Purpose: The study aimed to clarify the value of the Apparent Diffusion Coefficient (ADC) of EC MRI in determining molecular subtypes.

Material and Methods: We retrospectively recruited 109 patients with pathologically proven EC (78 endometrioid cancers and 31 non-endometrioid cancers) with available molecular classification from a tertiary centre. MRI was prospectively performed a month prior to surgery; images were blindly interpreted by two experienced radiologists with consensus reading. The ADC value was measured by an experienced radiologist on the commercially available processing workstation. Interoperator measurement consistency was calculated.

Results: Our sample comprised 17 PLOE, 32 MSI-H, 31 NSMP, and 29 P53abn ECs. Clinical information did not differ significantly among the groups. The maximum diameter and volume of the lesions differed among the groups. The ADC value in the maximal area (ADCarea) or region of interest (ROI, ADCroi) in the P53abn group was higher than that in the other groups (894.0 ±12.6 and 817.5 ± 83.3 x10-6 mm2/s). The ADC mean values were significantly different between the P53abn group and the other groups (P = 0.000). The nomogram showed the highest discriminative ability to distinguish P53abn EC from other types (AUC: 0.859).

Conclusion: Our results have suggested the quantitative MR characteristics (ADC values) derived from preoperative EC MRI to provide useful information in preoperatively determining P53abn cancer.

Methods: We retrospectively enrolled 27 patients with pathologically proven sex-cord tumours (14 GSTs, 8 fibromas, 4 fibrothecomas, and 1 sclerosing stromal tumour) from our institution. All MRI examinations were performed at least one month prior to surgery. MR image features were recorded by two radiologists with consensus readings. Histogram analysis was performed using FeAture Explorer software. The differences in histogram parameters between GCT (38.1 ± 14.6 years) and OSC (43.7 ± 18.0 years) groups were compared. Fourteen randomly selected cellular-type myomas who also underwent MRI in our hospital were considered as the control group. The intra-operator consistency of ADC value was evaluated across measurements twice.

Results: The repeatability of conventional ADC measurements on the tumor body was good. The values of ADC-mean, ADC-min, and ADC-max significantly differed across three groups (p < 0.001). The histogram variance on DWI, histogram percentage on T2WI, and ADC min showed the best discriminative performance in determining GCTs from other OSCs with an area under the receiver operator curve (AUC) of 0.997, 0.882, and 0.795, respectively. The histogram variance on DWI yielded a sensitivity of 92.3%, a specificity of 100%, and an accuracy of 96.6% in discriminating GSTs from other OSCs.

Conclusion: In the present study, feature analysis of tumor body MR imaging has helped to differentiate GST from OSC with better performance than conventional ADC measurements.

Materials and Methods: This was a retrospective cohort study. Patients were divided into two groups according to the stage of cervical cancer. The mean term of pregnancy at the time of the diagnosis was the early second trimester (range 10-27 weeks) and the median age was 33 years (range 26-40 years). The abdominal and pelvic MRI images and clinical data of these patients were reviewed. Tumor size, local tumor spread, and nodal involvement were evaluated using an MRI dataset. The treatment and follow-up imaging were analyzed as well, and the ADC was measured before and after the chemotherapy.

Results: 16 patients with histopathologically confirmed cervical cancer during pregnancy were retrospectively enrolled. 7 patients were diagnosed with local cervical cancer (FIGO stage IAI) and designated as early stage group, as the lesion was invisible on MRI. In this group, pregnancies were allowed to continue until cesarean delivery (CD) at 38-41 weeks. The other 9 patients presenting with local or extensive cervical cancer (FIGO stage IB2-IIA2) were designated as the advanced-stage group. The lesion could be measured and analyzed on MRI. They were treated with neoadjuvant chemotherapy in pregnancy. Among them, 6 patients underwent TP regimen (paclitaxel 135~175 mg/m2 plus cisplatin 70~75 mg/m2), while 3 patients received TC regimen (paclitaxel 135~175 mg/m2 plus carboplatin AUC=5). NACT was performed for 1 to 2 courses before surgery. ADC demonstrated significant differences before and after chemotherapy administered during pregnancy (1.06 ± 0.12 sec/mm2 vs. 1.34 ± 0.21 sec/mm2).

Conclusion: MRI has been found to be helpful in staging cervical cancer in pregnancy. Patients with stage IA confirmed by MRI can choose conservative treatment and continue the pregnancy until term birth. MRI can dynamically monitor the efficacy of chemotherapy for patients with stage IB and above during pregnancy. ADC value can have a potential role in the evaluation of chemotherapy efficacy.

Introduction: Our aim was to discuss the imaging findings of non-odontogenic jaw lesions to help the surgeon in the diagnosis and formulating a differential diagnosis for this vast spectrum of jaw lesions with overlapping clinical and imaging appearances.

Methods: CT and MR images of the mandible, maxillofacial region, and neck were retrieved from the archive of the Radiology Department of Pamukkale University for the duration between 2012-2023 and assessed.

Results: A total of 8125 CT and MR images were retrospectively analyzed. The mean age of the patients was 39.5 years in females and 43.2 in males, with a range varying from 15 to 72 years. Histopathologically approved benign and malignant non-odontogenic lesions were detected in only 19 patients out of 8125 images (0.23%). Osteomyelitis and abscess were the most common (n=3; 0.03%), followed by two cases (n=2; 0.02%) of each fibrous dysplasia, hemangioma, osteosarcoma, squamous cell carcinoma, and multiple myeloma, and one case (n=1; 0.01%) of each ossifying fibroma, osteoma, lymphoma, metastasis, and solitary bone cyst.

Conclusion: Although non-odontogenic benign and malignant lesions of the jaw are rare, awareness of the radiological features of these lesions plays an important role in their diagnosis and management.

Objective: The main objective of this review-type paper is to provide a detailed overview of PCOS along with the current concept of a clinical stance in this complex multigenic disorder.

Method : The following databases were used for literature searches: PubMed, Frontiers, Science Direct, Springer, Wiley, and MDPI. For the purpose of finding pertinent articles and contents, the keywords “PCOS; hirsutism; psychological burden; obesity” and others of a similar nature were utilized.

Conclusion: PCOS is a complicated hormonal, metabolic, and psychological condition with many different clinical manifestations. It is among the most prevalent causes of infertility. Before considering any medication choices, lifestyle modifications should be considered the primary therapeutic prescription for PCOS-related infertility. According to recent studies, PCOS does not affect the risk of ovarian or breast cancer, but it does raise the risk of endometrial cancer in women of all ages. These results suggest that PCOS may increase the risk of gynaecological cancer morbidity. The following stage is ovulation stimulation, which is best accomplished with letrozole and is followed by clomiphene citrate. Women who had not responded to the first-line oral ovulatory medicine were given gonadotropins as a backup. Early detection of girls with a high propensity to develop PCOS will be made possible by a comprehensive knowledge of the condition's etiology. Adolescent PCOS will be better managed overall, related comorbidities will be prevented, and quality of life will increase with customized therapeutic approaches.

Healthcare practitioners must have a fundamental grasp of the warning signs and symptoms of ovarian cancer, as well as the imaging techniques and treatment choices available, to give the patient the best care possible. The discipline of medical nanotechnology has gained a lot of momentum in recent years in resolving issues and enhancing the detection and treatment of different illnesses, including cancer.

This article gives a brief summary of types, risk factors and approaches to ovarian cancer treatment. We subsequently discussed the pathophysiology of ovarian cancer with the risk factors. This review also emphasizes the various signalling pathways involved in ovarian cancer. Our comprehensive integration of recent findings in fundamental research in the nano arena reveals the strong interest in these nanomedicines in ovarian cancer treatment. However, these nanomedicines still require more research, as indicated by the comparatively small number of clinical trials ongoing. This article will provide a reference for ovarian cancer treatment.

On the other hand, undergoing debulking surgery becomes challenging, and therapy with many chemotherapeutic medications has manifested resistance, a condition known as multidrug resistance (MDR). Although there are other therapeutic options for ovarian cancer, this article solely focuses on co-delivery techniques, which work via diverse pathways to overcome cancer cell resistance. Different pathways contribute to MDR development in ovarian cancer; however, usually, pump and non-pump mechanisms are involved. Striking cancerous cells from several angles is important to defeat MDR. Nanocarriers are known to bypass the drug efflux pump found on cellular membranes to hit the pump mechanism.

Nanocarriers aid in the treatment of ovarian cancer by enhancing the delivery of chemotherapeutic drugs to the tumour sites through passive or active targeting, thereby reducing unfavorable side effects on the healthy tissues. Additionally, the enhanced permeability and retention (EPR) mechanism boosts the bioavailability of the tumour site. To address the shortcomings of conventional delivery, the current review attempts to explain the current conventional treatment with special reference to passively and actively targeted drug delivery systems (DDSs) towards specific receptors developed to treat ovarian cancer. In conclusion, tailored nanocarriers would optimize medication delivery into the intracellular compartment before optimizing intra-tumour distribution. Other novel treatment possibilities for ovarian cancer include tumour vaccines, gene therapy, targeting epigenetic alteration, and biologically targeted compounds. These characteristics might enhance the therapeutic efficacy.

