Level of awareness of lung cancer risk factors, signs, symptoms and safe practices among college teachers of different states in India: do awareness programmes have an impact on adoption of safe practices?

Introduction: Lung cancer is the one of the most common cause of cancer mortality among men in India where incidence rates are increasing although they are largely preventable diseases. In India, late presentation is generally responsible for high mortality and morbidity rates and early detection is one of the best ways to control it. The purpose of this study is to measure the level of awareness on lung cancer among women represented by a sample of college teachers in India and the impact of awareness programs in changing or adopting safer practices and the prevention and early detection of the disease

Material and methods: The assessment was conducted during a Pink Chain Campaign on cancer awareness in 2011 in various women colleges in India. Pre-test related to lung cancer was followed by awareness programs. Post-test using the same questionnaire was conducted at the end of interactive session, at 1 year and 6 months

Results: A total of 156 out of 182 teachers participated in the study [overall response rate was 85.7%]. Mean age of the study population was 42.4 years [range- 28-59 yrs]. There was a significant increase in level of knowledge regarding lung cancer at 6 months and this was sustained at 1 year. Magazines and newspapers were the primary source for information regarding risk factors, signs and symptoms of lung cancer in more than 60% of teachers whereas more than 30% teachers were educated by doctors. At post-awareness after 1 year and 6 months, there was a significant change in alcohol and smoking habits. The main reasons for not undergoing screening tests are: ignorance [50%], lethargic attitude [44.8%] and lack of time [34.6%]

Conclusion: Knowledge about lung cancer was very low among teachers. Overall awareness of risk factors, signs and symptoms, and screening modalities of lung cancer have improved after 1 year along with practices related to smoking and alcohol consumption. There was a significant improvement in people undergoing regular check-up's. Improved means of communication, access to information and effective warnings about cigarette smoking are necessary to increase public awareness. To ensure the adoption of safe practices in the lifestyle of people who smoke and consume alcohol, awareness programmes such as the pink chain campaign should be conducted regularly, frequently and more widely in various areas of India

Network analysis of transcription factors for nuclear reprogramming into induced pluripotent stem cell using bioinformatics

Research related to induce pluripotent stem [iPS] cell generation has increased rapidly in recent years. Six transcription factors, namely OCT4, SOX2, C-MYC, KLF4, NANOG, and LIN28 have been widely used for iPS cell generation. As there is a lack of data on intra- and inter-networking among these six different transcription factors, the objective of this study is to analyze the intra- and inter-networks between them using bioinformatics. In this computational biology study, we used AminoNet, MATLAB to examine networking between the six different transcription factors. The directed network was constructed using MATLAB programming and the distance between nodes was estimated using a phylogram. The protein-protein interactions between the nuclear reprogramming factors was performed using the software STRING. The relationship between C-MYC and NANOG was depicted using a phylogenetic tree and the sequence analysis showed OCT4, C-MYC, NANOG, and SOX2 together share a common evolutionary origin. This study has shown an innovative rapid method for the analysis of intra and inter-networking among nuclear reprogramming factors. Data presented may aid researchers to understand the complex regulatory networks involving iPS cell generation

Anomalous cutaneous branch of median nerve in arm: a report of anatomical variation with clinical implications / 대한해부학회지

The objective of the study was to observe and document the variation on the subject of branches of the median nerve. This report will assist clinicians and surgeons by considering anatomical variation associated with the median nerve in interpreting atypical clinical presentations. The arm and forearm region of a 55 year embalmed male cadaver during educational gross anatomy dissection. We found that an anomalous cutaneous branch arising from the median nerve in the right arm which was passing deep to the tendon of the biceps brachii. Later it enters the cubital fossa and then it is accompanied by the superficial vein of the forearm. The other limb of the cadaver did not show any such variation. No other neural, arterial or muscular variation was observed in either of the limbs. A rare anatomical variation in which the anomalous cutaneous branch arising from the median nerve in the right arm which is later accompanied by a superficial vein in the forearm. Such knowledge is advantageous in nerve grafting and neurophysiological evaluation for diagnosing peripheral neuropathies.

Anomalous cutaneous branch of median nerve in arm: a report of anatomical variation with clinical implications / 대한해부학회지

The objective of the study was to observe and document the variation on the subject of branches of the median nerve. This report will assist clinicians and surgeons by considering anatomical variation associated with the median nerve in interpreting atypical clinical presentations. The arm and forearm region of a 55 year embalmed male cadaver during educational gross anatomy dissection. We found that an anomalous cutaneous branch arising from the median nerve in the right arm which was passing deep to the tendon of the biceps brachii. Later it enters the cubital fossa and then it is accompanied by the superficial vein of the forearm. The other limb of the cadaver did not show any such variation. No other neural, arterial or muscular variation was observed in either of the limbs. A rare anatomical variation in which the anomalous cutaneous branch arising from the median nerve in the right arm which is later accompanied by a superficial vein in the forearm. Such knowledge is advantageous in nerve grafting and neurophysiological evaluation for diagnosing peripheral neuropathies.

