Background: Wound closure following surgical extraction of impacted third molars directly influences postoperative recovery. Conventional vicryl sutures require knot placement, which prolongs closure time, increases infection risk, and may cause uneven tissue tension. Knotless barbed sutures eliminate these drawbacks through self-anchoring barbs. Objectives were to compare knotless barbed sutures with conventional vicryl sutures for soft tissue wound healing, wound closure time, postoperative pain, and trismus following bilateral impacted mandibular third molar surgery. Methods: A randomized split-mouth design was employed in 15 patients (aged 18-50 years) undergoing bilateral mandibular third molar extraction. One side received 3-0 knotless barbed sutures (study group); the contralateral side received 3-0 polyglactin 910 (Vicryl) sutures (control group). Parameters assessed on postoperative days 3 and 7 included wound healing (Landry-Turnbull index), suturing time (stopwatch), pain VAS (Visual analog scale), and trismus (maximal interincisal distance via Vernier caliper). Data were analyzed using SPSS Version 26. Results: Barbed sutures demonstrated significantly shorter closure time (2.6±0.35 min vs. 4.06±0.38 min; p<0.001), superior wound healing scores on day 7 (4.87±0.34 vs. 3.53±0.50; p<0.001), and lower pain scores on day 7 (0.87±0.88 vs. 2.0±0.89; p=0.002). No statistically significant difference in trismus was observed between groups at any time point. Conclusions: Knotless barbed sutures are a clinically superior alternative to vicryl sutures for closure after impacted third molar surgery, offering faster wound closure, improved healing, and reduced postoperative pain.
Cardiovascular disease (CVD) is the most common health problem worldwide and remains the leading cause of death and disease burden globally today. In recent years the increasing incidence of heart problems at younger ages has further exacerbated the situation. Furthermore, the rising cost of treatment places a significant financial burden on patients. Conventional treatment methods often face challenges such as non-targeted delivery, immediate release, short half-life and side effects. Considering these challenges nanoparticle-based drug delivery system has emerged as an increasingly effective technology. After successful use in cancer therapy, these techniques are now using their significant benefits in the treatment of CVD. Nanoparticle have the potential to deliver drugs at specific disease sites in a targeted manner, ensure controlled release, reduce side effects and improve drug biodistribution, thereby increasing treatment efficacy. Metal-based, lipid-based and polymer-based nanoparticles are considered suitable option for the therapy of CVD. In this review, we discuss how nanoparticles significantly improve upon conventional drug delivery systems by providing better targeting, controlled drug release, and reduced side effects and also cover mathematical modeling approaches that make nanoparticles more effective such as drug release models, drug diffusion model in heart tissue and non-Newtonian fluid models. These models help predict drug concentration, release rate and target site penetration making treatment more precise and personalized.
Postpartum depression (PPD) is a common maternal mental health problem with significant consequences for mothers, infants, and families. Despite growing research, evidence remains fragmented across different domains, limiting a comprehensive understanding. This scoping review aimed to map and synthesize the existing literature on the epidemiology, determinants, pathophysiological mechanisms, and prevention and management strategies of postpartum depression. A scoping review was conducted following the framework proposed by Arksey and O’Malley and reported in accordance with PRISMA-ScR guidelines. A comprehensive search of PubMed, Scopus, and Google Scholar was performed for studies published between 2000 and 2025. Studies addressing postpartum depression in terms of prevalence, risk factors, biological mechanisms, and interventions were included. Data were extracted and synthesized thematically. A total of 33 studies were included in the review. The global prevalence of postpartum depression was estimated at approximately 17%, with higher rates observed in low- and middle-income countries. Key determinants included antenatal depression, psychosocial stressors, lack of social support, and obstetric complications. Pathophysiological mechanisms involved hormonal withdrawal, hypothalamic-pituitary-adrenal axis dysregulation, neurochemical alterations, and inflammatory processes. Prevention strategies focused on early screening, psychosocial interventions, and the management of modifiable risk factors. Management approaches included psychological therapies, pharmacological treatment, and emerging therapies such as neurosteroid-based interventions. Postpartum depression is a complex condition that needs integrated, multidisciplinary strategies for effective prevention and management. Enhancing early screening, increasing access to mental health services, and implementing tailored, context-specific interventions are crucial to lowering the global burden of postpartum depression.
