Background and Objective: In Pakistan, the demand for surgery is not being met due to a shortage of both surgical equipment and healthcare workers. This gap in the availability of surgical equipment hinders the provision of safe surgeries. To develop strategies to improve availability, it is essential to understand the use of surgical equipment in this context. This study aims to: (1) map out the different phases that surgical equipment goes through during its lifespan (i.e., the surgical equipment journey) in Pakistan, and (2) identify the barriers perceived by biomedical equipment technicians (BMETs). Material and Methods: Seven semi-structured, in-depth interviews were conducted with 17 BMETs working in Pakistan. These participants were from 6 different hospitals (4 public, one private, and one mission). The interviews took place between December 2016 and December 2018. Participants were asked to describe or illustrate the surgical equipment journey and to identify perceived barriers during this journey. Results: The surgical equipment journey comprises three phases: procurement, usage, and disposal. Key stakeholders in this journey include users, BMETs, procurement officers, local distributors, and, in the case of donations, donation agencies. Identified barriers include bureaucratic hurdles during procurement, difficulties in obtaining consumables and spare parts (especially for donated equipment), cleaning with harsh chemicals, and usage in challenging environments. Conclusion: To optimize the surgical equipment journey in Pakistani hospitals, sustainable interventions at multiple organizational levels are necessary. Participants in this study identified several strategies to increase the availability of surgical equipment in Pakistan: implementing policies on donations, procuring durable equipment, training more BMETs and university-trained biomedical engineers, and developing designs and business models suited to local conditions in Pakistan and potentially other countries in the region.

International humanitarian law and international human rights law are two distinct but complementary bodies of law. They are both concerned with the protection of the life, health and dignity of individuals. IHL applies in armed conflict while human rights law applies at all times, in peace and in war. The interplay between human rights and humanitarian law in armed conflict remains a critical area of legal and ethical discourse. While international humanitarian law (IHL) governs the conduct of hostilities, human rights law ensures fundamental freedoms and protections even in war. This article examines the practical challenges in implementing these legal frameworks, the role of state and non-state actors, and mechanisms for enforcement and accountability. Through an analytical approach, the study evaluates case studies from recent conflicts to assess the effectiveness of international legal instruments.

Background: Chest pain is a prevalent complaint in emergency departments (EDs) and is associated with significant clinical decision-making challenges. The HEART score is a validated tool used for risk stratification of patients with suspected acute coronary syndrome (ACS). Objective: This study evaluates the effectiveness of the HEART score in risk stratification and patient outcomes at Northern Emirates Hospital, UAE. Methods: A retrospective analysis was conducted on 79 patients who presented with chest pain at Northern Emirates Hospital in January 2021. From the available date in patient record, the patients were classified into three risk categories based on the HEART score, and their actual dispositions were compared. Results: Of the 79 patients, 70.8% had a low HEART score (0–3), 25.3% had a moderate score (4–6), and 3.7% had a high score (>7). Discharge rates were 83.9% for low-risk, 70% for moderate-risk, and 33% for high-risk patients while the actual major adverse cardiac event (MACE) rates available from available data were 0%, 15%, and 66.6% for low, moderate, and high-risk patients, respectively. Conclusion: If used, the HEART score can useful in effectively stratifying chest pain patients, aiding in decision-making regarding discharge and admission. Its implementation in EDs could enhance patient care and resource allocation.

Background: Hypertension frequently coexists with Type 2 diabetes mellitus (T2DM), significantly increasing the risk of cardiovascular and kidney complications. This dual burden escalates morbidity and mortality, emphasizing the need for early detection and effective management. However, there is limited research on hypertension prevalence among T2DM patients in Bangladesh. Objective: This study aimed to assess the prevalence of hypertension among patients with Type 2 diabetes mellitus and to identify associated risk factors in a tertiary care hospital in Dhaka, Bangladesh. Methodology: A prospective observational study was conducted at the Department of Medicine, Community Based Medical College, Bangladesh, from June 2022 to December 2022. A total of 83 T2DM patients were selected through purposive sampling. Data were analyzed using SPSS version 23.0, focusing on demographic characteristics, diabetes duration, body mass index (BMI), glycemic control, and blood pressure readings. Results: The overall prevalence of hypertension in T2DM patients was found to be 70.1%. Among the hypertensive patients, 42.2% had Stage 1 hypertension, while 27.9% had Stage 2 hypertension. Hypertension was significantly associated with the duration of diabetes, poor glycemic control (HbA1c > 7%), and a BMI greater than 25 kg/m². Conclusion: Hypertension is highly prevalent among patients with Type 2 diabetes mellitus, with poor glycemic control and obesity being significant risk factors. Regular monitoring and effective management of hypertension in T2DM patients are essential to reduce the risk of cardiovascular complications.

