Introduction: The placenta is an organ that is attached to the uterine wall and connects the fetus with the mother through the umbilical cord. The placenta is said to be retained when it is not expelled out even half an hour after the birth of the baby. The study aimed to evaluate the retention of the placenta. Methods: This was a cross-sectional study was conducted at the Department of Obstetrics & Gynecology , Faridpur Medical College Hospital, Faridpur from June 2016 to November 2016. The sample was taken purposively and the sample size was 110. Patients were diagnosed with a case of 'retained placenta' through proper history, and clinical examination. Written informed consent was taken from every patient or their relatives. The information was collected in a preformed data collection sheet. Observation and results of the study and statistical analysis were presented in tables. Data were analyzed by using the computer-based program Statistical Package for Social Science (SPSS) software for windows. Result: Out of 110 study subjects about 58.18% were found in the age group of 21-30 years and 20% were found in the age group of 20 years. The age of the patients ranges from 18 to 40 years. Among 110 study subjects, 64.55% were from lower socioeconomic status, 27.27% were from middle socioeconomic status and only 8.18% belonged to affluent socioeconomic status. The majority (74.54%) of cases were delivered at home and 25.46% of cases were delivered at different levels of hospitals (among them 1.82% of cases occurred in the institute where the study was done). Among them 20% were para- 1, 54.54% were para-2-4 and 25.46% of respondents were para ≥ 5. The majority (60%) of study subjects were admitted between 3 to 8 hours after developing retained placenta, followed by 18.19% who came within 2 hours. Regarding the clinical presentation, 69.09% of study subjects presented with anemia of varying degrees, 24.53% presented with shock, 5.45% presented with sepsis, and only 0.93% (one patient) presented with acute renal failure. Concerning predisposing factors of retained placenta, 25.46% of study subjects were grand multipara, 11.82% had H/O MR or D & C, 10.90% with prolonged labor, 10.90% respondents had IUD, 10% with past H/O retained placenta, 8.20% had preterm labor, 2.72% had H/O LUCS/ other uterine surgery and 20% were without any predisposing factors. Among the respondents, 27.27% of study subjects presented with genital tract trauma, 5.45% with sepsis, 5.45% with acute renal failure, 0.91% with DIC, 0.91% with uterine prolapse 64.55% with no associated conditions/complications. Among the total study population, 58.18% of retained placenta cases required manual removal under G/A, and 41.82% were managed by manual removal of the placenta under deep sedation. Out of 110 respondents, 21.82% of cases of retained placenta did not require any blood transfusion, 58.18% received 1-2 units and 20% received 3 or more units of blood transfusion. During management, 13.63% of study subjects developed uterine atony, 0.91% developed uterine inversion, 2.73% were complicated by uterine perforation, 0.91% were complicated by anesthetic hazard; 81.82% had no complication during management. Out of 110, 18.18% of study subjects experienced various complications. Among them 9.10% were managed by intrauterine balloon tamponade,2.73% required hysterectomy, and 6.37% were managed by other measures. 70% of respondents stayed in the hospital for 1-3 days, 26.36% for 4 to 7 days, and 3.64% stayed more than 7 days before discharge. Regarding the outcome of retained placenta among study subjects, 80.91% improved and discharged, 10% had severe anemia and required subsequent blood transfusion, 6.36% developed an infection, 0.91% developed acute renal failure and 2 patients died (one due to DIC and another patient due to irreversible shock). Conclusion: The retained placenta is an obstetric emergency. Rapid recognition and treatments are essential because heavy blood loss with coagulation problems remains the lethal factor in this disease. Rapid control of hemorrhage should be the first initiative. Active management of the third stage of labor lowers the danger by a significant percentage.

Introduction: Peripartum hysterectomy has to be done repeatedly as the last resort in saving a woman's existence. Currently, several drugs and surgical techniques have been established for the management of postpartum haemorrhages. The foremost indication for peripartum hysterectomy is severe uterine haemorrhage that cannot be controlled by conservative methods. Objectives: This study intended to find out the indication and frequency of peripartum hysterectomy in MAG Osmani Medical College Hospital, Sylhet. Methods: This prospective cross-sectional study on 100 cases of peripartum hysterectomy was carried out at the Department of Obstetrics & Gynaecology at Sylhet M.A.G Osmani Medical College Hospital, Sylhet from January 2004 to June 2005. Verbal consent was taken before recruiting the study population. Data was compiled and analysed manually. Result: The commonest age group involved in peripartum hysterectomy was 31-35 years (38,38.0%). The incidence of peripartum hysterectomy was 0.70%. Rupture uterus (76%) was the most common cause. Other causes are uterine atony (12%), Placenta praevia (2%), placenta accreta (2%) & sepsis in 6% of cases. Maximum patients (82,82.0%) did not get any antenatal care. Of those who got antenatal care, eighteen patients (18,18.0%) were irregularly booked. Conclusion: Emergency peripartum hysterectomy is a vital lifesaving technique and remains to have a high incidence in our community. The choice to implement an emergency peripartum hysterectomy is usually obscure as the obstetrician's paramount wish is to preserve the uterus for future childbearing.

