bluuebunny/crossref_metadata_2025 huggingface dataset:
Comorbid Diabetes and Hypertension: Gender differences in prevalence and risk factors among adults (≥18 years) in an urban community in Kathmandu District in Nepal
Authors: Silvanus Vinutha , Dhakal Nishchal , Shrestha Niraj , Kafle Phanindra Prasad
Published: December 2023

Chronic diseases such as diabetes and hypertension are often influenced by biological, behavioural, environmental and social factors in women and men. This study aimed to identify the gender differences in prevalence and risk factors of comorbid diabetes and hypertension (CM) among adults aged 18 years and above in an urban community in Kathmandu, Nepal. A community-based cross-sectional analytical study was carried out in Gokarneshwor Ward 1, 2 and 3 among adults aged 18 years and above from September 2020- May 2023. Diabetes (DM) was defined as persons previously diagnosed by a physician and/or on anti-diabetic medication. Hypertension (HTN) was defined as a systolic blood pressure (SBP) of ≥140 mm Hg or a diastolic blood pressure (DBP) of ≥90 mm Hg or those who were diagnosed by a physician and/or receiving antihypertensive medication. Comorbidity (CM) was defined as persons with diabetes and hypertension. Information regarding socio-demographic data, behavioural and biological risk factors, anthropometric assessment and morbidity were obtained from adults aged 18 years and above using a Family study proforma. Multinomial logistic regression analyses with the referent category being persons with no diabetes or hypertension (NDH) were performed for three categories HTN vs NDH, DM vs NDH and CM vs NDH. Among 1538 adults with 776 women, overall prevalence of comorbidity was 5.3% (95% CI: 4.3 – 6.5); among men 6.1% and 5.5% among women. After adjusting for age, for both women and men, being currently married, alcohol use, family history of diabetes and generalized obesity were associated with comorbidity. However, these associations were more robust for men. Moreover, measures of central obesity were associated with comorbidity for men alone. Though alcohol use was higher among men, the association with comorbidity was more robust for women. Paradoxically, lower educational status among women and higher education among men were associated with higher odds of comorbidity. In conclusion, prevalence of comorbid diabetes and hypertension may differ marginally among men and women. Though comorbidity rates appear to be lower in Nepal in comparison to other countries in South Asia, the rising burden emphasizes the need for tailored public health interventions that address modifiable risk factors among men and women. Further research may help to elucidate the role of gender on cardiovascular risk and hard outcomes such as cardiovascular events and mortality among persons with comorbid diabetes and hypertension.
Screening for cognitive impairment and dementia among elderly persons attending a tertiary hospital
Authors: Pandey Srijana , Pandey Srijana , Lama Ishwori
Published: December 2023

Cognitive impairment is debilitating condition for elderly in their activities of daily living which can cause problem to self, others and society. Therefore, the researcher aims to screen the cognitive impairment among elderly population at Tertiary Hospital. Cross sectional, descriptive and exploratory design with Purposive sampling technique was used among elderly population at OPD of Tertiary hospital. Mini-mental status examination, activities of daily living, instrumental activities of daily living were used for screening cognitive impairment and dementia. The interview dates were set up for 15 days. Sampling procedure included quota of 20 cases per day and thus, the sample was 300 elderly. Total sample after four persons denied to participate was 296. The mean age of elderly respondents were 71.58 (±5.09). The study revealed that there was no cognitive impairment among 67.6%, mild cognitive impairment among 25.7% and moderate cognitive impairment among 6.8%. The activities of daily living in majority of respondents were 95.3% in full function and least 1% were in severe functional impairment. Instrumental activities of daily living indicated that three-fourths of the respondents 76.7% had high function, 16.2% needed assistance and 7.1% had low function. Age, living with status is significantly associated with cognitive impairment. Screening of cognitive impairment is necessary to identify the impairment among elderly which enhances the awareness of cognitive impairment.
Study of perioperative factors in postoperative chronicity of sternal pain
Authors: Yadav Lokesh , Sharma Praman , Ansari Afroz , Paudyal Nabin
Published: December 2023

Over two million people undergo sternotomy worldwide for heart surgery each year, and post operative sternal pain may last for months or reappears a long time after sternotomy. The exact etiology of post sternotomy pain is unknown. We aim to find out the association of peri-operative factors with chronicity of sternal pain after open-heart surgery. This is a retrospective observational study on 121 patients who underwent open heart surgeries for various cardiac problems from January 2020 to July 2022 at a tertiary care center. Convenient sampling was performed. Data were analyzed using SPSS-17. Male to female ratio similar with male 60 (49.6%) and female 61 (50.4%), and 95.0% had body mass index (kg/m2) <30. Ninety (76.9%) were individuals without diabetes, 75 (62.0%) were non-hypertensive, 97 (80.2%) were nonsmokers and 22 (18.2%) had abnormal thyroid function. Only 2 (1.7%) had chronic obstructive airway disease and 1 (0.8%) had renal failure. Majority was in sinus rhythm 88 (72.7). Forty (33.1%) had valvular and 53 (43.8%) had ischemic etiology. Majority 110 (90.9%) were ventilated for less than 6 hours and 15 (9.4%) had surgical site infection. Peri-operative risk factors like age of patient, etiology, hypertension, operative procedure, ventilator hours, cardiopulmonary bypass time, intensive care unit stay, and total hospital stay had a significant association with chronicity of pain.
Knowledge and perceived barriers for care provision regarding COVID-19 among hospital nurses in Nepal
Authors: Adhikari Bijaya , Mahato Anju , Acharya Tara , Kalikote Bhagawaty
Published: December 2023

