What is Journal of Carcinogenesis? Despite the advances in the treatment of cancer and the increasing knowledge of the processes responsible for the disease, there is a gap in the understanding of molecular events leading to cancer and the mechanisms of action by anticancer agents. The field of carcinogenesis is far from being completely explored. Many novel ideas and concepts still need to be introduced into the field, and the results of several provocative experiments are yet to be disseminated and shared. There is a need for multidisciplinary research in the field and a forum for accelerated publication of results. These are the considerations that led to the birth of the online journal, Journal of Carcinogenesis. Journal of Carcinogenesis is a peer-reviewed, online journal designed to bring together many aspects of research to develop the understanding of carcinogenesis. Edited by Gopala Kovvali, Journal of Carcinogenesis is supported by an international Editorial Board. Journal of Carcinogenesis considers manuscripts in many areas of carcinogenesis and Chemoprevention. Primary areas of interest to the journal include: physical and chemical carcinogenesis and mutagenesis; processes influencing or modulating carcinogenesis, such as DNA repair; genetics, nutrition, and metabolism of carcinogens; the mechanism of action of carcinogens and modulating agents; epidemiological studies; and, the formation, detection, identification, and quantification of environmental carcinogens. 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We follow closely the industry associations, such as the Committee on Publication Ethics (COPE), International Committee of Medical Journal Editors (ICMJE) and World Association of Medical Editors (WAME), that set standards and provide guidelines for best practices in order to meet these requirements. For a summary of our specific policies regarding duplicate publication, conflicts of interest, patient consent, etc., please visit Author Guidelines Open Access Publication and Creative Commons Licensing This is an open-access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. Digital Archiving Portico is a leading digital preservation service worldwide. The content is preserved as an archival version and is not publically accessible via Portico, but is provided when required under specific conditions, such as discontinuation of the collection or catastrophic failure of the website. Ahead of Print policy Articles published online under the Ahead of Print model are considered published and can be cited and quoted using the DOI as the reference source. The journal has a policy that changes will not be made after publication of an article without following accepted procedures for making corrections to the scientific record. Content overview Article types of interest to Journal of Carcinogenesis include but not limited to: Commentaries – short, focused and opinionated articles on any subject within the journal scope. These articles are usually related to a contemporary issue, such as recent research findings, and are often written by opinion leaders invited by the Editorial Board. Research – comprehensive reports of data from original research. Review articles – comprehensive, authoritative, descriptions of any subject within the journal scope; these articles are usually written by opinion leaders that have been invited by the Editorial Board. Short papers – articles of exceptional interest, intended for brief reports of findings. These will be considered for publication on a priority basis and are usually about 2000 words in length. Peer review policies Peer review in Journal of Carcinogenesis is designed to ensure that good science is published rapidly. Journal of Carcinogenesis considers manuscripts spanning a wide range of scientific interests, as long as the results and conclusions are scientifically justified. Articles that contribute to the significant advancement of knowledge in the field will be given wider publicity. Submitted manuscripts will be reviewed by two external experts. The authors are encouraged to submit names of potential reviewers to expedite the review process. The editors may choose reviewers from those suggested by the authors or may have the manuscript reviewed by experts chosen by them. Publishing in Journal of Carcinogenesis Articles in Journal of Carcinogenesis should be cited in the same way as articles in a traditional journal. However, because articles in this journal are not printed, they do not have page numbers. Instead, they have a unique article number. The following citation: J Carcinog 2004, 2:1 refers to article 1 from volume 2 of the journal. As an online journal, Journal of Carcinogenesis does not have issue numbers. Each volume corresponds to a calendar year. Submission of manuscripts Manuscripts should be submitted electronically to Journal of Carcinogenesis using the online submission system. Full details of how to submit a manuscript are given in the instructions for authors. General journal policies Journal of Carcinogenesis’s articles are archived in PubMed Central, the US National Library of Medicine’s full-text repository of life science literature. For further information about general policies please see the instructions for authors.
Correlation of Clinical Symptoms with Hematological and Biochemical Abnormalities Among Tuberculosis Patients.
Objective: Tuberculosis (TB) is a key health issue and is characterized by a wide variety of clinical symptoms which can be affected by the underlying biochemical and hematological status of the patients. Therefore, this study assessed the association of clinical symptoms with biochemical and hematological findings among patients with tuberculosis. Methodology: This cross-sectional experimental study was conducted in institute of Basic Medical Sciences (IBMS), Khyber Medical University. A total of 103 patients aged ≥15 years suspected with pulmonary tuberculosis, were included in the study. A chi-square test and Fisher’s exact test was used to observe the association between clinical symptoms and demographics, hematological, and biochemical findings. Additionally, a Mann Whitney test was employed to analyze the relationship between the means of demographic variables. Results: The study findings showed that all patients reported cough, and 100 (97.1%) had fever, with no significant association between symptoms and demographics, comorbidities, medication use, or hematological markers such as TLC and ESR (p>0.05). Significant associations were found with diabetes, where weight loss 48 (55.2%) (p=0.032) and reduced appetite (p=0.002) were more common among diabetics. Reduced appetite was also significantly linked to fasting blood sugar levels (p=0.017) and chronic illness (p=0.020), while all other variables showed no significant associations. Conclusion: This study concluded that comorbid diabetes and chronic illnesses were significantly associated with main clinical symptoms, such as weight loss and reduced appetite. A significant association was identified between fasting blood sugar levels and reduced appetite. In contrast, hematological parameters including Total Leukocyte Count (TLC) and Erythrocyte Sedimentation Rate (ESR), showed no significant association with clinical symptoms.
Pulmonary Tuberculosis, clinical symptoms, reduced apatite, weight loss, hematological parameters
Dr. Rahmat Ullah Jan, Prof Dr. Satheesh Babu Natarajan
Speech and Swallowing Following Tongue Cancer Surgery and Free Flap Reconstruction-A Systematic Review
Introduction-Tongue restoration presents a number of difficulties, including pedicle or free flaps, with variances resulting from the creation of the entire neotongue or the remaining native tongue tissue. Methods: Research on functional outcomes following tongue restoration with flaps was found using a thorough search of Embase, PubMed, the Cochrane Library, and Web of Science. 42 of the 782 articles were reviewed. The Critical Appraisal Skills Program instrument was used by four independent researchers to evaluate bias risk. Results: While free flaps like the radial forearm and anterolateral thigh were commonly utilised, the submental flap was the most common pedicle flap. Rebuilding type, postoperative radiation, and the extent of resection all affected functional results. In terms of functionality, neo-tongue reconstruction was different from oral tongue reconstruction. Speech results were comparable across pedicle and free flaps, while swallow outcomes were better with sensory or motor- innervated flaps. Conclusions: The study’s findings are limited by inconsistent data, retrospective designs, and lack of standardized methods, necessitating cautious interpretation. Free flaps consistently offer better functional outcomes for tongue reconstruction, improving over time with rehabilitation.