The aims of this study are to analyze and find weaknesses in the regulation of legal protection for wives who have been talak divorced by their husbands due to their husband's mistakes and to find a reconstruction of legal protection regulations for wives who are talak divorced by their husbands due to the husband's mistakes based on the value of justice in a research that uses constructivism paradigm. The approach method used is empirical juridical, namely the application of normative legal provisions in action on divorce legal events, especially divorce divorces. The data used are primary data, secondary data, and tertiary data which were analyzed descriptively. The legal theory used is the theory of Islamic justice, the theory of the legal system and the theory of legal protection. The results of the study show that the weakness of the regulation of legal protection for wives who got talak divorced by their husbands due to the husband's fault lies in the unclear article on the type of reason for the divorce and its consequences, especially when the husband who handed down the divorce was the perpetrator of the affair, and the wife as the victim did not receive compensation. therefore, the legal reconstruction can be done by adding new norms to Article 41 of Law no. 16 of 2019 concerning Amendments to Law No. 1 of 1974 concerning Marriage, and also Article 149 of the Presidential Instruction (INPRES) No. 1 of 1991 concerning the KHI, namely: "The ex-husband is obliged to provide compensation in the form of a year's income to the ex-wife if the divorce is due to the husband's fault, but if the husband is unable to fulfill it then he must make a statement of incapacity and apologize to the wife for not being able to do so able to pay for it.”

In order to treat Hyperlipidaemia, Rosuvastatin, a Dyslipidaemia drug, inhibits the HMG-CoA reductase enzyme. However, the calcium form of Rosuvastatin (RST) has low bioavailability, undesirable dissolving characteristics, and issues with absorption. Thus objective of the study is to increase the solubility and dissolution rate of Rosuvastatin calcium a poorly water-soluble 3-hydroxy 3-methyl glutaryl CoA (HMG-CoA) Reductase inhibitor through inclusion Complexation with β-cyclodextrin (β-CD). Therefore, the goal of the current study was to create a Rosuvastatin tablet formulation for oral dissolution. Rosuvastatin immediate tablets were developed using the direct compression showed good results, the prepared inclusion complex with β-CD by kneading method exhibited greatest enhancement in solubility and fastest dissolution (97.363) % RST release in 15 min. The inclusion complex contains RST: β-CD (1:1) and (1:2) was formulated into tablets using super disintegrants like Sodium starch glycolate, Cross povidone and Croscarmellose. All the mentioned batches were prepared and granules were evaluated for pre-compression parameters such as bulk density, tapped density and compressibility index. Tablets were evaluated for weight variation, thickness, hardness, friability; disintegration time and were found to be within the limits. In vitro dissolutions were carried out in 0.05M phosphate buffer with a pH of 6.8. The prepared tablet was evaluated for various post compression parameters like hardness, friability, weight variation, thickness, and in-vitro dissolution.

HIV (human immunodeficiency virus) is a virus that attacks the body's system. AIDS could be a chronic potentially life threatening condition caused by HIV. This article provides a summary of studies assessing the pharmacokinetics of antiretroviral drug Darunavir. Darunavir is a BCS class II drug which inhibits the HIV protease enzyme by forming an inhibitor-enzyme complex there by preventing cleavage of the polyproteins. This research work aims to increase the penetration of Darunavir into deeper layers of skin by formulating cubosomes of Darunavir into a genital Gel that helps in enhancing the Bioavailablity by providing first pass metabolism. Cubosomes were prepared by the Top- down approach (Emulsification method) employing GMO as a lipid phase vehicle, poloxamer 407 as a stabilizer and distill water as an aqueous phase. Darunavir is an antiretro viral drug with good bioavailablity. The prepared cubosomes were characterized by Visual examination, Entrapment efficiency, Particle size, Zeta potential, In-vitro drug release studies. Optimised formulation (F4) showed good response among all the opposite cubosomal preparation. This (F4) cubosomal prepration was made as Gel using Carbopol 974 BP,and are studied for pH, Drug content,and Diffusion studies. Among all the prepration DARf6 was found for example the utmost drug release. This novel cubosomal genital gel would be promising system for effective drug delivery.

