Background: Laparoscopic cholecystectomy (LC) is traditionally performed under general anesthesia (GA), which ensures airway protection and optimal surgical conditions. However, GA is associated with notable drawbacks including hemodynamic fluctuations, delayed recovery, and increased postoperative discomfort. Thoracic segmental spinal anesthesia (TSSA) has emerged as a potential alternative, offering improved intraoperative stability and postoperative outcomes. Objective: To compare the intraoperative hemodynamic responses, perioperative complications, postoperative pain, and recovery profile between thoracic segmental spinal anesthesia and general anesthesia in patients undergoing elective laparoscopic cholecystectomy. Materials And Methods: This prospective, comparative observational study was conducted in the Ad-Din Akij Medical College Hospital, Khulna, during over 18 months from January’2023 to June 2024 and included 90 ASA I–II patients aged 25–55 years undergoing elective LC. Patients were randomized into two equal groups: Group a (TSSA) received 1.75 ml of 0.5% isobaric levobupivacaine with 25 µg fentanyl intrathecally at T9–T10; Group B (GA) received standard general anesthesia. Intraoperative heart rate and mean arterial pressure (MAP) were recorded at regular intervals. Postoperative outcomes included VAS pain scores, time to first analgesic, time to ambulation, and incidence of complications. Results: Baseline demographics were comparable between groups. Group A demonstrated significantly lower intraoperative heart rates and higher MAP values from 5 minutes after incision to the end of surgery (p<0.01). Postoperative VAS scores were significantly lower in Group A at 1, 3, and 6 hours (p<0.05). Time to first analgesic was longer (3.4±1.1 vs. 2.2±0.9 hours) and time to ambulation shorter (3.3±1.0 vs. 5.1±1.4 hours) in Group A (p=0.001). Perioperative complications were similar and not statistically significant between groups. Conclusion: TSSA is a safe and effective alternative to GA for laparoscopic cholecystectomy, offering superior intraoperative hemodynamic stability, better early postoperative analgesia, and faster recovery without increasing perioperative complications.

Endometrioid borderline tumours (EBTs) of the ovary are uncommon, comprising about 0.2% of all epithelial ovarian tumours. Here we report a case of ovarian endometrioid borderline adenofibroma because of its rarity, emphasising on its challenging histological diagnosis and the significance of uterine curettage to exclude synchronous endometrial adenocarcinoma. A 64-year-old woman presented with post-menopausal bleeding and pan hysterectomy was performed. Uterus showed atrophic endometrium with an adenomyomatous polyp and left ovary showed a nodulocystic mass measuring 7.5 x 5 x 5cm which was diagnosed as a case of endometrioid borderline adenofibroma.

Background: Trichuris trichiura (whipworm) is a common soil-transmitted helminth that contributes to significant morbidity among children in low-resource settings. This study aimed to determine the prevalence of T. trichiura infection and identify associated sociodemographic, behavioral, and environmental risk factors among children. Methods: A cross-sectional study was conducted involving 126 children aged 1–15 years. Data on demographics, hygiene practices, environmental exposures, and health history were collected through structured questionnaires. Stool samples were analyzed using the Kato-Katz technique. Chi-square tests and multivariate logistic regression were used to identify factors associated with infection. Results: The overall prevalence of T. trichiura infection was high. Bivariate analysis revealed significant associations between infection and abdominal pain (p < 0.0001), presence of worms in stool (p = 0.0031), proximity to animals (p = 0.0006), lack of family prevention education (p = 0.0404), and use of plain water for handwashing (p = 0.0068). In the adjusted model, abdominal pain remained a strong predictor (AOR = 12.64, p = 0.002), while proximity to animals showed a positive trend (AOR = 4.18, p = 0.078). Family exposure to preventive education was borderline protective (AOR = 0.28, p = 0.051). Conclusion: Abdominal pain is a key clinical indicator of T. trichiura infection. Environmental and behavioral factors, particularly living near animals and inadequate handwashing practices, contribute to infection risk. Community-specific health education and integrated sanitation strategies are essential for effective control.

