Prescribing practices in the treatment of depression among psychiatrists in Oman.

OBJECTIVES: To examine the prescribing patterns of antidepressants among a sample of psychiatrists working in Oman and to compare these practices to the current evidence for prescribing specific antidepressant in particular clinical situations. METHODS: This retrospective cross sectional study. Massachusetts General Hospital Psychopharmacology Questionnaire, a 10-item questionnaire listing factors that might have influenced the choice of antidepressant medication, was sent to 83 psychiatrists working in governmental health sectors in Oman. The study was done from March to July 2019. RESULTS: A total number of 78 psychiatrists responded to the questionnaire. Of these, 44 of the psychiatrists (56.4%) believed that one type of antidepressant is more efficacious than others, while 74 psychiatrists (94.9%) indicated that selective serotonin reuptake inhibitors (SSRIs) were their first-line treatment preference. Mirtazapine was chosen as the most likely antidepressant to cause weight gain by two-thirds of the participants. For the treatment of anxious depression and depression with melancholic feature, SSRIs were the first choice of treatment for 64.1% and 7% of respondents, respectively. For depression with atypical features, 42.3% indicated that a monoamine oxidase inhibitor would be their first option. CONCLUSION: There is a discrepancy between the current antidepressant prescribing practices in Oman and empirical antidepressant-prescribing evidence, and this finding is consistent with previous studies.

Identifying an optimal lymph node yield for penile squamous cell carcinoma: prognostic impact of surgical dissection.

OBJECTIVE: To evaluate the prognostic impact of lymph node yield (LNY) on survival outcomes for penile squamous cell carcinoma (SCC). PATIENTS AND METHODS: In all, 532 patients who underwent inguinal LN dissection (ILND) across tertiary referral centres from Europe, China, Brazil and North America were retrospectively evaluated. From this cohort, 198 patients received pelvic LND (PLND).We identified threshold values for ILND and PLND using receiver operating characteristic curves. We tested prognostic value of LNY for recurrence-free survival (RFS), disease-specific survival (DSS), and overall survival (OS) using the Kaplan-Meir method and Cox proportional hazard regression models. RESULTS: The median (interquartile [IQR]) age was 59 (49-68) years and the median (IQR) follow-up after ILND was 28 (12-68.2) months. Overall, 85% of the patients had bilateral dissections. The median (IQR) number of inguinal LNs removed was 15 (10-22). Of those receiving PLND, The median (IQR) number of LNs was 13 (8-19). A LNY of ≥15 was used for dichotomisation of ILND patients, and a LNY of ≥9 was used in the PLND cohort. Patients with a LNY ≥15 had significantly better 5-year OS vs patients with a LNY <15 (70.1% vs 58.7%). On multivariable analyses, a LNY ≥15 was a predictor of OS (hazard ratio [HR] 0.68, P = 0.029). For cN0 patients, a LNY ≥15 was an independent predictor of RFS (HR 0.52, P = 0.043) and OS (HR 0.53, P = 0.021). In the PLND cohort, a LNY ≥9 was a predictor of RFS (HR 0.53, P = 0.032). CONCLUSIONS: Using one of the largest LND datasets to date, we found LNY to be a significant predictor of outcomes after lymphatic staging for penile SCC. Prospective validation is warranted.

Focal bipolar radiofrequency ablation for localized prostate cancer: Safety and feasibility.

