Myocardial infarction resulting from coronary embolism is a rare type of acute coronary syndrome, often going unnoticed. Distinguishing it from acute coronary syndromes arising from atherosclerosis is important, as it significantly influences the treatment approach. It is frequently associated with conditions that increase the risk of thromboembolism, such as infective endocarditis, atrial fibrillation, mitral valve disease, neoplasia and cardiac surgeries. We would like to present a case of coronary embolism involving a 42-year-old male with a history of rheumatic valve disease and atrial fibrillation who was admitted for acute chest pain. The diagnosis was confirmed through coronary angiography.

In the context of the energy transition, optimizing photovoltaic solar systems with charge controllers plays a crucial role in managing the energy produced by solar panels and its storage in batteries. Two dominant technologies are used in this field: MPPT (Maximum Power Point Tracking) and PWM (Pulse Width Modulation). This paper presents an in-depth comparative study of these two technologies, focusing on their efficiency, cost, and suitability for small-scale solar installations, particularly in rural African contexts where budget constraints are significant. The study begins with a detailed literature review, analyzing the operating principles of MPPT and PWM controllers, their respective advantages and disadvantages, and performance under various environmental conditions. Previous studies are examined to identify the conditions under which each type of controller offers the best performance. Empirical data and existing case studies are reviewed to establish a solid comparison base. This analysis is accompanied by tables and graphs illustrating the performance of both types of controllers. Based on the results of this analysis, the paper proposes the design of a PWM charge controller suitable for small solar installations in rural areas with budget constraints. This solution aims to promote energy accessibility while minimizing costs, offering a viable alternative for rural communities with limited resources.

Purpose: This study highlights the clinical and radiological challenges in distinguishing ovarian malignancy from pelvic tuberculosis (TB), underscoring the need for precise diagnosis and appropriate treatment. Background: Pelvic TB, a rare extrapulmonary form of tuberculosis, presents diagnostic challenges, particularly in developed countries where it is less prevalent. Its symptoms, including chronic pelvic pain, menstrual irregularities, and adnexal masses, can mimic those of ovarian cancer, leading to potential misdiagnosis. Although TB is uncommon in developed nations, it remains a significant global health issue, particularly affecting individuals from endemic regions. Pelvic TB typically spreads to reproductive organs through lymphatic dissemination, direct extension, or hematogenous routes. Case Presentation: A 46-year-old woman presented with abdominal pain, abnormal vaginal bleeding, breathlessness, weight loss, and night sweats. She had a history of lung sarcoidosis, recurrent chest infections, and prior TB exposure. Initial imaging suggested advanced ovarian malignancy, but an omental biopsy revealed granulomas consistent with sarcoidosis. Further tests confirmed disseminated TB, and the patient underwent a 9-month course of anti-tuberculous therapy, which resolved most disseminated TB lesions. However, a persistent complex pelvic cyst required conservative follow-up. Conclusion: Although pelvic TB is rare in developed countries, it should be considered in the differential diagnosis of pelvic masses with ascites and elevated CA 125, especially in patients with recurrent chest infections and TB exposure.

Introduction: Acute pancreatitis is an acute inflammatory condition of the pancreas involving varying degrees of regional tissues and distant organ systems. This study aims to investigate the clinical presentations and risk factors associated with acute pancreatitis to enhance understanding and guide more effective management strategies. Aim of the study: The aim of this study was to evaluate the clinical presentation and risk factors associated with acute pancreatitis. Methods: This retrospective study was conducted at Holy Family Red Crescent Medical College Hospital, Dhaka, from July 1, 2021, to December 31, 2023, spanning 2.6 years. The study included 42 consecutive patients diagnosed with acute pancreatitis. Data were collected by reviewing patient records for demographic details, clinical presentations, etiological factors, complications, and outcomes. Statistical analyses were conducted using SPSS version 23, with categorical variables expressed as numbers and percentages. Result: The majority of the 42 patients included in the study were within the age group of 20-39 years, 24 (57.14%) patients The most common clinical presentation was abdominal pain, reported by 40 (95.24%) patients. Biliary causes, including gallstones and common bile duct stones, were identified as the predominant etiology in 27 (64.29%) patients. Complications included necrotizing pancreatitis in 4 (9.52%) patients. Regarding outcomes, 27 (64.29%) patients recovered and were discharged. Conclusion: Effective management, emphasizing early diagnosis and treatment, is crucial for reducing the morbidity and mortality associated with acute pancreatitis.

