Female Cases Research Articles

Epidemiological features and risk factors of human psittacosis in Hangzhou City, eastern China

ObjectivesThis study aimed to investigate the epidemiological characteristics and risk factors associated with human psittacosis in Hangzhou city, eastern China.MethodsThe human psittacosis data from 2021 to 2024 were obtained from the China information system for diseases control and prevention infectious disease surveillance system. Epidemiological investigations were carried out on the patients' past medical history, clinical manifestations, chest CT results and treatment status. A community-based 1:3 matched case-control study was performed to investigate the risk factors associated with Chlamydia psittaci infection.ResultsDuring the study period, 137 confirmed cases of human psittacosis were identified through laboratory tests, of which 24 (17.52%) were classified as critical cases, including one fatality. The epidemic curve indicated that the majority of cases occurred between October and March. Among the cases, 48.91% were female, and the median age was 63 years. There were more female cases among those aged <60 years, while there were more male cases among those aged ≥60 years. Multivariate logistic regression analysis revealed that the presence of bird habitats within 500 m of the living area [odds ratio (OR) = 3.81, 95% confidence interval (CI) = 2.19–6.61], parrots kept (OR = 2.95, 95%CI = 1.10–7.89) and poultry kept (OR = 2.15, 95%CI = 1.02–4.53) remained significantly associated with the risk of disease infection.ConclusionsHuman psittacosis has become a notable public health concern in Hangzhou city, with an increase in psittacosis cases reported in recent years. Exposure to poultry, birds, or environments contaminated with Chlamydia psittaci was associated with infection. Urgent actions to reduce psittacosis cases and mitigate the impact of outbreaks are needed, including strengthening surveillance, raising public awareness, and promoting collaboration between the agricultural and health sectors.

Frequent detection of anti-nuclear antibodies and low-titer rheumatoid factor in female patients with undifferentiated peripheral spondyloarthritis in Japan: a prospective observational study.

Studies on the clinical features of undifferentiated peripheral spondyloarthritis (upSpA) are limited. This study explores sex-based manifestations of upSpA and compares upSpA with rheumatoid arthritis (RA) under conditions of low human leukocyte antigen B27 positivity in Japan. In this multicenter prospective observational study, physical and laboratory findings from 29 upSpA cases (19 females, 10 males) were collected to investigate sex differences. Fourteen patients with RA were also enrolled as a control group to evaluate clinical parameters distinguishing upSpA and RA. Tenderness at the humeral epicondyles and the Achilles tendon were more common in female patients with upSpA than in males. Serum C-reactive protein (CRP) levels were lower in female patients with upSpA than in male patients. Serum rheumatoid factor (RF) levels were lower in upSpA cases than in RA, with a cut-off value of 84 IU/mL differentiating RA from upSpA. An anti-nuclear antibodies (ANA) test at a dilution of ≥1:160 was detected in about half of the female upSpA cases but not in male cases. Among upSpA and RA cases, female patients with upSpA frequently present with multiple enthesitis, low serum CRP levels, low-titer RF positivity, and a high incidence of ANA positivity.

An Assessment of the Distribution and Prevalence of Benign Intraoral Pathologies

Objectives: The aim of this study is to evaluate the histopathological examinations of biopsy samples obtained from patients, and to determine the prevalence, age, and gender distribution of intraoral benign lesions. The study examines the distribution of all benign intraoral pathologies, including both soft tissue and hard tissue lesions, through which the goal is to contribute to clinical diagnostic processes. Methods: The histopathological evaluation results of 235 patients who underwent biopsy between 2021 and 2024 were retrospectively analyzed. Out of 235 patients, 123 (52.34%) were female and 112 (47.66%) were male. Lesions were categorized into two groups: soft tissue lesions and intraosseous lesions. The frequency, gender distribution, and age ranges of these lesions were assessed. Lesions exhibiting dysplasia or malignancy were excluded from the study. Results: The most common benign intraoral lesion was identified as the radicular cyst, observed in 69 patients. The age range for radicular cysts varied from 8 to 80 years, with 30 cases in females and 39 in males. The most frequently encountered soft tissue lesion was traumatic fibroma, which constituted 25.33% (19 patients) of all soft tissue lesions. Traumatic fibromas were observed in patients aged between 12 and 62 years. In terms of overall prevalence among all benign intraoral pathological lesions, radicular cysts ranked first (29.36%), followed by periapical granulomas (15.31%), dentigerous cysts (11.06%), and traumatic fibromas (8.08%). The occurrence of soft tissue lesions was significantly higher in females (66.66%) compared to males (33.34%). Conclusions: There are no recent studies in the literature evaluating the prevalence and demographic distribution of intraoral benign lesions. The most common lesions diagnosed in the study are typically associated with inflammation and irritation. The most common hard tissue lesion was the radicular cyst, which was seen across a wide age range and in similar proportions in men and women. Among soft tissue lesions, traumatic fibroma was the most common, particularly in women, and was seen across a wide age range. In terms of gender distribution, soft tissue lesions were twice as common in women as in men.

