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The prostate gland, found only in men, is an extremely important organ of the reproductive system, but it is not taken care of adequately, leading to prostate inflammation and benign hypertrophy or even cancer. Benign prostate enlargement compresses urine flow through the urethra, leading to uncomfortable urinary symptoms. Hyperplasia increases the risk of bladder stones, urinary tract infections, and kidney problems. In India prevalence of Benign Prostrate Hyperplasia (BPH) is around 50% of men by the age of 60 years. Studies suggest that benign prostatic hyperplasia is a result of the disproportion between oestrogen & testosterone. A higher proportion of oestrogen within the prostate boosts the growth of prostate cells. The management of BPH is streamlined in recent times and the majority are on medical treatment.Prostate cancers are one of the cancers showing a significant increase in incidence along with mouth and kidney and lung cancers among the male population. With an estimated population of 1400 million and about 98 million males over 50 years of age in mid-2022 and the average life expectancy increasing 68.4 years, has a bearing on the changing incidence and pattern of prostate cancer in the current decade in India. Based on the five population-based cancer registries in 2009-10, the age-adjusted annual incidence rates per lakh population of prostate cancers were highest in Delhi (10.2) followed by Bengaluru (8.7), Mumbai (7.3), Chennai (7) and Bhopal (6.1). Cancer can co-exist with BPH. Prostate cancer management is still in the development stage with a 5-year life expectancy of around 64%.The prostate is the second leading site of cancer among males in large Indian cities like Delhi, Kolkata, Pune, and Thiruvananthapuram, and the third leading site of cancer in cities like Bangalore and Mumbai. Despite the limitations of diagnosis, the annual cancer incidence rate ranges from 5.0-9.1 per 100,000/year, as compared to the rates in the United States and other developed countries of 110 &180 for whites and blacks respectively.This article is a review of Prostate health in India based on a personal observation of around 183 cases by the author in the last 10 years.Materials & methods: This is an observational study report of three cohorts of men across the country. The sample was of people encountering the author. The sample included i) 69 septuagenarians plus ii) 30 senior citizens aged 60 - 70 years and iii) 84 men in 40 – 60 - year age groups over the last decade. The data source was sharing annual check-up reports or consultation report in person for seeking 2nd opinion. A minimum of 2 consultations, first when diagnosed and the recent between July 2021 to June 2022.

Fungus belonging to the genus Aspergillus is considered highly important in the production of various types of enzymes and organic acids. Aspergillus species produce organic acids such as citric acid, itaconic acid, and malic acid, which are one of the most important alternate techniques for chemical processes. Citric acid is an important component in the manufacturing process of food and beverages, pharmaceuticals, cosmetics, toiletries, detergents, and other industries. In this work, A.niveus was isolated from the agricultural waste collected in Kotagiri, The Nilgiris, India. Submerged batch fermentation with a range of low-cost substrates, such as wheat flour, corn starch, and sweet potato, was used to successfully synthesize citric acid by the isolated fungus. In addition, production-related factors such as substrate concentration and incubation time were optimized. The maximum yield of citric acid was produced using A. niveus from corn starch at a concentration 7of 120 g/L after 168 hours at pH 3.2. Furthermore, with a degree of extraction of 91.96, citric acid was extracted from fermentation.

One of the most severe threats to world health is the Candida species. Many non-Candida species are the major cause of vulvovaginal candidiasis (VVC). During the development of VVC, the host environment and Candida vaginal colonization are assumed to be out of balance, and this might be owing to physiological or non-physiological changes. Host-related and behavioral risks have been connected to VVC. Novel antifungal medications with particular molecular targets may be developed with the use of molecular tools in epidemiological research and the study of resistant Candida species. Using the Vitek-2 Antifungal Susceptibility System, this review will explain the many approaches used to identify and characterize Candida species isolated from vulvovaginal candidiasis patients.