Tinospora cordifolia, or "guduchi," is a reported medicinal plant of high therapeutic value. Historically, it was utilized in Ayurveda and other herbal medicinal therapies, where it is valued for its efficacy in treating a range of diseases, such as metabolic disorders, infectious diseases, autoimmune diseases, and cancer. This manuscript presents the pharmacological significance of T. cordifolia, where its multi-dimensional bioactive molecules, such as alkaloids, diterpenoid lactones, and steroids, are responsible for its therapeutic actions. Recent scientific studies show its chemopreventive value, especially in regulating cellular proliferation and apoptosis. With the growing interest in the world for plant-based therapeutics, more studies are needed to prove its efficacy, to explain its mechanisms of action, and to determine its potential in today's medicine.

Infertility remains a significant public health concern in Bangladesh, with evolving socio-demographic, medical, and lifestyle factors influencing reproductive health. This study compares infertility patterns among Bangladeshi couples between 2007 and 2024 to identify key contributing factors and assess changes over time. A comparative cross-sectional study was conducted using data from 2007 and 2024. The study population included couples seeking infertility treatment at selected healthcare centers in Bangladesh. Data were collected through structured questionnaires and medical record reviews. Statistical analyses were performed using STATA 17 to evaluate trends in infertility prevalence, associated factors, and reproductive health outcomes. Among couples seeking infertility treatment, the proportion of female infertility cases increased from 43% in 2007 to 94.2% in 2024, while male infertility cases declined from 36% to 9.1%. Primary infertility cases accounted for 67% in 2007 but decreased to 51.9% in 2024, whereas secondary infertility increased from 33% to 48.1% over the same period. The proportion of women with irregular menstrual cycles and endocrine disorders, such as polycystic ovary syndrome (PCOS), rose significantly. Positive lifestyle modifications were observed, including reduced smoking and increased physical activity. Surgical histories showed a decline in laparotomy procedures among females and a shift toward minimally invasive interventions. The findings highlight shifting infertility trends, with a rise in female infertility and associated endocrine disorders. Improvements in lifestyle factors and reproductive healthcare access suggest progress in infertility management. Targeted public health strategies, enhanced diagnostic capabilities, and evidence-based interventions are essential to address the evolving infertility landscape in Bangladesh.

Background: Drug-eluting stents have significantly lowered the risk of restenosis. However, how to treat restenosis inside a DES is unknown. While the number of severe adverse cardiovascular events (MACE) linked to drug-eluting stents (DES) has significantly decreased, stent thrombosis (STH) and in-stent restenosis (ISR) continue to be significant clinical problems. Materials and Methods: This observation cohort study was conducted in the Department of Cardiology, Universal Medical College and Northeast Medical College, Sylhet. During study period 2016 to 2020 Universal Medical College and 2020 to 2022 Northeast Medical College. Among 509 lesions treated with DES, 26 required clinically driven revascularization for ISR. We identified 26 consecutive patients who developed ISR, among them Homo-Stents (n=17), Hetero-Stents (n=5) and (n=4) treated by other. Results: Three cases (75%) in the other ISR group and one (20%) in the hetero-stent group had a history of congestive heart failure. Of the three groups, only one had clinical characteristics that were statistically significant (p<0.05), whereas the other two did not (p>0.05). In the hospital, the differences between the three groups at six and twelve months were not statistically significant (p>0.05). Conclusion: There is a high long-term rate of MACE associated with current DES therapies for ISR or STH.

Carbon nanoparticles (CNPs) and carbon nanodots (CNDs) represent a revolutionary new frontier in nanotechnology with their distinct structural, optical, and chemical characteristics. Their unique properties have allowed them to be incorporated into various scientific and industrial applications. This comprehensive study delves into the synthesis, characterization, and functionalization of CNPs and CNDs, exploring the concepts underlying their remarkable qualities, which include excellent photostability, adjustable fluorescence, biocompatibility, and simplicity of surface modification. These nanostructures have various industrial applications, including electronics, energy, environmental research, and healthcare. Their potential to transform healthcare is fascinating, highlighted by their use in photothermal treatment, bioimaging, and drug delivery systems in biomedicine. The ability of CNPs and CNDs to tackle urgent ecological issues is further demonstrated by their application in environmental restoration, including water purification and pollution detection. The use of CNPs and CNDs in optoelectronics and energy storage devices like supercapacitors and batteries further illustrates their value in developing efficient and sustainable technologies. Even with these encouraging advancements, issues remain to be resolved, such as maximizing large-scale manufacturing, maintaining consistency, and dealing with long-term environmental effects. To overcome these obstacles and realize the full potential of carbon-based nanomaterials, this analysis highlights the necessity of multidisciplinary cooperation, which will eventually open the door for creative answers to pressing global issues.

