W reserpine), Group C (20 mg/kg/B.W fluoxetine), Group D (1000 mg/kg/B.W cocoa seed ethanolic extract), Group E (0.5 mg/kg/B.W reserpine + 1000 mg/kg/B.W cocoa seed ethanolic extract), and Group F (0.5 mg/kg/B.W reserpine + 20 mg/kg/B.W fluoxetine). The liver was harvested, placed in 10% neutral buffered formalin, and processed for biochemical, histological analysis. Also, liver tissues for cytokeratin-7 expression was processed according to standard immunohistochemical staining procedures. Data were analyzed using GraphPad Prism 9.0 software and one-way ANOVA. Results: There was a significant decrease in ALT, AST, and ALP levels in animals treated with cocoa extract compared to untreated animals. Meanwhile, cytokeratin expression was higher in the liver of untreated animals relative to the treated groups. Conclusion: Theobroma cacao seed extract shows potential in mitigating reserpine-induced hepatotoxicity, contributing to novel therapeutic strategies for liver disorders and providing insights into the mechanisms of cocoa seed bioactive compounds.

Background: All corneal diseases cause ocular morbidity and decrease vision, or even blindness, so early management intervention is critical. This study sought to evaluate several corneal disorders, including corneal foreign bodies, corneal tears, and ruptured globes. Methodology: This retrospective descriptive study was undertaken in El-Obeid Teaching Hospital's Ophthalmology Emergency Department in North Kordofan State, Sudan, as well as Dr. Khalil's Ophthalmology Center. This study sample, which represents the entire corneal illness, was obtained from 1000 patient files for various eye conditions. Results: This study examines 205 patients with corneal disorders to assess the prevalence of corneal diseases in North Kordofan State. The study found that the disease is more common in males, with 48 out of 78 patients (62%) being male and 38% being female. The male-to-female ratio is 1.6:1. The age group that is most affected is the group of individuals younger than 9 years, accounting for 34% of the affected population. This is followed by the age groups of 10–20 years, 21–32 years, 33–53 years, and >54 years, which account for 24%, 18%, 14%, and 9%, respectively. Regarding the classification of corneal disorders, the most prevalent form is foreign body corneal disease, accounting for 38% of cases. This is followed by corneal tear (16%), corneal opacity (15%), corneal tear with iris prolapses (10%), bacterial corneal ulcer (7%), and rupture globe (6%). The incidence rates of viral corneal ulcers, chemical trauma, burn trauma, and keratoconus are 3%, 3%, 1%, and 1%, respectively. Conclusion: Eye trauma is prevalent in north Kordofan, leading to an upsurge in corneal illnesses including foreign body cornea, corneal tear, and ruptured globe.

Measurement system analysis is crucial in the continuous improvement of manufacturing processes. Gauge Repeatability and Reproducibility (GR&R) is a process of examining the conformity or non-conformity of the major components of a measurement system; tools, equipment, and operators. This reveals the component contributing the most error or variation in the measurement system. This paper reviews GR&R in dimensional measurements with particular emphasis on accuracy, precision and reliability. There is an introduction to metrology and some metrology terminologies to lay the foundation for the appreciation of gauge repeatability and reproducibility. A critical review of some literature on GR&R studies is done and is expanded to cover general dimensional measurement and investigation of two main areas of measurement error in gauges. The effectiveness of a gauge as a measuring tool is crucial in determining the gauge capability thus, this GR&R review.

