Search results for: pelvic organ prolapse

Authors: Karim Adinehvand, Bakhtiar Azadbakht, Amin Sahebnasagh

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Relation to high absorption fraction of Tc SESTAMIBI by internal organs in heart scan, and these organs are near to generation organs (Ovaries and uterus). In this study, Liver is specified as source organ. Method: we have set amount of absorbed fraction radiopharmaceutical in position of Liver in RANDO-phantom in form of elliptical surfaces, then absorbed dose to ovaries and uterus measured by TLD-100 that had set at position of these organs in RANDO-phantom. Calculation had done by MIRD method. Results from direct measurement and MIRD method are too similar. The absorbed dose to uterus and ovaries for Rest are 26.05µGyMBq-1, 17.23µGyMBq-1 and for Stress are 2.04µGyMBq-1, 1.35µGyMBq-1 respectively.

Keywords: absorbed dose, TLD, MIRD, RANDO-phantom, Tc-99m

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Authors: Mukurdipi Ray, Seema Singh

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Extrauterine endometrial stromal sarcoma (ESS) is a rare entity and typified by delayed recurrence of primary ESS. Here, we present an unusual case of uterine ESS in a woman with a history of hysterectomy. A 19-year-old girl, underwent a hysterectomy and bilateral salpingo-oophorectomy for uterine ESS 12 months ago and now after remaining disease free for nine months ago she presented with ascites along with pelvic and peritoneal mass. Intraoperatively, the large omental mass was found, and optimal cytoreduction with total omentomy (supracolic and infracolic ) total peritonectomy and hyperthermic intraperitoneal chemotherapy (HIPEC) was offered to the patient. Final histopathology report showed the involvement of only omentum by ESS cells. Immunohistochemistry (IHC) and receptor study were done and it was positive for CD-10 and desmin and negative for CK- 7. This case highlights the rarity of extrauterine ESS in the omentum with a known history of primary uterine ESS which was treated successfully with the above-mentioned procedure. Though active and long-term surveillance is recommended to monitor for late recurrences.

Keywords: endrometrial stromal sarcoma, complete cytoreduction, hyperthermic intra peritoneal chemotherapy, total omentectomy

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Authors: El Khaddam Safaa, Soulaymani Abdelmajid, Mokhtari Abdelghani, Ouammi Lahcen, Rachida Soulaymani-Beincheikh

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The poisonings represent a problem of health in the world and Morocco, The exact dimensions of this phenomenon are still poorly recorded that we see the lack of exhaustive statistical data. The objective of this retrospective study of a series of cases of the poisonings declared at the level of the region of Tadla-Azilal and collected by the Moroccan Poison Control and Pharmacovigilance Center. An epidemiological profile of the poisonings was to raise, to determine the risk factors influencing the vital preview of the poisoned And to follow the evolution of the incidence, the lethality, and the mortality. During the period of study, we collected and analyzed 9303 cases of poisonings by different incriminated toxic products with the exception of the scorpion poisonings. These poisonings drove to 99 deaths. The epidemiological profile which we raised, showed that the poisoned were of any age with an average of 24.62±16.61 years, The sex-ratio (woman/man) was 1.36 in favor of the women. The difference between both sexes is highly significant (χ2 = 210.5; p<0,001). Most of the poisoned which declared to be of urban origin (60.5 %) (χ2=210.5; p<0,001). Carbon monoxide was the most incriminated among the cases of poisonings (24.15 %), them putting in head, followed by some pesticides and farm produces (21.44 %) and food (19.95 %). The analysis of the risk factors showed that the grown-up patients whose age is between 20 and 74 years have twice more risk of evolving towards the death (RR=1,57; IC95 % = 1,03-2,38) than the other age brackets, so the male genital organ was the most exposed (explained) to the death that the female genital organ (RR=1,59; IC95 % = 1,07-2,38) The patients of rural origin had presented 5 times more risk (RR=4,713; IC95 % = 2,543-8,742). Poisoned by the mineral products had presented the maximum of risk on the vital preview death (RR=23,19, IC95 % = 2,39-224,1). The poisonings by pesticides produce a risk of 9 (RR=9,31; IC95 % = 6,10-14,18). The incidence was 3,3 cases of 10000 inhabitants, and the mortality was 0,004 cases of 1000 inhabitants (that is 4 cases by 1000 000 inhabitants). The rate of lethality registered annually was 10.6 %. The evolution of the indicators of health according to the years showed that the rate of statement measured by the incidence increased by a significant way. We also noted an improvement in the coverage which (who) ended up with a decrease in the rate of the lethality and the mortality during last years. The fight anti-toxic is a work of length time. He asks for a lot of work various levels. It is necessary to attack the delay accumulated by our country on the various legal, institutional and technical aspects. The ideal solution is to develop and to set up a national strategy.

Keywords: epidemiology, poisoning, risk factors, indicators of health, Tadla-Azilal grated by anti-toxic fight

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Authors: Meli̇sa Aşci, Berk Kiliç, Emine Ulusoy

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Ingestion of microplastics in humans has been increasing rapidly, as such hazardous materials are abundant in multiple food products, specifically milks. With increasing consumption rates, humans have been ingesting microplastics on a daily basis, making them prone to be intoxicated and even cause the disruption of intracellular pathways and liver cell disruption, and eventually tissue and organ damage. In this experiment, different milk types(animal-based and plant-based) were tested for microplastics. Results showed that animal-based milks contained a higher concentration of microplastics compared to plant-based milks. Research has shown that in addition to causing health issues in humans, microplastics can also affect livestock animals and plants.

