Superficial Ewing sarcoma of the skin and dermis is extremely rare and may closely simulate benign adnexal tumors or neuroendocrine carcinomas, leading to major diagnostic pitfalls. We report the case of a 19-year-old woman presenting with a painful, rapidly enlarging 1.5 cm nodule at the cervico-occipital region. Histologically, the lesion exhibited a compact multilobulated architecture within the dermis, with a striking “blue ball in dermis” appearance suggestive of spiradenoma. Immunohistochemistry was misleading, showing focal dot-like AE1/AE3 staining, heterogeneous low-to-moderate synaptophysin and chromogranin expression, CD56 positivity, and CK20 dot-like staining, raising the possibility of Merkel cell carcinoma. Strong diffuse CD99 positivity and nuclear NKX2.2 expression supported a Ewing sarcoma family tumor. Molecular analysis confirmed an EWSR1 rearrangement. This case highlights the diagnostic challenges of superficial small round blue cell tumors and emphasizes the need for integrated histologic, immunohistochemical, and molecular assessment.

This study assesses the level of attainment of SDGs 3 (Health), SDG 4 (Education), and SDG 6 (Clean Water and Sanitation) in Bui Division, North West Region of Cameroon. To attain the study objective and obtain meaningful results, a convenient methodology was used. The methodology involved a mixed-methods approach where data was collected through field surveys, stakeholder interviews, observations and analysis of secondary sources. Findings indicate that health services are constrained by inadequate health infrastructure and facilities, limited medical personnel, and insufficient access to essential medicines, resulting in suboptimal health outcomes. The education sector faces challenges including insufficient educational facilities, depreciated and destroyed school infrastructures, inadequate teaching materials and qualified teachers, insecurity and disparities in access, particularly in rural communities. Access to safe and potable water remains limited, with many populations relying on unimproved sources, increasing vulnerability to waterborne diseases. Despite these challenges, communities have implemented adaptive strategies such as local health initiatives, informal educational support, and community-based water management. These efforts demonstrate resilience and highlight the critical role of community participation in advancing development goals. The study concludes by recommending that achieving SDGs 3, 4, and 6 in Bui Division requires a multi-faceted approach that combines increased government investment, infrastructural development, capacity building, safe environment and community engagement. Leveraging local adaptation strategies alongside systemic interventions by stakeholders is essential to improving health, education, and water access, thereby enhancing overall quality of life. These findings provide valuable insights for policymakers, development practitioners, and researchers working in similar sub-national contexts.

Background: Anatomy is a foundational component of medical education. However, many students find it challenging to apply anatomical knowledge in clinical problem-solving. Understanding their ability to interpret clinical scenarios during the pre-clinical phase can help identify educational gaps. This study evaluated the ability of undergraduate medical students to answer clinically oriented multiple-choice questions (MCQs) compared with non-clinical ones in regional anatomy, and compared performances between first- and second-year students. Methods: A cross-sectional analytical study was conducted among 220 Phase-I MBBS students (110 first-year and 110 second-year) in a government medical college in Dhaka, Bangladesh, from July 2022 to June 2023. Students were randomly assigned into clinical and non-clinical groups (n=55 each per year). Two validated sets of 10 MCQs were prepared from Snell’s Clinical Anatomy by Regions (10th edition), reflecting either clinically applied or descriptive content. Scores for correct, incorrect, and unattempted responses were compared using independent sample t-tests in SPSS version 25. Results: Non-clinical groups in both years achieved significantly higher mean scores than clinical groups (p<0.001). First-year non-clinical students scored 45.45±1.84 versus 37.02±2.95 in the clinical group, while second-year non-clinical students scored 42.89±2.84 versus 37.11±1.88 in the clinical group. Differences between first- and second-year clinical groups were not significant, but first-year non-clinical students performed slightly better than their second-year counterparts (p<0.05). Conclusion: Students demonstrated stronger factual knowledge than applied understanding. Early incorporation of clinical relevance in anatomy teaching, supported by case-based and interdisciplinary approaches, is recommended to enhance clinical reasoning.

Labor relations between enterprises and individuals are expressed in the legal form of labor contracts signed and implemented by the parties. In which, wage is a basic term, representing the value of labor, enterprises must clearly state in contracts and pay employees based on the effort they have put in. This not only ensures labor rights but also contributes to the development of the labor market, bringing business efficiency to enterprises. Any violation must be sanctioned in the form of late payment interest on late wages, except in cases where the enterprises encounter certain difficulties, as permitted by law. The research in this article clarifies wages and the obligation to pay wages of enterprises under Vietnamese law and proposes solutions to overcome the limitations arising from practice.

