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Background: Tumor budding refers to single or small cluster of tumor cells detached from the main tumor mass in histological sections. In colon cancer high tumor budding is associated with worse prognosis and correlates with metastatic lymph nodes. We studied tumor budding in modified radical mastectomy specimens to evaluate its utility as a prognostic factor by correlating high tumor budding score with known prognostic markers of breast cancer like axillary lymph nodal metastasis, clinical staging, tumor size, lymphovascular invasion, hormonal status and pathological grading. Aim was to evaluate tumor budding in invasive breast carcinoma and to describe clinical features and histopathological spectrum of Invasive Breast Carcinoma with/without lymph node metastasis on H&E slides. Secondly, to find association between grades of tumor budding and various clinical, gross, microscopic and immunohistochemical variables. Methods: The present study is a cross sectional study of 70 modified radical mastectomy specimens from June 2018 to Dec 2022. Along with tumor budding various prognostic parameters like hormonal markers, pathological grading and clinical grading were evaluated. Immunohistochemical marker Pancytokeratin was utilized for counting the tumor buds, wherever necessary. Statistical Analysis: Chi Square test was utilized to study significant differences between variables, p<0.05 was considered statistically significant. Results: A high tumor budding score (?4/HPF) had significant association with axillary lymph node involvement and clinical staging. Conclusions: In our study we detected the association of high tumor budding, PTB in invasive breast carcinoma with axillary lymph node involvement and clinical staging. Hence our results highlight the importance of tumor budding as a prognostic factor and submit that this histological feature could be included in diagnostic protocols just as in carcinoma of the colon.
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The phenomenon of autism, as in known today, has a history with several vicissitudes. Contemporary students and practitioners unconnected with its history are unlikely to see the larger picture. This article seeks to outline the timeline of autism before narrowing it into various controversial themes, unresolved issues, and unanswered questions on autism. The themes revolve around the disputed construct of autism, its meaning, definition, characteristics, theories, and official classifications. Equally debated are matters related to epidemiology, causes, and treatments for autism. There is disagreement whether autism is a disorder or a difference. The claims of freaks, exceptional prodigies, and savants in autism, the role of genetics, notions of posthumous diagnosis, commercialization, and commodification of autism in the media are raised. Raising controversies can lead to constructive discussion or further reflection than attempting to answer them.
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Background: Very few studies have attempted to investigate working memory (WM) in neurodevelopmental disorders (NDD). This study seeks to profile WM in children with NDD against their matched, typically developing children (TDC), all belonging to high socioeconomic status (SES) families. Secondary assessment of gender differences, if any, was also attempted. Profile analysis of certain domains in neuropsychological and behavioural functioning for the children is delineated. Methodology: The study employed a cross-sectional 2-group comparison design by drawing a purposive sample of 84 children (42 in each group of NDD and TDC) in 6 to 8 years from across Bangalore city, India. We recruited the groups by matching them on intelligence, developmental skills, and SES. Assessment of WM was using verbal and visual n-back and spatial span tasks. Results: The study depicted significant differences between the children of the groups in accuracy scores for the tasks. Errors from the n-back tasks showed significant differences, mostly in omission errors. We reported effect size and the probability of superior (PS) outcomes. We did not observe gender differences in the NDD group. Although, we have highlighted differences in profiles of neuropsychological and behavior functions between the groups. Discussion: This dwells on the aspects that might have caused WM's observed deficits and explains the differences in these children's neuropsychological and behavior profiles. Conclusion: WM differs significantly between children with NDD and TDC. However, we have not found differences in WM performance and gender in the NDD group.
