Background: Adults with diabetes mellitus (DM) are at increased risk of herpes zoster (HZ) and its complications because of impaired cell-mediated immunity, chronic hyperglycemia, and multiple comorbidities. Despite the availability of highly effective recombinant zoster vaccine (RZV), vaccine uptake remains suboptimal among patients with diabetes in Saudi Arabia. This consensus statement was developed to provide evidence-based recommendations for HZ vaccination in adults with DM within the Saudi healthcare setting. Methods: A multidisciplinary expert panel convened under the auspices of the Saudi Society of Diabetes conducted structured evidence review and consensus process. A comprehensive literature search of PubMed/MEDLINE, Embase, Scopus, Web of Science, and the Cochrane Library was performed to identify studies published during the previous 10 years on HZ epidemiology, vaccine efficacy and safety, and vaccination strategies in adults with diabetes. Evidence was critically appraised and integrated with expert opinion using a modified Delphi-informed consensus approach. Recommendations were categorized according to evidence strength (Level A–C) and aligned with national immunization policies. Results: Available evidence consistently demonstrates that diabetes is associated with an increased risk of HZ, postherpetic neuralgia, hospitalization, and other complications. Saudi epidemiological data identified 1,019 HZ cases over a 6-year period, with 31.3% developing complications, 12.5% requiring hospitalization, and 1.2% requiring intensive care. Randomized trials and real-world studies demonstrate that RZV provides approximately 94% efficacy against HZ with durable protection and an acceptable safety profile. The expert panel developed 10 evidence-based recommendations addressing patient selection, vaccination timing, immunocompromised populations, co-administration with other vaccines, risk stratification, healthcare provider education, patient awareness, electronic reminder systems, equitable vaccine access, and pharmacovigilance. The panel emphasized routine assessment of vaccination status during diabetes care and strong physician recommendation as key strategies to improve vaccine uptake. Conclusion: Adults with diabetes represent a high-risk population for herpes zoster and should be prioritized for recombinant zoster vaccination according to current national recommendations. Integrating vaccination assessment into routine diabetes care, strengthening healthcare provider engagement, and implementing system-level interventions may substantially improve vaccination coverage and reduce the burden of HZ among adults with diabetes in Saudi Arabia.

Sugarcane (Saccharum officinarum) is a highly efficient agro-industry plant with known ability to accumulate biomass and produce sucrose sugar, making it an essential cash crop globally. This also results in the environmental pollution due to the accumulation of sugarcane biomass, the plant residues. left behind after extraction of sugar. This study was conducted to determine the phytochemicals contents, proximate, mineral, and antioxidant activities of sugarcane and its biomass, with a focus on their sustainable utilization through agricultural, therapeutic and industrial application. The samples were collected from Sharada market, Kano State, Nigeria, and analyzed for phytochemical using quantitative and qualitative method and antioxidant activities using the (DPPH, FRAP) method, proximate using standard Association of Analytical Chemistry (AOAC) methods and mineral using the Atomic Absorption Spectroscopy (AAS).The results revealed that sugarcane biomass had higher fiber and carbohydrate content (26.01±0.02% and 79.34±6.96%, respectively) compared to raw sugarcane (19.19±0.02% and 62.75±0.96%). However, sugarcane had a higher moisture (2.41±0.34%), fat (1.52±0.64%), and protein content (0.42±0.01%) than the biomass. In terms of mineral composition, sugarcane exhibited higher iron (5.59±0.17 mg/l), manganese (0.20±0.002 mg/l), and calcium concentration (14.10±0.03mg/l), while the biomass contained more potassium (207.5±0.24 mg/l). The result revealed that sugarcane had higher total phenolic content (279.92±3.66), compared to sugarcane biomass (255.65±9.48), also contains higher total flavonoids content (95.90±2.04) compared to sugarcane biomass (88.79±1.33). However, sugarcane had a higher antioxidant activity in term of the DPPH assay with an IC50 value of (774.28±5.60) higher than the biomass which has (1234.64±8.03). In terms of Ferric reducing antioxidant power (FRAP) Sugarcane exhibited higher antioxidant activity at higher concentration while the biomass shows higher antioxidant activity at low concentration. Sugarcane and sugarcane biomass has strong antioxidant activity, this indicate that the sugarcane and sugarcane biomass are effective in giving antioxidant protection at various levels, inhibition of radical formation (by reducing iron complexes). These findings suggest that sugarcane and sugarcane biomass are richer in phytochemicals which makes it suitable for the treatment of several ailments. Also, that sugarcane is nutritionally richer in proteins and essential trace minerals, whereas the biomass is an excellent source of dietary fiber and macro minerals, making it suitable for bio-fuel production, animal feed, and soil enrichment. The utilization of sugarcane biomass as a renewable resource could alleviate environmental pollution caused by waste disposal while promoting sustainable agriculture and energy solutions. Therefore, utilizing the full potential of sugarcane

