Epidemiological review and clinicopathological study of gastric adenocarcinoma cases in a tertiary care center in North Chennai, India

Background: Gastric carcinoma is the third most common cause of cancer-related mortality worldwide. The Incidence of gastric carcinoma shows wide geographic and regional variation as well. The clinical presentation varies with the individual and hence histopathological evaluation plays a major role in the diagnosis and management of the patients. This study aims to evaluate the epidemiological and clinicopathological profile of gastric adenocarcinoma cases encountered in a tertiary care center in North Chennai where only limited statistical data available in literature.Methods: All the gastric adenocarcinoma cases diagnosed by histopathology who underwent total/subtotal gastrectomy were retrospectively collected for clinical as well as histopathological details for a year. Descriptive statistics were used for analysis.Results: The mean age of the study population is 59.3±11.3 with male: female sex ratio of 2.1:1. Higher prevalence noted in lower socioeconomic status (80%) and alcoholics (65%) with a history of high salted diet (62%). Most common presenting symptom was dyspepsia (94%). Upper GI endoscopy revealed antrum (42%) as the commonest site of tumor and majority were more than 5 cm size (75%). 62% of tumors were of moderately differentiated, predominantly intestinal type (86%) and mostly found to be in stage 3 (50%).Conclusions: Gastric adenocarcinoma was more common in elderly males and majority presented in advanced stage at the time of diagnosis. The General public needs to be creating awareness about variable nonspecific symptoms of an early stage of gastric carcinoma as well as the risk of poor dietary habits (high salted diet) and can enforce screening of high-risk category people.

Validation of PC 1000 Hz Reaction Timer with Biopac® MP 36 for Recording Simple Reaction Time

Background: In neuropsychological assessment, the time taken by a subject or patient to respond tostimulus provides valuable information about processing in central and peripheral nervous system. Reactiontime is a simple and inexpensive method commonly used in cognitive and sport physiology to assess thesensory-motor performance of an individual.Objective: To compare and validate the baseline values of simple reaction time obtained using the PC 1000Hz reaction timer with Biopac® MP 36.Materials and Methods: 50 healthy subjects (32 males and 18 females) with age of 22.78±3.90 yrs andBMI of 24.820±3.59 kg/m2 participated. Visual (VRT) and auditory (ART) reaction time were estimated usingPC 1000 Hz reaction timer and Biopac® MP 36 separately for minimum of three trials each.Results: There was no significant difference found in ART and VRT values of the subjects estimated by PC1000 Hz and Biopac® MP 36. A strong significant (P<0.01) correlation was found in ART (r=0.92) and VRT(r=0.94) in between the devices. Bland Altman plot also showed that variations for VRT and ART were withinthe acceptable range.Conclusion: The present validation study recommend that the assessment of simple reaction time forauditory and visual stimulus by PC 1000 Hz reaction timer is reliable one and compared with other techniquesit has more advantages such as portable in nature and simplicity to use either in laboratory or in fieldoriented study for the evaluation of psychomotor and cognitive function.

Perceptions of first year dental students on case based learning in Physiology

Background: Application of basic science knowledge to clinical practice is the aim of first year undergraduate dental curriculum. To bring in application of basic science theory to the clinical dental application, a case based learning (CBL) approach has been tried among first year dental students. Materials and methods: Randomized control trial was conducted by grouping first year undergraduate dental students (N= 73) into traditional group (N=35) and CBL group (N=38). Conventional lecture was given to traditional group and case based lecture and small group discussion for CBL group facilitated by faculty. Pre and post tests were administered for both the groups. Perceptions on CBL approach were collected using a questionnaire. Results were analyzed using paired and unpaired ‘t’ test. Results: Test scores were expressed in mean ± SD. deviation. Post-tests scores of traditional - (7.5 ±1.6) and CBL (7.7±1.9) groups were significantly higher than pretest scores of traditional - (5.7 ± 1.4) and CBL (4.9 ± 1.7) groups. Attitude score showed positive perceptions for most of the parameters. Conclusion: The first time CBL approach for Physiology concept provoked interest among dental students. Participants felt the method involved them in active learning and they recommended this approach to other sessions as well. Recall of factual knowledge did not improve significantly over traditional method, but was equally effective.

Predicted equations for pulmonary function in normal adolescent south indian population.

Pulmonary functions are affected by variables like age, sex, height, weight, and geographic location. Our study aims to establish predicted equations for pulmonary functions in normal South Indian adolescent population. 400 subjects were grouped into pre & peripubertal (10-14 years) and pubertal (15 to 18 years) age categories. Anthropometric data collected, PFT assessed using portable data logging Spirometer MIR II. Mean FVC and FEV1 values were 2.80 L, 2.49 L in boys and 2.34 L, 2.12 L in girls respectively. Predicted equations for both adolescent age groups were generated by using linear regression analysis. PFT were significantly different in both age categories in boys and girls. PFT increased with increasing age and significantly correlated with the anthropometric parameters. Region specific and age specific predicted equations for PFT are generated from this study.

Pulmonary functions in tannery workers – a cross sectional study.

