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Assessment of on farm agrobiodiversity and its role in food sufficiency in mid hill, Nepal

Published on: 31st March, 2023

A survey was conducted in the agricultural farms in Dhulikhel Municipality, mid-hill, Kavre, Nepal aiming at assessing the status of agrobiodiversity with the purpose of understanding its role in food security taking altogether 133 farming households scattered in several settlements with lowland, upland, and home garden being the general agricultural land use systems. Biodiversity index: Shannon-Wiener Index was used to assess diversity of plant. The main purpose was to assess the farm agrobiodiversity and to find out whether biodiversity level has a direct link to household food self-sufficiency. For descriptive analysis frequency, percentage, mean and standard errors were used. In the case of inferential statistics independent sample t - test and binary logistic was used to find the odd ratio of practicing home garden. The result showed that the average landholding size was 0.66 ha/household with 0.37 ha, 0.3 ha, and 0.06 ha being upland, low land, and home garden, respectively. A total of 136 plant species were documented out of which 74 were the effective number of species in the study area. Among the used plants, fodder shared 27% of the total plant diversity followed by fruit (21%), vegetable (19%), medicinal plants (8%), pulses (8%), spices (7%), oilseeds (5%) and cereals (5%). Similarly, the mean livestock unit (LSU) was 2.65. The overall Shannon-Wiener Index was 4.30 indicating high diversity of species and 87.7% of the species were evenly distributed. The Index was higher for vegetable (3.11) followed by fruits (2.9) and fodder (2.85). Higher diversity was found in fodder trees in lowlands whereas vegetable species were more diverse in upland and home garden. Similarly, the Index was 4.29 in the upland whereas it was 4.078 in the home garden followed by 3.13 in the lowland. The evenness was 0.899, 0.87, and 0.74 in upland, home garden and lowland, respectively. Higher species diversity revealed that the site was rich in agrobiodiversity. A significant positive correlation (0.22) was observed between Shannon-Wiener Index and farming years. Similarly, positive correlation (0.33) was found between an increase in the level of agrobiodiversity and food self-sufficiency. The result demonstrated that increasing crop diversity increases the household’s ability towards food sufficiency implying the need for the formulation and implementation of efficient policy to conserve the agrobiodiversity at municipality as well as national levels.
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Design and optimization of mRNAs encoding an Anti-TIGIT antibody with therapeutic potential for cancer in TIGIT-humanized BALB/c Mice

Published on: 7th April, 2023

mRNA drugs are synthesized using cell-free systems without complex and stringent manufacturing processes, which makes their preparation simple, efficient, and economical. Over the past few years, mRNAs encoding antibodies have been one of the research frontiers of antibody drug development. In cancer immunotherapy, mRNAs encoding immune checkpoint antibodies may be advantageous regarding antibody persistence and durability of the anti-tumor immune response of patients. In our previous study, a candidate antibody—AET2010—targeting the novel immune checkpoint TIGIT was reported. Its anti-tumor activity was also investigated using adoptive transfer of NK-92MI cells in a xenograft mouse model, but the limitations of the model did not facilitate precise evaluation. In the present study, we further investigated the therapeutic potential of AET2010 for cancer in TIGIT-humanized BALB/c mice. Next, we explored the design, synthesis, and optimization of mRNAs encoding AET2010 and ultimately obtained a candidate mRNA (mRNA-BU) with favorable in vitro and in vivo expression levels of active AET2010. Particularly, lipid-nanoparticle-encapsulated mRNA-BU delivered to mice produced AET2010 with significantly higher peak concentration and expression duration than an equivalent dose of original AET2010. This study provides a sound basis for developing novel drugs targeting TIGIT.
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Expanding human-based predictive models capabilities using organs-on-chip: A standardized framework to transfer and co-culture human iPSCs into microfluidic devices