Keywords: microplastics, plant-based milks, animal-based milks, preventive nutrition

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Authors: Inna Kornienko, Svetlana Guryeva, Natalia Danilova, Elena Petersen

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Drug toxicity often goes undetected until clinical trials, the most expensive and dangerous phase of drug development. Both human cell culture and animal studies have limitations that cannot be overcome by improvements in drug testing protocols. Tissue engineering is an emerging alternative approach to creating models of human malignant tumors for experimental oncology, personalized medicine, and drug discovery studies. This new generation of bioengineered tumors provides an opportunity to control and explore the role of every component of the model system including cell populations, supportive scaffolds, and signaling molecules. An area that could greatly benefit from these models is cancer research. Recent advances in tissue engineering demonstrated that decellularized tissue is an excellent scaffold for tissue engineering. Decellularization of donor organs such as heart, liver, and lung can provide an acellular, naturally occurring three-dimensional biologic scaffold material that can then be seeded with selected cell populations. Preliminary studies in animal models have provided encouraging results for the proof of concept. Decellularized Organs preserve organ microenvironment, which is critical for cancer metastasis. Utilizing 3D tumor models results greater proximity of cell culture morphological characteristics in a model to its in vivo counterpart, allows more accurate simulation of the processes within a functioning tumor and its pathogenesis. 3D models allow study of migration processes and cell proliferation with higher reliability as well. Moreover, cancer cells in a 3D model bear closer resemblance to living conditions in terms of gene expression, cell surface receptor expression, and signaling. 2D cell monolayers do not provide the geometrical and mechanical cues of tissues in vivo and are, therefore, not suitable to accurately predict the responses of living organisms. 3D models can provide several levels of complexity from simple monocultures of cancer cell lines in liquid environment comprised of oxygen and nutrient gradients and cell-cell interaction to more advanced models, which include co-culturing with other cell types, such as endothelial and immune cells. Following this reasoning, spheroids cultivated from one or multiple patient-derived cell lines can be utilized to seed the matrix rather than monolayer cells. This approach furthers the progress towards personalized medicine. As an initial step to create a new ex vivo tissue engineered model of a cancer tumor, optimized protocols have been designed to obtain organ-specific acellular matrices and evaluate their potential as tissue engineered scaffolds for cultures of normal and tumor cells. Decellularized biomatrix was prepared from animals’ kidneys, urethra, lungs, heart, and liver by two decellularization methods: perfusion in a bioreactor system and immersion-agitation on an orbital shaker with the use of various detergents (SDS, Triton X-100) in different concentrations and freezing. Acellular scaffolds and tissue engineered constructs have been characterized and compared using morphological methods. Models using decellularized matrix have certain advantages, such as maintaining native extracellular matrix properties and biomimetic microenvironment for cancer cells; compatibility with multiple cell types for cell culture and drug screening; utilization to culture patient-derived cells in vitro to evaluate different anticancer therapeutics for developing personalized medicines.

Keywords: 3D models, decellularization, drug discovery, drug toxicity, scaffolds, spheroids, tissue engineering

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Authors: Naima Jannat, Ariful Islam, Sharafat Hossain

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Due to the involvement of the large target volume, Craniospinal Irradiation makes it challenging to achieve a uniform dose, and it requires different isocenters. This isocentric junction needs to shift after every five fractions to overcome the possibility of hot and cold spots. This study aims to evaluate the Planning Target Volume coverage & sparing Organ at Risk between two techniques and shows that the Field Alignment Technique does not need replanning and resetting. Planning method for Craniospinal Irradiation by Eclipse treatment planning system Field Alignment and Extended Source to Surface Distance technique was developed where 36 Gy in 20 Fraction at the rate of 1.8 Gy was prescribed. The patient was immobilized in the prone position. In the Field Alignment technique, the plan consists of half beam blocked parallel opposed cranium and a single posterior cervicospine field was developed by sharing the same isocenter, which obviates divergence matching. Further, a single field was created to treat the remaining lumbosacral spine. Matching between the inferior diverging edge of the cervicospine field and the superior diverging edge of a lumbosacral field, the field alignment option was used, which automatically matches the field edge divergence as per the field alignment rule in Eclipse Treatment Planning System where the couch was set to 2700. In the Extended Source to Surface Distance technique, two parallel opposed fields were created for the cranium, and a single posterior cervicospine field was created where the Source to Surface Distance was from 120-140 cm. Dose Volume Histograms were obtained for each organ contoured and for each technique used. In all, the patient’s maximum dose to Planning Target Volume is higher for the Extended Source to Surface Distance technique to Field Alignment technique. The dose to all surrounding structures was increased with the use of a single Extended Source to Surface Distance when compared to the Field Alignment technique. The average mean dose to Eye, Brain Steam, Kidney, Oesophagus, Heart, Liver, Lung, and Ovaries were respectively (58% & 60 %), (103% & 98%), (13% & 15%), (10% & 63%), (12% & 16%), (33% & 30%), (14% & 18%), (69% & 61%) for Field Alignment and Extended Source to Surface Distance technique. However, the clinical target volume at the spine junction site received a less homogeneous dose with the Field Alignment technique as compared to Extended Source to Surface Distance. We conclude that, although the use of a single field Extended Source to Surface Distance delivered a more homogenous, but its maximum dose is higher than the Field Alignment technique. Also, a huge advantage of the Field Alignment technique for Craniospinal Irradiation is that it doesn’t need replanning and resetting up of patients after every five fractions and 95% prescribed dose was received by more than 95% of the Planning Target Volume in all the plane with the acceptable hot spot.

