Role of cyclin D1 in glial tumors—A retrospective and observational study

Aim: High-grade glial tumors remain as one of the most lethal malignancies. Cyclin D1 is expressed in some human malignancies and is the potential target of intervention. The present study aims to determine the relationship of cyclin D1 expression with other clinicopathological parameters. Materials and Methods: A cross-sectional study was carried out in a tertiary care center. Biopsy proven 66 cases of glial tumor patients were included in the study. The patients with incomplete clinical details were excluded from the study. Immunohistochemistry using antibodies for IDH 1 and cyclin d1 was done in all the cases. Glial tumors were reclassified according to WHO 2016 classification. Data analysis was performed using SPSS 26.0 for the windows. Result: Among 66 patients, 49 (74.3%) were males and 17 (25.7%) were females. The age of the patients ranged from 20 years to 70 years. Overall, 6.02% were of grade I Glial tumors, 22.7% were of grade II Glial tumors, 19.6% patients were of grade III Glial tumors, and 51.6% patients were of grade IV Glial tumors. Of 66 samples tested cyclin D1 was positive in 25 (37.87%) as high expressers and 7 (10.60%) were low expressers. Our study showed a significant correlation between the expression of cyclin D1 with grade and IDH mutation status, No significant correlation of cyclin D1 was noted with age or sex of the patient. Conclusion: Cyclin D1 was associated with a higher grade of the glial tumor. It can be a potential marker both for prognosis and treatment of glial tumors.

Structural-functional correlation using adaptive optics, visual fields, optical coherence tomography and multifocal electroretinogram in a case of torpedo maculopathy

We present a case of a 37-year-old gentleman with a rare diagnosis of Torpedo maculopathy (TM). We describe the multimodal imaging features of torpedo maculopathy using adaptive optics, visual fields, OCT and multifocal ERG, and understand the clinical and structural-functional correlation in TM. According to us, this is the first case report to describe the adaptive optics imaging findings in Torpedo maculopathy in English Medical literature.

Nursing Teachers’ Attitude Towards Suicide Prevention- A Study From Gujarat.

Background: Suicide is a global health problem and the second leading cause of death in 15-29 years of age. There were reports of nursing students committing suicide in Gujarat. As nursing teachers are the important gatekeepers, it was essential to study their attitude towards suicide prevention. Methodology: A questionaire containing 20 statements, derived from the Attitude towards suicide prevention scale and from the Suicide opinion questionnaire, to be marked as ‘agree’, ‘disagree’ or ‘uncertain’ was administered to 80 nursing teachers from Gujarat. This was followed by an interactive session on suicide prevention. Results: Most of the nursing teachers felt that suicide prevention was their responsibility, that a large proportion of suicides was preventable, most suicides were impulsive and that suicide in the young was particularly puzzling. However, nearly 80 % felt that those who are serious about committing suicide usually don’t tell anyone. Around one-fifth felt there was no way of knowing who was going to commit suicide and they were not comfortable in assessing suicide risk. Conclusion: The overall attitude of the nursing teachers towards suicide prevention was positive. However more educational and skill-based training programmes are required to better equip the nursing teachers for suicide prevention.

The Impact Of Mental Health Education On The Knowledge And Attitude Of The Peripheral Health Workers Of Dang.

Background & Objective: Mental health needs of a society are ideally met by integration in primary care. Under the District Mental Health programme, Surat is the nodal centre for Dang, a tribal region. In order to make medical care available to the patients in need, it was vital to train the peripheral health workers of the region. The aim was to provide mental health education to the peripheral health workers of Dang and assess its impact on their knowledge and attitude regarding mental health issues. Methodology: 150 peripheral health workers were posted in the Department of Psychiatry in batches of 20-30 each for a 7-day, extensive, in-house training. The improvement in knowledge and attitude was assessed by a pre-post semi-structured questionnaire and structured feedback. Results: The training resulted in a significant improvement in scores related to clarification of myths. The knowledge and attitude related to mental health issues improved significantly and the participants reported that they were sensitized by the training and would identify and refer patients to the visiting psychiatrist. Conclusion: The training in mental health could bring about improvement in the knowledge and attitude of the peripheral health workers. However, to what extent does this change reflect in actual practice, needs to be ascertained.

Current scenario of Opportunistic and co-infections in HIV-infected individuals at a tertiary care hospital in Mumbai, India.

