The appearance of a pregnancy without sexual intercourse with vaginal penetration has always given rise to many very lively debates. It is most often described as miraculous by some popular beliefs. In reality, some specific situations can exceptionally lead to a pregnancy without penetration. The authors report the case of a 20-year-old girl who became pregnant without having previously had sex with vaginal penetration. However, she strongly suspected her fiancé of abusing her during his last visit to her home and she had fallen asleep when he left her. After her period was two months late, she decided to have a gynecological consultation, after which an ultrasound concluded that there was a continuous intrauterine pregnancy for 10 weeks of amenorrhea plus 3 days. The parents, informed of the situation, raised awareness and supported her so that she could keep the pregnancy and carry out the prenatal follow-up. The pregnancy progressed normally. She gave birth to a daughter weighing 2600 grams by elective caesarean section to keep her virginity, which she appreciated very much before her marriage to another man.

The aim of this study was to determine the prevalence of malaria in children aged between 06 and 59 months in the Bougairé health center in Bongor, Chad. It was a cross-sectional, prospective study running from 1 March to August 2023. The children selected were all given a complete physical examination by the doctors or interns on the ward. A thick blood sample or rapid diagnostic test (RDT) was performed in the laboratory on admission to confirm the diagnosis. Microscopic diagnosis of Plasmodium was carried out using a light microscope under an oil immersion system with an x100 objective; this was recorded in each patient's file. During this study, 813 patients were consulted, of whom 328 cases of malaria were diagnosed on the basis of clinical and biological arguments. Malaria cases accounted for 40.34% of consultations, including 153 cases of uncomplicated malaria (46.7%) and 175 cases of severe malaria (53.3%). The 36-59 month age group was the most represented (50.3%), with males predominating (52.0%). Most of the children's parents did not attend school (87.8%). Mothers were housewives (89.9%), while fathers were mainly farmers (67.0%) and followed by shepherds (10.0%). Fever (99.6%), vomiting (59.9%) and abdominal pain (36.0%) were the most frequent reasons for consultation among the children in the study. The study revealed that the most commonly used antimalarial drug was Artemether injection, which accounted for 57.9% of cases. This was followed by artemisinin-based combination therapy, ACT (27.4%), and injectable artesunate with ACT relay (8.2%). Quinine infusion with CTA relay was the least used drug in the study (6.4%). Management complied with national malaria control guidelines in 43.7% of cases. These results justify the continuing training of health workers at the Bougaire Health Center to comply with national ...

Background: Effective regional anesthesia techniques are crucial for optimal pain management in upper limb surgeries. This study compares dexmedetomidine and dexamethasone as adjuvants to bupivacaine in ultrasound-guided supraclavicular brachial plexus block. Methods: This cross-sectional observational study was conducted in the Department of Anaesthesia, Analgesia, and Intensive Care Medicine at Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, over one year (June 2022 to May 2023). Sixty adult patients undergoing elective upper limb surgeries were randomized into two groups: Group A (dexmedetomidine 1 µg/kg with bupivacaine) and Group B (dexamethasone 4 mg with bupivacaine). Outcomes measured included onset and duration of sensory and motor blocks, duration of analgesia, and adverse events. Results: Group A demonstrated a significantly prolonged duration of analgesia (median: 1027.5 minutes; interquartile range [IQR]: 71.25) compared to Group B (median: 900 minutes; IQR: 108.75; p < 0.001). Sensory and motor block durations were also significantly longer in Group A (p < 0.05). The onset times for sensory and motor blocks were slightly delayed in Group A compared to Group B. No adverse events such as hypotension, bradycardia, or sedation were observed in either group. Conclusion: Dexmedetomidine provides superior prolongation of sensory and motor blocks and postoperative analgesia compared to dexamethasone when used as an adjuvant to bupivacaine in supraclavicular brachial plexus block. Both adjuvants were safe, with no reported complications.

Background: Secondary postpartum hemorrhage (PPH) defined as excessive vaginal bleeding from 24 hours after delivery up to 6 weeks postpartum, continues to be a major cause of maternal morbidity and mortality. Exploration of its causes and risk factors is essential to inform more effective prevention and management strategies, particularly in resource limited settings. This study aimed to assess the effectiveness of delivery methods, antenatal care and other related factors in determining incidence of secondary PPH. Methods: A descriptive cross sectional study was conducted in the Department of Obstetrics and Gynaecology of BSMMU, Dhaka during the period from March 2012 to August 2012. A total of 42 women with secondary PPH were included based on inclusion and exclusion criteria. The data were collected by means of structured interviews, clinical examinations and medical record reviews. Maternal age, delivery methods, timing and causes of secondary PPH were analyzed. Results: Secondary PPH was found most commonly during the second (38.1%), and third (28.57%) weeks postpartum. The leading causes were infections (52.38%), retained placental tissue (23.81%), uterine atony (16.67%), and lower genital tract injuries (7.14%). Women with inadequate antenatal care (61.9%) and who delivered vaginally (57.14%) had greater risk of secondary PPH. Cesarean deliveries contributed to 38.1% of cases. Conclusion: Infections, inadequate antenatal care and delivery methods are strongly associated with secondary PPH. Improving antenatal care, skilled care during delivery and postpartum monitoring can significantly reduce its occurrence and complications.

