bluuebunny/crossref_metadata_2025 huggingface dataset:
Usefulness of serum osteopontin level as a noninvasive parameter of portal hypertension
Authors: Fouad Ayman M. , Hussein Nagwa Ramadan Ahmed , Shaheen Iman A. E. , Ismael Mohammed A.
Published: September 2023

Background

Osteopontin (OPN) is a multifunctional protein that is physiologically expressed in the kidney and bone. Plasma OPN levels were shown to predict liver fibrosis in various chronic liver diseases and could be related to the degree of portal hypertension. The aim of the study is to investigate the usefulness of OPN as a noninvasive biomarker of portal hypertension.

Patients and methods

A case–control study including 90 (45 patients with confirmed liver cirrhosis and 45 normal healthy individuals) patients were enrolled in the study. Laboratory investigations with abdominal ultrasound and duplex of the portal system were carried out for all patients. OPN was measured using the enzyme-linked immunosorbent assay in the plasma.

Results

Compared with controls, the plasma levels of OPN in cirrhotic patients were significantly high (P<0.001). Also, plasma levels of OPN were significantly high in patients with portal hypertension (P<0.001). The cutoff value of OPN to detect the presence of portal hypertension is 1.65 ng/ml with sensitivity and specificity of 80 and 95.6%, respectively).

Conclusion

Serum OPN is a good noninvasive parameter to detect portal hypertension.
Noninvasive assessment of hepatic fibrosis regression in hepatitis C virus-infected patients treated with sofosbuvir-based therapy
Authors: Al-Khattib Ahmed , El-Nakeeb Adham , Musa Nevine I. , Dous Kerolous B. A. , Aly Heba
Published: September 2023

Background

Accurate evaluation of the degree of liver fibrosis in patients with chronic liver diseases is crucial to make therapeutic decisions and to determine the prognosis of liver disease and also the protocol of further follow-up. Multiple noninvasive methods have been used successfully in the prediction of fibrosis; however, early changes in noninvasive parameters of hepatic fibrosis after effective antiviral therapy are still not well unknown. The aim of the paper was to evaluate early changes in the hepatic fibrosis-related parameters in patients with chronic hepatitis C virus (HCV) infection using shear wave elastography (pSWE) and serum parameters [aspartate aminotransferase-platelet ratio index (APRI) and fibrosis-4 score (FIB4)] before and 24 weeks after sofosbuvir-based antiviral therapy.

Materials and methods

This is a prospective cohort study that included 109 Egyptian patients with chronic hepatitis C. pSWE values were recorded as well as APRI and FIB4 scores were calculated at baseline and at 12 and 24 weeks after treatment.

Results

A total of 109 HCV-infected patients were included, with mean age of 45.76±13.91 years. Overall, 25 (22.90%) patients had cirrhosis and were treated with sofosbuvir 400 mg/day, daclatasvir 60mg/day, and weight-based ribavirin. Moreover, 84 (77.10%) were treated with sofosbuvir 400 mg/day and daclatasvir 60mg/day. The overall sustained virological response-12 rate was 100%. There were significant improvements in APRI score (from 0.64±0.66 at baseline to 0.26±0.22 at 24 weeks after treatment) and FIB4 score (from 1.77±1.77 at baseline to 1.11±1.04 at 24 weeks after treatment), withPvalue of 0.0001 in both. In addition, there was a significant reduction in liver stiffness measurements by pSWE 24 weeks after treatment (from 1.72±0.55 m/s at baseline to 1.48±0.44 m/s at 24 weeks after treatment, withP=0.003).

Conclusion

Sofosbuvir-based treatment regimens for chronic HCV infection result in significant improvement of the fibrosis scores (FIB4 and APRI) 24 weeks after treatment. Moreover, there was a significant reduction in the liver stiffness measurements by pSWE.
The relationship between serum level of matrix metalloproteinase-7 and interstitial lung disease in patients with systemic sclerosis
Authors: Gabal Mervat M. Abo , Shedid Noha H. , Mohamed Elham S. , Abdelfattah Warda
Published: September 2023

Background

Interstitial lung disease (ILD) remains a leading cause of mortality in systemic sclerosis (SSc). Matrix metalloproteinases (MMPs) play an important role in inflammation, autoimmune diseases and aberrant fibrotic tissue remodeling.

Aim

The aim of this work was to evaluate the relation between serum level of MMP-7 and ILD in SSc patients.

Patients and methods

The study was conducted on 30 SSc patients. Pulmonary function tests and chest high-resolution computed tomography were assessed. Degree of fibrosis was assessed according to Warrick severity and extent scores. Serum level of MMP-7 was measured.

Results

The 30 patients had a mean age of 41.60±11.11 years and disease duration of 3.50 ±1.81 years; 23 with diffuse and seven with limited subtype. ILD was present in 20 patients. Serum MMP-7 was significantly higher in those with ILD (412.5±52.4 ng/ml) compared with those without (disease control group) (351.4±56.4 ng/ml) (P=0.007). In patients with ILD, MMP-7 was significantly higher in those with ground-glass opacities, honeycombing and reticular infiltration on high-resolution computed tomography; yet, it was comparable among the different grades of pulmonary restriction by pulmonary function test. There was a significant negative correlation between serum MMP-7 level and forced vital capacity and forced expiratory volume in one second (r=−0.46, P< 0.05 and r=−0.65, P< 0.0001, respectively). Correlations between MMP-7 and Warrick severity and extent were significant (P=0.002 and 0.007, respectively). MMP-7 at a cutoff value of 367.4 ng/ml was 85% sensitive and 80% specific for detection of ILD.

