Background: Post-partum hemorrhage (PPH) is a common complication, seen following 2-4% vaginal deliveries and 6% of caesarean sections. 35% of maternal mortality worldwide (1) and 38% of maternal mortality in India can be attributed to PPH. Material and Methods: Women who had B/L IIAL over a period of 1year 2021 at Dr. VVP Pravara Rural Hospital, Loni were reviewed retrospectively. Patients were identified using hospital records and operation theatre registers. Clinical history, routine blood investigations, patient demographic data including age, parity, mode of delivery and surgical outcome with complications of procedure were noted. Results: A total of 30 PPH deliveries were conducted during the year 2021. most common indication for B/L IIAL was PPH, seen in 26 out of 30 cases (86.6%) followed by 3 cases of placenta accreta spectrum (1%) and 1 (0.3%) with gynecological complication. Of the 30 cases requiring B/L internal iliac ligation, 9 (30%) were primigravida, 3 (10%) second gravida and 18 (60%) multiparas with 2 or more prior deliveries. Of the 5 cases further requiring obstetric hysterectomy, 2 were second gravidas and 2 multiparas. Conclusion: The ligation of the internal iliac artery as a procedure to stop pelvic hemorrhage is not practiced as commonly as it should be. However, it is safe and effective method to control massive pelvic hemorrhage in experienced hands.

Background: Hypertensive disorders of pregnancy are a significant contributor to maternal mortality, with early identification of risk factors being crucial for proactive management. This study explores the potential of mid-trimester maternal serum β HCG levels as a predictive marker for hypertensive disorders during pregnancy. Objective: The primary objective of this prospective study was to evaluate the clinical utility of second-trimester serum β HCG levels in predicting the development of hypertensive disorders during pregnancy. Methods: The study, conducted from June 2020 to July 2021, recruited pregnant women aged 13-20 weeks who were normotensive and non-proteinuric. Data from 100 respondents were collected, with 50 in each group (Group A with β HCG > 35000 m IU/ml and Group B with β HCG < 35000 m IU/ml). Statistical analysis was performed using SPSS 24.0, and the significance level was set at p < 0.05. Results: Group A had a significantly higher proportion of hypertensive disorders compared to Group B (38% vs. 10%, p < 0.001), with Group A being more than five times as likely to develop hypertensive disorders (cOR = 5.5, 95% CI: 1.862, 16.344). Serum β HCG levels in respondents with hypertensive disorders (Mean = 60626.88 m IU/ml) were significantly higher than those who were normotensive (Mean = 32812.18 m IU/ml, p < 0.001). Sensitivity was 79.17%, specificity was 59.21%, and positive and negative predictive values were 38% and 90%, respectively. Conclusions: Mid-trimester serum β HCG levels are an efficient non-invasive predictor of hypertensive disorders during pregnancy. With its high sensitivity and negative predictive value, this cost-effective test can aid in the early identification and proactive management of at-risk pregnancies.

Satisfactory restoration in a patient with a partially edentulous situation can be challenging especially when bilateral posterior segment of teeth is missing. Combined prosthesis still have a good place as a treatment option for partially edentulous Kennedy's class I conditions especially when implants are contraindicated for one reason or another. With proper case selection and treatment plan, precision attachments system can be used to improve retention and esthetics. The purpose of this article was to describe a case of a patient with extended Kennedy's class I condition, which was prosthetically restored by a combined prosthesis using a extracoronal precision attachment.

With the rising trend in obesity, the incidence of gestational diabetes mellitus (GDM) and perinatal complications associated with the condition are also on the rise. Since the early 1900s, much knowledge has been gained about the diagnosis, implications, and management of gestational diabetes with improved outcomes for the mother and fetus. Worldwide, there is variation in the definition of GDM, methods to screen for the condition, and management options. The International Association of Diabetes in Pregnancy Study Groups has published recommendations for a one-step approach to screen pregnant women for GDM, in order to develop outcome-based criteria that can be used internationally. However, management of GDM continues to be varied, and currently several options are available for treatment of hyperglycemia during pregnancy. A review of various aspects of GDM is discussed with a focus on the medical management during pregnancy, as practiced in the United States.

