Situs inversus totalis is a rare congenital anomaly characterized by the mirror-image arrangement of the thoracic and abdominal viscera. Although most patients remain asymptomatic, this condition presents a diagnostic challenge in the presence of cardiovascular disease. In patients with chronic kidney disease on dialysis, pericardial effusion is a potentially serious complication that can progress to cardiac tamponade. The coexistence of both conditions necessitates timely diagnosis and an individualized therapeutic approach to improve prognosis.

Streptococcus mutans is the leading one of the oral microbiota causing tooth caries. It forms biofilms on teeth providing protection against the host defenses by making extracellular polysaccharides and carbohydrates. These biofilms increase bacterial persistence and enhances the pathogenicity of S. mutans. Such emergence of antibiotic resistance has significantly reduced the long-term usage of both synthetic and conventional antimicrobials (β lactams and chlorhexidine). The need to find and develop novel alternatives is owing to this growing resistance. Natural antimicrobials, like enzyme-based medications and other antimicrobial peptides (AMPs), provide good treatments. AMPs also minimize the chance of developing resistance and disrupts bacterial membranes preventing the formation of biofilms. By directly breaking down biofilm matrix and virulence factors, enzyme-based antimicrobials such glucosidases and proteases improve bacterial clearance. Both strategies are viable substitutes for conventional antibiotics since they are biocompatible, environmentally benign, and have several targets of action. The relevance of switching to natural antimicrobial drugs is shown by the collective research on S. mutans prevalence, biofilm biology, and resistance mechanisms. Incorporating AMPs and enzyme-based treatments into oral healthcare may offer safe, efficient, and resistance-reducing methods for managing and preventing dental caries.

The concept of healthy span is gradually taking over the life span. Currently, one has to look at quality living rather than quantity living. Living longer life span sans the quality is actually painful. Hence, the current focus is to develop the background understanding behind quality living. Moving beyond hormones is the new approach where the concept of cellular energy, metabolic function & the antioxidant status of the body are the three pillars. Life style changes, dietary modification, physically & mentally activeness has to be achieved naturally. One may have normal hormonal levels & no deficiency but still suffer from fatigue, metabolic disorders, neuron-degeneration, cardiovascular disease, cancer, weakness, chronic inflammation and early ageing. The obstacle behind all these conditions is the poor mitochondrial health where the signals from the power house of the cells do not reach the cells. The article sees the role of homoeopathy to deal with these issues. As these issues are chronic & needs a holistic & individualized approach it is here that the homoeopathic system of therapeutics will prove to be effective. The holistic & individualized approach is the basic principle of treatment under the domain of homoeopathic therapeutics.

Pseudomyxoma peritonei (PMP) is a rare condition predominantly originating from appendiceal neoplasms, making true primary ovarian PMP an exceptional and widely debated clinical entity. Establishing a primary Müllerian origin requires exhaustive histological and immunohistochemical evaluation to exclude an occult appendiceal tumor. A highly unusual clinical scenario involves a 26-year-old nulliparous woman presenting with a large borderline mucinous ovarian tumor paradoxically associated with high-grade peritoneal implants. Comprehensive pathological workup (CK7+, PAX8+, CK20−, CDX2−) and completely normal appendiceal serial sections definitively confirmed the primary ovarian origin. Standard-of-care management relies on complete cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC). Successful CC0 cytoreduction and HIPEC were achieved, integrated with proactive ovarian cortex cryopreservation. This unusual presentation highlights the striking biological discordance that can exist between a primary tumor and its peritoneal dissemination, emphasizing the critical role of specialized multidisciplinary management, rigorous pathology, and early oncofertility integration for young patients.

