Histopathologic Outcomes of Robotic Radical Prostatectomy

Robotically assisted laparoscopic radical prostatectomy is a minimally invasive alternative for the treatment of prostate cancer. We report the histopathologic and shortterm PSA outcomes of 500 robotic radical prostatectomies. Five hundred patients underwent robotic radical prostatectomy. The procedure was performed via a six trocar transperitoneal technique. Prostatectomy specimens were analyzed for TNM stage, Gleason’s grade, tumor location, volume, specimen weight, seminal vesicle involvement, and margin status. A positive margin was reported if cancer cells were found at the inked specimen margin. PSA data were collected every 3 months for the first year, then every 6 months for a year, then yearly. The average preoperative PSA was 6.9 (1–90) with Gleason’s score of 5 (2%), 6 (52%), 7 (40%), 8 (4%), and 9 (2%); postoperatively, histopathologic analysis showed Gleason's 6 (44%), 7 (42%), 8 (10%), and 9 (4%); 10, 5, 63, 15, 5, and 2% had pathologic stage T2a, T2b, T2c, T3a, T3b, and T4, respectively. Positive margin rate was 9.4% for the entire series. The positive margin rate per 100 cases was: 13% (1–100), 8% (101–200), 13% (201–300), 5% (301–400), and 8% (401–500). By stage, it was 2, 4, and 2.5% for T2a, T2b, T2c tumors; 23% (T3a), 46% (T3b), and 53% (T4a). For organ-confined disease (T2), the margin rate was 2.5% and it was 31% for nonorgan-confined disease. There were a total of 47 positive margins, 26 (56%) posterolateral, 4 (8.5%) apical, 4 (8.5%) bladder neck, 2 (4%) seminal vesicle, and 11 (23%) multifocal. Ninety-five percent of patients (n = 500) have undetectable PSA (<0.1) at average follow-up of 9.7 months. Recurrence has only been seen with nonorgan-confined tumors. Of those patients with a minimum follow-up of 1 year (average 15.7 months), 95% have undetectable PSA (<0.1). Our initial experience with robotic radical prostatectomy is promising. Histopathologic outcomes are acceptable with a low overall, positive margin rate. Shortterm biochemical recurrence-free survival has also been good. We believe that the precise dissection allowed by the advantages of laparoscopic robotic surgery will translate into excellent long-term oncologic outcomes. At this time, the lack of maturity of the PSA data prevent definitive comparison to the open approach

UC-344 WiseWallet

WiseWallet is designed to help users manage their finances in a simple and intuitive way. The app provides an easy-to-use interface for tracking income, expenses, and savings, allowing users to set goals and monitor their progress towards achieving them. The app also features customizable categories and budgets, enabling users to tailor their budgeting approach to their individual needs and preferences. In addition, the app provides visual aids such as charts and graphs to help users better understand their spending patterns and make informed financial decisions. With its user-friendly interface and powerful features, the Flutter mobile app for budgeting is an ideal tool for anyone looking to take control of their finances and achieve their financial goals. WiseWallet is a mobile application designed for both iOS and Android platforms, utilizing Flutter and Dart technologies for its development. The app integrates Firebase as a back-end service to manage the flow of data to and from the app. Additionally, Plaid, a third-party financial technology provider, is incorporated into the app to enable users to connect their bank accounts with WiseWallet

Suspected immune mediated response to COVID-19 vaccine: two individual case reports

SARS-CoV-2, the virus that causes coronavirus disease 19 (COVID-19), has spread rapidly around the world. Researchers have been working round the clock to develop effective vaccines, which people started receiving in December 2020. Therefore, careful follow-up and surveillance studies for continued vaccine safety monitoring will be needed to ascertain the potential risks of such adverse events or disease. Here, we present two individual cases of pancreatitis and typhilitis following COVID 19 vaccination. In the first case of a 38 years old male patient developed pancreatitis after 4 days of COVID 19 vaccination and in second case, of a 60 years old female patient developing typhilitis after just one day after vaccination. All possible causes of this occurrence were ruled out. Two main factors suggest a possible link to the vaccine, the chronology of the events and the incongruent immune response to the vaccine component. It is not possible to establish a direct causal relation between vaccination and adverse event following immunization; however, this report can be used to alert practitioners to this possibility of adverse event following immunization after COVID-19 vaccine