Conclusion

There is a strong association between serum MMP-7 and the presence, severity and extent of ILD in scleroderma patients. It might be a useful marker for ILD in SSc.
Sonographic evaluation of enthesopathy in rheumatoid arthritis patients
Authors: Tharwat Samar , Nassar Mohammed Kamal , Enein Asmaa , Asad Muhammad Emran
Published: September 2023

Background

Rheumatoid arthritis (RA) is one of the most common autoimmune diseases. It affects mainly the synovial membranes of the small joints. However, it may also have extra-articular manifestations. Enthesopathy may occur as one of the extra-articular manifestations of RA and is not clinically detected. Ultrasound (US) is a relatively new tool for the detection of enthesopathy.

Aim

The aim of this study was to assess the presence and distribution of enthesopathy in RA patients using US.

Patients and methods

Twenty-nine consecutive patients with RA and 14 age-matched healthy controls were included in this study. All RA patients met the 2010 American College of Rheumatology/European League Against Rheumatism classification criteria for RA. Six entheses sites were evaluated using gray scale and Doppler US with a linear transducer and were scored using the Madrid Sonography Enthesitis Index (MASEI).

Results

US detected the presence of enthesopathy in patients with RA. There was a statistically significant difference in the enthesopathy score of plantar aponeurosis insertion and Achilles tendon insertion. The total enthesopathy score was statistically significant in patients with RA versus controls.

Conclusion

US entheseal abnormalities are present in a high percentage of RA patients. US enthesopathy is not associated with disease activity in RA patients.
Helicobacter pylori in benign versus malignant laryngeal lesions
Authors: El-Anwar Mohammad W. , Raafat Ashraf , Abdehady Mohammad , Eissa Eman A.
Published: September 2023

Objective

The aim was to investigate the existence of immunoglobulin (Ig)G antibody against Helicobacter pylori (H. pylori) in blood sample from patients having laryngeal lesions and comparing its level in benign versus malignant lesions.

Patients and Methods

Under general anesthesia, direct laryngoscopy was performed for patients having laryngeal lesions, and biopsy was taken and sent for histopathology. Anti-H. pylori IgG antibodies were measured by enzyme-linked immunosorbent assay from venous blood samples from each patient.

Results

Within the included 56 patients, 30 had benign lesion and 26 (46%) had squamous cell carcinoma (SCC). Overall, 73.3% of patient with benign lesions were seropositive and 92.3% of patient with laryngeal SCC were seropositive. The mean anti-H. pylori IgG antibody level was significantly (P=0.0041) higher in patients who had SCC (23.93±19.6) than patients who had benign laryngeal lesions (38.9±27.5).

Conclusion

Laryngeal lesions are commonly associated with H. Pylori infection and showed significantly higher level in laryngeal SCC than benign lesions, reflecting more association of larynx cancer with H. pylori infection.
Vestibular function assessment in cochlear implant patients
Authors: El-Karaksy Alia A. R. M. , Kouzo Hesham S. , Attallah Mohamed B. , Talaat Mohamed A.
Published: September 2023

Background

Anatomical and embryological relations between cochlear and vestibular end organs predispose them to same noxious or developmental factors, thus these may affect either or both systems. Cochlear implantation being a widely used procedure for restoration of hearing in patients who are not candidates for regular amplification, may affect by different means the vestibular system. One of these factors include the surgical procedure. The aim of this study is to assess the vestibular function in cochlear implant candidates before surgery to exclude coexisting vestibular affection with the sensorineural hearing loss (SNHL). Reassessment after operation was done to determine the risk posed by surgery and for correlating the surgical approach to vestibular findings.

Materials and methods

The case series presented herein is of cochlear implant candidates who underwent full audiological and radiological assessment. Vestibular assessment was done before and after operation and included cervical vestibular evoked myogenic potential (cVEMP) and ocular vemp (oVEMP) for evaluation of otolith organs. Video head impulse test (VHIT) was used to evaluate semicircular canal.

Results

Preliminary results show that patients may exhibit vestibular loss concomitant to the SNHL even with the absence of vestibular complaints. Patients who had normal preoperative vestibular function showed affected vestibular tests after the surgery. There was a mismatch between these objective findings and the subjective complaint of imbalance or vertigo.

