Repercussion Of Cultural Clashes In Manju Kapur's The Immigrant

Manju Kapur primarily writes about the plight and repression of Indian women as well as their resistance to it. Marriage, families, complexities in relationships and separation are some of the most pervasive themes in her fiction. Manju Kapur's The Immigrant is a story of dislocation and cultural conflict. The novel revolves around a thirty-one-year-old spinster, Nina, who lived with her widowed mother in Delhi. She marries Ananda, an NRI, dentist and she flies to Canada to start her new life. The paper discusses how the novelist brings up the life of a married woman, with only her husband to talk to, all alone in a foreign land where Indian culture and individualism have often remained alien ideas. This paper delves into the issues of alienation and the search for cultural identity, as well as transformation of Nina and Ananda as a result of becoming an immigrant.

Polycystic ovarian syndrome and insulin resistance: a South Indian study

Background: Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women of reproductive age. Some studies have characterized different aspects of women presenting with PCOS. In this study we characterise the association of insulin resistance (IR) in patients with PCOS in the southern Indian state of Andhra Pradesh.Methods: A total of 50 women diagnosed to have PCOS according to Rotterdam criteria were studied. IR was estimated using Homeostatic model assessment - insulin resistance (HOMA-IR) and clinical characteristics were recorded.Results: The prevalence of IR among the study population was 36%. All PCOS patients with IR were overweight or obese, and had impaired glycaemic status, 75% of PCOS patients with IR also had features of hirsutism.Conclusions: Considering the prevalence of IR, obesity and impaired fasting glucose in women with PCOS, early institution of treatment by lifestyle changes or medication would lead to improvement in reproductive and metabolic abnormalities.

Comparative study of solubility and hemoglobin electrophoresis with high performance liquid chromatography (HPLC) for screening of hemoglobinopathies and thalassemia: Study from central India

Introduction: High prevalence of hemoglobinopathies is seen in central India, screening and genetic counseling are essential for early detection and management. Aim: The retrospective study was performed at Regional hemoglobinopathy detection and management centre (RHDMC) Nagpur, central India to find out relative frequencies of hemoglobinopathies and thalassemia present using solubility test, hemoglobin electrophoresis and high performance liquid chromatography (HPLC) as screening method and to compare results of HPLC with solubility and electrophoresis. Materials and methods: A total of 105,211 cases were screened for sickle cell disease (SCD) and sickle cell trait (SCT) by solubility test during the period of January 2003 to January 2014. Of these 105,211 samples, 60,000 samples which were solubility positive, with doubtful solubility and solubility negative but suspicious for hemoglobinopathy and thalassemia also the cases of anemia were studied by hemoglobin electrophoresis at alkaline pH 8.6. Of which 5,111 cases were further Shrikhande Anuradha V., Pawar Prajkta S. Comparative study of solubility and hemoglobin electrophoresis with high performance liquid chromatography (HPLC) for screening of hemoglobinopathies and thalassemia: Study from central India. IAIM, 2019; 6(3): 111-126. Page 112 studied by HPLC and results of HPLC were compared with combined solubility and Hb electrophoresis. Results: Of 105,211 cases screened for hemoglobinopathy by solubility and electrophoresis, 12,979 (12.33%) were having sickle cell trait (SCT) and 3,062 (2.91%) were of sickle cell disease (SCD). Of 5,111 (100%) HPLC study cases, total SCD and SCT were 3,132 (61.27%) followed by 315 (6.16%) of beta-thalassemia trait and 264 (5.16%) cases of compound heterozygous for HbS and betathalassemia. Hemoglobinopathies E and D alone and its combination with HbS or beta-thalassemia were also found. Rare cases of HbD Iran, HbJ variant and HbQ India, Hb Abruzzo and delta-beta thalassemia were detected. Combined solubility and hemoglobin electrophoresis was effective for diagnosis of SCD and SCT when compared to HPLC with good agreement between two test by kappa statistics, however for detection of beta-thalassemia trait and for compound heterozygous for HbS and beta-thalassemia false negatives cases were more, chi square test showed highly significant P value <0.01. Conclusion: Combined solubility and electrophoresis are simple and cost effective alternative to HPLC for screening large population with high prevalence of SCD when resources are limited but for beta-thalassemia screening HPLC is mandatory.

