The use of Levonorgestrel-releasing Intrauterine System (LNG-IUS) in the treatment of symptomatic leiomyoma uteri: A systematic review

Background@#While surgical intervention has been the usual treatment option for leiomyomas, non-surgical methods have been gaining popularity over the years. The levonorgestrel-releasing intrauterine system (LNG-IUS) is said to be effective in alleviating the signs and symptoms brought by uterine leiomyomas.@*Objective@#To determine the effectiveness of LNG-IUS in the treatment of uterine leiomyomas presenting with abnormal uterine bleeding.@*Methods@#The study was conducted using the PRISMA 2020 guidelines. The literature search was performed using the following databases: Medline, Cochrane Library, PubMed, Elsevier, Embase, and Herdin. All identified studies published from January 2015 up to July 2023 were included. Titles and abstracts were screened independently by two reviewers. Data extraction and risk of bias assessment were done independently by two reviewers. Gathered information were managed using Microsoft Excel spreadsheet. Synthesis of study characteristics and findings were conducted using a descriptive narrative review. The main outcomes were uterine volume, fibroid size, menstrual blood loss or bleeding patterns, and serum hemoglobin and hematocrit levels. Secondary outcome was incidence of adverse events.@*Results@#A total of 5 studies were included with two having low methodological quality. One before-and-after cohort study showed that the use of LNG-IUS is effective in reducing menorrhagia with improvement in hematologic parameters. There is no change, however, in uterine volume. Another cohort study showed that the intervention is safe with low incidence of severe adverse events (0.5% in 595 patients). A comparative cohort study showed that LNG-IUS significantly decreased uterine volume and fibroid size, and a good alternative for treatment of heavy menstrual bleeding, as compared to intramuscular progestogen. Another before-and-after cohort study showed a significant decrease in uterine volume in women given LNG-IUS, but not in the control group. Finally, one comparative cross-sectional study showed that LNG-IUS did not effectively reduce heavy bleeding in 32.3% of patients, compared to laparoscopic hysterectomy, which was was 100% effective.@*Conclusion@#The use of LNG-IUS resulted in reduced menstrual bleeding and improved hematologic parameters after treatment. LNG-IUS was more effective compared to other hormonal treatments. However, when compared to laparoscopic hysterectomy, LNG-IUS was less effective in managing heavy bleeding. The incidence of adverse events reported in the studies was low.

Community health volunteers’ performance in rural areas of Yemen: a community-based satisfaction survey / Journal of Rural Medicine

Objectives: Many developing countries utilize the services of community health volunteers (CHVs) to enhance healthcare services in underserved regions. Evaluating client satisfaction with CHVs’ performance is crucial for ensuring the effective utilization of their services. This study aims to assess clients’ satisfaction with the provision of basic reproductive health services by CHVs in the governorates of Ibb and Al Mahweet, Yemen.Materials and Methods: A cross-sectional study was conducted, collecting data via structured questionnaires administered by trained data collectors to clients of CHVs. A total of 510 households were interviewed, with 255 from each governorate, distributed across 30 clusters (villages). Each governorate comprised 15 clusters in 12 districts (six districts in Ibb and five in Al Mahweet, excluding one district for security reasons). Within each cluster, 17 households were randomly selected for interviews. Descriptive analysis was performed using the SPSS version 22.Results: The majority of the clients were female (84.7%), most were aged 20–39 years (55.7%), and more than half of them had received at least primary education (54.2%). The study findings indicate that a significant proportion of respondents were highly satisfied with CHVs’ performance (93%). Almost all respondents confirmed that CHVs resided in their villages (94%) and were easily accessible for consultation (99%). Most of the respondents (97%) expressed trust in the CHVs, stating that they were helpful to all villagers and treated them well. Additionally, nearly all the respondents reported easy access to services (98.6%), although a considerable percentage experienced a gap of three months or more since their last interaction with a CHV (39.1%).Conclusion: The CHVs contribute to the well-being of the rural populations in Yemen by delivering satisfactory services, particularly regarding family planning. However, ensuring the sustainability of the CHV programs remains a challenge, which requires attention from the program managers and decision makers in the Yemeni healthcare sector.