Purpose: An update on opportunistic infections/co-infections (OIs/CIs) is essential to understand the success of highly active antiretroviral therapy offered by the government agencies in reducing AIDS-related OIs/CIs. Hence, the present study aimed to evaluate the frequency of OIs/CIs in HIV-positive individuals at a tertiary care hospital in Mumbai. Its’ association with CD4 counts, anti-retroviral treatment and on HIV transmission was also determined. Materials and Methods: An observational study was designed to evaluate different OIs/CIs in individuals, who tested positive for HIV infection at the ICTC/Shakti Clinic of Seth G.S. Medical College and KEM Hospital, Mumbai. Data analysis was done with the use of SPSS software (version 19.0, SPSS, Chicago, IL, USA). P value was considered signifi cant if it is < 0.05. Results: Heterosexual contact was the major route of transmission among the enrolled 185 individuals. Ninety (48.06%) HIV-infected individuals were with OIs/CIs. Tuberculosis (TB) was the most common OI (68.8%). Other CIs noted were Herpes zoster, syphilis, hepatitis C and B, malaria, typhoid and dengue. The median CD4 count in HIV-positive individuals with TB was 337 ± 248 cells/μl, and 67.7% of individuals with OIs/CIs had low CD4 counts (<400 cells/μl). Individuals in 31-40 years of age group had signifi cantly (P = 0.01) more OIs/CIs. More (53.7%) spouse/children of HIV-positive individuals without OIs/CIs were HIV-1 positive. Low proportions of individuals with or without OIs/CIs were on ART. Conclusion: Nearly half of HIV-infected individuals were with OIs/ CIs. Initiation of free ART programme since 2004 possibly associated with the type and rate of OIs/CIs. Tuberculosis and multiple OIs/CIs were associated with low CD4 counts. Infection was high in 31-40 years age group. Most of the spouses of individuals without OIs/CIs were HIV positive, indirectly indicates lack of condom use or lack of awareness of condom use.

Comparative evaluation of remineralization potential of casein phosphopeptide-amorphous calcium phosphate and casein phosphopeptide-amorphous calcium phosphate fluoride on artificial enamel white spot lesion: An in vitro light fluorescence study.

Background: World-wide, the contribution of dental caries to the burden of oral diseases is about 10 times higher than that of periodontal disease, the other common oral condition. Owing to its globally high prevalence, dental caries is a "pandemic" disease characterized by a high percentage of untreated carious cavities causing pain, discomfort and functional limitations. Untreated carious cavities; furthermore, have a significant impact on the general health of children and on the social and economic well-being of communities. A surgical approach to the elimination of carious lesion was developed a century ago; this approach was necessary at that time, because there was no valid alternative. The focus in caries has recently shifted to the development of methodologies for the detection of the early stages of caries lesions and the non-invasive treatment of these lesions. The non-invasive treatment of early lesions by remineralization has the potential to be a major advance in the clinical management of the disease. Remineralization of white-spot lesions may be possible with a variety of currently available agents containing fluoride, bioavailable calcium and phosphate and phosphate. This concept bridges the traditional gap between prevention and surgical procedures, which is just what dentistry needs today. Aims and Objectives: The aim of this in vitro study was to evaluate and to compare the remineralization potential of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and casein phosphopeptide-amorphous calcium fluoride phosphate (CPP-ACFP) on artificial white spot enamel lesions using the quantitative light fluorescence (QLF). Materials and Methods: A total of 45 caries-free extracted maxillary first premolars were embedded in acrylic resin. The samples were randomly divided into three groups namely control group, CPP-ACP group and CPP-ACFP group with 15 samples in each group. The samples of each group were subjected to demineralization process for a period of 96 h. The samples were then mounted in the artificial mouth model and subjected to remineralization and pH cycling for a period of 21 days. QLF readings were recorded at the end of demineralization (1 st , 7 th , 14 th and 21 st day) and were statistically analyzed. Results: As compared with artificial saliva both CPP-ACP and CPP-ACFP produced significant amount of remineralization of the artificial enamel white spot lesion (P < 0.001), however when the remineralizing effect of CPP-ACP was compared with the remineralizing effect of CPP-ACFP there was no significant difference. Significant amount of remineralization was produced by CPP-ACP and CPP-ACFP only after the 7 th day. After the 14 th day, the remineralization produced by both CPP-ACP and CPP-ACFP as compared to artificial saliva was non-significant.

Profile of deaths due to electrocution: A retrospective study.

