A cytological study of salivary gland lesions

Background: FNAC is very useful technique and routinely done on palpable lesion of the body as a diagnostic procedure. For preoperative diagnosis of salivary gland lesions, triple approach technique is used in which FNAC is one of the most important techniques. The main purpose of FNAC of salivary gland lesion is in the investigation of any palpable lump and to avoid unnecessary surgery in specific benign condition. The advantages are – it provides rapid and accurate diagnosis, is therapeutic as well as diagnosis in many cystic condition. Materials and methods: Retrospective study was done for 1year from January 21 to January 22 at SBKS MI & RC, Vadodara, Gujarat. In present study, 96 cases were taken with salivary gland lesions that underwent FNAC in our Department. Results: Out of 96 cases, 61 (63.54%) cases were neoplastic and 35 (36.46%) cases were non- neoplastic which exclude chronic sialedenites. Among cases 61, 52 (85.25%) cases were benign and 9 (14.75%) cases were malignant. Males predominate and were 59 cases whereas female comprising 37 cases. Male to female ratio was 1.6:1. The age range was from 11 to 73 years. Conclusion: The present was a single institutional experience where analysis of salivary gland lesion was carried out. The findings of age, sex, site distribution and pathologic features encountered in present study were comparable with those studies reported from India and other parts of the world. Although the number of salivary gland tumors discussed in this study is small, the findings should contribute in better understanding of the disease.

Evaluation of thrombospondin�gene polymorphisms in corneal allograft rejection in Asian Indian patients

Purpose: To evaluate the frequency and the association of Thrombospondin 1 (THBS1) gene single nucleotide polymorphisms (SNPs) in Asian Indian patients with optical full thickness corneal grafting surgery. Methods: Prospective case朿ontrol analysis of optical penetrating keratoplasty patients with and without immune rejection and controls for genotyping of 3 THBS1 gene SNPs (rs1478604 A>G; rs2228261 C>T; rs2228262 A>G) by Amplification Refractory Mutation System-Polymerase Chain Reaction (ARMS PCR). Results: Among 58 patients [45 with immune allograft rejection (DNA isolation was possible in 38 samples) and 13 without immune corneal allograft rejection] and 65 controls, allele frequencies observed for rs1478604 (A>G) are A: 69.7% and 72.6%, G: 30.2% and 27.3%; for rs2228261 (C>T) are T: 70.2% and 62.3%, C: 29.7% and 37.6%; and for rs2228262 (A>G) A: 97.4% and 98.4%; G 2.5% and 1.5% respectively. Genotype frequencies were rs1478604 (A>G) AA: 57.8% and 59.3%, AG 23.6% and 26.5%; GG 18.4% and 14%; for rs2228261 (C>T) TT: 40.5% and 33.8%, TC: 59% and 56.9%, CC: 0% and 9.2%; for rs2228262 (A>G) AA: 94.8% and 96.8%, AG: 5.1% and 3.1% in rejection and controls respectively. The allele and genotype frequency for the 3 described THSB1 SNPs did not show any difference between the corneal graft immune rejection patients and controls. Conclusion: Asian Indian population evaluated for THBS1 gene SNPs by ARMS PCR genotyping in Asian Indian population did not show any genetic association to immune rejection occurrence in our study.

Evaluation of Barrett universal II formula for intraocular lens power calculation in Asian Indian population

Purpose: Barrett Universal II (BU-II) is considered as one of the most accurate intraocular lens (IOL) power calculation formulas; however, there is no literature studying the same in Indian population. The aim of this study was to evaluate the accuracy of BU-II formula in prediction of IOL power for cataract surgery in Asian Indian population. This was an institutional, prospective, observational study. Methods: Patients with senile cataract who underwent phacoemulsification with posterior chamber IOL implantation were enrolled in the study. Biometry data from Lenstar-LS900 was used and IOL power was calculated using four IOL formulas: modified SRK-II, SRK/T, Olsen, and BU-II. Primary outcome was measured as the prediction error in postoperative refraction for each formula and secondary outcome was measured as the difference in mean absolute errors between the four formulas. SPSS Version-21 with P < 0.05 considered significant. Results: A total of 244 eyes were included in the study and were divided into three groups in accordance to axial length (AL): Group 1 (AL: 22�.5 mm; N = 135), Group 2 (AL <22 mm; N = 53), and Group 3 (AL >24.5 mm; N = 56). BU-II formula gave the lowest mean absolute error (0.37 � 0.27D) and median absolute error (0.34) in predicted postoperative refraction in the entire study population. When compared with the other formulas, mean absolute error was significantly lower in all three groups (P < 0.0005) as well, except for Olsen formula in the normal AL group, where the results were comparable (P = 0.742). Conclusion: BU-II performed as the most accurate formula in the prediction of postoperative refraction over a wide range of ALs.

