Objectives: To analyze the existing literature on the outcomes of metformin usage among prediabetic patients. Methods: A thorough search across four databases identified 914 relevant publications. After removing duplicates using Rayyan QCRI and screening for relevance, 77 full-text articles were reviewed, with 6 studies ultimately meeting the criteria for inclusion. Results: We included six studies with a total of 295 pre-diabetic patients and 197 (66.8%) were females. Across the included studies, metformin demonstrated consistent benefits in improving insulin sensitivity and lowering fasting glucose and HbA1c levels, particularly when combined with lifestyle interventions such as exercise. Several studies showed delayed or reduced progression to type 2 diabetes (T2D). Metformin was especially effective in individuals with higher baseline fasting plasma glucose or insulin resistance. Adverse effects were minimal and infrequently reported. However, metformin alone was not universally effective in preventing diabetes, emphasizing the importance of combined interventions. Conclusion: Metformin is a safe and effective adjunct therapy for delaying or preventing T2D in individuals with prediabetes, particularly when used alongside lifestyle changes. Early initiation may offer greater benefits in preserving insulin function and reducing β-cell stress. Future research should explore long-term outcomes and optimal patient selection criteria.

This study focuses on the successful production and detailed characterization of surfactant-aided bismuth vanadate (BiVO4) nanoparticles (NPs), designed specifically to enhance their use in environmental remediation. The BiVO4 NPs were synthesized using a simple co-precipitation method, followed by the addition of a surfactant before the final calcination step. The researchers proposed that this surfactant-assisted approach would allow for precise control over the particle size, morphology, and surface area, which, in turn, would significantly boost the material's catalytic action. The resulting BiVO4 NPs were thoroughly analyzed using various techniques, including X-ray diffraction (XRD), Fourier transform infra-red microscopy (FTIR), Energy dispersive X-ray microscopy (EDX), Raman spectroscopy, scanning electron microscopy (SEM), transmission electron microscopy (TEM), and UV-Vis diffuse reflectance spectroscopy (DRS). These tests confirmed the formation of crystalline BiVO4 NPs with highly desirable structural and optical properties, particularly strong visible-light absorption. The prepared BiVO4 NPs demonstrated exceptional efficiency in the photocatalytic degradation of organic contaminants (such as selected dyes or pharmaceuticals) when exposed to visible light. The rate of degradation was markedly superior to that achieved by BiVO4 synthesized without the surfactant. This enhanced performance is attributed to the resulting better charge separation and an increased number of available active sites on the nanoparticle surface. Furthermore, the surfactant-functionalized BiVO4 NPs also exhibited excellent antibacterial activity against both Gram-negative and Gram-positive bacterial strains, thereby establishing the material as a truly multi-functional agent. The combined, improved performance in both photocatalysis and antibacterial activity positions these surfactant-assisted BiVO4 NPs as a promising, cost-effective, and highly active nanomaterial for advanced applications in wastewater treatment and the preservation of public health.

The coconut or Cocos nucifera L., is a traditional plant that is treasured across the world for its many uses beyond its delicious taste and refreshing water. Coconuts harbor a rich array of phytochemicals, that include terpenoids contributing to their nutritional value and therapeutic potential. This review embarks on a journey to unveil the diverse profile and nutritional perspectives of terpenoids in coconut possessing health-promoting properties. Terpenoids, comprising a variety of compounds such as monoterpenes, sesquiterpenes, and triterpenoids, exhibit antioxidant, antimicrobial, and anti-inflammatory properties, thereby bestowing health benefits on consumption. Understanding the pharmacology of terpenoids in coconut and its nutritional implications helps for maximizing its utilization in functional foods, dietary supplements, and pharmaceutical formulations. This comprehensive review underscores the importance of phytoconstituent (terpenoids) in coconuts as a source of bioactive compounds and highlight avenues for future research that harness their full potential for human health and well-being.

Since the creation of the world, to the rising and falling of empires and kingdoms, the development and evolution of civilisations from one generation to another, from the movement of explorers to the days of colonisation, no country has ever existed as an island. Languages and cultures around the world have constantly influenced and impacted one another in different ways through the exchange of linguistic and cultural practices, and the world has increasingly remained a global village of diversities and similarities. Languages and cultures have consistently borrowed from one another and continue to do so. This article therefore, studies how the Ngwo language has borrowed and continues to borrow from other languages to enrich its linguistic repertoire. Sources, domains and modifications employed in the reception of lexical items into the Ngwo language system are discussed. The process of borrowing changes over time as discussed in new generation borrowing. The article shares opinion on the merits and demerits of the process to the Ngwo language. Relexicalisation is discussed as a negative aspect of borrowing as it can apply to other Cameroonian languages in particular and African languages in general.