COVID-19 pandemic is significantly affecting the overall health and healthcare system globally. It has not shown mercy to Nepal either. All the health facilities are full of COVID-19 patients. Almost all death from COVID-19, has occurred in hospital. Adequate knowledge of nurses regarding the source, transmission, symptoms, and preventive measures of COVID-19 helps to provide effective care and prevent spreading infections from patients to patients, and nurses to patients. Therefore, this study aimed to identify the knowledge regarding COVID-19 and perceived barriers for care provision regarding COVID-19 patients among hospital nurses in Nepal. A cross-sectional descriptive study was conducted in different COVID-19 care designated hospitals of Nepal. Data were collected by using self-administered validated questionnaire through online survey. Descriptive analysis was done by using SPSS-16. More than 80% of nurses had adequate knowledge regarding symptoms, route of transmission, vulnerable population and preventive measures of COVID- 19 and only 15.0% had got training related to COVID-19 pandemic. Nurses perceived negligence of the patients and community people on COVID-19 prevention (84.6%), fear of being infected and carrier to family and community while contacting with patients (80.0%), long duty hour (75.0%), inadequately supply of personal protective equipment and insufficient institutional preparedness (74.0%) were the major barriers for providing care of COVID-19 patients. Thus, hospital authority, nursing administration and nursing professionals’ organizations should play an important role in organizing training to nurses and awareness program to community people. It is also essential in providing required supplies, and facilitates the motivating environment for effective care and prevention of COVID-19.
Outcome of laparoscopic vs open appendectomy in the management of acute appendicitis
Authors: Limbu Yugal , Regmee Sujan , Adhikari Spandan Darshan , Acharya Bidur Prasad , Ghimire Roshan
Published: December 2023

The worldwide trend of appendectomy is shifting from conventional open to the laparoscopic technique. The study’s objective was to compare laparoscopic and open appendectomy in terms of various operative and postoperative parameters to find the best operative technique. A prospective comparative study was conducted on 142 patients undergoing laparoscopic (n=43) or open appendectomy (n=99) from 1st February 2022 to 30th January 2023 under the Department of Surgery of Kathmandu Medical College Teaching Hospital (KMCTH). In five patients, laparoscopic appendectomy was later converted to open and excluded from the study. The mean operating time for the open appendectomy group was 44.1±13.1 minutes while for the laparoscopic appendectomy group, it was 48.4±14.0 minutes (p=0.047). Visual analogue score taken on 1st, 7th and 30th post-operative day for open and laparoscopic appendectomy were 4.0±2.2 vs 3.6±1.9 (p=0.160); 1.4±1.3 vs 0.6±0.9 (p<0.001) and 0.2±0.5 vs 0.02±0.15 (p=0.107) respectively. The total days of postoperative hospital stay were 1.57±0.96 for open appendectomy and 1.58±1.07 for laparoscopic appendectomy (p=0.843). However, laparoscopic appendectomy group had an earlier return to normal activity (7.30±1.15 days) when compared to the open appendectomy group (8.05±2.42 days) (p=0.023). The laparoscopic appendectomy group also had fewer postoperative complications than the open appendectomy group (18.6% vs 24.2%) (p=0.411). Thus, laparoscopy is a safe and effective method of removal of appendix for acute appendicitis.
Knowledge, attitude and practice of pregnant women attending a health facility regarding the COVID -19 pandemic: pre and post-vaccination
Authors: Joshi Anshumala , Dhakal Nishchal
Published: December 2023

The world witnessed the introduction of the COVID -19 virus in December 2019. This caused a pandemic for the next two to three years causing 7,67,984,989 deaths worldwide. A hospital based cross sectional descriptive study conducted in the Obstetrics and Gynecology department of Nepal Medical College Teaching Hospital, which is located in a suburban area of Kathmandu. The objective of the study was to assess the knowledge, attitude and practice of the pregnant women regarding the COVID pandemic pre and post-vaccination and its correlation with socio-demographic factors like age and educational level. A total of 418 women participated in the study. In each phase there were 209 women. In the pre-vaccination phase, 8.1% women had good knowledge, 37.8% had positive attitude, and 37.3% good practice. In the post-vaccination phase, 44.5% had good knowledge, 65.5% had positive attitude, and 84.7% had good practices.
Nasal preparation prior to nasal endoscopy: a comparison of cotton pledget packing versus topical spray
Authors: Shrestha Kundan Kumar , Dhungana Anup , Rijal Anupama Shah , Joshi Rupesh Raj
Published: December 2023