Conclusion

Despite the minor risk posed by cochlear implant (CI) surgery for the subjective vestibular affection, the side with worse vestibular function should be chosen for CI if other factors are equal to avoid postoperative vestibular loss.
Nasopharyngeal cavernous hemangioma: an approach to remove
Authors: El-Anwar Mohammad W. , Elnashar Ismail , Elsheikh Ezzeddin
Published: September 2023

Introduction

Few nasal cavernous haemangiomas have been previously reported, only nasopharyngeal cavernous hemangiomas have been reported; both arise from the lateral wall of the nasopharynx. We reported the case of a 27-year-old woman who had repeated severe epistaxis and nasal obstruction of 6 months duration. Computed tomography showed a large vascular nasopharyngeal mass. Complete endoscopic removal of the mass that was found to arise from the posterior end of the nasal septum was achieved without complications. Histopathology showed a cavernous heamangioma. Epistaxis completely stopped throughout the 12-month follow-up. This is the first work to describe the management of nasopharyngeal cavernous heamangiomas originating from the posterior end of the nasal septum. Transnasal endoscopic approach permits adequate exposure of the lesion, control of bleeding, and complete hemangioma removal.
Hearing profile in Egyptian children with attention-deficit hyperactivity disorders
Authors: Salama Mohamed , Elbeh Khaled A. , Hammad Emad M. , Said Eman Abdel-Fattah , Nashaat Ahmed
Published: September 2023

Background

Attention-deficit hyperactivity disorder (ADHD) is a common neuropsychiatric syndrome with onset in childhood, most commonly becoming more apparent during the first few years of grade school. The aim of this study is to assess peripheral hearing and central auditory processing as well as cognitive function in 30 children diagnosed with ADHD. Their age ranged from 6 to 16 years (16 males and 14 females) and their IQ of at least 70. All of them were subjected to a basic audiological evaluation, and assessment of auditory brainstem responses, slow vertex response, and P300 waves using the oddball paradigm.

Results

No significant differences were found between pure tone thresholds and speech audiometry between the study and the control groups. There was a statistically significant increase in auditory brainstem response (ABR) absolute latencies (III and V) and interpeak latencies (I–III and I–V) at both low repetition rate and high repetition rate. Also, an increase in latencies of N1, P2, N2, and P300 latencies was observed with decreased P300 amplitude of the study group compared with the control groups. A significant mild positive correlation was found between P300 and both wave V latency and I–V interpeak latency.

Conclusion

The results of this study provide more evidence of central auditory processing involvement in children with ADHD and show the role of ABR and P300 in the management of these children.
Ebstein Anomaly of the Tricuspid Valve with Intact Inter-Atrial Septum and Cor Triatriatum Dexter in an Asymptomatic Adult
Authors: Shukla Madhu , Mohan Jagdish Chander
Published: September 2023

Ebstein anomaly of the tricuspid valve is characterized by apical displacement of septal and posterior leaflets of the tricuspid valve leading to the atrialization of right ventricular cavity and severe low-pressure tricuspid regurgitation. Cor triatriatum dexter is a rare congenital cardiac anomaly in which a membranous structure divides the right atrium into two chambers. This combination is rare and very few cases have been described in the literature. We herein report an asymptomatic young female who was incidentally detected to have these anomalies with intact atrial septum. Echocardiographic examination showed tri-chambered right atrium consisting of atrialized right ventricle, anterior right atrial chamber, and the posterior right atrial sinus portion.
Reperfusion Injury-Related Intramyocardial Hemorrhage
Authors: Mohan Jagdish Chander , Shukla Madhu , Burkule Nitin
Published: September 2023

Myocardial reperfusion injury is defined as the death of cardiomyocytes as a direct result of one or more events initiated by reperfusion. These events could be inflammation, oxidative stress, calcium overload, neurohumoral activation, cytotoxicity of anaerobic metabolites, etc. Intramyocardial hemorrhage as a consequence of ischemia–reperfusion injury during acute myocardial infarction and subsequently is frequent and portends worse prognosis. Animal studies have demonstrated that intramyocardial hemorrhage does not occur with ST-elevation myocardial infarction unless myocardium is reperfused with blood. Magnetic resonance imaging is the technique of choice for its detection but has limited availability in emergencies and is expensive. Echocardiography can be used for indirect myocardial tissue characterization. Echocardiography coupled with myocardial contrast imaging is increasingly being used for detecting hemorrhage in infarcted segments. In the presence of wall motion abnormality, increased segmental echogenicity, significantly increased wall thickness underlying hypermobile endocardium, and neocavitations within the myocardium are the characteristic features. Occasionally, extensive wall splitting and formation of pseudotumor due to large hematoma are the striking features of intramyocardial hemorrhage. Intramyocardial hemorrhage in acute myocardial infarction can occur during early phase, following reperfusion and during remodeling process. There is no definite echocardiographic imaging method to assess reperfusion hemorrhage in vivo, but signal-void cavity-like or cystic appearance within the myocardium in the setting of myocardial infarction is highly suggestive. Detecting hypointense area of hemorrhage could be complicated by low-intensity echoes emanating from the normal myocardium. Echocardiography should be performed in every patient before and after reperfusion therapy and serially till discharge. There are no studies comparing the diagnostic yield of echocardiography compared to magnetic resonance imaging. Those with obvious myocardial hematoma need special attention with regard to antiremodeling agents, dual antiplatelet therapy, and possibly surgery. A majority of patients with significant intramural hemorrhage end up having reduced left ventricular function, adverse remodeling, true or pseudo-aneurysms, and even heart failure although spontaneous resorption has also been reported.
An Observational Data Analytical Research on Pediatric Cardiomegaly as a Predictor of Structural or Functional Heart Diseases
Authors: Tomar Munesh , Ahmad Fatima Afreen , Chaudhuri Maitri , Agarwal Vikas
Published: September 2023

Background:

Chest X-ray (CXR) is a routine, noninvasive test advised in a plethora of pediatric non-cardiac conditions such as bronchopneumonia, respiratory distress, failure to thrive, suspected tuberculosis, and for preoperative anesthesia clearance. Finding of cardiomegaly (CM) on CXR is a common cause of referral to a pediatric cardiologist. The question lies in its significance: whether CM in CXR corroborates with cardiac disease (s), structural or functional.

