Background: Prenatal care has proven to play an invaluable role in the reduction of maternal and perinatal mortality. The care provided to the parturient includes risk assessment, health promotion and education, and therapeutic intervention if need arises. The cardinal point of antenatal care is mainly but not limited to ensuring the delivery of a healthy newborn with minimal or no risk to the mother. The importance of prenatal care cannot be overemphasized especially in developing countries with high fertility rate, increased tendency to large family size and increased maternal mortality. Objectives: To determine the sociodemographic characteristics of booked and unbooked pregnant women and to ascertain any differences in maternal and perinatal outcome. Materials and Method: A retrospective cohort study at 68 Nigerian Army reference hospital from January 2020 to December 2023. All the antennal records of women booked in our facility within the period of study were retrieved. Maternity records that included all unbooked deliveries were all retrieved. The variables of interest were maternal age, parity, educational status, antenatal care (ANC) attendance, mode of delivery, obstetrics complications and pregnancy outcomes. Data was analysed using SPSS version 29. P<0.05 was considered significant. Results: A total number of 5032 patients were seen during the four-year period of review. Booked cases were 3572 (70.99%) while unbooked was 1460 (29.01%). Fetomaternal adverse outcome and complication were more in the unbooked category with high operative delivery 87.05% in the unbooked patients. Conclusion: The study showed that more adverse pregnancy outcomes occurs when women are unbooked during pregnancy. Continued utilisation of quality antenatal and delivery care services in our environment will significantly improve pregnancy outcome while reducing maternal and perinatal mortality and morbidity.

Early Childhood Caries (ECC) remains a global public health challenge, particularly in underserved populations where access to conventional dental care is limited. Silver Diamine Fluoride (SDF) has emerged as a transformative approach in the management of ECC, offering a minimally invasive, cost-effective solution to arrest caries progression and prevent new lesions. This review provides a comprehensive evaluation of SDF, focusing on its mechanism of action, clinical efficacy, advantages, and limitations in pediatric dentistry. Evidence from recent studies demonstrates that SDF is highly effective in halting caries progression, significantly reducing the need for more invasive treatments, particularly in young or uncooperative patients. However, aesthetic concerns, primarily the black staining of treated lesions, and the need for informed parental consent remain key barriers to its widespread adoption. The article also explores the integration of SDF into broader public health strategies for ECC prevention and treatment, emphasizing its role in resource-constrained settings. Ethical and legal considerations, along with future research directions, are discussed to address gaps in understanding its long-term safety and efficacy. By advancing the use of SDF, this review highlights its potential to revolutionize the management of ECC, aligning with global goals of equitable access to essential health care.

Lipoma is a common benign tumor of soft tissues but rarely located in the hand or being responsible for neuropathy. A case of compressive lipoma of the Guyon canal with purely sensory disorders has been evolving for 04 years in a 56-year-old woman. The mass was removed without any damage to vascular, neural, or tendinous structures. Postoperative recovery was straightforward, and the patient regained good mobility in the hand and fingers.

Background: Primary amenorrhea, defined as the absence of menarche by age 15 in the presence of secondary sexual characteristics or by age 13 without them, arises from various etiologic factors. Timely diagnosis and targeted interventions, including genetic counseling and reconstructive surgeries, are essential for effective management. Aim of the study: The aim of this study was to prevalence of etiologic causes of primary amenorrhea among women in a tertiary care center. Methods: This cross-sectional study was conducted in Department of Obstetrics and Gynaecology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, during the period from June 2023 to May 2024. Total 120 women presenting with primary amenorrhea during the study period were included. Result: The study involved participants with a mean age of 17.8 ± 3.2 years, with 58.3% aged 15-20. Most were from low-income backgrounds (62.5%), and 33.3% reported parental consanguinity. Hormonal causes (41.7%) predominated, followed by structural (33.3%) and genetic causes (16.7%). Hypogonadotropic hypogonadism (60.0%) and Müllerian agenesis (62.5%) were leading subtypes, while Turner syndrome accounted for 60.0% of genetic cases. Diagnostic findings included pelvic ultrasound abnormalities (45.8%, p <0.001) and karyotype abnormalities (16.7%). Hormonal imbalances were most common (58.3%), reflecting the diversity of etiologies and the importance of advanced diagnostics in identifying underlying causes. Socioeconomic status and parental consanguinity significantly influenced etiological patterns. Conclusion: This study highlights significant associations between socio-demographic factors, such as age, consanguinity, socioeconomic status, and etiological categories were observed. Diagnostic findings underscored the importance of pelvic ultrasound, karyotyping, and hormonal evaluation in accurate classification.