Introduction: Chronic Kidney Disease (CKD) is a major global health issue, with an increasing prevalence in Bangladesh. It is associated with numerous complications, especially cardiovascular diseases, which are the leading cause of morbidity and mortality among CKD patients. Arterial stiffness, a key cardiovascular risk factor, has been shown to correlate with CKD progression. Recent studies suggest that serum 25-hydroxyvitamin D (25(OH)D) deficiency plays a significant role in the development of arterial stiffness and cardiovascular complications in CKD patients. Objective: This study aims to investigate the impact of serum 25-hydroxyvitamin D deficiency on arterial stiffness in non-dialysis CKD patients in Bangladesh. Methods: A cross-sectional observational study was conducted at the Department of Nephrology, Dhaka Medical College, between September 2021 and March 2023. A total of 100 non-dialysis CKD patients (Stages 3-5) were enrolled, with 50 patients each in the vitamin D deficient and non-deficient groups. Arterial stiffness was measured using established methods, and serum 25(OH)D levels were assessed. Statistical analysis was performed using SPSS version 26.0, with significance set at p<0.05. Results: The study found that 78% of patients in the vitamin D deficient group were in Stage 5 CKD, compared to 12% in the non-deficient group. A significant negative correlation was observed between serum 25(OH)D levels and arterial stiffness (r = -0.386, p = 0.001). Laboratory variables such as eGFR and hemoglobin levels were significantly lower in the vitamin D deficient group (p<0.05). Conclusion: The study concludes that vitamin D deficiency plays a critical role in the pathogenesis of arterial stiffness in CKD patients. Addressing vitamin D deficiency may offer potential benefits in mitigating cardiovascular complications and improving the prognosis of CKD patients in Bangladesh.

In rural communities, an efficient operation or governance model is crucial for fostering sustainable development and improving the quality of life of its inhabitants. According to World Bank data, nearly 45% of the rural population in Latin America lives below the poverty line, facing challenges such as limited access to basic services, education, and technology. The implementation of participatory governance models that involve local actors in decision-making has proven to be a catalyst for optimizing resource management and generating inclusive economic opportunities. This approach not only strengthens the social fabric but also promotes equity and resilience in the face of challenges such as climate change and fluctuations in agricultural markets. This study aims to explore the use of frameworks employed as successful cases for building digital communities or implementing improvement or governance models that enable better management or address a common area of interest. This is achieved through a qualitative analysis supported by a systematic literature review of 54 research articles published between 2018 and 2022, following clear discrimination criteria.

Background: Male infertility is a significant reproductive health concern affecting millions of couples worldwide. While conventional medical interventions offer viable solutions, an increasing number of individuals are turning towards traditional medicine, specifically herbal products, as an alternative approach to managing male infertility. Methods: The study employed a mixed-methods approach, combining quantitative and qualitative data collection methods. A survey questionnaire was administered to 100 consented adult men with fertility issues to explore their beliefs about traditional medicine and the effectiveness of the herbal products they used. Results: Out of the 100 participants recruited, about 74% preferred herbal products over orthodox medicines to manage infertility. The majority (75%) thought that herbal products were effective in managing male infertility, 41% of them noticed a change in their sperm parameters after using the herbal product of interest, and (33%) thought that the herbal product was responsible for them impregnating their partners. Most respondents (93%) did not experience any side effects after using the herbal products, with only a few of them (7%) reporting side effects. Conclusions: People's beliefs about traditional medicine vary based on their personal experiences and those of others. Based on research findings, herbal products' effectiveness in managing male infertility has shown promising results and should be investigated further.