Objective: In this review, the nutraceutical importance of pumpkin's seed anti-diabetic, hypoglycemic, cardiovascular preventive and anti-cancer effects are explored along with the nutraceutical effects of antidepressants, anti-helminthic and anti-oxidants effects are involved.

Methods: A comprehensive analysis of the literature search was conducted. A number of databases have been searched using the common terms \"pumpkin,\", \"pumpkin seeds\", \"cucurbita,\", \"functional food\", \"phenolic compounds\", \"minerals,\", and \"phytochemicals\" using PubMed and Google Scholar as search engines. The content was based on information from publications like Bentham Science, Elsevier, Taylor & Francis, Nature, Plos One, etc. We have focused on the review and research papers published between 2000 and 2023.

Result: Meanwhile, some research gaps on the biological activities of pumpkin seeds and their potential as a functional food element have been discovered in the current literature. The pharmacokinetics of Pumpkin seeds bioactives and the characterization and identification of functional molecules have received very little attention in the literature. It is necessary to conduct more studies to connect the pharmacodynamics and pharmacokinetics of Pumpkin seeds.

Conclusion: The therapeutic benefits of pumpkin seeds & the potential disease-preventing mechanisms are updated in this review article, also on the chemical make-up, nutritional value, phytochemical research, pharmacological characteristics, bioavailability, food use, & industrial applications of pumpkin.

Objective: To analyze pathophysiological characteristics/co-morbidities precipitating myocardial ischemia in patients with HTN LVH and provide a rationale for recommending beta-blockers (BBs) to prevent/treat ischemia in LVH.

Methods: We searched PubMed, SCOPUS, PubMed, Elsevier, Springer Verlag, and Google Scholar for review articles and guidelines on hypertension from 01/01/2000 until 01/05/2022. The search was limited to publications written in English.

Results: HTN LVH worsens ischemia in coronary artery disease (CAD) patients. Even without obstructive CAD, several pathophysiological mechanisms in HTN LVH can lead to myocardial ischemia. In the same guidelines that recommend BBs for patients with HTN and CAD, we could not find a single recommendation for BBs in patients with HTN LVH but without proven CAD. There are several reasons for the proposal of using some BBs to control ischemia in patients with HTN and LVH (even in the absence of obstructive CAD).

Conclusion: Some BBs ought to be considered to prevent/treat ischemia in patients with HTN LVH (even in the absence of obstructive CAD). Furthermore, LVH and ischemic events are important causes of ventricular tachycardia, ventricular fibrillation, and sudden cardiac death; these events are another reason for recommending certain BBs for HTN LVH.

Objective: In the current review, the potential therapeutic impacts of resveratrol during colorectal cancer chemotherapy were studied.

Methods: Based on the PRISMA guideline, we performed a systematic search in different electronic databases up to May, 2021. Following the search, 321 papers were found and then screened for eligibility. Twenty-seven papers were finally included in the present study

Results: Compared to the control group, the growth inhibition of cancerous cells treated with chemotherapeutic drugs was considerably higher, and resveratrol co-administration synergistically increased chemotherapy-induced cytotoxicity. Moreover, a reduction in the tumor weight, volume and growth of mice was observed following chemotherapy administration compared to the untreated groups, and these reductions were predominant in animals treated with resveratrol plus chemotherapy. Other findings showed that chemotherapy alone and in combination with resveratrol modulated the cell cycle profile of cancerous cells. Furthermore, chemotherapy treatment induced a set of biochemical and histopathological alterations in cancer cells/tissues, and these changes were synergized following resveratrol co-treatment (in most of the cases), excluding inflammatory mediators.

Conclusion: In most cases, resveratrol co-administration could sensitize cancerous cells to chemotherapy drugs through its oxidant, apoptosis, anti-inflammatory activities, etc. Nevertheless, suggesting the use of resveratrol during chemotherapy of colorectal cancer patients requires further clinical studies.

Methods: Virtual screening of Dakshina Kannada's plants was conducted, which are known for their antiviral activities. Potent plants were shortlisted as Tinospora cordifolia, Nyctanthes arbortristis, Bacopa monnieri, Bombax ceiba, and Curcuma longa based on molecular docking scores. Among these, the active plant Tinospora cordifolia possessed the most potent phytochemicals. Molecular dynamics (MD) simulation and MM/GBSA calculations have been performed on cordifolioside A, syringin, and cordioside.

Results: Initially, the selected plants were docked into the active site of SARS-CoV-2 protein. MD simulations were performed to investigate the various conformations and validate the docking results, revealing that cordifolioside A and syringin were more stable than cordioside. The stability of the phytoconstituents in complex with SARS-CoV-2 protein was steady throughout the 100 ns simulation time. Finally, the binding free energies were calculated using the MM/GBSA method. The pharmacophore model has confirmed the hydrogen bond interactions, and PASS prediction determined their antiviral activities.

Conclusion: Thus, the present study identified the most potent plant from Dakshina Kannada against the SARS-CoV-2 virus as Tinospora cordifolia with powerful phytochemicals (cordifolioside A, syringin and cordioside). Furthermore, in vitro and in vivo experiments are needed to provide experimental data to develop anti-SARS-CoV-2 drugs.

Objective: In the present work, the effective ingredients of YJD and their treatment mechanisms on PCOS were systematically analyzed.

Methods: The effective ingredients of YJD and targets of PCOS were selected from public databases. The network pharmacology method was used to analyze the ingredients, potential targets, and pathways of YJD for the treatment of PCOS.

Results: One hundred and three active ingredients were identified from YJD, of which 82 were hit by 65 targets associated with PCOS. By constructing the disease-common targetcompound network, five ingredients (quercetin, arachidonate, beta-sitosterol, betacarotene, and cholesterol) were selected out as the key ingredients of YJD, which can interact with the 10 hub genes (VEGFA, AKT1, TP53, ALB, TNF, PIK3CA, IGF1, INS, IL1B, PTEN) against PCOS. These genes are mainly involved in prostate cancer, steroid hormone biosynthesis, and EGFR tyrosine kinase inhibitor resistance pathways. In addition, the results of molecular docking showed that the ingredients of YJD have a good binding affinity with the hub genes.

Conclusion: These results demonstrate that the treatment of PCOS by YJD is through regulating the levels of androgen and insulin and improving the inflammatory microenvironment.

Objective: The morphological, chemical, and pharmacological characteristics of Boerhaavia diffusa are discussed in this article. The purpose of this review is to discuss the pharmacological profile of Punarnava and its chemical elements, as well as the benefits and drawbacks of its steroidal component β-Ecdysone.

Methods: This article compiled information by reviewing a variety of published articles and research papers from several sources, including Research Gate, WJPRT, IJPSM, Elsevier, Taylor & Francis, Springer Nature, and The Journal of Ayurveda and Integrated Medicine.

Results: It is a widely used remedy for numerous ailments among diverse cultural groups, Ayurvedic, and traditional practitioners. To some extent, it is used in a variety of formulations to treat sciatica, cancer, immunomodulation, obesity, diabetes, jaundice, inflammation, asthma, rheumatism, nephrological difficulties, ascites, anemia, and gynaecological disorders.

Conclusion: Herbal medications are becoming increasingly popular nowadays. Punarnava is one of the most beneficial herbs available. More analysis is needed to investigate the impacts of each chemical ingredient in Punarnava. β -Ecdysone is a key component of Punarnava, which is both beneficial and detrimental to humans in different ways. Hence, further research is also needed to emphasize the impacts of each Punarnava chemical ingredient.

Methods: Nanoparticles were synthesized by an ionic gelation method and were characterized for their morphology, particle size, and surface potential measurements by TEM and zeta sizer. This study was highlighted for the evaluation of drug entrapment, loading and in vitro drug release capabilities of the prepared nanoparticles by spectrophotometric analysis. The stability study was also conducted after 3 months for their particle size, zeta potential, drug loading and encapsulation efficiencies. Further, ovarian cancer cell line PEO1 was used to evaluate the toxicity and efficacy of nano-formulation by MTT assay. Additionally, the study was evaluated for apoptosis using flow cytometric analysis.

Results: The CS-PLGA-CP NPs were uniform and spherical in shape. The particle size and zeta potential of CS-PLGA-CP NPs were measured to be 156 ±6.8 nm and +52 ±2.4 mV, respectively. High encapsulation (87.4 ± 4.5%) and controlled retention capacities confirmed the efficiency of the prepared nanoparticles in a time and dose-dependent manner. The cytotoxicity assay results also showed that CS-PLGA-CP NPs have a high efficiency on PEO1 cells compared to the free drug. The flow cytometric result showed 64.25% of the PEO1 cells were apoptotic, and 8.42% were necrotic when treated with CS-PLGA-CP NPs.