Background: Substance use refers to the consumption of psychoactive substances such as alcohol, tobacco, illicit drugs. Substance use among individuals living with HIV AIDS is a significant public health issue. The World Health Organization (WHO) estimates that globally about 25- 90% of HIV AIDS patients engage in substance use. In Ethiopia, magnitude of HIV AIDS was 3.69% in 2022/2023. Therefore, this study was to identify the magnitude of substance use and associated factor among HIV/AIDS patients at Dessie Comprehensive Specialized Hospital, Ethiopia. Methods: A cross-sectional study was conducted from November to December 2025, involving 422 participants selected through stratified random sampling. Data were collected via structured face-to-face interviews and analyzed using statistical package for the social sciences (SPSS). Logistic regression identified factors associated with substance use. Result: this study showed that 20.8% of HIV-positive individuals reported substance use, with khat (64.2%) and alcohol (29.8%) being the most common substances. Males were four times more likely to use substances than females. Substance use history, peer substance use, and depression were significantly associated with increased substance use. Conclusion: These findings emphasize the need for integrated care approaches that combine HIV treatment with substance use interventions. It recommends routine screening for substance use and mental health disorders, gender-sensitive and peer-based interventions, and policy changes to improve access to comprehensive care for individuals living with HIV.
Intrauterine devices (IUDs) are among the most widely used reversible contraceptive methods worldwide and are generally considered safe and effective. However, rare complications such as uterine perforation and migration into adjacent organs may occur. We report a case of trans-vesical migration of a Copper-T IUD presenting as recurrent urinary tract infection (UTI) with vesical stone formation. A 34-year-old woman presented with recurrent episodes of dysuria, pelvic pain and gross haematuria. She had undergone Copper-T insertion five years earlier. Urinalysis demonstrated pyuria and microscopic haematuria, while urine culture grew Escherichia coli. Although symptoms improved with antibiotic therapy, persistent haematuria prompted further evaluation. Imaging studies revealed an extra-uterine Copper-T lodged within the urinary bladder with associated calcific encrustation. Cystoscopic examination confirmed an intravesical encrusted foreign body embedded in the posterior bladder wall. The patient underwent successful endoscopic cystolitholapaxy with complete removal of the migrated IUD and stone fragments. Postoperative recovery was uneventful and she remained symptom-free during follow-up. This case highlights the importance of considering migrated IUDs in women presenting with recurrent or refractory urinary symptoms, particularly when there is a history of prior IUD insertion. Early diagnosis using appropriate imaging modalities and timely surgical intervention are essential to prevent long-term complications such as recurrent infection, stone formation and bladder injury.
Adolescence signifies a vital stage in human development characterised by intense physical, cognitive, emotional, and social transitions that bridge the gap between childhood and adulthood. During this stage, adolescents face multiple challenges such as mood fluctuations, social pressures, identity conflicts, academic expectations, exposure to online stressors, and engagement in risk-taking behaviours. These factors can heighten susceptibility to psychological difficulties; however, adolescence also provides a unique window to strengthen resilience that shapes long-term mental and emotional health. Resilience refers to the ability to maintain or regain positive functioning in the face of hardship, stress, or trauma. It is not a fixed trait but a dynamic process influenced by individual attributes, interpersonal relationships, and contextual environments. Fostering resilience during adolescence contributes to better emotional well-being, improved academic outcomes, and stronger social relationships while reducing vulnerability to anxiety, depression, and behavioural problems. Comprehensive approaches, including mindfulness training, social and emotional learning, mentoring relationships, and positive school environments, have demonstrated success in enhancing coping capacities and self-efficacy. Building resilience thus requires collaboration among parents, educators, and community systems to create nurturing contexts that empower adolescents. Strengthened resilience not only helps adolescents to navigate immediate life challenges but also equips them with enduring skills to manage stress, pursue goals, and contribute constructively to society. Understanding the mechanisms underlying resilience and the strategies to promote it remains essential for stakeholders seeking to advance adolescent mental health and holistic development. This review explores the concept of resilience, its major protective factors, and evidence-based strategies to enhance resilience among adolescents.
