Background: Heart failure is a significant medical and societal concern worldwide. It continues to be a major source of morbidity and mortality and causes a significant and rising cost on the health care system. There is a seasonal fluctuation in the number of people who are admitted to hospitals for heart failure, with winter seeing the highest rate. Objective: To assess the seasonal variation of heart failure admission with age, sex, risk factors and co-morbidities in tertiary care hospital in Bangladesh. Materials and Methods: This cross-sectional study was carried out among the patients hospitalized with heart failure at the Department of Cardiology, Dhaka Medical College Hospital (DMCH), Dhaka, between April 2015 and March 2016. The history, clinical characteristics, and investigational data were used to diagnosis the patients. Statistical tests were used to examine the impact of seasonal fluctuation on patients admitted with heart failure. Results: In the age range of 41 to 60 years, 302 patients with heart failure at the highest level (51.7%) were hospitalized. Heart failure admission patients were 2.8 times more likely to be male than female, with a mean age of 55.18±12.42 years. Heart failure patients in the age ranges of 20 to 40, 41 to 60, and 61 to 80 years were hospitalized more frequently in the winter and post-monsoon. Seasons and gender had a statistically significant relationship (p=0.030). Smoking is the greatest risk factor compared to other risk factors in all seasons, and all risk factors were more prevalent in the winter than they were in other seasons. Conclusion: This study may help improve the healthcare system and alter how easily accessible hospital resources such as emergency rooms are throughout the winter. More information regarding the heart failure events that occur throughout the winter should be made available to patients and general practitioners.

Iron-deficiency anemia is very common among patients in gastroenterology. The digestive system plays a key role in the pathophysiology of iron-deficiency. Indeed, digestive causes are one the most fequent etiology. This is why endoscopic evaluation is part of the etiological assessment of iron-deficiency anemia. The aim of this study is to investigate the usefulness of esophagogastroduodenoscopy (EGD) and histopathology in the etiological diagnosis of iron-deficiency anemias. Materials and Methods: This is a monocentric study conducted from January 2019 to December 2023. All patients with iron-deficiency anemia who underwent EGD were included. Various data were recorded, including patients' epidemiological information, laboratory findings, and results from endoscopic examinations. Results: Out of 2960 EGD, 576 (19,5%) were included in the study. The mean age of the patients was 49.81 years, ranging from 18 to 83 years. The male-to-female sex ratio was 0.67. It is notable that 47.5% of the patients had various medical histories: inflammatory bowel disease (IBD) in 19.13% of cases, history of non-steroidal anti-inflammatory drug (NSAID) use in 12.17%, coeliac disease in 6.13%, cirrhosis with portal hypertension in 8.70%. All patients underwent EGD. An abnormality was found in 63.4% of cases, including: Esophageal lesions: gastroesophageal varices in 13.3% of cases, erosive esophagitis in 7.5%, esophageal tumor in 0.6% of cases. Gastric lesions: erosive gastritis in 35% of cases, ulcerative gastritis in 22%, erythematous gastritis in 17%, gastric tumor in 15% of cases, supra-centimetric hyperplastic polyps in 5% of cases. Bulboduodenal lesions: erosive bulboduodenitis in 25% of cases, ulcerative bulboduodenitis in 18%, duodenal fold rarefaction in 16%, angiodysplasia in 3.5%. Gastric and duodenal biopsies were systematically performed. Duodenal biopsies showed a celiac disease aspect in 7.6% of cases, and nonspecific duodenitis in 4.6% of cases. Gastric biopsies revealed gastritis with Helicobacter pylori (Hp) in 57.6% of cases. Thus, the diagnostic yield of EGD was 47.33%. Conclusion: Iron deficiency anemia are common medical conditions in daily clinical practice. The multiple etiologies of iron deficiency anemia and the nonspecificity of symptoms make diagnosis difficult. Gastrointestinal lesions are frequently observed in patients with iron deficiency anemia. Digestive endoscopy has a great value in the etiological investigation of this pathology. Gastroscopy allows for the etiological diagnosis for many patients that’s why it is systematically recommended do it.

Current scientific growths for implant over-denture attachments. We focused on the following topics: attachment systems, retention of various attachments, stress distribution with different attachments, the design and fabrication of attachments, digital techniques in over denture attachments, and the effects of attachments in two-implant health. We found that plastic resin is commonly used for ball and bar attachments, whereas nylon resin is commonly used in locator attachments. The locator system offers a valuable attachment option for implant-retained over denture. Attachment retention reduces while lateral force increases with implant inclination in over denture. The higher the retention of an over-denture attachment, the higher the transferred stresses. Additionally, clip loading produces more stress in implants and precision elements than bar-retained dentures.

