Background: The term ‘frozen shoulder’ should be reserved for a well-defined disorder characterized by progressive pain and stiffness of shoulder which usually resolves spontaneously after about 18 months. The objectives of treatment are to relieve pain and thus restore motion and function of shoulder. Recommended treatment approaches are physical therapy, local and systemic corticosteroid, anti-inflammatory drugs, antidepressants, nerve blocks and manipulation under anesthesia. Objective: Compare the efficacy of intra-articular corticosteroid injection and phonophoresis in the treatment of Adhesive Capsulitis. Method And Material: : This randomized clinical trial was performed in the Department of Physical Medicine and Rehabilitation, Dhaka Medical College Hospital, Dhaka, Bangladesh, over a period of six months. Study population was the patients of adhesive capsulitis disease attending the out- patient department of Physical Medicine and Rehabilitation during the study period. Meticulous history taking, clinical examination and relevant investigations were done. Eligible participants were allocated into two groups, group A-intra-articular corticosteroid injection and group B- phonophoresis by randomization with the help of lottery. Statistical Analysis: Statistical analysis was performed using the statistical program Statistical Package for Social Science (SPSS) version 16.0. Continuous variables (age, etc) were expressed as mean ± SD and comparison of socio- demographic variable of both groups was measures by chi-square test and outcome variables by t-test. A “p” value <0.05 was considered as significant with 95% confidence interval. Result: The mean age of the patients in this study was 51.47 ± 6.30 years. Out of 74 patients 44 were female & 30 were male and the ratio female: male ratio 1.46: 1. Out of 74patients 40.54% patients had right sided involvement and 59.45% patients had left sided involvement. Among 74 patients, service holder were 25 (33.80%), house wife 23 (31%), reteired (12.16%), labour 5(6.755), teacher 4(5.41%) and others 8(10.81%). Significant difference of VAS score and DASH score between Group A and Group B was found at week 2 and Week 6 follow up (P<0.05). Significant difference was found at week 2 and week 6 follow up (P<0.05) regarding ROM (flexion, abduction, internal rotation, external rotation) in Group A than Group B. Conclusion: Present study shown that intra-articular corticosteroid injection was more effective to reduce pain, improve ROM and disability in adhesive capsulitis.

Utero-cutaneous fistula (UCF) is a rare complication of pelvic surgeries in women. It occurs when there is a fistulous connection between the uterine cavity and anterior abdominal wall. It has been reported following open abdominal myomectomy, surgeries for endometriosis, chronic and granulomatous pelvic infection, poorly performed caesarean section, gynaecological malignancies, complication of the management of placenta accreta spectrum, and foreign body insertion for the treatment of infertility. We present three cases of Uterocutaneous fistulas post open abdominal myomectomies manged medically using high dose intramuscular depo-medroxy progesterone acetate (DMPA).

Background: Post-operative wound infections (POWIs) are a leading cause of morbidity and increase in healthcare costs, especially in low resource settings. The rising prevalence of antibiotic resistance among pathogens also increases the complexity of treatment strategies, highlighting the importance of local surveillance of microbiological and resistance patterns. This study aims to find out the antibiotic susceptibility patterns of gram positive and gram negative isolates from the post-operative wound infections from women undergoing obstetric and gynecological surgeries. Methods: A cross-sectional study was conducted at Department of Obstetrics and Gynecology, Dhaka Medical College Hospital, Dhaka from October 2019 to September 2021. A total of 200 women with post-operative wound infections were purposively selected. Among them, 134 had culture-positive findings. Bacteriological analysis and antibiotic susceptibility testing were performed on isolates following standard microbiological methods. Results: Among the 134 culture-positive cases, 33.6% of isolates were gram-positive, with Staphylococcus aureus being predominant. Gram-negative bacteria accounted for 66.4% of isolates, with E. coli and Pseudomonas aeruginosa equally prevalent (20.9%). Gram-positive isolates showed high sensitivity to piperacillin-tazobactam (91.1%) and sulbactam (53.3%) but were resistant to ceftriaxone (48.9%) and cefixime (51.1%). Gram-negative bacteria exhibited sensitivity to amikacin and meropenem but demonstrated widespread resistance to ceftriaxone and doxycycline. Conclusion: This study describes the diverse microbiological profile and high prevalence of antibiotic resistance in POWIs. Novel antibiotic therapy and strict infection control measures are essential to curb the burden of these infections.

