Search

The main objective of the present investigation is to examine the couple stress fluid flow occurring as a result of rotation of a disk. On implementing a suitable transformation, the governing system of partial differential equations (PDEs) is converted into nonlinear differential equations of a single independent variable. These equations are solved analytically by virtue of the Homotopy Analysis Method (HAM) which gives solutions in the form of a series. The solution of most of the governing problems is determined in terms of the absolute exponential and decaying functions by means of this powerful technique. To support analytic results, some graphs are plotted for determining the convergence of the solution. Also the graphical interpretation of velocity profiles corresponding to the effects of pertinent parameters are shown and discussed in detail. The numerical results are calculated for evaluation of the influence of fluid parameter. It can also be anticipated that the radial and axial velocity components show decreasing behavior due to rise in the values of couple stress parameter which conflict the behavior of the tangential component of velocity.

This paper provides analytical solution of the non-aligned stagnation point flow of second grade fluid over a porous rotating disk in the presence of a magnetic field and suction/injection at the disk surface. The mathematical formulation of the fluid model is obtained in terms of partial differential equations (PDEs). The PDEs governing the motion are transformed into a system of ordinary differential equations (ODEs) by means of a similarity transformation and these corresponding nonlinear ODEs are solved by employing the homotopy analysis method (HAM) and the convergence analysis of the presented method is also performed graphically. An inclusion of the influences of various admissible parameters has been shown numerically and graphically on the flow field. Furthermore, comparison is made and it concedes that the obtained results are found to be in good agreement with results existing in literature.

The solution of nonlinear mathematical models has much importance and in soliton theory its worth has increased. In the present article, we have investigated the Caudrey-Dodd-Gibbon and Pochhammer-Chree equations, to discuss the physics of these equations and to attain soliton solutions. The exp(−ϕ(ζ ))-expansion technique is used to construct solitary wave solutions. A wave transformation is applied to convert the problem into the form of an ordinary differential equation. The drawn-out novel type outcomes play an essential role in the transportation of energy. It is noted that in the study, the approach is extremely reliable and it may be extended to further mathematical models signified mostly in nonlinear differential equations.

In this paper, first order linear homogeneous difference equation is evaluated in fuzzy environment. Difference equations become more notable when it is studied in conjunction with fuzzy theory. Hence, here amelioration of these equations is demonstrated by three different tactics of incorporating fuzzy numbers.Subsequently, the existence and stability analysis of the attained solutions of fuzzy difference equations (FDEs) are then discussed under different cases of impreciseness. In addition, considering triangular and generalized triangular fuzzy numbers, numerical experiments are illustrated and efficient solutions are depicted, graphically and in tabular form.

Bearing in mind the considerable importance of fuzzy differential equations (FDEs) in different fields of science and engineering, in this paper, nonlinear nth order FDEs are approximated, heuristically. The analysis is carried out on using Chebyshev neural network (ChNN), which is a type of single layer functional link artificial neural network (FLANN). Besides, explication of generalized Hukuhara differentiability (gH-differentiability) is also added for the nth order differentiability of fuzzy-valued functions. Moreover, general formulation of the structure of ChNN for the governing problem is described and assessed on some examples of nonlinear FDEs. In addition, comparison analysis of the proposed method with Runge-Kutta method is added and also portrayed the error bars that clarify the feasibility of attained solutions and validity of the method.

Background: We investigated the aetiologic role of human papillomavirus (HPV) in 120 penile squamous cell carcinomas (PSCCs) from Vietnam.Methods: Human papillomavirus DNA was detected by PCR using SPF10 primers and a primer set targeting HPV-16 E6. The INNO-LiPA HPV genotyping kit was used to determine genotype. Human papillomavirus-16 viral load and physical status were determined by real-time PCR. P16(INK4A) protein expression was investigated by immunohistochemistry.Results: Human papillomavirus DNA was detected in 27 of 120 (23%) PSCCs. The most frequently detected genotype was HPV-16 (24 of 27 cases, 89%). In 16 of 18 (89%) HPV-16-positive cases, the HPV DNA was considered to be integrated into the host genome. The geometric mean of the HPV-16 viral load was 0.4 copies per cell. P16(INK4A) overexpression was significantly related to PSCCs infected with high-risk HPV (P=0.018) and HPV-16 copy numbers (P<0.001).Conclusion: Human papillomavirus-16 DNA integration and p16(INK4A) overexpression in high-risk HPV detected PSCCs suggested an aetiologic role of high-risk HPV in the development of PSCCs. [ABSTRACT FROM AUTHOR]

