Introduction: Open appendectomy (OA) and laparoscopic appendectomy (LA) are the choices of treatment for acute appendicitis. However, laparoscopic approach is emerging for the benefits it provides, but it also sometimes may has some drawbacks like OA including fistula. Objective: This retrospective study aims to investigate the management of fistula in 50 post appendicectomy fistula patients. Methods: A retrospective study was done at MH Samorita Medical College & Hospital, Hi-Tech Surgicare Hospital & Piles Centre, Savar Specialized Hospital and Lab Zone Hospital Savar, Bangladesh during January 2019 to December 2023 from January 2019 to December 2023, among the patients who had underwent laparoscopic appendicectomy and open appendicectomy. The total study population was 50, among which 33 (66%) patients were in open appendectomy and 17 (34%) were in laparoscopic appendectomy. The patients’ age group included 10 years to 50 years of both male and female patients. P< 0.005 was considered significant in this study. Results: Out of total study population, 33 were from OA (66%) and 17 were from LA (34%) group. Most of the study patients were male, aged 21-30 years age group. Fistulogram found to be the commonly use method to diagnose fistula. Tuberculosis was found to be the frequent cause of post appendicectomy fistula. Conclusion: Post appendicectomy seems to have different outcomes with some adverse impact, fistula is one of them. The present study finds that the chances of post appendicectomy fistula is less in LA group compared to OA. Proper study and better investigation may bring this to null with time.

Background: Pneumatic dilation (PD) is often presented today as a “short term” treatment for achalasia but, in truth, it can last for years. our study aims to determine the short and long-term efficacy of pneumatic dilatation on clinical remission in a treatment-naïve achalasia patient. Materials and Methods: A single center retrospective, descriptive and analytical study conducted between January 2007 and September 2022. Treatment naïve patients with manometric diagnosis of primary achalasia (subtype I and II) were included. We evaluated the clinical outcomes; single vs multiple PD, complications, and estimated duration of effect. Results: 121 patients were included, (mean age 42,2±14,5; 53,8% male), 88,4% (n=104) underwent 2 PD and 11,6% (n=17) underwent 3 PD, 23,1% (n=28) needed repeated PD at one year, The PD procedure was completed without major complications in all patients. Patients with subtype II had a better response to PD than subtype I(p=0,003). In the long-term follow up (median time: 50 months), the mean Eckardt score was 2.2. A subsequent 35 mm dilatation was associated with long-term clinical remission than an initial dilatation with 35 mm.(p=0.003). On univariate analysis, the non-responders more often was male gender, had age< 40 years (p=0.0006), and had high baseline LESP (lower esophageal sphincter pressure>50 mmHg), p=0.004). On multivariate analysis only age<or= 40 years (p=0.02) was associated with poor outcome. Conclusion: PD is an effective, durable and safe treatment for achalasia. A graded-protocol PD starting with a 30 mm dilation applied in the appropriate achalasia subtypes was shown to be a highly effective approach, in both the short- and long-term. Age<40 years, male patients and hight LESP have poorer outcomes following PD.

Within the context of enterprise resource planning (ERP) systems, this study aims to investigate the critical intersection of master information integrity with business rules. Quality master data that is in line with defined business regulations is crucial to the potency of data management systems in this era where data is the foundation for informed decision-making. The complex interplay between acquire data quality and business rule creation, deployment, and enforcement in various organizational settings is the focus of this research. The study takes a holistic view of the interdependent nature of master data quality & business rules by integrating theoretical frameworks, empirical analysis, and case studies. This research seeks to enhance our understanding of the opportunities and challenges that organizations encounter when trying to optimize the management of their information processes by analyzing practical situations and industry best practices to identify the critical factors impacting data quality and how they interact with business rules. In addition, the study delves into the impacts of poor mastery data quality on business rule effectiveness, and, on the other hand, how clearly specified business rules can improve master data quality. Researchers hope that businesses will be able to use the findings to strengthen their data governance plans and create a more flexible method of data management. Keeping ahead of the competition in today's data-driven world requires a deep grasp of the connection between core information integrity and business regulations, since data remains a valuable strategic asset for organizations.