Tripta Agarwal, Rakesh Nagaraju, Ajay Kumar Jagdish
Gastrointestinal Tract Duplications, a Multicenter study
Background: Gastrointestinal tract duplications are uncommon congenital abnormalities with variable clinical presentations, ranging from abdominal distension to intestinal obstruction. Objective: To describe the clinical characteristics, surgical management, and outcomes of pediatric patients with gastrointestinal tract duplications at a tertiary center. Methods: This retrospective study was conducted on 28 pediatric patients diagnosed with gastrointestinal tract duplications. Inclusion criteria comprised patients who underwent surgical management with complete medical records. Data on demographics, clinical presentation, anatomical site, duplication type, associated anomalies, surgical procedures, and postoperative outcomes were analyzed. Clinical evaluation, imaging, and histopathology confirmed diagnoses. Surgical approaches included resection with primary anastomosis, stoma formation, excision/enucleation, and partial excision with mucosal stripping, depending on lesion type and location. Results: The most prevalent symptoms were abdominal distension and vomiting (50%), followed by abdominal mass (28.6%). Ileal duplications were most frequent (67.8%), followed by jejunal (14.3%) and gastric (7.1%) lesions. Cystic duplications predominated (60.7%). Resection with primary anastomosis was performed in 75% of patients. Overall, 23 patients (82.1%) had favorable outcomes, while 5 (17.9%) experienced complications, primarily sepsis (4 cases) and anastomotic leak (1 case). Conclusion: Gastrointestinal tract duplications mainly present in early childhood with a slight male predominance. Early diagnosis and appropriate surgical management, primarily resection with anastomosis, result in favorable outcomes, with complications largely related to infection.
Gastrointestinal duplications, pediatric surgery, cystic duplication, ileum
Hatem W Alsherbiny,, Alsayed M Othman MD,
Endometrial Carcinoma With Prominent Squamous Differentiation In A Postmenopausal Woman: A Case Report
Background: Endometrial Carcinoma is the most common gynecological malignancy in the postmenopausal age group. Squamous differentiation is an uncommon histological variant that may pose diagnostic challenges, particularly in distinguishing it from primary cervical malignancy. Case Presentation: We report a case of a postmenopausal woman, who presented with complaints of postmenopausal bleeding. Imaging revealed a thickened endometrium. Histopathological examination of the endometrial sampling suggested invasive carcinoma with extensive squamous differentiation, raising a differential diagnosis between cervical and endometrial origin. The patient underwent staging laparotomy with total abdominal hysterectomy with pelvic lymphadenectomy. Final histopathological examination confirmed the diagnosis of endometrioid carcinoma with squamous differentiation with involvement of bilateral fallopian tubes in the absence of myometrial invasion. Conclusion-This case highlights the diagnostic challenge posed by squamous differentiation in endometrial carcinoma and demonstrates an unusual pattern of tumor spread to the fallopian tubes without myometrial invasion. Recognition of such atypical presentations is essential for accurate diagnosis, staging, and management.
Endometrial carcinoma, Squamous differentiation, Postmenopausal bleeding, Case report
Contraceptive Conversations: Exploring Awareness, Beliefs, and Stigma around Contraception in Urban India
Background: Despite improved access to contraceptive methods in urban India, widespread misinformation, social stigma, and limited education continue to restrict their effective use. Critically, poor contraceptive knowledge has direct implications beyond reproductive health — low condom uses increases exposure to oncogenic human papillomavirus (HPV), while gaps in knowledge around hormonal contraceptives leave users unaware of associated cancer risks. This study aimed to evaluate current knowledge, attitudes, and practices around contraception to identify persisting gaps and their potential carcinogenic implications. Objectives: To assess awareness, knowledge, attitudes, beliefs, and acceptance around contraceptive practices among urban Indians, with a focus on knowledge gaps that may contribute to increased cancer risk through suboptimal contraceptive behaviours. Methods: A cross-sectional online awareness survey of 240 participants (140 females and 100 males) aged 18 to 50 years was conducted between September and October 2025. Results: Females showed notably greater openness in discussing contraception than males. The male condom was the most recognised and used method, yet awareness of its role in HPV and cancer prevention was absent. Awareness of IUDs and implants was poor. Over 50% lacked knowledge on the correct use of oral contraceptive pills, including unawareness of associated cancer risk profiles. 30% believed contraceptives adversely affect fertility or sexual function. 75% equated emergency contraception with abortion. 80% found sex education inadequate and 70% had not received contraceptive counselling from a healthcare professional — counselling that would typically include cancer risk information. Over 50% expressed a need for a dedicated contraceptive helpline. Conclusion: Knowledge gaps, societal myths, and stigma continue to hinder the widespread acceptance and correct use of contraceptives in urban India. Addressing misinformation through comprehensive sex education, proactive healthcare counselling, and community-based awareness initiatives is crucial to promoting informed, appropriate, and stigma-free practices.
Contraception, Awareness, Urban India, Stigma, Hpv, Cervical Cancer, Oral Contraceptive Pill, Cancer Risk, Condom Use, Knowledge Gaps, Sexual Health, Family Planning
Dr. Suhani Chadha*, Dr. Tanya Buckshee Rohatgi
Sentinel Lymph Node Biopsy in Melanoma: Who and When? A Literature Review
Melanoma is the mostdeadly form of skin cancer globally and causes considerable morbidity if not detected early. Sentinel lymph node biopsy (SLNBx) is an important staging technique used to guide prognosis and therapy; however, its application in thin and thick melanomas remains controversial. This review examines evidence from studies identified through PubMed, Cochrane Review, and Google Scholar that address SLNBx techniques, outcomes, and indications. The findings indicate that SLNBx should be considered standard practice for intermediate-thickness melanomas (1.0–4.0 mm). In thin melanomas (<1.0 mm), it should be used selectively in patients with high-risk pathological features, while in thick melanomas (>4.0 mm), it provides staging value, although its impact on survival remains unclear. The MSLT-I trial demonstrated improved disease-free survival with early nodal treatment in sentinel node–positive patients with intermediate-thickness melanoma. In conclusion, SLNBx is a valuable tool in melanoma management and should be applied based on tumor thickness and associated risk factors.
