bluuebunny/crossref_metadata_2025 huggingface dataset:
Female adnexal tumour of probable wolffian origin: A rare case report
Authors: Dhaduk Nehal , Dagar Mamta , Srivastava Mala , Bhardwaj Punita , Verma Tina , Ganguli Indrani ,   Nayak
Published: February 2021

Introduction: Female adnexal tumour of probable wolffian origin (FATWO), is a rare neoplasm arising within the leaves of a broad ligament or hanging from it or a fallopian tube. It is considered a tumour of low malignant potential which shares similar histological and immunochemical features with mesonephric remnants.

Case: Here we present a case repot of a 40 years old, nulliparous female who presented with acute pain abdomen and fever since 2 days. Her LMP was 30.09.2015 and her past menstrual cycles were irregular. She was nulliparous with history of infertility. In past medical history revealed her to be a known diabetic for 5 years, with uncontrolled blood sugars. Patient was hemodynamically stable. On per abdominal examination there was generalized tenderness all over the abdomen with guarding and rigidity. On per speculum examination vaginal discharge was noted with unhealthy cervix. Per vaginal examination revealed a tender mass of approximately 8 cm × 6 cm was felt on left fornix. All her base line investigations were normal. The salient investigations like CA-125 35.60 IU/L, CEA 3.46, Beta-HCG 2.29 were normal. On imaging, MRI showed a well defined solid cum cystic space occupying lesion of 9 cm × 8 cm arising from left adnexa with evidence of right hemorrhagic adnexal cyst 6 cm × 7 cm and hydro/hematosalpinx noted. There was well defined space occupying lesion in the pelvis on the left of the uterus which is likely a broad ligament leiomyoma. Diagnosis of acute abdomen was made with adnexal mass probably infectious in origin. Injectable antibiotics were started. In view of acute pain abdomen decision for surgical intervention was taken. Laparoscopic findings revealed bilateral ovarian abscess with left sided broad ligament mass (solid consistency) probably leiomyoma. Right tube and ovary were normal. Drainage of tuboovarian abscess with left salpingo-oophorectomy with right salpingectomy with adhesiolysis was done and sent for histopathology. HPE reported Female adnexal tumour of probable wolffian origin (FATWO) which was positive for vimentin and CD10, possibly arising from left sided broad ligament. Patient underwent radical hysterectomy with omentectomy with appendicectomy was done.in view of FATWO.

Conclusion: Female adnexal tumour of probable wolffian origin (FATWO), is a rare neoplasm which is usually considered as benign, although in some cases metastasis on recurrences have been reported even after a long interval following the initial diagnosis. Pre-operative diagnosis of FATWO is very difficult because of the rarity of the disease and paucity of the literature available.
Gestational trophoblastic neoplasia: Retrospective analysis of clinical profile, treatment pattern and outcome
Authors: Kaur Paramjeet , Chauhan Ashok K. , Khurana Anil , Verma Yashpal , Bansal Nupur
Published: February 2021

Background: Gestational trophoblastic disease is a spectrum of cellular proliferation arising from the placental villous trophoblast. Gestational triphoblastic neoplasia (GTN) is a collective term for GTD that invade locally or metastasize. GTD includes hydatidiform mole (complete and partial) and GTN include invasive mole, choricocarcinoma, placental site trophoblastic tumor and epitheliod trophoblastic tumor.

Aim: To evaluate clinicopathological profile, treatment pattern and clinical outcome in patients with gestational trophoblastic neoplasia (GTN).

Materials and Methods: Twelve cases of gestational trophoblastic neoplasia treated between 2012 to November 2015 in Department of Radiotherapy – II, PGIMS, Rohtak were evaluated in this retrospective study. Data was analyzed on the basis of age, histopathology, stage, type of treatment received and treatment related toxicities. Disease free survival was estimated.

Result: Out of 12 women 7 (58 %) had hydatidiform mole, 4 (33%) invasive mole and 1 (8%) had choriocarcinoma. All the cases were given chemotherapy. Two patients had low risk disease. Among high risk group seven patients had score of less than 7 and five patients had risk score of 7 or higher. Five patients were given single agent methotrexate, seven patients received multidrug regimens. All patients are on regular follow up. One patient (high risk group) expired as she did not receive treatment.

Conclusion: GTN are rare and proliferative disorders with proper diagnosis and treatment most of the cases are amenable to treatment with favorable outcome.
Neoadjuvant chemotherapy in epithelial ovarian cancer: Largest single institute experience
Authors: Kumar Siva
Published: February 2021

Purpose: Neoadjuvant chemotherapy followed by interval debulking surgery (IDS) is an alternative treatment option, compared to the current standard of care primary debulking surgery for treating advanced epithelial ovarian cancer (EOC). We present our institute experience of neoadjuvant chemotherapy strategy in the management of EOC which is one of the largest single institute experience.

Methods: This is a retrospective analysis of patients with epithelial ovarian cancer who were treated in our institute between 2000 and 2006. Patient with advanced disease by clinical and imaging were treated with 3 cycles ofneoadjuvant chemotherapy and then taken up for interval debulking surgery (IDS) who had static or partial or complete response to chemotherapy. The remaining chemotherapy is delivered after the surgery. Patient who had limited disease had primary debulking surgery and then adjuvant chemotherapy according to institute protocol. Outcomes in terms of disease free and overall survival were analysed.