Background: The reverse dorsal metacarpal artery flap is a versatile solution for resurfacing soft-tissue defects of fingers. This is a widely used flap to cover finger defects. Materials and Methods: This prospective observational study was carried out at Dhaka Medical College Hospital, Dhaka from 1st July, 2018 to 30th June 2019. 30 patients were included in the study. Patient age, gender, defect type, defect location, donor site coverage, flap dimensions, range of motion of the meta-carpophalangeal joint and proximal interphalangeal joint, postoperative complications were evaluated. Follow up period was 3 months. Results: 30 patients underwent coverage of skin defects of the finger proximal to DIP joint with reverse dorsal metacarpal artery flap. All flaps survived completely. Flap size ranged from 2.5 cm 1.5 cm to 5.5cm 3.5 cm. 17 flaps were based on the second dorsal metacarpal artery. Skin paddle was taken from the dorsal aspect of the second, third, and fourth intermetacarpal area. All patients had full range of movement of the reconstructed and donor digits when followed at 3 months after surgery. Conclusions: The reverse dorsal metacarpal artery flap is a flap which is safe, easy to apply in the context of soft tissue coverage procedures and does not result in the loss of finger functions. It also confers excellent aesthetic skin suitability and does not require debulking procedures.

Blood flow restriction (BFR) training is increasingly applied in rehabilitation and performance settings as a low-load alternative to traditional resistance exercise. BFR neuromuscular activation during dynamic, functional activities is less understood, particularly in an acute scenario. Purpose: To investigate how inter-peak muscle activation time (IPMAT) of lower limb muscles (proximal and distal to the cuff) adapted to blood flow restriction while pushing a sled (constant resistance acquired with continuous speed) at two consistent walking speeds. Methods: Sixty-two healthy adults (8 men, 54 women; mean age = 23.0 ± 3.0 years) participated. Anthropometrics, vital signs, and limb dominance were documented. Surface electromyography (EMG; Delsys Trigno system) recorded activity of the gluteus maximus, medial gastrocnemius, and tibialis anterior of the dominant leg. Participants pushed an XPO Trainer sled (85 lb total load) over 40 ft at a slow walk (80 bpm) and a fast walk (140 bpm). Three randomized trials were performed under unrestricted and BFR conditions. BFR was applied with Delfi’s Personalized Tourniquet System at 80% limb occlusion pressure. The primary outcome was BFR versus non-BFR IPMAT for all muscles, analyzed using multivariate analysis of variance (MANOVA). Results: BFR significantly increased IPMAT in the gluteus maximus (slow walk: 1.0672 ± 0.1086 s vs. non-BFR 0.9524 ± 0.1228 s, p < .001; fast walk: 1.1061 ± 0.0955 s vs. non-BFR 0.9428 ± 0.1150 s, p < .001) and medial gastrocnemius (slow walk: 1.1076 ± 0.0798 s vs. 0.8040 ± 0.0969 s, p < .001; fast walk: 1.1435 ± 0.1064 s vs. 1.0719 ± 0.1292 s, p = .008). No significant differences were observed in the tibialis anterior (p > .05). Conclusions: During the blood-constriction settings, IPMAT adapts the primary pushing muscles (gastrocnemius and gluteus muscles), regardless of occlusion cuff location (proximal versus distal), suggesting delayed recovery between activation bursts due to increased neuromuscular demand under restricted blood flow. This adaptation may represent compensatory strategies to sustain task performance under fatigue or metabolic stress. Clinical Relevance: BFR sled pushing provides a low-load alternative that increases neuromuscular variation, increases fatigue and compensatory demands, and supports endurance. Clinicians should consider these timing adaptations when prescribing BFR to individuals with lower extremity weakness, balance deficits, or gait impairments.

Artificial intelligence (AI) is rapidly transforming healthcare delivery worldwide, offering promising solutions to improve diagnostics, treatment, and administrative efficiency. This study assessed the level of awareness and extent of utilisation of AI-based tools among healthcare professionals in South-East Nigeria. A descriptive cross-sectional survey was conducted using a structured questionnaire distributed via Google Forms to 450 healthcare workers, including doctors, nurses, laboratory scientists, physiotherapists, radiographers, and health information officers. Descriptive statistics and chi-square analysis were employed to analyse the data. Results showed that while 64.4% of respondents were aware of AI technologies, only 30% reported actively utilising these tools in clinical or administrative practice. A significant association was found between professional role and AI awareness (χ² = 12.35, p = 0.02), with doctors exhibiting higher awareness than other groups. Key barriers to adoption included inadequate infrastructure (66.7%), insufficient funding (60%), limited technical expertise (55.6%), data privacy concerns (44.4%), and lack of regulatory frameworks (33.3%). These findings highlight the need for targeted investments in infrastructure, capacity building, and policy development to accelerate AI integration into healthcare in resource-constrained settings. The study provides valuable insights for policymakers, healthcare administrators, and technology developers aiming to harness AI’s potential to improve health outcomes in Nigeria and similar contexts.

