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Aims and Objectives: It is impossible to precisely anticipate the course of the transverse and sigmoid sinuses and theirindividual relationship to superficial landmarks such as the asterion during retrosigmoid approaches. This study was done todetermine the position of the asterion and the relationship between asterion and the transverse-sigmoid sinus junction (TSSJ)in making precise burr hole without damaging sinuses during retrosigmoid craniotomies.Materials and Methods: Computed tomography (CT) angiography was performed in 50 patients to obtain 3D-CT volumerendering images of cranial bone and dural sinuses. After delineating the sinuses, by simple restructuring using software andopacity modulation, bone image is reinforced. Asterion type, distance from the tip of mastoid process to asterion and root ofzygoma (ROZ) to asterion, and location of asterion in relation to TSSJ and distance between asterion and TSSJ were analyzedand measured.Results: The incidence of type 1 (presence of sutural bones) in our study was 24% and type 2 (absence of sutural bones) was76%. There was no statistically significance in the side and gender differences. The distance between the asterion and fromthe ROZ was 54.70 ± 3.68 on the right side and 54.32 ± 3.41 on the left side (P-0.612). The distance between asterion and tipof mastoid was 50.51 ± 2.67 on the right side and 50.12 ± 3.06 on the left side (P-0.716). The asterion was located on the T-Ssinus complex in 36 (72%) cases. The asterion was below the T-S sinus complex in 13 (26%) cases, and above the T-S sinuscomplex in only 1 (2%) cases.Conclusion: 3D-CT volume rendering imaging is capable of accurately visualizing the bony landmark and dural sinuses. Aneasy and simple restructured image provides precision and safety for the patient by ready and easy localization of asterionand TSSJ. This study was done to show that the previous cadaver-based anatomical studies can be done now in a moresophisticated and accurate manner with the latest technological advancements. This offers new options for anatomic researchand morphometric investigations.
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Acquired thymic cyst are multilocular and they occur de novo or in association with mediastinal neoplasm, systemic autoimmune diseases and trauma. Here, we report a case of acquired multilocular thymic cyst due to non-specific inflammatory etiology in a 42-year old gentleman and our approach to diagnosis and management of anterior mediastinal mass. With no specific clinical symptom, he was diagnosed with anterior mediastinal mass incidentally by imaging studies. Definitive diagnosis of multilocular thymic cyst was obtained by tissue diagnosis of the anterior mediastinal mass resected during the surgery.
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Introduction: Colloid cysts are one of the benign intracranial tumors most commonly occurring in the rostral part of the thirdventricle. These may present with varied spectrum of clinical features that poses challenges in clinical diagnosis. The presentationmay range from being asymptomatic to simple headaches, seizures, and even sudden death. Most of the symptoms can beattributed to the development of obstructive hydrocephalus. Chemical or aseptic meningitis is unusual complication posingcomplicating differential diagnosis. We describe eight such cases with wide variety of symptoms.Materials and Methods: We present a case series of eight cases of the third ventricle colloid cysts presented at our institute.Age of the patients ranged from 15 to 55 and five of them were females. All the clinical features were recorded from eachone of them. Computed tomography and magnetic resonance imaging were used to diagnose the condition. Four of themunderwent excision of the cyst in single stage either by open or endoscopic approach. Two patients underwent preliminaryventriculoperitoneal shunt done in the view of poor neurological status and craniotomy and excision was done in later stage. Inone patient bedside external ventricular drain was inserted for emergency decompression of ventricles. One patient is underserial radiological follow-up.Results: Eight cases that we observed had wide variety of symptoms. Six patients had chronic headache with progressiveseverity, and four of them had nausea with vomiting, three patients had seizures. The cysts in two patients were discoveredaccidentally, during the evaluation of seizures in one patient and others in evaluation of traumatic head injury. One elderly patienthad presented with psychiatric symptoms, drop attacks along with the features of normal pressure hydrocephalus. One teenagepatient presented with sudden deterioration and went into cardiac arrest even after emergency decompression of ventriclesdone. Seven of them underwent surgery and one of them succumbed. The surgery improved health in all other seven patients.Conclusion: Colloid cysts may present with a wide range and beyond expected neurological manifestations. The severity orrapid clinical deterioration does not exactly correlate with depending on the site, size of the cyst. Leaking cysts with chemicalmeningitis may further complicate the diagnosis. Hence, early diagnosis and surgery with complete removal of cysts offer betterclinical outcomes in those patients.