Abstract TP143: Improving CT imaging in Non-Fatal strangulation Domestic Violence Victims

Introduction: The incidence of domestic violence (DV) can vary from 2 to 4 million in a year. Domestic violence can be broad in definition and not limited to physical assault. The role of the medical provider in caring for these patients can be difficult; studies suggest that less than 10% of these cases are diagnosed correctly in the emergency room. In collaboration with Brooklyn District Attorney office, we examined and designed a quality improvement study to look at the performance of CT imaging in non-fatal strangulation DV in the emergency department from 8/1/2021 to 3/31/2024 of all NYC Health and Hospitals System (NYCHH). The timely identification of arterial dissection can potentially lead to a decrease risk of stroke. Methods: We developed a non-fatal strangulation pathway in the emergency department for DV patients. We examined the use of CT head and CTA head and neck. The utilization of CT was monitored every quartile. Cases were abstracted with diagnoses of DV and asphyxiation. Strategies were employed to encourage and improve the utilization of pathway. Results: In total, 2163 domestic violence cases were abstracted from electronic medical records. 63% (n=1363) female 5.2% (113) male 31.7% (n=687) did not select for sex (NOA) The percentage of CT performance during 8/1/2021 through 3/31/2024 was 5.5% (116/2163). Upon further evaluation, the percentage of female cases imaged was 5.5% (75/116); by contrast, male cases were imaged at 24.8% (28/116), and NOA 1.9% (13/116). The odds ratio of CT performances in noted cases was 4.5 [95% CI 2.8016-7.2381], 13.0946 [6.5861-26.0349], 2.9 [1.6024-5.277], Male to female cases, male to NOA, and Female to NOA, respectively. Discussion: The literature on domestic violence range in incidence from 2 million to 4 million in a year. The identification of stroke risk factors from a domestic violence incident is a novel approach and has not been fully elucidated. Non-fatal strangulation is known to decrease cerebral perfusion; the risk of developing an arterial dissection is known. Arterial dissection is an independent risk factor for ischemic stroke. In this study, we have observed a low utilization of imaging to rule out dissection; there is a suggestion of disparity among the sexes in diagnosis. Conclusion: The observation from this study involving all hospitals in the NYCHH system reveals a need to better educate and improve diagnosis of domestic violence. This can lead to prompt intervention and medical stabilization.

Refining colorectal cancer screening strategies using polygenic risk scores and classical risk factors: A proof-of-concept study in the UK Biobank cohort.

104 Background: While the rising incidence of CRC in younger populations has led to a push for lowering the screening age to 40, current clinical guidelines lack sufficient consideration of individual risk variations, raising concerns about the potential harms of over-diagnosis and false positives. Our proof-of-concept study evaluates the utility of risk stratification for multi-target stool DNA (mt-sDNA) testing by integrating polygenic risk scores and traditional clinical risk factors, addressing gaps in current clinical CRC screening guidelines. Methods: Our study utilized the UK Biobank prospective cohort, consisting of 311,544 unrelated individuals of White British ancestry, aged 40-69, excluding those with any prior malignant cancer diagnosis. We developed a sex-specific Cox proportional hazards model to estimate the risk of developing CRC, with the primary outcome being the first incidence of CRC. Three models were assessed: a polygenic risk score (PRS)-only model, a classical risk factors (RF)-only model, and a combined (PRS + RF) model. The traditional risk factors considered were BMI, smoking status, pack years of smoking, and family history of bowel cancer in first-degree non-adoptive relatives. Model performance was evaluated using the area under the curve (AUC), hazard ratios (HR), and the positive and negative predictive values of mt-sDNA across various risk profiles. Results: The combined model for early CRC screening using mt-sDNA demonstrated superior risk stratification (Table) and improved PPV compared to the risk factors-only model, with enhanced performance even among younger individuals at lower baseline risk. If risk stratification was not used, the average PPV for the test in the general population (ages 40-80) would be 2.13% for males and 1.44% for females. In contrast, individuals in the top 1% of risk would have significantly higher PPVs: 5.62% for males and 3.51% for females. If we limit testing to only the high-risk group, per 100,000 individuals, approximately 3,490 additional cases for males and 2,070 additional cases for females would be detected compared to the average-risk population without stratification. Conclusions: The findings suggest that risk stratification may enhance the effectiveness of screening by identifying high-risk individuals who would derive the greatest benefit. In contrast, broad application of the test across the general population may not achieve an optimal risk-benefit ratio, given the relatively low PPV in average-risk individuals. Model performance of the PRS-only, RF-only, and PRS + RF (Combined) models for females and males, respectively. Hazard Ratio (95% CI) C-index (SE) 5-Year AUC Female PRS-Only 1.50 (1.37 - 1.64) 0.62 (0.01) 0.61 RF + PRS 1.49 (1.36 - 1.63) 0.62 (0.01) 0.61 RF Only 1.09 (0.99 - 1.20) 0.53 (0.02) 0.51 Male PRS-Only 1.49 (1.38 - 1.61) 0.63 (0.01) 0.69 RF + PRS 1.49 (1.38 - 1.61) 0.64 (0.01) 0.71 RF Only 1.23 (1.15 - 1.31) 0.57 (0.01) 0.57