Injectable platelet rich fibrin effect on laser depigmented gingiva: a clinical randomized controlled split mouth trial with histological assessment

Abstract Objective To determine whether intra-mucosal injection of injectable platelet-rich fibrin (i-PRF) can promote healing after Diode Laser Gingival Depigmentation (DLGD). Methodology A total of 20 arch sites of hyperpigmented gingiva of 10 patients underwent DLGD. For each patient, two arch sites were randomly assigned for either intra-mucosal injection of i-PRF (G1-i-PRF) (n=10 sites) or no treatment (G2-Control): (n=10 sites). Wound Healing Score (WHS), patient satisfaction, and Pigmentation Index (DOPI) were measured at 1 week and 1 and 3 months postoperatively. Histological assessment of tissue specimens was performed at baseline and 1 week. Results The percentage change in WHS at 1 week was significantly higher in G1 (58.34±15.43) compared to G2 (37.50±11.79). At day 1, 50% of patients in G1 were pain free compared with 75% in G2, who had mild pain. Mean DOPI decreased significantly at 3 months in both groups (P-value <0.001), without significant differences between groups. G1 specimens showed significantly higher epithelial thickness (P-value <0.001), as well as a higher number of blood vessels and less percentage of inflammatory cells. Conclusions i-PRF demonstrated better clinical and histological healing potential and less patient discomfort compared to sites without treatment after DLGD. Registered at https://clinicaltrials.gov/ as (NCT05283668).

Interleukin-37 has A Promising Cardioprotective Effect on Isoproterenol-Induced Myocardial Infarction / La Interleucina-37 tiene un Efecto Cardioprotector Prometedor sobre el Infarto de Miocardio Inducido por Isoproterenol

SUMMARY: The main cause of mortality and disability globally is myocardial infarction (MI). Isoproterenol (ISO), a β-adrenoceptor agonist, has been used to induce rat myocardial necrosis. Whereas interleukin-37 (IL-37) has anti-inflammatory and cytoprotective properties. The study aimed to investigate the potential protective effects of IL-37 administration on cardiac architecture, oxidative stress, and inflammatory markers during ISO-induced MI in rats. Three groups of adult male rats were used in this study, the normal control group (n=8), ISO-induced MI group (n=8) that received isoproterenol hydrochloride (ISO) (100 mg/kg/day, SC, for the first 2 consecutive days), and IL-37-treated group (ISO+IL-37) (n=8) that received recombinant human IL-37 (40 µg/kg /day, intraperitoneally, for 2 weeks during and after ISO injections. Heart rate (HR.) and ECG changes were monitored. Some oxidative stress markers such as superoxide dismutase (SOD), nitric oxide (NOx), malondialdehyde (MDA), and glutathione (GSH) tissue levels in the tissue homogenate were assayed. Interleukin- 6 (IL-6), tumor necrosis factor- α (TNF-α), caspase-8, P53, and C- reactive protein (CRP) were among the inflammatory markers examined. In addition, serum levels of creatinine kinase (CK-MB) and lactate dehydrogenase (LDH) were analyzed to evaluate the myocardial injury. For histological analysis, tissues were sectioned, fixed in paraffin, and stained with hematoxylin and eosin (H&E), Masson Trichrome and, immunohistochemical against NF-kB, TNF-α, and Caspase-9. IL-37 improved ECG changes, cardiac enzyme markers, and some inflammatory markers of oxidative stress in ISO-induced MI. It also improved the histopathological and immunohistochemical changes in MI. In conclusion: IL-37 might be a promising therapeutic modality in myocardial infarction.

La principal causa de mortalidad y discapacidad a nivel mundial es el infarto de miocardio (IM). El isoproterenol (ISO), un agonista de los receptores adrenérgicos β, se ha utilizado para inducir necrosis miocárdica en ratas. Mientras que la interleucina-37 (IL-37) tiene propiedades antiinflamatorias y citoprotectoras. El estudio tuvo como objetivo investigar los posibles efectos protectores de la administración de IL-37 en la arquitectura cardíaca, el estrés oxidativo y los marcadores inflamatorios durante el infarto de miocardio inducido por ISO en ratas. En este estudio se utilizaron tres grupos de ratas macho adultas, el grupo control normal (n=8), el grupo con IM inducido por ISO (n=8) que recibió clorhidrato de isoproterenol (ISO) (100 mg/kg/día, SC, durante los primeros 2 días consecutivos) y el grupo tratado con IL-37 (ISO+IL- 37) (n=8) que recibió IL-37 humana recombinante (40 µg/kg/día, por vía intraperitoneal, durante 2 semanas durante y después de las inyecciones de ISO. Se monitorearon la frecuencia cardíaca (FC) y los cambios en el ECG. Se analizaron algunos marcadores de estrés oxidativo como la superóxido dismutasa (SOD), el óxido nítrico (NOx), el malondialdehído (MDA) y los niveles tisulares de glutatión (GSH) en el homogeneizado de tejido. La interleucina-6 (IL-6), el factor de necrosis tumoral-α (TNF-α), la caspasa-8, la P53 y la proteína C reactiva (CRP) se encontraban entre los marcadores inflamatorios examinados. Se analizaron los niveles de creatinoquinasa (CK-MB) y lactato deshidrogenasa (LDH) para evaluar la lesión miocárdica; para el análisis histológico se seccionaron los tejidos, se fijaron en parafina y se tiñeron con hematoxilina y eosina (H&E), Tricromo de Masson e inmunohistoquímica contra NF-kB, TNF-α y Caspasa-9. IL-37 mejoró los cambios de ECG, los marcadores de enzimas cardíacas y algunos marcadores inflamatorios de estrés oxidativo en el IM inducido por ISO. Además mejoró los cambios histopatológicos e inmunohistoquímicos en MI. En conclusión: la IL-37 podría ser una modalidad terapéutica prometedora en el infarto de miocardio.

