Improving facial aesthetics is a major reason why patients with class II division 1 malocclusion look for orthodontic therapy. Two-phase approach that includes functional jaw orthopaedics as well as fixed orthodontic treatment is one of various techniques available to treat Class II malocclusions. The following case report describes a young growing female patient with a Class II Division 1 malocclusion. In the first stage, the patient was treated using Andresen activator for growth modification and correction of her overjet, overbite and profile. Then, fixed orthodontic appliance was used in the second phase, to ensure well-aligned arches and improve aesthetic and function.

Background: Antibiotic overuse and misuse significantly contribute to antimicrobial resistance (AMR), particularly in developing countries like Bangladesh. Despite national and international efforts to combat this issue, inappropriate antibiotic prescriptions remain common in hospital settings. This study aimed to assess the quality of antibiotic prescriptions and identify the reasons behind irrational antibiotic use at Gonoshasthaya Samaj Vittik Medical College Hospital. Methods: A retrospective cross-sectional study was conducted involving 1007 patients admitted to the Pediatrics, Medicine, Surgery, and Obstetrics & Gynecology departments of Gonoshasthaya Samaj Vittik Medical College Hospital from October 2021 to December 2021. Data were collected through medical record reviews, and antibiotic use was analyzed based on the Standard Treatment Guidelines (STG) for Bangladesh. The rationality of prescriptions was determined by comparing them against the policy-cited choices or microbiological culture and sensitivity results. Results: Antibiotics were prescribed in 90.2% of cases, with 99.5% being administered empirically and only 0.5% based on culture sensitivity tests. Preoperative surgical prophylaxis was the most common reason for antibiotic use (39.3%). Approximately 34.2% of antibiotic use was deemed inappropriate, with incorrect duration being the most frequent cause (32.4%). Antibiotic misuse was highest in the Surgery (61.2%) and Medicine (56.1%) departments, while the Obstetrics & Gynecology department had the lowest misuse rate (1%). Conclusion: Irrational antibiotic use is a major issue in Bangladesh, contributing to growing resistance. Strict adherence to antibiotic guidelines, especially in surgical and medical wards is essential to curb misuse. This study highlights the need for ongoing audits and the development of hospital-specific antibiotic guidelines to combat AMR effectively.

Tuffcrete concrete (ATC) has emerged as a promising material in modern civil engineering due to its enhanced durability and eco-friendly composition. This study presents the development of Artificial Neural Network (ANN) models to predict and optimize the compressive strength of Tuffcrete concrete based on experimental data. The dataset consists of 21 input features, including mix proportions (e.g., cement content, water-cement ratio, aggregate size distribution), material properties (e.g., tuffcrete polymer, slag content), and process parameters (e.g., mixing time, compaction level). The ANN models were trained and validated using these features to accurately forecast the compressive strength of Tuffcrete concrete under various conditions. The study demonstrates the model's ability to capture nonlinear relationships between input variables and compressive strength, achieving high accuracy metrics (e.g., R² and RMSE). Furthermore, optimization techniques were employed to identify the optimal mix design for maximizing compressive strength. Results reveal critical insights into the interplay between material properties and mechanical performance, paving the way for efficient mix designs tailored for specific applications. This work contributes to the advancement of machine learning applications in civil engineering, providing a robust framework for performance prediction and optimization of sustainable construction materials.

