Acute fatty liver of pregnancy (AFLP) is a rare but life-threatening obstetric emergency, often complicated by multiorgan dysfunction syndrome (MODS). We report a case of a 25-year-old primigravida woman at 34 weeks and 7 days of a twin pregnancy presenting with abdominal pain, nausea, and vomiting for three days. Diagnosis was established based on clinical, laboratory, and imaging findings. Prompt multidisciplinary management, including termination of pregnancy and intensive care support, resulted in a favorable maternal outcome. This case underscores the importance of early recognition and aggressive intervention in AFLP complicated by MODS.

Background: Cervical cancer remains one of the most prevalent cancers globally and a leading cause of cancer-related deaths among women. Early detection and precise prognostic assessment are vital for enhancing outcomes in cervical cancer patients. The purpose of this study is to evaluate the predictive value of preoperative PLR and serum albumin levels for clinicopathological outcomes in cervical cancer. Aim of the Study: The aim of the study was to evaluate the predictive value of preoperative Platelet-to-Lymphocyte Ratio and Serum Albumin levels on clinicopathological outcomes in patients with cervical cancer. Methods: This cross-sectional study, conducted at the Department of Gynecological Oncology, BSMMU, Dhaka (July 2022–June 2023), analyzed 120 women with early-stage (IA-IIA) cervical cancer to assess the association of PLR, S.Albumin for clinicopathological outcome using SPSS 27.0. Data included socio-demographics, clinical details, and serum markers. Results: The majority of participants were aged 30-44 years (46.7%) and married before 18 years of age (83.3%). Most had a PLR <128.3 (62.2%) and SA ≥3.5 (57.8%). Larger tumors (2-4 cm), higher prevalence of lymphovascular space invasion (LVSI), and deeper stromal invasion (≥½ thickness) were significantly associated with higher PLR (≥128.3) and lower SA (<3.5) (p < 0.001, p = 0.006). Conclusion: Preoperative Platelet-to-Lymphocyte Ratio and Serum Albumin levels can serve as valuable predictors of clinicopathological outcomes in cervical cancer, aiding in personalized treatment strategies.

Bone fracture is considered to be one of the common problems faced by the majority of population all over the globe. In this context the only option available with the person affected is the either the plaster or the surgery followed by the plaster. Along with this the anti-inflammatory medications as well as calcium containing drugs are being recommended for the early recovery of the patients. The problem with the medication and plaster is that the person feels a lot of discomfort. Itching, skin irritation, poor blood circulation due to tight plaster, pressure sores, infection with wetting of plaster and displacement of bones with losing of plaster might take place. Even the drugs recommended in this case like analgesic and anti-inflammatory medications might results in potential side effects. In this regard it is better to find some alternate for the same. In the recent, herbal plants are being recommended for the treatment of bone fracture. The different formulations can be designed for the delivery of the herbal constituents as the medication for fracture. In the present paper the detail description of herbal plants are being highlighted which have shown the potential of healing fracture.

The quality and design of instructional materials are fundamental in shaping learners’ motivation, engagement, and learning outcomes in Massive Open Online Courses (MOOCs). This study aims to examine the quality of instructional materials on learners' motivation in MOOCs through the lens of the ARCS Model by John Keller, focusing on Attention, Relevance, Confidence, and Satisfaction. By analysing learners’ perceptions and preferences, this research seeks to offer valuable insights into optimizing instructional materials to enhance motivation, engagement, and overall learning effectiveness. The study adopted a quantitative research method to assess the motivation levels of 42 MOOC learners using the Instructional Materials Motivation Survey (IMMS). Results indicated that the participants exhibited positive motivation levels, suggesting that the instructional materials effectively captured their interest and supported their learning experiences. Furthermore, learners expressed overall satisfaction with the quality and presentation of the content provided in the MOOCs. Despite the positive feedback, participants also highlighted areas for enhancement, particularly the need for more interactive elements to sustain engagement. Additionally, some learners recommended greater flexibility in content delivery, ensuring that materials cater to diverse learning preferences. These findings underscore the imperative need for continuous refinement of instructional materials in MOOCs to sustain learner motivation, maximize engagement, and foster a more immersive and effective learning environment. By addressing these critical aspects, MOOC providers can significantly enhance learner experiences and drive academic success in the digital learning landscape.