Background: The placenta is an organ that regulates fetal growth and affects the wellbeing of the fetus and the newborn. The aim of this study is to determine the average weight of placentas and neonates, and to evaluate the relationship between neonatal weight, placental weight and the effect of placental morphological deformations on these elements in Syria, as studies in Syria remain limited. Methods: A prospective cross-sectional study was conducted at Masyaf General Hospital, Syria, from July 1st to August 31st, 2024. Data was collected by using a structured questionnaire and by directly measuring the weights of the placenta and newborn of 186 participants at full-term, healthy, pregnancies (37+0 - 41+0 weeks). Statistical analysis was performed using statistical package for the social sciences (SPSS) version 25. Results: The mean of neonatal weight was 3017.47±374.78 g, the mean of placental weight was 535.08±117.76 g and the mean of neonatal weight-to-placental weight ratio was 5.826±1.04. A significant positive correlation was observed between placental weight and neonatal weight (Pearson’s r=0.603; p=0.01) and no statistically significant correlation was found between neonatal weight, maternal body mass index, age, smoking status and wrapping of the umbilical cord around neonate’s neck. Neonates born at 40 weeks had significantly higher birth weight, while placental weight was higher both at 37 and 40 weeks of gestation. Conclusion: Placental weight was significantly correlated with neonatal birth weight. The higher birth weight is at 40 weeks of gestation. This study provides reference data for the Syrian population and highlights the need for larger studies to establish national reference standards.
Background: Improper disposal of unused and expired medications from households poses significant environmental concerns due to Active Pharmaceutical Ingredients (APIs). These persist in the environment and bioaccumulate, disrupting ecological balance through various mechanisms. This cross-sectional study aimed to evaluate the knowledge, attitudes and practices (KAP) regarding ecopharmacology among MBBS students at Goa Medical College. Methods: A total of 270 participants were surveyed using a semi-structured questionnaire covering demographic information and KAP related to ecopharmacology. The collected data was transcribed into spreadsheets and analyzed using descriptive statistics. Results: Results indicate a satisfactory level of awareness among students, with the majority acknowledging the environmental implications of improper medication disposal, including pollution and antibiotic resistance. However, a significant gap was observed in awareness of guidelines for proper disposal. Despite positive attitudes towards raising awareness and implementing regulatory guidelines, many students reported engaging in improper disposal practices, such as throwing medications in household trash without segregation or flushing them down sinks or toilets. Proposed strategies for improvement include the establishment of pharmacy take-back programs and designated bins for pharmaceutical waste with waste collection systems. Conclusions: MBBS students at Goa Medical College have adequate knowledge and positive attitudes towards ecopharmacology; however, awareness of specific disposal guidelines is lacking. Integrating relevant content into the medical curriculum can help bridge this gap and promote eco-friendly healthcare practices among future physicians.
Background: Microbial inoculants are an important part of the integrated nutrient supply systems as they are a cost-effective and renewable source of plant nutrients, which complements chemical fertilizers and support sustainable farming. Liquid formulations of microbial inoculants typically are broth based, oil, or polymer-based products. Biofertilizer in form of liquid broth is a special formulation containing large number of desired microorganisms with maximum shelf life and minimum contamination. Methods: For present study, Soil survey and isolation of microbes was done. Results were showing that the growth of microbial inoculants on yeast extract MMannitol Agar (YEMA), Jensen’s Media, Mannitol Ashby agar medium, Pikovskaya’s (PVK) medium, NBRIP National Botanical Research Institutes’s medium, and Azospirillum media, Bunt and Rovira agar medium prominently very effective for carrier based liquid biofertilizers. Results: Isolation of Rhizobium, Azotobactor, Azospirillum, phosphate solubilizing bacteria (PSB) and different formulation are prepared at laboratory scale and carrier based microbial inoculants were also prepared and having very good shelf life. Conclusions: Different formulation of liquid inoculants are recomended for farming. Nitrogen fixer, phosphate solubilizer, potassium solubiliser, zinc solubiliser play important role in next generation farming.