P-1394. Scenario Projections of Congenital Syphilis Cases in California, 2023–2030

Abstract Background The yearly number of congenital syphilis (CS) cases in California is at its highest point since 1950. We explored how efforts in California to 1) reduce syphilis cases; and 2) increase adequate syphilis treatment among infected pregnant persons could impact CS case projections through 2030. Yearly projected incidence by scenario comparing the baseline scenario to a 10% reduction in infections, 10% increase in treatment adequacy, and both interventions combined Methods We developed a scenario modeling framework to project CS incidence between 2023–2030 using California 2015–2022 surveillance data on CS cases and female syphilis cases of childbearing age (15–44 years). We compared a baseline scenario where existing trends continued without additional interventions to scenarios that considered 1) the impact of an absolute reduction of 2–10% in the rate of female syphilis cases per year; and 2) a 2–10% increase in the proportion of pregnant persons adequately treated for syphilis. Results A reduction in the absolute rate of female syphilis cases by 2–10% led to an 8–31% decrease in cumulative CS cases between 2023–2030. Increasing the proportion of pregnant persons adequately treated for syphilis by 2–10% over baseline led to a 1–8% decrease in cumulative CS cases. Combining both scenarios resulted in an 8–37% reduction in cumulative cases. Conclusion This model shows that to reduce CS case incidence in California, the most important upstream intervention is to reduce the rate of syphilis among females. To this end, syphilis screening and treatment among those who infect females must be improved. Additionally, even assuming no changes in syphilis incidence in females, CS cases could be reduced to a lesser extent by increasing the proportion of pregnant persons with syphilis who are adequately treated above current rates. The results of this study can inform syphilis screening and treatment recommendations, and the magnitude of future CS case reduction will depend on intervention scope and implementation. Disclosures All Authors: No reported disclosures

Silent witnesses: unveiling the epidemic of femicides in North-west Tshwane, South Africa – a decade of analysis

BackgroundFemicides, defined as the gender-based killing of women, are a pressing public health issue worldwide, with South Africa experiencing some of the highest rates globally. This study focuses on the North-west region of Tshwane, particularly the Garankuwa area, aiming to address gaps in understanding the epidemiology, demographics, circumstances, and pathology associated with femicides. The Garankuwa mortuary serves as the primary site for this investigation, providing a detailed analysis over a ten-year period, shedding light on contributing risk factors in the context of systemic gender inequality.ObjectivesThe study had four main objectives: to analyse the demographics and incidence rates of femicides in the North-west Tshwane area, to examine the circumstances surrounding femicides (including the time, location, and demographic risk factors), to identify the causes and pathological characteristics of femicides; and to observe trends in femicide rates over the ten-year study period.MethodsThis study was a retrospective cross-sectional descriptive analysis, focusing on all deceased females admitted to the Garankuwa mortuary from 2009 to 2018. The inclusion criteria comprised female cases at autopsy, with a suspected homicidal manner of death. Excluded were cases classified as suicides, accidents, or natural deaths after further examination. Data was collected through the National Injury Mortality Surveillance System (NIMSS) and cross-verified with post-mortem reports, police data and death registers.ResultsOver the ten-year period, the Garankuwa mortuary admitted an annual average of 1131 bodies, with approximately 23.5% (266) being female. Of these, 17.5% were identified as femicides. The average incidence rate of femicides was 11.2 per 100,000 female population, showing a general decline over the study period, except for notable increases in 2013 and 2016. The study found that the most common months for femicides were September and December, with most incidents occurring at home, followed by residential areas and medical facilities. The geographic analysis identified Temba, Rietgat, and Akasia as the areas with the highest number of femicide cases. Demographically, the majority of femicide victims were black, with the most affected age group being 18–39 years. The leading causes of death were gunshot wounds, sharp force injuries and blunt force trauma, with significant incidences of strangulation and asphyxial deaths, primarily affecting the neck and head regions.ConclusionThis study highlights the high incidence and distinct characteristics of femicides in the North-west Tshwane area, underscoring the role of socio-economic disparities and racial demographics. The findings emphasize the necessity for targeted prevention programs, stricter firearm control measures, and community-based violence prevention strategies. The demographic data indicate that young black women are particularly vulnerable, necessitating protective and educational initiatives tailored to this group.

