Background: A clinically unhealthy cervix may be associated with benign inflammatory conditions as well as cervical intraepithelial neoplasia (CIN) and invasive carcinoma. Colposcopy provides magnified assessment of cervical abnormalities and facilitates targeted biopsy, while histopathology remains the definitive diagnostic method. This study evaluated colposcopic findings and their correlation with histopathological diagnoses among women with a clinically unhealthy cervix. Methods: This prospective observational study was conducted in the Department of Obstetrics and Gynecology, Dhaka Medical College Hospital, Bangladesh, from January to June 2026. A total of 150 women with a clinically unhealthy cervix were enrolled. All participants underwent clinical examination, colposcopic evaluation, and colposcopy-directed cervical biopsy. Histopathological findings were considered the reference standard. The diagnostic performance of colposcopy for detecting CIN 2+ was assessed, and agreement between colposcopic impression and histopathological diagnosis was evaluated using Cohen’s kappa. Results: The mean age was 44.1±10.2 years, and 31.3% were aged 41–50 years. Abnormal vaginal discharge was the commonest complaint (60.7%), while acetowhite epithelium was the most frequent colposcopic finding (48.7%). Histopathology revealed chronic cervicitis/inflammatory lesions in 34.7%, CIN 1 in 19.3%, CIN 2 in 11.3%, CIN 3 in 9.3%, and invasive squamous cell carcinoma in 6.7%. Overall, CIN 2+ was identified in 27.3%. Colposcopy showed 85.4% sensitivity, 83.5% specificity, and 84.0% diagnostic accuracy for CIN 2+. Agreement with histopathology was fair (κ=0.37, p<0.001). Conclusion: Colposcopy is a useful diagnostic tool for evaluating clinically unhealthy cervices, but histopathological confirmation remains essential for definitive diagnosis.

Background: Insulin therapy is required in gestational diabetes mellitus (GDM) when glycaemic targets are not achieved through lifestyle modification and rapid acting insulin analogues such as regular aspart insulin have been developed to provide more physiological postprandial and fasting glucose control than regular human insulin. This study aimed to compare glycemic control, including fasting, postprandial and glycated haemoglobin parameters, between regular aspart insulin and regular human insulin in women with gestational diabetes mellitus. Methods: This randomized controlled trial was conducted in the outpatient department of Obstetrics and Gynaecology, BIRDEM General Hospital, Dhaka, from October 2023 to January 2025, among 102 pregnant women with GDM diagnosed after 24 weeks of gestation. Participants were randomly allocated to regular aspart insulin (Group I, n=54) or regular human insulin (Group II, n=48); 49 and 46 women respectively completed follow up at 28, 32 and 36 weeks of gestation and after delivery. Fasting blood sugar, postprandial glucose two hours after breakfast, lunch and dinner and HbA1c were compared using SPSS version 26, with p&lt;0.05 considered significant. Results: Mean age of participants was 29.2 ± 4.6 years and 63.16% were obese before pregnancy. Fasting glucose was significantly lower in Group I at every assessment point (p&lt;0.0001). Postprandial glucose values were also significantly higher in Group II at 28 weeks (p&lt;0.05 for all three postprandial readings), but these differences attenuated by 32 and 36 weeks and after delivery. HbA1c was comparable between groups at 28 weeks (6.1 ± 1.0 versus 6.4 ± 1.4, p=0.327) and 36 weeks (5.8 ± 1.0 versus 5.9 ± 1.4, p=0.697). Conclusion: Regular aspart insulin provided superior fasting glycaemic control throughout pregnancy and more favourable early postprandial control than regular human insulin, while overall glycated haemoglobin remained comparable, supporting its use as an effective glycaemic management option in gestational diabetes mellitus.

