The present study was undertaken to examine the direct effect of second line anti-tuberculosis drugs Ethionamide (ETH), Para amino salicylic acid (PAS), Aloe vera on Mycobacterium tuberculosis (MTB) strain H37Rv ATCC No- 27294. It is found that Aloe vera does not interfere with single or in the combination of both ETH and PAS showing the bioenhancer activity. In vitro study of Aloe vera observed that the extract inhibited the growth of H37Rv strains. The present results will pave new avenues to find a new medicine that possesses Aloe vera alone or in combination with drugs to combat H37Rv strains controlling tuberculosis.

The combination of gastric tumor and hiatal hernia is a rare event, that makes management delicate, and the prognosis pejorative given the risk of multidirectional lymphatic dissemination. Through this case report, we present a fully laparoscopic management, in an 80-year-old woman with a gastric tumor of the upper 1⁄3 of the stomach, associated with a huge hiatal hernia. This lady presented to the emergencies during the period of the Covid 19 pandemic, for dyspnea crisis of progressive worsening. thoraco-abdominopelvic CT showed a huge hiatal hernia explaining its symptomatology. Esogastroduodenal fibroscopy showed a cardia-gastric tumor. A total laparoscopy gastrectomy with lymph node dissection D1.5 associated with a cure of hiatal hernia were performed. The postoperative follow-up was simple and the patient declared outgoing on Day 5 postoperative.

Background: Breast cancer is a heterogeneous, phenotypically complex disease made up of various biologic subgroups with unique behaviors and therapeutic responses. Noted that despite lack of a cure for metastatic breast cancer (MBC), there have been appreciable advancements in survival that have occurred at the same time as newer systemic treatments. BRCA1 or BRCA2 mutations cause homologous recombination deficient (HRD) cells, which are vulnerable to PARPi agent treatment. Case Report: This case report presents a 40 years old single female, known case of multiple co-morbidities who was diagnosed with Bilateral breast cancer in June 2022. She has a Positive family history of malignancy; mother died from endometrial cancer and aunt from paternal side has breast cancer. She underwent needle core biopsy from her Right breast mass, which revealed Invasive high-grade ductal carcinoma with metaplastic features (foci of keratinizing squamous differentiation, and myxoid stromal change). DCIS, of intermediate and high grades and a solid pattern, was noted, focally suspicious for lymphovascular invasion, Triple negative (ER negative (<1%), PR negative (<1%) and her-2 (+2) FISH negative (Her-2 Low), KI 67= 70%. Left breast mass Biopsy done on 12/9/2022 showed Invasive Lobular carcinoma, grade 3, ER negative, PR negative, Her-2 +1, KI 67=70%, BRCA2 POSITIVE & PDL1 CPS score 10%. Staging positron emission tomography scan done on 10 October 2022. She had a Large hypermetabolic fungating right breast mass infiltrating the chest wall, consistent with biopsy-proven malignancy. Additional smaller FDG-avid lesions noted in the right breast. Moreover, she had FDG-avid right axillary and right internal mammary nodal metastases. Mildly FDG-avid left breast mass, consistent with biopsy-proven malignancy. FDG-avid liver and pleural metastases. She was started on PARP inhibitor (Olaparib) on 20/9/2022 after which she had amazing fast clinical response leading to falling off the large fungating mass. Conclusion: The chance of developing breast and ovarian cancer is extremely elevated if one possesses BRAC 1 or BRCA 2 mutation. In this situation, PARP inhibitors, mutation-targeted therapy, has better outcomes in reducing the morbidity and mortality associated with metastatic breast cancer (Olaparib).

Clinical research ethics is founded on a few well-known rules and papers. The criteria differ from country to country, but the ideals of respect for humans, beneficence, and fairness remain consistent. These values are expressed in criteria for obtaining free and informed consent, minimizing risk or damage, and without disproportionately burdening or disadvantageous specific people. In hospitals, physicians frequently confront ethical difficulties that need appropriate abilities and the capacity to detect and manage. For research to be ethical, it must also be of such high quality and performed in such a way that it produces known and usable knowledge. Youngsters have a reduced ability for comprehension and may be more susceptible to compulsion. As a result, kids are seen as a particularly vulnerable demographic, and specific provisions for children are included in many standards. The level of risk permissible for minors participating in research is an important topic in these clauses. While it is widely acknowledged that children deserve special care due to their fragility, there is growing concern that children in general should not be disadvantaged by a lack of information because of decreasing research activities. The purpose of this study was to examine the ethical issues faced by physicians and nurses with medical education and pediatric care responsibilities, as well as whether those issues are related to their workplace, medical specialty, and area of clinical practice, as well as the primary role of parents and children in adhering to these ethics.