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Cloacogenic carcinoma also known as basaloid squamous cell carcinoma is a rare anorectal tumor presenting with varied histomorphology. In this case report, we describe a case of 58-year-old man presenting with bleeding per rectum and pain. A polypoidal tumor was noted in anal canal which on microscopy was diagnosed to be cloacogenic carcinoma with transitional carcinoma-like, basaloid and mucinous patterns. An unusual finding in the present case was the presence of signet ring cells in the mucinous areas. A thorough knowledge of the wide histomorphological spectrum of the tumor and a limited IHC panel are crucial for the diagnosis. Here, we also present a review of literature and describe in detail the origin and histopathological features of the tumor.
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Background & objectives: Polymerase chain reaction (PCR) has wide acceptance for rapid identification of pathogens and also for diagnosis of infectious conditions. However, because of economic and expertise constraints, a majority of small or peripheral laboratories do not use PCR. The objective of the present study was to develop a dry-reagent PCR assay as an alternative to conventional PCR to assess its applicability in routine laboratory practice using malB gene for identification of Escherichia coli as a model. Methods: A total of 184 isolates were selected for the study comprising clinical isolates of E. coli and non-E. coli including Shigella sp. and a few other control strains. The DNA was isolated from all the isolates. The isolated DNA as well as the overnight grown bacterial cultures were subjected to both conventional wet PCR and dry-reagent PCR. Results: The genomic DNA isolated from E. coli showed amplification of malB gene in both conventional wet and dry-reagent PCR and the band was observed at 491 bp. In dry-reagent PCR, the overnight grown E. coli cells also showed positive result. The non-E. coli strains other than Shigella sp. showed negative in both conventional wet and dry-reagent PCR. Shigella sp. showed positive in both conventional wet and dry-reagent PCR. Interpretation & conclusions: Considering the elimination of genomic DNA isolation step, and similar results with the conventional wet PCR, dry-reagent PCR may be a good alternative for the conventional wet PCR.
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Background: Most studies of lipid-lowering therapy for the prevention of coronary heart disease (CAD), focused on lowering low density lipoprotein cholesterol and non-HDL cholesterol. Other dyslipidemias, such as an elevated level of lipoprotein(a), also may promote atherosclerosis, establishment of relationship between lipoprotein(a) excess and risk for CAD, interventions directed toward altering these have only infrequently been evaluated in clinical trials. Objectives was to study the association of raised serum lipoprotein(a) in coronary heart disease.Methods: This study was conducted in 50 patients of CAD and 50 people as control group. All patients underwent a standard clinical examination and a blood draw for a lipid profile and lipoprotein(a) assay. Pearson chi-square test was used to assess the statistical significance.Results: Lipoprotein(a) value of more than 30 mg/dl is considered as elevated. In case group 19 patients (38%) were showed elevated lipoprotein(a) and in control group these were 9 patients (18%). p value is 0.026. It shows elevated lipoprotein(a) is statistically significant with the relative risk of 2.79.Conclusions: The association of elevated lipoprotein(a) with CAD was statistically significant. Higher lipoprotein(a) levels were observed in patient with family history of premature CAD.
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Background:Professional drivers, who maintain the same sitting posture, a taut hand grip, erratic rotations of the trunk and holding the pedals in same place with foot makes them susceptible for sensory and motor nerve damage and its consequences. This study was aimed to assess the motor nerve conduction velocity and pain threshold for the professional drivers who are exposed to the constant vibration during driving. Methods: 40 professional drivers and 20 controls were included in the study for analysis of nerve conduction study and pain threshold in upper limb and lower limb. Drivers with significant medical illnesses, alcoholism, hypertension and diabetes were excluded from the study. Results: Among the study group, both in the upper limb and in the lower limb there is a significant reduction in the motor nerve conduction velocity when compared to the control group. Regarding pain threshold there is a significant statistical difference between control group and heavy motor drivers group. Conclusion: There is a significant decrease in the motor nerve conduction of upper limb in heavy motor vehicle drivers than low motor vehicle drivers and there is a significant decrease in the motor nerve conduction velocity in lower limb and decrease in pain threshold among the heavy motor vehicle drivers.We recommend that all the professional drivers, particularly heavy motor vehicle drivers, should have periodic medical screening to prevent neuropathic changes and its devastating complications.
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In the current era, medicinal plants are the major resources of indigenous medicines in the traditional medicine system and are playing an important role. Over 80% of the world population mainly depend only on traditional/folk medicinal plants for plant-based medicines to control many of the diseases and their extracts for health care. In the present study, the medicinal plants commonly used by the local people and traditional practitioners of Kappathgudda area, Gadag District, North Karnataka region for treatment of Asthma viz. Acalypha indica L., Datura metel L. and Tylophora indica belongs to Euphorbiaceous, Solanaceae and Asclepiadaceae families were selected for elemental analysis due to its wider application in the traditional medicinal system. Analytical Atomic Absorption Spectrophotometer technique was adopted for the determination of various elements and indicated that Fe, Ca, K, Mg, Ti, Mn, V, Zn, Cu and Cd were present in all samples. The obtained results also revealed that the mineral and trace elemental contents were well within the permissible range and hence the medicinal plants are safe to be utilized in the drug formulations.