Melanoma, Sentinel Lymph Node Biopsy, Lymphatic Mapping, Tumor Thickness, Clinical Algorithm, Staging
Elaine S Cyrus, Ulrich Rodeck, Richard Wang
AI-Driven Mendelian Randomization for Biomarker Discovery in Rheumatoid Arthritis: A Systematic Review of Precision Medicine Approaches
Background: Rheumatoid arthritis (RA) still represents a heterogeneous autoimmune disease where the predictability of biomarkers is an important early step that is pivotal in personalized therapy. Mendelian randomization (MR) provides causal estimates of candidate biomarkers, despite the possible limitation of traditional MR with weak instruments and pleiotropy. Recent advances of artificial intelligence (AI) into MR processes hold the promise of better instrument selection and model stability, potentially revolutionizing precision medicine regarding RA. Objective: To perform a systematic review and synthesize of evidence about the application of AI-enhanced Mendelian randomization (AI-MR) to identify and confirm diagnoses and prognostic biomarkers in RA. Methods: PubMed, EMBASE, Web of science, Scopus, Cochrane library, IEE Xplorer and Google Scholar were searched systematically due to publications during 2012 to March 2025. Qualified articles used AI-based feature selection or pleiotropy-control of MR-based biomarker prioritization applications in RA. Two independent reviewers screened and extracted the data. The quality of the methodology was assessed with the help of ROBINS-I and QUADAS-2 and PRISMA 2020 guidelines were adhered to. Random-effects meta-analysis combined odds ratios (ORs), sensitivity, specificity and area under the curve (AUC). Correlation analysis was used to examine relationships between characteristics of study design and predictive accuracy. Results: Of the initial 4,615 records, 34 studies were included and they included 7,200 RA cases and 11,000 controls in multi-ethnic cohorts. Instruments were reinforced using AI techniques that included LASSO, elastic net, random forest, and deep neural pleiotropy filters ( median F-statistic 34). Combined diagnostic performance of AI-MR biomarker panels was sensitivity 0.81 (95% CI 0.770.85) specificity 0.79 (95% CI 0.740.83) and AUC 0.86. IL-6, TNF and IL-1b had the strongest causal information (average pooled OR of 1.5), and autoantibody panels (ACPA, RF) and metabolomic responses had moderate incremental value. Correlation was used to determine that sample size was positively correlated to AUC (r = 0.71), and the reproducibility was better with the use of AI-guided pleiotropy checks. External validation was only done in 41 percent of studies. Conclusions: AI-enhanced Mendelian randomization is a better causal inference than conventional MR and has higher diagnostic accuracy in RA biomarkers. Precision rheumatology can be improved by combining AI based optimization of instruments and multi-omics inputs, however, pipeline standardization, transparent reporting, and large multicenter validation are all pressing requirements before clinical culture adoption.
Rheumatoid arthritis; precision medicine; artificial intelligence; Mendelian randomization; biomarkers; causal inference; machine learning.
Md Ahnaf Tajwar Kamal, Saima Akter Shikha
Nawfat Kamal Munifa, Elton Bicalho do Carmo
Khandaker Ataur Rahman, Daniel Benniah John
Validation of LLM-Based Data Curation for Oncology Clinical Trials: A Review encompassing comparison with Manual Abstraction
The quick growth of clinical data in oncology research has made it difficult to extract and manage data which needs to be processed for clinical trials. The medical field considers manual curation to be the highest standard but its use has become restricted because of time and financial requirements and difficulties with different people judging the same material. Large Language Models (LLMs) which belong to artificial intelligence research work as effective automatic systems which can extract data from unstructured clinical documents that include electronic health records and pathology reports and clinical narratives. This review assesses how well LLMs perform data curation in oncology clinical trials by comparing their results to those of manual data curation processes. This research project has been collecting current evidence about accuracy and efficiency and scalability and reliability and cost-effectiveness of the solution. The study examined validation frameworks together with ethical matters and difficulties which arise during system implementation. Existing studies demonstrate that LLM-based approaches achieve high concordance with manual curation while dramatically reducing processing time and resource utilization. The system suffers from multiple problems which include data heterogeneity and difficulties with understanding data and bias issues and challenges from regulatory bodies. Hybrid human-AI models appear to be the most viable approach for near-term clinical integration. The review presents major advancements in research while showing existing research deficiencies and giving recommendations about how to use LLM-based systems in oncology clinical trial operations.
Karnaditya Rana, Shashidar Reddy Abbidi,
A Theoretical Exploration of the Psychosomatic Impact of COVID-19 on Women
This theoretical research examines how the COVID-19 pandemic intensified psychosomatic experiences among women. Psychosomatism—the manifestation of psychological stress through physical symptoms—is deeply influenced by biopsychosocial and gender-role dynamics. Drawing on established theories such as the Biopsychosocial Model, Gender Role Theory, Stress-Diathesis Model, and Trauma-Stress Response Theory, this paper conceptualises why women experienced heightened psychosomatic distress during the pandemic. It argues that the pandemic magnified structural inequalities, emotional labour, domestic responsibilities, and caregiving roles, leading to greater mind–body conflict and physical symptom expression. As a theoretical exploration, the study synthesises interdisciplinary perspectives to understand women’s psychosomatic vulnerability in crisis contexts.
Integrative Insights into Agni Dysregulation and Thyroid Hypofunction: Narrative Review
Introduction: In Ayurveda, Agni(digestive/metabolic factors) is regarded as the central regulatory force in maintaining physiological homeostasis. It is responsible for the digestion, absorption, assimilation and transformation of food into Dhatus(body tissues). Agnimandya (Impairment of Agni) is considered the root cause of most diseases. Ashtanaga Hridaya has quoted “Rogau Sarve Api Mandagnau” Which means disturbance in Agni due to improper diet, lifestyle and stress contributes to the development of dysbiosis, leading to various organ system diseases. Although, thyroid gland and its disorders are not explicitly referenced in Ayurvedic texts, the clinical features of hypothyroidism such as fatigue, weight gain, cold intolerance, and mental sluggishness closely correlate with the derangement of Agni, Kapha Dosha and Rasadhatu. Materials and Methods: A narrative review was conducted using classical Ayurvedic texts and contemporary scientific literature. Electronic databases including PubMed and the AYUSH Research Portal were searched using predefined keywords related to Ayurveda, Hypothyroidism, Agni AND homeostasis and Ayurveda AND thyroid disorders. English-language review and clinical studies were included. Reference lists of selected articles were also screened. Result: The review highlights that digestion is governed by Jatharagni and Panchabhautika Agni, while Dhatvagni facilitates molecular transformation of nutrients into Dhatus through Prasada (nutrient) and Kitta (waste) formation. Balanced Jatharagni and Dhatvagni are essential for proper tissue growth, metabolism, and nutrients transport at the cellular level. Findings suggest that hypothyroidism reflects a state of Agnimandya, particularly involving Rasadhatvagni, with predominant Kapha aggravation and sluggish metabolic activity. This imbalance disrupts Srotasa (bodily channels), leading to systemic dysfunction. Conclusion: Understanding hypothyroidism through Agni imbalance offers an integrative framework, linking Jatharagni, Bhutagni, and Dhatwagni to digestive, hepatic, and cellular metabolism. This perspective emphasizes Agni’s central role in maintaining homeostasis via regulation of digestion, metabolism, and waste elimination.
Agni, Agnimandya, Hypothyroidism, Homeostasis, Rasadhatvagni.
