Snakebites are serious public health problem in many regions of the world, particularly in rural areas lacking medical facilities. Snake bite is a well-known occupational hazard amongst farmers, plantation workers, and other outdoor workers and results in much morbidity and mortality throughout the world. This occupational hazard is no more an issue restricted to a particular part of the world; it has become a global issue. Accurate statistics of the incidence of snakebite and its morbidity and mortality throughout the world is difficult to publish, however, it is certain to be higher than what is reported. This is because even today most of the victims initially approach traditional healers for treatment and many are not even registered in the hospital. Hence, registering such patients is an important goal if we have accurate statistics and reduce the morbidity and mortality due to snakebite. World Health Organization (WHO) has published guidelines for the clinical management of snakebites. In this article the author tries to throw light on the incidence and clinical features of snakebite and the management and treatment guidelines as per the WHO recommendation.

Enhancing aesthetics, occlusion and functions is a primary motivation for individuals with open-bite malocclusion seeking orthodontic treatment. Open-bite malocclusion, characterized by a lack of vertical overlap of the anterior teeth, can be effectively treated with a combined surgical and orthodontic approach. In this case report, we present the treatment of a male patient with an open-bite malocclusion and a skeletal class II. Initially, the patient underwent a presurgical phase where fixed orthodontic appliance was bonded to achieve well-aligned arches, then came the maxillary impaction to normalize the overjet and overbite and enhance both aesthetics and functions. Keywords: Skeletal Class II, Open-Bite Malocclusion, Orthodontic Treatment, orthognathic surgery, Maxillary Impaction.

Background: Urinary tract infection (UTI) is one of the most prevalent bacterial infections during pregnancy, associated with significant maternal and fetal morbidity if left untreated. The physiological changes of pregnancy, such as urinary stasis and altered urine composition, increase the risk of both symptomatic and asymptomatic UTIs. Early identification and management are therefore crucial. Aim of the study: To evaluate the incidence of urinary tract infections during pregnancy and assess the associated maternal and fetal outcomes in a tertiary care setting. Methods: This prospective study was conducted over two years in the Department of obstetrics and Gynecology, Rangpur Community Medical College Hospital, Rangpur, Bangladesh. A total of 220 pregnant women aged 18–40 years were enrolled, of whom 41 were diagnosed with UTI based on clinical presentation, urine microscopy, and culture sensitivity. Patients were classified as having symptomatic or asymptomatic UTI and were followed throughout pregnancy and postpartum for adverse outcomes. Statistical analysis was performed using SPSS version 26. Result: Among the 41 UTI-positive cases, the highest incidence (60.98%) was observed in women aged 18–25 years and in primigravida patients (56.10%). The majority (58.54%) of infections occurred during the second trimester. Asymptomatic UTI accounted for 65.25% of cases. The most common pathogen was Escherichia coli (36.59%), followed by Klebsiella (24.39%). Adverse maternal outcomes included anemia (26.83%), puerperal pyrexia (24.39%), and abortion (12.20%). Fetal complications included preterm birth (36.59%), fetal growth restriction (14.63%), and perinatal mortality (12.20%). Conclusion: UTI during pregnancy is a frequent and often silent infection, with significant implications for both maternal and fetal health. Routine screening and prompt treatment are essential, especially during the second trimester, to minimize complications such as preterm labor, intrauterine growth restriction, and perinatal mortality.

Retroperitoneal teratoma represents 1-11% of primary retroperitoneal tumors [1]. It is generally benign whether mature or immature. The treatment is surgical and the prognosis is excellent in the absence of complications. We report a case of mature retroperitoneal teratoma in an 8-year-old girl revealed by an isolated right paramedian abdominal mass. CT revealed a right suprarenal mass, fatty density with calcifications, without invasion of neighboring structures, measuring 124 mm in transverse diameter, 104 mm in anteroposterior diameter and 174 mm in height. Management consisted of complete excision of the tumor without incident.

