Clinico-radio-pathological Features and Biological Behavior of Breast Cancer in Young Indian Women: A Prospective Study

Aims The aim of the study is to evaluate the characteristic imaging features of breast cancer on mammogram, ultrasound, and magnetic resonance imaging (MRI) in women less than 40 years of age and to assess the degree of correlation between clinico-radio-pathological features and biological behavior. Methods and Materials A prospective observational study on consecutive women under 40 years of age evaluated with ultrasound of breast, digital mammogram, or contrast-enhanced breast MRI, diagnosed with breast cancer on histopathology and molecular analysis done at our center between January and December 2019 were included. Patient demographics, clinical presentation, family history, BRCA mutation status, imaging, pathological findings, and molecular status were determined. Results Out of 2,470 women diagnosed with breast cancer, 354 (14.3%) were less than 40 years of age who were included in this study. Mammography showed positive findings in 85%, ultrasonography in 94.3%, and MRI in 96.4% of women. Majority of the women (69.6%) presented in the late stage (Stage III and IV) with high-grade carcinoma in 39.5% and triple-negative breast cancer (TNBC) in 45.7%. Tumors with human epidermal growth factor-2neu expression were associated with the presence of microcalcifications (p-value = 0.006), and TNBC with circumscribed margins or BI-RADS 3/4a category on imaging (p-value = 0.007) and high-grade invasive carcinoma compared with others (p-value <0.0001). Conclusion The incidence of breast cancer in Indian women less than 40 years of age is relatively high as compared with the West. The detection of breast cancer in young women remains challenging due to dense breast tissue, lower incidence rate, and lack of regular breast screening. While ultrasound is the recommended imaging method for evaluation of breast under the age of 40 years, we found a better characterization of lesions and higher cancer detection rates when they were also evaluated with mammography and MRI.

A machine-learning approach for detection of local brain networks and marginally weak signals identifies novel AD/MCI differentiating connectomic neuroimaging biomarkers

Introduction: A computationally fast machine learning method is introduced for uncovering the whole-brain voxel-level connectomic spectra that differentiates different status of Alzheimer's disease (AD). The method is applied to the Alzheimer's Disease Neuroimaging Initiative (ADNI) Fluorine-fluorodeoxyglucose Positron Emission Tomography (FDG-PET) imaging and clinical data and identified novel AD/MCI differentiating connectomic neuroimaging biomarkers. Methods: A divide-and-conquer algorithm is introduced for detect informative local brain networks at voxel level and whole-brain scale. The connection information within the local networks is integrated into the node voxels, which makes detection of the marginally weak signals possible. Prediction accuracy is significantly improved by incorporating the local brain networks and marginally weak signals. Results: Brain connectomic structures differentiating AD and mild cognitive impairment (MCI), AD and healthy, and MIC and healthy were discovered. We identified novel AD/MCI-associated neuroimaging biomarkers by integrating local brain networks and marginally weak signals. For example, network-based signals in paracentral lobule (p-value=6.1e-5), olfactory cortex (p-value=4.6e-5), caudate nucleus (1.8e-3) and precentral gyrus (1.8e-3) are informative in differentiating AD and MCI. Connections between calcarine sulcus and lingual gyrus (p-value=0.049), between parahippocampal gyrus and Amygdala (p-value=0.025), between rolandic opercula and insula lobes (p-values=0.0028 and 0.0026). An overall prediction accuracy of 95.3% was achieved by integrating the selected local brain networks and marginally weak signals, compared to 84.0% by not considering the inter-voxel connections and using marginally strong signals only. Conclusion: (i) The connectomic structures differentiating AD and MCI are significantly different to that differentiating MCI and healthy, which may indicate different neuronal etiology for AD and MCI. (ii) Many neuroimaging biomarkers exert their effects on the outcome diseases through their connections to other markers. Integrating such connections can help identify novel neuroimaging biomarkers and improve disease prediction accuracy.