Introduction: Fibrothecal group tumours are part of the gonadal stromal and sex cord tumours (GSST) and represent 1-4.7% of all organic ovarian tumours and are usually benign. We felt it important to report a case in order to share our experience in the management of fibrothecal tumours of the ovary. Observation: This was a 51-year-old postmenopausal patient who was referred to the hospital for abdominal pain in the context of an abdominal mass. A clinical examination and abdominal ultrasound concluded that the left ovarian tumour was benign. A left annecxectomy was performed and the histological examination concluded that the tumour was benign. No tumour marker was measured and no CT scan was performed. The postoperative course was simple and the patient was followed for 3 months.

Background: Stomal site incisional hernia is a common complication following ostomy closure. Prophylactic mesh reinforcement of the fascial defect is typically not considered due to the contaminated nature of the case. The effectiveness of prophylactic mesh placement at the time of stoma closure is unknown because of fear of mesh infection and subsequent wound complications. Purpose: To compare the results obtained by placing synthetic mesh in the stoma site during closure with conventional technique without mesh to prevent incisional. Patients and Methods: Prospective interventional study had been designed to compare the outcome of permanent synthetic mesh placement at the time of ostomy closure. Total 45 patients were selected purposively who were candidates for ostomy closure and presented at the Department of Colorectal Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU) from April 2019 to September 2020 and divided into two groups (no mesh and mesh). In the mesh group, permanent synthetic mesh (ProleneTM – Polypropylene) was placed. Primary outcome, incisional stomal hernia was assessed at regular follow-up for one year along with associated morbidities. Results: The primary outcome of this study i.e. incisional hernia (stomal site) was observed among 1 (4.8%) patients at 4th week, 3 (14.3%) at 3rd month, 7 (33.3%) at 6th month and 8 (38.1%) at 12th month follow-up in no mesh group. And, only 1 patient at 6th month and 12th month follow-up had hernia in the mesh group (Figure 3). There was no difference statistically between no mesh and mesh groups at 4th week and 3rd month but significant difference found at 6th and 12th month follow-up (p=0.280, p=0.344, p=0.033 and p=0.017, respectively). Conclusion: Prophylactic placement of permanent polypropylene mesh during ostomy closure placement significantly reduced the rate of incisional hernia without any additional morbidity. Placement of mesh was found to be both safe and effective.

Introduction: Neonatal septicemia is one of the most common causes of infection and mortality in neonates, due to which 30–50% of neonates die each year in developing nations. Various studies have suggested that bacteremia occurs in 20% of neonates, and approximately 1% die due to neonatal sepsis. It affects newborns below 1 month of age and encompasses systemic infections including meningitis, pneumonia, arthritis, osteomyelitis and urinary tract infections. Objective: To assess the Bacteriological profile of neonatal septicaemia and antibiotic susceptibility pattern of the isolates admitted in SCANU of a tertiary levels hospital of North Bengal, Bangladesh. Methods: A prospective study was conducted including 50 suspected cases of septicemia admitted to the Special Care Neonatal Unit (SCANU) of the selected Department of Paediatrics, TMSS Medical College, Bogura Bangladesh July to December 2022. Demographic data included birth weight, gestational age, postnatal age, and treatment as well as survival outcome. Clinical and laboratory data included the number of days between birth and admission to the SCANU, admitting and discharge diagnoses, and pharmacological treatment. Data was analysed by percentages of each antibiotic used. And which organism was responsible for neonatal sepsis. Results: Total 50 cases clinically suspected neonatal sepsis were included in the study. The mean age was 8.33±7.36 days, mean birth weight was 2816.25±288.6gm, male were predominant which was 70%. Among gestational age of the Neonates having septicemia Preterm (<37) 66% and Term (37 up to 42) 36%. Out of the 50 proven sepsis cases, 36 cases (72%) were early onset and 14 cases (28%) were late onset. In this study out of 50 cases 16 cases were culture positive septicemia which was 32%. Gram negative organism were predominant with 10 isolates (62.5%) in comparison to gram-positive 6 (37.5%) isolates was the most common S. aureus (25.0%) and E. coli (12.5%) among the organism isolated. Other organisms isolated were Staphylococcus Pneumoniae (6.3%), Staphylococcus epidermidis (18.7%), Proteus (18.7%), Listeria species (6.3%), Pseudomonas (6.3%), and Enterococci (6.3%). In this study, Staphylococcus aureus was the commonest organism isolated from both EOS (20%) and LOS (33.3%) followed by Staphylococcus epidermidis (10% & 33.3%). Amoxiclave is highly sensitive to S. aureus & E. coli. In this study, vancomycin showed 25.0% sensitivity to S. aureus but for Nitrofurantoin it was only 33.3%. The Listeria species isolates here were 100% sensitive to meropenum. In our study, ciprofloxacin showed 33.3% to 100% sensitivity to different isolates. Conclusion: In the present study, high bacterial resistance among the pathogens suspected to cause neonatal septicemia is demonstrated which can be controlled by prudent use of available antibiotics. This study suggests regular monitoring of the antimicrobial sensitivity of the causative organisms in a particular setting is very important.