Nasal endoscopy (NE) is an office procedure done to look at the nasal and sinus passages using an endoscope which could be either rigid or flexible. It allows the clinician to characterize the intranasal anatomy better compared to the conventional techniques of headlight, speculum and mirror thus aiding the diagnosis. Therefore its popularity has increased recently and is one of the most frequently performed diagnostic procedures in Otorhinolaryngology and Head and Neck Surgery OPD. A unanimous consensus has not been reached regarding the best method for preparing the patients for NE. This study compares two methods of nasal preparation; cotton pledget packing and topical spray. A total of 100 patients were randomised into two groups of 50 each (A and B). In Group A, the nasal cavity was packed with a cotton pledget soaked in 4% lignocaine and xylometazoline nasal drops. Whereas in Group B, xylometazoline nasal drops were instilled and nasal cavity was sprayed with 10% lignocaine spray. After performing rigid nasal endoscopy, a proforma based on the patients’ and consultant’s response was filled. Patients in the cotton pledget group experienced more discomfort during packing (p=0.04), during the waiting time (p=0.001) and also during the endoscopic procedure. From the clinician’s perspective, the duration for the overall endoscopic procedure was significantly less in the spray group (p<0.001). Visualisation of structures was comparable in both groups. Less bleeding was experienced in the spray group. We concluded that nasal spray is a better alternative to nasal packing for preparation of nose prior to nasal endoscopy.
Pengaruh Rasio Profitabilitas Dan Rasio Aktivitas Terhadap Nilai Perusahaan Pada Perusahaan Telekomunikasi Yang Terdaftar Di Bursa Efek Indonesia Periode 2022
Authors: Nur Rahmawati Desy , Erica Denny , Rachmah Siti Mabrur
Published: December 2023

The presence of telecommunications services is needed in the digitalization era to activate increasingly sophisticated telecommunications equipment. The development of the telecommunications sub-sector can already be seen from the large number of people using telecommunications equipment. Several telecommunications companies operating in Indonesia are listed as issuers on the Indonesia Stock Exchange. Telecommunications companies must be able to compete and improve their performance in order to maintain high corporate value in the eyes of investors. The purposes of this study are: 1. To test how the influence of the profitability ratio on firm value in telecommunications companies listed on the Indonesia Stock Exchange (IDX) for the 2022 period 2. To test how the effect of the activity ratio on firm value in telecommunications companies listed on the Stock Exchange Indonesia (IDX) for the 2022 period. The data collection technique in this study used secondary data. This study obtains data through storage, where a collection of information is obtained from documents such as records, financial reports, and others. The data used is obtained from the official website of the Indonesia Stock Exchange (IDX). This shows that the return on equity has a significant effect on the price to book value. The coefficient value (Sig2) on the variable X2 is 0.398. This shows that in the case of total assets turnover (X2) it has a significant effect on price to book value (Y).
ISAK 35 PRACTICES ON THE MANAGEMENT OF FINANCIAL REPORTING OF NON-PROFIT ORGANIZATIONS AT THE CATHEDRAL CHURCH OF ST. THERESIA LISIEUX SIBOLGA
Authors: Purba Sahala , Calista Calista
Published: December 2023

Cathedral Church of St. Theresia Lisieux and other non-profit organizations rely on the preparation and delivery of financial reports, so professional groups that provide support to Indonesian Accountants (IAI) must provide new interpretations of financial reporting norms. PSAK 1 Amendment to the Presentation of Financial Reports IAI publishes an explanation of Accounting Standards Number 35 (ISAK 35) to improve understanding of the financial reports prepared and submitted. Cathedral Church of St. Theresia Lisieux would benefit from this. in obtaining external financial support. The purpose of this research is to compare the financial statements of St. Theresia Lisieux's financial reports comply with the ISAK 35 financial reporting framework. This research uses qualitative technical methods; Practice at St. Paul's Cathedral Paul Descriptive analysis was used to compare Theresa Lisieux's theory and ISAK 35. Data for this research was collected through observation. Financial report of St. Cathedral Church Theresia Lisieux pointed out that the church has not yet developed its financial reporting mechanism in line with current requirements, especially ISAK 35, because the church only covers income and expenditure reports.
Theoretical aspects of the psychological preparation of an athlete for a match in kyokushin karate
Authors: Verbytskyi S. , Putrov S. , Putrov O. , Khyzhniak A. , Chernenko A. Ye.
Published: December 2023

The article discusses the key theoretical approaches that should be taken into account in the psychological preparation of athletes for an effective Kyokushin karate match. The obtained results of the generalization of scientific and special literary data highlight the issues of stress and adaptation, psychological self-regulation, psychological readiness, psychological support and how it can be applied to improve the psychological state of athletes in preparation for Kyokushin karate matches. The obtained data allow us to outline the importance of psychological training for athletes practicing Kyokushin karate, as it helps maintain a high level of concentration, control emotions, develop mental stability and prepare athletes for stressful situations that arise during matches. It was determined that for a successful performance in competitions, despite the excellent physical properties of data, technical and tactical training, a martial artist needs willful qualities such as initiative, confidence, courage and courage The materials in this article are a useful resource for coaches, psychologists, and athletes seeking a better understanding of psychological preparation and its impact on success in modern Kyokushin karate.
The effectiveness of using dance and gymnastics workouts as a means of musical and motor training of athletes in complex coordination sports (on the example of cheerleading)
Authors: Kravchuk T. , Riadynska I. , Miahka V.
Published: December 2023

