Agile methodology, a dynamic approach originally derived from software development, has rapidly gained substantial traction across a diverse range of industries due to its unparalleled adaptability, iterative nature, and customer-centric ethos. In the intricate and rapidly evolving landscape of the healthcare sector, where optimal patient outcomes, operational efficiency, and stringent regulatory compliance stand as imperatives, the thoughtful application of Agile principles emerges as a transformative catalyst for reshaping medical practices. This comprehensive review delves deeply into the nuanced underpinnings of Agile methodology in healthcare, exploring its manifold benefits, intricate challenges, successful case studies of implementation, and the boundless horizon of future prospects it holds.

The regulation of the mechanism for settling minor or simple lawsuits is done through conciliation efforts in Article 14 letter (b) PERMA Number 2 of 2015 has regulated that Judges must play an active role in seeking to settle cases peacefully but do not regulate the form of conciliation efforts and there is an overlapping role of the Judge as examiner of cases and as a mediator who has not achieved justice for the parties. The aim of the research is to analyze the weaknesses of conciliation efforts in resolving simple tort cases in Indonesia currently and to reconstruct peace efforts in resolving simple tort cases based on fairness values using a constructivist paradigm with empirical research and a socio-legal approach. Analysis of research data in a qualitative descriptive manner where the location of the research was the Batang District Court and the Pasuruan District Court. The results of the research show that the Weaknesses in conciliation efforts in resolving simple lawsuits are that the form of conciliation is not regulated and the overlapping role of the Judge as examiner of cases and as a facilitator/mediator. Therefore a legal Reconstruction is needed in Article 14 letter (b) PERMA Number 2 of 2015 where Judges are no longer required to play an active role but Judges seek peace through negotiations and oblige the parties to negotiate during the first trial and report the results to the examining Judge of the case to realize justice for the parties.

The aim of this research is to analyze and reconstruct the regulations on the role of Notaries in making will deeds without appointing an heir of the will in the midst of a pluralistic inheritance system in Indonesia using a constructivism paradigm, through direct interviews with informants empirically supported with studies literature through theoretical steps. Research Result shows that the weakness started from the kinship system in marriage in Indonesia which is the parental or bilateral kinship system where a child legally inherits from his father's and mother's lineage, the matrilineal system where a child legally inherits from his mother's lineage only, the kinship system patrilineal where a child legally inherits from his father's lineage only. This causes some residents to adhere to other laws such as Islamic inheritance law, and to some, the various customary law. Therefore It is not uncommon for there to be contradictions in inheritance law, especially between inheritance through a will and the inheritance system adopted by the heir. Therefore the legal reconstruction due to the pluralism of inheritance law in Indonesia is in the form where the procedures for making wills for each population group must be added to article 16 number (1) letters i and j of the Notary Position Law. based on the value of justice for both heirs, notaries, and parties related to wills, this should be done through harmonization of the legal system between population groups in Indonesia so as to provide beneficial values for heirs, heirs, and society in general.

Background: Polycystic ovary syndrome (PCOS) is one of the most common female endocrine disorders affecting the reproductive age group and is thought to be one of the leading cause of female infertility. Many patients with polycystic ovary syndrome (PCOS) also have features of the metabolic syndrome, including insulin resistance, obesity, and dyslipidemia. Vitamin D affects insulin and glucose metabolism, and a low vitamin D status maybe a risk factor for PCOS. Aim: To determine vitamin D status among the obese adolescent with Polycystic Ovary Syndrome (PCOS) and to compare the vitamin D level among obese and nonobese adolescent with PCOS. Methods: This cross sectional study was done at the out-patient department of Obstetrics and Gynecology in Bangabandhu Sheikh Mujib Medical University (BSMMU) during November 2017 to October 2018 but the patients enrollment was started after 16 July 2018. The study comprises of 80 adolescent girls diagnosed as PCOS according to Rotterdam criteria, in the age range of 9 to 18 years, out of which 50 obese adolescent girls was considered as group I and 30 non obese adolescent girls was considered as group II. The biochemical parameters measured in the study includes fasting blood sugar, fasting insulin level and serum 25-hydroxy vitamin D level. Serum 25 (OH) D level less than 20 ng/ml was classified as vitamin D deficiency. Results: In this study it was observed that maximum patients were vitamin D deficient in both groups. In group I, 76% and in group II, 60% were vitamin D deficient. Again in group I, 14% and 33.3% in group II were vitamin D insufficient. Only 10% in group I and 6.7% in group II were found to have sufficient level of vitamin D. The mean Vitamin D was found 18.25±5.51 ng/ml in group I and 19.66±5.21 ng/ml in group II. The mean difference of vitamin D level between two groups was statistically not significant. There is a negative significant correlation between vitamin D and BMI which indicates level of vitamin D decreases with increase of BMI of the participants. Conclusion: Vitamin D deficiency was predominant in both groups. Though the difference of vitamin D level was not significant between two groups but the mean level of vitamin D is lower in group I than in group II. There is a negative significant correlation between vitamin D and BMI which indicates that higher BMI levels were associated with lower vitamin D levels.