Published on: 13th April, 2023

There is an urgent need for predictive preclinical models to enhance the success rate of clinical trial outcomes. One of the main reasons for drug attrition is the lack of translational models, methods using human cells are particularly in the spotlight of regulatory bodies as they offer an alternative to in vivo studies and have the potential to improve the translational of preclinical trials. Organs-on-Chips (OoCs) are sensible candidates to reduce the cost and the ethical burden of animal models while accelerating and de-risking drug development. The innovation of such systems is based on both the increased relevance of the cells used and the ability to build precise, yet physiologically relevant, complex architectures. The use of microfluidic technologies with human induced pluripotent stem cells (hiPSCs) opens new routes to create relevant in vitro approaches as they will soon be able to reproduce clinical characteristics of donors or specific populations. The adoption of OoC models by pharmaceutical industries, and in fine by regulatory agencies, still requires: (i) establishing standardized, reproducible, robust, and replicable cell culture protocols with specific validation and characterization criteria, (ii) evidence that the technology predicts human responses, thus allowing to contribute efficiently and reliably to clinical trials success of novel therapeutics, and (iii) evidence that the models refine and reduce animal testing without compromising with the quality and the pertinence of the data generated.
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Diagnostic accuracy of apparent diffusion coefficient (ADC) in differentiating low- and high-grade gliomas, taking histopathology as the gold standard

Published on: 10th April, 2023

Gliomas are known to be one of the most grievous malignant central nervous system (CNS) tumors and have a high mortality rate with a low survival rate severe disability and increase risk of recurrence. Aim of his study is to determine the diagnostic accuracy of apparent diffusion coefficient (ADC) in differentiating low-grade and high-grade gliomas, taking histopathology as the gold standard. It is a Cross-sectional validation study conducted at the Armed Forces Institute of Radiology and Imaging, (AFIRI) Rawalpindi, Pakistan from 28th February 2022 to 27th August 2022.Materials and methods: A total of 215 patients with focal brain lesions of age 25-65 years of either gender were included. Patients with a cardiac pacemaker, breastfeeding females, de-myelinating lesions and malignant infiltrates, and renal failure were excluded. Then diffusion-weighted magnetic resonance imaging was performed on each patient by using a 1.5 Tesla MR system. The area of greatest diffusion restriction (lowest ADC) within the solid tumor component was identified while avoiding areas of peritumoral edema. Results of ADC were interpreted by a consultant radiologist (at least 5 years of post-fellowship experience) for high or low-grade glioma. After this, each patient has undergone a biopsy in the concerned ward, and histopathology results were compared with ADC findings. Results: Overall sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of apparent diffusion coefficient (ADC) in differentiating low- and high-grade gliomas, taking histopathology as the gold standard was 93.65%, 87.64%, 91.47%, 90.70% and 91.16% respectively. Conclusion: This study concluded that apparent diffusion coefficient (ADC) is the non-invasive modality of choice with high diagnostic accuracy in differentiating low- and high-grade gliomas.
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Comparative characterization between autologous serum and platelet lysate under different temperatures and storage times