Meningococcal meningitis remains a public health problem and threats to a number of populations associated with high mortality rates especially in Sub-Saharan Africa regions. Climate change and weather conditions are important factors influencing the occurrence, incidence, and transmission of meningitis. This review paper aims at evaluating the role of ambient temperature and humidity in the incidence and spatiotemporal distribution of meningococcal meningitis. The effects of temperature and humidity on the occurrence, incidence, and transmission of meningococcal meningitis were searched from the relevant literatures and documented. The relevant literatures were searched through ScienceDirect, PubMed, Web of Science, MDPI, Scopus, and Medline. It was found from the relevant literatures reviewed that temperature and humidity significantly influenced the occurrence, incidence, and transmission of meningococcal meningitis. High temperature and low humidity significantly increased the incidence and transmission of meningococcal meningitis. Thus, based on the available data and information in the literatures reviewed temperature and humidity are significantly associated with the incidence and spatiotemporal distribution of meningococcal meningitis.

Introduction: Pulmonary thromboembolism (PTE) and Deep vein thrombosis (DVT) are common complication following any type of surgery. Orthopedic surgeries have a risk higher than 10% of developing PTE. Therefore, a 2 to 5 weeks is given after the surgical procedure. The Aim: of this study was to present a case of PTE, preceded by local DVT, preceded by orthopedic surgery despite of prophylaxis with 4000 I.U of LMWH for 21 days and the 1year outpatient follow up afterwards. Materials and Methods: A full clinical analysis of a 20 years-old male athlete treated for PTE, DVT and Pleuropneumonia from 22.06.2024 to 05.07.2024 in inpatient setting and a follow up treatment in outpatient setting for 1 year. Results: The patient was admitted with d-dimer count of 3900ng/L, S1Q3T3 ECG pattern highly suspected of underlying PTE. What followed was 2 week long inpatient treatment and stabilization and 1 year-long outpatient treatment, evaluation and finally permanent discontinuation of anticoagulant therapy. Discussion: In an inpatient setting the treatment with LMWH is safer than any other type of anticoagulation for PTE when the right conditions are met and no imminent hemodynamic instability is present. DVT and PTE remain common complications of surgeries especially orthopedic ones. Conclusion: This case highlights the importance of circulatory complications related to surgeries, especially orthopedic ones and how sometimes the given prophylaxis can fail.