Multidisciplinary Cognitive Function Assessment of Good versus Poor Performance in Children with Cochlear Implants: An Observational Cross-Sectional Study

Abstract Introduction Despite the developing technology of cochlear implants (CIs), implanted prelingual hearing-impaired children exhibit variable speech processing outcomes. When these children match in personal and implant-related criteria, the CI outcome variability could be related to higher-order cognitive impairment. Objectives To evaluate different domains of cognitive function in good versus poor CI performers using a multidisciplinary approach and to find the relationship between these functions and different levels of speech processing. Methods This observational, cross-sectional study used the word recognition score (WRS) test to categorize 40 children with CIs into 20 good (WRS/65%) and 20 poor performers (WRS < 65%). All participants were examined for speech processing at different levels (auditory processing and spoken language) and cognitive functioning using (1) verbal tests (verbal component of Stanford-Binet intelligence [SBIS], auditory memory, auditory vigilance, and P300); and (2) performance tasks (performance components of SBIS, and trail making test). Results The outcomes of speech processing at different functional levels and both domains of cognitive function were analyzed and correlated. Speech processing was impaired significantly in poor CI performers. This group also showed a significant cognitive function deficit, in which the verbal abilities were more affected (in 93.5%) than in the good performers (in 69.5%). Moreover, cognitive function revealed a significant correlation and predictive effect on the CI speech outcomes. Conclusion Cognitive function impairment represented an important factor that underlies the variable speech proficiency in cochlear-implanted children. A multidisciplinary evaluation of cognitive function would provide a comprehensive overview to improve training strategies.

Prognostic roles and survival benefits of endoscopic resection versus surgical resection in the management of malignant colon polyps

Background: Due to few sufficient data regarding the comparison between endoscopic and surgical resection of malignant colorectal polyps regarding outcomes and survival benefits, there are no clear guidelines of management strategies of malignant colorectal polyps. The aims of the present study were to compare endoscopic resection alone and surgical resection in patients with malignant polyps in the colon (T1N0M0) readings advantages, disadvantages, recurrence risks, survival benefits, and long-term prognosis to detect how management strategy affects outcome. Patients and methods: we included 350 patients. All included patients were divided into 2 groups; the first group included 100 patients who underwent only endoscopic polypectomy and the second group included 250 patients who underwent endoscopic polypectomy followed by definitive surgical resection after histopathological diagnosis. We followed all patients for about 5 years, ranging from 18 to 55 months. The primarily evaluated parameters are surgical consequences and patients' morbidity. The secondary evaluated parameters are recurrence risks, recurrence free survival, and overall survival rates. Results: The age of patients who underwent polypectomy is usually younger than the surgical group, males have more liability to polypectomy in comparison with females. Patients with tumors in the left colon have more liability to polypectomy in comparison with the right colon (p< 0.0001). Tumor factors associated with more liability to surgical resection are presence of lymphovascular invasion, high grade, and poor tumor differentiation (p< 0.0001). The management strategy was the most significant predictor of overall and recurrence free survival rates in patients with malignant colon polyps (p< 0.001). Conclusions: We found that survival benefits and lower incidence of recurrence are detected in the surgical resection group more than in the polypectomy group. (AU)

Risk factors and outcomes of occurrence of anastomotic leakage and reoperations for its management after colorectal surgery

Background: Anastomotic leakage (AL) is still the most annoying postsurgery complication after colorectal resection due to its serious complications up to death. Limited data were available regarding differences in AL incidence, management, and consequences for different types of colorectal resection. The aim of the present work was to evaluate differences in incidence of AL, incidence of postoperative complications, and length of hospital stay in a large number of patients who underwent elective colorectal resection for management of colorectal lesions. In addition to detect when and what type of reoperation for management of AL occur after colorectal resection. Patients: All 250 included patients underwent elective surgeries for colorectal resection with performance of primary anastomosis for management of colorectal neoplastic and non-neoplastic diseases in the period between May 2016 and July 31, 2021. We followed the patients for 90 days; we registered the follow-up findings. Results: the rates of AL occurrence were variable after the different procedures. The lowest rate of AL occurrence was found in patients who underwent right hemicolectomy, then in patients who underwent sigmoidectomy, left hemicolectomy, transversectomy and anterior resection (p= 0.004). A stoma was frequently performed during reoperation (79.5%) which was significantly different between different procedures: 65.5% in right hemicolectomy, 75.0% in transversectomy, 85.7% in left hemicolectomy, and 93.0% in sigmoid resection (p< 0.001). Conclusion Rates, types, time of occurrence and severity of AL vary according to the type of colectomy performed and selective construction of stoma during AL reoperation is currently safely applied with comparable mortality rates for patients who did and who did not have a stoma after reoperation. (AU)