Improvement in cancer therapy has led to an increasing number of cancer survivors, some of whom may suffer from the cardiotoxic effects of chemotherapy. Cardiomyopathy can occur years after completion of the chemotherapy and it is important to recognize this early, as complete recovery of cardiac function is possible in some cases. In this article we will review chemotherapy-induced cardiomyopathy and discuss its treatment options. [ABSTRACT FROM AUTHOR]

Objective: Paraneoplastic neurological syndromes associated with anti-Hu antibodies (Hu-PNS) are mediated by a T-cell immune response that is directed against the Hu antigens. In pregnancy, many Th1-mediated autoimmune diseases such as rheumatoid arthritis and multiple sclerosis regress. We hypothesised that this decreased disease activity during pregnancy may be related to high human chorionic gonadotropin (hCG) levels.Methods: 15 Hu-PNS patients were treated in a prospective, uncontrolled and unblinded trial with 10,000 IU daily of hCG administered by intramuscular injection during 12 weeks. Primary outcome measures were functional improvement defined as a decrease of one or more points on the modified Rankin Scale (mRS) or stabilisation in patients with mRS score ≤3 and improvement of neurological impairment assessed with the Edinburgh Functional Impairment Tests (EFIT). Secondary end points included the change in activities of daily living as evaluated using the Barthel Index.Results: Seven of 15 patients (47%) improved on the mRS or stabilised at mRS score ≤3. Four patients (27%) showed significant improvement of neurological impairment as indicated by an overall Edinburgh Functional Impairment Tests score of ≥1 point. Five patients improved on the Barthel Index (33%).Conclusion: Comparison with previous studies suggests that hCG may have immunomodulatory activity and may modify the course of Hu-PNS, although well-established confounding factors may have contributed in this uncontrolled trial. [ABSTRACT FROM AUTHOR]

OBJECTIVE: We hypothesized that, similar to idiopathic hip osteonecrosis, the T-786C mutation of the endothelial nitric oxide synthase (eNOS) gene affecting nitric oxide (NO) production was associated with neuralgia-inducing cavitational osteonecrosis of the jaws (NICO). DESIGN: In 22 NICO patients, not having taken bisphosphonates, mutations affecting NO production (eNOS T-786C, stromelysin 5A6A) were measured by polymerase chain reaction. Two healthy normal control subjects were matched per case by race and gender. RESULTS: Homozygosity for the mutant eNOS allele (TT) was present in 6 out of 22 patients (27%) with NICO compared with 0 out of 44 (0%) race and gender-matched control subjects; heterozygosity (TC) was present in 8 patients (36%) versus 15 control subjects (34%); and the wild-type normal genotype (CC) was present in 9 patients (36%) versus 29 controls (66%) (P = .0008). The mutant eNOS T-786C allele was more common in cases (20 out of 44 [45%]) than in control subjects (15 out of 88 [17%]) (P = .0005). The distribution of the stromelysin 5A6A genotype in cases did not differ from control subjects (P = .13). CONCLUSIONS: The eNOS T-786C polymorphism affecting NO production is associated with NICO, may contribute to the pathogenesis of NICO, and may open therapeutic medical approaches to treatment of NICO through provision of L-arginine, the amino-acid precursor of NO. [ABSTRACT FROM AUTHOR]