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Genital Herpes Simplex Virus (HSV) is a major global public health issue where the number of patientsincreases every year. It has a variety of clinical presentations, and a tendency to recur when the immunesystem is compromised. Patients with human immunodeficiency virus (HIV) have a higher chance ofbeing infected with HSV possibly due to their high risk attributes. We reported a case of a 19-yearoldhomosexual male who was recently diagnosed with HIV and presented with perianal lesions for aduration of three months. This case is presented with the aim to highlight the differential diagnosis ofrash in immunocompromised patients and how to approach them.
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Objectives: The prevalence of urolithiasis is increasing worldwide. Diabetes mellitus [DM] is characterized by insulin resistance, which increases the risk of kidney stone formation. Adiponectin is an insulin-sensitizing and anti-inflammatory cytokine, which is known to improve glucose tolerance and insulin resistance in humans. The association of insulin and adiponectin with kidney stones is not clear. Hence, the present study aim to assess the serum levels of adiponectin and insulin resistance in DM patients with urolithiasis in comparison to those without
Methods: This study involved two groups, group A consisted of 30 patients with DM and urolithiasis, and group B consisted of 30 patients with DM but without urolithiasis [control group]. Biochemical parameters studied were serum adiponectin, insulin, glucose, urea, creatinine, and 24 hours urinary calcium and phosphate
Results: The serum adiponectin level was significantly increased in the diabetic urolithiasis cases [group A] compared to the control group [group B]. The levels of 24 hours urine calcium and phosphorus were also significantly increased in group A. There was no significant difference in serum insulin and homeostasis model assessment of insulin resistance between the two groups. A negative correlation was seen between serum adiponectin and insulin among the cases [r = -0.368 and p = 0.045]
Conclusions: We found that serum adiponectin levels are increased in patients with DM and urolithiasis
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A comparative study was done on the production of 4-ipomeanol from root tubers of Ipomoea batatas and its rhizogenic callus. Best callusing response was obtained on MS medium supplemented with 11 µM NAA (α-Naphthaleneacetic acid) and 1 µM KIN (Kinetin). Effect of various elicitors (Fusarium solani, chitin and chitosan) on the production of 4-ipomeanol was studied. Methanol extract of the samples were purified by column chromatography and detected using TLC. Identification of 4-ipomeanol was confirmed using HPLC and quantified spectrophotometrically. A mass spectrum was recorded to confirm the presence of 4-ipomeanol. The calli grown under chitin produced highest (6.61mg g-1) amount of 4-ipomeanol. This is the first report on in vitro production of 4-ipomeanol from I. batatas. Since 4-ipomeanol is reported to be present only in I. batatas, this study would help in standardizing protocols for large scale production without affecting its natural flora.
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Antineoplásicos/biosíntesis , Quitina/biosíntesis , Quitosano/síntesis química , Técnicas de Cultivo/métodos , Ipomoea batatas/química , Raíces de Plantas/química , Tubérculos de la Planta/química , Terpenos/biosíntesisRESUMEN
Context: Improvement in the quality of teaching has been one of the important items on the agenda of curriculum development in most medical schools in Malaysia. Active teaching strategies are designed to make the learning process more interesting and thought provoking
Aims: To study the students' perception of an integrated quiz as a teaching-learning activity
Materials and Methods: An integrated quiz was conducted among 2nd year medical students in a Malaysian University. The quiz comprised questions on anatomy, physiology, biochemistry, pathology, microbiology, parasitology and nutrition. There were 8 teams, and four rounds with the four levels of questions according to Bloom's taxonomy were given. The students were divided into two groups. Group A consisted of students who participated in the quiz and Group B formed the audience. The perception of the students on the integrated quiz was assessed by administering a structured questionnaire of 20 questions and using a Likert-type scale. The respondents indicated their perception as scores; 5, 4, 3, 2 and 1 for options of strongly agree, agree, uncertain, disagree and strongly disagree respectively. In addition to the above scale, the students were given the option to give their comments and suggestions related to the session. The mean scores for each item were calculated and a comparison of the two groups made. Data were analyzed using descriptive statistics and t-test
Results: A total of 103 students participated in the study. There were more females than males in both groups. The mean perception score for Group A and Group B was 3.3 +/- 0.2 and 3.5 +/- 0.3 respectively. When the mean scores were compared, a statistically significant result was revealed. The overall ratings for the quiz by both groups were good
Conclusions: We found that Group B had a more positive response towards the integrated quiz as an active learning technique than Group A
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The study aimed to find the living status and the emotional intelligence of the women police constables in Coimbatore city, TamilNadu. This descriptive research was covered randomly selected two hundred women police constables. The questionnaire method was used to collect the data.The personal information sheet was used to obtain the demographic information and Schutte Emotional Intelligence Scale (Schutte et al. 1998) was applied to measure emotional intelligence. The results showed that the majority of the respondents (62.5%) are in the age group of 21-25 years and nearly half of the respondents (44%) had less than two years of experience. Half (52%) of the respondents had a moderate level of emotional intelligence and education, monthly salary, experience, No. of training programmes attended and the type of family played a significant role in emotional intelligence of women police constables on the other hand age and marital status doesn‟t make any impact.
