Decoding pituitary tumors: a systematic analysis of diagnostic methods and treatment modalities

Pituitary tumors are growths that form in the gland these tumors are rare representing 10-15% of all brain tumors. They can disrupt the production of hormones, in the body leading to symptoms related to hormone imbalance. This review offers an overview of the methods used for diagnosing and treating tumors. It is worth noting that relying solely on references may restrict the scope and depth of discussions about tumors in this paper. Suggestions for research include exploring diagnostic tools like molecular imaging and liquid biopsy to enhance early detection and accurate assessment of these tumors. Additionally, more research is required to understand the long-term effects and quality of life outcomes for patients undergoing treatment options for tumors. In conclusion, significant progress has been made in diagnosing and treating tumors over time. Advances in imaging technologies such as diffusion-weighted imaging and magnetic resonance spectroscopy have enhanced precision and treatment strategies for these tumors. The discussion also covers the roles of surgery, radiation therapy and medical interventions, in managing tumor growth and hormonal imbalances further advancements, in research and innovation are crucial, for enhancing our knowledge and treatment of tumors ultimately bringing outcomes for both patients and healthcare professionals.

Roots and fates of congenital insensitivity to pain and anhidrosis: a human phenotype

Congenital insensitivity to pain is a rare neurological disorder characterized by the inability to perceive physical pain. Individuals with CIP lack the typical nociceptive responses to harmful stimuli, which poses significant challenges to their safety and well-being. This condition is often caused by genetic mutations affecting the nervous system's ability to transmit pain signals. Despite the apparent advantage of not experiencing pain, CIP presents severe risks as affected individuals may unknowingly sustain injuries or develop medical complications without timely intervention. The absence of pain perception hinders the learning of protective behaviour and responses to potentially harmful situations, making daily activities fraught with danger. Understanding the genetic basis of CIP has provided valuable insights into pain perception and the functioning of nociceptive pathways. While this knowledge may pave the way for potential therapeutic interventions, managing CIP remains a complex task. This article provides an overview of CIPA, its genetic basis, clinical manifestations, complications, treatment and the challenges associated with managing this complex condition. A multidisciplinary approach involving genetic counselling, pain management, and specialized care is crucial to support individuals with CIPA and improve their overall well-being.

Social media and mental health of undergraduate medical students of Mysuru: cross sectional study

Background: Social media is a form of electronic communication, through which people can share ideas and information. With the advent of internet and social networking sites, humans have become social more virtually than in person. This has led to people living more isolated lives affecting one’s health. Hence the objective is to assess the effects of social media on students and factors associated. Methods: It was a Cross sectional study among 367 undergraduates from a medical college in Mysuru, over a duration of 2 months. A self-administered questionnaire with socio- demographic variables and a standard GHQ-12 (general health questionnaire) was used for the scoring of their distress levels. Descriptive statistics were taken and Chi-square test was done for statistical significance. Results: Out of 367 students, the mean age of students were 21.5 years. The prevalence suggestive of distress was found to be 72.4% (265), and severe psychological distress was found to be 3.27%. Among usage of apps, people using 1 app had 48.5% distress, 2 apps had 75.6% distress, 3 apps had 63.3% distress and 4 apps 74.2% distress. There was no significant association between factors and severity of distress. Conclusions: From the above study, we have shown that social media with all its influence has a negative impact on the students’ behavior. With this the youth need to be educated on its use and its limitations counselled regarding its ill effects and necessary tolls for seeking help be made available at their disposal.

Correlating the altered bowel habits among young medical doctors when exposed to rural posting in the course of their training in India

Background: Altered bowel habits, is a commonly encountered presentation, especially among training professionals. During training, young doctors move to rural areas, experience the stress factors in food and environment causing the altered bowel habits. Hence correlating altered bowel habits among young medical doctors when exposed to relative culture barriers was the main aim of the study. Methods: It was a cross sectional study among interns and postgraduates from all over the country for a duration of 2 months from January 2023 to March 2023 for 150 participants. A self-administered questionnaire with socio- demographic variables and a standard PAC-SYM was used for the scoring of altered bowel habits. Data entered into Excel and analysed using SPSS software. Descriptive statistics were taken and Kruskal Wallis test was done for statistical significance. Results: 60% of the students belong to 20-24 age group. 55% of participants were female. 48.7% of mothers were homemakers and 46.6% were professionals. 90% of students were exposed to rural areas and 32% of them stayed there for more than 2 months. Gender, duration of stay, frequency of food consumption and bathroom comfort were statistically significant with the symptoms of altered bowel habits. Conclusions: From the above study, we have tried to prove poor water supply, poor hygiene, and multiple people sharing the toilet are significant stressor factors for the medical trainee during their stay in rural health centres across the country.

