Search Results

Abstract : Colorectal carcinoma (CRC) is the third most commonly diagnosed cancer and the second leading cause of cancer-related mortality worldwide. Despite advancements in screening and therapy, the rising incidence of CRC among younger populations highlights the need for novel prognostic markers. Mast cells (MCs), key components of the tumor microenvironment, may play a crucial role in CRC progression. This retrospective study analyzed 125 patients with histologically confirmed CRC who underwent radical tumor resection with lymph node dissection. Peritumoral stromal mast cell counts (MCCs) were evaluated using CD117 (c-Kit) immunohistochemical staining. Associations between MCCs and clinicopathological parameters—including tumor grade, stage, metastasis, lymphovascular invasion (LVI), and perineural invasion (PNI)—were statistically assessed. High stromal MCCs were significantly associated with higher histological grade, advanced tumor stage, presence of distant metastases, lymph node involvement, LVI, and PNI (p < 0.001). Moreover, increased MCCs correlated with higher mortality rates. No significant association was found between MCC and patient age, sex, or tumor location. Elevated mast cell infiltration in the peritumoral stroma is a significant independent predictor of poor prognosis in CRC. CD117-based immunohistochemical evaluation of stromal MCCs may serve as a useful adjunct for prognostication and individualized treatment planning in CRC management.

Abstract : Indonesia’s national oil company implements a structured Health, Safety, Security, and Environmental (HSSE) management system for sustainability and risk mitigation. However, variations in compliance and effectiveness across operational units necessitate evaluation. This study assesses the HSSE performance framework to identify strengths, challenges, and areas for improvement. This study utilized secondary data obtained from the company’s annual reports. Measurements were conducted based on reported outcomes since the implementation of the company framework. The research follows a cross-sectional study design, as it analyzes data collected at a specific point in time or within a defined period to assess the implementation and performance of the framework. No experimental interventions or variable manipulations were conducted, making this study an observational assessment of the framework’s effectiveness in enhancing HSSE management within the organization. The analysis was conducted using SPSS version 16, applying both descriptive and statistical methods. Findings indicate that major incidents receive thorough investigations, while minor incidents are often overlooked, contributing to cumulative risks. Risk assessment frameworks were applied systematically, yet inconsistencies in severity interpretation were observed. While management reviews were conducted annually, their impact depended on leadership engagement. Compliance with HSSE standards was high, but a compliance-driven approach sometimes hindered proactive safety culture development. Limited cross-departmental collaboration also restricted effective knowledge transfer. The study concludes that while the HSSE framework provides a solid foundation, continuous improvements are needed. Strengthening leadership involvement, standardizing risk assessment interpretations, and fostering a proactive safety culture are crucial for long-term sustainability and safety excellence.

Abstract : Achalasia is a rare esophageal motility disorder characterized by impaired lower esophageal sphincter (LES) relaxation and absence of peristalsis, resulting in dysphagia and reduced quality of life. Laparoscopic Heller myotomy (LHM) is considered the standard surgical treatment, aiming to improve LES function and relieve symptoms. This systematic review evaluates the functional and clinical outcomes of LHM in achalasia patients, focusing on LES pressure, esophageal diameter, and dysphagia scores before and after surgery. A comprehensive literature search was performed in PubMed, Google Scholar, and UpToDate using keywords “Esophagus”, “Achalasia”, “Myotomy”, and “Laparoscopy”. Studies included adult patients who underwent LHM with at least 12 months of follow-up and reported quantitative LES pressure or dysphagia outcomes. Study quality was assessed using the AXIS tool. Five studies including 232 patients (age range 9–78 years; 120 males, 112 females) met inclusion criteria. Postoperative outcomes showed significant reduction in basal LES pressure (mean decrease ~20 mmHg) and improvement in dysphagia (87.9%–97% of patients). Esophageal diameter decreased significantly where measured. Patient satisfaction was high, with 94–98% reporting improvement and willingness to repeat the surgery if needed. No perioperative mortality was reported. Laparoscopic Heller myotomy is a safe and effective treatment for achalasia, significantly improving dysphagia, LES function, and patient quality of life. LES pressure before surgery may predict symptomatic improvement.

Abstract : Myelin-Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD) is a novel autoimmune CNS disorder, previously categorized as a subtype of neuromyelitis optica. Although MOG-IgG antibodies are present in most cases, in some patients the disorder may develop without any detectable antibodies. Diagnosing such seronegative MOGAD is challenging and requires diagnostic vigilance. Accurate differentiation from other CNS autoimmune disorders is crucial for introducing effective treatment and improving patients’ long-term outcomes. A literature review was conducted using PubMed, Scopus, Web of Science, and ScienceDirect databases. Keywords included: Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease, Autoimmune Demyelinating Diseases, CNS Autoimmune Demyelinating Disorders, Neuromyelitis Optica, and Autoimmune Encephalitis. A total of 35 articles were selected based on relevance and quality of evidence regarding seronegative MOGAD. Patients with seronegative MOGAD often exhibit classical clinical phenotypes, such as optic neuritis, transverse myelitis, or acute disseminated encephalomyelitis, but lack detectable MOG antibodies in serum. Diagnostic reliance on cerebrospinal fluid analysis and imaging is critical for these cases. Advanced diagnostic techniques, including live cell-based assays and biomarker studies, improve sensitivity and specificity. Seronegative cases frequently present with monophasic disease courses and demonstrate variable responses to immunotherapy. High-dose corticosteroids and plasma exchange remain the cornerstone of acute management, while maintenance therapies such as rituximab and mycophenolate mofetil are employed in recurrent cases. Seronegative MOGAD requires a multifaceted diagnostic approach incorporating serological, imaging, and cerebrospinal fluid analyses. Continued research into antibody-independent mechanisms and biomarkers is essential for optimizing diagnosis and treatment.

Abstract : Cardiovascular disease (CVD) remains the world’s primary cause of premature mortality and economic burden. Exercise-based cardiac rehabilitation is a cornerstone for secondary prevention, however, the relative value of high-intensity interval training (HIIT) versus moderate-intensity continuous training (MICT) continues to be debated. This overview summarizes current physiological and clinical evidence to guide optimal exercise prescriptions in CVD. A comprehensive literature review of PubMed, Scopus, Web of Science and ScienceDirect databases was conducted utilising keywords and terms: Cardiac Rehabilitation, High-Intensity Interval Training, Moderate-Intensity Continuous Training, Coronary Artery Disease, Heart Failure and Telerehabilitation. After eligibility screening, 62 peer-reviewed articles- randomised trials, narrative reviews, meta-analyses and large cohort studies were included and narratively analysed with emphasis on physiological mechanisms, safety and clinical outcomes. Across multiple CVD populations, HIIT consistently produced larger short-term gains in peak oxygen uptake, greater improvements in endothelial function and autonomic balance, and comparable reductions in blood pressure and atherogenic lipids. MICT remained preferable for patients with low exercise tolerance or early post-myocardial-infarction. Adverse-event rates were low in both regimens. Hybrid and telerehabilitation programmes enhanced adherence without compromising safety or rehabilitation efficacy. Both HIIT and MICT are effective, safe strategies in modern cardiac rehabilitation. HIIT offers superior cardiorespiratory and vascular benefits within shorter sessions, whereas MICT provides a lower-strain alternative for high-risk or deconditioned patients. Personalised, stage-specific combinations, augmented by telerehabilitation techniques may maximise long-term participation and clinical outcomes.