Molar Incisor Hypomineralisation (MIH) is a prevalent enamel defect affecting both permanent and deciduous teeth, posing significant clinical challenges. This literature review aims to comprehensively evaluate the etiology, prevalence, clinical manifestations, diagnostic methods, and management strategies of MIH in permanent and deciduous dentitions, while identifying current knowledge gaps and suggesting directions for future research. The prevalence of MIH varies globally, ranging from 3% to 40%, with the highest rates observed in South America (7-40%) and Africa (10-30%), compared to Europe (8-25%) and Asia (3-20%). Gender distribution is nearly equal, though some regions report a slight female predominance. Genetic factors, prenatal and perinatal complications, childhood illnesses, and environmental exposures such as dioxins significantly contribute to MIH etiology. Clinically, MIH presents as demarcated opacities, post-eruptive enamel breakdown, and increased caries susceptibility, affecting approximately 70% of affected first permanent molars and 60% of incisors. Management strategies vary based on severity, with mild cases managed through preventive measures like fluoride varnish, while severe cases often require restorative interventions such as resin composites and stainless steel crowns. The economic burden is substantial, with affected individuals necessitating frequent and costly dental treatments, and MIH adversely impacts quality of life by increasing dental anxiety and affecting aesthetics. MIH is a widespread and multifactorial dental condition with significant clinical and socioeconomic implications. Effective management necessitates a multidisciplinary approach, and further research is essential to elucidate its etiology and develop robust preventive and therapeutic strategies.

Purpose/Objectives: The Bachelor of Dental Medicine and Surgery program at Taif University is a comprehensive six year program with one year of compulsory Field Experience. Many of the courses and Preclinical/clinical activities were conducted online in the academic year 2020-21 due to COVID-19 pandemic restrictions. Aim of this study was to identify the Impact of COVID-19 Pandemic on Dental curriculum achievement at Taif University. Methods: The scores and passing percentage of undergraduate dental students for the Academic year 2019-20 and 2020-21 were compared and analyzed. All courses were grouped into five categories- theoretical, theoretical-practical, theoretical-clinical, pure clinical and Interactive learning courses. A minimum of 60% aggregate score in each course was mandatory for a student to pass in the exam. Results: The results of all the exams were entered in SPSS, Version 21.0. The performance of the students were assessed and compared for both academic years using Chi square test. A p-value of less than 0.05 was considered significant. Considering the passing percentage of students, the performance of students in ‘Clinical’ courses was better in AY 2019-20 as compared to AY 2020-21. The difference in the mean scores for these two years was statistically significant across ‘theory+clinical’ category. Conclusion(s): The performance of students was much affected after the imposition of Covid-19 pandemic restrictions, where the courses had clinical component. In rest of the categories, students performed better in AY2020-21. A hybrid mode of Dental Education may be beneficial.

Stem cells are partially differentiated cells in multicellular organisms that can change into various types of cells and increase indefinitely to produce more of the same stem cell which is considered as the earliest type of cell in a cell lineage. Treatment with those cells is regarded as an innovative approach in regenerative medicine, offering promising capabilities for healing and restoring damaged tissues and organs. Mesenchymal stem cells, derived from different sources like bone marrow, fat, and dental pulp, are highlighted for their self-renewal, immune-modulation, and regenerative abilities. Regenerative medicine is one of the more recent fields or methodologies that revolutionizes the path for upgrading human health and quality of life, relying on the use of stem cells. The process of using stem cells indicates marvelous capabilities for healing and restoring damaged tissues and organs. The current overview examines the science or biology of stem cells, showing their various sources, and their potential applications across a wide range of medical fields, carried by discussing multiple studies exploring the stem cells. The review further explores the potential of stem cell therapy for treating neurological disorders, autoimmune diseases, cardiovascular conditions, liver diseases, ophthalmic conditions, bone injuries, kidney disorders, and dental issues.

Inflammasome protein cascades are very crucial as endogenous defence mechanisms. Nevertheless, their deregulation usually exacerbates deleterious chronic diseases. It is a large multicomplex cytosolic protein that plays a vital role in the innate immune system, therefore, acting as a vital mediator in the pathogenesis of non-communicable diseases. Pro-inflammatory cytokines like IL-1β and IL-18 are produced as a result of inflammatory reactions triggered by key inflammasomes. Notably, rheumatoid arthritis is largely caused by inflammasomes, particularly NLRP1 and NLRP3, which cause excessive inflammation and tissue damage by releasing cytokines that promote bone resorption and cartilage degradation. The development of stroke is facilitated by the NLRP3 inflammasome, which promotes inflammation and neuroinflammation, both of which cause brain damage. The pathogenesis of hypertension are significantly influenced by inflammasomes, especially NLRP3, which promote oxidative stress and inflammation, which worsen high blood pressure, cause cardiac fibrosis, and contribute to vascular and renal dysfunction. In asthma, inflammasomes primarily cause tissue damage and airway inflammation by activating NLRP3, which in turn causes the release of IL-1β and IL-18. This activation worsens asthma symptoms like inflammation and airway hyperresponsiveness while also boosting immunological responses, especially in Th2 and Th17 cells. The mechanisms governing inflammasome construction and activation, as well as the possibility of targeting inflammasomes to treat a variety of disorders, have thus become the focus of more recent study.

