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This article examines the relationship between Premenstrual Dysphoric Disorder (PMDD), neurovascular dynamics, and sensory sensitivities in autistic women during menstruation. The redirection of blood flow to the uterus during the menstrual cycle has been found to exacerbate cerebral perfusion deficits in neurodivergent individuals, particularly in the Prefrontal Cortex (PFC), which contributes to the mood dysregulation and emotional instability characteristic of PMDD. Autistic women, who often exhibit heightened sensory sensitivities, experience intensified discomfort during menstruation, as sensory overload and altered pain perception compound the emotional challenges of PMDD. These findings emphasize the need for neurodivergent-friendly menstrual products that mitigate both physical and emotional discomfort. Additionally, innovations using biodegradable materials, smart fabrics, and custom-fit menstrual solutions are discussed as potential breakthroughs to improve the quality of life for autistic women managing PMDD. This research highlights the importance of addressing both neurobiological and sensory aspects when designing interventions for PMDD in neurodivergent populations.

Uvular injuries are uncommon after general anesthesia and can result from direct trauma to the posterior part of the soft palate or compression and restriction of blood flow to the uvula caused by the inadvertent placement of the airway or suction devices in the oral cavity. There have been cases of inflammation and ulceration occurring in the midline oropharyngeal structures such as the uvula after general anesthesia with a tube or laryngeal mask airway, even in the absence of direct trauma or infection, presumably due to compression ischemia. While sore throat following general anesthesia is a common symptom, it is important to evaluate any severe or persistent pain to exclude uvulitis. Here we present a case of uvulitis that developed after the insertion of a flexometallic endotracheal tube using the midline technique during C-Mac video laryngoscopy. We also emphasize the measures that can be implemented to prevent such a complication. The entrapment of the uvula during intubation often goes unnoticed due to limited oral space after insertion of the video laryngoscope blade, with the intubating anesthetist staying focused on the monitor. This complication following the use of a C-Mac video laryngoscope has not been previously documented.

Background: The frequency of latex allergy is increasing, posing a major health problem. This increase is related to the widespread use of latex materials and cross-reactions between latex proteins and certain foods. This cross-reactivity makes latex avoidance difficult, and latex sensitization is likely to worsen atopic conditions. Objective: The authors evaluated the role of latex sensitization in the poor control of asthma and rhinitis. Methodology: An analytical cross-sectional study was conducted on 1860 patients of all ages and genders, followed up for allergic asthma and rhinitis since March 2012 in the Immuno-Allergology Unit of the Cocody University Hospital in Abidjan. Prick tests with native extracts and the European standard battery were performed to identify allergenic sensitization. The impact of latex sensitization on asthma and rhinitis control was assessed by calculating odds ratios. Results: A high frequency of latex sensitization was associated with asthma and rhinitis. The risks of poor control were related to monosensitization to latex and were even higher in the context of polysensitization. Conclusion: The impact of latex sensitization on the progression of asthma and rhinitis has been well demonstrated. It is recommended to integrate the latex sensitization status into the therapeutic management strategy of these two pathologies.

This paper examines the effects of globalization on nations, focusing on economic, social, and cultural dimensions. It analyzes the roles of protectionism and globalization in shaping consumer welfare and producer earnings through qualitative methods and the Customs Union theory framework. The study discusses the benefits and drawbacks of globalization in the context of World Trade Organization (WTO) regulations. The findings indicate that globalization has intensified financial flows between countries, which can exacerbate economic crises. Countries with abundant human resources can capitalize on the international division of labor to specialize in high-value sectors, while those with limited resources risk falling behind in the digital landscape. This division of labor fosters specialization and improves production efficiency through targeted education. However, multinational corporations often impede cost-effective production in developing nations, underscoring the necessity to restructure research and development to facilitate technology adoption in underdeveloped areas. This restructuring can help close the technological gap and encourage equitable participation in the global economy. Jel code Classification: D6: Welfare economics, Fo1 Global outlook, F40: General F4: Macroeconomics aspects of international trade and finance

Many studies from the early 20th century on the significance of the pores of Kohn were assessed based on the pathogenesis and pathology of pneumococci pneumonia occurring in man. The pneumococci were carried in the edema fluid directly from alveolus to alveolus through the pores of Kohn and from bronchiole to bronchiole as a result of repeated aspirations, aided by breathing, coughing, and gravity. With the emerging minimally invasive and non-invasive techniques experimentations and the current medications; tackling exacerbations and improving the pulmonary function in various lung diseases remains a dilemma for clinicians and researchers. In this article, we aim to review specifically the pores of Kohn as this is the portal for the spread of infection but also lung recruitment during breathing.

