Assessment of optic disk by disk damage likelihood scale staging using slit-lamp biomicroscopy and optical coherence tomography in diagnosing primary open-angle glaucoma

Purpose: The current study was aimed at assessment of optic disk by disk damage likelihood scale (DDLS) staging using slit?lamp biomicroscopy and optical coherence tomography (OCT) in diagnosing primary open?angle glaucoma (POAG) patients. Methods: This was a cross?sectional observational study of 106 POAG patients, which was conducted from April 2017 to April 2018. All patients underwent slit?lamp fundoscopy with a +78 D lens and high?definition (HD)?OCT, and the vertical cup disk ratios (VCDRs) were recorded. Disk size and neuroretinal rim assessment were done, and the disk was then staged using the recent version, which stages the optic nerve head (ONH) from 1 to 10 as read from the DDLS nomogram table. DDLS scores >5 indicate glaucomatous damage. Pearson coefficient was used to correlate the DDLS staging by slit?lamp biomicroscopy with best?corrected visual acuity (BCVA), intraocular pressure (IOP), disk size, and VCDR and VCDR, mean deviation, and DDLS staging by HD?OCT. Results: The mean age of the patients was 59.54 ± 6.61 years. The male: female ratio was 2:1. The mean IOP was 16.04 ± 1.97 mmHg, and BCVA was 0.72 ± 0.13 LogMAR units. The mean VCDR on 78 D slit?lamp biomicroscopy was 0.76 ± 0.09 (standard deviation [SD]) (range 0.1–0.77), whereas on HD?OCT, the mean VCDR was 0.81 ± 0.09 (SD) (range 0.07–0.81). The mean deviation on visual field testing in decibels was ?14.43 ± 3.31 (SD). The correlation coefficient between DDLS staging by slit?lamp biomicroscopy and DDLS staging by HD?OCT parameters was r = 0.96. Conclusion: There is a positive correlation between the DDLS system of optic disk evaluation on slit?lamp biomicroscopy and most of the HD?OCT evaluation parameters

Coronary arteritis as a cause of sudden cardiac death in a young girl

A case of probable coronary arteritis in a young girl who died suddenly and unexpectedly is presented. The histologic presentation of the disorder is discussed, especially the differential diagnosis of arteritis of the coronary arteries with an emphasis on tuberculosis (TB). TB myocarditis with or without concomitant lung involvement is rare, and tubercular coronary arteritis without underlying pulmonary Koch's disease is all the rarer. We herein describe a case where the cause of death was ascertained on post-mortem examination.

A Comparative Study on Brain Stem Evoked Response Audiometry among Pre-school Children with Normal and Delayed Development of Speech Attending Bankura Sammilani Medical College

Introduction: The main consequence of hearing loss,especially in children, is the impact caused by sensorydeprivation in the development of auditory and languageskills and learning. Any degree of hearing loss can resultin significant damage, as it interferes with perception andunderstanding of speech sounds.This proposed descriptivecross sectional study tries to compare BERA parametersbetween normal and delayed speech/language impairmentchildren. Study also examines possible abnormalities inBERA in children with speech and language impairment.Material and Methods: One descriptive study withcross-sectional design was conducted in neurophysiologylaboratory in the Department of Physiology, BankuraSammilani Medical College and Hospital for one year.About106 pre-school children (1 to below 6years) of eithersex were selected from those referred from Paediatric andENT Department with complaint of delayed speech who hadbeen advised BERA test. About 105 children without havingdelayed speech development were chosen randomly.Results: Descriptive analysis was done of BERA parametersamong all subjects. Mean and standard deviation of both maleand female were calculated separately. Independent ‘t’ testwas done between the BERA parameters of normal childrenand children diagnosed with speech impairment. The testshowed significant changes (p value <0.05) in waves I, IIIlatency, I-III, I-V, III-V inter peak in study subject.Conclusion: The brainstem speech evoked auditory responsescan serve as an efficient tool in identifying underlying auditoryprocessing difficulties in children with learning disability andcan help in early intervention.

Comparative evaluation of immunoperoxidase versus immunofluorescent techniques in interpretation of kidney biopsies.

Background: Immunofluorescence (IF) on frozen sections has been considered to be the gold standard for evaluation of kidney biopsy specimens. Immunohistochemistry (IHC) method can also be used for this purpose with advantages of being applicable on paraffin embedded tissue, providing permanent sections, and not requiring a specialized microscope for interpretation. Our aim was to evaluate IHC as an alternative to IF in the diagnostic assessment of kidney biopsy specimens. Methods: One hundred kidney biopsy specimens were subjected to both IF and IHC staining for immunoglobulins (Ig), IgG, IgA, IgM and complement components c3 and c1q. IF staining was done on frozen sections. IHC staining was performed on paraffin‑embedded tissue following proteolytic antigen retrieval. The sections were evaluated, and the results of IHC were compared with IF. Results: Concordant observations were 98%, 87%, 89%, 83%, and 89% for IgA, IgM, IgG, C3 and C1q, respectively. The sensitivity of IHC method for Igs was found to be high (92%, 86.5%, and 95.1%, respectively for IgA, IgM, and IgG). 91% cases showed concordance of the intensity of the deposits while 100% cases showed a concordance of the pattern. Statistically, there was no significant difference in outcomes between IF and IHC for IgA, IgM, and IgG. However, statistically significant difference was found in the results for complement proteins. Conclusion: In this study, it is documented that IHC is, with few exceptions, equal to IF for the detection of Igs. Standardized immunoperoxidase method on the paraffin embedded, formalin fixed needle kidney biopsies could successfully replace the IF method in the diagnosis of glomerulonephritis.

