OHVIRA (OBSTRUCTED HEMIVAGINA WITH IPSILATERAL RENAL AGENESIS) WITH VERTEBRAL FUSION ANOMALY, SCOLIOSIS AND ABSENCE OF COCCYX: AN UNCOMMON MEDLEY

OHVIRA(Obstructed hemi-vagina with ipsilateral renal agenesis),also known as Herlyn-Werner- Wunderlich syndrome(HWW) is a rare case of a complex uterine anomaly.Associationwith congenital vertebral fusion anomalies, curvature abnormality of spine and congenital absence of coccyx together in a single patient has been sparsely documented in literature. We present a case of 15 year old female with varied spectrum of radiographic, ultrasonographic and MRI ?ndings. MRI remains the gold standard investigation for diagnosing this rare congenital uro-genital anomaly.

Rare case of multiple primary malignant neoplasms

Multiple Primary Malignant Neoplasms (MPMNs) are rarely reported and are defined as the diagnosis of ?2 independent, primary malignancies of different histologies/ origins in a single individual. In this study, we report a patient with Male Breast Cancer (MBC) and coexisting Small Lymphocytic Lymphoma (SLL) and Chronic Lymphocytic Leukemia (CLL). A 65-year-old male with complaints of a lump in his left breast since 2 years. CT scan findings were a non-homogeneous mass in the left breast along with bilateral axillary lymphadenopathy. Modified radical mastectomy was done. Microscopic examination showed the features of infiltrating duct carcinoma NOS: Modified Nottingham Bloom Richardson抯 Grade II in breast specimen. A peripheral smear of the patient showed features of chronic lymphocytic leukemia (absolute lymphocyte count was 16400 cells/mm3). IHC of breast tumor showed ER/PR positivity with H scores of 350 and 240 respectively and HER- 2/Neu protein expression was negative with a score of (1+). Lymph nodes were immunoreactive for CD 19, CD 23 and CD 5. Cells were non-reactive for Cyclin D1a and CD3. This is probably the first case of MBC with SLL and CLL. The diagnosis is consistent with synchronous MPMNs, which are increasingly reported nowadays.

Impact of Internet Addiction on Academic Performance of Undergraduate Dental Students of Bhubaneswar, India

ABSTRACT Objective: To assess the level of internet addiction and its impact on the academic performance of undergraduate dental students of Bhubaneswar. Material and Methods: A cross-sectional descriptive survey was steered among 814 undergraduate dental students (representing first year through internship) in Bhubaneswar, India. Internet addiction was assessed with the Internet Addiction Test (IAT) developed by Young, which consisted of 20 items rated on a 5-point Likert scale. Google Forms were used to collect the data. Statistical tests like Chi-square, Kruskal-Wallis, and Spearman correlation coefficient were used to analyze the qualitative and quantitative variables, respectively, with the significance level set at p ≤ 0.05. Results: The prevalence of Internet Addiction was found to be 27.5%. Interns showed the highest mean Internet Addiction (57.91±10.71) score. The proportion of addicted students was higher in males, 74 (31.4%), than in females, 150 (26%). The mean scores for individual domains were overuse (16.31±3.64), non-restraints (7.77±2.66), inhibiting the flow of life (9.52±3.05), emotional state (11.25±2.86), and dependence (10.47±2.53). A correlation coefficient (Spearman's rho value of -.167) indicates a negative correlation between internet addiction and academic scores, which was statistically significant (p=0.001). Conclusion: This study revealed that internet use for varying purposes eventually leads to addiction and affects students' academic performance. The affected students need early intervention and control over internet usage.

