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The Dynamics of Eating Behavior Disorders and the Level of General Psychological Adaptation in Bodybuilding and Fitness Athletes

Published on: 30th August, 2023

Knowing the psychological traits and clinically relevant symptoms for the development and maintenance of Eating Behavior Disorders (EDD) in bodybuilding and fitness athletes is a necessity for early intervention and the elimination of stressors that contribute to improving sports performance and quality of life.The aim of the study: To know the dynamics of EDD and the level of general psychological adaptation in athletes who practice bodybuilding and fitness according to sports gender and age.By applying the Inventory of Eating Disorders, EDI-III on 30 participants, bodybuilding and fitness practitioners, aged between 19 and 53, of which 21 are male and 9 are female, psychological traits were investigated relevant (low self-esteem, perfectionism, asceticism, fear of maturity, interpersonal, emotional problems, exaggerated control, and others) in order to know the level of distress and the presence of clinically relevant symptoms for the development and maintenance of EDD (the desire to being thin, bulimia, body dissatisfaction)We concluded that most of the athletes fall within the limits of the threshold values ​​established for the evaluated scales, 30% of the athletes (3 female athletes and 6 male athletes), obtained scores rated above the threshold on at least one of the clinical scales, which means that the risk of EDD is present in some athletes. The average of the investigated psychological scales calculated for the rated scores to establish the level of general psychological adaptation does not exceed the specified threshold for each investigated dimension separately, except for the asceticism, interpersonal problems, and exaggerated control scales. Female athletes have greater psychological balance than male athletes and lower risk of ED than male athletes, important aspects of personality and mental health in psychological training as a screening tool in the process of optimizing the effectiveness of bodybuilding and fitness training.
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THz Analysis in the Depth of a Sunflower Leaf

Published on: 1st September, 2023

The internal structure of a sunflower leaf could be reconstructed by applying RET reverse engineering techniques on measurements from terahertz time-domain probing (Time Domain Spectroscopy TDS). This new and non-destructive method allows us to follow the evolution of this structure in time during a process of dehydration. This paper is a synthesis of our previous work.
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Impact of Biofertilizers & Different doses of NPK on Growth and Photosynthetic Pigments of Okra Plant (Abelmoschus Esculentus L. Moench)

Published on: 1st September, 2023

Okra is an herbaceous hairy annual plant that belongs to the family Malvaceae. It is cultivated in tropical, subtropical, and warm temperate regions around the world. The present work was carried out to study the effect of biofertilizers (Azotobacter + Bacillus) and different concentrations of Nitrogen, Phosphorus, and Potassium i.e.NPK on growth and photosynthetic pigments of okra (Abelmoschus esculentus L. Moench). Okra can be named a multipurpose crop as its various parts such as leaves, buds, flowers, pods, stems and seeds can be used for different purposes [1]. Okra is rich in dietary fiber, vitamins, oils, etc. Application of hazardous fertilizers causes a nutrient imbalance in soil, With respect to reducing the causes due to chemical fertilizers, biofertilizers are suited best to maintain higher productivity and yield of crops. Random block design (RBD) was selected as an experimental design. The treatments combination taken are T0- Control, T1- Azotobacter + 50% NPK, T2- Azotobacter (2.5 kg/ha) + 100% NPK, T3- Bacillus (2.5 kg/ha) + 50% NPK, T4- Bacillus (2.5 kg/ha) + 100% NPK, and T5 with NPK 100%. The final result revealed, that the treatment combination with Azotobacter + 100% NPK (T2) showed the highest value of plant height (65.60 cm), number of leaves per plant(62.36), number of flowers per plant (27.40), and also carotenoid content (2.82 mg/g), chlorophyll a(2.47 mg/g) and chlorophyll b(3.25 mg/g) were observed maximum. So, it can be concluded through this paper that the combination of Azotobacter 2.5 kg/ha + 100% NPK (T2) is suitable for the okra plant for better growth and enhancement of photosynthetic potential in-field practices.
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Utilization of Molecular Simulation Applications for Stability Testing of Anthocyanin Compounds in Black Elderberry

