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Background: Stature plays a major role in forensic identification. It is also considered to be one of the fundamental compo- nents of physical anthropology. When a full skeleton is not available, stature can be estimated from incomplete human remains. Teeth form an excellent material for anthropological, genetic, odontologic and forensic investigations. Various studies have ventured to ascertain the usefulness of tooth crown measurements in stature prediction. Methodology: Tooth lengths of all 28 teeth except 3rd molars were measured on digital OPG using inbuilt software IMPAXH (Agfa, Belgium). Stature was measured from the vertical distance from the vertex of head to the floor. Correlation between the tooth length and height of an individual was done by Pearson correlation test and linear regression analysis for prediction of stature from tooth length. Result & conclusion: Overall the results revealed that individual tooth variables have a good correlation with stature with r value ranging from 0.12-0.57 and p value less than 0.05. Among the tooth lengths, the length of the maxillary right molars showed the highest correlation with stature followed by maxillary right premolars and maxillary right canine than the other teeth. Regression equation was generated from tooth length, to predict height.
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Background: Growth and development of dentocraniofacial complex occurs during various stage of development of dentition with TMJ as one of its centres of growth. The condition of temporomandibular joint can be visible from its condylar head form; therefore, it is crucial to recognize the normal morphology of condylar head during different stages of development of dentition. Aims: The aim of the study is to view the morphological appearance of condylar head during primary dentition, mixed dentition and permenant dentition. Subject and Methods: 400 panoramic images of 194 boys and 296 girls were collected and were divided into three groups bases on the stage of dentition. Shape of the condylar head were determined by tracing the print out of the panoramic image on an X ray viewer. Results: The study showed that during primary dentition stage shape of the conylar head was dominated by round shape and as growth and development occurs the condylar head shape changes to convex. Conclusion: The study describes the normal morphology of mandibular condyles in a child population attending The dentition status as well as growth of craniofacial has a significant role in determining condylar morphology.
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Resumo Fundamento Doenças cardiovasculares (DCV) são uma das principais causas de mortalidade e morbidade em todo o mundo. O envelhecimento biológico tem sido associado à ocorrência de resultados cardiovasculares. Entretanto, o mecanismo subjacente desse processo ainda é desconhecido. Objetivos Buscamos avaliar se a senescência das células sanguíneas mononucleares periféricas (CSMP) e biomarcadores endoteliais poderiam influenciar o risco cardiovascular (CV) e ser marcadores adequados para a detecção precoce de doenças cardiovasculares em adultos. Métodos Neste estudo transversal, pacientes livres de DCV foram classificados como baixo (n=32) e alto (n=28) escore de risco intracardaco (IHR) A senescência das CSMP foi avaliada estimando-se a atividade de telomerase (AT) e detectando-se a presença de células senescentes e disfunção endotelial, estimando-se a concentração de nitrito e nitrato e a capacidade antioxidante total (CAT). A análise estatística foi realizada com o software SPSS, versão 16.0 (SPSS Inc., Chicago, IL). Todos os p-valores <0,05 foram considerados estatisticamente significativos. Resultados A senescência de CSMP de 0,95 [p-valor = 0,0001; 95% IC (0,874-1,026)] foi um indicador significativo de pacientes com escore de IHR mais alto, com um valor de corte de 21,65, com sensibilidade e especificidade de 92% e 88% respectivamente. Identificou-se que a senescência de CSMP, nitrito e nitrato, e AT eram independentemente associadas a um escore de IHR alto. Conclusão Os status de nitrito e nitrato e AT, e a senescência de CSMP são medidas adequadas para prever o alto risco cardiovascular em adultos com risco CV. Entretanto devem ser realizados estudos de acompanhamento de longo prazo para confirmar esses achados. (Arq Bras Cardiol. 2021; 116(1):37-47)