Introduction: Recurrent early spontaneous pregnancy loss is the most common negative outcome of pregnancy and identification of modifiable risk factors is potentially of great importance for public health. The immunological factors may play a role in failure of pregnancy in women with recurrent pregnancy loss. The role of this vitamin D has also been proved in the immune system. Aim of the Study: This study aim to determine serum vitamin D status among women with recurrent early spontaneous pregnancy loss and to compare the vitamin D level among them with healthy pregnant women. Methods: This cross sectional comparative study was done at the out patient department of obstetrics and Gynecology in Bangabandhu Sheikh Mujib Medical University during September 2018 to August 2019. The study comprises of 70 women carrying singleton fetus, gestational age between 8 to 12 weeks, in the age range of 18 to 35 years. The respondents were divided into two groups, 35 pregnant women in their early pregnancy loss with previous history of two or more early spontaneous pregnancy loss were considered as group I and 35 women in their early live pregnancy with previous history of one or more successful pregnancy and no history of any pregnancy loss were considered as group II. Fasting serum vitamin D level was measure by CMIA. Results: This study found that most the respondents were vitamin D deficient in both groups. In group I 17(48.6%) and in group II 10(28.6%) were vitamin D severe deficient. Again in group I 18(51.4%) and 24(68.6%) in group II were vitamin D deficient. The mean vitamin D level was 9.90±2.28 ng/ml in group I and 11.43±3.96 ng/ml in group II. The differences was statistically not significant (P>0.05) between two groups. There is a negative correlation (r-0.235; p 0.175) between serum vitamin D level and number of pregnancy loss. Which indicate increase number of pregnancy loss associated with decrease level of vitamin D. Conclusion: Vitamin D deficient in both groups, however the vitamin D level was comparatively low in women with recurrent early spontaneous pregnancy loss but the differences was not significant between two groups.

The development of the financing leasing system in China has been relatively slow. This paper primarily introduces the regulations on the financing leasing system by Article 388 of the Chinese Civil Code and related clauses. It addresses the characterization of ownership or security rights, as well as regulations on priority of rights, defective security responsibility, liability for damage to others, maintenance obligations, risk of destruction or loss, public notice, breach remedies, and right enforcement. Furthermore, this paper highlights the differences in regulatory frameworks for movable and immovable property financing leasing in China. Chinese law does not explicitly address issues related to immovable property financing leasing, as it focuses on the functionality of guarantees for movable property and rights due to the clear ownership registration authorities for immovable property, eliminating the issue of "hidden guarantees." Article 65 of the Interpretation of the Civil Code provides comprehensive regulations on the functionalization of financing leasing guarantees.

Introduction: Physical activity has been traditionally defined as any bodily movement produced by contraction of skeletal muscle that substantially increases energy expenditure, although the intensity and duration can vary substantially. Lack of physical activity is known to be one of the most important risk factors for leading to morbidity and mortality around the world leading to an estimated 3.2 million deaths globally. Objectives: To assess perception about less physical activity and its effect among service holders in Dhaka city of Bangladesh. Methods: The study was conducted in Civil Aviation Authority of Bangladesh, Kurmitola; Janata Bank Limited, Satmasjid Road Branch; Rayerbazar Government Primary School, Rayerbazar and six gyms (training centers) of Dhaka, Bangladesh. A total of 15 government workers and 15 key informants purposefully (trainers of physical activities) selected for in-depth interview. Socio-demographic data were entered into SPSS version 21. Thematic area were identified and analyzed based on the themes. Result: Total 30 study participants (15 Government office worker and 15 Key Informant) were interviewed. All participants have good perception of physical activities. 7 of workers are moderately physically active (fulfill globally recommended physical activity rate) with 150 minutes of physical activity performance per week. The rest 3 workers have insufficient physical activities which is less than 150 minutes of physical activity per week. Factor like laziness, overloaded by office work, lack of self-confidence in doing physical activity, lack of awareness about physical activity, place factor, poor time management, lack of communication and economic status of workers were found as behaviors or factors affecting doing of physical activities among government office workers. Conclusion and recommendations: There is high number of physical activity insufficiency among workers and there are large numbers of factors that affect physical activity doing of workers. Therefore, the government should work on these factors to make worker healthy and productive.