Published on: 1st September, 2023

Recently, many studies on the molecular activity of compounds have been carried out using simulations through computer programs or in silico simulations. Anthocyanins are one of the compounds that are often used as food coloring agents and can function as antioxidants to prevent blockage of blood vessels, as an anti-cancer that can prevent the development of cancer cells and tumors and have anti-inflammatory effects. The purpose of the research is to determine the stability of anthocyanins using molecular simulations and determine the best mixing sequence of ingredients to produce the most stable anthocyanin mixture. Based on the results of the simulations carried out, it can be proven that the final 3 sets (the modeled compound belonging to namely AP and AZ followed by a number based on the simulation order) selected are AP17, AP18, and AZ17. The AP17 set had the lowest potential energy at the end of molecular dynamics simulations, but molecular visualization showed structural instability indicated by the formation of gaps in the molecular conformation. The AP18 set had the second lowest potential energy at the end of molecular dynamics simulations and molecular visualization showed molecular conformation that tended to be stable during molecular simulations with no change in structure. The AZ17 set had the highest potential energy of the final 3 sets selected and molecular visualization showed a gap in the conformation at the beginning of the simulation, but over time the gap became denser, indicating that the molecule became more stable over time. Based on the research results, the AP18 set was chosen because it has relatively low potential energy and it can be proven that the structure visualization of this set tends to be more stable over time during molecular dynamics simulations.
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CT-guided Retrograde Urography as a Diagnostic Tool for Post-kidney Transplantation Evaluation: A Case Report

Published on: 4th September, 2023

The vast majority of urological complications occur at the ureterovesical junction and usually occur early after transplantation. The aim of this study is to enhance the quality of medical care provided to patients who undergo kidney transplantation. Cystography was conducted on renal transplant recipients utilizing computed tomography. The utilization of changes in the patient’s position and reconstructed images of the bladder can serve as a diagnostic tool to assess the normal functioning of the urinary tract system subsequent to kidney transplantation. To ensure adequate filling of the bladder and ureter, it is necessary to introduce varying amounts of contrast medium through the urinary catheter into these structures. This diagnostic procedure aims to verify the existence of stenosis or leakage occurring at the vesicoureteral junction. The evaluation and diagnosis of urinary tract problems subsequent to kidney transplantation can be effectively conducted. Furthermore, it has the potential to mitigate the adverse effects and alleviate the strain on the renal system resulting from the administration of contrast agents in computed tomography urography. CT-guided cystography can enhance the medical quality and comfort of Kidney transplantation patients.
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Microbial Conversion and Utilization of CO2

Published on: 4th September, 2023

Rising greenhouse gas emissions have contributed to unprecedented levels of climate change, while microbial conversion and utilization of CO2 is a practical way to reduce emissions and promote green manufacturing. This article mainly summarizes several natural CO2 pathways that have been discovered, including the Calvin cycle, the reduced tricarboxylic acid (rTCA) cycle, the Wood–Ljungdahl (WL) pathway, the 3-hydroxypropionate/4-hydroxybutyrate (HP/HB) cycle, the dicarboxylate/4-hydroxybutyrate (DC/HB) cycle, the 3-hydroxypropionate (3HP) cycle, the reductive glycine (rGly) pathway, and artificially designed carbon fixation pathways includes the CETCH cycle, the MOG pathway, the acetyl-CoA bicycle, and the POAP cycle. We also discussed applications of different carbon fixation enzymes, notably ribulose-1, 5-diphosphate carboxylase/oxygenase, pyruvate carboxylase, carbonic anhydrase, as well as formate dehydrogenase. This paper further addressed the development of photosynthetic autotrophs, chemergic autotrophs and model bacteria Escherichia coli or yeast produced main products for CO2 fixation through metabolic engineering, such as alcohols, organic acids, fatty acids and lipids, bioplastics, terpenoids, hydrocarbons, and biomass.  Future studies on CO2 microbial conversion should focus on improving the efficiency of carbon fixation enzymes, metabolic modules of the carbon sequestration pathway, and intracellular energy utilization. Coupled microbial and electrochemical methods for CO2 fixation, in addition to biological fixation, show considerable promise. 
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Comparison of Patient Satisfaction and Quality of Life Among Post-elbow Fracture Stiffness Patients Undergoing Proprioceptive Neuromuscular Facilitation Stretching vs. Passive Stretching

