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Background and aim: Congestive heart failure is a prevalent and serious condition that poses significant challenges in the emergency department setting. Prompt and accurate management of congestive heart failure patients is crucial for improving outcomes and optimizing resource utilization. This study aims to address these challenges by developing a machine learning algorithm and comparing it to a traditional logistic regression model that can assist in the triage, resource allocation, and long-term prognostication of congestive heart failure patients.Methods: In this investigation, we used the MIMIC-III database, a publicly accessible resource containing patient data from ICU settings. Traditional logistic regression, along with the robust XGBoost and random forest algorithms, was harnessed to construct predictive models. These models were built using a range of pretreatment clinical variables. To pinpoint the most pertinent features, we carried out a univariate analysis. Ensuring robust performance and broad applicability, we adopted a nested cross-validation approach. This method enhances the precision and validation of our models by implementing multiple cross-validation iterations.Results: The performance of machine learning algorithms was assessed using the area under the receiver operating characteristic curve (AUC). Notably, the random forest algorithm, despite having lower performance among the machine learning models still demonstrated significantly higher AUC than traditional logistic regression. The AUC for the XGBoost was 0.99, random forest 0.98, while traditional logistic regression was 0.57. The most important pretreatment variables associated with congestive heart failure include total bilirubin, creatine kinase, international normalized ratio (INR), sodium, age, creatinine, potassium, gender, alkaline phosphatase, and platelets.Conclusion: Machine learning techniques utilizing multiple pretreatment clinical variables outperform traditional logistic regression in aiding the triage, resource allocation, and long-term prognostication of congestive heart failure patients in the intensive care unit setting using MIMIC III data.

Background: CPTs are rare intraventricular papillary neoplasms derived from the choroid plexus epithelium. Anti-collagenase and extracellular matrix which have not been expressed in brain tumors. Objective: The purpose of this study was to investigate the expression levels of collagen type VI, anti-collagenase, laminin, MM9, claudins 1 and 5, N and E cadherins, and collagen VII, tejido, and collagen degradation enzyme complexes in choroid plexus tumors.Materials and methods: We studied the expression of adhesion molecules, extracellular matrix, and anticollagenase with an immunohistochemistry approach and electron microscopy analysis in 42 choroid plexus tumors. Results: 28(67%) were choroid plexus papillomas, 8 (19%) were atypical choroid plexus papillomas and 6 (14%) were choroid plexus carcinomas. The Ki67-li and MVD increased from CPC to ACPP, being the highest in malignant tumors as well as a strong immunoexpression of anti-collagenase and were inverse correlation with claudin 5, E, and N cadherin and collagen IV immunoexpressions which added further significant information to the prognosis and varied according to the histologic classification. By ultrastructure, the loss of basal membrane and cilia, disorganization, and proliferation of ECM were observed in CPC. Cerebral homeostasis largely results from the ability of both the Blood–Brain Barrier (BBB) at the brain microvascular endothelium and the Blood–Cerebrospinal Fluid Barrier (BCSFB) at the epithelium of the Choroid Plexuses (CPs), to control the composition of the CSF and cerebral extracellular fluid. Under expression of the tight junction proteins occludin, claudin-1 and claudin-5 are key molecular abnormalities responsible for the increased permeability of tumor endothelial tight junctions. Conclusion: The loss of basement membrane and ECM overexpression could be considered as a poor prognosis predictor in CPT. Anti-collagenase and MMP9 overexpression could be related to basal membrane and BBB plasticity in CPTs.

Tuva has been a cattle-breeding region since ancient times, extremely continental climate of this region is little suitable for agriculture. However, the steppes of intermountain depressions in Tuva were heavily plowed by the early 1980s. In the 1990s most of the arable lands were abandoned; the process of restoration (demutation) of natural vegetation on fallow lands began. By now, 30 years later, the old fallows are expected to achieve the stage of the secondary steppe.The purpose of this work is to estimate the differences between virgin steppes and corresponding secondary steppes in Tuva. Tussock, hummock, and desert virgin steppes have been compared with corresponding to three types of 30-year-old fallow communities. For this study, 330 geobotanical releves have been used. The criteria for comparison have been chosen as follows: the similarity of species composition, the spectrum of dominant species, species richness, grass cover, and grass height. The statistical validity of their differences has been verified. According to these criteria, virgin steppes and their 30-year-old fallow derivatives are shown to differ significantly.