Dr. Pradeep H S, Dr. Bhagat, Dr. Swati N. Khandale
Machine Learning–Based Predictive Models For Outcomes After Metabolic Bariatric Surgery: Accuracy, Validation, And Clinical Utility — A Systematic Review And Meta-Analysis
Background: To predict clinical outcomes, including weight-loss outcomes, diabetes remission, and postoperative safety, the use of machine learning (ML) predictive models is increasingly popular in metabolic bariatric surgery (MBS). However, these models possess lower predictive accuracy, external validity and clinical utility. Methods: We divided the PRISMA 2020 guidelines on how to conduct a systematic review and meta-analysis. PubMed, Embase, Scopus, Web of Science, and Cochrane Library (January 2015-September 2024) were detailed searched to identify the literature that developed or validated the ML models to predict the postoperative outcomes in the MBS patients. Data on the nature of the studies (type of surgical procedure, type of model, performance measures [area under the receiver operating characteristic curve [AUROC], accuracy, calibration], method of validation, and risk of bias [ PROBAST] were independently screened and extracted by two reviewers. Random-effects meta-analyses involved the utilization of the AUROC and accuracy along with the key outcomes consideration; I 2 and Cochran’s Q were used to measure heterogeneity whereas funnel plot and Egger test were used to measure publication bias. Results: 34 studies, with 42185 patients, were considered. The most common were the Roux-en-Y gastric bypass (52) and sleeve gastrectomy (41). The commonly used algorithms were the logistic regression, random forest, gradient boosting, and neural networks. The high-weight-loss-success, diabetes-remission, and prediction of complications had a high pooled discriminative performance: 0.83 (95% CI, 0.80786 I 2 = 58%), 0.81 (95% CI, 0.77884 I 2 = 61%), and 0.79 (95% CI, 0.74884 I 2 = 55%) respectively. Only 35 percent of the studies the external validation was only done in and had a marginally lower AUROC compared to internal validation (0.79 vs. 0.84, p = 0.04). Calibration reporting and clinical utility analysis was not widespread. The total threat of bias was medium, mostly due to the unreported predictors in all cases, and a complete lack of model transparency. The test of Egger and funnel plots showed that there was low publication bias. Conclusion: ML-based predictive models of MBS have high accuracy in weight-loss and remission of diabetes and moderate predictive accuracy of complication. However, the external validation remains weak and inconsistency in calibration exists which restricts the use in real life. In order to make these models part of the regularity of bariatric practice placing more emphasis on standardized outcome definitions, some transparent reporting and multi-centre validation would be needed.
Machine learning; predictive modeling; metabolic bariatric surgery; weight-loss success; diabetes remission; postoperative complications; external validation; systematic review; meta-analysis.
Saima Akter Shikha, Iftiaz Ahmed Alfi, Daniel Benniah John
Md Ahnaf Tajwar Kamal, Nawfat Kamal Munifa
Elton Bicalho do Carmo, Umme Sumaya Suravi
Mahedy Hasan Raihan, Nure Alam Howlader, Abdullah Al Masud
Lifespan Variabilities in Electrooculography Parameters: Role of Sex-Linked Hormonal Profiles and Neural Maturation
Purpose: Electrooculography (EOG) serves as a vital non-invasive technique for neuro-ophthalmological diagnostics and human-computer interface (HCI) development, yet its parameters may vary with demographic and physiological factors. Methods: This prospective study enrolled 50 healthy participants, stratified by age into three groups: child/adolescent (12–22 years, n=20), adult (23–40 years, n=24), and a pilot elderly group (≥40 years, n=6). EOG signals were recorded using a BIOPAC MP36 system, adhering to protocols informed by International Society for Clinical Electrophysiology of Vision (ISCEV) standards for electro-oculography. Standardized tasks assessed saccadic latency, blink dynamics, and signal-to-noise ratio (SNR) in horizontal and vertical planes. In adult females (n=12), menstrual cycle phase was determined via serum progesterone (≥3 ng/mL for luteal) and estradiol assays, synchronized with testing. Results: Adolescents exhibited significantly higher saccadic latency variability (210±30 ms; p=0.03 versus adults) and 40% lower vertical SNR, reflecting immature oculomotor control. Adult women in the luteal phase showed an 18% reduction in horizontal SNR (p=0.04), with estradiol levels inversely correlating with fixation duration (Spearman ρ=−0.58, p<0.05). Elderly participants demonstrated prolonged saccadic latency (p_adj=0.01) and 30% reduced blink amplitude compared to adults, indicating age-related declines in EOG signal quality. Conclusions: Age, gender, and menstrual cycle-related hormonal fluctuations systematically modulate key EOG parameters. These findings underscore the need for demographic-specific normative data in clinical electrophysiology and adaptive HCI applications, aligning with ISCEV recommendations for standardized interpretation.
Oculomotor Electrophysiology, Neuro-Ophthalmology, Saccadic Latency, Blinking Dynamics, Signal-To-Noise Ratio, Demographic Factors, Age Effects, Sex Differences, Ethnicity.
Epidemiology and Treatment Outcomes of Lymphoma in Karbala, Iraq: Insights from a Retrospective Analysis
Background: Lymphoma is a heterogeneous group of hematologic malignancies whose clinical behaviour and outcomes are variable. Local epidemiological data is needed to inform local management plans and maximize patient care in resource-limited environments. Objective: To assess the clinical features, modalities of treatment and outcome of lymphoma patients treated in oncology centres in Karbala and to examine the epidemiological trends of the study period. Methods: A retrospective cross-sectional study was done on the medical records of 120 histopathologically confirmed patients with lymphoma who were diagnosed and treated in Karbala. Descriptive statistics were used to extract and analyse the demographic, clinical, and staging data, treatment data, and outcome data. Findings: Non-Hodgkin lymphoma (NHL) was found to be 69.2 percent and Hodgkin lymphoma (HL) was found to be 30.8 percent. Fifty-five percent of the patients were reported to have advanced-stage disease (Ann Arbor stages III–IV). Fifty two and five percent of patients who received conventional first-line regimens achieved complete remission (CR). Later stage and high serum LDH were linked to poor prognosis. The total mortality during the period of data collection amounted to 25%. Conclusion: NHL predominates and high burden of advanced presentation at diagnosis is characteristic of lymphoma in Karbala. This needs enhancement of early detection programmes, development of diagnostic infrastructure, and establishment of formal regional lymphoma registries to improve survival outcomes across the Middle Euphrates region.
Lymphoma, Epidemiology, Treatment Outcomes, Retrospective Analysis.
