The physicochemical quality of the Tshopo River water before it enters the REGIDESO SA/Kisangani treatment plant in the Democratic Republic of Congo during the year 2024 was the subject of our research. The results show that the water quality of the Tshopo River does not differ significantly between quarters or between seasons in 2024, with p-values of 0.9647 and 0.9793, although there are noticeable differences between periods of heavy and dry rainfall. This is revealed by the results of analyses of more than seven physicochemical parameters, namely pH, turbidity, color, conductivity, temperature, oxidizable matter, and total alkalinity.

Background: Hypoglycemia in Type 2 Diabetes Mellitus (T2DM) is typically drug-induced. Persistent hypoglycemia after discontinuation of all glucose-lowering agents is rare and suggests alternative etiologies such as insulinoma. Case Presentation: A 56-year-old female with T2DM presented with recurrent fasting hypoglycaemia despite cessation of all oral antidiabetic medications. Initial attribution to sulfonylurea uses delayed further investigation. Persistent hypoglycemia prompted endocrine evaluation revealing endogenous hyperinsulinemia. MRI identified a pancreatic tail lesion consistent with insulinoma. Conclusion: This case highlights diagnostic anchoring bias in diabetic patients and underscores the importance of evaluating persistent hypoglycemia beyond medication-related causes.

Endoscopic polypectomy is the first-line treatment for colorectal polyps. However, this procedure carries an increased risk of bleeding in patients with hemostatic disorders, particularly in the presence of a large pedunculated polyp. We report the case of a 52-year-old man with hemophilia A and associated von Willebrand factor deficiency, admitted for rectal bleeding evolving over the previous year. Laboratory investigations revealed severe iron-deficiency anemia and a reduced factor VIII level. Colonoscopy showed a large pedunculated sigmoid polyp located 50 cm from the anal verge, with a 15 mm stalk and a 30 mm head. A multidisciplinary approach involving gastroenterologists and hematologists allowed endoscopic polypectomy to be performed using a hot snare after hemostatic preparation with coagulation factor concentrates and tranexamic acid, together with prophylactic placement of an end loop. No periprocedural or postprocedural bleeding complications were observed. Histopathological examination revealed a tubulovillous adenoma with low-grade dysplasia, with complete resection and negative margins. This case highlights that endoscopic polypectomy can be safely performed in a hemophilic patient, provided that careful preparation, appropriate hemostatic prophylaxis, and preventive endoscopic techniques are used.

Background: Traumatic brain injury (TBI) is a leading cause of death and disability worldwide, with post-traumatic seizures (PTS) representing a frequent and potentially devastating complication. While phenytoin has historically been the standard agent for early PTS prophylaxis, levetiracetam has emerged as an increasingly popular alternative despite limited high-quality comparative data. Objective: This systematic review aimed to summarize available evidence on the comparative effectiveness of levetiracetam and phenytoin for seizure prophylaxis following traumatic brain injury. Methods: A comprehensive literature search was performed across PubMed/MEDLINE, Embase, Scopus, and Web of Science for studies published within the last five years. Studies were included if they compared levetiracetam and phenytoin (or fosphenytoin) for PTS prophylaxis in TBI patients of any age. The primary outcome was incidence of early post-traumatic seizures (EPTS; ≤7 days post-injury). Risk of bias was assessed using the Newcastle-Ottawa Scale for cohort studies and the Joanna Briggs Institute checklist for cross-sectional studies. Due to substantial heterogeneity, a narrative synthesis was conducted. Results: Six studies met inclusion criteria, comprising 65,446 TBI patients and 220 clinicians. Studies demonstrated that levetiracetam and phenytoin have comparable efficacy in preventing EPTS. After adjustment for confounders, no significant difference in seizure occurrence was observed between agents (p>0.05 for all comparative analyses). Prophylactic antiseizure medication overall significantly reduced EPTS incidence compared with no prophylaxis (9.6% vs. 32.1%; p<0.001). Neither drug effectively prevented late post-traumatic seizures (>7 days). Levetiracetam offered practical advantages including no requirement for routine serum monitoring, and demonstrated a favourable adverse effect profile, though one meta-analysis reported a modest mortality signal requiring further investigation. Risk of bias was low in two studies, moderate in four studies. Conclusion: Levetiracetam and phenytoin demonstrate comparable efficacy for early post-traumatic seizure prophylaxis after TBI. Neither agent prevents late seizures, supporting current guideline recommendations limiting prophylaxis to the first 7 days post-injury. Clinicians may reasonably choose either agent based on patient-specific factors, institutional protocols, and drug availability.