Materials and Methods:

The data of 229 children (median age: 6 months), referred to pediatric cardiology unit for echocardiography with CXR depicting CM over a period of 2 years (June 2019 to July 2021), were retrospectively reviewed. Clinical and laboratory findings, CXR, and echocardiography were analyzed for all children to determine the positive predictive value of CM in CXR to detect cardiac disease. Echocardiography was taken as gold standard to reach the cardiac diagnosis.

Results:

True CM was noted in 85% (Group A), whereas 15% had false CM (Group B). Group A comprised structural heart defect in 71.7% and ventricular dysfunction in 13.3%. Less common causes were severe anemia, hypertensive heart failure, arrhythmogenic cardiomyopathy, diphtheritic cardiomyopathy, multisystem inflammatory syndrome in children, pericardial effusion, thiamine deficiency, and severe idiopathic pulmonary arterial hypertension. In Group B, the most common reasons for false diagnosis were expiratory film (n = 18), thymic shadow (n = 12), and chest deformity and mediastinal mass (n = 2 each).

Conclusion:

CM in CXR strongly correlates with cardiac involvement and has a high positive predictive value. Combining clinical, laboratory, and CXR interpretation enables the pediatrician to achieve a rapid functional diagnosis. Medical stabilization can be initiated with this knowledge pending the availability of echocardiography in resource-limited areas. Detailed evaluation at a pediatric cardiac center should be completed to reach a final diagnosis in all such patients. In the absence of congenital heart disease, known acquired causes leading to cardiac compromise should be actively looked for.
A Case of Bioprosthetic Valve Thrombosis
Authors: Rajappan Ramkumar , Vydianathan P. R. , Sundaram R. Shanmuga
Published: September 2023

Surgical valve replacement is a time-tested modality of treatment in patients with significant valvular heart disease. Bioprosthetic valves (BPVs) are preferred among certain patients because of less thrombogenicity which warrants only a short duration of anticoagulation as recommended by guidelines. Subclinical thrombosis as well as symptomatic BPV thrombosis is being increasingly recognized nowadays, more because of improvement in diagnostic modalities and increasing awareness. Our case report highlights the occurrence of BPV thrombosis in a patient who underwent surgical BPV implantation and was on anticoagulation for guideline recommended duration. This report also highlights the need for regular periodic echocardiographic screening of these patients to detect BPV thrombosis at an early stage.
Dirofilariasis of Breast Mimicking Malignancy – A Rare Entity
Authors: Srinivasan Sudha , Srinivaasan M.
Published: September 2023

Human dirofilarial infection usually presents as pulmonary coin lesion or as subcutaneous nodule. We report the case of a 60-year-old female presented clinically with swelling in the lower-outer quadrant of the right breast for 2 weeks. Ultrasound reported as atypical lesion suggest fine-needle aspiration cytology (FNAC) correlation and follow-up. Clinical examination – subcutaneous nodule of size 2 cm × 2 cm presents in the lower-outer quadrant. Clinical suspicious of carcinoma was considered and FNAC was done. Aspirated pus-like material and adult worm about 4 cm in length were attached to the needle. Smear was air-dried and stained with Giemsa. Smears were cellular and showed numerous neutrophils, eosinophils, and a few histiocytes in a necrotic background and also noted coiled adult dirofilarial worm. Cellblock was prepared and it showed the cut section of dirofilarial worm with cuticle, muscular layer, intestine, and reproductive tube. We report this case entity due to diagnostic confusion with breast malignancy clinically and radiologically.
Transcutaneous Temperature Controlled Radiofrequency: Groundbreaking Technology – Female Stress Urinary Incontinence and Overactive Bladder Can Be Treated Noninvasively and with Vulvovaginal Rejuvenation?
Authors: Mishra Vineet V. , Solanki Smit Bharat , Mishra Nita Vineet , Alinsod Red M.
Published: September 2023

It has long been difficult to treat vulvovaginal laxity, genitourinary syndrome of menopause, stress urine incontinence, overactive bladder (OAB), and other indications of sexual dysfunction because women traditionally find it difficult to discuss these difficulties with clinicians and because society generally accepts these diseases. Originating in esthetic medicine, noninvasive feminine rejuvenation that targets vaginal tissue with energy-based methods has recently become more popular. A more youthful-looking vulva, the restoration of vaginal elasticity and “tightness,” a significant improvement in stress urinary incontinence, a reduction in symptoms of OAB, and a decrease in sexual dysfunction are all benefits of transcutaneous temperature-controlled radiofrequency (TTCRF) therapy at the vulvovaginal region. It is also becoming more popular as a mild-to-moderate stress urinary incontinence and OAB noninvasive therapy option. Women will likely always be appreciative of their gynecologist for managing stress urinary incontinence with TTCRF therapy without making an incision, it would appear.
Determinants of Malnutrition among Elderly Women Living in Institutional Care
Authors: Moses Jessica Subashini , John Sheila , Monica Sarah Jane , Priyadarshini S.
Published: September 2023

Background:

Healthy aging and well-being are largely influenced by nutrition.