يعتبر شعر المناسبات من الفنون الأدبية الأكثر انتشار لدى الشعراء في دولة صكتو في القرن العشرين وكانوا يقرضون أشعارا في مناسبات وذكريات كثيرة لها أهيمة لديهم, ومن جملة هؤلاء الشعراء الشاعر أحمد صابر, وقد أدلى دلوه في هذا الفن حيث قرض أشعارا كثيرة في هذا المجال في أسلوب رائع مشتمل على الصور الفنية والظواهر البلاغية تشهد على تمكنه في قرض الشعر, والتعبير عما في ضميره وشعوره بكل فصاحة وبلاغة, يهدف هذا البحث إلى الوقوف على نونية الشاعر في ذكرى وفاة والده الحاج محمد نَتَعَالَى, لإخراج ما تضمنته من صور بلاغية وتحليلها حسب توظيف الشاعر لها, ثم الإشارة إلى أهم ما وصل إليه البحث من نتائج. ويشتمل البحث على الكلمات الافتتاحية التالية: الشاعر أحمد صابر, عرض القصيدة, صور بلاغية في القصيدة ,الخاتمة ونتائج البحث..

The study was carried out to detection of H.pylori in (200) patients who attended two teaching hospitals in Baghdad. The diagnosis done by Immunochromatography methods. Stools and blood samples was taken from each patient as well as other (30) healthy control matching in their age. The study included detection the Levels of Interleukin-39 and CRP in sera of patients and control. The result indicated presence of H pylori antigen in 115 cases 59 cases of males and 51 of females, Also, the result indicated increasing levels of IL-39 and CRP in patients sera in comparison with healthy control.

International humanitarian law and international human rights law are two distinct but complementary bodies of law. They are both concerned with the protection of the life, health and dignity of individuals. IHL applies in armed conflict while human rights law applies at all times, in peace and in war. The interplay between human rights and humanitarian law in armed conflict remains a critical area of legal and ethical discourse. While international humanitarian law (IHL) governs the conduct of hostilities, human rights law ensures fundamental freedoms and protections even in war. This article examines the practical challenges in implementing these legal frameworks, the role of state and non-state actors, and mechanisms for enforcement and accountability. Through an analytical approach, the study evaluates case studies from recent conflicts to assess the effectiveness of international legal instruments.

Background and Objective: In Pakistan, the demand for surgery is not being met due to a shortage of both surgical equipment and healthcare workers. This gap in the availability of surgical equipment hinders the provision of safe surgeries. To develop strategies to improve availability, it is essential to understand the use of surgical equipment in this context. This study aims to: (1) map out the different phases that surgical equipment goes through during its lifespan (i.e., the surgical equipment journey) in Pakistan, and (2) identify the barriers perceived by biomedical equipment technicians (BMETs). Material and Methods: Seven semi-structured, in-depth interviews were conducted with 17 BMETs working in Pakistan. These participants were from 6 different hospitals (4 public, one private, and one mission). The interviews took place between December 2016 and December 2018. Participants were asked to describe or illustrate the surgical equipment journey and to identify perceived barriers during this journey. Results: The surgical equipment journey comprises three phases: procurement, usage, and disposal. Key stakeholders in this journey include users, BMETs, procurement officers, local distributors, and, in the case of donations, donation agencies. Identified barriers include bureaucratic hurdles during procurement, difficulties in obtaining consumables and spare parts (especially for donated equipment), cleaning with harsh chemicals, and usage in challenging environments. Conclusion: To optimize the surgical equipment journey in Pakistani hospitals, sustainable interventions at multiple organizational levels are necessary. Participants in this study identified several strategies to increase the availability of surgical equipment in Pakistan: implementing policies on donations, procuring durable equipment, training more BMETs and university-trained biomedical engineers, and developing designs and business models suited to local conditions in Pakistan and potentially other countries in the region.