OBJECTIVES: To evaluate the safety and feasibility of focal bipolar radiofrequency ablation in men with localized prostate cancer. METHODS: A review of 10 patients treated with a novel bipolar radiofrequency ablation probe integrated in a coil design (Encage; Trod Medical, Bradenton, FL, USA) between 2011 and 2017 in two prospective pilot trials. All men had clinical stage T1c prostate cancer, prostate-specific antigen <10 ng/mL and Gleason score ≤7. Ablation was carried out under general anesthesia, and bipolar probes were inserted transperineally under transrectal ultrasound guidance. Treatment-related adverse events, quality of life and negative biopsy rate were evaluated at 6 months after ablation. The Wilcoxon signed-rank test was used to compare baseline and post-treatment symptom scores. RESULTS: The median age was 58 years (range 50-64 years) and the median prostate volume was 49.65 cc (range 21-68 cc). Prostate cancer with a Gleason score of 6 (3 + 3) and 7 (3 + 4) was noted in seven and three patients, respectively. The median number of radiofrequency ablation cycles was 2.5 (range 2-5). All patients were catheter-free and able to void the day of surgery. Within 6 months after ablation, all adverse events were low grade, with the exception of one grade 3 hematuria that required cystoscopy without coagulation. Six months after ablation bowel, urinary and hormonal functions, and overall satisfaction remained stable. Erectile dysfunction occurred in two out of four patients who had normal sexual function before the procedure. Neither urinary incontinence nor urinary infection was noted. CONCLUSIONS: This first report on focal bipolar radiofrequency ablation documents a safe and feasible treatment option for selected patients with localized prostate cancer.

Optimal Management of Upper Tract Urothelial Carcinoma: an Unmet Need.

OPINION STATEMENT: Upper tract urothelial carcinoma (UTUC) is a rare genitourinary entity of the renal pelvis and the ureter characterized by a more aggressive disease phenotype when compared with urothelial carcinoma of the bladder (UCB) with more than half of UTUC cases presenting with invasive disease at diagnosis compared to 20% for bladder tumors. There is growing evidence suggesting that its distinct natural history from that of bladder cancer can be related to several genetic and epigenetic differences. Treatment of low-risk disease consists of kidney-sparing surgeries such as ureteroscopic and percutaneous treatments, segmental ureterectomy, and adjuvant topical and intracavitary chemo-immunotherapies. The standard of care for high-risk non-metastatic disease remains radical nephroureterectomy and bladder cuff excision with increasing utilization rates of minimally invasive approaches leading to reduced morbidity without compromising outcomes while the role of lymphadenectomy is still being investigated. The prognosis of UTUC has been stagnant over the past decade highlighting the need for further studies on the role of multimodal therapy (neoadjuvant/adjuvant chemotherapy, immunotherapy, targeted therapy) to optimize management and improve outcomes.

Changes in blood ion levels after removal of metal-on-metal hip replacements: 16 patients followed for 0-12 months.

BACKGROUND AND PURPOSE: In patients with metal-on-metal (MoM) hip prostheses, pain and joint effusions may be associated with elevated blood levels of cobalt and chromium ions. Since little is known about the kinetics of metal ion clearance from the body and the rate of resolution of elevated blood ion levels, we examined the time course of cobalt and chromium ion levels after revision of MoM hip replacements. PATIENTS AND METHODS: We included 16 patients (13 female) who underwent revision of a painful MoM hip (large diameter, modern bearing) without fracture or infection, and who had a minimum of 4 blood metal ion measurements over an average period of 6.1 (0-12) months after revision. RESULTS: Average blood ion concentrations at the time of revision were 22 ppb for chromium and 43 ppb for cobalt. The change in ion levels after revision surgery varied extensively between patients. In many cases, over the second and third months after revision surgery ion levels decreased to 50% of the values measured at revision. Decay of chromium levels occurred more slowly than decay of cobalt levels, with a 9% lag in return to normal levels. The rate of decay of both metals followed second-order (exponential) kinetics more closely than first-order (linear) kinetics. INTERPRETATION: The elimination of cobalt and chromium from the blood of patients who have undergone revision of painful MoM hip arthroplasties follows an exponential decay curve with a half-life of approximately 50 days. Elevated blood levels of cobalt and chromium ions can persist for at least 1 year after revision, especially in patients with high levels of exposure.

Biomechanical evaluation of a new MatrixMandible plating system on cadaver mandibles.