Introduction: Pilocytic astrocytoma is the most common cerebral glioma in pediatric age, preferentially located in the posterior cerebral fossa. Atypical presentations have rarely been described in the literature. Clinical Case: We report a case of pilocytic astrocytoma whose appearance on CT scan is unusual. It concerns a young boy of 9 years old, who presented convulsive seizures since the age of 6 years old, followed by general practitioners with irregular treatment based on gardenal. 2 months ago the seizures became more frequent and this prompted a specialist consultation with the neurologist, after a brain scan he referred the patient to us. The neurological examination was unremarkable today. Brain CT with contrast showed a right parietal lesion. It was a lesion with a double cystic and fleshy component associated with calcifications with heterogeneous enhancement which amputated the posterior horn of the lateral ventricle. The radiological appearance was in favor of a low-grade oligodendroglioma. The patient underwent surgery with complete macroscopic excision of the lesion. Histological examination revealed a pilocytic astrocytoma (grade I). Conclusion: The usual radiological appearance of pilocytic astrocytoma combines a cystic part and a highly contrasting mural nodule. It rarely presents in the form of a supratentorial lesion with calcifications. This form of presentation is rare and can lead to confusion with other gliomas. We can achieve healing for the patient with total excision.

Renal pathologies following viral infections have become an emerging public health problem in both developed and developing countries. Diagnostic criteria are complex. In most cases, they involve correlation between clinical, biological and histological data, with occasional recourse to molecular biology techniques. Several mechanisms are involved in the pathogenesis of virus-related nephropathy, including virus tropism in the kidney, formation of immune complexes in situ or in the bloodstream, direct cytopathogenic effects, and multiple organ failure. The hepatitis C virus is responsible for three main types of kidney disease: membranoproliferative glomerulnephritis, cryoglobulinemia and membranous nephropathy. Hepatitis B virus is associated with membranous nephropathy, membranoproliferative glomerulnethritis, and IgA nephropathy. HIV (human immunodeficiency virus) infection is associated with several glomerular and tubular kidney damage. HIVAN (HIV-associated nephropathy), a specific entity mainly affecting Africans and African-Americans, presents as a rapidly progressive glomerulonephritis rapidly progressing to the terminal stage. Infections secondary to adenovirus, cytomegalovirus, epstein-barr virus, poliomavirus and coronavirus are often responsible for acute or chronic tubulointerstitial nephritis. Treatment is mainly symptomatic, based on nephroprotection measures, rarely combined with antiviral therapy. Prophylaxis with vacci-nation, when available, remains the best means of preventing viral nephropathy.

In order to effectively deliver drug molecules to their intended targets in the body, different dosage forms are utilized. Adapting dosage forms to the specific needs of the modern era and the condition of the disease can enhance the provision of healthcare to those in need, particularly through the use of herbal and traditional (Unani and Ayurvedic) products. Ayurveda employs various classifications of dosage forms, such as Aushadha kalpana and Ahara kalpana. Aushadha kalpana can be further categorized into Primary kalpana (Panchavidha kashaya Kalpana) and Secondary kalpana. These classifications are based on the origin of the ingredients, including plant, animal, and mineral sources. Dosage forms can also be classified based on their physical state, such as liquid, semi-solid, and solid forms. Furthermore, dosage forms can be categorized according to their intended usage, including Bahya kalpana (external application) and Abhyantara kalpana (internal administration). The importance of employing various dosage forms in Ayurveda lies in making them compatible and palatable to patients, as well as increasing their shelf life. One significant classification within Ayurveda is the topical dosage form (Bahya Kalpana), which encompasses formulations like lepa Kalpana, Malhara Kalpana, and Upnaha Kalpana. This article focuses specifically on exploring the topical dosage forms in Ayurveda.