Background: Red cell distribution width (RDW), a measure of erythrocyte size variation, has been implicated as a potential biomarker in various malignancies. However, its role in distinguishing between benign and malignant endometrial diseases remains unclear. This study aimed to evaluate the diagnostic utility of RDW and its correlation with disease severity in endometrial carcinoma. Methods: This cross-sectional study included 183 women diagnosed with either benign or malignant endometrial diseases. RDW levels were measured and analyzed for their diagnostic significance. Statistical analysis included independent t-tests to compare RDW values between groups and ROC analysis to determine diagnostic accuracy. Correlation between RDW and FIGO staging was also evaluated. Results: RDW was significantly higher in the malignant group (46.64±6.18) compared to the benign group (43.05±7.03; p < 0.001). A non-significant positive correlation was observed between RDW and FIGO staging (r = 0.031, p = 0.815). The ROC analysis yielded an area under the curve (AUC) of 0.463 (95% CI: 0.374–0.552; p = 0.414). The best cutoff value for RDW was 49.50, with a sensitivity of 17% and specificity of 90%. Conclusion: While elevated RDW is associated with endometrial malignancy, its diagnostic accuracy is limited. However, RDW may serve as a supplementary marker when combined with other diagnostic tools, particularly in low-resource settings. Further studies with larger cohorts are needed to validate these findings and explore RDW’s prognostic value.

The most common known forms of diabetes are type 1, an autoimmune disorder with auto antibodies and type II which is multi-factorial influenced by genetics, environment. Another form of diabetes is MODY (maturity onset diabetes in young), the most common form of monogenic diabetes, seen in non-obese children, adolescents and young adults. MODY a rare condition, accounts for 1–5% of all cases of DM and 1–6% of paediatric diabetes. This is non-ketotic and patients have no antibodies. Hepatocyte Nuclear Factor-1Beta is one of the several genes associated with this disease, causing beta cell dysfunction and extrapancreatic manifestations involving kidney, liver and intestines. In the present case glomerular cystic kidney disease is identified in a young male with diabetes raising clinical strong suspicion of maturity onset diabetes, which later showed Hepatocyte Nuclear Factor-1Beta mutation. A 17-year-old male, presumed type-1 diabetic who was under regular follow up with an endocrinologist, presented with elevated serum creatinine and protein in urine. On referral to our nephrologist, further evaluation was done when cortical kidney cysts were observed on imaging and on biopsy glomerular cystic kidney disease was identified. Genetic analysis revealed heterozygous missense variant of Hepatocyte Nuclear Factor-1Beta on Exon 4, thereby a final diagnosis of maturity onset diabetes in young-hepatocyte nuclear factor-1beta considered. His condition was stable during follow-up, despite the fact that chronic kidney disease is a progressive illness. Interdisciplinary approach helps in accurate typing of diabetes which has a bearing on prognosis and treatment.

Background: Preeclampsia (PE) affects 2-8% of pregnancies worldwide, leading to maternal and fetal complications such as abruptio placentae, renal failure, and HELLP syndrome. Objective: To investigate the association between plasma D-dimer levels and the severity of preeclampsia, along with its impact on fetomaternal outcomes. Methods: A case-control study was conducted at Dhaka Medical College Hospital from June 2021 to May 2022, enrolling 100 preeclamptic patients (50 with severe features and 50 without severe features). Participants were between 29-40 weeks of gestation. Exclusion criteria included chronic hypertension, renal/hepatic disorders, diabetes, and fetal anomalies. D-dimer levels were measured from 3 mL venous blood samples. Maternal and fetal outcomes were documented and analyzed using SPSS software. Results: The mean age of patients was 26.62 ± 3.99 years (PE without severe feature) and 27.26 ± 5.45 years (PE with severe feature). D-dimer levels were significantly higher in the severe feature group (2.91 ± 2.14 μg/mL) compared to the non-severe feature group (0.79 ± 0.45 μg/mL; p<0.005). Severe PE was associated with higher rates of postpartum hemorrhage (58.0%), HELLP syndrome (12.0%), abruptio placentae (44.0%), and fetal growth restriction (46.0%). The severe PE group also had significantly lower APGAR scores and higher NICU admissions (42.0%). Elevated D-dimer levels were significantly correlated with maternal and fetal complications, including eclampsia (p=0.020), HELLP syndrome (p=0.011), and fetal growth restriction (p=0.022). Conclusion: Elevated plasma D-dimer levels are significantly associated with the severity of preeclampsia and adverse maternal and fetal outcomes.

Waste management can be seen as the biggest global issue that affects people's well-being, our communities, and the natural world. This study goes into detail about how we can plan for waste; recycle what we can, and find effective ways to get rid of the rest. It looks at different types of waste, where it comes from, and the importance of finding balanced solutions. The study adopted a qualitative research approach while drawing from books, journals and articles. The study advocated for the importance of a nuanced understanding of waste and highlighting the existing practices while proposing the areas for improvement. It calls for taking into account diverse perspectives from NGOs, policy makers and government agencies for a sustainable and inclusive future. The study also offered some new ideas for how we can manage waste in a clever way that shows we're leading the way in innovation.