A Gamma Ionization Chamber was developed for the purpose of high gamma radiation detection during accident conditions in a Light Water reactor. The pre-eminence of the detector is that it was designed and developed to monitor gamma exposure rates in the wide range of 100 mR/hr to 107 R/hr. The detector has an overall diameter of 90 mm with a length of 400 mm. The response of the detector is accurate and the sensitivity is within ± 6% over gamma energies ranging from 660 KeV to 1.25 MeV. The detector operates with a DC voltage of 500V. The V0.9 voltage is about 250V for 107 R/hr. The estimated operation life of the detector is about 20 years. 

The Masquelet technique has become increasingly popular in reconstruction scenarios such as osteomyelitis, cancer, and nonunions. The procedure is a two-staged approach: first, a polymethylmethacrylate (PMMA) cement spacer is inserted to fill a bone void. The spacer induces a membrane to form around it, and 6-9 weeks later, the second stage involves carefully extracting the spacer and filling the membrane with bone graft. Most of the current literature has published either femoral or tibial involvement for Masquelet studies, with limited published data on foot reconstruction. Here, the authors used the procedure for the fourth metatarsal. Despite complications, this case proves a more excellent utility and warrants further investigation into Masquelet techniques in the foot.

Catheter-Related Bloodstream Infections (CRBSIs) are severe healthcare-associated complication that occurs when bacteria enter the bloodstream through a catheter. The risk of CRBSIs is influenced by various factors. Prolonged catheter placement increases the risk, as each day increases the potential for bacterial colonization and bloodstream infection. Proper aseptic technique and a sterile environment during catheter insertion are essential to minimize infection risk. Stringent infection control measures during insertion, including sterile gloves, thorough hand hygiene, and appropriate skin disinfection, are crucial. Inadequate catheter site care and suboptimal catheter management can contribute to CRBSIs. Regular cleaning, disinfection, and dressing changes are necessary to reduce the risk of infection. The type of catheter used also affects infection risk. Central Venous Catheters (CVCs) and arterial catheters, especially those inserted into the jugular or subclavian vein, carry a higher risk of CRBSIs compared to peripheral venous catheters. Individuals with compromised immune systems, such as chemotherapy patients, organ transplant recipients, and those with HIV/AIDS, are more susceptible to CRBSIs. Patients with existing infections, like pneumonia or urinary tract infections, are at a heightened risk of acquiring CRBSIs due to potential cross-contamination. Healthcare professionals who fail to practice thorough hand hygiene before and after catheter-related procedures can introduce pathogens into the bloodstream. Leaving catheters in place when no longer necessary or using them unnecessarily elevates the risk of infection. To prevent CRBSIs, strict infection control protocols, including effective hand hygiene, sterile catheter insertion techniques, routine site care, and prompt catheter removal when no longer needed, are imperative. Healthcare facilities often implement specific protocols to mitigate CRBSI risk and enhance patient safety.

Kidney transplantation is the therapy of choice for patients with end-stage kidney disease (ESKD). Nevertheless, the main limitation for long-term graft survival is immune-mediated rejection. Some authors have proposed that differences in immune effector mechanisms are influenced by underlying molecular mechanisms; thereby, the identification of differentially expressed genes in acute or chronic rejection in non-invasive samples such as urine may be essential for the identification of potential biomarkers and biological processes associated with allograft outcomes. Our aim was to explore differences in gene expression and functional categories associated with acute and chronic kidney rejection in blood, biopsy, and urine of kidney transplant patients using RNA-Seq. RNA was isolated and sequenced implementing standard protocols. Analyses were addressed to identify differentially expressed genes (DEGs) and Functional Categories of Gene Ontology comparing between samples. Then we focused on immune genes and pathways to identify their association with the allograft. We identified a significant transcriptional similarity between biopsy and urine, in comparison with blood in acute and chronic rejection. Functional analyses suggested an enrichment of immune processes such as antigen processing and presentation, and regulation of B cell receptor signaling pathway in blood of acute and chronic rejection, respectively. Additionally, we observed an increase in expression of chemokines in biopsy and urine of both outcomes along with an increase in chemokine receptors in blood. Our findings suggest that urine is suitable for identifying potential biomarkers and biological processes related to renal allograft rejection, as it shares a significant number of regulated genes with biopsy.