Results: This retrospective analysis included 59 patients with limited disease who had primary debulking surgeryand 283 patients with advanced disease who recievedneoadjuvant chemotherapy. The median age was 50 years and majority are in the 50-59 years age group. Age more than 60 years represent 14.5%. Postmenopausal women were 55.3% and premenopausal women were 44.7 %. Multiparity is higher 70.2% than the uniparity 16.4% ornulliparity 11.7%. Abdomen distension 42% and pain 25% are the most common symptoms. Advanced stage was the most common presentation 71% with stage III-56.1% and stage IV-14.9%. Among the neoadjuvant chemotherapy group 126/283 (44.5%) had optimal cytoreduction, 44/283 (15.5%) had suboptimal cytoreduction and 113/283 (40%) not suitable for IDS. The 5 year disease free and overall survival was 30.8% and 41.5% in the NACT group with advanced disease and 58.5% and 75.8% in the primary cytoreduction group who had limited diseaserespectively. The 5 years overall survival among the IDS group with optimal cytoreduction was 57.1% and 11.7% for the suboptimal cytoreduction group. The 5 years survival was not affected by the number ofneoadjuvant chemotherapycycles delivered before surgery in the IDS group. Patient who received paclitaxol + carboplatin as first line chemotherapy had better survival than carboplatin alone or cyclophosphamide + cisplatin.

Conclusion: NACT as an alternative option to primary debulking surgery in operable EOC is still debatable. But for patient with high disease burden where optimal cytoreduction is not possible NACT strategy is a valid option. Recent randomised controlled trials from Europe had shown the noninferiority of neoadjuvant chemotherapy followed by IDS when compared to the primary debulking surgery in operable advanced EOC.
Role of intraoperative frozen section in the diagnosis of ovarian tumors: Experience at Gujarat Cancer and Research Institute
Authors: Arora Ruchi
Published: February 2021

Background: The surgical management of ovarian tumors depends on their correct categorization as benign, borderline or malignant. Ovarian neoplasms are an important cause of morbidity and mortality in women. This study was undertaken to evaluate the accuracy of intra-operative frozen section in the diagnosis of various categories of ovarian neoplasms.

Methods: Intraoperative frozen section diagnosis was retrospectively evaluated in 125 patients with suspected ovarian neoplasms who underwent surgery as primary line of therapy at our institution. This was compared with the final histopathologic diagnosis on paraffin sections.

Results: In 125 patients frozen section report had a sensitivity of 100%, 95.55% and 50% for benign, malignant and borderline tumors respectively. The corresponding specificities were 92.45%, 98.75% and 99.14% respectively. The overall accuracy of frozen section diagnosis was 95.2%. The majority of cases of disagreement were in the mucinous and borderline tumors.

Conclusion: Intraoperative frozen section has high accuracy in the diagnosis of suspected ovarian neoplasms. It is a valuable tool to guide the surgical management of these patients and should be routinely used in all major oncology centers.
Pure primary non gestational choriocarcinoma ovary – diagnostic dilemma and treatment intricacy
Authors: Soni Abhishek , Bansal Nupur , Dhull A. K. , Kaushal Vivek , Chauhan A. K.
Published: February 2021

Introduction: Germ cell tumors of the ovary include all neoplasm derived from primordial germ cells of the embryonal gonad. Five percent of germ cell tumors are malignant, representing three to five per cent of all ovarian carcinomas of which pure primary non-gestational ovarian choriocarcinoma accounts for less than one per cent of ovarian tumors. Primary choriocarcinoma of ovary could be gestational or nongestational in origin. They pose diagnostic challenges in reproductive age group patients because of elevated human chorionic gonadotrophin (hCG). Non-gestational choriocarcinoma (NGCO) is resistant to single agent chemotherapy, requiring more aggressive combination chemotherapy post surgery. Due to the rarity of the disease, this article reviews the treatment protocol for NGCO.

Methods: All the articles related to choriocarcinoma of ovary at Pubmed, Google scholarly article and Scopus were assessed and reviewed and their references were also reviewed and included in this article.

Discussion: Clinical diagnosis of NGCO is often challenging because the clinical symptoms are often nonspecific and can mimic other, more common conditions that occur in young women, such as a hemorrhagic ovarian cyst, tuboovarian abscess, ovarian torsion, and ectopic pregnancy. The symptoms of vaginal bleeding, elevated hCG level, pelvic pain, and an adnexal mass often lead to incorrect diagnosis of ectopic pregnancy, threatened or incomplete abortion, cervical polyp, or other types of malignancy. Non-gestational choriocarcinomas have been found to be resistant to single agent chemotherapy, have a worse prognosis, and therefore require aggressive combination chemotherapy. Adjuvant chemotherapy with the EMA (etoposide 100mg/m2, methotrexate 100mg/m2, actinomycin-D 0.5mg) regimen may be given, for six to nine courses at seven days interval. Studies suggest that the disease responds well to the combination of surgery and postoperative adjuvant chemotherapy. However, long term effects of such therapy should be further studied with more cases.

Conclusion: Because of the small number of patients with pure ovarian choriocarcinoma, a consensus on the treatment regimen including surgery and chemotherapy is lacking. Surgery with adjuvant combination chemotherapy is the standard treatment of choice.
Juvenile granulosa cell tumor
Authors: Tuteja Geetanjali , Unmesh S. , Shree S. , Rudra S. ,   Archana
Published: February 2021

The differential diagnosis for precocious puberty in a young female includes peripheral causes. This case report documents a rare cause of isosexual precocious puberty, a juvenile granulosa cell tumour of the ovary–and a brief literature review. A one year-old baby girl presented with mass abdomen, vaginal discharge and rapid onset of pubertal development. She underwent an exploratory laparotomy for tumour resection. Pathology reported a juvenile granulosa cell tumour of the ovary. Early stage granulosa cell tumor surgically treated has good prognosis. Adjuvant chemotherapy is not indicated in this setting.
Outcomes of carcinosarcoma of the uterus
Authors: George Anne , Sebastian Ajit , Thomas Vinotha , Thomas Anitha , Chandy Rachel , Peedicayil Abraham
Published: February 2021

Objectives: To evaluate the outcome of women with uterine carcinosarcoma.