Background: Family physicians in primary healthcare (PHC) settings frequently encounter emergency cases of varying severity. Managing such cases effectively requires structured protocols, proper training, and adequate equipment. This study aimed to identify the barriers faced by primary care physicians (PCPs) in managing emergency cases in Al Ahsa, Saudi Arabia. Methods: A cross-sectional study was conducted among PCPs working under the Ministry of Health (MOH) and National Guard Health Affairs (NGHA) in Al Ahsa. Data were collected using a self-administered electronic questionnaire distributed via official email and social media platforms. The instrument included sections on socio-demographic characteristics, a 10-item competency scale, a 12-item satisfaction scale, and the frequency of emergency cases encountered over the past 12 months. Results: Of the 414 respondents, 81.1% were female and 83.5% were aged between 25 and 34 years. Attendance at BLS, ACLS, and ATLS courses within the last 1–2 years was reported by 45.8%, 58.5%, and 50.4% of participants, respectively. Low competency levels were reported by 15.6% of physicians, and 18.9% expressed dissatisfaction in handling emergency cases. Higher competency and satisfaction scores were significantly associated with younger age, female gender, Saudi nationality, and possession of a bachelor’s degree. A positive correlation was observed between competency and satisfaction scores. Conclusion: The findings reveal moderate levels of competency and satisfaction among PCPs in managing emergency cases. Notably, older, male, and non-Saudi physicians demonstrated lower levels in both domains. Targeted training and continuous professional development are essential to enhance emergency preparedness in PHC settings.

This paper presents a critical strategic analysis of international carbon pricing and its environmental, economic, and social impacts. This discussion will rely on peer-reviewed articles, policy reports, and empirical studies that have been published between 2007-2024. It examines the effect of carbon taxes and emissions trading systems (ETS) in reducing greenhouse gas (GHG) emissions, technological innovation, and long-term structural change using a systematic literature review and content analysis. Distributional equity, competitiveness, administrative capacity, and risk of carbon leakage are also examined in the study. It also analyzes the complementary tools such as voluntary carbon markets, carbon border adjustments (CBAM), revenue-recycling frameworks and just transition frameworks. It shows that carbon pricing alone cannot be used to achieve the level of decarbonization required to meet international climate targets, but is an important pillar when used in conjunction with more robust regulatory, fiscal and industrial policies. International coordination, better policy design, better revenue utilization and social fairness are important in maximizing the effectiveness and legitimacy of carbon pricing across the globe. This paper provides policy implications to policymakers, scholars, and climate negotiators to develop sustainable and equitable carbon pricing systems.

This paper examines the impact of digital financial inclusion on poverty reduction in Nigeria. The study is motivated by the report on the financial Inclusion Insights (FII), (2017) and (2022) which revealed that about 65.0% of the adult populace was financially excluded without any form of access to financial services. Data collection techniques employed was self-administered questionnaire. The questionnaire were administered to a total of 538 household that are financially included in rural area from the North-West region of Nigeria, by using convenient and simple random sampling techniques to select the sample. In analyzing the relationship among the variables, a Partial Least Square (PLS)-Structural Equation Modeling (SEM) technique was adopted. The findings of the study revealed that there is a positive and strong significant relationship between the digital financial inclusion and poverty reduction. The paper recommends the digital financial inclusion to be more robust in the rural areas, provide services at any time and any place through mobile terminals such as mobile phones and provide internet services across localities.

Pre-eclampsia is a significant complication that may occur during gestation. It elevates blood pressure and harms organs, typically the liver and kidneys. It often commences after 20 weeks of gestation, and if not promptly identified and addressed, it can have severe repercussions for both the mother and the infant. Extensive research in Saudi Arabia has indicated that pregnant women had limited knowledge on the signs, risk factors, and complications associated with pre-eclampsia. This narrative review aims to provide a comprehensive review about the efficacy of educational interventions, particularly educational videos, in enhancing women's understanding of pre-eclampsia. Audiovisual tools significantly enhance comprehension, engagement, and retention compared to conventional methods such as pamphlets or verbal communication. This review emphasizes how different educational intervention, and instructional videos assist mothers in acquiring knowledge, facilitate early symptom recognition, and enhance pregnancy outcomes.

Supply Chain Management (SCM) practices and organizational performance are looked at in this study through a detailed case study of GXO Logistics, which became the largest pure-play contract logistics provider in the world when it split off from XPO Logistics in August 2021. The study looks at how modern SCM practices, like automating tasks, integrating technology, and promoting sustainability, help with business efficiency and strategic success. The study uses a mixed-methods approach that includes both quantitative performance measures and qualitative insights from interviews with stakeholders to look at how GXO implemented advanced SCM practices during its most important formative years, 2021–2022. The results show that there are strong links between strategic SCM initiatives and organizational success. For instance, GXO had its best quarterly sales and adjusted EBITDA ever in the fourth quarter of 2021.GXO's quick success shows how good SCM practices can improve the performance of an organization. By the end of 2021, the company will have 195 million square feet of space in about 900 facilities around the world. The study adds to both the theoretical knowledge and practical applications of SCM. It gives logistics companies useful information for improving their operations in a world market that is getting more complicated. According to the results, strategic investments in automation (with 30% of warehouses adopting next-generation innovations), along with environmentally friendly practices and partnerships, make operations much more efficient and help them compete in the market. This study lays out a framework for understanding how modern logistics companies can use SCM techniques to achieve long-term growth and operational success.