Background: Traumatic brain injury (TBI) is a leading cause of mortality and disability worldwide, with intracranial haemorrhage and haematoma expansion representing critical determinants of poor outcomes. Tranexamic acid (TXA), an antifibrinolytic agent, has demonstrated mortality benefits in extracranial trauma, but its efficacy in isolated TBI remains debated, particularly regarding optimal patient selection, timing, and dosing. Objective: To systematically synthesise the available evidence on the efficacy of TXA in reducing mortality and haematoma expansion in patients with isolated traumatic brain injury treated in emergency department or prehospital settings. Methods: A comprehensive literature search of PubMed/MEDLINE, Embase, Cochrane CENTRAL, Web of Science, and Scopus was conducted for the five-year period ending in 2026. Randomised controlled trials, cohort studies, nested substudies, and post hoc analyses evaluating intravenous TXA versus placebo, no TXA, or standard care in adult patients with isolated TBI were included. Primary outcomes were all-cause or head injury-related mortality and radiographic haematoma expansion. Risk of bias was assessed using Cochrane RoB 2 (RCTs) and ROBINS-I (non-randomised studies). Due to substantial heterogeneity, a narrative synthesis was performed. Results: Thirteen studies (n = 24,227 patients) met inclusion criteria, including four RCTs, one prospective cohort, three retrospective analyses, and five secondary/post hoc analyses. In mild-to-moderate TBI (GCS 9–15), TXA significantly reduced mortality (CRASH-3 subgroup: RR 0.78, 95% CI 0.64–0.95; Bian meta-analysis: RR 0.71, 95% CI 0.60–0.85). In severe TBI (GCS 3–8), no mortality benefit was observed in RCTs (RR 0.98, 95% CI 0.91–1.05), while observational studies suggested potential harm due to confounding by indication (Bossers: OR 4.49, 95% CI 1.57–12.87). Haematoma expansion was reduced with TXA in two small RCTs (mean expansion 1.5±1.1 mL vs 4.6±1.9 mL), though the CRASH-3 imaging substudy found no prevention of established haematoma expansion but did show reduced new haemorrhage in patients with reactive pupils (aRR 0.80, 95% CI 0.66–0.98). Early administration (within 2 hours) was consistently associated with improved outcomes. Thromboembolic events were not significantly increased with TXA. A novel imaging biomarker (≥3% voxels in 10–20 Hounsfield unit range) showed promise for predicting TXA responsiveness but requires prospective validation. Conclusions: TXA reduces mortality in isolated mild-to-moderate TBI when administered early (within 2 hours), with the strongest evidence supporting its effect in patients with reactive pupils and smaller baseline bleeding volumes. TXA does not improve survival in severe TBI, and observed harm signals are likely confounded. Emergency physicians should consider early TXA administration in mild-to-moderate TBI with intracranial haemorrhage, while severe TBI patients should follow standard protocols pending further research.