The remarkable progress in nanotechnology in the last several decades has drawn attention to nanoparticles (NPs) and their characterization, synthesis, and applications. This phenomenon is caused by changes in the mechanical, chemical, and physical properties of the materials on this scale, including their optical properties, thermal conductivity, and melting point. Since many procedures for producing metal nanoparticles need high temperatures and harsh chemical conditions, scaling them up for large-scale manufacture can be challenging. Generally, there are two primary methods for synthesizing nanomaterials: the bottom-up method and the top-down method. A spinning disc reactor (SDR) is used in the spinning-assisted production of nanoparticles. Carbon fullerenes are spherical cages that contain anything from 28 to over 100 carbon atoms. Because of the way they interact with carbon to generate hexagons and pentagons, which result in hollow balls, they resemble soccer balls. The chemical or elemental makeup of nanoparticles directly affects their purity and functionality. The efficiency of the nanoparticle may decline if there is a rise in secondary or undesired materials present, since this might also result in secondary reactions and contamination throughout the process. Although they are commonly supplied as dispersions in different media, including glasses or liquid solvents, they may also be produced in the gas phase to create aerosols. When gold nanoparticles are exposed to a particular wavelength of light, the light's oscillating electromagnetic field causes the free electrons to collectively oscillate coherently. The nanoadsorbents are particularly effective in reducing pollutants, and very little nanoadsorbent is needed to absorb the pollutants' components.

Construction projects involve many parties and experts such as builders, contractors, designers, and consultants, which causes project arrangements to be complicated with many risks and uncertainties, including legal and financial risks. Legal risks include aspects of contracts, permits, certificates, claims, lawsuits, and sanctions. Conflicts or disputes can arise due to legal risks, which can lead to cost overruns and delays in project schedules. The project manager must be able to mitigate these risks in order to achieve the project objectives. This study uses descriptive qualitative and descriptive analytical methods to provide a detailed description of the research problem. The results showed that the risks adversely affect the legal aspects of construction, time, cost, and quality of the project. Legal risks in construction projects can arise due to several reasons, namely problems with documents and contract articles, lawsuits from third parties, and problems in acquiring project land. Good risk management is required to improve project efficiency, and project performance is improved when the organization can create a high fit between risk exposure and risk management profile.

This research examined the impact of students' characteristics and their perceptions about learning environment on mathematics and science achievement. It specifically aimed to demystify the effect of gender, economic, social and cultural status, immigrant background, teacher feedback, teacher support, exposure to bullying, and disciplinary climate on on mathematics and science achievement. Furthermore, it reanalyzed the results of the 2018 PISA-Saudi Arabia. Economic Social and Cultural Status, Gender, Teacher Support, and Immigrant Background found to have an influence on mathematics and science achievement. The study recommended that educational institutions in Saudi Arabia should pay attention to gender differences and the economic, social and cultural status, and immigrant backgrounds of students.

The increasing number of accidents and losses due to work accidents, as well as potential hazards in the production process, require effective, comprehensive, and integrated Occupational Safety Management in the management of the company. Work accidents are often caused by unsafe activities, which can be caused by lack of knowledge and skills, physical disabilities, fatigue, and unsafe attitudes and behaviors. This study uses normative legal research methods with a statutory approach and a case-based approach. Sources of legal materials used include primary, secondary, and tertiary legal materials. The results showed that corporate crimes, including criminal liability of negligent companies in managing worker safety, can result in the loss of workers ' lives. The government has very little control over the implementation of occupational safety laws, and companies are still minimal in capital to improve K3 services for employees. In addition, the lack of publications and information on Occupational Safety and health, especially in rural communities, contributes to the aggravation of this condition.