PURPOSE: Current mandibular plating systems contain a wide range of plates and screws needed for the treatment of mandibular reconstruction and mandibular fractures. The authors' hypothesis was that a single diameter screw could be used in all applications in a plating system. Therefore, the purpose of this study was to test if the 2.0-mm locking screws could replace the 2.4-mm screws to stabilize a 2.5-mm-thick reconstruction plate in the treatment of mandibular discontinuity. MATERIALS AND METHODS: Thirty-six fresh human cadaveric mandibles were used: 18 were plated using 2.0-mm locking screws (experimental) and the other 18 were plated using 2.4-mm locking screws (control). Each group was further divided into 3 subgroups based on the site of loading application: the ipsilateral (right) second premolar region, the central incisal region, and the contralateral (left) first molar region. The same ipsilateral (right) mandibular angular discontinuity was created by the same surgeon. The mandible was mounted on a material testing machine. The micromotions between the 2 segments, permanent and elastic displacements, were recorded after incremental ramping loads. The magnitude of screw back-out and the separation between plate and bone were recorded using a laser scanner (resolution, 0.12 mm) before and after the loading applications. The data were processed. Descriptive analyses and a general linear model for repeated measures analysis of variance were performed. RESULTS: There was no statistically significant difference in permanent displacement (mean, 1.16 and 0.82 mm, respectively) between the 2.0-mm and 2.4-mm screw groups. There also was no statistically significant difference in elastic displacement between the 2 groups (mean, 1.48 and 1.21 mm, respectively). Finally, there were no statistically significant differences in screw back-out or separation between plate and bone between the 2 groups. All means for screw back-out and separation between screw and bone for each group were judged within the error of the laser scanning system (<0.12 mm). CONCLUSION: One may anticipate that the mechanical functions of the 2.0-mm locking screws are not different from those of the 2.4-mm screws when a 2.5-mm-thick reconstruction plate is used to reconstruct mandibular angular discontinuity. However, further biomechanical studies (ie, fatigue of screws) are warranted before a randomized clinical trial can be conducted to definitively prove that the 2.4-mm screws can be replaced by 2.0-mm screws.

Idiopathic Granulomatous Mastitis: Six years of experience and the current evidence in literature.

Objectives: This study aimed to retrospectively describe the clinicopathological pattern and management experience of idiopathic granulomatous mastitis in women receiving care at the Royal Hospital, a tertiary care centre in Oman. The study then compared the researchers' experience with the current literature trends. Methods: The data of patients from January 2012 to December 2017 were reviewed retrospectively, after receiving ethical approval from the Centre of Studies and Research. Results: This retrospective study included 64 patients were confirmed to have idiopathic granulomatous mastitis. All patients were in the premenopausal phase, with only one being nulliparous. Mastitis was the most common clinical diagnosis; furthermore, half of the patients had a palpable mass. Most patients had received antibiotics during the span of their treatment. Drainage procedure was done in 73% of the patients, whereas excisional procedure was done for 38.7%. Only 52.4% of patients were able to achieve complete clinical resolution within six months of follow-up. Conclusion: There is no standardised management algorithm due to the paucity of high-level evidence comparing different modalities. However, steroids, methotrexate and surgery are all considered to be effective and acceptable treatments. Moreover, current literature tends towards multimodality treatments planned tailored case-to-case based on the clinical context and patients' preference.

Determination of meloxicam using europium sensitized luminescence in the presence of co-luminescence reagents.