Tendências na síntese e aplicação de alguns corantes reativos: Uma revisão

From last 25 years that many researchers have developed the novel reactive dyes with modification in structure of reactive dyes. In the present review paper concentrated development of reactive dyes. The review paper is focused on the highlight such dyes have having excellent dyeing properties and wet-fastness properties. This review paper express the monstrous impression of reactive dyes on the textiles coloration industry. Particularized details are given regarding evolution in the chemistry of reactive structure systems. It is additionally mentioned pointed out that advance research is mandatory to enhance dye fixation and wet-fastness properties. Reactive dyes have been used for the past hundred years for dyeing of cellulosic fabrics. A reactive dye has a chromophore, which is a group or an atom that is responsible for the dye’s colour. It has a component which reacts with the fabric or substrate. They have excellent fastness features due to the presence of covalent bonds that takes place during dyeing. The dyeing industry is dominated by the parties who can create dyes having excellent dyeing efficiency, stable, can be resistant to chemical actions and be affordable. In this review on development of synthesis reactive dyes has been provided. This review paper concentrated on research of reactive groups type.&nbsp;En los últimos veinticinco años, muchos investigadores han desarrollado nuevos colorantes reactivos con modificaciones en la estructura de los colorantes reactivos. En este artículo de revisión, nos enfocamos en el desarrollo de colorantes reactivos. El artículo de revisión se centra en resaltar tales tintes con excelentes propiedades de teñido y propiedades de solidez a la humedad. Este artículo de revisión expresa la monstruosa impresión de los colorantes reactivos en la industria del teñido textil. Se dan detalles particulares sobre la evolución en la química de los sistemas de estructura reactiva. Además, se menciona que se necesita investigación avanzada para mejorar las propiedades de fijación del tinte y resistencia a la humedad. Los colorantes reactivos se han utilizado durante los últimos cien años para teñir tejidos celulósicos. Un tinte reactivo tiene un cromóforo, que es un grupo o átomo responsable del color del tinte. Tiene un componente que reacciona con el tejido o sustrato. Tienen excelentes características de solidez debido a la presencia de enlaces covalentes que se producen durante el teñido. La industria del teñido está dominada por partes que pueden crear tintes con excelente eficiencia de teñido, estables, resistentes a los químicos y asequibles. En esta revisión, se proporcionó el desarrollo de colorantes de síntesis reactiva. Este artículo de revisión se centró en la investigación de tipo de grupo reactivo.Nos últimos vinte e cinco anos, muitos pesquisadores desenvolveram novos corantes reativos com modificações na estrutura dos corantes reativos. No presente artigo de revisão, concentrou-se o desenvolvimento de corantes reativos. O artigo de revisão está focado no destaque que tais corantes têm com excelentes propriedades de tingimento e propriedades de resistência à umidade. Este artigo de revisão expressa a impressão monstruosa de corantes reativos na indústria de coloração têxtil. Detalhes particulares são dados sobre a evolução na química de sistemas de estrutura reativa. Além disso, é mencionado que pesquisas avançadas são necessárias para melhorar a fixação do corante e as propriedades de resistência à umidade. Os corantes reativos têm sido usados nos últimos cem anos para tingir tecidos celulósicos. Um corante reativo tem um cromóforo, que é um grupo ou átomo responsável pela cor do corante. Tem um componente que reage com o tecido ou substrato. Possuem excelentes características de solidez devido à presença de ligações covalentes que ocorrem durante o tingimento. A indústria de tingimento é dominada pelas partes que podem criar corantes com excelente eficiência de tingimento, estáveis, resistentes a ações químicas e acessíveis. Nesta revisão, o desenvolvimento de corantes reativos de síntese foi fornecido. Este artigo de revisão concentrou-se na pesquisa do tipo grupos reativos