Cardiovascular diseases (CVDs) are common in patients with Non-insulin-dependent diabetes mellitus (NIDDM). Lack of exercise and obesity in the population; the main causes of T2D prevalence. Therefore there is a need for joint treatment of diabetes and CVDs. Calcium-channel-blocking drugs and angiotensin-converting–enzyme (ACE) inhibitors are considered very effective. Angiotensin-converting–enzyme (ACE) inhibitors are thought to be very efficient in reducing the risk of death and hospitalization in patients with HF (heart failure). These inhibitors act as potential regulators of insulin and cardiac failure. This review article focused on the mechanism of action of two the action of drugs, Enalapril (angiotensin-converting–enzyme (ACE) inhibitors) and nifedipine (Calcium-channel-blocker), and their clinical effect on reducing the CVDs and heart failure in T2DM patients. Furthermore, novel immuno targets are needed to discover in future that may lower the risk of deaths among diabetes patients.

Transdermal patches are a cutting-edge drug delivery technology that is essential in the management of many disorders. As first-pass metabolism is avoided, TDDS can effectively increase bioavailability and aid in the delivery of drug molecules into the systemic circulation at a planned and controlled rate. This study's goal was to create matrix-type simvastatin transdermal patches utilising the solvent evaporation method and various polymer ratios, including HPMC 15 cps, HPMC E5, and Eudragit S 100. Plasticizers like glycerine, propylene glycol, and PEG 200 are utilised, along with solvents like methanol and chloroform. According to FTIR studies, pure drugs and excipients are compatible with each other. The tested patches are assessed for thickness, weight variation, folding endurance, moisture content, drug content, surface pH, and in vitro diffusion studies. The results indicated that the formulation F5 showed better characteristic properties and in vitro drug diffusion.

Transdermal patches are cutting-edge drug delivery methods that are essential to the management of many diseases. Due to the avoidance of first pass metabolism the drug molecules are delivered into the systemic circulation at a controlled and predefined pace with the help of TDDS, which also helps to achieve efficient bioavailability. This study's goal was to create matrix-type Olmesartan medoxomil transdermal patches utilizing the solvent evaporation method and various polymer ratios, including HPMC 15 cps, HPMC 5 cps, and Eudragit S 100. Plasticizers like glycerin, propylene glycol, and PEG 200 are used, along with solvents like methanol and chloroform. According to FT-IR studies, pure drugs and excipients are compatible with each other. The generated patches are assessed for their thickness, weight variation, folding endurance, moisture content, drug content, surface pH, and in vitro diffusion studies. Among all the formulations, F6 showed the best characteristic properties and in vitro drug diffusion.

This paper explores the prevalence of sleeping sickness in British Southern Cameroons and examines the various preventive measures implemented by the colonial administration to slow down the scourge of the disease in Southern Cameroons. The disease had a deep rooted impact on the indigenous population and was recognized as public health problem in the territory. Hence there was the need to implement preventive measures against the prevalence of the disease. The British were obliged by articles 2 and 10 of the mandate and trusteeship agreements respectively to ensure the social advancement of the people. It was in this context that the colonial administration and native authorities faced with the scourge of the disease engaged preventive measures to control the disease. This explains why preventive measures including population resettlement, travel restrictions fly depopulation and bush clearing was primordial in the fight against the disease. This paper argues that preventive measures succeeded to an extent in rolling back the scourge of sleeping sickness in British southern Cameroons. Preventive measures impeded the advancement of socio-economic activities in most disease prevalent areas.

The ageing global population has necessitated adequate preparation for the healthcare needs of older adults. Nurses are front line staff in the health sector and are expected to a play major role in the care of the older adults. The study was descriptive and cross-sectional. Questionnaire was administered to 84 respondents who were final year students in two schools of nursing in Ekiti State, Nigeria. The study shows that 69.0% of the students perceived their experience while caring for older adults as interesting and this significantly influenced the decision of 31.0% of them who were willing to take up career in geriatric nursing. Adequate training and care facilities should be provided to give student nurses’ interesting experience during training in order to make geriatric nursing a more preferred area of specialization.

Verapamil Hydrochloride, an antihypertensive agent which is used as a calcium channel blocker. The aim of the present study was to formulate and evaluate Verapamil HCL sustained release pellets. The work is to obtain Verapamil HCL sustained release pellets by using HPMC based polymers i.e., HPMC AN6, HPMC E5, HPMC E15 in the sustained release layer. The verapamil Hydrochloride has pH-dependent solubility. To overcome the pH dependent solubility Fumaric acid was used that which provides micro-acidic environment. Different Ratios of Ethyl-cellulose and HPMC polymers were used to optimise and evaluate the formulation for the sustained release of the drug. It uses the Pelletization technology. This technique is practised to produce pellets of uniform size with high drug loading capacity and also to prevent the segregation and dust.