Background: Intraventricular conduction delay and QT interval dispersion may be related to electrical instability and the risk of ventricular arrhythmogenesis. The interlead variability of the QT interval on a surface 12-lead electrocardiogram (ECG) has been associated with an increased likelihood of sudden death in patients with long QT syndromes, in patients recovering from myocardial infarction, and dilated cardiomyopathy. We sought to determine the incidence of increased QT(c) dispersion (QT(c-d)) relative to biopsy grade of severity of rejection.Methods: Records of patients having undergone orthotopic heart transplantation (OHT) were reviewed focusing specifically on surface ECGs performed in temporal proximity to endomyocardial biopsy.Results: Seventy-five patients were evaluated on 1573 occasions, to include 999 surface ECGs, and 847 endomyocardial biopsies. There were 269 interpretable surface ECGs and endomyocardial biopsies performed within 1.1 +/- 4.6 days. There were no identifiable trends in atrioventricular or intraventricular conduction abnormalities (to include right bundle branch block) when comparing those with and without significant rejection on endomyocardial biopsy. The mean QT(c-d) of those with none (n = 34), mild (n = 194), moderate (n = 39), and severe (n = 2) rejection was 49 +/- 29, 49 +/- 35, 57 +/- 38, 81 +/- 7 ms, respectively (P = 0.28 by ANOVA of means). When comparing those with significant rejection so as to change management there was a trend toward increased dispersion (no to mild rejection, 49 +/- 34 ms vs moderate to severe rejection, 59 +/- 37 ms, P = 0.09).Conclusions: In this study investigating noninvasive ventricular depolarization/repolarization and correlation to histologic manifestation of rejection, there was suggestion, but no statistical significance, of QT(c-d) and severity of rejection. QT(c-d) should not be considered a sensitive marker for OHT rejection. [ABSTRACT FROM AUTHOR]

Background and Objective: Sorbitol is a non-toxic and slightly hygroscopic compound with different applications. Zymomonas mobiles produces sorbitol from sucrose or mixtures of glucose and fructose (formation is coupled with the dehydrogenation of glucose to glucono-δ- lactone). Recombinant Zymomonas mobilis may produce sorbitol and gluconic acid from glucose and fructose using different divalent metal ions with reduced the ethanol yield andsignificantly increased yield of sorbitol. Current study envisaged to alter the media components, physical process parameters and supplementation of amino acids for enhanced sorbitol production.Material and Methods: Several process variables were evaluated on sorbitol production including carbon sources (glucose, fructose, maltose, sucrose), carbon concentrations (5, 10, 20 and 25 g l-1), nitrogen sources (peptone, tryptone, yeast extract, beef extract and organic nitrogen mix), temperatures (25, 29, 33, 37, 41°C), pH (6, 6.5, 7 , 7.5 ,8), agitation rate (50, 100, 150, 200 rpm) and amino acids (cysteine, cystine, tryptophan)in batch cultivation ofLactobacillus plantarum NCIM 2912. Shake flask cultivation performed under optimum conditions like temperature 37°C, pH 7.0 and agitation rate of 150 rpm, resulted in enhanced sorbitol production. Comparative study of sorbitol production in solid state fermentation and submerged fermentation was also evaluated.Results and Conclusion: Batch cultivation under submerged conditions further performed in 7.5-l lab scale bioreactor (working volume 3.0-l) under optimized conditions resulted in maximum cell biomass of 8.95±0.03 g g-1 and a sorbitol content of 9.78±0.04 g l-1 after 42.0 h of fermentation. Scale up study on bioreactor resulted in maximum sorbitol yield (Yp/x) and productivity of 1.11 g g-1 and 0.50 g l-1 h under submerged fermentation, respectively.Conflict of interest: The authors declare no conflict of interest.

The outbreak of COVID-19 still represents a real risk for the increased death rate for the whole of human kind. In this context, the present research work aims at describing evolutionary data in a population of hospitalized COVID-19 positive patients based on selected epidemiological, clinical and paraclinical data at admission. In this cross-sectional study, we examined the data obtained from 108 patients hospitalized with COVID-19 in the VINCI clinic, Casablanca (Morocco) between August and September 2020. General characteristic, clinical, radiological and biological data as well as therapeutic management were assessed. The patients’ median age was 45-50 years old. Among our studied patients, 4.6% were transferred to the intensive care unit (ICU), 16.7% were cured after more than 15 days, while 78.7% were cured within 15 days. Those transferred to the ICU unit were either smokers, obese, or over 65 years of age. The majority of patients with normal radiological and cardiac parameters were cured within

The COVID-19 pandemic has had a significant impact on spread of the coronavirus disease. Currently, valuation and analysis of COVID-19 is a trending topic in the research industry that has been explored deeply. Many researches have been done in the selected time frame so far that evaluated the damages within the given conditions through different approaches. In our Study by taking certain parameters, we have deduced the direct relationship between spread of COVID-19 and the probable factors. This will be going to help researchers and stakeholders of the healthcare system to understand the pandemic in a better way, which may lead to potential enhancements that can be done in this field to counter this pandemic in a smarter way.