Heatstroke characteristics and meteorological conditions in Hefei, China: thresholds and driving factors

BackgroundDue to climate change and rapid urbanization, the frequency of heatwave events in East China has increased considerably since the 21st century, which has a considerable influence on human health, such as heatstroke. However, few studies have been conducted in this region on the relationship between heatstroke and meteorological conditions. To address this point, this study aimed to analyze the characteristics of heatstroke and their relationship with meteorological conditions in Hefei, China.MethodsThe 2008–2022 heatstroke data from Hefei Center for Disease Control and Prevention was used. The relationship between heatstroke and meteorological conditions was discussed by statistical methods, such as correlation analysis, cluster analysis and linear regression analysis.ResultsThe number of heatstroke cases fluctuated upward from 36 cases in 2008 to 1051 cases in 2022, with 71.5% of all cases for males and females accounting for 28.5%. The highest frequency of heatstroke occurrence was found to be concentrated in the middle age group (40–59 years old). According to the statistical analysis, air temperature and relative humidity were the most important meteorological factors that influenced the occurrence of heatstroke. Then a threshold system of meteorological factors for heatstroke was established by utilizing the relationship: daily average temperature (T) ≥ 30 °C & daily average relative humidity (RH) ≤ 80% and daily maximum temperature (Tmax) ≥ 35 °C & daily minimum relative humidity (RHmin) ≤ 65%. The threshold in group outbreak areas was stricter than it in high incidence areas. Furthermore, the Pacific Subtropical High (PSH) was found to be the primary climatic factor that determined the occurrence of heatstroke occurrence on a seasonal scale. In addition, significant differences in heatstroke risk were found among different groups of people. Heatstroke risk was substantially higher in males than in females due to larger opportunities for outdoor labor. The reduced physical fitness of elderly people raised the risk of heatstroke more than other age groups in extremely high temperatures.ConclusionsA meteorological threshold system had been established to forecast heatstroke occurrence in a short-term time, and a key climate driving factor of heatstroke was found for long-term heatstroke prediction in Hefei. These findings could facilitate the disease control department to take preventive and control measures to reduce the impact of heatstroke on human health and society.

Pro-inflammatory dietary pattern and the risk of female gout: sex-specific findings from three prospective cohort studies.

We aimed to determine whether a pro-inflammatory dietary pattern (mechanism-based diet) is associated with incident female gout among two large cohorts of US women. We prospectively followed 79,104 women from Nurses' Health Study (NHS; 1984-2016) and 93,454 women from NHSII (1991-2017); 45,445 men from Health Professionals Follow-up Study (1986-2016) served as a comparison cohort. Validated food frequency questionnaires were used to calculate Empirical Dietary Inflammatory Pattern (EDIP; food-based index predictive of circulating inflammatory biomarkers) scores every 4-years. Cox proportional hazards models were used to evaluate multivariable associations between EDIP and incident, physician-diagnosed gout. We further tested whether these associations were independent of key guideline-based healthy eating patterns that previously showed beneficial associations with gout (i.e., Dietary Approaches to Stop Hypertension [DASH], Alternative Health Eating Index [AHEI]). We documented 5,425 incident female gout cases over 4,372,320 person-years. EDIP was positively associated with female gout risk; hazard ratio (HR; 95% confidence interval [CI]) for the most vs. least pro-inflammatory quintile was 2.02 (1.83, 2.22). Additional adjustment for BMI attenuated this association (HR=1.71 [1.55, 1.88]). Reversing the EDIP score, women in the most anti-inflammatory EDIP quintile had largest magnitude of protective association for gout (HR=0.58 [0.53, 0.65]) compared to HRs for healthiest DASH (0.80 [0.73, 0.87]) and AHEI quintiles (0.81 [0.74, 0.89]). The magnitude of association between EDIP and male gout was substantially smaller (HR=1.24 [1.13, 1.37]; P-heterogeneity <0.0001). These findings support a pivotal role of inflammation as a potential modulator between diet and gout onset, particularly among women.

