The increase in the incidence of hepatotoxicity resulting from exposure of individuals to toxic substances from the environment especially industrial hazards as well as toxicity from drug intake calls for search of more sources of hepatoprotective substances. African walnuts (Tetracarpidium conophorum) have been widely used not only as food but for various acclaimed medicinal purposes. The protective effects of Tetracarpidium conophorum seed oil against carbon tetrachloride (CCl4) - induced liver injury in wistar rats was evaluated. The oil was extracted with n-hexane from the walnut seed using Soxhlet apparatus. Forty eight male Wistar rats (100-120g) were used. These were divided into four groups of 12 rats each. Groups A and D were fed with normal rats’ feed and water while Groups B and C were fed with diet containing 10% extracted Tetracarpidium conophorum seed oil throughout the experiment. Group C and D received 200mg/kg CCl4 intraperitoneally once after 30 days of feeding. The administration of the African walnut oil attenuated the levels of serum aspartate aminotransferase, alanine aminotransferase, and liver lipid peroxidation in CCl4 – treated rats. Histopathological studies of the rats’ liver revealed that pretreatment of the animals with African walnut oil reduced the incidence of liver lesions induced by CCl4. African walnut oil also increased the antioxidant capacity of the rats by increasing reduced glutathione (GSH) content and decreased malondialdehyde (MDA) that was formed due to CCl4 administration in CCl4-treated rats. The results show that Tetracarpidium conophorum seed oil has hepatoprotective effect against CCl4 - induced liver toxicity.

To analyse the drug prescription pattern for secondary prevention of stroke, medication adherence, knowledge and awareness about the disease, and direct medical costs involved in the treatment of stroke. A Prospective observational study was carried out for 6 months in the inpatient department. The inclusion criteria of the present study are patients of either sex aged ≥ 18 years, patients who were diagnosed as stroke patients and admitted to the intensive care unit of the hospital. About 120 prescriptions in total were examined during the 6-month trial. Men aged 64 showed a higher prevalence of this (53.33%). 120 individuals were included in the study, 115 (95.5%) of whom had ischemic stroke, while 5 (5%) had a haemorrhagic stroke. Hypertension, dyslipidemia, and diabetes mellitus were the three main co-morbidities found; these conditions were present in 82 (68.0%), 80 (66.6%), and 73 (60.8%%) individuals, respectively. The majority of the patients in this study on pharmacological prescriptions for stroke were being treated with statin and antiplatelet medications. 109 (90.8%) of the 120 patients received statin (Atorvastatin) medication. This study found that clopidogrel, prescribed to 102 (84.8%) and 19 (15.8%) patients, was the most widely used antiplatelet. In our facility, the sole anticoagulant utilized for stroke victims was heparin.

Introduction: Signing against medical advice (SAMA) or discharge against medical advice (DAMA) is a fairly common occurrence among patients presenting to trauma with extremity fractures. The study aims to report the reasons for SAMA among these patients. Materials and Methods: This was a retrospective study of 105 admitted patients and later SAMA at the trauma centre of the Usmanu Danfodio University Teaching Hospital (UDUTH), Sokoto, Nigeria between February 2023 and December 2024. The study criteria included all patients with extremity fractures. The reason for SAMA within or more than 24 hours of admission includes the type of fractures (closed fracture, poly-trauma, multiple fractures or open fracture), financial, preference to traditional bone setting or proximity to home. The data analysis was done using SPSS Version 23. Results: There was a total of 105 patients in the study who SAMA. The SAMA prevalence was 3.7%. There were 90 (85.7%) males and 15 (14.3%) females. The mean age of patients was 32±19.55 (range 2 to 85). The most frequent age affected was 25 (9 patients) and the most involved age group was from 20 to 40 years with 54 (51.4%) patients. Eighty-one (77.1%) patients have SAMA within the first 24 hours of admission while 24 (22.9%) SAMA after 24 hours of admission (p-value <0.0001). There were 70 (66.7%) with closed fractures, 19 (18.1%) with polytrauma, 11 (10.5%) with multiple fractures, and 5 (4.8%) with open fractures. The reasons for SAMA were due to financial factors in 66 (62.9%) patients, preference for traditional bone setting (TBS) in 28 (26.7%) patients, and due to being closer to home in 11 (10.5%) patients. Conclusion: This study shows majority of patients had SAMA within the first 24 hours and occurred commonly among younger age groups, male gender, in patients with financial issues, preference for TBS, and closed fractures.