Keywords: craniospinalirradiation, cranium, cervicospine, immobilize, lumbosacral spine

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Authors: Seda Sahin, Emin Akata

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Obturator foramen is a specific structure in pelvic bone images and recognition of it is a new concept in medical image processing. Moreover, segmentation of bone structures such as obturator foramen plays an essential role for clinical research in orthopedics. In this paper, we present a novel method to analyze the similarity between the substructures of the imaged region and a hand drawn template, on hip radiographs to detect obturator foramen accurately with integrated usage of Marker-controlled Watershed segmentation and Zernike moment feature descriptor. Marker-controlled Watershed segmentation is applied to seperate obturator foramen from the background effectively. Zernike moment feature descriptor is used to provide matching between binary template image and the segmented binary image for obturator foramens for final extraction. The proposed method is tested on randomly selected 100 hip radiographs. The experimental results represent that our method is able to segment obturator foramens with % 96 accuracy.

Keywords: medical image analysis, segmentation of bone structures on hip radiographs, marker-controlled watershed segmentation, zernike moment feature descriptor

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Authors: Nourhan G. Sahly, Ahmed Moustafa, Mohamed S. Zaghloul, Tamer Z. Salem

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The gut microbiome plays important roles in the human body that includes but not limited to digestion, immunity, homeostasis and response to some drugs such as chemotherapy and immunotherapy. Its role has also been linked to radiotherapy and associated gastrointestinal injuries, where the microbial dysbiosis could be the driving force for dose determination or the complete suspension of the treatment protocol. Linking the gut microbiota alterations to different cancer treatment protocols is not easy especially in humans. However, enormous effort was exerted to understand this complex relationship. In the current study, we described the gut microbiota dysbiosis in pediatric sarcoma patients, in the pelvic region, with regards to radiotherapy and antibiotics. Fecal samples were collected as a source of microbial DNA for which the gene encoding for V3-V5 regions of 16S rRNA was sequenced. Two of the three patients understudy had experienced an increase in alpha diversity post exposure to 50.4 Gy. Although phylum Firmicutes overall relative abundance has generally decreased, six of its taxa increased in all patients. Our results may indicate the possibility of radiosensitivity or enrichment of the antibiotic resistance of the elevated taxa. Further studies are needed to describe the extent of radiosensitivity with regards to antibiotic resistance.

Keywords: combined radiotherapy and chemotherapy, gut microbiome, pediatric cancer, radiosensitivity

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Authors: Dr. Jenit Gandhi, Dr. Manojith SS, Dr. Nakul GV, Dr. Sharath Honnani, Dr. Shaurav Ghosh, Dr. Neel Shetty, Dr. Nagabhushan JS, Dr. Manish Joshi

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Introduction: Acute pancreatitis is an inflammatory condition of the pancreas which begins in pancreatic acinar cells and triggers local inflammation that may progress to systemic inflammatory response (SIRS) and causing distant organ involvement and its function and ending up with multiple organ dysfunction syndromes (MODS). Aim: A comparative study in acute pancreatitis to find out the effectiveness of early addition of Ulinastatin to current standard care in Indian subjects . Methodology: A current prospective observational study is done during study period of 1year (Dec 2018 –Dec 2019) duration to evaluate the effect of early addition of Ulinastatin to the current standard treatment and its efficacy to reduce the early complication, analgesic requirement and duration of hospital stay in patients with Acute Pancreatitis. Results: In the control group 25 were males and 05 were females. In the test group 18 were males and 12 females. Majority was in the age group between 30 - 70 yrs of age with >50% in the 30-50yrs age group in both test and control groups. The VAS was median grade 3 in control group as compared to median grade 2 in test group , the pain was more in the initial 2 days in test group compared to 4 days in test group , the analgesic requirement was used for more in control group (median 6) to test group( median 3 days ). On follow up after 5 days for a period of 2 weeks none of the patients in the test group developed any complication. Where as in the control group 8 patients developed pleural effusion, 04-Pseudopancreatic cyst, 02 – patient developed portal vein and splenic vein thrombosis, 02 patients – ventilator with ARDS which were treated symptomatically whereas in test group 02 patient developed pleural effusions and 01 pseudo pancreatic cyst with splenic artery aneurysm, 01 – patient with AKI and MODS symptomatically treated. The duration of hospital stay for a median period of 4 days (2 – 7 days) in test group and 7 days (4 -10 days) in control group. All patients were able to return to normal work on an average of 5days compared 8days in control group, the difference was significant. Conclusion:The study concluded that early addition of Ulinastatin to current standard treatment of acute Pancreatitis is effective in reducing pain, early complication and duration of hospital stay in Indian subject

Keywords: Ulinastatin, VAS – visual analogue score , AKI – acute kidney injury , ARDS – acute respiratory distress syndrome

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Authors: Mary Rose Eunice S. Gundayao, Manolo M. Fernandez

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Metachromatic leukodystrophy (MLD) is a rare lysosomal storage disorder with an autosomal recessive inheritance pattern. Lysosomal storage disorders are often severe, follow a progressively neurodegenerative path, and may result in multi-organ failure, potentially leading to death within 5 to 6 years in cases of early-onset forms. There are limited data regarding cases of MLD in Filipino children. This is the case of a 2-year-old Filipino girl who presented with progressive neurological deterioration and was diagnosed with metachromatic leukodystrophy by molecular genetic testing. This case report aims to present this patient’s clinical history, neurological findings, diagnosis and novel genetic mutations causing MLD. A concise review of updated literature on MLD will be discussed.