Solriamfetol impurities:Synthesis,characterization,and analytical method(UPLC-UV)validation / 药物分析学报

Given that impurities may affect the quality and safety of drug products,impurity identification and profiling is an integral part of drug quality control and is particularly important for newly developed medications such as solriamfetol,which is used to treat excessive daytime sleepiness.Although the high-performance liquid chromatography analysis of commercial solriamfetol has revealed the presence of several impurities,their synthesis,structure elucidation,and chromatographic determination have not been reported yet.To bridge this gap,we herein identified,synthesized,and isolated eight process-related solriamfetol impurities,characterized them using spectroscopic and chromatographic tech-niques,and proposed plausible mechanisms of their formation.Moreover,we developed and validated a prompt impurity analysis method based on ultrahigh-performance liquid chromatography with UV detection,revealing that its selectivity,linearity,accuracy,precision,and quantitation limit meet the acceptance criteria of method validation stipulated by the International Council for Harmonization of Technical Requirements for Pharmaceuticals for Human Use.Thus,the developed method was concluded to be suitable for the routine analysis of solriamfetol substances.

Artificial Intelligence Increases the Agreement among Physicians Classifying Focal Skeleton/Bone Marrow Uptake in Hodgkin’s Lymphoma Patients Staged with ­ 18 FFDG PET/CT—a Retrospective Study / 대한핵의학회잡지

Purpose@#Classification of focal skeleton/bone marrow uptake (BMU) can be challenging. The aim is to investigate whether an artificial intelligence–based method (AI), which highlights suspicious focal BMU, increases interobserver agreement among a group of physicians from different hospitals classifying Hodgkin’s lymphoma (HL) patients staged with [ ­ 18 F]FDG PET/CT. @*Methods@#Forty-eight patients staged with ­[ 18 F]FDG PET/CT at Sahlgenska University Hospital between 2017 and 2018 were reviewed twice, 6 months apart, regarding focal BMU. During the second time review, the 10 physicians also had access to AI-based advice regarding focal BMU. @*Results@#Each physician’s classifications were pairwise compared with the classifications made by all the other physicians, resulting in 45 unique pairs of comparisons both without and with AI advice. The agreement between the physicians increased significantly when AI advice was available, which was measured as an increase in mean Kappa values from 0.51 (range 0.25–0.80) without AI advice to 0.61 (range 0.19–0.94) with AI advice (p = 0.005). The majority of the physicians agreed with the AI-based method in 40 (83%) of the 48 cases. @*Conclusion@#An AI-based method significantly increases interobserver agreement among physicians working at different hospitals by highlighting suspicious focal BMU in HL patients staged with ­[ 18 F]FDG PET/CT.

Biochemical and insecticidal efficacy of clove and basil essential oils and two photosensitizers and their combinations on Aphis gossypii glover (Hemiptera: Aphididae)

The present study investigates the insecticidal and biochemical effects of two essential oils (EOs) and two photosensitizers against cotton aphids in a laboratory setting. The EOs evaluated were clove (Syzygium aromaticum L.) and basil (Ocimum basilicum), while the photosensitizers were rose bengal and rhodamine B. The individual median lethal concentrations (LC50) revealed that clove was ~4.44 times more potent than basil, and rhodamine B was ~1.34 times more potent than rose bengal. The mortality rates increased using higher concentrations of the photosensitizers and prolonging exposure time to sunlight. The most effective combination against adult aphids was found to be a mixture of sub-lethal concentrations of clove and rhodamine B, resulting in a mortality rate of 92.31%. Conversely, the combination of basil and rose bengal exhibited the lowest efficacy with a mortality rate of 33.33%. Biochemical analyses indicate that Rhodamine B, basil, and the basil-rhodamine B mixture (mixture C) significantly reduced trehalase activity. However, the protease activity significantly increased in aphids treated with rose bengal, clove, and the clove-rose bengal mixtures (mixtures A and B). The lipase activity is notably decreased upon treatment with rhodamine B and clove. Glutathione S-transferase (GST) activity decreased in aphids treated with rose bengal and the basil-rhodamine B mixtures (mixtures C and D), suggesting that GST did not play a role in detoxifying these compounds, thereby explaining the susceptibility of A. gossypii. Overall, the combination of essential oils and photosensitizers has demonstrated a synergistic effect in controlling Aphis gossypii, offering great potential as an effective strategy for aphid management.