Background: Differentiating benign from malignant adrenal tumors is critical for determining appropriate clinical management. Although histopathology is the definitive diagnostic tool, contrast-enhanced computed tomography (CT) offers valuable non-invasive insights. Specific morphologic features- such as size, shape, margins, and enhancement patterns- can help predict malignancy. Establishing reliable CT-based criteria enhances diagnostic confidence and aids in selecting patients who may benefit from surgery or further evaluation. Objective: To evaluate the diagnostic value of CT morphologic features and tumor size in distinguishing benign from malignant adrenal tumors. Methods: This cross-sectional study was conducted at the Department of Radiology and Imaging, Bangladesh Medical University (BMU), Dhaka, over a two-year period and included 30 patients with clinically or radiologically suspected adrenal masses. All patients underwent contrast-enhanced CT (CECT) using a standardized adrenal protocol, including unenhanced, portal venous, and delayed phases. Tumor characteristics such as size, shape, margins, enhancement pattern, internal architecture, necrosis, calcification, and attenuation were assessed. CT findings were interpreted by radiologists blinded to histopathological results. Final diagnoses were confirmed by histopathological examination of biopsy or surgical specimens. CT features and lesion size were then correlated with histopathological outcomes to evaluate their significance. Results: Among the 30 patients evaluated, the mean age was 40.9 ± 17.8 years, with a male-to-female ratio of 1.3:1. CT revealed left-sided adrenal masses in 40%, right-sided in 33.3%, and bilateral involvement in 26.7%. Most lesions (63.3%) were <4 cm, and 53.3% appeared hypodense on pre-contrast imaging. Post-contrast, 50% of lesions showed homogeneous enhancement, while 46.7% showed heterogeneous enhancement. Hemorrhage and necrosis were noted in 23.3% of cases, and invasion into adjacent structures was observed in 6.7%, both exclusively in malignant lesions. Hypodensity was predominantly seen in benign lesions (46.6%), whereas hemorrhage, necrosis, and invasion were exclusive to malignancies. Among lesions <4 cm, 94.7% were benign; among those ≥4 cm, 54.5% were malignant. The odds of a lesion ≥4 cm being malignant were 21 times higher (OR: 21; 95% CI: 2.1–223.6; p = 0.002). Malignant tumors had a significantly larger mean diameter (8.05 ± 5.06 cm) than benign tumors (3.90 ± 2.14 cm; p = 0.003). Adrenal adenoma was the most common lesion (50%), followed by hyperplasia (13.3%) and adrenocortical carcinoma (10%). Conclusion: CT morphologic features, particularly lesion size, enhancement pattern, and structural alterations such as necrosis or invasion, are valuable indicators for distinguishing benign from malignant adrenal tumors. Lesions ≥4 cm and those showing heterogeneous enhancement or invasive characteristics were significantly associated with malignancy.

Clinical laboratory professionals and diabetes educators play pivotal roles in improving diagnostic accuracy and patient outcomes in diabetes management. Laboratory professionals are responsible for conducting precise and reliable laboratory tests, such as fasting blood glucose, HbA1c, and oral glucose tolerance tests, which are crucial for diagnosing diabetes and assessing glycemic control. Their expertise ensures that test results are accurate, timely, and interpret correctly to aid clinicians in making informed treatment decisions. Additionally, they maintain strict quality control measures and stay updated with advancements in diagnostic technologies to minimize errors and improve the overall quality of laboratory data used in diabetes care, Diabetes educators complement this by empowering patients through education about disease management, medication adherence, lifestyle modifications, and self-monitoring techniques. They help interpret test results and translate complex medical information into understandable advice, enhancing patient compliance and engagement. This collaborative approach between laboratory professionals and educators ensures that diabetes is managed effectively, reducing the risk of complications and enhancing patient outcomes. Together, they create a comprehensive support system that promotes accurate diagnosis, personalized treatment plans, and sustained disease control.