Pulmonary disease due to mycobacterium massiliense.

We report a case of a patient suffering from multidrug-resistant pulmonary tuberculosis (MDR-PTB) who later developed an invasive infection of the respiratory tract with a rapidly growing non-tuberculous mycobacteria (NTM), recently identified as Mycobacterium massiliense, closely related to M. abscessus. To the best of our knowledge, this is the first case of M. massiliense infection being reported from India.

Cytomorphology and immunohistochemistry of extrarenal rhabdoid tumor: A case report with review of literature.

Extrarenal rhabdoid tumor (ERRT) is a rare, aggressive tumor with extremely poor prognosis. We report a case of ERRT with intraspinal extension in a 1.5-year-old child diagnosed by fine needle aspiration cytology (FNAC) and immunohistochemistry. The child presented with a right lumbar region lump of two months duration. Ultrasound guided FNAC was performed and cell block was prepared. Smears were highly cellular and showed a dispersed population of large round cells having abundant pale eosinophillic cytoplasm, centrally to eccentrically placed nucleus with large prominent nucleoli. Immunohistochemistry was carried out on cell block which was positive for epithelial membrane antigen EMA and Vimentin. It was negative for leucocyte common antigen [LCA], wilms tumor 1, WT1, desmin and neuron specific enolaseNSE, thus ruling out other tumors like lymphoma, Wilms tumor, rhabdomyosarcoma, and neuroblastoma. A final diagnosis of ERRT was given. ERRT is an extremely rare tumor of retroperitoneal area; it should be included in the differential diagnosis of malignant round cell tumor in children. Cell block in this case is mandatory for putting up the panel of immunohistochemistry which can clinch the diagnosis of rhabdoid tumor and treatment can be started as early as possible.

Assessment of Nutritional Status of Rural Tribal Children in Tripura.

This cross-sectional study evaluated the nutritional status of 608 rural tribal children (age 6 to 15 years) from Jampuijala block of West Tripura district, India. Prevalence of stunting, thinness and overweight were 23.7%, 33.4% and 0.8%, respectively. The prevalence of stunting and thinness was found to be higher in boys than in girls.

Omental myxoid hamartomas - A case report with review of literature.

Omental mesentric myxoid hamartomas are benign infantile lesions, however they may simulate a malignant tumour both clinically and pathologically. Here, we report the case of an omental myxoid hamartoma in a 10-months old infant which was per operatively suspected to be a malignant retroperitoneal tumour, due to adhesions with the surrounding structures as well as the presence of satellite nodules.

Choledochal cysts in infancy and childhood.

OBJECTIVE: To study the clinical presentation, management and results of treatment of 41 consecutive cases of choledochal cyst (CC) managed from 1999 to 2006. METHODS: The age of the patients ranged from 20 days to 11 years. Eleven cases were 1 year or less in age (infantile group) and 30 patients were more than 1 year old (classical pediatric group). Children less than 1 year old presented with jaundice (72%), hepatomegaly (54%) and clay-colored stools (63%); whereas those above one year in age presented with pain (83.3%) and jaundice (47.6%). Three cases had biliary perforation with localized or generalized biliary peritonitis. Ultrasonography (US) diagnosed/suggested CC in all 41 patients, however, contrast-enhanced computed tomographic (CECT) scan (n=12), radionuclide DISIDA scan (n=5) and magnetic resonance cholangiopancreatogram (MRCP) (n=3) also contributed to the diagnosis. 19 patients, including 4 from the 'infantile' group, had significant dilatation of intrahepatic biliary ducts. RESULTS: Nine patients from the 'infantile' group had cystic type I CC (type Ic), while 2 patients had fusiform dilatation of the common bile duct (type If disease). In contrast, 21 of the older patients had type If disease while 9 had type Ic disease. Operative management included primary complete excision of the cyst with a Roux-en-Y hepaticodochojejunostomy (HDJ) (n=32), Lilly's modification of submucosal resection with a HDJ (n=8) and cyst excision with a hepaticodochoduodenostomy (HDD) (n=1). All 3 patients with biliary perforation had primary excision of the CC with a HDJ. Unusual operative findings included accessory hepatic ducts (n=2), anteriorly placed common or right hepatic arteries (n=3) and partially or completely blocked proximal extrahepatic bile ducts (n=3). There were 2 postoperative deaths, one had cirrhotic liver disease with portal hypertension, the other had deep icterus with poor general condition. Both patients succumbed to overwhelming sepsis. One patient required reexploration and refashioning of the HDJ for biliary leak. Short-term follow-up was satisfactory in all 39 patients. CONCLUSION: Infants with CC constitute a distinct group with regard to clinical presentation and the pathological should be kept in mind while evaluating neonates and infants with cholestatic jaundice and older children with recurrent abdominal pain. Primary excision of the cyst with a HDJ provides satisfactory results in the management of the vast majority of cases of CC including those in infants, massive CC and in the presence of biliary perforation and peritonitis.