Published on: 12th April, 2023

Therapies using autologous serum and platelet lysate have shown promise among blood and biological products in the treatment of various diseases. The autologous serum has been shown to be a superior alternative to traditional eye drops in treating eye diseases in ophthalmology. Platelet lysate (PL) has recently been considered a more interesting alternative for the treatment of multiple tissues, as it does not have the unfavorable reactions seen with traditional platelet-rich plasma (PRP), making it a valuable blood derivative for use in ocular therapy. There is no definitive comparison in veterinary medicine between PL and autologous serum in terms of the content of Transforming Growth Factor beta 1 (TGF-1), which is known to have chemotactic, mitogenic, matrix formation, and angiogenesis effects on tissues, and beneficial proteins in ocular tissue. This study aimed to estimate the concentrations of TGF-1, total protein, and albumin, as well as autologous serum and platelet lysate, in horses over an 8-day storage period at temperatures of 4 °C and 37 °C.To produce autologous serum, 63 ml of blood was collected from each animal in seven 9 ml tubes without anticoagulant. For platelet lysate, 180 ml of blood was collected in 50 tubes of 3.6 ml with 3.2% sodium citrate. The most significant findings were the positive relationship between the baseline platelet count in the blood and the final platelet concentration in PRP. Specifically, we found a correlation (R = 0.9) with a p - value of 0.005 between the average baseline platelet level of seven animals and their corresponding PRP results, both on an individual level and as a group. Additionally, there was a correlation between growth factor concentration and PRP platelets, with the highest growth factor concentration in PL. The temperature storage group exhibited higher concentrations of total protein and serum albumin, as well as the maximum amount of growth factor for both products at a temperature of 37 °C.
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Effectiveness, longevity, and color stability of in-office bleaching (6% H2O2 gel/Violet LED) and diastema closure with direct composite: 3-year follow-up

Published on: 14th April, 2023

To reduce bleaching side effects, the use of low concentrations of Hydrogen Peroxide (HP) agents associated with hybrid light (violet LED/Diode Laser) has gained interest. Case report: The aim of this report is to describe a case of a 16-year-old patient that presented a complaint related to the color of his teeth and a maxillary midline diastema. In-office bleaching with 6% HP associated with hybrid light (violet LED/Diode Laser) was performed. The bleaching gel was applied once on the teeth and light-activated for 1 minute (15 times) followed by 1min intervals (15 times) with a total bleaching time of 30 minutes. After the bleaching procedure, the teeth were polished and the desensitizer was applied for 4 minutes. Two bleaching sessions were performed at a 1-week interval. The diastema was closed with direct resin composite restorations without any tooth preparation. The conventional 3-step bonding agent was used and A1 dentin shade and B1 enamel shade were used followed by polishing discs. At 3-year recall, discoloration and fractures were not found on the the teeth or restorations and patient was completely satisfied. Conclusion: the conservative and safe option of bleaching with a low-concentrated HP gel associated with violet LED light is an interesting option for young patients and presents longevity over time.
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Current and emerging trends in oro-dental healthcare and cranio-maxillo-facial surgery

Published on: 14th April, 2023

Dentistry is an ever-evolving field that has seen significant advances in recent years. This article sheds light on some of the current and emerging trends in oral health care, including digital dentistry, regenerative medicine, and the use of lasers. For example, digital dentistry involves the use of computer-aided design and manufacturing technology, which enables more accurate and efficient production of dental devices. On the other hand, regenerative medicine and nanoDentistry can be considered promising area that combines the use of stem cells, growth factors, biomaterials, and nanotechnology to regenerate damaged tissue and improve treatment outcomes. Lasers are increasingly being used in dentistry for a range of applications, including the treatment of gum disease and teeth whitening. Other developing technologies such as 3D printing and artificial intelligence are also being increasingly incorporated into dentistry, providing improved treatment options for our patients. Last yet definitely would/will not least, controlled drug delivery systems are being developed to deliver drugs to specific target sites in a localized and sustained manner, reducing the risk of adverse effects. Currently, these emerging trends are transforming the landscape of odontology and beyond. Hence, in this mini-Review, we explore such trends in oro-dental and cranio-maxillo-facial indications to highlight the potential benefits, advancements, and opportunities of applications for improved patient care.
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Role of measurable residual disease quantified by 4 to 6 color flow cytometry before allogeneic hematopoietic stem cell transplantation for high-risk Philadelphia-negative acute lymphoblastic leukemia