Background: Astrocytomas are among the most frequent brain tumors affecting both children and young adults. Objective: To analyze brain tissues with astrocytomas grades II obtained from a group of Iraqi patients for the rate of DNA detection by PCR of oncogenic Epstein- Barr virus. Materials and Methods: (75) brain tissue specimens have been enrolled from patients, which were related to patients; among them 50 patients, aged 20 to 77 years, ( 58 % males and 42% were females) had operations in neurosurgical theatres of Ghazi Al- Hariri Teaching Hospital at The Medical City Complex for astrocytoma (grade 2) and also a number of (25) patients has enrolled, aged 21 to 70 years, (56 % males and 44% were females ), whom brain tissues have histopathological examination shown neither in line of benign brain tumors nor brain cancers, and were including as the control group of the present research work. The current method was performed by using the technique of polymerase chain reaction that was done to amplify and localize of the examined DNA sequence of EBV. Results: 28% (14 out of 50) of the examined brain tissues from astrocytomas grade 2 cases were positive for EBV genome detection. The most infected brain tumor tissues with EBV- DNA are related to the age stratum (20-40 years), which accounted for 14 %, while the age strata of (41-60 years) and (61- 80 years) accounted for 12% and 2 %, respectively. The male patients accounted for 71.4 % while females accounted for 28.6 %, while positive EBV-PCR detection result in brain tissues from control patients without tumors was found in 8% of the examined tissues. Conclusion: high rate of EBV detection in this percentage of the studied astrocytoma grade 2 tissue samples can possibly considered playing in the induction of these brain tumors.

The current economic context requires finding a reliable global solution that meets the wishes and interests of investors, decision makers and all categories of users involved in order to create the necessary premises for the design of an integrated reporting system that provides relevant and qualitative information while facilitating the creation of newly added value. This first step is aimed at bringing a plus to the business and at the same time ensuring high levels of productivity, efficiency and effectiveness to maintain a state of balance favourable to the good development of economic activity. In this sense, emphasis is placed to establish and organize an International Sustainability Standards Board ("ISSB") following all the steps to make this possible being of particular importance to fructify the independence and success of IFRS governance (more specifically the Board of Monitoring and Administrators of the IFRS Foundation) to draft global standards aligned with the conditions of the microeconomic and macroeconomic environment. These intensified efforts want to clarify and help users of financial statements to act in conditions of efficiency and effectiveness to significantly contribute to the formation of the image and reputation of the economic entities involved through active participation with business ideas, working and fixed capital and human resources. In order to support initiatives to improve corporate reporting, it is based on the reasoning that the integration of financial and non-financial information is desired to encourage a sustainable development of the constantly changing business environment. The pressures exerted both from the internal and external environment of financial markets have influenced the assumption of a degree of responsibility towards the environment and people, compliance with new requirements from stakeholders, especially financiers and investors. Thus it became necessary to report ESG indicators (environmental, social, governance) has captured attention in recent years and is an important element found in business strategies to ensure an acceptable level of profitability within reasonable limits based on a European legislative landscape that is subject to changes. In order to quantify the contribution of economic entities to solving certain social and environmental problems with the general objective of registering high global performances of the asset and liability structures taking into account the human resource, the environment and the involvement of the community in the formation of a sustainable, prosperous future for the future generations that come after us and exercise their informational values in the context of the informational age in which we find ourselves dictated by the digitization and integration of specialized software incorporating some support programs that it allows us to avoid a titanic work to withstand financial difficulties that may endanger the existence and continuity of the business. A good knowledge of ESG rating is an important guide used by the management and leadership of an entity to have the alternative to adapt its business and orient in the right direction to improve the transparency of the dialogue carried out with the shareholders. An in-depth market research and analyzed from all the angles used by the parties leads to a correct assessment of the impact of the topics addressed in the context of ESG and how they can influence the overall performance of the entity.

Background: Preeclampsia is one of the most common causes of maternal morbidity and mortality. Extensive research into biomarkers that can help us understand the disease is vital to alleviating its burden. Catestatin, an endogenously produced regulator of cardiac function and blood pressure, may be associated with the severity of the disease. Methods: This was a cross-sectional study involving 56 pregnant women with varying forms of preeclampsia. Blood samples were obtained at diagnosis, centrifuged and the sera were stored at -200C until analysis. The catestatin levels of the sera were then measured by enzyme-linked immunosorbent assays. Results: The mean serum catestatin among patients with mild preeclampsia and severe preeclampsia were 3.3 ±1.2ng/ml and 4.5±2.5ng/ml, respectively (p=0.011). Conclusion: The serum catestatin level significantly relates to the increasing severity of preeclampsia. There might be a potential value for using serum catestatin to assess the severity of the disease.

The Niger Delta, a region rich in biodiversity and natural resources, has been significantly impacted by environmental degradation, primarily due to oil exploration and extraction activities. The main causes of environmental degradation in this region include oil spills, gas flaring, deforestation, and industrial pollution. Oil spills, often resulting from pipeline leaks and operational failures, have led to the contamination of waterways and soil, adversely affecting aquatic life and local communities that depend on these resources for their livelihoods. Gas flaring contributes to air pollution and climate change, while deforestation driven by oil-related activities results in habitat loss and decreased biodiversity. The effects of environmental degradation in the Niger Delta are profound and multifaceted. They include health problems among local populations, loss of agricultural productivity, displacement of communities, and social conflicts over resource access. The degradation of the environment has not only undermined the ecological balance but has also exacerbated poverty and social unrest in the region. To mitigates the adverse effects of environmental degradation, several measures can be implemented. These include enforcing stricter regulations on oil companies, promoting sustainable agricultural practices, and investing in environmental restoration projects. Community engagement and empowerment are crucial, ensuring that local populations have a voice in decision-making processes related to resource management. Furthermore, leveraging technology for environmental monitoring and promoting alternative livelihoods can help reduce dependency on oil and foster resilience among communities. In conclusion, addressing the causes and effects of environmental degradation in the Niger Delta requires a multifaceted approach that combines regulatory enforcement, community involvement, and sustainable practices. These efforts are essential for restoring the health of the environment and improving the quality of life for the region's inhabitants.

