Neurological Complications in Benign Parapharyngeal Space Tumors - Systematic Review and Meta-Analysis

Abstract Introduction Parapharyngeal space tumors with complex anatomy and diverse histology have remained a challenging phenomenon for treating physicians. Objectives We have conducted a comprehensive web search on the PubMed, Web of Science, EMBASE, Cochrane Library, Biomedical Literature Database (CBM), and Clinicaltrials.gov databases to determine the factors that are associated with postoperative complications in parapharyngeal space tumors. Data Synthesis Two researchers reviewed all identified articles independently with a third reviewer for adjudication. Patient demographics and other clinicopathological characteristics were explored. The systematic review has identified 631 benign parapharyngeal space tumors with neurogenic and salivary tissue histology in 13 studies, with a mean age of 42.9 ± 7.76 years old and a median follow-up of 40.98 ± 19.1 months. Salivary gland (50.8%) and neurogenic (49.1%) tumors were the most common histological entities. Tumor size, location, histology, deep parotid lobe involvement, and proximity to great vessels or to the skull base were the deciding factors in selecting the surgical approach. The factors considered to select the surgical approach do not seem to have a correlation with the outcome in terms of neurological sequalae (p = 0.106). Tumors with neurogenic histology have significantly increased chances of developing neurological complication (OR 6.07; p = 0.001). Conclusion Neurologic complications are significantly associated with neurogenic benign tumors rather than surgical approach.

Survival Outcomes and Patterns of Failure in Maxillary Alveolus Squamous Cell Carcinoma

Abstract Introduction Squamous cell carcinoma (SCC) of the maxillary alveolus is a relatively rare disease. There is lack of data on this subsite as compared with other sites. The factors that affect survival in cases of maxillary alveolar SCC are tumor stage, local and cervical metastases, histological grading, and the margin status. Objectives To evaluate the overall survival (OS), the disease free survival (DFS), and the complex interaction and effects of margin status, histological differentiation, habits (such as smoking and the use of smokeless tobacco products), and cervical and distant metastases based on clinicopathological data. Methods We examined the electronic database at our hospital from 2003 to 2017. We included all cases with a histopathological diagnosis of SCC of the maxillary alveolus. Tumors originating primarily from the maxillary alveolus were included, while those originating from adjacent subsites, like the hard palate, the buccal mucosa or the maxillary sinus were excluded. We also excluded all the patients who were not operated on with a curative intent. Results More than half of the patients had stage-IV tumors at the time of presentation, while only one fourth of them had nodal metastasis. The rate of recurrence increased in cases of primary tumors in advanced stages and the degree of histological differentiation. The 2-year and 5-year OS rates were of 54.5% (18 patients) and 30.3% (10 patients) respectively. Conclusion Primary tumors in advanced stages, histological grade, and presence of nodal metastasis are poor prognostic markers in terms of long-term survival.

Survival Outcome in True Carcinoma of Unknown Primary (tCUP) with p16 + Cervical Metastasis

Abstract Introduction Age and lymph node ratio have been attributed as independent predictors for survival and recurrence in carcinoma of unknown primary (CUP). Objective The purpose of this study was to analyze the prognostic value of p16 overexpression for CUP in the absence of true primary (TP). Methods The study involved 43 patients who underwent therapeutic lymph node dissection (LND) from 2000 to 2015 after all the diagnostic work up for CUP. Immunohistochemistry for p16 overexpression was performed. Cox proportional hazard regression analysis was used to analyze the prognostic impact on 5-year overall survival (OS) and recurrence-free survival (RFS). Results The male-to-female ratio was 5.1:1, with a median age of 62 years. The clinicopathological data, except for p16 overexpression, did not differ significantly in terms of 5-year OS and RFS. The Cox regression analysis proposed p16 positivity to be an independent prognosticator of regional recurrence-free survival (RRFS) (hazard ratio [HR] 6.180, p = 0.21). The median time to recurrence and death were 10 and 25 months, respectively. Conclusion Cervical metastasis with p16 overexpression is a significant prognostic factor of improved RFS after surgery in CUP. The prognostic significance of lymph node p16 positivity should be further studied.

