According to "Never Events", insulin administration errors are serious preventable adverse events that should not have occurred if adequate preventive measures had been implemented. The event "insulin administration error" is on the ANSM list published in 2012. The National Health Service's (NHS) "Never Events insulin" has developed a module on insulin therapy management entitled "Preventing insulin-related medication errors". Proper use and knowledge of insulin management can prevent these events. Our study presents the results of a survey designed to assess both the knowledge of healthcare personnel and a group of diabetic patients in the Souss Massa region of Morocco. Our survey was an opportunity to re-educate our patients and review the knowledge of a group of staff interviewed, underlines the important deficit in knowledge and practice of nursing staff and insulin-treated patients, suggests that urgent intervention should be considered, particularly with young nursing staff, and also to review the therapeutic education of insulin-treated diabetics in order to improve their knowledge and better prepare them for the advent of new generations of insulin.

The case of a patient with a septal abscess is reported, with the aim of providing a comprehensive analysis of the diagnostic approach and the various stages of treatment, as well as prompting in-depth reflection on the implications that this particular case could have for medical practice in general. It also highlights the vital importance of early recognition of this condition, and of responding rapidly and appropriately to the patient's needs. It also highlights the value of clinical experience in improving the management of similar cases in the future.

Objectives: To assess the level of awareness among obstetrical care providers about preeclampsia prevention including risk factors, good practice in aspirin prophylaxis, and to analyze the associated factors. Methods: A cross-sectional study conducted among gynecologists and obstetricians, maternal and fetal medicine specialists, and internal or family medicine physicians working in public or private care centers whom involved in obstetric care in Saudi Arabia. An online-administered questionnaire was designed to assess familiarity of aspirin role in prevention of preeclampsia and fetal growth restriction including proper dose, timing of intake, gestational age to start and discontinuation of treatment as well as the risk factors of PE among set of 13 conditions. An awareness score was calculated and divided into two levels: adequate and inadequate familiarity and knowledge. Practice in PE prevention and attitude towards aspirin use, in addition to participants’ demographic and professional factors, were investigated and analyzed as profound factors. Results: Hundred sixty physicians were participated, 85% were obstetrician/gynecologists and 13.1 were maternal fetal medicine Specialists. Less than half of participants have adequate knowledge and awareness in aspirin role and a minority provided correct answers regarding the recommended aspiring dose, timing of intake, gestational age to start and discontinuation of treatment. However, knowledge about preeclampsia risk factors was relatively acceptable. Maternal fetal medicine specialist and physicians working in teaching hospitals were remarkably with better knowledge compared to their respective counterparts in primary and secondary centers. The existence of institutional guidelines about ASA use in pregnancy did not improve the knowledge level. Conclusion: The overall familiarity and knowledge in that regard was relatively poor, associating misconceptions about the risk factors and substantial gaps regarding the optimal timing and prescribing practice. Formal and continuous medical education curricula should be reviewed to promote good clinical practice in preeclampsia prevention as an essential dimension of maternal and fetal care.

Background: Molecular pathogenesis of CRC represents a major target for understanding and controlling of the disease in the Sudan. Therefore, the present study aimed to explore the clinicopathological pattern of CRC in the Sudan with specific emphases in the role KRAS and P53 genes mutations. Methodology: This study was carried out in El-Obeid, North Kordofan state, Sudan, using CRC samples from patients who presented to the Al-Obeid teaching hospital between 2017 and 2022 and had a biopsy for histopathological diagnosis. This series featured everyone who has CRC. Results: The most prevalent CRC subtype is adenocarcinoma, which is followed by mucinous adenocarcinoma and metastatic adenocarcinoma, which constitute 74%, 20%, and 6%, respectively. KRAS mutation was found in 40% patients 48% males and 33.3% females). P53 mutation was found in 46% individuals 43.5% men and 48% females. Positive correlations between KRAS and P53 were found in 26% cases, while negative correlations were found in 40% cases. Conclusion: Many CRC patients in Sudan present at advanced stages of the illness and at a younger age, necessitating early screening measures. CRC patients have been discovered to have KRAS, P53, or both mutations. As a result, precise preventative and therapeutic methods are considered essential.

Introduction: Hypertension, commonly known as high blood pressure, stands as a pervasive global health concern, often referred to as the "silent killer" due to its asymptomatic nature. The management of hypertension is critical to prevent cardiovascular complications and other associated health risks. This study aimed to observe the long-term effects of olmesartan combined with amlodipine among hypertensive patients. Methods: This was a retrospective observational study conducted in the Department of Medicine, Popular Medical College Hospital, Dhaka, Bangladesh during the period from January, 2023 to December, 2023. In our study, we included 210 hypertensive patients who were divided into three groups: Group A -Patients who received Olmesartan (OM 40 mg), Group B -Patients who received Amlodipine (AML 5 mg), and Group C -Patients who received the combination of Olmesartan (OM 40 mg) and Amlodipine (AML 5 mg). Result: We found the mean age was 52.8 ± 11.3 years. Most of our patients were male (68.10%). The majority of patients in Group B had ≤140⁄90 mmHg blood pressure than the other groups at the end of our study. Patients with ≤130⁄85 mmHg, were higher in Group A. Patients with ≤130⁄80 mmHg blood pressure during the last week of the study were highest in Group C. Drowsiness/dizziness, headache, nausea/vomiting, and stomach /abdominal pain were the most common side effects. Conclusion: In our study, we discovered that Olmevas AM (OM/AML) 40/5 mg was more effective at decreasing blood pressure than either OM (Olmesartan) 40 mg or AML (Amlodipine) 5 mg. There were no unexpected or unusual safety concerns found with OM/AML combo therapy.

