A Very Rare Case of Pancreatic Acinar Variant of Gastric Adenocarcinoma with Review of the Literature

A pancreatic acinar variant of gastric adenocarcinoma is a very rare presentation, and only six cases have been reported worldwide.A 55-year-old male came with complaints of vomiting and weight loss. By PET-CT, a growth was found in the gastric antrum.Distal gastrectomy was done and a histopathology report of a pancreatic acinar variant of gastric adenocarcinoma was done.

Analysis of clinico-demographic risk factors for postoperative pulmonary complications following gastrointestinal surgery

Background: Postoperative pulmonary complications (PPC) are one of the commonest complications following gastrointestinal surgery. They lead to increased mortality, increased length of intensive care unit (ICU) stay, and higher cost of treatment. Identifying the risk factors of PPC helps in predicting its occurrence and to develop preventive measures. The objectives of the present study were to study the clinical and demographic risk factors for PPC following gastrointestinal surgery.Methods: The study was designed as an observational descriptive analytic study. All the patients ≥18 years of age undergoing gastrointestinal surgery were included. The patients with preoperative lung pathology requiring ICU care or ventilatory support and patients with lung metastasis were excluded. The demographic and clinical parameters at admission were recorded. The details of pulmonary complications like the time of occurrence after surgery and the mode of treatment for pulmonary complications were noted. The risk association was assessed for statistical significance.Results: A total of 100 patients were underwent various gastrointestinal surgeries during the study period. The incidence of PPC was 34% in our study. Age, education status, smoking, and presence of comorbidities were found to be positively associated with an increased incidence of PPCs. The serum albumin of less than 3.5gm and the haemoglobin of less than 8 gm were also associated with an increased incidence of PPC. Pleural effusion was the commonest PPC seen in 15 (44.1%) patients followed by pneumonia in 9 (26.5%).Conclusions: Age, smoking, education status, serum albumin, haemoglobin, emergency surgery, elective postoperative ventilation, nasogastric intubation and blood loss in the intraoperative period were found to associated with increased risk of PPCs.

Prevalence of possible depression and associated biosocial risk factors among adolescents in a private school in Chennai, South India

Background: Depression among adolescents is often undetected because of lack of awareness in mental health. Schools are the best place to study, analyze and report adolescent depression. The objective of this survey is to find out the prevalence of possible depression and associated bio-social risk factors among high school going adolescents aged 15 and 16 years. This can help reform school curriculum based on the prevalence of depression.Methods: A school based cross-sectional study done by randomly selecting 10 classrooms from the 11th standard high school compartment in a private school. Data was collected using a pre-designed and structured questionnaire based on Kutcher's Adolescent Depression Scale. The results were analyzed using R Studio software with Pearson Chi-square test and a p-value of <0.05 was considered statistically significant.Results: Out of 486 students included in the study, 164(33.7%) have 'possible depression' and adolescents aged 16 years(39.5%) has higher proportion of possible depression than adolescents aged 15 years(29.2%), which is statistically significant(p=0.016). About 46.2% of adolescents having illiterate mothers had a possibility of depression. With regards to physical activity 28.1% who played for 3 hours and more had depressive signs and adolescents who played less had 37.2%. This difference is statistically significant (p=0.039).Conclusions: Being a dormant and hidden disease, depression is one such disease that must be probed by regular health screening. Mother's literacy status and a modifiable factor 'physical activity' have shown promising statistical significance. Adequate physical activity must be included in school curriculum to reduce the risk of depression.

Abruptio placenta retrospective study: maternal and fetal outcome

Background: Placental abruption is the most common cause of antepartum haemorrhage. Incidence appears to be increasing due to increase in prevalence of risk factors like age, parity, anaemia, poor nutrition, Preeclampsia, PROM, previous MTP. Abruption may be partial or total. Pain and Vaginal bleeding hallmark of abruption.Methods: Retrospective observational study carried out during period of October 2017 to October 2018 at Govt Theni medical college- tertiary care institute. To investigate incidence, cause, maternal and perinatal outcome. Maternal Data includes incidence, age, parity, gestational age, risk factors, intra-operative events, amount of blood loss. Other causes of APH-Placenta praevia and extra-placental causes are excluded. Neonatal data includes Term/preterm, Birth weight, NICU admission, perinatal morbidity and mortality.Results: Total number of deliveries from October 2017 to September 2018 were 7010. Total number of abruptio placenta cases were 55. This study shows increased incidence of severe preeclampsia with abruption. Increasing age as predisposing factor. Mean age of abruption was 26-30 years mainly seen in term pregnancy. Mode of delivery varied. Major complication were PPH and shock managed with blood products.Conclusions: This study reveals increasing age, parity, severe preeclampsia are risk factors. Routine and regular antenatal checkup early detection and correction of Preeclampsia, anemia helps to deduce no of abruption and improving maternal and fetal outcome though maternal morbidity is reduced with modern management of abruption, Timely diagnosis and intervention is necessary. Team efforts by obstetricians, anesthetist and neonatologist is required for better maternal and fetal outcome.

Milky Mangrove Excoecaria agallocha L. Plant as a source for potential mosquito larvicides.

Mosquitoes are one of the most dangerous vectors among the group of arthropods. Infections due to mosquitoes are a major worldwide health problem, with high endemicity in developing countries. In the present study, we determined the larvicidal activity of Methanol, Acetone, Hexane, Chloroform and Aqueous extracts of a mangrove plant Excoecaria agallocha against (4th instar larvae) Aedes aegypti and Culex quinquefasciatus. Mosquito larvicidal assays were conducted and their mortality rate was identified after 24hours to evaluate the larvicidal activity of the crude extract of Excoecaria agallocha.

ACTH acts directly on melanocytes to stimulate melanogenesis--an in vitro study.

A total of 108 whole skin organ cultures taken from vitiliginous skin were incubated in MEM containing ACTH. It was observed that 53.7% that is 58 showed a positive response with an increase in pigment production and enzyme activity, as observed on frozen sections stained for dopaoxidase activity. On immunohistochemical staining for locating ACTH binding, it is observed that 27.3% control skin and 72.7% ACTH treated skin show positivity. The ACTH is seen to bind with the melanocyte membrane as well as the cytoplasm. This indicates that ACTH can bind to the MSH-receptors expressed by the melanocyte. Thus, ACTH acts directly on the melanocyte to enhance melanogenesis and does not require to act via the adrenal-pituitary axis. This also indicates that the response is not associated with immune suppression by ACTH.