Microfilaria in malignant pleural effusion: an unusual incidental finding or causative association.

Lymphatic filariasis is common in tropical countries and is endemic in India. Filaria has a wide spectrum of presentation. Filarial lung involvement is usually in the form of tropical pulmonary eosinophilia with pulmonary infiltrates and peripheral eosinophilia. Filariasis presenting with pleural effusion is an unusual presentation. Malignancy in association with filarial pleural effusion is extremely rare and its role in tumorigenesis is controversial. In this context, we hereby report a case of 60 year old male, chronic smoker, who presented with left sided chest pain, cough, breathlessness, generalized weakness and swelling over left infrascapular region. Pleural fluid cytology repeated thrice due to degenerative changes, finally revealed malignant cells along with microfilaria. FNAC from left infrascapular swelling showed cytological features suggestive of metastatic deposits of Adenocarcinoma.

Cavernous haemangioma of spleen: a rare case report.

Tumours of the spleen are as such rare. Of these rare tumours, haemangioma is the most commonly encountered benign tumour with fewer than 100 cases reported. It is either an incidental finding or presents as splenic enlargement or with complications. Preoperative investigations are often inconclusive and may not distinguish between haemangioma and metastases. We report a case of 40 years female with cavernous haemangioma of spleen presenting as massive splenomegaly. Splenic haemangioma presenting as massive splenomegaly is extremely rare and deserves a mention.

Clinicopathological study of salivary gland tumors: An observation in tertiary hospital of central India.

Background: The salivary glands are one of the few tissues in the body that are subjected to diverse and heterogeneous range of tumors and tumor like conditions. The relative infrequency of these tumors makes their diagnosis and management quite complicated. Fine needle aspiration cytology (FNAC) is a useful diagnostic procedure which has a recognized role in the evaluation of salivary gland lesions. A pre-operative diagnosis about nature of lesion, whether benign or malignant, will help in making decision about proper management of patient. Objective: Aim of this study was to know the epidemiology of salivary gland tumors in our region and to evaluate sensitivity, specificity and diagnostic accuracy of fine needle aspiration cytology taking histopathology as the gold standard. Method: It was prospective observational study conducted in department of pathology in our institute. Total 100 cases were studied with particular reference to age, sex, site, cytologic details & histological types as per WHO classification. FNAC & histopathological examination was done in all cases. Correlation between cytological & histopathological diagnoses was assessed. Diagnostic accuracy of FNAC was evaluated by comparing cytological & histopathological diagnoses. Results: Parotid gland was the most common site of involvement (70% cases). Maximum number of patients was in age range of 41-50 years & male to female ratio was 0.8:1. Most common benign & malignant tumors were pleomorphic adenoma (69.89% cases) & mucoepidermoid carcinoma (8.60% cases) respectively. On cytology, 93 cases while on histopathology 96 cases were diagnosed as neoplastic. Cytological diagnoses correlated with histopathological diagnoses in 94% cases. Sensitivity, specificity & diagnostic accuracy of FNAC were found to be 96.87%, 100% & 96% respectively. Conclusion: FNAC in salivary gland masses is fairly reliable for correct preoperative diagnosis. Multiple sampling and special attention to cytologic features should help to minimize errors.

Coexistence of breast hemangioma with fibroadenoma: a rare case report.

Vascular tumors of the breast are uncommon and include angiosarcomas and hemangiomas. Angiosarcomas are more common and benign hemangiomas are rare. We report a case of 16 years old female patient with hemangioma of breast coexisting with very commonly occurring breast fibroadenoma. The rarity of literature on breast hemangioma especially coexistent with fibroadenoma, and its importance in differentiation from the more common malignant counterpart, the angiosarcomas deserves mention.