Background information: Cultural practices play an important role on the development of pathogens (Datnoff, et al. 2007). In this context, several authors have been interested in studying the effects of mineral nutrition on the resistance of vegetables and fruits to fungi during storage, especially nitrogen.The purpose of the study: In this work we tested the effects of three contrasted regimes of nitrogen supply, with nitrate concentrations in the nutrient solutions of 2 mM (low), 10 mM (normal) and 20 mM (high) on the susceptibility of Lactuca sativa L towards Botrytis cinerea (BC87) and Sclerotinia minor (SM) during storage.Once harvested, the outerleaves of the plants derived from the three nitrogen regimes were inoculated with either Botrytis cinerea (BC87) or Sclerotinia minor (SM). Data showed that the resistance to this two pathogens increase when plants were developed under low nitrogen concentration. This resistance observed is correlated with low values in oxidative stress indicators (MDA and H2O2) and high values in total phenols.

It has been reported that Japanese people sleep for an average of 7 hours and 22 minutes per night, with those in their 40s and 50s sleeping the least. This is much less than in other developed countries. Aging has also been reported to decrease the total sleep time and sleep latency as well as increase wake after sleep onset (WASO). Crocetin is a carotenoid with antioxidant activity. It has been reported that 14 consecutive days of crocetin intake increases delta power during sleep and decreases WASO. However, the benefits of short-term ingestion have not been clarified. In this double-blind, randomized crossover study, we examined the effects of crocetin-containing edible films consumed for seven consecutive days on the sleep quality of healthy Japanese subjects working in management positions who were aged 45 years or older.The study participants comprised 20 subjects (12 males and 8 females; mean age 50.4 ± 4.8 years; body mass index (BMI) 22.5 ± 2.7). An electroencephalography (EEG) measuring device (InSomnograf®) was used to measure sleep objectively and a questionnaire, OSA Sleep Questionnaire MA version (OSA-MA) was used to assess sleep subjectively upon waking. The crocetin group demonstrated significantly higher values of OSA-MA Factor 3 (frequent dreaming) than the placebo group (placebo: 46.8 ± 6.9; crocetin: 49.5 ± 7.4). No differences were observed for the other four factors. No differences were observed in the sleep parameters determined with InSomnograf®.Our findings suggest a new effect of crocetin on sleep quality of frequent dreaming.

Background: Maternal near-miss (MNM) events occur more frequently than maternal deaths; therefore, more detailed and comprehensive studies on maternal morbidity have been conducted and are of value to clinical audits and practices. Purpose: This study aimed to determine the frequency of maternal near misses and the nature of near-missevents. Methodology: This descriptive, retrospective, cross-sectional study over 12 months duration was conducted at the Alobied Teaching Hospital in 2018. Data were collected from patient notes, partographs, and other relevant documents. Demographic and clinical data concerning personal history, obstetric history, and near-miss events. Results: A total of 15202 women were admitted, 339 cases of maternal near misses, maternal near-missrate (MNMR) of 22.3|1000 live births, 200(59%) had an infection, 80(23.6%) hemorrhage, 20(5.9%) severe pre-eclampsia,12(3.5%) eclampsia, 20(5.9%) anemia, convulsions 5 (1.5%) 17(5%) of the cases were admitted to intensive care unit (ICU), 9(2.7%) had liver dysfunction, 9(2.7%) coagulation dysfunction, 8(2.4%) renal dysfunction, 5(1.5%) cerebral problems, 4(1.2%) cardiac dysfunction, and 2(0.6%) had developed respiratory dysfunction.Conclusion: The maternal near-miss rate was 22.3|1000 live births. Most near-miss cases occurred before the women arrived at the hospital. The major causes of maternal near misses were infection, hemorrhage anemia, pre-eclampsia, and eclampsia.