In this paper, an investigation has been made to validate the variational approach to obtain soliton solutions of the Klein-Gordon-Zakharov (KGZ) equations. It is evident that to resolve the non-linear partial differential equations are quite complex and difficult. The presented approach is capable of achieving the condition for continuation of the solitary solution of KGZ equation as well as the initial solutions selected in soliton form including various unknown parameters can be resolute in the solution course of action. The procedure of attaining the solution reveals that the scheme is simple and straightforward.

Time-Frequency (t-f) distributions are frequently employed for analysis of new-born EEG signals because of their non-stationary characteristics. Most of the existing time-frequency distributions fail to concentrate energy for a multicomponent signal having multiple directions of energy distribution in the t-f domain. In order to analyse such signals, we propose an Adaptive Directional Time-Frequency Distribution (ADTFD). The ADTFD outperforms other adaptive kernel and fixed kernel TFDs in terms of its ability to achieve high resolution for EEG seizure signals. It is also shown that the ADTFD can be used to define new time-frequency features that can lead to better classification of EEG signals, e.g. the use of the ADTFD leads to 97.5% total accuracy, which is by 2% more than the results achieved by the other methods.

Ibrahim M Abdulbaqi, Yusrida Darwis, Nurzalina Abdul Karim Khan, Reem Abou Assi, Arshad A Khan School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia Abstract: Ethosomal systems are novel lipid vesicular carriers containing a relatively high percentage of ethanol. These nanocarriers are especially designed for the efficient delivery of therapeutic agents with different physicochemical properties into deep skin layers and across the skin. Ethosomes have undergone extensive research since they were invented in 1996; new compounds were added to their initial formula, which led to the production of new types of ethosomal systems. Different preparation techniques are used in the preparation of these novel carriers. For ease of application and stability, ethosomal dispersions are incorporated into gels, patches, and creams. Highly diverse in vivo models are used to evaluate their efficacy in dermal/ transdermal delivery, in addition to clinical trials. This article provides a detailed review of the ethosomal systems and categorizes them on the basis of their constituents to classical ethosomes, binary ethosomes, and transethosomes. The differences among these systems are discussed from several perspectives, including the formulation, size, ζ-potential (zeta potential), entrapment efficiency, skin-permeation properties, and stability. This paper gives a detailed review on the effects of ethosomal system constituents, preparation methods, and their significant roles in determining the final properties of these nanocarriers. Furthermore, the novel pharmaceutical dosage forms of ethosomal gels, patches, and creams are highlighted. The article also provides detailed information regarding the in vivo studies and clinical trials conducted for the evaluation of these vesicular systems. Keywords: ethosomes, transdermal, lipid-based vesicles, delivery systems

In this paper the helical flows of fractionalized Maxwell fluid model, through a circular cylinder, is studied. The motion is produced by the cylinder that at the initial moment begins to rotate around its axis with an angular velocity Omegatp, and to slide along the same axis with linear velocity Utp. The solutions that have been obtained using Laplace and finite Hankel transforms and presented in series form in terms of the newly defined special function M(z), satisfy all imposed initial and boundary conditions. Moreover, the corresponding solutions for ordinary Maxwell and Newtonian fluid obtained as special cases of the present general solution. Finally, the influence of various pertinent parameters on fluid motion as well as the comparison among different fluids models is analyzed by graphical illustrations.

In this paper, we examine the fractional differential-difference equation (FDDE) by employing the proposed sensitivity approach (SA) and Adomian transformation method (ADTM). In SA the nonlinear differential-difference equation is converted to infinite linear equations which have a wide criterion to solve for the analytical solution. By ADTM, the FDDE is converted into ordinary differential-difference equation that can be solved. We test both the techniques through some test problems which are arising in nonlinear dynamical systems and found that ADTM is equivalently appropriate and simpler method to handle than SA.