The global climate continues to deteriorate, resulting in excessive carbon emissions, heavy metal pollution possesses serious threats to human life and modern civilization. The concentration of Zn, Fe, Cr, Pb, Cu and Cd in soil and rice grown in two locations (A and B) AROUND Edozhigi river were determined using standard methods og analysis. Results obtained for location A, indicate high concentration of Zn 9.75±0.55, 9.61±0.54, 1.03±0.58 and 1.69±0.66 mg/kg in soil, root, stem and seed of rice plant respectively. The order of Zn concentration of Zn metal in location B is 2.07±0.55 (soil) > 1.70±0.54 (root) > 1.67±0.58 (stem) > 1.27±0.66 (seed). Concentration of Fe (mg/kg) in soil (25.50±0.00) and root (26.32±0.00) from location B were significantly higher than those of stem (8.46±0.00 mg/kg) and seed (6.98±0.00 mg/kg) respectively. Concentration of Cu (mg/kg) in soil, root, stem and seed from location A and B were between 0.00±0.00 - 0.03±0.40 mg/kg respectively. The low concentration of these metals in soil around Edozhigi river makes the soil fit for growing crops.

The civil service played a critical role in fostering socio-economic development, particularly in developing countries like Nigeria. This paper examined the role of the civil service in driving socio-economic progress, with a focus on Akwa Ibom State. The study assessed how civil service structures and policies influenced key areas such as employment generation, economic growth, infrastructure development, and public service delivery. To achieve the study objectives, the researcher utilized both descriptive and ex post facto research designs to analyze civil service operations and their impact on socio-economic development. The descriptive design provided a detailed overview of the current state of civil service practices, while the ex post facto design allowed for the examination of past policies and their outcomes without manipulating variables. Data were collected from a variety of secondary sources, including textbooks that offered foundational knowledge, journals with empirical studies, civil service information handbooks detailing regulations, and government bulletins providing insights on policies and challenges. The findings revealed that inadequate allocation of resources; bureaucratic delays, corruption, and ineffective human resource management were major factors that hindered the civil service's ability to achieve socio-economic development. The paper concluded with recommendations for enhancing the efficiency of the civil service, including policy reforms, capacity building, and strategic leadership, to better align with national development goals in Akwa Ibom State.

The halal lifestyle is now widely adopted in Muslims' lives, including medical practice. The study aims to determine the level and correlation of knowledge, perception, and attitude of doctors toward readiness to enter the era of mandatory halal certification of drugs and the demographic factors that influence it. A cross-sectional study was conducted online using a questionnaire validated by experts and previous validation and reliability tests. This study was attended by 400 respondents from five provinces in Java, using purposive sampling. The results of the study showed that doctors had sufficient knowledge (mean 38.50 ± 2.293), sufficient perception (mean 40.92 ± 5.076), and sufficient attitude (mean 39.14 ± 4.523) towards halal drugs. There is a weak correlation between knowledge perception (r=0.306, p<0.05), a very weak correlation between knowledge attitude (r=0.297, p<0.05), and a robust correlation between perception attitude (r=0.828, p<0.05). Doctors' knowledge, perception, and attitudes about halal medicine influence each other (p value<0.05). Factors such as workplace, position, and length of service influence knowledge (p value<0.05), and age, workplace, position, and length of service influence perception and attitude (p value<0.05.) of doctors about halal medicine. It is concluded that doctors have sufficient knowledge, perception, and attitude and influence each other; the correlation between knowledge-perception is weak, knowledge-attitude is very weak, and perception-attitude is very strong. Age has a relationship with knowledge, perception, and attitude, education has a relationship with knowledge, and the workplace has a relationship with doctors' perception of halal medicine.