Effects of Vitamin D On Cisplatin Induced Heart and Lung Toxicity in Albino Rat

Background: While Cisplatin (CP) is a powerful DNA alkylating agent used to treat many malignancies, its clinical use is linked to a number of negative side effects. It has been proposed that vitamin D can shield biological systems against harm caused by CP. The current study’s objective was to look into how vitamin D protects the rat heart and lung against cisplatin-induced damage. Material and methods: Thirty adult male Albino rats; 180–220 g body weight were allocated into 3 groups; Group I (n=10) receiving saline, Group II (n=10); rats receiving CP (single dose of 6.5 mg/kg intraperitoneal) and Group III (n=10); receiving CP and 50 ng/kg/day alfacalcidol. Results: Alterations included a significant increase in malondialdehyde (MDA) level in the CP group compared with the other groups (p value for comparing between control and each other group, statistically significant at p < 0.05). Histopathologically, CP induced severe changes were observed. However, the CP-induced disturbances significantly improved by treatment with Vitamin D. Conclusion: According to this study, CP treatment significantly harmed rats’ hearts and lungs; however, treatment with vitamin D significantly lessened these harms.

Abordaje rehabilitador de paciente con distrofia facioescapulohumeral y fractura de cadera / Rehabilitative Approach to a Patient with Facioscapulohumeral Dystrophy and Hip Fracture

La distrofia facioescapulohumeral es una miopatía progresiva de base genética, con gran variabilidad fenotípica. Se caracteriza por la progresión de cambios distróficos en la dirección cráneo-caudal con lesiones asimétricas de los músculos faciales, cintura escapular, hombros y piernas. Se expone este caso con el objetivo de demostrar la importancia de la rehabilitación en el manejo integral de pacientes con distrofia muscular y fractura de cadera. Se presenta el abordaje rehabilitador en una paciente con distrofia facioescapulohumeral y fractura de cadera tratada mediante artroplastia total de cadera. El tratamiento rehabilitador precoz contribuyó a mejorar el control del dolor y su recuperación funcional(AU)

Facioscapulohumeral dystrophy is a genetically based progressive myopathy (4q35), with great phenotypic variability. It is characterized by the progression of dystrophic changes in the craniocaudal direction with asymmetric lesions of the facial muscles, shoulder girdle, shoulders, and legs. We report the rehabilitation approach in a female patient with facioscapulohumeral dystrophy and hip fracture treated by total hip arthroplasty. A rehabilitation program was included and improvement in pain control and functionality was observed. Rehabilitation is a fundamental pillar in the comprehensive management of patients with muscular dystrophy and hip fracture(AU)

The prognostic roles of PYCR2 and ZBTB18 expression in tissues of colorectal carcinoma and non-neoplastic tissues: an immunohistochemical study

Background: It is important to detect novel biomarkers responsible for the progression and spread of colorectal cancer (CRC) to better evaluate the prognosis of the patients, provide better management, and foster the development of therapeutic targets. In humans, pyrroline-5-carboxylate reductase 2 (PYCR2) is encoded on chromosome 1q42.12, and its metabolic activity has been linked to oncogenesis in many cancers. Zinc finger and broad-complex, tramtrack, and bric-à-brac (BTB) domain-containing protein 18 (ZBTB18), a zinc finger transcriptional repressor, has been found to have a tumor-suppressor role and to be methylated in CRCs. To date, the prognostic roles of PYCR2 and ZBTB18 in CRC patients have not been thoroughly studied. Objective: To evaluate the tissue protein expression of PYCR2 and ZBTB18 in CRC and adjacent non-neoplastic intestinal tissues, to detect their roles in CRC carcinogenesis, progression and metastases. Patients and methods: After applying the inclusion criteria, 60 CRC patients were included in the study. Tissue samples from the tumor and the adjacent non-neoplastic tissues were stained with PYCR2 and ZBTB18. The patients were followed up for about 30 months (range: 10 to 36 months). We performed a correlation regarding the expression of the markers, and clinicopathological and prognostic parameters. Results Upregulation of PYCR2 and downregulation of ZBTB18 were found to be higher in CRC tissue than in the adjacent non-neoplastic colonic mucosa (p = 0.026 and p < 0.001 respectively). High expression of PYCR2 and low expression of ZBTB18 were positively correlated with large tumor size, higher tumor grade, advanced tumor stage, presence of spread to lymph nodes, and presence of distant metastases (p < 0.001). High PYCR2 and low ZBTB18 expressions were significantly associated with poor response to therapy (p = 0.008 and 0.0.17 respectively), as well as high incidence of progression and recurrence (p = 0.005), and unfavorable overall survival (OS) rates (p = 0.001). Conclusion: High expression of PYCR2 and low expression of ZBTB18 were independent predictors of CRC, progression, poor prognosis and unfavorable patient OS and progression-free survival (PFS) rates. (AU)