In vitro Antioxidant Activity and In vivo Anti-inflammatory Effect of Ricinus communis (L.) and Withania somnifera (L.) Hydroalcoholic Extracts in Rats

Abstract Ricinus communis L. and Withania somnifera L. have traditionally been used as analgesic and anti-inflammatory remedies. The current study was aimed to evaluate the in vitro antioxidant potential and anti-inflammatory activity of hydroalcoholic extract of R. communis leaves (RCE) and W. somnifera roots (WSE) in Wistar rats. Total phenolic and flavonoid contents were quantified and in vitro antioxidant activity of extracts was determined through DPPH* scavenging, superoxide anion scavenging and reducing power activities, while anti-inflammatory activity was observed by xylene-induced ear edema and paw edema induced by egg albumin and carrageenan. RCE and WSE demonstrated considerable antioxidant activity in DPPH* scavenging (IC50: 250.10 and 309.42 µg/mL), superoxide anion scavenging (IC50: 193.42 and 206.81 ug/mL), and reducing power (maximum absorbance: 1.47±0.01 O.D and 1.28±0.01 O.D at 500 ug/mL) activities, respectively, with high phenolic and flavonoid contents. Both extracts showed dose-dependent edema inhibition in inflammation models. A maximum ear edema inhibitions by RCE (51.49±2.54%) and WSE (49.28±1.90%) at 500 mg/kg were observed when compared to indomethacin (56.42±13.17%) in xylene-induced ear edema. RCE and WSE showed a maximum percentage of paw edema inhibitions of 46.62±8.98% and 43.00±12.44%, respectively as compared to chlorpheniramine (62.02±12.21%) after 4 h in the egg albumin model. In carrageenan-induced paw edema, RCE (72.88±13.79%) significantly inhibited paw edema in comparison to WSE (57.81±17.43%) against diclofenac (89.93±18.53%). Conclusively, both plants have shown plausible antioxidant and anti-inflammatory activities that might be due to high phenolic and flavonoid contents. Moreover, RCE demonstrated more promising effects than WSE.

Knowledge regarding renal stone among the nurses working in a selected specialized hospital in Bangladesh

Background: Renal stone disease is a considerable burden on public health worldwide. This study aimed to assess the nurse’s knowledge regarding renal stone among the nurses working at a selected specialized hospital.Methods: A total of 120 samples were collected through purposive sampling technique. A descriptive cross-sectional study was conducted under quantitative approach. Data were collected using a structured questionnaire through face to face interview. A written informed consent was obtained from the hospital authority and nurses. Data were analysed using SPSS version 20.Results: In this study ninety percent of the respondents were female and about 43.3% of the respondents were in the age group 31-35 years. About 35.8% of the respondents had postgraduate qualification and the majority (63.3%) of the respondents had 4 years and above years of service experience. More than nine-tenths (95.8%) of the respondents mentioned that renal stone is one kind of urological disease and 75.8% of the respondents mentioned that calcium oxalate is responsible elements for formation of renal stone. About 63.3% of them mentioned pain or burning during urination as the symptoms of renal stone. 66.7% of the respondents mentioned that a patient with renal stone should be counseled on stone-specific dietary interventions.Conclusions: The findings reveal that most of the study participants had good level of knowledge regarding the renal stone. It was recommended that a special training on renal stone for nurses might be geared up to increase their level of knowledge.

Threats of sedimentation to agricultural land due to land use and degradation of watershed physical environmental

Background:The Lake Lindu sub-watershed has experienced environmental damage, mainly as a result of various activities of the surrounding community who are less aware of the principles of environmental sustainability. This study aims to determine the effect of land use area and environmental physical conditions on sedimentation and water debit in the Lake Lindu sub-watershed. Methods:This research was carried out by implementing survey and non-experimental method at 3 rivers: Langko(P1), Wongkodono (P2), and Kati (P3). The dependent variable in this study is the area of land use (area of farm, shrub, paddy field, forest, and settlement) and the physical condition of the environment (the width of the catchment area and annual averagerainfall). Then, the independent variables are sedimentation and water debit. Statistical analysis used is a multiple regression model.Results:The results of this study are that the wider shrub (X2) reduces the sedimentation (Y1) and increases the water debit (Y2). Each addition of one shrub unit will reduce the sediment by 0.208 mg/L and affect the water debit of 0.258 m3/ s-1. The regression equation is Y1=185.903 -0.208X2-587.269X8and Y2=6.854+0.258 X2-71.708 X8. As for the coefficient of the shape of the river (X8). The bigger the shape of the river, the smaller the average of the water debit. Thus, each reduction of one coefficient unit of the river shape will affect the water debit of 71,708 m3/s-1.Conclusions:The significant predictor factors for sedimentation and river water debit are the shrubs and the coefficient of the river shape.