Safety and Efficacy of First Arterial Approach in Management of Pancreatic Head Carcinoma
Objective: This prospective investigation sought to assess the technical safety, possibility, & effect of the first arterial approach(FAA) throughout PD for pancreatic head adenocarcinoma on R0 resection rates, loss of blood during operation, duration of operation, as well as early detection of unresectable illness. Patients and Methods: 100 consecutive cases having a PD for pancreatic head adenocarcinoma at Al-Azhar University Hospitals (Jan 2023–Dec 2024) usually utilized the FAA, involved the 1st dissection & control of the common hepatic artery & SMA prior to venous dissection or pancreatic transection. 1ry results included R0 resection rate, operative time, loss of blood during operation, and proportion of early diagnosis of unresectability. 2ry results comprised postoperative complications (bleeding, delayed gastric emptying, pancreatic fistula) & short-term survival. Results: FAA was technically viable in all instances. An R0 resection has been done in eighty-eight percent(88/100) of cases. Mean loss of blood during the operation was 350±120 milliliter; mean operative time was 380±75 minutes. Unresectable illness has been detected early in ten percent (10/100) of cases, avoiding additional wide dissection. Clinically relevant pancreatic fistula(Grade B/C) was fifteen percent, bleeding following pancreatectomy was seven percent, & delayed gastric emptying was 18%. The death rate within 30-days was 2%. Conclusion: FAA in pancreatic head carcinoma is a safe and effective method for early resectability assessment, enhancing R0 resection rates, avoiding unnecessary dissection in unresectable cases, and demonstrating acceptable perioperative results, thereby warranting its implementation in specialized environments.
Pancreaticoduodenectomy, Pancreatic Cancer, Superior Mesenteric Artery, Pancreatic Fistula, First Arterial Approach.
Ahmed Elsayed Abdelrahman, Tamer A. Abouelgreed
Mohamed I. Shalamesh, Alsayed B. Moghazy
Mohamed A. Nafea, Esam M. Osman, Mohammed Abbas
Mahmoud A. El-Hussieny, Mohammed M. Elrefaey
Mahmoud S. Shehata, Mohammad Thabet Alnajem
Lamiaa Saad Khalil, Abd El_fattah Al Sheikh, Ahmed Lamey
Accuracy of computer-aided indirect bonding using hard resin trays
Objective Many computer-aided solutions for indirect bonding have been proposed to increase the accuracy of bracket placement. The purpose of this study is to evaluate the accuracy of bracket placement using hard three-dimensional (3D) printed transfer trays. Method: Virtual bracket placement was performed on digitally scanned upper arches; transfer trays were virtually designed and 3D-printed using hard resin material. The transfer trays were used to indirectly bond one hundred brackets on the patients’ upper arches. The actual bracket positions were scanned after bonding, and virtual versus actual models were superimposed to measure linear and angular deviations from the planned positions. Result: The mean linear transfer errors were 0.315 ±0.025 mm mesiodistally and 0.366 ±0.014 mm occlusogingivally, with brackets tending toward distal and incisal positions. Angular errors averaged 1.632° ±0.091° for tip and 1.245° ±0.069° for rotation, showing directional bias toward clockwise tipping and mesial-in rotation compared to the planned positions. Conclusion: Indirect bonding with 3D-printed hard trays provides clinically acceptable accuracy in transferring bracket positions from the virtual setup to the patient’s dentition in both linear and angular dimensions
Tarek Hamdy Ali, Dr. Ahmed Mohamed Kilany,
Socio Economic Benefits of Bamboo Livelihood and Rural Development
By generating jobs, raising incomes, empowering local communities, and fostering environmental sustainability, bamboo-related occupations offer significant socioeconomic advantages for rural development. For rural residents, bamboo farming and associated businesses offer a steady source of income. These businesses can build infrastructure and support livelihoods in remote areas. Nutrition, health, education, and quality of life are all positively impacted by more income. This prevents rural residents from migrating to cities in search of employment, helping to preserve local culture in rural areas. Women's socioeconomic standing in society is enhanced by their direct contribution to raising family income. In rural areas, the growth of bamboo businesses often leads to the development of infrastructure, including improved utilities and roads. In addition to making bamboo a sustainable alternative material for infrastructure development, a planned, scientific, and comprehensive approach to bamboo cultivation, processing, and management can significantly contribute to the revitalization of rural and national economies for farmers. The majority of infrastructure demands in developing nations will be satisfied by the adoption and application of technology suitable for bamboo and its products. This chapter examines the socioeconomic advantages of bamboo, with a focus on its contributions to rural development and livelihood security. Bamboo has been identified as a possible tool for socioeconomic development due to its quick growth, perceived environmental benefits, promising material properties, and wide range of applications.
HPV, cervical cancer, vaccine, knowledge, attitude, practice, India
Quorum Sensing: Mechanisms, Applications, and Emerging Trends in Microbial Communication
Quorum sensing (QS) refers to the mechanism through which bacteria interact and collaborate based on their population density. According to their population size, they produce distinctive chemical signals called autoinducers that modify their genetic expression. This allows them to support other organisms, form biofilms, or lead to diseases. This paper explores new concepts and challenges in utilizing quorum sensing (QS) for innovation, along with its functions and advantages in industry, agriculture, and healthcare.
The Influence of Lyophilized Platelet-Rich Fibrin in The Treatment of Periodontal Intra-Bony Defects (A Randomized Clinical Trial)
Objectives: The current research aimed to evaluate the influence of lyophilized platelet-rich fibrin (Ly-PRF) in the management of periodontal intra-bony deformities. Patients and Methods: 36 intra-bony deformities (IBD) in 36 individuals with stage III periodontitis of both genders participated in the present randomized controlled prospective clinical investigation. The participants were randomly received either OFD alone [group I (control, n=18)] or OFD with combination of Ly-PRF [group II (test, n=18)]. All patients were evaluated clinically at; baseline, 3- and 6-month utilizing plaque index (PI), gingival index (GI), probing pocket depth (PPD), and clinical attachment level (CAL). Radiographic evaluation of the marginal bone level (MBL) and defect depth (DD) was evaluated at baseline and after 6-month. Results: The two treatment regimens lead to statistically significant PPD decreases and CAL gain from baseline to 6 months; the decrease in PPD and the gain in CAL were significantly greater in group II in comparison to group I. Radiographically, the mean value of MBL for the two groups showed additional marginal bone loss at 6 months; this loss was non-significant between the groups. The mean DD for both groups displayed statistically significant decrease from baseline values to 6-month; the decrease in DD was significantly greater in group II in comparison to group- I. Conclusions: Given the constraints of this research, it may be concluded that the adjunctive utilize of Ly-PRF in the surgical management of periodontal intra-bony deformities exhibited promising results on the clinical and radiographic results regarding to the PPD decrease, CAL gain as well as DD reduction.
Open flap debridement, Periodontal intra-bony deformities, Lyophilized platelet-rich fibrin.
Ibraheem Mahmoud Mwafey, Ahmed Mohamed Abd Al Rahman, Hamdy A Abol-Khair, Abdullah Ibrahim Abd Rabbouh Ali, Mahmoud Ahmed Mizar
Precision of two different electronic apex locators for working length determination across various embedding media: an in vitro assessment.