Objective:

The objective of the study was to evaluate the risk of malnutrition in elderly women residing in institutional care and its contributing factors.

Methodology:

One hundred institutionalized women aged 60 years and above were screened for malnutrition using Mini Nutritional Assessment (MNA) tool. Details on sociodemographic profile, physical activity, medical conditions, and food habits were gathered through researcher administered survey method.

Results:

The study participants had an average height of 149.70 cm (±7.31), weight of 50.72 kg (±9.11), body mass index of 22.77 kg/m2 (±4.68), body fat percentage of 31.30% (±8.99), mid-arm circumference of 27.36 cm (±7.84), calf circumference of 30.11 cm (±7.51), MNA score of 10.42 (±4.06), and hand grip strength score of 18.69 kg/lbs (±3.80). Upon analyzing the MNA scores, it was found that 9% of elderly women were well nourished, 62% were at risk of malnutrition, and 29% were malnourished. A significant difference was observed in the mean MNA scores (P < 0.05). Age, education level, body fat percentage, appetite, and dental problems were significantly associated with malnutrition (P < 0.05).

Conclusion:

Geriatric residents in old-age homes require adequate nutrition to maintain health. This can be achieved by providing individualized meal planning, reducing barriers to eating, and incorporating nutrient-dense foods.
Histopathological Study of Spectrum of Lesions of Uterine Cervix
Authors: Jadhav Aditi , Sanklecha Vandana , Natekar Ashwini , Mahra Richa
Published: September 2023

Context:

Uterine cervix is a gateway to several neoplastic and nonneoplastic lesions. Cervical carcinoma accounts for 20%–25% of all cancers and 80%–85% of all genital tract cancers worldwide. It is the most common malignancy in Indian women.

Aim:

The aim of this study was to study the histopathological spectrum, incidence, and distribution with respect to the age of various cervical lesions and to determine their clinicopathological correlation.

Settings and Design:

A prospective observational study of 200 cases of cervical lesions was carried out in the histopathology section of the Department of Pathology for the duration of 2 years after obtaining permission from the Institutional Ethics Committee.

Materials and Methods:

Study participants were selected from the study population admitted at the study center based on the inclusion and exclusion criteria.

Statistical Analysis Used:

Statistical software GraphPad InStat.v3.0 was used for statistical analysis.

Results:

In our study, 49.5% of cases were malignant and 50.5% of cases were benign. The most common malignant lesion on histopathological examination was squamous cell carcinoma (SCC). Majority of the lesions were in the 41–50 years of age group. Clinicopathological agreement was noted in 93.5% of cases. Twenty-eight out of 30 cases of SCC (93.33%) were positive for p16 staining. Agreement between Pap smear findings and histopathological diagnosis was 100% in cases of malignant and premalignant lesions of the cervix.

Conclusion:

Histopathological examination is important not only for confirmation of the preoperative diagnosis but also in evaluating the incidence and age-wise distribution of both neoplastic and nonneoplastic cervical lesions. Early and accurate diagnosis of cervical lesions provides an opportunity for appropriate interventions to prevent further complications.
Histomorphological Evaluation of Desmoplastic Tumor Stroma in Malignant Ovarian Surface Epithelial Tumors
Authors: Ahuja Sana , Zaheer Sufian , Ranga Sunil
Published: September 2023

Background:

Ovarian cancer is the 8th most common cancer in women worldwide. Tumor budding is defined as a type of invasive growth in carcinomas with either a single tumor cell or a cluster of up to four cells at the invasive tumor front and is associated with epithelial–mesenchymal transition. A reactive stroma rich in cancer-associated fibroblasts is associated with higher tumor grade and poorer prognosis in breast, colorectal, and oral cancers.

Aims and Objectives:

The present study was conducted to highlight the prognostic significance of tumor budding and fibrotic cancer stroma in malignant ovarian surface epithelial tumors with known prognostic parameters.

Materials and Methods:

This was a retrospective cross-sectional study conducted over a 2-year period, in which all histologically diagnosed cases of malignant ovarian surface epithelial tumors who underwent surgery were included. The fibrotic stroma was classified into three distinct categories – mature, intermediate, and immature. The number of tumor buds was counted at the invasive front of the tumor and graded based on the number of buds – 0–5, 5–9, and ≥10 buds.

Results:

Among the 50 cases, 32% (16 cases) had mature stroma, whereas 30% (15 cases) and 38% (19 cases) had intermediate and immature stroma, respectively. Although a significant association could not be established between tumor budding and stroma grade, a fair agreement was established between them. A significant association could be established between histological grade with both tumor budding (P = 0.03) and fibrotic stroma grade (P = 0.02).

Conclusion:

The study highlighted the role of stromal response in malignant surface epithelial tumors of the ovary since a higher-grade tumor was associated with an immature stroma, whereas a lower-grade tumor was associated with a mature stroma.
Effect of Pain Neuroscience Education with Conventional Physiotherapy via Telerehabilitation on Pain Catastrophizing and Function in Patients with Osteoarthritis Knee: A Randomized Controlled Trial
Authors: Supe Hiral Manohar , Mungikar Sanket S. , Katage Goutami A. , Garg Kapil A. , Wani Surendra Kiran
Published: September 2023

Aim:

By explaining to the patient the biological processes underneath their pain condition, pain neuroscience education (PNE) is a form of educational intervention that aims to relieve pain and impairment.

