Effect of Oral intake of Stevia Leaf Powder on Body Weight – An Experimental study

Introduction: The steviol glycosides are found  in the stevia leaf. These glycosides possess sweetening properties as well as they have antioxidant, anti-microbial, anti-inflammatory, antihyperglycemic, and anti-hypertensive effects. This study was conducted to  find out the effect of Stevia leaf on body weight in obese Sprague Dawley male rats. Materials and Methods: This experimental study was carried out on 90 Sprague Dawley male rats. Group1(normal control) was given a standard diet for the entire study period, while the remaining sixty rats were given a high-fat diet (HFD) for 8 weeks to induce obesity. The obese rats were randomly assigned to group 2 (Obese Control) and Group 3 (obese + Stevia) and given HFD for another 6 weeks. The stevia leaf powder was added to the diet of group 3. Diet intake was noted for all the groups. Rats were weighed on the first day of every week, for six weeks, and then at the end of the study period.      Results: Body weights of rats in each group, at the start and end of the 6-week intervention period, when compared, showed a significant increase in group 1 (p=0.001), and group 2 (p = 0.001), while group 3 showed a non-significant increase (p = 0.248). The percentage increase in body weight for groups 1, 2, and 3 was 4.8, 9.3, and 1.1, respectively. Graphically, the weekly increase in average body weights of the three experimental groups showed maximum values for group 2. Conclusions: Stevia leaf possesses weight-reducing effects which may be due to inhibition of appetite, reduction in food intake, and consequent weight loss. Keywords: Obesity, weight loss, Natural non-nutritive sweeteners, Stevi

Alanine Transaminase levels in Patients of Dengue Fever in the Suburbs of Islamabad

Introduction: Hepatic dysfunction is a highly varied condition that can show up as minor damage with elevated levels of transaminases, or appear as extensive damage and failure of liver cells. Thus, in order to reduce associated morbidity and mortality, this ailment should be diagnosed at the earliest possible so that appropriate therapy can be instituted. Our study was carried out to observe hepatic damage in patients with dengue fever (DF) by measuring alanine transaminase levels. Materials and Methods: A cross-sectional study of three months duration was carried out in the Department of Medicine, Dr. Akbar Niazi Teaching Hospital affiliated with Islamabad Medical & Dental College, Pakistan. The sampling technique was Non-Random consecutive sampling and 118 patients were included in our study. Serum Alanine Transaminase (ALT) (normal = 7-56 IU/L), serum Aspartate Transaminase (AST) (normal = 10-40 IU/L) were determined and ultra-sound abdomen was performed. Statistical analysis was done using SPSS Version 24. The Chi-square test was used to observe the relationship between categorical variables. Phi, Cramer’s V, Pearson’s, and Spearman’s Correlation tests were used to study the association of age and gender with ALT levels. Results: There were 72% males (n=85) and 28% females (n=33). Patients were grouped according to age and mean ALT (95+86 IU/L) and AST (134.7+ 98 IU/L) levels were calculated in the different age groups. These levels were found to be significantly raised (P=0.00) in the age groups of 9-18 years and 19-25 years as compared to the other age groups. Moreover, males had high ALT levels as compared to females, however, a significant difference was not observed. There was also no association seen of gender with raised ALT levels (P=0.564), Phi & Cramer’s V=0.56, and Spearman’s correlation coefficient=0.320.Conclusions: ALT and AST levels were elevated above the normal in our sample indicating hepatic involvement

Association Of Maternal Age And Hemoglobin Level With Apgar Score Of Newborns In A Tertiary Care Hospital Of Suburbs Of Islamabad

Objectives: To determine the association of Apgar score with maternal age and hemoglobin. Methods A cross-sectional study was conducted on mothers (n=306) delivering live, full-term, singleton babies by spontaneous vertex delivery. Women who suffered stillbirths had babies of unknown gestational age or showed co-morbidities were excluded. SPSS version 26 was used for data analysis. Mean + standard deviation, and percentages were calculated. Cross-tabulation and logistic regression were done to see the association between dependent and independent variables. A p-value of <0.05 was statistically significant. Results The ages of women ranged from 20 to 40 years (mean= 25+1.9).  The number of patients aged 24 years with Hb <7g/dl was 6 (37.5%). Out of all, 90 (29.4%) patients had Hb >11g/dl, and their ages were 30 years which was significant (p = 0.000). Apgar score for the neonates showed that 258 (84.3%) had an Apgar score >7 while 48 (15.7%) had a score < 7. Babies of mothers whose age was 26 years had Apgar score < 7(25%) (p = 0.001). Neonatal birth weight, of <2kg was observed in infants born to young mothers of 26 years of age (20%) (p = 0.001), and a weight >3.5kg was recorded in 20 infants (6.5%). The younger mothers had lower Hb, and their babies had low Apgar scores <7 at the time of birth (p = 0.001). Conclusion Women of younger age and lower hemoglobin levels give birth to infants with low Apgar scores and birth weight. Low birth weight in neonates is significantly associated with a low five-minute Apgar score

Neoadjuvant Chemotherapy Modulates the Immune Microenvironment in Metastases of Tubo-Ovarian High-Grade Serous Carcinoma

This research was funded by Swiss Cancer League (BIL KLS-2883-02-2012), the European Research Council (ERC322566), Cancer Research UK (A16354), and Barts and The London Charity (467/1307)