Aim/Objective: This study aimed to examine how a buddy-supported onboarding program affected early-career nurses in medical-surgical units, focusing on their integration, perceived support, sense of belonging, confidence, competence, and turnover intention. Background: Early-career nurses often face significant obstacles when they enter clinical practice, including stress, low self-esteem, and a lack of professional support. These difficulties can increase job dissatisfaction and turnover intention, particularly in demanding settings such as medical-surgical units. Many healthcare organizations have adopted buddy-supported onboarding programs to help new nurses integrate, develop professionally, and stay in their roles. Design: The study used a qualitative phenomenological design. Method: The researcher recruited seven registered nurses with fewer than three years of clinical experience in medical-surgical units at King Abdulaziz National Guard Hospital in Al Ahsa, Saudi Arabia, using purposive sampling. Data were gathered through semi-structured, in-person interviews and analyzed thematically using Braun and Clarke’s approach. Results: The analysis produced six themes: structured onboarding supports early adjustment; buddy support acts as an emotional and practical anchor; a sense of belonging develops gradually and depends on team dynamics; psychological safety strengthens learning and confidence; inconsistent support hinders confidence development; and interpersonal and family-related factors shape turnover intention. Conclusions: Buddy-supported onboarding programs can build early-career nurses’ confidence, strengthen their professional integration, and ease their early adjustment. To support nurses’ transition and improve workforce retention, healthcare organizations should reinforce structured onboarding frameworks and ensure consistent coaching.

Forensic science is a broad field that covers a variety of scientific disciplines used to investigate crimes through the examination of physical evidence found at the crime scenes. Evidence can determine if a crime has occurred or not. Evidence is a vital object in all crime scenes, which may exist in the form of solid, liquid or gas. Sometimes, it may be visible or invisible, and most of the impression evidence found at the scenes is visible. Some of the examples of impression evidence include fingerprints, handprints, footprints, tyre prints and so on. The first officer who visits the crime scene preserves the crime scene to avoid evidence damage until the police investigator arrives. At the initial stage of investigation, forensic officers give importance to estimating stature, gender and body weight from physical evidence left by the offenders through the anthropometric technique. Researchers have shown that impression evidence can be used to determine the above three components. But whenever dealing with stature estimation from impression evidence, ethnicity should be considered because impression evidence varies from one ethnicity to another. Hence, the present study was planned to investigate the relationship between stature and handprint among Indians living in the Klang Valley region in Selangor state, Malaysia. It is the maiden study conducted in the Klang Valley, one of the regions in Selangor state, Malaysia.

Background: Early mobilization (EM) is an evidence-based approach that promotes physical activity in critically ill patients in intensive care units, though its implementation remains challenging. Aims: To examine the perceived barriers to EM and assess differences according to clinical role, unit type, and years of experience among healthcare providers in critical care units. Methods and Materials: A cross-sectional, survey-based design was used. Using convenience sampling, 376 healthcare providers were recruited from critical care units across Saudi Arabia. Data were collected via the validated Patient Mobilization Attitudes and Beliefs Survey for Intensive Care Unit (PMABS-ICU). Descriptive statistics and one-way analysis of variance (ANOVA) were used for analysis. Results: Participants were 39.1% male and 60% female. Respiratory therapists reported the highest overall perceived barriers (M = 40.4, SD = 7.4), followed by nurses (M = 38.5, SD = 9.3), physicians (M = 36.1, SD = 8.1), and physical/occupational therapists (M = 33.7, SD = 8.1); (p = 0.001). Attitude-related barriers had the highest mean score (M = 39.6, SD = 11.7), followed by knowledge (M = 37.7, SD = 16.8) and behavior (M = 37.3, SD = 9.5). Significant associations were observed between barriers and clinical role (p = 0.001), unit type (p < 0.001), and years of experience (p = 0.001). Conclusions: Findings highlight that attitude-related barriers were the highest among healthcare providers. Therefore, targeted training programs are essential to strengthen healthcare providers' confidence and competence in implementing safe mobilization practices for critically ill patients.