Introduction: Electronic apex locators (EALs) are essential for precise working length determination, but their accuracy can be influenced by the electrical properties of the surrounding tissues. Objectives: This study aimed to evaluate the E-PEX EAL's accuracy in comparison to Root ZX II in determining working length across three various embedding mediums. Materials and Methods: 42 extracted human teeth with a single root were decoronated, and actual lengths (AL) were established microscopically. Specimens were randomly assigned to alginate, agar, or bovine gelatin embedding media (n = 14 per medium). Canal lengths were measured using E-PEX and Root ZX II. Data were analyzed using a Mixed-Model ANOVA with Bonferroni correction. Results: Both EALs demonstrated high accuracy across all media, ranging from 85.7% to 100% of readings within ±0.5 mm of AL. There were no statistically significant differences between the devices in any medium after correction. In the bovine gelatin group, the E-PEX showed a trend toward greater deviation compared to Root ZX II (uncorrected p = 0.042); however, following controlling for multiple comparisons, this variation was not statistically significant (p > 0.05). Conclusions: Both the E-PEX and Root ZX II electronic apex locators provide high precision in determining working length, with most readings falling within ±0.5 mm of the actual length across all tested embedding media. Additionally, the E-PEX performs comparably to the recognized Root ZX II in simulated clinical conditions.
Electronic apex locators; working length determination; embedding medium; endodontics.
Mahmoud Y. Abou-Elnaga, Amr A. Bayoumi, Ahmed Gamal Shaban, Mohamed Samir Yousef, Mohamed K. Abo Amo, Hossam Hazem Hagras, Mohamed Ahmed Mahmoud Hamed
A Clinical Study on the Prevalence and Risk Factors of Surgical Site Infections in Postoperative Patients”; A cross sectional study
Background: Surgical site infections (SSIs) remain one of the most common postoperative complications worldwide, contributing significantly to morbidity, prolonged hospitalization, and increased healthcare costs. The global incidence varies widely from 1% to 30% depending on surgical type and patient-related factors. Recent studies report prevalence rates ranging between 5% and 12% in well-equipped tertiary care settings. Aim: To determine the prevalence and risk factors associated with surgical site infections among postoperative patients. Methods: A hospital-based cross-sectional study was conducted among 128 postoperative patients. Data regarding demographic variables, type of surgery, comorbidities, and perioperative factors were collected and analyzed. Results: The overall prevalence of SSI was 10.2% (n=13). Higher infection rates were observed in contaminated and dirty surgeries. Significant risk factors included diabetes mellitus, obesity, smoking, prolonged duration of surgery (>2 hours), and extended hospital stay. Similar findings have been reported in recent studies, where SSI incidence ranged from 9.3% to 11.7% with comparable risk factors. Conclusion: SSI remains a significant postoperative complication despite advancements in surgical care. Identification and modification of risk factors can substantially reduce infection rates and improve patient outcomes.
Clinical, Prevalence, Risk Factors, Surgical Site Infections, Postoperative Patients
Dr. Vivek Maurya, Dr. Vibhor Jain, Dr. Saurabh Singh
Evaluation of Serum Sodium Alterations in Patients Receiving Carbamazepine Therapy: A Prospective Observational Study
Background: Carbamazepine is a widely used antiepileptic drug with established efficacy in epilepsy, trigeminal neuralgia, and bipolar disorder. However, it is frequently associated with electrolyte disturbances, particularly hyponatremia, due to its antidiuretic hormone-like effects. Hyponatremia can lead to significant clinical consequences ranging from mild symptoms to severe neurological complications. Aim: To evaluate serum sodium alterations in patients receiving carbamazepine therapy and to determine the incidence and severity of hyponatremia. Methods: A prospective observational study was conducted on 100 patients receiving carbamazepine therapy in a tertiary care center. Serum sodium levels were measured and categorized as normal (135–145 mEq/L), mild hyponatremia (130–134 mEq/L), moderate (125–129 mEq/L), and severe (<125 mEq/L). Associations with duration of therapy and age were analyzed. Results: Among 100 patients, 62% had normal sodium levels, while 38% developed hyponatremia. Mild hyponatremia was observed in 20%, moderate in 12%, and severe in 6% of patients. Hyponatremia was more frequent in patients receiving therapy for more than 6 months and in elderly individuals. A statistically significant association was observed between duration of therapy and sodium levels (p < 0.05). Conclusion: Carbamazepine therapy is associated with a significant incidence of hyponatremia, particularly in long-term use and elderly patients. Regular monitoring of serum sodium is essential to prevent complications.
Carbamazepine, Hyponatremia, Serum Sodium, Antiepileptic Drugs, Electrolyte Imbalance
Dr. Akansha Arora, Dr. Madhulika Peter Samuel, Dr. Taskeen Tufail, Dr. Anubha
Impact Of Telecardiology And Remote Patient Monitoring On Hospital Readmissions And Mortality In Chronic Heart Failure: A Systematic Review
Background:According to the new pharmacological as well as device based treatments, chronic heart failure (CHF) has remained to be one of the significant reasons of hospital rehospitalizations and other deaths in the world. The innovative tools that have been proposed to contribute to the improvement of clinical outcomes are telecardiology and remote patient monitoring (RPM) as they have been argued that they would be effective to assist in the early detection of decompensation, enhanced involvement with patients, and persistent clinical monitoring. It is a systematic review of how telecardiology and RPM have an effect on hospital readmissions and all cause mortality among CHF populations. Methods: The systematic search of the databases PubMed, Scopus, Web of Science, and Google Scholar was carried out in order to locate articles published in 2010-2021 according to the recommendations of PRISMA 2020. The studies that passed the eligibility criteria were randomized controlled studies, cohort studies, and systematic reviews investigating the telecardiology interventions or RPM interventions among the adults with CHF. The readmission, mortality, compliance and patient participation in the hospitals were the data mining targets. The quality of methods evaluation was performed with assistance of Newcastle-Ottawa Scale (NOS) and Cochrane Risk of Bias 2. Results: They incorporated 22 (n = 8,450 patients) studies. Telecardiology and RPM interventions continued to reduce hospital readmission, and the relative risk was reduced by 21%. The outcomes of mortality showed that all-cause mortality reduced by 12 per cent (HR = 0.88; 95 per cent CI: 0.790.97) and the high-risk patients (NYHA class III-IV) in particular. The domain score was the most related with the engagement and adherence (3.62) and engagement was positively related with the decreased readmissions (r = 0.72). Still, the lowest score was credibility in digital systems (2.94), which reflects the remaining panic over data privacy and reliability and integration of digital systems into clinical processes. Conclusion: The presented systematization review demonstrates that telecardiology and RPM have the potential to eliminate readmissions and yield relatively better survival outcomes in CHF patients, especially those with more severe stages of the disease. The involvement of the patients turned out to be the mediator of the outcomes and the lack of the trust and the inconsistency of the implementation are taken as the key barriers. The upcoming research ought to focus on long-term trials and normal outcomes reporting, and the way of improving patient trust and system integration. Telecardiology is a potentially disruptive component of CHF management, and its success in implementation must be based on a patient-centered design, equal access, and comprehensive policy support
Telecardiology; tele-patient monitoring; chronic heart failure; readmission rates; mortality; digital health; PRISMA 2020.