Introduction: Head trauma is a major public health problem and a major cause of morbidity and mortality, particularly in young adults. Objective: To clarify the interest of computed tomography in the management of cranioencephalic trauma in the radiology and medical imaging department of the CHU GT. Methods: This was a retro and prospective study of 5 months ranging respectively from January to March 2010 on 103 cases, from August to November 2010 on 12 cases and concerned 115 patients who came for a CT scan in a context of traumatic brain injury. Results: The average age was 26.6 years with extremes from 4 years to 65 years. The sex ratio was 4.7%. Road accidents accounted for 80.9% of cases. All patients with computed tomography abnormalities, fractures of the vault represented 74.1% of cases, the base with 17.2% and in 8.5% of cases the fracture concerned both the vault and the base. The linear fracture interested the arch in 39.6% of cases. Pericerebral lesions were dominated by meningeal hemorrhage and extradural hematoma with 63.2% and 22.8% of cases. Hemorrhagic edema accounted for 81.7% of intracerebral lesions and in 12% of cases, intracerebral lesions were associated. Based on these data 48.3% of patients were operated on in neurosurgery. The mortality rate was 7.8%. Conclusion: CT remains the examination of choice in the management of craniocerebral trauma.

The aim of this study is to find out the effect of phenylhydrazine on creatinine clearance, hence GFR and the relationship between GFR and aldosterone. Sixteen 16 male Wistar rats weighing 200 – 250 grams were randomly divided into four groups namely: Group 1 – Normal control Group 2 - Hematinic group (Fes): fed normal rat chow + tap water + ferrous sulphate (using an oral gavage at 75mg/kg bw); Group 3 - Anemic -treated group (AFes): administered Phenylhydrazine (PHZ) intraperitoneally for two consecutive days to induce anemia at a dose of 40mg/kg bw + normal rat chow + tap water + ferrous sulphate at 75mg/kg bw. Group 4 (Anu) – Anemic control group: administered Phenlyhydrazine (PHZ) intraperitoneally at a dose of 40mg/kg of bw + normal rat chow + tap water (as in group one). After 15 days, blood and urine samples were collected into sterile sample bottles for analysis. There was a significant (P<0.01, P<0.01, P<0.05) increase in aldosterone levels between Anu, control, Fes and AFes respectively. There was a significant (P<0.001) decrease in control compared with Anu. There was also a significant (P<0.01, P<0.001) decrease in Fes with AFes and Anu. Anu creatinine clearance was also significantly (P<0.001) lower than AFes. Phenylhydrazine intoxication led to a reduction in creatinine clearance and an increase in aldosterone levels, confirming a negative correlation (r= 0.9956, P<0.01) between aldosterone and creatinine clearance. Also, ferrous sulphate tends to reduce the extent to which aldosterone levels increased hence narrowing the margine and or reducing the significance of the correlation.