HUBUNGAN PARITAS DENGAN KEJADIAN PREEKLAMPSIA PADA IBU HAMIL

Preeklampsia merupakan penyulit dalam kehamilan, persalinan maupun post partum yang tidak dapat dicegah dan yang dapat dilakukan adalah mencegah terjadinya komplikasi yang lebih berat dan menghindari faktor resiko atau predisposisi untuk terjadinya Preeklampsia. Faktor-faktor yang mempengaruhi preeklampsia adalah riwayat hipertensi dan paritas. Tujuan penelitian ini adalah untuk mengetahui hubungan paritas dengan kejadian preeklampsia. Desain penelitian ini adalah analitik dengan rancangan cross sectional. Populasi dalam penelitian ini adalah seluruh ibu hamil di Puskesmas Batu Aji Kota Batam mulai dari bulan Febuari hingga Juli 2019, sampel diambil menggunakan purposive sampling sebanyak 88 responden. Hasil dari penelitian yang telah dilakukan uji chi-square untuk paritas dengan preeklampsia di dapatkan nilai P value 0,015 < α 0,05. Kesimpulan dari penelitian ini ada hubungan paritas dengan preeklampsia pada ibu hamil. penelitian ini dapat menjadi bahan pertimbangan untuk membuat kebijakan dalam upaya peningkatan kualitas pelayanan kesehatan pada ibu hamil.

Cognitive Capacity Genomewide Polygenic Scores Identify Individuals Resilient to Cognitive Decline in Aging

The genetic underpinnings of cognitive resilience in aging remains unknown. Predicting an individual’s rate of cognitive decline—or cognitive resilience—using genetics will allow personalized intervention for cognitive enhancement and optimal selection of target samples in clinical trials. Here, using genome-wide polygenic scores(GPS) of cognitive capacity as the genomic indicators for variations of human intelligence, we examined the genetic liability of cognitive abilities in the behavioral/cognitive phenome to understand individual phenotypic differences over time. We analyzed the 18-year records of the cross-sectional and longitudinal sociogenomic data of 8,511 European-ancestry adults from the Wisconsin Longitudinal Study (WLS), especially focusing on the cognitive assessments that were repeatedly administered to the participants at their average ages of 64.5 and 71.5. Our linear mixed-effects model identified a significant interaction effect between age and cognitive capacity GPS, which indicates that a higher cognitive capacity GPS significantly correlates with a slower cognitive decline in the domain of immediate memory recall (p-value = 1.79E-03, β = 1.86E-01). Also, the phenome-wide analysis identified several significant associations of cognitive capacity GPSs on the cognitive and behavioral phenome, such as Similarities task (p-value = 3.59E-74, β = 1.36, 95% CI=(1.22, 1.51)), Number Series task(p-value = 2.55E-78, β = 0.94, 95% CI=(0.85, 1.04)), IQ scores(p-value = 7.74E-179, β = 1.42, 95% CI=(1.32, 1.51)), high school class rank (p-value = 3.07E-101, β = 1.86, 95% CI=(1.69, 2.02), Openness from the BIG 5 personality factor(p-value = 2.19E-14, β = 0.57, 95% CI=(0.42, 0.71)), and social participation of reading books (p-value = 2.03E-21, β = 0.50, 95% CI=(0.40, 0.60)), attending cultural events, such as concerts, plays or museums (p-value = 2.06E-23, β = 0.60, 95% CI=(0.49, 0.72)), and watching TV (p-value = 4.16E-18, β=-0.48, 95% CI=(-0.59, -0.37)). As the first phenome-wide analysis of cognitive and behavioral phenotypes, this study presents the novel genetic protective effects of cognitive ability on the decline of memory recall in an aging population.

Effects of Elastic Taping Application Added on Conventional Rehabilitation Therapy to Improve Shoulder Pain and Upper Extremity Motor Function on Subacute Phase Stroke Patients with Shoulder Subluxation

ABSTRACTIntroduction: To determine the effect of adding elastic taping to conventional rehabilitation therapy on the improvement of shoulder pain and motor function of the upper limbs in patients with subacute strokewith shoulder subluxation.Methods: Research subjects who met the inclusion criteria were recruited from medical rehabilitation clinic in RSUD Dr, Soetomo. The total research subjects were 20 people (10 in treatment group and 10 incontrol group). The parameters were Visual Analoque Scale (VAS) for assessing shoulder pain and Fugl Meyer Assessment (FMA) for assessing motor function in the upper limbs.Results: There were significant differences before and after therapy for 3 weeks for VAS (p value = 0.00) in the treatment and control groups, there were significant differences in FMA in the treatment group (p value = 0.04), there were no significant difference in FMA in the control group (p value = 0.06). There was no significant difference in changes of VAS (p value = 0.23) and FMA (p value = 0.32) between the treatment and control groups before and after therapy for 3 weeks.Conclusion: The treatment group and the control group gave the same results on improvement of shoulder pain and motor function of the upper limbs before and after therapy for 3 weeks. There was an improvement in motor function of the upper limbs in the treatment group and there was no improvement in motor function of the upper limbs in the control group befor e and after therapy for 3 weeks.Keywords: conventional rehabilitation therapy, elastic taping, Fugl Meyer Assessment (FMA), Glenohumeral subluxation (GHS), Hemiplegic shoulder pain (HSP), Visual Analoque Scale (VAS).

