Correction to: Development of typological classification and its relationship to microdifferentiation in ethnic India

Prostate cancer (PCa) represents the most frequently diagnosed cancer in men. Cisplatin, also known as cis-diamminedichloroplatinum (DDP), is a standard chemotherapeutic agent used to treat PCa, and DDP resistance remains one important obstacle inDDP-based chemotherapy. In our research, we found miR-425-5p was down-regulated in PCa and even lower in DDP-resistantPCa determined by quantitative polymerase chain reaction; in contrast, GSK3b mRNA expression was upregulated in PCa andeven higher in DDP-resistant PCa. Moreover, there was a modest but significant inverse correlation between the expression ofGSK3b mRNA and miR-425-5p. Functional experiments showed that miR-425-5p mimic inhibited DDP resistance as evidencedby a promoted apoptosis rate (flow cytometry) and suppressed cell viability (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazoliumbromide assay) and expressions of MDR1 and MRP1 (western blotting) in DU145/DDP and PC3/DDP cells. Luciferase reporterassay and RNA immunoprecipitation identified GSK3b was a potential target of miR-425-5p. The effect of miR-425-5p mimic onDDP resistance was partially reversed by pcDNA-GSK3b. Mechanically, miR-425-5p mimic reduced expression of b-catenin,cyclin D1 and C-myc, which was further blocked when GSK3b overexpressed. In vivo experiments, recovery of GSK3bprevented xenograft tumor growth and DDP resistance in the presence of miR-425-5p mimic. To sum up, miR-425-5p upregulation might sensitize human PCa to DDP by targeting GSK3b and inactivating the Wnt/b-catenin signaling pathway

A 3-year prospective study on ocular injuries with tennis or cricket ball while playing cricket: A case series

Purpose: The purpose of this study is to study the clinical features, visual outcome, management, and ocular complications of ocular injury, following trauma with tennis or cricket ball. Methods: A prospective, noncomparative case study of patients having injury with tennis/cricket ball while playing cricket was conducted between January 2013 and April 2016. Seventy-six eyes of 76 patients were studied. Presenting vision, age, gender, time since injury, general and ocular examination, intraocular pressure, indirect ophthalmoscopy, B scan, and X-ray/computed tomography scan findings were noted. Patients were managed medically or surgically as per the need and followed up at least for 6 months. Results: Seventy-six eyes of 76 patients were studied. All cases were male, except two. Majority (80.2%) were <25 years. Median presenting visual acuity (VA) was 6/36 and median final VA was 6/18. Significant findings in the decreasing order of frequency were sphincter tear (26.3%), retinal detachment (23.6%), angle recession (18.4%), choroidal rupture (17.1%), and Berlin's edema (15.7%). Most of the cases (69.7%) were managed medically. Only 30.2% cases needed surgical intervention. Final visual outcome in our study was depended on initial VA (P = 0.000). It was also correlating with presenting clinical feature (P = 0.010) and type of intervention (medical/surgical) (P = 0.001). Conclusion: Cricket-related ocular injury generally has a poor prognosis with most cases being closed globe injury; retinal detachment is the most common vision-threatening presentation. In spite of being a common event, cricket-related injury is sparingly documented and hence needs further studies for proper documentation, prognostication, and formulation of definitive management plan.

A comparative evaluation of efficacy and safety of daily dosing versus alternate day dosing of Rosuvastatin for dyslipidemic patients.

of morbidity and mortality in underdeveloped and developing countries and places a huge burden on the society in terms of health care resources and loss of productivity. Statins are the most popular hypolipidemic drug used to treat hyperlipidemia which is generally administered daily. Objectives: The study was conducted to compare the percent change of LDL-C, TC, TG and HDL and compare the safety of Rosuvastatin in patients of dyslipidemia. Material and Methods: Sixty patients were randomly divided into two groups: once daily group and Alternate day group of rosuvastatin 10mg for six weeks. The lipid profile was compared from the baseline and at end of six weeks. Results: Baseline characters of both the groups were well balanced. LDL-C was reduced by 23.8 % in once-daily group and 26.05 % in alternate-day group, respectively. Changes were also recorded for the other lipid parameters (TC, TG, HDL). Such changes were found to be of no significant difference when compared between the two groups (p>0.05 NS) Conclusion: Alternate day therapy is as effective as the once -daily dosing with rosuvastatin in Indian population in improving the lipid parameters in dyslipidemic patients.