Published on: 5th September, 2023

Background: Post-fracture prolonged immobilization or post-operative elbow stiffness is relatively common and markedly interferes with normal upper extremity function. This study aims to evaluate and compare the levels of patient satisfaction and quality of life in individuals with post-elbow fracture stiffness who undergo Proprioceptive Neuromuscular Facilitation (PNF) stretching versus those who receive passive stretching.Methodology: This (six months) analytical comparative cross-sectional study was conducted at various healthcare institutions. The sample consisted of 377 patients using non-probability convenient sampling. Inclusion criteria included specific types of elbow fractures, a minimum immobilization period of three weeks, and limited range of motion (ROM). Exclusion criteria covered various medical and psychological conditions. Standardized questionnaires Short Form 36 Health Survey Questionnaire (SF-36) and Patient Satisfaction Questionnaire (PSQ-18) were used for measuring Quality of life and patient satisfaction. Data analysis was done using SPSS version 22.Results: Short Form 36 Health Survey Questionnaire scores were significantly higher in the PNF Stretching group (mean 82.34 ± 6.63) compared to the Passive Stretching group (mean 63.98 ± 14.42), with a p - value of 0.000. Similarly, Patient satisfaction questionnaire scores were significantly higher in the PNF Stretching group (mean 77.61 ± 4.43) compared to the Passive Stretching group (mean 70.93 ± 8.49), with a p - value of 0.000. These findings indicate that there is a statistically significant difference observed between the two groups.Conclusion: There is a statistically significant difference observed between both groups as the patients undergoing PNF stretching have higher satisfaction and better quality of life, in comparison to the passive stretching group.
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Cardiovascular Response to Head Down Crooked Kneeling Position Among Type 2 Diabetic Patient

Published on: 5th September, 2023

Background: Factors like emotions, lifestyle choices, and physical activities, including posture changes, have a significant impact on cardiovascular indicators like blood pressure and heart rate. The study aims to examine the cardiovascular reactions in individuals with type 2 diabetes while performing the head-down crooked kneeling (HDCK) or Sujood position, resembling poses found in hatha yoga. This position emphasizes relaxation, body awareness, and meditation. Those with type 2 diabetes who engage in yoga have reported enhancements in their management of blood sugar levels and insulin resistance. Methodology:  A cross-sectional study was conducted in different hospitals. The sample size was 312 which was calculated by using the Rao soft calculator. The participants were selected by non-probability convenience sampling technique. Inclusion Criteria were male and Female diagnosed with Type 2 DM, Subjects with a history of smoking, Cognitive Impairment, Sepsis, Cardiac pathology, Respiratory disorders, and Malignancy were excluded. Blood pressure and heart rate were monitored initially, during the Crooked Down Kneeling position, and after the Crooked Down Kneeling Position. A Digital Sphygmomanometer was used to measure blood pressure and a pulse rate-demographic Assessment form was used to collect data. Ethical consideration is maintained. Informed consent was taken from participants. Results: The result shows a significant effect of head down crooked kneeling position on cardiovascular response in type 2 diabetic patients (p < .001). Systolic, diastolic blood pressure, and heart rate before, during, and after HDCK were significantly increased (p < .001) as compared to the baseline value, and after 5 min returning to the upright position it reverted to the initial value. Conclusion: This study revealed a significant increase in systolic and diastolic blood pressures and an increase in pulse rate during HDCK. Also, our findings showed no significant gender difference in the effect of HDCK on all the other cardiovascular parameters except systolic bp.
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Healthcare Bioethics: A Vital Branch of Bioethics and a New Possible Pillar for Modern Healthcare Systems Strengthening Worldwide

