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

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

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

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

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

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

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

Non-alcoholic fatty liver disease (NASH) has become the most widespread liver disease in the world, mainly due to obesity and metabolic syndrome. We conducted a retrospective study, selecting the records of patients followed for obesity over a 2-year period. All patients over 18 years of age, with a BMI greater than 30kg/m2, without diabetes or hypertension were included. After eliminating patients with chronic liver disease, thrombocytopenia or elevated liver enzymes associated with other pathologies, notably muscular, drug or thyroid disease, we collected clinical and biological data. The FIB-4 score was calculated according to the formula: (age (years) × ASAT (U/L)/platelets (PLT) (109/L) × √ALAT (U/L)). We found that in 50 patients, a FIB-4 score below 1.30 was associated with a high negative predictive value, suggesting that severe fibrosis was unlikely in these cases. In the zone of uncertainty, corresponding to FIB-4 values between 1.30 and 2.67, we identified 18 cases, and which require further evaluation to accurately determine the level of fibrosis. Two cases had a positive predictive value for advanced fibrosis, underlining the need for early and specialized management. These results may help to improve clinical management by identifying patients at risk of severe fibrosis and providing them with the appropriate treatment.

Background: Medical device-associated healthcare infections [MDHAIs] represent a critical threat to patient safety worldwide, constituting approximately 30% of nosocomial infections and imposing substantial morbidity, mortality, and financial burdens on healthcare systems. Objectives: This comprehensive review synthesizes current evidence on the epidemiology, microbiology, pathogenesis, prevention, and quality-of-life implications of MDHAIs, with emphasis on sterilization protocols, reprocessing standards, and emerging antimicrobial technologies. Methods: A systematic literature review was conducted examining device-associated infections in intensive care settings, including central line-associated bloodstream infections [CLABSI], catheter-associated urinary tract infections [CAUTI], and ventilator-associated pneumonia [VAP]. Key Findings: The epidemiology of MDHAIs continues to evolve, with multidrug-resistant [MDR] and extensively drug-resistant [XDR] pathogens demonstrating enhanced biofilm formation capacity [up to 1000-fold increased resistance to antimicrobial agents compared to planktonic cells]. Current surveillance data reveals CAUTI incidence of 1.67 per 1000 catheter-days, CLABSI at 0.59 per 1000 central line-days, and VAP at 4.63 per 1000 ventilator-days. Evidence-based prevention bundles have achieved CLABSI reductions of 60–90% and VAP reductions exceeding 40% in institutional settings. Device-associated infections profoundly impact quality of life through extended hospitalization, prolonged recovery, and significant psychological morbidity including anxiety, depression, and post-intensive care syndrome. Conclusions: Effective prevention of MDHAIs requires multifaceted approaches encompassing appropriate device classification, adherence to ISO 17664:2021 reprocessing standards, rigorous quality assurance monitoring, comprehensive staff training, implementation of bundle prevention strategies, and integration of clinical engineering expertise. Novel antimicrobial technologies [bacteriophages, endolysins, antimicrobial peptides] and anti-adhesion surface coatings offer promise for future device sterilization. Sustainability imperatives and evidence supporting reusable device efficacy warrant reconsideration of single-use device reliance, coupled with investment in institutional reprocessing infrastructure and patient-centered education.

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

Parkinson's Disease (PD) is a debilitating neurodegenerative disorder characterized by motor deficits and dopaminergic neuron degeneration. Haloperidol, a widely used antipsychotic, has been reported to induce parkinsonism-like symptoms in animal models. This study investigates the potential neuroprotective effects of lutein, a carotenoid with antioxidant properties, against haloperidol-induced Parkinson's disease in Wistar rats. A total of Thirty (30) healthy Wistar rats weighing between 100 -150g were used for this study. The rats were acclimatized and divided into six groups (n=5 per group); Group 1 (Control), Group 2 (Haloperidol group), Group 3 (Haloperidol + 20mg/kg of lutein), Group 4 (Haloperidol + 40mg/kg of lutein), Group 5 (Haloperidol + 60mg/kg of lutein) and Group 6 (Haloperidol + donepezil group). Motor deficits were assessed using behavioral tests like Barnes maze test, hand grip test, rotarod test and Y maze test. While biochemical analyses were performed to evaluate oxidative stress markers. The results demonstrated that rats treated with haloperidol alone had a significantly higher latency compared to the control group. This suggests that haloperidol negatively impacted spatial learning and memory, as indicated by the increased time taken to find the target. Lutein, especially at 40mg/kg and 60mg/kg, as well as the standard drug donepezil were seen to have neuroprotective effects against the spatial learning and memory deficits induced by haloperidol in Wistar rats. This study showed that Haloperidol induced both the motor symptoms such as muscle rigidity and also the non-motor symptoms of Parkinson disease such as anxiety, oxidative stress, and impaired memory on the rats and lutein possesses a dose-dependent increase in learning ability and cognitive functions and decrease in oxidative stress and fatigue.