Conclusion: Chitosan-PLGA combinational polymeric nanoparticles were not only steady but also non-toxic. Our experiments revealed that the chitosan-PLGA nanoparticles could be used as a challenging vehicle candidate for drug delivery for the therapeutic treatment of ovarian cancer.

Objective: The purpose of this study was to examine the altered expression of miRNAs and their target genes in placental tissue (PL), cord blood (CB), and maternal blood (MB) of matched non-glucose tolerant (NGT) and GDM mother.

Methods: In a case-control study, micro-RNA was quantified from forty-five serum (MB n = 15, CB n = 15, and PL n = 15) and matched placental tissue using stem-loop RT-qPCR followed by target prediction, network construction and functional and pathways enrichment analysis. Further, target genes were verified in-vitro through transfection and RT-qPCR.

Results: Five miRNAs, namely hsa-let 7a-5P, hsa-miR7-5P, hsa-miR9-5P, hsa-miR18a-5P, and hsamiR23a- 3P were significantly over-expressed (p < 0.05) in all three samples namely PL, CB, and MB of GDM patients. However, the sample-wise comparison reveals higher expression of miRNA 7 in MB while lowest in CB than control. Furthermore, a comparison of fold change expression of target genes discloses a lower expression of IRS1, IRS2, and RAF1 in MB while comparatively higher expression of NRAS in MB and CB. In-vitro validation reveals lower expression of IRS1/2 and RAF1 in response to overexpression of miR-7 and vice-versa. Thus it is evident that increased miRNA7 expression causes down-regulation of its target genes IRS1, IRS2, and RAF1 in GDM mother compared to control. Further, target prediction, pathway enrichment, and hormone analysis (significantly higher FSH & LH in MB of GDM compared to NGT) revealed insulin signaling, inflammatory and GnRH signaling as major pathways regulated by miRNA7.

Conclusion: Thus, an elevated level of miRNA7 may be associated with the progression of GDM by altering the multiple pathways like insulin, GnRH, and inflammatory signaling pathways via targeting IRS1, IRS2, and RAF1, implicating a new therapeutic target for GDM.

Methods: SBMBs were prepared using mechanical vibration. The viability of A2780 cells was determined using the MTT assay. Flow cytometry was performed to detect cell apoptosis and the cell cycle. The expression of Receptor Tyrosine Kinase (RTK)-associated downstream proteins was detected using multiplex assays and Western blots.

Results: The present study designed and synthesized SBMBs. SBMBs in combination with ultrasound decreased A2780 cell viability in a dose- and time-dependent manner. The half maximal inhibitory concentration (IC50) showed that the cytotoxicity of the SBMBs was approximately 1.5 times greater than that of the SB in A2780 cells. SBMBs in combination with ultrasound resulted in significantly higher apoptosis efficiency compared to the SB group, and the SBMB population of cells was arrested in the G1/G0 phase. Further experiments demonstrated that SBMBs decreased the expression of signal transducer and activator of transcription 3 (STAT3), Ak strain transforming (AKT), and extracellular signal-regulated kinase (Erk) and had a greater effect than SB in A2780 cells. Inhibitors of AKT, Erk and STAT3 promoted the cytotoxicity of SBMBs.

Conclusion: SBMBs in combination with ultrasound may enhance the cytotoxicity efficiency of SB via the promotion of apoptosis and cell cycle arrest in ovarian cancer cells and the inactivation of the STAT3, AKT and Erk signalling pathways.]]> https://www.benthamscience.comarticle/114676Aims: The present study was conducted to know presentations and nature of Müllerian- duct anomalies in rural women.

Background: Müllerian anomalies are congenital defects of female reproductive tract resulting from faulty development and fusion of Müllerian ducts. Objectives: To identify common Müllerian anomalies, their presentation, radiological appearances, complications, associated renal anomalies in rural women of Northern India.

Methods: Present observational study was conducted on 181 female patients with suspected Müllerian anomalies presenting to the outpatient department of Obstetrics and Gynecology with various complaints. Data included age, religion, menarche, previous pregnancy if any, duration of infertility, presenting complaints, type of Müllerian anomaly, incidental or symptomatic, diagnostic method, associated anomalies. Statistical analysis was done using SPSS 22.0 version software.

Results: Of 181 patients, 16.5% were adolescents, 83.5% adult women with an overall mean (SD) age of 25.02 (5.96) years. Of these, 170 had true Müllerian-duct anomalies and 11 had defects other than Müllerian anomalies, hence excluded. Total 158 (92.9%) patients were symptomatic and 12 (7.1%) asymptomatic at presentation. The majority (75.9%) were diagnosed incidentally during their visit to the department for various complaints of which infertility (32.4%) was most common. Septate uterus (29.4%) was most common anomaly diagnosed followed by Müllerian agenesis/hypoplasia (22.9%). Around 11.2% of cases had associated renal and collecting system anomalies with unilateral renal agenesis (47.4%) being most common.

Conclusion: Hence, Müllerian-duct anomalies have diverse presentations and most of them are diagnosed incidentally. The exact prevalence of Müllerian-duct anomalies may be high, especially in rural India, due to lack of knowledge and societal pressures.

Methods: Publications on thyroid diseases during pregnancy from 1926 to hitherto were retrieved based on the Web of Science database. The publications and references, the institutions and countries, the journals, the keywords and citations were analyzed by utilizing VOSviewer, CiteSpace and Cit- NetExplorer.

Results: A total of 3310 publications were retrieved and were cited 87913 times. The United States took the dominant position in outputs and collaborations. Harvard University had the most articles 86, which also had the highest h-index 30. Thyroid ranked first with 201 publications and Journal of Clinical Endocrinology Metabolism had the highest h-index 67. Among the 49 burst keywords, \"antibody\" had the longest burst period from 1991 to 2012, \"thyroxine\" had the strongest burst strength 16.7026, \"hypothyroxinemia\" appeared most recently in 2018. The most frequent keyword was \"pregnancy\" which occurred 1324 times. All the top 98 frequent keywords were clustered into 4 clusters. The citation network visualization was grouped into 8 groups.

Conclusion: The research focus of thyroid diseases in pregnancy ranged from clinical thyroid dysfunction to milder thyroid dysfunction. Guidelines published by the American Thyroid Association enacted a crucial purpose in the treatment and development of thyroid diseases during pregnancy. Some randomized controlled studies of unresolved problems and long-term follow-up of offspring may be the direction of future research. In the meantime, bibliometric methods can help scholars choose journals, track research hotspots, and identify the direction or focus of future research.

Methods and Results: We used primary terpene alcohols and carboxylic acids with a length of two to nine carbon atoms. The structure of the alcohols had an influence on the esterification efficiency, which decreased in the following order: monocyclic > linear > bicyclic. Terpene alcohols and their esters only induced apoptotic cell death, which is highly desirable from a therapeutic point of view, but did not induce autophagy and necrosis. The esterification of perillyl alcohol with butyric acid caused a 4-fold increase in cell death induction in the T98G line. Citronellol valerate, caprylate, and pelargonate and myrtenol butyrate, caprylate and pelargonate also showed higher activity than their alcohol precursors.

Conclusion: We have herein shown that esterification of natural alcohols by biocatalysis can be used for improving the activity of other compounds investigated for their anti-glioma activity.]]> https://www.benthamscience.comarticle/114049 Objective: This study aims to analyse the causes of the postponement of motherhood, to address the maternal and fetal consequences and to explore the solutions to this problem, one of which is the applicability of fertility preservation techniques.

Methods: A bibliographic search of studies published between 2008 and 2020 was conducted in the PubMed database using the MeSH terms “fertility preservation” and “maternal age”, among others.

Results: The reasons that lead to the postponement of motherhood are the difficulty in establishing stable relationships, the expansion of differentiated education and demanding labor conditions, the use of contraceptive methods, economic insecurity, ideational changes and the lack of information about this issue. The increased infertility, fetal death, chromosomal anomalies, multiple pregnancies, preterm birth and increased caesarean sections are the associated medical consequences. The review of social policies and the provision of information about fertility constitute possible solutions to this phenomenon. Fertility preservation techniques, especially oocyte cryopreservation, appear as an option but cannot totally compensate for the age-related fertility decline.