We carried out a retrospective analysis of deaths due to electrocution from the medico-legal deaths reported to our institution. Majority of the victims were males belonging to the age group of 11-50 years. Almost all deaths were accidental and most of them were concentrated in the period of monsoon implicating the important role of wetness in causing these deaths. In contrast to the studies done in the West, bathtubs, heaters or hair dryers were not involved in any of the deaths. The mortality rate due to electrocution was significantly higher at 4.4 per one lakhs (100000) population in the present study as against the figures of 0.94 and 0.14 from Bulgaria and Canada respectively. Most of the deaths were either instantaneous or immediate and most of the deaths were preventable by electrocution. It signifies that people living at home did not have elementary knowledge of risks of electrocution; therefore awareness about use of good quality electric appliances and cables is the need of the hour.

A double blind, randomised placebo controlled trial of rifampicin with omeprazole in the treatment of human cutaneous leishmaniasis.

BACKGROUND & OBJECTIVES: This study was conducted on 50 patients of Anthroponotic cutaneous leishmaniasis (oriental sore) to assess the efficacy of rifampicin and omeprazole through a double blind, randomised placebo control study. METHODS: The diagnosis of Anthroponotic cutaneous leishmaniasis (ACL) caused by Leishmania tropica was done by demonstration of Leishmania tropica (LT) bodies from the painless, dry ulcerative lesion. Each patient was assessed clinically in the beginning of the study, at the end of 2,4 and 6 weeks and all observations were compared in both the groups. Twenty-five patients received rifampicin with omeprazole (Group A) whereas other 25 patients received placebo (Group B) for a period of six weeks. RESULTS: Altogether 23 cases in group Aand 21 cases in group B completed the study. About 16 (69.7%) cases in group A and 3 (14.29%) cases in group B had complete healing, whereas 3 patients (13.04%) of group A and 4 patients (19.05%) of group B had partial response and 4 patients (17.93%) of group A and 14 patients (66.67%) of group B had no response at the end of study. The difference of two groups was statistically highly significant (p < 0.00025). All patients tolerated the drug and placebo very well and no side effect was reported. INTERPRETATION & CONCLUSION: In our opinion rifampicin and omeprazole is a highly effective, less toxic and cheaper alternative for the management of cutaneous leishmaniasis.

Amoebiasis cutis in HIV positive patient.

Protozoan infections of the skin, particularly cutaneous amoebiasis, are rare in HIV-positive patients. We report a case of amoebiasis cutis in an HIV-positive truck driver with a history of frequent unprotected sexual exposures. He presented with multiple painful ulcers and sinuses with purulent discharge, necrotic slough and scarring in the perianal and gluteal region for the last 2 years. He was positive for HIV-1 and -2. Cutaneous biopsy revealed numerous Entamoeba histolytica in the trophozoite form, in addition to an inflammatory infiltrate and necrotic debris. He responded well to oral metronidazole and chloroquine. Amoebiasis cutis should be considered in the differential diagnosis of perianal ulcers, particularly in HIV-positive patients.

Oral rifampicin in cases of cutaneous leishmaniasis with multiple lesions (a pilot study).

The multiple lesions of cutaneous leishmaniasis (CL) require an effective oral agent. We are reporting a pilot study of oral rifampicin 600 mg. bid or 20 mg/kg. body weight in cases of CL with multiple lesions. Our study shows 83.3% parasitological and clinical cure with insignificant side effects after 4 weeks of therapy. No relapse upto 6 months of completion of study was seen.

Electrocardiographic changes in craniocerebral trauma--could they serve as prognostic indicators?

Electrocardiographic (ECG) changes were analysed in one hundred patients of craniocerebral injuries irrespective of age and sex. Males comprised 82% of patients and most vulnerable age group was 15-40 years (66%). Although the overall mortality was 17%, the maximum mortality (44.44%) was observed in the age group of 41-60 years. Computed tomographic scan proved lesions in intracerebral haemorrhage, subdural haematoma, mixed lesions and extradural haematoma were associated with mortality rates in 66.66, 33.33, 20 and 11.11 per cent respectively. ECG changes of some or the other type were present in almost all patients (99%) but ST-segment shift, sinus tachycardia/bradycardia, T-wave changes and prolonged QTc-interval (> 440 msec) carried high mortality rates of 60, 34.6/27.3, 19.6 and 17.3 per cent respectively, especially if these changes persisted for long duration. Occurrence of supraventricular tachycardia and nodal arrhythmia, although associated with high (50%) mortality rates, were probably terminal events rather than the cause of increased mortality. There was, however, no direct correlation between the type of craniocerebral injury and specific ECG changes.