Class III malocclusion, resulting from mandibular prognathism, maxillary retrusion, or a combination, can severely affect function and facial aesthetics. While mild forms respond to orthodontic camouflage, severe skeletal discrepancies in adults usually require surgical correction. This report presents two adult cases treated with Le Fort I maxillary advancement and bilateral sagittal split osteotomy (BSSO) setback, followed by post-surgical orthodontic finishing to ensure occlusal stability and facial harmony. Orthognathic surgery not only corrected the skeletal disharmony and improved masticatory function but also enhanced patient self-esteem and quality of life, emphasizing the importance of coordinated orthodontic–surgical planning.

The Contemplation Sutra is central to the Pure Land Buddhist tradition, although its philosophical elements have received little scholarly study beyond doctrinal exegesis. This paper addresses the sutra as a systematic "salvific paradigm," using phenomenological tools to explain the fundamental patterns of religious awareness and soteriological orientation. Through rigorous examination of the sutra's symbolic imagery, contemplative activities, and doctrinal formulations, the research uncovers a coherent framework in which faith cultivation, meditative visualization, and ethical discipline interact to produce transforming liberation experiences. Central motifs, including the luminous body of Amitābha, the architecture of the Pure Land, and the sequential practices of visualization, are interpreted as expressions of intentionality and numinous encounter, rather than mere ritual prescriptions. By situating the sutra within the phenomenological discourse of Otto, Eliade, and Husserl, the paper demonstrates how its narrative and symbolic elements constitute a rigorous philosophical system oriented toward human emancipation. The analysis further suggests that the Contemplation Sutra exemplifies a dynamic interaction between experiential insight and doctrinal articulation, providing a model for understanding religious texts as cognitive and affective systems. Ultimately, this study contributes to both Buddhist studies and philosophy of religion by offering a framework that interprets traditional devotional practice as a philosophically coherent structure, bridging the domains of textual scholarship, phenomenology, and ethical reflection.

This study investigates the linguistic characteristics, pragmatic functions, and legal implications of formal and humorous speech across digital media by employing a forensic linguistic and multimodal analytical framework. Drawing on data from the Indonesian comedy program Lapor Pak! and the Korean film Vincenzo, the research examines how formal and humorous utterances are constructed, interpreted, and potentially contested within online and audiovisual environments. The analysis focuses on the interplay between linguistic form, speaker intention, and contextual cues, as well as the extent to which multimodal elements—such as visual cues, sound effects, gestures, and cinematography—shape or intensify meaning. Findings reveal that formal speech, although structurally explicit, may still generate legal vulnerabilities when embedded in parody or institutional impersonation. Conversely, humorous speech, characterized by ambiguity, irony, and linguistic deviation, is prone to misinterpretation as defamation, hate speech, or harassment, particularly in digital settings lacking shared contextual knowledge. The study further argues that multimodality amplifies interpretive risks by reinforcing or altering the illocutionary force of an utterance. Overall, this research demonstrates the value of integrating pragmatic, discourse, and multimodal perspectives within forensic linguistic analysis to better understand how digital communication practices may trigger social and legal consequences. The findings contribute to the development of digital literacy, ethical communication guidelines, and more context-sensitive approaches to evaluating public speech in online environments.

This study investigates the influence of fin morphology on predator-prey dynamics among selected fish species in Kwatan Giwa River, Niger State, Nigeria. A total of 192 fish samples representing eight species were collected biweekly from June to August 2024 at the Kwatan Giwa River fish landing site. Fish species were identified using standard taxonomic guides. Morphometric measurements of tail, pectoral, dorsal, and ventral fins were recorded using vernier calipers. Gut content analysis was conducted following modified Waraniak et al., (2019) procedures to determine dietary components and establish trophic relationships. Data were statistically analyzed to assess variations in fin structures and their ecological implications. The findings revealed significant interspecific variations in fin morphology. Species like Tilapia zilli and Auchenoglanis biscutatus possessed higher pectoral and ventral fin lengths, facilitating better maneuverability and habitat adaptability. Conversely, Siluranodon auritus exhibited consistently low fin measurements, indicating limited mobility and habitat specialization. The gut analysis revealed that Clarias gariepinus, identified as a piscivorous predator, had gut contents containing scales and remains of Tilapia spp, juvenile Synodontis, Labeo senegalensis, and Marcusenius senegalensis. In contrast, Tilapia spp, Labeo senegalensis, Auchenoglanis biscutatus, and Siluranodon auratus showed no fish remains in their guts, indicating non-piscivorous diets. The study successfully highlighted the relationship between fin size and predation strategies among selected fish species in the study area. However, Efforts should be made to protect the natural habitats of these fish species from degradation due to pollution, deforestation, and human encroachment.