Abstract Background Cardiovascular diseases (CVD) are one of the leading causes of mortality and morbidity worldwide. Biological aging has been associated with the occurrence of adverse cardiovascular outcomes; however, the underlying mechanism of this process remains unknown. Objectives This study sought to evaluate if peripheral blood mononuclear cell (PBMC) senescence and endothelial biomarkers could influence cardiovascular (CV) risk and be suitable markers for the early detection of cardiovascular diseases in adults. Methods In this cross-sectional study patients free of CVD were classified as lower (n=32) and higher Interheart Risk (IHR) scores (n=28). PBMC senescence was assessed by estimating the telomerase activity (TA) and detecting the presence of senescent cells and endothelial dysfunction by estimating the concentration of nitrite and nitrate and of total antioxidant capacity (TAC). Statistical analysis was performed with SPSS version 16.0 (SPSS Inc., Chicago, IL). All p-values <0.05 were considered statistically significant. Results PBMC senescence 0.95 [p-value = 0.0001; 95% CI (0.874-1.026)] was a significant predictor of patients with higher IHR scores with a cut-off value of 21.65 with a sensitivity and specificity of 92% and 88% respectively. PBMC senescence, nitrite and nitrate and TA were found to be independently associated with high IHR scores. Conclusion PBMC senescence, TA and nitrite, and nitrate status are suitable measures to predict high cardiovascular risk in adults with CV risk. Nevertheless, long-term follow-up studies are needed to confirm these findings. (Arq Bras Cardiol. 2021; 116(1):37-47)
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Humanos , Adulto , Leucocitos Mononucleares , Enfermedades Cardiovasculares/diagnóstico , Estudios Transversales , Factores de Riesgo , Factores de Riesgo de Enfermedad CardiacaRESUMEN
Leukemoid reaction and myeloproliferative syndrome are close mimickers and frequently pose a diagnostic dilemma, particularly when the leukocyte count is very high. Leukocyte alkaline phosphatase score frequently aids in diagnosis but may or may not be contributory, especially in differentiating chronic neutrophilic leukemia. Herein, we document a case of leukemoid reaction with extensive hyperleukocytosis in a 46-year-old female with poorly differentiated carcinoma. The tumor itself as well as the associated leukocytosis portends a poor prognosis
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Myelodysplastic syndromes (MDSs) are characteristically defined by the presence of specific karyotypic abnormalities, based on which they have been prognosticated. Translocation t(9;22)(q34;q11.2) (Philadelphia positive [Ph +ve]) and corresponding BCR-ABL fusion transcript is the defining parameter of chronic myeloid leukemia. It is also seen in a fair proportion of adult acute lymphoblastic leukemia. Occurrence of a Ph +ve MDS is very uncommon, and that too is seen mostly on progression to higher stage/acute leukemia. Even rarer is the de novo presence of Ph positivity in an MDS. A literature search through PubMed has shown only about forty cases of Ph +ve MDS among which less than half had shown Ph positivity at the time of initial diagnosis. Due to its rarity, this entity has not yet found its space in current WHO 2008 classification and is still under “yet to be validated phase” in current practice of hematological malignancies. The benefit of using a tyrosine kinase inhibitor in such a situation is also debatable. We report here two such cases of de novo Ph +ve MDS, diagnosed in last 1½ year at our institute along with brief literature review
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Filariasis is among the common parasitic infestations found in India, with Wuchereria bancrofti being the most common causative organism. Presentation ranges from clinically asymptomatic to profound elephantiasis. It is also detected incidentally in diagnostic samples such as body fluids, fine needle aspirates, peripheral blood smears, and other cytological smears. Its detection in bone marrow aspirates with an associated hematolymphoid neoplasm is rare, with only a few case reports. We report one such case of young male who presented with leukocytosis of 253 × 109/L with basophilia and massive splenomegaly. Bone marrow aspirate smears showed the presence of microfilariae along with other features of a myeloproliferative neoplasm (MPN). The present case is probably the first case of finding a microfilaria in a case of MPN
