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Stroke, is a significant cause of morbidity and mortality in sickle cell disease, occurring with an incidence of 10 to 25%. The risk of Stoke is highest during the first decade of life, Extensive research has established that cerebral stenosis, involving the circle of Willis, is the most common mechanism in children. A report of 11-year-old boy with Sickle Cell Anemia presented with history of left sided hemiplegia for 3 weeks that was of sudden onset. Computerized tomography of the brain revealed an increasing sulcal space more marked in frontal lobes associated with hypo attenuating area in the right frontal lobe. Features suggestive of Brain atrophy and right frontal lobe Ischemic.

ABSTRACT
Delayed in menstrual period is a concern among ladies and this delayed have called the attention of parents to ascertain the caused. In course of finding a solution to this reproductive issue, the family spent a lot of money to get a solution and this may have led the family to face financial problem. This research is to Evaluate the Economic Impact of Delayed Menstrual Period on The Family of Affected Female Students in South-South Nigeria. Sample size for the study was 250 and participant were randomly selected and the questionnaire were issued to the participants to fill and return it to the researcher. Data was analyzed with SPSS version 26 and P value < 0.05 was considered significant. The results revealed that 98.4% of the participants agreed that delayed menstrual period have economic impact on the family, 96.0% took family’s attention, 96.0% borrowed money and 94.4% of the family finds it difficult to meet up with its needs. Delayed in menstrual period among students of tertiary institutions have brought economic hardship to families of those students facing the delayed.

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Background: Ophthalmoscopic examination is one of the most critical but often neglected portions of clinical evaluation in case of headache as many secondary causes of headache show ophthalmoscopic change like papilloedema Optic atrophy, subhyaloid hemorrhage, cytoid body, choroid tubercle. So, a clinical examination is only complete with an ophthalmoscopic examination. With this view, this study is done on patients presenting with headaches in neurology outdoors for appropriate clinical evaluation. Aims & objectives: To evaluate ophthalmoscopic changes in patients presenting with headaches in the neurology outpatient department of a tertiary-level hospital. Method: This cross-sectional study included 300 patients presenting with headaches in the neurology outpatient department of DMCH. Result: Among the abnormal findings, papilloedema was the most common finding, present in (21.0%) of patients, followed by arteriovenous nipping & silver wiring detected in (18.0%) of patients; flame-shaped hemorrhages in 12.0% of cotton-wool spots in 9.0% patients and hard exudates in 8.0% patients. Conclusion: Ophthalmoscopic examination should be done routinely for headaches.

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(80) swabs were obtained from children with otitis media who visited the ENT consulting clinics at the Women's and Children's Hospital in Diwaniyah Governorate between 1-2-2025 and 1-4-2025. A specialist physician assisted in the collection of samples from patients of both sexes ranging in age from (1-6) years. Microscopy and biochemical testing were used to identify the isolated bacteria based on their cultural and physical traits. 80 bacterial isolates were recovered and diagnosed from children with otitis media, which are distributed as follows: 35 bacterial isolates from Pseudomonas aeruginosa with a growth rate of 43.75%, while 35 isolates from the Staphylococcus species were distributed as follows: There were 20 Staphylococcus aureus isolates with a growth rate of 25% and 15 Staphylococcus epidermidis isolates with a growth rate of 18.75%. 8 isolates from the Streptococcus pneumoniae genus were also collected with a growth rate of 10%, and two isolates from Klebsiella pneumoniae with a growth rate of 2.5% by biochemical tests. Antibiotic sensitivity testing was performed on every identified bacterial species, and the isolates' susceptibility to the antibiotics utilized varied significantly. P. aeruginosa showed 99% resistance to amoxicillin, it also demonstrated significant resistance to antibiotics (amikacin, ampicillin, and tetracycline), with rates of 75, 72, and 78%, respectively, and the lowest resistance rates to the drug cefotaxime, at 15%. St. aureus were resistant to antibiotics (amoxicillin, rifampicin, amikacin, ampicillin, and trimethoprim) at rates of 56, 50, 44, 39, and 36%, respectively, while cefotaxime sensitivity was documented at 98%. St. pneumoniae bacteria exhibited the highest resistance to amoxicillin, reaching 97%, while remaining sensitive to ampicillin at 88%. It also resisted the antibiotics (rifampicin, trimethoprim, cefotaxime, and ceftazidime) with rates of 40, 55, 59, and 64, respectively.

