Study of Anatomical Variations of Number of Pulmonary Veins and its Clinical Significance

Introduction: The pulmonary veins play an important rolein the pulmonary circulation by receiving oxygenated bloodfrom the Lungs and delivering it to the left atrium. Pulmonaryvein anatomy piqued curiosity of researchers off late afterthe discovery of its role in genesis of atrial arrhythmias andincreased incidence of pulmonary hypertension in COPD.The congenital variations in number of pulmonary veinsand their drainage patterns, encompass a wide spectrum ofanomalies and are not uncommon in general population. Theaim of the study was to observe the variations in the numberof pulmonary veins and pulmonary ostia.Material and Methods: The present study was done on 25formalin fixed hearts aged 18-70 years, obtained from thedepartment of anatomy, Sri Padmavathi Medical college forwomen, Tirupathi. These hearts were observed for the numberof pulmonary veins, their drainage into left atrium, variationsin pulmonary ostia on right and left sides and were comparedwith previous studies.Results: Out of the 25 specimens studied, 23 hearts (92%)had normal pattern of four pulmonary veins, two from eachlung extending to the left atrium and opening into it via twoseparate pulmonary ostia, on either side. In 2 (8%) out of 25specimens, variations in the number of pulmonary veins andthe pulmonary ostia were observed.Conclusion: The awareness of the variant anatomy ofpulmonary veins and their drainage is of paramountimportance to Radiologists, Electrophysiologist and Cardiothoracic surgeons while performing surgical procedures onHeart.

Accuracy of the smartphone-based nonmydriatic retinal camera in the detection of sight-threatening diabetic retinopathy

Purpose: To evaluate the sensitivity and specificity of smartphone-based nonmydriatic (NM) retinal camera in the detection of diabetic retinopathy (DR) and sight-threatening DR (STDR) in a tertiary eye care facility. Methods: Patients with diabetes underwent retinal photography with a smartphone-based NM fundus camera before mydriasis and standard 7-field fundus photography with a desktop mydriatic fundus camera after mydriasis. DR was graded using the international clinical classification of diabetic retinopathy system by two retinal expert ophthalmologists masked to each other and to the patient's identity. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) to detect DR and STDR by NM retinal imaging were assessed. Results: 245 people had gradable images in one or both eyes. DR and STDR were detected in 45.3% and 24.5%, respectively using NM camera, and in 57.6% and 28.6%, respectively using mydriatic camera. The sensitivity and specificity to detect any DR by NM camera was 75.2% (95% confidence interval (CI) 68.1–82.3) and 95.2% (95%CI 91.1–99.3). For STDR the values were 82.9% (95% CI 74.0–91.7) and 98.9% (95% CI 97.3–100), respectively. The PPV to detect any DR was 95.5% (95% CI 89.8–98.5) and NPV was 73.9% (95% CI 66.4–81.3); PPV for STDR detection was 96.7% (95% CI 92.1–100)) and NPV was 93.5% (95% CI 90.0–97.1). Conclusion: Smartphone-based NM retinal camera had fairly high sensitivity and specificity for detection of DR and STDR in this clinic-based study. Further studies are warranted in other settings.

Expression profile of salivary micro RNA-21 and 31 in oral potentially malignant disorders

Abstract Oral potentially malignant disorders (OPMD) possess significant chances of malignancy conversion. In order to develop an early diagnostic tool, the present study evaluated the expression of miRNA-21 and 31 as salivary markers. The case-control study was carried out in 36 healthy participants as controls and in 36 patients who were newly diagnosed as OPMD having four different lesions including leucoplakia, oral sub mucous fibrosis (OSMF)궱, oral lichen planus, and (OSMF)궱 with leucoplakia. The samples were also classified as non-dysplastic, or with mild, moderate, and severe dysplasia according to their histopathological reports. The salivary miRNA-21 and 31 expressions were studied using real-time PCR. The statistical analysis was carried out using SPSS version 22. Salivary miRNA-21 (p-value = 0.02) and 31 (p-value = 0.01) were significantly upregulated in severe dysplasia compared with control. Among the different lesions, leucoplakia had significant upregulation of miRNA-21 and 31. miRNA-21 can be used as a diagnostic marker with specificity of 66% and sensitivity of 69%. The area under the ROC curve was 0.820 for miRNA-21 and 0.5 for miRNA-31, which proved that miRNA-21 is a better diagnostic marker than miRNA-31 for OPMD.