Published on: 5th September, 2023

Globally, all people deserve the highest level of respect for their dignity, rights, and health. Bioethics has been recognized as a powerful discipline that aims to ensure such respect. Fritz Jar (1895–1953) and Van Rensselar Potter (1911–2001) will remain heroic men who ushered in the existence of the discipline of bioethics. Bioethics has been recognized as the science of survival and a bridge to the future. Thus, bioethics aims to enrich people’s wisdom. Wisdom is the knowledge of how to use knowledge for human survival and improvement in the quality of life. Worldwide, all people must widely possess such knowledge. Unfortunately, after many years of existence, implementing the principles and goals of bioethics remains centralized and confined to academic fields. Due to its centralized status, few branches of bioethics have been recognized. Besides, both pre-standard and standard practices still exist in the field of bioethics. Healthcare bioethical principles have been mentioned in numerous publications. However, healthcare bioethics has not been recognized as a vital branch of bioethics. The lack of well-established healthcare bioethics hinders strategies for eradicating many of the ephemeral and heuristic approaches that are still obstructing the achievement of optimum health status for numerous people worldwide. Integrating bioethical principles in all healthcare sectors in decentralized manners would lead to the existence of healthcare bioethics. The purpose of this manuscript is to describe healthcare bioethics as a vital branch of bioethics with respect to its description, branches, core principles, functions, system components, and pre-standard and standard practices of healthcare bioethics.
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Hypersexual Disorder: A Comprehensive Review of Conceptualization, Etiology, Assessment and Treatment

Published on: 6th September, 2023

Hypersexual disorder, also known as compulsive sexual behavior or sex addiction, is a complex and clinically significant condition characterized by intense and recurrent sexual fantasies, urges, or behaviors that significantly disrupt an individual’s daily life and overall well-being. Despite its importance, hypersexual disorder remains a controversial and debated topic, lacking standardized diagnostic criteria in major classification systems.This review paper provides a comprehensive examination of hypersexual disorder, encompassing its definition, conceptualization, etiology, co-occurring conditions, effects on mental and physical health, assessment, treatment approaches, cultural and ethical considerations, and future research directions. By synthesizing information from existing literature and research, this review aims to deepen our understanding of hypersexual disorder and contribute to the development of evidence-based interventions.The review begins by exploring the evolution of the term “hypersexual disorder” and its current status in diagnostic classifications. It then delves into the potential etiological factors contributing to the development of hypersexual behaviors, including neurobiological, genetic, and psychosocial factors.Furthermore, the review discusses the common comorbidities associated with hypersexual disorder, emphasizing the importance of addressing co-occurring mental health conditions in treatment planning. The psychological and physiological effects of hypersexual behaviors on affected individuals are examined, underscoring the urgency of early intervention and comprehensive treatment.The assessment and diagnosis of hypersexual disorder are thoroughly examined, considering the challenges and methodologies involved in identifying and evaluating affected individuals. Cultural and ethical considerations are highlighted, stressing the significance of providing culturally sensitive and ethical care to diverse populations.In the context of treatment, the review discusses various therapeutic approaches, including psychotherapy, medication, support groups, and harm-reduction strategies. The need for evidence-based treatments tailored to hypersexual disorder is underscored while recognizing the challenges of developing standardized protocols in this evolving field.Finally, future research directions are outlined, focusing on the standardization of diagnostic criteria, prevalence studies, neurobiological investigations, and the integration of cultural competency in treatment approaches.In conclusion, this review paper aims to contribute to a comprehensive understanding of hypersexual disorder and its implications for affected individuals and society. By exploring the multifaceted aspects of the condition, this review seeks to provide insights into effective treatment approaches and inspire further research in the study of hypersexual disorder.
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Deep Venous Thrombosis as the Clinical Expression of POEMS Syndrome