Introduction: Oligohydramnios or decreased amniotic fluid volume (AFI<5cm) is associated with adverse maternal & Pregnancy outcome. Amniotic fluid is a very complicated yellowish fluid located between the amniotic sac and the fetus. Oligohydramnios is associated with adverse Pregnancy outcome in the form of meconium staining, intrauterine growth restriction (IUGR), caesarean section for abnormal fetal heart rate tracing, low Apgar score and neonatal intensive care unit (NICU) admission. Objective: To evaluate the pregnancy outcome of oligohydramnios and borderline amniotic fluid index. Methods: This was a prospective study was carried out at Department of Obstetrics & Gynaecology, Rangpur Medical College & Hospital, Rangpur, Bangladesh from January 2022 to June 2022. Total number of sample size will be taken 100. Among them 50 patient of oligohydramnios and 50 patients with borderline amniotic fluid index will be taken as group-A & group-B respectively. 100 singleton pregnancies beyond 28 weeks of gestation with AFI< 8 cm, delivered within seven days of admission. Patients were divided in two groups, those with AFI ≤ 5 cm and borderline AFI of 5.1 to 8 cm. Pregnancy outcome was studied in the form of onset of labor, mode of delivery, fetal heart rate variations, meconium staining and lower segment caesarean section (LSCS) for fetal distress, Apgar score, birth weight, NICU admission and neonatal mortality. Results: Amongst the study group, 50% of cases had oligohydramnios (AFI ≤5 cm) as against 50% with marginal or borderline AFI. There was no statistical difference in age, parity and gestational age in both the groups. The mean amniotic fluid index in the first group with AFI ≤5 cm was 3.48±1.10 and that of second group with AFI of 5.1 to 8 cm was 6.69±0.75. On comparison of mode of delivery in between both the groups, a statistically significant difference was observed for caesarean section in oligohydramnios with AFI ≤ 5 cm group compared to AFI of 5.1 to 8 cm group. Patients with oligohydramnios with AFI ≤5 cm were significantly associated with IUGR and presence of abnormal umbilical artery Doppler velocimetry (p <0.05). Adverse Pregnancy outcome was seen in higher percentage of patients having AFI ≤5 cm than with borderline AFI. The difference was statistically significant for overall caesarean delivery rate and LSCS for fetal distress (p <0.05). Conclusion: An amniotic fluid index of ≤5 cm is commonly associated with intrauterine growth restriction and abnormal umbilical artery Doppler velocimetry studies. Adverse Pregnancy outcome is seen in higher percentage of patients having oligohydramnios than that of borderline AFI. Statistically significant difference for overall caesarean delivery rate as well as LSCS for fetal distress mandates the need for close antepartum and intrapartum monitoring.

Balangu (Lallemantia royleana) is a member of the Lamiaceae or Labiateae family. In Pakistan commonly called Tukhmalanga. This valuable medicinal plant is indigenous to tropical Asia, including India, Afghanistan, and Pakistan. The chemical analysis of Lallemantia royleana seed showed that the seeds contained: protein 25.60%, fat 18.27%, fiber 1.29%, alkaloids, anthraquinones, flavonoids, glycosides, pholobtannin tannins, volatile oils, mixed fatty acids and terpenoids. It exerted many pharmacological effects included antimicrobial, antioxidant, antidepressant, anxiolytic, sedative, antiemetic, hypolipidemic, protective and many other pharmacological effects. The current review discussed the Lallemantia royleana as a beneficial medicinal plant. It can be a good remedy for skin disease. Further screening for phytochemicals should be carried out in search of novel therapeutic compounds.

Pseudoangiomatous stromal hyperplasia (PASH) is a lesion that is often discovered incidentally in breast biopsies performed for benign or malignant lesions of the breast. More rarely, it may present as a palpable lesion. The term "Pseudoangiomatous" has been proposed to underline its particular histological aspect simulating a vascular proliferation. We report a case of PASH in a 42-year-old female patient presenting as a recurrent lesion that resulted in a considerable and rapid increase in breast volume (135 x 100 x 97mm) requiring a large lumpectomy with muscular-fat remodeling. Angiosarcoma and fibroadenoma remain the main differential diagnoses. Anatomopathological examination allows us to eliminate them, in particular through immunohistochemistry.

General academic English has been attached greater importance in higher education in China. This paper focuses on the teaching effect of general academic English in North China Electric Power University（Baoding）from the perspective of PCT（Projects+Cases+Texts）. Through the analysis of students’ questionnaire and interview, it is proved that PCT is an effective way in general academic English teaching. This paper aims to provide practical experience for the further development of general academic English curriculum.