Methods: The medical records of all patients admitted with uterine carcinosarcoma between January 2012 and October 2015 were reviewed. Baseline characteristics were compared and survival was calculated using Kaplan Meier method and compared using log rank test.

Results: The total number of uterine malignancies operated in our centre over this time period was 247 of which 33 were sarcomas (13%). Median age of presentation was 56 years (21-77 years). Most women were postmenopausal (76%) and 46% of them presented with post menopausal bleeding.

There were 16 carcinosarcomas of the uterus. Eight presented at Stage 1 (50%) and the remaining 8 in stage III or IV. All patients had TAH/BSO but only 15 had omentectomy and 12 had pelvic and para-aortic lymphadenectomy. Adjuvant treatment was given only to 10 (63%). Seven patients had expired at the time of follow up. The mean survival was 502 days (304-699) with a median of 284 days. Patients who received adjuvant therapy did better compared to those who did not (p=0.05).

Conclusions: Carcinosarcomas are aggressive tumours and the optimal therapy is yet to be determined. Adequate surgical staging followed by adjuvant therapy improves survival.
Gestational choriocarcinoma after term pregnancy: A case report
Authors:   Radha
Published: February 2021

Choriocarcinoma coexisting with or after a “normal” pregnancy has an incidence of one per 1,60,000 pregnancies. In case of choriocarcinoma after term pregnancy, early diagnosis by histopathological examination of the placenta is very important, the precocity of the diagnosis influencing the prognosis and tumor response to chemotherapy. In, this paper we report the case of a 28-year-old woman parity 2 with metastatic choriocarcinoma after term pregnancy, diagnosed at four months after the delivery of a healthy baby. An episode of abundant vaginal bleeding occurred after four months from delivery. The local examination revealed a vaginal tumor whose pathological examination on biopsy sample was inconclusive. Subsequently, she was admitted in our hospital with abundant vaginal bleeding, severe anemia and fever. Abdominal ultrasonography revealed an intracavitary uterine tumoral mass with signe of myometrial invasion to the uterine serosa, strong Doppler signal and moderate ascites. Pulmonary X-Ray and computed tomography scan excluded extrapelvic tumoral masses. The pretreatment human chorionic gonadotropin (HCG) level was 310300 Miu/ml and her FIGO risk factor score was 8 (high–risk group). Total hysterectomy with bilateral salpingo-oophorectomy and omentectomy was performed as an optimal cytoreduction. Postoperative remaining presented by the metastasis located in the lower two-thirds of vagina. Histopatholgical examination revealed uterine choriocarcinoma. Postoperative was initiated four courses of polychemotherapy. Case evaluation was favorable, with the normalization of the Beta-HCG value in two months postoperative and complete remission of vaginal metastasis in six weeks posteoperative.
Chronic vulval problems: A gynaecologist’s perspective
Authors: Sharma Akanksha , Shamsunder Saritha , Khanna Geetika , Khunger Neeti , Zutshi Vijay
Published: February 2021

Introduction: Chronic vulval symptoms are common complaints in women seeking health care and can significantly interfere with a woman’s sexual function and sense of well being. Many practitioners feel diagnostically challenged, particularly by chronic or recurrent forms of vulval disease. The aim of this study was to assess the role of various diagnostic modalities in evaluation of chronic vulval symptoms.

Methods: Between August 2012 and February 2014, 100 women presenting with chronic vulval symptoms (i.e. ≥ 3 months duration) were evaluated. All of them had a thorough clinical history taken including use of vulval washes and creams, a general and gynaecological examination. Patients having chronic vaginal discharge in addition had urethral, vaginal and cervical smear and culture. All women had a careful examination of the vulva with and without magnification. Vulval scrape cytology was taken after moistening the vulva with normal saline and stained by Pap stain. Colposcopy of the vulva was then carried out after applying 5% acetic acid and 1% toluidine blue dye. Vulval biopsy was taken from suspicious areas on colposcopy and further management was based on histopathology report.

Results: The mean age of women in our study was 43.57 years (range 22-80 years.), 70% women were pre-menopausal and 30% were post-menopausal. The mean duration of symptoms was 1.625 years (range 6 months - 15 years) and atypical vulval hygiene practices (excessive washing with soaps) was used in 77% of women. The commonest presenting complaint was pruritus in 92% of women; visible lesions on vulva were seen in 20%, pain in 6% and burning sensation in vulva in 5% of women. The histopathology was abnormal in 77 patients; the most common histopathological finding was non-neoplastic epithelial disorders in 64 women {Squamous cell hyperplasia (n=52), Lichen Sclerosus et atrophicus (n=6), other dermatoses including lichen Planus (n=6)}. Vulvar Intra-epithelial Neoplasia (VIN) was seen in 6 patients, 5 were squamous type VIN and 1 was non-squamous type (Paget’s disease). Squamous cell carcinoma was seen in 3 patients; malignant melanoma, benign appendiceal tumor, angiofibroma and neurofibroma in 1 patient. Examination without magnification had sensitivity of 25.97% and with magnification was 29.87% and specificity was 100% for both of them. Cytology had sensitivity and specificity of 75.32% and 86.95% respectively and sensitivity and specificity of colposcopy was 77.92% and 17.39% respectively.