This research aims to determine the limits of hudud in Islamic law so that law enforcement can run fairly. Allah's decree regarding hudud issues has been outlined in the Al-Qur'an in order to preserve social life based on Islamic rules. Hudud is a sanction given to violators of behavior that is contrary to Islamic teachings. In various cases, rebellion, robbery, wine, stealing, verbal abuse and adultery, all have provisions for punishment in the Koran. However, the role of Ulama in interpreting verses is very open to outlining the limits of sanctions for law violators. The existence of Islamic law certainly refers to the main teachings, namely the Al-Qur'an and hadith, then developed through Ijma' Ulama which can be implemented in society as a limitation of sanctions.

Aim: This review explores the potential of bioactive glasses in dentistry, focusing on their applications in dental restorations, implants, and tissue regeneration. The aim is to assess the challenges and opportunities in their use, as well as the future directions for enhancing their performance. Materials and Methods: A comprehensive review of recent literature was conducted to analyze the properties, applications, and limitations of bioactive glasses in dental materials. Studies on the composition, mechanical properties, biocompatibility, and long-term in vivo performance were included. Methods to enhance the mechanical strength of bioactive glasses, such as the formation of composites and advanced nano structuring, were also explored. Results: Bioactive glasses have shown great promise in promoting remineralization, supporting tissue regeneration, and bonding with hard tissues. However, challenges such as mechanical brittleness, high costs, and limited long-term stability have been identified. Research on enhancing mechanical strength through composites, as well as developing more cost-effective production methods, is ongoing. Conclusion: Bioactive glasses offer significant potential for improving dental treatments and advancing regenerative medicine. Future research should focus on enhancing their mechanical properties, developing personalized bioactive materials, and exploring their integration with stem cell therapies and growth factors. With continued development, bioactive glasses could revolutionize dental restorations, implants, and oral tissue regeneration, providing innovative solutions for oral healthcare.

COVID-19 not only generated challenges but also brought new chances in the construction industry of Nepal. The goal of this research is to investigate opportunities created by COVID-19 in the construction industry of Nepal. For this, a total of 309 responses from clients, consultants and contractors were obtained. Principal Component Analysis was deployed and major opportunities obtained were technological transformation, and health and safety culture improvisation with variance of 31.46% and 20.14% respectively. It is recommended that policies should be prepared to make technology use and change adopted sustainable and long-lasting. Also, use of advanced technologies and scientific planning should be encouraged by the government and strategies should be prepared so that difficult situations like pandemic could also be utilized in fruitful ways.

This study critically examines the involvement of extension and innovation strategies in advancing sustainable agriculture in Somalia. Agricultural extension services, which involve disseminating agricultural knowledge, information, and technologies to farmers, are essential for enhancing farmers' skills, practices, and decision-making abilities. The study explores the complex relationship between socioeconomic challenges-such as limited access to resources, infrastructure, and markets-extension strategies, and sustainable agricultural development in Somalia. A key obstacle identified is the inadequate infrastructure for mobile phone applications in agriculture, which limits the effectiveness and widespread adoption of farming technologies. Utilizing a descriptive research design, data was gathered from 211 participants across seven regions, including Southwest, Hirshabelle, Benadir (Mogadishu), Galmudug, Puntland, Jubaland, and Somaliland. The analysis assessed the demographic and educational characteristics of the participants and the impact of extension services and innovation strategies on sustainable agricultural practices. The variability in the support provided by extension services emphasizes the need for targeted improvements to foster sustainable agriculture and enhance food security in Somalia. Institutional challenges, including policy frameworks, governance issues, and capacity-building deficits, also impede the effective implementation of agricultural innovation and extension strategies. Additionally, resistance to change, cultural differences, and a lack of supportive policies hinder the adoption of new practices. Unpredictable weather patterns, overuse of natural resources, and extreme climatic events further complicate the success of sustainable practices. Despite these challenges, agricultural extension services play a critical role in facilitating the dissemination of knowledge, training, and community engagement for sustainable farming practices. The study underscores the need for strengthened infrastructure, improved governance, and targeted interventions to overcome existing barriers and promote sustainable agricultural development in Somalia.