Coronary Artery Disease (CAD) is a leading cause of mortality worldwide, with coronary angioplasty being a crucial intervention for patients with significant disease. This study aimed to identify and analyze the causes of coronary angioplasty denial in patients with significant coronary artery disease in Afghanistan, focusing on demographic, socioeconomic, and clinical factors.A case-control study was conducted with a sample size of 213 patients diagnosed with significant CAD at tertiary care center in Afghanistan. The case group consisted of 106 patients who were denied angioplasty, and the control group included 107 patients who underwent the procedure. Data were collected on demographic characteristics, comorbidities, education, residence, functional status, income, and the reasons for angioplasty denial. Descriptive statistics and comparative analyses were performed to assess the factors associated with denial.The primary reasons for angioplasty denial were financial constraints (45.3%, p < 0.001), limited hospital facilities (15.1%, p = 0.045), patient refusal (23.6%, p < 0.001), and physician preference for conservative management (12.3%, p = 0.091). Denial rates were higher among patients who were older, had multiple comorbidities, were from rural areas, and had lower education and income levels. Illiteracy and cultural beliefs contributed significantly to patient refusal, while inadequate healthcare infrastructure disproportionately affected rural populations.Financial and infrastructural barriers are the leading causes of coronary angioplasty denial in Afghanistan, exacerbating disparities in healthcare access, particularly among low-income and rural patients. Addressing these issues through policy reforms, improved healthcare infrastructure, and targeted public health education is essential to reducing CAD-related morbidity and mortality in the country.

Background: Clinical education is an important component of physiotherapy education programs. It provides insights to the students in the fields of physiotherapy practice, develops leadership, and enhances their clinical skills in patient assessment, examination, diagnosis, treatment, planning, and intervention selection. The dimension of physiotherapy education is in the developing phase in Nepal. For further growth, the experience and the perception of the students are very important. Through this, the facilitators and barriers in physiotherapy clinical education need to be recognized. Therefore, this study aimed to explore the facilitators and barriers in physiotherapy clinical education in Nepal from a student’s perspective.Objectives: The main objective of this study was to identify the perception of physiotherapy undergraduate students about their clinical education and to find out the facilitators and barriers in clinical education.Methods: A qualitative research using focused group discussion was conducted. Ethical considerations were taken from respective departments and IRC approval was taken. BPT 3rd year, 4th year, and intern students of KUSMS were called to participate in the study. After the consent from the participants, focus groups of 6 participants (2 participants from each 3rd year, 4th year, and intern) were formed. In five FGDs, data saturation was observed and no further FGDs were conducted. FGDs were collected with audio tape recordings. The data were transcribed verbatim and translated into the English language. Then data coding was done and themes and sub-themes were generated from the codes.Results: Through the transcribed and translated data, seven themes were generated which were clinical education, student expectation, student attitude and behavior, roles and responsibilities of clinical educators, exposure, resources, and miscellaneous. These headings explained the perception of facilitators and barriers.Conclusion: The facilitators and barriers to physiotherapy clinical education were identified through student’s perspectives. These findings should be considered while preparing the guiding document for clinical education to enhance the quality of education.

