Rectosigmoid resection morbidity in ovarian cancer cytoreductive surgery.

This case series evaluated morbidity following rectosigmoid resection during cytoreductive surgery for advanced ovarian cancer at the Shaukat Khanum Memorial Cancer Hospital, Lahore. The data of 20 female patients with complications corresponding to the Clavien-Dindo classification was included; the patients received treatment between January 2016 and January 2021. The mean age was 45.05± 13.11 years. Complications were observed in 3 (15.0%) cases, i.e., urinary complications in 2 (66.7%), and intra-abdominal abscess in 1 (33.3%) case. Clavien-Dindo classification grade II was noted in 2 (66.7%), while grade III-B in 1 (33.3%) case. Surgical risk factors were noted as appendectomy in 6 (66.7%) cases, bowel resection in 1 (11.1%), left colectomy in 1 (11.1%), sigmoid colectomy in 1 (11.1%), and stoma formation in 11 (55.0%) cases. In this reported case series, significant complications were observed in women undergoing rectosigmoid resection as cytoreductive surgery for advanced ovarian cancer.

Interactive mode of biochar-based silicon and iron nanoparticles mitigated Cd-toxicity in maize.

Cadmium contamination poses severe environmental and health threats, necessitating effective mitigation strategies. Rice husk biochar (BC) and nanoparticle (NP) treatments are emerging strategies with limited research on their synergistic benefits. This study assesses BC, silicon NPs (nSi), and iron NPs (nFe) modifications (B-nSi, B-nFe, and B-nSi-nFe) to reduce Cd-bioavailability in soil and its toxicity in maize, not reported before. Characterization of amendments validated, nSi and nFe attachment to BC, forming new mineral crystals to adsorb Cd. We found that B-nSi-nFe induced Cd-immobilization in soil by the formation of Cd-ligand complexes with the effective retention of NPs within microporous structure of BC. B-nSi-nFe increased soil pH by 0.76 units while reducing bioavailable Cd by 49 %, than Ck-Cd. Resultantly, B-nSi-nFe reduced Cd concentrations in roots and shoots by 51 % and 75 %, respectively. Moreover, the application of B-nSi-nFe significantly enhanced plant biomass, antioxidant activities, and upregulated the expression of antioxidant genes [ZmAPX (3.28 FC), ZmCAT (3.20 FC), ZmPOD (2.58 FC), ZmSOD (3.08 FC), ZmGSH (3.17 FC), and ZmMDHAR (3.80 FC)] while downregulating Cd transporter genes [ZmNramp5 (3.65 FC), ZmHMA2 (2.92 FC), and ZmHMA3 (3.40 FC)] compared to Ck-Cd. Additionally, confocal microscopy confirmed the efficacy of B-nSi-nFe in maintaining cell integrity due to reduced oxidative stress. SEM and TEM observations revealed alleviation of Cd toxicity to stomata, guard cells, and ultracellular structures with B-nSi-nFe treatment. Overall, this study demonstrated the potential of B-nSi-nFe for reducing Cd mobility in soil-plant system, mitigating Cd-toxicity in plants and improving enzymatic activities in soil.

Incidence and Survival Rates for Female Malignant Germ Cell Tumors: An Institutional Review.

Background Germ cell tumor survival rates have improved over the past few decades. However, there is a lack of data on survival rates and the incidence of female germ cell tumors. This study aims to determine the incidence and survival rates of female germ cell tumors in our institution. Methodology This retrospective cross-sectional study was carried out at Shaukat Khanum Memorial Hospital and Research Centre, and the records over 10 years, from January 2010 to December 2020 were examined. The data of 290 females with malignant germ cell tumors were selected from 1387 females with ovarian masses, and their survival records were examined. For statistical analysis, SPSS software (version 24.0; IBM Corp. Armonk, NY) was utilized. The survival analysis was determined using the Kaplan-Meier method. Results The mean age of patients was 21.45 ± 9.28 years. The mean duration of diagnosis was 4.53 ± 2.59 years. In 245 (84.5%) patients, ovarian malignancy was involved while uterine malignancy was observed in 44 (15.2%) cases and there was one (0.3%) case of cervical carcinoma. The most common stage at diagnosis of malignancy was IA (96 (33.1%)), followed by IIIC (58 (20.0%)), IV (56 (19.3%)) and IC (26 (9.0%)). Chemotherapy was given in 244 (84.1%) cases. Out of 290 cases, 26 (9.0%) had a recurrence of the tumor while 264 (91.0%) did not have a recurrence of the tumor. Out of 290 cases, 46 (15.9%) died during follow-up, 129 (44.4%) had disease-free survival while 115 (39.7%) were healthy till the end of the study. The mean duration of survival was 3.56 ± 2.33 years. When patients' survival was compared between treatment groups, patients who did not receive chemotherapy fared better than those who did. Conclusion Female germ cell tumor patients have a good overall survival rate of more than 20% after 10 years of follow-up with effective adjuvant therapy and conservative surgery. However, more research is needed to determine the long-term effects of chemotherapy on ovarian function.