Antenatal Diagnosis and Treatment in Congenital Adrenal Hyperplasia Due to 21-hydroxylase Deficiency and Congenital Adrenal Hyperplasia Screening in Newborns

Signs of virilization, such as clitoromegaly, labio-scrotal fusion, and urogenital sinus may be observed in females with 21-hydroxylase deficiency (21-OHD) and other rare virilizing forms of congenital adrenal hyperplasia (CAH). This makes sex determination difficult, and multiple reconstructive surgeries in the postnatal period may be required. As 21-OHD is an autosomal recessive disease, the chance of any child being affected is one in four and so only one in eight will be an affected female. The primary objective of antenatal diagnosis is to identify only the affected fetus in the early gestational weeks before the onset of genital organogenesis and to treat that case. Therefore, studies aimed at antenatal diagnosis and preventing adrenal androgen exposure in the female fetus with CAH have long been of interest. Antenatal steroid treatment is considered experimental and controversial for safety reasons in recent clinical guidelines. If antenatal treatment is to be used, it is recommended that it should be performed in experienced centers that can collect data on a large number of cases which will help to define the benefits and harms of treatment better. In the postnatal period, a severe deficiency of the 21-hydroxylase enzyme leads to life-threatening adrenocortical insufficiency in both sexes and varying degrees of pathology of the external genitalia in females. This condition is also associated with high mortality in the first days of life and an increased risk of incorrect sex assignment. Neonatal screening for 21-OHD CAH effectively detects the severe forms and reduces mortality, and it is instrumental in the correct sex assignment of female cases.

The Role of de novo and Ultra-Rare Variants in Hirschsprung Disease (HSCR): Extended Gene Discovery for Risk Profiling of Patients.

Hirschsprung disease (HSCR) is a rare neurodevelopmental disorder caused by disrupted migration and proliferation of enteric neural crest cells during enteric nervous system development. Genetic studies suggest a complex etiology involving both rare and common variants, but the contribution of ultra-rare pathogenic variants (PAs) remains poorly understood. We perform whole-exome sequencing (WES) on 301 HSCR probands and 109 family trios, employing advanced statistical methods and gene prioritization strategies to identify genes carrying de novo and ultra-rare coding pathogenic variants. Multiple study designs, including case-control, de novo mutation analysis and joint test, are used to detect associated genes. Candidate genes are further prioritized based on their biological and functional relevance to disease associated tissues and onset period (i.e., human embryonic colon). We identify 19 risk genes enriched with ultra-rare coding pathogenic variants in HSCR probands, including four known genes ( RET , EDNRB , ZEB2 , SOX10 ) and 15 novel candidates (e.g., COLQ , NES , FAT3 ) functioning in neural proliferation and neuromuscular synaptic development. These genes account for 17.5% of the population-attributable risk (PAR), with novel candidates contributing 6.5%. Notably, a positive correlation between pathogenic mutational burden and disease severity is observed. Female cases exhibit at least 42% higher ultra-rare pathogenic variant burden than males (P = 0.05). This first-ever genome-wide screen of ultra-rare variants in a large, phenotypically diverse HSCR cohort highlights the substantial contribution of ultra-rare pathogenic variants to the disease risk and phenotypic variability. These findings enhance our understanding of the genetic architecture of HSCR and provide potential targets for genetic screening and personalized interventions.

