Role of cancer antigen-125 in diagnosing malignant adnexal masses: a prospective observational study

Background: Adnexal masses present a diagnostic and therapeutic dilemma across age-groups. This study aimed to evaluate the performance of cancer antigen-125 (CA-125) in distinguishing between benign and malignant adnexal masses.Methods: This was a prospective, observational, single tertiary-care center study, done in North India from January, 2011 till December, 2012. Serum CA-125 levels was obtained preoperatively in consecutive patients presenting with ultrasonography confirmed adnexal masses. The cut-off value between benign and malignant was taken as 35 IU/ml. Histopathological diagnosis was obtained in all patients.Results: A total of 126 patients presented with adnexal masses, of which 100 were enrolled (mean age: 37.5±14.4 years, range: 18-80 years). Most of the masses were benign 81% (malignant=19%). Dermoid cyst (25.9%) and endometriomas (21%) were the most common benign masses. Serous (21%) and mucinous cystadeno-carcinoma (15.8%) were the most common malignant masses, more often seen in elderly, married, parous and post-menopausal patients. Mean CA-125 levels were significantly higher in malignant masses (257.30 [105.68-408.92] versus 19.26 [16.53-22.00], p<0.001). Overall sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CA-125 for diagnosing malignant adnexal mass was 94.7%, 87.65%, 64.28%, 98.6%, and 88.91% respectively. The same was 100%, 85.1%, 54.5%, 100%, 87.3% in premenopausal and 85.7%, 100%, 100%, 93.3%, 95.2% in postmenopausal women respectively.Conclusion: Benign masses form the bulk of the adnexal masses in all age groups. CA-125 levels has high sensitivity and negative predictive value in premenopausal patients while as high specificity and positive predictive value in postmenopausal patients

Exploring the relationship of Domestic violence on Health Seeking behavior and Empowerment of Women in Pakistan

Background: Violence against women is considered as a global problem and the trend for abusing domestically is very much up. This not only violates the human rights and it has got major implications on physical, mental, social and sexual health of a woman. Worldwide there is little research work on how domestic violence has affected women’s health and their decision-making power. This study aimed to explore the relationship between domestic violence on empowerment of women and their health seeking behavior in Pakistan. Methods: This research has used secondary data from Pakistan Demographic and Health Survey data 2012-13. About 3687 ever-married women were selected and interviewed for domestic violence from 248 urban and 252 rural areas of Pakistan. Results: Both chi-square and binary logistic regression analyses were performed. The results show that women with no education have suffered more (43%) from domestic violence. Almost 68% women reported that who have seen their parents beating their mothers have also experiences domestic violence. Logistic regression shown that women from rural areas are highly likely to be victims of domestic violence (OR=1.28, 95% CI 1.07-1.52, p-value<. 001). ANC visit is also found statistically significant with those who suffered violence at home. Conclusion: Policy makers and other stakeholders should take measures to control and stop violence against women and help them to live equally like a ma

Molecular Targeting of Carbonic Anhydrase IX in Mice with Hypoxic HT29 Colorectal Tumor Xenografts

Background: Carbonic anhydrase IX (CAIX) is a membrane spanning protein involved in the enzymatic regulation of tumor acid-base balance. CAIX has been shown to be elevated in a number of hypoxic tumor types. The purpose of this study was to determine the efficiency of intact and IgG fragments of cG250 to target CAIX in vivo in a hypoxic tumor model. Methodology/Principal Findings: Conventional biodistribution studies were performed with 111 In-DO3A-cG250, 111 In-DO3A-F(ab’)2-cG250 and 111 In-DO3A-Fab-cG250. Additional ex vivo analysis of the tumor was performed with markers for tumor hypoxia, blood perfusion and endogenous CAIX expression. All four data sets were digitally correlated to determine the optimal agent for determining hypoxia in a HT29 colon cancer xenograft. The HT29 human colorectal tumor xenografts show strong CAIX expression in hypoxic areas of poor blood perfusion. The intact IgG had an initial high focal uptake at the periphery of these hypoxic regions and penetration into the areas of highest CAIX expression over the 7-day study period. The lower molecular weight antibody fragments had a faster uptake into areas of high CAIX expression, but had a much lower absolute uptake at the optimal imaging times. Conclusions/Significance: For the clinical detection of hypoxia induced CAIX using cG250 antibody based agents, imagin

Exploring the relationship of Domestic violence on Health Seeking behavior and Empowerment of Women in Pakistan

Background: Violence against women is considered as a global problem and the trend for abusing domestically is very much up. This not only violates the human rights but it has got major implications on physical, mental, social and sexual health of a woman. Worldwide little is known on how domestic violence can women’s health and their decision-making power. The present study aimed to explore the relationship between domestic violence on empowerment of women and their health seeking behavior in Pakistan. Methods: This research used secondary data from the Pakistan Demographic and Health Survey data 2012-13. About 3687 ever-married women were selected and interviewed for domestic violence from 248 urban and 252 rural areas of Pakistan. Results: Both chi-square and logistic regression analyses were performed. The results show that women with no education have suffered at lot as a result of domestic violence. Almost 68% women reported that those who have seen their parents beating their mothers have also experiences domestic violence. Logistic regression reveals that women from rural areas are highly likely to be victims of domestic violence (OR=1.28, 95% CI: 1.07-1.52, p<. 001). ANC visit is also found to be statistically significant for those who suffered from domestic violence in Pakistan. Conclusion: Policy makers and other stakeholders should take measures to control and stop violence against women and help them to live dignified human being