Published on: 6th September, 2023

This case suggests that POEMS syndrome does present with a constellation of signs and symptoms that may lead a clinician to a multitude of other possible diagnoses. Diagnosis is often difficult and delayed. A good history and physical examination as well as a careful review of all workups are paramount in establishing this particular diagnosis. The major criteria of diagnostic for the syndrome are polyradiculoneuropathy, clonal plasma disorder, sclerotic bone lesions, the presence of Castleman disease, and elevated vascular endothelial growth factor. Minor features include organomegaly, extravascular volume overload, endocrinopathy, characteristic skin changes, papilledema, and thrombocytosis. The diagnosis is made with three of the major criteria, two of which must include polyradiculoneuropathy and clonal plasma cell disorder, and at least one of the minor criteria. In this article, we discuss the differential diagnosis and outline the clinical evaluation indicated.
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Potential Use of Essential Oils and Their Individual Components in Cosmeceuticals: A Review

Published on: 7th September, 2023

The cosmetic industry is searching for new active ingredients from renewable natural sources to make more environmentally friendly and safe products. Botanical extract is a nearly limitless source of these new actives due to the current consumer demands as well as international regulations. Due to both their fragrant nature for the creation of fragrances and perfumes and the numerous advantageous properties of their individual components (EOCs), such as anti-inflammatory, antimicrobial, and antioxidant properties, essential oils (EOs) emerge as a very common natural ingredient in cosmetics and toiletries. Additionally, nowadays, the cosmetic industry includes EOs or different mixtures of their individual components (EOCs), either as active ingredients or as preservatives, in various product ranges (e.g., moisturizers, lotions, and cleansers in skin care cosmetics; conditioners, masks or anti-dandruff products in hair care products; lipsticks, or fragrances in perfumery). However, because each essential oil’s distinct chemical profile is linked to a different set of advantages, it is challenging to generalize about how they might be used in cosmetics and toiletries. Formulators frequently spend time looking for appropriate combinations of EOs or EOCs to achieve particular advantages in the finished products. The literature on the most recent developments in the use of EOs and EOCs in the production of cosmetic products is updated in this work’s review of the literature. Additionally, certain particular issues pertaining to the security of EOs and EOCs in cosmetics will be covered. It is expected that the information contained in this comprehensive review can be exploited by formulators in the design and optimization of cosmetic formulations containing EOs.
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Orthodontic Patients’ Perception of Orthodontic Office Changes during COVID-19 Pandemic in Brazil: A National Cross-Sectional Survey

Published on: 7th September, 2023

There is still limited information regarding patients’ perception of the dental approach changes in the pandemic circumstance. Therefore, the aims of this study were, firstly, to evaluate patient perception regarding the COVID-19 infection risk in the orthodontic office in Brazil, and to assess the influence of age in infection risk perception. Orthodontic patients from five states answered an online questionnaire, anonymously, about quarantine behavior, perception of the infection risk in the orthodontic office, as well as the apparent need for the new biosafety approach. Descriptive analyses were performed for each question. Correlations between age and concern of getting infected were calculated with Spearman correlation tests. There were 406 responses. Most patients respected the quarantine, and 93.10% of those who were scheduled for appointments realized that their appointment would be safe enough. From the total, 83.99%, 84.98%, 89.90%, and 95.81% of patients judged, respectively, health status checks by phone, temperature checking, disposable coat, and face shield, as necessary. Only 6.40% reported an increase in the concern of returning to appointments. The younger the patient, the greater the concern of getting infected in future appointments (p = 0.042). Most patients were confident in the professional care before the appointment. The new biosafety approach was well accepted by the majority, with less agreement with temperature checking and the use of disposable coats. The younger the patient, the greater the concern of getting infected in future appointments. The rate of patients with risk factors for COVID-19 was 14.77%.
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Impact of Primary Cesarean Section on Grand Multiparous Women