Background: The educational environment (EE) has a significant impact on medical students' learning, academic success, and professional development. Systematic EE evaluation provides important data for curriculum reform and quality assurance. However, evidence from resource-limited and underrepresented settings remains limited. This study aims to assess medical students' perceptions of the EE at the University of Gadarif in Sudan using Dundee Ready Educational Environment Measure (DREEM). Methods: A cross-sectional descriptive study was carried out with third, fourth, and fifth-year medical students. A total of 125 out of 361 eligible students participated. The standardized DREEM questionnaire, which assesses five domains—students' opinions of learning, instructors, academic self-perception, environment, and social self-perception—was used to gather the data. SPSS version 20 was utilized for data analysis. Descriptive statistics were computed, and independent samples t-test and one-way ANOVA were used to assess associations between students’ characteristics and DREEM domain scores, with statistical significance set at p < 0.05. Results: Of 361 eligible students, 125 participated (response rate 34.6%). The mean total DREEM score was 111.2/200 (55.6%), indicating a borderline positive EE. Domain scores ranged from 53.9% to 57.5%, reflecting consistently moderate perceptions across all domains, with students’ social self-perceptions scoring the lowest. Eleven items (22%) scored below two, highlighting key problem areas, particularly related to timetabling, teaching effectiveness, and student support systems. DREEM domains are variably affected by gender, residence, and academic level. Conclusions: The EE at the Faculty of Medicine, University of Gadarif was perceived as borderline positive, which is comparable to regional and international institutions. However, the relatively low response rate may limit representativeness. The findings highlight specific domains requiring targeted interventions and demonstrate the value of systematic EE assessment in informing evidence-based improvements, particularly in resource-limited medical schools.

Background: Osteogenesis imperfecta (OI) is a rare heritable connective tissue disorder which is characterized by fragile bones and heterogeneous clinical presentation. There is mutation in genes of collagen Type I- COL1A1 and COL1A2 genes. Case Presentation: We report the case of a 16 year old male with a history of recurrent fractures since early infancy following the trivial trauma. The patient sustained multiple fractures involving long bones, associated with progressive deformities of the lower extremities. Notably, no etiological workup had been performed during childhood. There was no significant family history. On admission, physical examination revealed blue sclerae, dentinogenesis imperfecta, short stature, arachnodactyly, scoliosis and bowing deformity of bilateral lower limbs. Radiographic evaluation showed sequelae of previous fractures associated with bone deformities and cortical thinning. Based on the clinical presentation and radiological evaluation, a diagnosis of osteogenesis imperfecta was established. Conclusion: This case underscores the critical importance of early recognition of suggestive clinical features in children presenting with recurrent fractures. Improved clinician awareness may help reduce diagnostic delays, prevent complications, and enable timely genetic counselling and appropriate multidisciplinary management.

Background: Subchorionic hemorrhage (SCH), also referred to as subchorionic hematoma, is the most common sonographic abnormality associated with first-trimester vaginal bleeding. It occurs between 6 and 13 weeks of gestation and is reported in approximately 11% of pregnancies. SCH is characterized by bleeding between the chorionic membrane and the uterine wall. Aim: This study aimed to evaluate the association between the volume of first-trimester subchorionic hematoma and the risk of spontaneous miscarriage. Methods: A cross-sectional study was conducted involving 53 pregnant women in their first trimester, aged 18–35 years, who attended the obstetric clinic at Al-Diwaniyah Maternity and Children Teaching Hospital between May and November 2022. Women with a viable intrauterine pregnancy, gestational age between 6 and 13 weeks, and an ultrasound-confirmed diagnosis of subchorionic hematoma were included in the study. Fetal viability was assessed by ultrasonography. Hematomas were categorized according to their volume. Data were collected and analyzed using Statistical Package for the Social Sciences (SPSS) version 23. Results: The mean age of the participants was 28.3 ± 6.4 years (range: 18–35 years). Participants were stratified into three age groups. The mean hematoma volumes were 9.4 ± 2.5 cm³ for small hematomas, 16.3 ± 1.2 cm³ for medium hematomas, 22.7 ± 3.4 cm³ for large hematomas, and 37.2 ± 9.4 cm³ for very large hematomas. Women who experienced spontaneous abortion had significantly larger hematoma volumes compared with those who maintained their pregnancies (p < 0.05). The mean gestational age was 8.9 ± 1.3 weeks among women with small hematomas and 10.2 ± 1.9 weeks among those with very large hematomas. Conclusion: An Increased Volume of Subchorionic Hematoma during the First Trimester is Significantly Associated with a Higher Risk of Spontaneous Abortion.