The article is devoted to the study of the effectiveness of the use of dance-gymnastic workouts in the educational and training process for cheerleading. The aim of the study is to study the influence of dance and gymnastics workouts on the musical and motor training of athletes in complex coordination sports (on the example of cheerleading). Research methods: study and analysis of scientific, educational-methodical and special literature; pedagogical experiment; expert assessment of the level of musical-motor readiness, testing the ability to rhythmic activity; methods of mathematical statistics, including calculating the t -criterion of the Student. In the course of the study, based on the analysis of competition rules and other normative and educational documentation, it is shown that the main requirements to music motor training in complex coordination sports is the ability of athletes to combine expressive movements in harmony with the theme, character, pace and dynamic tones of music. Two types of exercises have been developed: rhythmic (using rhythmic gymnastics) and aerobic (using basic and dance aerobics). A pedagogical experiment was held, in which 24 students participated, who were part of the team cheerleading of the H.S. Skovoroda Kharkiv National Pedagogical University. They were divided into experimental (n=12) and control (n=12) groups. The effectiveness of the developed workouts was tested by their introduction into the training process of the pilot group. Positive statistically probable influence of dance-gymnastic workouts on the following indicators of musical-motor preparation: harmony of movements with rhythm of music (at p<0,01), harmony of movements with tempo of music (at p<0,005) and walk with a clap of hands in the set rhythm (at p<0.05).
The characteristics and historical aspects of the emergence and development of volleyball in Ukraine as a means of physical activity of applicants of the higher education institutions
Authors: Kramarenko Valentyna , Slobodianiuk Oleh , Yevarnytskyi Ihor
Published: December 2023

Modern volleyball is an athletic form of team sports, which is recognised as an Olympic and professional sport in more than 200 countries. The specifics of competitive activity are characterised by high variability of game situations and their rapid change.

Purpose of the study: to provide a meaningful description and highlight the history of the emergence and development of volleyball in Ukraine as a means of physical activity of applicants of the higher education institutions. Results of the study. The article describes the game of volleyball. The historical aspect of the formation of the game in Ukraine is considered.

Conclusions. Volleyball is a sports team game with a ball played by two teams of 12 people (6 playing and 6 substitutes) on a special court separated by a net. The aim of the game is to send the ball over the net to the opponent's side so that it touches the opponent's area.

Volleyball began to be played in Ukraine in 1925 in Kharkiv.

As a sport, volleyball appeared in Kyiv in early 1926, in Dnipro around 1925–1927, and in Odesa in the second half of the 1920s.

The news of the new game came from Kharkiv, along with a list of basic rules.

Over the years, the popularity of volleyball has grown. The game has spread to other cities in Ukraine. It is gaining national recognition as a sport.

Today, the Ukrainian Volleyball Federation unites representatives from all regions of the country. Ukraine has produced an impressive lineage of Olympic volleyball champions.

Ukraine's strongest players play in prestigious foreign clubs. This demonstrates the high level of development of Ukrainian volleyball.

The volleyball is an effective means of optimising physical activity in different segments of the population, including in the applicants of the higher education institutions.
Views on negative factors influencing the formation of motivation to engage in physical exercises in students of higher education institutions
Authors: Mospan Yana , Sobolenko Andriy , Matviіenko Mykhailo
Published: December 2023

The purpose of the study was to clarify the views of the authors on the peculiarities of the formation of motivation to use physical exercises as specialized motor actions; the formation of students' competence abilities to use the acquired knowledge of health and sports technologies in their own lives and professional activities.

The paper analyzes the characteristics of motivations for doing physical exercises and the conditions of their formation. It is emphasized that for a positive result of formative processes, a teacher of a higher school must constantly raise the level of his own qualifications [4], expand the range of his own knowledge and improve the methodical skills of teaching them. The authors emphasize that the formation of sustainable motivational attitudes is significantly influenced by the level of the material and technical base for classes, the condition of sports facilities, the novelty and quality of equipment, inventory, simulators.

The novelty of the study should be considered the vision proposed by the authors of the factors that negatively affect the formation of the students' motivation system for physical exercises; highlighting the peculiarities of the pedagogical influence on students who are skeptical about physical education activities.

The conclusions point to the understanding of the contents defined by the topic, reveal views on the main directions of the formation of motivation to engage in physical exercises of students of higher education institutions; emphasize the need to identify and take into account negative factors in terms of fostering students' motivation to engage in physical exercises through the study of students' social and everyday problems, predicting the conditions of public demand and bringing educational activities closer to the requirements of professional training.
Terminology of movements and construction of physical exercises as the basis of the professional formation and improvement jf higher education students
Authors: Liakhova I. , Khatuntseva S.
Published: December 2023

The article analyzes the essence of the definitions "terminology," and "sports terminology" and their meaning for specialists in general and the role of the terminology of movements and the construction of physical exercises in the professional formation and improvement of higher education students of the specialty 017 - Physical culture and sports and 227 - physical therapy, occupational therapy of the first (bachelor's) level of higher education, in particular.