In this paper, we deal with some linear and nonlinear Klein-Fock-Gordon (KFG) equations, which is a relativistic version of the Schrödinger equation. The approximate analytical solutions are obtained by using the homotopy analysis method (HAM). The efficiency of the HAM is that it provides a practical way to control the convergence region of series solutions by introducing an auxiliary parameter }. Analytical results presented are in agreement with the existing results in open literature, which confirm the effectiveness of this method.

In this paper, Sumudu transform is advanced and designed for the solution of linear differential models with uncertainty. For this purpose, Sumudu transform is coupled with fuzzy theory and all its fundamental properties are formalized in fuzzy sense. At last, to demonstrate the accuracy of this approach, fuzzy Sumudu transform is employed to some examples of fuzzy linear differential equations considered under generalized H-differentiability and analytical solutions are obtained efficiently.

Introduction: Coronary artery disease (CAD) is a persistent public health problem worldwide.Chest pain is one of the perceptible symptoms of the same disease. Literature has found acute chest pain as plausible risk factors for CAD. Nevertheless, none of the study has estimated duration from chronic chest pain to the diagnosis of CAD. The objective of the study was to estimate duration from chronic chest pain to CAD and to assess impact of risk factors on same duration. Methods: Data were obtained from community based study on 17,232 Saudi adults. History of patients about onset of chest pain and other risk factors were inquired. Descriptive measures were obtained by Kaplan-Meier curve. Effect of demographic and clinical factors was assessed by Cox regression models. Results: Out of 24% patients with chest pain, 21% diagnosed with CAD. The average duration was5 years. About 12% of patients with chest pain diagnosed with CAD after one year. Advancing age, female gender, no exercise and reduced high density lipoprotein (HDL) were significantly hazardous predictors throughout duration from chest pain to diagnosis of CAD. Conclusion: The duration from chest pain to CAD was 5 years. Age, gender, exercise and HDL can be variables of concern to deteriorate hazards of CAD for patients with chest pain.

The objective of this paper is to present an investigation to analyze the vibration of a conservative nonlinear oscillator in the form u" + lambda u + u^(2n-1) + (1 + epsilon^2 u^(4m))^(1/2) = 0 for any arbitrary power of n and m. This method converts the differential equation to sets of algebraic equations and solve numerically. We have presented for three different cases: a higher order Duffing equation, an equation with irrational restoring force and a plasma physics equation. It is also found that the method is valid for any arbitrary order of n and m. Comparisons have been made with the results found in the literature the method gives accurate results.

In this note, traveling wave solutions for (3 + 1) dimensional fluid models of incompressible flow are considered. The governing partial differential equations of two models are reduced to ordinary differential equation by employing wave parameter and exact solutions are obtained. It is shown that these fluid models allow 3 + 1 dimensional solutions amongst each other. The methodology used in this work is independent of symmetric consideration and other restrictive assumption. Finally, a set of example of boundary condition is discussed for the couple stress fluid. It is observed that velocity profile strongly depends upon couple stress parameter.

In this paper, numerical simulation of linear and nonlinear fuzzy initial value problems of fractional order has been done. A modificaton in the improved Euler’s method for fuzzy fractional order is proposed and utilized. Also, the two component homotopy perturbation method also known as a modified homotopy perturbation method (MHPM) is employed to solve the considered problems. The results obtained from the considered techniques are compared. These methods are illustrated by solving several examples. Effciency and exactness of results worked out from MHPM is examined from the tables and comparatively it is found that MHPM is more accurate and closer to the exact solutions than the existing methods.

An investigation has presented to analyze the heat transfer in a boundary layer flow of an incompressible couple stress fluid over a nonlinear stretching sheet. The heat transfer problem have been analyzed for the two heating processes, 1) PST (prescribed surface temperature case) and 2) PHF (prescribed heat flux case). The governing partial differential equations for flow and heat transfer are transformed to ordinary differential equations. The numerical solutions have been obtained by using fourth order Runge-Kutta method coupled with shooting method. The effects of dimensionless surface temperature, couple stress parameter beta, Prandtl number Pr, Eckert number Ec, nonlinear stretching sheet parameter n and lambda1; lambda2 have been observed by graphical illsurations.

