Background: Cervical spondylotic myelopathy (CSM) is the leading cause of spinal cord dysfunction in adults over 55, resulting from degenerative cervical changes that compress the spinal cord and lead to functional impairment. Laminoplasty, a posterior decompression technique, is widely used for multilevel cervical stenosis, preserving spinal stability while improving neurological outcomes. Objective: To evaluate the functional and neurological outcomes of en-bloc cervical laminoplasty in patients with CSM and to identify prognostic factors influencing recovery. Methods: This retrospective study included 85 patients who underwent en-bloc cervical laminoplasty at different private hospital and Bangabandhu Sheikh Mujib Medical University Bangladesh between January 2007 and June 2019. Preoperative symptom duration was categorized as <6 months, 6–18 months, and >18 months. Neurological and functional status were assessed using the modified Japanese Orthopaedic Association (mJOA) score and Nurick grading scale. Postoperative recovery rates were calculated using the Hirabayashi method. Data were analyzed using SPSS 22, with Fisher’s exact test, ANOVA, and Spearman’s correlation applied as appropriate. A p-value <0.05 was considered significant. Results: The mean age of patients was 65.8 ± 8.9 years, with 62.35% males. Multilevel stenosis was common, with four-level involvement in 37.65% of patients. Patients with shorter symptom duration (<6 months) achieved the best neurological recovery, with all reaching mJOA scores >15. Recovery rates varied according to preoperative mJOA and Nurick scores: complete recovery was observed in 75.0% of patients with mJOA ≥15 and 75–100% of patients with Nurick grades 0–2, whereas those with mJOA <12 or Nurick grades 3–4 experienced partial recovery, no change, or worsening. Conclusion: Early surgical intervention in CSM is associated with superior neurological outcomes. Higher preoperative mJOA scores, lower Nurick grades, and shorter symptom duration were strong predictors of complete recovery, while prolonged symptoms and severe baseline deficits limited postoperative improvement. These findings underscore the importance of timely diagnosis and surgical management in optimizing patient outcomes.

Background: The aim of this study is reviewing the histopathological spectrum of malignant neoplastic lesions of the large intestine. Methods: This is a retrospective & prospective study carried out in the department of pathology from June 2017 to June 2019. The specimens from the medical and surgical gastroenterology department were studied. Variables like age, sex, tumor size, location, type of lesion, the histological pattern of patients were studied. Results: In the series of 140 patients of colorectal neoplasm, the maximum number of patients presented in the fourth decade of life (34.28%) with a mean age of presentation at 53.7years.The youngest patient with adenocarcinoma was 24years (male) of age, and the oldest one was 80 years (male) of age. The male to female ratio was 1.12:1. The proportion of well-differentiated carcinoma was highest in left side colon and rectum, whereas the incidence of moderately and poorly differentiated adenocarcinoma was higher on the right-side colon. Conclusion: Adenocarcinoma is the most common histological variant of colon carcinomas showing slight male preponderance and the most common site being rectum.

Intracranial tuberculous subdural empyema originating from otitis media and mastoiditis is rare. Timely diagnosis and prompt surgical management, followed by microbiological confirmation of the causative agent is known to be life-saving. We report a case of a 10-year old child with subdural empyema with fronto-parietal involvement, who was managed by craniotomy and antitubercular therapy was instituted after microbiological investigations. We urge the necessity of clinical suspicion and immediate surgery for management of such cases.