Mahedy Hasan Raihan, Mehedi Hasan Pritom
Momtaz Akter Mitu, Elton Bicalho do Carmo
A Study on Evaluation of Spot Urine Microalbumin and Protein Creatinine Ratio in Newly Diagnosed Type 2 Diabetic Patients
Background Type 2 Diabetes Mellitus (T2DM) is a rapidly increasing global health problem associated with significant microvascular complications, particularly diabetic nephropathy. Early detection of renal involvement is essential to prevent progression to chronic kidney disease. Microalbuminuria and protein-creatinine ratio (PCR) in spot urine samples have emerged as simple and non-invasive biomarkers for early detection. However, their comparative diagnostic utility in newly diagnosed T2DM patients remains an area of ongoing research. Methods This case-control study was conducted in the Department of Biochemistry, Malwanchal University, Indore. A total of 636 participants were included, comprising 318 newly diagnosed T2DM patients (cases) and 318 non-diabetic individuals (controls). Clinical, anthropometric, biochemical, and lifestyle-related data were collected. Spot urine samples were analyzed for microalbuminuria and protein-creatinine ratio (PCR), while blood samples were evaluated for fasting blood sugar and HbA1c. Lipid profile and urinary parameters were also assessed. Statistical analysis was performed using appropriate tests, with p < 0.05 considered statistically significant. Results Diabetic patients demonstrated significantly higher fasting blood sugar (264.6 ± 81.58 mg/dL vs 158.6 ± 52.38 mg/dL) and HbA1c levels (10.2 ± 2.01% vs 8.42 ± 2.07%) compared to controls (p < 0.001). Lipid profile abnormalities, including elevated triglycerides, LDL, and VLDL, along with reduced HDL levels, were also statistically significant (p < 0.001). The protein-creatinine ratio was significantly higher in cases (2.46 ± 1.39) compared to controls (1.82 ± 0.99) (t = 6.72, p < 0.001), indicating early renal involvement. In contrast, microalbuminuria did not show a statistically significant difference between groups (p = 0.07). Urinary findings such as glucosuria, ketonuria, hematuria, and increased urinary sediments were more prevalent in diabetic patients. Strong correlations were observed between glycemic parameters and lipid profile in the case group. Conclusion The study concludes that protein-creatinine ratio (PCR) is a more sensitive and reliable marker than microalbuminuria for early detection of renal impairment in newly diagnosed T2DM patients. Spot urine analysis provides a simple, non-invasive, and cost-effective screening tool suitable for routine clinical practice. Early identification of renal dysfunction, along with comprehensive metabolic control, can significantly reduce the progression of diabetic nephropathy and improve patient outcomes.
Type 2 Diabetes Mellitus, Microalbuminuria, Protein-Creatinine Ratio, Diabetic Nephropathy, Renal Biomarkers, Glycemic Control
The Role of Epigenetics in Psychological Disorders: A Neurobiological and Environmental Interface
A complex interaction of neurological, environmental, and hereditary factors results in psychological diseases. Emerging studies in epigenetics provide a revolutionary lens through which we can comprehend the dynamic control of gene expression without changing the underlying DNA sequence, whereas classic models have mostly concentrated on inherited predispositions and neurochemical imbalances. The genesis, course, and response to therapy of conditions like depression, schizophrenia, bipolar disorder, and anxiety are increasingly being linked to epigenetic mechanisms, including DNA methylation, histone modification, and non-coding RNAs. This study examines what is now known about the epigenetic modification of genes related to neurodevelopment, stress response, and synaptic plasticity. It also looks at how trauma, early-life hardship, and lifestyle choices might leave enduring epigenetic traces that affect mental susceptibility throughout life.
The Accuracy of Bracket Placement using L-Shaped Printed Guide Method and the Digital Indirect Tray Method
Objectives: to compare the accuracy of bracket placement using L shaped printed guide and digital indirect tray using virtual models. Methods: This randomized clinical trial included 20 patients selected from the orthodontic outpatient clinics at Al-Azhar University, Assiut. Patients with full permanent dentition with complete clinical crown height and no previous orthodontic treatment were randomly assigned to receive bracket bonding by L shaped guide and digital indirect tray to obtain virtual models prebonding and post bonding to detect the deviation (linear and angular) of brackets for two methods. The variables were measured for each patient in each group for incisors, canines, and premolars. Results: The guided group showed less deviation than indirect group with significant difference between them present at all linear variables for all teeth except for premolar at mesiodistal deviation while angular deviation showed only differences in some brackets for certain teeth. Conclusion: Guided method provided more precise technique for bracket bonding at accurate position at different planes when compared to indirect tray method.
Orthodontics brackets, Guide, indirect bond, soft tray, and virtual models
Ahmed Mohamed Kilany, Mostafa Magdi Abdelmonem AbdelAllah, Mostafa Mohamed Mahmoud Dawaba, Hussein Shokry Hassan Ahmed, Esmail Kamal Hewy Raslan, Ahmed Mahmoud Ahmed Ali, Mahmoud Mohamed Salah Eldin
Biomimetic Remineralization of Dentin Using Aspartic Acid Pre-conditioning with Different Remineralizing Agents: An FTIR Analysis
Introduction: Effective dentin remineralization necessitates functional nucleation sites, often compromised during demineralization from non-collagenous protein degradation. Aspartic acid (Asp) can mimic these proteins and may facilitate intrafibrillar mineral deposition. Objective: This in-vitro study evaluated the efficacy of Asp pre-conditioning on dentin remineralization using Chitosan-loaded Nano-hydroxyapatite (Cs-nHA), Bio-Active Glass (BAG), and Silver Diamine Fluoride (SDF). Materials and methods: Sixty human dentin specimens were pH-cycled to produce standardized lesions and divided into two main groups (n=30): Asp-conditioned and non-conditioned groups. Each main group was subdivided by remineralizing agent treatment (n=10): chitosan-loaded nano-hydroxyapatite (Cs-nHA), bioactive glass (BAG), or 38% silver diamine fluoride (SDF). Treated specimens were stored in artificial saliva for 2 or 6 weeks. The remineralization potential was quantified via Fourier Transform Infrared Spectroscopy (FTIR) before and after treatment by calculating the Mineral-to-Matrix (M:M) ratio. Results: All remineralizing treatments demonstrated significant improvement in M:M ratios compared to the untreated demineralized dentin baseline. Asp pre-conditioning produced significantly higher M:M ratios compared to non-conditioned controls across all groups. Cs-nHA achieved the highest M:M ratios, outperforming SDF and BAG, while SDF and BAG did not differ significantly from each other. All groups showed greater M:M ratios at 6 weeks versus 2 weeks. Conclusions: Preconditioning dentin surfaces with Aspartic acid markedly enhances the dentin remineralization potential of the tested remineralizing agents. The application of various remineralizing agents improves dentin remineralization, with Cs-nHA yielding the best results among SDF and BAG, while there was no significant difference in efficacy between them. Additionally, extending the storage time of the remineralizing agents further promotes dentin remineralization.