The Prevalence Of Covid-19 In High-Risk District Of Kpk, Mardan, Pakistan

Objectives: to investigate the prevalence of COVID-19 and to find out the prevalence of COVID-19 positive individuals with full-vaccination, partial-vaccination and those who were non-vaccinated individuals in Mardan, Khyber Pakhtunkhwa, Pakistan. Study Design: This Multi-Center and retrospective study was carried out to determine the prevalence of COVID-19 in children, adults and aged old individuals using RT-PCR as a method of detection. Place and Duration of the Study: Department of Pathology at Mardan Medical Complex from August 1st, 2021 to August 31st 2021. Methodology: A random sample was taken from the population as well as all suspected persons who were admitted to various isolation wards and quarantine centres throughout District Mardan to be tested. The real-time RT-PCR tests were performed for testing the COVID-19 samples. The statistical analysis was performed with a 5% significance level. Results: A total of 2960 samples were collected. Among all the samples, 1536 individuals were male while females were 1424. The ages of the participants ranged from 0 to 80 years, with the average age being 40 years. The patients' median age was discovered to be 40.66 years. The youngest patient was only 1.5 months old, and the oldest patient was 80 years old. Males were particularly affected when compared to females. The RT-PCR tests were performed for testing the COVID-19 samples. The overall prevalence in Mardan was found 10.03 % (297 out of 2960), in which 161 out of 1536 (10.48%) were males positive cases and 136 out of 1424 (9.55%) were female positive COVID-19 cases whereas 2663 out of 2960 (89.96%) were reported as negative COVID-19 cases. Conclusions: The prevalence of COVID-19 in the Mardan district is extremely high, necessitating the implementation of WHO-recommended SOPs to control the spread of COVID-19. Keywords: Sars-Corona virus-2, COVID-19, Prevalence, RT-PCR, Statistical Package for Social Sciences version 28 (SPSSv28), Mardan Khyber Pakhtunkhwa, Pakistan

Refining breast cancer genetic risk and biology through multi-ancestry fine-mapping analyses of 192 risk regions.

Genome-wide association studies have identified approximately 200 genetic risk loci for breast cancer, but the causal variants and target genes are mostly unknown. We sought to fine-map all known breast cancer risk loci using genome-wide association study data from 172,737 female breast cancer cases and 242,009 controls of African, Asian and European ancestry. We identified 332 independent association signals for breast cancer risk, including 131 signals not reported previously, and for 50 of them, we narrowed the credible causal variants down to a single variant. Analyses integrating functional genomics data identified 195 putative susceptibility genes, enriched in PI3K/AKT, TNF/NF-κB, p53 and Wnt/β-catenin pathways. Single-cell RNA sequencing or in vitro experiment data provided additional functional evidence for 105 genes. Our study uncovered large numbers of association signals and candidate susceptibility genes for breast cancer, uncovered breast cancer genetics and biology, and supported the value of including multi-ancestry data in fine-mapping analyses.

Distribution and Treatment of Hepatitis C in Libyan Population

Viral hepatitis refers to inflammation of the liver that is caused by viral infection. It is a major public health issue in the world wide. Not only does viral hepatitis carry a high morbidity, but it also stresses medical resources and can have severe economic consequences. The majority of all viral hepatitis cases are preventable. HCV infection is rarely diagnosed during the acute phase of infection. Although a variety of host-factors play a role in eradication of HCV, only 15%-25% of adults spontaneously clear the infection. The objective: Distribution of hepatitis C virus and the incidence rate between males and females in Libya. What are causes, symptoms and complications of hepatitis C virus infection. How to diagnose hepatitis C virus infection in the lab. A total of 64 anti-HCV positive serum samples from individuals of physical examination were recruited from the Tripoli central Hospital infectious department Tripoli from January 2023 to June 2023. 64 samples with a positive PCR for HCV RNA. The age of anti-HCV positive individuals of physical examination ranged from 20 to 90 years old. Through the results, we find that the number of male cases is 42 for 65.62%, and the number of female cases is 22; with a rate of 34.37%. The age group (50-59) year was 23 cases with a rate of 35.93%. No cases of a Decrease of WBC, and we found that most of the cases had normal rate of WBC 19 cases by 86.3%, and 3 cases had increase rate of WBC by 13.6%. In conclusion, we conclude that men are more infected with hepatitis C. Also, the most age group infected with hepatitis C is (50-95), and this is not a good indicator and should be alerted. Acronyms HCV: Hepatitis C virus. PCR: Polymerase chain reaction. ALT: Alanine aminotransferase. AST: Aspartate transferase. BIL: Total bilirubin.