Materials and Methods:

Patients with knee osteoarthritis (OA) referred to outpatient physiotherapy clinic in India during August 2021 to June 2022 were asked to participate. Out of the eligible patients, 35 were randomly assigned to PNE group and 35 to the control group. Self-reports of Pain Catastrophizing Scale (PCS), Patient Specific Function Scale (PSFS), and Numerical Pain Rating Scale (NPRS) were recorded at baseline (T1) and at 2 weeks (T2).

Results:

After 2 weeks of follow-up, all the three outcome measures were found to be significant in the PNE group. The results of the unpaired t-test revealed statistically significant result posttest for PCS (mean difference 11.4) and NPRS (mean difference 1.20). There was no mean difference found in the patient function (PSFS) between groups.

Conclusion:

The results suggest that adding a program of PNE to conventional physiotherapy exercises led to a greater reduction in pain catastrophization, patient-specific function, and pain intensity rather than conventional physiotherapy alone in patients with knee OA at 2 weeks’ follow-up.
A Cross-sectional Assessment of Depression, Anxiety, and Cognition in Perimenopausal and Menopausal Women
Authors: Nagda Anjalee L. , Datar Manjiri Chaitanya , Naphade Nilesh Mahadeo , Shetty Jyoti V.
Published: September 2023

Introduction:

Menopausal transition involves failure of ovarian function followed by cessation of menstruation. This has been said to lead to psychiatric comorbidities such as depression and anxiety. Estrogen also has beneficial effects on cognition and thus fluctuation in the same can lead to cognitive decline. Given the number of women undergoing menopause, timely screening of the comorbidities is of importance.

Aims and Objectives:

Our study aimed at assessment of anxiety, depression, and cognitive impairment in perimenopausal and postmenopausal women presenting in the medicine and gynecology units of a tertiary care hospital. The objectives were to screen the peri- and postmenopausal women presenting with medical and gynecological complaints for the presence of depression and anxiety and assess their cognitive function. To find association of their symptoms with psychosocial and menopausal factors with the psychiatric parameters.

Settings and Design:

Our study was conducted among the perimenopausal and postmenopausal women visiting gynecology and medicine units in a tertiary care hospital. One hundred and five women in the age group of 45–55 were assessed using a specialized pro forma, Beck’s Anxiety Inventory, Beck’s Depression Inventory, and Addenbrooke’s Cognitive Examination III.

Statistical Analysis Used:

The results were analyzed using SPSS software (version 20.0).

Results:

21.9% of females had moderate levels of anxiety, 24.76% had clinical depression, and 13.33% had mild cognitive impairment. The presence of psychosocial stressors had a significant impact on the anxiety, depression, and cognitive impairment. There was no significant association found between psychiatric parameters and peri- and postmenopausal stage as well between natural or surgical menopause.
Proportion, Pattern, and Predictors of Falls in Older Adults – A Community-based Observational Study in Rural West Bengal
Authors: Jana Dipankar , Sahu Monalisha , Paul Bobby , Chakraborty Sandipta , Bandyopadhyay Lina , Das Ranjan
Published: September 2023

Introduction:

In spite of falls being a major public health problem, where most of the falls are preventable, there is a lack of epidemiological investigation among those aged 50 and above, especially in developing countries. Hence, we investigate the proportion, pattern, and predictors of falls in this age group.

Materials and Methods:

This cross-sectional community-based study was done in the Uluberia-II block of Howrah district, West Bengal, from February to July 2021. A multistage cluster sampling method was used to meet the sample size. Data were collected with the help of a structured interview schedule. Predictors were estimated by the SPSS version 16 and defined in adjusted odds ratio (AOR) with a 95% confidence interval.

Results:

Among 170 study participants, 34.7% (59/170) experienced at least one episode of fall, while 20.6% (35/170) experienced recurrent falls in 12 months. Most (78%; 46/59) falls occurred in the home environment and due to slippage (67.8%; 40/59) on the floor. 84.7% (50/59) sustained any type of injuries, 47.5% (28/59) required either consultation of a physician or medication, and 6.8% (4/59) required hospitalization. Safety Checklist Score measured 75.3% (128/170) had a poor household environment, within that 30.6% (52/170) had a seriously poor household environment, which was an important predictor of falls ([AOR] = 3.59 [1.24–10.38]). Fear of fall (AOR = 6.18 [1.77–21.53]) measured by shortfall efficacy scale and nonformal education (AOR = 5.05 [1.33–19.07]) were also predictors of falls.