Anticonvulsant activity of Adhatoda vasica leaves by pentylenetetrazol model: preliminary evaluation in rats

Background: Epilepsy is a disorder characterised by recurrent seizures of cerebral origin with episodes of sensory, motor phenomenon with or without loss of consciousness. The present study was taken up to evaluate the anticonvulsant effect of aqueous extract of leaves of Adhatoda vasica in rats. Objectives of this study is to evaluate the effect of aqueous extract of Adhatoda vasica leaves on Pentylenetetrazol induced seizures in albino rats and to compare the effect of aqueous extract of Adhatoda vasica leaves with standard dose of sodium valproate on Pentylenetetrazol induced seizures in albino rats.Methods: Anticonvulsant activity of aqueous extract of Adhatoda vasica was analysed using PTZ (Pentylenetetrazol) model. Groups used were distilled water as control group, Sodium valproate as standard for Pentylenetetrazol and two doses of aqueous extract of Adhatoda vasica (100mg/kg and 200 mg/kg) for this screening model. Parameters observed for PTZ models were abolition of clonic seizures and time duration between injection of PTZ and onset of seizures.Results: In PTZ model, test group at 200 mg/kg showed 33.33% protection for abolition of clonic seizures, though not comparable to standard group. There was significant increase in the duration of onset of clonic seizures after PTZ injection in both test groups (at 100 mg/kg and 200 mg/kg) when compared to control group.Conclusions: Aqueous extract of leaves of Adhatoda vasica has shown significant anticonvulsant action in PTZ model.

An Experimental Evaluation Of Haritamanjari (acalypha Indica Linn) For Mutrala Karma W.s.r To Diuretic Activity

Diuretics are widely employed drugs used to treat extra cellular fluid volume expansion caused due to renal, cardiac, liver disorders etc. These diuretics are effective but have side effects. Acalypha Indica Linn is a herb of Euphorbiaceae family, found throughout India as a weed. Many studies have been carried out but sufficient data is not available to establish its diuretic activity. Hence the study is focused on the assessment of Harita Manjari for its diuretic action in animal model. Methods: The trial drugs are administered for 7 days prior to the day of evaluation of diuretic action; the rats were individually placed in the metabolic cages to collect urine. The volume of the urine collected in graduated vials was measured after 6 hours and expressed in terms of ml/100gm of body weight. Results: The invivo study demonstrated that crude suspension of Harita Manjari in a dose of 450mg/kg has significant diuretic activity. The statistical analysis has been carried out and results on continuous measurements are presented on Mean ± SEM were calculated. Urine output, pH and urine electrolytes were compared with control groups by one-way ANOVA followed by Dunnett’s multiple comparison test. The P Value <0.05 were considered as statistically significant. Conclusion: Order of diuresis: Crude suspension >Alcoholic extract >Aqueous extract.

Application of e-learning in dental radiology education at undergraduate level ­a systematic review / Aplicação do e-learning no ensino de radiologia dentária em nível de graduação - uma revisão sistemática

With the increase in internet technology as well as the electronic content the web-based learning has become the desirable medium in the field of education. In medical, dental and allied health science education, the conventional method involves the use of textbooks, lectures, and images. But trends suggest that a change is poised in this field. Objective: the systematic review aims to evaluate the literature of studies about the application of the e-Learning methods in radiology education at the undergraduate level in comparison to conventional teaching-learning methods. Material and Methods: prominent scientific databases were searched for literature related to the application of e-Learning in undergraduate radiology education. The search keywords used for the search were- E-learning, dental radiology, oral radiology, undergraduate. English language full text of eligible article was systematically reviewed. Results: seven full text articles were obtained after scrutiny of the available literature. Most of the research work was carried out in the past decade and dental schools in different parts of the world. Almost all the studies showed that e-learning was as either equally effective or more effective when compared to conventional teaching in dental radiology. Conclusion: e-learning could be a suitable alternative to conventional teaching-learning method with significant improvement in student attitude and knowledge however, the influence of e-learning in improving the practical or clinical skills of dental radiography is still debatable (AU)

