Background: Gestational Diabetes Mellitus (GDM) is a common pregnancy complication linked to higher perinatal risks for mother and baby. Elevated serum uric acid levels can contribute to insulin resistance by inhibiting the insulin-mediated release of endothelial nitric oxide and directly impacting the adipocytes. During the first trimester, serum uric acid levels are similar to pre-conception levels, so increased levels may signal a higher GDM risk. Objective: Our study was conducted to analyse the relationship between first-trimester serum uric acid levels and the development of GDM. Additionally, we sought to evaluate the potential of elevated serum uric acid as an early predictor of GDM. Methods: This prospective observational study recruited eligible antenatal women with live singleton pregnancies and a gestational age of less than 15 weeks who attended the outpatient clinic using convenience sampling. Pregnant women with a gestational age above 15 weeks, overt diabetes mellitus, those taking steroids in any form, or consuming drugs known to increase serum uric acid levels, as well as women with gout, other endocrine disorders, chronic renal disease, liver disease, cardiovascular disorders, or who smoked, were excluded. Blood tests were conducted, and serum uric acid levels exceeding 3.5 mg/dL were regarded as elevated. The study participants underwent an oral glucose tolerance test (OGTT) between 24 and 28 weeks of gestation. GDM was diagnosed according to the criteria of the Diabetes in Pregnancy Study Group India (DIPSI). A statistical analysis was performed, including measures of diagnostic performance. Results: One hundred and eight antenatal women participated in the study, with a mean age of 23.6 (± 4.08) years. Most women (46.3%) were aged 21 to 25, and the majority (56.5%) were primigravida. The prevalence of GDM in this group was 19.4% (21/108). A univariate analysis was performed to investigate the relationship between serum uric acid levels and various factors. Women with first-trimester serum uric acid levels exceeding 3.5 mg/dL demonstrated a significant (p < 0.001) correlation with abnormal OGTT results. The diagnostic performance tests for elevated first-trimester serum uric acid levels in predicting GDM revealed a sensitivity of 90.5% and a negative predictive value of 97.1%. Conclusion: We concluded that elevated serum uric acid in the first trimester is linked to a higher risk of developing GDM and may serve as a screening tool for early identification.

Background/aim: The PMS2 gene was evaluated for its role in the pathogenesis of breast cancer by analyzing its expression in blood samples obtained from healthy postmenopausal women, newly diagnosed breast cancer patients, and the same patients following surgical and therapeutic treatment. Materials and Methods: A total of 47 blood samples were analyzed, including 7 from healthy controls, 20 from newly diagnosed breast cancer patients (disease group), and 20 from the same patients’ post- treatment (cure group, 4 months’ post-surgery or therapy). RNA extraction, cDNA synthesis, and RT-PCR analysis were performed on blood samples to determine the expression levels of the PMS2 gene across groups, providing insight into the genetic changes associated with breast cancer progression and the impact of clinical interventions. SPSS was used for statistical analysis, including correlation and paired-sample t-tests. Results: PMS2 expression exhibited a highly significant difference between group 1 (healthy control), which showed no expression, and group 2 (disease group), which demonstrated upregulation of the PMS2 gene (P < 0.001, paired sample t-test) with a 99% confidence interval. A downregulation of gene expression was observed in group 3 (cure group) after treatment, and the comparison between the disease and cure groups revealed a statistically significant difference (P = 0.042, paired t-test) with a 95% confidence interval. The majority of patients aged 50–60 were diagnosed with stage 2 invasive ductal carcinoma. This systematic regulation of PMS2 expression highlights its role in disease development, progression, and therapeutic response. Conclusion: The data confirmed the involvement of the PMS2 gene in breast cancer aggressiveness and progression.

This article identifies the critical legal and sociolegal issues of marital rape in Islamic countries, and calls for immediate reform. Despite recent achievements in promoting women's rights and facilitating access to justice, marital rape remains legally and socially undefined in many Islamic countries. This article employs a comprehensive comparative analysis of statutory law, case laws, and judgements in Islamic countries such as Bangladesh, Saudi Arabia, and Malaysia, comparing this to developed Western jurisdictions, including the UK, the US, and Australia. The analysis draws upon statutory law, landmark cases, and scholarly literature to identify the significant gaps produced by traditional interpretations of marital acquiescence. These results highlight the need for substantial legislative reforms, and encourage policymakers and human rights to advocate the adoption of progressive and consent-based approaches in line with universal human rights principles. More importantly, this study provides practical recommendations for bringing about real policy changes and for enhancing the protection of women's rights and dignity in marriages in Islamic-majority countries.