Quality nursing care is subjective and influenced by individual expectations and needs. Evaluating it is complex due to varying client standards, although client satisfaction remains a key measure of nursing quality. This study explores patient satisfaction with nursing care during hospital stays, examining factors affecting quality and demographic variables related to satisfaction. Continuous evaluation helps healthcare managers identify areas for improvement. Nurses play a crucial role in overall patient satisfaction by providing emotional and psychological support. This descriptive study, conducted with 100 patients at a private hospital in Bangalore, used the “Patient Satisfaction with Quality of Nursing Care” scale to assess satisfaction levels.

The quest for a potent treatment to combat cancer, which has emerged as the primary ailment afflicting mankind, has spurred the advancement of many approaches to investigate this affliction. Researchers and medical professionals have faced significant challenges in developing innovative treatments to overcome obstacles in cancer treatment and uncovering crucial insights into cancer development and progression. Comprehending the fundamental principles of the interaction between the human immune system and tumor cells has facilitated the development of novel and inventive approaches to cancer immunotherapy. The first progress witnessed in immunotherapy sparked enthusiasm among the scientific and clinical communities, since these approaches demonstrated significant potential for cancer treatment. However, there are other obstacles that currently hinder immunotherapy from being recognized as a truly effective treatment in the battle against malignant neoplasms. This review is trying to identify, assess, characterize, and define the main novel trends in immunotherapy and biotechnological therapies for cancer treatment.

Background: Chalazion, a common benign eyelid lesion caused by chronic inflammation of a blocked meibomian gland, often requires intervention for larger or recurrent lesions. Incision and curettage (I&C) and intralesional steroid injections are common treatment methods, each with distinct advantages and challenges. This study aims to compare the efficacy, safety, and patient satisfaction of these treatments to guide clinical decision-making. Objective: To evaluate and compare the effectiveness and safety of triamcinolone acetonide (TA) injection, methylprednisolone acetate (Depo) injection, and I&C in the treatment of large chalazia. Methodology: A total of 60 patients with recurrent chalazia were randomly assigned to three treatment groups: TA injection, Depo injection, or I&C. Patients were followed up at 1, 2, and 6 weeks post-treatment. The primary outcome was the complete resolution of the chalazion, defined as an 80% reduction in size with no recurrence. Results: The demographic characteristics, including age and gender, showed no significant differences between groups. The overall success rate for all treatments was 95%, with only 5% of patients in each group experiencing incomplete resolution. A single injection group showed higher success rates (27 successful cases) compared to the two-injection group (13 successful cases), with a statistically significant difference (p < 0.05). Resolution rates improved over time, with 95% complete resolution achieved by 6 weeks in all groups. However, there were no significant differences in resolution rates between groups at any time point (p > 0.05). Conclusion: This study supports that both steroid injections and I&C are highly effective treatments for recurrent chalazions, achieving a 95% success rate. Single injections were more effective than multiple injections. While the resolution rates improved over time, no significant differences were observed between treatment groups. These findings suggest that either treatment option can be selected based on patient preference, with I&C remaining an effective choice for more persistent cases.

Mononuclear Co(II), Ni(II), Cu(II), Zn(II) and Zr(IV) complexes with new bidentate Schiff base ligand 2-hydroxy-N’-(2-oxoindolin-3-ylidene)benzohydrazide (LH2) were synthesized and the complexes were characterized by elemental analysis, IR, FAB-mass, molar conductivities, magnetic measurements, electronic spectra and thermal analysis. The Cu(II) complex was additionally characterized by ESR study. The ligand behaves as a monobasic bidentate ligand, coordinating through azomethine Nitrogen and the deprotonated Oxygen atom. Analytical data suggested 1:2 (metal: ligand) mole ratio for all the complexes. The low molar conductance values of the all metal complexes in DMSO reveal their non-electrolytic nature. The physicochemical data suggested an octahedral geometry for Zn(II) and Zr(IV) complexes, distorted octahedral geometry for Cu(II), whereas square planar geometry for Co(II) and Ni(II) complexes. The thermodynamic analysis showed that the complexes loose hydrated and/or coordinated water molecules in the first step followed by decomposition of ligand moiety in the further steps leading to formation of stable metal oxide. The antibacterial as well as antifungal activities of the ligand and its metal complexes were evaluated.