Com o aumento da tecnologia da Internet, como também o conteúdo eletrônico da aprendizagem baseada na web, estes tornaram-se um meio desejável no campo da Educação. Em ciências médicas, odontológicas e afins, o método convencional envolve o uso de livros didáticos, palestras e imagens. Mas tendências sugerem que há uma mudança nesse campo. Objetivos: esta revisão sistemática visa avaliar literatura de estudos sobre a aplicação de métodos de e-Learning no ensino de radiologia no nível de graduação em comparação com os métodos convencional de ensino-aprendizagem. Material e Métodos: bases de dados científicas importantes foram pesquisadas sobre literatura relacionada à aplicação do e-Learning na graduação em radiologia. As palavraschave usadas para a pesquisa foram: E-learning, radiologia dentária, radiologia oral, graduação. O texto completo do artigo elegível em inglês foi sistematicamente revisado. Resultados: sete textos completos foram obtidos após análise minuciosa da literatura. A maior parte dos trabalhos de pesquisa foi realizada na década passada em escolas de odontologia em diferentes partes do mundo. Quase todos os estudos mostraram que o e-learning era igualmente eficaz ou mais eficaz quando comparado ao ensino convencional em radiologia dentária. Conclusão: o e-learning pode ser uma alternativa adequada ao ensino-aprendizagem convencional, com melhoria significativa nas atitudes e conhecimentos aluno. No entanto, a influência de e-learning para melhorar as habilidades práticas ou clínicas da radiolog ia dentária ainda é discutível(AU)

Evaluation of dermatoglyphic patterns using digital scanner technique in skeletal malocclusion: A descriptive study

Skin is the largest human organ, which performs a dynamic role in life. The ectodermal layers of the skin found on the palm with intricate lines are stable throughout life and have grabbed scientific attention. Any disturbances during their formation might possibly have the likelihood of a person developing malocclusion. Aims and Objectives: The aims of this study were to evaluate and compare the dermatoglyphic pattern with various skeletal malocclusions. Materials and Methods: The study was carried out on 40 outpatients reported with an age group of 18–20 years divided into four groups as follows: Group: I – 10 (Class I occlusion), Group: II – 10 (skeletal Class I malocclusion), Group: III – 10 (skeletal Class II malocclusion), and Group: IV – 10 (skeletal Class III malocclusion). The fingerprints were recorded using scanner exclusively designed for diagnostic purpose of the study. The collected data were analyzed using SPSS statistics software Version 23.0 to find which groups had significant differences. Results and Conclusion: Increased frequency of arch pattern was present in participants with Class I malocclusion, and loop patterns were observed in those with Class I occlusion and Class III malocclusion and whorl patterns in Class II malocclusion with P < 0.05. Dermatoglyphic pattern remains constant throughout life and it can be used as a noninvasive aid in determining the development of malocclusion at a very early age.

Study on prevalence of peripheral neuropathy among patients on hemodialysis

Background: The incidence and prevalence of Chronic Kidney Disease is increasing slowly. Peripheral Neuropathy among CKD patients is the most common neurological complication of uremia, but still it is an under estimated problem adversely affecting the patient’s quality of life. It is more often a silent burden for the patient, progressively affecting his/her quality of life. Hence, this study aimed at analyzing and elaborating the diverse manifestations of CKD and establish the prevalence of peripheral neuropathy among patients with CKD undergoing hemodialysis in our Hospital. Materials and methods: This was a cross sectional study done on patients with CKD undergoing hemodialysis at Government Vellore Medical college and Hospital for a duration of 6 months from July 2017 to December 2017. After obtaining informed consent, the participants satisfying the inclusion criteria were asked detailed history and clinical examination was performed according to the well-designed proforma cited below. The presence of neuropathy was assessed using Michigan Neuropathy Screening Instrument (MNSI) Scores. Results: The mean age of the study subjects was 47.87 years. Most of the patients belonged to the age group 40-70 years. Out of 60 cases, there were 35 (58.0%) males and 25 (42.0%) females. The Male to Female sex ratio was 1.38:1. The prevalence of clinical Uremic distal symmetrical sensory-motor peripheral neuropathy assessed by MNSI in the CKD on HD population was 71.66%. The smallest MNSI score obtained in the study population was 2 and the largest score was 7. Conclusion: Uremic neuropathy is the most common neurological complication in patients with uraemia. MNSI physical assessment could be used as a simple bed side examination to determine the presence or absence of uremic peripheral neuropathy