Conclusion: Clinical examination with and without magnification had low sensitivity but were highly specific in diagnosing vulvar lesions. A normal vulval smear and colposcopy have a high negative predictive value and are very reassuring. Colposcopy and biopsy is the gold standard for diagnosis, however clinical examination with naked eyes and magnifying glass are invaluable and can diagnose most of the neoplastic lesions.
Collision tumor of endometrial stromal sarcoma and squamous cell cancer: A rare entity
Authors: Gupta Bindiya , Rajaram Shalini , Jain Sandhya , Goel Neerja , Tanwar Naveen
Published: February 2021

A collision tumor is defined by the presence of two separate tumors in one organ on gross, microscopic, and immunohistochemical studies and they should be distinguished from malignant mullerian mixed tumors. A 60 year old lady P8L8 presented with blood stained vaginal discharge and post menopausal bleeding. Examination revealed a 1 x 2 cm cervical growth which was reported as squamous cell carcinoma cervix. Imaging revealed myohyperplasia with normal uterine cavity. The patient underwent Type III radical hysterectomy, bilateral salphingo-oophorectomy and bilateral pelvic lymphadenectomy. The uterine corpus revealed 5 cm growth in uterine cavity which was reported as high grade endometrial stromal sarcoma and the cervical growth was non keratinising squamous cell carcinoma infiltrating the former. The lymph nodes, parametria and vaginal cuff were free of tumor. The patient was referred for adjuvant chemotherapy and radiation therapy.
A rare case of invasive mole following evacuation of molar pregnancy and its management
Authors: Gandhi Krati , Dahiya Pushpa
Published: February 2021

Introduction: Gestational trophoblastic disease (GTD) is a spectrum of abnormal growth and proliferation of trophoblasts that continue even beyond the end of pregnancy. It comprises of hydatidiform mole, invasive mole, choriocarcinoma and placental site tumor. Invasive mole (Choreoadenoma destruens) comprises about 5-8% of all GTD. It has invasive and destructive potentialities.

Case Report: We report a case of 22 yr old female, G3P0A2, with 3 months amenorrhea with c/o pain abdomen since 4 days with no c/o bleeding p/v, with raised level of β hcg after two spontaneous abortions. On clinical examination vitals were stable. P/A ut 16-18 wks, doughy feel, slight tender. P/V os closed, ut 16-18 wks, bpv+. Ultrasonography shows multicystic lesion in cervix and vagina with loss of fat planes with UB. β hcg level was more than 5,00,000. Suction evacuation was done and products sent for histopathology. MRI Pelvis was also done in which invasive mole was diagnosed. 4 doses of inj. Methotrexte f/b folinic acid was given but β hcg levels did not fall by log 10. On histopath there was no evidence of invasive mole but 2nd line chemotherapy (EMACO) was started on the basis of MRI findings. Patient has received 5 cycles of EMACO REGIME with β hcg level being followed and is on decreasing trend, has reached to 5.90 mIU/ml.

Conclusion: Patient of molar pregnancy should be followed regularly for early diagnosis of persistent gestational trophoblastic disease and adequate management as loss to follow up patients may land up into complications.
Gestational trophoblastic neoplasia: Retrospective analysis of clinical profile, treatment pattern and outcome
Authors: Kaur Paramjeet , Chauhan Ashok K. , Khurana Anil , Verma Yashpal , Bansal Nupur
Published: February 2021

Background: Gestational trophoblastic disease is a spectrum of cellular proliferation arising from the placental villous trophoblast. Gestational triphoblastic neoplasia (GTN) is a collective term for GTD that invade locally or metastasize. GTD includes hydatidiform mole (complete and partial) and GTN include invasive mole, choricocarcinoma, placental site trophoblastic tumor and epitheliod trophoblastic tumor.

Aim: To evaluate clinicopathological profile, treatment pattern and clinical outcome in patients with gestational trophoblastic neoplasia (GTN).

Materials and Methods: Twelve cases of gestational trophoblastic neoplasia treated between 2012 to November 2015 in deptt of Radiotherapy – II, PGIMS, Rohtak were evaluated in this retrospective study. Data was analyzed on the basis of age, histopathology, stage, type of treatment received and treatment related toxicities. Disease free survival was estimated.

Results: Out of 12 women 7 (58 %) had hydatidiform mole, 4 (33%) invasive mole and 01 (8%) had choriocarcinoma. All the cases were given chemotherapy. Two patients had low risk disease. Among high risk group seven patients had score of less than 7 and five patients had risk score of 7 or higher. Five patients were given single agent methotrexate, seven patients received multidrug regimens. All patients are on regular follow up. One patient (high risk group) expired as she did not receive treatment.

