Giant Cell Tumour (GCT) of bone is a benign, locally aggressive neoplasm. GCT of the foot is rare, comprising of about 5% of cases of all GCTs. GCT of Calcaneus is exceedingly rare, comprising of 1.2% of all calcaneal tumours. Due to its uncommon occurrence at this site, diagnosis can be delayed. In this report, we present the case of a Campanacci Grade 3 GCT of calcaneus in a 43-year-old female patient with 8 months history of worsening pain and disability. We treated her successfully by resection of Oscalcis and reconstruction with a femoral head allograft and K-wire fixation, a relatively cheaper and technically lesser challenging method of reconstruction. Three years’ postsurgery, she remains disease free, and her graft has healed. She continues to walk independently and remains disease free clinically and radiologically. We discuss a comparison with other reported cases where surgeons have opted for detailed intra-lesional curettage (DILC) and cementoplasty to fill the defect for a Grade 2 disease, some have even used a sural for soft tissue coverage with a maximum follow-up of two years. While in our patient we went for Calcanues resection and reconstruction with allograft because of a Grade 3 disease that poses greater risk of local recurrence with just DILC. Our patient has a three-year follow-up where she remains disease free

Despite publishing and securing research grants being obligatory in research universities, the literature on the factors influencing academic productivity is relatively scarce. Thus, in this study, we aimed to determine the personal and behavioural-related factors that influence the culture of publishing and securing research grants among academicians with lower research-related performance. This cross-sectional study was conducted among 49 academic staff members of Universiti Kebangsaan Malaysia (UKM). A self-administered questionnaire consisting of personal, attitude and behavioural (barriers, perceived stress scale, work extrinsic and intrinsic motivation scale, psychological well-being scale, and basic needs satisfaction scale) questions were distributed during a workshop and online. Simple linear regression (SLR) analyses were performed for each variable, followed by multiple linear regression (MLR) to identify the associated factors of research output. After adjusting for covariates, having a doctoral degree (β=0.396, 95% CI=0.221-2.146, p<0.05) and integrated regulation (β=0.574, 95% CI=0.036-3.612, p<0.05) were found to be associated with research grant acquisition (R2=0.273). Moreover, increasing age (β=0.426, 95% CI=0.088-0.397, p<0.05), living alone (β=0.331, 95% CI=0.944-6.626, p<0.05), having a doctoral degree (β=0.248, 95% CI=0.174-6.747, p<0.05), environmental mastery (β=0.318, 95% CI=0.013-0.347, p<0.05), self-acceptance (β=0.284, 95% CI=0.010-0.242, p<0.05), satisfaction incompetence (β=0.273, 95% CI=0.001-0.200, p<0.05) and relatedness (β=0.280, 95% CI=0.001-0.116, p<0.05) were found to be the factors that influence the publications produced among participants (R2 =0.423). The findings of this study could be used by management to formulate effective strategies to increase the productivity of academics in their research-related performance.

BACKGROUND AND OBJECTIVE

Nutritional anemia has become a national public health problem, particularly among female workers, who are a high-risk group. Dates can be formulated into functional food to treat anemia in this group. This study aimed to examine the effectiveness of date biscuits formulated with 10% (A1) and 20% (A2) substitutes in treating anemia among female workers in Makassar, Indonesia.

Experimental research design using a Randomized Controlled Trial (RCT) with a pre-test post-test randomized group was used. The population of this study were female workers in Makassar City, with a total sample of 61 participants. The study randomly divided the sample into three groups: the intervention group that received formula A1 date biscuits (10%), the intervention group that received formula A2 date biscuits (20%), and the control group that did not receive any intervention. The researchers administered 20 grams of biscuits for 60 days. Hemoglobin levels were measured twice, at baseline and after the intervention. The study further performed a bivariate test by comparing the hemoglobin examination results before and after the intervention using the paired t-test, and analyzed differences between groups using the ANOVA test. The significance value was set at pRESULTS

The results showed that A1 date biscuits reduced the case of anemia by 23.8%, from 38.1% to 14.3%. Meanwhile, provision of A2 date biscuits reduced the case of anemia by 13.7%, from 36.4% to 22.7%.