Objectives: To investigate the existing literature on the pharmacokinetics (PK) and pharmacodynamic (PD) of anesthetic agents in obese children. Methods: A total of 419 pertinent publications were found after a comprehensive search across four databases. 26 full-text publications were examined after duplicates were eliminated using Rayyan QCRI and relevance was checked; five studies finally satisfied the requirements for inclusion. Results: We included five studies with a total of 10,570 children and less than half of them 4741 (44.8%) were females. Research on the PK of propofol in obese adolescents identified total body weight (TBW) as a key determinant of drug clearance, emphasizing the limitations of relying solely on clinical factors for dosing. Additionally, a study on fentanyl highlighted the importance of TBW for loading doses and LBW/ lean body weight (LBW) for maintenance dosing, while cautioning against the heightened susceptibility of severely obese patients to fentanyl's respiratory side effects, necessitating careful PD considerations. Conclusion: Anesthesia management in obese children requires addressing unique physiological and pharmacological challenges. This review emphasizes the importance of TBW in dosing strategies and the integration of LBW and IBW for maintenance regimens to minimize risks. While offering valuable insights, further research is needed to validate these findings and establish standardized protocols, ultimately enhancing safety and efficacy in anesthetic care for obese pediatric patients.

Introduction: Determining whether an ovarian tumor is benign or malignant before surgery can change the treatment plan and aid in early identification. Transvaginal ultrasonography, in particular, is a useful technique for ovarian tumor detection. Early diagnosis is crucial since the majority of ovarian cancers are epithelial ovarian cancers (EOC), which grow quickly. Treatment can be more successful if a gynecologic oncologist is consulted right away to diagnose the type of tumor. Methods: A descriptive cross-sectional study was conducted among 400 patients presenting with adnexal masses at the Saudi Hospital for Obstetrics and Gynecology in Khartoum, Sudan, from January to May 2025. Transvaginal and abdominal ultrasonography were utilized to evaluate adnexal lesions. Data on patient demographics, symptoms, and medical history were analyzed to assess correlations with ultrasound findings and final diagnoses. Results: The study found that the most affected age group by ovarian tumors was those in 26-40 years, which constituted 42% and 41-55 years represented 28.25%. Approximately 43.3% of patients were asymptomatic, more than half were symptomatic, with pain being the most prevalent symptom. Ultrasonography classified 68.8% of masses as benign and 22% as malignant. Significant associations were found between ultrasound features, such as irregular contour, ascites, papillary projections, and vascularity, and the presence of malignancy. Older age and a history of breast cancer were also significantly associated with malignant lesions. Statistical analyses demonstrated that specific ultrasonographic features effectively predict ovarian malignancy. Conclusion: Ultrasonography is an efficient and dependable method for identifying, assessing, and categorizing ovarian cancers. Combining the patient's age, medical history, and ultrasound characteristics improves diagnostic precision, enables prompt and effective treatment, and lowers the risk of surgery.

Student enrolment, financial challenges, technology integration, and curriculum diversification have increasingly competition among higher education institutions. The ideal future workforce must possess not only technical expertise but also strong skills in complex problem solving, critical thinking, creativity, human resource management, and teamwork. In addition to analytical and leadership capabilities, these competencies are essential for thriving in a rapidly evolving digital economy. However, limited study has been conducted to assess Indonesia's readiness to engage with this digital transformation. The aim of this study to examine the correlation of 4.0 educational adaptation and school management on student performance in higher education in Borobudur University. This study uses applied research with a cross-sectional design to examine the impact of technological infrastructure and faculty management on student’s performance. The population consists of employee at Borobudur University with a sample 40 respondents including leaders, lecturer and education staff. The result found that, the bivariate analysis of technological infrastructure, strategic planning and policy making, operational management, student assessment have significant relationship with performance. p value 0.000. The final model the variable technological structure significant correlation and operational management as confounding factor of student assessment R 0.603, RR 0,364 (36.4%) VIF 2.955.; Strategic planning and policy making was significant with Student performance and technological infrastructure as confounding factor with student performance R 00,609, R2 0,371 (37.1%), VIF 2,277. Student performance, student assessment significant correlation with Student Performance R 0,460, R2 0211 (21,1%), p 0.003, VIF 1.000. Conclusion technological infrastructure and operational management correlation with student assessment; strategic planning and policy and technological infrastructure correlation with student performance; student performance significant correlation with student performance.