Published on: 14th April, 2023

Background: Measurable residual disease (MRD) status before allogeneic hematopoietic stem cell transplantation (AHSCT) is commonly associated with a high risk of relapse. It is still uncertain whether AHSCT could overcome the negative impact of MRD positivity (MRD+), especially in patients with high-risk Philadelphia negative acute lymphoblastic leukemia (Ph-negative ALL). Materials and methods: An observational retrospective study was conducted on patients with high-risk Ph-negative ALL who underwent AHSCT between January 2005 and June 2022. The patients selected were in complete remission (CR): with 80% in CR1 (n = 69) and 20% in CR2 (n = 17). Graft sources were bone marrow (BM) in 71% of patients and peripheral blood stem cells in 29% of patients. The conditioning regimen was TBI or chemotherapy-based (CT). Bone marrow MRD level was quantified using 4-6 color multiparametric flow cytometry (MFC). The threshold for MRD positivity was ≥ 0.1%. Results: The study included 86 patients (45 B-ALL and 41 T-ALL) with a median age of 18 years (range, 4–55 years). The median level of MRD pre-AHSCT (pre-MRD) was 0.4×10-3 (range, 0.01-75.6×10-3). After a median follow-up of 25 months (range 1-205 months), the cumulative incidence of relapse (CIR) was significantly higher in the MRD+ group (39% vs. 20%, p = 0.04). The median time of relapse post-AHSCT was 14 months (range, 1-203 months) in the MRD+ group and 32 months (range, 4-209 months) in the MRD- group (p = 0.28). Non-relapse mortality (NRM) was 15% in both groups (p = 0.97). The 2-year estimated overall survival (OS) and event-free survival (EFS) were 61% vs. 74% (p = 0.07) and 58% vs. 70% (p = 0.10) in the MRD+ and MRD- groups, respectively. A subgroup analysis in MRD+ patients showed that a TBI-based conditioning regimen was distinctly associated with lower CIR (22% vs. 60% respectively, p = 0.04), improved OS (82% vs. 36% respectively, p = 0.007) and better EFS (73% vs. 38%, p = 0.04) compared to CT-based. In a multivariate analysis, pre-AHSCT MRD+ status and non-TBI-based conditioning were significantly associated with inferior OS (OR, 2.30; 95% CI, [1.027-5.168], p = 0.04 and OR, 3.91; 95% CI, [1.624-9.418], p = 0.002, respectively). The only predicting factor of lower EFS was the non-TBI-based regimen (OR, 2.82; 95% CI, [1.308-6.097], p = 0.008). Non-TBI-based and CR2 were significantly associated with higher CIR (OR, 6.25; 95% CI, [1.947-20.055], p = 0.002 and OR, 4.74; 95% CI, [1.197-18.791], p = 0.03, respectively). Peripheral stem cell source was significantly associated with higher NRM (OR, 6.55; 95% CI, [1.488-28.820], p = 0.01). Conclusion: High-risk Ph-negative ALL patients with MRD ≥ 10-3 prior AHSCT had lower OS compared to MRD- patients and may benefit from TBI as a conditioning regimen before AHSCT.
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Cognitive behavioral therapy treatment for drug addiction

Published on: 17th April, 2023

Drug addiction remains a major health concern following its devastating consequences to the users and the economy. Current statistics show a rising trend in substance abuse around the globe with approximately 284 million people engaging in drug abuse. Various approaches are used to treat the victims of drug abuse. Cognitive behavior therapy, a form of nonpharmacological intervention, has also been shown to be an effective treatment option for drug addiction. The use of Cognitive Behavioral Therapy (CBT) has grown since the 1970s to become one of the most important models of psychotherapy in this decade. Various empirical studies have shown the efficacy of CBT in well-controlled trials. A total of 19 randomized trials (cases) (with over 1400 patients treated) were selected and studied. In the various cases, results showed that patients were treated for drug and substance abuse disorders with the majority being those who abused cannabis, cocaine, alcohol and other opioids. In most cases, the CBT techniques that were used for drug addiction included cognitive restructuring, relapse prevention and contingency management. Components of CBT for drug addiction include skills and training, amplification of non-substance-related activities, approaches for managing urges, drug rejection and improvement of social aptitudes. Cognitive restructuring focuses on the identification of misconceptions and influencing the way people think about themselves by eliminating distorted thinking. Relapse prevention focuses on the identification and prevention of high-risk situations that may trigger the patient to engage in drug abuse. Contingency management reinforces positive behaviors and reduces negative behaviors through the use of rewards and incentives.
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Nuclear science and magnetic carbon: a promising way from a chemical method to detect and fight cancer and tumors/neoplasms