This paper delves into the critical yet often overlooked aspect of disaster and emergency management: the rights and needs of children. Recognizing that children form a vulnerable segment of society during disasters, this study seeks to evaluate how effectively their rights are being protected and implemented in such crises. Utilizing the United Nations Convention on the Rights of the Child as a framework, the research examines key disasters like Hurricane Katrina (2005) and the 2004 Indian Ocean earthquake and tsunami to assess advancements and gaps in child-centric disaster response. Our findings reveal that children's experiences and needs in disaster scenarios are complexly intertwined with socio-political and economic factors. Despite the ratification of child rights treaties by numerous countries, the actual execution of these rights in disaster situations varies significantly. The paper highlights that children's vulnerability is not just physical but extends to psychological and educational aspects, often exacerbated by inadequate disaster preparedness and response strategies. The study emphasizes the importance of education in mitigating the psychological impact of disasters on children. Post-Hurricane Katrina initiatives, for instance, have shown the effectiveness of educational programs in disaster preparedness. However, challenges in coordination among NGOs and government entities often lead to ineffective implementation of child-focused disaster management strategies. In conclusion, while strides have been made in recognizing and addressing children’s needs in disasters, much work remains. The paper calls for a more nuanced understanding of child vulnerability and advocates for comprehensive strategies that prioritize children's rights in disaster management.

According to "Never Events", insulin administration errors are serious preventable adverse events that should not have occurred if adequate preventive measures had been implemented. The event "insulin administration error" is on the ANSM list published in 2012. The National Health Service's (NHS) "Never Events insulin" has developed a module on insulin therapy management entitled "Preventing insulin-related medication errors". Proper use and knowledge of insulin management can prevent these events. Our study presents the results of a survey designed to assess both the knowledge of healthcare personnel and a group of diabetic patients in the Souss Massa region of Morocco. Our survey was an opportunity to re-educate our patients and review the knowledge of a group of staff interviewed, underlines the important deficit in knowledge and practice of nursing staff and insulin-treated patients, suggests that urgent intervention should be considered, particularly with young nursing staff, and also to review the therapeutic education of insulin-treated diabetics in order to improve their knowledge and better prepare them for the advent of new generations of insulin.

It is commonplace that the knowledge and use of foreign languages contribute positively to various and diverse fields in all countries of the world as well as to many social, cultural, labour, commercial, economic, political discussions and interactions of any civil society. Their role has been decisive in the past, still is today and it is more than evident that foreign languages will continue to play a decisive role in the future, especially on the personal, collective, state and cross-border levels, due to the ever-increasing mobility of people, whether voluntarily or involuntarily, from one continent to another, from one country on the same continent to another, from one poor, war-torn, oppressive and fascist country to a peaceful, democratic one, from one democratic country to another democratic one, etc. In particular, it plays a key role in: a. the acceptance of others with different origins, culture, religion, language, etc.; b. the mutual understanding, communication and the establishment of social relations between citizens of different cultures; c. the intellectual cultivation, cultural exchange, personal, professional rehabilitation and development of people; d. the conception and understanding of citizens that education and culture are the main pillars of the economic development of a country and of each individual; e. the cultivation and promotion of interdisciplinarity and the general progress of science and research; f. the friendship between States; g. the diplomatic (inter)negotiations, commercial transactions, various agreements between States. The present paper has been written for all these reasons and a few more discussed further on. It studies in a critical-interpretative way various aspects of the teaching and learning of German as a foreign language in Greece, a language spoken by several million people all over the world.