Background: Thyroid dysfunction is common in critically ill neonates and has been repeatedly implicated in gastrointestinal dysmotility and sub optimal growth. Yet, the magnitude and nature of its relationship with feeding difficulties in the neonatal intensive care unit (NICU) remain uncertain. Objectives: We synthesized contemporary evidence on the prevalence of thyroid disorders among NICU patients, quantified the frequency of concomitant feeding difficulties, and explored mechanistic links and therapeutic implications. Methods: A systematic search of PubMed, Web of Science, Scopus and ScienceDirect was performed from inception to 1 March 2025. Very low birth weight and term neonates admitted to NICU settings were eligible. Two reviewers independently screened records, extracted data and assessed risk of bias with the Joanna Briggs Institute tool. Results: From 812 unique records, 10 studies met inclusion criteria (4 cohort, 3 case control, 1 prospective crossover trial, 2 case reports; cumulative N = 2 387 neonates). Congenital or acquired hypothyroidism predominated; one series reported delayed thyrotropin elevation and another synthesized thyroid dysfunction secondary to maternal Graves’ disease. Across studies, hypothyroid infants required significantly longer periods nil per os, tolerated lower enteral volumes and had more frequent gastric residuals than euthyroid peers. Initiation of L thyroxine—typically 5 15 µg kg⁻¹ day⁻¹—consistently accelerated achievement of full feeds and resolved abdominal distension. Quality appraisal rated eight studies moderate and two high. Conclusion: The best available evidence indicates that untreated thyroid hypofunction is an under recognized, reversible contributor to feeding intolerance in the NICU. Routine thyroid re evaluation in hard to feed infants and prompt thyroxine replacement when indicated may shorten parenteral nutrition dependency and hospital stay. Robust multicenter trials are warranted to define optimal screening intervals and dosing strategies.

Background: Oral diseases remain a significant global health burden. The traditional restorative approach to dental care, focused on repairing disease outcomes, is increasingly recognized as insufficient for managing these chronic, multifactorial conditions. This highlights a critical need for a more preventive and holistic paradigm. Objective: This review aims to synthesize the current evidence on key dietary and pharmacological adjuncts that supplement and enhance standard mechanical dental care. Furthermore, it seeks to critically analyze the essential role of interprofessional collaboration (IPC) in the effective implementation of these adjuncts to optimize patient outcomes and facilitate a shift towards comprehensive, patient-centered oral healthcare. Methods: A comprehensive literature search was conducted across multiple electronic databases, including PubMed, Scopus, and Web of Science, for articles published up to June 2025. The review prioritized systematic reviews, meta-analyses, randomized controlled trials, and authoritative position papers. Findings: The evidence strongly supports the efficacy of various pharmacological adjuncts, including topical fluorides for remineralization, chlorhexidine for short-term microbial control, and sub-antimicrobial dose doxycycline for host modulation in periodontitis. Dietary adjuncts, such as polyphenols, probiotics, and dietary nitrates, show promising potential in modulating the oral microbiome and host response. The synergistic potential of these adjuncts is most effectively realized when managed by a cohesive interprofessional team. This collaborative model, involving dentists, physicians, pharmacists, and dietitians, allows for comprehensive management of interconnected factors such as systemic disease, polypharmacy, and complex nutritional needs. Conclusion: The integration of evidence-based dietary and pharmacological adjuncts through a structured interprofessional collaborative model is fundamental to advancing modern dental care.

Research aimed to assess how work stress and work engagement affect employee performance, with organizational commitment as an intervening. This study uses a quantitative methodology. The study use the census sampling technique to collect data from workers in the General Affairs Department. In this study, the sample consisted of 70 Civil Servants. Analysis method in this research use Structural Equation Model (SEM) and supporting by SmartPLS v3.0 application. The results of this research indicated that employee performance affected by work stress, employee’s performance is affected by work engagement, organizational commitment is affected by work stress, organizational commitment is affected by work engagement, employee’s performance is impacted by organizational commitment, employee’s performance is affected by work stress through organizational commitment, and employee’s performance is affected by work engagement through organizational commitment among employees in the General Affairs Division of Pemalang Regency.