The financial crisis in 2007–2008 shake the fiscal world with a wave of massive economic losses, which caused the biggest economic and financial disruption in the world’s financial system and lead to the banking sector recapitalization in many countries. Perennial banks failures attributed in severe losses, capital erosion and triggered a series of mergers and acquisitions, equity issues and government intervention in the Nigerian banking sector. This study is to evaluate the matrix analysis for the effect of merger and acquisition, equity issues and intervention on the performance of Nigerian banking sector. However, the nature and existence of this potential relationship were found to be mixed, which prompted this study to re-examine the relationship. This study employed the quantitative survey research design, stratified sampling method and Partial Least Squares (PLS) algorithm (bootstrap techniques) were used to test the hypotheses. Results obtained supported the hypothesis on the influence of mergers and acquisitions, equity issues, intervention on the banks' performance. The importance-performance map analysis was applied in this study to allow enriching the PLS-SEM analysis and thereby gain additional results and findings, although its application to banking is still at its embryonic state. In addition, the results from importance-performance map analysis indicate that the first priority by managers is to improve the performance aspects captured by equity issues, as this construct have the highest importance in the model, but relatively low performance. Finally, this study has succeeded in validating the aforementioned conceptualization as well as advancing significant theoretical and practical contributions to both researchers, regulatory authorities and managers for further understanding on the influence of recapitalization and banks performance. Further suggestions for future research directions are also offered.

The primary objective of this study is to determine how different supply chain management (SCM) approaches affect how well DPD Logistics runs its business. The research examines the impact of digital transformation, operational integration, and long-term initiatives on three critical aspects of a company's performance: profitability, operational efficiency, and customer satisfaction. This study uses a variety of methods to fill in the gaps in our knowledge of how to manage transportation. New supply chain strategies help firms remain ahead of the competition by allowing them to change with the times. The results show that DPD's strategic supply chain management (SCM) efforts have improved the company's measurable results. This is particularly relevant for projects like becoming digital, keeping track of stock, and using green logistics. The organization will be able to ship and manage more than 2.1 billion items throughout the world by 2024. Thanks to integrated supply chain management systems, this is possible. This study shows that different needs can be met in different ways. Supply chain management has become more open and flexible because of the introduction of new technologies such as data-driven forecasting and automated storage. The service is not as pleasant or as inexpensive as they were in the past. This research enhances the existing knowledge of supply chain management (SCM). To do this, people look at things from the Resource-Based View (RBV) and Systems Theory points of view. Transportation workers can also use the information to help supply lines run better and be more competitive. The study reveals that transportation businesses may do better with SCM if they apply modern technologies and green ideas.

Background: The most prevalent consequence of Diabetes Mellitus (DM) is Peripheral Neuropathy (PN), which is frequently undiagnosed and untreated and consequently leading to physical and emotional damage to an individual. Therefore, this study was designed to explore the proportion of peripheral neuropathy among diabetic patients in tertiary care setting. Methods: This cross-sectional observational study among 403 participants was conducted at the out-patient department of Dhaka Medical College Hospital, Sir Salimullah Medical College, BIRDEM Hospital for one year of period. Data collection was conducted with a pre tested semi structured questionnaire and were analyzed using the statistical software SPSS 26. Results: Mean age of the respondents was 50.92±10.56 (SD) years with a majority in age group 60-69years (29%). Male and female was observed as equally 51.9% male and 48.1% male. The majority of patients (60.5%) have been living with diabetes for 2-5 years. Significant proportion of the patients (64%) have uncontrolled diabetes, while only 36% have achieved control over their condition. Overall, 48.4% respondents had peripheral neuropathy among diabetic respondents. Among the respondents with peripheral neuropathy, 97(24.1%) respondents had mild NSS, 69(17.1%) had moderate NSS and 29(7.2%) had severe NSS. BMI (25.75±2.65 and 24.81±2.98 kg/m2), HbA1C (8.48±0.78 and 7.98±1.13 %) and triglyceride level (318.79±46.28 vs. 282.52±76.45 mg/dl) were significantly higher among peripheral neuropathy respondents compared to non-neuropathy respondents. Conclusion: The findings have important clinical implications Lifestyle modifications, such as weight management and diet control, may also be essential in preventing or managing peripheral neuropathy. Early detection of intervention to manage pain should be a priority.