Based on the analysis, synthesis and generalization of scientific and scientific-methodological literature, the Internet, as well as the educational programs of the above-mentioned specialities of the first (bachelor) level of higher education, such research methods as comparison, pedagogical observation, analysis of one's own longitudinal pedagogical experience of teaching academic disciplines of practical character, it is determined that the majority of students of higher education do not pay due attention to the acquisition of special terminology during their studies in higher education, and therefore, do not use it at the proper level in the practice of work in their specialty. At the same time, the terminology is always related to the content of specific science, theory and practice. There is the so-called special terminology of an engineer, philologist, lawyer, sociologist, doctor, designer, etc., as well as a specialist in the field of physical education and sports - sports terminology.

It is noted that special terminology, including sports terminology, is the basis of professional communication, which requires deep knowledge, constant development and improvement from specialists. Mastering the terminology of movements by future specialists of the specialty 017 - Physical culture and sports and 227 - physical therapy, occupational therapy of the first (bachelor) level of higher education is an urgent necessity because it is the language of these specialties, which allows communication both between specialists and during interaction specialists with those who are learning physical exercises of various orientations.

The article highlights the positive experience of solving the problem of forming among future specialists in the field of physical education and sports solid knowledge of the terminology of movements and its practical use during the construction of various physical exercises due to the introduction of a new educational discipline into the educational program according to (the student's choice) "Terminology and construction in physical education and sports." It is emphasized that this is an urgent necessity because the terminology of movements is the language of these specialties, which specialists in their work have to face every day during training and correction of physical exercises.
Palestine: The Pearl of the World
Authors: Farah Liyana Saiful Raslin
Published: December 2023

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An Overseas Chinese Author on Chineseness: A Study of Catherine Lim’s Novels
Authors: Kasempat Poolsawas
Published: December 2023

The objectives of this documentary research are to study Catherine Lim’s concept of Chineseness in the Chinese diasporic context as well as to investigate the identity and existence of the ethnic culture of the Chinese diaspora in the Straits Settlement. This study is analyzed through Lim’s three novels: The Bondmaid (1995), The Teardrop Story Woman (1998), and The Song of Silver Frond (2003). All the novels present stories of the Straits Chinese or the Chinese diaspora in the Straits Settlement, the territories under the British occupation in the age of colonisation. The findings reveal that Lim’s cultural and social upbringing in Straits Chinese society helped mold her as a female diasporic Chinese. Straits Chinese society in Lim’s novels is one that adheres to Chinese beliefs and cultural norms as well as their cultural roots. However, Lim still reflects how the context of displacement from the motherland becomes an important factor to dilute the sense of Chineseness among the Straits Chinese. Moreover, Lim also interestingly presents the images of Chinese diasporic women in various dimensions in her novels.
Roles of journalists in media literacy initiatives: trainees and trainers. Continuity, collaboration, and sustainability of media literacy trainings to mitigate disinformation in Portugal
Authors: Foà Caterina , Tomè Vítor , Margato Dina , Paisana Miguel , Crespo Miguel , Cardoso Gustavo
Published: December 2023

This paper aims to foster the debate on Media Literacy (ML) projects with a focus on disinformation. We analyse initiatives carried out locally in Portugal, considering the principles of ML, the necessary development of skills and competences, as well as the importance of the journalistic action and the consequences of platformization on professional practices. Mixed methods are applied to collect and analyse quali-quantitative data from ML projects and trainings involving multiple stakeholders. Inquiring three independent samples (editors-in-chief, journalists trained in ML, teachers trained by journalists in ML) the research questions address the importance of journalists’ participation in ML within different roles, as well as the training quality and projects’ assessment. Findings show a lack of specialised knowledge, practical tools, and continuous training as well the need for more tailor-made programs and evaluation resources that allow for the creation and promotion of more effective ML training programs. This contribution is therefore two-folded: a) it aims to enhance the operational aspects of media training in the field, based on a continuous improvement logic and b) it explores a specific evaluative example on how the feedback from training can help improve research efforts in the media literacy field. Conclusions systematise the assumptions, stemming from an articulation of ML stakeholders’ perspectives, that guide the implementation, improvement, and assessment of training: collaboration, continuity, and sustainability. These inductive categories allow for the development of theoretical-practical dimensions of the processes for evaluating innovative training against disinformation which may in turn have an inoculation role in the wider public sphere. We suggest improvements to the methodological-operational processes to involve journalists, to do follow-up, assessment, and implementation of wider training projects, contributing to applied research.
Review on Automated Skin Cancer Detection Using Image Processing Techniques
Authors: Jafari Haniye , Esmailpour Roshan Mojtaba
Published: December 2023