The research investigates the allelopathic influence of Euphorbia hirta extracts on the germination and seedling development of various cucurbit species, including Bottle gourd (Sp. A), Winter melon (Sp. B), Ridged gourd (Sp. C), Sponge gourd (Sp. D), Bitter gourd (Sp. E), Snake gourd (Sp. F), Muskmelon (Sp. G), and Pumpkin (Sp. H). The experimental design incorporated the use of both aqueous and methanol extracts of E. hirta, applied at different concentrations, with distilled water employed as the control. The findings reveal that the methanolic extract of E. hirta significantly impedes both the germination process and the subsequent growth of seedlings for all cucurbit species tested. For instance, at 12 days post-treatment, control groups exhibited high germination percentages (78%, 90.67%, 95.33% and 90% for Sp. A, Sp. C, Sp. D and Sp. E, respectively), which drastically declined with a 20% methanol extract concentration (23.33%, 18.33%, and 17.67% and 18.33% for the same species, respectively). Similarly, shoot and root length measurements indicated that higher concentrations of both extracts suppressed growth, with methanol extract showing a stronger inhibitory effect compared to the aqueous extract. Interestingly, Lower extract concentrations occasionally boosted shoot growth, revealing a hormetic effect. This two-fold response, notably in Pumpkin and Snake Gourd, illuminates the complexity of allelopathic interactions. The study suggests E. hirta extracts could serve as eco-friendly herbicides, urging further research to isolate their active components. This could lessen synthetic herbicide use, promoting sustainable agriculture and environmental protection.

In our article, we report the case of a patient with metastatic endometrial cancer whose risk factor was an intrauterine device worn for over ten years.

In the present era, the cases of renal diseases are speedily growing and relapses of these diseases are also very frequent. Diuretics in contemporary science, play a major role in the treatment of renal anomalies, but they have side effects too. So, to combat the situation, Ayurvedic Mutral drugs are gaining wide acceptance as they are safe and effective. In Ayurveda, great importance has been given to Mutra and Mutravaha srotas in maintaining the health of an individual. This can be illustrated by the fact that to deal with urinary disorders, Acharya Charak has specifically mentioned the Mutravirechaniya Mahakashaya and Acharya Sushruta and Acharya Vagbhata have mentioned Veertarvadigana and Trinapanchmoolagana. The herbs of the above-mentioned Kashaya and Gana are used to treat various renal ailments like burning micturition, scanty urine, calculi, etc. Apart from this, they also help to re-establish the normal physiological function of the affected renal tissues and organs. Hence, due to these attributes, they are the components of a wide number of Ayurvedic Mutral formulations. The current review is undertaken for screening the therapeutic action on the renal system of a total twelve herbs, taken from Mutravirechaniya Mahakashaya, Veertarvadigana and Trinapanchmoola gana. Various research studies concerning property of increasing urinary output (Mutral) of such plants are compiled here. These drugs are mostly sheet virya and snigdha guna, so increase the watery content of urine, thereby increasing its amount and flow.

Ovarian cancer, the fifth most common neoplasia in women, presents challenges in diagnosis and treatment, often resulting in poor prognosis due to advanced stage at diagnosis and limited treatment options. Platinum-based chemotherapy and surgery have been the mainstay treatments, but efforts to improve outcomes with additional cytotoxic drugs have yielded mixed results. Angiogenesis plays a crucial role in tumor growth and metastasis, leading to the investigation of bevacizumab, a monoclonal antibody targeting vascular endothelial growth factor (VEGF). Clinical trials have demonstrated its efficacy in delaying disease progression in ovarian cancer. This case report illustrates the successful use of neoadjuvant chemotherapy followed by surgery and maintenance therapy with bevacizumab and olaparib in a patient with advanced ovarian cancer, highlighting the potential benefits of this treatment approach in improving survival outcomes.

The voluntary and willing participation of followers is a necessary prerequisite for the emergence of the leadership phenomenon. However, followers' view about leaders and leadership is usually overlooked in research. The present study therefore aims to explore teachers' opinions about the ideal school leader and the effect of leadership in education. Data for this study were collected using free text as a research tool and qualitative content analysis as a research method. Findings reflect the leadership models that participants preferred for education, the qualifications that -in their opinion- the ideal leader possesses in a school unit, as well as the influence that they estimated that leadership has in the educational field.