EFEKTIFITAS JUS SELEDRI TERHADAP PENURUNAN TEKANAN DARAH PADA LANSIA PENDERITA HIPERTENSI DI WILAYAH KERJA PUSKESMAS SIMALINGKAR

Hipertensi adalah peningkatan tekanan darah sistolik lebih dari 140 mmHg dan tekanan darah diastolik lebih dari 90 mmHg pada dua kali pengukuran dengan selang waktu lima menit dalam keadaan cukup istirahat.Pengendalian hipertensi dapat dilakukan dengan pendekatan farmakologisdan non-farmakologis. Salah satu pengobatan non farmakologis adalah dengan menggunakan seledri. Seledri mengandung apigenin, flavonoid, vitamin C, apiin, kalsium, dan magnesium untuk mencegah penyempitan pembuluh darah dan membantu menurunkan tekanan darah tinggi. Penelitian ini bertujuan untuk menganalisis efektivitas jus seledri dalam menurunkan tekanan darah pada lansia hipertensi di wilayah kerja Puskesmas Simalingkar tahun 2020. Penelitian ini menggunakan desain pre post eksperimental. Jumlah responden di wilayah kerja Puskesmas Simalingkar sebanyak 10 responden dengan tingkat signifikansi <0,05. Rata-rata penurunan tekanan darah sistolik 30 mmHg dan distolik 14 mmHg. Hasil Uji statistik didapatkan p- value 0,000 (<0,5), disimpulkan bahwa jus seledri efektif terhadap penurunan tekanan darah.

Evidence for the Continued Occurrence of Chorioretinopathy in Working Sheep Dogs in New Zealand in 2010

A study in conducted 1987 by Hughes et al., found that 39% of working sheep dogs had multifocal retinitis. One of the identified causes was ocular larval migrans, which were a result of migrating ascarid larvae. Since that paper was published, anthelmintic use in farm dogs has been highly recommended. There has been no follow-up study to determine if fundic lesions are still present. The current study aimed to investigate the prevalence of chorioretinopathy in working sheep dogs in the South-West, Waikato, New Zealand. This was a cross-sectional study of 184 working sheep dogs and 51 owners, undertaken in 2010 with owners sampled from New Zealand’s South-West Waikato and Tux North Island Dog Trial Championship. Two-way tables were used to explore the relationship between variables. Significance of association was assessed using a Chi-squared or Fisher exact test as appropriate, with a p-value of <0.05 considered significant. Overall prevalence of chorioretinopathy in the working sheep dogs was 44/184 (24%). A significantly higher prevalence of chorioretinopathy was shown in dogs with increasing age, from 2 years to >8 years (p = 0.0007) and in males (p < 0.0001). This study concluded that lesions of chorioretinopathy are still present in working sheep dogs in New Zealand.

Food insecurity and mental health of women during COVID-19: Evidence from a developing country

Background This study examines the association between food insecurity and mental health of women during the COVID-19 pandemic in a resource poor setting. Materials and methods Data were collected at two time-points (wave 1 and 2) from 2402 women, one per household, participating in a larger study during extended COVID-19 lockdown in the rural areas of the southwest region of Bangladesh. The primary outcome of the analyses is the association between food insecurity, measured using the Food Insecurity Experience Scale (FIES), and stress level, measured using the Perceived Stress Scale (PSS), for women during the lockdown. General awareness about COVID-19 and attitude towards prescribed preventive measures were also measured since COVID-19 health concerns could exacerbate food insecurity. Results An individual-level evaluation of the effect of wave 2 FIES score on PSS score showed that worsening of the food security status increasing the stress level of the participants (95% CI: 1.61; 2.13; p-value: <0.001). Additionally, a significant negative association was observed between the PSS score and change in food security status between the two waves (Coefficient: -1.15, 95% CI: -1.30; -0.99, p-value: <0.001), indicating that deterioration in food security status over the pandemic period increasing the stress level. At the village level, the results showed a similar pattern. General awareness around ways coronavirus spreads was high, yet there were misperceptions at a higher level. Maintaining hand hygiene, wearing face masks outside the home, and going outside only when necessary were widely practised. Fewer respondents could maintain a 1.5-metre distance from others in the outside and maintained cough and sneeze etiquette. Conclusion The results indicate a higher stress level, a potential contributor to poor mental health, as food insecurity deteriorated. Policy initiatives in ameliorating immediate food insecurity during crises, improving long-term wellbeing, and expanding the reach of mental health support are warranted.