Risk of fatty liver disease in alcoholics

Background: Fatty liver (FL) disease is commonly divided into non-alcoholic (NAFLD) and alcoholic (AFLD) FL disease categories. Although it has long been known that long-term heavy drinking is a cause of liver cirrhosis and liver cancer, the findings from recent observational studies have shown that light, moderate, and even heavier alcohol consumption may decrease the risk of FLD. This study aims to elucidate the quantity and pattern of alcohol consumption and fatty liver prevalence. We conducted a cross sectional study on semi urban population at our tertiary care centre Materials and methods: We performed a cross sectional observational study on male patients admitted for various ailments in medical wards of Government Omandurar Medical college during the period March 2018 to May 2018. Results: Among 100 cases fatty liver was present in 40% of cases and there is significant association between fatty liver and liver enzymes. The chances of fatty liver increase with duration of alcohol intake also there was significant association between fatty liver and BMI. Conclusion: In conclusion, this study demonstrates that the major risk factors for FL in alcoholic are factors related to adiposity, alcohol consumption, and that consistent consumption of alcohol for prolonged period may lead to FL. These results suggest that lifestyle modifications aimed at fighting central obesity and metabolic abnormalities should be the most important recommendations for the management of FL.

Does tight control of systemic factors help in the management of diabetic retinopathy.

Diabetic retinopathy (DR), one of the leading causes of preventable blindness, is associated with many systemic factors that contribute to the development and progression of this microvascular complication of diabetes. While the duration of diabetes is the major risk factor for the development of DR, the main modifiable systemic risk factors for development and progression of DR are hyperglycemia, hypertension, and dyslipidemia. This review article looks at the evidence that control of these systemic factors has significant benefits in delaying the onset and progression of DR.

In vitro antioxidant activity of the individual herbs of DIA-2, a herbal mixture containing standardized extracts of Allium sativum and Lagerstroemia speciosa.

Hyperglycemia induced oxidative stress is one of the main mechanism involved in the pathogenesis of diabetic complications. Use of antioxidants as an adjuvant therapeutic approach in diabetes could prevent or delay the progression of oxidative stress induced diabetic complications. Many herbal drugs possess multiple pharmacological actions like anti-hyperglycemic, anti-obesity and anti-oxidant properties etc., which could act through multiple pathways and may offer beneficial effect in the management of multi-factorial diseases such as diabetes. Development of herbal formulation with ingredients having multiple actions could be a potential approach for improving therapeutic efficacy. We here report the free radical scavenging activity of a herbal mixture, DIA-2 and its individual herbs. DIA-2, a herbal formulation containing fixed combination of standardized aqueous extracts of Allium sativum (ASE) bulbs and Lagerstroemia speciosa (LSE) leaves. The present study was undertaken to investigate whether a combination of ASE and LSE shows a synergistic antioxidant effect than its individual herbs. In vitro antioxidant activity for individual herbs and DIA-2 was determined by DPPH radical scavenging, nitric oxide scavenging assay, total antioxidant capacity, reducing power assay and ABTS radical scavenging methods respectively. Our results suggest that DIA-2 could synergistically enhance the antioxidant activity and could be attributed due to the synergistic actions of the individual ingredients. The data obtained suggests the combined use of ASE and LSE as active ingredients in the development of antidiabetic herbal formulation, synergizing its therapeutic value in treating hyperglycemia and associated oxidative stress.

An approach on microbial biosynthesis of L-glutaminase: a tumour inhibitor.

L-Glutaminase, an amidohydrolase enzyme has been a choice of interest in the treatment of lymphoblastic leukemia. This study investigates the production of extracellular L-glutaminase synthesis were carried out by using Aspergillus oryzae was evaluated under different fermentation parameters by employing submerged fermentation method. The L-glutaminase producers detected by the pink zone around the colony by simple plate assay method. Aspergillus oryzae S2 is the potential strain among the fungal isolates. The L-glutaminase synthesis were increased their yield after the optimization of fermentation parameters. The optimum pH 5.0, temperature 350C and inoculum size 1.0 ml and it showed 217.65 IU.

Solid variant of papillary carcinoma of nipple: An under recognized entity.

Papillary lesions of the breast represent a heterogeneous group with differing biological behavior. Solid papillary carcinomas are uncommon tumors composed of circumscribed large cellular nodules separated by bands of fibrosis. Correct diagnosis is crucial but may be difficult, as many other benign and malignant lesions have similar histological appearances. Immunohistochemistry plays a useful role in their differentiation. We describe one such case of a solid variant of papillary carcinoma of the left nipple in a 75-year-old woman, who had no other palpable mass in rest of the breast tissue. The case is documented for the rarity of its occurrence and significance of recognition of this lesion.