During the production of cement, a significant amount of CO2 emissions is generated. To address this issue, Lime Stone Calcinated Clay (LC3) was introduced in cement as a sustainable alternative, reducing the use of cement by 40-50% by replacing LC3 in the cement. This study investigates the effectiveness of LC3 in the hydration process, microstructural analysis, and sustainability. At the time of hydration, calcium hydroxide was generated, which, when mixed with metakaolin, produced a significant amount of CSH gel, thereby enhancing the mechanical strength and microstructural properties. Sturdy carboaluminates are created when limestone and aluminates interact, increasing chloride and sulfate resistance. Geometrical stability is ensured by controlled ettringite development and calcium Aluminate Ferrite trisubstituted (Aft)- Alumina-Ferric oxide-mono (AFm) transitions, although reinforcement is sustained by carbonation resistance. LC³ attains mechanical and durability properties when compared with conventional cement by decreasing emissions by reducing approximately 50% clinker factor and calcination temperatures from 700-900 °C.

The research highlights the crucial need for a robust framework to assess return efficiency and risk exposure, focusing on an analysis of mutual fund performance. It explores the interrelation among key risk-adjusted performance metrics such as the Sharpe ratio, Treynor ratio, and Jensen's alpha, along with beta and standard deviation, which signify systematic and total risk. 38 Indian value mutual funds were analysed using MoneyControl (Shano, Ganesh, & Mwaura, 2017) secondary data. Regression, correlation, and descriptive statistics were employed. Results indicate risk-adjusted efficiency was moderate to strong, always higher than the average Sharpe, Treynor, and Jensen alpha values. Research demonstrates a strong positive correlation between the Sharpe, Treynor, and Jensen ratios (Lee, Keegan, Piggott, & Swann). Conversely, negative correlations with beta and standard deviation indicate that efficiency diminishes as total and systematic risk increase. Regression analyses indicate that risk variables significantly influence the Sharpe and Treynor indices. Conversely, Jensen's alpha seems to be autonomous, suggesting that it encapsulates the diverse impacts of managerial competence. The results validate the correlation among common risk-performance indicators, refute the null hypothesis of independence, and demonstrate the variability in the influence of market and management factors on these metrics. The report says that SEBI and AMFI should use a framework that has more than one metric to make things clearer. Fund managers should keep getting better at what they do by using methods that are flexible and take risks into account.

Cervical cancer, the second most common malignancy among Indian women, primarily arises from the transformation zone of the cervix. High-risk HPV types, especially 16 and 18, are implicated in approximately 70% of cases. The median age of diagnosis is around 50 years. Metastasis to the gastrointestinal tract is rare, occurring in less than 4% of cases, with small bowel involvement being extremely uncommon.

This study examines the effect of credit risk management (CRM) on the financial performance of Saudi Arabian banks and investigates whether this relationship differs between Islamic and conventional banking models. Using panel data from 40 banks covering 2020–2024, the study incorporates key credit-risk indicators including NPLA/PLAL, PLAL/TLA, NPLA/TLA, TLA/TAS, and LDR and applies multiple regression and group-comparison tests. The results reveal that CRM significantly influences profitability, with higher non-performing loan ratios reducing ROE, while stronger lending intensity (LDR) and higher loan concentration (TLA/TAS) enhance performance. Comparative tests indicate substantial differences in credit-risk profiles across bank types but no significant difference in financial performance levels. However, interaction-term analysis demonstrates that the impact of credit-risk indicators on ROE varies meaningfully between Islamic and commercial banks. Overall, the findings underscore CRM’s essential role in sustaining profitability and highlight the moderating effect of banking model structures within Saudi Arabia’s Basel-aligned regulatory environment.