Sleep disorders represent a significant public health concern due to their widespread prevalence, impact on overall health, and the economic burden they impose. These disorders encompass a broad spectrum of conditions, ranging from insomnia and obstructive sleep apnea (OSA) to narcolepsy, restless legs syndrome (RLS), and parasomnias. They are often associated with comorbidities such as cardiovascular diseases, metabolic dysfunctions, and mental health disorders, making their identification and management critical.The publication of this work is of high interest as it contributes to the expanding body of literature focused on understanding the complex interplay between sleep disorders and health outcomes. By presenting detailed case reports, this study provides valuable insights into the diagnostic challenges, treatment modalities, and potential avenues for personalized interventions in sleep medicine. Case reports are particularly important in this field as they shed light on unique presentations and rare conditions that might otherwise go unnoticed in large-scale epidemiological studies. From an epidemiological perspective, sleep disorders are highly prevalent globally. According to the World Health Organization (WHO), approximately 30% - 45% of the global population experiences sleep disturbances. Obstructive sleep apnea, for instance, affects nearly 1 billion individuals worldwide, with varying prevalence across age, gender, and geographic regions. Insomnia affects roughly 10% - 30% of adults, with rates as high as 50% - 60% in older populations.Meanwhile, narcolepsy, though rare, is estimated to affect 1 in 2,000 people in the general population. These statistics underscore the pressing need for enhanced diagnostic methods, improved treatment strategies, and comprehensive patient management. By detailing real-world cases, this publication aims to bridge the gap between clinical observations and broader scientific understanding. The insights gained from these case studies have the potential to inform future research directions, improve clinical practices, and ultimately enhance patient outcomes in sleep medicine.Sleep disorders affect millions of individuals globally, disrupting physical, mental, and emotional well-being. Conditions such as insomnia, obstructive sleep apnea (OSA), narcolepsy, and restless legs syndrome (RLS) are among the most studied. This paper examines the etiology, diagnosis, and management of sleep disorders, presenting detailed case reports and integrating relevant sleep study findings. Figures such as polysomnography (PSG) outputs and statistical trends provide visual insights into diagnostic and therapeutic interventions. Sleep disorders encompass a wide range of conditions that significantly disrupt sleep quality and overall well-being. Common disorders such as insomnia, obstructive sleep apnea (OSA), narcolepsy, and restless legs syndrome (RLS) affect millions globally, posing risks to physical health, mental stability, and cognitive performance. This study explores the clinical presentation, diagnostic approaches, and management of sleep disorders through the lens of detailed case reports and sleep study data.Polysomnography (PSG), the gold standard for sleep disorder diagnosis, plays a pivotal role in identifying abnormal sleep patterns, respiratory irregularities, and neural disruptions. Multiple sleep latency tests (MSLT) and actigraphy complement PSG, offering insights into disorders like narcolepsy and circadian rhythm abnormalities. This paper presents three representative case reports: chronic insomnia, severe OSA, and narcolepsy with cataplexy. Each case is analyzed in-depth, highlighting patient history, PSG findings, treatment interventions, and outcomes. For chronic insomnia, cognitive-behavioral therapy for insomnia (CBT-I) and pharmacological intervention resulted in marked improvements in sleep latency and efficiency. In the OSA case, continuous positive airway pressure (CPAP) therapy significantly reduced the apnea-hypopnea index (AHI) and alleviated daytime symptoms. The narcolepsy case demonstrates the efficacy of modafinil and sodium oxybate in managing excessive daytime sleepiness and cataplexy.Despite advancements, challenges persist in the field, including patient adherence to therapy, accessibility to specialized sleep studies, and the ethical implications of AI-driven diagnostic tools. Future research should focus on scalable, patient-centric approaches and the role of emerging technologies in enhancing diagnostic accuracy and treatment efficacy. This paper aims to contribute to the evolving understanding of sleep disorders, bridging clinical case insights with the broader implications for sleep health and research.

Africa is one of the continent’s most vulnerable to the effects of climate change despite contributing the least to global greenhouse gas emissions. The continent has faced many environmental challenges recently, including rising temperatures, altered precipitation patterns, frequent droughts, and extreme weather events. These changes exacerbate existing vulnerabilities in agriculture, water resources, human health, and infrastructure, which are vital for the livelihoods of millions of people. Africa’s population is 60% occupied by agriculture and is threatened by shifting rainfall patterns and extended droughts. Crop yields are increasingly variable, leading to food insecurity and exacerbating poverty. Water scarcity is another pressing concern, as reduced rainfall and more frequent droughts strain already limited water resources, affecting agriculture and access to clean drinking water. Coastal regions are also at risk, with rising sea levels threatening millions living in low-lying areas. In effect, the impacts of climate change extremely affect Africa’s low-level income populations, deepening social and economic inequalities. Africa’s limited financial resources and infrastructure hinder its ability to adapt to these challenges. Nonetheless, Africa also has the potential for resilience through nature-based solutions, renewable energy investments, and regional cooperation. Efforts to enhance climate adaptation, such as sustainable farming practices, improved water management, and climate-smart policies, are critical in building the resilience of communities in combating climate change.

Burnout among clinicians is a pressing concern worldwide, manifesting as emotional exhaustion, depersonalization, and reduced professional efficacy. This article explores the intersection of burnout and allostatic load, the physiological burden resulting from chronic stress, to elucidate the consequences for healthcare providers. Burnout impacts clinicians’ mental and physical health, leading to compromised patient care, reduced job satisfaction, and increased attrition rates. A comparative analysis of recent scholarly works reveals converging evidence on systemic contributors such as excessive workloads, inadequate support systems, and organizational inefficiencies, further compounded by individual vulnerabilities like lack of resilience. These challenges have been exacerbated by the COVID-19 pandemic, which has significantly increased stress levels among healthcare professionals globally. This article synthesizes insights from studies conducted between 2020 and 2024, emphasizing the need for holistic approaches to mitigate burnout. It highlights the physiological underpinnings of allostatic load, including chronic dysregulation of stress-response systems that predispose clinicians to adverse health outcomes like cardiovascular diseases, immune dysfunction, and mental health disorders. To address these issues, the article proposes a multidimensional strategy encompassing organizational reforms, evidence-based interventions, and policy advocacy. Recommendations include reducing administrative burdens, fostering supportive work environments, and integrating wellness programs targeting both systemic and individual stressors. Limitations and directions for future research emphasize the importance of inclusive, longitudinal studies focusing on diverse populations to develop tailored solutions. This comprehensive approach aims to enhance clinician well-being and improve healthcare outcomes globally.

