The article is devoted to one of the main problems of the evolution of the earth's crust, where from the position of the concept of the dynamics of the evolution of the earth's crust (CDEEC) the nature of numerous geological processes is clarified. Including the origin of geodynamic forces and those geotectonic processes that directly occur under the influence of these forces: such as volcanoplutonic; seismotectonic processes; global deep fault networks; divergent and convergent zones; active and passive margins; riftogenic processes; the origin of arc systems, etc. The origin, mechanism of formation, as well as their distribution patterns on the face of the Earth and other characteristic features of these natural processes are clarified from the position of CDEEC. From the position of this concept, geodynamic forces are formed during the rotation of the Earth around its axis and they are distributed on the face of the Earth with certain patterns, which are predetermining factors in the development of geological processes. These geological processes, both in scale and in form of distribution, have their own specific features, which are important in the formation of various genetic types of mineral deposits. Therefore, the study of these processes is one of the priority areas of geological research.

This study explores the historical roots and cultural significance of Female Genital Mutilation (FGM) in ancient Egyptian civilization and its persistence in modern times. It examines how ancient cultural practices were transmitted and adapted across generations, influencing contemporary societal norms. It should be noted that cultural exchanges play a significant role in shaping attitudes towards Female Genital mutilation. Cultural exchange facilitates the sharing of experiences, promotes understanding, and fosters a sense of community actions. The transfer of ancient traditions, including Female Genital Mutilation, through trade, exchange of cultures and many others, is complex. Historically, trade routes and cultural exchanges, spread ideas and practices. This paper highlights the complex interplay between cultural heritages, how cultural exchanges influence the transmission of FGM from communities to communities beyond Egypt, Egyptian life and the mode of transmission.

Background: A near-miss obstetric morbidity means a woman who almost died but survived by chance due to any pregnancy related complication. Postpartum hemorrhage has been the leading cause of maternal mortality and morbidity worldwide. The near-miss morbidity due to PPH is an important indicator of maternal care and could be used to compare improvements in treatments more accurately than mortality rate alone. Objective: To evaluate the near miss cases due to PPH in MMCH. Methods: It will be a cross-sectional descriptive study on near miss patients admitted in the Department of Obst& Gynae of MMCH during six months study period. 50 patients will be purposively enrolled according to inclusion and exclusion criteria. Socio demographic character of the patients, clinical presentation, risk factors, mode of delivery, extent of morbidity, amount of blood transfusion, duration of hospital stay, need of ICU support, incidence of peripartum hysterectomy or other surgical interventions will be considered as major variable of the study. Results: Among 50 patients of near miss cases, 21-25 years group belonged to the highest (40%) 30 (60%) patients came from poor class. 32(64%) patients underwent irregular ANC. 27(54%) patients were multipara. 15(30%) had our hospital and 35(70%) patients had delivery in outside hospital. Besides, 27(54%) and 23(46%) patients had vaginal delivery and cesarean delivery respectively. Regarding clinical presentation 17(34%) and 8(16%) patients came with atonic uterus and retained placenta respectively. 32(64%) patients were managed conservatively and 18(36%) patients needed surgical management. 21(40.36%), 9(18%), 8(16%), 5(10%) patients required >3 unit blood transfusion, ICU admission, hysterectomy and laparotomy respectively. Conclusion: 'Near miss' events are important indicators for monitoring the quality of maternity services in health care facilities. Maternal near miss in association with PPH shows better results in case of our hospital managed patients whereas the worse outcome was observed in case of patients who were managed outside hospital.

