Dieulafoy’s lesion – A rare case of jejunal aneurysm

Despite being a rare condition, Dieulafoy's lesion, also known as the persistent artery, is a serious cause of gastrointestinal bleeding. Only 1–2% of acute gastrointestinal bleeding is caused by it. Most commonly affects the stomach and duodenum, rarely affecting jejunum, ileum, caecum, etc. Our case presents a 21-year-old male who presented with lower gastrointestinal bleeding secondary to jejunal dieulafoy’s lesion.

Sodium alginate-guar gum and carbopol based methotrexate loaded mucoadhesive microparticles for colon delivery: An in vitro evaluation

Methotrexate (MTX) is famous for its therapeutic potential against different cancers including colorectal cancer. Goal of the present investigation was to formulate MTX loaded mucoadhesive microparticles for colon targeting. The optimized formulation (MTX-MS2) was composed of mucoadhesive polymers (sodium alginate, guar gum and carbopol 940) in an appropriate ratio. MTXMS2 was developed by ionic-gelation method. The suitable particle size and zeta potential were found to be 21.10 ± 0.18 µm and 3.01 ± 0.16 mV for MTX-MS2 respectively. The % yield (98.60 ± 2.12), % entrapment efficiency (97.98 ± 1.22) and % drug loading (1.04 ± 0.03) were estimated for MTXMS2. The swelling index (0.99 ± 0.04 θ) and mucoadhesion (97.29 ± 4.61%) were significantly (***P ˂ 0.01) achieved with MTX-MS2 as compared to other formulations. The optimum drug release (96.07 ± 4.52%) was significantly achieved with MTX-MS2 at simulated gastric fluid (pH 7.4) for 36 h in a sustained manner. This profile may be attributed towards excellent mucoadhesivness of the polymers used in the formulation. Therefore, the current investigation suggests that mucoadhesive carrier system could be promising approach for colon delivery. Thus, the proposed work would be helpful for the treatment of colorectal canc

Inguinal abscess in twin infants

Inguinal abscess is uncommon in infants and children. Majority of cases in the infantile period is primary and they present as leg or groin swelling, limitation of limb movement and pain. The source of microorganism is from the haematogenous spread of normal flora of the skin due to immature immune system. Ultrasound is the investigation of choice which confirms the diagnosis and delineates the areas of collection. Antibiotic alone is insufficient in most cases and drainage is required. Delayed treatment and inadequate drainage carry a high risk of mortality and sequelae due to damage to the underlying joint. We present 2 cases of primary inguinal abscess in twin infants who presented at 1 month and 2 months of age correspondingly, in whom early diagnosis and management lead to quick recovery.

Knowledge of disaster preparedness among medical professionals in JNU Institute for Medical Sciences and Research Centre, Jaipur, Rajasthan

Background: Disaster causes widespread destruction, disrupting people's lives and causing human suffering with communities finding it difficult to cope. Human beings may not have the power to stop it but they may have the ability to be prepared and minimize the impact of the disaster. The medical professionals play a pivotal role in a disaster situation and its knowledge is a must during their academics. This study was aimed to assess the level of knowledge of disaster preparedness among medical professionals.Methods: A cross-sectional study was conducted among the medical professionals in JNUIMSRC, Jaipur, Rajasthan. A total of 225 people were selected and interviewed. Data was collected using self-administered semi-structured questionnaire and scoring was done for the assessment of knowledge on disaster preparedness. Epi-info software version 7.2.3.1 was used for statistical analysis.Results: Out of a total of 225 respondents, 140 were females and 85 were males. The mean age of respondents was 20±0.58 and most of them were in the 18-24 years age-group (61.33%). A total of 191 (88.9%) respondents had either partial or total lack of knowledge regarding disaster preparedness. Most of the respondents, 195 (86.67%) had a view that there is a need to introduce disaster preparedness training program.Conclusions: The findings revealed that most of the study participants had not attended any training on disaster management and most of them had low knowledge about disaster preparedness. The integration of disaster education into the curriculum is believed to be the most effective strategy.

A clinicopathological study of primary central nervous system lymphomas & their association with Epstein-Barr virus.