Recent studies on boron neutron capture therapy (BNCT) have focused on investigating the appropriate neutron sources based on accelerators for neutron production, such as 7Li(p,n)7 Be. The therapeutic abilities of BNCT have been studied for the possible treatment of lung cancer using thermal and epithermal neutron beams. For neutron transport, the Monte Carlo N-particle transport code was used, and doses in the organs of different Oak Ridge National Laboratory phantoms were evaluated. The right lung was meshed with voxels to obtain depth-dose distributions using 1 eV, 10 eV, 100 eV, 1 keV, 5 keV, 8 keV and 10 keV energy sources. These results suggest that BNCT with an epithermal neutron beam can be used to treat lung cancer. By evaluating the biological dose rate and dose-depth distribution curves in healthy tissues and tumors by simulating a lung phantom, the quantities in the phantom were also evaluated. Our calculations show that with increasing boron concentration applied to the tumor, the dose is increased and the 100 eV energy source has the greatest effect on the tumor dose.

The fiber characteristics and basic density of Acacia melanoxylon were investigated for its potential as a raw material for pulp and paper production. Six trees from the even-aged stand and similar diameter class were selected randomly from the Chencha district of Ethiopia. Wood disks were systematically cross-cut from a log along tree height levels, at the bottom (10%), middle (50%) and top (90%) of the merchantable height and blocks of wood (2 cm x 2 cm x 2 cm)were taken from pith to periphery at near pith (10%), middle (50%) and near bark (90%) of disk radius. Fiber maceration and basic density were determined, by 50% nitric acid solution and water displacement method respectively. All the data were analyzed using a two-way analysis of variance at α = 0.05. The fiber characteristics of the selected trees; the fiber length, fiber diameter, lumen diameter and cell wall thickness were measured while the-slenderness ratio, Runkel ratio, flexibility coefficient and wall coverage ratio of the fibers were derived from the measured fiber dimensions. The result showed that- the overall mean were, 1.04 mm, 21.60 µm, 15.36 µm, 3.75 µm, 0.48, 48.05%, 71.10%, 0.34 and 0.56 g/ml, for fiber length, fiber width, lumen diameter, cell wall thickness, Runkle ratio, slenderness ratio, flexibility ratio, wall coverage ratio and basic density, respectively. Generally, Acacia melanoxylon wood is suitable for pulp-and-paper-production, to due-to-its adequate-fiber dimension, derived fiber value and basic density. Therefore, attention should be given to tree growers, government and non-governmental organizations on the plantation expansion of Acacia melanoxylon.

Through the development of new analysis technologies, many issues regarding the approach to tumoral diseases have been elucidated. With analytical assays developed in the last years, various omics technologies have evolved in such a manner that the characteristics of tumor cells and products can be evaluated (assessed) in the bloodstream of cancer patients at different times. Ovarian Cancer (OC) is one of the most difficult to diagnose umors, with low survival rates due to the high heterogeneity of these diseases that are distinct in terms of etiology and molecular characteristics, but which simply share an anatomical appearance. Recent findings have indicated that several types of ovarian cancer classified into different histotypes are in fact derived from non-ovarian issues and share few molecular similarities. Within this context, ovarian cancer screening and diagnosis can be made through the evaluation of circulating tumor cells in peripheral blood using liquid biopsy technologies. Advances in the study of various molecules analyzed by liquid biopsy have shown that elucidation of intratumoural and intertumoural heterogeneity and spatial and temporal tumor evolution could be traced by serial blood tests rather than by histopathological analyses of tissue samples from a primary tumor. Therefore, evaluation of some molecules such as circulating tumor cells (CTC), circulating tumor DNA (ctDNA), circulating cell-free RNA (non-coding and mRNA, extracellular vesicles), tumor-educated platelets or different miRNAs using liquid biopsy could lead to improvement of patient management.