प्राचीन काल में हिमाचल के मंडी जिले में, समुद्र तल से 9000 फुट की ऊंचाई पर स्थित, पराशर ॠषि की तपोस्थली रही पराशर झील में एक तैरता हुआ द्वीप है। ऊंचे पहाड़ों के मध्य में स्थित इस झील पर आने वाले पर्यटक इस तैरते हुए द्वीप को देखकर हैरान रह जाते हैं, क्योंकि ये द्वीप झील में अपनी जगह लगातार बदलता रहता है। हालांकि, ज्योतिष, आयुर्वेद, वनस्पति विज्ञान, भूविज्ञान, जल-विज्ञान और कृषि सहित, ज्ञान के चौदह क्षेत्रों के विशेषज्ञ महान ॠषि पराशर के लिए इस तैरते हुए द्वीप का निर्मांण करना कोई कठिन काम नहीं रहा होगा। आज भी श्रीनगर की विशाल डल झील में बहुत से ऐसे तैरते हुए द्वीप बनाए जाते हैं और उनका उपयोग सब्जियाँ उगाने के लिए किया जाता है। सम्भव है कि प्राचीन ऋषियों ने, जो ऋषि पराशर के समकालीन रहे होंगे, कश्मीर में तैरते हुए सब्जियों के खेत बनाने की लंबे समय से चली आ रही कला का आविष्कार किया होगा। प्राचीन ऋषियों ने न केवल अपने आश्रमों और स्थलों में तैरते द्वीप जैसी रहस्यमय कलाकृतियों का निर्मांण किया, बल्कि उन्होंने इन स्थलों को रहस्यमय नाम भी दिए जो आने वाली पीढ़ियों के लिए सुराग या संकेत के रूप में काम करते रहें। पराशर झील में तैरते हुए द्वीप का नाम टहला है, जो राजस्थान के अलवर जिले की उस बस्ती का नाम भी है, जहाँ से सरिस्का टाइगर रिजर्व के कठिन पहाड़ी क्षेत्र में प्रवेश करने का मुख्य मार्ग हो कर गुजरता है। जब पांडवों को अपने निर्वासन के अंतिम वर्ष के दौरान अज्ञातवास में छिपे रहना था, तो सरिस्का जंगल के उबड़-खाबड़ इलाके ने उन्हें सुरक्षित आश्रय प्रदान किया था। इस सफल प्रयास में पराशर ॠषि ने तथा उनके पुत्र और वेदों के रचेता मुनि वेद व्यास ने पांडवों की सहायता की थी, तथा महर्श्री पराशर का धाम भी सरिस्का के प्रवेश मार्ग पर टहला के समीप ही स्थित है।

Introduction: It is undeniable that the NPC plays a crucial role in the development process of nations; “because maternal and neonatal deaths, which hinder economic growth and cause global losses in productivity, can be avoided thanks to ANC, which is all the more effective if it is early and regularly repeated. This consultation effectively contributes to avoiding “complications of pregnancy and its consequences, which are a major challenge for the health of women of childbearing age; and the leading global cause of morbidity, disability and mortality in this target, especially in developing countries. This research seeks to determine the repercussions and explanations explanations of the beginning late arrival of women to prenatal consultation. Method: This study is quantitative of the cross-sectional descriptive correlational type, carried out at the MAZIBA health and maternity center, more precisely in the Bonhomme district, in the commune of Matete, city of Kinshasa, in the Democratic Republic of Congo, during the period from January 29 2022 to April 8, 2023. It used the survey method, combined with the interview technique and a survey questionnaire as the data collection instrument. Results: The late onset of CPN remains a major public health issue in the study region. The late arrival of pregnant women at the CPN is influenced by different variables such as neglect, fatigue, distance, lack of financial means, high cost of care, poor reception, lack of space, lack of chairs or benches. The consequences linked to late arrival at the ANC are on two levels: the consequence for the pregnant woman and for the fetus. In the pregnant we obtained an average of 18.7% and 31.3% in the fetus. This study demonstrated that there is a significant statistical relationship between It also appears that there is a significant statistical relationship between personal, socio-economic, organizational, cultural factors and the consequences in the fetuses (p = 0.00. P=0.01, and p=0.00). Conclusion: Thus, healthcare professionals have the opportunity to provide ongoing education on the importance of starting prenatal care visits early to avoid adverse pregnancy outcomes, taking into account all the elements mentioned.

Breast cancer is a common disease worldwide, with over two million cases reported in 2018. Various therapy modalities use biological characteristics that influence treatment and outcomes to provide individualized care. Some biomarker advancements, such as hormone receptors, vascular endothelial growth factors, and HER2/neu receptors, have significantly contributed to the biological characterization of breast cancer. Triple-negative breast cancer is defined as malignancies that do not express hormone responsiveness or HER-2. Approximately 12% of women with breast cancer will have triple-negative illness, which is more common among non-Hispanic black women regardless of age, but is detected at a younger age than other subtypes. Women with triple-negative illness are more likely to be diagnosed at a later stage (stage III or IV). The pathogenesis of breast cancer is complex and poorly understood, however many risk factors are known. This cross-sectional study spanned from 2010 to 2022. In this study, the prevalence of triple-negative breast cancer in archived breast cancer cases at Federal Medical Centre Yenagoa, Bayelsa State, was analyzed using the Haematoxylin and Eosin Staining Technique on breast cancer samples collected over the study period. This study, done at Bayelsa State's Federal Medical Centre Yenagoa, analyzed 178 breast specimens. Ninety-six percent (96%) of the patients were IDC, and 5% were TNBC. The average age at presentation was 48.21 years, with 59.1% of patients being under 50 years. 40% of the patients exhibited HER-2/neu positive, and 65% had estrogen receptor (ER) positivity. The study was conducted in a single medical institution, and specific types of lesions were not included. Other potential limitations include comparing findings with various techniques and diagnostic protocols.

