RESUMO
Background and Objectives@#Cholesteatomatous chronic otitis media acquires epithelial proliferation and differentiation characteristics, which render it able to erode the underlying bone and cause complications. We attempt to characterize the cholesteatoma epithelium by observing the expression of cytokeratins (such as 34ße12, CK17, and CK13) and Ki67 among patients with cholesteatoma with different aggressiveness as compared to disease-free controls. @*Subjects and Methods@#In this prospective study (2017-2021), we enrolled all consenting consecutive patients with cholesteatomatous chronic otitis media. They were staged in accordance with the staging guidelines of the European Academy of Otology and Neurotology and the Japanese Otological Society. Bony external auditory canal (EAC) skin specimens of the patients undergoing tympanoplasty were chosen as controls. We did an immunohistochemical analysis of the cholesteatoma specimens and normal bony EAC controls by observing the expression of 34ße12, CK17, CK13, and Ki67 across the layers of the epithelium. Fisher’s exact test and chi-square test were used to evaluate any statistical significance between the cases and the controls, and the subgroups were made based on the clinical stage. @*Results@#An increased expression of CK17 (p<0.001), CK13 (p<0.03), and Ki67 (p<0.001) was observed in cholesteatoma specimens when compared to normal bony EAC controls. Also, there was a loss of expression of 34ße12 in a subset of cholesteatoma specimens, all of which showed full-thickness expression of CK13. There was no difference in the expression of cytokeratin among specimens from patients belonging to different subgroups based on clinical stage, age, sex, duration of ear symptoms, or type of hearing loss (conductive vs. sensorineural). @*Conclusions@#The majority of cholesteatoma specimens significantly overexpressed CK17, CK13, and Ki67 when compared to normal bony EAC skin controls, while a subset showed loss of expression of 34ße12, which provides some insight into its pathogenesis.
RESUMO
Background: The preference for a son over female offspring continues to be a prevailing norm within the ancient Indian family. Sons are expected to work within the fields, give bigger financial gain and look after parents. Additionally, in Indian patriarchal society, sons are a unit responsible for the preservation of the family name. The preference for a son and female feticide continues to be a prevailing norm in ancient Indian families (urban and rural) leading to declining sex ratio to an alarming level. With this background the following study was conducted in Gautam Buddha Nagar with the objective of finding out gender bias in rural and urban area.Methods: A study was carried out in rural and urban field practice area of the Department of Community Medicine, district Gautam Buddha Nagar of Uttar Pradesh. The study was conducted among 270 married women of reproductive age group. The women were interviewed using a semi structure questionnaire.Results: More than half of the respondents in the rural areas (57.7%) preferred son while in the urban areas, 43% of women preferred a son. The most important reason for preferring a son in the rural area was a support to the parents. While in urban area son was preferred because of the continuation of a family line.Conclusions: Preference for son was found to be high. Further amendments in the existing laws and quality education may help in breaking gender stereotypes and minimizing gender bias.
RESUMO
Background: Visual health is both visual function and individual’s perception of vision. This study was conducted to estimate visual function and individual’s perception of vision and to understand the impact of sociodemographic factors and treatment seeking behaviour for eye morbidities among women in our society. The aim of the study was to obtain visual acuity scores and the perceived visual function score and analyse both objective and subjective visual health.Methods: A community based cross-sectional study was conducted among 182 women aged 18-59 years residing in rural practice area of School of Medical Sciences and Research, Sharda University, Greater Noida.Results: The most common problem in the study group was moderate visual impairment (23.1%), followed by severe visual impairment (8.2%) and blindness (1%). The common causes being uncorrected refractive errors followed by cataract. Visual impairment was maximum among 49-59 years (47.46%), illiterate (54.24%) and in lower socio-economic status (54.24%).Conclusions: An intersectoral approach involving the PRI, ASHA/ANM at all levels of the health system may be appropriate. Strategies involving the communities, schools, colleges, workplaces and shifting to preventive and curative approach instead of only curative approach may help to create more awareness about common avoidable causes of blindness namely refractive errors and cataract. Comprehensive eye care services from early screening to treatment need to be made accessible, affordable and available at all levels of health system irrespective of gender, literacy, age and socioeconomic status to improve visual health and thus quality of life.