Cymbopogon citratus (DC.) Stapf. (lemongrass) is a widely used medicinal grass valued for its essential oils and diverse therapeutic properties; however, comprehensive pharmacogenetic documentation of the whole plant remains limited. The present study provides an integrated evaluation of the pharmacobotanical, antimicrobial, antioxidant, and chemical fingerprinting characteristics of C. citratus collected from the northeast coast of Tamil Nadu, India. Macroscopic and microscopic analyses established diagnostic features including sclerenchyma Tous vascular bundle sheaths, bulliform cells, dumb-bell-shaped silica bodies, prickle hairs, and annular vessels, providing robust anatomical markers for authentication. Physicochemical parameters (LOD, ash values, extractive values, pH) confirmed good-quality raw material with minimal foreign matter. The hydro-alcoholic whole-plant extract exhibited broad-spectrum antimicrobial activity, with pronounced inhibition against Staphylococcus aureus and Enterococcus faecalis. Potent antioxidant activity was recorded in the DPPH assay, with an IC₅₀ of 39.37 µg/mL, attributed to phenolic and flavonoid constituents. HPTLC profiling generated a reproducible chromatographic fingerprint with recurring marker bands at Rf 0.08, 0.04, and 0.01 under 254 nm and 366 nm, reflecting the chemical diversity of the extract. This study provides the first complete pharmacogenetic framework for C. citratus whole plant, offering essential baseline data for authentication, standardization, and future phytopharmaceutical development. Further studies on quantitative marker estimation, MIC/MBC analysis, and bioactivity-guided fractionation are recommended to strengthen its therapeutic applicability.

Hernias remain one of the most frequently encountered surgical conditions worldwide, with more than 20 million hernia repairs performed annually. Inguinal hernias constitute nearly 75% of all abdominal wall hernias, with a significantly higher lifetime risk in men (27%) than in women (3%). Innovations in mesh technology, minimally invasive techniques, and enhanced recovery pathways have transformed outcomes, reducing recurrence rates from 20–30% in the pre-mesh era to approximately 1–5% with contemporary mesh-based repairs. Despite these advances, complications such as chronic postoperative pain still affect 10–12% of patients. This review synthesizes current evidence on the epidemiology, pathophysiology, risk factors, diagnostic strategies, and evolving surgical approaches in hernia management, highlighting global trends and future directions.

This cross-sectional comparative study was done at radiotherapy department of Rajshahi Medical College Hospital, Rajshahi from July, 2009-June, 2010. A total number of 60 diagnosed cases of carcinoma larynx (Histologically squamous cell carcinoma) were enlisted and were divided into study group e.g. Chemo-Radiotherapy group (Group A) consisting 30 patients were treated by sequential chemo-radiotherapy with two cycles of cisplatin (20mg/m2) & 5-FU (500mg) per day for 4 days 3 weeks apart followed by radiotherapy after 1½ weeks at 60-66 Gray in 30-33 fractions in 6-6½ weeks and control group e.g. radiotherapy group (Group B) consisting 30 patients were treated with conventional radiotherapy of 60-66 Gray in 30-33 fractions in 6-6½ weeks. The objective of the study was to observe and compare the results of treatment & side effects of treatment on both arms during & after treatment. In chemo-radiotherapy group (Group-A) complete response (CR) was found in 20 cases (66.67%) and partial response (PR) was found in 10 cases (33.33%). In radiotherapy group (Group-B) complete response (CR) was found in 12 cases (40%) and partial response was found in 18 cases (60%). It was found that complete & partial response was 100%. There was no death or no major complications throughout the study period. Calculated 2 value was 4.28 was greater than the table value 2 i.e. 3.84. It corresponds to probability of 0.05 in 2 table (P < 0.05). Hence treatment of laryngeal cancer with sequential chemo-radiotherapy was statistically significant.

