Exploring treatment outcomes in Stage II-III rectal cancer patients undergoing neoadjuvant therapy at a tertiary care center in Pakistan: a comprehensive analysis of pathological outcomes.

BACKGROUND: Rectal cancer treatment has transformed in recent years, with neoadjuvant treatment (NT) and total neoadjuvant treatment (TNT) aiming to enhance pathological responses. This pioneering study in our country delves into rectal cancer management, offering crucial insights by examining pathological outcomes in patients treated with the NT and TNT approach, shaping the evolving landscape. METHODS: In this retrospective-cohort study spanning January 2017 to December 2022 at a tertiary care hospital in Pakistan, ethical approval was obtained to examine outcomes of two treatments. Patients were divided into TNT (chemoradiation and pre-surgery 5 FU-based chemotherapy) and NT (chemoradiation, surgery, and subsequent 5 FU-based chemotherapy). The primary end-point was response rates-no response, pathological complete response (pCR), near complete response (near CR), and partial response (PR). The Chi-Square Test for Independence assessed the association between treatment response and type (TNT or NT). Data analysis used STATA MP 64; significance was set at p < 0.05 for all two-tailed tests. RESULTS: We analyzed 77 patients, 60 underwent standard neoadjuvant chemoradiation, and 17 followed the total neoadjuvant approach. Predominantly male, most were > 65 with ECOG 0-1. The TNT group showed higher response rates (76% vs 62%, p = 0.039), with 40.38% achieving pCR. In the overall population, pCR and near-CR were similar (27.2% vs 26%), while PR were 14%. Treatment characteristics correlated significantly with chemotherapy type, concurrent chemoradiation, LVI, PNI, and T, N, M staging (p < 0.05). Median overall survival was not reached, and mean survival was 89.1 months (CI: 95.0 to 83.3). Side effects varied, with notable differences in neuropathy, diarrhea, oral mucositis, and thrombocytopenia between NT and TNT groups. CONCLUSION: Our study adds to evidence favoring neoadjuvant approaches in managing rectal cancer in pakistan. Demonstrating a favorable pcr rate, ongoing research with extended follow-up is essential, given the dynamic landscape of rectal cancer treatment for improved patient outcomes.

Energy Enhancement of a Nickel-Cobalt-Mixed Metallic Metal-Organic Framework Electrode and a Potassium Iodide Redox Mediator Bound with an Aqueous Electrolyte for High-Performance Redox-Aided Asymmetric Supercapacitors.

Enhancing the energy density of a supercapacitor requires the use of novel electrode and electrolyte materials that can withstand high voltages and have rapid electrochemical kinetics. Pesudocapacitance, high energy density, and specific capacitance may be provided by electrodes and redox mediator electrolytes used in redox-aided asymmetric supercapacitor equipment (RAASC), which are essential for their practical implementation. In this work, the rod and microsphere structure of the Ni/Co-mixed metal-organic framework (MOF) positive electrode material was synthesized using the hydrothermal method. Because of the high proposition of active sites and fluent ionic channels created by the rod and microsphere structure, as-prepared Ni/Co-MOF materials were used as three different organic linkers. CNN-MOF material has a rodlike structure and good capacitance value, so we further increase the capacitance value that we introduced in a KI redox mediator bound with a KOH electrolyte, and in this combination, a high specific capacitance up to 612 F g-1 was reached in a three-electrode system. Additionally, an electrical double layer capacitor nature of the graphite anode material with CNN-MOF as a cathode material and a KI redox mediator bound with the KOH gel polymer electrolyte was observed in the assembled RAASC. The RAASC device had reached a high energy density of 84.2 W h kg-1 with a power density of 532 W kg-1. At the same time, it showed good cyclic stability and could retain 97.4% of initial capacitance after 11,200 charge and discharge cycles. This work demonstrates efficient fabrication of high-performing MOF electrodes, and the fabrication of KI redox electrolyte-constructed RAASC devices offers a novel window into the creation of cutting-edge energy storage devices.

Dead bone in bladder- sequestrum perforating into urinary bladder leading to hydroureteronephrosis masquerading as bladder calculus.

Sequestrum formation is a known complication of osteomyelitis. This is usually a source of chronic non resolving infection and inflammation. We present a rare case of pelvic sequestrum following septic arthritis of hip joint invading into the urinary bladder mimicking a bladder calculus and leading to hydroureteronephrosis.

Intraductal and invasive adenocarcinoma of duct of Luschka, mimicking chronic cholecystitis and cholelithiasis.

BACKGROUND: Intraductal and invasive adenocarcinoma of duct of Luschka is rare. To the best of our knowledge, this is the second case report of intraductal and invasive carcinoma arising from ducts of Luschka. CASE PRESENTATION: Patient presented to hospital with signs and symptoms of chronic cholecystitis and cholelithiasis. Ultrasound examination revealed thickening of gallbladder wall with abnormal septation around liver bed. Patient underwent laparoscopic cholecystectomy and resection of the adjacent liver bed. Histologic examination confirmed an intraductal and invasive adenocarcinoma arising from Luschka ducts. CONCLUSION: Adenocarcinoma of ducts of Luschka should be considered among differential diagnoses for the patients with typical clinical presentations of chronic cholecystitis and cholelithiasis.

Fine-needle aspiration cytology of a primary ectopic meningioma.

Meningiomas are benign tumors derived from arachnoid cells. Most commonly an intracranial lesion, meningiomas may be found extracranially in various anatomic sites. A 23-yr-old white female presented with left-sided palpable mass located submucosally in the floor of the mouth. CT scan revealed no evidence of mass elsewhere in the head and neck region. Fine-needle aspiration cytology (FNAC) showed loose and cohesive cellular fragments with lobular growth pattern and uniform round or ovoid cells. The diagnosis of low-grade salivary gland neoplasm, not further classified, was made. The tumor was locally excised. The differential diagnoses of an extracranial meningioma and pleomorphic adenoma were discussed at the frozen section. Based on light microscopic, immunohistochemical, and electron microscopic (EM) findings, the final diagnosis of an ectopic meningioma was rendered. Ectopic meningiomas may pose a diagnostic challenge to clinicians and cytopathologists. It is easily forgotten in the list of differential diagnosis at an ectopic site. Primary ectopic meningioma in a region containing salivary gland(s) may mimic benign and low-grade malignant salivary gland tumors in FNAC.