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Objective: The presence of specific chemotherapeutic protocols for hairy cell leukemia (HCL) makes it essential to discriminate this entity from other lymphoproliferative disorders. Hence, awareness of the variations in clinical presentations and immunophenotypic aberrancies is requisite to ensure diagnostic accuracy. Materials and Methods: A retrospective study was carried out to analyze the clinical-pathological profile of patients with HCL diagnosed over a period of 81 months (2010–September 2017) in our institute. Flow cytometry was performed in all the patients, and further, BRAFV600E mutation analysis was performed by real-time polymerase chain reaction in a limited number of samples. Result: A total of 353 lymphoproliferative disorders were assessed during the period, of which 16 (4.5%) were diagnosed as HCL, which included 15 cases of classical HCL and single case of HCL-v. Striking male predominance was noted with a median age of 52 (range 22–90 years). 47% patients presented with pancytopenia, while 20% cases had leukocytosis. Three patients presented with bleeding diathesis in the form of melena and purpuric spots. The absence of splenomegaly was observed in 20% patients (4/15) while 2 (13.3%) cases had lymphadenopathy. Hypocellular marrow was observed in 13% cases. Bright expression of CD20/CD22 along with CD25/CD103/CD123/CD11c was noted in all the patients of classical HCL. Aberrant expression of CD23 and CD5 was seen in 33% ( n =5) and 6.7% ( n =1) cases respectively. CD200 was positive in all the 5/15 cases tested. The case of HCL–v presented with very high leukocyte count and exhibited a CD103/CD11c+ and CD123/CD25- profile. BRAFV600E, mutation was present in all the four patients tested who included patients with a hypocellular marrow and absent splenomegaly. Conclusion: HCL has characteristic profiles, yet it may exhibit unusual clinical and immunophenotypic presentations. Perspicacious use of flow cytometry and BRAFV600E mutation analysis will aid in the diagnosis in unprecedented cases
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Dermoid cysts are benign entities, characterized histologically as- if it is lined by squamous epithelium, it is known as epidermoid cyst, if it contains skin adnexa, it is called true dermoid and if it contains tissue of all three germ layers like muscle, teeth, bone, cartilage it is called teratoid cyst. Prevalence is 7% and 1.6 % in head & neck and oral cavity respectively. According to literature the term dermoid cyst can be used interchangeably for any of the three histologically distinct entities. They occur at areas of embryonic fusion. Dermoid cyst are classified into four categories based on location 1. Periorbital 2. Nasal 3. Submental 4. Lower neck region.[1],[2]
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Aim: This study is designed to determine better intervention strategies between pain coping strategies and kinesthesia, balance and agility exercises for chronic knee OA. Study design: Experimental study, Randomized Clinical Trial. Method: 40 participants both male and female with physician diagnosed chronic knee OA were assigned into two groups. The objective of the study was explained, and the subjects were screened based on the inclusion and exclusion criteria. Group A received kinesthesia, balance and agility exercises which include- Wedding march, Backward wedding march, Side stepping, tandem walk, toe walking, heel walking and then exercises progress into leaning forward, backward and sideways, rocker bottom balance board, carioca cross over maneuver and modified grapevine. Group B received Pain coping strategies involving 10 supervised sessions. Both the groups received treatment protocol of 6 weeks with sessions 3 times / week. WOMAC scores were taken at baseline as well as after 6 week of treatment. Results: Both the groups showed clinically and statistically significant improvement in WOMAC scores at the end of 6-weeks of treatment session. i.e., 47.043±11.753 to 5.815±11.079 in group A and 44.579±8.045 to 27.849±5.216 in group B. Conclusion: A significant improvement were observed in both the groups; however the study has demonstrated that KBA exercises presented more beneficial effects in reduction of pain and improvement of functional status whereas pain coping strategies had beneficiary effects in cognitive and behavioral reactions to pain as they affect pain, functional capacity and psychological functioning.