This study documents the diversity of epiphytic lichens inhabiting crop trees in the lowlands of Pathanamthitta district, Kerala, India. A total of 32 lichen species were identified, with 12 crustose and 20 foliose forms. The family Caliciaceae was the most prevalent, with eight recorded species. Notably, foliose lichens exhibited reduced thallus size and smaller lobes compared to typical growth patterns. Parmotrema praesorediosum was the sole exception, displaying larger lobes than the other collected foliose specimens. The study identified Areca catechu and Cocos nucifera as the tree species supporting the highest lichen diversity. The findings are crucial for understanding lichen biodiversity in anthropogenically modified habitats and will establish a foundational baseline for conservation and ecological monitoring in the agro-forestry systems of the Western Ghats biodiversity hotspot.

This article revisits Souvenirs d’autrefois (1916) by Martin Jérôme, a little-known memoir written by a Métis politician and public servant in early twentieth-century Manitoba, Canada. Far from a nostalgic recollection, the text is analyzed here as a civic intervention, a political, cultural, and linguistic act that anticipates contemporary debates on multilingual coexistence and linguistic justice. To interpret Jérôme’s work, the article introduces the concept of relational bilingualism, a framework that foregrounds language as a lived, asymmetrical, and historically embedded practice shaped by memory, place, and affect. Unlike institutional models based on legal symmetry, relational bilingualism emerges through negotiation, vulnerability, and community transmission. Through close reading and historical contextualization, the article positions Jérôme alongside other contemporaries such as Lionel Groulx, Donatien Frémont, Adrien-Gabriel Morice, and A.-H. de Trémaudan, mapping the intellectual and ideological field of francophone Western Canada. The final sections explore the enduring relevance of Jérôme’s vision for present-day debates on official bilingualism, digital archives, education, and Métis media. Manitoba, often seen as peripheral, appears here as a microcosm of global struggles around memory, reconciliation, and linguistic pluralism. Comparative perspectives from postcolonial contexts such as Algeria, Lebanon, or New Zealand help frame Jérôme’s narrative as part of a broader inquiry into how minoritized communities sustain language and identity in multilingual societies. By tracing the entanglements of language, land, and memory, this article argues that Jérôme’s bilingual modernity is not only historically significant, but theoretically generative: it offers a grammar of relational belonging that resonates beyond Canada’s borders.

The study assesses the variation in depth along the main channel of Otamiri River, in Rivers state, Nigeria. Quasi-experimental (field survey) research design was adopted for the study, as it involves observation on the morphometry parameters of the tributaries of Otamiri river. Primary data were collected through tape, ranging pole, float, and Stopwatch, while drainage maps and topographic map become secondary sources of data. The sample frame for this study is total length of all tributaries of Otamiri-river basin, in the study area. The total length of the tributary streams is 320 kilometers, the data were collected at interval 1 kilometre since total length is 320 kilometres, then 320 divide by 1, therefore the sample frame is 320 Sampling Station. Analysis of variance (ANOVA) was used in testing the various conjectural statements at 5% level of significance for acceptance or otherwise. Findings revealed that, there is variation in a significant variation in the depth along the main channel of the Otamiri river basin in the Southern Nigeria. From the findings, it was inferred that geomorphic and morphometric variations exist both with the main trunk of the Otamiri river as well as the major tributaries. These variations could be a function of temporal variation in the input factors as well as process modifications along the river channel and its basin area. Thus, the researcher recommends, adequate and periodic channelization through dredging of the downstream River channel as to improve channel capacity in order to reduce the menace of flooding that causes displacement of settlement and other human meaningful activities within the area concerned.