The study investigates the effect of convective flow on entropy generation for MHD heat transfer flow of viscous fluid embedded in a porous channel due to thermal radiation. The governing equations were transformed using the non-dimensional parameters. The solution of the resulting coupled dimensionless differential equations with a constant coefficient describing the momentum, energy, and mass transfer equations was obtained by using the method of undetermine coefficient. The parameters embedded in the flow are thermal radiation , Prandtl number, entropy generation , Suction/injection parameter , heat source/sink , porous material . In addition, physical quantities of engineering interest such as the Bejan number , Brinkman number , volumetric flow rate , skin friction coefficient, and heat transfer rate were computed. It is noticed that velocity and temperature increase significantly with an increase in heat source and suction parameters, while a reverse trend is observed when heat sink and injection are present. It is also evident that, the heat source increases the temperature profile in the presence of injection parameter, and a reverse trend is observed when the heat sink increases in the presence of the suction parameter. skin friction is decreasing with increase higher values of porous material in both at when injection and , volume flow rate reduces with increasing values of heat source and shot-up with decreasing values of heat sink, its observed that entropy generation is increasing for higher values of ...........

Introduction: Blood flow restriction (BFR) combined with resistance training can promote hypertrophy, enhance muscle activation, and improve function. Muscle electromyography (EMG) is commonly used to elucidate neuromuscular recruitment and highlight adaptive changes in recruitment due to BFR. Purpose: This study used electromyography (EMG) to determine the influence of BFR on lower-extremity (LE) neuromuscular activation timing during resistive sled training. Methods: Sixty-two participants were recruited (eight males and 54 females; mean age, 23 years). EMG) electrodes were placed on the belly of selected muscles of the dominant LE to record muscle activation. Participants pushed an XPO sled trainer at slow (60 bpm) and fast (140 bpm) walking speed protocols (three trials each) with and without the application of BFR to the LE for a total of 12 trials. The EMG variables assessed were time to peak, decay, and duration of muscle activation. Results: The outcomes revealed several adaptations in EMG variables for functionally activated muscles above and below the cuff when pushing a sled while using BFR. Conclusions & Clinical Relevance: Several tendencies have been identified in the gastrocnemius, tibialis anterior, and hip extensors depending on walking speed, which may be foundational to future research and should be explored further. Our results suggest that low-load BFR can benefit patients with leg musculature weakness, extensor musculature fatigue, and proximal thigh musculature rehabilitation.

Family characteristics and work relationships have effects on teachers’ retirement decision-making in the country. This has led to much frustrations of life for some retired teachers in Ghana. The study was guided by the following research objectives: Effects of family characteristics on retirement decision-making, the influence of work relationships on retirement decision-making and the strategies that can be put in place to improve retirement decision-making among teachers. A quantitative approach and descriptive survey design were used. The target population comprised teachers in public Basic schools in the Agona West Municipality. 150 teachers formed the sample for the study. Data was obtained using a self-developed questionnaire. It emerged from the findings that high financial demands stemming from home expenses, expectations from family members, and being first-borns hindered individuals’ ability to save and plan for their retirement. Also, it revealed that teachers in the Agona Swedru Municipal place considerable importance on their interactions with colleagues when it comes to retirement decision-making. It was found that teachers in the Agona Swedru Municipal place considerable importance on their interactions with colleagues when it comes to retirement decision-making. It was therefore recommended that retirement planning initiatives and financial education programmes should prioritize offering diverse and adaptable forms of psychoeducation and guidance to cater for the varying expectations and preferences of respondents. Educational institutions and policymakers should encourage and support peer relationships to improve retirement preparedness and satisfaction among teachers in the Municipality. Prioritize and tailor retirement planning guidance and education to address the diverse preferences and needs of respondents.

The red queen effect is a metaphor used in the business world to describe the unsuccessful efforts of a company to get ahead of its competition. The red queen effect is the need to continually adapt and evolve to maintain relevance in an ever-changing environment. Companies must constantly innovate and find new ways to stay ahead of the competition to ensure their survival and success. Companies typically research or study the competition and then implement strategies to help boost their company sales and profits. This is an effective and practical method of outmaneuvering the competition. While this technique works in theory, companies might not achieve their goals because the competition engages in the same business practice. Despite a company's efforts to surpass the competition, the company does not move forward or grow. The aims of research paper are bifold firstly it attempts to identify the contributions of the RQE theory and secondly to enable corporates to evade the Red Queen Effect by using generative artificial intelligence to be prepared for Industry 5.0.

Cupriavidus pauculus is an environmental gram-negative bacilli of low virulence, being increasingly reported to be associated with invasive infections in immunocompromised patients and device related infections. Often undetected or misidentified in most microbiology laboratories, identification of this organism requires increased suspicion and automated identification or molecular methods. We hereby describe a curious case of post-operative acute sinusitis caused by this rare yet emerging human pathogen.

