Ovarian collision tumour: a rare case of serous cystadenoma with granulosa cell tumor of ovary

A collision tumor is the coexistence of two distinct tumours without any histological intermixing in the same organ or tissue. Each component of collision tumors occurs coincidently and biologic behaviour depends on their own tumor characteristics. A 48 year aged P2L2 women with pain abdomen since 15 days, on abdominal examination-a cystic mass occupying left iliac fossa present, bimanual examination a cystic mass measuring 13x10x8 cm in size, felt separately from the uterus. Sonography of abdomen and pelvis revealed a large cyst in the right adnexa 11.5x10.5x9.5 cm extending upto umbilical region. The serum tumor markers were within the normal range. Patient complained of severe pain abdomen on next day. Emergency laparotomy was done. Left ovarian cyst measuring 13x12x7 cm in size with one loop of torsion seen. Left salphingo-ophorectomy done and specimen sent for frozen section. It reported as serous cystadenoma of left ovary. Then proceeded to total abdominal hysterectomy with right salphingo-oophorectomy. Histopathology reported Serous cystadenoma with focal Granulosa cell tumour- left ovary. Patient was followed up with serum inhibin and CECT abdomen. The demographic factors, presentations and diagnosis of collision tutors are as similar as with single ovarian tumours. It is important for gynaecologist, radiologist and pathologist to be aware of occurrence of collision tumours. Histopathogical diagnosis of such neoplasms becomes very important, to provide appropriate treatment based on the individual biological characteristics of each component of collision tumours

Monetary Policy and Financial Asset Prices: Empirical Evidence From Pakistan

Monetary transmission mechanism assumed to be significantly influenced by the effect of policy decisions on financial markets. However, various previous studies have come up with different outcomes. The purpose of this study is to examine the impact of monetary policy on different asset classes (shares and bonds) in Pakistan. This study using stock price and bond yield as dependent variable and discount rate, money supply, inflation, and exchange rate are independent variables. Data of all variables have collected from 2010 to 2016, and Vector Autoregressive (VAR) technique has applied. The empirical results indicate that there is an impact of monetary policy components on both stock and bond market as an increase in policy rate causes decline in stocks prices and bonds yields. The findings of this study will help the potential investors in making long-term (in general) and short-term (in particular) investment strategies concerning monetary policy.DOI: 10.15408/sjie.v7i2.709

Effect of anatomical variability in brain on transcranial magnetic stimulation treatment

Transcranial Magnetic Stimulation is a non-invasive clinical therapy used to treat depression and migraine, and shows further promise as treatment for Parkinson’s disease, Alzheimer’s disease, and other neurological disorders. However, it is yet unclear as to how anatomical differences may affect stimulation from this treatment. We use finite element analysis to model and analyze the results of Transcranial Magnetic Stimulation in various head models.A number of heterogeneous head models have been developed using MRI data of real patients, including healthy individuals as well as patients of Parkinson’s disease. Simulations of Transcranial Magnetic Stimulation performed on 22 anatomically different models highlight the differences in induced stimulation. A standard Figure of 8 coil is used with frequency 2.5 kHz, placed 5 mm above the head. We compare cortical stimulation, volume of brain tissue stimulated, specificity, and maximum E-field induced in the brain for models ranging from ages 20 to 60. Results show that stimulation varies drastically between patients of the same age and health status depending upon brain-scalp distance, which is not necessarily a linear progression with age

The stellar mass function and evolution of the density profile of galaxy clusters from the Hydrangea simulations at 0<z<1.50<z<1.5