Published on: 17th April, 2023

In 2005 we reported for the first time on a chemical route aiming to synthesize stable magnetic carbon/graphite. By using the Nuclear Magnetic Resonance (NMR) technique we have verified that its magnetism is an intrinsic property of this synthesized material and not originated from ferromagnetic impurities of any kind. Through direct measurement of the local magnetic field using Carbon-13, we have concluded that its magnetism originated from defects in the structure. From its biocompatibility, we have been working on the use of magnetic carbon/graphite to deliver many compounds aiming to fight different diseases. Despite all the scientific and technological advances of the present day, cancer is a multifactorial and difficult-to-treat disease, killing hundreds of thousands of people a year worldwide. Therefore, the development of a new and efficient drug delivery system to fight cancer – among other diseases - is as important as the discovery of a novel active molecule. In this review of our own work, we show the drug delivery system named MAGUS® (an acronym for Magnetic Graphite Universal System) we have built based on nanostructured magnetic carbon/graphite. This is an innovative and promising system composed of a biocompatible nanostructured particle of magnetic carbon/graphite functionalized with different molecules and materials. MAGUS®, depending on what we link to its structure, is so versatile and can be used to detect a wide range of specimens, from tumors and cancers to chemical and biological agents used as non-conventional weapons. That is why we call it universal. In the present work, MAGUS® will be acting as a biosensor, where the magnetic carbon/graphite is functionalized with radioactive particles of Iodine-131 and antibodies of different types of cancer. Then, by focusing on both the antigen-antibody interaction and the spatial guiding through an external magnetic field we are providing our drug delivery system a double way to detect and reach just the target. Based on these strategies, the functionalized magnetic carbon/graphite will reach only the neoplasm and not the surrounding healthy cells around. In a general view, it means that we are giving specificity to the MAGUS® drug delivery system as a pioneering and effective way to detect and treat cancers. We are also working on this unprecedented and efficient drug delivery system using the principles of Boron Neutron Capture Therapy (BNCT) with Boron-10 instead of Iodine-131. BNCT technique uses neutrons as the external source and is frequently employed to treat specific tumors that are radio resistant or very difficult to kill using conventional radiation therapy. In summary, we show here for the first time that our Magnetic Graphite Universal System associated with nuclear techniques can be successfully used as a biosensor to detect and fight cancers and tumors with powerful features that conventional delivery drug systems and other treatments do not have at all.
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Systemic sclerosis sine scleroderma presenting as renal crisis, a case report and review of the literature

Published on: 17th April, 2023

Systemic sclerosis sine scleroderma is a rare subset of systemic sclerosis with isolated organ involvement. Scleroderma renal crisis is a severe manifestation of systemic sclerosis characterized by malignant hypertension, oligo/anuric renal failure, and thrombotic microangiopathy. We present a case of a 55-year-old male with uncontrolled hypertension who presented with hematospermia and was found to have acute renal failure, microangiopathic hemolytic anemia, concerning thrombotic microangiopathy. Empiric management for thrombotic thrombocytopenic purpura (TTP) with plasma exchange and corticosteroids yielded a paradoxical response, ultimately leading to the diagnosis of systemic sclerosis sine scleroderma presenting as scleroderma renal crisis (SRC) after serological confirmation. Given the morbidity and mortality associated with scleroderma renal crisis, it should be increasingly considered as a differential for thrombotic microangiopathy even without outward manifestations of systemic sclerosis. Additionally, the empiric management of TTP can include the use of corticosteroids which can exacerbate SRC, an early clinical clue in the diagnosis of this disease.
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A brief evaluation of the concepts of omics, genomics, proteomics and metabolomics in terms of sperm cell