SARS-CoV-2 is the virus associated with the disease called COVID-19 and become a global pandemic. The only way to prevent its severe scenarios is through timely and rapid testing. In comparison to more time taking gold-standard RT-PCR testing, rapid diagnostic kits are used. For better prevention and diagnosis of SARS-CoV-2, the analysis of rapid diagnostic kits' accuracy and specificity is necessary. This study is meant to assess and examine the viability, responsiveness, and explicitness of quick antigen distinguishing nasopharyngeal swabs (NPS), and saliva-based units. The study was conducted on 200 suspected COVID-19 patients from Islamabad, 100 of which were RT-PCR positive while 100 were RT-PCR negative. For the analysis of Rapid diagnostic COVID-19 kits (RDT), nasopharyngeal swabs (NPS) and saliva samples were taken from the RT-PCR positive and negative patients. Among 100 RT-PCR positive patients, 62% were males (19 - 91 years), 34% were females (20 - 78 years) and 4% were children (6 - 17 years). False-negative results were significantly more observed in saliva-based RDTs of the sample (49%) as compared to nasopharyngeal swab RDT (38%). There were 2% invalid results in saliva-based RDT and 3% invalid results in Nasopharyngeal swab RDT. While among 100 RT-PCR negative patients 69% were males (19 - 80 yrs), 27% were females (18 - 77 yrs) and 4% were children (12 - 16 yrs.). False positive results were significantly more in saliva-based RDT (22%) as compared to Nasopharyngeal swab RDT (13%). The sensitivity and specificity of saliva-based RDT were 67% and 87% respectively while that of Nasopharyngeal swab (NPS) was 72% and 82% respectively, both of which were less than the gold standard RT-PCR sensitivity demanding the introduction of more sensitive RDT kits in Pakistan for accurate detection of COVID-19.

The birth of a high-risk infant such as an extremely premature infant can represent an important traumatic experience for mothers. Perinatal Post Traumatic Stress Disorder Questionnaire (PPTSDQ) explores retrospectively maternal post-traumatic stress reaction. This shelf-rating questionnaire explores the potential for experiencing posttraumatic symptoms related to childbirth and the ensuing post-natal period. The PTSD questionnaire was originally developed by DeMier and Hynan and their colleagues at the University of Wisconsin and has been widely used in research and in clinical practice for identifying mothers experiencing significant emotional distress during the post-natal period, so they may be referred for mental health services. The present study aims to introduce this tool in perinatal settings as an early intervention. It has been widely used with other measures of post-traumatic stress and depression, such as the Openness Scale from the NEO-PR, the self-report measure of depression BDI-II, the IES (Impact Event Scale) and the EPDS (Edinburgh Postnatal Depression Scale). Although already a useful clinical instrument the current study used the revised version. This modification refines the response options from dichotomous choices to a Likert scale format by Callahan Borja and Hynan. Numerous qualitative and quantitative studies state that premature delivery is a highly stressful event and document the full range of post-traumatic sequelae, such as intrusive recollections, behavioral avoidance, and hyperarousal, as well as attachment difficulties following childbirth. Furthermore, the severity of neonatal complications and gestational age have been found to be predictive of PTSD symptomatology in parents as measured by the PPQ. For this reason, the current study aims to give increased focus to mothers having a premature birth and often expecting their children to die. The sample comprises 25 mothers of prematurely born infants hospitalized in the NICU and 25 mothers of full-term infants born in the maternity ward of the same Greek hospital who responded to the Perinatal PTSD Questionnaire and equally the PERI a postnatal complication rating inventory and the clinical interview for parents CLIP.Mothers of high-risk infants present post-traumatic stress reactions related to prematurity. The Perinatal PTSD Questionnaire identifies postnatal maternal distress but should not substitute a clinical interview, yet findings indicate that equally identifies pre-existing distress symptoms associated with maternal personality traits that emerged with the traumatic event of the unexpected birth.Due to the consistency of the population of the experimental group, who come mostly from the provinces, the possibility of a follow- up of the cases is quite limited.