Published on: 11th September, 2023

Background: Grand multiparty is common obstetrical problem, in Sudan large families is desirable for cultural and religious backgrounds and higher incidence of grandmultipra is expected, the risk factors associated with adverse maternal outcomes have yet to be adequately investigated among grand multiparity need to delivered by primary cesarean section.Objective: The main objective was to determine impact of primary cesarean section on grand multiparous, it is indications and complications.Methodology: It was a descriptive prospective cross-sectional hospital-based study conducted at Omdurman Maternity Hospital during period October 2016 to March 2017.An interview questionnaire was used for data collection. Demographic and clinical data concerning personal history, parity, indications of primary cesarean section, type of Cs, maternal complication and neonatal complications were recorded. Also, multiparous less than five delivery, previous lower segment caesarean section, known medical disorders except anemia and twin pregnancy were excluded.Results: During the study period total of 113 grand multipara included, incidence of primary cesarean section in grand multipara was 10%. Indication in our study 22.1% due to malpresentation, fetl distress 15% and prolonged first stage 13.4%, prolonged second stage 12.4% and antepartum haemorrhage 11.5%.  Postpartum haemorrhage developed in 9.7%, hysterectomy 1.8%, uterine tear 5.4% bladder injury fetal laceration 3.6%, spinal anesthesia headache 7%, post-partum pyrexia 5.3%, sepsis 4.4%, urinary tract infections were 2.7%.Conclusion: The finding in this study showed 10% incidence of primary cesarean section in grandmultipra. The most indications of primary cesarean section in grandmultipra malpresentation, fetal distress, prolonged first and second stage of labour. Most CS were emergency. 
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Case Report of a Child with Beta Thalassemia Major in a Tribal Region of India

Published on: 8th September, 2023

Introduction: Thalassemia is an inherited blood disorder of haemoglobin (Hb) synthesis, which affects different regions around the world. India has the largest number of children with beta-thalassemia major in the world, particularly in the tribal population. Heterozygous conditions are milder and even go unreported than the condition of homozygous where regular blood transfusion is required.Case report: This report focuses on a case of major beta-thalassemia in a child, whose parents are beta thalassemia minor to intermediate conditions, and who was treated by blood transfusion once a month. However, Thalassemia may be cured by allogeneic hematopoietic stem cell transplantation, although not everyone is a good candidate. Genetic counselling, prenatal diagnosis, and selective termination of affected fetuses are effective ways to control thalassemia.Discussion and conclusion: The paper reports a unique case of Thalassemia in rural India. The blood disorder while commonly presented in a juvenile whose parents were Thalassemia positive resulted in the termination of a fetus diagnosed with it. It archives the story of the parents who are now in the process of planning future offspring while mitigating disease risk. The case leads the way for effective management and containment of hereditary genetic disorders through carrier detection while planning alliances and offspring.
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The Ramifications of Loneliness: A Commentary

Published on: 8th September, 2023

Loneliness was a major concern of people during the recent COVID-19 pandemic. Now, that the pandemic is mainly gone, it is still a global issue. This commentary reviews the impact on that loneliness has on our cognitive, behavioral and affective functioning. These effects are described, along with the stigma that often accompanies loneliness and which makes it hard for people to acknowledge and admit that they are lonely, and seek help from healthcare professionals. This commentary, aside from describing the various negative implications of loneliness, highlights the need for society to address the issue. While it cannot be eliminated, the population can be taught how to recognize it, and how to offer assistance to those who struggle with it.
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Hazardous Effects of Malaria for Patients Residing in Low-probability Malaria Areas: A Case Report and Critiques of the Literature for Cerebral Malaria