Published on: 24th April, 2023

The ability to live things to transfer their genetic heritage to future generations in a healthy way forms the basis of the science of reproduction. In this sense, understanding the structure and functions of the sperm cell, which is one of the sexual cells, is one of the important issues that should be emphasized. Methods such as omics, genomics, proteomics, and metabolomics, which have been found in research in recent years, are also used to evaluate the functions of the sperm cell.
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Does change in cervical dilation after anesthesia impact latency after cerclage placement?

Published on: 24th April, 2023

Background: Pregnant individuals with early cervical dilation have a high risk for preterm birth. The authors encountered cases where cervical dilation increased after anesthesia administration for a cerclage. Objective: The primary objective was to assess if a change in cervical dilation after anesthesia administration for a cerclage was associated with a shorter latency to delivery. Study design: This was a retrospective chart review of pregnancies from January 1, 2011, to December 31, 2021, who had a cerclage and delivered at our institution. Maternal demographics, obstetrical history, operative details, and delivery information were collected. Multi-fetal gestations, un-indicated cerclages, and abdominal cerclages were excluded. The primary outcome was the difference in cervical dilation between the office and the operating room after spinal anesthesia administration. A multivariable regression was performed. Results: A total of 183 pregnancies were included. The mean gestational age at cerclage placement was 18 weeks (STDEV 3.6). Twenty-nine percent of patients (53/183) were more dilated in the operating room compared to the office The latency between cerclage and delivery was not different if there was a cervical change between these settings (p = 0.655). There was an increased risk for preterm delivery with dilation in the office (OR 1.01, CI 1.01 to 2.5), but not with dilation in the operating room (OR 1.4, CI 0.9 to 2.0). Conclusion: Cervical dilation between the office and the operating room is different. Pregnancies with more dilation delivered at earlier gestations. However, a change in dilation between the office and the operating room was not associated with a shorter latency. 
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Minimally invasive cytoreductive surgery in advanced ovarian cancer: A nonselected consecutive series of robotic-assisted cases

Published on: 28th April, 2023

The gold standard for advanced-stage ovarian cancer surgery entails exploration via a midline vertical laparotomy. Studies have shown that minimally invasive surgery (MIS) can be a safe and effective method for the surgical management of early ovarian cancer. In some cases, MIS can also be selectively used for cytoreductive surgery in cases with advanced-stage ovarian cancer. The robotic platform has the potential to provide similar outcomes to the laparotomy-based standard of care in advanced complex surgery while accelerating recovery, minimizing morbidity, and reducing perioperative complications. The primary objective of this study was to evaluate surgical and perioperative outcomes in patients with advanced ovarian carcinoma who underwent robotic-assisted cytoreduction. A chart review of a nonselected consecutive series of all patients undergoing surgical management of advanced ovarian cancer between 7/1/2017 and 12/31/2021 was conducted. All patients that were diagnosed with Stage III to IV ovarian cancer between the timeframe underwent robotic-assisted cytoreductive surgery at two urban community teaching hospitals in Los Angeles. Twenty-five patients were identified and included in this study. All surgeries were performed by a single surgeon. Optimal or complete CRS was achieved in 96% of the patients (24 of 25 cases). Seven (28%) underwent primary cytoreduction (PCRS) and 18 (72%) underwent interval cytoreduction (ICRS). The estimated median blood loss was 100 mL (25-500 mL), the median operative time was 5.9 hours (3.1-10.5 hours), and the conversion rate to open laparotomy was 0%. There were no intraoperative complications and the readmission rate within 30 days was 4% (1 patient) for ileus, which was managed conservatively. Currently, 64% of the patients in the case series remain alive. The median survival has not been reached. The median follow-up is 4.08 years. Results presented from this nonselected, consecutive case series illustrate how a minimally invasive robotic approach can be safely used in place of the standard exploratory laparotomy for ovarian cytoreduction.
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Anatomy and biomechanics of the rat knee ligaments