Background: Lots of religious beliefs and doctrines among clergy in Christianity, Islam and traditional worshippers have determined the outcome of pregnancy and health of pregnant mothers in developing countries making them occasionally go through unnecessary risks of childbirth and postpartum conditions. Hence, a study to assess the influence of belief of religious leaders on the acceptance of Caesarean Section as a choice of child delivery is paramount. Methods: A cross-sectional study was conducted in April, 2023 among religious leaders and a total of 422 of them were selected randomly and interviewed using a structured interviewer-administered questionnaire. Results: About 164(38.9%) were below 40 years, 272(64.5%) were males, 150(35.5%) were females; majority 273(64.7%) practice Christianity, 138(32.7%) practice Islam; 354(83.9%) belong to the Yoruba ethnic group; more than half of the respondents 293(69.4%) were married; 314(74.4%) had a nuclear family structure; majority 302(71.6%) had tertiary education; 186(44.1%) were employed, 168(39.8%) were self-employed. 372(88.2%) believed that Caesarean sections a method of child delivery; less than half 144(34.1%) believed that Caesarean section is only used for emergency; 151(35.8%) believed that Complications of caesarean section are more than normal vaginal delivery; 198(46.9%) believed that Caesarean section is an easy way of delivery; 82(19.4%) believed that Caesarean section benefits only the mother; 80(19.0%) believed that Caesarean section affects the bonding between mother and child; amongst others. Conclusion: The study reveals that religious leaders in Ogbomoso will require more scientific information about caesarean section, and a significant proportion of them hold misconceptions about the procedure. Nevertheless, the majority of the religious leaders in the study were willing to accept caesarean section as a mode of delivery. Given their role in influencing their members' health-seeking behaviour, religious leaders could play a significant role in improving maternal and child health outcomes in the community by promoting accurate information about caesarean section and encouraging its acceptance.

This study aims to examine the effect of earnings smoothing and dividend policy on tax avoidance practices in manufacturing companies listed on the IDX for the 2016-2020 period. This study takes population and samples from financial reports and annual reports of manufacturing companies that contain financial transactions in companies listed on the Indonesia Stock Exchange for the 2016-2020 period. The results of this study indicate that earnings smoothing has a significant effect on tax avoidance in manufacturing companies listed on the Indonesia Stock Exchange (IDX) for the 2016-2020 period. Then, dividend policy has a significant effect on tax avoidance found in manufacturing companies listed on the Indonesia Stock Exchange (IDX) for the 2016-2020 period. Furthermore, profit smoothing and dividend policy together have a significant effect on tax avoidance practices.

An investigation into the effects of combustible materials on the refractory properties of Ugwuoba clay, using corncob ash has been undertaken. Ugwuoba clay was sourced from Ugwuoba town in Oji River Local Government Area of Enugu State, Nigeria, while corncobs were collected at New Artisan Market in Enugu Metropolis. The clay was processed using standard beneficiation and purification procedures at the Ceramics Department of Projects Development Agency (PRODA), Enugu. The corncobs were calcined into amorphous ash by heating in a furnace at 650oC. The refractory blends were compounded at the ratio of 90:10, 80:20, 70:30, and 60:40 for Ugwuoba clay (UGC) to Corncob Ash (CCA) respectively. These blends were subsequently moulded into the standard test pieces for the various properties determination and subjected to firing at temperatures of 900oC, 1000oC, 1100oC and 1200oC. Thereafter, the fired samples were characterized for fired shrinkages, total shrinkages, apparent porosities, water absorption coefficients, apparent densities, bulk densities and cold crushing strengths. The results obtained for each of the blends showed that the values were within the tolerable limits for industrial refractories with the 20%CCA blends showing the best results when compared with the other blends. A conclusion is drawn to the effect that corncob ash can serve as good organic admixtures for refractory bricks production for the lining of melting furnaces in the metals industry, hence opening new frontiers for recycling of these agricultural wastes for environmental safety and economic development in Nigeria.

Background: The decline in kidney function experienced by people with type 1 and type 2 diabetes who are chronically ill is known as diabetic nephropathy (DN) or diabetic kidney disease. The condition is known to progress in a number of stages and is related to blood pressure and glycemic management. Nevertheless, despite strict blood sugar management, the prevalence of chronic kidney disease (CKD) in diabetic patients has not decreased over the past 20 years, which has led to the discovery of new risk factors for the illness's development. The medical characteristics of the Paper Flower, Bougainvillea spectabilis, include anti-inflammatory, anti-hepatotoxic, anti-inflammtory, anti-hyperlipidemic, antibacterial, antioxidant, and antiulcer capabilities. Alkaloids, flavonoids, glycosides, phenolics, phytobannins, quinones, saponins, tannins, and terpenoids are examples of phytoconstituents that have been claimed to have medicinal characteristics. Method: In the current study, a molecular docking technique was used to try and identify mTORC1protein inhibitors. A grid-based docking strategy was used to determine the binding using the Auto Dock software. Merck Molecular Force Field was used to build the 2D structures of compounds, convert them to 3D, and then energetically reduce them up to arms gradient of 0.01. (MMFF). Result: The molecular docking of Ferulic acid & Gallic acid with mTORC1 protein showed binding energy (Kcal/mol) -5.37 & -4.56 respectively. Conclusion: Theoretically, all the ligand molecules have shown encouraging docking score. The docking result of ferulic acid revealed that their docking scores was -5.37 kcal mol–1, and it can be predicted as good inhibitor of mTORC1 protein and thereby prevents dysregulation of intracellular protein synthesis and the metabolic balance along with decreasing oxidative stress on the kidney.

