Ovarian teratomas: clinicopathological study at tertiary care center

Background: Teratomas are belonging to a group of germ cell tumors. It is also referred to as dermoid cyst. Teratomas are most common germ cell tumor of the ovary. Teratomas are composed of various histological types. In this article we are presenting various morphological patterns, its clinical manifestation and its clinical significance.Methods: This is prospective study for a period of 3 years from March 2016 to February 2019 at tertiary care hospital. It consists of total evaluation of 82 cases of ovarian lesions which were surgically excised for clinically or radiologically suspected of ovarian neoplasm.Results: A total of 82 cases of ovarian specimen were included out of which 18 cases were of ovarian teratoma. In these 17 cases were benign teratomas, 1 case of immature teratoma. All the cases of mature teratoma were predominantly of cystic type with focal solid areas. Right sided ovary was involved in44.5% cases while left sided in 55.5% cases. The tumor size ranges from 2.5 cm to 20.8 cms. The age range in this study was from 20 to 60 year. The common age observed for ovarian teratoma was in group of 31-40 years, having 6 cases. The clinically most of cases were asymptomatic or presented with unexplained abdominal pain or palpable mass. USG finding in most of cases were diffuse or partial echogenic mass lesion with cystic nature and echogenic bands.Conclusions: In our study showed mature cystic teratoma is the most common type of ovarian teratomas. The immature and monodermal types are rare. The histopathological examination plays important role in final diagnosis   and patient management

Transcriptomic and proteomic insight into the effects of a defined European mistletoe extract in Ewing sarcoma cells reveals cellular stress responses

Background The hydrophobic triterpenes, oleanolic and betulinic acid as well as the hydrophilic mistletoe lectins and viscotoxins possess anticancer properties. They do all occur in combination in European mistletoe (Viscum album L.). Commercial Viscum album L. extracts are aqueous, excluding the insoluble triterpenes. We have previously shown that mistletoe lectins and triterpene acids are effective against Ewing sarcoma in vitro, ex vivo and in vivo. Methods We recreated a total mistletoe effect (viscumTT) by combining an aqueous extract (viscum) and a triterpene extract (TT) solubilised with cyclodextrins and analysed the effects of viscumTT and the single extracts on TC-71 Ewing sarcoma cells in vitro by transcriptomic and proteomic profiling. Results Treatment with the extracts strongly impacted Ewing sarcoma cell gene and protein expression. Apoptosis-associated and stress-activated genes were upregulated, proteasomal protein abundance enhanced and ribosomal and spliceosomal proteins downregulated. The mechanism of action of viscum, TT and viscumTT in TC-71 and MHH-ES-1 cells suggests the involvement of the unfolded protein response. While viscum and viscumTT extract treatment indicate response to oxidative stress and activation of stress-mediated MAPK signalling, TT extract treatment suggests the involvement of TLR signalling and autophagy. Conclusions Since the combinatory extract viscumTT exerts highly effective pro-apoptotic effects on Ewing sarcoma cells in vitro, this phytopolychemotherapy could be a promising adjuvant therapeutic option for paediatric patients with Ewing sarcoma

A Meta-Analysis on the Effects of Hydroxychloroquine on COVID-19.

Introduction Since December 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly spread throughout the world with a large medical and economic impact. On March 12, 2020, the World Health Organization (WHO) classified SARS-CoV-2 as a pandemic. As a result of this worldwide public health crisis, politicians, elected officials, and healthcare professionals emergently began trialing hydroxychloroquine (HCQ) in efforts to treat and prevent the transmission of the virus. This meta-analysis was performed to assess the effects of HCQ on patients with COVID-19. Methods This meta-analysis adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRIMA) guidelines. Selected articles published between December 2019 and July 2020 were found utilizing the following search engines: PubMed, Google Scholar, Cochrane Library, DisasterLit, Clinicaltrials.gov, Medrxiv, and Embase. Two independent physician reviewers screened eligible articles that met the inclusion and exclusion criteria of the analysis. The outcome measures analyzed were mortality rate, rate of disease progression/improvement, rate of disease severity, and adverse effects of treatment. Six out of 14 studies that met the study\u27s eligibility criteria were selected and further analyzed, with a total of 381 participants (n= 381). Conclusion From the studies analyzed, it was found that groups treated with HCQ had an overall mortality rate that was 2.5 times greater than that of the control group. HCQ treated patients had higher rates of adverse clinical outcomes and side effects compared with the control populations. Lastly, there was a 1.2 times higher rate of improvement in the group of HCQ treated patients with mild to moderate symptoms as compared to the control group

Transitioning from Aflibercept to Biosimilar Ranibizumab in Neovascular AMD (The TRANSFORM Trial): A Multicenter Observational Study

