Preventing Ovarian Cancer through early Excision of Tubes and late Ovarian Removal (PROTECTOR): protocol for a prospective non-randomised multi-center trial.

BACKGROUND: Risk-reducing salpingo-oophorectomy is the 'gold standard' for preventing tubo-ovarian cancer in women at increased risk. However, when performed in pre-menopausal women, it results in premature menopause and associated detrimental health consequences. This, together with acceptance of the central role of the fallopian tube in etiopathogenesis of high-grade serous carcinoma, by far the most common type of tubo-ovarian cancer, has led to risk-reducing early salpingectomy with delayed oophorectomy being proposed as a two-step surgical alternative for pre-menopausal women declining/delaying oophorectomy. PRIMARY OBJECTIVE: To evaluate the impact on sexual function of risk-reducing early salpingectomy, within a two-step, risk-reducing, early salpingectomy with delayed oophorectomy tubo-ovarian cancer prevention strategy in pre-menopausal women at increased risk of tubo-ovarian cancer. STUDY HYPOTHESIS: Risk-reducing early salpingectomy is non-inferior for sexual and endocrine function compared with controls; risk-reducing early salpingectomy is superior for sexual/endocrine function, non-inferior for quality-of-life, and equivalent in satisfaction to the standard risk-reducing salpingo-oophorectomy. TRIAL DESIGN: Multi-center, observational cohort trial with three arms: risk-reducing early salpingectomy with delayed oophorectomy; risk-reducing salpingo-oophorectomy; controls (no surgery). Consenting individuals undergo an ultrasound, serum CA125, and follicle-stimulating hormone measurements and provide information on medical history, family history, quality-of-life, sexual function, cancer worry, psychological well-being, and satisfaction/regret. Follow-up by questionnaire takes place annually for 3 years. Women receiving risk-reducing early salpingectomy can undergo delayed oophorectomy at a later date of their choosing, or definitely by the menopause. MAJOR INCLUSION/EXCLUSION CRITERIA: Inclusion criteria: pre-menopausal; aged >30 years; at increased risk of tubo-ovarian cancer (mutation carriers or on the basis of a strong family history); completed their family (for surgical arms). EXCLUSION CRITERIA: post-menopausal; previous bilateral salpingectomy or bilateral oophorectomy; pregnancy; previous tubal/ovarian/peritoneal malignancy; <12 months after cancer treatment; clinical suspicion of tubal/ovarian cancer at baseline. PRIMARY ENDPOINT: Sexual function measured by validated questionnaires. SAMPLE SIZE: 1000 (333 per arm). ESTIMATED DATES FOR COMPLETING ACCRUAL AND PRESENTING RESULTS: It is estimated recruitment will be completed by 2023 and results published by 2027. TRIAL REGISTRATION NUMBER: ISRCTN registry: 25 173 360 (https://doi.org/10.1186/ISRCTN25173360)

Agriculture in Bangladesh : Recent Trend and Agroenvironment toward Sustainability

Bangladesh is an agriculture-based country whose 85% people depends on agriculture for their daily livelihood. Soil fertility and agro ecological condition in favorable for growing a large number crops. Recently the land productivity is declining due to HYV (High Yielding Variety) production, intensive cropping, and indiscriminate use of fertilizers, pesticides and water irrigation. Dependence on agrochemicals leads the negative effect on environment and causes natural-health hazards. Practicing IPM (Integrated pest management) helps to grow healthy crops and improve environment and community health. This is a reviewed paper based on secondary data (year 1994 to 2000) published in different literatures focusing recent agricultural trends and agrochemicals use profile of Bangladesh in context of sustainable agriculture.Article信州大学農学部紀要. 43(1-2): 17-25 (2007)journal articl

Magnetic resonance urography in the evaluation of obstructive uropathy

Purpose: The purpose of this study was to study the utility of magnetic resonance urography (MRU) in the evaluation of obstructive urological diseases in comparison to intravenous urography (IVU). Materials and Methods: The study was carried out over a period of 2 years. A total of 55 patients were included in this study with ages between 14 and 70 years (average age 37 years). The patients were selected on the basis of ultrasonographic findings of hydronephrosis. The patients were subjected to IVU followed by static and dynamic MRU. The results obtained were compared and the inferences drawn thereof. Results and Conclusions: MRU has high sensitivity in the diagnosis of urinary tract obstruction, detecting the level of obstruction and acts as an aid in the diagnosis of obstructive uropathy, thus showing promising results. MRU is safer than IVU due to avoidance of iodinated contrast material and could also be done without using contrast material so having less contrast related events

6. Etika Dalam Kebijakan Luar Negeri: Kebijakan Ethiopia Menampung Pengungsi Perang Saudara Sudan Selatan Tahun 2013-2015

Ethics is one of the important factors that could affect the pattern of a country's policies.South Sudan civil war occuring in 2013 has enforced its residents to flee to theneighboring countries. Ethiopia, which is a country bordering South Sudan has long had anopen border policy for refugees looking for security. For a developing country, hostingrefugees may provide economic and social burdens, but these burdens do not affectEthiopia to close its borders for refugees. Through Ethiopia's Refugee Proclamation No.409/2004, Ethiopia with its all limitations has been committed to upholding public interest,that is to continue opening its borders for refugees under any circumstances

Genetic variability in physic nuts cultivated in Northeastern Brazil.

This research had as objective to characterize genetically individuals of physic nut cultivated in experimental areas in Sergipe, Brazil by means of RAPD molecular markers. Leaves of 40 individuals were collected and DNA was isolated using CTAB 2% method. Were used 30 primers RAPD for DNA amplification, and this data was used to estimate the genetic similarity among the pairs of individuals, using Jaccard coefficient, and group them out for the UPGMA method. Also, the genetic structure and diversity of the populations were assessed using AMOVA. Of the 100 fragments generated, 29 of were polymorphic. A similarity average of 0.54 among the individuals was found and the amplitude similarities varied from 0.18 to 1.00. One of them (U5) was unit clusters and formed by the most divergent individuals. AMOVA indicated that there is more variation within (63%) the population. In conclusion, it was possible verify genetic variability in201