Corneal transplantation in the modern era

Corneal blindness is one of the major causes of reversible blindness, which can be managed with transplantation of a healthy donor cornea. It is the most successful organ transplantation in the human body as cornea is devoid of vasculature, minimizing the risk of graft rejection. The first successful transplant was performed by Zirm, and since then, corneal transplantation has seen significant evolution. It has been possible because of the relentless efforts by researchers and the increase in knowledge about corneal anatomy, improvement in instruments and advancements in technology. Keratoplasty has come a long way since the initial surgeries wherein the whole cornea was replaced to the present day where only the selective diseased layer can be replaced. These newer procedures maintain structural integrity and avoid catastrophic complications associated with open globe surgery. Corneal transplantation procedures are broadly classified as full-thickness penetrating keratoplasty and partial lamellar corneal surgeries which include anterior lamellar keratoplasty [sperficial anterior lamellar keratoplasty (SALK), automated lamellar therapeutic keratoplasty (ALTK) and deep anterior lamellar keratoplasty (DALK)] and posterior lamellar keratoplasty [Descemet stripping automated endothelial keratoplasty (DSAEK) and Descemet membrane endothelial keratoplasty (DMEK)] broadly.

Human Trafficking: New Challenge to Humanity

This paper addresses the situation of human trafficking inIndia. It argues that the focus on trafficking either as an issueof illegal migration or prostitution still dominates the discourseof trafficking, which prioritizes state security over humansecurity and does not adequately address the root causes oftrafficking and the insecurity of trafficked individuals. The rootcauses or vulnerability factors of trafficking such as structuralinequality, culturally sanctioned practices, poverty or economicinsecurity, organ trade, bonded labor, gender violence, whichare further exacerbated by corruption, have remainedunrecognized in academic and policy areas. This paper arguesthat emphasis needs to be given to such underlying rootcauses and modes and also crimes related to humantrafficking, that threatens human security of the traffickedpersons in India. Accordingly, it provides some preventivemeasures to address and deal with the problem.

Diameters of Perikarya in Different Regions of Rat Central Nervous System after Streptomycin and Kanamycin Intoxication

Introduction: Streptomycin and Kanamycin, an aminoglycosidic antibiotic, is known to destroy the ventral cochlear nuclei of brainstem in man. Ototoxicity is well known side effect of kanamycin, the effect on central nervous system in general and central auditory pathway in particular is still unclear. Subjects and Methods: Thirty albino rats were divided into three groups I, II and III of ten animals each. Group III was control. Group I and II received Streptomycin (30mg/Kg body weight) and kanamycin (400mg/kg body weight) intramuscular injections, daily for 3 weeks. Paraffin embedded sections of cerebellum, spinal cord, dorsal cochlear nucleus, inferior colliculus nucleus and auditory cortex were stained with haematoxylin and eosin stains and perikarya measured using slide and ocular micrometres. Results: Size of cerebellar Purkinje cells increased significantly in control rats for streptomycin and kanamycin intoxicated animals respectively. Ventral horn cells of spinal cord are affected highly significantly only by streptomycin. Vestibular nucleus also showed similar results i.e. neuronal body. Neurons of dorsal cochlear nucleus is affected significantly by both the drugs i.e. streptomycin and kanamycin. Conclusion: Streptomycin causes an increase in diameter of auditory cortical cells on other hand kanamycin led to highly significant decrement in size of cells of same region. Preferential affinity and differential effects were noticed. The latter throws some clues about mechanism of action.

Overexpression of cyclin A in oral dysplasia: An international comparison and literature review.

Oral squamous cell carcinoma (OSCC) is one of the most debilitating cancers in the world and while its causes have been heavily researched, the outcome remains grim. Most of these cancers are identified in the late stage and as a result treatment options are limited. Therefore, researchers have focused their efforts on recognizing and identifying dysplastic tissue that has an increased chance of progressing to cancer. Research has begun to look at cell cycle dysfunctions and in particular, aberrant protein functions as a way of identifying the cellular mechanism at fault. The overexpression of a group of regulatory proteins called cyclins has been demonstrated in many types of dysplasia and carcinomas. Although researchers have identified several different types of cyclins as potential culprits, we chose to focus our study primarily on the overexpression of cyclin A. While most research on oral dysplasia and OSCC has been focused on cyclin D, studies have been done on cyclin A. While the etiology of oral dysplasia/SCC appears to be multifactorial, we chose to compare our results with those of similar studies performed across the globe. The social factors, such as the increased use of tobacco that may have contributed to our results, were compared with similar studies performed in Europe and Asia. While our results were remarkably similar and demonstrated a link between the overexpression of cyclin A in oral dysplasia, there exists some differences and thus may require a multicenter, longitudinal study.