Presence of suicidality as a prognostic indicator.

BACKGROUND: Suicidal symptoms in depression are often thought to predict a higher severity of illness and a worse prognosis. AIMS: To determine if suicidal ideation at the time of treatment for major depression can predict response to antidepressant medication in primary care. SETTINGS AND DESIGN: A retrospective analysis of subjects receiving anti-depressant drugs in a primary care setting METHODS AND MATERIAL: Nine depressed patients (14%) who acknowledged suicidality on the PHQ-9 depression scale were followed up for and compared to a group of 54 (86%) depressed patients (controls) who did not have suicidal thoughts for four months. All were given treatment with antidepressants and followed with a disease management protocol where the PHQ-9 was used as a systematic outcome measure. STATISTICAL ANALYSIS: Descriptive measures and t-tests were utilized to show statistical significance. RESULTS: There were no statistical differences in remission from depressive symptoms based on the PHQ-9 scale after antidepressant treatment, between patients with suicidal thoughts (56%) and those without (44%). CONCLUSION: The presence of suicidality as a depressive symptom did not predict poorer clinical outcome when treating depression in the primary care setting in the patients studied.

Noise pollution: a study of noise levels in the operation theatres of a general hospital during various surgical procedures.

Noise, defined as any unwanted or undesirable sound, is a known environmental pollutant and health hazard. Sound levels during the entire surgical procedures were measured in the operation theatres (OTs) of a general hospital in Delhi, using a sound level meter, B & K 2209, on the dB(A) scale. The sound levels were found to be higher as compared to the recommended international standands. The noise was contributed mainly by doors, trolleys, equipment and alarms and the incessant conversation among the operation theatre (OT) staff. It is well documented that noise is stressful eliciting changes in the autonomic nervous system, impairing mental faculties and producing masking that could affect the staff and the conscious patient alike, leading to decreased work performance and increased anxiety respectively. Better acoustic designing and maintenance of equipment together with an increased awareness of the OT staff towards this vital factor of work environment may effectively reduce the noise pollution in OTs.

Efficacy of magnesium sulphate in aluminium phosphide poisoning--comparison of two different dose schedules.

The results of an open randomised study on the efficacy of magnesium sulphate therapy in aluminium phosphide poisoning are presented. One hundred and fifty five patients divided in three groups and matched for age, sex, dose, duration and severity of poisoning constituted the subject matter. Significant hypomagnesemia was observed in patients who did not receive magnesium sulphate (group 1). Two dose schedules of MgSO4 therapy were tried. The dose schedule No.1 given to patients of group 2 did not raise the magnesium levels significantly as compared to controls (group 4). The difference in the mortality between groups 1 & 2 was also not significant. On the other hand, the dose schedule No.2 given to patients of group 3 raised the magnesium levels significantly and these remained above normal limits throughout the observed period. This dose schedule brought down the mortality significantly than dose schedule No.1 (p < 0.001). It was also found that dose schedule No.2 has been effective in reducing the mortality irrespective of dose of pesticide consumed and its efficacy was due to rapid rise in magnesium levels. It is suggested that hypomagnesemia might be responsible for high mortality of patients of aluminium phosphide poisoning and its correction has beneficial effect on the management and ultimate favourable outcome of the illness.

Outcome of patients with pre-existing hepatitis B virus infection following renal transplant.

Twenty four patients who were HBsAg positive prior to renal transplantation were studied with respect to their hepatic and renal outcome. The kidneys in all patients were obtained from living related donors. The standard immunosuppressive therapy consisted of azathioprine and prednisolone. Post-renal transplant follow-up varied from 32-86 months (mean 55 +/- 9). Renal functions, liver functions, HBsAg and HBsAb status was closely monitored during follow-up. One patient developed acute hepatitis four months after transplantation; this resolved in 10 weeks. Four patients showed transient elevations of liver enzymes. The results of liver biopsy in 16 cases revealed, normal histology (8), virus in hepatocytes (5), and acute hepatitis (3). None of the patients had evidence of chronic liver disease. Two patients died due to chronic rejection/chronic renal failure and two patients died due to septicaemia. Five living patients have mild to moderate chronic rejection. It was concluded that pre-existing HBsAg carrier state in transplant patients had no deteriorating effect on the liver. The mortality was related to chronic rejection and septicaemia.