In the development process of humans and human society, accompanying factors such as economics, politics and culture are the factors of spiritual life, belief and religion. Particularly, it is believed that thinking and lifestyle are the two fundamental components that best capture the evolution of human existence and progress throughout any nation's history. Likewise, for the Southern Khmer community in Vietnam, during the process of settlement and long-term survival in the new land, the thinking and lifestyle of the Khmer community are always influenced by foreign influences. Many different factors to form a community with diverse but profound lifestyles and ways of existence to be able to stand and live for a long time for centuries in the South. Belief and religion are regarded as the two main factors in that significant impact of living circumstances, directly impacting the way the Khmer community thinks and lives as spiritual therapy. Assists in resolving issues and ideas that people are unable to resolve on their own as well as life's challenges. To be able to maintain long-term survival, the Southern Khmer community in Vietnam relies on gods and placing full trust in the gods to ask for salvation and protection from the strong impact of climate change natural event. Among them, the image of Neak Ta is mentioned in the entire way of living in the community, having a significant influence on the thinking and lifestyle of the Khmer people during the process of settlement and gathering long-term in the Southern region.

Jasmine is one of the plants with large number of species naturally occurring and cultivated species for fragrant flowers and their multiuse. People make religious sacrifices to gods like Lord Shiva and Lord Vishnu using jasmine flowers. Jasmine leaves can be deciduous or evergreen. This suggests that the leaves will either remain evergreen or drop off when they reach maturity. In the present study, the aqueous extracts of Jasminum sambac, J. malabaricum, J. grandiflorum leaves were studied for their phytoconstituents using standard protocols. Jasminum sambac and J.malabaricum showed the presence of alkaloids, tannin, protein, flavonoid, steroid and carbohydrates. Antioxidant activity was studied by DPPH and FRAP assay methods. DPPH antioxidant assay showed highest reducing power in Jasminum malabaricum compared to other two species. Antibacterial activity studied by well diffusion method in which J.malabaricum and J.sambac showed higher antibacterial activity whereas antifungal property was more showed by J.malabaricum extracts.

New pharmaceuticals developed from the current medicinal plants can treat the ailment more successfully, potentially aiding the treatment, since a safer and more effective way may be discovered in the future. Nutritional value of medicinal plants and searching of novel compounds enhance the with therapeutic use in the different sectors. Secondary metabolites are created as byproducts or intermediates of secondary plant metabolism. Polymeric nanoparticles are colloidal structures that act to control the novel delivery of medications by guiding them to certain locations. Curcumin is one of the plant-based compounds with some medical potential. It a yellow polyphenol that typically targeted the cells of the viral particles. Ganoderma lucidum is a well-known treatment for hemiplegia and stroke. Nanoparticles are used in cancer diagnosis and therapy because of their ability to target tumours, deliver drugs, and boost the immune system. Among their advantages are their mucoadhesive, biocompatible, and biodegradable properties, as well as their multifunctional physicochemical properties that allow for site-specific targeting and allows the chemical modification. Nanoemulsions are currently appealing nanocarriers due to their ability to enhance the drug transport across bio-membranes, prolong the half-life in the body, and encapsulate medications with a high lipophilic aptitude. These days, nanoparticles provide a vast array of biological applications or an expanded the different fields.

The Agile transformation of 132/11 kV Capital Substation Projects has significantly improved efficiency, cost-effectiveness, and sustainability in infrastructure development. By leveraging Lean and Agile methodologies, including Scrum frameworks, process streamlining, and extensive workforce training, project delivery timelines were reduced by 30%, cutting construction duration from 30 to 21 months. This transformation resulted in AED 1.8M in cost savings per substation, amounting to AED 27M annually, alongside an 84% improvement in first-time drawing approvals. Additionally, the integration of precast construction methods reduced 3,165 tons of CO₂ emissions across 15 substations, reinforcing Agile’s role in sustainable project management. The benchmarking of these innovations against other government authority CFR process further highlights Agile’s scalability and industry relevance. These findings demonstrate that Agile is not only a project management methodology but a transformative approach that enhances speed, cost-efficiency, governance, and sustainability in capital infrastructure projects.