A sensitive time-resolved luminescence method for the determination of meloxicam (MX) in methanol and in aqueous solution is described. The method is based on the luminescence sensitization of europium (Eu(3+)) by formation of ternary complex with MX in the presence of 1,10-phenanthroline as coligand, Tween-80 as surfactant and gadolinium ion as a co-luminescence reagent. The signal for Eu-MX-1,10-phenanthroline is monitored at λ(ex) = 360 nm and λ(em) = 620 nm. Optimum conditions for the formation of the complex in aqueous system were 0.01 M TRIS buffer, pH 8.0, 1,10-phenanthroline (6.0 × 10(-6) M), Gd(3+) (7.0 × 10(-6) M), Tween-80 (0.28%) and 1.75 mM of Eu(3+) which allows the determination of 20-800 ppb of MX with limit of detection (LOD) of 7 ppb. The relative standard deviations of the method range between 0.1 and 1.1% indicating excellent reproducibility of the method. The proposed method was successfully applied for the assay of MX in pharmaceutical formulations, plasma and in urine samples. Average recoveries of 99.8 ± 1.1%, 100.2 ± 0.9% and 100.9 ± 1.1% were obtained for MX in tablet, plasma and urine sample respectively.

Constrained cups appear incapable of meeting the demands of revision THA.

BACKGROUND: Failure rates of constrained cups for treating recurrent dislocation in revision THA range from 40% to 100%. Although constrained liners are intended to stabilize the hip by mechanically preventing dislocation, the resulting loss of range of motion may lead to impingement and, ultimately, implant failure. QUESTIONS/PURPOSES: We therefore documented the mechanisms of failure of constrained acetabular cups in revision THA and determined the type and severity of damage (wear, fracture, and impingement) that occurs in situ. METHODS: We retrieved 57 constrained components of four different designs at revision THA and examined for the presence of rim impingement, oxidation, cracks within the liner, backside wear, pitting, scratching, abrasion, burnishing, and the presence of embedded particles. Articular wear was calculated from the volume of the concave articular bearing surface, which was measured using the fluid displacement method. RESULTS: Failure of the locking ring was responsible for 51% of failures, whereas 28% of revisions were the result of acetabular cup loosening, 6% backside wear, and 22% infection. Impingement damage of the rim of the polyethylene liner was seen in all retrievals with moderate or severe damage in 54%. The average volumetric wear rate of the articular surface was 95 mm(3)/year. CONCLUSIONS: Failure of the locking liner ring and loosening of the acetabular cup are the primary causes of mechanical failure with constrained liners; polyethylene is an inadequate material for restricting motion of the hip to prevent instability. The durability of these devices is unlikely to improve unless the mechanical demands are modified through increased range of motion leading to less frequent rim impingement.

Estimation of phytochemicals and antioxidant activity of underutilized fruits of Andaman Islands (India).

The present study aimed to determine the antioxidant activity and phytochemical contents in 10 underutilized fruits of Andaman Islands (India) namely Malpighia glabra L., Mangifera andamanica L., Morinda citrifolia L., Syzygium aqueum (Burm.f) Alst., Annona squamosa L., Averrhoa carambola L., Averrhoa bilimbi L., Dillenia indica L., Annona muricata L. and Ficus racemosa L. The antioxidant activity varied from 74.27% to 98.77%, and the methanol extract of M. glabra showed the highest antioxidant activity (98.77%; inhibitory concentration, IC(50) = 262.46 µg/ml). Methanol was found to be a better solvent than acetone and aqueous for estimating the antioxidant activity. M. glabra was found to be rich in phytochemicals viz. polyphenol (355.74 mg/100 g), anthocyanin (91.31 mg/100 g), carotenoids (109.16 mg/100 g), tannin (24.39 mg/100 g) and ascorbic acid (394.23 mg/100 g). Carbohydrate content was estimated to be highest in M. glabra (548 mg/100 g). Phenols, tannins, anthocyanins and carotenoids contents showed positive correlation (r² = 0.846, r² = 0.864, r² = 0.915 and r² = 0.806, respectively) with antioxidant activity. The information generated in present study will be useful for bioprospecting of underutilized fruits of Andaman Islands.

Intravenous cannula induced phlebitis in a tertiary care referral hospital: A prospective observational study with implication from patient's feedback system.