Keywords: metachromatic leukodystrophy, ARSA gene, peripheral neuropathy, case report, demyelinating disease

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Authors: Sally Shepherd, Craig Murphy

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Introduction: The uterus or cervix are unusual locations as metastatic sites for cancers. It is further unusual for it to be a site of metastasis, whilst the primary malignancy remains occult. Case Report: A 63-year-old female with three months of altered bowel habits underwent a CT scan of the abdomen and pelvis, revealing a bulky uterus and left ovary, nonspecific colonic thickening, and diffuse peritoneal changes. She underwent colposcopy, which revealed a large endocervical polyp that was excised, revealing strongly hormone-positive metastatic invasive lobular breast cancer. She subsequently underwent a PET scan, which showed moderately diffuse activity in the cervix and left adnexa. Breast examination was unremarkable, and screening mammography, ultrasound, and MRI of the breast did not identify any lesions. Her blood tests revealed a Ca 15-3 of 934, CA-125 of 220, and CEA of 27. She was commenced on letrozole and ribociclib with an improvement in her symptoms. Conclusion: It is rare for occult breast cancer to be established and diagnosed by pelvic imaging and biopsy. Suspicion of uterine or cervical metastasis should be heightened in patients with an active or past history of breast cancer.

Keywords: occult breast cancer, cervical metastasis, invasive lobular carcinoma, metastasis

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Authors: M. Hakami, A. Jammaly, I. Attafi, M. Oraiby, M. Jeraiby

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We reviewed an unusual case of a 65-year-old male taking an herbal mixture containing compounds with anticholinesterase activity for a long period of time, presented with acute my myocardial infarction and multiple organ dysfunction syndrome followed by death. Clinically, there are findings correlated with anticholinesterase activity, such as bilateral miosis, diaphoresis, vomiting and fasciculation without a history of any toxic ingestion or exposure. Gas chromatography–mass spectrometry screening studies identified the presence of thymol, anethole in the herbal extract and butylated hydroxytoluene in the blood sample. Hence, with this case report, we intend to highlight the necessity of evaluating the long-term use of the herbal mixture.

Keywords: cholinesterase inhibitors, thymole, anethole, butylatedhydroxytoluene, cardiac toxicity, myocardial infarction

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Authors: Ojiegbe Ikenna Nathan

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Obesity is a medical condition in which excess body fat has accumulated to the extent that it leads to reduced life expectancy and or increased health problems. Obesity as a worldwide problem is seen clustered in the families and it moves from generation to generation. It causes some disabilities, mortality and morbidity if left unattended to. The predisposing factors to obesity are either genetic or environment in origin. Nevertheless, the main predisposing factor to obesity is the excessive consumption of food rich in low-density lipoprotein (LDL) such as organ meats, saturated fats etc. This low-density lipoprotein causes an increase in adipose tissue and complicates to obesity. There are varieties of obesity which one needs to take appropriate measures to avoid; such as android, gynoid and morbid obesity. Nonetheless, studies have shown that there is hope for the obese individuals, despite the cause, type and degree of their obesity. This is through the use of the different available treatment measures which increase in physical activities, caloric restrictions, drug therapy and surgical intervention.

Keywords: low-density, lipoprotein, culprit, obesity

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Authors: Farida Eid, Hala Nasseif, Hana Mokhtar, Labib Riachi, Mudhar Hasan

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Bladder Endometriosis is a rare form of endometriosis and is defined as the presence of endometriotic tissue in the detrusor muscle of the bladder, either in full or partial thickness. Women typically present with dysuria, urinary frequency, hematuria, and recurrent urinary tract infections. Bladder endometriosis is typically found at the bladder base and bladder dome. Transvaginal ultrasound is considered first-line imaging, and the condition is typically managed with laparoscopic partial cystectomy. A 33-year-old nulliparous woman presented with chronic pelvic pain, severe dysmenorrhea, and metrorrhagia. The patient was previously diagnosed with bladder endometriomas two years ago with multiple recurrences. MRI revealed urinary bladder endometriosis measuring 3 x 2 x 1.5 cm. Accordingly, the patient underwent a cystoscopy-guided robotic-assisted excision of the endometriotic implant in the bladder with cystotomy and repair of the bladder mucosa. The operation was tolerated well, and the postoperative period was uneventful. Bladder Endometriosis (BE) typically presents with urinary symptoms and can be mistaken for a bladder tumor upon further imaging. The case was successfully managed with cystoscopy-guided, robotic-assisted excision and fulguration of the endometriotic implant in the bladder.

Keywords: endometriosis, bladder endometriosis (BE), urinary tract endometriosis (UTE), robotic-assisted surgery

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Authors: V. Diaz, B. Pardo , D. Villegas

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In premature births most babies have complications at birth, these complications can be reduced, if an atmosphere of relaxation is provided and is also similar to intrauterine life, for this, there are programs where their mothers lull and sway them; however, the conditions in which they do so and the way in they do it may not be the indicated. Here we describe an investigation based on the biomimics of the kinematics of human fetal movement, which consists of determining the movements that the fetus experiences and the deformations of the components that surround the fetus during a gentle walk at week 32 of the gestation stage. This research is based on a 3D model that has the anatomical structure of the pelvis, fetus, muscles, uterus and its most important supporting elements (ligaments). Normal load conditions are applied to this model according to the stage of gestation and the kinematics of a gentle walk of a pregnant mother, which focuses on the pelvic bone, this allows to receive a response from the other elements of the model. To accomplish this modeling and subsequent simulation Solidworks software was used. From this analysis, the curves that describe the movement of the fetus at three different points were obtained. Additionally, we could found the deformation of the uterus and the ligaments that support it, showing the characteristics that these tissues can have in the face of the support of the fetus. These data can be used for the construction of artifacts that help the normal development of premature infants.