Background: Chest pain is a prevalent complaint in emergency departments (EDs) and is associated with significant clinical decision-making challenges. The HEART score is a validated tool used for risk stratification of patients with suspected acute coronary syndrome (ACS). Objective: This study evaluates the effectiveness of the HEART score in risk stratification and patient outcomes at Northern Emirates Hospital, UAE. Methods: A retrospective analysis was conducted on 79 patients who presented with chest pain at Northern Emirates Hospital in January 2021. From the available date in patient record, the patients were classified into three risk categories based on the HEART score, and their actual dispositions were compared. Results: Of the 79 patients, 70.8% had a low HEART score (0–3), 25.3% had a moderate score (4–6), and 3.7% had a high score (>7). Discharge rates were 83.9% for low-risk, 70% for moderate-risk, and 33% for high-risk patients while the actual major adverse cardiac event (MACE) rates available from available data were 0%, 15%, and 66.6% for low, moderate, and high-risk patients, respectively. Conclusion: If used, the HEART score can useful in effectively stratifying chest pain patients, aiding in decision-making regarding discharge and admission. Its implementation in EDs could enhance patient care and resource allocation.

Infertility remains a significant public health concern in Bangladesh, with evolving socio-demographic, medical, and lifestyle factors influencing reproductive health. This study compares infertility patterns among Bangladeshi couples between 2007 and 2024 to identify key contributing factors and assess changes over time. A comparative cross-sectional study was conducted using data from 2007 and 2024. The study population included couples seeking infertility treatment at selected healthcare centers in Bangladesh. Data were collected through structured questionnaires and medical record reviews. Statistical analyses were performed using STATA 17 to evaluate trends in infertility prevalence, associated factors, and reproductive health outcomes. Among couples seeking infertility treatment, the proportion of female infertility cases increased from 43% in 2007 to 94.2% in 2024, while male infertility cases declined from 36% to 9.1%. Primary infertility cases accounted for 67% in 2007 but decreased to 51.9% in 2024, whereas secondary infertility increased from 33% to 48.1% over the same period. The proportion of women with irregular menstrual cycles and endocrine disorders, such as polycystic ovary syndrome (PCOS), rose significantly. Positive lifestyle modifications were observed, including reduced smoking and increased physical activity. Surgical histories showed a decline in laparotomy procedures among females and a shift toward minimally invasive interventions. The findings highlight shifting infertility trends, with a rise in female infertility and associated endocrine disorders. Improvements in lifestyle factors and reproductive healthcare access suggest progress in infertility management. Targeted public health strategies, enhanced diagnostic capabilities, and evidence-based interventions are essential to address the evolving infertility landscape in Bangladesh.

Background: Hypertension frequently coexists with Type 2 diabetes mellitus (T2DM), significantly increasing the risk of cardiovascular and kidney complications. This dual burden escalates morbidity and mortality, emphasizing the need for early detection and effective management. However, there is limited research on hypertension prevalence among T2DM patients in Bangladesh. Objective: This study aimed to assess the prevalence of hypertension among patients with Type 2 diabetes mellitus and to identify associated risk factors in a tertiary care hospital in Dhaka, Bangladesh. Methodology: A prospective observational study was conducted at the Department of Medicine, Community Based Medical College, Bangladesh, from June 2022 to December 2022. A total of 83 T2DM patients were selected through purposive sampling. Data were analyzed using SPSS version 23.0, focusing on demographic characteristics, diabetes duration, body mass index (BMI), glycemic control, and blood pressure readings. Results: The overall prevalence of hypertension in T2DM patients was found to be 70.1%. Among the hypertensive patients, 42.2% had Stage 1 hypertension, while 27.9% had Stage 2 hypertension. Hypertension was significantly associated with the duration of diabetes, poor glycemic control (HbA1c > 7%), and a BMI greater than 25 kg/m². Conclusion: Hypertension is highly prevalent among patients with Type 2 diabetes mellitus, with poor glycemic control and obesity being significant risk factors. Regular monitoring and effective management of hypertension in T2DM patients are essential to reduce the risk of cardiovascular complications.