BACKGROUND: Medicines delivered directly to systemic circulation have saved many lives from life-threatening conditions, but also can impart undesirable effects. MATERIALS AND METHODS: A prospective observational study was performed for 10 months in the tertiary care hospital to identify and evaluate cannula induced phlebitis in our study population. The data collection form retrieved demographic details, diseases and cannulation particulars of each patient. Moreover, a patient feedback questionnaire (Cronbach's alpha=0.70) retrieved their concerns toward cannulation. RESULTS: Phlebitis was identified in 96 patients out of 146 subjects enrolled in the study; 52% had the first sign of phlebitis. Female patients were more prone, and the complication occurred irrespective of age (p>0.05). On the other hand, those on IV cefoperazone-sulbactam (n=13, 13.5%) followed by amoxicillin clavulanic acid (n=6, 6%) had significant cannulation complication (p<0.01). The cannula indwells time (p=0.001) and vein assessment (p=0.001) were statistically associated with incidence of phlebitis. Half of our samples had pain lasting about five minutes (χ2=9.2, p<0.05). Nevertheless, limited patients (n = 35, 36.5%) were prescribed topical Heparin Benzyl Nitrate, and none preferred to self-medicate nor opted for other home remedies. CONCLUSIONS: The study depicted high prevalence of phlebitis factored in by poor vein assessment and increase in indwelling time. We recommend proper awareness with on-site skill improvement program for health professionals on administration techniques and monitoring principles in order to lower cannulation related complications.

In Situ Ethanolamine ZnO Nanoparticle Passivation for Perovskite Interface Stability and Highly Efficient Solar Cells.

Zinc oxide (ZnO) has interesting optoelectronic properties, but suffers from chemical instability when in contact with perovskite interfaces; hence, the perovskite deposited on the top degrades promptly. Surface passivation strategies alleviate this instability issue; however, synthesis to passivate ZnO nanoparticles (NPs) in situ has received less attention. Here, a new synthesis at low temperatures with an ethanolamine post treatment has been developed. By using ZnO NPs prepared with ethanolamine and butanol (BuOH), (E-ZnO), the stability of the FA0.9Cs0.1PbI3 (FACsPI)−ZnO interface was achieved, with a photoconversion efficiency of >18%. Impedance spectroscopy demonstrates that the recombination at the interface was reduced in the system with E-ZnO/perovskite compared to common SnO2/perovskite and that the quality of the perovskite on the top is clearly due to the ZnO in situ passivation with ethanolamine. This work extends the use of E-ZnO as an n-type charge extraction layer and demonstrates its feasibility with methylammonium perovskite. Moreover, this study paves the way for other in situ passivation methods with different target molecules, along with new insights regarding the perovskite interface rearrangement when in contact with the modified electron transport layer (ETL).

Therapeutic potential of induced iron depletion using iron chelators in Covid-19.

Ferritin, which includes twenty-four light and heavy chains in varying proportions in different tissues, is primarily responsible for maintaining the body's iron metabolism. Its normal value is between 10 and 200 ngmL-1 in men and between 30 and 300 ngmL-1 in women. Iron is delivered to the tissue via them, and they act as immunomodulators, signaling molecules, and inflammatory markers. When ferritin level exceeds 1000 µgL-1, the patient is categorized as having hyperferritinemia. Iron chelators such as deferiprone, deferirox, and deferoxamine are currently FDA approved to treat iron overload. The inflammation cascade and poor prognosis of COVID-19 may be attributed to high ferritin levels. Critically ill patients can benefit from deferasirox, an iron chelator administered orally at 20-40 mgkg-1 once daily, as well as intravenous deferoxamine at 1000 mg initially followed by 500 mg every 4 to 12 h. It can be combined with monoclonal antibodies, antioxidants, corticosteroids, and lactoferrin to make iron chelation therapy effective for COVID-19 victims. In this article, we analyze the antiviral and antifibrotic activity of iron chelators, thereby promoting iron depletion therapy as a potentially innovative treatment strategy for COVID-19.

