Ovarian-sparing surgery for ovarian tumors in children: A systematic review and meta-analysis.

INTRODUCTION: An increased number of children and adolescents with ovarian tumors have been managed with ovarian-sparing surgery in the last few years. However, comprehensive data on fertility outcomes and local relapse are scarce. In this study, we systematically describe the contemporary outcomes of ovarian-sparing surgery, as reported in the literature. MATERIALS AND METHODS: Using PRISMA guidelines, we analyzed studies reporting ovarian-sparing techniques for ovarian tumors in children and adolescents. from 1980 to 2022. Reports with fewer than three patients, narrative reviews, and opinion articles were excluded. Statistical analysis was performed for dichotomous and continuous variables. RESULTS: Of 283 articles screened, 16 papers (3057 patients) met inclusion criteria (15 retrospective/1 prospective) and were analyzed. The vast majority of studies had no long-term fertility follow-up data and direct comparison between ovarian-sparing surgery vs oophorectomy was reported in only a few studies. Ovarian sparing surgery was not associated with worse oncologic outcomes in terms of (i) tumour spillage or (ii) recurrence rates, and of key importance allowed a higher ovarian reserve at long term follow-up. CONCLUSIONS: Ovarian-sparing surgery is a safe and feasible technique for benign tumors. Long-term outcome studies are needed to show efficacy and fertility preservation.

Clinical Utility of Protein Induced by Vitamin K Absence-II in Patients with Hepatocellular Carcinoma.

OBJECTIVE: Despite moderate sensitivity, alpha fetoprotein (AFP) is widely used in screening and prognostication for hepatocellular carcinoma (HCC). The objective of the current study was to assess clinical utility of Prothrombin induced by Vitamin K absence-II (PIVKAII) in addition to AFP in patients with HCC. METHODS: We retrospectively reviewed 244 patients with documented AFP, PIVKA II and dynamic imaging of the liver. Using ROC curves, cutoff values for AFP and PIVKAII for HCC detection, tumor grade and microvascular invasion (MVI) were assessed. In patients who underwent liver transplantation (LT) for HCC, survival was determined using Kaplan Meier curves. RESULTS: The median PIVKAII in healthy living donors was 28.6mAU/ml (15.9-55). In cirrhotics, the sensitivity of an AFP cutoff of 7.6 ng/ml or PIVKAII  cutoff of 250 mAU/ml for HCC detection was 91.7% (176/192) and specificity was 62.9%(68/108) (p <0.0001). In patients with HCC, PIVKAII values were significantly elevated with tumor size > 5 cm (P < 0.0001), tumor nodules > 3(P=0.01), and macrovascular invasion(p <0.0001).  The high risk group (patients with AFP ≥ 40 ng/ml + PIVKAII ≥ 350 mAU/ml), had a sensitivity of (23/33) 69.6% and specificity of (22/22)100% for MVI (P <0.001). The estimated 3 year RFS after LT in the low risk group (AFP.

Utilization of potato peels and sugar beet pulp with and without enzyme supplementation in broiler chicken diets: effects on performance, serum biochemical indices and carcass traits.

This study was conducted to investigate the effects of including potato peels (PP) and sugar beet pulp (SBP), as unconventional feeds, with and without enzyme in broiler diets from 1 to 42 days of age by observing the growth performance, blood parameters and carcass characteristics. A total of 150, 1-day old, chicks were randomly assigned into five groups, each with 30 chicks. Birds in group 1 were fed on the control diet. Chicks in groups 2 and 3 were offered diets containing PP and SBP at the rate of 15% and 7.5%, respectively, while those in groups 4 and 5 were fed the same diets but with adding an enzyme mixture. Using the unconventional feeds in the diets was found to decrease the body weight (BW). However, the feed intake, weight gain and feed conversion did not differ from the control in PP at the grower period, but decreased in SBP throughout the experiment. Addition of enzyme greatly improved the BW in PP and SBP to a degree that it surpasses the control and also increased the feed intake and conversion. The total cholesterol and low-density lipoprotein cholesterol serum levels were decreased in all tested groups. Carcass yield was not affected by treatments, but the carcass fat content was reduced using the unconventional feeds with or without enzyme. In conclusion, PP can be used at a rate of 15% in the grower diets of broilers. Furthermore, 15% PP or 7.5% SBP can be included in starter and grower diets, but with the addition of enzymes. This can help in solving the problem of current shortage and rising costs of conventional feeds.

Cultural interrelationships and the lived experience of Pakistani breast cancer patients.

AIM: There is a paucity of British and international literature on the psychological, sociological and cultural correlates of breast health in ethnic minority women. METHODS: This two centre qualitative study was part of a larger study that aimed to examine the influence of culture on the lived experience of Pakistani Muslim breast cancer patients. Thirty six patients attending hospital out-patient breast cancer clinics in Lahore, Pakistan and London, UK were recruited to the study. Women were predominantly married, 20-76 years of age with an average of three children. Semi-structured interviews were undertaken. Interview data were analysed using thematic analysis. RESULTS: Five themes emerged: Discovery and reaction to the disease; disclosure to family; developing emotions; emerging reality; long term uncertainty. CONCLUSIONS: Data infer that irrespective of city of residence, the cultural attributes of women, breast health awareness and reactions to the diagnosis and treatment are similar. To raise awareness, more focused health education interventions are needed.

Growth characteristic of Camel pox and Vaccinia viruses in embryonated eggs and cell culture.

Camel pox viruses isolated in Sudan and VD45 (African camel pox strain) and Vaccinia virus (Elstree strain) were used for inoculation of chorioallantoic membrane (CAM) of embryonated eggs (EE) and cell culture (CC). In EE Lesions were seen as pocks ranging in size from 1 to 1.5 mm in diameter, and they increase in size with serial passage and taking opaque- white and opaque- yellow colors. When propagated in Vero cells, these viruses gave clear CPE, characterized by rounding of cells, plaque formation, syncytia and detachment of cells from the glass.

Effects of dietary phosphorus and calcium on the intestinal absorption of Ca in sheep.

1. Wether sheep were used, some of which were prepared with a Thiry-Vella loop of jejunum. The long-term use of these loops was ensured by regular perfusion with fresh nutrient solution. 2. The net calcium absorption rate from a Thirty-Vella loop of jejunum increased with increasing intraluminal Ca concentration and was increased by the addition of 1 alpha-hydroxy-cholecalciferol (3 micrograms/l) to the loop fluid. 3. When the diet of sheep was changed from one which was normal in Ca to a diet low in Ca there was an increase in the efficiency of net Ca absorption from the jejunal loop. This dietary change was accompanied by an increase in the circulating concentration of 1,25-dihydroxy-cholecalciferol (1,25(OH)2D3). 4. An intravenous infusion of the Ca chelating agent EDTA increased the efficiency of net Ca absorption from the jejunal loop. The use of 47Ca demonstrated that this reflected an increase in the true absorption rate of Ca. 5. Dietary phosphorus deficiency reduced the efficiency of intestinal Ca absorption and was associated with a reduction in the plasma concentration of 1,25(OH)2D3.