Skin is the most important part of the human body, protecting the muscles, bones and the entire body. One of the most common diseases affecting many people today is cancer, and skin cancer is one of the most common cancers known to man. As one of the deadliest cancers, skin cancer requires special attention. Skin cancer is caused by genetic defects or mutations caused by unreduced deoxyribonucleic acid in skin cells. One of the most dangerous types of skin cancer is melanoma, which has a high survival rate if detected early. Accordingly, early detection of melanoma is very important. To this end, this paper presents a computer-aided method that uses image processing tools to detect skin cancer, especially melanoma. This system takes an image of a skin lesion and uses new image processing techniques to determine the presence of skin cancer. The lesion image analysis tool evaluates various features of melanoma, including asymmetry, contour, color, diameter (ABCD), and more. Then these extracted parameters are used to classify the images as benign or malignant lesions. This article describes methods and approaches for automatic skin cancer detection. This article provides researchers with useful information about the methods, databases, and procedures required for early detection of skin cancer.
Combined Metronomic Chemo-Immunotherapy in Metastatic Carcinoma of Esophagus in Second Line and Beyond
Authors: Kallolli Mahesh , Madabhavi Irappa V , Chavan Chidanand , Revannasiddaiah Swaroop , Gupta Ishu , S. Sarkar Malay
Published: December 2023

Background and Aims: Approximately 570,000 new cases are diagnosed with esophageal cancer worldwide annually and approximately 510,000 deaths from this disease per year. There are currently no effective second-line treatments for patients who progress on cisplatin and 5-fluorouracil. Esophageal squamous cell carcinomas and adenocarcinomas have proven to be inherently resistant to systemic treatments as a result of histological, molecular and etiological heterogeneity, with limited responses seen after first line therapy. Methods: We are presenting 3 case reports of 57 year old man, 53 year old man & 47 year old woman who, presented with dysphasia for solid foods, weight loss and dyspepsia since 1 month, 3 months & 1.5 months respectively. Upper gastro oesophageal endoscopy shows ulcerated friable lesion with minimal luminal compromise with biopsy showing poorly differentiated adenocarcinoma (PDAC) and PECT-CT showed FDG avid lesions in gastroesophageal junction, gastric cardia, multiple retroperitoneal lymph nodes and bilateral liver lesions. All 3 were having stage IV disease, with PDAC, squamous cell carcinoma & PDAC respectively. We have started 1st patient on DOX regimen containing Docetaxel, Oxaliplatin and Capecitabine at an interval of 2 weeks and after 4 cycles he was having stable disease in GE junction, liver and slightly increased size of retroperitoneal lymph nodes. Second & 3rd patient was put on Pclitaxel-carboplatil protocol, after 6 cycles both were having partial response & was managed with 6 cycles CAPOX as second line che otherapy. After 5th & 6th months of second line chemotherapy both patients were having progressive disease. Results: In view of radiological progression we started him on Injection, Nivolumab 240mg intravenously every 2 weekly along with low dose capecitabine 500mg twice a day. After 4 cycles of treatment his PET-CT showing complete metabolic response in GE junction, liver and retroperitoneal lesions. Now we are continuing Nivolumab and low dose capecitabine planned to complete for 2 years. Conclusion: So to conclude nivolumab along with metronomic chemotherapy with low dose capecitabine was very well tolerated and exhibited antitumor activity in extensively pretreated patient with metastatic esophageal poorly differentiated adenocarcinoma. Additional studies of Nivolumab and metronomic chemotherapy and immuno-immuno combination therapy in these diseases are ongoin.
Prevalence of Osteoporosis and Osteopenia among Cancer Patients and Its Risk Factors: A Retrospective Analysis at Najran Cancer Center, Saudi Arabia
Authors: Badheeb Ahmed , Al Sulieman Mohamed , Ahmed Faisal , Asiri Ahmed , Badheeb Mohamed
Published: December 2023

Objective: The assessment of bone mineral density (BMD) in patients with a higher risk for significant bone loss, such as cancer patients, was recommended by recent clinical guidelines. Herein, we aim to report the prevalence of osteoporosis and osteopenia and their associated factors in cancer patients.Methods: This retrospective cross-sectional study was conducted from February 2021 to March 2022, and it included 39 adult cancer patients who were being treated at the King Khalid Hospital Cancer Center in Najran, Saudi Arabia. The participants were interviewed, and their BMD was assessed using Dual-energy X-ray absorptiometry (DXA) scans of the lumbar spine and femur neck. Univariate analysis was carried out to examine the association between osteoporosis and osteopenia and other variables. Results: The study involved 39 adult cancer patients in Najran, Saudi Arabia with a mean age of 60.15 ± 12.26 years, the majority of patients (53.8%) were aged between (60-69) years old, and most of them (64.1%) were female. The primary diagnosis was mostly breast cancer (35.9%) followed by prostate cancer (25.6%). 66.7% received chemotherapy and 64.1% received hormone therapy. Results showed osteopenia, osteoporosis, and normal BMD in 7 (17.9%), 28 (71.8%), and 4 (10.3%) patients respectively. 43.6% had low serum vitamin D levels. There was no significant relationship between osteopenia/osteoporosis and various factors, but it was more frequent in older patients, those undergoing chemotherapy, and those with low vitamin D levels (p=0.04, 0.05, 0.005). Conclusion: Higher prevalence of osteoporosis and osteopenia were observed in cancer patients undergoing chemotherapy, older patients, and those with low vitamin D levels. Further research is necessary to determine the most effective strategies for minimizing bone loss in this population.
Desmoplastic Small Round Cell Tumors- Case series of a Rare Tumor and Review of Literature
Authors: D. Harindran Vallathol , Moideenkutty Sajna Vengasseri , Kuni Thanseer Neeliyath Thazha , Prashanth Parameswaran , Warrier Narayanankutty
Published: December 2023