Introduction: Lead (Pb) is a hazardous metal that presents substantial health hazards to both humans and animals. Extended exposure to lead can result from various causes, such as contaminated water, soil, and industrial emissions, causing nephrotoxicity and kidney damage. Methods: This study investigated the long-lasting impact of lead acetate on the kidneys of Wistar rats. The rats were categorized into four distinct experimental groups, consisting of one control group and three treatment groups. The treatment groups were exposed to varying amounts of lead acetate (2.5%, 3.0%, and 3.5%). The rats had a 35-day treatment period during which their weights was closely monitored, and after sacrificing, kidney function, and histological alterations were assayed. Findings: The data revealed a significant increase in weight among the groups receiving therapy, which can be attributed to the accumulation of water and edema. The 2.5% lead acetate treatment group exhibited higher creatinine levels, suggesting kidney damage. The histological examination showed evidence of kidney injury, including glomerular lesions, fibrotic lesions, and the buildup of leukocytes. Conclusion: Lead acetate induces nephrotoxicity and weight gain in Wistar rats, resulting in a substantial effect on both kidney function and structure. The study emphasizes the significance of taking into account several biomarkers and histological observations in order to comprehend the effects of toxic chemicals such as lead acetate. The results indicate that exposure to lead acetate can result in the development of chronic kidney disease, highlighting the importance of appropriately managing and disposing of items that contain lead.

Background: Non-healing corneal ulcers pose a significant challenge in ophthalmology, often resulting in persistent pain, visual impairment, and corneal perforation. Conventional medical treatments may fail to promote healing in refractory cases, necessitating surgical intervention. Conjunctival flap surgery provides a vascularized and protective layer that facilitates corneal healing and structural preservation. Objective: This study aims to evaluate the effectiveness of conjunctival flap surgery in managing non-healing corneal ulcers by assessing its impact on corneal healing, symptom relief, and overall visual prognosis. Methods: A retrospective study was conducted at a tertiary eye hospital in Bangladesh, including 47 patients who underwent conjunctival flap surgery for non-healing corneal ulcers between April 2020 and January 2022. Patients were assessed preoperatively and postoperatively using visual acuity testing, slit-lamp examination, fluorescein staining, and anterior segment optical coherence tomography. Data were analyzed using SPSS version 25. Results: The study population consisted of 63.82% males and 36.17% females, with the majority (57.4%) aged between 41 and 60 years. Infectious etiology was the most common cause of corneal ulcers (65.96%). Postoperatively, best-corrected visual acuity (BCVA) improved in 31.91% of patients, decreased in 46.81%, and remained unchanged in 21.28%. Anatomic cure was achieved in 72.34% of cases, with only 3 eyes requiring evisceration. Postoperative complications included flap necrosis (14.89%), flap displacement (8.51%), anterior corneal staphyloma (2.13%), and corneal perforation (2.13%), while 72.34% experienced no complications. Conclusion: Conjunctival flap surgery is an effective treatment for refractory corneal ulcers, preserving ocular integrity and facilitating corneal healing. While visual acuity may not always improve, the procedure remains a crucial alternative to emergency penetrating keratoplasty, particularly in regions with limited access to corneal tissue.