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Background: Gestational Diabetes Mellitus (GDM) is a complex metabolic condition that has a detrimental effect on both maternal and foetal outcomes. Oxidative stress contributes to the pathogenesis of GDM by causing insulin resistance in peripheral tissues and affecting insulin production from pancreatic β cells. Oxidative stress is defined as an increase in free radical activity and lipid oxidation levels. GGT could be utilised as an indicator of the GDM. Objective: To measure serum gamma-glutamyl transferase (GGT) in first, second and third trimester of pregnancy. Materials and Methods: This study was a cross sectional study was conducted the department of Clinical Pathology in collaboration with the department of Obstetrics and Gynecology, BSMMU, Dhaka from July 2015 to June 2016. Total 149 pregnant women at 1st, 2nd and 3rd trimester of pregnancy. The WHO criteria for diagnosing gestational diabetes mellitus (GDM) in 2015 include fasting plasma glucose 5.1-6.9 mmol/L and a 2-hour plasma glucose level of 8.5-11.0 mmol/L after a 75g oral glucose tolerance test (OGTT). These criteria are used to identify women at risk of adverse neonatal outcomes due to gestational diabetes were included in this study. Women with previous diagnosis of DM, systemic disease (HTN, Collagen tissue disease, Heart disease. Renal disease, Chronic liver disease) and history taking Alcohol and some drugs that affects GGT (Phenytoin, Phenobarbital, Acetaminophen, HMG CO reeducates inhibitor, OCP) were excluded in this study. Results: The mean OGTT was found 4.43±0.50 mmol/L in first trimester and 5.17±12.9 mmol/L in second trimester and 6.60±1.26 mmol/L in third trimester respectively. That were statistically significant between each group. Mean blood glucose after 2 hours was 5.59±1.11 mmol/L and 7.25±1.87 mmol/L in first and second trimester and 6.60±1.26 mmol/L in third trimester respectively. That were statistically significant between each group. Mean GGT was 23.36±6.89 IU/L in 1st trim

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Purpose: The purpose of this study is to assess risk factors of AMD and its demographic characteristics in the population. Age related macular degeneration is one of the reasons which affects quality of vision directly and eventually overall health. Materials & Methods: The prospective, observational, hospital-based study was conducted. Patients attending eye OPD above the age of 40 years with complaints of diminution of vision and distorted vision were evaluated and detailed ophthalmic examination was done. Particulars of patients were taken; detailed ocular history was recorded. Personal, family history and medical history along with smoking history in particular was recorded. FFA was done to confirm the diagnosis of AMD. Result: In 200 subjects, Mean age of presentation is 59.52 ± 9.19 years and median are 60.5 years, out of which 120 were males and 80 were females with male: female ratio as 1.50:1. Out of 200 subjects, 60 patients had a history of hypertension and 48 were diabetic. 140 subjects were smokers, 116 patients were illiterate and 108 patients belonged to urban areas. Conclusion: The study reported various risk factors of AMD as increasing age, smoking, illiterate population, patients living in urban areas as of the risk factors of AMD.

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Background: African trypanosomiasis, a disease caused by Trypanosoma brucei, remains a significant health challenge in sub-Saharan Africa, particularly in rural communities with limited healthcare access. Despite control efforts, the disease persists due to the parasite's complex immune evasion mechanisms, including antigenic variation and destruction of the host's humoral immune response. Current treatments face limitations, and the development of an effective vaccine is stalled by the parasite's genetic diversity and insufficient research funding. Objective: This review aimed to compile recent advancements in vaccine development against African trypanosomiasis, evaluate potential vaccine candidates, and identify challenges and future directions for developing an effective vaccine. Method: We adopted the PRISMA protocol to guide our systematic literature on Medline/PubMed and Google Scholar databases, focusing on studies published between 2005 and April 2025. Results: The findings revealed several encouraging approaches to vaccine development against African trypanosomiasis. DNA vaccines targeting specific parasite proteins have demonstrated partial protection in animal studies, stimulating immune responses that delay disease progression. The T. brucei membrane surface protein B (Tbmsp-b) gene was cloned into a pVAX-1 plasmid and administered into a BALB/c mice model, conferring partial protection. Similarly, DNA plasmid encoding an invariant surface glycoprotein (ISG) of T. brucei provided partial protection against T. brucei in the BALB/c mice model. Plasmid DNA containing the 5′-terminal region of the T. brucei brucei trans-sialidase (nTSA) gene also provided partial protection in BALB/c mice. Innovative computer-designed vaccines, which combine multiple T. brucei epitopes, showed particular promise against the parasite's variability in terms of antigenicity. Finally, another promising approach involves the application of virus-like particles (VLPs) as vaccine a