Comparison of pregnancy success rates in ICSI (Intracytoplasmic Sperm Injection) success rates in cases of male and female infertility at the Graha Amerta Fertility Clinic, RSUD Dr. Soetomo Hospital, Surabaya, for the period 2018 – 2022: A Literature Revi

Infertility, defined as the inability to conceive after one year of unprotected intercourse (WHO, 2012), affects 8–10% of couples worldwide, equivalent to 50–80 million couples, with 2 million new cases annually (WHO, 2013). In Indonesia, 10–15% of the 39.6 million reproductive-age couples face infertility, with primary causes including sperm issues (35%), ovulatory disorders (20%), fallopian tube blockages (20%), endometriosis (20%), and idiopathic factors (10%). The prevalence is rising both globally and domestically, with infertile women in the U.S. projected to reach 7.7 million by 2025. Assisted reproductive technologies like IVF achieve a success rate of 40–50%, while ICSI, a more advanced technique, offers higher success rates, particularly for cases of poor sperm quality (Wulaningsih, 2021; Aurel et al., 2023). However, routine ICSI use without clear indications should consider associated risks and costs (ASRM, 2020). ICSI success rates have improved from 44.6% in 2014 to 59.5% in 2023 (Palermo et al., 2014; Batha et al., 2023). Further research is needed in Indonesia to comprehensively compare ICSI success rates between male and female infertility cases.

Risk factor for stress incontinence in female patients over 65 years of age: Visceral Adiposity Index

Aims: To investigate whether there is a relationship between stress urinary incontinence and visceral adiposity index (VAI) in older women adults. Methods: Among 498 patients aged over 65 years who applied to the internal medicine-geriatrics outpatient clinic between January 2024 and June 2024, 95 female patients with stress incontinence (group-1) and 94 female control patients without incontinence (group-2) were included in the study. The remaining 309 patients were patients with other types of incontinence and were excluded from the study. Demographic characteristics, biochemical parameters and VAI values of patients (group-1) and (group-2) were compared statistically. Results: A total of 95 incontinent female cases with a mean age of 71.7±5.7 years and a total of 94 control female cases with a mean age of 72.0±5.2 years were included in the study. No statistically significant difference was found between the groups in terms of mean age distribution (p&amp;gt;0.05). The mean body-mass index (BMI) value of the patients in group 1 was statistically significantly higher than the patients in group 2 (p=0.037). The median visceral adiposity index value of 3.44 [3.07] in group 1 was 2.00 [1.4] higher than the median VAI value in group 2, and a statistically significant difference was observed between the groups (p&amp;lt;0.001). Conclusion: We observed that VAI levels showed comparable values in older patients with and without urinary incontinence (UI), suggest a potential association between increased levels of VAI and the presence of stress urinary incontinence (SUI) in the geriatric population.

Genetic Association Study of Acetylcholinesterase (ACHE) and Butyrylcholinesterase (BCHE) Variants in Sudden Infant Death Syndrome (SIDS).

Sudden infant death syndrome (SIDS) is the leading cause of death among infants aged between one month and one year. Altered enzyme activities or expression of acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) have been observed in SIDS patients that might lead to disturbed autonomic function and, together with other risk factors, might trigger SIDS. To explore the contribution of AChE and BChE from a genomic viewpoint, we sought to investigate the association between SIDS and selected single nucleotide polymorphisms (SNPs) in the ACHE and BCHE genes. In this case-control study, 13 potentially regulatory SNPs were selected from ACHE and BCHE and were genotyped in 201 SIDS cases and 338 controls. The association of SIDS with the 11 successfully genotyped candidate variants was examined using statistical analyses of overall or stratified cases and haplotype analyses. No significant overall associations were observed between SIDS and ACHE and BCHE variants in allele, genotype, and haplotype analyses. In subgroup analyses, eight variants were found to be nominally associated with SIDS, though these associations did not remain statistically significant after correction for multiple comparisons. One haplotype (T-C-G-C-C in rs3495-rs1803274-rs1355538-rs2048493-rs1126680) of BCHE was associated with the female SIDS subgroup (57.3% in controls vs. 46.3% in female SIDS cases, p = 0.010). The selected variants in ACHE and BCHE were not overall associated with SIDS in this study, and thus cannot generally explain the previously reported dysregulation of enzyme activities in SIDS. However, some evidence of association in subgroups and a possible contribution of variants other than those tested here would need to be explored in larger studies.

Metastatic risk in clear cell renal cell carcinoma: a tool incorporating sex, size, and grade.