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Mullerian duct anomalies are congenital defects of female genital system that arise from abnormal embryological development of mullerianducts. Uterusdidelphys also known as double uterus is one of the least mulleriananomalies. Here we present a case of a woman with uterus didelphys and her successful full pregnancy. Patient came to our hospital with diagnosis of G1P0L0 with 39 weeks with antepartum hemorrhage with active bleeding. On ultrasound she was found to be type iv placenta previa, in view of same we had done her lower segment cesarean section with delivery of a 2.5 kg female baby with intraoperative findings of two uterus and two cervix i.e uterus didelphys in which pregnancy was present in right uterus, placenta covering os. Post operative period was uneventful. Patient who have uterus didelphys due to mullerian defect not associated with difficulty in conception but there is increase incidence of preterm labour, malpresentation and malposition. Howeverwith appropriate antenatal and intrapartum surveillance pregnancy outcome are good.
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Introduction: The Pulmonary function tests in subjects withnormal BMI and with obese individuals were done andcorrelated with the severity of obesity. Considering the PFTchanges, normal study was present in 17%. But, remainingindividuals showed proportionate decrease in both FEV1 andFVC values. These changes were independent of age, sex andblood pressure.Methods and Results: Selection of the Subjects Obeseindividuals of about 30 people with BMI >30 of both sexes ofage group between 30 -45 years were included in this study.The healthy volunteers, visitors or relatives of patients visitingS. P. Medical College Hospital, Bikaner Rajasthan were takenas subjects. So, the PFT changes are more of restrictive thanobstructive pattern which can leads to decreased chest walland lung compliance, respiratory muscle strength andendurance which ultimately ends in poor pulmonary ventilation.Hence, this non-invasive procedure may be utilized as aroutine screening test for obese people for better medical care.Conclusion: Thus, obesity is associated with a wide variety ofPFT abnormalities, many of which can be corrected by weightloss
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Introduction: Diabetes is a universal endemic with fastincreasing prevalence in both developing and developedcountries. Obesity is an unnecessary accumulation of body fatand in its gross manifestation possesses a real hazard tohealth. It is well recognized that obesity is directly or indirectlyassociated with type 2 diabetes mellitus. The aim was tocompare lipid profile in Type 2 diabetics with obesity and nondiabetic obese subject.Materials and Methods: This study was conducted inDepartment of Physiology, S.P. Medical College and Hospital,Bikaner, Rajasthan during the period from March 2015 toFebruary 2016. Weight was record in kilograms with thesubject standing on the weighing machine without shoes andmini-mum clothing.Results: Present study showed that the obese T2DM patientshad significantly higher serum triglycerides, LDL-C levels andserum VLDL-C levels; with significant lower HDL-C levels whencompared to obese non diabetic cases. Total cholesterol levelswere increased without significant ‘p’ value.Conclusion: We conclude that all the lipid fractions (exceptHDL-c) are strangely elevated in obese type 2 diabetics whencompared with obese controls.
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BACKGROUND AND OBJECTIVES: Most studies in cardiac regeneration have explored bone marrow mesenchymal stem cells (BM-MSC) with variable therapeutic effects. Amniotic fluid MSC (AF-MSC) having extended self-renewal and multi-potent properties may be superior to bone marrow MSC (BM-MSC). However, a comparison of their cardiomyogenic potency has not been studied yet.METHODS: The 5-azacytidine (5-aza) treated AF-MSC and BM-MSC were evaluated for the expression of GATA-4, Nkx2.5 and ISL-1 transcripts and proteins by quantitative RT-PCR and Western blotting, respectively as well as for the expression of cardiomyogenic differentiation markers cardiac troponin-T (cTNT), beta myosin heavy chain (βMHC) and alpha sarcomeric actinin (ASA) by immunocytochemistry.RESULTS: The AF-MSC as compared to BM-MSC had significantly higher expression of GATA-4 (183.06±29.85 vs. 9.80±0.05; p<0.01), Nkx2.5 (8.3±1.4 vs. 1.82±0.32; p<0.05), and ISL-1 (39.59±4.05 vs. 4.36±0.39; p<0.01) genes as well as GATA-4 (2.01±0.5 vs. 0.6±0.1; p<0.05), NKx2.5 (1.9±0.14 vs. 0.8±0.2; p<0.01) and ISL-1 (1.7±0.3 vs. 0.9±0.1; p<0.05) proteins. The AF-MSC also had significantly elevated expression of cTNT (5.0×10⁴±0.6×10⁴ vs. 3.5 ×10⁴±0.8×10⁴; p<0.01), β-MHC (15.7×10⁴±0.9×10⁴ vs. 8.2×10⁴±0.6×10⁴; p<0.01) and ASA (18.6×10⁴±4.9×10⁴ vs. 13.1×10⁴±3.0×10⁴; p<0.05) than BM-MSC.CONCLUSIONS: Our data suggest that AF-MSC have greater cardiomyogenic potency than BM-MSC, and thus may be a better source of MSC for therapeutic applications in cardiac regenerative medicine.