In vitro effects of lapachol and β-lapachone against Leishmania amazonensis

Leishmaniasis is a neglected disease that affects millions of people worldwide, and special attention should be given to treatment because the available drugs have limitations, which can lead to low therapeutic adherence and parasitic resistance. This study evaluated the activity of the bioactive naphthoquinones, lapachol and β-lapachone, against Leishmania amazonensis. The cell alterations were evaluated in vitro on promastigote and amastigote forms. The lethal dose (LD50) at 24, 48, and 72 h on the promastigote's forms using lapachol was 75.60, 72.82, and 58.85 μg/mL and for β-lapachone was 0.65, 1.24, and 0.71 μg/mL, respectively. The naphthoquinones significantly inhibited the survival rate of L. amazonensis amastigotes at 83.11, 57.59, and 34.95% for lapachol (82.28, 41.14, and 20.57 µg/mL), and 78.49, 83.25, and 80.22% for β-lapachone (3.26, 1.63, and 0.815 µg/mL). The compounds on the promastigote's forms led to the loss of mitochondrial membrane potential, induced changes in the integrity of the membrane, caused damage to cells suggestive of the apoptotic process, and showed inhibition of tumor necrosis factor (TNF)-α and interleukin (IL)-6 production. The results showed that these naphthoquinones are promising candidates for research on new drugs with anti-Leishmania activity derived from natural products.

DEVELOPMENT OF NANOTECHNOLOGY: PROS AND CONS

Nanotechnology is developing rapidly in various industrial applications, medical imaging, disease diagnosis, drug delivery, cancer treatment, gene therapy and many more. However, some concerns have been expressed about risks posed by engineered nanomaterials (ENMs), their potential to cause undesirable effects, contaminate the environment and adversely affect susceptible parts of the population. Thus, substantial attention has to be paid to the potential risks of Nanoparticles. Some studies showed that numerous types of Nanoparticles are able to pass certain biological barriers and exert toxic effects on crucial organs like brain, liver, kidney and skin. Recently some of the studies showed that there may be reproductive toxicity of the nanomaterials. Nanotechnology is at the cutting edge of rapid technological development as it has many potential human health benefits, but it is perceived with some apprehension for its potential human health risks

Assessing The Anxiety Levels Among Mbbs Students During Covid-19 Lockdown

Introduction: The outbreak of COVID-19, which started in China in December 2019, has spread around the entire world. Due to the COVID-19 pandemic, lockdowns have been implemented in numerous countries around the world. On 23 March 2020, India went into Nation-wide lockdown. Schools, Colleges & Universities were closed nationwide. The disruption in academics, daily routines and isolation had a deeply negative impact on students, making them extremely vulnerable to mental health issues like mood and anxiety disorders and depression. The main aim of this study is toAim: assess the level of anxiety among MBBS students during the COVID-19 lockdown. A cross-sectionalMethodology: online survey was conducted on 632 MBBS Students. A survey invitation through Google Forms was sent to students via WhatsApp & was assured regarding the confidentiality of their responses. Anxiety levels were assessed using Zung's self-rating anxiety scale (SAS). Results: Out of 632 Students, 24.07% of students experienced mild to moderate levels of Anxiety, 6.48% of students experienced Marked to Severe Levels of Anxiety and 0.92% of Students experienced Extreme levels of Anxiety. Gender wise nearly 46.54% of female students and 16% of male students experienced different levels of anxiety. Academic Year wise 57.13% 1st MBBS, 7.69% 2nd MBBS, 11.53% Final MBBS Part 1 & 53.56% Final MBBS Part 2 students experienced different levels of anxiety. Gender, Academic Year wereConclusion: significantly associated with anxiety levels. Predominant stressors were online learning & uncertainty related to their academic performance.