Scleredema of Buschke: a rare post-streptococcal complication.

A 19-year male presented with acute onset, gradually progressive symmetric indurations involving the skin over the face, neck, shoulders and upper part of chest following an upper respiratory tract infection. Detailed history and examination did not reveal evidence of Raynauds' phenomenon, nail changes, digital ulcers, pigmentation or any systemic involvement. Autoantibodies for systemic sclerosis were absent. Histopathology of skin biopsy documented scleredema. Antistreptolysin O (ASO) titer was elevated. We diagnosed a case of Scleredema adultorum of Buschke following a streptococcal throat infection. We report this case to highlight the importance of clinically differentiating this relatively benign, self-limiting disorder from systemic sclerosis.

Congenital cystic adenomatoid malformation associated with ipsilateral eventration of the diaphragm.

A two-month-old girl was operated for a left-sided eventration of the diaphragm. At surgery, a mass representing an extralobar pulmonary sequestration (EPS) was found inferior to the left lobe of the lung and was excised. Histopathological examination of the resected specimen showed presence of a type II congenital cystic adenomatoid malformation (CCAM) within it. A review of the relevant literature is presented.

Bilateral adrenal abscess in a neonate.

A 23-day-old male baby with a history of perinatal hypoxia presented with refusal of feeds and abdominal distension. The child had a right-sided cystic upper abdominal mass and features of neonatal septicemia. Abdominal ultrasound (US) and contrast-enhanced CT scan showed bilateral adrenal abscesses. Laparotomy with drainage of the abscesses successfully treated the condition. The literature on the subject is reviewed.

Anatomical study on true hermaphroditism in an Indian pig (Sus Scrofa Domesticus)

A pig was confirmed to be a true hermaphrodite on the basis of gross and histomorphological studies of the genital organs. The genitalia was consisted of left ovary, oviduct, two coiled uterine horns, body of uterus alongwith right testis and an epididymis. Vagina and vulva were absent but male urethra with prostate gland was present. Grossly the size of all the genital organs appeared to be normal. Histomorphologically, testis and epididymis were underdeveloped as there was no clearcut spermatogenia and sertoli cells but Leydig cells were normal. The ovary presents normal histological features with some portion of testicular tissue. Degeneration of uterine epithelium was observed along with normal endometrial glands.

Total gastric necrosis in a neonate.

Necrosis of the entire stomach is extremely rare in neonates. We report a case of total gastric necrosis in a full-term neonate. The possible pathophysiology, diagnostic features and therapeutic options for gastric necrosis in a newborn are discussed.

Advanced hepatoblastoma: successful liver resection following preoperative chemotherapy.

We present a case of advanced hepatobastoma in a 9-month-old child who was treated with chemotherapy (three cycles of PLADO regimen conisting of cisplatin and Adriamycin) followed by surgical excision (left lobectomy). At 1-year follow up, the is doing well and is disease-free.

Embryonal rhabdomyosarcoma of the common bile duct.

A two-and half-year-old boy presented with a short history of fever, jaundice and abdominal distension. At laparotomy, a rhabdomyosarcoma (RMS) arising from the common bile duct (CBD) was found. The tumor including the CBD was successfully excised and a Roux-en-Y hepaticodochojejunostomy was performed. Postoperatively, the child received chemotherapy and is doing well on one-year follow-up the recent literature on the subject is reviewed.

Pain during mammography: impact of breast pathologies and demographic factors

The aim of this study was to systematically assess the pain experienced by patients undergoing mammography for various clinical presentations. Subjects and Two hundred and twenty-five patients aged 25-85 years [45.43 +/- 8.25 years] presenting for mammography were included in the study. Presenting symptoms and clinical diagnosis were provided by the referring physicians and demographic information was obtained from self-reported questionnaires. Mammography results were recorded by the radiologist. Two different but reliable and valid measures of pain - Visual Analog Scale [VAS] and Pain/Discomfort Rating Scale [DRS] - were used to assess pain during mammography and data were statistically analyzed to examine the possible predictors of pain. Forty-nine% of the patients reported pain during mammography when cut-off level of VAS score was 40; however, when the cut-off level was raised to 60 [considering the preexisting pain as presenting symptom in some patients] only 23% reported pain. With DRS, 7% reported pain, 27% discomfort and 66% neither pain nor discomfort. Biserial correlation between the VAS and DRS scores suggested strong positive agreement between the two measures of pain [r = 0.56, d.f. = 90, p < 0.01]. Patients presenting with coexisting breast lumps and preexisting breast pain and those diagnosed with inflammatory conditions of the breast and fibrocystic changes experienced more pain during mammography. Preexisting breast pathologies and demographic factors such as age and educational level of the patient were important in reporting pain during mammography. This finding indicates that proper assessment of pain using standard measures and its association with breast pathologies and demographic factors is important for planning pain management in women undergoing mammography