Data shows sudden cardiac arrest is still one of the leading causes of death in Europe and the United States (Berdowski et al., 2010). Healthcare professionals must provide immediate and proper resuscitation, which directly impacts the patient likelihood of survival. Mock code drills play a pivotal role in healthcare education and training, by enhancing the participants' confidence levels. This increased confidence, in turn, contributes to improved clinical performance and patient outcomes. Within the hospital setting, resources and personnel are readily available in the event of a medical emergency, however in the outpatient setting the stakes may be higher due to lessened resources and manpower (Urman, Punwani and Shapiro, 2012). To date, there is very little research surrounding medical emergencies in the outpatient settings, this highlights the need for further investigation as cardiac arrest is a high risk low volume emergency that many healthcare professionals feel unprepared and ill equipped for (Monachino et al., 2019). This Quality Improvement (QI) project explored the impact of mock code blue drills on healthcare professional’s confidence levels in the outpatient setting. Over three months, monthly code blue drills were conducted in two separate outpatient locations. Staff involved in this QI completed a pre and post drill survey consisting of nine statement with five-point Likert scaling assessing their confidence levels. Results in this QI showed an overall improvement in the confidence of clinical staff after taking part in mock code blue drills. There were limitations to this QI including a low response rate, small sample size, as well as external factors such as a faulty public announcement system impacting the drills. Future recommendations include increased frequency of drills, qualitative research to explore staff’s perceptions and high-quality simulation equipment. Code blue drills should be completed every three months to safeguard patient safety and promote staff responsiveness in a true cardiac arrest event.

Background: Management of IUFD has immense significance in today’s obstetric practice. To summarize, dinoprostone gel, misoprostol and intra cervical catheter can be used for induction of labour in second and third trimester IUFD. Mechanical methods, i.e. the use of Foley’s catheter balloon, though effective have not gained much popularity because of the fear of infection. Objective: To observed the complications of induction of labor with Foley's catheter in patients with a previous cesarean section. Materials and Methods: The observational study was carried out in the Department of Obstetrics & Gynecology, Dhaka Medical College Hospital. Dhaka, Bangladesh. Total 52 patients with singleton pregnancy with IUFD, at ≥28 weeks of gestation was attending in the Department of Obstetrics & Gynae were included in this study. Details of history, general physical and systemic examination, ultrasonography, basic laboratory investigations like haemoglobin level, and DIC profile were recorded. Results: Forty three (82.7%) received augmentation with oxytocin, 3(5.8%) developed scar tenderness and 8(15.4%) had failed induction. Failed ICC was found 8 cases, among them 5(62.5%) had dinoprostone gel used followed by vaginal birth, 2(25.0%) had LUCS and 1(12.5%) had laparotomy. Induction delivery interval was found 16.3±5.5 hours. Regarding maternal outcome 49(94.2%) patients had normal vaginal delivery, 4(7.7%) had PPH, 3(5.8%) had fever, 2(3.8%) were ICU admission, 1(1.9%) had laparotomy and 1(1.9%) had rupture uterus. Conclusion: Common maternal complications were PPH, fever, ICU admission, laparotomy and rupture uterus. Induction can be done safely in carefully selected cases of previous LSCS with Foley’s Balloon.

To support sustainable environmental management and agricultural practices, this study examines the sophisticated uses of nanoparticles and nanotubes in the remediation of industrial, farming, and sewage wastes and their function in creating biofertilizers. Because of their unique qualities, which include a large surface area, reactivity, and adjustable features, nanoparticles are very good at adsorbing, breaking down, and eliminating contaminants from wastewater. Because of their conductivity and structural robustness, nanotubes further improve cleanup procedures by enabling quick pollutant absorption and destruction, particularly for complex pollutants, including organic compounds, heavy metals, and pesticides. The efficacy, stability, and possible environmental hazards of several nanomaterial types, such as metal oxides, carbon-based nanoparticles, and functionalized nanotubes, are examined in this study. The article also emphasizes the dual use of these nanotechnologies in creating biofertilizers, which can support agricultural yield increase, soil health improvement, and nutrient cycling. This strategy offers a viable technique to lower environmental pollutants and promote sustainable farming methods using nanotechnology in wastewater treatment and agriculture. The paper also discusses the obstacles and restrictions to widespread use, including expense, possible toxicity, and regulatory issues. This article sheds light on nanotechnology's present and potential agricultural and environmental management applications, thoroughly examining its contribution to developing sustainable and environmentally friendly solutions.

