Background: The occurrence of metastatic colon lesions in various organs has been documented extensively in the literature. The liver, lungs, and bones are the most frequently affected sites. Metastasis in the duodenum due to colon cancer is an infrequent occurrence. Case Presentation: We present a detailed case report of a 65-year-old female patient diagnosed with metastatic colon cancer to the duodenum. The patient initially underwent extended right hemicolectomy for stage III low-grade adenocarcinoma of the colon. Adjuvant chemotherapy was administered, resulting in a period of apparent remission. However, in 2020, the patient experienced elevated tumor marker levels, prompting further investigations. Endoscopy revealed an irregular mass infiltrating the muscle layer in the duodenum, confirming malignant involvement. The patient underwent curative distal gastric duodenectomy, with pathology results indicating a colonic origin of the tumor. The patient received first-line palliative chemotherapy with FOLFOX rechallenge and the addition of AVASTIN. Several cycles of chemotherapy were completed, with satisfactory tumor response observed in follow-up PET scans. Maintenance therapy was initiated after achieving disease-free status on CT scans. However, in October 2022, the patient exhibited increasing tumor marker levels and new findings on PET scan, leading to the initiation of second-line palliative therapy with FOLFIRI and ramucirumab. The patient has received multiple cycles of second-line therapy, with the most recent PET scan in February 2023 showing a favorable treatment response, including a decrease in the size of existing nodes and no identification of new lesions. Conclusion: In conclusion, this case exemplifies the journey of a patient with stage 3 colon cancer who initially responded well to surgery and adjuvant chemotherapy, but experienced subsequent relapse in the duodenum. Despite surgical intervention and palliative chemotherapy, the patient developed metastasis in the liver, lung, and multiple lymph nodes.

Aims: The World Health Organisation defines self-medication as the act of selection and use of medicine by individuals to treat self-recognized illnesses and symptoms or by health professionals to use drugs not prescribed by the treating physician. WHO has reported a prevalence of self-medication of 32.5% to 81.5% worldwide. In Cameroon a prevalence of 67,8%, and 41,9% has been reported in some studies. This study sought to assess the socio-demographic characteristics, prevalence, associated risk factors and the common medications of self-medication at the Bonassama and Cite des Palmiers Health Districts of Douala, Cameroon. Place and duration of the study: the study was conducted from December 2022 to May 2023 in two health districts in Douala, Bonassama and Cite des Palmiers. Methodology: It was a descriptive and analytic cross-sectional study. Sociodemographic, reasons for self-medication, class of medications commonly self-medicated data was collected. Descriptive statistics, univariate and multivariate analyses will be made by Chi square and Fisher’s exact test and reported as odd ratios, adjusted odd ratios and 95% confidence intervals. Statistical significance was set at p<0.05. Results: 83% of participants carried out the practice of self-medication. One of the major reasons for self-medicate was the fact that they thought that the illness was not serious with a prevalence of 46,6%, followed by cost saving (33,2%). The most common disease treated by self-medication was headache (81,5%), and the most represented class of drug were analgesics (84,7%); drugs were bought in community pharmacies (64,7%) and illicit market (44,9%). The statistically significant reasons for self-medication were cost saving, convenience, not serious illness, prior experience, long wait times in hospitals and accessibility of pharmacies. Conclusion: Self-medication is a widespread practice throughout the world, particularly in developing countries. This study has illuminated the prevalence and causes of self-medication in our environment. The prevalence of self-medication is high due to several factors and arguments, including cost saving, convenience, illness was not serious, prior experience, long wait times at hospitals, and availability of pharmacies.

Background: Ankylosing spondylitis can lead to heart disease, including aortic incompetence, conduction defects, mitral valve disease, cardiomyopathy, and pericarditis. Early detection of cardiac abnormalities is crucial for effective treatment and prognosis, as they increase with age, disease duration, and peripheral arthritis presence. Objectives: This study aimed to determine the type, prevalence, and extent of cardiac involvement in patients diagnosed with ankylosing spondylitis. Methods: The study were collected in the Department of Medicine and Rheumatology units of Bangabandhu Sheikh Mujib Medical University and Dhaka Medical College Hospital from January 2022 to December 2022. Diagnosis was established based on clinical features, physical examinations, and relevant laboratory and imaging studies. Patients with a history of rheumatic fever, syphilis, or those who declined participation were excluded from the study. Results: A total of 80 patients with ankylosing spondylitis underwent clinical examination, electrocardiography, and echocardiography to assess cardiac involvement. Among the participants, eight patients (10%) were found to have aortic insufficiency. Two patients had both aortic insufficiency and first-degree heart block, one had only first-degree heart block, and one had mitral insufficiency. Presents the cardiovascular manifestations detected in 12 patients (14%) with ankylosing spondylitis. Peripheral arthritis was present in 64% of the 12 patients with cardiovascular lesions, compared to only 34% of the 68 patients without such lesions. Conclusion: This hospital-based observational study investigated cardiac involvement in ankylosing spondylitis patients. Due to the small sample size, definitive conclusions were difficult to make, but the findings suggest that cardiac involvement is relatively common, emphasizing the need for early detection of cardiac abnormalities for effective treatment and prognosis.