To identify predictors of metastases, estimate the proportion of metastatic clear cell renal cell carcinoma (ccRCC) cases according to these predictors, and subsequently create a risk table showing the absolute difference in metastasis proportion for each 10 mm increase in tumour size. Patients diagnosed with histopathological confirmed ccRCC in 2010-2018 in Denmark identified in the nationwide Danish Multidisciplinary Renal Cancer Group (DaRenCa) Study-3. Association between diagnostic variables and metastases were assessed with logistic regression analyses. Proportion of cases with metastases were assess based on tumour sizes using a logistic regression model. The study included 2109 cases with non-metastatic ccRCC at diagnosis and 450 cases with metastatic ccRCC. Multivariable logistic regression analyses found sex, tumour size and grade were associated with metastatic ccRCC, whereas age was not. The proportion of cases with metastasis increased with larger tumours sizes and higher grade. As an example, the proportion of metastases in female cases with tumour size of 40 mm was 2.9% (95% confidence interval [CI] 1.7-4.8%) in Grade 1 and 16% (95% CI 12-22%) in cases with Grade 4. Comparable numbers in cases with a tumour size of 70 mm were 6.6% (95% CI 4.0-11%) and 31% (95% CI 25-38). The absolute increase in the proportion of cases with metastases with a 10 mm increase in size was <2% for tumours <40 mm and Grade 1-2. In contrast, cases with tumour sizes >50 mm and/or Grade 3-4 had a moderate (2-<4%) to high (≥4%) absolute increase in the proportion of cases with metastases with each 10 mm increase. The risk table presented offers a valuable tool for discussing the risk of progression to metastases in patients under expected management for ccRCC, enabling clinicians to make more informed, evidence-based decisions.

American College of Surgeons Cancer Programs Annual Report from 2021 Participant User File.

The National Cancer Database (NCDB) collects data from approximately 1500 Commission on Cancer (CoC) facilities and represent 73.7% of newly diagnosed cancer cases nationwide.The American College of Surgeons Cancer Program developed it first annual report from the NCDB 2021 participant user file reporting new observations and recent trends of cancer diagnoses, patient demographics, and treatments as well as an in depth report on treatment and outcomes in breast, pancreas and colon cancer.Of the 1,328,131 cancers diagnosed in 2021 at 1,281 reporting CoC hospitals, one-fifth continue to be female breast cancer cases. In 2021, the NCDB's five most common adult cancers were: Breast, Prostate, Lung, Colon, and Melanoma and varied by patient sex. Use of neoadjuvant systemic therapy increased in recent years in pancreas, breast and urinary bladder, although a slight decrease in pancreas and breast was observed in 2021.Breast cancer has high survival rates, especially in lower stage disease and ER+/HER2- disease. There is increase in neoadjuvant systemic therapy use especially in HER2+ disease and ER- disease.Colon cancer presents most commonly as stage III or II with a primary in the cecum or ascending colon in 38.9%. The majority are MSI stable, KRAS normal and CEA positive. Survival is most dependent on stage but also associated with MSI stability, abnormal KRAS and positive CEA.Pancreatic cancer presents with stage IV disease in nearly half, although an increase in stage I disease is seen. The most common location is pancreatic head. Survival is relatively low and most dependent on stage.

Determination of sex by morphometric study of malleus bone in human cadaver

Identification is the process of determining a person's uniqueness, whether they are alive or dead. Skeletal remains contain an abundance of information which is helpful in determination of identity of an individual. This is an Analytical Cross-Sectional Study carried out on 45 adult male and 45 female cases that came for medico-legal autopsy at Guru Teg Bahadur Hospital, Dilshad Garden, and East Delhi with known sex and of any age from January 2021 to Aug 2022.The three measurements were taken for malleus bone i.e. Total length of malleus bone, the length of manubrium (handle) of malleus bone and Index of malleus bone. The bone was then measured by using digital vernier calipers of least count 0.001mm. In this study, we found that length of malleus bone was range from 7.15mm to 8.83mm inMales (Mean±SD, 7.97± 0.433) whereas in females it range from 6.67mm to 8.29mm (Mean±SD, 7.73± 0.296).The Maximum length of Handle (5.41mm) of malleus bone was in Males (Mean±SD, 4.79 ± 0.297) whereas in Females the maximum length of handle of malleus bone observed was 5.29mm (Mean±SD, 4.54± 0.282).The Total length of Malleus bone, Handle of malleus and Malleus index were more is Male as compared to Female and which is found to be statistically significant (p=0.003), (p=0.001) and (p=0.019) respectively. There is a clear-cut demarcation between the values of male and female bone and considered fairly good criteria in sex determination. The sexual dimorphism is most marked in the Total length of Malleus bone, Handle of malleus and Malleus index of Malleus bone, and there is a significant difference was observed.