Conclusion: GTN are rare and proliferative disorders with proper diagnosis and treatment most of the cases are amenable to treatment with favorable outcome.
A prospective observational analysis: Poor quality of life in cancer patient population of South Indian Territory Hospital, MGM Hospital, Warangal
Authors: Rao A. Yedukondala
Published: February 2021

Over the ten years, Quality of Life (QOL) investigations of cancer patients have become an important evaluation parameter in the cancer clinical research and treatment evaluation programs. This study was carried out in tertiary hospital located at Warangal, Andhra Pradesh, India. We assessed the overall QOL of patients affected by cervical, breast, head and neck, and stomach cancers by using EORTC QLQ C-30, QLQ-BR23, QLQ-H&N35, QLQ-CX24, and QLQSTO22 on ≤2 cycles as Review-I and ≥5 cycles as Review-II. The data were analyzed for 104 individuals with mean age of 46.1} 11.2 years. In In head and neck cancer patients, physical, role, social function, pain, insomnia, diarrhoea, speech problems, swallowing, dry mouth were significant (P < 0.05). Breast cancer patients, physical, role function, future perspective, fatigue, pain, arm symptoms and upset by hair loss were significant (P < 0.05). In stomach cancer patients, physical, role function, nausea and vomiting, pain, financial problems, Dysphagia, reflux symptoms and eating restrictions were significant (P < 0.05). In cervical cancer patients, physical, emotional function, fatigue, nausea and vomiting, pain, insomnia, symptom experience scale, menopausal symptoms were significant (P < 0.05). Most of the findings are similar to earlier studies, which shows that, QOL was predominantly influenced by the above mentioned factors in this study population and they also have some interesting implications for.
Can initial grade of endometrial cancer presenting at Tata Medical Center, predict high risk factors which will require lymph node dissection and adjuvant therapy?
Authors: Chakraborti Basumita , Ghosh Anik , Bhaumik Jaydip , Mukhopadhyay Asima
Published: February 2021

Background: Pre-operative tumor grade influences the type of surgery planned for endometrial cancer, while the final grade affects the adjuvant therapy.

Aims and Objectives: To predict whether pre surgery tumour grade can predict tlymph node dissection and adjuvant therapy in endometriod endometrial cancer.

Methods: Retrospective observational study. Data was obtained from electronic hospital medical records system. All women with a diagnosis of endometrioid endometrial cancer who attended TMC, Kolkata between September 2011 and June 2015 included. Review of the histology was asked in all patients and MDT was planned for all patients. Most of the patients operated in TMC underwent standard pre-operative imaging work up like MRI pelvis and CT upper abdomen and chest evaluation. Staging/completion surgery included total hysterectomy, BSO, pelvic +/- para aortic lymphadenectomy +/- Omental biopsy. The surgico-pathological evaluation included histology, grade, myometrial invasion, adnexal involvement and nodal involvement.

Results: 155 patients had both initial and final histology. Of total 67 patients with initial grade 1 histology, 8 (12%) were upgraded to G2 and 1 (1.5%) was upgraded to G3. 35 patients with G2 disease 2 (5.7%) were upgraded to G3. Among 8 patients with G3, 7 continued to be G3. Of the 67 patients with initial grade 1, > 50% invasion was seen in 25 (37.3%). Of 35 patients with initial G2, > 50% myometrial invasion was seen in 13 (37.1%) patients. Among 8 initial G3 patients, > 50% invasion was seen in 3 (37.5%) patients. Of these 67 patients with grade 1, pelvic lymph nodes were involved in 4 (6%) patients. None of the grade 2 tumors had pelvic lymph node involvement. One (12.5%) out of 8 patients with initial G3 tumor had pelvic lymph node involvement. Recurrence was seen in 3/67 (4.5%) of G1 patients, 7/35 (20%) with G2 cases and 1/8 (12.5%) with G3 cases.

Conclusion: Patients with initial G1 disease, about 13% were upgraded. Recurrence rate increased with G2 patients. For all initial grade tumors the mymetrial involvement > 50% was 37%. For initial G1 patients the pelvic lymph node involvement was found to be 6%. For G3 tumor the pelvic lymph node involvement was 12.5%.
Poster Abstract
Authors: Das Sujata
Published: February 2021

Haemangiomas of the ovary are very rare neoplasms with a wide age range and present with pain lower abdomen and adenexal mass. Many a times this is an incidental finding on surgery. These neoplasms should be considered in the differential diagnosis of haemorragic ovarian lesion. A 48 yr old female presented to us with pain lower abdomen and adenexal mass. Her routine investigations were normal. Her tumour markers were S. LDH 213, CEA 1.72, CA 125 was 2.3. Ultrasound findings showed a well defined echogenic mass in left ovary measuring 6 x 3.4 cm with no ascitis. Her cervical cytological findings were with in normal limits. Staging laprotomy was done and a bilobed solid ovarian mass was identified on left side. TAH with BSO was done and specimen saved for histopathology that finally showed cavernous haemangioma of ovary. Post op recovery was uneventful with subsequent relief of pain.
COVID-19 and Its Implications for Thrombosis and Anticoagulation
Authors: Berkman Samuel A. , Tapson Victor F.
Published: February 2021

Venous thromboembolism, occlusion of dialysis catheters, circuit thrombosis in extracorporeal membrane oxygenation (ECMO) devices, acute limb ischemia, and isolated strokes, all in the face of prophylactic and even therapeutic anticoagulation, are features of novel coronavirus disease 2019 (COVID-19) coagulopathy. It seems well established at this time that a COVID-19 patient deemed sick enough to be hospitalized, should receive at least prophylactic dose anticoagulation. However, should some hospitalized patients have dosage escalation to intermediate dose? Should some be considered for full-dose anticoagulation without a measurable thromboembolic event and how should that anticoagulation be monitored? Should patients receive postdischarge anticoagulation and with what medication and for how long? What thrombotic issues are related to the various medications being used to treat this coagulopathy? Is antiphospholipid antibody part of this syndrome? What is the significance of isolated ischemic stroke and limb ischemia in this disorder and how does this interface with the rest of the clinical and laboratory features of this disorder? The aims of this article are to explore these questions and interpret the available data based on the current evidence.
The Effect of Lavender Oil on Perioperative Pain, Anxiety, Depression, and Sleep after Microvascular Breast Reconstruction: A Prospective, Single-Blinded, Randomized, Controlled Trial
Authors: Shammas Ronnie L. , Marks Caitlin E. , Broadwater Gloria , Le Elliot , Glener Adam D. , Sergesketter Amanda R. , Cason Roger W. , Rezak Kristen M. , Phillips Brett T. , Hollenbeck Scott T.
Published: February 2021

Background Psychosocial distress, depression, or anxiety can occur in up to 50% of women after a breast cancer diagnosis and mastectomy. The purpose of this study was to assess the potential benefit of lavender oil as a perioperative adjunct to improve anxiety, depression, pain, and sleep in women undergoing microvascular breast reconstruction.