Background: In Nigeria, sustained constraints in federal health funding have increased public hospitals' dependence on internally generated revenue (IGR). Despite its growing importance, evidence on the link between IGR and healthcare institutional performance at the subnational level remains limited. This study examined the association between IGR and the perceived performance of public healthcare institutions in Edo State, Nigeria. Methods: A cross-sectional analytical design was employed. Data were collected from July to November 2025. Structured questionnaires were administered to 150 purposively selected administrative, financial, and clinical staff across four public hospitals in Edo State. A total of 120 valid responses were analysed. Reliability testing showed acceptable internal consistency (Cronbach's alpha≥0.76). Data were analysed using descriptive statistics, Pearson correlation, and simple linear regression in IBM SPSS version 26. Results: Respondents reported high perceptions of IGR functionality and institutional performance. IGR showed a strong positive association with healthcare performance (r=0.742, p<0.001) and significantly predicted performance, explaining 55.1% of the variance. Major challenges identified included weak accountability, limited autonomy, and inadequate monitoring. Conclusions: IGR is strongly associated with improved perceived performance of public healthcare institutions in Edo State, highlighting the need for stronger governance mechanisms.
Functional endoscopic sinus surgery (FESS) frequently requires controlled hypotensive anaesthesia and topical adrenaline to minimize intraoperative bleeding and improve surgical visualization. However, the concurrent use of these techniques may result in significant haemodynamic instability due to systemic absorption of adrenaline. This case report highlights the haemodynamic challenges encountered during FESS for a 45-year-old male with bilateral nasal polyposis under general anaesthesia. Controlled hypotension was achieved using propofol infusion. Following the application of a large amount of adrenaline-soaked gauze at 1:1,000 concentrations by the surgeon bilaterally, which precipitated a haemodynamic crisis marked by profound hypotension (80/40 mmHg), rebound hypertension (180/110 mmHg), and tachycardia (150 bpm), with consequent deterioration of the surgical field leading to poor visibility. Prompt substitution with a diluted 1:10,000 preparations restored haemodynamic stability. The patient recovered uneventfully and remained symptom-free at one-year follow-up. The anaesthetic dilemma of combining controlled hypotensive anaesthesia with topical adrenaline during FESS remains a significant challenge. Topical adrenaline use may cause profound systemic cardiovascular effects; however, vigilant monitoring, prompt recognition of haemodynamic disturbances, and the use of lower adrenaline concentrations are essential to ensure patient safety.
This paper examines the practical case for dynamically generating graphics interchange format (GIF) outputs within web geographic information system (WebGIS) platforms as a response to a concrete operational problem: the difficulty of delivering large, complex geospatial datasets — particularly NetCDF and JSON files — to users operating in bandwidth-constrained or offline environments such as deep ocean voyages and remote maritime deployments. The proposed approach involves server-side rendering of time-series geospatial data into animated GIF sequences that users can download in advance and consult without any live network connection. Key findings indicate that this method significantly extends the practical reach of WebGIS platforms, improves operational safety for navigators and researchers at sea, and does so at substantially lower bandwidth cost than raw data transfer. The paper further establishes the technical, compatibility, and intellectual property considerations that govern effective GIF deployment.
Pantothenate kinase associated neurodegeneration (PKAN) is a rare autosomal recessive disorder and the most common subtype of neurodegeneration with brain iron accumulation (NBIA). While classical PKAN typically presents in childhood, atypical forms may manifest later in life with heterogeneous neurological and psychiatric features, often resulting in diagnostic delay. We report a case of atypical PKAN in a 45-year-old woman who presented with a three-year history of progressive dysarthria, involuntary tongue protrusion, sialorrhea, difficulty in jaw closure, and involuntary movements of the right upper limb. Neurological examination revealed spastic dysarthria, oromandibular dystonia, orolingual chorea, rigidity, resting tremor, hyperreflexia, and a positive Hoffmann sign. Psychiatric manifestations included anxiety, depressive episodes, and impulsivity. Routine laboratory investigations were unremarkable except for mild iron deficiency anaemia. Magnetic resonance imaging of the brain demonstrated the characteristic bilateral “eye of the tiger” sign in the globus pallidus, strongly supporting the diagnosis of PKAN. The patient was treated with trihexyphenidyl, tetrabenazine, botulinum toxin injections, and supportive therapy. This case highlights the importance of considering PKAN in the differential diagnosis of adult onset movement disorders with psychiatric manifestations. Recognition of its characteristic neuroimaging features is essential for timely diagnosis, appropriate symptomatic management, and genetic counselling. The rarity of adult onset PKAN and its diverse clinical presentation underscore the need for greater awareness among clinicians.