Surgical roles in the management of metachronus para-aortic lymph node recurrence and synchronous para-aortic lymph node metastasis in colorectal cancer patients

Background: The relative rarity of synchronous para-aortic lymph node (PALN) metastasis (SPM) and metachronous PALN recurrence (MPR) in colorectal carcinoma (CRC) patients leads to a limited number of studies on patient management, and no treatment guidelines have been established to date. Objective: To assess the prognostic, predictive roles, and long-term outcomes of different management strategies for isolated MPR and SPM in CRC patients to establish the best one. Materials and Methods: We included 35 CRC patients with isolated MPR and 25 patients with isolated SPM who underwent curative R0 resection. We performed PALN dissection (PALND) in 15 cases in MPR group and in 10 cases in the SPM group; all remaining patients in both groups underwent chemoradiotherapy (CRT) without further surgical intervention. During the study period of about 5 years, we compared the patients who underwent PALND and those who underwent CRT. Results: The overall survival and recurrence-free survival rates were significantly longer in patients who underwent PALND (p = 0.049 and 0.036 respectively). (AU)

Response of three wheat varieties to nitrogen levels, seeding rates and their combination; 2: Spike characters

To achieve larger production per unit area, sciences and farmers face a great defiance in improving cropping practices and elicitation new top yielding wheat varieties and also to establish the effects of these factors on the spike characters. Two years experiment were conducted to evaluate the effect of three nitrogen fertilizer levels (recommend rate 80 kg N/fed and 25% lower and higher than the recommended, i.e. 60 and 100 kg N/ fed, three seeding rates (40, 60 and 80 kg grains/fed) and there varieties (Giza-171, Gemmiza-12 and Shandawil-1), on spike characters of wheat at the Agricultural and experimental Research Station, Faculty of Agriculture, Cairo University, Giza, Egypt during 2018/2019 and 2019/2020 seasons. The experimental design was a split- split plot in randomized complete block arrangement with three replications. Nitrogen levels were allocated to the main plots, while the sub plots were assigned for seeding rates. Wheat varieties were distributed at random in the sub-sub plots. Each sub-sub plots area 4 m (2 x 2m). Generally, results indicated that significant effect on spike length and number of grains/ spike in both seasons and on weight of grains/ spike and 1000-grain weight in one season, where the tallest and heaviest spike as well as the heaviest 1000-grain weight were produced at the 100 kg N/fed in both seasons but the highest number of grains/spike was obtained at 80 kg N/fed in one season. It could be concluded that application nitrogen at the rate of 100 kg/fed proceed the favorable effect on spike characters under the environmental conditions of the experimental site and the similar conditions. Seeding rates caused a significant effect on all studied traits in one season, so the highest values were at 80 kg grains/fed, but this effect on 1000-grain weight was true in both seasons, where the highest value was at 60 kg grains/fed. Moreover, varieties were significantly differed in all spike character in both seasons except number and weight of grains/spike in one season where Giza-12 variety surpassed others. Al studied interactions had significant effect on all studied traits either in one or two season. Planting Giza-171 with 80 kg grains/fed and application of 100 kg N/fed was the pest treatment.

A comparison between different management surgical approaches in the treatment of splenic flexure colon cancer

Background: There are many surgical approaches which described extent of resection of the colon for adequate surgicalmanagement of splenic flexure cancer, but up till now there is no established surgical procedure, this is because the presence of double lymphatic drainage of themesenteric vessels. Segmental resection of the colon for the management of splenic flexure cancer was a recently accepted surgical procedure. Objective: In the present study, we aimed to compare three surgical management techniques to clarify the best management approach of Egyptian patients with splenic flexure cancer regarding operative, clinical, and oncological outcomes: segmental resection, and extended left or right hemicolectomy,. Materials and Methods In the present study, we included 90 patients with splenic flexure cancer. Cases were divided into 3 groups. Each group included 30 patients in order to compare three surgical techniques: segmental resection, extended left hemicolectomy, and extended right hemicolectomy. Results: We have found no statistically significant differences between the three included groups regarding operative findings, postoperative complications, local recurrence, distant recurrence, disease progression, recurrence-free survival rate, progression-free survival rate, and overall survival rate. The operative time was longer, and the number of lymph nodes was higher in the extended right hemicolectomy group (p<0.001). Conclusion: We have shown that segmental resection of the splenic flexure is surgically and clinically suitable for the adequate management of operable cases of carcinoma of the splenic flexure. (AU)

Consecutive versus concomitant follicle-stimulating hormone and highly purified human menopausal gonadotropin: A milder response but better quality / 대한생식의학회지