In order to achieve oil increment and water cut reduction in the heterogeneous oil reservoirs, a conformance control technology by using HPAM/Al3+ systems has been widely used due to the low price and environmental friendliness. However, the complex structure and state of high-valent metal ions in brine water can directly affect the properties of the different HPAM/Al3+ systems, which may lead to unreasonable applications. Therefore, in order to better utilize the HPAM/Al3+ systems, the characteristics of gelation of HPAM and the three types of aluminum citrate under different salinities are systematically studied. Experimental results show that an important reason for the cross-linking reaction of HPAM/Al3+ being affected by salinity is that the morphology and structure of the aluminum citrate complex is different under the different salinities. Although the change of characteristics of the reaction time and the cross-linking degree of the three HPAM/Al3+ systems are different, the process of the cross-linking reactions of the three HPAM/Al3+ systems are the same. Besides, the thermal stability of the HPAM/Al3+ gels is weakened with the increasing of salinity regardless of the ratio of citrate ligands to Al3+. According to the matching relationship between salinity and HPAM/Al3+ systems, the reaction time can be controlled to achieve the requirements of on-site construction operation for the conformance control of a given heterogeneous oil reservoir.

This study is an investigation of fully-developed laminar flow in a two-layer vertical channel; one part filled with couple stress nanofluid and the other part with clear couple stress fluid. The flow is examined for combined heat and mass transfer using uniform wall temperature and concentration boundary conditions. Optimal homotopy analysis method (OHAM) is used to solve the nonlinear coupled ordinary differential equations (ODEs) governing the flow in each region. This method is based on the homotopy analysis method (HAM)which is an effective method to analytically approximate the solution of highly nonlinear problems. The influence of pertinent parameters is observed on velocity, temperature, and concentration distributions, specifically, the effect of Brownian parameter on couple stress fluid is mentioned.

In a globalized world, there are clear differences in ideologies that are usually not spelled out. The paper follows the approach prescribed by Ben David’s “Victim’s Victimology” (2000) and applies a classical approach to ideologies in social sciences by W.B. Miller (1973). The main subject of this paper is the difference between local order ideology and human rights ideology. The aim is to show that formal social control is determined or influenced by these different ideologies. The authors analyze four cases of victimization of women in different social settings , in Sudan (2012), Canada (2012), India (1985) and in Pakistan (2002). In all these cases the local order ideology clashes with a human rights ideology. Limits to tolerance must be clear.

A long cystic duct remnant may be found after laparoscopic cholecystectomy. Stone may form in the remnant cystic duct and can cause postcholecystectomy syndrome. Remnant cystic duct calculus may rarely result in postcholecystectomy Mirizzi′s syndrome. Traditionally, Mirizzi′s syndrome has been diagnosed with endoscopic retrograde cholangiopancreatography (ERCP) and treated with open surgery. We report a case of postcholecystectomy Mirizzi′s syndrome that developed 3 years after laparoscopic cholecystectomy. A non-invasive diagnosis of Mirizzi′s syndrome was made comprehensively by magnetic resonance cholangiopancreatography. Endoscopic stone removal was achieved successfully with ERCP without any complication.

Background/Aim: To compare outcomes of light and heavy weight mesh for repair of inguinal hernia. Materials and Methods: This study was conducted at the Department of Surgery; Lady Reading Hospital, Peshawar from January 1, 2007 to December 31, 2008. Patients were divided into two groups based on the type of mesh implanted for inguinal hernia repair. Group 1 included patients in whom light weight composite (VyproII; ) mesh is implanted: Group 2 included patients in whom polypropylene (Prolene R ) mesh is implanted. Data concerning the complications and post operative pain in the perioperative and postoperative period were collected and analyzed. Categorical data were presented as percentages with 95% confidence intervals and compared using a χ2 test and P < 0.05 were considered significant. Results: Following allocation and exclusion of violating cases, 111 patients in group 1 and 138 patients in group 2 were analyzed. The mean age in group 1 was 38.20 ± 13.34 years and in group 2 was 39.55 ± 13.70 (P = 0.434). In group 1, hematoma formation was observed in four cases (3.6%), while it was observed in six cases (4.2%) in group 2 (P = 0.766). During the entire study, ten patients in all developed urinary retention, three of which required transient catheterization. One year post operation, there was a recurrence in only five cases overall, while only two patients complained of pain (P = 0.826). Conclusion: The frequency of postoperative pain and complications in patients was similar in both groups.