Implementation of Multigene Germline and Parallel Somatic Genetic Testing in Epithelial Ovarian Cancer: SIGNPOST Study

We present findings of a cancer multidisciplinary-team (MDT) coordinated mainstreaming pathway of unselected 5-panel germline BRCA1/BRCA2/RAD51C/RAD51D/BRIP1 and parallel somatic BRCA1/BRCA2 testing in all women with epithelial-OC and highlight the discordance between germline and somatic testing strategies across two cancer centres. Patients were counselled and consented by a cancer MDT member. The uptake of parallel multi-gene germline and somatic testing was 97.7%. Counselling by clinical-nurse-specialist more frequently needed >1 consultation (53.6% (30/56)) compared to a medical (15.0% (21/137)) or surgical oncologist (15.3% (17/110)) (p 0.001). The median age was 54 (IQR = 51–62) years in germline pathogenic-variant (PV) versus 61 (IQR = 51–71) in BRCA wild-type (p = 0.001). There was no significant difference in distribution of PVs by ethnicity, stage, surgery timing or resection status. A total of 15.5% germline and 7.8% somatic BRCA1/BRCA2 PVs were identified. A total of 2.3% patients had RAD51C/RAD51D/BRIP1 PVs. A total of 11% germline PVs were large-genomic-rearrangements and missed by somatic testing. A total of 20% germline PVs are missed by somatic first BRCA-testing approach and 55.6% germline PVs missed by family history ascertainment. The somatic testing failure rate is higher (23%) for patients undergoing diagnostic biopsies. Our findings favour a prospective parallel somatic and germline panel testing approach as a clinically efficient strategy to maximise variant identification. UK Genomics test-directory criteria should be expanded to include a panel of OC genes.Peer reviewe

Pathological chemotherapy response score is prognostic in tubo-ovarian high-grade serous carcinoma: A systematic review and meta-analysis of individual patient data

There is a need to develop and validate biomarkers for treatment response and survival in tubo-ovarian high-grade serous carcinoma (HGSC). The chemotherapy response score (CRS) stratifies patients into complete/near-complete (CRS3), partial (CRS2), and no/minimal (CRS1) response after neoadjuvant chemotherapy (NACT). Our aim was to review current evidence to determine whether the CRS is prognostic in women with tubo-ovarian HGSC treated with NACT.This article is freely available via Open Access. Click on the Publisher URL to access the full-text via the publisher's site

Impact of COVID-19 on Antenatal, Natal, and Postnatal Care of pregnant females at Akbar Niazi Teaching Hospital

Objective: To determine the perception of pregnant patients regarding the COVID pandemic, preventive measures taken by the patients during the pandemic, and the impact of COVID on their Natal, Intrapartum, and Postpartum Care.Materials and Methods: This study included 850 patients presenting in the Obstetrics and Gynaecology department for antenatal care, inpatient care (delivery and caesarean section), and postpartum complications. Percentages were calculated for descriptive variables like demographic factors, source of information, and opinion of patients about COVID-19, preventive measures are taken by the patients, their Antenatal, Natal, and Postnatal fears. An independent t-test was applied and a p-value of ˂0.05 was taken as statistically significant.Results: We enrolled 850 patients in this study with a mean age of +28 years,mean gravidity of +3, 50% were matriculated and 75% of our patients belonged to middle-class families.. Among our patients, 96% were in fear of getting infected along with their fetus, if they visited the hospital for antenatal care, which is why a majority of them did not visit the hospital for antenatal care and a statistically significant percentage (80%) of them missed antenatal care for 5 months. While the same number of patients (96%, p-value ˂0.05) shared their fear regarding contracting the infection from the hospital during delivery and postnatal care in the hospital, and the same percentage were of the opinion that the baby would get infected during and after delivery in a hospital.Conclusion: Antenatal care is a basic right of every pregnant female. During emergencies like pandemics ways and means should be devised, not only to provide care but, also, to address the fears of pregnant females to prevent complications during this important phase of life

Practical Guidance for Measuring and Reporting Surgical Margins in Vulvar Cancer.

Surgical resection with free surgical margins is the cornerstone of successful primary treatment of vulvar squamous cell carcinoma (VSCC). In general reexcision is recommended when the minimum peripheral surgical margin (MPSM) is <8 mm microscopically. Pathologists are, therefore, required to report the minimum distance from the tumor to the surgical margin. Currently, there are no guidelines on how to make this measurement, as this is often considered straightforward. However, during the 2018 Annual Meeting of the British Association of Gynaecological Pathologists (BAGP), a discussion on this topic revealed a variety of opinions with regard to reporting and method of measuring margin clearance in VSCC specimens. Given the need for uniformity and the lack of guidance in the literature, we initiated an online survey in order to deliver a consensus-based definition of peripheral surgical margins in VSCC resections. The survey included questions and representative diagrams of peripheral margin measurements. In total, 57 pathologists participated in this survey. On the basis of consensus results, we propose to define MPSM in VSCC as the minimum distance from the peripheral edge of the invasive tumor nests toward the inked peripheral surgical margin reported in millimeters. This MPSM measurement should run through tissue and preferably be measured in a straight line. Along with MPSM, other relevant measurements such as depth of invasion or tumor thickness and distance to deep margins should be reported. This manuscript provides guidance to the practicing pathologist in measuring MPSM in VSCC resection specimens, in order to promote uniformity in measuring and reporting