Background: Manual vacuum aspiration (MVA) is a widely used procedure for the management of early pregnancy loss, primarily in low resource settings. A highly successful analgesic method with few side effects is paracervical block (PCB). This study aims to evaluate the patient’s satisfaction and adverse effects associated with PCB during MVA for early pregnancy loss. Methods: This cross-sectional prospective observational study was conducted at Rajshahi Medical College Hospital, Bangladesh, from January to June 2019. Fifty-two women with early pregnancy loss were included through convenience sampling. PCB administered before MVA; pain, satisfaction, effects assessed systematically. Results: This study found that, 23.07% of patients had a just palpable uterus and tenderness in 88.5%. 73.10% patients presented with active bleeding. The cervical OS was open in 76.93% of patients and in 42.30%, the product of conception was felt. Regarding resuscitation, 73.07% required IV fluid infusion, all needed antibiotics and 23.1% required blood transfusions. Most patients (69.23%) had minimal per vaginal bleeding and the average procedure duration was 8-10 minutes (80.77%). The procedure was reported easy by 86.54% of patients, 7.7% reported discomfort and 88.46% would recommend it to others. Adverse effects included nausea in 1.92%, epigastric pain in 3.85%, and excessive bleeding in 5.77%, which was effectively controlled by pressure. Conclusions: Paracervical block is a safe, effective, and well-tolerated analgesic option for MVA in managing early pregnancy loss. Its minimal adverse effects and high patient satisfaction suggest its routine use in clinical practice.

Insulinoma is a rare functional pancreatic neuroendocrine tumour that is usually sporadic and solitary. It can have a varied presentation. Neuroglycopenic manifestations of hypoglycemia due to insuline hypersecretion can mimic neurological or psychiatric disorders, thus often a diagnosis and treatment delay. Insulinoma is a potentially curable condition, but it can be fatal if left unrecognized. We report a case of A 45-year-old woman who had a 9-year delay before diagnosing insulinoma after being initially assessed with anxiety–depressive disorder. The case report below provides a detailed review of the diagnosis, tumour localization, and the successful surgical intervention implemented for the patient.

Drug Utilization Evaluation (DUE) is a comprehensive study examining the marketing, distribution, prescription, and use of medications within a society. This evaluation encompasses a range of medical, social, and economic factors related to drug use, with the primary goal of ensuring that drug therapy adheres to current standards of care. This prospective observational study conducted at Navodaya Medical College Hospital and Research Centre (NMCH & RC) from 15th February to 15th August 2024 aimed to evaluate prescription patterns for gastrointestinal disorders, focusing on drug utilization from the Essential Drug List (EDL) and adherence to WHO core prescribing indicators.150 prescriptions were analyzed, revealing that 64.66% of patients were male, with the majority aged 20-39 years. Acute gastroenteritis was the most common diagnosis (34%), and common symptoms included abdominal pain, loose stools, and vomiting. Antibiotics, particularly metronidazole, were the most prescribed drug class (25.35%). Of the prescribed drugs, 75.95% were from the EDL, but only 8.91% were prescribed by generic name, and 64.82% involved injections. The average number of drugs per prescription was 6.65, indicating polypharmacy and drug interactions were prevalent. The study highlighted concerns about moderate antibiotic use, high injection rates, low generic drug prescriptions, and polypharmacy, underscoring the need for improved rational prescribing practices to enhance patient safety and cost efficiency.

The adoption of artificial intelligence (AI) in various sectors, including healthcare, has gained significant popularity due to its potential to improve services. In the medical field, misdiagnosis has been a major problem, leading to increased mortality rates. Accurate diagnosis is crucial for effective treatment and management of diseases. This research aims to develop a machine-learning model for segmenting small blood vessels in magnetic resonance angiography (MRA) and magnetic resonance imaging (MRI) datasets using bilateral filtering. The research identifies the limitations of existing machine learning models in blood vessel segmentation, particularly the loss of important edge information due to convolutions that blur images. To address this issue, a non-linear bilateral filter is introduced to enhance the segmentation of blood vessels in MRI images. The proposed framework aims to improve the accuracy of the segmentation algorithm by reducing image blurring and noise through bilateral filtering. The objectives of this research include training and testing a machine-learning prototype using bilateral filtering, exploring the weaknesses of existing models in blood vessel segmentation, and developing a machine-learning model specifically designed for segmenting small blood vessels using bilateral filtering. Various studies have proposed machine learning algorithms, such as convolutional neural networks, for blood vessel segmentation. The review emphasizes the importance of bilateral filtering in improving classification accuracy by reducing image blurring. In conclusion, this research aims to contribute to the field of medical image analysis by developing a framework that utilizes bilateral filtering to enhance the segmentation of small blood vessels in MRA and MRI datasets. The proposed machine learning model has the potential to improve the accuracy of blood vessel segmentation, enabling more accurate diagnoses and reducing misdiagnosis-related mortality rates.