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Femenino , Humanos , Actinina , Líquido Amniótico , Antígenos de Diferenciación , Azacitidina , Western Blotting , Médula Ósea , Inmunohistoquímica , Células Madre Mesenquimatosas , Regeneración , Medicina Regenerativa , Usos Terapéuticos , Troponina T , Miosinas VentricularesRESUMEN
Background: Rheumatoid Arthritis (RA) is a chronic disabling disorder that lowers quality of life in the affected patients. Early treatment with disease-modifying anti-rheumatic drugs (DMARDs, provides better control of disease and minimize joint destruction. Long term therapy imparts considerable economic burden to the patients. Cost effective analysis was performed among the patients treated with methotrexate (MTX) alone, hydroxychloroquine (HCQ) alone, and both (MTX+HCQ).Methods: A prospective, observational study for six months to analyze the cost-effectiveness in RA patients with DMARDs-MTX, HCQ and MTX+HCQ. A total of 91 patients were included for analysis; 43 patients in MTX and HCQ group; 37 patients in MTX group and 11 patients in HCQ group. To assess the functional disability,” Stanford Health Assessment Questionnaire - Disability Index” (HAQ-DI) was administered. The patients were followed up for four months. The HAQ-DI at the baseline was compared with that of final follow up. The change in HAQ-DI and the total costs were used to find out the average cost- effective ratio (ACER).Results: The least ACER was obtained for Hydroxychloroquine and highest was for Methotrexate. But there was no statistically significant difference in ACER between various treatment groups. There was no significant difference in the disease activity improvement between the three groups.Conclusions: MTX, HCQ and MTX+HCQ showed improvement in disease activity without any significant difference. MTX is superior considering direct cost but there is no difference in the total cost between three groups.
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In addition to online questionnaires, many medical schools use supplemental evaluation tools such as focus groups to evaluate their courses. Although some benefits of using focus groups in program evaluation have been described, it is unknown whether these inperson data collection methods provide sufficient additional information beyond online evaluations to justify them. In this study, we analyze recommendations gathered from student evaluation team (SET) focus group meetings and analyzed whether these items were captured in open-ended comments within the online evaluations. Our results indicate that online evaluations captured only 49% of the recommendations identified via SETs. Surveys to course directors identified that 74% of the recommendations exclusively identified via the SETs were implemented within their courses. Our results indicate that SET meetings provided information not easily captured in online evaluations and that these recommendations resulted in actual course changes.
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Humanos , Recolección de Datos , Grupos Focales , Evaluación de Programas y Proyectos de Salud , Facultades de Medicina , Estudiantes de Medicina , Estados UnidosRESUMEN
In addition to online questionnaires, many medical schools use supplemental evaluation tools such as focus groups to evaluate their courses. Although some benefits of using focus groups in program evaluation have been described, it is unknown whether these inperson data collection methods provide sufficient additional information beyond online evaluations to justify them. In this study, we analyze recommendations gathered from student evaluation team (SET) focus group meetings and analyzed whether these items were captured in open-ended comments within the online evaluations. Our results indicate that online evaluations captured only 49% of the recommendations identified via SETs. Surveys to course directors identified that 74% of the recommendations exclusively identified via the SETs were implemented within their courses. Our results indicate that SET meetings provided information not easily captured in online evaluations and that these recommendations resulted in actual course changes.