Nowadays, the majority of seizure patients have lost confidence in themselves and are worried about their self-image, so they attempt to conceal their illness from others. Once a decision to treat epilepsy has been made, it is necessary to have a thorough knowledge of the choice of drug, toxic effects, mode of action with each antiepileptic drug. However, by determining the serum concentration and manipulating it within the therapeutic range it should be possible to find a regimen that adequately controls seizures without introducing unnecessary toxic effects. Since valproic acid is also a first-line treatment for epilepsy, it is now the most effective medication used. Over time, these medications are taken regularly.

The digital transformation of global supply chains has introduced unprecedented opportunities for efficiency and automation, alongside new cybersecurity risks and legal challenges. This study focuses on the impact of these factors on international trade efficacy, as well as the complex connection between data sovereignty requirements and cybersecurity strategies within smart supply chains. We look at how businesses balance following the rules with good logistics performance using case studies, professional interviews, and data analysis. Our results show that data sovereignty rules add a lot of work to operations, but they also make supply lines stronger and safer. The study also shows that companies that can balance these different needs have 23% fewer cyber events while still getting the benefits of cross-border logistics. One thing that is often seen as a problem is becoming more and more important in shaping hacking and the future of smart supply chains, as this study clearly shows. Rules about where data is stored, rules that are specific to a sector, and sending data across borders all cause big problems, such as higher costs to comply, limited data movement, broken IT setups, and difficult audits. This research indicates that enterprises that synchronize their data governance with sovereignty-focused policies are more inclined to use advanced security architectures. Sovereign cloud environments are one of these architectures. They make sure that data stays inside the right bounds. Edge computing is another. It lets processing happen locally, which lowers exposure. Zero-trust models are another. They check access across distributed assets all the time. Today's technologies improve the safety, reliability, and availability of supply chain data in a few locations. The newly established standards are easier to follow, the operations are more stable, and the partners trust each other more.

This paper analyzes the economic and strategic ramifications of AI-driven cybersecurity solutions in alleviating digital commerce disruptions in emerging economies. The effects of AI-enhanced security solutions on digital resilience and global economic relations are examined under escalating cyber threats and regulatory chaos. Researchers are examining the impact of security policies, including AI, on technology resilience and international economic connections, in response to the increasing prevalence of cyberattacks and political instability. Data was collected from several rising nations for this study between 2023 and 2025. Data breaches, system failures, intellectual property theft, and reputational damage can be mitigated, and markets that use artificial intelligence cybersecurity technologies have seen a 78% drop in successful cyberattacks, with an average cost savings of $4.2 million per incident averted, according to studies. The research demonstrates that those governments engaging in AI-driven cybersecurity solutions had a 21.9% compound annual growth rate (CAGR) in digital commerce volume, far above that of comparable nations that did not invest. This signifies a clear multiplier effect on the economy. The results demonstrate that heightened participation in the global digital economy is associated with cybersecurity expertise. This research changes the way we think about cybersecurity, especially hacking, as more than just a technical safety measure. It talks about how AI-enhanced cybersecurity is important for advancing state digital sovereignty, especially in the Global South. Researchers say that lawmakers, regulators, and business leaders should put money into things like AI-driven threat detection, automated incident response, and predictive analytics. Not only do these kinds of activities make digital systems better, but they also help the economy flourish and link more with the digital economy around the world.

Crime narratives often reflect underlying power dynamics, with marginalised groups, particularly women and individuals with disabilities, frequently portrayed as voiceless or vulnerable. These depictions reinforce systemic injustices and cultural perceptions that can be critically examined through the intersection of disability, gender, and crime. Drawing on Jack A. Nelson’s stereotype theory and a disability studies methodology, this paper analyses the Malayalam courtroom drama Neru (The Truth, 2023), focusing on its portrayal of disability within a legal and social context. The film centres on Sara Muhammed, a visually impaired sculptor and survivor of sexual assault, whose pursuit of justice, supported by public prosecutor Vijayamohan, reveals both entrenched ableist attitudes and moments of narrative empowerment. By positioning a disabled woman at the centre of a judicial narrative, Neru both reflects and challenges dominant media stereotypes outlined by Nelson, including the tropes of the pitiable victim, the burden, and the supercrip. Sara’s character oscillates between being framed as a tragic figure and a resilient agent of change, thereby complicating traditional portrayals of disability in Indian cinema. Through close analysis of specific scenes and dialogues, this paper highlights how Neru critiques institutional and cultural ableism, especially in the context of credibility, trauma, and justice for disabled women. This paper places Neru within the broader context of Malayalam cinematic traditions, demonstrating how it addresses systemic inequities and stereotypes about disability. As such, Neru offers a meaningful intervention in contemporary criminal storytelling, redefining how disability, gender, and justice intersect in Indian cinema and echoing Nelson’s call for more inclusive and authentic media representations.