Rheumatic fever & rheumatic heart disease: The last 50 years.

Rheumatic fever (RF) and rheumatic heart disease (RHD) continue to be a major health hazard in most developing countries as well as sporadically in developed economies. Despite reservations about the utility, echocardiographic and Doppler (E&D) studies have identified a massive burden of RHD suggesting the inadequacy of the Jones’ criteria updated by the American Heart Association in 1992. Subclinical carditis has been recognized by E&D in patients with acute RF without clinical carditis as well as by follow up of RHD patients presenting as isolated chorea or those without clinical evidence of carditis. Over the years, the medical management of RF has not changed. Paediatric and juvenile mitral stenosis (MS), upto the age of 12 and 20 yr respectively, severe enough to require operative treatement was documented. These negate the belief that patients of RHD become symptomatic ≥20 years after RF as well as the fact that congestive cardiac failure in childhood indicates active carditis and RF. Non-surgical balloon mitral valvotomy for MS has been initiated. Mitral and/or aortic valve replacement during active RF in patients not responding to medical treatment has been found to be life saving as well as confirming that congestive heart failure in acute RF is due to an acute haemodynamic overload. Pathogenesis as well as susceptibility to RF continue to be elusive. Prevention of RF morbidity depends on secondary prophylaxis which cannot reduce the burden of diseases. Primary prophylaxis is not feasible in the absence of a suitable vaccine. Attempts to design an antistreptococcal vaccine utilizing the M-protein has not succeeded in the last 40 years. Besides pathogenesis many other questions remain unanswered.

Study to assess the pathophysiological role of VEGF in patients with chronic myeloid leukemia(CML) .

Background: VEGF play a significant role in the pathogenesis of chronic myeloid leukemia. Aims & Objective: (1) Assess the pathophysiological role of VEGF in patients with chronic myeloid leukemia (CML). (2) Study the effect of Hydroxyurea and Imatinib on serum VEGF level. Material and Methods: A total of 40 cases of chronic myeloid leukemia (CML) and 20 age and sex matched healthy controls were included in this study. The patients were divided into 3 subcategories: Untreated cases (which did not receive any treatment); patients who were treated with Hydroxyurea and patients who were treated with Imatinib Mesylate. 5 ml of blood was collected, were centrifuged at 5000 rpm for 10 minutes and stored at - 20°C until assay. Results: On comparing the various subgroups with control, the value was 726.61 ± 199.67 pg/ml in untreated group. It was 573.53 ± 213.423 pg/ml in Hydroxyurea group and 530.00±180.96 pg/ml in Imatinib group. Fresh cases had significantly elevated VEGF value (P value < 0.001). VEGF level significantly elevated in Untreated cases when compared to treated groups either hydroxyurea (p=0.02) or Imatinib (p=0.019). There was no significant difference between Hydroxyurea and Imatinib groups. Conclusion: This study suggests that VEGF play a significant role in the pathogenesis of chronic myeloid leukemia. Understanding this may help in designing new therapeutic strategies (antiangiogenic agents) for this dreaded disease.

A Prospective Study on MBBS Student About Different Visual Aids.

Background: To enhance successful communication medical teachers are increasingly using different visual aids. Objective: To determine medical students perception of different visual aids like black board (BB), over head projector transparencies (OHPT) and, LCD and to generate recommendations for their optimal use. Methods: A questionnaire based study was carried out among first year MBBS students of Government Medical College, Kota, India. The survey was undertaken among 84 Medical students of first year MBBS of batch 2008 after exposing them to different visual aids like BB, OHPT and LCD in Physiology lectures. A few lectures were absolutely on BB, and some were on OHPT and on LCD. Few classes were taken with mixed visual aids. Students were exposed for such visual aids for one year and then they were requested to complete a questionnaire. Data were statistically analyzed by One Sample Chi-square test. Results: 55 (65.48%) students rated chalk & black board as best visual aids in understanding the topic better as compared to OHPT and LCD (P<0.01). 47 (55.95%) students have good learning experience with black board teaching and it is best mode to note down important points. 56 (66.66%) students favored LCD as more interesting and interactive visual aids (P<0.01). It also complete the lecture faster which was advantageous for 69(82.17%) students. 77 (91.66%) students wanted mixing of different visual aids (P<0.01). Mostly (75%) do not find any difficulty in switching from one mode to another. No significant gender difference was observed. Conclusion: To improve students learning medical teachers should match the lectures with preferred visual aids. It will maintain interest and enthusiasm among pupil.

Oxidative stress in hypertension : Association with antihypertensive treatment.