Introduction The Indian society is a traditional society following many customs during pregnancy and post-partum. The study is around understanding the cultural beliefs of educated Indian women around childbirth, prevalent in the society. Since Indians are living in different countries, the understanding of such customs can make it easier for obstetrician or mid wife to treat such couples and also give relevant information around the belief. 196 women were given an online survey in English to fill post-partum to document the common beliefs. The questions asked tried to understand background of the patient (age, education, occupation, no of children) and also included questions about common customs and traditions practiced during pregnancy and post-partum. The common Indian traditions were highlighted which are followed post partum and during pregnancy. The study concluded some harmful practices still in use can be discouraged and pregnancy is a good opportunity to counsel the couple about scientific evidence based practice and not just myths. Good practices can be carried on. • What is already known on this topic – Indians have a strong, cultural and traditional practices around child birth. Understanding these practices helps the midwife/Obstetrician in promoting good and healthy practices • What this study adds – The practices in pregnancy and post-partum in educated urban population of India. Many Indians are residing in The UK, The USA and other countries. It helps understand traditional beliefs during pregnancy and post-partum for smoother nine months. • How this study might affect research, practice or policy Around 386 thousand Indians reside in The UAE making it around 38% of population. Hence its important to be aware of cultural practices of the population.

Objectives: To provide an updated synthesis of the evidence on the management of pulmonary hypertension (PH) in pediatric patients. Methods: We performed a thorough search of electronic databases such as PubMed, Science Direct, Cochrane Library, and Scopus. Two independent reviewers evaluated and retrieved information from qualifying papers. Results: Our data consists of eight studies with 2003 children, 930 (46.3%) of whom were female. Prostacyclin agonists were found to significantly improve hemodynamic parameters and reduced BNP levels, which implies that they have promising clinical efficacy and a good tolerance profile. No major side effects were noted except for headaches and gastrointestinal symptoms. Systemic glucocorticoids, inhaled NO, endothelin receptor antagonists, and PDE showed tolerability and clinical improvements in pediatric PH. Side effects such as acute kidney damage, renal failure, and methemoglobinemia were noted with the inhaled NO. Conclusion: Pediatric PH is still a difficult condition with high morbidity and mortality. All of the reported pharmacological interventions demonstrated good clinical outcomes and almost no adverse effects. Healthcare practitioners can improve the care of children with PH and eventually improve their quality of life and long-term survival by incorporating new research into clinical practice.

Background: The primary acute outcome of sickle cell disease (SCD) is a vaso-occlusive crisis (VOC) with extreme pain. More than three vaso-occlusive crisis (VOC) hospitalizations in a year increase the risk of early death. The objective of the study was to evaluate the hematological alterations in complete blood count (hemoglobin, red blood cell indices, white blood cell count, and platelets) and C-reactive protein levels during vaso-occlusive crises in patients with sickle cell anemia (HbSS) compared to a stable symptomatic state. Methodology: This study is a prospective descriptive study conducted in a hospital setting. During the period from February to June 2015, a Sudan Sickle Cell Anemia Center (SSCAC) in North Kordofan State, Sudan, treated a total of 100 patients with sickle cell anemia. Out of these patients, 74 had a vaso-occlusive crisis and 26 had a steady-state condition. All patients had measurements of their complete blood count (CBC) and C-reactive protein (CRP) levels. We calculated the average values of CBC and CRP level counts during vaso-occlusive crises and compared them to the values during steady state using independent t-tests. We analyzed the collected data using the Statistical Tool for Social Sciences (SPSS) software tool, specifically version 13. Results: The statistical analysis of the patient sample during vaso-occlusive crisis and steady state revealed that the concentration of hemoglobin (Hb) was 6.55 g/dl ± 1.3 and 9.8 g/dl ± 2.4, respectively, with a p-value of 0.000. The packed cell volume (PCV) was 20.4% ± 3.9 and 30.7% ± 7.1, respectively, with a p-value of 0.000. The red blood cell (RBC) count was 2.5×106/µl ± 0.57 and 3.9×106/µl ± 1.1, respectively, with a p-value of 0.000. A lot more white blood cells (WBC) were present in vasoocclusive than in steady state, with numbers 19.36 x 109/l ± 10.645 and 76.76 x 109/l ± 20.19, respectively, and a P-value of ≤0.000. There was a notable statistical disparity in the platelet count, with values of (357.108109/l ± 162.838) and (290.4610×9/l ± 124.40), with a P value of 0.05. In vaso-occlusive crises, the amounts of hemoglobin, packed cell volume (PCV), and red blood cells (RBCs) are lower than they are in the steady-state phase. Conversely, white blood cell (WBC) and platelet levels are much greater in patients experiencing vaso-occlusive crises compared to those in a steady state. The levels of C-reactive protein (CRP) were significantly different between patients experiencing vaso-occlusive crises and those in a stable condition.