Study of Salivary Gland Neoplasms.

Tumors of the salivary glands are uncommon and they present a great variety of histological types with many structural variation. They have a low incidence and their anatomical relationship especially that of the parotid gland to the facial nerve make their management challenging. The present study was carried out to find out the prevalence of salivary gland neoplasms, to see associated conditions like sialadenitis, sialolithiasis coexisting with salivary gland neoplasms and to do cytohistopathological correlation. Total 96 cases were collected of which 66.7% were benign and 33.3% were malignant. In 81 (84.3%) cases tumors occurred in major salivary gland while 15 (15.6%) cases in minor salivary gland. Among major salivary gland, parotid was the commonest site and in minor salivary glands, palate was the commonest site followed by lips. Pleomorphic adenoma was the commonest benign tumor and adenoid cystic carcinoma was the commonest malignant tumor followed by mucoepidermoid tumor. There was one case of synovial sarcoma. Associated pathology like sialadenitis and sialolithiasis were present in 16 benign and 5 malignant tumors. Cytohistocorrelation was seen in 63 out of 64 (98.4%) benign and 16 out of 18 (88.8%) malignant tumors.

Pneumatosis cystoides intestinalis- a morphological curio or a pitfall for surgeons: report of two cases and literature review

Pneumatosis Cystoides Intestinalis (PCI) is an uncommon but well recognised clinical entity in which gas-filled cysts appear in the intestinal wall.PCI can be an incidental finding or it may be detected during radiography or laparotomy. We came across two cases of PCI with characteristic morphological features associated with perforation peritonitis in and sigmoid volvulus respectively. In both cases PCI was not suspected pre-operatively.Both patients underwent urgent surgical exploration for the abdominal emergencies and were discharged in good general condition. It is imperative that the imaging finding of PCI is carefully correlated with the findings of physical examination, clinical history, and laboratory test results to determine which patients can be managed medically by treating the underlying disease and which will require emergency surgery. This decision can be difficult because the origin of the gas is often unclear and the patient's symptoms can be volatile, presenting a major dilemma for the surgeon.

Tuberculous neuritis: A rare sequel of a common disease.

Tuberculosis (TB), a disease caused by Mycobacterium tuberculosis is an infectious disease that continues to be a significant health problem in a developing country like India. The cause of peripheral neuropathy associated with tuberculosis is controversial. Possibilities include the toxic effects of antituberculous chemotherapy (especially, rifampicin, streptomycin & ethambutol), immune mediated neuropathy, direct invasion of nerves, vasculitic neuropathy, compressive neuropathy, and meningitic reaction. This report describes an unusual fi nding of tuberculous granulomas in the peripheral nerve (Greater auricular nerve) of a patient ,who presented with a painful neck swelling. Granulomas were present in Greater auricular nerve (C2,C3) biopsy specimen associated with tuberculous peri-neuritis, but with no more specifi c indications of the mechanism of the neuropathy.

Growth of Short Children Born Small for Gestational Age and Their Response to Growth Hormone Therapy.

Growth hormone [GH] is licensed for use in children born small for gestational age (SGA) who fail to catch-up. We retrospectively compared the response of twenty children born SGA (who satisfied the auxological criteria) to growth hormone (Group I) versus randomly selected age and sex matched controls from a group of SGA children with growth related complaints, not treated with GH (Group II). After 2 years of GH therapy the HAZ increased from -2.8 to -1.6 in Group I, compared 2.2 to -1.7 in group II (P-value < 0.05). The percentage of pubertal children rose from 55% to 65% in cases versus 60% to 75% in the controls (P>0.05). GH resulted in increase in growth velocity Z-score during the first year and (4.3±0.5 in Group-I versus - 0.5±0.6 in Group-II, P<0.05) second year of treatment (1.7±0.4 in cases versus -0.6±0.7 in controls, P<0.05).Thus, GH improves height of short SGA children without accelerating pubertal progression.