Keywords: simulation, biomimic, uterine model, fetal movement study

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Authors: Amil Suleimanov, Aigul Saduakassova, Denis Vinnikov

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Objective: To assess functional visceral fat (VAT) activity evaluated by ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography/computed tomography (PET/CT) as a predictor of metastases in colorectal cancer (CRC). Materials and methods: We assessed 60 patients with histologically confirmed CRC who underwent 18F-FDG PET/CT after a surgical treatment and courses of chemotherapy. Age, histology, stage, and tumor grade were recorded. Functional VAT activity was measured by maximum standardized uptake value (SUVmax) using ¹⁸F-FDG PET/CT and tested as a predictor of later metastases in eight abdominal locations (RE – Epigastric Region, RLH – Left Hypochondriac Region, RRL – Right Lumbar Region, RU – Umbilical Region, RLL – Left Lumbar Region, RRI – Right Inguinal Region, RP – Hypogastric (Pubic) Region, RLI – Left Inguinal Region) and pelvic cavity (P) in the adjusted regression models. We also report the best areas under the curve (AUC) for SUVmax with the corresponding sensitivity (Se) and specificity (Sp). Results: In both adjusted for age regression models and ROC analysis, 18F-FDG accumulation in RLH (cutoff SUVmax 0.74; Se 75%; Sp 61%; AUC 0.668; p = 0.049), RU (cutoff SUVmax 0.78; Se 69%; Sp 61%; AUC 0.679; p = 0.035), RRL (cutoff SUVmax 1.05; Se 69%; Sp 77%; AUC 0.682; p = 0.032) and RRI (cutoff SUVmax 0.85; Se 63%; Sp 61%; AUC 0.672; p = 0.043) could predict later metastases in CRC patients, as opposed to age, sex, primary tumor location, tumor grade and histology. Conclusions: VAT SUVmax is significantly associated with later metastases in CRC patients and can be used as their predictor.

Keywords: ¹⁸F-FDG, PET/CT, colorectal cancer, predictive value

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Authors: Feng Guo

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Human brain organoids, 3D brain tissue cultures derived from human pluripotent stem cells, hold promising potential in modeling neuroinflammation for a variety of neurological diseases. However, challenges remain in generating standardized human brain organoids that can recapitulate key physiological features of a human brain. Here, this study presents a series of organoids-on-a-chip systems to generate better human brain organoids and model neuroinflammation. By employing 3D printing and microfluidic 3D cell culture technologies, the study’s systems enable the reliable, scalable, and reproducible generation of human brain organoids. Compared with conventional protocols, this study’s method increased neural progenitor proliferation and reduced heterogeneity of human brain organoids. As a proof-of-concept application, the study applied this method to model substance use disorders.

Keywords: human brain organoids, microfluidics, organ-on-a-chip, neuroinflammation

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Authors: Izabela Poprawa, Alina Chachulska-Zymelka, Lukasz Chajec, Grazyna Wilczek, Piotr Wilczek, Sebastian Student, Magdalena Rost-Roszkowska

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Heavy metals polluting the environment, especially soil, have a harmful effect on organisms, because they can damage the organ structure, disturb their function and cause developmental disorders. They can affect not only the somatic tissues but also the germinal tissues. In the natural environment, plants and animals are exposed to short- and long-term exposure to these stressors, which have a major influence on the functioning of these organisms. Numerous animals have been treated as the bioindicators of the environment. Therefore, studies on any alterations caused by, e.g., heavy metals are in the center of interests of not only environmental but also medical and biological science. Myriapods are invertebrates which are bioindicators of the environment. One of the species which lives in the upper layers of soil, particularly under stones and rocks is Lithobius forficatus (Chilopoda), commonly known as the brown centipede or stone centipede. It is a European species of the family Lithobiidae. This centipede living in the soil is exposed to, e.g., heavy metals such as cadmium, lead, arsenic. The main goal of our project was to analyze the impact of long-term exposure to cadmium on the structure of ovary with the emphasis on the course of oogenesis. As the material for analysis of cadmium exposure to ovaries, we chose the centipede species, L. forficatus. Animals were divided into two experimental groups: C – the control group, the animals cultured in laboratory conditions in a horticultural soil; Cd2 – the animals cultured in a horticultural soil supplemented with 80 mg/kg (dry weight) of CdCl2 for 45 days – long-term exposure. Animals were fed with Acheta and Chironomus larvae maintained in tap water. The analyzes were carried out using transmission electron microscopy (TEM), flow cytometry and laser scanning (confocal) microscopy. Here we present the results of long-term exposure to cadmium concentration in soil on the organ responsible for female germ cell formation. Analysis with the use of the transmission electron microscope showed changes in the ultrastructure of both somatic and germ cells in the ovary. Moreover, quantitative analysis revealed the decrease in the percentage of cells viability, the increase in the percentage of cells with depolarized mitochondria and increasing the number of early apoptotic cells. All these changes were statistically significant compared to the control. Additionally, an increase in the ADP/ATP index was recorded. However, changes were not statistically significant to the control. Acknowledgment: The study has been financed by the National Science Centre, Poland, grant no 2017/25/B/NZ4/00420.

Keywords: cadmium, centipede, ovary, ultrastructure

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Authors: A. F. Suleimanov, A. B. Saduakassova, V. S. Pokrovsky, D. V. Vinnikov

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Relevance: Epithelial ovarian cancer (EOC) is the most lethal gynecological malignancy, with relapse occurring in about 70% of advanced cases with poor prognoses. The aim of the study was to evaluate functional visceral fat activity (VAT) evaluated by ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography/computed tomography (PET/CT) as a predictor of metastases in epithelial ovarian cancer (EOC). Materials and methods: We assessed 53 patients with histologically confirmed EOC who underwent ¹⁸F-FDG PET/CT after a surgical treatment and courses of chemotherapy. Age, histology, stage, and tumor grade were recorded. Functional VAT activity was measured by maximum standardized uptake value (SUVₘₐₓ) using ¹⁸F-FDG PET/CT and tested as a predictor of later metastases in eight abdominal locations (RE – Epigastric Region, RLH – Left Hypochondriac Region, RRL – Right Lumbar Region, RU – Umbilical Region, RLL – Left Lumbar Region, RRI – Right Inguinal Region, RP – Hypogastric (Pubic) Region, RLI – Left Inguinal Region) and pelvic cavity (P) in the adjusted regression models. We also identified the best areas under the curve (AUC) for SUVₘₐₓ with the corresponding sensitivity (Se) and specificity (Sp). Results: In both adjusted-for regression models and ROC analysis, ¹⁸F-FDG accumulation in RE (cut-off SUVₘₐₓ 1.18; Se 64%; Sp 64%; AUC 0.669; p = 0.035) could predict later metastases in EOC patients, as opposed to age, sex, primary tumor location, tumor grade, and histology. Conclusions: VAT SUVₘₐₓ is significantly associated with later metastases in EOC patients and can be used as their predictor.