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Prognosis of acute myeloid leukemia relies heavily on the cytogenetic and molecular abnormalities. AML1-ETO fusion protein resulting from t[8;21], a recurring cytogenetic abnormality, is known to be associated with favorable prognosis. Additional molecular defects may, however, co-operate with the fusion proteins and alter the course of the disease. Among the additional cytogenetic defects, presence of Philadelphia [Ph] chromosome has rarely been documented in this subtype. Little is known about the consequences of its interactions with AML1-ETO, and its effect on morphological and clinical picture. Moreover, Ph[+] clones or subclones may appear at any point during the disease course. We herein report one such unusual case of a 26-year-old female, who was diagnosed to have t[8;21] and managed accordingly. During disease relapse after 2.5 years, the bone marrow showed extensive eosinophilia and basophilia. Subsequent molecular testing showed the presence of BCR-ABL in addition to the AML1-ETO fusion product
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Background: In COPD, acute exacerbation is the common problem during natural course. Studies of sputum samples using standard culture and molecular techniques have demonstrated that it is associated with increased prevalence of bacteria. Methods: 200 clinically diagnosed cases of AECOPD of age ≥45 years were recruited. Two sputum samples each were processed by conventional methods. Preparation of media, reagents, Gram staining, identification of culture isolates, different tests, including antibiotic sensitivity tests were carried out following standard laboratory. Results: The prevalence of AECOPD was more common in the age group of fifty six to sixty five years (43%) with ratio between male and female of 2.12:1. Klebsiella pneumonia was the predominant organism isolated in 42.55%, followed by Staphylococcus aureus in 28.73%, P. aeruginosa in 14.89%, E coli in 8.51%, CONS in 4.26% and S. pneumoniae in 1.06%. Gram negative bacteria were most sensitive to meropenem, imepenem, amikacin, followed by cefotaxime ceftriaxone, levofloxacin, Cefepime and aztreonam. Gram-positive bacterial isolates were most sensitive to linezolid (34.04%) followed by vancomycin (32.98%), cefoxitin (31.91%).Conclusion: Sputum culture is a good and simple diagnostic tool to study the etiology due to bacteria in AECOPD. Antibiogram helps in the formation of the correct treatment protocol, screening resistant pathogens and better drug for treatment, thereby helping to decrease the mortality and morbidity.
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Background: A rare case of bilateral multiple anatomical variations in the upper extremity, was found in a male cadaver, during routine dissection in the Anatomy department at TN Medical College, Mumbai. Observation: The variations included absence of Musculocutaneous nerve of right arm and communication of Musculocutaneous nerve with median nerve in the left arm, bilateral three heads of Biceps Brachii muscle and bilateral multiple tendons of Abductor Pollicis Longus muscle in both the arms. Conclusion: Medical significance of an absent Musculocutaneous nerve and the presence of three heads of Biceps Brachii lies in the fact that it can cause traumatic nerve compressions or complications in anaesthetic block etc. Anatomic variations of tendons of abductor pollicis longus are significant in assessment of hand injuries and surgeons performing hand reconstructive surgery.
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Background: Present study aimed to assess peripheral neuropathy in stable COPD patients, its prevalence, type and distribution and correlate the changes with severity of COPD. Methods: Study comprised of 60 healthy adults and 60 stable nonalcoholic and normo-glycemic COPD patients (30-70yrs) with no clinical symptoms and signs of neuropathy. Severity of COPD was classified as per WHO GOLD criteria. Nerve conduction study of four motor and four sensory nerves of upper and lower limb was done and parameters like distal latency, amplitude and conduction velocity was studied. Results: Study revealed prolonged distal latency, reduced conduction velocity and reduced amplitude in COPD patients as compared to controls. More number of nerves involved with increasing severity of disease. The observations revealed that demyelinating motor and axonal sensory neuropathy can be seen in COPD patients and neuropathy occurred even in mild COPD patients. Conclusion: Sensory polyneuropathy predominant in lower limb was present in majority of patients.