Role of FNAC in the diagnosis of salivary gland lesions - A tertiary care hospital experience

Introduction: Swelling of salivary glands, specifically parotid and submandibular gland presents as a common problem and being readily visible creates havoc among patients. In addition parotid/ submandibular swellings also remain a diagnostic challenge among clinicians. The aim of this study was to examine the sensitivity and specificity of Fine Needle Aspiration Cytology (FNAC) as a tool for diagnosis of salivary gland lesions. Materials and Methods: This prospective observational study was done for 6 months from January 2022 to June 2022 at Dhiraj General Hospital, SBKSMI and RC, Waghodia, Gujarat. In present study, total 42 cases were taken with salivary gland lesions that underwent FNAC in Pathology department. Results: In the present study, we had included 42 cases of salivary gland lesions. Out of 42cases, 12 (28.5%) cases were neoplastic and 30 (71.5%) cases were non-neoplastic. Among 12 neoplastic cases, 8 (67%) cases were found out to be benign and 4(33%) cases were diagnosed as malignant. Among malignant lesions, mucoepidermoid carcinoma has the highest number of cases (50%) followed by Carcinoma-ex pleomorphic adenoma and Adenoid cystic carcinoma. Conclusion: We found a good concordance between FNAC and final histology. Awareness of the therapeutic implications and limitations of the cytological interpretation amongst both the clinicians and the cytopathologists should enable FNAC to its best advantage.

Comparing retinal sensitivities on blue-on-yellow and green-on-yellow perimetry in glaucoma suspects

Purpose: To compare the retinal sensitivities between the blue?on?yellow perimetry (BYP)/short?wavelength automated perimetry (SWAP) and green?on?yellow perimetry (GYP) among patients with and without nuclear sclerosis among glaucoma suspects. Methods: After ophthalmic examination, patients were subjected to two perimetric tests: BYP and GYP. The visual field (VF) parameters were compared between the two perimeters (p < 0.05 was considered significant). Results: Fifty?five eyes of 39 patients with a mean age of 60.53 ± 9.70 years were included in the study. Twenty?one eyes had clear lens or pseudophakia. Twenty?six eyes had lower grades of nuclear sclerosis (NO2NC2, NO3NC3) and eight eyes had higher grades of cataract (NO4NC4, NO5NC5). The mean retinal sensitivity (RS) in BYP was 22.08 ± 5.02 (dB) and in GYP was 23.84 ± 5.50 (dB) (p = 0.08). The mean defect in BYP was ?2.56 ± 4.40 (dB) and in GYP was ?3.24 ± 5.05 (dB), pattern standard deviation (PSD) in BYP was 3.65 ± 1.91 (dB) and in GYP was 3.83 ± 1.99 (dB), and foveal threshold (FT) was 24.20 ± 4.32 (dB) in BYP and 28.10 ± 4.50 (dB) in GYP. The two perimeters showed good agreement by the Bland–Altman plot for all parameters. Fourteen eyes showed perimetric changes suggestive of glaucoma by BYP. In these, GYP had a sensitivity of 92.86% (95% CI of 66.13% to 99.82%) and specificity of 95.12% (95% CI of 83.47% to 99.40%). Conclusion: BYP and GYP show good agreement. They are comparable in clear media as well as in different grades of nuclear sclerosis. GYP showed good sensitivity and specificity compared to BYP.

Age-related gene expression alterations by SARS-CoV-2 infection contribute to poor prognosis in elderly

The ongoing pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has affected millions of people worldwide and with notable heterogeneity in its clinical presentation. Probability of contracting this highly contagious infection is similar across age groups but disease severity and fatality among aged patients with or without comorbidities are reportedly higher. Previous studies suggest that age associated transcriptional changes in lung and immune system results in a proinflammatory state and increased susceptibility to infectious lung diseases. Similarly, SARS-CoV-2 infection could augment ageing-related gene expression alterations resulting in severe outcomes in elderly patients. To identify genes that can potentially increase covid-19 disease severity in ageing people, we compared age associated gene expression changes with disease-associated expression changes in lung/BALF and whole blood obtained from publicly available data. We observed (i) a significant overlap of gene expression profiles of patients’ BALF and blood with lung and blood of the healthy group, respectively; (ii) a more pronounced overlap in blood compared to lung; and (iii) a similar overlap between host genes interacting with SARS-CoV-2 and ageing blood transcriptome. Pathway enrichment analysis of overlapping gene sets suggest that infection alters expression of genes already dysregulated in the elderly, which together may lead to poor prognosis. eQTLs in these genes may also confer poor outcome in young patients worsening with age and comorbidities. Further, the pronounced overlap observed in blood may explain clinical symptoms including blood clots, strokes, heart attack, multi-organ failure etc. in severe cases. This model based on a limited patient dataset seems robust and holds promise for testing larger tissue specific datasets from patients with varied severity and across populations