Clinicoepidemiological study of fixed drug eruption in tertiary care hospital

Background: Adverse cutaneous drug reactions pose diagnostic difficulties due to a varied clinical manifestations and broad categories of causative agents. Fixed drug eruptions (FDE) are one of them. Present study aims i) to record various clinical features of FDE, their causative agents and ii) to study the pattern of morbidity in patients with FDE in a tertiary care hospital, Rajkot, Gujarat, India.Methods: The 88 patients with FDEs attending department of dermatology, venereology and leprosy at PDU govt. medical college and hospital, Rajkot, Gujarat from September 2018 to September 2020 were included after informed consent. After taking thorough history, complete blood count and biochemical tests were done. HIV testing was done in severe reactions with generalised involvement. Appropriate treatment was given with counselling regarding the offending drug for prevention of reaction in future.Results: The male patients were more affected than female patients with M: F ratio of 1.3:1. The most common age group affected was 21-30 years (22.7%). Antimicrobials were the most common offending drugs (43.2%). None of the patients were HIV reactive in our study. No mortality was reported in our study.Conclusions: The patterns of FDE and the causative drugs are remarkably different in our study. Knowledge of patterns and the causative agents helps in prevention of same reactions in future in patients

Assessment of functional outcome of surgical management of proximal humerus fracture treated with PHILOS plate

Background: Proximal humeral fractures were treated conservatively in the past and often had compromised functional results. With the advancement of surgical techniques, these fractures, especially displaced, are now more often managed operatively; to meet the needs of the patient, provide early rehabilitation and better functional outcome. The aim of this study was to assess the functional outcome of operative management of proximal humeral fractures with Philos plate fixation.Methods: In this prospective study, 30 patients aged 19-75 years (mean age 47.1 years) with fractures of the proximal humerus, including two-, three-, and four-part fractures, were treated by open reduction internal fixation with Philos plating. Patients’ functional outcomes were evaluated based on subjective (35 points) and objective (65 points) parameters, as per the constant scoring system.Results: Functional outcome based on the constant scoring system of the patient at 6 month follow-up were compared. Excellent results were seen in 12 patients (40%), 2 had very good results (6.66%), 9 patients were having good (30%) and 6 had fair (20%) functional outcome. One patient had poor functional results (3.33%). Avascular necrosis (AVN) of the humeral head was observed in one patients.Conclusions: Philos plate fixation for proximal humeral fractures provides good stable fixation with good functional outcome and is a feasible option.

Measurement of cervical length using transvaginal sonography for prediction of preterm labour

Background: Preterm labour and delivery cause major health burden to the society due to high perinatal morbidities and mortality and long-term health implications and also affects maternal. An effective and objective way for predicting preterm delivery is measurement of cervical length by transvaginal sonography as it allows better quality and accurate visualization of uterine cervix. Cervical length (<25 mm) is good and accurate cervical biometry for prediction of preterm birth. The objective of this study was to measure cervical length by transvaginal sonography for predicting preterm labour and fetal outcome.Methods: This prospective observational study was conducted in department of obstetrics and gynaecology, at SVPIMSR hospital, Ahmedabad from July 2018 to December 2019 in 150 antenatal women to assess cervical changes (cervical length, dilatation of internal OS, funnelling etc.) between 16 to 24 weeks of gestation and these cases followed till delivery and results were analysed.Results:150 antenatal women who fulfilled the selection criteria were studied using transvaginal ultrasound between 16-24 weeks of gestation, out of them 36 (24%) women delivered preterm babies. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) recorded in this study were 80.5%, 94.73%, 82.85% and 93.91% respectively.Conclusion: Transvaginal sonography is the most useful and better, safe, accurate, most effective, less expensive, objective and acceptable technique for assessing cervical length in all antenatal women and predicting the preterm labour when assessed between 16 -24 weeks of gestational age

A hospital based retrospective study of thyroid disorders on obstetric and perinatal outcomes