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In this research work to evaluate in vitro antioxidant activity and HPTLC finger printing analysis of Physalis peruviana fruits. The chemical fingerprinting was carried out by high performance thin layer chromatography. It was carried out by the CAMAG HPTLC system equipped with Linomat V sample applicator, twin through plate development chamber, TLC scanner III and integration software WIN CATS-4.02. Physalis peruviana fruit extract was tested for phytochemical screening and in vitro anti-oxidant enzymes like 2, 2-diphenyl-1-picryl hydrazyl radical (DPPH), total antioxidant activity and reducing ability. Physalis peruviana fruit extract effectively scavenged free radicals at all different concentrations and showed its potent antioxidant activity. Phytochemical analysis revealed the presence of various major phytoconstituents like alkaloids, flavonoids, saponins, phenolics, tannins and anthraquinones. The HPTLC fingerprint qualitatively revealed predominant amount of quercetin. Physalis peruviana fruit extract will be subjected to further extensive studies to isolate and identify their active constituents which are useful for understanding their mechanism of action as antioxidants.
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Headache is one of the most common neurological symptom occurring worldwide. Here, we present a unique case of secondary headache in a young female which got reversed with appropriate treatment. A young female who presented with a severe subacute unilateral left-sided intractable headache with papilledema and obstructive hydrocephalus was found to have 4th ventricular neurocysticercosis causing obstruction of the foramen of Magendi and Luschka, relieved on timely surgical excision and with medical management. This case is reported to highlight the rare causes of secondary headache and various presentations of neurocysticercosis, in endemic areas like India as it causes neurological morbidity which can be alleviated on appropriate treatment, thereby preventing economic hardship and improving the quality of life.
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Availability of adequate and proper drug information helps in rational prescription of essential drugs. This can be obtained from various sources such as National Formularies; other sources such as Current Index of Medical Specialties, Monthly index of medical specialties and the information available with the regulators and drug package inserts (PI). In this study, we assessed the drug information of the drugs used for treatment of both type of lepra reactions. Five drugs used for treating Lepra reactions were analyzed for any variation (Qualitative) in information on various parameters as mentioned in commonly used drug information sources such as CIMS India, MIMS India, Central Drugs and Standards Control Organization (CDSCO) website and National Formulary of India (NFI). We observed some gross qualitative variation regarding drug information given in different commonly used sources. Variation exists in the quality of information available on indications, contraindications, dosage and completeness of the dosing schedule about drugs available in various sources. As management of Lepra reactions is crucial in achievement desirable outcome of treatment of leprosy, it is important that information regarding drugs used for such indications should be 100% uniform in all commonly used and available sources.
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Background. We report the short-term maternal and neonatal outcomes for all deliveries conducted in a midwiferun labour room located at an urban health centre serving an urban population of Vellore, Tamil Nadu. Methods. This 5-year (2005–10) retrospective study included all birth records including those of women and neonates transferred to our tertiary care referral centre. Maternal and neonatal outcomes were analysed among deliveries in the urban health centre and at the tertiary care referral centre. Results. There were 1873 deliveries during the study period. One-third of women (679, 36.3%) were referred to the tertiary care centre. Seven (0.6%) women had postpartum haemorrhage. There were neither any maternal deaths nor any women with postpartum sepsis. Among the neonates, there were 20 (1.7%) stillbirths, 4 (0.3%) early neonatal deaths and 56 (4.7%) born with an Apgar score of <8. Conclusion. Skilled midwife care during the antenatal period and during labour leads to good maternal and neonatal health outcomes. Implementing similar programmes could immensely improve the maternal and neonatal health indicators of India.
Subject(s)
Apgar Score , Female , Humans , India , Infant Mortality , Infant, Newborn , Midwifery , Nurse Midwives , Outpatient Clinics, Hospital , Pregnancy , Pregnancy Outcome , Retrospective Studies , Urban Health ServicesABSTRACT
The story of Mr K illustrates how a busy urban health centre working with poor people confronted and dealt with ethical problems arising while treating a homeless and psychiatrically unwell patient. This story has been mentioned in an earlier publication in the context of how psychiatry could be practiced indigenously. The present discussion outlines the ethical dilemmas faced by the clinicians who took care of Mr K.