Pemanfaatan Effective Microorganisms 4 (EM4) Menggunakan Media Biofilm untuk Menurunkan Amonia dan Fosfat pada Limbah Cair Rumah Sakit

Air limbah yang dihasilkan oleh kegiatan rumah sakit merupakan salah satu sumber pencemaran air yang sangat potensial karena mengandung senyawa organik yang cukup tinggi, senyawa kimia berbahaya, radioaktif, serta mikroorganisme yang berbahaya bagi lingkungan dan kesehatan. Tujuan penelitian ini untuk mengetahui perbedaan penurunan kadar amonia dan fosfat dengan pemanfaatan Effective Microorganisms 4 (EM4) menggunakan media biofilm pada limbah cair Rumah Sakit Jiwa Daerah Atma Husada Mahakam. Penelitian ini merupakan penelitian quasi experiment dengan rancangan non equivalent control group design. Sampel penelitian terdiri dari 1 bak kontrol dan 2 reaktor. Pada bak anaerob-aerob terdapat media biofilm berbahan dasar PVC. Air limbah dialirkan secara kontinyu dalam waktu tinggal 2 minggu, 3 minggu, dan 4 minggu. Hasil penelitian menunjukkan rata-rata penurunan kadar amonia dengan penambahan EM4 5% sebesar 92,5% dan penambahan EM4 10% sebesar 92,1%. Sedangkan rata-rata penurunan kadar fosfat dengan penambahan EM4 5% sebesar 92,19% dan penambahan EM4 10% sebesar 65,56%. penelitian ini secara statistik menunjukkan tidak ada perbedaan penurunan kadar amonia dengan pemanfaatan EM4 menggunakan media biofilm (P value> α atau 0,941 > 0,05) dan ada perbedaan penurunan kadar fosfat dengan pemanfaatan EM4 menggunakan media biofilm ( P value < α atau 0,001 < 0,05).

Psychological distress and its associated factors in the hypertensive patient (HTN-Pt) in Ludhiana, Punjab: A questionnaire-based retrospective study

An elevation in blood pressure is an important risk factor of cardiovascular disease and several factors that can contribute to hypertension induce psychological distress. This study was aimed at estimating the prevalence of psychological distress and to assess general awareness regarding disease, concomitant substance abuse, and use of herbal drugs among hypertensive patients (HTN-Pt) at Satguru Pratap Singh (SPS) Hospitals, Ludhiana. The psychological distress was assessed using the standard Kessler-10 scale along with face-to-face interview among 275 outpatient department (OPD) HTN-Pt on follow-up. 15.30% (n=33) of total participants (n=213) had alcohol use disorders and 8.80% (n=19) of them were addicted to smoking habits. K10 scale results in patients, showed 46.9% (100) patients were suffering from psychological distress out of which 26% (n=56) were having mild, 17% (n=36) moderate and 4% (n=8) patients were having severe psychological distress. Highest percentage (33.80%) of patients with psychological distress were from age group 31-60 years of age (p value=0.003, COR= 0.240, 95% CI 0.072, 0.584). Many HTN-Pt were consuming the herbal supplements out of which 92 % of patients consuming grapes were found to have psychological distress (p value=0.034, COR= 0.380, 95% CI 0.155, 0.930). The results of the study indicated that there was a high prevalence of psychological distress in HTN-Pt belonging to age group of 31-60 years of age and patients involved in the consumption of grapes. This study asks for supervision on the concomitant administration of herbal supplements with allopathic medicines in HTN-Pt to avoid psychological distress.