In the current professional and educational environment, students must enhance their language abilities to capitalize on career and academic opportunities. Although reading is a crucial skill for youngsters, many struggle to comprehend, understand, and assimilate the content. This study investigates an interactive supplementary tool that enhances reading proficiency and facilitates students' comprehension of the text. During the academic year 2022–2023, a cohort of 120 female students was surveyed over the course of two semesters. The data collection methods used in this study consisted of a questionnaire that examined students' perspectives on advertising materials utilized in reading skills classrooms, along with a semi-structured questionnaire administered at the end of each unit. The results of this study suggest that the usage of commercial advertising improved students' reading ability, making it a great resource for teaching language skills.

Introduction: During their placements in healthcare establishments, nursing students are assigned to members of the nursing staff who, as tutors, are responsible for supporting and assessing them as part of their professional training [1]. As such, it is vital that the hospital environments hosting these students pay the utmost attention to how these placements are carried out. This study explored our respondents' perceptions of the quality of teaching supervision during their clinical placements at the Bandundu general referral hospital (HGR). We opted for a qualitative, case study approach. Data were collected from individual, semi-structured, face-to-face interviews with 9 third-year graduate students. The aim of these interviews was to gather information based on the students' previous experiences of their placements. Materials and Method: The analysis method used for this research was content analysis, also known as thematic content analysis. The data were analysed using ATLAS.ti7 software. A main theme was identified for this study. Three sub-themes emerged from this central theme: students' perceptions of their needs in terms of teaching support, their perceptions of the teaching strategies used by the support staff, and their perceptions of the quality of the training provided by the support staff in the field. Results: With regard to teaching support needs, it is important to emphasise the lack of prior and intermediate assessment, the inadequacy of care materials, the excessive number of trainees, the lack of support for assessment, the failure to comply with placement objectives and the lack of autonomy, all of which appear to hinder students' learning progress in the clinical environment. With regard to teaching strategies, it is interesting to note that the methods of education, training and advice were more frequently mentioned than those of confrontation. With regard to the quality of training, the majority of participants judged supervision at the placement to be satisfactory. Conclusion: Although the majority of students were satisfied with the quality of the supervision they received at their placement, the results suggest the need for innovation in current approaches to clinical teaching in order to foster student autonomy and enable them to develop essential skills.

The aim of this study is to identify and analyze environmentally conscious approaches that can be integrated into the Islamic Religious Education (PAI) curriculum at various levels of education, from elementary to tertiary education. This research also explores teaching strategies that can be used to introduce environmental concepts within the context of PAI. The research method employed is a literature review, involving the collection and analysis of relevant literature on environmental education, the PAI curriculum, and environmentally conscious approaches in religious education. The results of this research are expected to provide guidance for the development of a more inclusive PAI curriculum regarding environmental issues, as well as practical guidelines for PAI educators to integrate environmentally conscious aspects into their teaching. This research has the potential to make a positive contribution to sustainable religious education understanding and practices, promoting environmental awareness and social responsibility among students and university students. In conclusion, the integration of environmentally conscious perspectives into the PAI curriculum can be a crucial step in preparing the younger generation to face global environmental challenges in the future.

With the continuous development of globalization, English has become one of the important languages of China and international communication, playing an important role in our life. English has always been the traditional main subject of education at all levels in China, whether primary school, middle school, high school and university, all occupy a pivotal position. And in middle school education, English performance can affect the situation of admission, and English is also a subject with a huge gap. Middle school is a key period to learn English. How should we learn English well? As we all know, the important condition for learning English well is vocabulary. Only by mastering vocabulary can we learn English well. Vocabulary is the basis of learning English well. However, from the current situation of junior high school students learning vocabulary, it is not optimistic, and students face many difficulties to master vocabulary. The main difficulties we have include: firstly, students, only have single memory method and insufficient memory s in vocabulary memory skills, which make them difficult to master the vocabulary. secondly, the traditional classroom teaching approach is single, boring and inefficient; thirdly, many teachers ignore thinking and interest cultivation, and students can only memorize words and phrases, difficult to use flexibly in life, so that students often lack interest in vocabulary, and will be afraid when they face with vocabulary. we can’t learn English well in such a situation. Now, it is a common challenge for teachers and students to change the situation at present. In order that students can better master vocabulary, for this reason, teachers can find more appropriate teaching methods to change the dilemma they face. With the further research on the theories of vocabulary teaching, we understand some relevant teaching approaches and theories gradually, such as situational language teaching (SLT). Due to introduction of SLT, it has played a great influence in China’s basic education and made great progress in China’s education. Although the current situational teaching method is often used in English teaching, it has not always been applied to vocabulary teaching. It is unclear whether SLT is suitable for vocabulary teaching and can improve the efficiency of vocabulary teaching and change the current situation. Therefore, this article studies whether SLT is applicable to English vocabulary teaching in middle schools and verifies whether it is effective. However, SLT through the data analysis of post-trial test and questionnaire is suitable and feasible. By creating a real situation, let the students experience the true feelings, and then master the vocabulary, improve the interest in learning, improve the classroom efficiency. By creating a real situation, let the students experience the true feelings, and then master the vocabulary, improve the interest in learning, improve the classroom efficiency.