Desmoplastic small round cell tumor (DSRCT) is an uncommon and aggressive malignancy with male predominance. It commonly occurs in the abdominal cavity and is usually diagnosed with help of histopathology. It shows a characteristic EWSR1-WT1 gene fusion in most cases. We hereby report a series of 3 cases of DSRCT that we encountered at our institute. All of them presented in an advanced stage as quoted in the previously available literature. The ideal treatment should include a multidisciplinary team. The chemotherapy regimen used is usually Ewing’s sarcoma protocol of multiagent chemotherapy. Surgical approaches which include cytoreduction and intra-peritoneal hyperthermic chemotherapy are the procedure of choice but rarely feasible. Newer clinical trials of targeted therapy are in progress for improving the treatment and thereby the prognosis of DSRCT.
The Prevalence of Anxiety and Depression in Breast Cancer Patients and their Correlation with Socio-Demographic Factors
Authors: Dadheech Apoorva , Kumawat Suman , Sharma Deepesh , Gothwal Ravinder Singh , Dana Rohitashwa , Meena Chetna , Saini Naresh Kumar
Published: December 2023

Introduction: Being diagnosed with breast cancer or receiving surgery, radiation or chemotherapy as a treatment modality in itself is seen as a traumatic experience for many women. This emotional distress is in turn associated with reduced quality of life and can pose a negative influence on compliance with treatment. Ultimately leading to an elevated risk of mortality which is also seen as the sixth vital sign in cancer care.Aim & Objectives: The purpose of our study is to estimate the prevalence of depression and anxiety in breast cancer patients and their correlation with socio-demographic factors. Materials and Methods: A cohort of 140 breast cancer patients registered in the Department of Radiation Oncology, SMS medical College, Jaipur from January 2022 to December 2022 were recruited and interviewed with a structured questionnaire including socio-clinical and demographic factors and PHQ-2 and GAD-2 scales. Results: Prevalence of depression among patients were 37.9% (53/140) and almost one third (33.6%, 47/140) of cases had anxiety. Around two thirds (69.3%, 97/140) cases had stage III breast cancer, followed by stage II in 23 (16.4%) cases and 20 (14.3%) cases had IV stage breast cancer. The place of residence, educational status, employment status, accompanying person and marital status emerged as significant predictors of depression risk, while age group, marital status and financial status were found to have statistically significant association with elevated anxiety symptoms.Conclusion: This study shows that prevalence of anxiety and depression in breast cancer patients is high and patients from rural areas, single, low monthly income, younger age group and low education level were more prone. Therefore, special care and support and often referral to psychiatry department may be required in such group of patients.
Correlation of Plasma Cell Percentage and Monoclonal Gammapathies with Biochemical Parameters in Multiple Myeloma Patients: A Retrospective Study
Authors: R Sindhu Edakkadath , Das Aptha Y , Padmanabhan Maya , K Nair Chandran
Published: December 2023

Background: Multiple myeloma is characterized by the uncontrolled proliferation of monoclonal plasma cells in the bone marrow, leading to the production of non-functional intact immunoglobulin chains. This retrospective study aimed to investigate the correlation between plasma cell percentage (below 60% and above 60%) in different types of monoclonal gammapathies (IgA, IgG) and various biochemical parameters.Methods: This analysis was conducted at the Division of Biochemistry in the Malabar Cancer Centre, a tertiary care cancer center in Kerala, India. A total of 89 patient case reports were reviewed, and complete treatment data were available for 60 patients. The study aimed to evaluate the relationship between plasma cell percentage (below 60% and above 60%) in different types of monoclonal gammapathies (IgA, IgG) and various biochemical parameters. Results: The majority of the patients enrolled in the study were above 60 years of age, and more men were included than women. Among the parameters studied, a significant increase in plasma protein level was observed in the group with a plasma cell percentage below 60% and IgG type monoclonal gammapathy (P value = 0.014, p < 0.05). Additionally, there was a significant elevation in WBC count in patients with plasma cell percentage below 60% and IgG type MM when compared to IgA type MM patients (p = 0.023, p < 0.05). However, no significant changes were observed in plasma protein level, liver enzyme activity, renal function, serum electrolytes, CBC, and calcium level between patients with plasma cell percentages above and below 60% in multiple myeloma. Conclusion: This study found that only a few biochemical and hematological parameters showed significant deviations between plasma cell percentages above and below 60% in different types of monoclonal gammapathies in multiple myeloma patients.
Pattern of Head and Neck Cancers in Karbala Province of Iraq: Data from Developing Country
Authors: Mjali Ahmed , Hassan Abdulrazzak Kalaf , Nassrullah Hassan Ali Abood , Sedeeq Alaa Othman , Abbas Nareen Tawfeeq , Al-Shammari Haider Hasan Jaleel , Alwakeel Afnan Fouad , Mjali Bahaa
Published: December 2023