RESUMO
Background: Liver vary widely according to age. Many diseases can affect their size ranging from infectiveprocesses to malignant disorders. Palpation and percussion are standard bedside techniques to document butare far from accurate to detect small increases in size.Variations in the anthropometric features of variouspopulations, races and regions are an established fact.Ultrasonography is widely used in medicine.It is possible to perform both diagnosis and therapeutic procedures.Sonography is effective for imaging soft tissues of body. Ultrasound is an extremely important imaging methodin evaluation of liver in children due to the fact that it is easy to use, non invasive, safe, quick and accurate. Inpresent study, aim is to evaluate correlation of liver size with the parameters such as age, sex and height inchildren.Objective: To know whether there is any correlation between the normal liver size with parameters such as age,sex and height in children.Materials and Methods: Present study is cross-sectional in nature and conducted in Government Medical Collegeand District Hospital, Bidar. Sample size of 260 cases was taken between the age group of 1 to 17 years, infancyto middle adolescence period living in North-east part of Karnataka.Results: The mean liver length is greater in males in all age groups and it increases in older children in the agegroup of 10-13yrs and 14-17 yrs among both males and females. Liver length highly correlated with each age andheight in both male and female children.Conclusion: The methods of measurement and analysis used in this study is standardized and easy to apply.Findings are handy and reliable and is suitable particularly for radiology and pediatric departments. Theresults of this study can be used as a practical and comprehensive guide to indicate the normal liver lengthrange for every child, according to his/ her age
RESUMO
Background: high rates of sub-fertility and adverse pregnancy outcomes were seen after age 40. In contrast to oogenesis, spermatogenesis continues in elderly men
Objective: to retrospectively study the impact of aging on semen parameters in male partners of infertile couples in the rural area of developing country over 10 years and to find out whether aging affects male factor fertility and various semen parameters in this part of developing country
Materials and Methods: in this cross sectional study, the laboratory semen analysis records of 1219 male partners of infertile couples of a rural tertiary care center of Central India in a 10-year period from January 2005 to December 2014 were evaluated into 5 groups based on men age: Group 1: 21-28 yr [n=57]; group 2: 29-35 yr [n=450]; group 3: 36-42 yr [n=532]; group 4: 43-49 yr [n=165], and group 5: 50-60 yr [n=15]. Evaluation of all semen parameters were done according to WHO standard criteria [1999]
Results: the analysis of semen records revealed the significant negative association of semen volume, total sperm count, sperm motility, and morphology with age. There was a significant fall in total sperm count, sperm motility, and morphology after the age of 35 yr
Conclusion: age has significant negative effect on semen volume, total sperm count, and sperm motility and morphology in this region of India
RESUMO
Electroconvulsive therapy (ECT) is a time tested treatment modality for the management of various psychiatric disorders. There have been a lot of modifications in the techniques of delivering ECT over decades. Despite lots of criticisms encountered, ECT has still been used commonly in clinical practice due to its safety and efficacy. Research evidences found multiple neuro-biological mechanisms for the therapeutic effect of ECT. ECT brings about various neuro-physiological as well as neuro-chemical changes in the macro- and micro-environment of the brain. Diverse changes involving expression of genes, functional connectivity, neurochemicals, permeability of blood-brain-barrier, alteration in immune system has been suggested to be responsible for the therapeutic effects of ECT. This article reviews different neurobiological mechanisms responsible for the therapeutic efficacy of ECT.
Assuntos
Encéfalo , Eletroconvulsoterapia , Sistema Imunitário , Transtornos Mentais , Neurobiologia , Permeabilidade , Usos TerapêuticosRESUMO
No abstract available.
Assuntos
Transtorno Depressivo Resistente a Tratamento , Estimulação Magnética TranscranianaRESUMO
Tuberculosis [TB] is caused by Mycobacterium tuberculosis [MTB] and the disease has remained a major health problem in most of the developing countries, particularly after the emergence of multidrug-resistant TB [MDR-TB]. The MDR-TB is an intriguing subject and very little is known about the in vivo processes which take place during the acquisition of MDR. This study describes a unique case of pulmonary TB [PTB] from which four sequential isolates of MTB could be isolated while the patient was on anti-tubercular treatment. The first baseline isolate was sensitive to all drugs, but the subsequent three isolates acquired resistance to multiple drugs and finally the patient died after 27 months post-diagnosis when his fourth isolate became resistant to isoniazid, rifampicin, ethambutol and kanamycin. All sequential cultures were identified as MTB using conventional and molecular methods, including 16s RNA sequencing and the spoligotyping. Spoligotyping followed by comparison with SITVITWEB database revealed that all the isolates belonged to the family of the Central Asian Strain Delhi [CAS1_Delhi, ST26] genotype, and no cross or mixed infections were observed. The drug resistance was further characterized at the molecular level by sequencing the target genes [katG, inhA, rpoB, embB, eis promoter region and rrs]. The results revealed mutated alleles associated with resistance to the respective drugs. This unique case indicates that it is possible to isolate MTB during treatment if the strain is acquiring resistance. The data presented from four sequential isolates provides an insight into what sequential genetic and proteomic changes occur in the bacteria during the in vivo acquisition of MDR.
Assuntos
Humanos , Masculino , Mycobacterium tuberculosis , GenótipoRESUMO
The objective of the present study is to analyze the early indicators of renal injury in children with bilateral pelviuretric junction obstruction. We investigated 23 children, 46 kidney units who were diagnosed with bilateral pelvi-ureteric junction obstruction [PUJO] and underwent unilateral or bilateral pyeloplasty between January 2001 and December 2011. Ipsilateral kidney biopsy was performed during pyeloplasty. Kidney biopsy results were divided into three categories. Pre-operative investigation included ultrasonography with the Society of Fetal Urology [SFU] grading, plasma rennin activity [PRA] and differential renal function [DRF]. Out of 23 children there were 17 [73.9%] boys while 6 [26.1%] girls. Median age at operation was 35.4 months [range: 9-60 months]. Unilateral pyeloplasty was performed in 14 [60.8%], simultaneous bilateral pyeloplasty in 2 [8.6%] and sequential bilateral pyeloplasty in 7 [30.4%]. In bilateral PUJO where DRF and SFU grading of hydronephrosis did not correctly reflect renal injury, PRA showed a significant relationship with renal histopathologic grade and could be an early indicator of renal injury in bilateral PUJO