Estimation and investigation of an earth’s albedo is significant in the evaluation and design of solar energy collectors, atmospheric radiative transfer and studies that relates to atmospheric thermal balance. This study employed the shortwave solar energy balancing at the edge of the Earth’s atmosphere to estimate and compare the variation of albedo for Nguru situated in the Sahelian region of Nigeria, using measured monthly mean daily meteorological parameter of global solar radiation obtained from the National Aeronautics and Space Administration (NASA) during the period of thirty-eight years (1984 – 2021). The variation of albedo with surface temperature, maximum wavelength, clearness index, global solar radiation, relative humidity and mean temperature for this location was investigated. The results in this study show that the estimated surface albedo depicts a direct opposite relationship with the clearness index, an inverse relationship with the emitting Earth’s surface temperature and a direct relationship with the wavelength for the studied location. The highest and lowest values of albedo for the location was in the months of August and January with 0.4628 and 0.3403 respectively. The emitting Earth surface temperature ranged between 238.5837 K in August and 251.1607 K in January. These values agreed closely to the standard emitting Earth surface temperature value (255.0000 K). The maximum emitting wavelength values for the location revealed that the radiation is longwave and is found within the infrared region of the electromagnetic spectrum.

Marjolin ulcer is a rare malignancy that arises in previously traumatised or chronically inflamed skin, particularly after burns, with an average latency period of 36 years. Nearly 75-90% marjolin ulcers are diagnosed as squamous cell carcinoma but other neoplasms like basal cell carcinoma, melanoma, fibrosarcoma etc have also been rarely reported. In this case, a 52-year-old male presented with a painless bleeding mass over lower chest wall rapidly increasing in size from last 2 years. He had suffered burn at the same site 20 years ago. Biopsy was reported as spindle cell neoplasm. Wide local excision revealed a poorly circumscribed subcutaneous spindle cell neoplasm exhibiting variable cellularity, fascicular to storiform architecture, mild to moderate nuclear atypia and scattered gaping thin-walled blood vessels. The neoplastic cells showed diffuse strong staining with CD34 in the less cellular area and patchy positivity in the cellular more mitotically active areas. The tumor cells were immunonegative for EMA, p63, SMA, CD99 and STAT6. The final diagnosis rendered was Dermatofibrosarcoma Protuberans dedifferentiating in to fibrosarcoma. Although sarcoma presenting as a Marjolin ulcer is exceedingly rare, it should be kept in mind in differential diagnosis of spindle cell malignancy arising at a burn site.

In this paper, the monthly variation of Surface Water Vapour Density (SWVD) with meteorological parameters of monthly average daily mean temperature, relative humidity, surface pressure, cloud cover and sunshine hours during the period of thirty-eight (38) years (1979 - 2016) for Akure (Latitude 7.280N, Longitude 5.300E, 375m above sea level) were investigated. The daily variation of surface water vapour density for the two distinct seasons considering two typical months in each during the period of year 2014 was examined. The results showed fluctuation in the amount of surface water vapour density in each day of the month for the period under investigation. The monthly average daily values indicated that the surface water vapour densities are greater during the rainy season than in the dry season. It was observed that the maximum average value of surface water vapour density of 20.1019 gm-3 occurred in the month of September during the rainy season and minimum value of 15.5110 gm-3 in the month of January during the dry season. The highest value of surface water vapour density was observed on the 4th of June, 2014 with 26.3320 gm-3 and the lowest on the 31st day of December, 2014 with 6.0276 gm-3. The comparison assessment of the developed two variable SWVD based models was carried out using statistical indices of coefficient of determination (R2), Mean Bias Error (MBE), Root Mean Square Error (RMSE), Mean Percentage Error (MPE), Nash – Sutcliffe Equation (NSE) and Index of Agreement (IA). The developed multivariate correlation regression model that relates pressure and precipitable water vapour with R2 = 100%, MBE = -0.0177, RMSE = 0.0179, MPE = 0.1034, NSE = 99.9956% and IA = 99.9989% was found more suitable for surface water vapour density estimation with good fitting and therefore can be used for estimating surface water vapour density in Akure.