Background/Aim: To assess the prognostic indicators preoperatively presenting and influencing the mortality rate following esophagectomy for esophageal cancer. Materials and Methods: This study was a retrospective cohort study, conducted at the Department of Surgery, Lady Reading Hospital, Peshawar, from 1 January 2003 till 31 December 2008. Group 1 included patients who had undergone sub-total esophagectomy and were alive at completion of 12 months; whereas Group 2 included those patients who died by the completion of 12 months. Data were recollected from the Data Bank. A list of variables common to all patients from both groups was categorized and subsequently all data related to each individual patient were placed and analyzed on the version 13.0 of SPSS R for Windows. Results: Significant findings of a lower mean level of serum albumin from Group 2 were observed, whereas serum transferrin levels, also found lower in Group 2, were not statistically significant. Findings of serum pre-albumin, with a mean value of 16.12 mg/dl (PP = 0.051) on multivariate analysis. Conclusion: Pre-operative variables including weight loss, low serum albumin and pre-albumin, Geansler′s index, postoperative chylothorax, pleural effusion, and hospital stay, are predictive of mortality in patients who undergo esophagectomy for esophageal cancer.

Background: Evaluation of cytologic features is indispensable in the preoperative diagnosis and grading of infiltrating ductal breast carcinoma (CA) in fine-needle aspiration cytology (FNAC) material and this method can also provide additional information regarding intrinsic features of the tumor as well as its prognosis. Aim: This study has been done to evaluate comparatively the cytologic and histomorphologic grading of infiltrating ductal carcinoma of breast with specific reference to lymph node metastasis and its role in prognostication. Materials and Methods: Forty three patients who underwent FNAC and mastectomy for infiltrating ductal carcinoma were cytologically and histologically graded (employing Robinson′s cytologic grading system and Elston′s modification of Bloom-Richardson system, respectively). Statistical analysis was done employing ′z′ test and c2 test to compare the two grading system and to examine the degree of correlation between the cytologic and histologic grades. Multiple regression analysis was done to assess the significance of every cytologic and histologic parameter. All 43 cases, graded cyto-histologically were also evaluated for presence or absence of metastasis to the regional lymph nodes employing c2 test. Results: With histologic grade taken as the standard, cytology was found to be fairly comparable, for grading breast carcinoma (overall sensitivity 89.1%, specificity 100%). Further comparison of the two grading systems by Z-test showed that difference between the cytologic and histologic grading was insignificant in all the three grade (p > 0.05). Of the six parameters studied, cell dissociation, nucleoli and chromatin pattern were the most influential features (p < 0.001). The statistically significant difference (p < 0.001) was found in incidences of axillary lymph node metastatic rate in three cytologic grades (15.4% in grade I vs. 83.3% in grade III) as well. Conclusions: Apart from being simple and noninvasive, cytologic grading is comparable to histologic grading and might provide relevant information on the aggressiveness of invasive ductal carcinoma of breast and could be a useful parameter to take into consideration when selecting mode of therapy and to predict tumor behavior.

Objective : To evaluate the role of fine needle aspiration cytology (FNAC) in the distinction between neoplastic and nonneoplastic ovarian masses. Materials and Methods : One hundred and twenty patients with ovarian masses were studied. After detailed history and clinical examination, ultrasound (USG)-guided FNAC was performed in 92 clinical benign cases while FNAC and/or imprints of surgically resected ovarian masses was performed in 28 clinically suspected malignant cases. The smears were stained with Papanicolaou stain and histopathological sections were stained with hematoxylin and eosin stain with inclusion of special stain whenever required. Serum b-human chorionic gonadotrophin and a-fetoprotein estimations were carried out in cytologically diagnosed germ cell tumors. Results : The overall sensitivity, specificity and diagnostic accuracy of FNAC in diagnosing various ovarian masses were 79.2%, 90.6% and 89.9%, respectively. Conclusions : The clinical examination, pelvic ultrasound and FNAC were complementary and none of the methods was, in itself, diagnostic. However, USG-guided FNAC was found to be a fairly specific and accurate technique and should be employed as a routine, especially in young females with clinically benign ovarian lesions. The reasons for false diagnosis and limitations of USG and FNAC have been analyzed.