This study investigated the influence of cartoon viewing on English language proficiency among children aged 4 to 8 years in Nairobi City County. Recognizing the importance of English as the official language and medium of instruction in Kenyan educational institutions, this research addressed the challenges of English language acquisition in a culturally and linguistically diverse environment. Using an experimental research design, the study evaluated the impact of cartoon viewership on speech proficiency, focusing on four key components: watching and listening to cartoons, cartoon imitation, preference for specific cartoon programs, and cartoon viewership patterns. The target population comprised both public and private primary schools, reflecting Nairobi's varied socio-economic landscape. Participants were divided into experimental and control groups, with pre-test and post-test assessments conducted to measure changes in speech proficiency. Additionally, in-depth interviews with teachers of Grades 1 to 4 provided qualitative insights. Quantitative data were analyzed using paired t-tests, while qualitative data underwent content analysis. The study found that cartoons significantly enhance speech proficiency in children when integrated with active participation like singing, drawing, and role play. Imitating cartoon characters' speech and gestures improved vocabulary, sentence structure, and expressive communication. Children’s preferences, such as genre, language, and character type, also influenced speech development, with dialogue-rich, English-language cartoons proving most effective. In addition, viewing patterns like time of day, frequency, and duration impacted outcomes, with consistent, structured exposure yielding better results. The study recommends that practitioners use cartoons intentionally to enhance speech development in children by encouraging active engagement and imitation of characters’ speech and gestures. Educators should integrate dialogue-rich, age-appropriate content into lessons and tailor it to children’s preferences. Viewing should be structured, preferably in the morning, and should exceed one hour to ensure effective learning. Policymakers are urged to embed cartoon-based learning in early education frameworks aligned with the Competency-Based Curriculum. Communities and caregivers should support educational cartoon viewership at home and in communal settings, fostering shared learning and reinforcing communication skills beyond the classroom.

Background: Carcinoma of the cervix remains a leading cause of cancer-related morbidity and mortality among women in developing countries, where organized screening coverage is limited and most patients present only after the disease becomes symptomatic. Objective: To describe the pattern of clinical presentation, disease stage and clinical findings among women with histologically confirmed carcinoma cervix attending a tertiary-level teaching hospital in Bangladesh. Methods: This cross-sectional, prospective study was conducted in the Department of Obstetrics and Gynaecology, Rangpur Medical College Hospital, over one year. Fifty consecutive patients diagnosed with carcinoma cervix who fulfilled the inclusion criteria were enrolled after informed consent and data on presenting symptoms, clinical stage, general and local examination findings and imaging correlates were recorded on a structured questionnaire and analyzed as frequencies and percentages. Results: Most patients (60%) were 41-50 years old. Blood-stained per-vaginal discharge (94%), foul-smelling discharge (50%) and post-coital bleeding (50%) were the commonest complaints. Forty-eight patients (96%) presented in stage IIB or beyond. Nearly all patients (100%) were anaemic, 80% had a cauliflower-like cervical growth and 92% had squamous cell carcinoma on histopathology. Ultrasonography showed cervical growth in 52%, hydronephrosis in 44% and pelvic lymphadenopathy in 22% of patients. Conclusion: Carcinoma cervix in this tertiary-hospital population presents predominantly with abnormal vaginal bleeding and discharge at an advanced clinical stage, underscoring the continued need for symptom awareness and organized early-detection services.

The present study was designed to examine the effects of three differentiated handball training interventions on dribbling ability and skill performance among male collegiate handball players. Sixty male college handball players aged 18–24 years were assigned to four groups: Fitness Handball Training (FHT), Technical Handball Training (THT), Integral Handball Training (IHT) and Control Group (CG), with 15 participants in each group. The experimental programmes were structured to emphasize physical conditioning, technical execution or an integrated combination of physical and handball-specific skills. The intervention was planned for eight weeks, with three training sessions per week, each lasting 60 minutes. Dribbling ability was evaluated using a standardized handball dribbling obstacle-course test, in which lower completion time represented superior performance. Pre-test and post-test measurements were obtained before and after the intervention. The statistical plan consisted of descriptive statistics, paired-samples t-tests, analysis of covariance (ANCOVA) and Scheffe’s post-hoc comparisons, with statistical significance established at the 0.05 level. The intervention framework was informed by evidence indicating that handball performance depends on repeated acceleration, sprinting, changes of direction, technical execution and rapid transitions between physical and skill demands [1–8]. Previous intervention research has also shown beneficial effects of small-sided games, high-intensity training, plyometric training, resistance training and integrated handball-specific conditioning on selected performance characteristics [9–18]. The proposed study therefore examines whether integrating physical and technical stimuli produces greater improvement in dribbling ability than isolated fitness- or technique-oriented training. The expected practical implication is that an appropriately structured integrated handball programme may provide a more ecologically valid stimulus for improving ball-control performance under movement constraints.