Background: An ischemic stroke is a condition that causes permanent damage to brain tissues and neurological disorders when blood flow to the brain is blocked. The lipid profiles can provide the baseline data, but more precise predictions of patient recovery can be affected by researchers studying some ratios between the lipoproteins called atherogenic indices. The research will help evaluate and determine the dependence of atherogenic indices of lipids on predictive value on ischemic stroke and to investigate potentially existing gender differences in the predictive value. Methods: This was a retrospective cohort study conducted from June 2025 to January 2026 in one of the tertiary Neuropsychiatric centers in Northern India and followed up on 80 cases of ischemic stroke patients (20-90) in 6 months. The research participants were divided into two groups (with and without stroke), and those who had hemiplegia caused by a stroke. Lipid profile data was used to calculate atherogenic indices: Atherogenic index of plasma (AIP=log[TG/HDLc]), Castelli risk indices I and II (CRI-I=TC/HDLc and CRI-II=LDLc/HDLc), and atherogenic coefficient (AC=[TC–HDLc]/HDLc). Indices were evaluated separately for males and females. Results: Males were reportedly seen to associate significantly with stroke and hemiplegia (p=0.027). There were more males affected by hypertension (p=0.046), but no significant gender difference in diabetes. A statistically significant difference found between genders in AIP (p=0.032). In males, CRI-II was the highest-predicting variable (AUC=0.503; CI=0.373-0.632), but it was not significant. Conclusions: AIP and CRI-II could be useful as gender-sensitive predictors of ischemic stroke, as they provide cost-effective tools in clinical risk assessment.
Ectopic kidney is described as the failure of either one or both kidneys to ascend into their anatomical position. The major classifications are simple ectopia (thoracic, abdominal and pelvic) - abnormally located kidney on the same side and cross ectopia- abnormally located kidney on the opposite side. It is a rare occurrence with a prevalence of 1 in 3000 and very limited data especially with the co-association with erectile dysfunction (ED). This is a case report of a 47-year-old male civil servant with difficulty sustaining penile erection noticed one week before presenting at the hospital facility. Prior to onset of symptom, he had over 40-hours weekly work-relate. He had no chronic diseases. Although overweight, general and systemic examination findings were normal. Investigations done were ultrasound and computed tomography scan of the Abdomino-pelvic region which revealed a right kidney located in the right iliac fossa and pelvis respectively. He was subsequently counseled on the need for adequate rest and stress management. A rare incidental finding of ectopic kidney co-occurring with ED, this case underscores the importance of maintaining a high index of suspicion for congenital renal anomalies, especially when adult patients present with non-specific genitourinary symptoms such as ED. Although, ED can be asymptomatic, their presence can lead to complications such as urinary tract infections, nephrolithiasis, and renal dysfunction. In this case, the discovery of a right-sided pelvic ectopic kidney in a patient with ED highlights the importance of comprehensive diagnostic evaluation in patients presenting with urological symptoms.
Angina bullosa hemorrhagica (ABH) is a benign condition characterized by the sudden onset of painless, blood-filled bullae in the oral mucosa without systemic or hematologic disorders. During the COVID-19 pandemic, both virus-induced coagulopathy and anticoagulant therapy may be etiologies of unusual bleeding manifestations. A 46-year-old male presented with a sudden, painless swelling on the inner cheek that gradually enlarged over three days. The patient had a recent history of severe COVID-19 infection, treated with paracetamol, corticosteroids, and anticoagulants around two weeks before this lesion. Intraoral examination revealed a well-defined bluish-purple lesion on the right buccal mucosa, measuring approximately 3 cm, with no signs of trauma, ulceration, or active bleeding. Hematologic investigations showed normal hemoglobin and platelet counts, mildly prolonged PT and aPTT, slightly elevated INR, and increased D-dimer levels. The lesion was managed conservatively and resolved spontaneously within a week. This case highlights the potential for anticoagulant-associated or post-COVID microvascular fragility leading to oral mucosal hematomas such as ABH. Clinicians should remain vigilant about spontaneous oral hemorrhagic lesions in COVID-19 patients receiving anticoagulant therapy.