Introduction: Larrey’s cleft hernia is defined by the permanent or intermittent passage of part of the abdominal contents through the costo-xyphoid hiatus of the diaphragm. Its occurrence in trisomy 21 is classic, but its association with diaphragmatic eventration is rare. We report the case of a 03-year-old patient with Down syndrome who presented an anterior diaphragmatic hernia associated with diaphragmatic eventration. Observation: A.H, aged 03 with Down syndrome, was admitted to the Thoracic Surgery Department of Fann Hospital for the management of a hernia of the Larrey’s cleft. On admission, she presented a sub occlusive syndrome, without vomiting or rectal bleeding, the abdomen was supple, depressible, with no palpable mass. Thoracic-abdominal-pelvic computed tomography showed a midline anterior diaphragmatic hernia (Larrey). The barium enema showed an uninhabited right iliac fossa with intra thoracic digestive gas in front of the heart, an attachment anomaly affecting the cecum, with sigmoid dollish-colon. Larrey's hernia was repaired by supra umbilical midline laparotomy. After 3 weeks, the child again presented an occlusive syndrome, and the CT scan was strongly suggestive of a recurrence of the hernia. Revision by right thoracotomy supplemented by a mini subcostal approach made it possible to rectify the diagnosis, highlighting diaphragmatic eventration, which was treated by plication. The suites were simple. Conclusion: The association of diaphragmatic eventration and hernia of Morgagni is possible and surgical treatment gives good results.

Background: Pediatric focal epilepsy is a common neurological disorder that requires early and effective treatment to prevent long-term cognitive and psychosocial consequences. Levetiracetam (LEV) is widely used as a first-line antiseizure medication, while brivaracetam (BRV), a newer SV2A ligand with higher binding affinity, has limited comparative data in children. Aim: Our aim is to compare the effectiveness and tolerability of BRV and LEV in children with newly diagnosed focal epilepsy. Materials and Methods: This retrospective comparative study was conducted at Mount Adora Hospital, Sylhet, Bangladesh, between July 2024 and June 2025. A total of 62 children aged 1–18 years with new-onset focal epilepsy were included, with 31 receiving LEV and 31 receiving BRV. Seizure frequency and treatment response were assessed at 2 weeks, 1 month, and 3 months. Common adverse effects of both drugs were also documented. Results: After 3 months, the mean seizure frequency was significantly lower in the BRV group (0.42) compared to the LEV group (1.58; p<0.001). Complete response was achieved in 87% of BRV patients versus 61% of LEV patients (p=0.042). Both drugs were generally well tolerated. Somnolence was reported in 12.9% of LEV and 9.7% of BRV patients. Behavioral adverse effects were more frequent with BRV (hyperactivity 19.4%, irritability 12.9%) compared to LEV (hyperactivity 3.2%, no irritability). Conclusion: Brivaracetam demonstrated superior seizure control efficacy as compared to levetiracetam in children with new-onset focal epilepsy, although behavioral adverse effects were more common.

This study aimed to characterize the association of diabetes with pregnancy in the Souss Massa Agadir population, focusing on epidemiological and clinical profiles, therapeutic aspects, and prognosis, while also identifying factors linked to glycemic control and maternal-fetal complications. We conducted a descriptive and analytical single-center cross-sectional study on 67 diabetic parturients at Hassan II University Hospital. Our findings reveal that half of the patients were aged 30-39, with 90% having low socioeconomic status, 55% from rural areas, and 34% illiterate. Common antecedents included family history of Type 2 diabetes (68.7%), spontaneous miscarriages (31.3%), and macrosomia (23.9%). Gestational diabetes was prevalent (60%), often incidentally diagnosed by fasting blood glucose (87.5%). While 52% of gestational diabetes cases managed with diet and lifestyle modifications alone, only 63% achieved balanced FBG and 49% balanced PPG. PPG (P=0.018) and BMI (P=0.020) were associated with FBG balance, while FBG (P=0.036), pre-gestational diabetes (P=0.029), and adherence to DLM (P=0.040) influenced PPG balance. Maternal-fetal complications occurred in 60% of cases, primarily urogenital infections, hydramnios, anemia, and macrosomia, with rural origin being a significant risk factor (OR: 3.56, P=0.01). These results underscore the critical need for multidisciplinary preconception care, early gestational diabetes diagnosis, and long-term metabolic follow-up to ensure better pregnancy outcomes and reduce future diabetes risk.