Background: Drug-eluting stents have significantly lowered the risk of restenosis. However, how to treat restenosis inside a DES is unknown. While the number of severe adverse cardiovascular events (MACE) linked to drug-eluting stents (DES) has significantly decreased, stent thrombosis (STH) and in-stent restenosis (ISR) continue to be significant clinical problems. Materials and Methods: This observation cohort study was conducted in the Department of Cardiology, Universal Medical College and Northeast Medical College, Sylhet. During study period 2016 to 2020 Universal Medical College and 2020 to 2022 Northeast Medical College. Among 509 lesions treated with DES, 26 required clinically driven revascularization for ISR. We identified 26 consecutive patients who developed ISR, among them Homo-Stents (n=17), Hetero-Stents (n=5) and (n=4) treated by other. Results: Three cases (75%) in the other ISR group and one (20%) in the hetero-stent group had a history of congestive heart failure. Of the three groups, only one had clinical characteristics that were statistically significant (p<0.05), whereas the other two did not (p>0.05). In the hospital, the differences between the three groups at six and twelve months were not statistically significant (p>0.05). Conclusion: There is a high long-term rate of MACE associated with current DES therapies for ISR or STH.

Carbon nanoparticles (CNPs) and carbon nanodots (CNDs) represent a revolutionary new frontier in nanotechnology with their distinct structural, optical, and chemical characteristics. Their unique properties have allowed them to be incorporated into various scientific and industrial applications. This comprehensive study delves into the synthesis, characterization, and functionalization of CNPs and CNDs, exploring the concepts underlying their remarkable qualities, which include excellent photostability, adjustable fluorescence, biocompatibility, and simplicity of surface modification. These nanostructures have various industrial applications, including electronics, energy, environmental research, and healthcare. Their potential to transform healthcare is fascinating, highlighted by their use in photothermal treatment, bioimaging, and drug delivery systems in biomedicine. The ability of CNPs and CNDs to tackle urgent ecological issues is further demonstrated by their application in environmental restoration, including water purification and pollution detection. The use of CNPs and CNDs in optoelectronics and energy storage devices like supercapacitors and batteries further illustrates their value in developing efficient and sustainable technologies. Even with these encouraging advancements, issues remain to be resolved, such as maximizing large-scale manufacturing, maintaining consistency, and dealing with long-term environmental effects. To overcome these obstacles and realize the full potential of carbon-based nanomaterials, this analysis highlights the necessity of multidisciplinary cooperation, which will eventually open the door for creative answers to pressing global issues.

Tinospora cordifolia, or "guduchi," is a reported medicinal plant of high therapeutic value. Historically, it was utilized in Ayurveda and other herbal medicinal therapies, where it is valued for its efficacy in treating a range of diseases, such as metabolic disorders, infectious diseases, autoimmune diseases, and cancer. This manuscript presents the pharmacological significance of T. cordifolia, where its multi-dimensional bioactive molecules, such as alkaloids, diterpenoid lactones, and steroids, are responsible for its therapeutic actions. Recent scientific studies show its chemopreventive value, especially in regulating cellular proliferation and apoptosis. With the growing interest in the world for plant-based therapeutics, more studies are needed to prove its efficacy, to explain its mechanisms of action, and to determine its potential in today's medicine.

The Agile transformation of 132/11 kV Capital Substation Projects has significantly improved efficiency, cost-effectiveness, and sustainability in infrastructure development. By leveraging Lean and Agile methodologies, including Scrum frameworks, process streamlining, and extensive workforce training, project delivery timelines were reduced by 30%, cutting construction duration from 30 to 21 months. This transformation resulted in AED 1.8M in cost savings per substation, amounting to AED 27M annually, alongside an 84% improvement in first-time drawing approvals. Additionally, the integration of precast construction methods reduced 3,165 tons of CO₂ emissions across 15 substations, reinforcing Agile’s role in sustainable project management. The benchmarking of these innovations against other government authority CFR process further highlights Agile’s scalability and industry relevance. These findings demonstrate that Agile is not only a project management methodology but a transformative approach that enhances speed, cost-efficiency, governance, and sustainability in capital infrastructure projects.