The paper presents a comprehensive collection of the latest scholarly works on Environmental, Social, and Governance (ESG) perspectives in accounting. It aims to serve as a critical reference for students, academics, policymakers, analysts, and professionals engaged in this evolving field. By integrating interdisciplinary and multi-disciplinary perspectives and considering relevant societal and political dimensions, this publication aspires to become a staple resource in major university libraries and among policymakers and financial professionals worldwide.

Introduction: Cesarean section is the most commonly performed operation in obstetric practice to circumvent maternal complications. Re-laparotomy after cesarean section (C/S) is considered a near-miss fatality situation. Emergency laparotomy has inherent complications culminating in significant morbidity and mortality. This study aimed to evaluate indications and outcomes of re-laparotomy after cesarean section. Methods: This longitudinal study was carried out at the Department of Obstetrics & Gynaecology, in Rangpur Medical College Hospital from July 2019 to June 2020. A total of 30 patients were selected as study subjects by purposive sampling method. All data were collected using a pre-formed questionnaire. The collected data were compiled and findings were presented in the form of tables and graphs. Appropriate statistical analysis of the data was done using a statistical package for social science (SPSS, version 23.0). Result: The most common indication of re-laparotomy in this study was primary postpartum hemorrhage 14 (46.7%) followed by secondary PPH 7 (23.3%), rectus sheath hematoma 6 (20.0%), and septicemia or pelvic abscess 3 (10.0%). Regarding procedures performed at re-laparotomy, a maximum of patients 23 (76.7%) had total abdominal hysterectomy followed by drainage of sub-rectal hematoma 6 (20.0%) and drainage of pus 1 (3.3%). Concerning outcome, there were 2 (6.7%) maternal deaths following re-laparotomy caused by shock following cardiac arrest, and PPH. Conclusion: The re-laparotomy rate following C/S was 0.96% due to uncontrolled primary PPH, rectus sheath hematoma, and secondary PPH. In this study, re-laparotomy after C/S was associated with a case fatality rate of 6.7%.

Background: Androgenetic alopecia (AGA) is a common form of hair loss affecting both men and women, characterized by progressive thinning of hair, particularly in the scalp's vertex and frontal areas. Treatments such as minoxidil and platelet-rich plasma (PRP) have been developed to manage AGA, each with distinct mechanisms and efficacy profiles. Objective: This study aimed to compare the efficacy of Minoxidil, Dermaroller, and PRP in treating AGA, evaluating their impact on hair growth and patient satisfaction. Methodology: This prospective comparative parallel-group interventional study was conducted on the outpatient department of Dermatology, tertiary hospital, between December 2022 and May 2023. Where male participants aged 18-45 years with grade II, III, or IV AGA were enrolled. Ninety patients were randomly assigned to three groups: Group A received 5% minoxidil twice daily; Group B received the same minoxidil regimen with monthly dermaroller treatment; Group C received 5% minoxidil along with monthly PRP injections. Participants were assessed at baseline, 3 months, and 5 months using photographic documentation and dermoscopy to measure hair growth improvements. Results: The mean age of participants was 29.90 ± 5.50 years, with a balanced gender distribution (1:1 male to female ratio) and a significant family history of AGA (70%). PRP with minoxidil demonstrated superior efficacy compared to minoxidil alone or minoxidil with dermaroller, showing significant improvements in hair counts at both 3 months (p=0.01) and 5 months (p<0.001). Dermaroller with minoxidil also showed improvements, though not statistically significant compared to minoxidil alone. Secondary efficacy analysis revealed significant shifts towards hair growth enhancement in the PRP + minoxidil group. Conclusion: PRP combined with minoxidil represents a promising and effective treatment option for AGA, offering superior outcomes compared to minoxidil alone or minoxidil with dermaroller. This combination therapy enhances hair growth through its regenerative effects on hair follicles, making it a valuable option for patients seeking non-surgical interventions with high satisfaction rates.