Antimicrobial resistance (AMR) poses an immense worldwide health threat, predicted to result in as many as 10 million mortalities by 2050. With the stagnation of antibiotic discovery as well as the rapid growth of multidrug-resistant pathogens, novel therapeutic strategies are urgently required. Microbes engineered or naturally therapeutic—offer innovative approaches for targeted pathogen elimination. These include bacteriophage therapy, engineered probiotics, synthetic biology-based organisms, and microbial consortia. This review synthesizes recent advances, evaluates their clinical potential, and highlights the limitations, regulatory obstacles, and future potential for these novel therapies. Collectively, microbial-based interventions represent a promising, yet underutilized, frontier within the fight over AMR.

This research aimed to evaluate a range of targeted nutritional strategies focused on both growth performance and carcass characteristics, as well as economic efficiency in broiler chickens under standard conditions based on four diets, including a usual control diet, an energy-dense diet, an amino acid (AA) optimized diet, and an AA-optimized-cost ration supplemented with multi-enzyme preparations. Four hundred eighty-one-day-old broiler chicks (Ross 308) were randomly allocated to four treatments and raised for 42 days. The results showed that the final body weight, weight gain, and feed conversion ratios were significantly greater in the groups fed the energy-dense and amino acid–nutrient density diets compared to the control group. This suggests better growth efficiency. Carcass analysis showed that chickens fed diets with higher energy and optimized amino acid levels had a higher dressing percentage and more breast meat. This suggests that nutrients were better directed into building lean tissue. Although the enzyme-based, cost-optimized diet did not match the biological performance of the nutrient-rich diet, it performed similarly to the control group. As a result, feed costs were reduced, contributing to economic benefits. Economic research indicated that feeding the high-energy diet gave the lowest feed cost per kg body weight gain and highest gross margin/bird. Adhering closely was the diet with optimized amino acid composition. Taken together, these results emphasize that precise nutrition, the correct level of calories, amino acid profile and the strategic inclusion of enzymes is necessary in broiler production industry to improve growth performance and carcass yield. This research gives valuable insight for developing feed formulation systems that maximize biological and economic efficiency in modern poultry production.

Rhinoplasty (RPT) is one of the most commonly performed cosmetic and functional procedures in facial plastic surgery worldwide. More than 200,000 cases are performed each year in the United States. This reconstruction technique is rarely performed in West Africa. After reviewing the literature, no cases have been reported to date. It is in this context that we undertook this work, which aims to describe the technical aspects and results of a functional rhinoplasty case treated in the maxillofacial and plastic surgery department of the military hospital in Dakar, with a review of the literature. We report on closed rhinoplasty for post-traumatic nasal deviation with functional impairment in a 31-year-old police officer who was referred to the department for a specialist consultation reconstructive plastic surgery. The surgical approach consisted of nasal reconstruction combined with septoplasty using the endonasal approach technique under general anesthesia. Four months after surgery, the patient was very satisfied with the morphological and functional results. African noses are generally described as having thick skin and abundant subcutaneous fibro-adipose tissue. The success of the procedure is based on functional and/or aesthetic results and is reflected in patient satisfaction. This African rhinoplasty requires a fundamental understanding of acceptable beauty standards, the associated psychological underpinnings, and the facial and nasal characteristics specific to Africans. Considered one of the most complex procedures, this reconstruction technique deserves to be mastered and practised in Senegal and even in West Africa in order to reduce medical evacuations and medical tourism.

This study aimed to evaluate the diagnostic tests and management approaches for dry eye disease (DED) among eye care practitioners in Saudi Arabia. A cross-sectional, questionnaire-based survey was sent to 200 practitioners, with 88 responses, resulting in a 44% response rate. Of the respondents, 68.2% were optometrists and 31.8% were ophthalmologists. The fluorescein tear break-up time (TBUT) and Schirmer test were the most commonly used diagnostic methods due to their simplicity and accessibility, while assessing the meibomian glands was less frequent. The main causes of DED identified were environmental factors and meibomian gland dysfunction. The most commonly reported symptoms included dry eyes, tearing, and itching. The preferred management options were aqueous-based artificial tears (46.3%) and lipid-based artificial tears (40.1%), with minimal use of advanced therapies. These findings underscore the reliance on conventional diagnostic and treatment methods and highlight the need for standardized protocols and broader adoption of modern diagnostic technologies to improve DED care in Saudi Arabia.