This review explores the evolving landscape of psoriasis treatment with a focus on the transformative impact of biologic drugs. Psoriasis, a prevalent and persistent skin condition characterized by red and scaly patches, historically relied on topical, phototherapeutic, and systemic treatments, each with limitations. The advent of biologics represents a significant advancement, offering targeted interventions by addressing specific immunologic mechanisms underlying the disease. Biologics are now considered the preferred systemic therapy for chronic moderate-to-severe plaque psoriasis, particularly when conventional treatments prove ineffective or present disadvantages.The review delineates the mechanisms of action for biologics targeting tumour necrosis factor-alpha (TNF-α), interleukin-17 (IL-17) and interleukin-23 (IL-23). Specific drugs under each category, including etanercept, infliximab, adalimumab, secukinumab, ustekinumab, and others, are detailed with recommended dosages. Biologics have demonstrated substantial effectiveness, with clinical trials and real-world studies showcasing significant improvements in disease severity and patient’s quality of life. Notably, these drugs exhibit rapid action, often yielding noticeable changes within weeks.While biologics have revolutionized psoriasis treatment, the review emphasizes the importance of judicious use due to potential side effects such as injection-site reactions and respiratory infections. Serious adverse events, including infections and autoimmune reactions, necessitate careful patient selection and monitoring for safety. In conclusion, biologics offer a precise and effective approach to psoriasis treatment, promising marked symptom improvement and enhanced quality of life. The review underscores the need for responsible utilization, considering patient-specific factors, and anticipates ongoing advancements in biologics for improved control over this chronic dermatitis.

The determination of a protein structure by using X-ray diffraction encompasses a series of sequential steps (including gene identification and cloning, protein expression and purification, crystallization, phasing model building, refinement, and validation), which need the application of several methodologies derived from molecular biology, bioinformatics, and physical sciences. This article thoroughly examines the complicated procedure of elucidating protein structures within plant biology, using X-ray diffraction as the primary methodology. Commencing with the gene identification process and progressing toward crystallography, this article explores the many obstacles and achievements in acquiring diffraction pictures and their subsequent conversion into electron density maps. The ensuing phases of model construction, refinement, and structural validation are thoroughly examined, providing insight into the inherent complexity associated with each stage. The paper also discusses the critical component of understanding the resultant model and scrutinizing its biological significance. By comprehensively examining these stages, this article presents a nuanced comprehension of the intricate procedure in ascertaining protein structures within plant biology. It offers valuable insights into the obstacles encountered and the biological importance of the acquired structural data.

The intricate interplay between viral infections and cardiovascular complications has garnered significant attention from 2018 to 2023. Extensive research during this period has unveiled substantial connections between various viruses and cardiovascular diseases. Notable examples include Cytomegalovirus (CMV), coxsackievirus, influenza, Human Immunodeficiency Virus (HIV), Epstein-Barr Virus (EBV), Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), as well as coxsackievirus A and B, enteroviruses, adenovirus, and parvovirus B19. These viruses exert diverse influences on cardiovascular health through various pathways, contributing to endothelial dysfunction, inflicting direct damage on cardiac tissue, and triggering inflammatory responses. The intricate interplay between viral infections and cardiovascular health underscores the importance of considering viral pathogens within the framework of cardiovascular disease development, clinical management practices, and future research initiatives. This systematic review comprehensively scrutinizes the cardiovascular impacts stemming from various viral infections, casting a revealing light on their underlying mechanisms and associated clinical implications. These valuable insights can guide clinical management strategies, preventive measures and further investigations into the complex connection between viral infections and cardiovascular diseases, emphasizing the necessity for ongoing research and vigilance in comprehending and managing these pathogen-induced cardiac manifestations.

In order to integrate and enhance the health of people, animals, and the environment, a multidisciplinary “One Health” concept has been coined. However, developing countries have frequently lagged in embracing this innovative vision. Pakistan’s ecology, human health, and animal health have all been severely jeopardized due to a lack of resources. Human health is significantly impacted by the spread and comeback of zoonotic illnesses, especially for people who live in rural regions and frequently interact with domestic or wild animals. More than 75% of zoonotic diseases were transmitted contiguously from animals to humans or indirectly through interactions among agents or vectors (including both humans and other animals). This review article gives critical insights into the most common zoonotic diseases found in Pakistan in addition to underlining the importance of the “One Health” philosophy in the management of these illnesses. Interdisciplinary research efforts are required given the current circumstances in order to politicize sustainable solutions for decreasing the disease burden in human and animal populations simultaneously.

