The impact of hirsutism on the mental status of Indian women

Objective To determine mental status of the hirsute women using Hospital Anxiety and Depression Scale [HADS]

Methods Hirsutism was assessed quantitatively by Ferriman-Gallwey score [F-G score] and qualitatively by self-administered questionnaires of Hospital Anxiety and Depression Scale [HADS]. Other parameters such as age, occupation, comorbidities, socio-economic status, marriage status, religion, educational status were assessed

Results Mean HADS score of 100 hirsute patients was 12.66+/-6.11 which is abnormal. HADS was normal in 18 percent, 24 percent had borderline abnormal and in 58 percent it was abnormal. Mean anxiety score of HADS was 8.71+/-4.06, which was higher than the mean depression score which was 3.95+/-2.93, which was statistically significant [p=0.008]. HADS score was not affected by severity of hirsutism, age, occupation, socio-economic status, marriage status, presence of polycystic ovarian syndrome, religion and educational status

Conclusion The presence of hirsutism had significant impact on the mental status of the patients which lead to anxiety and depression. There was a greater increase of anxiety in comparison with depression

GIST: institutional experience at SRMS-IMS, India

Gastro-Intestinal Stromal Tumors [GIST] is a malignant, non-epithelial, mesenchymal tumor of the digestive tract that is not uncommon in clinical practice nowadays; diagnosis being based upon immuno-histo-chemical analysis of the resected or biopsied [FNAC] specimen. Abdominal lump with or without intra-luminal bleed is a common mode of presentation. Early diagnosis and appropriate management with surgery and/or Imatinib therapy improves recurrence free survival and may impact overall survival. We present here our institutional experience of four patients, admitted in Onco-Surgery Dept., with pain abdomen and upper/lower gastrointestinal bleed, which, on subsequent workup were diagnosed to be cases of GIST, were appropriately managed according to their disease stage and show recurrence-free survival on follow-up

Bilateral diffuse tuberculosis of the parotid gland

Tuberculosis of the parotid gland is an unusual occurrence. We describe here a case of bilateral parotid gland tuberculosis showing diffuse involvement, which is even more rare. The patient was diagnosed on fine needle aspiration cytology and treated with WHO-approved Directly Observed Treatment Short Course [DOTS] category III regimen under Revised National Tuberculosis Programme with effective remission

Megaloblastosis: from morphos to molecules

Megaloblastosis [i.e., megaloblastic transformation of erythroid precursor cells in the bone marrow] is the cytomorphological hallmark of megaloblastic anemia resulting from vitamin B[12] and folate deficiency. It is characterized by a finely stippled lacy pattern of nuclear chromatin, which is believed to be an expression of deranged cellular DNA synthesis. However, the molecular basis of these cytomorphological aberrations still remains obscure. The current presentation describes the results of our studies on some molecular events associated with the development of megaloblastosis. Transmission electron microscopy was used to study megaloblasts as well as DNA fibers extracted from megaloblastic and normoblastic bone marrows with and without treatment with proteinase K during the extraction procedure; cellular DNA synthesis in bone marrow cultures was studied by incorporation of [3]H-thymidine and deoxyuridine suppression test, while histone biosynthesis in bone marrow cells was studied by in vitro incorporation of [3]H-tryptophan, [3]H-lysine and [3]H-arginine into histones. Derangement of DNA synthesis occurred due to an impaired de novo pathway of thymidylate synthesis in both vitamin-B[12]- and folate-deficient human megaloblastic bone marrows as well as in the bone marrows of rhesus monkeys and rats with experimentally induced folate deficiency. Interestingly, folate-deficient monkeys developed frank megaloblastic bone marrows, but folate-deficient rats did not. On the other hand, megaloblastic changes in the bone marrow of human patients with myelodysplastic syndrome and erythroleukemia were not associated with this DNA synthetic abnormality. Biosynthesis of predominantly arginine-rich histones in megaloblastic bone marrows was markedly reduced as compared to normoblastic bone marrows, which was consistently associated with elongation and despiralization of chromosomes and finely stippled nuclear chromatin in megaloblasts. The impaired biosynthesis of predominantly arginine-rich nuclear histones appeared to be a common molecular event [a denominator] underlying the development of megaloblastosis with or without abnormal DNA synthesis

Comparison of pharmacokinetics of two preparations of cyclosporine in end stage renal disease patients on maintenance haemodialysis

To compare the pharmacokinetics and tolerability of two preparations of cyclosporine. The bioavailability of two preparations of cyclosporine [Panimun Bioral, Panacea Biotec India and Sandimmun Neoral, Novartis Switzerland] was compared in 10 adult patients of ESRD on maintainence haemodialysis by enzyme multiplied immunoassay technique [EMIT] after 6.5 days of cyclosporine [5 mg/kg body weight/day in two divided doses] of either brand, with a clearance period of one week in between the two. Area under the curve [AUC], maximum whole blood concentration [Cmax], time to achieve Cmax [Tmax], half life [T1/2], constant of elimination [Kel] was calculated by computer software programme [PK Solutions]. The relative bioavialability of Panimun Bioral was 93%. The AUC [0-12] hours. Cmax Tmax, T1/2 and Kel was not statistically significantly different and side effects with both were minimal. The two preparation were bioequivalent

Rupture of the stomach following blunt abdominal trauma-a-case report

A 38 year old, Libyan, male, was hit on his abdomen during a fight. He presented with features of acute abdomen. Laparotomy revealed tears on both the anterior and posterior walls of the stomach near the lesser curve in the antral region. Isolated ruptures of the stomach following trivial trauma is known but rare

Injection sclerotherapy for early hemorrhoids experience at Central Hospital, Tripoli

Two hundred and twenty five patients of symptomatic first and second degree hemorrhoids treated by injection sclerotherapy over the last 2 years at the anorectal clinic, Central Hospital, Tripoli are presented. Sixty eight% of the patients became asymptomatic at 1 month, and another 28% improved and considered the treatment satisfactory. Six patients had to be referred for surgery. Similar results are maintained after 4 months and 1 year of followup. No serious side effects were encountered, and only a small number of the patients [11.5%] required repeated treatment. A long term follow up is planned

Synthesis and reactions of some new keto anils

A number of new keto anils obtained from p-ethoxy phenyl Glyoxal hydrate and different aromatic amino compounds have been synthesized and characterized through the formation of 2,4-dinitro-phenyl hydrazones, semicarbazones, oximes and their elemental analysis. I R spectral studies of these anils have also been carried out with a view to ascertain the presence of different functional groups in the proposed structures