Purpose: To evaluate the role of dietary components, physical activity, smoking and Obesity in colorectal cancer.Materials and methods: With a population-based case-control study, 49 colorectal cancer patients and 72 controls were interviewed with uniform questionnaires. Conditional logistic regression was used for multivariate analysis of colorectal cancer. A total of 121 pairs of case controls were interviewed.Results: Relationship between body mass index (BMI) and colorectal cancer was shown in this study, obesity was shown in 21 patients (42.86) before cancer and in 0% of patients during colorectal cancer. Physical activity was a significant risk factor p < 0.0001. Malnutrition was noted in 48 patients (97. 96%) according to Brachial muscular circumference in patients with colorectal cancer (p = 0.002). Daily consumption of sugar Khi² of Wald (5.423) and butter Khi² of Wald (7.694) is higher in cases than in controls.  During that time, high daily consumption of pasta (p = 0.018) and vegetables (p = 0.045) was a protective factor for colorectal cancer.Conclusion: Colorectal cancer in Algeria was related to dietary and environmental factors. The research results support the colorectal cancer etiological hypothesis of deficiency vegetable and high consumption of lipids and sugar.  Obesity and lack of physical activity were also correlated with colorectal cancer.

Numerous studies of bullying in schools have identified aspects of the environment (E) and aspects of the person (P) as contributing to the prevalence of bullying in schools. It is proposed that the concept of desire can play a central role in explaining how bullying in schools arises and how it can be effectively addressed by schools by promoting social and emotional learning, mindfulness, and problem-solving techniques such as the Method of Shared Concern. The article identifies a need for further research to confirm the hypothesized relationships and assess the utility of the concept of desire as a variable in research and the practice of bullying prevention in schools.

Studies in children with eosinophilic esophagitis (EoE) have reported esophageal strictures but none have examined risk factors associated with strictures. Aim: To assess risk factors associated with strictures in children with EoE. Methods: In this retrospective study, children with EoE seen over 20 years were separated into two groups; with and without strictures. Physical features, CBC, endoscopic findings, and biopsy of the distal and mid-esophagus were captured. Statistical significance with p - value and multivariate logistic regression was done. Results: Total patients 222 and 20 (9.1%) had strictures. Mean age of stricture patients 12.7 years (range 7-18) and non-stricture 9.3 years (range 1-17) (p = 0.006). Among stricture patients following were prevalent and significant; dysphagia (stricture 100% vs. non-stricture 41.6%, p = 0.0005) and food impaction (70.04% vs. 4%, p = 0.0005); EGD: rings and exudates were strongly associated with stricture, 45.0% vs. 4.5%, p = 0.0005 and 60% vs. 30.7%, p = 0.008, respectively. Abdominal pain was lower in the stricture group (5% vs. 31.2%, p = 0.017). Eosinophil counts were numerically more in the stricture group but not significant. Multivariate logistic regression confirmed that strictures are likely to occur among patients with dysphagia (p = 0.02, OR = 11.7, 95% LCL 2.0) and food impaction (p = 0.0001, OR = 80.9, 95% LCL 15.4), respectively, adjusted for age and gender. Conclusion: EoE children with dysphagia or food impaction have a higher chance of having an esophageal stricture. These EoE children 12 years or over with exudates or rings on endoscopy, should be treated and carefully monitored, to reduce the risk of stricture formation.