Conclusion: Advanced maternal age is a public health issue, essentially explained by a set of interconnected social factors, involving considerable risks for maternal and fetal health. Fertility preservation techniques, although promising, may contribute to the perpetuation of this reality.]]> https://www.benthamscience.comarticle/114035Background: Sarcoidosis is usually diagnosed by ruling out other granulomatous inflammatory diseases. Rarely, it may be suspected with a pathological examination after surgical intervention for another disease. The sarcoid reaction is noninfectious granulomatous lymphadenitis, which can occur at nodes draining a neoplasm. We demonstrated granulomatous lesions masquerading metastasis by Positron Emission Tomography/Computed Tomography (PET/CT) in endometrial cancer. We presented two cases of endometrial cancer with sarcoidosis and sarcoid-like reactions because of their challenging clinical and radiological findings.

Cases: In case 1, there was diffuse granulomatous inflammation (no metastasis) in lymph nodes (n = 92) and giant cells containing calcifications (Schaumann bodies). In case 2, PET/CT revealed hypermetabolism with malignancy suspicion in the pelvic lymph nodes (maximum standardized uptake value= 13) and pathological evaluation reported a 4.5 cm tumor within the uterine cavity without any nodal metastasis.

Results: PET/CT has no role in the evaluation of differential diagnosis between granulomatous lymphadenitis and metastatic disease.

Conclusion: Granulomatous lesions might mimic the metastasis of coexisting malignant diseases.

Methods: Therapies that target EGFR-mediated signaling are the latest keystones for treating these two types of cancers. They comprise of two main treatment modalities: firstly, against the extracellular fields that include monoclonal antibodies, and secondly, mechanisms that create interferences in the signaling pathways, primarily the small molecule tyrosine kinase inhibitors.

Results: Quality of life (QoL) is one of the key advantages of erlotinib therapy over chemotherapy.

Conclusion: The present review reports the role of Erlotinib in improving the quality of life of cancer patients, especially in NSCLC and pancreatic cancers. The studies or trials establishing the relations between Erlotinib and QoL are discussed in detail in this review.]]> https://www.benthamscience.comarticle/113504 https://www.benthamscience.comarticle/116501Background: The prognosis of Epithelial Ovarian Cancer (EOC) is poor, but the prognostic biomarkers are neither sensitive nor specific. Therefore, it is very important to search novel prognostic biomarkers for EOC.

Objectives: The present study aimed to investigate Myosin Light Chain 9(MYL9) expression in Epithelial Ovarian Cancer (EOC) tissues (including paraffin-embedded and fresh tissue samples) and its relationship with clinicopathological characteristics, as well as its potential prognostic value in patients with EOC.

Methods: Between March 2009 and December 2018, all of 184 paraffin-embedded cancer tissues from patients with EOC and 41 paratumor tissues, pathologically confirmed at the Memorial Hospital of Sun Yat-sen University and Integrated Hospital of Traditional Chinese Medicine, Southern Medical University, were collected for the present study and were assessed for MYL9 protein expression patterns using Immunohistochemistry (IHC). Furthermore, from August 2013 to November 2019, 16 fresh EOC tissues and their paired paratumor tissues, pathologically confirmed at the Integrated Hospital of Traditional Chinese Medicine, Southern Medical University were analyzed using Reverse-Transcription Quantitative PCR (RT-qPCR) to detect MYL9 mRNA expression levels.

Results: The results showed that MYL9 expression was higher in cancer tissues compared with that in paratumor tissues, and MYL9 overexpression was associated with shorter Recurrence Free Survival (RFS) and Overall Survival (OS) of EOC patients. Furthermore, multivariate Cox model analysis indicated that MYL9 overexpression was an independent poor survival prediction in patients with EOC.

Conclusion: MYL9 is upregulated in EOC and may serve as a useful patent of prognostic biomarker in EOC, and it may demonstrate an important value for the clinical treatment and supervision of patients with EOC.

Objective: The present study is aimed at exploring chemical composition, pharmacological and biological activities of Ajuga species as worked out by researchers and scientific community. Due to the excessive use of Ajuga species it needs to be conserved and requires important measures for its conservation.

Methods: The analysis of essential oils and plant extract has been reported through solvent extraction, steam distillation method, GC-MS analysis and HPLC.

Results: Literature survey revealed reports of Ajuga L. to be used against various ailments such as stomach-ache, dermatitis, malaria, snake-bite, ear-ache, arthritis, bleeding, wounds, asthma, pneumonia, respiratory problems, fever, dysentery, and joint pain.

Conclusion: The detailed description would be helpful in future studies. Recent biotechnological approaches have been reported useful to conserve A. bracteosa due to over exploitation for research purpose whereas A. brachystemon and A. macrosperma have been reported rarely in the wild.

Methods: Nine Corriedale sheep that had been monitored for 10 minutes during a basal stage underwent 5-minute myocardial ischemia, followed by 60-minute reperfusion. Seven of them were subjected to an induced heart failure through an overdose of halothane, two of which were treated with intra-aortic counterpulsation during the reperfusion stage. The remaining two animals were monitored during their ischemia-reperfusion stage.

Results: Data obtained in the 5 animals suffering from heart failure followed by myocardial ischemia showed that: a) heart failure induction determined decrease in cardiac output, cardiac index and systolic and diastolic aortic pressure (AoP) with respect to their basal values (p<0.05), b) myocardial ischemia decreased the WTF compared with basal and induced heart failure values (p<0.05), c) during the reperfusion stage accompanied by induced heart failure, WTF increased with respect to values observed during the ischemia induction stage (p<0.05); nevertheless, basal values were not recovered after reperfusion (p<0.05). During this 60-minute stage, systolic and diastolic AoP values were lower (p<0.05) than those at the basal stage.

Conclusion: AIx and WTF values calculated from synchronically recorded values of aortic pressure and left ventricular wall thickness during the reperfusion stage in all animals (n = 9) showed a negative correlation (p<0.05). Analysed data provided evidence of a negative relationship between a left ventricular index of myocardial function and an arterial index obtained from AoP waves.

Case Presentation: We describe the Magnetic Resonance Imaging (MRI) features of a case of uterovaginal diffuse large B-cell lymphoma in a 50-year-old postmenopausal woman emphasizing Diffusion-Weighted Imaging (DWI) as a diagnostic and follow up tool. We reviewed the literature regarding the diagnostic methods for female genital lymphoma. Forty-five cases, including our patient, were reviewed with an age range from 22 to 85 years. Vaginal bleeding was the most common presentation. The diagnosis was established by Papanicolaou smear, cervical biopsy (25/45), endometrial biopsy (6/45), vaginal biopsy (2/45), pelvic mass biopsy (2/45), iliac LN biopsy (1/45) and surgical diagnosis (8/45). Diffuse Large B-Cell Lymphomas (DLBCL) constitute the vast majority of the cases (82%). The uterine cervix was involved at diagnosis in the majority of these cases (68%), while the uterine body (42%) and vagina (28%) were less involved. Pelvic lymphadenopathy was found in 15 cases, while extra genital lymphomatous infiltration in 13 cases. Sonographic findings were nonspecific, while CT provided excellent data about extra-genital involvement. Thirteen cases underwent pelvic MRI that displayed superior detection of disease extension and parametric involvement. Diffusion restriction was reported only in one case without quantitative analysis of ADC map.

Conclusion: MRI shows unique features that differentiate uterovaginal lymphoma from the much more common carcinomas and discriminate post-operative changes from tumor recurrence. It exhibits a marked restricted diffusion pattern with lower ADC values than carcinomas and post-operative changes.

Objective: Here, we shed light on the recent advances that have been made in understanding how calpain contributes to stromal regulation in cancer.

Conclusion: Calpains are activated in stromal cells, including pancreatic stellate cells and mesenchymal cells. They induce fibrogenic responses in cancer stroma. Moreover, these molecules contribute to epithelial-mesenchymal transition and endothelial-mesenchymal transition to provide mesenchymal stromal cells in the microenvironment and concomitantly participate in cancer angiogenesis. In addition to the conventional calpains, the unconventional calpain-9 is associated with epithelial-mesenchymal transition. Animal experiments showed that targeting calpain systems antagonizes cancer development; thus, this approach is promising for cancer control.

Objective: This study aimed to investigate the synergistic effects of lumiflavin and ionising radiation on ovarian cancer CSCs and explore the association of this metabolite with autophagy.

Methods: CSCs of human ovarian cancer cell lines HO8910 were treated with lumiflavin and rapamycin and then subjected to irradiation at a cumulative dose of 8 Gy. Cell proliferation ability, clonal formation ability, apoptosis rate, autophagy changes and autophagy-related protein changes were detected.

Results: Lumiflavin and ionising radiation synergistically reduced cell vitality and clone formation and increased the apoptosis of CSCs compared with irradiation alone. In addition, ionising radiation increased autophagy and the expression of associated proteins, whereas lumiflavin reduced those changes in autophagy progression. Moreover, rapamycin, an autophagy inhibitor, was observed to block the synergistic effects of lumiflavin and ionising radiation on CSC apoptosis.