Keywords: ¹⁸F-FDG, PET/CT, EOC, predictive value

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Authors: Natalie A. Sterk, Bernard van Vuuren, Petrie Marais, Bongani Mthombeni

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Injuries to the internal structures of the thorax and abdomen remain a leading cause of death among soldiers. Body armour is a standard issue piece of military equipment designed to protect the vital organs against ballistic and stab threats. When configured for maximum protection, the excessive weight and size of the armour may limit soldier mobility and increase physical fatigue and discomfort. Providing soldiers with more armour than necessary may, therefore, hinder their ability to react rapidly in life-threatening situations. The capability to determine the optimal trade-off between the amount of essential anatomical coverage and hindrance on soldier performance may significantly enhance the design of armour systems. The current study aimed to develop and pilot a methodology for relating internal anatomical structures with actual armour plate coverage in real-time using low-dose diagnostic X-ray scanning. Several pilot scanning sessions were held at Lodox Systems (Pty) Ltd head-office in South Africa. Testing involved using the Lodox eXero-dr to scan dummy trunk rigs at various degrees and heights of measurement; as well as human participants, wearing correctly fitted body armour while positioned in supine, prone shooting, seated and kneeling shooting postures. The verification of sizing and metrics obtained from the Lodox eXero-dr were then confirmed through a verification board with known dimensions. Results indicated that the low-dose diagnostic X-ray has the capability to clearly identify the vital internal structures of the aortic arch, heart, and lungs in relation to the position of the external armour plates. Further testing is still required in order to fully and accurately identify the inferior liver boundary, inferior vena cava, and spleen. The scans produced in the supine, prone, and seated postures provided superior image quality over the kneeling posture. The X-ray-source and-detector distance from the object must be standardised to control for possible magnification changes and for comparison purposes. To account for this, specific scanning heights and angles were identified to allow for parallel scanning of relevant areas. The low-dose diagnostic X-ray provides a non-invasive, safe, and rapid technique for relating vital internal structures with external structures. This capability can be used for the re-evaluation of anatomical coverage required for essential protection while optimising armour design and fit for soldier performance.

Keywords: body armour, low-dose diagnostic X-ray, scanning, vital organ coverage

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Authors: B. Selma, S. Chouraqui

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The pancreas is an elongated organ that extends across the abdomen, below the stomach. In addition, it secretes certain enzymes that aid in food digestion. The pancreas also manufactures hormones responsible for regulating blood glucose levels. In the present paper, we propose a mathematical model to study the homeostasis of glucose and insulin in healthy human, and a simulation of this model, which depicts the physiological events after a meal, will be represented in ordinary humans. The aim of this paper is to design an algorithm which regulates the level of glucose in the blood. The algorithm applied the concept of expert system for performing an algorithm control in the form of an "active" used to prescribe the rate of insulin infusion. By decomposing the system into subsystems, we have developed parametric models of each subsystem by using a forcing function strategy. The results showed a performance of the control system.

Keywords: modeling, algorithm, regulation, glucose-insulin, blood, control system

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Authors: Nikita Sankhe

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A Frenum is a band or fold of mucous membrane, which is usually with enclosed muscle fibers, that attaches the lip and cheek to the alveolar mucosa or the gingiva and the underlying periosteum. It curbs or limits the movements of an organ. A frenum becomes a problem if its attachment is too close to the marginal or papillary gingiva, namely localized gingival recession and a midline diastema or it may pull the gingival margin away from the tooth allowing plaque accumulation and inhibit toothbrushing. Frenectomy is the complete removal of the frenum including its attachment to the underlying bone. Miller suggested a technique where by a closure was done across the midline by laterally positioned gingiva. Healing by primary intention resulted in aesthetically acceptable attached gingiva across the midline. This paper aims at showing how a lateral pedicle graft technique combined with frenectomy proves to be more advantageous than any other technique.

Keywords: frenum , frenectomy , lateral pedicle graft , classical frenectomy

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Authors: Ahmad Shanei, Milad Baradaran-Ghahfarokhi

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This study aimed to investigate testicular dose (TD) and the associated risk of heritable disease from common pelvis radiotherapy of male patients in Iran. In this work, the relation between TD and changes in beam energy, pelvis size, source to skin distance (SSD) and beam directions (anterior or posterior) were also evaluated. The values of TDs were measured on 67 randomly selected male patients during common pelvis radiotherapy using 1.17 and 1.33 MeV, Theratron Cobalt-60 unit at SSD of 80 cm and 9 MV, Neptun 10 PC and 18 MV, GE Saturne 20 at SSD of 100 cm at Seyed-Al Shohada Hospital, Isfahan, Iran. Results showed that the maximum TD was up to 12% of the tumor dose. Considering the risk factor for radiation-induced heritable disorders of 0.1% per Sv, an excess risk of hereditary disorders of 72 per 10000 births was conservatively calculated. There was a significant difference in the measured TD using different treatment machines and energies (P < 0.001). The TD at 100 cm SSD were much less than that for 80 cm SSD (P <0.001). The Pearson Correlation test showed that, as expected, there was a strong correlation between TD and patient’s pelvis size (r = 0.275, P <0.001). Using the student’s t-tests, it was found that, there was not a significant difference between TD and beam direction (P = 0.231). Iranian male patients undergoing pelvic radiotherapy have the potential of receiving a TD of more than 1 Gy which might result in temporary azoospermia. The risk for induction of hereditary disorders in future generations should be considered as low but not negligible in comparison with the correspondent nominal risk.