Neurological disorders are a significant cause of mortality and disability across the world. The current aging population and population expansion have seen an increase in the prevalence of neurological and psychiatric disorders such as anxiety, bipolar disorder, depression, epilepsy, multiple sclerosis and schizophrenia. These pose a significant societal burden, especially in low - and middle-income countries. Many neurological disorders have complex mechanisms and lack definitive cures; thus, improving our understanding of them is essential. The pathophysiology of neurological disorders often includes inflammation, mitochondrial dysfunction and oxidative stress. Oxidative stress processes, especially the generation of reactive oxygen species, are key mechanisms in the development of neurological disorders. Oxidative stress refers to an imbalance between the production of reactive oxygen species and antioxidants that can counteract them. Through their impacts on the pathophysiology of neurological disorders, nutrients with anti-inflammatory, neuroprotective and antioxidative properties have been suggested to prevent or mitigate these disorders. Certain vitamins, minerals, polyphenols and flavonoids may have therapeutic effects as adjuvant treatments for neurological disorders. Diet quality is also a risk factor for some neurological and psychiatric disorders and addressing nutritional deficiencies may alleviate symptoms. Therefore, optimizing nutritional intake may represent a potential treatment or prevention strategy. This review summarizes a selection of promising nutrients for the prevention and amelioration of neurological disorders to provide a summary for scientists, clinicians and patients, which may improve understanding of the potential benefits of nutrients in the treatment of neurological disorders.

Background: Leiomyomas beyond the uterus are defined by benign smooth muscle cell tumors outside of the uterus. Intravenous leiomyomatosis is a rare type of uterine leiomyoma and is characterized by the formation and growth of benign leiomyoma tissue within the vascular wall. Herein, we present a case of Intravenous leiomyomatosis successfully treated by surgical removal and a review of actual medical recommendations.Case presentation: A 49 - year-old woman, maghrébin, G3 P2, no family history of uterine myomas mentioned, having systemic arterial hypertension, presented to our department with hypogastric pain and abnormal uterine bleeding in the prior five months resulting in anemia which required iron supplementation. On physical examination the vital signs were normal. A palpable mass in the hypogastrium was noted. The rest of the exam was unremarkable. Pelvic ultrasound showed a huge uterus with multiple heterogeneous leiomyomas, including at least one intracavity. Computed tomography scans and magnetic resonance imaging were not done initially due to the unaffordability of the patient. The initial diagnosis was leiomyoma. The decision to perform a total abdominal hysterectomy and bilateral salpingo-oophorectomy was taken. The abdomen was opened by a midline vertical incision. During surgery, multiple subserosal, intramural and submucosal fibroids ranging from 2 cm × 3 cm to 10 cm × 10 cm were seen. On pathological examination, the uterus measured 19 cm in the largest diameter and weighed 1.3 kg. The cut section showed white nodular myometrial masses. Microscopically, intravascular growth of benign smooth muscle cells is found within venous channels lined by endothelium. The diagnosis of Intravenous leiomyomatosis of the uterus without malignant transformation was retained. The patient was monitored for 14 months and subsequent computed tomography did not reveal any evidence of tumor recurrence. The follow-up will be performed annually till the age of menopause.Conclusion: Intravenous leiomyomatosis is a benign, rare and potentially lethal pathology. It especially affects premenopausal women with a history of uterine myoma, whether operated on or not. They require close and prolonged follow-up because of the high risk of recurrence.

Background: Public health policies in the area of food and diets tend to separate recommendations on food safety and nutrition. However, food products can simultaneously have risks and benefits. Risk-benefit assessment (RBA) seeks to integrate the assessment of both risks and benefits to aid complex decision-making using a multidisciplinary approach. In this study, a systematic literature review of recent RBA studies was performed, focusing on food consumption and human health following earlier reviews by Boué, et al. (2015) and Thomsen, et al. (2021). Results: A total of 50 new RBA studies were reviewed since 20 May 2014. Our current literature review shows that the majority of RBA studies conducted in recent years remain focused on seafood, with studies on fish alone comprising 34% of all studies; the focus being on the benefits of fish consumption versus contaminant exposure. Most of the studies have been conducted in Europe (n = 31) and Asia (n = 11). Conclusion: RBA has the potential to be applied more widely to other food choices such as alternative proteins, yet application remains limited to specific applications and contaminant/nutrient case studies. In recent years, a few RBA studies have been reported on less mainstream food sources and one specifically on novel foods. Novel foods offer a unique application space for RBA as their development is focused heavily on the benefits to the consumer, society, and environment, yet there remains uncertainty as to their safety. 