Background: Cataract remains a leading cause of avoidable blindness worldwide, particularly in low- and middle-income countries. Despite advances in surgical techniques, millions, especially in rural and underserved areas, remain visually impaired due to inadequate access to cataract surgery. In Bangladesh, cataract-related blindness is a significant public health concern, particularly in the southern regions where access to specialized healthcare is limited. Objective: This study aims to assess the prevalence of cataract-induced visual impairment and blindness among adults aged ≥50 years in the southern region of Bangladesh. It further evaluates the coverage and barriers to cataract surgical services to inform targeted interventions aimed at reducing avoidable blindness. Methods: A cross-sectional study was conducted using the Rapid Assessment of Avoidable Blindness (RAAB) methodology. A total of 4,868 individuals were selected through probability-proportionate-to-size cluster sampling. Ophthalmic examinations, including visual acuity and lens status assessments, were performed following standardized protocols. Cataract surgical coverage was calculated, and the primary causes of visual impairment were identified. Data were analyzed using RAAB V.3.1 software. Results: The prevalence of bilateral severe visual impairment (visual acuity <6/60) was 1.6%, and bilateral visual impairment (<6/18) was 8.4%. Cataract was responsible for 79% of bilateral blindness cases, 78.2% of severe visual impairment, and 41.9% of visual impairment. Cataract surgical coverage for individuals with a visual acuity <3/60 was 60.9%, indicating moderate access to surgical services. The main barriers to surgery included financial constraints, lack of awareness, and fear of surgery. Conclusion: Cataract remains the primary cause of avoidable blindness in the southern region of Bangladesh, with significant gaps in surgical coverage. Addressing barriers to cataract surgery through enhanced outreach programs, financial assistance, and community education is crucial in reducing the burden of blindness. Strengthening healthcare infrastructure and increasing the availability of ophthalmic professionals can further improve access to timely cataract treatment.

Mental health significantly influences employee outcomes and organizational performance, particularly in high-pressure environments such as government organizations. Mixed-method research incorporating structured questionnaires and interviews with 30 employees across hierarchical levels in Dubai highlights key challenges and opportunities. Quantitative findings reveal stress and anxiety as major concerns, with absenteeism (20%) and presenteeism causing substantial productivity losses. Turnover rates among untreated employees with poor mental health were 15% higher, supported by regression models linking poor mental health to low performance. Cultural stigma emerged as a barrier, with 60% avoiding support. Organizations with mental health programs demonstrated 30% higher employee satisfaction and a 4:1 ROI. Addressing these challenges through tailored interventions can enhance well-being and drive organizational success.

Type 2 diabetes mellitus (T2DM) and cardiovascular diseases (CVD) share an underlying pathology with thyroid dysfunction, affecting glycemic and lipid profiles, particularly in rapidly transitioning populations. This study, conducted at a tertiary care hospital in Dhaka, Bangladesh, explored the association of thyroid disorders with glycemic and lipid profiles in subjects with T2DM. Blood samples from 172 subjects (75% male and 25% female) were analyzed for fasting plasma glucose (FPG), plasma glucose after breakfast (PGABF), glycated hemoglobin (%HbA1c), lipid profiles, and thyroid-stimulating hormone (TSH) levels. Subjects were categorized as euthyroid, hypothyroid and hyperthyroid groups according to TSH levels. The euthyroid group had FPG 6.1±0.8 mmol/L, PGABF 7.5±1.3 mmol/L, and HbA1c 6.2±0.5%, while higher FPG was observed in hypothyroid [10.3±4.2 (p < 0.001)] and hyperthyroid [10.3±4.6 (p = 0.001)] groups, along with increased PGABF and HbA1c levels. The euthyroid group presented with 52% elevated total cholesterol, 45% elevated triglycerides, 41% low high-density lipoprotein (HDL) cholesterol, and 51% elevated low-density lipoprotein (LDL) cholesterol. Notably, the hyperthyroid group showed 87% elevated serum triglycerides (p < 0.001), whereas the hypothyroid group had 23% elevated serum total cholesterol (p < 0.001). Findings indicate thyroid disorders are linked to elevated plasma glucose and HbA1c, with hyperthyroidism potentially elevating triglycerides in T2DM.