Background & objectives: Primary central nervous system lymphomas (PCNSLs) are relatively uncommon, accounting for 2-3 per cent of primary brain tumours. Majority of these are diffuse large B cell lymphomas (DLBCL) occurring both in immunocompromised and immunocompetent patients. We undertook this study to classify PCNSL into germinal centre (GC) and non-germinal centre (NGC) type based on Hans classification and to find the role of Epstein-Barr virus (EBV) in pathogenesis both by conventional immunohistochemistry (IHC) and chromogenic in situ hybridization (CISH). Methods: The consecutive cases of PCNSL during a 10 years period were analysed by IHC for CD45, CD20, CD3, B-cell lymphoma 2 and 6 (Bcl-2 and Bcl-6), B-cell specific octamer binding protein-1 (BOB-1), multiple myeloma oncogene-1 (MUM-1), EBV latent-membrane protein 1 (LMP-1), cyclin-D1, CD10, CD5 and CD23, as well as by CISH for EBV. Results: During a period of 10 years, 65 PCNSL were diagnosed which comprised 0.69 per cent (65/9476) of all intracranial tumours. The mean age of presentation was 49 yr with sex ratio (M:F) of 1.4:1. Most common location was supratentorial region with predominant involvement of frontal lobe. Single lesions were seen in 38 (58.4%) and multifocal lesions in 27 (41.5%) patients. None of the patients were immunocompromised. All cases were B cell immunophenotype and were DLBCL except one case of follicular lymphoma. According to Hans classification, majority of them were NGC (n=51, 79.6%) and 13 (20.3%) were GC type. Bcl-2 expression was noted in 34 (52.3%) tumours. EBV was positive in three (4.6%) cases; two were detected both by IHC and CISH and one case by CISH only. Interpretation & conclusions: In Indian population, PCNSL occurs mainly in immunocompetent patients, and a decade earlier than in western population. Immunophenotyping revealed that all cases were DLBCL with predominance of NGC type. No prognostic difference was seen between GC and NGC DLBCL. Association of EBV was rare and this virus was possibly not involved in the pathogenesis of PCNSL in immunocompetent individuals. CISH was an easy, economical and less cumbersome method for detection of EBV in PCNSL.

Predictive factors for residual tumor and tumor upstaging on relook transurethral resection of bladder tumor in non-muscle invasive bladder cancer

Relook transurethral resection of bladder tumor [TURBT] improves the diagnostic and therapeutic efficacy of primary TURBT. However, it is still not established as to which category of patients would benefit most from this repeat invasive procedure. This prospective interventional study was designed to identify the category of patients with non-muscle invasive bladder cancer who may benefit from a routine relook procedure. A total of 52 consecutive patients with biopsy proven non muscle invasive bladder cancer on primary TURBT underwent a relook TURBT between March 2011 and September 2012. The incidence of residual tumor and tumor upstaging on relook procedure was correlated with various histopathological [stage, grade, CIS, presence of muscle] and cystoscopic [type and focality of tumor, any apparent field change] parameters on primary TURBT. Out of the total 52 patients, 23 [44.2%] had a residual tumor on relook TURBT. 12 [23.1%] were upstaged [of these 9 i.e. 17.3% to muscle invasion]. While most of the parameters studied showed a positive correlation with incidence of residual tumor and upstaging to muscle invasion, statistical significance [for both] was reached only for tumor stage [P = 0.028 and 0.010], tumor grade [P = 0.010 and 0.002] and tumor type [solid vs. papillary; P = 0.007 and 0.001]. Carcinoma in situ showed a significant correlation with incidence of residual tumor [P = 0.016] while the absence of muscle in the primary TURBT specimen was significantly associated with upstaging to muscle invasive disease [P = 0.018]. The data was analyzed using SPSS software v. 16.0. Relook TURBT may be especially recommended for high grade and T1 tumors and tumors with a solid/sessile appearance on primary TURBT especially when deep muscle was absent in the primary TURBT specimen

Mortality and testicular derangements in red flour beetles, Tribolium castaneum (Herbst) exposed to hen’s egg white proteins.

Red flour beetle (T. castaneum) is a major pest of stored grains and is known for its adaptability to all classes of insecticides. The present study was carried out to determine the insecticidal potential of egg white proteins to manage beetle population. Protein samples obtained through salt fractionation were lyophilized and were used separately and simultaneously in different concentrations by adding them to wheat flour and milk powder. The results indicated that the mortality rate of the adult beetles was dependent on the type of treatment, concentration of protein samples and duration of feeding. In multiple-choice feeding trials beetles showed their movement towards the control section as the concentration of treatment increases. Marked abnormalities were observed in appearance and dimensions of the testes which indicated that the egg white proteins caused considerable effect on the process of spermatogenesis and sperm functions. SEM study revealed the formation of deep wrinkles and folds on the testicular surface of the testes of beetles fed on treated diets, points towards the depletion of internal cellular material. The results suggest that egg white protein affects the survival and cause subsequent derangements in the testis of red flour beetle.

Secondary signet-ring cell adenocarcinoma of urinary bladder from a gastric primary

Primary bladder tumor is a frequent urological malignancy, whereas the incidence of secondary bladder tumor from a distant organ is quite rare. Secondary bladder neoplasms represent 1% of all malignant bladder tumors, of which distant metastases from stomach account for about 4% of cases. We present the case of a 30-year-old male who underwent partial gastrectomy for Signet-ring cell carcinoma of the stomach and presented 2 years later with hematuria. On computerized tomography scan, a bladder tumor was found which was resected cystoscopically. The histopathological examination revealed secondary Signet-ring cell adenocarcinoma of the urinary bladder