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Ocular dirofilariasis mostly presents as a subconjunctival or eyelid lesion.[1] Intraocular dirofilarial infestation is rare.[2,3] We report a case of a young woman who was accidentally detected to have a live motile worm in the anterior segment in one eye and a cystic lesion on the optic disc in the other eye. To our knowledge, bilateral intraocular dirofilariasis has never been reported.
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Sperms are highly specialized cells for delivering DNA from male to the ovum. Incredibly, wide degree of diversity in sperm morphology in their basic structures i.e. head, middle piece and tail is found across species. Differences in terms of overall size of the sperm, shape and number of sperm produced are also incredible. One of the key for this variations or diversity in sperm may be associated with female reproductive tract, sperm competition, testicular size and sperm size and number. Establishing a correlation between sperm morphology and factors influencing them is a phenomenal task. In this mini-review these associations and the anatomical and functional adaptations among different from of sperm cells that have evolved to optimize fertilization success are discussed. Nevertheless, explaining these morphological diversities in sperm cells is a challenging question and it seems that evolutionary biologists have only recently engaged in exploring its links and patterns. From the literatures it seems that there is no causal relationship between sperm size and testicular size, however, the accumulated knowledge do indicates evolution of sperm morphology across species has some associations with female reproductive tract, sperm competition and sperm size and number, however interpreting these results for phylogentic correlations should be approached with caution
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A qualitative study using in-depth interviews was carried out among patients and doctors working in a private hospital in Tamil Nadu, to understand perceptions of informed consent. Audio-recorded interviews were transcribed verbatim and a framework analytical approach was used in analysis. Emergent themes ranged from perceptions on informed consent, and discussing health concerns and decision making, to information provided by and expectations from doctors, and suggestions for improvement. Most patients were unfamiliar with the kind of information provided in the informed consent process; a few felt that the information was inadequate. Decision making about surgery was left mostly to the doctor. Poor literacy in patients was seen as a barrier to effective communication by doctors.
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Urbanization and rapid growth of population in India has led to drastic increase in municipal solid waste. Unscientific disposal of municipal solid waste is one of the main reasons attributed for environmental degradation. The present work concentrates on municipal solid waste management in Tiruchirappalli City which comprises of four zones namely Srirangam, Goldenrock, Araiyamangalam and Abishekapuram. This study also attempted to assess the physical composition, characteristics and the heavy metals content in municipal solid waste. It can be observed that the bio-degradable fraction of municipal solid waste is found to be 74 percent of the total solid waste generated from the city. Hence composting could be the best option for the treatment of municipal solid waste.
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Hydroxy Propyl Methyl Cellulose [HPMC] 5cPs, an aqueous soluble polymer was employed for coating diclofenac sodium [DFS] tablets 25mg for protecting the integrity of the drug yet rendering the drug to release at a faster rate on contact with the gastric environment. Proper optimization for the aqueous based film coating formulation was undertaken primarily employing plasticizers like polyethylene glycol [PEG] 400 and propylene glycol [PG]. The defect free selected formulations were further subjected for studying the effects of surfactants like Sodium Lauryl Sulphate [SLS] and Tween-80 along with the plasticizers. The quality of the aqueous film coats or the plasticizer efficiency in case of PEG-400 is in the order 1.5%>0.5%>1.0% and for PG 1%> 4%> 3% which can be stated on the basis of less incidence of major coat defects like chipping, cracking, orange peel, roughness, blistering, blooming, picking. The quality of aqueous film coat or the surfactant efficiency in case of SLS+PEG-400 is in the order 0.3%< 0.5%< 0.1% and SLS+PG is in the order 0.5%< 0.1%< 0.3%. In case of Tween-80+PEG-400 the order is 0.3%< 0.5%< 0.1% and Tween-80+PG is in the order 0.3%< 0.1%< 0.5%. Elegant film formation can be stated from fewer incidences of coat defects. The obtained coated tablets eventually satisfied all the normal physical parameters like thickness, weights, and weight gain, drug content, crushing strength, percent friability, disintegration time, dissolution profile and possible drug-polymer interactions. ANOVA was undertaken followed by Dunnet multiple comparison for the dissolution profile considering uncoated as the standard. The difference was considered significant at p