Background: Early initiation of breastfeeding within the first hour of life is a critical intervention for reducing neonatal morbidity and mortality. However, timely initiation remains suboptimal in many settings. This study aimed to identify maternal and neonatal characteristics associated with early initiation of breastfeeding. Methods: This cross-sectional study was conducted in the Department of Obstetrics and Gynaecology at Dhaka Medical College Hospital from July 2012 to December 2012. A total of 100 postpartum mothers were enrolled using purposive sampling. Data were collected through direct interviews using a pre-designed data collection sheet and analyzed using SPSS software. Results: Among the 100 mothers, 57% were below 25 years of age, 62% had primary level education, 82% were housewives, 72% were Muslim and 68% resided in rural areas. The majority (58%) belonged to the lower socioeconomic group and 72% were primipara. Regarding neonatal characteristics, 74% of babies were born at term, 58% were male and 62% had low birth weight (< 2.5 kg). Statistically significant associations were observed for gestational age (P = 0.001) and birth weight (P = 0.001), while gender did not reach statistical significance (P = 0.060). Conclusion: Maternal characteristics such as younger age, lower education, primiparity, lower socioeconomic status, along with neonatal factors like preterm gestational age and low birth weight, were prominent among the study population. These findings highlight the need for targeted breastfeeding support and counseling, particularly for vulnerable groups, to promote early initiation and improve neonatal outcomes.

The vitality of the ocean as concerns navigation, mineral resource extraction, environmental protection and national security cannot be over emphasised. The strategic and indispensable importance of the ocean has resulted in conflicts between countries over its control. This is further exacerbated with the commencement and operationalisation of offshore mining. The practicality and legality in the exercise of jurisdiction in maritime zones such as the Exclusive Economic Zone and the Continental Shelf have been met with stiff resistance in some circumstances. This article therefore seeks to determine and evaluate the legal dispensations permitting Cameroon to legislate and enforce its national laws in the maritime zones beyond its territorial sovereignty. To effectively do this, this research adopts both the empirical and doctrinal research methodology, making use of both primary and secondary data. The legal and genetic methods were used to analyse the data. The research concludes that, the sovereign rights enjoyed by Cameroon over the Exclusive Economic Zone and the Continental Shelf are legally backed by both international and national laws. However, these rights are limited to exploration, exploitation, conservation and management of maritime resources, with third States enjoying some freedoms over these maritime zones. The freedoms include navigation, overflight, laying of submarine cables and pipelines within these maritime zones as long as these third States comply with the sovereign rights of the State of Cameroon. It is therefore recommended that, the existing sectoral laws adopted by Cameroon over these maritime zones should be rigorously implemented and enforced in order to ensure uniformity and compliance.

Introduction: Preeclampsia constitutes a significant complication during pregnancy, contributing notably to maternal and perinatal morbidity and mortality on a global scale. Calcium is vital for the functioning of vascular smooth muscle and the regulation of blood pressure. However, the association between maternal serum calcium levels and the severity of preeclampsia remains insufficiently elucidated, particularly within the context of Bangladesh. Objective: To evaluate the association between maternal serum calcium levels and the severity of preeclampsia among pregnant women at Dhaka Medical College Hospital. Methods: This cross-sectional observational study was conducted in the Department of Obstetrics and Gynecology, Dhaka Medical College Hospital, Bangladesh, from January to June 2026. A total of 120 pregnant women diagnosed with preeclampsia, categorized into non-severe (n=70) and severe (n=50) groups. Serum calcium levels were measured, and demographic, obstetric, and clinical characteristics were recorded. Data were analyzed using appropriate statistical tests, with p<0.05 considered significant. Results: Women with severe preeclampsia had significantly lower mean serum calcium levels compared to those with non-severe disease (7.82 ± 0.61 mg/dL vs. 8.64 ± 0.52 mg/dL; p<0.001). Serum calcium <8.5 mg/dL was strongly associated with severe preeclampsia (OR=4.5, 95% CI: 1.96–10.15, p<0.001), and this association persisted after multivariable adjustment (AOR=3.92, 95% CI: 1.64–9.37, p=0.002). Significant negative correlations were observed between serum calcium and both systolic (r=-0.49) and diastolic (r=-0.43) blood pressures. Conclusion: Low maternal serum calcium is linked to severe preeclampsia, suggesting it could help identify women at risk. However, causality can't be confirmed due to the study's cross-sectional nature. Longitudinal research with ionized calcium, vitamin D, and diet assessment is needed to clarify mechanisms before clinical use.