Keywords: pelvis radiotherapy, testicular dose, infertility, hereditary effects

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Authors: Berrak Yildiz, Hinal Shah, Justine Fernandez, Nazje James, Anna Brown

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Cervical ectopic pregnancy, a rare type of ectopic pregnancies, is defined by blastocyst implantation within the cervical canal rather than the endometrium. Its rarity and potential for severe hemorrhage make cervical ectopic pregnancy a diagnostic and therapeutic challenge. A 39-year-old woman, G5P2022, with a history of two cesarean sections and two elective terminations, presented to the emergency department with vaginal bleeding and pelvic pain. Initial assessment showed a beta-hCG level of 2,853 mIU/mL, and transvaginal ultrasound revealed a small, irregular gestational sac at the level of the internal cervical os. Serial betahCG measurements over subsequent visits showed a declining trend, consistent with a nonviable pregnancy. The patient was ultimately treated with methotrexate at a dose of 50 mg/m² (total 100 mg), following which she reported no further symptoms. On follow-up, her beta-hCG level returned to the normal non-pregnant range, with no additional intervention needed. This case highlights the importance of early diagnosis in cervical ectopic pregnancy to avoid complications like hysterectomy. Methotrexate is an effective first-line treatment in hemodynamically stable patients, offering a conservative approach that can preserve fertility. The success in this patient underscores the role of prompt diagnosis and careful management in achieving resolution while minimizing invasive procedures.

Keywords: beta-hCG, cervical, ectopic, methotrexate

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Authors: Ferjani Hanen, El Arem Amira, Boussema Ayed Imen, Bacha Hassen

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Tacrolimus (TAC), a calcineurin inhibitor, is clinically used as an immunosuppressive agent in the transplant recipient, but its use associated-hepatotoxicity. Mycophenolate mofetil (MMF), an anti-metabolite, is a potent immunosuppressive drug. MMF is not hepatotoxic and is the most common adjunctive immunosuppressant for TAC. The effects of TAC and MMF combination in the liver is still not well understood. This work aimed to investigate their combined effect against in liver in rats Wistar after 24 h. The oral median lethal doses (LD50) of TAC and MMF alone were evaluated in rats are 240 mg/kg and 500 mg/kg respectively. Oral administration of the MMF at 50 mg/kg to male Wistar intoxicated with TAC at 60 mg/kg, demonstrated a significant protective effect by lowering the levels of hepatic markers enzymes (AST, ALT) in the serum rat. MMF attenuated oxidative stress by restoring the activities of SOD, CAT and by reducing the malondialdehyde (MDA) and protein carbonyl levels liver. This study provided evidence that MMF protects rat liver from TAC-induced injury and suggests a most combination use for organ transplantation.

Keywords: tacrolimus, mycophenolate mofetil, combination, liver, rat

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Authors: A. Askerov, Y. Teterin, P. Yartcev, S. Novikov

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Introduction: Acute pancreatitis (AP) is a socially significant problem for public health and continues to be one of the most common causes of hospitalization of patients with pathology of the gastrointestinal tract. It is characterized by high mortality rates, which reaches 62-65% in infected pancreatic necrosis. Aims & Methods: The study group included 63 patients who underwent transluminal drainage (TLD) fluid collection (FC). All patients were performed transabdominal ultrasound, computer tomography of the abdominal cavity and retroperitoneal organs and endoscopic ultrasound (EUS) of the pancreatobiliary zone. The EUS was used as a final diagnostic method to determine the characteristics of FC. The indications for TLD were: the distance between the wall of the hollow organ and the FC was not more than 1 cm, the absence of large vessels on the puncture trajectory (more than 3 mm), and the size of the formation was more than 5 cm. When a homogeneous cavity with clear, even contours was detected, a plastic stent with rounded ends (“double pig tail”) was installed. The indication for the installation of a fully covered self-expanding stent was the detection of nonhomogeneous anechoic FC with hyperechoic inclusions and cloudy purulent contents. In patients with necrotic forms after drainage of the purulent cavity, a cystonasal drainage with a diameter of 7Fr was installed in its lumen under X-ray control to sanitize the cavity with a 0.05% aqueous solution of chlorhexidine. Endoscopic necrectomy was performed every 24-48 hours. The plastic stent was removed in 6 month, the fully covered self-expanding stent - in 1 month after the patient was discharged from the hospital. Results: Endoscopic TLD was performed in 63 patients. The FC corresponding to interstitial edematous pancreatitis was detected in 39 (62%) patients who underwent TLD with the installation of a plastic stent with rounded ends. In 24 (38%) patients with necrotic forms of FC, a fully covered self-expanding stent was placed. Communication with the ductal system of the pancreas was found in 5 (7.9%) patients. They underwent pancreaticoduodenal stenting. A complicated postoperative period was noted in 4 (6.3%) cases and was manifested by bleeding from the zone of pancreatogenic destruction. In 2 (3.1%) cases, this required angiography and endovascular embolization a. gastroduodenalis, in 1 (1.6%) case, endoscopic hemostasis was performed by filling the cavity with 4 ml of Hemoblock hemostatic solution. The combination of both methods was used in 1 (1.6%) patient. There was no evidence of recurrent bleeding in these patients. Lethal outcome occurred in 4 patients (6.3%). In 3 (4.7%) patients, the cause of death was multiple organ failure, in 1 (1.6%) - severe nosocomial pneumonia that developed on the 32nd day after drainage. Conclusions: 1. EUS is not only the most important method for diagnosing FC in AP, but also allows you to determine further tactics for their intraluminal drainage.2. Endoscopic intraluminal drainage of fluid zones in 45.8% of cases is the final minimally invasive method of surgical treatment of large-focal pancreatic necrosis. Disclosure: Nothing to disclose.