Methods This was a prospective, single-blinded, randomized, controlled trial of 49 patients undergoing microvascular breast reconstruction. Patients were randomized to receive lavender oil or placebo (coconut oil) throughout their hospitalization. The effect of lavender oil on perioperative stress, anxiety, depression, sleep, and pain was measured using the hospital anxiety and depression scale, Richards–Campbell Sleep Questionnaire, and the visual analogue scale.

Results Twenty-seven patients were assigned to the lavender group and 22 patients were assigned to the control group. No significant differences were seen in the perioperative setting between the groups with regard to anxiety (p = 0.82), depression (p = 0.21), sleep (p = 0.86), or pain (p = 0.30) scores. No adverse events (i.e., allergic reaction) were captured, and no significant differences in surgery-related complications were observed. When evaluating the entire cohort, postoperative anxiety scores were significantly lower than preoperative scores (p < 0.001), while depression scores were significantly higher postoperatively as compared with preoperatively (p = 0.005).

Conclusion In the setting of microvascular breast reconstruction, lavender oil and aromatherapy had no significant adverse events or complications; however, there were no measurable advantages pertaining to metrics of depression, anxiety, sleep, or pain as compared with the control group.
Marketing response and temporal aggregation
Authors: Franses Philip Hans
Published: February 2021

This paper deals with inferring key parameters on marketing response at a true high frequency while data are partly or fully available only at a lower frequency aggregate levels. The familiar Koyck model turns out to be very useful for this purpose. Assuming this model for the high-frequency data makes it possible to infer the high-frequency parameters from modified Koyck type models when lower frequency data are available. This means that inference using the Koyck model is robust to temporal aggregation.
An electrochemical setup designed for carbon dioxide solubility measurements in ionic liquids
Authors: Bruzon D. A. V. , Tapang G. A. , Martinez I. S.
Published: February 2021

An electrochemical setup was designed and built to evaluate carbon dioxide solubility in ionic liquids. The setup can simultaneously measure amounts of CO2 in the gas and in the ionic liquid phase, making it very useful for in situ electrochemical measurements. The home-built glass cell is able to withstand high vacuum allowing the ionic liquid samples to be properly evacuated before characterization and kept free of contaminants during experiments. A pressure gauge attached to the setup enables continuous monitoring of gas added to the system. This kind of configuration can measure gas solubility in ionic liquids expressed as Henry’s constants determined from generated plots of dissolved gas concentration in the ionic liquid vs headspace gas pressure. It also serves as a more economical alternative to other gas solubility measurement techniques, as it is predominantly made of glass, and requires minimal sample amounts. The setup can be useful in determining the solubility of various gases in ionic liquids.
Assessing intermittency characteristics via cumulant analysis of floating wind turbines wakes
Authors: Kadum Hawwa , Rockel Stanislav , Viggiano Bianca , Dib Tamara , Hölling Michael , Chevillard Laurent , Cal Raúl Bayoán
Published: February 2021

Turbulence intermittency in the wake behind a single floating wind turbine as well as merging wakes due to a pair of floating turbines is investigated using magnitude cumulant analysis and non-analytical cumulant analysis. This low-order statistical approach is used to compute the intermittency for its impact on fatigue loading and power output signals. In the near wake, a 60% increase in the intermittency coefficient compared to the inflow is found. Pitch motion causes a 17% increase in intermittency compared to fixed turbines. The pitch-induced intermittency depletes in the far-wake, and hence, investigating whether a pitch-induced intermittency of one turbine affects a successive one in a wind array setting is recommended. Non-local scale interactions near rotor tips are observed as undulations in the cumulant profiles, referred to as tip-effect fluctuations. The impact of turbulence intensity on intermittency is also examined, and a positive correlation between the two is found in the near-wake. In the far-wake, however, it is found to speed up the pitch-induced intermittency depletion. The wake merging region between two neighboring turbines experiences lower intermittency and damps tip-effect fluctuations. This work provides more reliable intermittency estimation by utilizing lower moment statistics. The findings aid description, turbulent loading quantification, and stochastic modeling for floating wind farm wakes as well as fixed ones for both single and merging wakes.
Ionic liquid gating of single-walled carbon nanotube devices with ultra-short channel length down to 10 nm
Authors: Janissek Alexander , Lenz Jakob , Giudice Fabio del , Gaulke Marco , Pyatkov Felix , Dehm Simone , Hennrich Frank , Wei Li , Chen Yuan , Fediai Artem , Kappes Manfred , Wenzel Wolfgang , Krupke Ralph , Weitz R. Thomas
Published: February 2021