The impact of vitamin D on the musculoskeletal system is well known. The diverse role of vitamin D is well supported by the functionality of vitamin D receptors and vitamin D activating enzymes (hydroxylase) present in tissues and cells. Hypovitaminosis D causes rickets, osteomalacia, hyperparathyroidism, and an increased risk of bone fracture. Vitamin D has immune-stimulatory effects on both the innate and adaptive immune systems. Vitamin D induces antimicrobial peptide cathelicidin and defensin that can inhibit viral replication of pro-inflammatory cytokines that regulate inflammatory encasement. Moreover, several studies on vitamin D have shown its interdictory role in the immune and respiratory systems. This global crisis, the COVID-19 pandemic condition has increased the risk of acute respiratory tract infection by immune dysregulation along with cytokine storm, which further progress into acute respiratory distress syndrome. Vitamin D has immunomodulatory and anti-inflammatory properties which are effective against respiratory viral infections. Vitamin D supplementation has shown a compatible effect on viral infection. This review article discusses the role of vitamin D in reducing the risk of respiratory infections including the severity of COVID-19 infections. This review focuses on the therapeutic role of vitamin D to improve clinical outcome during COVID-19 infection and suggest its possible role in the prevention and treatment of respiratory infections.

The utilization of the Internet and wireless communication reaches its pinnacle from one side of the planet to the other. Marking the rise of criminal activity in recent years sees enormous growth in security breaches and data theft-related cases in mobile phones. To mitigate them, the implementation of security patches, safety fixes, and updates in mobile devices is of high priority for the organization. The need to foster techniques and procedures in the field to be able to extract and precisely dissect digital crime cases, providing valuable tactical data about the investigation. Mobile forensics is a developing branch assisting the investigator in criminal trials and investigations. Acquisition, Collection, and Analysis of mobile phones settle the purpose of recovering cumulative and corroborative evidence. Upgradation and innovation of mobile devices with time imposed a challenge to mobile forensic technology to extract information from such devices. The study aims at extracting comparative and statistical approaches in the analysis of Physical data acquisition utilizing significant versatile mobile criminological proprietary tools. The proposed study also introduces newly developed utility tools along with their characteristic features which help in successful data extraction from mobile devices.

Infections caused by extended-spectrum β-lactamases (ESBLs)-producing bacteria in particular Klebsiella Pneumoniae (KPE+), are on a constant rise and are a noted cause of outbreaks in neonatal intensive care units (NICUs). In the NICU of Policlinico di Foggia, an outbreak of infections in 2018 brought to the start of a serial check of presence and favorable conditions associated with KPE+ diffusion. The outbreak was controlled by improving basic hygiene measures such as hand washing, the use of disposable gloves and gowns, and removing a potential environmental contamination source such as the water bottle warmer.

