Dens invaginatus (DI) is a rare developmental anomaly with an unknown etiology and different complexity. It is classified into three types according to Oehler’s classification 1957 based on the extent of invagination. This case involves an upper lateral tooth demonstrating Dens invaginatus type 2, an open apex, and a separate root sheath and diagnosis of necrotic pulp with symptomatic apical periodontitis. A cone beam computed tomography (CBCT) assessment was conducted prior to nonsurgical root canal treatment, which included apexification with bio ceramic material and internal bleaching to address both healing potential and aesthetics. The procedure was performed under an operating microscope, and a 6-month follow-up was conducted with both clinical and radiographic signs of healing.

Biological therapy increases the risk of fungal infections in chronic inflammatory rheumatism patients. Objectives: To determine the incidence of fungal infections in spondyloarthritis patients on biotherapy in the Moroccan registry (RBSMR) during 3-year follow-up and to identify associated factors. Methods: Patients' socio-demographic, clinical and para-clinical data were collected. The type of biotherapy used and episodes of fungal infections were determinated. Also, the frequency of corticosteroids and NSAIDs use, disease activity, and various comorbidities before and at the time of fungal infection during the 3 years of follow-up were defined. Regarding fungal infection, the germ and location were specified. Results: Seven spondyloarthritis patients out of 194 had a fungal infection (with 8 episodes). Mean age was 44±17 years, with mean disease duration of 11 years. All these patients had comorbidities before and during the fungal infection. At the time of this, all patients were on TNF alpha inhibitors, specifically, one patient was on Adalimumab but later switched to Etanercept, five were on Etanercept, and one was on Infliximab. No case of systemic fungal infection was noted. In the 8 fungal infection episodes, there were 7 cases of appendages’ involvement and 1 case of vaginal candidiasis. Conclusion: The incidence of fungal infections in patients with spondyloarthritis remains low and seems to be related to disease activity and type of biologics.

The present paper deals with the seasonal abundance and distribution of micro algae in the estuarine habitats of the Gosthani River near Bhimili, Andhra Pradesh, India. Water samples were collected for a period of one year from January 2023 to December 2023. A total of 44 species belongs to four major groups such as Chlorophyceae (12), Cyanophyceae (7), Euglenophyceae (5) and Bacillariophyceae (20) were reported from the estuarine regions of Gosthani River. The density of phytoplankton populations in Gosthani estuary varied seasonally with maximum number of cells per liter (5186) was observed in the month of March and minimum number of cells (789) was recorded in the month of August.

Background: Obstetric fistula remains a significant public health issue in low-resource settings, with high prevalence in countries like Bangladesh. The condition often results from prolonged, obstructed labor, compounded by socio-cultural factors such as early marriage, financial constraints, and lack of access to skilled birth attendants. This study aimed to explore the socio-demographic characteristics and surgical outcomes of women undergoing fistula repair at a private hospital in Dhaka, Bangladesh. Methods: This observational descriptive study included 62 women who underwent obstetric fistula repair between September 2010 and September 2012. Data were collected on socio-demographic characteristics, fistula details, and surgical outcomes through a structured booklet completed at various stages of patient care. Surgical success, complications, and post-operative outcomes were analyzed to identify factors influencing recovery and success rates. Result: The study found that 100% of participants were married at an early age, with significant financial barriers reported by all. A majority (87.10%) had home deliveries attended by unskilled birth attendants. Surgical repair was successful in 88.71% of cases, with a small proportion (11.29%) of unsuccessful repairs. Residual stress incontinence was noted in 4.84% of participants. The mean hospital stay was 17.52 days, with 95.16% of participants requiring continuous catheterization for 7 to 10 days. Conclusion: The high success rate of surgical repairs is promising, but the persistence of socio-cultural barriers and residual complications highlights the need for improved access to maternal healthcare and enhanced post-operative care. Addressing these issues is critical for reducing the burden of obstetric fistula and improving outcomes for affected women.