Objective@#This study investigated the impact of two stimulation protocols using highly purified human menopausal gonadotropin (HP-hMG) on the endocrine profile, follicular fluid soluble Fas levels, and outcomes of intracytoplasmic sperm injection (ICSI) cycles. @*Methods@#This prospective clinical trial included 100 normal-responder women undergoing ovarian stimulation for ICSI; 55 patients received concomitant follicle-stimulating hormone (FSH) plus HP-hMG from the start of stimulation, while 45 patients received FSH followed by HP-hMG during mid/late follicular stimulation. The primary outcome was the number of top-quality embryos. The secondary outcomes were the number and percentage of metaphase II (MII) oocytes and the clinical pregnancy rate. @*Results@#The number of MII oocytes was significantly higher in the concomitant protocol (median, 13.0; interquartile range [IQR], 8.5–18.0 vs. 9.0 [8.0–13.0] in the consecutive protocol; p=0.009); however, the percentage of MII oocytes and the fertilization rate were significantly higher in the consecutive protocol (median, 90.91; IQR, 80.0–100.0 vs. 83.33 [75.0–93.8]; p=0.034 and median, 86.67; IQR, 76.9–100.0 vs. 77.78 [66.7–89.9]; p=0.028, respectively). No significant between-group differences were found in top-quality embryos (p=0.693) or the clinical pregnancy rate (65.9% vs. 61.8% in the consecutive vs. concomitant protocol, respectively). The median follicular fluid soluble Fas antigen level was significantly higher in the concomitant protocol (9,731.0 pg/mL; IQR, 6,004.5–10,807.6 vs. 6,350.2 pg/mL; IQR, 4,382.4–9,418.4; p=0.021). @*Conclusion@#Personalized controlled ovarian stimulation using HP-hMG during the late follicular phase led to a significantly lower response, but did not affect the quality of ICSI.

Value of fertility-sparing surgery for young females with epithelial ovarian cancer: a comparative study / Valor de la cirugía de preservación de la fertilidad en mujeres jóvenes con cáncer de ovario epitelial: un estudio comparativo

Resumen OBJETIVO: Comparar la cirugía radical con la cirugía conservadora de la fertilidad en mujeres con cáncer de ovario epitelial en estadio 1A-C con respecto a la tasa de recurrencia y las tasas de supervivencia. Además, evaluar los desenlaces reproductivos y obstétricos para las mujeres con cáncer de ovario epitelial en estadio I tratadas con una conducta conservadora de la fertilidad. PACIENTES Y MÉTODOS: Estudio prospectivo efectuado en pacientes con cáncer de ovario epitelial, estadio I, con edad ≤ 40 años. A las pacientes del grupo de preservación de la fertilidad se les practicó salpingooforectomía del lado del ovario afectado y una biopsia por incisión o escisión en cuña del ovario contralateral. A las pacientes del grupo de cirugía radical se les practicó la histerectomía total y salpingooforectomía bilateral. Para evaluar los desenlaces reproductivos y oncológicos se dio seguimiento a todas las pacientes durante cinco años. RESULTADOS: Se estudiaron 60 pacientes; las del grupo de cirugía de preservación de la fertilidad eran significativamente más jóvenes (30 ± 4 en comparación con 35 ± 5) (p < 0.001), el tamaño de sus tumores era más pequeño 3.4 ± 1.3 en comparación con 6.0 ± 2,6 (p < 0.001), de menor grado (p < 0.001). = 0.011), estadio más precoz (p < 0.001) y con más histología mucinosa que las pacientes del grupo de cirugía radical. No hubo diferencias estadísticamente significativas entre ambos grupos en cuanto a la recurrencia tumoral o las tasas de supervivencia. De 25 pacientes operadas para preservación de la fertilidad 18 de 25 intentaron quedar embarazadas. Se registraron 15 de 18 embarazos, incluidos 13 nacidos vivos, 1 aborto espontáneo y 1 muerte fetal intrauterina. CONCLUSIÓN: La cirugía conservadora de la fertilidad podría ser una alternativa adecuada a la cirugía radical para mujeres jóvenes con cáncer epitelial de ovario en estadio I.

Abstract OBJECTIVE: In the current study, we aimed to compare between radical surgery and fertility saving surgery in females with stage 1A-C EOC regarding recurrence rate and patients survival rates in addition to evaluating reproductive and obstetric outcomes for stage I EOC females who were managed by fertility saving surgery. PATIENTS AND METHODS: We prospectively identified 60 patients diagnosed with stage I EOC aged ≤ 40 years. Patients in the fertility-preservation group underwent salpingo-oophorectomy on the side of the affected ovary in addition to incisional biopsy or wedge excision of the ovary on the other side. Patients in the radical surgery group underwent total hysterectomy and bilateral salpingo-oophorectomy. We followed up all patients for 5 years to assess their reproductive and oncological outcomes. RESULTS: Patients in the fertility preservation surgery group were significantly younger (30 ± 4 versus 35 ± 5) (p < 0.001), their tumor sizes were smaller 3.4 ± 1.3 versus 6.0 ± 2.6 (p < 0.001), of lower grade (p = 0.011), earlier stage (p < 0.001) and has more mucinous histology than patients in the radical surgery group. There were no statistically significant differences between both groups regarding tumor recurrence or survival rates. Of 25 patients underwent fertility preservation surgery, 18/25 (72%) tried to get pregnant. 15/18 (83%) pregnancies were recorded, including 13 live births, 1 miscarriage, and 1 intrauterine fetal death. CONCLUSION: Fertility sparing surgery could be adequate alternative to radical surgery for young females with stage I EOC.