Introduction: Pre-eclampsia is a pregnancy-specific disorder characterized by hypertension and proteinuria occurring after 20 weeks of gestation, impacting various organ systems like the placenta, kidneys, liver, and cardiovascular system. Early-onset pre-eclampsia, occurring before 34 weeks, poses significant challenges due to its unpredictable progression and heightened maternal and fetal risks. It is linked to higher rates of maternal complications, including multi-organ dysfunction, and obstetric issues like premature birth and fetal growth restriction. Women with a history of early-onset pre-eclampsia face increased risks of cardiovascular disease and metabolic disorders post-pregnancy. The study, conducted at Pravara Rural Hospital, Maharashtra, aims to explore the complexities of early-onset pre-eclampsia and improve maternal and fetal health outcomes. The study aims to investigate maternal and fetal outcomes in early-onset severe pre-eclampsia. Materials And Methods: A prospective cross-sectional study was conducted at Pravara Rural Hospital, Loni, with 208 participants. Data were analyzed using appropriate statistical tests. Inclusion criteria included patients with gestational age between 24 and 34 weeks, diastolic BP ≥90 mmHg, proteinuria ≥+1, and certain symptoms like persistent headache or blurred vision. Exclusion criteria included patients with co-morbidities or outside the specified gestational age range. Results: The study revealed high maternal complications, including anemia, abnormal coagulation, and organ dysfunction. Treatment involved magnesium sulfate and antihypertensive drugs. Maternal mortality was 4.32%, with significant fetal mortality (18.88% intrauterine death, 13.33% neonatal death). Conclusion: Vigilant monitoring and individualized care are critical for improving outcomes in early-onset pre-eclampsia.

I present several ideas to stimulate the readers’ curiosity so that they seek, find, and modify their inner world. I present an analysis of the relationships between the Ladder model of Plato’s Cave, Schopenhauer Representations and Nietzsche’s master and slaves. The impossibility of knowing how similar my normal state of consciousness is to the state of consciousness of other human primates is disputed. The existence of different levels of understanding is abundantly exemplified. The generation and destruction of the Demons within us is analyzed in detail. Their destruction is a necessary step in progressing into the higher states of consciousness of the human mode. I reaffirm my ideas that the history of human primates is created by the actions of some individuals and never of the masses. I comment on the role of 'fear' in the development of the first cosmogonies.

Fresh water aquaculture is considered as the most prominent type of aquaculture in the world. Nile tilapia aquaculture is favored because it can adopt to wide range of environments and can tolerate various abiotic stresses. However, the success, profitability of aquaculture and nutritional composition of fishes depends upon nutritional values of meal provided to them. For this purpose, aquafeeds industries are trying to prepare complete meal for favorable nutrition. An experiment was performed to examine the effectiveness of five biochar experimental diets on growth, body composition, hematological and mineral content of Nile tilapia fingerlings. These fingerlings were acclimatized for ten days under laboratory conditions and were fed with commercial diet. After acclimatization 30 fingerlings were distributed randomly in each tank and there were three replicates of each experimental diet. Fingerlings were fed with their respective biochar experimental diet twice a day for 60 days. Data were recorded for growth, body composition, hematological and mineral content attributes. Analysis of data revealed that D3 (CCBC) experimental diet performed exceptionally well for all growth, hematological and mineral attributes of Nile tilapia. D3 caused 44% increase in final weight and provided highest value of SGR (0.96) as compared to controlled. D3 (CCBC) fed fingerlings also showed significant increase in RBC’s, WBC’s, platelates, hemoglobin and PCV. Supplementation of 2% CCBC also provided the maximal absorption efficiency of minerals (Ca, Na, K, Fe and Zn). So form these findings it can be assumed that supplementation of 2% CCBC has the potential to be used as envirnonment friendly, cost effective and sustainable supplement in Nile tilapia diets.