Patient safety has become a central concern in healthcare systems worldwide due to its direct impact on healthcare quality, patient outcomes, and overall public health. It encompasses not only the delivery of clinical care but also the creation of a patient safety culture within healthcare organizations. Patient safety culture refers to the collective attitudes, behaviors, reporting, auditing, values, and beliefs that influence safety-related practices in healthcare institutions [1]. A strong safety culture is crucial because it shapes how healthcare professionals approach safety, address potential hazards, and collaborate in preventing errors. This literature review explores recent developments in the implementation of patient safety culture within the healthcare system in Saudi, highlighting successful strategies, challenges encountered, and gaps in existing research.

Introduction: The worrying increase in multi-resistant Gram-negative bacilli (GNB) infections and the glaring lack of therapeutic alternatives has allowed colistin to regain a place in the antibiotic arsenal, often as a last resort. This study aimed to evaluate a method for testing sensitivity to colistin that is simple, inexpensive, and accessible: disk diffusion, compared to the gold standard method of liquid microdilution. Materials and methods: A comparative study was conducted on 124 strains of Gram-negative bacilli. Each strain was tested by agar diffusion (50 µg colistin disk) and broth microdilution (Sensititre® plate). Results: Our results showed that the diffusion method does not meet the performance criteria established by the CLSI, with a particularly high major error rate (45.8%) and a categorical agreement of 83.1%. Conclusion: Disk diffusion cannot be considered a reliable method for testing colistin susceptibility in the laboratory.

Genital tuberculosis is a rare but significant cause of infertility and chronic pelvic disease, particularly in countries with a high tuberculosis burden. It is often underdiagnosed due to its asymptomatic or non-specific clinical presentation. We report the case of a 38-year-old woman with a history of treated peritoneal tuberculosis, in whom ovarian tuberculosis was revealed by bilateral pyosalpinx.

Chryseobacterium indologenes is a rare but emerging opportunistic Gram-negative pathogen, primarily isolated from hospital environments and associated with severe infections in immunocompromised or critically ill patients. We report the case of a 2-year-old girl with a history of recurrent bronchopulmonary infections and recent cardiac surgery for a subaortic membrane, who developed sepsis postoperatively.

All of forms life needs water to survive. Therefore provision of clean water for consumers either for drinking or for irrigation purpose is necessary. But nowadays the quality of water is deteriorating day by day due to exposure of several contaminants like domestic and industrial solid waste and effluents, different microbial pathogens and toxic chemicals which frequently cause waterborne pathogenesis and diseases in Pakistan. In current study, the water samples from tehsils of district Kasur were collected which is considered as an industrial hub and center of agriculture and much populated too. That is why; different physiochemical and microbial parameters of water samples of tap, filter plants, tube well and canals of Kasur region were examined. In these parameters the pH, turbidity, hardness, acidity of water, alkalinity of water, total dissolved solids, microbial contamination, level of bioaccumulation and many other factors were observed. A hospital based survey was also performed to gather information about the waterborne diseases. The obtained results showed that the values of some parameters were within permissible limit whereas some of them were not according to the WHO standard. It was concluded that the water of district Kasur is not good for drinking and irrigation purposes. In this regard a proper guideline should be provided to the general public by government and private sector concerned departments to improve public health of selected region.