Cystic carcinoma of the neck

Malignant cystic lesions of the lateral side of the neck are usually due to metastasis and are rarely primary carcinoma. The most common is metastatic cystic squamous cell carcinoma arising from a primary site at the Waldeyer's ring. However, they can arise from papillary carcinoma of thyroid, lung and mediastinum but very rarely from the abdominal and pelvic organs without regional lymph node involvement. Therefore, accurate diagnosis is very important for appropriate management. We report two cases of cystic squamous cell carcinoma of the lateral neck; cystic metastasis from an occult squamous cell carcinoma of the tongue and a primary branchiogenic carcinoma. We emphasize the importance of meticulous search for the primary malignant lesions in cases of cystic carcinoma of the neck.

Coronary atherosclerosis in sudden cardiac death: An autopsy study.

Background: The incidence of ischemic heart disease (IHD) has markedly increased in India over the past few years. Considering the variations in racial, dietary and lifestyle patterns in our population, it is essential to study the biology of coronary atherosclerosis in our patients. Vulnerable plaques have a large number of foam cells, extracellular lipid, thin fibrous caps and clusters of inflammatory cells and are more prone to rupture. These plaques are nourished by the microvessels arising from the vasa vasorum of the blood vessels and by lumen-derived microvessels through the fibrous cap. This autopsy study was designed to analyse the coronary arterial tree in cases of sudden cardiac death, classify coronary atherosclerotic plaques and to assess the factors contributing to vulnerability of the plaques including inflammation, calcification and microvascular density. Materials and Methods: Seven cases of sudden cardiac death were included in the study. The hearts were perfusion-fixed and the coronary arteries along with their main branches were dissected and studied. The location of the plaques, type of plaques, presence of inflammation and calcification were assessed. The cap thickness and microvessel density per 1000um 2 were assessed. The statistical significance was estimated. Results and Conclusions: Extensive high-grade coronary atherosclerotic disease was seen in all sudden cardiac death cases. Majority of the plaques were vulnerable. High-grade inflammation was seen in most of the vulnerable and ruptured plaques. All the ruptured plaques were uncalcified indicating that calcification probably stabilizes the plaques and protects against rupture. Increased microvessel density was noted in ruptured plaques compared to vulnerable plaques. However, it was not statistically significant.

Autofluorescence: a screening test for mycotic infection in tissues.

Fungal infection is a major health concern as the clinical features are not very distinctive. Lack of rapid diagnostic techniques results in delay in diagnosis, which may even culminate in a fatal outcome. The fact that many pathogenic fungal organisms autofluoresce in hematoxylin and eosin (H and E)-stained sections under ultraviolet illumination led us to evaluate the role of autofluorescence as a rapid screening technique for fungal infections. The aim of the present study was to assess the value of autofluorescence as a screening method for detecting fungi on tissue sections and to compare the results of autofluorescence with conventional histochemical stains for fungi. Hematoxylin and eosin-stained slides of mycotic lesions were examined under fluorescent microscope and the findings were compared with results of Gomori's methenamine silver and periodic acid-Schiff stains. We found fungal autofluorescence in 63 out of 64 cases studied, with a sensitivity of 97.8% and specificity of 100% in comparison with fungal stains. This was statistically significant (P < 0.05). We conclude that autofluorescence can be used as a rapid screening method for identification of fungi in tissue sections as it does not require any other specialized staining procedure.

Disseminated malignant fibrous histiocytoma (giant cell rich): a case report.

Giant cell rich malignant fibrous histiocytoma accounts for 3 -15% of all malignant fibrous histiocytomas. Currently, the nomenclature giant cell malignant fibrous histiocytoma is reserved for undifferentiated pleomorphic sarcomas with prominent osteoclastic giant cells. It is considered to be synonymous with malignant giant cell tumor of soft parts. We report a case of disseminated giant cell malignant fibrous histiocytoma involving the scalp, cervical node, lungs, spine, abdominal wall, base of penis, gluteal cleft, paraspinal region and back. The diagnosis was established after staining for a panel of immunohistochemical markers namely cytokeratin, vimentin, S100, desmin, CD68 and smooth muscle actin. CD68 positivity in tumor cells helped in arriving at the final diagnosis. It is essential to recognize this tumor as a giant cell rich distinct entity and differentiate from other giant cell rich pleomorphic sarcomas since therapeutic and prognostic differences are being appreciated currently.