Tannery workers are at potential exposure to detrimental agents rendering them vulnerable to respiratory and dermal problems. Thus by performing pulmonary functions among leather tannery workers, we can decipher the effect of chromium and leather dust on lung functions and also the decline of respiratory functions with increasing years of exposure to leather dust. Pulmonary functions were assessed for 130 tannery workers and compared with the 130 unexposed office workers. Pulmonary function measurements namely FVC, FEV1, FEF25-75% and PEFR were measured using portable data logging Spirometer (KOKO Spirometer). The observed pulmonary functions of Tannery workers in this study showed a reduction in FEV1, FVC, FEV1/FVC ratio, FEF25-75 and PEFR in relation to their predicted values and also compared to the unexposed. Smokers showed a decline in pulmonary functions compared to the non smokers because smoking acts as an additional risk factor in the development of respiratory illnesses. It is worthy to mention that the pulmonary function values correlate negatively with the duration of exposure to leather dust. So this study could provide base line information based upon which legal implementation of preventive measures could be undertaken.

A case report of a urothelial carcinoma arising in the renal pelvis with exuberant chondrosarcomatous element associated with adrenal metastasis.

Sarcomatoid carcinoma is a rare malignant tumor that has both malignant epithelial and mesenchymal components. We describe a sarcomatoid carcinoma arising in the left renal pelvis of a 49-year-old man. The dominant component of the tumor was chondrosarcomatous, but there were also focal carcinomatous areas. The carcinomatous tumor cells consisted of papillary urothelial carcinoma. Immunohistochemical assay showed that the sarcomatous tumor cells were positive for vimentin and S 100 and negative for cytokeratin. The papillary urothelial carcinoma was positive for cytokeratin and negative for vimentin. The patient underwent neoadjuvant chemotherapy and after downsizing the tumor, radical nephrectomy was performed with excision of the cuff of bladder.

Skeletal muscle endurance is reduced in chronically energy deficient adults.

Fifty eight adult males (well nourished; WN = 25, underweight; UW = 13, chronically energy deficient; CED = 20), aged 18 to 30 yr underwent an assessment of skeletal muscle function using a load cell based handgrip dynamometer coupled to a polygraph. WN subjects had higher handgrip strengths than either the UW or CED subjects (P < 0.05), though not when corrected for forearm muscle area or forearm volume. CED subjects fatigued faster than WN subjects during sustained maximal isometric contraction (P < 0.05) as well as during prolonged isotonic exercise (P < 0.05). During the latter, the onset of fatigue in the CED subjects was also faster than that in their anthropometrically similar UW controls. These data are consonant with reports of decreased productivity in undernourished adults during real life tasks.

Gender differences in muscle strength & endurance in young Indian adults.

Muscle strength was studied in 70 males and 53 females between the ages of 17-30 yr, using a handgrip dynamometer. In a subset group of 31 males and 20 females, muscle endurance during sustained isometric contraction was studied using a load cell based handgrip dynamometer coupled to a polygraph. The males had a significantly greater muscle mass and lower body fat as compared to the females. Males had close to twice the handgrip strength of females in absolute terms (P < 0.01) and this difference persisted after correction for forearm muscle area (P < 0.05). In contrast, the rate of decline of muscle strength during sustained isometric contraction was lower in females as compared to males (P < 0.05), suggestive of greater skeletal muscle endurance in females. Physical activity patterns were not a determinant of skeletal muscle function. These findings are consistent with gender specific muscle fibre characteristics reported in literature in other racial groups.

Body fat topography in Indian and Tibetan males of low and normal body mass index.

Body fat topography was determined using anthropometric techniques in young, healthy, Indian and Tibetan adults. Indian subjects had significantly higher fat contents with greater abdominal obesity when compared with Tibetans matched for body mass index (BMI). This differential fat distribution may contribute, in part, to the greater cardiovascular risk of Indians. Using a cross sectional model, the data was also analysed to assess the probable changes in body fat topography with weight gain. This model suggests a preferential gain in abdominal subcutaneous fat as compared to other sites. This data may have implications while evaluating disease risks with weight gain.

Integrating biostatistics and experimental physiology: students' perceptions and future scope.

The use of biostatistics in experimental physiology is recognised by researchers. However, there has been no concerted attempt to integrate biostatistics into the undergraduate experimental physiology programme. This paper describes one such initiative. The student's response to the exercise was largely positive; it enabled them to describe and interpret data more effectively and understand the experiments more completely. The attitudes of the students to the exercise and their performance at a statistics examination at the end of the exercise was determined by a number of parameters, including prior statistical knowledge, general academic performance and the extent to which they liked mathematics. However, even those students who disliked mathematics indicated that they appreciated the value of the exercise. The results indicate the need to integrate biostatistics into the undergraduate physiology course.

The perceptions of first-year medical students on animal and human experiments in physiology.

This study was conducted to ascertain the attitudes of first year medical students to human and animal experimentation, while undergoing a course in Muscle and Nerve experimental Physiology. At the time of administration of the questionnaire, students had been exposed to both human as well as animal experiments. Approximately 81% of the students preferred human experiments (P < 0.05). This preference, however, was related more to the issue of enjoyability rather than the extent to which the experiment contributed to overall understanding and learning. 55% of students identified ethical issues related to laboratory experimentation. Gender and academic performance were not determinants of student's attitude to animal and human experimentation, although ethical insight was. The results suggest that while students recognize the importance and value of animal experiments, they would prefer the introduction of a larger number of human experiments.