Role of Non-stress Test and Vibroacoustic Stimulation Test in Prediction of Perinatal Outcome in High-risk Pregnancies

Objectives: The aim of the study was to evaluate the fetal well being by non-stress-test (NST) and vibroacoustic stimulationtest (VAST) in high-risk pregnancies, to assess the perinatal outcome, to study the ability of the VAST to convert a false-positive(non-reactive) NST to a reactive one.Materials and Methods: Atotal of 100 pregnant women with >32 weeks gestation having certain high-risk factors were subjectedto NST and if NST came out to be non-reactive, vibroacoustic stimulation was given with artificial larynx. Perinatal outcome wasassessed by various parameters (meconium stained liquor, Apgar score at 5 min, neonatal intensive care units admission). Theresults were analyzed by Chi-square test to find the association between NST, VAST results, and perinatal outcome.Results: It was found that VAST reduced the number of false-positive results by 31%. As compared to NST, VAST had lesssensitivity (78.05% vs. 80.48%), and better specificity (95.08% vs. 83.61%), better positive predictive valve (91.43% vs. 82.35%)in predicting perinatal outcome.Conclusion: The addition of vibroacoustic stimulation to the NST reduced significantly the number of non-reactive tests. NSTwhen reactive does represents a satisfactory indicator for fetal well-being but non-reactive test needs further evaluation beforeany active intervention.

Knowledge and Awareness of Role of Endodontics in Forensic Odontology- A Questionnaire Based Survey among Postgraduate Students

The unique nature of human teeth has always been a special aid in personal identification throughout history.[1] Forensic odontology is a branch of dentistry that deals with the application of dental knowledge to those criminal and civil laws that are enforced by the investigative agencies in a criminal justice system.[2] Dental tissues are the strongest tissues in the human body and therefore their characteristics remain unchanged even in extreme environment and can survive long periods in conditions like burial under soil, fire and exposure to any biological agents in the environment.[3] Therefore, the importance of teeth in forensics is profoundly increasing. Endodontics in particular plays a pivotal role in forensic investigation by providing adequate knowledge of root canal anatomy, periapical radiographs, dental restorations, which favour comparison and personal identification of a deceased person.[1]We wanted to evaluate the knowledge and awareness of the role of endodontics in forensic odontology among postgraduate students enrolled in the specialty of Conservative Dentistry and Endodontics.METHODSA standardized web-based questionnaire survey was conducted in a group of post graduate students n=306 (endodontists) in which 20 questions related to the role of endodontics in forensic odontology were included. The responses were recorded, and the data was analyzed using statistical analysis. Based on the responses obtained, data was analysed, and the frequencies and percentages were calculated.RESULTSThe results of the present survey revealed that 6% of total participants had good awareness (>16 Qs), 62% of total participants showed moderate awareness (10-16 Qs) and 32% of total participants had poor awareness (<10 Qs)CONCLUSIONSThis survey was conducted to assess the knowledge and awareness on practical usefulness of endodontics in forensic odontology. By considering the present expansion in field of forensic odontology, endodontists should be knowledgeable of the role and importance of their specialization in personal identification.

Effectiveness of pre-emptive thoracic epidural analgesia for acute post thoracotomy pain relief: a randomised blinded study

Background: Thoracotomy is one of the most damaging surgical insults on respiratory mechanics and management of post-thoracotomy pain is a challenge. This study was conducted to compare intensity of postoperative pain, measured by VAS, in patients receiving Pre-emptive TEA compared to patients receiving epidural analgesia during surgical closure.Method: Group A comprised of patients receiving Pre-emptive TEA with 0.1%Ropivacaine and 2 μg/ml fentanyl, 20 minutes before incision. Group B comprised of patients receiving the same drug, during surgical closure.Results: Demographic profile was comparable between both groups. Both groups offered good analgesia, but pre-emptive group took an upper hand upto4th postoperative hour (p<0.05), both at rest and coughing. Beyond 4thhour, analgesic efficacy of both groups was comparable.Conclusion: Pre-emptive technique offered better analgesia over the postoperative technique up to 4th postoperative hour, both at rest and coughing.

