Atrophic kidney-like lesion: A rare benign entity and mimicker of thyroid follicular-like carcinoma of kidney

Atrophic kidney like lesion (AKLL) is a recently described benign entity with only 14 cases reported so far. Genitourinary Pathology Society proposed inclusion of AKLL as a provisional entity in 2021. It mimics thyroid follicular-like carcinoma of kidney as it has a follicular architecture. We report a case of an 18-year-old female with detection of renal mass, while the patient was being investigated for abdominal pain. Mediastinal nodes were also enlarged with detection of necrotizing granulomas on biopsy. Histology revealed a tumor enveloped by a thick capsule with smooth muscle fibers, varying sized follicles, interspersed atrophic tubules, and calcifications. Immunohistochemically, the “cystic follicles” show WT1 +/PAX8 -/CK7-phenotype, while atrophic tubules present between “cystic follicles” harbor WT1 -/PAX8 +/CK7 + phenotype. Morphological diagnosis and differential diagnosis will be discussed.

Ewing sarcoma arising in colon and ovary––Two rare sites of presentation

Ewing sarcoma is a rare aggressive malignant round cell tumor, primarily presenting in bone and soft tissues. This study presents two cases of this tumor in unusual locations, one in right colon which presented with intussusception and other in ovary which presented clinically as carcinoma ovary. Both the cases showed histomorphology of primitive round cell tumor with characteristic immunohistochemical profile and was confirmed on molecular analysis. We aim to highlight the importance of considering Ewing sarcoma in the differential diagnoses in these locations as they have dismal prognosis with no standard treatment modality.

Prevalence of overweight obesity among M.B.B.S. students

Background: Prevalence of overweight-obesity is rising in India. Medical Professionals are vulnerable to overweight-obesity because of the sedentary lifestyle which is frequently adopted due to massive work burden. Aim & Objective: To assess prevalence of overweight-obesity and associated factors among MBBS students in a medical institute in north-Indian state of Uttarakhand. Settings and Design: Descriptive cross-sectional study Methods and Material: This study was conducted among 310 M.B.B.S. students at Himalayan Institute of Medical Sciences, Uttarakhand, between March and May 2019. Socio-demographic details were recorded using a structured pro forma. A pre-validated IPAQ questionnaire was used for assessment of physical activity. Anthropometric and clinical parameters were measured using standard techniques. Statistical analysis used: Independent student’s t test and Chi square test were used to compare the quantitative variables and categorical variables, respectively. Pearson’s correlation test was used to study the correlation of BMI with clinical parameters. Results: Among 310 study subjects, 164 (52.9%) were overweight-obese. The prevalence of abdominal obesity was 30.3 percent. Subjects with overweight-obesity, in comparison to normal BMI group, had higher frequency of smoking, higher systolic blood pressure, higher mean arterial pressure, higher pulse pressure and engaged more in high (category 3) physical activity. Conclusions: There was 52.9% prevalence of overweight-obesity in study cohort. Overweight-obese subjects had higher blood pressure and frequency of smoking, both traditional cardiovascular risk factors. Interestingly, more overweight-obese subjects engaged in high physical activity.

Synthesis And Anticancer Screening Of Triazine Analogues

Objective: The study was aimed to investigate the cytotoxic effect of S-5H-[1,2,4]-triazino (5,6-b) indol-3-yl-3,4-phenylethane-thioate derivatives as epidermal growth factor Receptor (EGFR) inhibitors. Methods: In the present study 14 novel triazine analogues were synthesized and characterized using different spectroscopic techniques such as FT-IR, NMR and Mass Spectroscopy. The anticancer activity was performed using MCF-7 (breast cancer) and K-562 (leukaemia) cell lines. Further, molecular docking was carried out using Vlife Molecular Docking Software (MDS) on crystal structure of epidermal growth factor receptor (EGFR) to identify the binding mode of interaction with an active site. Results: Compounds MA-7, MA-8, MA-12, MA-13 and MA-14 show potent activity against cancer cell lines in the range of<10 to 84.4 µg/ml. Further molecular docking on EGFR also supports that there is a strong correlation between in silico and in vitro biological activity. The results of this study may be further useful for lead optimization process. Conclusion: The results of this study indicates that the synthesized triazine analogues can give a potential lead as an anticancer agent.