Comparative analysis of three vs. four cycles of neoadjuvant gemcitabine and cisplatin for muscle invasive bladder cancer.

PURPOSE: Because the optimal number of cycles of neoadjuvant gemcitabine and cisplatin chemotherapy (GC) is unclear, we aimed to compare disease response and survival outcomes of patients receiving either 3 or 4 cycles of neoadjuvant GC for muscle-invasive bladder cancer (MIBC). METHODS: A total of 166 patients who were treated with neoadjuvant GC and radical cystectomy for clinical stage T2-4N0M0 were identified. Response and effectiveness of different cycle counts were assessed using downstaging (complete pathologic and partial pathologic response), cancer-specific survival (CSS), and overall survival (OS). Response and survival outcomes were examined with adjusted logistic regression and Cox regression models. Statistical significance was defined as P < 0.05. RESULTS: Of 166 patients who received neoadjuvant GC, 107 (64.5%) received 3 cycles and 59 (35.5%) received 4 cycles. Age, insurance, comorbidity, tumor histology (pure urothelial carcinoma, urothelial with divergent differentiation, variant histology), and tumor stage were similar between the 2 treatment groups. Rates of complete response or any downstaging were similar between groups (21.5% and 40.2% in the 3-cycle group and 20.3% and 44.1% in the 4-cycle group, respectively). While disease response was similar (OR 1.03, 95% CI 0.43-2.45), both cancer-specific survival (HR 1.69, 95% CI 0.87-3.26) and overall survival (HR:1.88, 95% CI:1.02-3.48) were more favorable among patients managed with 4 cycles of neoadjuvant chemotherapy compared to those who received 3 cycles in adjusted models. CONCLUSIONS: Our analysis demonstrated that survival outcomes tended to be better among patients who received 4 cycle of neoadjuvant GC compared to those treated with 3 cycles. Although potential benefits of omission of fourth cycle may include expedited time to surgery, reduced chemotherapy-associated toxicity, and lower treatment costs, continuation of treatment with a fourth cycle of neoadjuvant GC chemotherapy may benefit patients with muscle-invasive bladder cancer and further improve disease outcomes.

Clinical indications for necessary and discretionary hospital readmissions after radical cystectomy.

BACKGROUND: To assess predictors, indicators and medical necessity of readmissions after neoadjuvant chemotherapy and radical cystectomy in order to identify opportunities for reducing readmission rates. METHODS: Records for patients treated with cisplatin-based neoadjuvant chemotherapy followed by radical cystectomy between 2007 and 2017 were reviewed for 90-day complications and readmission. Readmissions were classified as necessary vs. discretionary based on independent clinician review. The association between postoperative complications and necessary or discretionary readmission were examined with adjusted regression models. RESULTS: Among a total of 250 patients, 76 patients (30.4%) were readmitted within 90 days of surgery (19 discretionary and 57 necessary). Age, insurance coverage, and comorbidity were similar between readmitted and non-readmitted patients. Readmission was more likely after neobladder than ileal conduit (39% vs. 23%, P = 0.02). Major (grade ≥ 3) complications within 90-day of surgery including index admission and post-discharge period were significantly more common among re-admitted patients compared to patients who were not readmitted (40% in necessary, 21% in discretionary, 3% in none, P < 0.001). Median length of stay on readmission was twice as long in necessary cases compared to discretionary cases (5 vs. 2.5 days, P < 0.001). Gastrointestinal and infectious complications were associated with discretionary readmission in adjusted analyses, while infectious, renal/genitourinary and thromboembolic complications were associated with necessary readmission. CONCLUSIONS: Twenty-five percent of readmissions were categorized as discretionary and were driven primarily by low-grade gastrointestinal complications, marginal oral intake and failure to thrive, suggesting that better coordinated post-discharge supportive care could help avoid a substantial proportion of readmissions.