Trying to understand the causes of climate change can be confusing. On the one hand, methane (CH4) emissions from cattle, and methane emissions from food wastes in landfills, are said to contribute to greenhouse gases (GHGs) that drive climate change.  People are working on feed additives for dairy cows to reduce their methane emissions. But, at the same time, cattle manure and food wastes can be fed into anaerobic digesters to convert these organic wastes to biogas; the resulting “renewable methane” or “renewable natural gas” (RNG), can be used in place of fossil natural gas and avoid extra GHG emissions and stop global warming. Can we have it both ways?  Burning gasoline in our cars and trucks generates carbon dioxide (CO2), which is said to contribute to climate change. But more than 8 billion people on planet Earth, breathe in oxygen and exhale carbon dioxide every minute of the day. And so do all the other animals who live on this planet, breathe in oxygen and exhale carbon dioxide. Is our breathing also contributing to climate change, just as the emissions from our automobile tailpipes?It is time to step back from all the hype, evaluate the various sources of CO2 and CH4 being generated and review the “mass balance” of these gases in our atmosphere. Some of these are part of the natural biogenic carbon cycle and some are simply adding to the overall mass balance. What is driving climate change - excess GHGs from the biogenic carbon cycle, excess emissions from other sources, or both? Let’s take a fresh look at the available data.  (Of course, water vapor also plays a part in the climate change story, as a “positive feedback” effect. As non-condensable GHGs rise in concentration and slightly warm the planet, slightly warming oceans add a bit more water vapor to the story and push the warming up a bit more).  During the past few decades, a great deal of pertinent data has been carefully observed and recorded, by world-class scientists and engineers. This data is available in the public domain and is now easily available on the internet. These data sources come from reputable organizations, such as NASA (National Atmospheric and Space Administration), NOAA (National Oceanic and Atmospheric Administration), USGS (United States Geological Survey) and international organizations such as the “Global Carbon Project” and “Our-World-in-Data”.  How much of the growing concentration of CO2 (and CH4) in our atmosphere can be attributed to out-of-control emissions of biogenic carbon? How much of the CO2 rise can be attributed to fossil fuel emissions: 10%, 50%, 90%, or more?  The available data appear to show that the emissions from burning fossil fuels, more than account for all of the rise of carbon dioxide in our atmosphere during the past 60 years, or longer.  In comparison, the biogenic carbon cycle data seem to be very consistent, year after year, decade after decade and have little or no impact on climate change. But, let’s have a closer look at the available data, and let the data speak for itself.

Background: Having claimed lives, HIV/AIDS is still a significant global public health concern. Antiretroviral therapy (ART) is now widely available, and this rapid expansion of access is dramatically improving HIV epidemic survival rates worldwide.Objectives: The aim of this study was to identify the mortality risk factors and survival status of ART patients attending Hawassa Comprehensive Specialized Hospital in 2020.Methods: In a five-year retrospective cohort research, all patients seen between January 2015 and December 2019 were analyzed. The data were analyzed with SPSS 25.0. The Kaplan-Meier Log-rank model was employed to gauge the survival time of ART patients based on explanatory variables. Both bivariate and multivariate Cox proportional hazards regression models were employed to identify the independent causes of mortality.Results: Patients on ART had a 74% overall survival probability. With a median survival of 34 months, there are 0.135 deaths for every 100 person-years. Hemoglobin level (HR = 2.38; 95% CI = 3.3-6.3), WHO clinical stage III and IV (HR = 3; 95% CI = 2.2-9.5, p = 0.04), Age >=60 (HR = 1.6; 95% CI = 1.3-2, p = 0.04) and Functional status bed ridden (HR = 3.1; 95% CI = 1.2-9.4,p = 0.04) were all independent predictors of death among RVI patients.Conclusion: In comparison to trials conducted in wealthy countries, the survival rate of ART patients in this study was low. Patients who are anemic; WHO advanced clinical stage; old age, and functional status bedridden should be closely followed and monitored.

Malignancy of the small bowel is exceedingly rare, accounting for 3% - 5% of all gastrointestinal malignancies [1-3]. However, in recent years because of improved diagnostic accuracy, the incidence of small bowel cancer is rising. It is estimated that 10, 470 new cases of primary SI cancer will be diagnosed in the US with 1450 cancer-related deaths [4]. The most frequent histologic types of small bowel malignant tumors include adenocarcinomas, carcinoids, lymphomas, and sarcomas. Adenocarcinoma of the small intestine is the second most common histologic type of SI cancer. The most frequent location of SI adenocarcinoma is the duodenum (57%), followed by the jejunum (29%) and ileum (13%) [5]. SI cancers are more common in men than women [6]. They occur more commonly in the African-American population and after 60 years of age [7].