Published on: 27th April, 2023

In this study, the authors systematically examined the anatomical and biomechanical properties of the ligaments in the normal rat knee. These biomechanical data will facilitate the use of the rat knee model for future studies of knee ligament injury, repair, and reconstruction. Fifty-six fresh cadaver male Sprague-Dawley rats, aged 16 weeks, were used for this study, with 48 rats for biomechanical testing and 8 for micro-CT and histological evaluation. Our findings suggest that the gross anatomy of the rat knee joint and ligaments is very similar to humans despite some minor differences and features unique to the rat knee. The patella tendon and ACL are the two strongest soft tissue structures in the rat knee joint, with the highest failure force and stiffness, and both play a role in the anterior stability of the knee. In comparison, the failure force and stiffness of the LCL is half of the MCL, suggesting that other structures, such as the popliteal tendon, may play some role in lateral knee stabilization besides the LCL. In addition, our data suggest that anterior knee stability was improved after ACL reconstruction, but was not fully restored to intact ACL function. In conclusion, our study indicates the anatomical and biomechanical properties of the knee joint and ligaments of rat knees. Then we could confirm a reproducible and realistic rat model of knee ligaments like the clinical cases, and provide a basis for the study of knee ligament biology that simulates techniques used in humans.
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The lateralization pattern has an influence on the severity of ankle sprains

Published on: 28th April, 2023

Study design: Descriptive study.Background: Many risk factors contributing to ankle sprains have been studied in medical literature with coordination and balance being two of the major endogenous factors described. These are influenced by lateralization – a developmental and adaptive ability determined by the asymmetrical construction of the human brain, with cross-laterality referring to mixed limb dominance.Objectives: To determine whether cross lateralization is a risk factor for the severity of ligamentous injuries in ankle sprains since no data is yet available on such correlation. Methods: Two hundred forty-four patients with acute ankle sprains (136 men and 108 women) were prospectively evaluated between April 2006 and March 2009. The mean age was 30 (ranging from 18 to 76). Clinical and ultrasonographic examinations were performed on the study subjects. Laterality was then assessed by the Coren questionnaire and the AOFAS score was calculated. Patients with syndesmotic injuries and fractures were excluded from the study. Those qualified were divided into straight and crossed groups, according to their laterality type. Results: One hundred forty-four patients displayed straight lateralization, while cross-laterality was found in 100 subjects. Patients in the crossed group experienced more multi-ligamentous injuries than those in the straight group (p = 0.02). Following trauma, a higher AOFAS score was attributed to subjects that displayed a straight lateralization pattern, in comparison to subjects presenting with crossed laterality (p = 0.04).Conclusion: Crossed lateralization is associated with higher severity of ligament injuries in ankle sprains and may be considered a risk factor for calcaneofibular ligament injuries.
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Single brain metastasis as onset of stage I endometrial carcinoma in patient affected by multiple sclerosis: the first case in literature

Published on: 25th April, 2023

Brain metastases in any gynecological cancer are a rare occurrence. Even more so, it is extremely rare for a gynecological malignancy to manifest itself with symptoms indicative of cerebral involvement. Literature regarding the association between MS and cancer is conflicting. We herein report a rare presentation of single metastasis of endometrial carcinoma in a 59-year-old woman affected by Primary Progressive Multiple Sclerosis (PPMS). A head CT scan was performed, which revealed the presence of an expansive lesion in the left parietal region. After careful assessment, a high-grade endometrial carcinoma was diagnosed and a decision was made to remove both the primary lesion and the brain metastasis in one sitting, through a conjoined surgery session involving neurosurgeons and gynecologists. The postoperative course was free from complications up until a few days after being transferred to a rehabilitation center, where she died following respiratory complications.
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Evaluation of catheter related bacteremia in patients with end stage renal disease on hemodialysis