Verbal autopsy completion rate and factors associated with undetermined cause of death in a rural resource-poor setting of Tanzania.

BACKGROUND: Verbal autopsy (VA) is a widely used tool to assign probable cause of death in areas with inadequate vital registration systems. Its uses in priority setting and health planning are well documented in sub-Saharan Africa (SSA) and Asia. However, there is a lack of data related to VA processing and completion rates in assigning causes of death in a community. There is also a lack of data on factors associated with undetermined causes of death documented in SSA. There is a need for such information for understanding the gaps in VA processing and better estimating disease burden. OBJECTIVE: The study's intent was to determine the completion rate of VA and factors associated with assigning undetermined causes of death in rural Tanzania. METHODS: A database of deaths reported from the Ifakara Health and Demographic Surveillance System from 2002 to 2007 was used. Completion rates were determined at the following stages of processing: 1) death identified; 2) VA interviews conducted; 3) VA forms submitted to physicians; 4) coding and assigning of cause of death. Logistic regression was used to determine factors associated with deaths coded as "undetermined." RESULTS: The completion rate of VA after identification of death and the VA interview ranged from 83% in 2002 and 89% in 2007. Ninety-four percent of deaths submitted to physicians were assigned a specific cause, with 31% of the causes coded as undetermined. Neonates and child deaths that occurred outside health facilities were associated with a high rate of undetermined classification (33%, odds ratio [OR] = 1.33, 95% confidence interval [CI] (1.05, 1.67), p = 0.016). Respondents reporting high education levels were less likely to be associated with deaths that were classified as undetermined (24%, OR = 0.76, 95% CI (0.60, -0.96), p = 0.023). Being a child of the deceased compared to a partner (husband or wife) was more likely to be associated with undetermined cause of death classification (OR = 1.35, 95% CI (1.04, 1.75), p = 0.023). CONCLUSION: Every year, there is a high completion rate of VA in the initial stages of processing; however, a number of VAs are lost during the processing. Most of the losses occur at the final step, physicians' determination of cause of death. The type of respondent and place of death had a significant effect on final determination of the plausible cause of death. The finding provides some insight into the factors affecting full coverage of verbal autopsy diagnosis and the limitations of causes of death based on VA in SSA. Although physician review is the most commonly used method in ascertaining probable cause of death, we suggest further work needs to be done to address the challenges faced by physicians in interpreting VA forms. There is need for an alternative to or improvement of the methods of physician review.

Estimation of proximate composition, micronutrients and phytochemical compounds in traditional vegetables from Andaman and Nicobar Islands.

In present study, 10 preferred traditional vegetables from Andaman and Nicobar Islands, India, were analysed for nutritional profiles. Moisture content in their edible parts ranged from 83.43 to 94.78%. Maximum ash content was recorded in Portulaca oleracea, crude protein in Colocasia esculenta, crude fibre in Eryngium foetidum and fat in E. foetidum. Phosphorus was maximum in Ipomea aquatica, potassium in C. esculenta, zinc, calcium and manganese in Centella asiatica, copper in Sauropus androgynous, sodium and iron in P. oleracea, magnesium in Amaranthus viridi and cobalt in C. esculenta. Maximum polyphenol was recorded in Hibiscus sabdariffa, carotenoids in A. viridi, ascorbic acid in Saursops androgynus, anthocyanin in C. esculenta and chlorophyll in S. androgynus. Antioxidant activity was maximum in P. oleracea. Positive correlation was observed between polyphenol and tannin content and also between antioxidant activity and photochemicals. The developed nutritional profiles is being used in health and nutrition related schemes in Islands.

Boosting Long-Term Stability of Pure Formamidinium Perovskite Solar Cells by Ambient Air Additive Assisted Fabrication.