Antenatal is an important process that every pregnant woman must experience or undergo, either through church, traditional or hospitals after their missed period to ensure a safe delivery. It is a crucial period during pregnancy, because its identify pregnancy that are at risk and also to enlighten expectant mothers with good information that will keep them healthy and eat good food and also to carryout basic investigations and provide routine drugs. The aim of this study is to evaluate the Choice of Antenatal Among Women In Rural Areas Of South-South, Nigeria. The study was a cross-sectional study and a total of 260 female students within participated in the study. A well-structured questionnaire was distributed to each participant by the research assistant after consent was granted by the participants. The study was carried out in the six States that make up South-South Geopolitical Zones and it lasted for a period of 4 months. The findings revealed that 38.50% of the participants are between the 28-32 years of age. Also, 42.20% of the participants had primary education, 38.50% had secondary education while 19.20% had tertiary education. The research showed that 57.70% of the participants were farmers, 31.20% traders, 7.70% civil servants, and 3.50% were students. The study revealed that, 61.50% of the participants were married, 11.50% single, while 26.90% were divorced. 73.10% of the participants agreed that they were pregnant and 26.90% agreed that there were not pregnant. The findings revealed that 73.06% of the participants have choice of antennal and 26.92 did not. Reasons for choice of antenatal were comfortable (7.70%), stress less (7.70%), cheap (15.40%), accessible (38.50%), available (7.70%) and it was both spiritual and medicinal (23.10%). Again, the research revealed that 73.10% of the participants did not registered for antenatal and 92.30% said no health centre in their community. The data were analysed using SPSS version 23 and P < 0.05 was said to be significant.

Malignant transformation in a mature cystic teratoma of the ovary is rare, occurring in only 1-2% of cases, with squamous cell carcinoma consisting of about 75% of malignant transformations. Various genomic alterations take part in this pathogenesis but due to its rare incidence, not many cases have been reported in respect to this transformation. Hence, we describe a rare case of 45-year-old female with a 7.5 cm ovarian mature teratoma with an incidental finding of squamous cell carcinoma. With this case report, we also wish to create an awareness of this entity among pathologists and physicians while dealing with dermoid cysts of large sizes in older patients.

The sole hilly region in Bangladesh is known as the Chattogram Hill Tracts (CHT), which is comprised of the three hill districts of Khagrachari, Rangamati, and Bandarban. Due to population dynamics, economic development, climatic change, improved accessibility, and agricultural developments, land usage is changing at an increasingly rapid rate in the CHT. This research was carried out in Khagrachari Sadar upazila in the Khagrachari district of Bangladesh. This study looked at how farmers perceive changes in land use patterns and the factors that influence such perceptions. A total of 180 households were sampled using the proportional random sampling technique, and the survey was conducted using a previously created, closed-ended questionnaire. The average land ownership of the farmers was 4.22 acre, although the average agricultural and forest land holding was 1.37 acre and 1.54 acre, respectively. Although, the farmers also possessed considerable amount of vegetable land and flat land also and these lands were utilized to produce different types of vegetables, crops, fruit and timber trees. Average age of the farmers was 49.75 years and 32% of them did not receive any formal education. About 62% of them did not take part any agriculture related training program. Although, 95% of the farmers had medium to poor perception on land use pattern change. Moreover, many farmers perceived that currently overall soil fertility status of the hilly land had been decreased compared to 10 years back. In addition, out of thirteen attributes, four attributes, namely, educational attainment, family annula income, agricultural training received and agricultural land ownership had significant influence on the perception of land use pattern change by the respondents. The findings from the research can be used by the nation's decision-makers and planners to create future CHT land allocation policies.