Conclusion: Lumiflavin can enhance the effects of ionising radiation on ovarian cancer CSCs. The mechanism by which these effects are exerted is related to blocking the autophagy pathway.

Exclusion Criteria: Patients are seen in A/E and ambulatory care who did not stay overnight and those who received antimicrobials for perioperative or medical prophylaxis were excluded.

Statistical Analysis: Statistical Analysis was done using excel program descriptive statistics were used to describe the baseline demographic data and clinical characteristics. Categorical variables are presented as counts and percentages, whereas continuous variables are presented as mean.

Results: A total of 666 patients’ medical records were reviewed during January 2020 to April 2020. Respiratory tract infections were the most common diagnosis encountered (456/666), representing 68.5% in total. A total of 994 courses of antimicrobials were prescribed during the study period. Antimicrobial was considered 'appropriate' in 70.3% (979/1393), and ‘not indicated' in 19.7% (273/1393) of cases. In the remaining 10% of cases (141/1393), antimicrobial was indicated but required antimicrobial stewardship team (A.M.S) intervention. The compliance to accept antimicrobial stewardship team recommendations and change therapy accordingly in our study was only 32.6% (133/412)

Conclusion: In this study, the prevalence of inappropriate antimicrobial prescribing is comparable to that found in other studies worldwide. However, the compliance with AMS recommendations is much lower than described in the literature.]]> https://www.benthamscience.comarticle/116269 Objective: Here, we aimed to determine the prevalence of different HPV genotypes in women with abnormal Cervical cytology in the United Arab Emirates (UAE), evaluate correlations between HPV genotypes and the degree of cervical dysplasia, and observe distributions of HPV genotypes across age groups.

Methods: The study included 442 women who underwent HPV genotyping at our institution between January 2018 and September 2019. A retrospective chart review was conducted for all 442 cases, and data were collected from hospital records.

Results: The overall HPV positivity rate was 56.1%. The prevalence of high-risk HPV was 48%; 35.4% of patients had multiple high-risk HPV strains, whereas 64.6% had a single high-risk HPV strain. The most common high-risk HPV genotype was HPV-16 (15.2%), followed by HPV-31 (11.7%), HPV-53 (8.9%), HPV-66 (8.6%), and HPV-51 (8.3%). The prevalence of HPV-18 was only 3.8%. The high-risk HPV positivity rate Increased from 39% in women with Atypical Squamous Cells of Undetermined Significance (ASCUS) to 81% in women with Low-grade Squamous Intraepithelial Lesions (LSILs), 81.3% in women with atypical squamous cells cannot rule out High-Frade Lesions, and 80% in women with High-Grade Squamous Intraepithelial Lesions (HSILs). The multiple high-risk HPV strain positivity rate increased from 32.4% in ASCUS to 44.7% in LSIL and 62.5% in HSIL. Increased HPV positivity rates and prevalence of HPV-16 were noted with increasing severity of cervical dysplasia. Decreased HPV positivity was observed with increasing age.

Conclusion: Overall, because the prevalence and distribution of different high-risk HPV genotypes affect HPV vaccination strategies, our findings may be useful for the design of cervical cancer prevention programs.]]> https://www.benthamscience.comarticle/104641 Methods: In the current research, 514 vaginal discharge samples were obtained from women with vaginitis. The specimens were evaluated by the direct wet mount examination, Dorset culture medium, and PCR technique. Primers were designed for the detection of TVK3/TVK7, TVA5/TVA6 genes specific for the identification of T. vaginalis. The PCR-positive samples were sequenced and compared with the sequences registered in the GenBank database.

Objective: This study aims to evaluate the antiproliferative activity, inhibition of cell migration and cell cycle arrest by the chloroform extract of leaves of Nerium Oleander L. in HeLa cervical cancer cells. The chloroform extract of Catharanthus roseus which contains anti-cancer compounds, Vinblastin and Vincristin, was used as a positive control for this study.

Methods: The chloroform extracts of Nerium oleander L. and Catharanthus roseus were prepared using the standard protocol. The cytotoxic effects were studied by MTT assay. Cell migration was studied by in vitro scratch assay. Analysis of the cell cycle was carried out by Propidium iodide staining and Flow Cytometry. The expression level of various proteins was evaluated by immunocytochemistry.

Results: In this study, we showed that the leaf extract of Nerium oleander inhibited the growth of HeLa cervical cancer cells in culture and inhibited cell migration. Besides, it arrested the cell cycle at the G2/M phase. The Epidermal Growth Factor Receptor (EGFR) expression and phosphorylated p-Rb (Ser 780) level were significantly downregulated by leaf extract of Nerium oleander.

Conclusion: The extract of Nerium oleander L. contains potential bioactive compounds that inhibit HeLa cell proliferation, cell migration and arrest cell cycle at the G₂/M phase.

Objective: The objective of this review is to elucidate the role of the microbiome in cancer metabolism and the tumor microenvironment. It also focuses on the importance of therapeutic opportunities and challenges in the manipulation of the cancer microbiome.

Methods: A literature search was conducted on the role of the microbiome in cancer initiation, progression, and therapy.

Conclusion: The tumor microenvironment and cancer metabolism are significant in host-microbiome interactions. The microbiome can modulate standard cancer therapies like chemotherapy and immunotherapy. Microbiome transplantation has also been demonstrated as an effective therapy against cancer. Furthermore, the modulation of the microbiome also has potential clinical outcomes in modern medicine.

Objectives: The aim of this study was to create a miR-based signature to effectively predict the prognosis for patients with uterine corpus endometrial carcinoma (UCEC).

Methods: Using UCEC data set in TCGA, we identified differentially expressed miRs between UCEC and healthy endometrial tissues. The LASSO method was used to construct a miR-based signature prognosis index for predicting prognosis in the training cohort. The miR-based signature prognosis index was validated in an independent test cohort. MiRNet tool was applied to perform functional enrichment analysis of this miR-based signature.

Results: A total of 208 miRs were differentially expressed between UCEC and healthy endometrial tissues. Five miRs (miR-652, miR-3170, miR-195, miR-34a, and miR-934) were identified to generate a prognosis index (PI). The five-miR signature is a promising biomarker for predicting the 5-year-survival rate of UCEC with AUC = 0.730. The PI remained an independent prognostic factor adjusted by routine clinicopathologic factors. Using the PI, we could successfully identify the high-risk individuals, furthermore, it still worked in an independent test cohort. The five miRs involved in various pathways associated with cancer.

Conclusion: We proposed and validated a five-miR signature that could serve as an independent prognostic predictor of UCECs.

Methods: We undertook a structural search of peer-reviewed published studies based on 1). Characteristics of programmed cell death ligand-1/programmed cell death-1(PD-L1/PD-1) expression in cervical cancer and upstream regulatory signals of PD-L1/PD-1 expression, 2). The role of the PD-L1/PD-1 axis in cervical carcinogenesis induced by HPV infection and 3). Whether the PD-L1/PD-1 axis has emerged as a potential target for cervical cancer therapies.

Results: One hundred and twenty-six published papers were included in the review, demonstrating that expression of PD-L1/PD-1 is associated with HPV-caused cancer, especially with HPV 16 and 18 which account for approximately 70% of cervical cancer cases. HPV E5/E6/E7 oncogenes activate multiple signalling pathways including PI3K/AKT, MAPK, hypoxia-inducible factor 1α, STAT3/NF-kB and microRNA, which regulate PD-L1/PD-1 axis to promote HPV-induced cervical carcinogenesis. The PD-L1/PD-1 axis plays a crucial role in the immune escape of cervical cancer through inhibition of host immune response. Creating an "immune-privileged" site for initial viral infection and subsequent adaptive immune resistance, which provides a rationale for the therapeutic blockade of this axis in HPV-positive cancers. Currently, Phase I/II clinical trials evaluating the effects of PDL1/ PD-1 targeted therapies are in progress for cervical carcinoma, which provide an important opportunity for the application of anti-PD-L1/anti-PD-1 antibodies in cervical cancer treatment.

Conclusion: Recent research developments have led to an entirely new class of drugs using antibodies against the PD-L1/PD-1 thus promoting the body’s immune system to fight cancer. The expression and roles of the PD-L1/ PD-1 axis in the progression of cervical cancer provide great potential for using PD-L1/PD-1 antibodies as a targeted cancer therapy.