Pentoxifylline - A Boon In Medical Management Of Oral Submucous Fibrosis ??

AIM- OSMF is very prevalent and most premalignant condition in South East Asian population especially in India now days. There is numerous management modalities documented but still it is challenging to come up with definitive treatment of OSMF. In the wake of searching the effective medical management of OSMF here we have compare the two drugs Pentoxifylline and Antioxident over 50 affected individuals

A prospective randomised open labelled comparative study of anti inflammatory effects of topical 5% benzoyl peroxide gel vs topical 4% nicotinamide gel for grade I-II acne in a tertiary care hospital

Background: Acne vulgaris is a dermatological disorder characterised by formation of comedones and inflammatory lesions. The treatment of acne basically involves reduction of lesions. Benzoyl peroxide, in concentrations of 5%, 10%, and 20%, has been used effectively in the treatment of acne for more than 20 years. Nicotinamide/ Niacinamide is a newly-approved anti-acne drug with a potent anti-inflammatory effect. The present study assessed the efficacy of 5% Benzoyl peroxide gel in comparison to 4% Nicotinamide gel for topical treatment of mild to moderate acne vulgaris.Methods: In this study, the patients with mild to moderate acne vulgaris with inflammation were divided into two groups, group I was treated with topical 5% Benzoyl peroxide gel whereas topical Nicotinamide gel was given to the group II. Assessment of efficacy was done by total lesion counting according acne global severity index, the results were compared at the end of 2 weeks and 4 weeks with the baseline values.Results: At the end of this study, it was found that the reduction of inflammatory and total percentage of decrease in counts of lesions from baseline were highly significant in both the groups (p<0.001), between the groups, differences were statistically significant (p<0.001), therefore 5% Benzoyl peroxide gel has better efficacy than 4% Nicotinamide gel.Conclusions: Benzoyl peroxide is more efficacious than 4 % Nicotinamide gel in mild to moderate acne.

Unusual false passage formation during nasogastric tube insertion in an anesthetized patient / 대한마취과학회지

No abstract available.

Forgotten, excluded or included? students with disabilities: a case study at the University of Mauritius

Background: Students with disabilities in the tertiary education sector are more than a just a phenomenon, they are a reality. In general, little attention is devoted to their needs despite the fact that they need more care and attention.Objectives: This paper, through a case study at the University of Mauritius, sought to answer some pertinent questions regarding students with disabilities. Does the University of Mauritius have sufficient facilities to support these students? Are students aware of existing facilities? What additional structures need to be put in place so that students with any form of disability are neither victimised, nor their education undermined? Are there any local laws about students with disabilities in higher education?Method: To answer these questions and others, an online questionnaire was sent to 500 students and the responses were then analysed and discussed. The response rate was 24.4% which showed that students were not reticent to participate in this study.Results: Our survey revealed that most students were not aware of existing facilities and were often neglected in terms of supporting structures and resources. ICT facilities were found to be the best support that is provided at the University of Mauritius. The right legal framework for tertiary education was also missing.Conclusion: Ideally, students with disabilities should have access to special facilities to facilitate their learning experiences at tertiary institutions. Awareness about existing facilities must also be raised in order to offer equal opportunities to them and to enable a seamless inclusion

Humble Foley's catheter to the rescue in a case of T-tube insertion: a case report / 대한마취과학회지

The Montgomery T-tube poses a challenge to anesthesiologists because of loss of anesthetic gases through the open proximal end of the vertical limb and lack of standard anesthesia circuit connectors. Here, we present a case of a 25-year-old woman with a reported history of accidental strangulation 18 months previously. The patient had a metallic tracheostomy tube in situ due to the development of tracheal stenosis. Computed tomography showed significant narrowing in a 7–8-mm segment, 2 cm proximal to the tracheostomy tube in situ. She was scheduled for tracheal reconstruction surgery and T-tube insertion due to persistent subglottic stenosis. In this case, the Foley's catheter, which was inserted into the glottis orally, not only aided easy insertion of the T-tube into the trachea through the tracheal stoma, but also enabled us to stop the loss of anesthetic gases through the proximal vertical limb of the T-tube.