Background: Oral cavity bacteria can be mostly harmful if inhaled into the lungs. Hospital acquired pneumonia (HAP), a critical condition that presents clinically two or more days after hospitalization, which may increase the risk of mortality. Lacking oral care can lead to Hospital acquired pneumonia. Objective: to explore effective oral care consequence on hospital acquired pneumonia prevention. Methods: This review article is performed according to the PRISMA guidelines. The literature exploration was done in Google Scholar and PubMed databases for articles published between 2017 and 2020. The search words were “oral care, oral hygiene, intensive care, critical care, ICU, respiratory infection, lung infection, pneumonia, and adult". Results: A total of 6 studies were included, the studies were randomized controlled trials (RCTs) and observational studies. Oral care with tooth brushing and purified water twice daily can significantly reduce the incidence of HAP. Brushing patient mouth with chlorhexidine is also effective in decreasing the HAP incidence. Implementing oral care protocols in ICU with chlorhexidine solution and nurse education can significantly lower the incidence of HAP. Conclusions: Good oral and dental care, particularly with tooth brushing and purified water twice daily, can significantly reduce the incidence of HAP in intensive care unit patients.

Lipids are indispensable in the SARS-CoV-2 infection process and studies have focused on investigating the clinical significance of plasma lipid profile on COVID-19 patients. There are studies in patients with COVID-19 that document that blood lipid levels change in individuals who have been infected by SARS-CoV-2 and that their increase is consistent with the degree of morbidity and mortality. At the same time, it has been measured that during the complete recovery of the patients there is also a complete normalization of the lipid profiles. Furthermore, it has been reported that a large proportion of COVID-19 patients continue to receive lipid-lowering therapy after recovery. Lipid-lowering medication is generally continued throughout the period of active infection and beyond. The present review focuses on investigating the relationship between low-density lipoproteins (LDL) and SARS-CoV-2 infection and how lipid levels can predict prognosis or mortality in patients with COVID-19.

Scoliosis, also known as lateral curvature of the spine or spinal lateral deviation, is a three-dimensional spinal deformity characterized by the bending of one or multiple segments of the spine to the side accompanied by vertebral rotation. It appears in the shape of an "S" or "C" and can cause pain during standing, walking, or lifting heavy objects, leading to a reduction in physical activity. Scoliosis is the most common spinal disorder among children and adolescents. Adolescent Idiopathic Scoliosis (AIS) refers to scoliosis that occurs during the teenage years and its etiology remains unclear. AIS is a spinal condition characterized by a three-dimensional deformity in the coronal, sagittal, and axial planes, with a Cobb angle of 10 degrees or more. The global prevalence of AIS ranges from 0.47% to 5.2% (Erwin et al., 2020; Konieczny et al., 2013). According to a study by Qiu Guixing et al., the prevalence of scoliosis in China is estimated to be approximately 0.6% to 2.0%, with 90% of cases being AIS. Jia Juanjuan et al., conducted a scoliosis screening of 8,026 students in Jiaxing City in 2019, with initial screening identifying 218 positive cases. Among them, 132 cases were confirmed through X-ray examination, estimating a scoliosis prevalence rate of 5.46% among primary and secondary school students in Jiaxing City. Chen Xiaosheng, Ru Shouhang et al., conducted a scoliosis survey among students from the fourth grade of primary school to the second grade of high school in various districts of Shenzhen City from January to December 2020, with the results showing a scoliosis prevalence rate of 5.01% among primary and secondary school students in Shenzhen City. The prevalence rate was higher in females than males and increased with age. If scoliosis in adolescents is not promptly and effectively treated during their growth process, the spinal deformity can rapidly progress and lead to various complications. For example, scoliosis can cause changes in the shape of the ribs, resulting in unequal thoracic cavity volume and breathing difficulties. Prolonged restricted breathing can lead to complications such as chest tightness and shortness of breath. Additionally, scoliosis can affect the functioning of abdominal organs, leading to pulmonary dysfunction and hypoxia, and in severe cases, it can cause cardiorespiratory failure. Furthermore, scoliosis not only affects the physical health of patients but also their mental well-being. The physical appearance changes caused by scoliosis deformity can potentially lead to psychological disorders.