Published on: 13th September, 2023

Despite decades of global and country commitments towards eradicating malaria, malaria remains the most hazardous parasitic disease and the most common cause of fever for humans, especially in tropical countries. Plasmodium falciparum causes 90% of malaria cases. Coma [Cerebral Malaria (CM)], acidosis, hypoglycemia, severe anemia, renal dysfunction, and pulmonary edema are the most common complications of malaria caused by Plasmodium falciparum and the most common cause of death related to malaria. People from less prevalent malaria areas are at high risk of developing these complications. A 16-year-old male from a low malaria transmission area was diagnosed with CM. Prior to developing CM, he was treated with Coartem. CM is a medical emergency and one of the forms of severe malaria. CM has high mortality and morbidity rates. Yet, international health-related agencies, funders, and policy-makers are unfamiliar with it. The continuous occurrence of CM validates the considerable need for global investment in malaria control and elimination programs. Early administration of Artesunate to all patients suspected of having severe malaria would reduce global malaria-related mortality and morbidity. Simple tests, such as the determination of malaria parasitic density either with thin or thick blood smears, may influence the proper management of all severe malaria cases. However, in clinical practice, the determination of malaria parasitic density is not routinely done. Further commitments are needed to ensure routine determination of malaria parasitic density for all suspected severe malaria cases. Moreover, further commitments are needed to guarantee the proper management of CM because it is a major cause of reversible encephalopathy in tropical countries.
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Acute Inflammatory Reaction After Radiotherapy to Bilateral Orbital Metastasis from Melanoma

Published on: 15th September, 2023

Orbital melanoma is a subtype of periocular melanoma that can present from primary, secondary (arising from local invasion), or metastatic disease [1]. Melanoma metastasis to the orbit is rare with the majority of metastases occurring in subcutaneous tissue, nonregional lymph nodes, lungs, liver, brain, and bone [2]. Despite melanoma being relatively radioresistant, radiation therapy can be considered in an adjuvant or palliative setting [3]. In the palliative setting specifically, radiation therapy is highly effective in alleviating symptoms due to mass effect [3]. However, significant ocular and orbital complications may occur as a direct result of radiation therapy.
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Multiparametric MRI for the Assessment of Treatment Effect and Tumor Recurrence in Soft-tissue Sarcoma of the Extremities

Published on: 20th September, 2023

Soft-tissue sarcomas are a rare and complex group of malignant tumors. Advanced MRI sequences such as diffusion-weighted imaging (DWI) and perfusion-weighted imaging/dynamic contrast enhancement (PWI/DCE) can provide valuable tumor characterization and treatment response assessment. In the case of archetypical cellular tumors such as Pleomorphic Undifferentiated sarcoma (UPS), Good responders often display right-side displacement of the ADC intensity histogram, resulting in increased ADC-mean and decreased kurtosis and Skewness compared with Baseline and poor responders’ more left-sided curve. The PWI/DCE pattern most often associated with a good response is the presence of a “capsular-like” enhancement and a TIC type 2. Sarcoma hemorrhage patterns on SWI emerge during treatment, including “interstitial,” globular,” “luminal,” and incomplete and complete “peripheral ring-like” tumor wall hemosiderin impregnation. Treatment-induced bleeding is typically associated with low SWI-mean values and a left-sided intensity histogram with positive Skewness.During post-surgical surveillance, DCE MR imaging can reliably distinguish recurrent sarcoma from post-surgical scarring. TICs III, IV, and V raise the suspicion of local tumor recurrence, while TIC type II usually represents benign post-operative change such as granulation tissue. Advanced MRI is an essential tool for assessing sarcomas during and after therapy.
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A Case of X-Linked Hypophosphatemia: Exploring the Burden in a Single Family and the Significance of a Multidisciplinary Approach

Published on: 24th September, 2023

A 46-year-old lady was diagnosed clinically with X-linked hypophosphatemia (XLH) with a rare pathogenic variant detected using exome sequencing. Phosphate-regulating endopeptidase homologous X linked (PHEX) is normally expressed in osteoblasts and osteocytes, and senses phosphate regulation. More than 1000 PHEX variants have been detected to date, which are caused by missense, nonsense, and frameshift mutations in addition to splice variants and copy number changes. The aberration in the PHEX gene leads to the upregulation of fibroblastic growth factor 23 (FGF23), which leads to defects in phosphate metabolism. This results in impaired bone growth and mineralization, short and disproportionate stature, leg bowing, musculoskeletal pain, spontaneous dental abscesses, rickets, and osteomalacia in XLH patients. The spectrum of manifestations differs between pediatric and adult patients. In our case study, two of the patient’s children started showing symptoms at a younger age, unlike their mother. Timely diagnosis and the start of treatment would help in their better management and improved quality of life.
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