Background: Artificial intelligence (AI) is increasingly being integrated into healthcare systems, including dentistry, where it has applications in diagnosis, treatment planning, digital imaging, and patient communication. Public understanding of AI technologies may influence future adoption of digital healthcare systems; however, awareness of AI applications in oral healthcare among community populations remains inadequately explored. Aim: To assess digital literacy and awareness regarding artificial intelligence technologies in oral healthcare among participants attending a community oral health screening setting. Materials and Methods: A cross-sectional questionnaire-based survey was conducted among 250 participants attending a community oral health screening setting. A structured and validated questionnaire assessed awareness of artificial intelligence, familiarity with AI applications in healthcare and dentistry, and sources of digital health information. Associations between demographic variables and AI awareness were analyzed using Chi-square tests. Statistical significance was set at p < 0.05. Results: Awareness regarding artificial intelligence technologies varied among participants. Educational status demonstrated a significant association with AI awareness (p = 0.021), with participants having higher educational attainment exhibiting greater familiarity with AI applications in healthcare. Participants with greater exposure to digital technologies showed improved awareness regarding AI-based healthcare systems. No statistically significant association was observed between age group and AI awareness (p = 0.084). Conclusion: Educational status and digital literacy appear to influence community awareness regarding artificial intelligence technologies in oral healthcare. Improving public familiarity with digital healthcare systems may support future integration of AI-assisted technologies into oral healthcare delivery and patient communication.

Following the complete removal of fuel subsidy in 2023 by the Nigerian government, the effects are still subject of debate to both proponents and opponents of the policy. While its proponents believe it had saved huge revenue and blocked leakages in government expenditures thereby saving funds for developmental project, its opponents believe it has worsened the socioeconomic conditions of the populace through wide spread poverty and inequality in the society. The study focuses on a critical analysis of the effect of fuel subsidy removal on poverty alleviation and bridging the inequality in Nigeria. The work adopted the documentary and qualitative research design. Also, secondary sources of data were explored to generate data needed for the study and content analysis method was used to analyze the derived data. The study findings reveal that the removal of subsidy have strong effects on societal poverty and inequality in Nigeria and thus far the impact of palliative measure put in place are yet to meaningfully change the status quo. The study therefore recommends the need for the government to ensure its policy formulation and policy implementation process are well guided to address the challenges posed by the removal of fuel subsidy.

Background: School vision screening is an effective strategy for early detection of visual impairment among children. However, shortage of eye care personnel in low- and middle-income countries necessitates the involvement of non-eye health workers such as school teachers. This study assessed the usability of trained school teachers for vision screening and identification of common eye conditions among primary school pupils in Kaduna North Local Government Area, Nigeria. Methods: A cross-sectional analytic study was conducted among 352 primary school pupils aged 5–15 years selected from 11 public and private schools in Kaduna North Local Government Area. Twenty-two teachers (two per school) underwent structured training on visual acuity assessment using Peek Acuity and Tumbling E-chart as well as identification of common external eye abnormalities. Teachers screened pupils for vision impairment and ocular abnormalities and referred suspected cases for evaluation by an ophthalmology research team. Data were analysed using Stata MP version 14. Results: The teachers successfully screened all 352 pupils comprising 704 eyes. Eighteen pupils (2.6%) were identified as having visual acuity worse than 6/12 using Peek Acuity while 14 pupils (2.0%) were identified using the Tumbling E-chart. Teachers identified ocular abnormalities in 96 pupils (27.3%), including itching (16.8%), eye discharge (5.4%), red eye (4.6%), and abnormal whitish reflex (0.6%). Overall, 110 pupils (31.3%) were referred for further ophthalmic assessment. Subsequent evaluation by the ophthalmology team confirmed ocular conditions among referred pupils, including conjunctivitis, refractive errors, cataract, ptosis, and corneal scars. The prevalence of refractive error was 2.3%, while vision impairment was detected in 2.27% of pupils. Agreement between teacher-administered visual acuity assessments using Peek Acuity and Tumbling E-chart was high (Cronbach’s alpha = 0.804). Conclusion: School teachers can effectively participate in vision screening following structured training. Their ability to identify visual impairment and common ocular abnormalities demonstrates the feasibility of integrating teacher-led screening into school eye health programmes. This approach may improve early detection and referral of eye conditions in resource-limited settings.