Debdulal Chakraborty,1 Subhendu Boral,1 Tushar Kanti Sinha,1 Arnab Das,1 Angshuman Mukherjee,1 Saptorshi Majumdar,1 Ranabir Bhattacharya,2 Ritobroto Maitra3 1Department of Vitreoretinal Services, Disha Eye Hospitals, Kolkata, West Bengal, India; 2Department of MIS, Disha Eye Hospitals, Kolkata, West Bengal, India; 3Radical Health Tech, New Delhi, IndiaCorrespondence: Debdulal Chakraborty, Department of Vitreoretinal services; Disha Eye Hospitals, Kolkata, West Bengal, India, Tel +91 33 66360000, Email [email protected]: This study investigates the efficacy of transitioning patients with neovascular age-related macular degeneration (nAMD) from aflibercept (T1) to biosimilar ranibizumab (T2), an approach not previously documented in literature.Methods: In this multicenter observational study, patients over 50 years of age with nAMD were shifted from intravitreal aflibercept (IVI AFL) to biosimilar ranibizumab (B-RBZ) due to financial constraints. This study employed standardized ophthalmological methods to assess visual acuity (VA), central macular thickness (CMT), and subretinal and intraretinal fluid. Statistical analyses included paired t-tests, Wilcoxon signed-rank tests, and linear regression.Results: A total of 29 eyes (12 males and 17 females) were analyzed. Mean age was 72.55 ± 6.43 years. VA improved significantly during T1, with a mean increase from 55.0 ± 10.2 to 70.0 ± 8.5 ETDRS letters at the switch time point (p < 0.01), then a slight decrease to 62.3 ± 8.9 at 12 months (p < 0.05) was noted during T2. The mean CMT decreased notably from 400 ± 50 to 290 ± 45 μm at the switch. The final CMT at 12 months after switching to B-RBZ was 280 ± 40 μm (p < 0.01). There was a significant decrease in the retinal and intra retinal fluid during T1, followed by a gradual increase during T2. A significant correlation (p < 0.05) was noted between the presence of intraretinal fluid and increased injection frequency of B-RBZ.Conclusion: The switch from IVI AFL to IVI B-RBZ in patients with nAMD demonstrated efficacy in maintaining the VA and macular anatomy, with some challenges in fluid management.Keywords: neovascular AMD, aflibercept, biosimilar ranibizumab, subretinal fluid, intraretinal flui

Changes in physical activity during hospital admission for chronic respiratory disease: Inpatient step count does not recover

Background and objectiveEstablishing the amount of inpatient physical activity (PA) undertaken by individuals hospitalized for chronic respiratory disease is needed to inform interventions. This observational study investigated whether PA changes when a person is an inpatient, how long is required to obtain representative PA measures and whether PA varies within a day and between patients of differing lengths of stay.MethodsA total of 389 participants were recruited as early as possible into their hospitalization. Patients wore a PA monitor from recruitment until discharge. Step count was extracted for a range of wear time criteria. Single‐day intraclass correlation coefficients (ICC) were calculated, with an ICC ≥ 0.80 deemed acceptable.ResultsPA data were available for 259 participants. No changes in daily step count were observed during the inpatient stay (586 (95% CI: 427–744) vs 652 (95% CI: 493–812) steps/day for day 2 and 7, respectively). ICC across all wear time criteria were > 0.80. The most stringent wear time criterion, retaining 80% of the sample, was ≥11 h on ≥1 day. More steps were taken during the morning and afternoon than overnight and evening. After controlling for the Medical Research Council (MRC) grade or oxygen use, there was no difference in step count between patients admitted for 2–3 days (short stay) and those admitted for 7–14 days (long stay).ConclusionPatients move little during their hospitalization, and inpatient PA did not increase during their stay. A wear time criterion of 11 waking hours on any single day was representative of the entire admission whilst retaining an acceptable proportion of the initial sample size. Patients may need encouragement to move more during their hospital stay

Age impairs soluble guanylyl cyclase function in mouse mesenteric arteries

Endothelial dysfunction (ED) comes with age, even without overt vessel damage such as that which occurs in atherosclerosis and diabetic vasculopathy. We hypothesized that aging would affect the downstream signalling of the endothelial nitric oxide (NO) system in the vascular smooth muscle (VSM). With this in mind, resistance mesenteric arteries were isolated from 13-week (juvenile) and 40-week-old (aged) mice and tested under isometric conditions using wire myography. Acetylcholine (ACh)-induced relaxation was reduced in aged as compared to juvenile vessels. Pretreatment with L-NAME, which inhibits nitrix oxide synthases (NOS), decreased ACh-mediated vasorelaxation, whereby differences in vasorelaxation between groups disappeared. Endothelium-independent vasorelaxation by the NO donor sodium nitroprusside (SNP) was similar in both groups; however, SNP bolus application (10(-6) mol L(-1)) as well as soluble guanylyl cyclase (sGC) activation by runcaciguat (10(-6) mol L(-1)) caused faster responses in juvenile vessels. This was accompanied by higher cGMP concentrations and a stronger response to the PDE5 inhibitor sildenafil in juvenile vessels. Mesenteric arteries and aortas did not reveal apparent histological differences between groups (van Gieson staining). The mRNA expression of the α1 and α2 subunits of sGC was lower in aged animals, as was PDE5 mRNA expression. In conclusion, vasorelaxation is compromised at an early age in mice even in the absence of histopathological alterations. Vascular smooth muscle sGC is a key element in aged vessel dysfunction