Background: Synovial sarcoma is a translocation-associated mesenchymal neoplasm that represents around 10% of all soft tissue sarcomas. Diagnosing biphasic synovial sarcoma is generally straightforward, owing to distinctive histologic features. Transducer-like enhancer of split 1 (TLE1) is overexpressed in synovial sarcomas. Study aimed to evaluate sensitivity and specificity of TLE1 immunohistochemical expression in synovial sarcoma and its histological mimics. Methods: Conventional sections from 30 cases of synovial sarcoma, 24 cases of monophasic synovial sarcoma mimics and 6 cases of poorly differentiated sarcoma mimics were subjected to TLE1 IHC staining. TLE1 immunostaining was graded from 0, 1+, 2+, 3+, with 2+ or 3+ grades interpreted as positive staining. Results: Of the 60 tumours, majority are monophasic spindle cell type (56.6%), followed by biphasic (16.6%), monophasic epithelial (6.6%), poorly differentiated (13.3%) and calcifying type (6.6%). Upon expression ofTLE1 in tumors, 20c ases showed Grade 3, 8 cases shown Grade 2, 2 cases shown Grade 1 TLE1 Expression in Synovial sarcoma. 2 cases shown Grade 3 and 2 cases shown Grade 2 TLE1 expression in Schwannoma. Whereas 1case shown grade 2 in Rhabdomyosarcoma. 1case shown grade 2 in Hemangiopericytoma. TLE1 sensitivity for diagnosis of synovial sarcomas was 93.3%, and specificity of 73.3% with positive predictive value of 77.77% and negative predictive value of 91.6%. Conclusion: Specificity can be increased with optimal IHC panel which includes BCL2, Pan Cytokeratin, EMA, CD99 and CD34. Molecular confirmation is the diagnostic gold standard for synovial sarcoma, TLE1, in view of its high sensitivity may be a useful marker within the optimal IHC panel for substantiating a diagnosis of synovial sarcoma. Awareness of TLE1 expression in other tumours and its correct interpretation are necessary.

Due to long term morbidity and mortality associated with transfusion transmissible infections (TTI), the present study was undertaken to find out the prevalence of transfusion transmissible seropositive infections among both voluntary and replacement blood donors over a period of ten years at a tertiary care hospital. Aim: The aim of this study is to determine the seroprevalence of transfusion transmissible infections among blood donors. Material and methods: This is a retrospective study conducted on all voluntary and replacement blood donors in a tertiary care hospital for a period of 10 years from 2010 to 2019. Blood samples were screened for HIV, HBV, HCV by ELISA, for syphilis by rapid plasma reagin test and malarial parasites. All seroreactive blood bags considered as positive for TTIs were discarded. Result: Out of total 18490 donor’s blood units screened using standard blood tests for transfusion transmissible infections, replacement donors constituted 26.2% and 73.8% were voluntary blood donors. A total of 161 samples (0.87%) were found to be positive for TTIs. Seroprevalence of HIV, HBV, HCV and Syphilis was found to be 0.13%, 0.62%, 0.08% and 0.02% respectively. No donors were found positive for malaria parasites. Conclusion: Overall seroprevalence of TTI was 0.87% with high prevalence of HBV infection when compared to other TTIs. Safe blood transfusion is still a challenge with this prevalence rate. Hence there is a need of more sensitive screening tests especially in screening HBV infection to minimize TTIs along with strict donor selection criteria.

Dengue, an arboviral infection is a notifiable disease in India and is endemic in many regions of the country. CRP levels help in knowing the severity of the disease. Patients with signs and symptoms of Dengue were included in the study. Their demographic data was noted. Serum was tested for NS1 ELISA, IgM ELISA. Positive samples were tested for CRP levels. Platelet count, Blood transfusion information was noted. Dengue positivity was 21%, with male predominance (55.6%), common in young children and teens. CRP level of 12 mg/L was seen in 28.40% of patients. Patients with CRP of 48mg/L required multiple platelet transfusion. Conclusion: our study has correlated dengue positive patient’s platelets, CRP levels and need for blood transfusion. CRP levels help in knowing the severity of dengue disease.

The flipped classroom is an active learning strategy in which what normally is done at home is flipped or switched with what is done during the classroom time. The objective of this work was to use the flipped classroom for the students learning improvement in the Pharmaceutical Quantitative Analysis Laboratory at the Pharmacy Faculty of the Universidad de Costa Rica. For this purpose, students were divide in groups, and a laboratory practice with its respective support material was assigned to each one. This information was explained to each member of the group, as well as other aspects that were considered pertinent. At the end of the groups’ presentations, a survey was given for the evaluation of each student about this didactic strategy. In this experience, from the total enrolled population, 94.23% approved the course. As a complement, the students’ opinion revealed that for 86.54% of the didactic strategy improved their academic performance and/or learning process. This positive impact was due to the contents explanation by their peers, the learning deepening to teach the lesson in the best possible way, having the study material since the course beginning, and the acquisition of tools and/or skills necessary to make public presentations. Nevertheless, the most frequent negative comments were that there is no difference between this flipped classroom and traditional lectures. In addition, the complexity found for the class preparation was not well received.