Background: Preventive dentistry plays a crucial role in maintaining optimal oral health and preventing dental diseases such as caries, periodontal disease, and oral cancer. Knowledge and awareness of preventive measures significantly influence patient behavior, improving oral health outcomes. This study aimed to assess the awareness of preventive dentistry practices among patients attending Karary University Dental Clinic in 2022. Methods: A descriptive cross-sectional study was conducted with 151 patients attending the dental clinics at Karary University. A structured questionnaire was used to evaluate participants' knowledge and attitudes regarding preventive dentistry practices. Descriptive and inferential statistical methods were employed for data analysis. Results: The majority of participants (54.7%) exhibited fair awareness of preventive dentistry, with 39.3% showing good awareness, 4.7% demonstrating poor awareness, and only 1.3% displaying excellent awareness. Awareness was significantly higher among females, individuals aged 19-40 years, and those with a university education. While most patients (90.4%) recognized the preventability of dental diseases, gaps in knowledge were evident regarding the use of preventive tools such as dental floss and the importance of regular dental checkups. Conclusion: This study highlights a significant variation in preventive dentistry awareness among patients at Karary University Dental Clinic. Despite general awareness of dental disease prevention, specific areas, such as the use of dental floss and understanding advanced preventive measures, require further attention. Targeted educational interventions, particularly for high-risk groups, are essential to improve preventive dental practices and ultimately enhance oral health outcomes.

Background: Conventional public health statistics, which concentrate on mortality rather than morbidity or dysfunction, severely underrepresent the massive burden of sickness caused by behavioral and psychiatric illnesses. Objective: To determine the prevalence of psychiatric disorders and the patterns of psychotropic drug prescriptions. Materials and Methods: It was a hospital-based prospective observational study was conducted in the Department of Pharmacology & Therapeutics, Sir Salimullah Medical College & Hospital during July’ 2022 to December’ 2022. A total of 765 prescriptions were selected. All patients attending the psychiatry OPD during the period of the study were included and analyzed as per the WHO drug indicators. Results: Clonazepam constitutes 119 (51.74%), Lorazepam 74 (32.17%), and Others 37 (16.09%) of the 230 anxiolytics listed in the table. In 195 antidepressant drugs, 76 (38.97%) were escitalopram, 33 (16.92%) were amitriptyline, 47 (24.10%) were imipramine, and 39 (20%) were other antidepressants. Antipsychotics were detected in 194 patients (21% of the cohort population). This includes Olanzapine (88.36%), Haloperidol (34.54%), Risperidone (14.22%), and Other Antipsychotics (12.89%). Trihexyphenidyl was prescribed to 75 of the 88 study participants, accounting for 85.23% of the total. Prescribing Indicators and it was observed that an average number of drugs per prescription were 2.59±1.37. Average number of Antipsychotics prescribed per prescription was 2.73±1.46. The number of antipsychotic drugs prescribed by generic name was 52.94%. Percentage of injectable drugs prescribed 2.48%, Percentage of the prescriptions containing psychotropic FDC 20.78%, Percentage of psychotropic drugs prescribed from essential drug list 42.75%, Percentage of psychotropic drugs prescribed from hospital pharmacy 62.22%. Conclusion: The most frequently prescribed antidepressant, antipsychotic, and BZD medications were escitalopram, olanzapine, and clonazepam, in that order. Carbamazepine was preferred over lithium as a mood stabilizer.

Worldwide, infertility is a prevalent problem that poses a threat to couples, either the male or female partner, or both spouses, may be the cause of infertility. Numerous elements about the patient's general health or way of life may be to blame. Systemic or gonadal dysfunction may be the cause of the patient's health issues. Hematological factors may be one of the systemic reasons. Thalassemia major (TM) and sickle cell disease (SCD) are the two most prevalent hemoglobinopathies that are suspected to be the cause of infertility, particularly male infertility. Through pathophysiological changes, these two hemoglobinopathies result in male infertility. In particular, they change red blood cells' (RBCs') capacity to carry oxygen, resulting in tissue hypoxia that impacts spermatogenesis and the body's natural process of producing new cells, ultimately leading to infertility. Semen analyses and other systemic blood testing can be used to investigate male infertility. Both hemoglobinopathies can be helped by blood transfusions, which can then alleviate male infertility. This paper aims to explore the relationship between hemoglobinopathies (SCD and TM) and their role in contributing to male infertility, in addition to the role of blood transfusions in addressing male infertility by correcting the root cause.

