Right Femoral Lengthening: A Case Report

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We present the case report of a 34-year-old female patient with a history of epilepsy, presenting with a 10-cm congenital shortening and varus deformity of the right femur, in addition to a 1-cm tibial shortening resulting from a previous open fracture during adolescence. Surgical correction was performed using diaphyseal osteotomy and bone lengthening with a monoplanar external fixator (Orthofix). Following a 6-day latency period, progressive distraction was initiated at a rate of 0.75 mm/day. A total femoral lengthening of 9 cm and axis correction were achieved over 4 months. The consolidation phase lasted 9 months. Complications included superficial pin-tract infection and knee stiffness, both successfully managed with medical treatment and physical therapy. The fixator was removed after 14 months of evolution. Upon discharge, the patient achieved stable functional recovery without significant claudication.

Pediculicide Resistance and Current Therapeutic Effectiveness in Pediculus Humanus Capitis: A Literature Review

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Pediculus humanus capitis infestation remains a persistent global public health burden, with recent evidence showing a sharp decline in treatment success due to widespread pediculicide resistance. Over the past decade, molecular studies have consistently identified a high frequency of voltage-gated sodium channel (kdr) mutations—particularly T917I, L920F, T929I, and L932F—which significantly reduce lice sensitivity to pyrethroid-based agents such as permethrin and fenothrin. These mutations are often accompanied by increased activity of detoxification enzymes, including acetylcholinesterase, glutathione S-transferase, and cytochrome P450 oxidase, which contribute to cross-resistance and explain repeated treatment failures in communities. Clinical and laboratory bioassays conducted between 2020 and 2025 in Indonesia, Thailand, Iran, India, Saudi Arabia, Turkey, and several African regions consistently reported low mortality and longer survival after pyrethroid exposure, confirming that resistance is now globally entrenched. In contrast, emerging non-pyrethroid therapies such as dimethicone formulations, 0.5% topical ivermectin, squalane-based preparations, and standardized botanical shampoos demonstrate strong and sustained pediculicidal activity with minimal evidence of resistance, reduced reinfestation, and a good safety profile. These alternatives primarily work through physical mechanisms or neuro-inhibitory pathways unaffected by kdr mutations, making them promising first-line options. This literature review synthesizes findings from 10–12 primary studies supported by 26 recent publications to provide an up-to-date overview of resistance mechanisms, kdr mutation distribution, and the comparative effectiveness of existing therapies. Overall, the available evidence highlights the need to revise treatment guidelines, enhance molecular surveillance, and prioritize non-pyrethroid agents.

Assessment of Systemic Inflammatory and Metabolic Markers in Patients of Waja’ al-Rukba (Knee Pain): A Clinical Laboratory-Based Study

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Osteoarthritis (OA) is the most common form of arthritis and a leading cause of disability in older adults. Knee osteoarthritis, a major subtype, closely resembles Waja’-al-Rukba described in Unani medicine, both sharing chronicity, pain, stiffness, and restricted mobility. Unani scholars attribute its origin to Sū’-i-Mizāj (abnormal temperament) and accumulation of Mawād-e-Fuzūni (morbid material) in joints.

Our aim is to evaluate the relationship between Mizāj (temperament) and biochemical markers of inflammation and metabolism (CRP, uric acid, BMI) in patients with Waja’-al-Rukba (knee pain), and to assess their role in disease risk and progression.

A cross-sectional study was conducted on 75 patients (aged 40–80 years) attending the OPD and IPD of of Ilaj bit Tadbeer and Moalejat in Ajmal Khan Tibbiya College and hospital, Ajmal Khan Tibbiya College, AMU, Aligarh. Mizāj was assessed using standard Unani parameters. Laboratory investigations included ESR, CRP, uric acid and BMI.

In our study we have find that most of the patients (76%) were aged between 40–50 years with females predominance (89%). Balghamī Mizāj (phlegmatic) was the most common temperament (41%), followed by Ṣafrāwī (27%), Damawī (20%), and Sawdāwī (12%). Balghamī individuals had the highest mean BMI (27–29.6 kg/m²) and mean uric acid level (5.98 ± 0.9 mg/dl). CRP positivity was also highest in the Balghamī group (12 cases). These findings indicate a strong association of Balghamī Mizāj with obesity, hyperuricemia, and inflammation.

The study demonstrates a significant correlation between Mizāj (temperament) and metabolic–inflammatory markers, validating Unani concepts through modern biomedical parameters. Balghamī temperament predisposes individuals to inflammatory and metabolic derangements such as osteoarthritis, supporting the integration of Unani temperament-based assessment in preventive and therapeutic frameworks.

The Effect of Health Education on Knowledge and Attitudes Toward Depression Among Eleventh-Grade Students at SMK Umi Kulsum Banjaran Bandung

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Objective: This study aimed to evaluate the effect of health education on students’ knowledge and attitudes toward depression among adolescents.