Quantum fluctuations, usually arising from the inherent uncertainty in the quantum fields, are pivotal in understanding the universe at both the small and large scales. Even though fluctuations are usually unobservable and rather small, they give significant observable effects during specific epochs under specific conditions. During the early epochs of the universe, the fluctuations were scaled, resulting in the primordial density perturbations that gave rise to the large-scale structure of the universe and the observed inhomogenities. In this paper, we study the basic origin, structure, evolution, and imprints of fluctuations during the inflationary period resulting in large-scale structure formation. We use the Mukhanov-sasaki formalism to model scalar perturbations, embedding the theoretical results into observations. Theoretical predictions show an almost scale-invariant power spectrum with stringent constraints on the inflationary parameters. It further states that in the very early universe, the inflatons that are quanta of the primordial field were highly filled in the degenerate quantum state. This carries large potential energy that results in an exponential expansion of the universe. During post post-inflationary period the inflaton dominated the Universe’s energy density; they interact among themselves and due to non-linear effects, these inhomogeneities grow which amalgamate into spatially distinguishable patches in our observable universe. Our understanding projects us towards the fact that fluctuations play a pivotal role in understanding the structure formation at micro, macro, and far-macro scales. This study also addresses the significance of quantum fluctuations in cosmic evolution and manifests the enduring relevance in addressing some of the profound mysteries of our universe.

In the digital age, media offenses pose significant threats to privacy and reputation. Digital forensics plays a crucial role in combating these crimes by providing systematic methods and valuable knowledge. This work reviews how the field has proven effective in solving cases and preventing offenses, offering a solid career path for those interested in crime-solving and digital evidence collection.

Background: Studies explored the therapeutic role of agents inhibiting RAS in epilepsy. Fewer studies addressed the electrophysiological changes associated with angiotensin converting enzyme inhibitors (ACEIs) in terms of sustained seizures (status epilepticus). Sodium valproate (SVPA), a broad-spectrum anticonvulsant, has been associated with adverse cardiac events upon long-term use, in contrast to the beneficial role of ACEIs in cardiovascular disorders.  This work explored the potential effects of ramipril, an ACEI, compared to SVPA, on the behavior, and electrophysiology of the brain and heart in a rat model of status epilepticus. The dose dependent pattern of the presumed ramipril activities was investigated. Methods: Adult male rats were assigned into seven groups, controls, IP pyridostigmine (36 mg/kg)-induced status epilepticus (PISE), oral SVPA (5 mg/kg), and three groups receiving oral ramipril at respective doses of 5 (R5), 10 (R10), and 20 mg/kg (R20). Rat behavior was assessed using Racine’s motor convulsion scoring for 10 minutes.  Blood pressure was recorded, and electroencephalography (EEG) and electrocardiography (ECG) were performed on the sedated rats 24 hours after recovery. Results: Despite the partial behavioral improvement of motor convulsions with R5 and R10 exhibited epileptogenic activity, as indicated by the increased relative power of fast and slow gamma waves and total EEG power. R10 triggered arrhythmia and cardiac ischemia as indicated by absence of P wave, along with ST elevation and tall T wave, slowed heart rate and prolonged QRS, QTc, and RR intervals. Conclusion: PISE was resistant to sodium valproate and ramipril. Ramipril at low and moderate doses induced epileptogenic activity and, especially at moderate dose, precipitated cardiac ischemia and arrhythmia. SummaryThe debatable role of ramipril in epilepsy was studied in a rat model of pyridostigmine-induced status epilepticus, compared to sodium valproate. Increasing ramipril doses did not resolve status epilepticus in rats. Instead, low and moderate doses exhibited epileptogenic activity, opposite to high dose ramipril and sodium valproate. Blood pressure was dose-dependently reduced with ramipril. Electrocardiography showed evidence of cardiac arrythmia and ischemia, especially with the moderate ramipril dose. The behavioral and EEG indices correlated with systolic blood pressure and ECG changes.