Functional Movement Screening (FMS) has emerged as a vital tool in sports science for identifying movement inefficiencies, preventing injuries, and enhancing athletic performance. In cricket, a sport characterized by its unique combination of asymmetrical movements, repetitive actions, and high physical demands, FMS offers significant potential to optimize player outcomes. This paper investigates the application of FMS in cricket, focusing on its role in detecting biomechanical dysfunctions, designing corrective interventions, and monitoring performance improvements over time. By examining a cohort of state-level cricketers, the study highlights the effectiveness of FMS in reducing injury incidence, improving movement efficiency, and enhancing key performance metrics such as agility and accuracy. The findings underscore the importance of integrating FMS into cricket training programs and emphasize the need for a multidisciplinary approach involving coaches, physiotherapists, and sports scientists. Despite challenges in implementation, such as resource limitations and the need for specialized training, FMS proves to be a transformative tool in advancing the health and performance of cricketers. Future research directions include the establishment of sport-specific benchmarks, the integration of wearable technology for real-time assessments, and longitudinal studies to explore sustained benefits.

Background: Ovarian tumour preferably malignant one is the leading cause of morbidity and mortality of women. Despite of advancement in surgical and chemotherapeutic treatment during the last decade, still survival rates are poor mainly due to late and incidental diagnosis. Objective: To find out correlation of raised serum CA -125 level with laparotomy and histopathological findings of ovarian tumours. Methodology: This observational descriptive study was conducted in the department of Obstetrics & Gynaecology in Combined Military Hospital, CMH Dhaka from January 2023 to December 2023 and data collection period of 6 months. Total 30 patients having ovarian tumour diagnosed clinically, by ultrasonography and with raised serum CA125 level were included in the study who underwent laparotomy and diagnosis confirmed by histopathology. Results: Total 30 cases of ovarian tumour with raised serum CA-125 were enrolled in the study. Patient presented with lump in the abdomen 26(86.7%) as the commonest presentation. The commonest tumour was epithelial tumour 22 (73.3%) followed by germ cell tumour 8(26.7%). Serous cyst adenoma (47.4%) was common benign tumour& serous cyst adenocarcinoma was the commonest malignant variety (36.3%). Serum CA-125 level was raised in all cases but highly raised in almost all the malignant ovarian tumour 10(90.9%), among them in poorly differntiated 2(18.2%) cases CA-125 level is markdly raised average is 433.5U/ml, then in moderately differentiated cases CA-125 level is highly raised avgerage is 221.5U/ml. In undifferentiated variety average level of CA-125 is 272.5U/ml. In well differentiated case CA-125 level raised to 69U/ml. And on laparotomy, tumours with malignant features has high serum level of CA-125 (>100U/ml). Conclusion: As serum CA-125 is highly raised in most of malignant ovarian tumour, mainly of epithelial variety and moreover makdly raised in poorly differented ones as well as these tumours are found to have features of malignancy on laparotomy, so we can conclude that raised serum CA-125 is a useful tumour marker for early screening, and as well as it can be used as a marker for assumption of the nature and aggresiveness of ovarian malingnancies. Thus, serum level of CA-125 can be used as a tool for detection of ovarian malignancy at early stage, to reduce the morbidity and mortality of patients, as well as to improve the survivility also to reduce the disease burden of the patient with ovarian tumour.