Methods: Sprague Dawley rats' heart and myocardial cells I/R model were established in vivo and vitro, then 100 mg/kg and 10 μmol/l baicalin were administrated, respectively. The experiment was randomly divided into 4 groups (n=10): Control; I/R; IR+DMEM; and I/R+baicalin groups. Postoperation, the Left Ventricular (LV) End-Diastolic Pressure (LVEDP), the maximum velocity of LV contraction (dP/dtmax) and the maximum velocity of LV diastole (dP/dtmin) were recorded by the transthoracic echocardiography; the myocardial apoptosis percentage was analyzed by Annexin VFITC/ PI and TUNEL staining, and the apoptosis gene and protein were detected by RT-PCR and western blot. Furthermore, the protein expression of the calcium-sensing receptor (CaSR) and ERK1/2 phosphorylation were observed by western blot and Fura-2-acetoxymethyl ester. Moreover, primary rats’ cardiomyocytes were cultured and ERK1/2 specific inhibitor PD98059 was added to the culture medium. The cell survival rate, vitality and apoptosis were detected by MTT, lactate dehydrogenase (LDH) and TUNEL staining assay Kit, respectively.

Results: Our present study showed that baicalin significantly improved LV hemodynamic parameters and myocardial apoptosis in myocardial I/R injury rats. Furthermore, we found that baicalin could down-regulate the protein expression of CaSR, but up-regulate the protein expression of ERK1/2. Furthermore, when the cells were pretreated with ERK1/2 inhibitor PD98059, the cells survival rate significantly decreased, but LDH activity and apoptosis significantly increased. The results indicated that the effect of baicalin on myocardial I/R injury could be inhibited by ERK1/2 inhibitor.

Conclusion: In conclusion, our data suggests that baicalin attenuates I/R-induced myocardial injury maybe through the suppression of the CaSR/ERK1/2 signaling pathway.

The treatment of various gynecological problems, which cause physical, biological and psychosocial conditions such as fear, shame, blame and anger, has been important throughout the history. Treatment with herbs has become popular nowadays due to the serious side effects of the synthetic drugs used in treatment and the medical and economical problems caused by them. Many scientists have identified various active drug substances through in vivo and in vitro biological activity studies on medicinal plants from the past to the present. While the intrinsic complexity of natural product-based drug discoveries requires highly integrated interdisciplinary approaches, scientific and technological advances and research trends clearly show that natural products will be among the most important new drug sources in the future.

In this review, an overview of the studies conducted for the discovery of multitargeted drug molecules in the rational treatment of gynecological cancers is presented.

Background: Alterations of the PAM-pathway are common in both endometrial and ovarian cancers, and are described in specific histology-defined subtypes. PAM seems to be involved in critical steps of endometrial and ovarian carcinogenesis, often mechanistically involved in the acquisition of a phenotype of treatment resistance, which could be targetable. However, early clinical trials with PAMinhibitors (PAMi) have provided disappointing results, particularly when non isoform-specific inhibitors were tested in unselected populations, accompanied by an adverse safety profile. Since then, more encouraging observations have been collected when targeting specific isoforms of PAM proteins with more selective drugs, resulting in encouraging activity and more manageable toxicity.

Conclusion: Although the rationale of inhibiting the PAM-pathway has been demonstrated in several promising preclinical studies, no Phase III clinical trial is available to demonstrate a significant benefit of PAM-inhibitors. A way to manage targeted agents is to tailor their use to particular subpopulations most likely to obtain a considerable benefit, namely pursuing an individualized, precision-medicine approach.

Objective: The Ethanolic Extract of roots of F. Glomerata (EEFG) belonging to the family Moraceace, was investigated for its antidiabetic activity using alloxan induced diabetic rats.

Methods: Thirty rats were divided into 5 groups having 6 rats in each group. The alloxan was administered to the rats of all groups except normal control group through intraperitoneal route at a concentration of 140mg/kg body weight. A dose of 100mg/kg and 200 mg/kg body weight of EEFG was administered to alloxan induced diabetic rats. The administration of the extract was lasted for 11 days. Effectiveness of the extract on glucose, cholesterol, triglycerides, and high density lipoprotein and protein concentrations was analyzed.

Results: Significant (p<0.05) reduction in the levels of glucose, cholesterol, triglyceride of the diabetic rats was observed after treatment with ethanolic extract. After subjecting to oral glucose tolerance test EEFG also showed significant improvement in glucose tolerance.

Conclusion: F. glomerata root ethanolic extract showed that it possesses antidiabetic effect and can be found useful for the management of diabetes mellitus.

Objective: Here, we evaluated the accumulation of the novel hNIS-substrate [¹⁸F]tetrafluoroborate ([¹⁸F]TFB) in the endogenously hNIS-expressing breast cancer cell line MCF-7 after an improved radiosynthesis and pharmacological stimulation.

Methods: [¹⁸F]TFB was prepared under mild reaction conditions (40°C, 25 min) and its uptake properties were investigated in MCF-7 cells pretreated with a combination of all-trans retinoic acid plus methasone-derivatives and compared to the clinically established tracers [¹³¹I]iodide and [^99mTc]pertechnetate. Specificity of the tracer accumulation was assessed by inhibition experiments using NaBF₄, KSO₃F, KI and KIO₃.

Results:[¹⁸F]TFB was obtained with a radiochemical yield of 24.0 ± 6.6 % (n = 17) within 40 min after high pressure liquid chromatography-separation and with 26.8 ± 6.2 % (n = 13) within 45 min after adapting the procedure on a synthesis module using higher starting activities (> 10 GBq). After pharmacological treatment, a 4-fold increase in hNIS-expression on the MCF-7 cell surface was achieved, resulting in a significantly higher [¹⁸F]TFB uptake into the cells (up to 58-fold) as compared to control experiments. Inhibition studies using various NIS-substrates confirmed the specificity of [¹⁸F]TFB for hNIS.

Conclusion: [¹⁸F]TFB was shown to be a promising hNIS-substrate in our model using the human MCF-7 breast cancer cell line mandating in vivo evaluations in xenografted studies and in patients.

Methods: Male C57BL/6J mice were fed with a normal diet (10% kcal as fat, lean group) or a high-fat diet (60kcal as fat, obese group) for 12 consecutive weeks. To detect the MIF expression and AMPK activation in response to I/R in isolated hearts from lean and obese mice, myocardial samples were collected from left ventricular areas at different time points. To determine whether MIF supplementation is protective against I/R injury, recombined MIF (10 ng/mL) was applied before ischemia. Myocardial infarct size was estimated by triphenyltetrazolium staining. Western blot was used to detect myocardial MIF expression, AMPK activation and membrane glucose transporter 4 (Glut4) expression.

Results: The expression of MIF was remarkably higher in obese group compared to lean group. Ischemia increased myocardial MIF expression and phosphorylation of AMPK in lean mice, whereas it had no significant effect on obese mice. Furthermore, administration of recombinant MIF increased ischemic AMPK activation and membrane Glut4 expression in both lean and obese mice, while it reduced the infarct size in lean mice only.

Conclusion: An impaired MIF/AMPK activation response and consequent reduced membrane Glut4 expression may play an important role in increasing myocardial susceptibility to I/R in obesity.

Discussion: Currently, single-photon emission computed tomography (SPECT) and positron emission tomography (PET) centered imaging techniques are being developed for use in patients with GCCa as a diagnostic tool. The present work elucidates several clinical studies on the use of radiopharmaceuticals, based on their effectiveness, in the early detection and management of GCCa. It also highlights the importance of reconsidering the biology for nuclear imaging as a future modality for early, rapid and efficient diagnosis of gynecological cancers. This comprehensive review is a part of our study designed to detect gynaecological cancers at an early stage using radionuclide complex, 99m Tc-Cisplatin.

Conclusion: This article summarizes the significance of radioscintigraphy such as single-photon emission computed tomography (SPECT) and PET for identification of GCCa in the experimental humans and animals.

Objective: This review aims to present the phytochemicals isolated from the genus Bombax and their pharmacological applications.

Methods: The literature from research and review papers was analyzed and the information was compiled to present the pharmacological applications of various secondary metabolites from genus Bombax.

Results: The genus Bombax belongs to the family Malvaceae and known for its therapeutic applications. The crude, semi-purified and purified extracts of different parts of this plant have shown potential therapeutic applications. A total of 96 articles including research and review papers were referred for the compilation of isolated phytochemicals and their chemical structures.

Conclusion: We systematically summarized 176 isolated compounds from the genus Bombax. The findings show that this plant shows potential towards pharmacological activities. The activities were found more from extracts than the single isolated compounds.

Objective: The study aimed to discuss the available evidences on the possible association of ET to cognitive impairment in breast cancer patients, gathering up-to-date information from clinical trials, meta-analysis, as well as expert opinions.

Method: Appropriate and pertinent articles were retrieved through PubMed search.

Results: Controversial data emerged from clinical trials as well as observational studies and metaanalysis. Many authors have shown that verbal memory is negatively affected by exposure to tamoxifen. Moreover, significant lower memory test scores in the aromatase inhibitor-treated patients have been reported. On the other hand, there are clinical and preclinical evidence suggesting that tamoxifen may have a protective role in the Central Nervous System.