Risk Factors of Childhood Obesity and Overweight in Young Children and Adolescents Aged Between 5 to 15 Years in Urban Bangladesh: A Scoping Review

Childhood obesity is one of the most serious public health challenges of the 21st century. The problem is global and is steadily affecting many low- and middle-income countries, particularly in urban settings. Risk factors for obesity in this context have not been explored. The objective of this study was to identify the risk factors associated with childhood obesity/overweight among young children and adolescents 5-15 years of age in urban Bangladesh. Methods: A scoping review based on York methodology was performed. This methodology involves a comprehensive search of published academic articles, conference proceedings and grey literature through PubMed, Bangla JOL, Google and Google scholar, limited to English-written papers. Results: Findings revealed that having at least one overweight parent and engaging in sedentary activities for more than 4 h a day were independent risk factors for childhood overweight and/or obesity.Children who spent ≥ 30 min each day in outdoor games at home that involved physical exercise had decreased odds (OR = 0.38, 95% CI: 0.1–0.8) of being overweight or obese compared to children who did not exercise at home. Conclusion: Spending much time seated or somewhat inactive were key risk factors for childhood obesity and overweight. More research, prevention and management of childhood obesity/overweight in young children and adolescents in urban Bangladesh should be a policy priority.

Characterization and Metal Detoxification Potential of Moderately Thermophilic Bacillus cereus from Geothermal Springs of Himalaya

Two thermophilic Bacillus cereus strains (B. cereus-TA2 and B. cereus-TA4) used in the present study were isolated from the geothermal spring of Hunza valley, Gilgit, Pakistan. They showed the ability to withstand and grow at high temperature (85°C). Both these strains could resist multiple metals (copper, cadmium, mercury, manganese, zinc, arsenic, chromium and selenium). Strain B. cereus-TA4 reduced Cr (VI) at pH 5.0 to 9.0 but maximum reduction (83%) was observed at pH 7.0 after 48 h when initially supplied with 200 µg mL-1 of K2CrO4. Lower initial concentrations such as 100 µg mL-1 supported higher reduction (90 to 95%) than that of high concentration such as 500 µg mL-1 (20 to 30%). Both the strains reduced nearly 70% of Se (IV) after 48 h of growth at pH 7.0 when initially supplied with 200 µg mL-1 of Na2SeO3. The optimum temperature for maximum Se (IV) reduction was 45°C for both the strains.

Comparative study of wild and transformed salt tolerant bacterial strains on Triticum aestivum growth under salt stress

Eleven salt tolerant bacteria isolated from different sources (soil, plants) and their transformed strains were used to study their influence on Triticum aestivum var. Inqlab-91 growth under salt (100 mM NaCl) stress. Salt stress caused reduction in germination (19.4 percent), seedling growth (46 percent) and fresh weight (39 percent) in non-inoculated plants. In general, both wild and transformed strains stimulated germination, seedling growth and fresh weight in salt free and salt stressed conditions. At 100 mM NaCl, Staphylococcus xylosus ST-1 caused 25 percent increments in seedling length over respective control. Soluble protein content significantly enhanced (49 percent) under salt stress as compared to salt free control. At 100 mM NaCl parental strain PT-5 resulted about 32 percent enhancement in protein content over respective control treatment. Salt stress induced the promotion of auxin content in seedlings. Overall, Bacillus subtilis HAa2 and transformed E. coli-SP-7-T, caused 33 percent and 30 percent increases in auxin content, respectively, were recorded under salt stress in comparison to control.

Successful treatment of diabetes insipidus with oral desmopressin

Acute-onset polyuria, with urine volumes exceeding 3 litres per day, is a relatively uncommon clinical condition. If managed on appropriate guidelines, an excellent recovery is expected