Nepal's construction industry faces persistent challenges including payment delays, contract management inefficiencies, supply chain opacity, and systemic governance failures. Blockchain technology offers potential solutions through smart contracts, immutable record-keeping, and transparent shared ledgers. This paper systematically reviews blockchain applications in construction management and documented challenges in Nepal's construction sector from peer-reviewed studies. The review identifies four primary blockchain applications: smart contracts for payment automation, supply chain traceability, immutable document management, and shared transparent ledgers. Documented challenges in Nepal include payment delays (RII=0.80-0.92), contract management inefficiencies (78.6% expert agreement), low bidding averaging 37.52% below tender prices, NPR 20 billion in outstanding contractor payments, land acquisition taking 2-3 years, tree cutting approval taking 2 years, average project lag of 37 months with only 15% completed on time, and 17 National Pride Projects requiring 41 years to complete at current funding levels. Blockchain can strongly address payment delays, document coordination, supply chain tracking, and transparency. Blockchain technology offers targeted solutions for specific documented challenges in Nepal's construction sector.

Introduction: Mucinous anal adenocarcinoma is a rare and often misleading entity, because its presentation may mimic suppurative perineal disease [abscess/fistula]. We report a case of fistulizing mucinous anal carcinoma diagnosed by endoscopic ultrasound and fine-needle aspiration, and discuss the diagnostic and therapeutic aspects. Case presentation: A 73-year-old man with a history of surgery for an anal fistula [2000] presented with purulent anal discharge associated with mild anal incontinence, without rectal bleeding or bowel habit disorders, and with preserved general condition. Proctological examination found fistulous openings and sphincter hypotonia. Pelvic MRI showed a mass in the left ischioanal fossa fistulizing toward the anal canal. Rectal endoscopic ultrasound showed a heterogeneous pararectal mass measuring 33 × 47 mm, with a fluid component and sparing the rectal wall; histological examination of the fine-needle aspiration sample confirmed mucinous adenocarcinoma. The staging work-up found no secondary lesions. A multidisciplinary decision was made to proceed with chemoradiotherapy, followed by reassessment and surgical discussion according to the clinical course. Conclusion: In the presence of a chronic, recurrent, or complex anal fistula, particularly when associated with a mass, induration, or functional impairment, malignant degeneration should be considered and documented by tissue sampling. MRI and endoscopic ultrasound with fine-needle aspiration/biopsy guide the diagnosis. Management is often multimodal and resembles that of rectal adenocarcinomas, with discussion of neoadjuvant treatment followed by radical surgery such as abdominoperineal resection.

Background: Hypoglycemia in Type 2 Diabetes Mellitus (T2DM) is typically drug-induced. Persistent hypoglycemia after discontinuation of all glucose-lowering agents is rare and suggests alternative etiologies such as insulinoma. Case Presentation: A 56-year-old female with T2DM presented with recurrent fasting hypoglycaemia despite cessation of all oral antidiabetic medications. Initial attribution to sulfonylurea uses delayed further investigation. Persistent hypoglycemia prompted endocrine evaluation revealing endogenous hyperinsulinemia. MRI identified a pancreatic tail lesion consistent with insulinoma. Conclusion: This case highlights diagnostic anchoring bias in diabetic patients and underscores the importance of evaluating persistent hypoglycemia beyond medication-related causes.

This study investigates the state of Qatar in its cyberterrorism-combating endeavors. The research tool designed was a questionnaire. A convenience sample (N = 200) was used, and the majority of participants were older than 35 years old (70.0%): Males and females comprised 80.5% and 19.5%, respectively. The study findings showed that more people identified cyberterrorism as a real threat to national security. Exploring the Qatari youth view on institutional capacities, legal frameworks, and education/community programs. Along with this, the results also show that Qatari institutions are deemed reliable in addressing cyberterrorism, as 89.5% place belief and capability on these institutions. One of the main findings is that an alarming 96.0% agree that decreasing awareness on digital platforms decreases extremist behavior reporting. All respondents agreed that legislation and cooperation at the regional level were required, while fewer supported educating youngsters as an appropriate strategy against digital radicalization. To sum up, the study provides insights into areas to improve upon when it comes to education programs and policy initiatives in preventing cybersecurity threats.

Endoscopic polypectomy is the first-line treatment for colorectal polyps. However, this procedure carries an increased risk of bleeding in patients with hemostatic disorders, particularly in the presence of a large pedunculated polyp. We report the case of a 52-year-old man with hemophilia A and associated von Willebrand factor deficiency, admitted for rectal bleeding evolving over the previous year. Laboratory investigations revealed severe iron-deficiency anemia and a reduced factor VIII level. Colonoscopy showed a large pedunculated sigmoid polyp located 50 cm from the anal verge, with a 15 mm stalk and a 30 mm head. A multidisciplinary approach involving gastroenterologists and hematologists allowed endoscopic polypectomy to be performed using a hot snare after hemostatic preparation with coagulation factor concentrates and tranexamic acid, together with prophylactic placement of an end loop. No periprocedural or postprocedural bleeding complications were observed. Histopathological examination revealed a tubulovillous adenoma with low-grade dysplasia, with complete resection and negative margins. This case highlights that endoscopic polypectomy can be safely performed in a hemophilic patient, provided that careful preparation, appropriate hemostatic prophylaxis, and preventive endoscopic techniques are used.

The physicochemical quality of the Tshopo River water before it enters the REGIDESO SA/Kisangani treatment plant in the Democratic Republic of Congo during the year 2024 was the subject of our research. The results show that the water quality of the Tshopo River does not differ significantly between quarters or between seasons in 2024, with p-values of 0.9647 and 0.9793, although there are noticeable differences between periods of heavy and dry rainfall. This is revealed by the results of analyses of more than seven physicochemical parameters, namely pH, turbidity, color, conductivity, temperature, oxidizable matter, and total alkalinity.

Background: Artificial intelligence (AI) is increasingly being integrated into healthcare systems, including dentistry, where it has applications in diagnosis, treatment planning, digital imaging, and patient communication. Public understanding of AI technologies may influence future adoption of digital healthcare systems; however, awareness of AI applications in oral healthcare among community populations remains inadequately explored. Aim: To assess digital literacy and awareness regarding artificial intelligence technologies in oral healthcare among participants attending a community oral health screening setting. Materials and Methods: A cross-sectional questionnaire-based survey was conducted among 250 participants attending a community oral health screening setting. A structured and validated questionnaire assessed awareness of artificial intelligence, familiarity with AI applications in healthcare and dentistry, and sources of digital health information. Associations between demographic variables and AI awareness were analyzed using Chi-square tests. Statistical significance was set at p < 0.05. Results: Awareness regarding artificial intelligence technologies varied among participants. Educational status demonstrated a significant association with AI awareness (p = 0.021), with participants having higher educational attainment exhibiting greater familiarity with AI applications in healthcare. Participants with greater exposure to digital technologies showed improved awareness regarding AI-based healthcare systems. No statistically significant association was observed between age group and AI awareness (p = 0.084). Conclusion: Educational status and digital literacy appear to influence community awareness regarding artificial intelligence technologies in oral healthcare. Improving public familiarity with digital healthcare systems may support future integration of AI-assisted technologies into oral healthcare delivery and patient communication.