Prevalence and Risk Factors of Low Anterior Resection Syndrome in Epithelial Ovarian Cancer Surgery.

Background In this study, we aimed to determine the prevalence and risk factors of low anterior resection syndrome (LARS) in epithelial ovarian cancer (EOC) surgery. Methodology A descriptive cross-sectional study was conducted at the Gynecologic Oncology Section of the Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital & Research Centre, Lahore, Pakistan. Using non-probability consecutive sampling technique, all patients who underwent cytoreductive surgery involving low anterior resection for EOC between January 2016 and January 2021 were included. Patients were assessed for LARS symptoms using the LARS score, along with its risk factors. Descriptive statistics, that is, continuous variables were expressed as the median and interquartile range, while categorical variables were expressed as frequencies and percentages. The LARS score was categorized according to a two-tier model with "no or minor LARS" and "major LARS." Univariate analyses were performed by the chi-square tests providing odds ratios and 95% confidence intervals to identify risk factors for major LARS. Results Overall, 95% of cases had LARS scores that fell in "no or minor LARS," while only 5% of cases had "major LARS." Univariate analyses relieved no statistically significant association between the occurrence of major LARS and any of the risk factors. Conclusions The prevalence of LARS was 5%, and no risk factors were associated with major LARS in our study population.

Comparative analysis of neutrophil to lymphocyte ratio and derived neutrophil to lymphocyte ratio with respect to outcomes of in-hospital coronavirus disease 2019 patients: A retrospective study.

Introduction and objectives: In patients with coronavirus disease 2019 (COVID-19), several abnormal hematological biomarkers have been reported. The current study aimed to find out the association of neutrophil to lymphocyte ratio (NLR) and derived NLR (dNLR) with COVID-19. The objective was to compare the accuracy of both of these markers in predicting the severity of the disease. Materials and methods: The study was conducted in a single-center having patients with COVID-19 with a considerable hospital stay. NLR is easily calculated by dividing the absolute neutrophil count (ANC) with the absolute lymphocyte count (ALC) {ANC/ALC}, while dNLR is calculated by ANC divided by total leukocyte count minus ANC {ANC/(WBC-ANC)}. Medians and interquartile ranges (IQR) were represented by box plots. Multivariable logistic regression was performed obtaining an odds ratio (OR), 95% CI, and further adjusted to discover the independent predictors and risk factors associated with elevated NLR and dNLR. Results: A total of 1,000 patients with COVID-19 were included. The baseline NLR and dNLR were 5.00 (2.91-10.46) and 4.00 (2.33-6.14), respectively. A cut-off value of 4.23 for NLR and 2.63 for dNLR were set by receiver operating characteristic (ROC) analysis. Significant associations of NLR were obtained by binary logistic regression for dependent outcome variables as ICU stay (p < 0.001), death (p < 0.001), and invasive ventilation (p < 0.001) while that of dNLR with ICU stay (p = 0.002), death (p < 0.001), and invasive ventilation (p = 0.002) on multivariate analysis when adjusted for age, gender, and a wave of pandemics. Moreover, the indices were found correlating with other inflammatory markers such as C-reactive protein (CRP), D-dimer, and procalcitonin (PCT). Conclusion: Both markers are equally reliable and sensitive for predicting in-hospital outcomes of patients with COVID-19. Early detection and predictive analysis of these markers can allow physicians to risk assessment and prompt management of these patients.

Is Prednisolone Useful in Treatment of Hyperemesis Gravidarum?

OBJECTIVE: To compare the outcome of prednisolone versus placebo in females presenting with hyperemesis gravidarum during first trimester of pregnancy. METHODS: Randomized controlled trial was conducted in the Department of Obstetrics & Gynecology of Jinnah Hospital, Lahore over a period of 12 months. A total of 300 patients were divided equally into two groups, i.e. prednisolone 20 mg orally 12 hourly for seven days and placebo for the same duration. Follow up in the outpatient department after one week was done to assess for continuous and/or high-frequency vomiting (as per operational definitions). Statistical Package for Social Sciences (SPSS) Statistics version 22 (IBM Corp., Armonk, NY, USA) was used to analyze data. Quantitative and qualitative variables were assessed in terms of mean/standard deviation and frequency/percentage respectively. Comparison of two study groups and stratified confounding factors (age and parity) were assessed by chi-square test (significant P-valve ≤ 0.05). RESULTS: 28.7% of cases of the prednisolone group had continuous and/or high frequency vomiting in comparison to 46% of the placebo group (p=0.002). CONCLUSIONS: Prednisolone is effective for treating women with hyperemesis gravidarum during the first trimester of pregnancy.