Published on: 25th April, 2023

Infections are common complications among patients on chronic hemodialysis. Hemodialysis patients with a catheter have a 2- to 3-fold increased risk of hospitalization for infection and death compared with patients with an arteriovenous fistula or graft [1]. 
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Estimating minimum post-mortem interval in a Nigerian murder case using Chrysomya megacephala (Fabricius, 1794) (Diptera: Caliphoridae): The first use of forensic entomology

Published on: 26th April, 2023

Introduction: This paper presents the first application of forensic entomology in a murder investigation in Nigeria involving the remains of a 54-years victim, on January 9th, 2019 in a shaded wooded area in advanced decomposition, with no clear indication of the time of death. Objectives: To estimate the minimum post-mortem interval of a 54-year-old corpse recovered in the advanced decomposition stage using the blowfly Chrysomya megacephala and the Advance-Degree-day (ADD) method.Results: An autopsy report revealed multiple wounds to the forehead including a bullet hole. Dead embalmed dead maggots recovered from the body were identified as C. megacephala, and an accumulated degree-day model was used to estimate the minimum post-mortem interval. The findings revealed that the recovered larvae were still within the third-instar stage and had accumulated thermal energy between 58 hours (= 1.6 days, equivalent to 38.7 ADD) and 102 hours (= 2.8 days, equivalent to 68.0 ADD), suggesting that the body may have been exposed to insect activity between January 1st and 9th January 2019 after expanding the range to cater for some uncertainties. Conclusion: In this Nigerian murder case, forensic entomology used the calliphorid species C. megacephala to estimate the minPMI to be between 2 and 9 days before the body was discovered, which translates to 1st - 9th January 2019 after consideration of some uncertainties and limitations. This confirmed the crucial role that insects play in providing valuable evidence to complement forensic pathological findings in homicides when conventional methods failed. Notwithstanding difficulties with employing insect evidence in forensic investigations in Nigeria, the application of this modern forensic technique has the potential to aid in the resolution of many unsolved murder cases and expedite the delivery of justice. The ability of law enforcement agencies in Nigeria to use the potential of insects in criminal investigations can be improved through collaborations and training with professionals from diverse professions.
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Association between the victim’s menstrual cycle phase and genital injuries following sexual assault

Published on: 2nd May, 2023

Background: It is unknown what effect the menstrual cycle can have on the susceptibility to trauma following sexual assault. Objectives: To compare the incidence of genital injuries following sexual assault in women with relationship to the three phases of the menstrual cycleMethods: The design was a retrospective, cohort analysis set in a community-based nurse examiner program over a five-year study period. Sexual assault victims were between the ages of 13 - 40 years and agreed to a forensic examination. The menstrual cycle was divided into three phases: follicular, luteal and menses phase. The primary outcomes were the frequency and type of genital injuries documented in relation to the different phases of the menstrual cycle.Results: Case files of 1376 cases of sexual assault were reviewed; 682 (49.6%) met the inclusion criteria. A total of 220 victims (32.3%) were in the follicular phase, 361 (52.9%) were in the luteal phase and 101 (14.8%) were in the menses phase. The three groups were comparable in terms of demographics, assault characteristics, and overall frequency of non-genital injuries. Assault victims in the follicular phase of the menstrual cycle had significantly more documented genital injuries (72.3%; 95% CI 66.4 - 78.2) compared to the luteal phase (64.0%; 95% CI 59.0 - 68.9) and the menses phase (58.4%; 95% CI 48.8 - 68.0). Conclusion: Forensic examiners documented more genital injuries in the follicular phase of the menstrual cycle. Sex hormones may have confounding effects through influences on vaginal epithelial and mucosal integrity.
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