There is growing evidence that oxidative stress contributes to the pathogenesis of hypertension. Our aim was to measure oxidative stress in hypertensive subjects, and assess the potential confounding influences of antihypertensive therapy. Serum malondialdehyde and antioxidant levels were estimated in patients at the time of presentation and also after a antihypertensive therapy for 3 months. During the period of study no antioxidant/s was given to the patients and control subjects. Mean blood pressure values were altered in the hypertensive patients following antihypertensive therapy from their respective values observed at the time of presentation. Serum malondialdehyde levels were significantly higher in the hypertensive patients in comparison to control cases. The antioxidant activity of enzymes super oxide dismutase, glutathione and non enzymatic antioxidant levels of vitamins E and C were significantly lower in patients compared to controls. After 3 months of antihypertensive treatment all the above parameters showed reversal in the respective levels of serum malondialdehyde and antioxidant activity. Antihypertensive medications lower the blood pressure and thereby results in reduced oxidative stress which indicates that oxidative stress is not the cause, but rather a consequence, of hypertension.

Hepatic calcification following dengue virus-induced fulminant hepatic failure.

Hepatic calcification can be seen with various infectious and neoplastic conditions. We report a 32-year- old man who developed massive calcification in the right lobe of liver following recovery from dengue virus-associated fulminant liver failure.

Retroperitoneal teratomas in children.

OBJECTIVE: This paper aims to highlight the clinical features, investigations and treatment of retroperitoneal teratomas condition. METHODS: 12 patients (8 females and 4 males, age range-2 months to 14 yrs) of retroperitoneal teratoma admitted to the department of Pediatric Surgery, King George Medical University, Lucknow between 1980 and 2004 were studied. Investigations included hematology, plain X-ray of the abdomen, intravenous urography, ultrasound, computerised tomography (CT) of the abdomen (after 1990, 8 patients) and serum alpha-fetoprotein assay (after 1991, 6 patients, preoperatively). All patients underwent surgery. Serum alpha-fetoprotein assay was used during follow-up to detect recurrence. RESULTS: Majority of the tumors were left pararenal in location. In two patients there was bilateral involvement. In all except one, the tumor could be excised easily preserving the kidneys. In one child with a massive cystic tumor with bilateral involvement, the tumor was marsupialised in the first stage and excised subsequently. One child died postoperatively, the other 11 children are well and there has been no tumor recurrence on follow-up. CONCLUSIONS: Retroperitoneal teratomas are uncommon lesions in children mostly arising in close relation to the kidneys. The majority are benign but complete excision is necessary for cure. Even large tumors with bilateral involvement of the retroperitoneum can be excised while preserving adjacent organs. Serum alpha-fetoprotein assay is a reliable method of detecting recurrence.

Oxidative stress in patients with essential hypertension.

BACKGROUND: Free oxygen radicals react with membrane lipids to form lipid hydroperoxides, a destructive process known as lipid peroxidation. Lipid hydroperoxides decompose to form a variety of products including malondialdehyde, which is used as an indicator of the oxidative damage of cells and tissues. Endogenous antioxidant enzymes such as superoxide dismutase counteract the oxidative damage from oxidative stress. There is increasing evidence that free radicals are involved in the pathogenesis of hypertension by altering endothelial function. We evaluated the oxidative stress and endogenous enzymatic antioxidant status in patients with essential hypertension before and 3 months after treatment with antihypertensives. METHODS: Fifty patients with essential hypertension attending the outpatient services of the Department of Medicine, Institute of Medical Sciences, Banaras Hindu University and 20 age- and sex-matched healthy controls were studied. The serum malondialdehyde and superoxide dismutase levels were measured in patients at the time of presentation and after 3 months of antihypertensive treatment. No antioxidants were given to the patients during the period of the study. RESULTS: The mean (SD) serum malondialdehyde level was found to be significantly higher (0.33 [0.07] mmol/L) in patients with hypertension compared with controls (0.21 [0.05] mmol/L; p < 0.001). This showed a significant decrease following antihypertensive therapy (0.23 [0.06] mmol/L; p < 0.001) compared with pre-treatment values. The serum superoxide dismutase activity was significantly lower in patients (6.93 [1.35] mg protein/ml of serum) compared with controls (20.12 [3.65] mg protein/ml serum; p < 0.001) at the time of presentation and, compared with the pre-treatment values, increased significantly after 3 months of treatment (10.66 [2.91] mg protein/ml of serum; p < 0.001). CONCLUSION: Our study shows that essential hypertension is associated with increased oxidative stress and reduced antioxidant status. Adequate control of blood pressure with antihypertensive therapy decreases oxidative stress and improves the antioxidant status in these patients.