Study of placenta in sickle cell disorders.

Remarkable changes are seen on gross and microscopic examination of placenta of patients with sickle cell disorders, hence the present study was undertaken to find out the pathological changes seen in the placenta of sickle cell disorder patients, as compared to control and to study the effect of maternal sickling on the fetus. It includes total 73 cases, of which 10 were of control group and 63 were from patients with sickle cell disorders, which included 47 sickle cell trait (AS) and 16 sickle cell disease (SS) patients. In group II, 9 (14.28%) patients with SS pattern developed complications during pregnancy, in the form of vaso-occlusive and hemolytic crises. Pregnancy induced hypertension was seen in 4 (25%) out of 16 SS and 11 (23.40%) of the 47 AS patients. Urinary tract infection (UTI) was seen in 6 (37.5%) out of 16 SS and 8 (17.02%) out of 47 AS patients. Placentae in sickle cell disorders showed pathological changes in the form of infarction, calcification, sickled red blood cells and hemorrhage in intervillous spaces, increased syncytial knots, fibrinoid necrosis, stromal fibrosis, hyalinised villi and compensatory proliferation of trophoblastic cells.

Triangular approach for the diagnosis of monoclonal gammopathy in malignancies.

Monoclonal Gammopathy (MG) in multiple myeloma (MM) is an established association but its occurrence in nonmyelomatous malignancies and other inflammatory conditions is still a subject of research. We carried out this study to detect monoclonal gammopathy in myelomatous and nonmyelomatous malignancies by adopting the triangular approach of correlating radiologic findings, bone marrow studies and electrophoretic findings. 200 cases of malignancies (25 cases of multiple myeloma and 175 cases of nonmyelomatous malignancies) were studied. Serum and urine electrophoresis was carried out in every case and positive cases were subjected for typing by immunoelectrophoresis (IEP). The incidence of monoclonal gammopathy in nonmyelomatous malignancies was 2.29% (4/175 cases), in epithelial malignancies was 0.8% (1/125 cases) and 6% (3/50 cases) in haematological malignancies. Though the study sample was small, these interesting findings warrant more exhaustive research in this field.

Detection of anti-nuclear antibodies from filter paper blood clots using indirect immunoenzyme technique: preliminary experience and results.

BACKGROUND: The facilities to detect antinuclear antibodies (ANA) patterns in patients with systemic rheumatic diseases/connective tissue disorders (CTD) using indirect immunofluorescence (IIF) technique (the gold standard) are sparse; the technique is technically difficult and expensive. A simpler technique, such as the indirect immunoenzyme (IIE) which uses light microscopy, ought to be evaluated for widespread use in our setting. OBJECTIVE: To study the feasibility and relevance of IIE in demonstrating ANA patterns, both from serum and filter paper blood clots (FPBC), in patients with CTD. METHODS: In this pilot study, ANA were detected from sera and FPBC of 21 patients with proven CTD using IIE; paired FPBC and serum samples were simultaneously collected in 10 patients. All samples, coded randomly, were tested by IIE and IIF, along with positive and negative controls. RESULTS: Using IIE, the results of the ANA patterns obtained from FPBC eluates and sera were similar; homogenous (SLE-6, PSS-1, RA-4), speckled (SLE-8, PSS-2, Overlap CTD-1) and centromere (PSS-1). Four SLE patients showed mixed pattern; sensitivity of IIE for lupus was hundred percent. On comparing the results with the serum IIF, the Kappa statistic of agreement was 1 (perfect) and 0.4 (fair) for FPBC-IIF and FPBC-IIE respectively; the results matched between serum IIF and FPBC-IIE in 8 of the 10 paired samples tested. CONCLUSIONS: IIE can demonstrate ANA both from sera and FPBC. This pilot study besides demonstrating positive trends for further probe also creates an awareness for such a feasible technique. However a larger sample size would be required to carry out its evaluation as an alternative to IIF and as a screening technique.