IgA associated glomerulonephritis.

Immunohistological analysis of 1146 renal biopsies revealed IgA associated glomerulonephritis (IgAGN) in 83 (7.24%) patients (33 children, 50 adults). Clinical features were unusually severe in a high proportion. Nephrotic syndrome (NS) responding poorly to prednisolone was found in 24%, hypertension (HT) in 39%, and azotemia in 34% of patients. NS was slightly more frequent in children than in adults, but HT and azotemia occurred twice as often in adults as in children. Histologically, extensive glomerular crescents and sclerosis were prominent. In addition, moderate arteriolitis and arteriolosclerosis and marked tubulointerstitial nephropathy were notable features. Thus, a low incidence and marked severity characterized IgAGN in this study.

A clinico-investigative profile in Graves' ophthalmopathy.

A clinico-investigative profile was studied in 30 patients with Graves' Ophthalmopathy (GO) (15 each with early and late). In accordance to the thyroid status 63.3% of patients were hyperthyroid and 36.7% euthyroid. There was slight female preponderence, with ratio being 1.5:1. Exophthalmometric readings were significantly high in GO patients as compared to controls. However, no significant diagnostic role of postural exophthalmometry was seen. Positional tonometery may have respectable place among the tests for early diagnosis of GO; however, it could not differentiate between hyperthyroid and euthyroid cases. Further the role of ultrasonography, if available could not be overemphasized.

Magnesium levels in acute cardiotoxicity due to aluminium phosphide poisoning.

Significant hypomagnesemia and hypomagnocytia were observed in patients of aluminium phosphide (AIP) poisoning having evidence of acute cardiotoxicity while magnesium levels were normal in patients of AIP poisoning without shock or cardiotoxicity as well as in controls. There was a direct relationship between electrocardiographic findings and low magnesium levels. The mortality was also related directly to hypomagnesemia. The dose of pesticide also influenced the mortality adversely. Autopsied heart showed changes of toxic myocarditis on histopathology.

Lung transfer components in hyperthyroidism.

Pulmonary functions were studied in twenty hyperthyroid non smoker patients. Their FVC, PEFR and MVV were significantly lowered while FEV1/FVC% and EFR25-75% were normal. Amongst the diffusion functions, Tlco, Dm and VA were reduced and VC increased, though these changes were not statistically significant. After the achievement of euthyroid state, statistically significant increase was seen in FVC, PEFR, MVV, Tlco120, Dm and VA with significant decrease in Vc from the basal levels. FEV1/FVC% and EFR25-75% were not affected. These observations suggest that the principal abnormalities in pulmonary functions in the hyperthyroid state are increased pulmonary capillary blood volume and respiratory myopathy, which are reversed as euthyroid state is achieved.

Reversion of ventricular and supraventricular tachycardia by magnesium sulphate therapy in aluminium phosphide poisoning. Report of two cases.

Two patients with aluminium phosphide poisoning developed supraventricular tachycardia and ventricular tachycardia (one each). These reverted successfully with magnesium sulphate therapy.

Incidence & outcome of aluminium phosphide poisoning in a hospital study.

A total of 418 patients with aluminium phosphide poisoning admitted during January 1981 to December 1987, were studied and analysed for various clinical parameters. A steady increase in the number of patients was seen during the last 7 yr. Maximum number belonged to the younger generation and nature of poisoning was suicidal in most of these patients. Dose of poison consumed varied, but most patients consumed two tablets (6 g). A wide range of symptoms and signs was seen, the commonest being gastrointestinal manifestations and shock. Cardiac arrhythmias and conduction disturbances were seen in 38.2 per cent patients. The overall mortality was 77.2 per cent. Indices of a bad prognosis included poor response to dopamine infusion and continuous increase in its dosage, chest infections, adult respiratory distress syndrome and disseminated intravascular coagulation. The complications noticed were pericarditis, congestive cardiac failure, acute gastrointestinal haemorrhage and acute respiratory arrest. Histopathology of various organs showed changes suggestive of cellular hypoxia but the mechanism of ECG changes and of the complications could not be elucidated.