Ionic liquids enable efficient gating of materials with nanoscale morphology due to the formation of a nanoscale double layer that can also follow strongly vaulted surfaces. On carbon nanotubes, this can lead to the formation of a cylindrical gate layer, allowing an ideal control of the drain current even at small gate voltages. In this work, we apply ionic liquid gating to chirality-sorted (9, 8) carbon nanotubes bridging metallic electrodes with gap sizes of 20 nm and 10 nm. The single-tube devices exhibit diameter-normalized current densities of up to 2.57 mA/μm, on-off ratios up to 104, and a subthreshold swing down to 100 mV/dec. Measurements after long vacuum storage indicate that the hysteresis of ionic liquid gated devices depends not only on the gate voltage sweep rate and the polarization dynamics but also on charge traps in the vicinity of the carbon nanotube, which, in turn, might act as trap states for the ionic liquid ions. The ambipolar transfer characteristics are compared with calculations based on the Landauer–Büttiker formalism. Qualitative agreement is demonstrated, and the possible reasons for quantitative deviations and possible improvements to the model are discussed. Besides being of fundamental interest, the results have potential relevance for biosensing applications employing high-density device arrays.
Eliminating synchronization of coupled neurons adaptively by using feedback coupling with heterogeneous delays
Authors: Zhou Shijie , Lin Wei
Published: February 2021

In this paper, we present an adaptive scheme involving heterogeneous delay interactions to suppress synchronization in a large population of oscillators. We analytically investigate the incoherent state stability regions for several specific kinds of distributions for delays. Interestingly, we find that, among the distributions that we discuss, the exponential distribution may offer great convenience to the performance of our adaptive scheme because this distribution renders an unbounded stability region. Moreover, we demonstrate our scheme in the realization of synchronization elimination in some representative, realistic neuronal networks, which makes it possible to deepen the understanding and even refine the existing techniques of deep brain stimulation in the treatment of some synchronization-induced mental disorders.
Elongated long-lived jet of dense plasma produced by a hollow laser beam
Authors: Tsygvintsev I. P. , Romanov I. V. , Paperny V. L.
Published: February 2021

Numerical simulation of the dynamics of plasma jets planned for use for the initiation of vacuum pinch discharges has been carried out. Jets of the “laser-metal-plasma-liner” type are created by laser beams with different spatial intensity distributions, which irradiate targets of various configurations. The three variants of plasma-jets formation are considered: irradiation of a target by (i) a Gaussian beam from a neodymium laser, (ii) the same Gaussian beam incident on a hole in the target, and (iii) a beam with the intensity distribution of the Laguerre–Gaussian mode. The dynamics of spatial distributions of the electron density, jet plasma temperatures, and the target mass ablated by laser radiation is calculated. It is shown that for quite moderate laser beam energies and intensities ∼400 mJ and ∼109 W/cm2, respectively, in the second and third cases, jets are produced with the lifetime of a few tens of nanoseconds and the maximum density ∼1019 and 1021 cm−3, respectively. The use of such jets can increase the pinching efficiency and improve plasma parameters in laser-induced discharges.
Magnetization switching induced by spin–orbit torque from Co2MnGa magnetic Weyl semimetal thin films
Authors: Tang Ke , Wen Zhenchao , Lau Yong-Chang , Sukegawa Hiroaki , Seki Takeshi , Mitani Seiji
Published: February 2021

This study reports the magnetization switching induced by spin–orbit torque (SOT) from the spin current generated in Co2MnGa magnetic Weyl semimetal (WSM) thin films. We deposited epitaxial Co2MnGa thin films with a highly B2-ordered structure on MgO(001) substrates. The SOT was characterized by harmonic Hall measurements in a Co2MnGa/Ti/CoFeB heterostructure, and a relatively large spin Hall efficiency (ξSH) of −7.8% was obtained. The SOT-induced magnetization switching of the perpendicularly magnetized CoFeB layer was further demonstrated using the structure. The symmetry of second harmonic signals, thickness dependence of ξSH, and shift of anomalous Hall loops under applied currents were also investigated. This study not only contributes to the understanding of the mechanisms of spin-current generation from magnetic-WSM-based heterostructures but also paves the way for the applications of magnetic WSMs in spintronic devices.
Relationship between charge transfer state electroluminescence and the degradation of organic photovoltaics
Authors: Arneson Claire , Huang Xinjing , Huang Xiaheng , Fan Dejiu , Gao Mengyuan , Ye Long , Ade Harald , Li Yongxi , Forrest Stephen R.
Published: February 2021

The degradation of archetype organic photovoltaics comprising both vacuum and solution-deposited bulk heterojunction active regions is investigated and quantified using a theory based on detailed balance, which relates the open-circuit voltage to the efficiency of charge transfer state emission. To describe this relationship, we account for the difference between electroluminescent external quantum efficiency and the charge transfer emission efficiency. An empirical factor, m, is introduced to distinguish between nonradiative defect sites both within, m = 1, and outside, m >1, of the photoactive heterojunction. The m-factor is used to determine the primary sources of degradation for archetype solution- and vacuum-processed material systems. We conclude that degradation occurs primarily within the donor–acceptor heterojunction for the vacuum-processed devices (where m = 1.020 ± 0.002) and outside of the photoactive heterojunction for the solution-processed devices studied, both with and without an anode buffer layer (where m = 2.93 ± 0.09 and m = 1.90 ± 0.01, respectively).
Magnetoresistive sensor detectivity: A comparative analysis
Authors: Davies J. E. , Watts J. D. , Novotny J. , Huang D. , Eames P. G.
Published: February 2021