Accidents are a leading cause of morbidity and mortality among under-five children globally. Mothers play a pivotal role in ensuring child safety and preventing accidents within home environments. This descriptive study aimed to assess the knowledge and practice of mothers regarding child safety and accident prevention in selected community areas in Bengaluru, India. A total of 60 mothers of under-five children were selected through Non-Probability Convenient Sampling technique. Data was collected using a structured questionnaire to evaluate their knowledge and a checklist to assess their practice. The findings revealed that while the majority of mothers had an adequate level of knowledge regarding child safety, but there were significant gaps in the practical implementation of safety measures. The vast majority of mothers (86.6%) were categorized as having good practices concerning child safety and accident prevention. Meanwhile, 11.7% exhibited acceptable practices, and 1.66% were found to have poor practices. The correlation analysis, reveals that there was no significant relationship between knowledge and practice regarding child safety and accident prevention among mothers of under-five children. The computed correlation coefficient (r = 0.001) was less than the table value, leading to the acceptance of the null hypothesis, which stated that there is no relationship between knowledge and practice. Factors such as education level, socio-economic status, previous experience of accidents, and other basic variables were found to have no influence on knowledge and practice. The study underscores the need for targeted educational interventions to further more improve maternal knowledge and enhance the practice of safety measures to prevent childhood accidents.

Several NPs are being protect plants from various environmental stresses and encourage plant growth. Plant extract-mediated AuNP synthesis has drawn a lot of interest in this field since it can produce AuNPs effective results. AuNPs have better biocompatibility without harboring hazardous chemicals. The physical properties of nanoparticles, such as size, chemical makeup, surface charge, and surface modification, influence the absorption and transportation processes. Applying nanoparticles can assist plants in reducing abiotic stressors. Silver, gold, and other metallic nanoparticles have been produced using a variety of bacterial species. Some strains Staphylococcus aureus, Acinetobacter calcoaceticus were used to create AgNPs with antibacterial qualities. The exogenous NP administration allows plants to maintain their photosynthetic efficiency under DS while also stabilizing the ultra-structure of the mitochondria and chloroplasts. The application of SiO2 NPs to the leaves enhanced the elasticity and expansion of the cucumber's cell wall during the growth period and increased the accumulation of nitrogen and phosphorus elements in the leaves, thereby reducing the salt stress on cucumber plants. Silver nanoparticles are formed by natural biomolecules present in plants, including proteins, enzymes, amino acids, polysaccharides, alkaloids, alcoholic chemicals, and vitamins. Additionally, nanoparticles have different effects on seed germination and plant growth as they move throughout the plant body.

Background: Choledochal cysts are rare congenital anomalies of the biliary system, presenting variably across age groups. Early diagnosis is crucial to avoid complications such as cholangitis, pancreatitis, and malignancy. Advancements in diagnostic imaging have significantly improved the detection and management of this condition. Objective: To assess the clinical features and diagnostic strategies for choledochal cysts using improved diagnostic techniques. Methodology: A retrospective observational study was conducted in the Hepato-Biliary-Pancreatic Surgery (HBPS) department of BIRDEM Hospital, Dhaka, spanning five years from January 2003 to January 2008. Thirty patients diagnosed with choledochal cysts were included based on clinical history, examination, and imaging. Data analysis was performed using SPSS version 22, with descriptive statistics and chi-square tests employed to explore associations between variables. Results: The study cohort comprised 21 females (70%) and 9 males (30%), with the majority of cases (49.5%) occurring in the 0–15 years age group. Jaundice (36%), abdominal mass (32%), and right upper quadrant pain (32%) were the most common clinical features. Complications such as cystolithiasis (24%) and pancreatitis (29%) were observed, while cirrhosis and malignancy were rare. Ultrasonography was utilized in all patients as an initial diagnostic tool, while MRCP (33%) and CT scans provided additional insights. ERCP was performed in 42% of cases, but its use has since declined due to associated risks. Conclusion: This study highlights the demographic and clinical features of choledochal cysts, with a focus on the utility of advanced imaging modalities like MRCP for non-invasive and accurate diagnosis. Early detection and intervention are key to reducing complications and improving outcomes.