The compositional range of materials to be welded, the thickness of the base materials, and current type are the main determining variables in the choice of welding. However, thermal expansion in mild steel weldments occurs when the material expands or contracts when subjected to changes in temperature during welding or subsequent heating and cooling cycles. This expansion and contraction can lead to residual stresses, distortion, and even cracking in the weldment if not properly managed. Mild steel, like many other metals, expands when heated and contracts when cooled. One major challenge occurs when during welding, the high temperatures cause the metal to expand in the heat-affected zone (HAZ) and the weld zone itself, then as the weldment cools down, it contracts, but this contraction might not be uniform due to differences in cooling rates across the weldment. The present study aims to predict the thermal expansion of mild steel weldments in relation to the current, voltage and gas flow rate. The central composite design is used for the design of experiment of 20 experimental runs, while the Response Surface Methodology (RSM) was used for the analysis. The model used in the RSM is Quadratic, while the coefficient of determinant, R-Squared of 0.9642, Adj R-Squared, 0.9319, Pred R-Squared, 0.7133, Adeq Precision 22.307 were obtained. There was no outliner which showed that the model adequately predicted the response. The study establishes that thermal expansion of mild-steel weldment can be adequately predicted by applying expect system such as the Response Surface Methodology.

This paper aims to critically analyse two conflicting ethical orientations that dominate the debate on the issue of justice in the post-war phase: minimalism and maximalism. The former approach narrows down the scope of the third aspect of just war theory, known as jus post bellum (justice after war), to the restoration of peace and the prevention of future hostilities. In contrast, the latter emphasizes the importance of achieving political objectives via military triumph and the use of force. Furthermore, it underscores the need for conscientious state-building after a military triumph in order to guarantee the welfare of individuals and the effectiveness of the justly established state. In line with Immanuel Kant's philosophy, it argues for minimalism by giving importance to upholding the rights of civilians and prisoners of war while striving to achieve enduring peace. In addition, it analyzes the fundamental concepts of Orend's maximalist approach to peace accords. These principles give priority to social justice, equality, human rights, democratic government, and social and economic progress. Orend's criteria for a fair peace settlement after a morally justified conflict include the vindication of rights, proportionality, discrimination, punishment, compensation, and rehabilitation. It also discusses the justifiability of regime change in this context. In line with Walzer, it contends that instances in which a new regime will be significantly better compared to the old one should be the only ones in which regime change is appropriate.

Background: Sleep quality is one of the important aspects among nurses as it has a significant impact on nurses’ work productivity, and work quality and is found to be associated with quality of life for nurses. Purpose: This study aims to assess the sleep quality among Saudi nurses. Method: This cross-sectional study included 323 Saudi nurses to measure their sleep quality using the Pittsburgh Sleep Quality Index (PSQI). Results: The study included 75% female and 25% male, with an advantage for age 25-34 (36.9%). The majority (61.61%) held a bachelor's degree in nursing, 49.11% were unmarried, 46.73% were married, 56.55% had fixed morning shifts, and 43.45% had shift days. 27.08% of participants had experienced 10 to 20 years of working experience. The study found that 67.86% had moderate sleep difficulty, followed by mild sleep difficulty, while only 2.08% had severe sleep difficulty. In addition, It was found that female (176.9) was significantly higher than male (143.3) in sleep difficulty (U=8467, p<0.01=0.002). It was found the distribution is significantly different in terms of age (X2=10.52, p<0.05=0.02), and the post hoc (pairwise test) found that the 25-34 group (185.81) was higher than the 35.44 group (143.79). It was found that shift day (189.32) was significantly higher than Fixed morning shift (152.5) in sleep difficulty (U=1083.5, p<0.01=0.006). It was found that female (176.9) was higher than male (143.3) in sleep difficulty (U=8467, p<0.01=0.006). Conclusion: This study examined Saudi nurses' sleep difficulties and related factors in a specific healthcare setting. The findings highlight sleep difficulties and their causes in this population. The study findings emphasize the need to treat sleep difficulties among Saudi nurses to improve their well-being and job effectiveness. Healthcare organizations should promote sleep hygiene and provide sleep management resources. This may involve mental health education, scheduling changes, and support.