Keywords: acute pancreatitis, fluid collection, endoscopy surgery, necrectomy, transluminal drainage

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Authors: Azadeh Jafari, Mohammad Taghi Karimi, Azadeh Nadi

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Background: Scoliosis is the lateral curvature of the spine which may influence the abilities of the subjects during standing and walking. Most of the scoliotic subjects use orthosis to reduce the curve and to decrease the risk of curve progression. There was lack of information regarding the effects of orthosis on kinematic and joint contact force. Therefore, this research was done to highlight the effects of orthosis on the aforementioned parameters. Method: 5 scoliotic subjects were recruited in this study, with single curve less than 40 (females with age 13.2 ± 1.7). They were asked to walk with and without orthosis. The kinematic of the joints, force applied on the legs, moments transmitted through the joints and joint contact forces were evaluated in this study. Moreover, the lengths of muscles were determined by use of computer muscle control approach in OpenSim. Results: There was a significant difference between the second peak of vertical ground reaction force while walking with and without orthosis (p-value < 0.05). There was no difference between spatiotemporal gait parameters while walking with and without orthosis (P-value > 0.05). The mean values of joint contact forces (vertical component) increased by the use of orthosis, but the difference was not significant (p-value > 0.05). Conclusion: Although the kinematic of most of the body joints was not influenced by the use of orthosis, the joint contact force may be increased by orthosis. The increase in joint contact force may be due to the performance of orthosis which restricts the motions of pelvic and increases compensatory mechanism used by the subjects to decrease the side effects of the orthosis.

Keywords: scoliosis, joint contact force, kinetic, kinematic

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Authors: Gulten Yilmaz, A. Beril Tugrul, Mustafa Demir, Dogan Yasar, Bayram Demir, Bulent Buyuk

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A Positron Emission Tomography (PET) is a radioisotope imaging technique that illustrates the organs and the metabolisms of the human body. This technique is based on the simultaneous detection of 511 keV annihilation photons, annihilated as a result of electrons annihilating positrons that radiate from positron-emitting radioisotopes that enter biological active molecules in the body. This study was conducted on ten patients in an effort to conduct patient-related experimental studies. Dosage monitoring for the bladder, which was the organ that received the highest dose during PET applications, was conducted for 24 hours. Assessment based on measuring urination activities after injecting patients was also a part of this study. The MIRD method was used to conduct dosage calculations for results obtained from experimental studies. Results obtained experimentally and theoretically were assessed comparatively.

Keywords: PET/CT, TLD, MIRD, dose measurement, patient doses

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Authors: Halimah Al Hifzi, Waseem Al-Talalwah, Shorok Al Dorazi, Hassan Al Mousa, Zainab Al-Hashim, Roger Soames

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The obturator artery is one branches of anterior division of the internal iliac artery. It passes on the lateral wall of pelvis to escape into thigh region via obturator foremen. Based on previous research studies, it found to be extremely variable in origin and course. It may arise from internal or external iliac artery. The current study includes 82 dissected specimens to investigate the origin of the obturator artery and explain the clinical importance. The obturator artery arises from the internal iliac artery in 75% either from its anterior or posterior division in 46.9% or 25% respectively. Further, it arises neither from the anterior nor posterior division of the internal iliac artery but it arises between them in 3.1%. In 25%, the obturator artery arises from the external iliac artery. In case of aneurysmectomy of posterior division, carries a high risk of insufficient of vascular supply for demand structures such as proximal adductors attachment and hip joint. Therefore, vascular surgeons have to pay attention to the posterior division being an origin of the obturator artery beside its usual three classical branches: superior gluteal, iliolumbar and lateral sacral arteries. Further, the obturator artery arising from the external iliac system is in great dangerous of laceration in case of anterior pelvic fracture. Therefore, it may lead to haemorrhagic shock threatening life.

Keywords: obturator artery, external iliac, internal iliac artery, anterior division, posterior division, superior gluteal, iliolumbar and lateral sacral, pubic fracture, aneurysm, shock

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Authors: Salahud Din, Saima Masood, Hafsa Zaneb, Habib –ur- Rehman, Imad Khan, Muqader Shah

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The objective of this study was to examine the osteomorphological differences between the long bones of adult Chinkara and an adult Beetal goat, using visual observation, which has still not studied. The osseous remains of these small-sized ungulates often encountered, but cannot distinguish, because of the lack of literature. Specimens of the adult Chinkara of known age and sex for osteomorphological studies are collected from the Manglot Wildlife Park and Ungulate Breeding Centre, Nizampur, Pakistan, while the bones of adult Beetal goats are obtained after slaughtering in a slaughterhouse. The research is carried out at the University of Veterinary and Animal Sciences, Lahore, Pakistan. In this research, the main morphological features recorded in the long bones of thoracic limb and pelvic limb of the adult Chinkara, by comparing them to those of the Beetal goat. The most important differences between the two species are noted in the scapula, the humerus, the radius and ulna, the metacarpal, femur, tibia metatarsal and phalanges. In conclusion, the present study suggests that the morphology of the long bones of adult Chinkara has different from the Beetal goat in various points of view. Based on these recorded points, long bones of these two species can easily be differentiated. The study is helpful in zooarcheological, comparative osteometric studies, for forensic specialists and veterinary anatomists.

Keywords: Beetal goat, Chinkara, comparative morphological features, long bones, osteology

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