Background: Low back pain and sciatica are two of the most common health disorders that people experience. Both the number of hours that employees put in and the amount of money that is lost by the nation as a whole see significant reductions as a result of these changes. Before beginning any kind of treatment with these individuals, it is very necessary to do a thorough physical assessment on them. It is possible for symptoms to worsen as a result of receiving insufficient medical or surgical treatment, which increases the likelihood of this happening. The purpose of this study is to evaluate the effectiveness of acupuncture in conjunction with PLID treatment. Methods: This inquiry took place at SUOXI Healthcare Limited in Shantinagar, Dhaka, Bangladesh. A 36-year-old male patient has been complaining of lower back discomfort, tingling and numbness of right leg for the last two years. The diagnosis was confirmed with a MRI of lumber spine. Results: Follow-up research showed promising outcomes. He no longer felt discomfort in his lower back and tingling and numbness of right leg, which he had been experiencing for two years. PLID patients may benefit from acupuncture, according to the findings of this study.

Background: Solid waste management has become the greatest problem facing many semi-urban and rural communities like Elele in Nigeria, and is fast becoming a serious health concern. The study therefore was carried out to assess the strategies developed by Elele community in solid waste management and recommend proper solid waste disposal strategies. Materials and Methods: The study adopted survey research method using data collected through self-administered questionnaire which were analyzed to generate data for the study. Results and Discussions: The result from the field research showed that majority 96.19% of the respondents have heard of solid waste, and (34.83%) of the solid wastes generated in Elele community was Garbage, composed majorly of food waste which were compostable to make local manure; 29.62% refuse waste made up of papers, plastics, cans and glass were generated. The result revealed also that dumping in open spaces (69.82%) was the most prominent disposal method practiced in Elele and only 1.09% of the population practice Land fill (Burial method). There was inadequate provision of closed top compacting trucks (29.03%) to handle refuse collection with protective measure in mind. The respondent’s acknowledgement on the indiscriminate disposal of Solid waste in Elele was high (96.67%) and listed factors responsible like: lack of awareness on accepted methods of solid waste disposal (38.55%), Lack of Community Participation (16.23%), and Financial inadequacy of government (l4.78%). Conclusion: The study revealed that dumping in open spaces (69.82%) was the most prominent disposal method, while the least was land fill practice (Burial method) 1.09%. The study recommends the participation of the Local Governments in enhancing and building the capacities of local communities to identify and promote proper waste disposal and management. In addition, develop strategies that minimize waste at household and community levels through re-use like in manure, or recycling in their vicinity.

Background: Supracondylar fractures are a common type of elbow fracture in children, and Gartland type III fractures are the most severe form of this injury. These fractures may be treated with either closed reduction and percutaneous pinning or open reduction and internal fixation using pins. Objective: To evaluate the outcome of pediatric stiffness in Gartland type III supracondylar fractures using the Flynn's criteria. Materials and Methods: A Multicentered based prospective study was performed in 250 Beded District Hospital, Chapainawabganj, Rajshahi, Bangladesh, from January 2021 to December 2022. A total of 80 patients with displaced type III extension supracondylar fractures were included, all of whom were treated at two separate facilities in a systematic way. Closed reduction and percutaneous cross-pinning were the major components of treatment at (n = 43). ORIF was the treatment plan (n = 37) for patients. Their stiffness was evaluated over a 6-month follow-up period. Result: A total of 80 displaced type III extension supracondylar fractures treated primarily closed reduction and percutaneous cross-pinning (n=43), while the other used primarily open reduction and internal fixation (n=37) with two lateral parallel pins (n=11), cross pins (n=11) and two lateral and one medial pin (n =15), 28 patients (75.6%) had an excellent result, six patients (18.9%) had a good result, two patients (4.6%) had a fair result, and one patient (2.7%) had a poor result in the ORIF group. In the CRPF group, 33 (76.7%) patients had an excellent result, seven (16.2%) patients had a good result, two (4.6%) patients had a fair result, and one (2.4%) patient had a poor result. The stability and configuration of the fracture open and closed reduction groups were not statistically significant according to Flynn's criteria (P>0.05). Concision: This study provides valuable information on the evaluation of pediatric stiffness in Gartland type III supracondylar fractures and highlights the need for careful follow-up to detect and manage any potential stiffness. Although closed reduction did not show any superiority over open reduction, it was suggested as the first treatment choice due to its low morbidity and short hospital stay.