Introduction: Gallbladder disease is one of the most common conditions affecting the digestive tract. Autopsy reports have shown a prevalence of gallstones ranging from 11-36%, with cholecystitis being one of the most prevalent complications. Although cholecystoenteric fistulas are rare, with an incidence of 0.15-0.5% among patients undergoing cholecystectomy, they can present significant diagnostic and therapeutic challenges. The transverse colon is the second most common site for these fistulas after the duodenum. A high degree of suspicion is required to diagnose it preoperatively. Here, we present a noteworthy case of a 65-year-old male patient with a fistula between the gallbladder and transverse colon, complicated by severe adhesions and a large stone, underscoring the complexities associated with this condition. Case Presentation: The patient had a history of hypertension and gallbladder stones when he was admitted during the COVID-19 pandemic with acute cholecystitis. Two years later, he had an elective laparoscopic cholecystectomy and, during surgery, the surgical team noticed significant adhesions around the gallbladder. Further inspection during dissection of the gallbladder bed revealed a fistula between the transverse colon and the gallbladder, and a single large stone was identified. The patient’s surgical procedure was successful, and his postoperative recovery was uncomplicated. Conclusion: A fistula between the gallbladder and transverse colon is a rare complication of gallbladder disease, and the transverse colon is the second most common cholecystoenteric fistula after the duodenum. The presence of a fistula is usually a late sequence of chronic gallstone disease that requires appropriate diagnosis and correct treatment. In this case, the surgery was complicated by extensive adhesions around the gallbladder with an adjacent colon and a large stone with a fistula noted between the transverse colon and the gallbladder. However, through careful planning, correct surgical procedures, and skilled surgical expertise, the patient’s condition after surgery lacked complications. This case focuses on the importance of addressing all possible complications of gallbladder disease and adjusting surgical procedures accordingly.

Introduction: The pharmacy-led discharge medication delivery to bedside (Med-to-bed) service in a tertiary care Johns Hopkins Aramco Healthcare (JHAH) hospital aims to optimize medication management during patient transitions from admission to discharge, especially for those with chronic conditions. The service entails the direct delivery of discharge medications to patients at the pharmacy following their discharge from inpatient wards, accompanied by comprehensive medication counseling. The pharmacy-led Med-to-Bed service aims to reduce patient wait times and improve overall clinical outcomes. Methods: This article highlights common challenges in medication reconciliation and post-discharge prescription fulfillment, highlighting the need for standardized protocols and improved hospital adherence to ensure seamless care transitions. It also discusses future considerations for optimizing the Med-to-Bed service, including proposed pharmacy renovations, installing a dedicated robotic dispensing system, and providing private spaces for patient counseling during medication pickup. Additionally, the proposal suggests deploying more pharmacy staff to address delayed discharge orders and making systemic enhancements to the EHR system to streamline prescription pickup. Result: The successful implementation of the proposed pharmacy-led Med-to-Bed service demonstrates the efficacy of interdisciplinary collaboration among nurses, physicians, and pharmacists. Through this collaborative approach, the Med-to-Bed service has shown tangible improvements in operational efficiency and patient outcomes, underscoring its potential to transform healthcare delivery models. Conclusion: Overall, this proposed model provides valuable insights into the transformative impact of integrated care initiatives like the Med-to-bed service in tackling complex medication management and enhancing quality patient care in hospitals.