Conclusion:

Considerable proportion of falls occurred in the past year, which can be preventable by improving modifiable environmental factors and detection of fear of fall in persons at different levels of health-care facilities.
A universal inequality for Neumann eigenvalues of the Laplacian on a convex domain in Euclidean space
Authors: Funano Kei
Published: September 2023

We obtain a new upper bound for Neumann eigenvalues of the Laplacian on a bounded convex domain in Euclidean space. As an application of the upper bound, we derive universal inequalities for Neumann eigenvalues of the Laplacian.
The Water Disinfection with Different Type UV Lamp Systems on Bacterial Load in Small Scale Recirculating Aquaculture Systems
Authors: Uygun Mustafa , Firat Muammer Kursat , Antepli Onurkan , Bulat Fevziye Nihan , Hekimoglu Muge Aliye , Bagci Muhammet Kursat , Gulec Fatih , Suzer Cuneyt , Kose Ibrahim , Saka Sahin , Kilinç Berna
Published: September 2023

The present study was planned with the aim of inactivating the total bacterial load and species in tilapia fish tanks kept in fresh and seawater conditions with high stock density with different UV lamp models. In this context, the UVC+UVA-Led lamp system was compared with the conventional UVC lamp system and the total bacterial load in the tanks and the inactivation effect on the bacterial species were determined. Total bacterial load on the medium and bacteria species were identified in terms of their morphological characteristics using the spread plate method. Bacteria that emerged at different times in the trial sets were identified as Edwardsiella tarda, Salmonella sp., Aeromonas hydrophila, Pantoea sp., Citrobacter youngae, Serratia ficaria and Citrobacter freundii. The total bacterial load in both freshwater and seawater environments in both lamp groups showed a decrease compared to the control group. With this, the conventional lamp model was more effective on the total bacterial load in the samples taken during the trial. Although all bacteria were inactive in both lamp groups, Serratia ficaria bacteria were not eliminated in the seawater environment. The results show that UV LEDs can be a better alternative to traditional UV mercury lamps for water disinfection.
Duckweed as an Underutilized Species Having Potential in Feed Sector
Authors: Abdullahi Abdurrazzaq Ibrahim , Mohammed Tukur
Published: September 2023

This study evaluated the importance of duckweed and compared it with soybean as an alternative feed. Determination of proximate composition of all samples was done in triplicate. Toasted soybean meal had significantly the highest protein content of 38.00% while raw duckweed meal recorded the least of 35.08%. The cost-benefit evaluation revealed that 75% blanched duckweed meal gave the highest net profit (₦3,682) and lowest incident cost (₦6.49). This study revealed that blanched duckweed meal has great potential in feed sector and can serves as an alternative to soybean and also will reduce the cost of feed production and maximize profit.
Gender Determination of Pearl Mullet by Geometric Morphometric Method
Authors: Delibas Veysel , Soyguder Zafer , Cakmak Gamze
Published: September 2023

Pearl mullet (Alburnus tarichi, Güldenstadt 1814) is an endemic fish species of great importance worldwide. This species is an important economic and cultural resource for the region since it lives in Lake Van, one of the world's largest sodic lakes. It is often not possible to determine the sex of fish based on morphological characteristics. In this study, landmark-based geometric and morphometric method was preferred to identify the shape difference between male and female sexes of pearl mullet fishes species in Lake Van. A total of 100 pearl mullet fish (50 females and 50 males) were used as material. Significant morphological differences were found between the male and female sexes (P<0.001 in canonical analysis of variance). These differences were found that the male fishes were longer than the female fishes on the lateral side and the head of the male fishes were larger than the female fishes. In addition, female fishes formed a deeper abdominal line towards the ventral side in the wireframe graph. The presence of a large gill positioned cranially is another important feature that distinguishes female fishes from male fishes. Lateral and ventral body differences between the sexes were statistically determined by ANOVA test results.
Electromagnetic Interference Measurement Impulse Generators: Standard Calibration Requirements and Techniques
Authors:   AE-4 Electromagnetic Compatibility (EMC) Committee
Published: September 2023

This Aerospace Recommended Practice (ARP) describes a standard method and means for measuring or calibrating the "Spectrum Amplitude" output of an impulse generator.
Metoda obrnjenega učenja pri pouku slovenščine (književnosti)
Authors: Žbogar Alenka
Published: September 2023

In the paper, a novel approach to teaching literature in Slovenian classrooms is established. It is based on an American didactic approach known as “flipped learning” or the “flipped classroom”, and because it is based on a widely recognized idea, I will refer to it as the “flipped learning method”. I compare it to the home reading approach and the school interpretation method because it seems comparable to both. Although the flipped learning approach has not yet been statistically relevantly tested in Slovenian literature classrooms at the elementary and/or secondary levels of the Slovenian educational system, I also highlight some of the method’s potential disadvantages in addition to its benefits.
Frazeosemantično makropolje ‘bogastvo, bogat človek’ v slovenskem in slovaškem jeziku
Authors: Dobríková Mária , Kmecová Svetlana
Published: September 2023

Since the phraseology of any language is anthropocentric, it reflects in a metaphorical way various phenomena of human life, including interpersonal relationships based on the disproportionate distribution of financial and material resources that characterizes all the stages of the development of human society. Therefore, the phraseo-semantic macrofields “poverty, poor man” and “wealth, wealthy man” are very broad in all languages. In this paper, the authors deal with the second group, i.e. phrases referring to different aspects of wealth, comparing the presence of units from the studied semantic spectrum in Slovak and Slovene. They divide them into several groups according to their origin, components and meaning. On the basis of the comparative analysis, they conclude that the phrases are structurally and semantically very diverse, expressing similar or identical thought content in both languages by different linguistic means. Some of the phrasemes are older examples which are nowadays used minimally or not at all. Nevertheless, they are an important part of the cultural heritage of both linguistic communities.
Foreword to Volume VII
Authors: Faure Michael
Published: September 2023