C-shaped canal configuration is a complex anatomical variation most commonly in mandibular second molars. It is characterized by fused roots and a continuous or semicircular canal system with fins, webs, and interconnections that complicate cleaning, shaping, and obturation. The prevalence of C-shaped canals varies significantly among different populations, with higher incidence reported in Asian groups encountered and frequent bilateral occurrence when present unilaterally. Fan’s classification provides a standardized method to categorize C-shaped canal morphology. Successful management requires modification of conventional endodontic techniques and the use of thermoplastic obturation methods to achieve three-dimensional sealing. This case report describes the nonsurgical management of bilateral continuous C-shaped canals (Fan’s C1 configuration) in mandibular second molars of a 24-year-old male patient using controlled rotary instrumentation up to size 25/.06 followed by single cone obturation technique.

This study scrutinizes the history curriculum's pedagogical approaches and civic engagement in Lakes State, South Sudan. History curriculum in South Sudan is evolving from a colonial-influenced system towards a national framework emphasizing peacebuilding, critical thinking, and civic engagement, though it faces severe challenges, including a lack of qualified teachers, limited resources, and contested historical narratives. The curriculum prioritizes “unity in resistance" to foster national identity while struggling with the challenges of teaching sensitive, recent conflict history. History curriculum’s pedagogical approaches have shifted from a 19th century focus on nationalistic, elite-driven narratives to a 21st century emphasis on critical thinking, inquiry, and civic engagement. This evolution aims to use the study of the past to prepare students for active participation in democratic societies through pedagogical strategies like historical thinking, empathy, and evidence analysis. The study was analyzed under historical thinking / disciplinary theory, critical constructivism theory and narrative/chronological theory. A case study design was used, with a sample of 429 history teachers and head teachers from public secondary schools in Lakes’ state, South Sudan. The study's results are reliable with existing research on civic education and civic engagement, which suggests that the development of the understanding of historical and chronological time, independent of cognitive development of the person, must be understood above all as an educative process in which strategies and mediums employed are fundamental.

For a sociologist, poverty is a social evil. A social worker does modalities related to poverty alleviation. An anthropologist sees the phenomenon as an obstacle in the human race. For a student of human development, it hiders the development right at the budding stage. A philosopher has so many unanswered questions related to poverty. An economist sees the phenomenon as a multidimensional process. Public health sees the phenomenon as the background of all ill health where as an epidemiologist sees it as a stage of health in the domain of epidemiology. In India, Bollywood made movies like ‘Mother India’ & ‘Boot Polish’ to portray poverty. Least of all, it is a tool that politicians use 24*7. The current article sees the phenomenon of poverty in the current circumstances especially in India. Process, obstacles, challenges, opportunities, emerging issues, alleviation strategies are all discussed upon in the article. Views of academicians, policy makers, nobel laureates, politicians, executives, civil society organizations & think individuals & institutions are embedded in the current article.

Behçet’s disease is a chronic multisystem inflammatory disorder in which vascular involvement represents a major cause of morbidity and mortality. Although venous thrombosis is common, pulmonary embolism remains a rare and potentially life-threatening manifestation related to an inflammation-driven thrombotic mechanism. We report the case of a 70-year-old man with long-standing Behçet’s disease complicated by previous superior vena cava thrombosis, who was diagnosed with pulmonary embolism. Clinical presentation was nonspecific. Clinical probability assessment using the Wells and revised Geneva scores guided the diagnostic approach. Electrocardiographic findings were non-diagnostic, while transthoracic echocardiography allowed hemodynamic assessment and risk stratification. Computed tomography pulmonary angiography confirmed the diagnosis. This case underscores the diagnostic and therapeutic challenges of pulmonary embolism in Behçet’s disease and highlights the need for individualized management balancing immunosuppressive therapy and anticoagulation