This article analyzes the famous soliloquies in Shakespeare’s play Hamlet through the concept of ideational function in Halliday’s systemic functional grammar theory. The focus is on how this theory reveals the deep structure of the text and the complex psychology of the characters, particularly through six processes of ideational function. The analysis demonstrates that these processes not only enhance the understanding of Hamlet’s inner conflicts but also highlight the philosophical reflections embedded in the text. The article emphasizes that while systemic functional grammar theory provides rich perspectives and profound insights for literary text analysis. Overall, this theory offers a structured analytical framework for understanding Hamlet and deepens the appreciation of this classic text.

Background: Hemorrhoids are a prevalent condition affecting the anal and rectal area, often resulting in symptoms such as bleeding, pain, and prolapse. While typically benign, they can coexist with other anorectal issues, including anal fissures and polyps. Rarely, neuroendocrine tumors may be discovered in patients with hemorrhoids, underscoring the necessity for thorough evaluation and histopathological examination to identify and address any significant underlying conditions. Case Presentation: This case describes a 39-year-old male presenting to the clinic on August 13, 2024. He reported a one-year history of rectal bleeding, pain, burning, and prolapse during defecation, along with occasional constipation. Physical examination revealed third-degree hemorrhoids, a chronic anal fissure, and an anal polyp. The primary diagnosis was third-degree hemorrhoids, with secondary diagnoses of chronic anal fissure, anal polyp, and constipation. The patient underwent elective surgical interventions, including stapler hemorrhoidopexy, fissurectomy, sphincterotomy, and excision of the anal polyp, all performed under general anesthesia without complications. Histopathological analysis of the excised hemorrhoidal tissue revealed a Grade 1 neuroendocrine tumor measuring 3 mm, with no evidence of malignancy elsewhere. Postoperative recovery was stable, with the patient reporting no significant complications during follow-up. Conclusion: This case illustrates the complexity of managing hemorrhoidal disease and its potential associations with other anorectal conditions, such as anal fissures and polyps. The identification of Grade 1 neuroendocrine tumors emphasizes the importance of thorough evaluation in patients presenting with rectal symptoms, even when benign conditions are suspected.

Abrus precatorius, Linn commonly known as jequirity bean or rosary pea, is a herbaceous flowering plant in the bean family Fabaceae. The plant is best known for its leaves and seeds, which are used as beads and in percussion instruments, and which are toxic because of the presence of abrin. The phytochemical evaluation of the different extract of the Abrus precatorius leaves shows the presence of carbohydrates, alkaloids, steroids, sterols, flavanoids, tannins, phenolic compounds proteins and amino acids, fixed oil, and the absence of glycoside, saponin, and anthraquinone. This study aims to determine the antibacterial activity of extracts and fractions from leaves on the growth of Staphylococcus, E.coli, and Pseudomonas. The leaf powder was macerated using 96% ethanol, chloroform, petroleum ether, and aguish then fractionated using as solvent. The antibacterial activity test using the diffusion method showed that the extract of leaves had antibacterial activity against Staphyloococcus E.coli and Pseudomonas. The most active fraction was the ethanol fraction, with a concentration of 50% with an average inhibition zone diameter of 12.2 mm.

Epilepsy requires a constant medication during pregnancy. Maintaining, monitoring and a stability of pregnant women with epilepsy between restricting seizures and reducing fetal exposure to the antiepileptic drugs are essential. Major and minor malformations were presented in children subjected to the antiepileptic drugs during pregnancy. This review article aimed to highlight some of antiepileptic drugs as potential teratogen to understand the associated congenital malformation risks with these drugs, differences in hazards between several selection treatment are essential to safe both mother and fetus.

The present study was carried out on Safari Park, Lahore, Punjab, Pakistan. The sampling was carried out randomly in different seasons from different water bodies of the park especially from Lake. Thirty-seven species belonging to six genera i.e., Pediastrum (4 species & 11% abundance), Trachelomonas (4 species & 11% abundance), Euglena (11 species & 30% abundance), Phacus (12 species & 32% abundance), Lepocinclis (1 species & 3% abundance) and (5 species & 13% abundance). All genera belong to kingdom Protista, two phyla i.e., Volvocophycota and Euglenophycota, two classes i.e., Volvocophyceae & Euglenophyceae, two orders chlorocoocales and Euglenales and three families i.e., Hydrodictyaceae, Euglenaceae and Naviculaceae.