The coexistence of Primary Hyperparathyroidism (PHPT) with Papillary Thyroid Carcinoma (PTC) is a rare clinical occurrence. Thyroid pathology is reported in 20% to 84% of Primary Hyperparathyroidism (PHPT) cases, with malignancies identified in 2% to 20% of instances. We report a case of a 49-year-old woman referred for evaluation of left iliac wing and hip pain with elevated parathyroid hormone levels. Imaging revealed a toxic multinodular goiter with a parathyroid adenoma. The patient underwent total thyroidectomy with parathyroid adenoma excision. Subsequent histological examination unexpectedly identified a papillary thyroid microcarcinoma associated with the parathyroid adenoma. The association between PHPT and PTC is complex, influenced by shared embryological origins and genetic factors. Elevated PTH levels in PHPT may contribute to thyroid cell proliferation, and hypercalcemia is suggested to promote thyroid carcinogenesis. Molecular analyses suggest the involvement of pathways like MAPK and Wnt/β-catenin. The coexistence of PHPT and PTC highlights the necessity for thorough preoperative assessment and the ongoing need for research. While minimally invasive parathyroid surgery is favored, the risks associated with coexisting thyroid pathology should be carefully considered. Routine thyroid ultrasonography in PHPT patients is crucial to exclude nodular thyroid disease, emphasizing the role of research in guiding clinical practices. A balanced approach integrating technical advancements and thoughtful risk assessment is essential in navigating this complex clinical scenario.

Acute lung injury is a disorder of acute inflammation that causes disruption of the lung endothelial and epithelial barriers. Acute Respiratory Distress Syndrome or ARDS is a diffuse inflammatory lung process that frequently manifests in critically ill patients, with an estimated incidence of 3 million people a year. Clinically, ARDS is manifested by bilateral or diffuse radiographic infiltrates, hypoxemia, decreased lung compliance, and increased ventilatory dead space. The histological manifestation of ARDS is diffuse alveolar damage as defined by epithelial injury, hyaline membrane formation and alveolar flooding with proteinaceous fluid, increase alveolar surface area and frequently neutrophilic inflammation. The animal model correlate to ARDS as an acute lung injury (ALI). Models were employed to test potential new therapeutic interventions and to investigate under-lying mechanistic pathways that lead to diffuse lung injury. In this study cage cigarette smoke model was used for an acute lung injury. For that purpose, thirty (30) young albino healthy rats were used, and their duration of trial was 21 days. Each group was given an oral drug administration containing MgO-150mg/kg, MgO-300mg/kg BW for treatment and diet schedule in young albino rats of male sex for the experimental procedure of 0 to 21 days. Mean body weight, BALF, lipid profile, liver profile and lung histology were assessed. Results revealed that MgO nanoparticles exhibited antioxidant capacity at dosages of 300mg/kg, and 150mg/kg. This formulation of selected nanoparticles at high dose exhibited an acute lung injury and antioxidant effects as compared to low dose extract. Additionally, transcriptional factors revealed up-regulation at high dose in contrast to the low dose extract in lung injury treated groups.

Introduction: The aim of this study was to describe the epidemiological and clinical aspects of low-lying ARF in children aged 1 month to 14 years seen in the emergency department of the Nianankoro Fomba Ségou Hospital. Methodology: We included for this prospective descriptive study all children aged 1 month to 14 years of both sexes, seen in consultation at the pediatric emergency department, presenting with low-onset ARF, from January to December 2020. Results: The frequency of low ARF was 6.5%. More than half the patients were aged between 3 months and 2 years. Males predominated. The most frequent reason for consultation was fever. The most common diagnosis was bronchitis (63.23%). 78.6% of patients had moderate anemia and hyperleukocytosis. An opacity was found in 66.67 of the radiographs taken. Amoxicillin was the antibiotic of choice. Hospital mortality was 3.59%. Conclusion: ARIs are frequent in emergency consultations.