Due to the high industrial interest for perovskite-based photovoltaic devices, there is an urgent need to fabricate them under ambient atmosphere, not limited to low relative humidity (RH) conditions. The formamidinium lead iodide (FAPI) perovskite α-black phase is not stable at room temperature and is challenging to stabilize in an ambient environment. In this work, we show that pure FAPI perovskite solar cells (PSCs) have a dramatic increase of device long-term stability when prepared under ambient air compared to FAPI PSCs made under nitrogen, both fabricated with N-methylpyrrolidone (NMP). The T 80 parameter, the time in which the efficiency drops to 80% of the initial value, increases from 21 (in N2) to 112 days (in ambient) to 145 days if PbS quantum dots (QDs) are introduced as additives in air-prepared FAPI PSCs. Furthermore, by adding methylammonium chloride (MACl) the power conversion efficiency (PCE) reaches 19.4% and devices maintain 100% of the original performance for at least 53 days. The presence of Pb-O bonds only in the FAPI films prepared in ambient conditions blocks the propagation of α- to δ-FAPI phase conversion. Thus, these results open the way to a new strategy for the stabilization in ambient air toward perovskite solar cells commercialization.

Topical chemotherapy for penile carcinoma in situ: Contemporary outcomes and reported toxicity.

PURPOSE: The toxicity of topical chemotherapeutics has been well-characterized in extra-genital squamous cell carcinoma; however, there is limited data regarding the use of topical agents for penile squamous cell carcinoma in situ (CIS). We aim to describe the clinical outcomes and toxicities associated with the use of topical fluorouracil and imiquimod for penile CIS. MATERIALS AND METHODS: We performed an observational analysis of penile CIS cases treated with topical chemotherapy from 2009 to 2019 at a tertiary cancer center. RESULTS: Twenty patients with penile CIS received fluorouracil (n= 17, 85%) or imiquimod (n = 3, 15%). The median age was 66 years. The median follow-up was 18 months. Complete response (CR) was achieved in 65% (n= 13/20), partial response in 25% (n = 5/20), and no response in 10% (n = 2/20). Overall, 50% required additional alternative treatments due to lack of CR or relapse. The median recurrence-free survival was 14 months. Fifty percent of patients reported Common Terminology Criteria for Adverse Events v5.0 grade 1 to 2 acute toxicities, including local skin irritation (40%), pain (35%), dysuria (5%), or nausea (5%). Only 65% completed the full course of treatment. Nonadherence was associated with a diminished CR rate of 28.6%. CONCLUSIONS: Topical chemotherapy is a reasonable first-line therapy for penile CIS. A substantial proportion of patients experience acute toxicity and are unable to complete the full course of therapy. We recommend that patients with penile CIS be monitored regularly in order to promptly address issues with adherence and toxicity associated with topical treatment.

Contemporary management of early stage testicular seminoma.

Therapy for early stage testicular seminoma has changed radically over the past several decades. Given high cure rates and clinical trials supporting less active therapy in most cases, close observation after radical orchiectomy is now considered standard of care for clinical stage (CS) IA/IB seminoma, with either radiation therapy (RT) or chemotherapy salvage options possible. For CS IIA/IIB seminoma characterized by non-bulky retroperitoneal lymph node involvement (≤5 cm in greatest dimension), RT or combination chemotherapy are the standard of care. Given high comparable survival rates, preventing treatment-related toxicity and second malignancy, and limiting quality of life deficits associated with intense treatment has gained much greater importance. Clinical trials are currently testing the feasibility of retroperitoneal lymph node dissection (RPLND) for low volume CS IIA/IIB metastatic testicular seminoma to this end. Likewise, one cycle of chemotherapy is being evaluated as an adjuvant approach to reduce recurrence rates in CS I disease with unfavorable risk factors. Moreover, recent genomic and molecular studies have recently identified novel signatures and a potential biomarker for testicular seminoma. In this review, we first summarize the evolution of early stage seminoma management and discuss the effectiveness and drawbacks of contemporary treatment strategies. We further outline future perspectives and potential challenges in management of early stage testicular seminoma.