Schmidt's syndrome combines several autoimmune diseases, including Addison's disease, thyroiditis and peripheral gonadal insufficiency. A 21-year-old female presented 15 days prior to admission with a digestive complaint of nausea, vomiting, generalised asthenia and epigastric pain, all evolving in a context of weight loss. Clinical examination revealed an altered patient, hypotensive to 80/60 mmHg, normocardial to 70 bpm. Paraclinical examinations revealed acute renal failure, hyperkalaemia (8 mmol/l) and hyponatraemia (124 mmol/l). Given the hyperkalaemia without electrical signs on ECG, the patient was treated with Kayxalate and calcium gluconate and hydration with saline and sodium; the blood ionogram improved. In the face of chronic constipation, a TSH was performed, returning to 11 uui/ml with antiTPO antibodies at 1000. An ultrasound scan revealed thyroiditis, and the patient was put on levothyrox 50ug/d. The patient continued to suffer from profound asthenia and also reported secondary amenorrhoea for 4 months with negative BHCG and a hypophysiogram showing hypergonadotropic hypogonadism in favour of primary ovarian failure. On re-examining the patient, our attention was drawn to the presence of hyperpigmentation of the skin and slate- coloured patches, slate-coloured patches in the oral mucosa. The diagnosis of Addison's disease was suspected. A cortisol assay was ordered, which came back collapsed at 0.01μg/dl with ACTH elevated to 199pg/ml with anti-21-hydroxylase antibodies at 5.0U/ml (VN<0.4) confirming the diagnosis. The patient was started on intravenous hydration and hydrocortisone, with marked improvement in clinical and paraclinical parameters and restoration of menstrual cycles, followed by oral hydrocortisone and fludrocortisone. As part of the etiological diagnosis, an adrenal CT scan revealed adrenal atrophy (absence of visible adrenal parenchyma). Other autoimmune disorders in the context of polyendocrinopathy were ruled out in our patient. Adrenal insufficiency is most often caused by an autoimmune disease. Autoantibodies to steroidogenic enzymes in the adrenal cortex are present in 86% of patients with primary autoimmune adrenal insufficiency, the most common antibody being anti-21- hydroxylase.

This study aims to analyze the implementation of restorative justice-based prosecution terminations as an effort to strengthen the role of the Prosecutor's Office in Indonesia. To date, the Prosecutor's Office has been more dominant in carrying out conventional prosecution functions oriented towards retaliation. However, with the growing paradigm of restorative justice, an approach focused on restoring relationships, compensation, and reconciliation between perpetrators, victims, and the community has become relevant. This study uses normative legal research methods with a statutory and conceptual approach. The results show that restorative justice-based prosecution terminations, as stipulated in various Prosecutor's Office regulations, offer significant potential to reduce case backlogs, provide substantive justice for victims, and encourage more constructive accountability of perpetrators. The Prosecutor's Office's role in this process is no longer merely to prosecute, but also to facilitate dialogue, mediation, and ensure the achievement of restorative agreements. Effective implementation of this policy is expected to strengthen the Prosecutor's Office's image as a humanistic law enforcement agency responsive to the needs of the community, while supporting the creation of a more just and dignified criminal justice system in Indonesia.

Background: With the increasing global movement of labor migrants, the risk of cross-border transmission of infectious diseases remains a public health concern. Pre-departure medical screening plays a vital role in identifying asymptomatic carriers and preventing disease spread. This study aimed to evaluate the seroprevalence of key infectious markers among pre-departure migrant workers and highlight implications for public health screening policies. Methods: This cross-sectional study was conducted at the Department of Biochemistry, Muscat Medical Center, Dhaka, Bangladesh, from January to December 2024. A total of 450 migrant workers undergoing routine pre-employment medical screening were enrolled. Blood samples were analyzed for HIV I/II, Hepatitis B surface antigen (HBsAg), Hepatitis C virus (HCV) and syphilis (VDRL and TPHA). Data were analyzed using SPSS version 25. Results: Among the 450 participants, the majority were male (92%) and aged between 20–39 years (82%). Most had completed at least primary (30%) or secondary education (42%). Regarding medical fitness, 93.8% were declared fit, 5.1% held up and 1.1% unfit. Only HBsAg showed seropositivity: 5 individuals (1.1%) tested positive, of whom 2 were unfit and 3 held up for confirmation. All participants tested negative for HIV, HCV, TPHA and VDRL. A detailed review showed 442 (98.2%) were HBsAg negative, 2 (0.4%) positive and 6 (1.3%) required retesting. Conclusion: The overall seroprevalence of infectious markers was low, with Hepatitis B being the only positive finding. These results support the importance of maintaining comprehensive pre-departure infectious disease screening to ensure public health safety and early intervention.

A comparison of Automated and manual methods to determine the hemoglobin concentration and Hematocrit was done using a specified sample size of randomly selected patients. All the samples were subjected to Hb and Hematocrit estimation by using both manual and Automated methods. A significant difference between manual and automated Hct mehods was found. There was a good correlation between Cyanmeth-Hb and Automated method. The Cyanmeth-Hb is a gold standard for Hb estimation and also carries a biotoxic hazard. However, there was a statistically significant difference between Sahli’s and cyanmeth- Hb method, but there was a good correlation. The Hct estimation by manual and automated methods showed an excellent relationship and no significant difference was noted between two methods and that can be used interchangeably.