The Elgar Encyclopedia of Environmental Law is a landmark reference work, providing definitive and comprehensive coverage of this dynamic field. The Encyclopedia is organised into 12 volumes around top-level subjects – such as water, energy and climate change – that reflect some of the most pressing issues facing us today. Each volume probes the key elements of law, the essential concepts, and the latest research through concise, structured entries written by international experts. Each entry includes an extensive bibliography as a starting point for further reading. The mix of authoritative commentary and insightful discussion will make this an essential tool for research and teaching, as well as a valuable resource for professionals and policymakers.
Access to justice in environmental matters: recent developments at international and regional level and the repercussions at the national level
Authors: Karageorgou Vasiliki (Vicky)
Published: September 2023

The Elgar Encyclopedia of Environmental Law is a landmark reference work, providing definitive and comprehensive coverage of this dynamic field. The Encyclopedia is organised into 12 volumes around top-level subjects – such as water, energy and climate change – that reflect some of the most pressing issues facing us today. Each volume probes the key elements of law, the essential concepts, and the latest research through concise, structured entries written by international experts. Each entry includes an extensive bibliography as a starting point for further reading. The mix of authoritative commentary and insightful discussion will make this an essential tool for research and teaching, as well as a valuable resource for professionals and policymakers.
Indivisibility of human and environmental rights
Authors: Daly Erin , R May James
Published: September 2023

The Elgar Encyclopedia of Environmental Law is a landmark reference work, providing definitive and comprehensive coverage of this dynamic field. The Encyclopedia is organised into 12 volumes around top-level subjects – such as water, energy and climate change – that reflect some of the most pressing issues facing us today. Each volume probes the key elements of law, the essential concepts, and the latest research through concise, structured entries written by international experts. Each entry includes an extensive bibliography as a starting point for further reading. The mix of authoritative commentary and insightful discussion will make this an essential tool for research and teaching, as well as a valuable resource for professionals and policymakers.
Identifying legal claims to human rights and the environment
Authors: Rajan S Ravi , Davies Kirsten , Iorns Magallanes Catherine
Published: September 2023

The Elgar Encyclopedia of Environmental Law is a landmark reference work, providing definitive and comprehensive coverage of this dynamic field. The Encyclopedia is organised into 12 volumes around top-level subjects – such as water, energy and climate change – that reflect some of the most pressing issues facing us today. Each volume probes the key elements of law, the essential concepts, and the latest research through concise, structured entries written by international experts. Each entry includes an extensive bibliography as a starting point for further reading. The mix of authoritative commentary and insightful discussion will make this an essential tool for research and teaching, as well as a valuable resource for professionals and policymakers.
Biodiversity and human rights
Authors: Yun Santoso Wahyu
Published: September 2023

The Elgar Encyclopedia of Environmental Law is a landmark reference work, providing definitive and comprehensive coverage of this dynamic field. The Encyclopedia is organised into 12 volumes around top-level subjects – such as water, energy and climate change – that reflect some of the most pressing issues facing us today. Each volume probes the key elements of law, the essential concepts, and the latest research through concise, structured entries written by international experts. Each entry includes an extensive bibliography as a starting point for further reading. The mix of authoritative commentary and insightful discussion will make this an essential tool for research and teaching, as well as a valuable resource for professionals and policymakers.
The human right to landscape *
Authors: Prieur Michel
Published: September 2023

The Elgar Encyclopedia of Environmental Law is a landmark reference work, providing definitive and comprehensive coverage of this dynamic field. The Encyclopedia is organised into 12 volumes around top-level subjects – such as water, energy and climate change – that reflect some of the most pressing issues facing us today. Each volume probes the key elements of law, the essential concepts, and the latest research through concise, structured entries written by international experts. Each entry includes an extensive bibliography as a starting point for further reading. The mix of authoritative commentary and insightful discussion will make this an essential tool for research and teaching, as well as a valuable resource for professionals and policymakers.
Environmental rights of children
Authors: E Makuch Karen
Published: September 2023

The Elgar Encyclopedia of Environmental Law is a landmark reference work, providing definitive and comprehensive coverage of this dynamic field. The Encyclopedia is organised into 12 volumes around top-level subjects – such as water, energy and climate change – that reflect some of the most pressing issues facing us today. Each volume probes the key elements of law, the essential concepts, and the latest research through concise, structured entries written by international experts. Each entry includes an extensive bibliography as a starting point for further reading. The mix of authoritative commentary and insightful discussion will make this an essential tool for research and teaching, as well as a valuable resource for professionals and policymakers.
Human rights to the city: urban ecologies and Indigenous justice
Authors: Osborne Natalie , Carlson Anna , Butler Chris
Published: September 2023

The Elgar Encyclopedia of Environmental Law is a landmark reference work, providing definitive and comprehensive coverage of this dynamic field. The Encyclopedia is organised into 12 volumes around top-level subjects – such as water, energy and climate change – that reflect some of the most pressing issues facing us today. Each volume probes the key elements of law, the essential concepts, and the latest research through concise, structured entries written by international experts. Each entry includes an extensive bibliography as a starting point for further reading. The mix of authoritative commentary and insightful discussion will make this an essential tool for research and teaching, as well as a valuable resource for professionals and policymakers.