The provision of A1 date biscuits is more effective than A2 for women with anemia. Date biscuits should be specifically provided to workers or women with anemia as they are less effective for those with normal hemoglobin levels. To further increase hemoglobin levels, female workers should also be given additional nutrient- rich foods

Diabetes mellitus (DM) is a metabolic condition marked by disrupted insulin regulation. Mesenchymal stem cellderived exosomes and conditioned medium (CM) have emerged as promising therapeutic candidates for DM. This research explored the medical benefits of exosomes and CM in treating streptozotocin-induced type 1 DM (T1DM) in rats, comparing their efficacy to bone marrow-derived mesenchymal stem cells (BM-MSCs). Fifty albino rats were grouped into five groups (n=10 each): healthy controls, untreated T1DM rats, T1DM rats treated with intravenous BM-MSCs, T1DM rats treated with intravenous exosomes, and T1DM rats treated with intravenous CM. Plasma glucose and insulin concentrations were monitored weekly. Pancreatic β-cell regeneration was analyzed via qRT-PCR, focusing on the expression levels of TGF-β, Smad3, Ngn3, Pdx1, MafA, and insulin genes. Histological evaluation of pancreatic tissue regeneration was performed at weeks 2 and 4 using hematoxylin & eosin and Masson’s trichrome stains. The exosomes- and CM-treated groups demonstrated significantly higher expression of β-cell regeneration markers (TGF-β, Smad3, Ngn3, Pdx1, MafA, and insulin) than the BM-MSCs group. Additionally, these groups demonstrated a marked rise in the area percentage of pancreatic islets and a significant reduction in pancreatic fibrosis, with more pronounced effects at week 4. Exosomes and CM exhibit superior therapeutic efficiency and regenerative potential over BM-MSCs in T1DM, suggesting their promise as cell-free alternatives for diabetes treatment.

Thioacetamide (TAA)-induced liver fibrosis, triggered by inflammation and oxidative stress, is prompted by hepatic stellate cells (HSCs) activation via several pathways. This study explores the hepatoprotective effect of aloe vera gel (AVG) extract and bone marrow mesenchymal stem cells (BM-MSCs) transplantation on regulating long intergenic noncoding RNA (lincRNA-p21) and microRNA (miR-17-5p) expressions and their impact on TGF-β1/Smad-3 and Wnt-10a/ β-Catenin cascades in TAA-induced liver damage. The study involved 48 adult male albino rats divided into four groups:control, TAA, TAA treated with BM-MSCs, and TAA treated with BM-MSCs+AVG extract. After 8 weeks, liver enzymes and hepatic oxidative parameters were evaluated alongside lincRNA-p21, miR-17-5p, TGF-β1, Smad-3, Wnt-10a, and β-Catenin expressions. Liver tissue sections were examined by light and electron microscopes and analyzed morphometrically. Group II showed increased aspartate aminotransferase, alanine aminotransferase, malondialdehyde, reduced glutathione levels, and deteriorated hepatocytes with distorted mitochondria and dilated rough endoplasmic reticulum. Group IV restored lincRNA-p21 expression, which downregulated miR-17-5p and suppressed activated HSCs by inhibiting TGF-β1/Smad-3 and Wnt-10a/β-Catenin pathways, and improved hepatic tissue architecture. Additionally, immunohistochemically, alpha-smooth muscle actin and cyclin D1 expressions were markedly decreased in group IV compared to group II. We concluded that AVG suppresses fibrotic pathways, boosts BM-MSCs differentiation, and reduces HSCs activation in liver fibrosis caused by TAA.

Background: s/Aims: Subtotal cholecystectomy is a salvage procedure when critical safety margins cannot be achieved in difficult cases. This study evaluated the impact of surgical approach and technique on short- and long-term outcomes. Methods: A retrospective review of 101 patients who underwent subtotal cholecystectomy between January 2010 and November 2024 was conducted. Patients were grouped by approach: laparoscopic (n = 42), open (n = 31), and conversion (n = 28). Techniques were classified as fenestrating or reconstituting. Complications were assessed using the Clavien-Dindo classification. Logistic regression identified risk factors, and Cox regression evaluated long-term outcomes. Intention-to-treat analysis was performed. Results: The mean follow-up was 6.7 years. Morbidity was lower in the laparoscopic group (9.5%) than in the open group (45.2%) (p < 0.001). However, after adjustment for age, American Society of Anesthesiologists score, and emergency status, surgical approach was not an independent risk factor (adjusted odds ratio 1.54, p = 0.214). No significant differences were observed between fenestrating and reconstituting techniques. Five-year complication-free survival was 92.9% in the laparoscopic group and 74.2% in the open group (p = 0.018). No stone recurrence was observed. Conclusions Subtotal cholecystectomy is a safe option in complex cases. Outcome differences are likely related to patient selection rather than technique. Technique selection should be based on intraoperative findings.