Background: The study was undertaken in pregnant women to understand and analyze the obstetric and foetal outcomes of thyroid disorders.Methods: TSH estimation was used as universal screening in their first visit to our hospital. Those patients with abnormal TSH values, i.e. above 2.5 mIU/ml in first trimester and above 3 mIU/ml in second and third trimesters were evaluated for free T3, free T4 and TPO Abs. They were treated accordingly and dosage adjustments made and the tests repeated once in 4-6 weeks. They were followed throughout pregnancy and delivery.Results: Total no of pregnant women screened were 904 over a period of 1 year from 15 March 2019 to 14 March 2020, of which 115 had abnormal thyroid functions, thereby the prevalence of thyroid disorders being 12.72%. Of the 115 patients with thyroid disorders, 112 were hypothyroid and 3 were hyperthyroid. Among the 112 hypothyroid cases, 48 were known cases and 64 were new cases. The total cases of subclinical hypothyroidism were 88, prevalence being 9.73% and overt cases were 24, prevalence being 2.65%; 3 cases were overt hyperthyroid, prevalence being 0.33%. 66% of subclinical hypothyroidism were TPO positive and 34% of overt hypothyroidism were TPO positive (p<0.05). Out of 115 abnormal thyroid function patients, 92 patients delivered in our hospital. There were 15 abortions, 13 spontaneous and 2 terminations of pregnancies; 7 patients have delivered outside and 1 patient lost follow up.Conclusions: The prevalence of thyroid disorders during pregnancy was significantly more in our study, hypothyroidism being the commonest. Significant numbers of cases were newly diagnosed on universal screening. The commonest disorder was subclinical hypothyroidism. Adverse maternal and foetal outcomes were almost similar in both subclinical and overt hypothyroidism. The common adverse outcomes noted were abortions, pre-eclampsia, gestational diabetes mellitus, preterm births and increased rates of caesarean sections. The adverse outcomes were significantly more in autoimmune antibody positive patients

Pan-Cancer Analysis of lncRNA Regulation Supports Their Targeting of Cancer Genes in Each Tumor Context

Long noncoding RNAs (lncRNAs) are commonly dys-regulated in tumors, but only a handful are known toplay pathophysiological roles in cancer. We inferredlncRNAs that dysregulate cancer pathways, onco-genes, and tumor suppressors (cancer genes) bymodeling their effects on the activity of transcriptionfactors, RNA-binding proteins, and microRNAs in5,185 TCGA tumors and 1,019 ENCODE assays.Our predictions included hundreds of candidateonco- and tumor-suppressor lncRNAs (cancerlncRNAs) whose somatic alterations account for thedysregulation of dozens of cancer genes and path-ways in each of 14 tumor contexts. To demonstrateproof of concept, we showed that perturbations tar-geting OIP5-AS1 (an inferred tumor suppressor) andTUG1 and WT1-AS (inferred onco-lncRNAs) dysre-gulated cancer genes and altered proliferation ofbreast and gynecologic cancer cells. Our analysis in-dicates that, although most lncRNAs are dysregu-lated in a tumor-specific manner, some, includingOIP5-AS1, TUG1, NEAT1, MEG3, and TSIX, synergis-tically dysregulate cancer pathways in multiple tumorcontexts

Association between the choice of the conditioning regimen and outcomes of allogeneic hematopoietic cell transplantation for myelofibrosis

Allogeneic hematopoietic cell transplantation (allo-HCT) remains the only curative treatment for myelofibrosis. However, the optimal conditioning regimen either with reduced intensity conditioning (RIC) or myeloablative conditioning (MAC) is not well known. Using the Center for International Blood and Marrow Transplant Research database, we identified adults aged ≥18 years with myelofibrosis undergoing allo-HCT between 2008-2019 and analyzed the outcomes separately in the RIC and MAC cohorts based on the conditioning regimens used. Among 872 eligible patients, 493 underwent allo-HCT using RIC (Fludarabine/busulfan=166, Fludarabine/melphalan=327) and 379 using MAC (Fludarabine/busulfan=247, Busulfan/cyclophosphamide=132). In multivariable analysis with RIC, Fludarabine/melphalan was associated with inferior overall survival (HR 1.80, 95% CI 1.15-2.81, p=0.009), higher early non-relapse mortality (HR 1.81, 95% CI 1.12-2.91, p=0.01) and higher acute graft versus host disease (GVHD) (grade II-IV- HR 1.45, 95% CI 1.03-2.03, p=0.03; grade III-IV HR 2.21, 95%CI 1.28-3.83, p=0.004) compared to Fludarabine/busulfan. In the MAC setting, Busulfan/cyclophosphamide was associated with a higher acute GVHD (grade II-IV HR 2.33, 95% CI 1.67-3.25, p\u3c0.001; grade III-IV HR 2.31, 95% CI 1.52-3.52, p\u3c0.001) and inferior GVHD-free relapse-free survival (GRFS) (HR 1.94, 95% CI 1.49-2.53, p\u3c0.001) as compared to Fludarabine/busulfan. Hence, our study suggests that Fludarabine/busulfan is associated with better outcomes in RIC (better overall survival, lower early non-relapse mortality, lower acute GVHD) and MAC (lower acute GVHD and better GRFS) in myelofibrosis