Theoretical Framework: The research is grounded in health behavior theories such as the Health Belief Model and mental health literacy frameworks, emphasizing the role of education in shaping awareness and behavioral responses to mental health issues.

Method: A pre-experimental one-group pretest-posttest design was used. The sample consisted of 85 eleventh-grade students at SMK Umi Kulsum Banjaran Bandung, selected through total sampling. Data were collected using structured questionnaires before and after a health education session on depression. Statistical analysis was conducted using the Wilcoxon Signed-Rank Test.

Results and Discussion: The study revealed a statistically significant increase in students’ knowledge (p = 0.000) and attitudes (p = 0.001) regarding depression after the intervention. These results indicate that structured health education effectively enhances awareness and fosters a more positive attitude toward mental health issues in adolescents. Limitations include the absence of a control group and short-term evaluation.

Research Implications: The findings suggest that integrating mental health topics into school-based health education programs can improve mental health literacy among students, potentially leading to earlier recognition and intervention in cases of adolescent depression.

Originality/Value: This research contributes to the growing field of adolescent mental health promotion by demonstrating the practical impact of targeted educational interventions in vocational school settings.

Acute and Sub acute Toxicity Studies of Euphorbia hirta on Mice and Wistar rats

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This study aimed at evaluating the acute and subacute toxicity of the aqueous leaf extract of Euphorbia hirta in experimental animals. For acute toxicity assessment, mice were orally administered single doses of 2000 and 3000 mg/kg  body weight (bw), with the administration volume set at 1 mL/100 g bw. A limit test was conducted to estimate the median lethal dose (LD₅₀). In the subacute toxicity study, rats received daily oral doses of 500, 1000, 2000 and 3000 mg/kg bw for 28 consecutive days. A control group received distilled water. Biochemical parameters including alanine aminotransferase (ALT), aspartate aminotransferase (AST), Alanine phosphatase (ALP), Total protein, creatinine and Urea were analyzed in plasma samples. Hematological parameters such as red and white blood cell counts, hemoglobin, hematocrit and platelets were also evaluated. Histopathological examination of the liver and kidneys was performed to assess organ-specific toxicity. The results indicated that the LD₅₀ of the aqueous extract of Euphorbia hirta is greater than 3000 mg/kg, suggesting low acute toxicity. In the subacute study, histological examination of rat organs revealed no acute or chronic damage, although minor liver changes such as sinusoidal dialatation and mild portal inflammation were observed at high doses which is supported with elevated AST and ALT. In conclusion, the toxicological profile indicates that these extracts are safe at tested doses, although higher concentrations may warrant caution due to mild histological and biochemical changes.

Analysis of Patient Safety Culture among Healthcare Workers at Community Health Centers in Bandar Lampung, Indonesia

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This study aims to analyze the culture of patient safety among healthcare workers at Way Halim II Inpatient community health center, Satelit Inpatient community health center, and Pasar Ambon community health center in Bandar Lampung, Indonesia, in 2025. This cross-sectional survey used quantitative data that were collected through questionnaires distributed to all 200 healthcare workers using total sampling and analyzed with SPSS software. The research looks at 12 aspects of patient safety culture, such as how openly information is shared, how feedback and communication about mistakes happen, how often safety incidents are reported, how handoffs and transitions are managed, the support from management, responses that don’t punish mistakes, learning within the organization, views on patient safety, staffing levels, actions to promote safety, cooperation between different units, and cooperation within the same unit. The findings indicate that, overall, patient safety culture in the three community health centers is relatively good, particularly in staff support, cross-unit collaboration, and leadership openness. However, challenges remain, especially regarding low reporting rates for non-severe incidents, suboptimal non-punitive environments, and uneven information completeness during handoffs. Promoting inclusive leadership, strengthening teamwork, and fostering open communication are critical for enhancing patient safety practices. This study provides recommendations for policy development, capacity building, and future research directions to foster a sustainable, safety-oriented organizational culture in primary healthcare settings.

Pineal Body Tumour, A Very Rare but Often Misdiagnosed in Our Clinics and Literature Review

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This publication aims to review and remind Medical Practitioners of a very rare and often misdiagnosed case of a central nervous system tumour, pineal body tumour. A 4-year old boy child referred from a peripheral hospital in a neighbouring town on account of not responding to several treatments. Mother booked for antenatal care by 3rd month of the pregnancy. She adhered to her treatments and kept to her appointments throughout the care. Mother had a hitch-free labour and delivery. Immediate neonatal and postnatal life was good up to the onset of the present illness. Pineal body tumour is a very rare and often misdiagnosed malignancy because of its several mimicries, which demands a very high index of suspicion and extensive clinical assessment to diagnose. Presently there is daft information on this rare brain tumour, and so this publication.