Background: Reflective practice is internationally recognised as a foundational mechanism for nursing professional development; however, no validated structural model links Gibbs’ Reflective Cycle to measurable clinical performance, evidence-based practice (EBP) adoption, professional competence, and patient safety outcomes among Saudi Arabian hospital nurses. The Gibbs Reflective Nursing Excellence Model (GRNEM) is proposed to address this gap. Objectives: This review synthesises peer-reviewed evidence (2021–2026) on: (1) the application of Gibbs’ Reflective Cycle among clinical nurses; (2) relationships between reflective practice and clinical performance, EBP, professional competence, and patient safety; and (3) the evidence base supporting GRNEM development and validation in Saudi Arabian hospital settings. Methods: A systematic review followed PRISMA 2020 guidelines. Six databases (PubMed, CINAHL, Scopus, Web of Science, MEDLINE, and the Cochrane Library) were searched for studies published between January 2021 and June 2026. Two independent reviewers screened 1,247 records; 24 studies met all inclusion criteria. Quality appraisal was performed using the Mixed Methods Appraisal Tool (MMAT) and Joanna Briggs Institute (JBI) checklists, with narrative and thematic synthesis. Results: Five overarching themes were identified: Gibbs’ Reflective Cycle as a structured professional development framework; reflective practice and clinical performance; EBP adoption in Saudi Arabian nursing; professional competence and nursing values; and patient safety culture in MNGHA and Saudi hospital settings. Structured reflective practice was consistently associated with improved clinical performance (k=9), EBP adoption (k=7), professional competence (k=5), and patient safety culture (k=3). Conclusion: Findings provide a robust evidence base confirming the theoretical plausibility, contextual relevance, and empirical foundation of GRNEM for Saudi Arabian tertiary hospital nursing, with implications for nursing education, clinical governance, and Saudi Vision 2030 health policy.

Background: Nursing research and scholarly publication underpin evidence-based practice, yet many nurses report barriers that limit their engagement in conducting and disseminating research. Data on these barriers among hospital-based nurses in Saudi Arabia's Eastern Province remain limited. Objectives: This study aimed to identify the barriers nurses face in conducting and publishing scientific research at King Abdulaziz Hospital, Al-Ahsa; to assess the impact of these barriers; and to examine their association with nurses' socio-demographic and professional characteristics. Methods: A quantitative, descriptive, cross-sectional study was conducted among 127 nursing staff (33.0% response rate from a target population of 385), recruited via convenience sampling. Data were collected using a 45-item structured, self-administered questionnaire adapted from Hakami (2023) and distributed through Microsoft Forms. Thirty-four barrier items were scored on a 4-point scale (strongly disagree = 0, disagree = 0, agree = 1, strongly agree = 2); an overall score ≥ 60% of the maximum was classified as “high barrier.” Descriptive statistics, chi-square tests, independent-samples t-tests, and one-way ANOVA were used (α = .05). Results: Respondents were predominantly female (90.6%) and non-Saudi (85.8%), with a mean age of 40.9 years (SD = 9.3). The most highly endorsed barriers were limited training courses on publishing (85.0% agreement), insufficient time to conduct research (82.7%), high cost of publication (83.5%), and lack of clarity around journal guidelines (89.8%). Only 10 respondents (7.9%) met the high-barrier threshold overall; mean total barrier score was 25.6 (SD = 12.9) of 68 (37.7% of maximum). No demographic variable was significantly associated with the high/low barrier classification, although age group was significantly associated with the continuous barrier score, F(3, 123) = 3.80, p = .012, with nurses younger than 30 years reporting the highest scores. Conclusion: Structural and institutional barriers — particularly insufficient training, time, and financial support — are more salient than personal writing or language barriers among this nursing population. Targeted institutional interventions, especially for early-career nurses, are recommended to strengthen nursing research capacity.