Herlyn-Werner-Wunderlich Syndrome Complicated with Vesicovaginal Fistula: A Rare Case Report.

Herlyn-Werner-Wunderlich (HWW) syndrome is characterized by obstructed hemivagina and ipsilateral renal anomaly, a rare congenital anomaly of the genitourinary tract, resulting from malformations of the renal tract associated with Müllerian duct anomalies. The initial symptoms of HWW frequently present after menarche and may be nonspecific, leading to a delayed diagnosis. We presented a 19-year-old female with 3-year hematuria and abdominal pain. The final diagnosis of HWW syndrome with a rare vesicovaginal fistula was made. The treatment of HWW syndrome typically involves surgical intervention. The primary treatment is resection or removal of the obstructed vaginal septum. The patient underwent excision of vaginal septum and vaginal reconstruction via hysteroscopy, as well as repair of the vesicovaginal fistula. The patient improved well after surgery and fully recovered without sequelae after 3 months. In addition, unilateral renal agenesis is one of congenital abnormalities of the kidney and urinary tract, which are the most frequent cause of chronic kidney disease (CKD) in children. This report describes a patient of HWW syndrome with rarely combined vesicovaginal fistula, and highlights the importance of early recognition and management to prevent associated complications.

Green supply chain, green leadership, consumer preferences, sustainability attitudes, and sustainable business advantage: a case of Vietnamese textile industry.

Surging environmental issues confiscate stakeholders' attention due to growing competition. Sustainable performance in this regard is viewed as a suitable tool because it not only gauges firm's financial performance but also covers social and environmental areas. However, sustainable performance cannot be achieved without creating sustainable business advantage. Green supply chain practices are known to be implemented in terms of sustainability as they are cross-looped as well as cross-organizational. The practices help in the reduction of environmental impact of business activities without compromising on quality, performance, cost, and energy usage efficiency. The reason encourages the authors to explore the role of selected green supply chain factors, customer preference, and leadership factors in shaping sustainable business advantage. The study has examined the association by adopting the quantitative research method. The researcher has gathered data from 530 employees in the purchasing department, logistics, import/export officers, and packing staff. The data was analyzed statistically by employing SPSS for preliminary analysis and AMOS for testing the structural model and the hypotheses of the study. Using confirmatory factors analysis and structural equational modeling, the researcher has analyzed the study's measurement model and the hypotheses of the study. The findings of the research have depicted that there is a significant positive impact of lean management and green product design with sustainable business advantage. Moreover, there exists a mediation of customer preferences and leadership factors between green product design and sustainable business advantage. The study has a few limitations as well and uses a quantitative method; therefore, the study has recommended that future researchers utilize qualitative or mixed methods. The study has several theoretical and practical implications.

The moderating impact of government support on the relationship between tourism development and growth, natural resources depletion, sociocultural degradation, economic environment, and pollution reduction: case of Indonesian economy.

Tourism development is being treated as an essential element of national establishment as it has the potential of promoting cultural diversity and increase economic growth of country. However, it is also viewed as a culprit due to depletion of natural resources. In this respect, it is quite thoughtful to probe the government support and its moderating impact on association of tourism development with sociocultural degradation, national resource depletion, economic environment, and pollution reduction in Indonesian context, as Indonesia is known to be rich in terms of natural resources and recognized as the multicultural country. By using PLS methodology, the association among outlined construct and model significance has been probed in the sample of tourism management authorities. Findings disclose that government support and policy intervention significantly moderates tourism development and growth and depletion of natural resources in Indonesia. Insights from the findings finally help in proposing some unique implications that are beneficial for policymakers and practitioners.

Pregnancy in a noncommunicating rudimentary horn of a unicornuate uterus: Prerupture diagnosis and management.

OBJECTIVE: The estimated incidence of rudimentary horn pregnancy is one in 76,000. It is a life-threatening entity with a 50% risk of uterine rupture. With advances in prenatal ultrasound in recent decades, there may be an opportunity to detect rudimentary horn pregnancy earlier, resulting in a lower incidence of maternal morbidity and mortality. Management is typically resection of the rudimentary horn and the ipsilateral fallopian tube by either laparotomy or laparoscopy. CASE REPORT: Here, we present the case of a 22-year-old woman with a suspected ectopic pregnancy of 12 weeks' gestation. Ultrasound and magnetic resonance imaging were performed as preoperative evaluations. A definitive diagnosis was made during laparotomy, and resection of the rudimentary horn pregnancy was performed. CONCLUSION: Diagnosis and management of rudimentary horn pregnancy remain a challenge. We should be alert to prenatal ultrasound with the intention of making an earlier diagnosis, thereby resulting in decreased maternal morbidity and mortality.