Aspartic acid, Bioactive Agents, Silver Diamine Fluoride, Biomimetic dentin remineralization, FTIR spectroscopy.
Ibrahim El Dossoky Basha, Walaa Mohamed Ahmed Alsamoully, Hamed Ibrahim Mohamed Ibrahim, Eslam Hassan Gabr, Mohamed Ahmed Basha, Osama Nasr Elden Eltobgy, Ashraf Marawan El Azzazy, Galal Eldeen Mosaad Sadek, Ahmed Elbakry Khder
To Study the Sodium Valproate Levels in Patients attending a Tertiary Care Centre
Background: Sodium valproate is commonly used in clinical practice, and maintaining appropriate drug levels is important for effective treatment and safety. Aim: To assess sodium valproate levels in patients receiving therapy. Materials and Methods: A cross-sectional study was conducted on 100 patients receiving sodium valproate. Drug levels were measured under steady-state conditions. Patients were grouped into low, normal, and high levels based on standard reference ranges. Data were analyzed using simple descriptive statistics. Results: Out of 100 patients, 62% had normal levels (50–100 µg/mL), 24% had low levels (<50 µg/mL), and 14% had high levels (>100 µg/mL). The mean level was 68.5 ± 17.6 µg/mL, with values ranging from 33 to 118 µg/mL. Conclusion: Most patients had sodium valproate levels within the normal range, but a considerable proportion showed levels outside the desired range. Monitoring drug levels can help in better management.
Sodium valproate, Drug levels, Patients, Monitoring
Assessing Diagnostic Concordance: A Retrospective Review of Preoperative Ultrasound and FNAC Against Final Histopathology
Background- Accurate preoperative diagnosis of thyroid nodules is essential to guide appropriate management and avoid unnecessary surgery. Ultrasound (USG) and fine-needle aspiration cytology (FNAC) are widely used diagnostic tools; however, their concordance with histopathology varies. Aim: To evaluate the diagnostic concordance and sensitivity of USG and FNAC compared with final histopathology in thyroid malignancies. Methods: This retrospective study included 15 patients with thyroid swelling who underwent USG, FNAC, and subsequent thyroid surgery between November 2022 and September 2024. Preoperative findings were compared with histopathological examination (HPE). Sensitivity and positive predictive value (PPV) were calculated. Results: All 15 cases were histopathologically confirmed malignancies. USG detected 6 true positives and 9 false negatives (sensitivity: 40%, PPV: 100%). FNAC detected 9 true positives and 6 false negatives (sensitivity: 60%, PPV: 100%). Papillary carcinoma was the most common malignancy (73.3%), followed by follicular (13.3%) and medullary carcinoma (13.3%). Conclusion: FNAC demonstrated higher sensitivity than USG, but neither modality alone was sufficient for detecting all malignant cases. A combined diagnostic approach improves accuracy and clinical decision-making.
Thyroid nodules, FNAC, Ultrasound, Histopathology, Diagnostic accuracy
Dr. Jubina PP, Dr Sanjana Khati, Dr Kalpana Rajiv Kumar, Dr Swapnil Gosawi
Unified Graph Query Engine for Heterogeneous Databases: Enabling High-Performance Graph Queries Without Data Migration
Graph query paradigms, which are popularized by data engineering, are highly efficient with complex, connected data in comparison to traditional SQL. Multi-join operations are exponentially complex in relational systems. Graph benefits may need expensive migration or ETL to specialized databases, which are hard to use with heterogeneous environments. Based on PuppyGraph's zero-ETL querying over relational and lakehouse target sources, this paper introduces a single overall graph query engine as a lightweight overlay. This solution is compatible with a wide variety of backends (RDBMS, NoSQL (MongoDB, Cassandra), big data (Hadoop/Spark), columnar (ClickHouse), and parquet-based Iceberg tables). It eradicates migration, achieves better storage efficiency through compression, increases security through column-level encryption and snapshots, and increases performance. Significant innovations are conditional lazy materialization to optimize Parquet/Iceberg with high-hop (>5), long-running (>5 s), or repeated (>= 3 in 24 hours) queries; a federation layer to hybrid cross-database queries; and graph optimization, such as index-free adjacency and rewrite rules. Experiments on reduction in versions of TPC-H and LDBC SNB-like graphs indicate a 55-70% reduction in latency on 3-10+ hop traversals, and a 40% reduction in storage by Iceberg compression and selective materialization. This can be achieved through introducing graph analytics to polyglot infrastructures without interference, redundancy, and data movement.
graph query engine, zero-ETL, heterogeneous databases, graph querying, data federation, Apache Iceberg, conditional materialization, multi-hop traversal
Venkata Harikishan Koppuravuri Aparna Kumar
Long-Term Neurodevelopmental and Clinical Outcomes Following Repeated Anesthesia Exposure in Pediatric Oncology: A 10-Year Multinational Cohort Study
Background: Pediatric oncology patients frequently undergo repeated procedures requiring general anesthesia. Concerns persist regarding the cumulative neurotoxic effects of anesthetic agents on the developing brain, particularly with repeated exposure. However, long-term data in oncology populations remain limited. Objective: To evaluate the association between repeated anesthesia exposure and long-term neurodevelopmental and clinical outcomes in pediatric oncology patients over a 10-year period. Methods: This multinational retrospective cohort study included pediatric oncology patients (≤18 years) from tertiary care centers across North America, Europe, and Asia between 2013–2023. Patients were stratified based on anesthesia exposure: single exposure, 2–4 exposures, and ≥5 exposures. Primary outcomes included neurodevelopmental impairment (cognitive delay, learning disability, behavioral disorders). Secondary outcomes included overall survival, treatment complications, and hospital readmission rates. Multivariable regression models adjusted for confounders including age, cancer type, chemotherapy, and socioeconomic status. Results: A total of 8,742 patients were included. Patients with ≥5 anesthesia exposures demonstrated a significantly higher risk of neurodevelopmental impairment (adjusted OR 1.82; 95% CI 1.45–2.29; p<0.001) compared to single exposure. Dose-dependent associations were observed with increasing exposure frequency. No significant difference in overall survival was noted (HR 1.05; 95% CI 0.92–1.19). However, higher exposure groups showed increased hospital readmissions and perioperative complications. Conclusion: Repeated anesthesia exposure in pediatric oncology patients is associated with a dose-dependent increase in neurodevelopmental impairment without affecting overall survival. Strategies to minimize anesthesia exposure and optimize neuroprotective approaches are warranted.
Pediatric oncology, anesthesia exposure, neurodevelopment, cohort study, cognitive outcomes