We report on the noise performance characteristics of magnetic sensors using both magnetic tunnel junction (MTJ) and giant magnetoresistance (GMR) elements. Each sensor studied has a notably different noise and detectivity. Of the sensors we measured, those based on GMR multilayers have the lowest noise and detectivity. However, the GMR sensor also has a significantly smaller linear range. To make a direct comparison between sensors, we scale the linear operating ranges of each sensor to be the same. This is the phenomenological equivalent of modifying the flux concentration. Upon scaling, the low frequency detectivity of the tunneling magnetoresistance (TMR) sensors becomes essentially equal to that of the GMR sensor. Using the scaling approach, we are able to place the detectivity in the context of other key parameters, namely, size and power consumption. Finally, we use this technique to examine the upper limit for magnetoresistive sensor performance based on a notional MTJ sensor using present record setting TMR values.
A physics-based statistical model for nanoparticle deposition
Authors: Sidnawi Bchara , Zhou Dong , Li Bo , Wu Qianhong
Published: February 2021

In this study, a general theoretical framework is proposed to analyze particle deposition on a substrate, based on statistical and physical considerations. A model is developed in the context of the proposed framework to quantitatively predict the particle deposition on the substrate in terms of coverage evolution. Its validity was then verified by a dip coating experiment, where a polydimethylsiloxane substrate was periodically immersed in a sonicated graphene solution. An extension of the model was subsequently developed to describe the growth of the deposition thickness. The proposed framework's general applicability in any situation where particle deposition is taking place is expected to spur future endeavors in systematically characterizing film coating, drug delivery, and other processes involving particle deposition.
Local structure and molecular dynamics of highly polar propylene carbonate derivative infiltrated within alumina and silica porous templates
Authors: Tarnacka Magdalena , Geppert-Rybczyńska Monika , Dulski Mateusz , Grelska Joanna , Jurkiewicz Karolina , Grzybowska Katarzyna , Kamiński Kamil , Paluch Marian
Published: February 2021

Herein, we examined the effect of finite size and wettability on the structural dynamics and the molecular arrangement of the propylene carbonate derivative, (S)-(−)-4-methoxymethyl-1,3-dioxolan-2-one (assigned as s-methoxy-PC), incorporated into alumina and silica porous templates of pore diameters d = 4 nm–10 nm using Raman and broadband dielectric spectroscopy, differential scanning calorimetry, and x-ray diffraction. It was demonstrated that only subtle changes in the molecular organization and short-range order of confined s-methoxy-PC molecules were detected. Yet, a significant deviation of the structural dynamics and depression of the glass transition temperatures, Tg, was found for all confined samples with respect to the bulk material. Interestingly, these changes correlate with neither the finite size effects nor the interfacial energy but seem to vary with wettability, generally. Nevertheless, for s-methoxy-PC infiltrated into native (more hydrophilic) and modified (more hydrophobic) silica templates of the same nanochannel size (d = 4 nm), a change in the dynamics and Tg was negligible despite a significant variation in wettability. These results indicated that although wettability might be a suitable variable to predict alteration of the structural dynamics and depression of the glass transition temperature, other factors, i.e., surface roughness and the density packing, might also have a strong contribution to the observed confinement effects.
Effects of duration of betaine supplementation on growth performance and blood IGF-1 in light- and normal-weight weaner pigs under commercial conditions
Authors: Liu Fan , Ford Erin M. , Brewster Chris J. , Henman David J. , Smits Robert J.
Published: February 2021

Context Betaine supplementation has been reported to increase insulin-like growth factor 1 (IGF-1) in pigs. Betaine is not generally added to weaner pig diets due to a lack of knowledge on the duration of supplementation and effect on targeted bodyweight class. Light-weight weaners, known for their inferior growth performance, may benefit from betaine supplementation during the early days post-weaning. Aims This experiment aimed to identify the timing of betaine supplementation over the weaner phase (early (0–7 days) or late (7–35 days) post-weaning periods) and targeted weaning weight class (light vs normal). Methods The experiment followed a 2 × 2 × 2 factorial arrangement for studying the effects of 0.1% betaine supplementation during early (0–7 days post-weaning) and late (7–35 days post-weaning) weaner phase in light-weight and normal-weight weaners. One hundred and forty-four pens (18 pigs/pen) of weaned pigs (26 days age) were allocated into a 2 × 2 × 2 factorial arrangement on the basis of weaning weight class ((light (3.6 ± 0.75 kg, mean ± s.d.) vs normal (6.6 ± 0.84 kg, mean ± s.d.)), early weaner phase diet (control vs 0.1% betaine) and late weaner phase diet (control vs 0.1% betaine). Basal diets contained sufficient methionine and choline as per industry practice. Growth performance during early, late and whole weaner phase were recorded. Blood IGF-1 was measured at 7 days and 35 days post-weaning. Key results Supplementing 0.1% betaine during the early weaner phase reduced (P < 0.05) growth rate over the early post-weaning period (0–7 days) in both light- and normal-weight weaners, although blood IGF-1 concentration (7 days post-weaning) was not affected. Betaine supplementation during early or late weaner phase did not affect growth performance over the late weaner phase (7–35 days), whole weaner phase (0–35 days) or blood IGF-1 concentration (35 days) of light- or normal-weight weaners. Light-weight weaners had a lower feed intake, and a lower average daily gain than did the normal-weight weaners during the early, late and whole post-weaning periods (all P < 0.01). Conclusions Light-weight weaners had inferior production performance during the weaner phase, which was not improved by betaine supplementation. Implications Betaine supplementation is not recommended in the weaner phase when other dietary methyl donors are sufficient.