Introduction: The sinus lift technique is a widely used procedure for the rehabilitation of the atrophic maxilla in terms of height in the posterior regions. Initially, it was performed through a lateral approach with an open window, until a less invasive procedure, the transcrestal elevation, began to be used. Today, this approach is almost exclusively performed, with the lateral approach being reserved for extreme atrophies (1–2 mm in height). Regarding graft material, there have also been modifications over time, evolving from block grafts and particulate autologous bone to mixtures of different materials, and more recently, to graft-free techniques. In these cases, only the pressure from the implant apex and space maintenance contribute to new bone formation within the augmented space. This article presents cases treated with transcrestal sinus lift without graft material, with a follow-up period of up to 15 years. Materials and Methods: Patients who had undergone a transcrestal sinus lift without graft material and had a minimum follow-up of 10 years and a maximum of 15 years were consecutively recruited. Follow-up evaluations were conducted every six months, assessing bone gain over the implant apex and its stability over time, as well as mesial and distal crestal bone loss and implant survival. Results: A total of 27 patients who received 45 implants meeting the inclusion criteria were recruited. Among them, 44.4% were women, with a mean age of 68 years (±4.5). The mean initial bone height at implant placement sites was 5.75 mm (±1.11), ranging from 2.07 to 7.10 mm. At the end of the follow-up period, which had a mean duration of 12.8 years (±1.32), ranging from 10 to 15 years, the final mean bone volume at the implant site (implant length + bone gain) was 8.99 mm (±1.91). The mean bone gain over the apex across all implants was 4.21 mm (±1.89). Regarding bone loss, the mean mesial crestal bone loss across all implants was 0.66 mm (±0.46), with a range of 0 to 2.21 mm, while the mean distal crestal bone loss was 0.87 mm (±0.53 mm), ranging from 0 to 3.03 mm. Conclusions: Transcrestal sinus lift without graft material, using short and extra-short implants along with a specific drilling sequence, is a safe and predictable technique, even in the long term. The results of this study, with a follow-up period of 10 to 15 years, support its effectiveness and reliability.

This study examines the feasibility of utilizing atmospheric air as a clean water alternative to address water scarcity, considering Oman's normal humidity levels of 75% to 85%. The study utilizes a thermoelectric cooler (TEC 1-12706), augmented by a heatsink and fan on its hot side to improve heat dissipation. A copper cooling coil functions as both a heat absorber and a condenser for ambient air flowing through it. The coil, with a diameter of 7.9 mm and a length of 1000 mm, receives its cooling source from a water block affixed to the cold side of the cooler. Experiments were performed in three environmental conditions: laboratory, residential area, and coastal area, with variations in the airflow rate of the heatsink cooling fan. The data collection encompassed a humidity range of 72.27% to 83.01%. The findings indicated a clear association between the air mass flow rate of the heatsink cooling fan and the volume of water extractable from the air. During preliminary laboratory testing, a mass flow rate of 0.046 kg/s yielded 4.25 ml/hour, 0.069 kg/s resulted in 4.625 ml/hour, and 0.092 kg/s produced 5.5 ml/hour. Moreover, among the three environmental settings evaluated, a greater volume of water may be retrieved from coastal regions compared to labs and residential areas. In coastal regions, the air mass flow rate is 0.092 kg/s, with a potential water extraction of 7.75 ml/hour; in laboratory settings, it is 5.5 ml/hour, and in residential zones, it is 4.75 ml/hour. These encouraging results advocate additional research to enhance water extraction by optimizing the contact area between the air cooler and the coil surface, potentially providing a feasible solution for the scarcity of clean water.

Fibrous polyp: it is a fibroid, endocavitary, pedunculated and delivered through the uterine cervix with a pedicle arising from the uterine fundus or one of the walls of the uterine cavity. Their treatment is surgical and requires skill and a suitable technical platform. To our knowledge, no cases have been published in Mali. We report a fibrous polyp occurring in a 41-year-old patient, multi-gesture 5th procedure 5th parous with 5 living children, evacuated from a community health center located 60 km away, who presented episodes of metrorrhagia. The gynecological examination shows the presence of a “fibroid” delivered through the cervix. She was surgically managed vaginally for lumpectomy. It was a mass composed histologically of uterine leiomyofibroma remodeled by inflammation.