Chlorophyll treatment combined with photostimulation increases glycolysis and decreases oxidative stress in the liver of type 1 diabetic rats

Photodynamic therapy (PDT) promotes cell death, and it has been successfully employed as a treatment resource for neuropathic complications of diabetes mellitus (T1DM) and hepatocellular carcinoma. The liver is the major organ involved in the regulation of energy homeostasis, and in pathological conditions such as T1DM, changes in liver metabolic pathways result in hyperglycemia, which is associated with multiple organic dysfunctions. In this context, it has been suggested that chlorophyll-a and its derivatives have anti-diabetic actions, such as reducing hyperglycemia, hyperinsulinemia, and hypertriglyceridemia, but these effects have not yet been proven. Thus, the biological action of PDT with chlorophyll-a on hepatic parameters related to energy metabolism and oxidative stress in T1DM Wistar rats was investigated. Evaluation of the acute effects of this pigment was performed by incubation of isolated hepatocytes with chlorophyll-a and the chronic effects were evaluated by oral treatment with chlorophyll-based extract, with post-analysis of the intact liver by in situ perfusion. In both experimental protocols, chlorophyll-a decreased hepatic glucose release and glycogenolysis rate and stimulated the glycolytic pathway in DM/PDT. In addition, there was a reduction in hepatic oxidative stress, noticeable by decreased lipoperoxidation, reactive oxygen species, and carbonylated proteins in livers of chlorophyll-treated T1DM rats. These are indicators of the potential capacity of chlorophyll-a in improving the status of the diabetic liver.

Formulation And Comparative Evaluation Of Ondansetron Hydrochloride Mouth Dissolving Tablets In India

Objective: The aim of the present study was to prepare the ondansetron hydrochloride Mouth Dissolving Tablets (MDTs) followed by its comparison with ethical and non-ethical (generic) marketed tablets. Methods: Prior to the formulation, drug excipient compatibility study was carried out by FTIR spectroscopy. The λmax was determined by UV spectroscopy. The ondansetron hydrochloride MDTs were prepared by direct compression method using Sodium Starch Glycolate (SSG) as super disintegrant and camphor as a sublimating agent. Then the prepared MDTs were subjected to evaluation of post compression parameters such as thickness and diameter, weight variation, wetting time, hardness, friability, disintegration and dissolution. The results obtained were compared with that of ethical and non-ethical marketed ondansetron hydrochloride 4 mg tablets. Results: The λmax was found at 310 nm. FTIR study revealed that excipients used in the prepared formulations are compatible with the drug. The thickness and diameter was in the range of 2.646 to 3.27 mm and 6.0 to 8.12 mm, respectively. Friability was in the range of 0.43 to 0.88 % and had a slightly higher friability (1.27%) for sublimated tablets. Wetting time and disintegration time were in the range of 15 to 40 sec and 23 to 50 sec, respectively. The 100 % drug release was found within 180 sec for all the codes. These results were then compared with non-ethical film coated ondansetron marketed tablets. Conclusion: Ondansetron hydrochloride MDT 4 mg tablets prepared in the laboratory were under specified IP limits. The experimental findings demonstrated that any of these ethical and non-ethical tablets of ondansetron hydrochloride can be selected, advised by the physician or pharmacist, as per the patient’s need and economical status.

Comparative cytogenetics of Astyanax (Teleostei: Characidae) from the upper Paraguay basin

Astyanax is one of the most abundant and diverse taxa of fishes in the Neotropical region. In order to increase the amount of cytogenetic information for Astyanax as well as to exhibit data to subsidize future taxonomic studies, this work analyzed three species of Astyanax: two species are cryptic, and are here reported to live in syntopy (A. abramis and A. lacustris); the first karyotype description for A. pirapuan is also presented. Cytogenetic analyzes reveal a diploid number of 2n=50 chromosomes for three species, yet with differences in their karyotype morphology. The physical mapping of 18S rDNA showed up to thirteen sites in A. pirapuan and two in A. abramis and A. lacustris. The physical mapping of 5S rDNA has proven to be an effective marker for the characterization of species of Astyanax studied in this work.(AU)