Background: Chronic hepatitis B (CHB) is a significant global health burden, Patients with CHB are at increased risk of developing cirrhosis, liver failure and hepatocellular carcinoma (HCC). Even in asymptomatic state, there may be much progression of necroinflammation and fibrosis in liver in many patients specially in patients with elevated HBV DNA with normal alanine aminotransferase. Liver biopsy is the gold standard for fibrosis evaluation but has limitations, necessitating non-invasive alternatives like transient elastography in CHB patients with elevated DNA and normal ALT. Objective: This study aims to assess the correlation between TE and liver biopsy findings in CHB patients with elevated HBV DNA and normal ALT, evaluating TE's diagnostic accuracy in detecting significant fibrosis. Methodology: A cross-sectional study was conducted at the Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, from June 2019 to February 2020. Forty CHB patients (HBsAg positive >6 months, ALT <40 IU/L, HBV DNA >2,000 IU/mL) underwent TE and percutaneous liver biopsy. Fibrosis stages were evaluated using the METAVIR scoring system. TE findings were correlated with histological fibrosis using Pearson's correlation test, with statistical analysis performed via SPSS version 23. Results: The mean age of patients was 30.20 ± 8.3 years, with a male predominance (75%). TE classified 77.5% of patients as having F0-F1 fibrosis and 22.5% as F2 fibrosis. Histological analysis identified 57.5% with F0-F1 fibrosis and 42.5% with significant fibrosis (F2-F4). TE and biopsy findings showed a positive correlation (p<0.001). The receiver-operating characteristic (ROC) curve for TE demonstrated an area under the curve (AUC) of 0.774, with a cut-off value of 5.9 kPa yielding a sensitivity of 70% and specificity of 91% for detecting significant fibrosis. Conclusion: TE shows a strong correlation with liver biopsy findings in CHB patients with elevated HBV DNA and normal ALT, demonstrating its potential as a reliable, non-invasive alternative for fibrosis assessment. Utilizing TE in clinical settings could enhance early detection and management of liver fibrosis, reducing the need for invasive biopsies.

The present study provides a qualitative and quantitative account of the rhetorical use of metadiscourse markers in Chomsky’s On Nature and Language, claiming that interaction is an essential component of persuasion in social fields in general and in linguistic discourse in particular. Persuasion, therefore, relies on effective argument and writer-reader interaction as writers are uncertain when dealing with human subjects and data, on one hand, and unable to draw on empirical demonstration or trusted quantitative methods (Hyland, 2000). As a result, writers use language to engage their readers by positioning, persuading and including them as discourse participants (Hyland, 2019). Chomsky’s linguistic discourse received several studies, however, writer-reader interaction as an integral component of the construction and attainment of ethos was marginalized and overlooked. Accordingly, the study hypothesizes that metadiscourse plays an essential role in Chomsky’s persuasive discourse. Moreover, the study addresses the question of how metadiscourse is deployed to engage and persuade the reader, on one hand, and to create a credible persona, on the other hand. The study identified 4,724 instances of metadiscourse in a corpus of 38,183 words. This is a frequency of one every 8 words. It also shows that instances of interactional metadiscourse are significantly greater than interactive ones, and the most frequent categories are engagement markers (35.9), hedges (27.1), transitions (18.7) and boosters (16.1).

Increase in the demand for consumer electrical and electronics equipment which is driven in part by the rate of technological advancements invariably gives rise to more products requiring the use of circuit boards. This paper analyses the manufacturing process of printed circuit board (PCB), disposal of waste PCBs at the end-of-life and how it affects the environments. Legislation on production and waste disposal was also be examined with specific interest in how these laws affect production and sustainable alternative ways to manufacture PCBs. Research into new types of environmentally friendly printed circuit boards, with particular interest in the recycle and re-use of the boards and components respectively and the life cycle assessments (LCA) which analyses the entire life phase of PCBs. In conclusion, the paper confirms the possibility of developing an environmentally friendly circuit board as an alternative to PCB.

Background: Prolonged hypertension is believed to affect brain structure due to chronic vascular stress. Objective: To assess the correlation between hypertension duration and changes in brain volumes using 3D MRI. Methods: This cross-sectional study involved 100 hypertensive individuals aged 30–60 years. Brain volumes (gray and white matter) were measured using 3D MRI. Pearson correlation analysis was used to evaluate associations with hypertension duration. Results: Strong negative correlations were found between hypertension duration and both gray and white matter volumes (r = -0.49 to -0.56, p < 0.001). Conclusion: Longer duration of hypertension is associated with reduced brain volume, reinforcing the need for early detection and sustained management of blood pressure.