Introduction: Uterine rupture is a solution of complete or incomplete non-surgical continuity of the wall of the gravid uterus. It is a dreaded obstetric disease with a poor maternal-fetal prognosis in terms of morbidity and mortality. Objective: To study the epidemio-clinical, therapeutic and prognostic aspects of uterine rupture at the Fousseyni Daou Hospital in Kayes. Materials and Methods: This was a cross-sectional, descriptive and analytical study with retrospective collection, from 1 January2012 to 31 December 20121. We included in our study all cases of uterine rupture diagnosed and treated at the Fousseyni Daou Hospital in Kayes during the study period. Results: The frequency of uterine rupture was 0.3%. The mean age of parturients was 29 years with extremes of 15 and 45 years. Parturients were evacuated in 78.74% of cases. Prolonged work was the leading reason for evacuation with a frequency of 14.2%. Uterine scarring was the top risk factor with 27.6%. Complete ruptures accounted for 81% and the breech was segmental in 69.8% of cases. Hysterorrhaphy was performed in 75.6% of parturients. The outcome was favourable in 59.52% of cases and anaemia was the most frequent postoperative complication with 34.1%. The maternal death rate was 7.9% and the fetal death rate was 74.6%. Conclusion: Uterine rupture is an obstetric-surgical emergency whoseprognosis depends on the speed of diagnosis andmanagement.

Background: In developing countries like Bangladesh, posterior urethral valves (PUV) are typically diagnosed postnatally, whereas in developed countries, they are often identified prenatally. Early diagnosis, complete fulguration, and regular follow-up are crucial to prevent renal impairment in PUV patients. Objective: This study aimed to evaluate the outcomes of endoscopic fulguration in PUV patients in a Bangladeshi medical setting. Method: Conducted at the Department of Urology, Dhaka Medical College & Hospital, this observational study spanned from July 2018 to June 2019. Thirty-five patients meeting inclusion and exclusion criteria were initially included, with five dropping out during follow-up. Endoscopic valve ablation was performed on all patients, followed by catheterization for 14 days. Post-procedure, patients were discharged within 48-72 hours with oral antibiotics and behavioral therapy advice. Follow-up visits over six months included assessments of height, weight, urine analysis, serum creatinine, kidney ultrasonography, and eGFR. Voiding cystourethrograms were performed at one- and six-months post-fulguration. Result: Most patients presented at ages 11-20 months (36.7%) and 21-30 months (26.67%). Poor urine stream and dribbling were the most common symptoms, seen in 83.33% and 76.67% of patients, respectively. Repeated fever was noted in 63.33% of patients, while 43.33% exhibited failure to thrive. VUR was present in 46.7% of patients; 42.86% had unilateral VUR and 57.14% had bilateral VUR. Following six months of fulguration, complete resolution of reflux occurred in 40% of right-side and 50% of left-side renal units. Decreased reflux grade was noted in 20% of right-side and 16.67% of left-side units, while persistence was seen in 40% and 33.33% respectively. Significant improvements in eGFR and serum creatinine levels were observed (p<0.001). Hydroureteronephrosis decreased from 22 to 8 cases, though this was not statistically significant (p=0.06). Conclusion: Endoscopic fulguration significantly improves renal function in PUV patients. About half of VUR cases resolved completely within six months post-procedure.