Background: The management of ectopic pregnancy has undergone a revolution in the past few decades. Evidence suggests that the incidence of ectopic pregnancies has been rising. Earlier diagnosis also plays a role by identifying ectopic pregnancies that would have spontaneously resolved. Objectives: The aim of the present study is to describe the presentation and different modalities of management of ectopic pregnancies admitted to the Gynecology ward over the study period. Methods: This was a cross-sectional study was done in the Obs & Gynae Department, Shaheed Suhrawardi Medical College Hospital. Fifty patients who were clinically suspicious of ectopic pregnancy and also supported by positive urinary pregnancy tests, beta hCG and no intrauterine gestational sac in ultrasonography was included for the study. Data were collected in a preformed questionnaire and analyzed by SPSS (version 22.0). Results: Maximum respondents (60.0%) age 21-30 years, mean age 27.71±5.3 years. The past history of pelvic inflammatory disease (PID) forms the major bulk of the risk factors of ectopic pregnancy. Patients had H/O pelvic inflammatory disease was 54% of the study population. Patients had H/O of menstrual regulation 16.0% and history of abortion (spontaneous and induced) 20.0%. Most of the patients 56% having history of < 8 wks. of amenorrhoea, 6% having no history of amenorrhoea and least (4%) having more than 10 weeks amenorrhoea. All (100%) of the patients having history of Abdominal pain; Amenorrhoea was found in (94%), Vaginal bleeding was found in (82%) and general weakness was found in (90%). On the other hand less than 40% had symptoms of fainting attack (36%) and early pregnancy sign-symptoms (38%). Among 50 patients 43(86%) undergone surgical operation,5(10%) receive medical treatment and 2(4%) are managed expectantly, 93.02% cases of ectopic pregnancy occurred in the fallopian tube, 4.6% cornual, 2% ovarian among the study population undergone laparotomy. Right tube was found to be involved more often (55%) than left (45%) and in most of cases (93.02%) the tube was found to be ruptured. Out of 43 cases of laparotomy 37 (86.04%) cases unilateral salpingectomy, 3(6.9%) cases unilateral salpigectomy with contralateral tubectomy and 1(2.3%) cases unilateral salpingo-oophorectomy were done. one case removal of cornu and repair done. Small number of patients had developed minor complications like pyrexia alone 23.25%, Pyrexia with lower abdominal pain (18%), wound gap (2.3%), mild abdominal distension (4.6%), UTI with pyrexia (6.9%) and loose motion (4.6%) among the study population. Conclusion: Pelvic inflammatory disease and multiple induced abortions and menstrual regulations are the strongest risk factors of ectopic pregnancy. Prevention of PID may not only reduce the ectopic pregnancy but also reduce adverse effects on tubal patency. Child birth in total aseptic conditions by a skilled birth attendant to prevent incidence of pelvic infection.

Capturing data for both operating machinery and its environment is of priority in most industries especially heavy industries. Some industries need to continuously and simultaneously monitor physical quantities such as temperature, pressure and speed of various parts of different equipment used in other to maintain and improve the quality of products and the efficiency of the process. The common and oldest system used to gather data is the wired sensor systems. This paper looks at wireless sensor technologies that can be used in heavy industries to capture much-needed data for analysis and logging. A few of the technologies were looked at. Challenges and advantages of each were highlighted. It was concluded that ZigBee communication technology has a better chance in the industrial environment.

Background: Tapentadol having both mu-opioid receptor agonist and norepinephrine reuptake inhibitor characteristics has better GI profile and analgesic efficacy in acute and chronic including neuropathic pains. Post operative pain using tapentadol nasal spray with quicker recovery helps in minimizing the amount of time required for patient to be on bed rest, reduced hospital day, hospital expenditure and overall patient satisfaction. Objectives: We conducted this study to compare the efficacy of Tapentadol Nasal Spray and Diclofenac IV in the Post operative patients of Laparoscopic Cholecystectomy by using VAS (Visual Analogue Scale), to compare tapentadol and diclofenac in terms of safety of administration and to study the cost effectiveness. Methods: Using randomized, prospective study design, half of post-operative cases were prescribed tapentadol nasal spray and were assigned Group A. The second half of the postoperative cases received intravenous diclofenac and were assigned Group B. Scheduled dose of tapentadol nasal spray was 22.5 mg in each nostril and for intravenous diclofenac dose was 75 mg. Results: It was observed that the mean pain score in the subjects of the tapentadol nasal spray group was comparatively lower than intravenous diclofenac group by VAS (p<0.05). Conclusion: Tapentadol nasal spray at 22.5 mg in each nostril was found to be effective in managing the post operative pain with minimal side effects.