A Systematic Review of Open Access Institutional Repositories (OAIRs)

The article tries to explore the existing literature on Open Access Institutional Repositories (OAIRs) so that the existing developments can be identified and research gaps can be investigated. This structured review was carried out with the aid of three indexing databases, Web of Science, Scopus, and Google Scholar. Different search terms showcasing multiple dimensions of OAIRs were executed across the three databases. After eliminating the duplicate records, the papers were scanned for final review. The paper tries to highlight the status, content management policies, and Web 2.0 use/ Interactive features of the OAIRs. How the OAIRs are used by academia is also a highlight of the paper. The paper also focuses on the studies that showcase the awareness of the users using the OAIRs. Furthermore, the studies featuring the problems, and challenges have also been incorporated. Studies that focus on the factors and motivators in the use of OA IRs also form a part of the paper

Synthesis and Processing of Solution Spun Cellulose Acetate Fibers Reinforced with Carbon Nanotubes

We report the fabrication of Cellulose Acetate (CA) based fibers reinforced with Multi-Walled Carbon Nanotubes (MWCNTs) using a solution spinning process. The motivation of this work is to produce high performance fibers based on sustainable natural materials as an alternative to synthetic fibers for structural applications. A 30 wt% solution of CA in a binary solvent system of N, N-dimethylacetamide (DMAc) and Acetone (3:7 v/v) was used for the solution spinning of CA fibers. Both neat and CNT-loaded CA fibers were produced. The CNT loading with respect to the polymer was at 0.5 wt%. For CA-MWCNT spinning solutions, the MWCNTs were initially dispersed in the solvent and then CA is added and mixed together. The mixing temperature kept 40–45°C. The viscosity of the CA solution was 8,000 cP. Addition of MWCNT increased the viscosity of the CA solution to 32,000 cP. A lab-scale solution spinning line consisting of a constant torque high temperature gear pump and heated extrusion channels was used to produce both neat and CA-MWCNT fibers. The solution was pumped through a spinneret at the end of the extrusion channel with an orifice as a viscous gel-like filament which was passed through a spool placed in a coagulation bath and then it formed as fiber. The fibers are collected to a takeup roll at a draw ratio of 8.0. Characterization studies of both neat and MWCNT loaded fibers were performed differential scanning calorimetry (DSC), thermo-gravimetric analysis (TGA) and scanning electron microscopy (SEM). DSC analysis of fibers showed reduction in crystallinity of CA upon inclusion of 0.5 wt% MWCNT. TGA analysis showed improvement of thermal stability in CA-MWCNT fibers compared to neat CA. Cross-sections of neat CA fibers showed smooth surfaces with no significant defects, while CA-MWCNT showed formation of micro-voids and irregular features. Longitudinal views of outer surface of both neat CA and CA-MWCNT fibers showed no indication of surface defects or protrusions

Investigation of Mechanical Properties and Morphology of Multi-Walled Carbon Nanotubes Reinforced Cellulose Acetate Fibers

Cellulose acetate (CA) fibers were reinforced with multi-walled carbon nanotubes (MWCNTs) at 0.5%, 1.0%, 1.5% and 2.0%. Yield strength, ultimate tensile strength, fracture strain and toughness of the nanocomposite fiber increased up to 1.5 wt. % of the carbon nanotube (CNT) loading, however, further inclusion (2.0%) of MWCNTs in CA decreased the mechanical properties. Experimental properties were also compared with analytical predictions using a Shear lag model for strength and the rule of mixture for modulus. A solution spinning process, coupled with sonication, mixing, and extrusion, was used to process the CNT-reinforced composite fiber. Scanning electron microscopy (SEM) images of the cross sections of neat CA and CA-MWCNT fibers showed the formation of voids and irregular features. The enhanced interconnected fibrillation in the CNT-reinforced CA samples resulted in improved mechanical properties, which were observed by tensile testing. Fourier transform infrared spectroscopy (FTIR) spectra showed the area under the curve for C–H bonding after the inclusion of CNT. There was no significant shift of wavenumber for the inclusion of MWCNT in the CA matrix, which indicates that the sonication process of the CNT-loaded solution did not degrade the CA bonding structure

Management of treatment-resistant depression with esketamine nasal spray: clinical questions for daily practice in Gulf Cooperation Council countries

Abstract Background There is a high unmet need among patients with treatment-resistant depression (TRD) as treatment with standard therapies is associated with low response and remission rates and high rates of relapse. Esketamine nasal spray, an N-methyl-D-aspartate receptor antagonist, is a novel, fast-acting treatment option for TRD. This article addresses common questions in Gulf Cooperation Council (GCC) countries regarding esketamine nasal spray by discussing the latest clinical evidence and by providing expert opinions. Methods Six expert psychiatrists from the GCC region with clinical experience in TRD reviewed and critically appraised published evidence on esketamine nasal spray for TRD and considered clinical guidelines, expert opinions and consensus statements. Consensus views were reached on clinical questions pertinent to implementing esketamine nasal spray for TRD in the GCC region. Results Clinical questions on patient identification, selection of serotonin reuptake inhibitors/serotonin and norepinephrine reuptake inhibitors, treatment duration, management of adverse events and clinical requirements for the safe administration of esketamine nasal spray were addressed. Conclusions Esketamine nasal spray represents a new treatment paradigm for TRD. This article provides clinical guidance based on the latest evidence and clinical experience to help mental health practitioners implement esketamine nasal spray into everyday clinical practice