Background: Polycystic Ovary Syndrome (PCOS) is a common hormonal disorder affecting 5-10% of women worldwide, characterized by irregular menstrual cycles and cysts on the ovaries. Its exact cause is unknown, but early identification and intervention can reduce the risk of complications like diabetes and heart disease. PCOS manifests in various ways, impacting reproductive, cosmetic, metabolic, and psychological aspects. Prevalence is higher in certain ethnic groups, and diagnosis can occur in adolescence but is often delayed. Despite its global impact, most studies focus on developed countries. Aim of the study: The study aims to explore the diagnosis and treatment procedures for managing adolescent PCOD in Bangladesh. Methods: This study, conducted at the Holly lab hospital &Missionary Hospital Brahmanbaria, Bangladesh. The study spanned one year from January 2023 to December 2023. Diagnosis relied on clinical and biochemical evidence of hyperandrogenism and persistent menstrual irregularities. A one-on-one interview gathered comprehensive medical information. Inclusion criteria covered females aged 10 to 19, while exclusions involved specific medical conditions and ongoing treatments. Statistical analyses using SPSS included expressing variables and logistic regression to identify metabolic syndrome risk factors. The significance level was set at p ≤ 0.05 for statistical relevance. Result: The study involves 107 adolescent participants with Polycystic Ovary Syndrome (PCOD). Most were aged 10-15 (55.14%) with an average age of 16.8. BMI analysis showed high prevalence of overweight (29.70%) and obesity (39.40%). Abdominal obesity was normal in 76.60%, while 20.00% were pre-hypertensive, and 3.40% had hypertension. Glycemic status varied, with 76.00% normoglycemic, 21.10% prediabetic, and 2.90% diabetic. Dyslipidemia was present in 90.90%, and metabolic syndrome in 42.30%. Biochemical hyperandrogenism was observed in 33.70%. PCOD features included hirsutism (94.90%) and menstrual irregularities (oligomenorrhea 87.85%). Ovarian morphology showed diverse patterns. Hyperandrogenism, ovulatory dysfunction, ovarian morphology, and metabolic factors were primary contributors to PCOD diagnosis. Treatment approaches varied, including classical interventions (34.58%), lifestyle changes (14.95%), combined oral contraception (12.15%), and antiandrogens (7.48%). Therapeutic treatments included N-acetylcysteine, Inositol, Vitamin D supplementation, and Chromium supplementation. Conclusion: Managing adolescent Polycystic Ovary Syndrome (PCOS) is challenging due to the high prevalence of metabolic complications. Diagnostic complexity emphasizes careful evaluation to prevent premature labelling and psychological stress. Treatment involves lifestyle interventions, hormonal contraceptives, and anti-androgen medications. Standardized diagnostic criteria and a multidisciplinary approach are crucial. Early intervention and continuous monitoring are essential for mitigating long-term health risks. Further research on PCOS in diverse populations is recommended for tailored interventions and a nuanced understanding.

There are 150 species of the genus brassica that are grown globally as oilseed crops or vegetables. Mustard plants belong to the family brassicaceae. Oil is obtained from mustard seeds, their leaves are edible and can be consumed as mustard greens. Gibberellic acid (GA) is a hormone or growth regulator present in variable amounts in all sections of plants. The presence of heavy metals has turned into a problem because of their harmful results on plants even at low concentration. The present study comprises of a pot experiment that was perform at the Old Botanical Garden, University of Agriculture Faisalabad to examine the effect of exogenous supplication of gibberellic acid on development and various morphological parameters of mustard (Brassica napus L.) within NiSo4 tensity on two varieties (super canola and sherilla). The experiment was designed CRD (completely randomized design) by factorial arrangement and 3 replications. A 300 µM nickel sulphate stress was applied and to overcome the effect of metal stress a foliar application of (0.25 mM) gibberellic acid was applied. The samples were dividing into two different sampling bags with three replicates. Plastic zipper bags containing fresh samples were kept in the freezer for different biochemical analysis like chlorophyll and carotenoids and the data were collected for the determination of various morpho-physiological parameters. While the remaining samples were placed in the oven for dry analysis for samples Na+, K+ and Ca+. These parameters were analyzed by using CO-STAT software program.