The floral diversity contributes to invaluable ecosystem services and habitat values in a rich forested area. The Hirikatu Oya sub-watershed in the southwestern central mountain area of Sri Lanka is also one of the important forested areas with many recent challenges. This study aims to examine current changes in floral species in the Hirikatu Oya sub-watershed from the year 2000 to 2022. For the study, primary data were collected from a field survey of 25 stratified purposive sample sites (20 m × 20 m plots), along with 30 questionnaire surveys and 14 interviews. Primary-level findings were blended with secondary data sources. A mixed-methods strategy was employed to analyze the data. The study area is home to a diverse range of plant species, including woody, medicinal, tree species as well as, endemic and invasive plant species. Notably, the study revealed that 7 invasive plant species are available, while 4 plant species are already extinct and about 14% of tree species and 50% of vines are threatened. The outcome of the study highlights the need for effective management strategies and continuous efforts need to be made to strengthen management techniques, enforce relevant rules, encourage community involvement, and implement targeted initiatives for the sustainability of the forested area in the Hirikatu Oya sub-watershed in Sri Lanka.

Antimicrobial resistance (AMR) represents a profound and escalating global health crisis, threatening to dismantle the foundations of modern medicine. In response, healthcare systems worldwide have implemented antimicrobial stewardship programs (ASPs) to optimize antimicrobial use, improve patient outcomes, and curb the emergence of resistant pathogens. This review article explores the central thesis that the efficacy and success of contemporary ASPs in tertiary care settings are not merely enhanced by but are fundamentally dependent on the synergistic and deeply integrated collaboration of pharmacists, laboratory specialists, and nurses. We dissect the unique and indispensable contributions of each profession: the pharmacist's expertise in medication optimization, prospective audits, and formulary management; the laboratory specialist's foundational role in rapid diagnostics, susceptibility testing, and data-driven guidance; and the nurse's critical frontline position in timely administration, clinical monitoring, and patient education. By examining the intricate workflows and communication pathways that bind these roles, we present a model for an ideal "stewardship handshake," illustrating how their combined efforts lead to targeted, effective, and safe antimicrobial therapy. Furthermore, this review addresses the significant barriers to effective interprofessional collaboration—such as communication silos, hierarchical structures, and workflow inefficiencies—and proposes evidence-based solutions to overcome them. We also delineate key performance indicators for measuring the collective impact of this collaborative model. Finally, we look toward the future, considering the integration of emerging technologies like artificial intelligence and telehealth into stewardship, and conclude with a call to action for healthcare institutions to recognize, foster, and invest in these interprofessional teams as the primary defense in preserving the viability of antimicrobials for generations to come.

Magnetohydrodynamic (MHD) flow past a flat plate over an outer flow turbulence subjected to a defect-layer has been examined. It finds a novel approach to a Blasius equation with a view to analyze outer flow turbulence by analytical method, neglecting numerical method to describe the physical situation on outer flow which does not seems to appeared in the literature. In a defect-layer it is rigorously stated that outer flow in a defect layer is independent of Reynolds number. To solve Blasius equation subject to boundary conditions it is stated that numerical results are obtained by analytical method. A graphical representation shows that the velocity distribution is merged with different values of Hartmann number (magnetic pressure) so that velocity increases with indefinite period. In this situation, outer flow turbulence in a defect layer holds stress free so that the existence of a magnet field dominates the entire outer flow situation. In relating to the physical situation of interest, the universe is expanding slowly and slowly subject to a Hot Big Bang with a decisive importance to a microwave background of radiation.

This paper analyzes the effects of tariff policies on international trade flows and national competitiveness between 2018 and 2024, a time of revival of protectionism, the COVID-19 crisis, and a general surge in supply-chain disruptions. Using harmonized data sources provided by the WTO, UNCTAD, World Bank, and IMF, we implement a two-way fixed-effects gravity model in order to provide a rigorous assessment of the effect of tariff changes on trade flows between developed and developing economies. To help counter the possibility of endogeneity, we create a weighted tariff shock variable and apply system GMM regressions. We further expand the study with multidimensional measures of competitiveness such as export sophistication, logistics efficiency, and innovation capacity in order to confirm the consistency of our findings. The findings are consistent with the conclusion that increased tariffs reduce the performance of exports, and the negative effect is most pronounced in developing economies that are defined by a small industrial base and low technological potential. On the other hand, those economies that have high regional trade relations and sophisticated digital infrastructure have greater resilience to tariff shocks due to diversifying supply chains and updating technology. In our analysis, we find that there are always negative impacts on the performance of exports due to higher tariffs, but the most negative impacts were observed in developing countries that are not technologically developed and whose industrial bases are small. This paper provides practical policy advice on the need to balance short-term industrial security with long-term economic sustainability in a more globalized economy.

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

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

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

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

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