Environmental deterioration has, over the years, produced unpleasant results with effects on health and economic development on earth. These health and economic ills are brought to the fore by pollution, inappropriate waste disposal, deforestation and wildlife extinction, most of which constitute criminal acts or omissions. In the wake of this, criminalizing environmental harm has become the mainstay of environmental legislation in Nigeria and even with the environmental laws and policies targeted at solving the problems, the situation in the country appears to be increasingly added-to, thanks to the weakness of the punitive measures and the sterility of the enforcement agencies in the country. This paper, therefore, scrutinizes the use of environmental law by selected enforcement agencies in Nigeria (federal and state levels alike) to curb environmental harm, prosecute green crimes, the methods of enforcement invoked by these agencies over the years, as well as the perceived challenges encountered in the enforcement of the relevant criminal provisions of the laws. Consequently, this paper proffers pragmatic solutions to the challenges of green crime enforcement in the country.

The aim of this study was to investigate the some selected physicochemical parameters in soil samples. The soil characterization was carried out for parameters like moisture content, pH, electrical conductivity, organic carbon and organic matter, cation exchange capacity and exchangeable base (K, Na, Ca and Mg). The results obtained revealed that the physicochemical parameters in the soil samples were in the range of:10.50-11.25% for moisture content, 6.45-6.66 for pH, 0.63-0.89 dS/m for electrical conductivity, 4.27-8.03% for organic carbon, 7.34-13.86 % for organic matter, 33.54-48.45 cmol/kg for cation exchange capacity, exchangeable base (0.77-0.86 cmol/kg for Na, 2.63-3.01cmol/kg for K, 10.25-10.89 cmol/kg for Ca and 0.52-1.40 cmol/kg for Mg). pH was found to slightly acidic and good for maximum availability of the primary nutrients required for plant growth. The values of electrical conductivity indicated that all samples of the soil are good in soil. Statistical test of significance using ANOVA revealed that there were significant differences (P>0.05) between the values of physicochemical parameters in the soil samples obtained from three sampling sites except exchangeable base. Correlation analysis was also employed to examine the relationship between the various parameters in the soil samples.

Background: Male infertility is a multifaceted state and overlaps a lot of factors and affects infertility in about 8–5 % of the people in the world and the man is responsible for 40% of these cases. Dietary insufficiency of trace element, zinc and copper may play a role in male infertility as trace element plays an important role not only in normal testicular improvement, but also in spermatogenesis and sperm motility. Objective: The current study was intended to analyze the level of seminal plasma trace elements mainly zinc and copper amongst dissimilar groups of infertile men. Method: The concentrations of zinc and copper were measured in 160 semen samples from normozoospermic, oligoathenospermic, and azoospermic men using the atomic absorption spectroscopy, data was analyzed using the statistical software package SPSS version 17. Result: Outcomes showed that the mean values of seminal plasma zinc concentrations were significantly decreased in the two groups of infertile male subjects, azoospermic (P.value=0.000), and oligozoospermic (P.value=0.013) compared with fertile males, while there was significant decrease in seminal plasma copper concentration of azoospermic patients compared to control (P.value=0.000), and significant decrease in oligozoospermic patients compared to control (P.value=0.000).

Pregnancy is the time in which a foetus develops inside a woman’s womb or uterus which usually last about 40 weeks or just over 9 months from the last menstrual period to delivery. The incidence of pregnancies in India is 48.1 million pregnancies, a rate of 144-7 pregnancies per 1000 women aged 15-49 years, and a rate of 70.1 unintended pregnancies per 1000 women aged 15-49 years. Abortions account for one third of all pregnancies and nearly half of pregnancies were unintended. Hence the present study to assess the Women’s experience of midwifery support during pregnancy - A step in the Validation of scale. 100 samples who met the inclusion criteria were selected by using a purposive sampling technique. Based on the objectives of the study and review of literature, interview schedule to assess the midwifery support was prepared. It had four areas of midwifery support. The data were analyzed by using descriptive and inferential statistics. The findings of the study revealed that according to the area of midwifery support, the mean percentage score of informational support was 89.29%, followed by financial support of 87.5%, social support of 62.5% and emotional support of 58.33%. Hence in the area of emotional support the women received average level of support.