This study aimed to explore the family caregivers (FCs) perception of patients’ symptom burden as well as their experience and satisfaction with specialized palliative care services (PCS) in a tertiary care center in Kingdom of Saudi Arabia (KSA). Methods: A cross-sectional design assessed patients known to the PCS in a tertiary care center in Saudi Arabic from May 2023 to September 2023. FCs perceptions of patient’s symptom burden and satisfaction with PCS were studied through the Family Satisfaction with End-of-Life Care Scale (FAMCARE-2) and Arabic Questionnaire for Symptom Assessment (AQSA). Results: A convenience sample of 264 FCs agreed to participate (response rate = 94%). Approximately half of the participants were male (n=146; 55.7%). Participants were mostly aged between 30 to 50 years (n =148; 56%). Approximately half were receiving disease-modifying treatments. 101 (38.3%) had a Do-Not-Attempt-Resuscitation (DNAR) order. There was high satisfaction with how the services respected the dignity FCs (M = 4.6; SD=0.6). FCs were less satisfied with ‘the practical assistance provided by the PCS’ (M = 4.1; SD = 0.9). Satisfaction was higher in the outpatient setting (M = 4.3, SD = 0.7). The most severe symptom reported by FCs was ‘tiredness’, followed by ‘pain’. The mildest ones were ‘shortness of breath’, followed by ‘nausea/vomiting’. Conclusion: Overall, FCs have reported a positive experience with inpatient and outpatient PCS. FCs' greater satisfaction was observed in the outpatient setting with the possible rationale that inpatients are often more unstable and symptomatic.

The study examined traditional crime control measures and criminality in Akwa Ibom State, Nigeria. It identified various traditional crime control measures practiced by Akwa Ibom people. The research made use of primary data which were collected through in-depth interview with the use of interview schedule. Four hundred (400) study respondents were engaged as calculated sample size, Four hundred respondents were randomly selected from twelve (12) purposively selected villages across twelve (12) Local Government Areas of Akwa Ibom State. The state was divided into three clusters namely: Annang, Ibibio and Oron ethnic groups. Routine Activity (RA) theory of crime by Cohen and Felson (1979) was used in the study. Data collected were analyzed thematically in line with the objectives of the study. Findings revealed that there were traditional crime control measures among Akwa Ibom people which include; Idiong, Mbiam, Ukang. Ekpo, Akata, Ekpe, Iban Ison, Nka Nkparawa, Asian Uboikpa, Ayai, Adagha, Ibed Ukot, and Ibed Eyeyen. It was discovered that the rise in crime in the state is due to the abandonment of some traditional crime control measures. It was discovered also that, there exist poor relationship between the police and traditional institutions and this has caused increase in crime in the state. It was recommended that there should be partnership and synergy among traditional and modern crime control agencies in the study area to increase crime control effectiveness Also, government should develop policies that creates avenue for partnership between the police and other traditional institutions toward effective crime control.

Purpose: The paper describes the contribution of Archbishop Zacchaeus Okoth to the development of higher education in the Nyanza Region of Kenya. It also dealt with the nature of the Nyanza region before the development of Uzima University. Methodology: Being a historical study, the historical method of inquiry was used to enable a deeper understanding of the phenomenon. Primary sources of data accessed included oral testimonies of actual participants' archival documents like personal materials and institutional information of written notes, photographs, minutes of meetings before the establishment of the institution, and publications. Secondary sources included books, journals, published and unpublished. The oral interviews were recorded, transcribed, and analyzed using qualitative methods. Results: The study findings demonstrated that Archbishop Okoth as an individual has contributed greatly not only to education but also to the medical sector in the Nyanza Region and Kenya. In addition, the study reveals that the Archdiocese of Kisumu together with the people of Nyanza region had an impact on the establishment of the institution and development. It can be concluded that Archbishop Zacchaeus played a vital role in the growth and development of higher education in Nyanza Region through the establishment of Uzima University. The institution has contributed a lot not only to the people of the Nyanza region but to Kenya at large. The impact has been felt a lot by the people of Kisumu and the Archdiocese of Kisumu, producing qualified doctors and nurses.