Global warming is currently one of the world's most pressing issues. It has been a reason behind the proliferation of renewable energy (RE) systems. The majority of renewable energy sources are sustainable and release less carbon, in contrast to fossil fuels, which is why they have recently gained favour. Solar, wind, and geothermal energy have the potential to be employed in these Gulf countries to meet the region's power production needs. This is due to the Gulf country's strategic location as well as its immense oil and natural resource richness. According to previous researchers, the primary source of economic benefits for Gulf countries is global energy consumption by using crude oil and fossil fuels. The GCC is a major player in the global energy market. It is home to some of the world's largest oil and gas reserves and plays a significant role in producing and exporting energy resources. In future, as the world's energy needs shift towards renewable sources, the demand for traditional energy sources like oil and gas may decline. This could reduce the GCC's importance as a global energy supplier. Hence Saudi Arabia and the United Arab Emirates have made efforts to diversify their economies away from dependence on oil and gas exports. Saudi Arabia has launched several initiatives aimed at diversifying its economy. The most notable of these is the Vision 2030 program, which seeks to reduce the country's dependence on oil and create new economic sectors, such as tourism, entertainment, and technology. The government has also invested heavily in infrastructure projects, such as the construction of the NEOM megacity and the Red Sea Project, which are aimed at attracting foreign investment and creating new jobs. Similarly, the United Arab Emirates has been at the forefront of economic diversification, with its government launching several initiatives aimed at promoting innovation, entrepreneurship, and knowledge-based industries. One of the most notable initiatives is the Dubai Future Accelerators Programme, which brings together startups and government agencies to work on cutting-edge technologies and solutions. Additionally, the United Arab Emirates is investing heavily in renewable energy to generate 50% of its electricity from clean sources by 2050. Both Saudi Arabia and the United Arab Emirates are working towards building more diversified, knowledge-based economies that can compete in the global marketplace. At the same time, the road ahead may be challenging because of technical challenges, Economic challenges, lack of infrastructure, Regulatory challenges, Heavy Dependence on oil, Skilled labour shortage, and Regulatory environment. While taking the above as the context, the paper shall look at renewable energy development in Saudi Arabia and the United Arab Emirates. The following are major research questions which shall be explored and analysed: • How has the development of renewable energy technologies and infrastructure in Saudi Arabia and the United Arab Emirates progressed over time, and what factors have influenced this development? • What are the future plans and potential for continued growth and expansion of renewable energy in these countries? • What will be the future and potential renewable energy sources and policies in Saudi Arabia and the United Arab Emirates, and what are the barriers and opportunities for their adoption and integration into the energy mix? • How successful have Saudi Arabia and United Arab Emirates' economic diversification efforts been in reducing reliance on oil revenues? • What are the similarities and differences between the development of renewable energy technologies and policies in Saudi Arabia and the United Arab Emirates compared to the rest of the world? • What are the factors that have contributed to the similarities and differences, and how do they impact the potential for further growth and expansion of renewable energy in these countries relative to the rest of the world? This paper presents a literature-based study. The study covers capacities, projects, policies, and frameworks in Saudi Arabia and the United Arab Emirates. In this study, we would make use of secondary data that has been gathered from previously published statistics and relevant literature.

Agriculture and rural areas play an important role in the economy and the stable development of society. Along with the country's innovation process after the mistakes and limitations of the planning mechanism and centralized subsidies, our country has entered a period of stability, development and integration with the world. An Giang is a key province in agricultural production in the Mekong Delta and the whole country. The achievements of the renovation process have promoted positivity and created personal motivation for people to promote creativity in agricultural production, contributing to raising and improving life, escaping the situation of food shortage, abandoned land and damaged agricultural tools. However, An Giang in particular and the Mekong Delta provinces in general are facing challenges due to climate change, water scarcity and saline intrusionex, cessive crop growth, along with flood control dykes, has made the land inhospitable, excessive use of chemical fertilizers and pesticides has led to serious environmental pollution, ecosystem destruction, and biodiversity changes over hundreds of years, affecting people's health and causing many new diseases, especially cancer. Therefore, changing the way of production, following nature, towards ecological and sustainable agriculture for a clean environment and public health is an urgent issue that needs to be changed.

The presence of secondary metabolite, particularly aflatoxin produced by fungi, poses economic challenges in food and feed industries. This study aimed to identify aflatoxigenic Aspergillus species inedible oil and quantify total aflatoxins levels. We collected thirty sample of edible oil from various local market in Karachi and tested them for presence of Aspergillus flavus and total aflatoxin levels. Out of thirty, four samples tested positive for Aspergillus flavus using culture-based methods, which were subsequently confirmed by amplification of partial transcribed (ITS) region. Aflatoxin production was assessed using colorimetric methods, revealing that all A. flavus positive isolates (JB2, MGM4, LMM1, and RLM2) exhibited a plum red change upon exposure to ammonium hydroxide vapors on Sabouraud Dextrose Agar. Notably, JB2 also demonstrated color change on Yeast extract Sucrose and Coconut Agar medium, and exhibited blue fluorescence under UV light on coconut Agar medium. Aflatoxins were extracted from edible oil sample using solvent extraction method and quantified using a VICAM fluorometer. Among samples one exhibited total aflatoxin levels between 20-30ppb, five samples had levels below 20ppb, while 24 samples were negative for aflatoxin. These finding underscore the need of continued monitoring of aflatoxin contamination in edible oil.