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.

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.

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.

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.

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.

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.

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.

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.

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.

Nursing leaders play a critical role in guiding and directing nursing staff to guarantee high-quality healthcare delivery. The impact of nursing leadership on patient outcomes, quality of care, patient safety, collaboration with other healthcare professionals, and professional growth and mentoring is critically examined in this manuscript. The analysis highlights that nursing leadership had a significant impact on patient outcomes by encouraging evidence-based practices and increasing nursing staff engagement and job satisfaction. Furthermore, nursing leaders that prioritize patient satisfaction and hospital readmissions. Nursing leaders develop a culture of safety, enforce adherence to safety regulations, and support continual progress in terms of patient safety. Collaboration with other healthcare professionals is essential for nursing leaders to improve healthcare delivery, care coordination, and patient outcomes. Nursing leaders are also responsible for offering professional development opportunities and mentoring to nursing personnel, which improves staff engagement and retention. Regardless of the beneficial impact, nursing leaders confront problems such as insufficient personnel, restricted resources, and insufficient support from organizational leaders. It is the role of the leadership to mitigate risks and opportunities for safe patient care.

The research is dedicated to investigating the sociocultural characteristics of digitalization. The Digital Age has a great impact on the formation of individuals’ moral consciousness, and the main trends of digitalization and modern social development are examined in this work. The peculiarities of the influence of information and communication technologies on the formation of the value system of individuals are analyzed. The authors consider digitalization in the context of the formation of the world’s digital image and a digital individual. The problem of comprehension of digitalization processes in science and philosophy is presented. An examination of concepts such as “digitalization”, “information society”, and “social network” is carried out. The relevance of the topic is due to the fact that digitization and, by extension, informatization, are developing and significantly expanding the horizons of global scientific, technical, and socio-economic progress. Together, these lead to serious interactions between the ultramodern and traditional, the latter being formed over centuries’ of events in institutions and structures, but rapidly transformed in the the world of social communications. With traditional societies increasingly replaced by those which are virtually augmented, additional grounds are created for vast changes in various spheres of public life, in increasingly numerous locations, and sometimes also creating bases for the growth of instability and conflicts. The work aims to show the effect of digitalization on the value system of individuals, especially young people, based on theoretical analysis.The research methodology focuses upon a conceptualization of the phase model of digitalization, the problem of social Internet networks, the theory of the Information Age.

The paper assessed 28 Value Engineering (VE) reports of studies conducted by third party VE consultants on Saudi Aramco capital projects from January 2020 to August 2022. The findings indicate that there is an inverse relationship between accepted number of VE proposals and the size of the workshop review team (the larger the team, the smaller percentage of accepted proposals). It, also, showed that accepted number of VE proposals is not influenced by the duration of VE workshops. The paper recommends the optimization of the size of VE teams and optimized workshop durations to be aligned to Saudi Aramco (SA) capital management system project classifications. The recommendations may result in increasing the number of quality accepted VE proposals while reducing the cost of VE workshops.

Background: One of the most serious complications of diabetes that places an enormous strain on the patient, the healthcare system, and the world economy is diabetic retinopathy (DR). It includes long-term exposure to the metabolic changes linked to diabetes, which cause damage to the retina's microvasculature. Objectives: The aim of the study was to assess the prevalence of diabetic retinopathy and associated risk factors among diabetic patients in a tertiary care hospital. Methods: This cross-section observational study was carried out in the Department of Ophthalmology, North Bengal medical College. Convenience sampling technique was followed. Face to face interview was done to collect data with a semi-structured questionnaire. After collection, the data were checked and cleaned, followed by editing, compiling, coding and categorizing according to the objectives and variable to detect errors and to maintain consistency, relevancy and quality control. 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). The duration of the period from July 2018 to July 2022. A total of 120 patients were participate in the study. Results: About 58.33% respondents were male and 41.67% were female. Majority (33.33%) of the respondents were within the age group of 50-59. 33.33% were service holder, 41.67% were businessman, 12.5 were day labor, 6.67% were farmer. 75% were from urban area and 25% from rural area. The prevalence of DR in this study was 41.1%. About 90% had DM of <5 years, 55% had 6-10 years, 40% had 15-20 Years, 30% had 16-20 years and only 7% had >21 years. About 50% had normal grade of diabetic retinopathy in the worse eye, 15% had Mild NPDR, 8.33% had Moderate NPDR, 6.67% had Mild to moderate NPDR with non-CSME, 2.5% Moderate NPDR with CSME, Severe NPDR with non-CSME Severe NPDR with CSME and Advanced PDR respectively. Mean FBS (mg/dl) was 160.86±70.6, Total cholesterol (mg/dl) was 183.2 ± 2.1, Triglycerides (mg/dl) was 161.2 ± 2.6, Systolic BP was 130.56±15.7 and Diastolic BP was 80.86±13.4. Patients with baseline age of <60 years were three times (AOR = 3.2:95% CI: 1.19–8.63) more likely to develop DR. The odds of DR is about 3 times (AOR = 2.91:95% CI: 1.01–8.35) higher for patients with disease duration of ≥6 years as compared to disease duration of <6 years. Systolic blood pressure also had statistically significant association with patients having blood pressure of <140 mmHg being about 3.6 times (AOR = 0.28:95% CI: 0.09–0.82) less likely to have DR as compared to hypertensive patients with systolic blood pressure of ≥140 mmHg. The other cofactors, history of hypertension, and total cholesterol level were not independent significant factors for the development of DR in our study. Conclusion: Systolic hypertension, being on insulin alone or in combination with OHA, and having diabetes for a longer period of time were all independently linked to the occurrence of DR. The significant DR prevalence our study suggests that routine patient care, including treatment facilities, has to be improved. Healthcare practitioners must make a consistent effort to educate diabetic patients about the importance of blood sugar control and hypertension management in lowering the risk of the start and progression of DR. It is advised that diabetic patients get health education regarding the importance of routine eye exams for the early detection and treatment of diabetes-related eye problems.

A pharmacist in general and community pharmacist in specific is a key member of the “healthcare team” involved in achieving a common objective of better healthcare provision. The emergence of “community pharmacy” during post-world war-II era, with a known motto of “drug control” and “patient oriented practice” (POP) came in to existence. The modern pharmacy practices, are not devoid of obstacles and challenges specifically for “Newbie Community Pharmacist (NCP)”, who comes in to direct patient contact at root level, thus necessitates to strict to standards which will help not only in quality care provision but will enhance the abilities of the pharmacist to cope challenges facing at community level. Herein, we will discuss some of the concerns for NCP and their considerations to deal with.