Galaxy clusters are excellent probes to study the effect of environment on galaxy formation and evolution. Along with high-quality observational data, accurate cosmological simulations are required to improve our understanding of galaxy evolution in these systems. In this work, we compare state-of-the-art observational data of massive galaxy clusters ($>10^{14} \textrm{M}_{\odot}$) at different redshifts ($0<z<1.5$) with predictions from the Hydrangea suite of cosmological hydrodynamic simulations of 24 massive galaxy clusters ($>10^{14} \textrm{M}_{\odot}$ at $z=0$). We compare three fundamental observables of galaxy clusters: the total stellar mass to halo mass ratio, the stellar mass function (SMF), and the radial mass density profile of the cluster galaxies. In the first two of these, the simulations agree well with the observations, albeit with a slightly too high abundance of $M_\star \lesssim 10^{10} \textrm{M}_{\odot}$ galaxies at $z \gtrsim 1$. The NFW concentrations of cluster galaxies increase with redshift, in contrast to the decreasing dark matter halo concentrations. This previously observed behaviour is therefore due to a qualitatively different assembly of the smooth DM halo compared to the satellite population. Quantitatively, we however find a discrepancy in that the simulations predict higher stellar concentrations than observed at lower redshifts ($z<0.3$), by a factor of $\approx$2. This may be due to selection bias in the simulations, or stem from shortcomings in the build-up and stripping of their inner satellite halo.Comment: 14 pages, 9 figures (excluding appendices), Accepted for publication in MNRA

Social and individual features affecting natal dispersal in the colonial Lesser Kestrel

Causes of natal dispersal were studied in an isolated population of the migratory, facultatively colonial Lesser Kestrel (Falco naumanni) in northeastern Spain. During a seven-year study, we gathered information on natal dispersal of 751 individuals and on 24 explanatory variables that evaluated individual traits, conspecific cues in terms of colony size, and different ecological and populational features. We examined separately whether or not individuals changed colonies and how far they moved. Dispersal from the natal colony was high (83%), and dispersers covered a median distance of 7225 m (range 112-136 500 m). The probability of natal dispersal decreased with the size of the natal colony and with the distance to the nearest colony, but not with the distance to unoccupied buildings, in the year of recruitment. Moreover, the shorter the distance to the nearest colony, the shorter the distances that individuals dispersed, particularly to large colonies (>10 pairs). These results support the conspecific attraction hypothesis. Accordingly, the probability of recruiting in the natal colony increased with the proportion of philopatric adults, although beyond a threshold individuals were prevented from recruiting by the more dominant adults in a despotic way. The timing of arrival from the wintering grounds was positively related to the probability of colony change, especially in males. To the extent that this variable is related to the phenotypic quality of individuals, it reinforces the idea that natal dispersal is shaped by intraspecific competition in crowded colonies. Males showed lower frequencies of colony change and dispersed shorter distances than did females, as explained by the different role of the sexes in nest acquisition and defense. Our results indicate that natal dispersal is an evolutionarily labile trait simultaneously influenced by ecological, social, and individual features both within and between populations.Peer Reviewe

Can contracted out health facilities improve access, equity, and quality of maternal and newborn health services? evidence from Pakistan.

BACKGROUND: The case of contracting out government health services to non-governmental organizations (NGOs) has been weak for maternal, newborn, and child health (MNCH) services, with documented gains being mainly in curative services. We present an in-depth assessment of the comparative advantages of contracting out on MNCH access, quality, and equity, using a case study from Pakistan. METHODS: An end-line, cross-sectional assessment was conducted of government facilities contracted out to a large national NGO and government-managed centres serving as controls, in two remote rural districts of Pakistan. Contracting out was specific for augmenting MNCH services but without contractual performance incentives. A household survey, a health facility survey, and focus group discussions with client and spouses were used for assessment. RESULTS: Contracted out facilities had a significantly higher utilization as compared to control facilities for antenatal care, delivery, postnatal care, emergency obstetric care, and neonatal illness. Contracted facilities had comparatively better quality of MNCH services but not in all aspects. Better household practices were also seen in the district where contracting involved administrative control over outreach programs. Contracting was also faced with certain drawbacks. Facility utilization was inequitably higher amongst more educated and affluent clients. Contracted out catchments had higher out-of-pocket expenses on MNCH services, driven by steeper transport costs and user charges for additional diagnostics. Contracting out did not influence higher MNCH service coverage rates across the catchment. Physical distances, inadequate transport, and low demand for facility-based care in non-emergency settings were key client-reported barriers. CONCLUSION: Contracting out MNCH services at government health facilities can improve facility utilization and bring some improvement in quality of services. However, contracting out of health facilities is insufficient to increase service access across the catchment in remote rural contexts and requires accompanying measures for demand enhancement, transportation access, and targeting of the more disadvantaged clientele