Background: Numerous obligatory intracellular bacteria from the Alphaproteobacteria genus Rickettsia can cause rickettsial infection. The most prevalent newly emerging and reemerging diseases are rickettsial infections. Objectives: The aim of the study was diagnosis and management of rickettsial infections among febrile patients attending in inpatient and outpatient department in a district hospital in Bangladesh. Methods: This cross-section observational study was carried out in the 250 Beded District Hospital, Joypurhat. The duration of the period from March 2022 to February 2023. A total of 250 patients participated in the study. Both male and female with any age, patients with elevated body temperature, headache, malaise, rash, nausea, and vomiting and gave consent to be included in the study. Severely ill patients, not willing to participate were excluded from the study. Weil Felix test was used in this study and a titre of 1:80 was considered to be positive. Statistical evaluation of the results used to be obtained via the use of a window-based computer software program devised with Statistical Packages for Social Sciences (SPSS-24). Results: The mean age of the patients was 39 ± 1.9. 8% of the patients had ≤18 years of age. 16% were within the age group of 19-29 years, 28% were within the age group of 30-39 years, 24% were within the age group of 40-49 years, 14.4% were within the age group of 50-59 years and 9.6% were ≥60 years and 52% of the patients were male. 100% of the respondents had fever, 20% had generalized weakness, 15.2% had headache, 16% had cough and cold, 24% had body ache, 8% had vomiting and abdominal pain respectively, 4% had per nasal watery discharge, 36% had rash, 16% had nausea, 24% had anorexia and 4% had other symptoms. CBC & ESR and Weil Felix test were the most common (100%) investigation among the patients, Urine R/M/E in 68%, serum creatinine in 18%, USG of W/A in 15%, CRP in 18%, PBF in 7, Urine C/S in 10%, S. Electrolytes in 4% cases. We found 90 Rickettsial Infection positive patients. Doxycycline and Paracetamol and Esomeprazole were prescribed to all patients 90(100%) and followed by Linagliptin+Metformin to 20(22.22%), Glimipiride to 19(21.11%), Azithromycin to 18(20%) and Domperidon to 10(1.11%), Montelukast 9 (10%), Pantoprazole to 8(8.89%), Rupatadine to 7(7.77%), Ondansetron to 6(6.67%), Tiemonium to 5 5.57%), Fexofenadin to4(4.44%) and other treatment along with the prescribed medicines was given to 40(44.44%) patients. Authors studied the response of Doxycycline which showed 85(94.44%) cases improved within 48 hours of start of treatment. Remaining 5(5.55%) cases showed delayed response due to late presentation. Conclusion: Rickettsial illness is inextricably linked to the sociocultural life of the majority of metropolitan residents. However, a lack of medical facilities and qualified doctors makes it challenging to identify rickettsial disease in febrile patients. It's important to make an early diagnosis when treating rickettsial illness.

Despite the fact that the World Health Organization (WHO) had provided an average global reference data of Coagulation Properties (CP) of blood in the world, available statistics still suggest a significant discrepancy in CPs of blood among various age groups, socioeconomic classes and races in different locations of the world. Here in Port Harcourt Nigeria, absence of such local reference data had continued to pose over-reliance on the WHO global standards without recourse to our distinctive geospatial and socioeconomic peculiarities. As a result, this study therefore investigated coagulation properties of blood in healthy university students in Port Harcourt. A total of 157 participants were recruited into the study using Stratified Random Sampling techniques. They were administered well-structured questionnaires for an on-the-spot data collections. Thereafter, 5ml of venous blood were aspirated for various coagulation properties (Bleeding, clotting and Prothrombin times and Platelets Counts) investigation. Clotting and bleeding times were measured instantly using capillary and Ivy’s methods respectively. Results from the study revealed a significant (ρ≤0.05) coagulation difference between the WHO standards and both gender (male, 311032 ± 17300* and female, 293600 ± 12800*) for platelets counts. In the age groups, only ≥40 group were significant to all CP (10.30 ± 0.00* for BT, 10.00 ± 1.30* for CT, 10.22 ± 2.88* for PT and 190320.73 ± 1886.45* for PC). Similar significant result was also noted for Obese Class 2, morbid obesity and protein diet groups as compared with the Control. This study therefore concluded that CP significantly vary with the WHO standards, age, gender, BMI and nutritional background and recommended similar study be conducted in other locations in Nigeria and Africa.