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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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]