Russell–Silver syndrome (RSS) is a clinically and genetically heterogeneous condition characterized mainly by intrauterine and postnatal growth retardation. It is also associated with several dysmorphic features, such as a triangular face, prominent forehead, body asymmetry, and feeding difficulties. The syndrome is usually sporadic. Because the clinical spectrum is broad, both the frequency and the severity of findings vary among individuals. Here, we present a child who had fifth-finger clinodactyly, growth retardation, body asymmetry, relative macrocephaly, and a triangular facial appearance consistent with RSS, and who also had torticollis a rare accompanying finding.
Background: Solar activity, characterized by sunspots and solar cycles, has been hypothesized to influence human health outcomes. This study investigates the correlation between solar activity and health outcomes, including cardiovascular, neurological, and heat-related mortality. Methods: This observational ecological study analyzed solar activity data from 1950 to 2024, including sunspot numbers and geomagnetic indices (Kp). Health outcomes were obtained from the WHO mortality database, stratified by latitude. Statistical analysis included correlation, regression, and stratified analysis to assess the relationships while accounting for confounders such as temperature anomalies and air pollution. Results: Geomagnetic activity (Kp Index) showed a significant correlation with cardiovascular (r=0.72, p<0.001) and neurological mortality (r=0.65, p<0.01). Sunspot numbers correlated with heat-related mortality (r=0.48, p=0.03). Regression analysis revealed that geomagnetic activity was the strongest predictor of cardiovascular outcomes, with a coefficient of 14.18 (p<0.001). Conclusions: Geomagnetic activity significantly impacts cardiovascular and neurological health. Public health strategies should consider monitoring solar activity to mitigate risks during extreme geomagnetic events.
Muscular strength, including dynamic (isotonic) and static (isometric) forms, is critical for athletic performance and is commonly assessed through maximal effort tests. The javelin throw differs from other throwing events due to its higher release velocity and very short execution time, requiring athletes to generate maximal force rapidly. Consequently, event-specific training is essential. The purpose of this study was to examine the relationship between upper arm strength and throwing velocity in university-level male javelin throwers. Eight male university javelin throwers (mean age=21.50±1.20 years) performed the seated medicine ball throw (5-kg) to assess upper arm strength and three maximal javelin throws to measure throwing velocity. The highest score from each test was used for analysis. Pearson’s correlation examined the relationship between upper arm strength and throwing velocity (p<0.05). University-level male javelin throwers demonstrated a mean seated medicine ball throw of 2.88±0.35 m and a mean throwing velocity of 87.78±1.94 km/hour. A Pearson correlation showed a very strong positive relationship between upper arm strength and javelin throwing velocity, r (8)=0.916, p=0.001. The findings indicate that greater upper arm strength is strongly associated with higher javelin throwing velocity. This underscores the importance of upper arm strength in javelin performance, while also suggesting that other factors may contribute to throwing velocity and merit further investigation.
Anemia remains a major public health challenge in India and has important clinical implications for individuals with type 2 diabetes mellitus (T2DM). In this population, anemia is a significant comorbidity rather than an incidental finding, contributing to poorer glycemic control, increased risk of microvascular and macrovascular complications, reduced functional capacity, and overall diminished quality of life. Iron deficiency anemia (IDA) is the most prevalent in this patient population. These interconnected mechanisms contribute to both absolute and functional iron deficiency, yet anemia often remains underdiagnosed and undertreated in routine diabetes management. Conventional oral iron salts, though widely used, are frequently limited by gastrointestinal intolerance, interactions with dietary phytates, and poor long-term adherence, reducing their therapeutic effectiveness. Ferrous bisglycinate, a newer iron-amino acid chelate, has emerged as a promising alternative that addresses many of these limitations. Its chelated structure enhances bioavailability, minimizes gastrointestinal irritation, and allows more efficient absorption even in the presence of dietary inhibitors common in Indian diets. Clinical studies from India consistently demonstrate that ferrous bisglycinate can achieve significant improvements in Hb and ferritin levels at lower elemental iron doses compared with traditional iron salts, with better tolerability and higher adherence. This review consolidates current evidence on burden, mechanisms, and clinical relevance of anemia in T2DM and evaluates therapeutic advantages of ferrous bisglycinate. Together, these insights underscore the need for improved recognition of anemia in diabetes care and support the integration of newer, more tolerable iron formulations to enhance long-term clinical outcomes.