The domestic dog is a non-seasonal breeder. The female is monestrus and has a reproductive cycle that is marked by extended periods of proestrus and estrus. The estrous period is characterized by an estrogen peak that coincides with rising circulating progesterone concentration prior to ovulation. After estrus is diestrus and then anestrus, with the ovarian cycle regulated by the hypothalamic-pituitary-gonadal axis. In the male spermatogenesis is controlled by the hypothalamic-pituitary-gonadal axis with testosterone playing a vital role. The reproductive cycle of most wild canids is similar to that of domestic dogs. Diestrus is followed by an extended period of ovarian inactivity. The causes of breeding failure in dogs are numerous and require thorough investigations for accurate diagnosis. Breeding failures can be infectious or non-infectious. Among the infectious causes in the bitch, bacterial endometritis was found to be responsible for the majority of reported cases. Non-infectious causes include primary and secondary anoestrus, cystic conditions of the uterus, and degenerative diseases of the endometrium. In the male, the causes can also be infectious and non-infectious. Non-infectious causes like bilateral cryptorchidism and acquired anatomical abnormalities can also cause male infertility. Spermatocele or sperm granulomas, obstruction of the genital ducts or inguinal or scrotal hernia, and prostatitis lead to infertility. Infections can lead to orchitis/epididymitis, with alteration of the quality of the semen. Nutrition also has important implications for reproductive performance. Undernutrition can result in loss of body condition, delay the onset of puberty, and ultimately lead to infertility.

Background: Heart failure is a significant medical and societal concern worldwide. It continues to be a major source of morbidity and mortality and causes a significant and rising cost on the health care system. There is a seasonal fluctuation in the number of people who are admitted to hospitals for heart failure, with winter seeing the highest rate. Objective: To assess the seasonal variation of heart failure admission with age, sex, risk factors and co-morbidities in tertiary care hospital in Bangladesh. Materials and Methods: This cross-sectional study was carried out among the patients hospitalized with heart failure at the Department of Cardiology, Dhaka Medical College Hospital (DMCH), Dhaka, between April 2015 and March 2016. The history, clinical characteristics, and investigational data were used to diagnosis the patients. Statistical tests were used to examine the impact of seasonal fluctuation on patients admitted with heart failure. Results: In the age range of 41 to 60 years, 302 patients with heart failure at the highest level (51.7%) were hospitalized. Heart failure admission patients were 2.8 times more likely to be male than female, with a mean age of 55.18±12.42 years. Heart failure patients in the age ranges of 20 to 40, 41 to 60, and 61 to 80 years were hospitalized more frequently in the winter and post-monsoon. Seasons and gender had a statistically significant relationship (p=0.030). Smoking is the greatest risk factor compared to other risk factors in all seasons, and all risk factors were more prevalent in the winter than they were in other seasons. Conclusion: This study may help improve the healthcare system and alter how easily accessible hospital resources such as emergency rooms are throughout the winter. More information regarding the heart failure events that occur throughout the winter should be made available to patients and general practitioners.

Background: Hepatic encephalopathy (HE) is a significant neuropsychiatric complication of liver disease, causing substantial global morbidity and mortality. Advances in our understanding of HE pathogenesis have led to the development of new management strategies. Documenting the disease profile, precipitating factors, and prognostic indicators is crucial, given the need to widely apply these new strategies. Objectives: This study aims to assess the immediate prognosis, identify presenting features, and categorize patients based on the Child-Pugh Class at Rajshahi Medical College Hospital. Materials and Methods: This cross-sectional descriptive study conducted in the Department of Medicine at Rajshahi Medical College Hospital from January to December 2010 aimed to assess the immediate prognosis of HE, determine its presenting features, and categorize study subjects based on the Child-Pugh Class. Sixty-six patients with chronic liver disease and HE were included in the study. Comprehensive data were collected through detailed history-taking, physical examinations, and investigations that adhered to the inclusion criteria. Results: The study cohort included 42 male and 24 female patients, with the majority (69.7%) falling within the age group of 30-60 years, with a mean age of 47.29 (±13.5). Most patients presented with grade II HE (40.9%). Hepatitis B, C, or both were positive in 63.6% of cases. Confusion was the most common presenting feature due to encephalopathy (53.0%). A majority of patients (62%) were in Child Class C. Electrolyte imbalance (54.4%), and constipation (34.8%) were the most common precipitating factors. 74.2% of patients survived, while 25.8% succumbed to the condition. Conclusion: Hepatic encephalopathy is a well-recognized complication of chronic liver disease, predominantly presenting with mental confusion. Despite many patients presenting with severe encephalopathy (Child Class C), the immediate survival rate was deemed satisfactory. The study underscores the importance of early hospitalization, identification of precipitating factors, and timely treatment in improving outcomes for this fatal condition.

Acromegaly is a rare disorder resulting from the excessive secretion of growth hormone (GH) and causing a specific form of cardiomyopathy. Until now, it has been widely recognized that individuals with acromegaly face an elevated risk of arrhythmias. However, high-grade atrioventricular blocks are a very rare complication of acromegaly. We report the clinical observation of a 75 years old acromegalic male presenting with high-grade atrioventricular block requiring permanent stimulation with a pacemaker.