Herein, embodies the result of a study under a topic titled, Review on the Historical Development and Challenges Faced by Almajiri Educational System in Northern Nigeria. This study relied upon primary data collected from the literature, and aimed at investigating and feeding the general public with factual information concerning the original and eventual nature of Almajiri educational system in addition to the causes of transformation of the system into current state. The result of this study highlighted in the context of the literature, certain factors that might have influenced the Almajiri Education in Nigeria as suggested by different researchers. Such factors were classified according to this research, into eight categories which include: the economic-, educational-, environmental-, geographical-, legal-, political-, religious-, as well as socio-cultural- factor. However, the fact that such factors may vary depending upon the living conditions for the individual citizens of the country, this study recommended the need for carrying out another fresh research in the form of field survey for either validation and/or identification of the various contemporary factors resulting in the high resistance of such educational system under discussion.

The Abhaluyia, Kenya's second-largest ethnic group, present an intriguing case for philosophical inquiry, particularly with regards to their conception of personhood – a notion that arguably lies at the heart of African philosophical thought. This emic study seeks to address a significant lacuna in scholarship by reconstructing the traditional Luyia understanding of personhood, prevalent from 1850 to 1910, prior to the profound influences of colonialism and missionary activity. This inquiry aims to illuminate the Abhaluyia's distinctive perspective on what it means to be human by examining their cultural beliefs and practices including proverbs, idioms, oral narratives, and rituals, The paper reveals that, at its core, the Luyia concept of personhood revolves around the essence of being human (imero yo omundu) seen as inextricably linked to the interdependent entities of the physical body (omubhiri), the inner self (omwoyo), and the posthumous liminal entity (eshimakombe). Within this framework, personhood is not simply a biological given, but rather a lifelong journey of cultivating one's innate capacities for knowledge and wisdom (obhuchesi or obhunina) and moral consciousness (ebhima or emima). Individuals strive to attain the revered status of dignified personhood (oluyali), which embodies the full actualization of human potential through socialization, experiential learning, and personal agency. This understanding of personhood acknowledges the interplay between genetic influences, human fallibility, and the communal, culturally particularistic context in which individuals develop.

The article is devoted to an interdisciplinary analysis of the transformation of Roman law in the transitional period from the Republic to the Empire through the category of the megalopolis as a special legal-architectural and cultural phenomenon. It is shown that Roman law during this period acted not only as a conservative regulator ensuring the stability of the political-legal order, but also as a technology of institutional engineering creating conditions for the release of the creative potential of society. Based on the philosophical and legal heritage of the Roman Stoics (Seneca, Marcus Aurelius, Cicero), modern studies in the field of legal history, neurobiology and the theory of creativity, as well as on the example of Francis Ford Coppola’s feature film Megalopolis (2024), the image of the megalopolis is reconstructed as a model of a legal environment in which the law does not suppress, but structures and protects the creative activity of passionary individuals. The thesis is substantiated that the fluctuations of law in the era of the crisis of the Roman Republic became a condition for the creative bifurcation of the state system, opening the way to a new imperial configuration capable of integrating diverse cultural codes and architectural practices. Comparison of the Roman experience with examples of legal modernization in Singapore and the UAE makes it possible to conclude that an effective legal environment is a necessary condition for the formation of a megalopolis as a space of innovative development, where the protection of private property, contractual freedom and personal autonomy becomes a key resource of humanistic progress.

Climate change has emerged as a critical global threat, exerting profound stress on food systems and accelerating nutritional insecurities across regions. Rising temperatures, shifting precipitation patterns, soil degradation, and extreme weather events are increasingly disrupting agricultural productivity, diminishing nutrient quality, and destabilizing food supply chains. These changes have intensified the triple burden of malnutrition undernutrition, micronutrient deficiencies, and obesity particularly in vulnerable populations with limited access to affordable, diverse, and nutritious foods. Despite ongoing global efforts, existing food and dietary systems remain ecologically unsustainable, heavily dependent on high-emission production practices, and constrained by socioeconomic and cultural barriers. This study critically examines the intersection of climate stress, food system vulnerabilities, and nutritional challenges, presenting an integrated framework that links environmental pressures with dietary outcomes. Using a comparative and analytical approach, the research identifies the limitations of current strategies and highlights the need for climate-resilient food production, including climate-smart agriculture, crop diversification, technological innovation, and localized circular food systems. The study further outlines pathways toward sustainable human diets that balance nutritional adequacy with environmental stewardship, emphasizing plant-based dietary patterns, biofortified crops, and culturally adaptive nutrition models. The findings underscore that achieving nutritional security under climate stress requires coordinated action across policy, governance, production systems, and consumer behavior. This work contributes to the evolving discourse by proposing strategic, science-driven solutions for building adaptive, nutritious, and sustainable global food futures.

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