Enfermeiro: ator no empreendedorismo social / Nurse: actor in social entrepreneurships

Introdução: O empreendedor social é um agente de mudanças que inspira outras pessoas a se engajarem em torno de uma causa comum e corrobora com a melhoria de ambientes onde os recursos são escassos. O enfermeiro realiza o empreendedorismo social, uma vez que busca soluções inovadoras e busca a sustentabilidade social. Objetivo: discutir o papel do Enfermeiro como ator no empreendorismo social. Método: Estudo descritivo e qualitativo de revisão integrativa de literatura nas bases de dados Pubmed, Lilacs, Scielo e indexador Spell, entre 2010 a 2020 sobre empreendedorismo social e enfermagem. Resultados: Foram encontradas vinte pesquisas, do qual 25% retrata as características empreendedoras de acadêmicos, docentes e enfermeiros; 25% aborda o empreendedorismo na formação dos enfermeiros; 15% dos estudos trazem informações nacionais e internacionais sobre a temática. Conclusão: É essencial discutir sobre o papel do enfermeiro enquanto empreendedor social, sua formação e atuação para seu empoderamento na assistência de saúde.(AU)

Introduction: The social entrepreneur is an agent of change that inspires others to engage around a common cause and supports the improvement of environments where resources are scarce. Nurses carry out social entrepreneurship, as they seek innovative solutions and seek social sustainability. Objective: to discuss the role of the nurse as an actor in social entrepreneurship. Method: Descriptive and qualitative study of an integrative literature review in Pubmed, Lilacs, Scielo and Spell indexer databases, between 2010 and 2020 on social entrepreneurship and nursing. Results: Twenty researches were found, of which 25% portray the entrepreneurial characteristics of academics, teachers and nurses; 25% addresses entrepreneurship in the training of nurses; 15% of the studies bring national and international information on the subject. Conclusion: It is essential to discuss the role of nurses as social entrepreneurs, their training and performance for their empowerment in health care.(AU)

El emprendedor social es un agente de cambio que inspira a otras personas a involucrarse en una causa común. El enfermero realiza emprendimiento social al buscar soluciones innovadoras y la sostenibilidad social. Objetivo: discutir el rol del enfermero como actor en el emprendimiento social. Método: Estudio descriptivo y cualitativo de revisión integradora de literatura sobre emprendimiento social y enfermería en las bases de datos Pubmed, Lilacs, Scielo y Spell index, entre 2010 y 2020. Resultados: Se encontraron veinte encuestas, de las cuales el 25% retrata las características emprendedoras de académicos, docentes y enfermeros; El 25% aborda el espíritu empresarial en la formación de enfermeros; El 15% de los estudios aportan información nacional e internacional sobre el tema. Conclusión: Discutir sobre el rol del enfermero como emprendedor social, su formación y desempeño para que estos profesionales se empoderen en el cuidado de la salud.(AU)

A mothers' perspective on fish and her child's fish consumption in Surakarta, Indonesia

SUBJECTS/METHODS@#Two hundred thirty-one elementary school children grade 3–6 and their mothers in Surakarta were recruited using multi stage random sampling for this study.Data was collected in July and August 2017. A validated questionnaire consisted of 3 topics including knowledge related to the health benefits and organoleptic properties of fish and cooking technique-related attitudes on fish were used to measure the mother's response to the fish properties. A validated food frequency questionnaire and a food picture book of fish specifically designed for the survey were developed and used to assess fish consumption of the children. A χ2 test was used to analyse the correlation between the mothers' perspective on fish and their children's fish consumption. @*RESULTS@#The median fish consumption in children was 65 g/d with fried non-oily or lean fish, e.g., milkfish (locally called Bandeng) and catfish (locally called Lele) were consumed more than oily fish as well as processed fish products. Of all children, 31% met the fish consumption recommended by the Environmental Protection Agency-Food and Drug Administration 2017. There was no relationship between a mother's knowledge related to health benefits, organoleptic properties and cooking technique-related attitude toward fish and her child's fish consumption. @*CONCLUSIONS@#The fish consumption of children is not influenced by their mother's perspective on fish. Nutrition education strategies are warranted to improve fish consumption and maintain the optimal benefits by consuming fish, including fish high in n-3 LCPUFA.