Histopathological changes in gallbladder mucosa associated with cholelithiasis: A prospective study

Background and Aims: Cholelithiasis is known to produce diverse histopathological changes in the gallbladder mucosa. In the present study, we aimed to find the correlation between various gallstone characteristics (i.e., number, size, and morphological type) with the type of mucosal response in gallbladder mucosa (i.e., inflammation, hyperplasia, metaplasia, and carcinoma). Methods: The present study was conducted prospectively on 100 patients undergoing cholecystectomy for symptomatic cholecystitis. Gallstones were assessed for various parameters, i.e., number, size, and morphological type. Gallbladder mucosa was subjected to histopathological examination. Sections were taken from body, fundus, and neck of gallbladder. Results: Of 100 cases, maximum type was of mixed stones (54%) and was multiple in number (46%). However, gallstone type and number are nonsignificant variables to produce precancerous lesions (i.e., hyperplasia and metaplasia). Statistically significant results were obtained while comparing the mucosal response with gallstone size (P = 0.012). Conclusion: As the gallstone size increases, the response in gallbladder mucosa changes from cholecystitis, hyperplasia, and metaplasia to carcinoma. Gallstone type and number are nonsignificant variables to produce precancerous lesions

Scaling up Weekly Iron and Folic Acid Supplementation in Jharkhand, India Minimizing Challenges, Maximizing Opportunities.

Objectives: Jharkhand is a predominantly tribal Indian state. Home to 3.5 million adolescent girls, two-thirds of Jharkhand's adolescent girls were reported to be anaemic. In 2000, the Government of Jharkhand launched the Adolescent Girls Anemia Control Programme (AGACP) in five of its 24 districts with technical support by UNICEF. This presentation summarizes a decade of experience in scaling up Jharkhand's AGACP. Methods: In its initial phase, the programme covered around 250,000 school-going adolescent girls in 2800 schools. The intervention included weekly iron and folic acid (IFA) supplementation, bi-annual deworming, and nutrition counselling. The second phase was launched in 2009 to cover two million adolescent girls. During this phase the programme faced important challenges due to a break-down in the supply chain of IFA supplements and deworming tablets. However, weekly nutrition counselling sessions continued. The third phase of the programme was inaugurated in 2012 with the advent of the National Weekly Iron and Folic Acid Supplementation (WIFS) programme implemented in a convergent manner by the Departments of Health and Family Welfare, Women and Child Development, and Education. Results: The programme has been universalized across all 24 districts, by the state government. Currently, the programme covers 3 million adolescents. Conclusions: Approaches used for stabilizing the programme are valuable lessons (do's and dont's) in piloting, stabilizing and scaling up a large scale programme for the control of anaemia in adolescent girls in resource-constrained settings.

Preliminary and Pharmacological Profile of Melia azedarach L.: An Overview.

The tree Melia azedarach (Family: Meliaceae) is known locally as bakain or drek (Hindi), Persian lilac or China tree (English), and Fleurs lilas (French). In South America is commonly known as “paraiso” or paradise, and in the US as Indian lilac or white cedar. The whole plant or its specific parts (leaves, stem, and roots) are known to have medicinal properties and have a long history of use by indigenous and tribal people in India. Melia azedarach is used as an ayurvedic medicine in India and Unani medicine in Arab countries as an antioxidative, analgesic, anti-Inflammatory, insecticidal, rodenticidal, antidiarrhoeal, deobstruent, diuretic, antidiabetic, cathartic, emetic, antirheumatic and antihypertensive. It is highly nutritious having a calorific value at 5100 kcal/kg. Also, it is used to manufacture agricultural implements, furniture, plywood, boxes, poles, tool handles and fuel wood. It is widely planted as a shade tree in coffee and abaca (Musa textilis) plantations. It is a wellknown ornamental tree. The present review is therefore, an effort to give a detailed survey of the literature on its botanical details, phytochemical reports, pharmacological studies and its therapeutic importance.

Lymphangioma of the fallopian tube--a case report.

Lymphangioma of the fallopian tube is very rare. Only one such case has been reported. A 30-years-old female with lymphangioma of the left fallopian tube is described here. She presented with fever, vaginal bleeding and foul smelling discharge. A mass was felt in left fornix. On exploratory laparotomy, a left tubo-ovarian mass adherent to the surrounding structures was seen. Clinical diagnosis was septic abortion with adhesions. Left-sided partial tubectomy was performed. Histology of the left tube revealed large dilated channels containing lymph in the submucosa. Lymphocytes were also seen in some channels. Histogenesis of lymphangioma remains uncertain. Presence of adhesions in this case suggests a reactive origin. Histopathology is confirmatory for diagnosis.