Background: Anemia is one of the common complication of Chronic Kidney Disease that intensifies in grade and severity as eGFR decline which also increases the risks for cardiovascular mortality. The development of anemia and elevated fibroblast growth factor 23 levels are the earliest changes observed in chronic kidney disease. Objective: This study aims to understand the association of FGF23 levels development of anemia in chronic kidney disease patients prior to renal replacement therapy. Methods: This is an analytical type of cross sectional study carried out among 95 respondent'1ged between 18 and 75 years with CKD stage 1-5 before dialysis, divided into two groups- Group I­ comprised of 68 patients and Group 11- included 27 age and sex matched respondents not having CKD, enrolled from two te1tiary-care hospitals, namely- Sir Salimullah Medical College & Mitford Hospital and National Institute of Kidney Diseases & Urology (NIKDU). Socio-demographic status, disease profile and laboratory findings including serum iron, iron binding capacity, ferritin, transferrin saturation, calcium, phosphorus, intact parathormone, vitamin D, eGFR and FGF-23 levels were studied. Result: Mean age of the respondents was 50.1±10.74 (SD) years, mean estimated glomerular filtration rate was 35.92± 22.61 in group I and 91.66± 14.2 in group II. The mean FGF23 level in group I and II were 85.76± 207.54, 21.99± 12.12 pg/mL respectively, serum iron level was 81.61± 39.24 mcg/dL and 95.0± 32.38 mcg/dL in group I and II respectively, serum ferritin level was 225.59± 2 I 2.5 ng/mL and 157.85± 220.89 ng/ml. TIBC was 312.65± 95.83 mcg/dL and 418.85± 118.25 mcg/dL in group I and II respectively. In Group I and II, iron deficiency was found in 23% and 25%respectively when stratified according to serum ferritin level and 26.5% and 22.22% respectively, when stratified according to serum transferrin saturation level. This difference was significant among the group. Serum iron, ferritin, TIBC and TSAT were significantly associated with serum FGF23 levels. Conclusion: Disrupted iron metabolism and high FGF23 levels is commonly found in chronic kidney disease. Clinical laboratory findings have revealed the relation between FGF23 and anemia in no dialysis chronic kidney disease patients.

The aim of this study was to examine the effect of concurrent training on cardiorespiratory endurance, flexibility and speed on male middle distance runners. The study employed experimental research design. All 26 Awuscod male middle distance runners were taken with EG and CG and divided randomly into two equal groups. Both the (EG= 13) and (CG= 13) had taken PT and POT of 12-minute run test, sit-reach test, and 30 meter acceleration test to assess cardiorespiratory endurance, flexibility and speed respectively.EG participated in additional 10 weeks concurrent interventions. While, the CG continued with their usual training The data collected from the study subject were analyzed using SPSS version 25 software by using descriptive statistics (mean and SD) and inferential statistics (paired t-test and independent t-test) with level of significant 0.05. The results showed concurrent training has significantly improved cardiorespiratory endurance and speed on EG (p<0.05). But no significant difference was observed in flexibility. Furthermore, no more significant differences were found in all of the variables in CG (p>0.05). Based on this finding, it can be concluded that concurrent training has a positive impact on the improvement of cardiorespiratory endurance and speed. Therefore, concurrent training is suggested for middle distance runners to improve physical fitness for athletic performance.

Background: Despite different strategy to retard the progression of CKD, majority still progress to ESRD. Other than conventional risk factors inflammation is considered as one of the reversible factors responsible for CKD progression which can be intervened. Therefore, we have studied the level of inflammatory marker CRP and IL-6 at stages 3-5 of CKD patients and their association with CKD stage progression determined by eGFR. Methods: We have conducted a cross sectional study among 150 CKD patients and 32 healthy controls at OPD of Nephrology department of National Institute of Kidney Diseases and Urology, Dhaka from January`2016 to December`2016. Purposive sampling method was the tool for case selection and CKD was defined as eGFR <60ml/min/1.73m2. AKI, history of dialysis, kidney transplant, patients having acute infection, malignancy or liver disease, received chemotherapy or immunotherapy (<6 months) and patients with connective tissue disease were the exclusion criteria. Fasting blood glucose, Hb%, serum Ca++, serum PO4, serum total cholesterol and serum triglyceride level were measured for both case and controls. eGFR has been calculated using MDRD equation. For the cases CRP had been measured on two occasions at an interval of one and half month. Those cases who had raised CRP level in both occasions were selected for measurement of IL-6 from second sample. CRP had been measured by turbidimetry method using fully automated chemistry analyzer. IL-6 had been measured using enzyme linked immunosorbent assay (ELISA) based on the Biotin double antibody sandwich technology. Scatter diagram and multiple regression models were used to examine the association between CRP and IL-6 with stage 3-5 of CKD denoted by eGFR. Results: The mean of CRP were 9.5±2.7 mg/L in CKD patients vs. 2.9±0.5 mg/L in controls without CKD and the mean of IL-6 were 29.5±13.0 pg/ml in CKD patients vs. 3.3±0.3 pg/ml in controls without CKD. Both were elevated and significant statistically (p=.001). Scatter diagram showing correlation coefficient (r value) -0.592 and -0.615 for eGFR vs. CRP and eGFR vs. IL-6 respectively which indicate both are negatively correlated with eGFR. But IL-6 had a more strong negative correlation. Multiple regression analysis shows regression co efficient (B) for CRP and IL-6 is -1.251 and -2.826 respectively after taking into account other factors which can alter eGFR level (age, Hb%, serum Calcium, S. Total Cholesterol, S.PO4, S. Triglyceride) that indicates in the prediction of eGFR, IL-6 had significant negative association than CRP after adjusting the conventional factors responsible for CKD progression. Conclusion: Our data suggest that though CRP and IL-6 both are significantly raised in advanced CKD stage 3-5, IL-6 is more rapidly increasing and more strongly associated than CRP with the severity of CKD measured by eGFR.