Astyanax é um dos táxons mais representados e diversos na região Neotropical. Com o intuito de aumentar as informações citogenéticas para Astyanax e apresentar dados que possam subsidiar estudos taxonômicos futuros, este trabalho traz uma análise citogenética de três espécies de Astyanax: duas espécies consideradas crípticas, aqui reportadas em sintopia (A. abramis e A. lacustris) e a primeira descrição cariotípica de A. pirapuan. As análises citogenéticas revelaram 2n=50 cromossomos para as três espécies, com diferença na morfologia cariotípica de cada uma. Foram observados apenas dois sítios de rDNA 18S em A. abramis e A. lacustris e até 13 para A. pirapuan. O mapeamento físico do rDNA 5S se mostrou como um marcador efetivo para a caracterização das espécies de Astyanax abordadas neste estudo.(AU)

Factors associated with health-related quality of life for adults with stroke sequelae / Fatores associados à qualidade de vida relacionada à saúde de adultos com sequelas de AVC

OBJECTIVE: To assess health-related quality of life (HRQoL) among adults with stroke sequelae and to identify the factors that influenced the domains of HRQoL. METHOD: The subjects were adults with stroke who were admitted to a rehabilitation program between March and August 2008. They were investigated using the following instruments: Medical Outcomes 36-Item Short-Form Health Survey (SF-36), Functional Independence Measure (FIM) and Beck Depression Inventory (BDI). Sixty-four adults of mean age 58.8 years were evaluated. RESULTS: The individuals who had had their injuries for longer times and who were more independent and younger had better HRQoL regarding physical functioning. Social participation was associated with better HRQoL, and there was a difference between groups with and without depressive symptoms. CONCLUSION: HRQoL was compromised primarily with regard to functional characteristics. Moreover, the presence of depressive symptoms contributed towards a decline in HRQoL. Rehabilitation needs to focus on improving functionality and social participation, which may stimulate reductions in depressive symptoms and improvement of HRQoL.

OBJETIVO: Avaliar a qualidade de vida relacionada à saúde (QVRS) de adultos com sequelas de acidente vascular cerebral (AVC) e identificar os fatores que influenciam os domínios da QVRS. MÉTODO: Adultos com AVC admitidos para programa de reabilitação de março a agosto de 2008, investigados com os seguintes instrumentos: SF-36, Medida de Independência Funcional e Inventário de Depressão de Beck. Foram estudados 64 adultos, média de idade de 58,8 anos. RESULTADOS: Os indivíduos com maior tempo de lesão, mais independentes e jovens tiveram melhor QVRS na capacidade funcional. Participação social foi associada com melhor QVRS, e houve diferença entre os grupos com e sem sintomas depressivos. CONCLUSÃO: QVRS foi comprometida principalmente em seus aspectos funcionais. Por outro lado, a presença de sintomas depressivos contribuiu para a piora da QVRS. A reabilitação deve buscar a melhora da funcionalidade/participação social, o que pode contribuir na redução de sintomas depressivos e a melhora da QVRS.

Relação entre intensidade de dor e capacidade funcional em indivíduos obesos com osteoartrite de joelho / Relationship between pain intensity and functional capacity of obese individuals with knee osteoarthritis

CONTEXTUALIZAÇÃO: A osteoartrite (OA) de joelho é uma doença crônica que acomete a cartilagem articular, provocando alterações ósseas, dor e rigidez à movimentação. A obesidade é um dos seus principais fatores de risco. As queixas de dificuldades funcionais são freqüentes, especialmente para a locomoção, que se torna mais lenta. Com os crescentes níveis de obesidade no Brasil, torna-se importante compreender como a OA de joelho afeta a capacidade funcional humana, a fim de se elaborar medidas de tratamento e prevenção. OBJETIVO: Analisar a influência da intensidade de dor, gravidade radiográfica, grau de obesidade e duração dos sintomas na capacidade funcional de indivíduos obesos com OA de joelho. MÉTODO: A intensidade de dor foi medida pelo questionário Western Ontario and McMaster Universities Index (WOMAC) e durante os testes funcionais. A gravidade radiográfica foi analisada pela classificação Kellgren-Lawrence e o grau de obesidade pelo índice de massa corporal (IMC). Foram realizados quatro testes funcionais de velocidade: marcha usual e rápida, subir e descer escadas. RESULTADOS: A amostra foi constituída de 31 mulheres e 4 homens, com idade média de 51,65 ± 10,72 anos e IMC médio de 41,16 ± 8,37 kg/m². As atividades em escadas estavam associadas a níveis mais intensos de dor. Apenas a intensidade de dor apresentou correlações significativas com os resultados nos testes de velocidade. CONCLUSÃO: A intensidade de dor é um fator que influencia a realização de atividades funcionais em indivíduos obesos com OA de joelho, mas outros estudos são necessários para identificar os fatores determinantes de capacidade funcional nesta população.