Purpose: Individuals who exercise commonly consume commercial beverages for rehydration and performance maintenance. Nevertheless, differences in carbohydrate and sodium content can influence hydration efficacy. This study aims to compare the effects of demineralized water (DW), sweetened tea (ST), and electrolyte-containing beverage (EB) on rehydration after exercise-induced dehydration. Methods: A three-way, randomized, crossover design was applied in nine healthy male participants (age, 24.9 ± 1.8 years; body mass index, 21.1 ± 0.9 kg/m 2 ). Participants performed cycling exercise in a hot environment to induce approximately 2% body mass loss during the dehydration stage. During the rehydration stage, participants consumed DW, ST, or EB in volumes equivalent to body mass loss under temperature-controlled conditions. ST contained 7.8% carbohydrate and 1.59 mEq/L sodium; EB contained 3.8% carbohydrate and 23.73 mEq/L sodium, while DW contained neither. Hydration status was assessed using body mass, blood, and urine parameters. Results: Participants lost 2% of body mass within 84.4 ± 8.5 minutes. During the rehydration stage, plasma volume increased earlier in the EB group, with a significant increase observed at 60 minutes (5.4 ± 5.0%, p < 0.05). Blood sodium levels in the DW group were significantly lower than those in the ST and EB groups at 60 minutes and remained lower than in the EB group until 180 minutes (p < 0.05). The EB group exhibited a higher median fluid retention (86.6 [66.5; 91.0]) than the DW group (84.3 [65.5; 89.7]) and ST group (83.8 [75.7; 87.9]), but these differences were not significant. Conclusion The EB group showed earlier plasma volume recovery than the DW and ST groups, and maintained higher blood sodium levels than the DW group. These findings suggest a supportive role of EB in early post-exercise rehydration and electrolyte balance.Future studies should investigate the effects of increased fluid volumes and prolonged rehydration durations.

Purpose: This study aims to determine the mediating role of trust in the physician in the effect of the physician’s open communication on patients’ adherence to treatment. Methods: This cross-sectional study included 594 patients who applied to a public hospital in Turkey for healthcare services. Participants completed scales for physicians’ open communication, trust in physicians, and treatment adherence. Data were analyzed using descriptive statistics, Pearson correlation, and structural equation modeling. SPSS and AMOS programs were used to analyze the research data. Results: Open communication of physicians was significantly associated with trust in physicians (r=0.752, p<0.01) and treatment adherence (r=0.612, p<0.01). Trust in physicians and treatment adherence were also significantly associated (r=0.671, p<0.01). Structural Equation Model and bootstrap analysis showed that trust in physicians fully mediated the relationship between open communication and treatment adherence (β=0.529; 95% confidence interval, 0.390–0.712). Conclusion This study found that open communication and trust increased patient adherence to treatment and confirmed that trust fully mediated adherence to treatment. Physicians’ open communication with patients increases patients’ trust in their physicians, thereby improving their treatment adherence. These findings demonstrate the importance of both physicians and medical students gaining competence beyond their technical competence to communicate effectively and build trust. In medical education, students should be given importance in acquiring behavioral skills.

Purpose: To evaluate systemic oxidative stress by comparing serum 8-hydroxy-2′-deoxyguanosine (8-OHdG), coenzyme Q10 (CoQ10), malondialdehyde (MDA), and 25-hydroxyvitamin D (25(OH)D) levels between primary open-angle glaucoma (POAG) patients and healthy controls. Methods: This prospective case-control study included 37 POAG patients and 35 age-matched controls. Serum levels were measured via enzyme-linked immunosorbent assay. Nonparametric tests (Mann-Whitney U-test and Spearman correlations) and multivariate linear regression adjusting for age and sex were used. Results: POAG patients showed significantly higher MDA (3.01 vs. 2.46 nmol/mL, p = 0.021) and 8-OHdG (9.34 vs. 6.52 ng/mL, p < 0.001), but lower CoQ10 (7.28 vs. 8.98 ng/mL, p < 0.001) and 25(OH)D (15.02 vs. 17.45 ng/mL, p = 0.013). MDA and 8-OHdG showed a strong positive correlation (rho = 0.855, p < 0.001). CoQ10 and 8-OHdG showed a moderate positive correlation (rho = 0.466, p = 0.004). No significant correlation was found between 25(OH)D and 8-OHdG (rho = –0.118, p = 0.488). After adjusting for age and sex, POAG remained independently associated with lower CoQ10 (p < 0.001). No oxidative marker correlated with intraocular pressure, visual field mean deviation, or retinal nerve fiber layer thickness in POAG patients (all p > 0.05). Conclusions POAG patients exhibit systemic oxidative imbalance with elevated oxidative damage and reduced antioxidant capacity. The positive CoQ10–8-OHdG correlation may suggest a compensatory relationship. This imbalance is associated with POAG but does not correlate with clinical severity cross-sectionally, suggesting it reflects a systemic disease component rather than a direct severity marker.