Secretory cell outgrowths, p53 signatures, and serous tubal intraepithelial carcinoma in the fallopian tubes of patients with sporadic pelvic serous carcinoma.

Context: High‑grade serous carcinomas of ovarian, tubal, and peritoneal origin are together referred as pelvic serous carcinoma. The fallopian tubes, ovarian surface epithelium, and the tuboperitoneal junctional epithelium are all implicated in pelvic serous carcinogenesis. Aims: The aim of this study is to identify putative precursor lesions of serous carcinoma including secretory cell outgrowths (SCOUTs), serous tubal intraepithelial carcinoma (STIC), and p53 signatures and assign its probable site of origin. Settings and Design: Prospective case–control study of consecutive specimen comprising 32 serous carcinomas and 31 controls (10 normal adnexa, 10 benign and 6 atypically proliferative surface epithelial tumors, and 5 other carcinomas). Subjects and Methods: Sectioning and extensive examination of the fimbrial end (SEE‑FIM) protocol along with immunohistochemistry for Bcl‑2, p53, and Ki‑67 was employed for evaluating invasive carcinoma and precursor lesions in cases versus controls. Results: SCOUT, p53 signatures, and STIC were most frequent in the serous carcinomas. p53 signatures and STIC were always seen in the fimbrial end. STICs were exclusively present in serous carcinomas, more common in ipsilateral tubes of cases with dominant ovarian mass. Multifocal p53 signatures with STIC were seen in 7 (21.9%) cases. STIC was present with or without an invasive carcinoma in 25% and in 6.25% of cases of pelvic serous carcinomas, respectively. The junctional epithelia did not show any lesion in any group. Conclusions: SEE‑FIM protocol is recommended for evaluation of sporadicpelvic (ovarian/tubal/peritoneal) serous carcinoma. Based on the presence of STIC or invasive carcinoma, nearly 60% of all pelvic serous carcinomas are of fallopian tubal origin.

Predictive Perspectives of Disease-Transformed Protein Biomarkers.

With advancement in instrumentation, computation and understanding of disease etiology, proteomics has been expanded to harness the knowledge of change in protein folding and misfolding, protein-protein interaction, protein modification, etc. during progression of disease which is a source of discovery for various biomarkers including predictive biomarkers. Various methodologies for disease prediction are reported using ‘omics’ technology; however, advancement in proteomics with discovery of protein biomarker allows for the estimation of disease risk from years to decades before any disease even manifests internally. Specific proteins as disease biomarkers that appear in the body fluid/diseased tissues are generally measured. Recently, new proteomics technologies are also being developed in order to facilitate both the highthroughput and high-sensitivity requirements of diseaserelated applications of proteomics and possibly providing the framework for prediction of diseases. Therefore, there is a growing interest in proteomics technologies to discover processes that are involved in various diseases, to discover new biomarkers that correlates with the prediction and early detection of diseases. Now there is change in research thinking where already known biomarkers alone or in combination of others are under investigation for advanced application like in prediction and early detection of chronic diseases. In this review, we have emphasized the prediction perspective of some of the protein biomarkers like CA-125, Lp-PLA2 and tau protein for diseases like cancers, cardiovascular diseases, and Alzheimer’s respectively.

Cervical strongyloidiasis in an immunocompetent patient: A clinical surprise.

A 32-year-old lady came for a routine gynecological check up. Her cervical cytologic smear was reported as low grade squamous intraepithelial lesion. As a part of basic routine investigation, cervical punch biopsy was done. Astonishingly it revealed multiple rhabditiform larvae of Strongyloides stercoralis. These were curved thick with pointed end and a short buccal cavity. She did not have any history of immunosuppression including steroid therapy and was otherwise normal. Extensive review of the literature on parasites encountered in cervix yielded few case reports on strongyloides in cytologic smears, but failed to reveal any report till date on S. stercoralis found in histopathology section. Our case is probably the fi rst in the world and the fi rst reported from India to the best of our knowledge. We describe this case of strongyloidiasis of cervix with review of the literature on various parasites encountered in the cervix because of its rarity and also to keep this parasitic infestation as a differential diagnosis of cervical lesions.