RAAI Project: Life-prediction and prognostics for railway axles under corrosion-fatigue damage

Corrbosion damage induced by atmospheric agents has been shown to be able to trigger fatigue failures of railway axles. In this tphaepenIreDwMetEofiCorl,sDrtleyelpideasirstocmnuesnast nocefowMnseaoculhitadonamitceadtlerEdensgucilnatensenirneinrmga,boIldnesetltilotiunetogffiStchuipeengrtirloyrwaTtnéhcanolyifcsode,aoUmpnatigvcearlusimnddaeedaresucdoreerLmroisesbniotasn,-oAffavt.tihRgeouvceiosacrnroodPdiaetsids,da1ex,tle1ec0ts4iu9or-nf0a.0c1eLainsbdoa, paper we firstly discuss consolidated results in modelling the growth of damage under corrosion-fatigue and its detection. Portugal craTchkisgrioswththebsiamckuglartoiuondtofolrtduensecdribthinrogutghhefduelvl-eslcoaplmemenetaosfuraemneewntpsrofganxolseticotrorolsiwonit-hfiantitghueeRdAamAaIgEeU.-fundedproject.Indetails, This is the background for describing the development of a new prognostic tool within the RAAI EU-funded project. In details, cCeFEMA, Department of Mechanical Engineering, Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais, 1, 1049-001 Lisboa, the new tool relies on a new automated scanner able to efficiently analyse optical measurements of the corroded axle surface and a the new tool relies on a new automated scanner able to efficientlPyoartnuaglaylse optical measurements of the corroded axle surface and an axle corrosion-fatigue mode

Risk of Invasive Fungal Infections in Patients with Chronic Lymphocytic Leukemia treated with Bruton Tyrosine Kinase Inhibitors – A Case-Control Propensity Score Matched Analysis

Background: Prior reports have suggested a possible increase in the frequency of invasive fungal infections (IFIs) with use of a Bruton tyrosine kinase inhibitors (BTKi) for treatment of chronic lymphoid malignancies such as chronic lymphocytic leukemia (CLL), but precise estimates are lacking. We aim to characterize the prevalence of IFIs among patients with CLL, for whom BTKi are now the first line recommended therapy. Methods: We queried TriNetX, a global research network database, to identify adult patients with CLL using the ICD-10 codes (C91.1) and laboratory results. We performed a case-control propensity score-matched analysis to determine IFIs events by BTKi use. We adjusted for age, sex, ethnicity, and clinical risk factors associated with an increased risk of IFIs. Results: Among 5,358 matched patients with CLL, we found an incidence of 4.6% of IFIs in patients on a BTKi vs. 3.5% among patients with CLL not on a BTKi at five years. Approximately 1% of patients with CLL developed an IFI while on a BTKi within this period. Our adjusted IFI event analysis found an elevated rate of Pneumocytis jirovecii pneumonia (PJP) (0.5% vs. 0.3%, p = 0.02) and invasive candidiasis (3.5% vs 2.7%, p = 0.012) with the use of a BTKi. The number needed to harm for patients taking a BTKi was 120 and 358 for invasive candidiasis and PJP, respectively. Conclusions: We found an adjusted elevated rate of PJP and invasive candidiasis with BTKi use. The rates are however low with a high number needed to harm. Additional studies stratifying other IFIs with specific BTKi are required to identify at-risk patients and preventive, cost-effective interventions