Introduction: Hysterectomy is a very frequent pregnancy-unrelated surgical procedure performed in women, which may be accomplished either by abdominal or vaginal route. This study aims to assess the advantages of vaginal hysterectomy compared to abdominal hysterectomy in women with benign gynecological disorders other than prolapse. Aim of the study: The aim of this study was to compare the outcomes of vaginal hysterectomy and abdominal hysterectomy in treating benign non-prolapsed uterus. Methods: This cross-sectional comparative study was conducted among 60 patients at the Department of Obstetrics and Gynaecology, Institute of Child and Mother Health (ICMH), Dhaka, from May 2015 to October 2015. The study included 30 patients who underwent vaginal hysterectomy and 30 patients who underwent abdominal hysterectomy. Data collection involved recording patient history, conducting clinical examinations, and documenting information in a pre-designed data collection sheet. Data were analyzed using SPSS version 22.0. Result: This study included a total of 60 patients, with 30 undergoing abdominal hysterectomy (AH) and 30 undergoing vaginal hysterectomy (VH). Baseline characteristics were similar between the two groups. There were no intraoperative complications in either group. The operation time, intraoperative blood loss, time to out-of-bed activity, mean maximum postoperative body temperature, and duration of fever were all significantly shorter and less severe in the VH group compared with the AH group. Additionally, vaginal length in the VH group was significantly shorter than in the AH group. Conclusion: Vaginal hysterectomy offers advantages over abdominal hysterectomy in treating benign gynecological diseases, providing greater efficacy and safety with less invasiveness.

This study delves into the intricate contribution of net exports and remittances on economic growth of Bangladesh with a focus of their impact on Gross Domestic Product (GDP). Net exports along with remittances are considered as key independent variables influencing the economic landscape of the country. The long-run and short-run effects of net exports and remittances on GDP are analyzed by conducting the Autoregressive Distributed Lag (ARDL) model over time period 1980-1922. The results of this study show that there is a positive effect of net export, remittance and gross capital formation on economic growth. On the other hand, all these independent variables have negative impact in short run and will adjust in long run significantly. As Bangladesh is a large remittance receiving country, export also increases in large volume by gross capital formation which increases domestic investment and output. The effects of remittances on GDP growth and exports on economic growth have each been the subject of much research, but independently. Buckling the payoff of exports and remittances on economic growth has not been studied. To fill this inane, we have tried to show how remittances and exports together boost economic growth. The findings contribute to a deeper understanding of the mechanisms through which net exports and remittance inflows shape economic outcomes in Bangladesh, offering insightful information to stakeholders and policymakers who are active in promoting sustainable economic development.

Purpose: This paper describes the contribution of church missionary society (C.M.S) to the development of teacher education in Kahuhia Normal school. Methodology: This being a historical study, it is based on the analysis of Primary sources of data local written sources, oral sources and archival material through an historical inquiry. Other archival sources referred to were school records documents, photographs, correspondences, minutes and reports of colonial annual meeting. Secondary sources were used to supplement primary data such as books and unpublished and published documents. The interviews were noted, transcribed and a thematically analyzed using qualitative method. Results: The findings demonstrated that Missionaries were major providers of teacher education in the colonial Kenya leading them to gain acceptance and this culturally and socially changed the people of Kahuhia. Consequently, Church Missionary Society employed a strict program of enculturation of African catechist through the provision of education. This led to the emergence of pioneer teacher evangelists and educated elites.it can be concluded that C.M.S played a vibrant role on the growth and development of teacher education in Kenya through the establishment of Kahuhia Normal School. The historical growth and development of the institution from 1922 to 1961 can be greatly attributed to the activities of the C.M.S as well as the Africans who played significant role such as providing land for the establishment of as schools in their area. The establishment of Kahuhia Normal school in turn was consolidated Kahuhia’s social and economic power bring transformation in Kahuhia community and Kenya at large.

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.

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.

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 ...........

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.