Co-occurrence of emphysematous cystitis and emphysematous myositis in type 2 diabetes.

Emphysematous cystitis (EC) and emphysematous myositis (EM) are rare disorders and concurrent occurrence of both in a patient with type 2 diabetes has not been reported previously. We report a patient who presented with pneumaturia and later with pain in thigh and diagnosed of both concurrently.

Rhino-orbital-cerebral mucormycosis in type 1 diabetes mellitus.

AIM: To describe the presentation and outcome of rhino-orbital-cerebral mucormycosis (ROCM) in adolescents with type 1 diabetes mellitus (T1DM). METHODS: The medical records of six patients of T1DM with ROCM admitted between October 2001 to January 2004 were analysed. RESULTS: The mean (+/- SD) age and duration of DM of these patients were 16.1+/-3.0 years and 26.3 +/- 24.9 months respectively. Four patients had ROCM at presentation, while two developed it during their hospital stay when recovering from diabetic ketoacidosis. Proptosis (100%) and ptosis (100%) were the most common symptoms, and ophthalmoplegia (85%) and vision loss (85%) were the most common signs. Maxillary sinus (85%) was the commonest paranasal sinus to be involved. All patients received amphotericin B and had appropriate surgery except one. Four patients survived. Patients who had altered sensorium, facial necrosis, palatal perforation and cerebral involvement at presentation had poor outcome. CONCLUSION: High index of suspicion of ROCM in T1DM and combined approach with amphotericin B and appropriate surgery is rewarding.

Association of serum antioxidants and risk of coronary heart disease in South Indian population.

BACKGROUND AND AIM: Higher prevalence of coronary heart disease (CHD) has been reported in south Indian population, which cannot be accounted for by the traditional risk factors like hyperlipidemia. Identification of new risk factors may help in treatment and prevention of CHD in this part of the world. In an attempt to investigate the causes of increased incidence of CHD in this part of the world, we intended to look for oxidative stress in our patients as a possible risk factor. As an initial step in this perspective, a case- control study was conducted to find out the serum antioxidant levels and their association with CHD in south Indian population. SETTINGS AND DESIGN: A tertiary care hospital; Case--control study. MATERIALS AND METHODS: One hundred thirty nine angiographically proven CHD patients (aged 29-75 years) were studied against 59 population based healthy controls (aged 29-72 years) free of CHD. Fasting serum cholesterol, triglycerides, HDL cholesterol, erythrocyte and plasma glutathione peroxidase and superoxide dismutase were estimated on automated clinical chemistry analyzer. LDL cholesterol and VLDL cholesterol were calculated. Vitamins A and E were estimated using high performance liquid chromatography (HPLC). STATISTICAL ANALYSIS: Unpaired t test was used to compare means. Binary logistic regression was done to find out the association between dependent and independent variables. RESULTS: Significantly higher levels of Total Cholesterol/HDL cholesterol and LDL cholesterol/HDL cholesterol ratio and lower HDL cholesterol levels were observed in patients when compared to controls. No significant difference of plasma and erythrocyte glutathione peroxidase and superoxide dismutase activity was observed between patients and controls. Significantly lower levels of vitamin E in patients than in controls was observed (P<0.001). Serum vitamin E was inversely associated with coronary heart disease even after controlling for age and other coronary risk factors (Odds ratio 0.898, 95% CI 0.826-0.976 P=0.01). CONCLUSIONS: The results of present study suggest that deficiency of vitamin E may be an independent risk factor of CHD. This study brings out the need for long- term monitoring of vitamin E supplementation as a preventive measure for CHD in the population studied.