Myasthenia gravis (MG) is an autoimmune disease of the neuromuscular junction affecting mainly young women, on this poster reporting a clinical case of a parturient parturient of 21 years old, primiparous, diagnosed myasthenia for 6 years, thymectomized, under corticosteroid therapy, azathioprine and mytelase, who presents for a pregnancy of 36 SA + 3 without signs of muscle weakness. The delivery was carried out vaginally under epidural analgesic giving birth to a newborn of 2kg800, male, Apgar a 4/4/4, lethargic with congenital myasthenia who died after 10 hours of life. The diaper suites were simple at day 4 of the postpartum the parturient presented a serious myasthenic crisis at the paraclinical exploration the biological assessment showed a slight inflammatory syndrome the therapeutic approach consisted in a conditioning of the patient, corticosteroid, prostigmine, azathioprine, mytelase, as well as a cure of 5 days of immunoglobulin. The evolution was favorable at the end of the 3rd day and the patient was transferred to the neurology department on the 6th day and left home at the end of the 10th day.

Objective: To study the incidence of placenta previa. To examine the risk factors and fetomaternal outcomes in placenta previa in previously scarred and unscarred uterus in Dept. of Obstetrics & Gynecology, S.P. Medical College, Bikaner. Methodology: The patients who came with complaint of painless bleeding per vagina after 28 weeks of gestation were hospitalized and were divided into two groups, Group A in which placenta previa occurred in a previously scarred uterus and Group B in which placenta previa occurred in an unscarred uterus. Results: The overall incidence of the placenta previa was 0.56 %. Incidence of placenta previa in group A (Scarred uterus) was 1.15% which was higher than group B (Unscarred uterus) i.e. 0.35%. Cesarean section with Uterine artery ligation and uterine packing was present in 12.9% cases and 3.70% cases respectively in group A while in 2.08 % cases each in group B. Previous 1 LSCS and previous 2 LSCS was present as a risk factor in group A only in 88.89% cases & 11.11% cases respectively. Conclusion: An increase in incidence of prior cesarean section and advanced maternal age probably contributes to a rise in number of pregnancies complicated with placenta praevia and its association with adverse maternal & perinatal outcome. Early diagnosis by ultrasound and planned delivery should be the mainstay of management.

"Il n'est pas possible de réduire l'activité tumultueuse des humains à un ordre géométrique exempt d'irrégularité et de confusion. De même que les lois simples et constantes de la nature ne peuvent éviter les perturbations qui surviennent dans le cours des planètes, les lois humaines sont incapables d'empêcher le trouble et le désordre résultant des forces d'attraction innombrables et opposées du plaisir et de la douleur. C'est pourtant la chimère que poursuivent les hommes aux facultés limitées quand ils ont en main le pouvoir. Lorsqu'on défend une foule d'actes indifférents, on ne prévient pas des délits qui ne sauraient en résulter, mais on en crée de nouveaux en déplaçant arbitrairement, entre le vice et la vertu, des limites que l'on proclame cependant éternelles et immuables. (...) Si l'on veut prévenir les délits, il faut faire en sorte que les lois soient claires et simples, et que tous les membres de la nation unissent leurs forces pour les défendre, sans qu'aucun ne puisse travailler à les détruire."

The study investigates the impact of the credit crunch and shadow economy on economic growth in the Libyan banking sector using an autoregressive distributed lag (ARDL) approach for hypotheses testing. The proxy for economic growth is GDP in current price growth; the annual negative change of ratio for total credit in a commercial bank to GDP in current value is the indicator for credit crunch; and complete economic transactions or activities outside of conventional banking system as a ratio to GDP as a proxy for shadow economy. We transform the dataset into log-linear before data analysis for standardisation and consistency. The empirical evidence from this study shows the existence of a credit crunch and shadow economy in the banking sector in Libya. Results from ARDL analysis reveal that there is a profound impact of the credit crunch and shadow economy on economic growth. We also find that the shadow economy is thriving in the existence of a credit crunch despite the effort by the government to increase the money supply M2 in the banking sector. The liquidity problem caused by the credit crunch in the banking sector is significantly related to the shadow economy. Though the shadow economy contributes to economic growth without government intervention, it can deprive the money supply and the people's trust in the banking sector.