Study of complement activation, C3 and interleukin-6 levels in burn patients and their role as prognostic markers.

Purpose: The management of burn patients is always challenging for the clinician due to high risk of bacterial sepsis, multi‑organ failure and death. Our objective was to study complement activation, C3 and interleukin‑6 (IL‑6) levels in burn patients and evaluate their role as prognostic markers. Materials and Methods: A total of 63 burn patients and 60 healthy controls were included in this study. Blood was collected from patients within 24 h and at 7th day of injury. Complement activation was determined by crossed electrophoresis and counter‑current immunoelectrophoresis. C3 levels were measured using a single radial immunodiffusion. IL‑6 was detected by ELISA. Results: All patients showed initial complement activation. Mean C3 levels showed an inverse correlation with the severity of burn. Patients with ≥20% burns had lower C3 than the controls (P < 0.001) and those with <20% burns (P < 0.001). Patients with ≥40% burns had activated complement and low C3 in 2nd week; they subsequently developed infection. Complement was inactive and C3 levels recovered in patients with <40% burns. The non‑survivors showed significantly lower C3 than the survivors (P < 0.05) in 2nd samples. Patients who developed infection had C3 significantly lower than those who remained free of infection (P < 0.05). All patients showed initial elevation in IL‑6 levels. Patients with ≥60% burns had significantly higher IL‑6 than controls (P < 0.001) and those with <60% burns (P < 0.001). Non‑survivors had higher IL‑6 than survivors in both samples (P < 0.001). Patients who developed infection showed significantly higher IL‑6 in 2nd samples than those without infection (P < 0.001). Conclusions: Complement activation, C3 and IL‑6 levels correlated well with the severity of injury and development of infection in burn patients. These parameters can be used to predict the onset of infection, septicaemia and mortality in burn patients.

Assessment of lexical semantic judgment abilities in alcohol-dependent subjects: An fMRI study.

Neuropsychological studies have shown that alcohol dependence is associated with neurocognitive deficits in tasks requiring memory, perceptual motor skills, abstraction and problem solving, whereas language skills are relatively spared in alcoholics despite structural abnormalities in the language-related brain regions. To investigate the preserved mechanisms of language processing in alcohol-dependents, functional brain imaging was undertaken in healthy controls (n=18) and alcohol-dependents (n=16) while completing a lexical semantic judgment task in a 3 T MR scanner. Behavioural data indicated that alcohol-dependents took more time than controls for performing the task but there was no significant difference in their response accuracy. fMRI data analysis revealed that while performing the task, the alcoholics showed enhanced activations in left supramarginal gyrus, precuneus bilaterally, left angular gyrus, and left middle temporal gyrus as compared to control subjects. The extensive activations observed in alcoholics as compared to controls suggest that alcoholics recruit additional brain areas to meet the behavioural demands for equivalent task performance. The results are consistent with previous fMRI studies suggesting compensatory mechanisms for the execution of task for showing an equivalent performance or decreased neural efficiency of relevant brain networks. However, on direct comparison of the two groups, the results did not survive correction for multiple comparisons; therefore, the present findings need further exploration.

Thrombolytic therapy in clotted prosthetic mitral valve.

Thrombosis of a Bjork-Shiley valve in the mitral position was suspected clinically and confirmed by echocardiography and cine fluoroscopy. Streptokinase therapy followed by intravenous heparin infusion was given and the clot lysed successfully. The patient was asymptomatic upto two years of follow-up.

Spectrophotometric measurements on verdo-myoglobin: relevance to the oxidation of ferri-myoglobin by chlorite ion.

Spectrophotometric observations on verdo-myoglobin, reconstituted from apomyoglobin and verdo-heme and its oxidation products, are described. Relevance of these results to the oxidation of ferri-myoglobin by chlorite ion is also discussed.