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Nanotechnology is the application of science to control matter at the molecular level. A nanometer (nm) is one billionth of a meter, or roughly the length of three atoms side by side. A nanoparticle is a microscopic particle with atleast one dimension less than 100 nm. The applilcation of nanoscale materials and structures, usually ranging from 1 to 100 nanometer are an emerging area of nanoscience and nanotechnology. Gold nanoparticles, in particular, are of interest, due to their stability under atmospheric conditions, resistance to oxidation and biocompatibility. Microorganisms as possible eco–friendly nanofactories can exert control over size, morphology, composition and crystallographic orientation of the as–prepared metal nanostructured particles. In the area of nanotechnology, the development of techniques for the controlled synthesis of metal nanoparticles of well defined size, shape and composition is a big challenge. This work was highly focused on the Gold nanoparticles production from Pseudomonas sp. and concentrating the work towards the production at controlled size by means of various parameter optimization studies like pH, temperature and concentration. The optimization work was characterized by means of TEM. With the results of TEM, the small sized nanoparticle of about 10nm was observed at pH of 9 and 12nm was produced at the pH of 3. Low temperature of 25oC favored the small size nanoparticle at a concentration of 250 mg/l using HAuCl4.
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BACKGROUND AND AIMS: Mental stress is considered to be a precipitating factor in acute coronary events. We aimed to assess the association of subjective or 'perceived' mental stress with the occurrence of acute coronary events. SETTINGS AND DESIGN: Prospective case-control survey was carried out in a referral teaching hospital. SUBJECTS & METHODS: Consecutive patients with acute myocardial infarction and ST elevation on electrocardiogram who were admitted to the Coronary Care Unit of a referral teaching hospital were enrolled in the study as cases. Controls were unmatched and were enrolled from amongst patients with coronary artery disease who did not have recent acute coronary events. Subjective Stress Functional Classification (SS-FC) for the preceding 2-4 weeks was assessed and assigned four grades from I to IV as follows: I - baseline, II - more than usual but not affecting daily routine, III - significantly high stress affecting daily routine and IV - worst stress in life. STATISTICAL ANALYSIS: Proportions of different characteristics were compared using chi-square test with Yates continuity correction. Student's unpaired t test was applied for mean age. 'p' value of < 0.05 was considered statistically significant. RESULTS: SS-FC could be reliably (99%) and easily assessed. Eighty (53%) of the total 150 patients with acute MI reported 'high' levels of stress (stress class III and IV). This is in contrast to only 30 (20%) of 150 healthy controls reporting high stress for the same period (p value < 0.001). CONCLUSION: Patients with acute myocardial infarction report a higher subjective mental stress during 2 to 4 weeks preceding the acute coronary event.
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Case-Control Studies , Female , Humans , Interview, Psychological , Male , Middle Aged , Myocardial Ischemia/psychology , Prospective Studies , Stress, Psychological/classificationABSTRACT
The aim of this study is to measure phosphate levels in AMI, compare and analyse its relation with left ventricular (LV) dysfunction and mortality. Serum phosphate was measured by kinetic assay method in 40 patients with acute myocardial infarction (AMI). Echocardiographic LV function was assessed in all and the patients were followed up for 30 days. Hypophosphatemia (< 2.5 mg/dl) was observed in 27% of AMI patients (11/40). These patients formed group 1 of our study. The rest 73% patients (29/40) with normal phosphate levels formed group 2. Mean Phosphate level in group 1 was 1.96 mg/dl (range 1.2-2.37) and mean ejection fraction (EF) was .35 (range .25-.50, p value < .001). Mean phosphate in group 2 was 3.693 (range 2.6-6.00) and mean EF was .53 (range .38-.65, p value < .001). In hospital mortality of the group 1 was 28% (3/11) while in group 2 was 6.8% (2/29). We conclude hypophosphatemia in AMI is associated with LV dysfunction which results in increased 30 day mortality.