Autotransplantation of a maxillary premolar tooth is a considerable option for tooth replacement in young adult patients, while Hemisection is a conservative way of preserving teeth. In this case report, we describe successful autotransplantation of the mesial root of the mandibular molar to replace the first maxillary premolar with complete root formation. The donor root was immediately placed at the recipient site and splinted for 14 days. Root canal treatment (RCT) was initiated 3 weeks after transplantation. Clinical and radiographic findings at 24 months of follow-up are compared with the results described in the literature. In case of non-extraction, adjacent teeth can be preserved in an economical way, also, case selection is essential in performing sequences of procedures for the success of treatment.

Colorectal carcinomas (CRC) are associated with several histopathological and molecular factors of prognostic and hence therapeutic implications, including for epithelial mesenchymal transition (EMT) and angiogenesis. Downregulation of E-cadherin is a crucial step in EMT, directly related to tumor progression, invasion, and metastasis. Vascular endothelial growth factor (VEGF) induces angiogenesis and thereby tumour progression and metastases. Our objective was to analyse VEGF and E-cadherin expression in patients with CRC and to effectively assess the relationship of these with histopathological factors. 50 cases of CRC obtained over eighteen months duration, were included in the study. Haematoxylin and Eosin-stained sections were studied for histopathological factors. Immunohistochemistry with E-Cadherin and VEGF were performed on representative sections and evaluated. Histopathological features of importance noted were low grade tumour budding (55.5%), Infiltrative invasive front (83%), lympho-vascular invasion (50%). Preserved expression of E-Cadherin was seen in 66% of the cases, and 34% reduced expression, predominantly noted in patients above the age of 50, increased tumour size, mucinous variants, advanced TNM stage, lymph node involvement and high-grade tumour budding. VEGF staining was seen in 64% of the cases with varying intensity. Increased VEGF expression was noted in poorly differentiated tumours, advanced Duke’s stage and with lymph node metastasis. Colorectal carcinomas with high grade tumour budding were associated with lymph vascular invasion, infiltrative invasive front and significantly correlated with TNM stage. High grade tumours and adverse histopathological prognostic factors revealed a reduced E-cadherin expression and increased VEGF expression.

Vasculitis may be due to various causes, including connective tissue disorders, medications, and infections. Histopathology shows similar features in different diseases so DIF (direct immunofluorescence) helps to categorize these vasculitic lesions on basis of positivity of different immunoglobulins. In this study, 40 cases of suspected vasculitis were confirmed by histopathology. Females were more commonly affected and the age range was from 9 to 71 years. Among these cases, 21 were immune complex mediated vasculitis of which c3 and IgG were the most commonly found immunoglobulins. Two of these cases were IgA mediated vasculitis. DIF was of great importance for the diagnosis of the disease for appropriate treatment.

Background: Bolton’s ratio is a useful tool in orthodontic studies which helps determine the ratio of dental proportions. It is considered the 7th key to normal occlusion. Variations in different malocclusions can aid in diagnosis and planning the treatment. This study determines Bolton’s overall and anterior ratios for male individuals with different classes of malocclusion in the western region of Saudi Arabia. Methods: Ninety-six study model records were obtained from male patients attending the Orthodontic division of Preventive Dentistry, Faculty of Dentistry at Taif University, Saudi Arabia. The participants’ average age was 19.6 years. The study models were divided into three categories: Angle’s Class 1 (n=40), Angle’s Class 2 (n=36), and Angle’s Class 3 (n=20). To prevent bias, one of the authors measured the study casts using the ORTHOASSISTANT software program at two different time intervals. Intergroup differences were analyzed using one-way ANOVA. Results were considered statistically significant if the p-value of ≤ 0.05. Results: No statistically significant difference was observed in the overall ratio between the three types of malocclusions. However, class 2 and 3 malocclusions demonstrated significant differences in the anterior ratio. Both overall and anterior ratios in this population were higher than normal Bolton’s ratios. Conclusions: Bolton’s overall ratio did not differ significantly between various malocclusions, but Bolton’s anterior ratio did show significant differences between Class 2 and Class 3 malocclusion groups. This highlights the importance of orthodontists’ appropriate diagnosis and treatment planning in such cases.