Background: Head and neck cancers (HNCs) patterns vary worldwide in relation to demographic and environmental factors. Objective: The aim of our study was to investigate the pattern of HNCs in Karbala province of Iraq, compare and identify possible changes with other populations.Methods: A retrospective descriptive study was carried out at Al-Hussein Cancer Center in Karbala, Iraq, on 302 patients diagnosed with HNCs between January 2012 and December 2021 with evaluation of age, gender distribution and sites of cancers.Results: Among total 302 patients, median age was 58 years. Males accounted for a higher proportion of patients, (67.55%) were males and (32.45%) were females, with an M:F ratio of 2.08:1. Larynx was the most affected site among our patients contributing (28.48%) followed by nasopharynx (28.14%), lip & oral cavity (14.57%), salivary glands (11.59%), oropharynx (8.28%), paranasal sinuses (5.30%) and hypopharynx (3.64%). The most frequent site of HNCs in males was larynx, while the most frequent site in females was nasopharynx. Conclusion: This is the first statistical study of HNCs in Karbala province of Iraq. It can be used as basic information to investigate epidemiological characteristics, to evaluate progress in recent years and to develop treatment strategies.
Myelomatous Pleural Effusion – A Case Series
Authors: Thomas Ajai , Thambi Sugeeth M , Narayanan Geetha , AV Jayasudha , Prestine Antony , Nair Sreejith G
Published: December 2023

Background: The extramedullary disease usually occurs in the advanced stages of multiple myeloma and predicts poor survival. Commonly involved extramedullary sites in multiple myeloma include the nasal cavity, lymph nodes, lung, central nervous system, liver, spleen, skin, and orbit. Pleural effusion in multiple myeloma is unusual and rarely due to multiple myeloma itself. Myelomatous pleural effusions occur in less than 1% of cases of multiple myeloma. Material and methods: Eight patients were diagnosed with myelomatous pleural effusion in the Department of Medical Oncology at a tertiary cancer care center in India, during the 7-year period (2012 to 2018). Clinical presentation, diagnosis, treatment, and survival details were abstracted from medical records. Results: We report eight patients with myelomatous pleural effusion, constituting 0.45 % of all multiple myeloma cases treated during the study period. Five out of the eight patients were females with a median age of 58 years. Three patients had myelomatous pleural effusion at the time of initial diagnosis and five developed pleural effusion at disease progression. IgG was the common immunoglobulin subtype. The International staging system stage was stage I in one patient and stage III in seven patients. After the diagnosis of multiple myeloma, all patients developed myelomatous pleural effusion at a median of 7 months and all patients died within 2 weeks.Conclusion: Pleural effusions in multiple myeloma should be investigated to rule out myelomatous pleural effusion. Myelomatous pleural effusion is rare, having a poor prognostic outlook and an aggressive natural course.
Epitheloid Haemangioma of Spine - A Rare Case Report and Review of Literature
Authors: Vedagiri Vydia Gautam , . Ramaniah , . Sadanand , . Mukesh
Published: December 2023

Introduction: Epitheloid hemangioma (EH) of spine is a rare vascular disease. Haemangiomas are tumours typically composed of thin walled blood vessels, of which EH is an infrequent variation. The exact incidence of EH is not known. EH, though is considered to be benign disease it can be locally aggressive. EH most commonly affects the integumentary system. IT most commonly involves liver, lungs and bones. Here we report a 25 years old male with complete work up for EH including clinical data, MRI spine, surgical, histopathological information and adjuvant radiation therapy following surgical management. In addition to the case report, we reviewed literature on EH of bones. Case Report: A 25 years old male came to our emergency department with complaints of severe lower back pain. He also complained of difficulty in walking for the past 3 months. MRI Lumbosacral (LS) with whole spine screening was done 1 month back and it showed Multifocal vertebral lesions involving D4, D5, D6 vertebra predominantly in posterior elements, expansion of the transverse processes and involvement of costochondral junction, left 5th rib with extensive soft tissue component indenting on the pleura. He was seen by Neurosurgery team at our hospital and was planned for surgical decompression and stabilisation of D4-D6 vertebrae. He underwent D3 to D6 laminectomy and stabilization under general anaesthesia. Final histopathology along with IHC correlation was suggestive of Epitheloid Hemangioma. Case was discussed in our hospital multidisciplinary tumor board and was planned for adjuvant radiotherapy (RT). Then he received adjuvant radiotherapy total dose (TD) 45 Gray (Gy) to D3-D6 region. Post treatment 6 months, his power is improved and is near normal. Conclusion: To summarize our case appears as a typical features of EH like young male patient, lytic lesions with sclerotic rim, IHC confirmation
The Need to Consider Lymphoma as a Differential Diagnosis in Suspicious Bony Lesions
Authors: Rao Vrushab , Zade Bhooshan
Published: December 2023

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