Conclusion: To date, the association between ET and cognitive impairment has not yet been proven. Future studies on available and upcoming drugs will need to include proper cognitive evaluation scales and an adequate number of participants in order to better define the role of ET in the possible development of cognitive impairment in breast cancer patients.]]> https://www.benthamscience.comarticle/95428

Method: We focus on non-PARPi novel targeted therapies that are completed or on-going in phase III clinical trials by searching databases of Pubmed and Clinicaltrials.gov. Keywords of “ovarian cancer, targeted therapy and phase III trial” were used for publications and information from May 2012 to May 2018.

Results: There are total 150 viable EOC phase III studies listed in Clinicaltrials.gov., including 20 completed studies with results and 73 on-going studies. Bevacizumab plus chemotherapy is the only medication with government approval for recurrent EOC. Targeted therapies against other growthrelated factors, cytokines and folate receptor are failed in phase III trials or still on-going.

Conclusion: Implications of on-going phase III trials are: 1) combination therapy of bevacizumab with atezolizumab may be the most anticipated studies for approvals; 2) mirvetuximab soravtansine plus chemotherapy may generate positive results to justify an approval; and 3) Immune therapy for EOC may bring new treatments for the patients.]]> https://www.benthamscience.comarticle/84161

The autophagic-lysosomal degradation pathway plays an important role in clearing dysfunctional and redundant mitochondria through a specific quality control mechanism termed mitophagy. Mitochondria could be targeted for autophagic degradation for a variety of reasons including basal turnover for recycling, starvation induced degradation, and degradation due to damage. While the core autophagic machinery is highly conserved and common to most pathways, the signaling pathways leading to the selective degradation of damaged mitochondria are still not completely understood. Type 1 mitophagy due to nutrient starvation is dependent on PI3K (phosphoinositide 3-kinase) for autophagosome formation but independent of mitophagy proteins, PINK1 (PTEN-induced putative kinase 1) and Parkin. Whereas type 2 mitophagy that occurs due to damage is dependent on PINK1 and Parkin but does not require PI3K.

Autophagy and mitophagy play an important role in human disease and hence could serve as therapeutic targets for the treatment of mitochondrial as well as neurodegenerative disorders. Therefore, we reviewed drugs that are known modulators of autophagy (AICAR and metformin) and may affect this by activating the AMP-activated protein kinase signaling pathways. Furthermore, we reviewed the data available on supplements, such as Coenzyme Q and the quinone idebenone, that we assert rescue increased mitophagy in mitochondrial disease by benefiting mitochondrial function.]]> https://www.benthamscience.comarticle/84899 https://www.benthamscience.comarticle/91210 https://www.benthamscience.comarticle/91343 https://www.benthamscience.comarticle/84738 https://www.benthamscience.comarticle/92252 https://www.benthamscience.comarticle/92843

Objective: To prove the effect of Moringa oleifera leaf extract in various doses might decrease the insulin levels and increase folliculogenesis in female PCOS-insulin resistant rats.

Methods: The three month old white rat of Wistar strain (Rattus norvegicus) 100-130 grams were divided into five groups (n=8) including normal control, PCOS-insulin resistance, PCOS-insulin resistance given metformin and PCOS-resistance insulin were given Moringa oleifera leaf extract in two doses. Then, the PCOS model-insulin resistance by injection of testosterone propionate for 28 days. After 14 days treatment, we analysed insulin levels and folliculogenesis.

Results: The PCOS control group showed a significant increase in insulin levels compared to the normal control group. The insulin levels from group treatment with Moringa oleifera leaf extract of 250 mg/kgBW was significantly lower than the PCOS control group. Ovarian histology analysis found that the number and diameter of follicle of PCOS control group showed a significant decrease compared to normal control group. In addition, the treatment with metformin and leaf Moringa oleifera dose 250 mg/kgBW and 500 mg/kgBW showed significant increase of folliculogenesis compared to PCOS control group.

Conclusions: Moringa oleifera could lowering the blood insulin levels, subsequently decreasing the androgen thus allowed the increasing of folliculogenesis in PCOS.]]> https://www.benthamscience.comarticle/88812

Objective: This study aims to review the use of antidepressants for physical and psychological symptoms in cancer patients.

Results: Our findings showed the mixed result of positive and negative findings in various symptoms associated with cancer patients. These studies are categorised according to the hierarchy of evidence from high to low level, namely randomised controlled trials, cohort studies, case-control studies, case series, case reports, as well as other type of publications. The majority of antidepressants used in cancer patients seem to be beneficial for the treatment of depression, anxiety, hot flashes and other symptoms such as sexual dysfunction, fatigue, nicotine dependence, vasomotor symptoms, executive functions, sleep problems, pruritus, as well as for hypochondriasis. While fluoxetine was found to be associated with the reduction of antiemetic property in ondansetron, mirtazapine was identified to be a good alternative in treating nausea and cachexia among cancer patients.

Conclusion: More research studies with adequate statistical power are warranted to validate the use of antidepressants among cancer patients in treating these physical and psychological symptoms.]]> https://www.benthamscience.comarticle/896363 cm in diameter, uterine artery embolisation and myomectomy are recommended. However, some women prefer conservative management, particularly those close to menopause. A case series was undertaken to determine the effectiveness of ulipristal acetate (Esmya), a potent selective progesterone receptor modulator, possibly followed by insertion of a LNG-IUS, to treat HMB in women close to menopause.

Methods: Women presenting to a community gynaecology service with HMB who were suitable for ulipristal acetate followed by insertion of LNG-IUS are included in this case series. Fibroid size was measured at presentation and three months after treatment with ulipristal acetate. Other outcomes and side effects were recorded.

Results: This case series included 15 women. Mean reduction in fibroid size in 14 women was 35.0% (range 2.6–73.3%). Nine women were fitted with a LNG-IUS following ulipristal acetate, three were referred to secondary care for consideration for surgical treatment, one had repeated courses of ulipristal acetate, one became amenorrhoeic due to the menopause, and one incidentally developed breast cancer and had no further treatment for HMB.

Conclusions: Ulipristal acetate followed by LNG-IUS significantly reduces HMB, with variable reductions in fibroid size, often controlling symptoms to such a degree that surgery may be avoided.]]> https://www.benthamscience.comarticle/87670 https://www.benthamscience.comarticle/84251 https://www.benthamscience.comarticle/87826

Methods: The information about the impact of cytokine from IL-1 cytokine family on the pathogenesis and development of endometriosis was obtained with an electronic literature search based on the PubMed and Medline databases, spanning the period of January 1950 to July 2017 and includes associated references in the published studies.

Results: The impairment of the IL-1 family cytokine-network may lead to changes in the activation of immune system in the peritoneal cavity of women with endometriosis. The aberrant ectopic endometrial cell properties of adhesion, implantation and proliferation may be the result of a reduced suppressive capacity controlling the IL-1. The imbalance between IL-1α, pro-IL-1β, mature IL-1β and sIL-1R2 and sIL-1RAcP in the peritoneal fluid and serum of women with endometriosis may be linked to the ability of transforming an acute inflammation into a chronic one. Despite the fact that peritoneal macrophages secrete more antiinflammatory IL-1Ra and less proinflammatory IL-1 in the peritoneal cavity in affected women, the inflammation still develops.

Conclusions: This observation clearly suggested a significant inadequacy in the specific regulatory mechanisms of IL-1 activity at the peritoneal cavity level. The imbalance between all studied cytokines in endometriosis may escalate peritoneal inflammation and, in consequence, develop endometriosis.]]> https://www.benthamscience.comarticle/81634

Based on these features, B-RAF inhibitors and their combination with immunotherapy could represent the upcoming therapeutic strategy.]]> https://www.benthamscience.comarticle/81641

It is important to distinguish between local disease, in which tumor may be considered localized in the gland and a systemic disease characterized by high tumor burden and/or dissemination of circulating tumour cells.

All the prostate cancers, at first diagnosis, are characterized by high sensitivity to the androgen deprivation therapy (ADT); however, during the natural history, after a variable period, they become castration resistant. In the past, few therapy options were available for castration resistant prostate cancer, while at present much more approaches can be employed, both hormone-based therapies and chemotherapy regimens. Hypercastration agents are defined as drugs capable to target the androgenandrogen receptor axis even in castrate resistant conditions. Abiraterone and enzalutamide are the only two hypercastration agents available for clinical use.

Osteoclast targeted agents, such as zoledronic acid and denosumab can always been employed, but their use should be limited to the castrate resistant setting.

The optimal understanding of all phases characterizing the natural history of prostate cancer may certainly be useful for the selection of the best therapeutic options in prostate cancer.]]> https://www.benthamscience.comarticle/81642 https://www.benthamscience.comarticle/80608

Methods: We undertook a structured search of bibliographic database for peer-reviewed research literature using a focused review question and inclusion/exclusion criteria. The quality of retrieved papers was appraised using standard tools. The characteristics of screened papers were described, and a deductive qualitative content analysis methodology was applied to analyze the interventions and findings of included studies using a conceptual framework.