This article examines the use of oral antidiabetic agents in the treatment of heart failure. Heart failure is a serious condition that is often associated with diabetes mellitus, which worsens the prognosis for patients. Oral antidiabetic agents, such as SGLT2 inhibitors and GLP-1 receptor agonists, have recently gained increasing interest due to their potential beneficial effects on cardiac function. Clinical studies have shown that these medications reduce cardiovascular morbidity and mortality, decrease hospitalizations for heart failure, and improve cardiac function in patients with heart failure, whether they are diabetic or not. The mechanisms of action of these medications include blood pressure reduction, improvement in endothelial function, modulation of cardiac energy metabolism, and reduction of oxidative stress and inflammation. While these findings are promising, further research is needed to better understand the long-term effectiveness and optimization of the use of these medications in the context of heart failure.

This study aims to test and determine the effect of taxation knowledge, taxpayer morals, and taxpayer awareness on taxpayer compliance in MSMEs in DKI Jakarta which is moderated by tax sanctions. This research is quantitative research. The research population is MSME players in DKI Jakarta. The sample used in this study were taxpayers in DKI Jakarta with a total of 106 respondents. This study uses SmartPLS4 software version 4.0.9.4 with the aim of testing hypotheses. The results obtained in this study are: First, the influence of taxation has no significant effect on taxpayer compliance. Second, taxpayer morale has no significant effect on taxpayer compliance. Third, taxpayer awareness has a significant effect on taxpayer compliance. Fourth, tax sanctions have a significant effect on taxpayer compliance. Fifth, the effect of tax knowledge on taxpayer compliance has no significant effect on moderation of tax sanctions. The sixth effect of taxpayer morale on taxpayer compliance has no significant effect on moderating tax sanctions. Seventh, the effect of taxpayer awareness on taxpayer compliance has no significant effect on moderating tax sanctions.

The recent changes in our dietary habits & lifestyle have welcomed a huge number of metabolic diseases. Most common being the fatty liver and the liver cirrhosis. People who are obese or consume alcohol on the daily basis are more prone to hepatic diseases. But there is a change in the trend, Non-alcoholic fatty liver disease has come into limelight due to our changes in dietary habits and the unseen toxicity that our liver is exposed on daily basis. Prataha-Kalik Yoga mentioned in the Pandu Roga by Acharya’s can be effective as a therapeutic option for liver. After analysis of its Rasapanchak, with the dominance of Tikta and Kashya Rasa it seems to be a promising Yoga. A review study has been done to know the hepatoprotective activity of Prataha-Kalik Yoga.

Objective: The objective of this work is to list the surgeries using the fascia lata. Background: The fascia lata finds a place in decayed tissues. The indications are getting wider and wider. Method: We used the PubMed database with the following words: fascia lata, ilio-tibial band, fascia lata and surgery, ilio-tibial band and surgery, fascia lata and reconstruction, ilio-tibial band and reconstruction. Results: Fascia lata is used in the reconstruction of anatomical defects. Specifically, it is used in: Hip to supplement abduction- Shoulder in glenohumeral instability, repair of the cap- Hand and fingers to reconstruct tendons- Eyes: for palpebral ptosis and scleritis - Base of the skull to reconstruct defects- Central nervous system: cerebral dura mater and Cerebrospinal Fluid leak- Otorhinolaryngology: thyroplasty, parotid surgery, rhinoplasty, tympanoplasty- Digestive tract- Tendons: Achilles, patellar, fibular, patellar, patellar, bicipital brachial and crural tendons - Ligaments: anterior cruciate ligament reconstruction, inguinal and retinaculum patellar - Perineum and penis reconstruction - Urology: Genital prolapse, fistulas and penile reconstruction - Abdominal incisional hernias - Breast reconstruction - Eschar - Thorax - Encology. Finally, in experimentation, the fascia lata is tested on cadavers, animals and in vitro. Conclusion: Because of the particular properties of fascia lata in reconstruction, it renders an enormous service to surgery. The development of techniques in surgery would allow its use in other indications.

This study aims to determine the effect of OSH work programs, factors that cause work accidents and their learning, culture or work climate, and OSH competencies on safety performance. The populations of this study were employees of PT XYZ which is one of the state-owned construction companies in Indonesia, with a total sample of 110 respondents. The data collection method uses a survey method, with the research instrument being a questionnaire. The data analysis method uses the Structural Equation Model-Partial Least Square (SEM-PLS). The results of the study found that the OSH work program, factors causing work accidents and learning, culture or work climate, and OSH competencies have a positive and significant impact on safety performance. This can be concluded, the better the HSE work program, the factors that cause work accidents and their learning, the culture or work climate, and the HSE competencies implemented, the better the company's safety performance will be.