Background: Miscarriage is a common gynecological problem and early pregnancy loss occurs in the first trimester. Early pregnancy miscarriage is managed expectantly, surgically, and medically. Medical management is a new treatment option, also surgical evacuation is the standard treatment for some types and presentations of miscarriage. Medical management might be more suitable instead of surgical evacuation, it may be less costly than surgical treatment and consequently, due to its lower complications, most patients prefer it.Purpose: This study aimed to determine women's perception of medical treatment versus surgical intervention, complications associated with surgical procedures, and medical treatment.Methodology: It was a comparative, hospital-based study conducted in Bashair Teaching Hospital, on 336 patients diagnosed with miscarriage in the first trimester, 168(group A) were treated medically while 168(group B) were treated surgically. All participating patients in the study fulfilled the selection criteria, that is, the provision of an informed consent and agreement to participate in the study. Results: The total number of women during the period of study was 336. The study found that 239(71%) of women prefer medical management compared to 97 (29%) preferring surgery. The complications associated with the medical treatment were (4.2%) infection, (0.6%) bleeding, and (95.2%) without obvious complications. The complications associated with surgical procedures were (7.7%) developmental infection, (16.1%) bleeding, (10.7%) incomplete evacuation, (1.8%) uterine perforation, and (63.7%) without obvious complications.Conclusion: The study found that over two-thirds of patients Favor medical treatment over surgical procedures. It has also revealed that medical treatment is very effective in terminating pregnancies within the first trimester.

Aim: Kidney stone disease, which can affect people of all ages and whose incidence increases day by day, is becoming a public health problem due to treatment costs. This study aims to determine how factors related to kidney stones affect the diagnosis of the disease when taken together, rather than determining their relationship with the disease one by one.Materials and methods: An open-access dataset containing kidney stone status and associated factors was used in the study. Mann Whitney U test and independent sample t-test were used in data analysis. Logistic regression was performed with the backward variable selection method to determine the factors associated with kidney stones. ROC analysis was used to determine the power of the variables that were significant as a result of logistic regression analysis, individually and together, in discriminating kidney stones.Results: According to the results of logistic regression analysis, gravity, cond, and urea calc variables were found to be associated with kidney stones. With ROC analysis, it can be said that urea, calc, and gravity variables with AUC values above 0.60 can distinguish kidney stones. When the combinations of these variables are examined, the AUC values of the binary combinations are between 0.734 and 0.759, while the AUC value obtained for the triple combination is 0.831.Conclusion: According to the results obtained from the article, it can be said that while the factors associated with the disease and used in the diagnosis have little effect on the diagnosis of the disease alone based on the AUC values obtained from the ROC analysis, it can be said that considering them together increases the accuracy in diagnosis. Therefore, considering the factors thought to be associated with the disease together may be more appropriate in diagnosis and may give more accurate results.

Naturalistic enclosures have become a popular exhibition technique for zoos, and reptiles and amphibians are regularly housed in these exhibits. While a considerable sum of research indicates that visitors prefer naturalistic exhibits, there are fewer studies documenting the behaviour and welfare of animals housed under these conditions. This study investigated the impact of a naturalistic enclosure on the behaviour of the turquoise dwarf gecko (Lygodactylus williamsi), and the welfare perceptions of visitors. When kept under naturalistic enclosures, dwarf geckos were seen to bask (p = 0.022), and engage in inactive behaviours (p = 0.001) significantly less frequently. A non-significant decrease was also seen in locomotion | (p = 0.074). While time spent hidden remains a confounding factor for behavioural analysis, the study indicates that when provided with hiding opportunities, L. williamsi may spend a considerable amount of time hidden from the public. Questionnaire analysis revealed that 84.6% of individuals believed that naturalistic enclosures demonstrated better welfare. Additionally, individuals who had previously owned a reptile were more likely to identify that areas to hide, enrich, and mimic the natural environment were important aspects of enclosure design. While the actual benefits of naturalistic enclosure design cannot be fully addressed by this study, this work suggests that visitors tend to inherently believe that naturalistic enclosures facilitate better welfare, even if they are not aware of the natural environment of the species being housed. This requires keepers to consider both aspects of functionality and enclosure relevance when designing exhibits for herptiles.