Results: Twenty-one papers were included in the review, eight papers outlined the relationship of Cx43 and reperfusion arrhythmias. Eight papers pointed out the effect on the infarct size of Cx43.

Conclusion: The findings of this review confirm that Cx43 is the most abundant member of Cx family in the heart and is vital for myocardial protection during ischemia/reperfusion process and for ischemia/reperfusion injury. Many of its mechanism are still not very clear and require future research in the future.]]> https://www.benthamscience.comarticle/86018

In this review, we first summarize two key learnings from the initial studies of inhibitors of this pathway, including the profile of immune-related adverse events such as colitis, transaminitis and pneumonitis and the increased incidence of infections with the majority of agents that target the PI3K-AKT-mTOR pathway. We then discuss recent advances in our understanding of the role of this pathway in the tumour micro-environment, and in the regulation of innate and adaptive immune responses, and propose synergistic combination strategies with PI3K-network inhibitors and cancer immunotherapy.]]> https://www.benthamscience.comarticle/84267

In the present narrative review, we discuss the links between MetS and NAFLD in terms of prevalence, risk factors and treatment (both lifestyle interventions and drug therapy). Such associations highlight the common pathophysiological pathways of these metabolic disorders, although data for an independent association are not robust. Nevertheless, NAFLD may be regarded as a hepatic manifestation of MetS.]]> https://www.benthamscience.comarticle/88158

Method: We screened a chemical compound library assembled during the COST CM1106 action to search for compound classes active in targeting ovarian stem cells. We here report the results of the high-throughput screening assay in two ovarian cancer stem cells and the differentiated cells derived from them.

Results and Conclusion: Interestingly, there were compounds active only on stem cells, only on differentiated cells, and compounds active on both cell populations. Even if these data need to be validated in ad hoc dose response cytotoxic experiments, the ongoing analysis of the compound structures will open up to mechanistic drug studies to select compounds able to improve the prognosis of ovarian cancer patients.]]> https://www.benthamscience.comarticle/81971 https://www.benthamscience.comarticle/81499

Objective: To review recent advancements in laparoscopic instrumentation and emerging best practices around gynecologic laparoscopy.

Results: New instrumentation reviewed include sub-5 mm instruments, three-dimensional imaging, narrow band imaging (NBI), and articulated instruments. Smaller (mini-laparoscopy and percutaneous) instruments can provide equivalent outcomes for certain operations with less abdominal wall trauma. Three-dimensional imaging may be particularly helpful for learners in the laparoscopic environment. NBI may pick up more endometriosis lesions but the clinical impact the small increase in sensitivity appears to be negligible over conventional white light laparoscopy. Adding articulation to certain advanced energy devices may facilitate division of vascular pedicles difficult to reach with standard straight instruments.

Evidence suggests that mechanical bowel preparation before gynecologic laparoscopy and the routine use of adhesion barriers in myomectomy have doubtful value and can likely be abandoned. Preventative salpingectomy at the time of hysterectomy does not afford additional complications but likely has a role in prevention of some ovarian cancers. Good fetal outcomes are seen with laparoscopic cerclage, equivalent to outcomes seen with the traditional abdominal approach. Achieving hemostasis with electrosurgical energy is more detrimental to ovarian function than other methods, such as suturing. Excision may be superior to ablation of endometriosis lesions, and excision of bowel and bladder disease may be aided with the use of transanal staplers and barbed suture. Pretreatment with Gonadotropin Releasing-Hormone Analogues may have a role in laparoscopic myomectomy for large fibroids. The risk of uterine rupture after laparoscopic myomectomy appears to be low when proper technique is used.

Conclusion: Gynecologic laparoscopists should consider available new technology in instrumentation and practice as the field continues to evolve.]]> https://www.benthamscience.comarticle/82762

Objective: In this article, we will review the current status of minimally invasive surgical techniques utilized in the treatment of fibroids.]]> https://www.benthamscience.comarticle/82772

Objective: This review outlines key issues in the implementation of pharmacogenetics of cytochrome P450 and tamoxifen as a model for optimal use of aromatase inhibitors in postmenopausal women with estrogen receptor positive breast cancer.

Methods: Lessons learnt from the association between tamoxifen and CYP2D6 genotyping were applied to identify polymorphisms with the potential to change clinical decision-making in patients on aromatase inhibitors. The ability of next generation sequencing to supersede single-gene analysis was furthermore evaluated in a subset of breast cancer patients on aromatase inhibitors selected from a central genomics database.

Results: Methodological flaws in major randomised controlled trials and continued referral to incorrect results in expert consensus statements are important factors delaying the implementation of CYP2D6 pharmacogenetics in tamoxifen treatment. This highlighted the importance of a clinical pipeline including comprehensive genotyping, to define the target population most likely to benefit from aromatase inhibitor pharmacogenetics.

Conclusion: The clinical utility of CYP2D6 genotyping is well-established in patients at increased risk of tamoxifen resistance due to cumulative risk. The pharmacogenetics of CYP19A1 requires further clarification in terms of bone risk assessment for appropriate use in the treatment algorithm of high-risk patients at the onset of aromatase inhibitors.]]> https://www.benthamscience.comarticle/81952

Results: Acting through a variety of downstream mechanisms, urocortin has been shown to alter cellular metabolism and modulate the mechanism of cell death occurring as a result of ischemia-reperfusion injury. New evidence continues to accumulate in support of urocortin’s beneficial role in cytoprotection.

Conclusion: We present here an updated review largely focused on the various mechanisms through which urocortin alters cellular metabolism, and discuss the clinical potential of urocortin’s cardioprotective ability in myocardial ischemia-reperfusion injury.]]> https://www.benthamscience.comarticle/81520 https://www.benthamscience.comarticle/82229

Objective: According to the “guilt by association” (GBA) principle, proteins interacting with each other are very likely to function similarly or the same. Based on this assumption, we tried to obtain EBOV infection-related human genes in a protein-protein interaction network using Dijkstra algorithm.

Conclusion: We hope it could contribute to the discovery of novel effective treatments. Finally, 15 genes were selected as potential EBOV infection-related human genes.]]> https://www.benthamscience.comarticle/70781

Objective: In this review, various pharmacological interventions to treat myocardial reperfusion injury including the antioxidant flavonols, hydrogen sulfide, adenosine, opioids, incretin-based therapies and cyclosporin A which targets the mitochondrial permeability transition pore are discussed.

Conclusion: The processes involved in reperfusion injury might provide targets for improved outcomes after myocardial infarction but thus far that aim has not been met in the clinic.]]> https://www.benthamscience.comarticle/84155

Case: A 34-year-old man treated with clomiphene for oligoteratospermia presented anxiety, decreased appetite, and mood change making him unable to function properly at work, five days after initiation of therapy. Symptoms required reduction followed by discontinuation of treatment four days later because of absence of improvement. Following cessation, the patient noted a gradual then a complete resolution approximately one week later. The patient did not have any psychiatric or other medical condition neither drug nor substance abuse that could explain this clinical presentation. The Naranjo's score was used to prove the clomiphene's imputability.

Conclusion: Health care providers should advise patients of the risk of psychological adverse effects when initiating treatment with clomiphene and should provide a close monitoring of mood change, especially during the initial weeks.]]> https://www.benthamscience.comarticle/81723

Objective: This review study focused on the role of long non coding RNAs (lncRNAs) in OS progression, and presented update reports on OS treatment by targeting specific lncRNAs.

Method: We have acquired information on OS and lncRNAs from scientific databases like google scholar, pubmed and scopus, and reviewed for this study.

Results: The lncRNAs regulate a number of biological processes, and abnormal expression of lncRNAs could play role in many cancers and other human diseases. Interestingly, some lncRNAs can act as oncogenes, while some act as tumor suppressor genes. A number of studies revealed that targeting the specific lncRNAs by RNA interferance technology may provide a novel therapeutic strategy in the treatment of OS.

Conclusion: LncRNAs could be a promising biomarker and might be a potential therapeutic target in OS patients.]]> https://www.benthamscience.comarticle/81724

Objective: The major aim of this work is to address fundamental key challenges for the development of versatile technology platform for generating homogenous immunotheranostic reagent.

Method: We conjugated the theranostics reagent IRDye700dx to a recombinant antibody fusion protein containing a self-labeling protein (SNAP-tag) which provides a unique reaction site.

Results: The resulting conjugate was suitable for the imaging of cancer cells expressing the epidermal growth factor receptor and demonstrated potent phototherapeutic and imaging activities against them.

Conclusion: Here, we describe a simple, rapid and robust site-directed labeling method that can be used to generate homogeneous immunoconjugate with defined pharmacological properties.]]> https://www.benthamscience.comarticle/80605