Fallopian Tubes: Keep or Remove.

Ovarian cancer is a devastating disease. The pathogenesis of ovarian carcinomashas always remained unclear. Enough evidence is now available clearly highlighting distal fallopian tube as the site of origin for serous ovarian carcinomas particularly in women with BRCA mutations. The ovaries and fallopian tubes may not be simultaneously involved. After the completion of childbearing, there exists no known physiological benefit of retaining the fallopian tubes. Post-salpingectomy,the ovarian endocrine function remains unaffected. Removal of premenopausal ovaries leads to attainment of early surgical menopause. Prophylactic salpingectomy at hysterectomy for benign reasons or sterilization rules out any subsequent tubal pathology and offers considerable protection against later tumor development. Risk reducing salpingectomy even if the ovaries are retainedare beneficial especially in young women with BRCA mutations.

Oncofertility: Realizing a Couples’ Dream of Parenthood.

Oncofertility is an emerging fi eld, merging oncology and reproductive endocrinology. Any woman facing a cancer diagnosis is devastated especially if she is young. Young women diagnosed with cancer face an additional burden of compromise of future fertility. Oncofertility aims to explore and expand fertility options to address reproductive concerns of young women with cancer diagnosis. Th is review aims to highlight the available and emerging options for young women diagnosed with gynecological cancers to enable them to realize their dream of parenthood.

Conserved C-terminal nascent peptide binding domain of HYPK facilitates its chaperone-like activity.

Human HYPK (Huntingtin Yeast-two-hybrid Protein K) is an intrinsically unstructured chaperone-like protein with no sequence homology to known chaperones. HYPK is also known to be a part of ribosome-associated protein complex and present in polysomes. The objective of the present study was to investigate the evolutionary influence on HYPK primary structure and its impact on the protein’s function. Amino acid sequence analysis revealed 105 orthologs of human HYPK from plants, lower invertebrates to mammals. C-terminal part of HYPK was found to be particularly conserved and to contain nascent polypeptide-associated alpha subunit (NPAA) domain. This region experiences highest selection pressure, signifying its importance in the structural and functional evolution. NPAA domain of human HYPK has unique amino acid composition preferring glutamic acid and happens to be more stable from a conformational point of view having higher content of α-helices than the rest. Cell biology studies indicate that overexpressed C-terminal human HYPK can interact with nascent proteins, co-localizes with huntingtin, increases cell viability and decreases caspase activities in Huntington’s disease (HD) cell culture model. This domain is found to be required for the chaperone-like activity of HYPK in vivo. Our study suggested that by virtue of its flexibility and nascent peptide binding activity, HYPK may play an important role in assisting protein (re)folding.

Primary Fallopian Tube Serous Adenocarcinoma.

Tumours of the fallopian tube can be suspected pre-operatively with current radiological facilities. Aggressive search should also be made for a concomitant primary or as an isolated metastatic secondary of another primary cancer. Presentation and management on the lines of ovarian cancer in a 79 year old with primary fallopian tube cancer is described.

Effects of Exogenous Ethinyl Estradiol on Endometrial Receptivity in Clomiphene Induced Cycles in Infertile Women with Polycystic Ovaries

To compare the effectiveness of clomiphene citrate used alone and in combination with ethinyl estradiol on endometrial receptivity in infertile women with polycystic ovaries (PCO). Color doppler ultrasonographic evaluation of endometrial thickness (ET) and pulsatility index (PI) was done for 27 infertile women with polycystic ovaries. These women were studied for one control unmedicated cycle and randomized to receive clomiphene citrate (CC) alone and CC with ethinyl estradiol (EE) in subsequent 2 cycles. The total duration of follow up of patients was 77 months in which 2 women conceived in control cycle and 1 conceived in CC+ EE cycle. On day of HCGinjection, mean ET was 6.96 + 1.63mmin control cycle, 7.25 + 1.64mmin CC and 8.53 + 1.36mmin CC + EE cycle, whereas, the mean pulsatility index (PI) of dominant uterine arteries was 4.09 + 0.97 in control cycle, 3.96 + 0.95 in CC cycle and 3.75 + 0.98 in CC + EE cycle. On day of HCG injection, mean PI of non-dominant uterine arteries was 4.06 + 1.01 in control, 4.00 + 1.02 in CC and 3.71 + 0.95 in CC + EE cycles. A statistically significant change (p< 0.05) was observed in ET and PI of dominant and non-dominant uterine arteries in control and CC+ EE cycle and those in CC and CC+ EE cycles. Addition of ethinyl estradiol to clomiphene induced cycles produces a favorable endometrial response in infertile women with PCO.