Introduction: Adolescents and young adults often engage in oral sex. However, the factors affecting the development of agreeing with oral sex are not clear enough.Objective: We aimed to assess the degree of agreement with oral sex among high school students and to search for background factors affecting this.Material and method: We conducted a quantitative cross-sectional study among 157 females and 38 male high school students over the age of eighteen by using an anonymous, paper-based, multiple-choice, self-administered questionnaire. For statistical analysis, we used descriptive statistics, two-sample t-tests, and Spearman rank correlation. Results: Of the respondents 67.9% were sexually active and 31.6% of them had more than one sexual partner. Of males 97.1% and of females 84.9% agreed with accepting oral sex. Degree of agreement with oral sex was higher in those who had had partnered sexual experience, and in those females who more frequently met close friends outside of school. Most participants were not in a current relationship with a partner, and for those who were, its duration did not affect the degree of accepting oral sex. The degree of agreement with the proficiency in male sexuality, and the degree of agreement with those dimensions of sexuality that most expressed the sexual drive and the desire to gratify it with the partner showed the strongest positive correlation with the degree of agreement with oral sex. In addition, the degree of agreement with the items of expressing sexual openness showed correlations with the degree of accepting oral sex. Conclusion: The degree of agreement with oral sex is high among high school students. Among the factors influencing this, the intensity of meeting friends seems to be important. We therefore recommend that the schools improve sex education in groups, highlighting the risks of oral sex, to reach the target individuals and their friends as well as their potential partners.

Background: Faba bean (Vicia faba L.) is one of the most important grain legume crops in Egypt and many other countries of the world because the seeds offer a low-cost source of protein, lysine, carbohydrates, minerals, and vitamins. Chocolate spot disease is a stress-related fungal disease produced by Botrytis fabae that causes plant damage, limits photosynthetic activity, and reduces yield. Results: Trichoderma atroviride greatly reduced mycelial growth by 90.00% in vitro, followed by T. harzianum (86.67%) and T. album (83.89%) on average. In vivo, all studied antagonists dramatically reduced Botrytis fabae disease incidence and severity in both seasons 2021/22 and 2022/23. T. atroviride showed the highest efficacy bioagent (73.55 and 85.15%), followed by T. harzianum (72.55 and 81.22%), in controlling B. fabae of faba bean plants in both seasons. In addition, the results also showed that all tested biological treatments had an impact on yield components and increased levels of chlorophyll, protein%, phenols, flavonoids, Peroxidase (PO), polyphenol Oxidase (PPO), chitinase, and -1, 3-glucanase activities compared to control treatment in both seasons. In this regard, spraying T. atroviride showed the highest efficacy as a bioagent, followed by T. harzianum. Contrary, T. hamatum showed the lowest efficacy compared to other treatments in both seasons. Conclusion: This investigation was carried out to determine the effectiveness of several different antagonists, i.e., T. album, T. atrovirde, T. hamatum, and T. harzianum (30 x 106 spore/ml), Blight Stop, and Bio Zeid, for controlling Botrytis fabae on bean plants and evaluating their effect on yield parameters, components, and quality.

Background: Tuberculosis (TB) is a significant global health problem, and extrapulmonary TB can present with no specific clinical or radiographic findings. Genito-urinary TB is often associated with elevated tumor markers and can be misdiagnosed as ovarian/fallopian tube carcinomas, especially in elderly female patients, as genitourinary TB commonly affects women of reproductive age.Objective: We present a rare case of genito-urinary TB in an elderly female patient who was initially misdiagnosed with ovarian cancer with metastasis.Case presentation: An 83-year-old woman with a medical history of diabetes and hypertension presented with complaints of abdominal distension. Diagnostic imaging revealed lesions in the ovaries and omentum and tumor markers were elevated, leading to a suspicion of ovarian cancer with metastases to the omentum. The patient underwent a diagnostic laparotomy and surgical removal of ovaries, fallopian tubes, and the lesion of the greater omentum. However, no malignancy was found during the morphological evaluation. Further histopathological examination confirmed the final diagnosis of genito-urinary tuberculosis, and the patient received anti-TB drugs. The postoperative period was uneventful, and tumor marker levels decreased.Conclusion: As the clinical presentation of genito-urinary TB can mimic ovarian cancer, a histopathological examination should be performed for differential diagnosis, thereby reducing the possibility of inaccurate treatment. This case report highlights the importance of considering genito-urinary TB as a differential diagnosis in elderly female patients presenting with elevated tumor markers, abdominal distension, and suspected genital malignancy. It is crucial to carefully evaluate these cases and explore the possibility of genital TB as an alternative diagnosis, given the overlapping clinical presentation. This highlights the importance of a comprehensive diagnostic approach that includes considering TB in addition to malignancy, even in the context of elderly female patients.