Clinicopathological correlation of various prostatic lesions with serum prostate-specific antigen level – A hospital-based cross-sectional study

Background: The prostate is a male reproductive accessory gland which gives rise to several pathological conditions. The present study aims to study the correlation of histopathology of prostatic diseases with the clinical profile of the patient coming to VSS Medical College (VSSMC), Burla for histopathological reporting of prostatic biopsies. Aim and Objectives: The objectives of this study were as follows: (1) To correlate serum prostate-specific antigen (PSA) level with various clinical and pathological lesions of the prostrate gland, in a Hospital-based sample of Western Odisha population. (2) As the male gender represents almost half of the entire population, to find out different clinicopathological lesions, percentage-wise, so as to know the frequency of occurrence of such lesions. Materials and Methods: Fifty-seven cases of prostatic diseases were recorded in the Department of Pathology, VSSMC, Burla for histopathological examination of prostatic tissue for 2 years from September 2017 to August 2019. All the samples were fixed in 5 ? sections with 10% neutral buffered formalin. Then Hematoxylin and Eosin stain (H and E stain) was used for staining. Appropriate clinical data comprising signs and symptoms, laboratory findings, and serum PSA levels were recorded. Results: The present study, in the beginning, consisted of 64 patients, out of which seven patients were excluded by exclusion criteria, and finally, 57 cases were analyzed. The most prevalent age group for all prostatic diseases was 61–70 years with a mean of 67 years. The majority of the cases (73.67%) were benign mostly benign prostatic hyperplasia (BPH). Prostatic intraepithelial neoplasia (PIN) was 12.29% and malignant cases (all adenocarcinoma) were also 12.29%. All patients showed prostatomegaly. About 50% of cases suggestive of malignancy by digital rectal examination (DRE) were confirmed to be carcinoma by histopathological study. Serum creatinine level was raised in 16.27% of benign and 21.42% of premalignant and malignant conditions. Serum PSA level below 4 ng/mL were all benign and above 10 ng/mL were majority malignant conditions. However, at level 4–10 ng/mL, BPH and PIN cases were overlapped with cases of carcinoma. Conclusion: Benign prostatic hyperplasia is the most commonly encountered prostatic lesion. Serum PSA level <4 ng/mL is associated with benign conditions and more than 10 ng/mL is associated more with carcinomas. Although, investigations such as DRE and serum PSA estimation aid in diagnosis, a definitive diagnosis of benign and malignant lesions of prostate can be made by histopathological study of prostatic biopsies.

Clinico-cytomorphological features and thyroid function tests of different thyroid lesions – A hospital-based cross-sectional study

Background: Thyroid gland is an endocrine organ. The non-neoplastic and neoplastic conditions affecting the gland can manifest as the swelling of the gland with thyroid dysfunction. Based on cytology, the diseases can be categorized into non-neoplastic, benign neoplastic, and malignant neoplastic conditions and according to hormone status, the lesions of thyroid can be categorized in hypothyroid, euthyroid, or hyperthyroid condition. Aims and Objectives: Our study was done to find out the various cytomorphological spectrum of thyroid diseases and to record their common clinical presentation along with hormonal status in a tertiary care hospital in Northern Odisha. Materials and Methods: A total of 220 cases of thyroid disorder were taken for analysis over a period of 2 years. Patients demographic data, brief clinical features, finding on FNAC (cytomorphology), and thyroid function status were analyzed with appropriate statistical method. Results: The predominant age group affected was 21–40 years and total female to male patient ratio was 5.5:1. Most common presentations were heat intolerance (22.27%), cold intolerance (28.63%), and tachycardia (27.72%) apart from thyroid enlargement. Most common non-neoplastic lesion were multinodular and colloid goiter constituting 38.18% of total cases and most common neoplastic lesion was papillary carcinoma constituting 14.55% of total cases. Thyroid function test showed predominantly euthyroid states for all conditions. Conclusion: As the rest part of India, this part of Odisha also showed that thyroid disorders are more common in females and the most affected age group is 21–40 years. Multinodular and colloid goiter are the most common thyroid lesions. Most of the cases present with euthyroid state.

Prevalence of color vision deficiency and it’s relation with ABO blood group among medical students

Background: Normal human beings can appreciate color in all three of it’s attributes; Hue, intensity, and saturation. Human beings can perceive three primary colors, that is, red, green, and blue. Any defect in appreciation of colors is known as color vision deficiency (CVD). Complete inability to appreciate color is known as color blindness. The genes for red and green cone pigments are found in the q arm of the X chromosome. Hence, red and green CVD are inherited as X-linked recessive diseases. Blue CVD is autosomaly inherited. Blood groups are genetically inherited as well. Although it is a known fact that there is a preponderance of genetic diseases in subjects belonging to a specific blood group, no such study was available in Western Odisha as per our knowledge. This becomes more relevant as consanguineous marriages are a serious social problem in that part of Odisha. Aim and Objectives: Therefore, the study was undertaken to find out the prevalence of CVD among Medical students in Western Odisha and to find out it’s relation, if any, with ABO blood groups, as these two entities are genetically inherited. Record should be kept for future use, especially for counseling at the time of marriage and if necessary, to choose a subject for further study, where color detection does not play an important part. Materials and Methods: Prior permission was taken from the Institutional Ethics Committee to carry out this study. The study was carried out among the 1st–4th year medical students of V.S.S. Medical College and Hospital (n = 690) from August 2022 to October 2022. Ishihara test plates for color vision and agglutination method for ABO blood grouping were employed to get the prevalence of CVD and to get the percentage of subjects belonging to each blood group among those having CVD. The observations were noted carefully. Results: After careful screening, it was seen that 647 (93.76%) were normal, 42 (6.08%) had CVD, and 1 (0.14%) subject was completely color blind. All those affected were males. Distribution of blood group in CVD subjects showed 7 (16.27%) numbers belonging to blood group A, 22 (51.16%) belonging to blood group B, 1 (2.3%) belonging to blood group AB, and 12 (27.9%) belonging to blood group O. The only color blind student belonged to blood group B (2.3%). Conclusion: As medical students have to deal with colors throughout their career, the study helps the subjects to be aware of their condition early in their professional life. It also tried to find out the percentage distribution into ABO blood groups. A larger population should be included to get more accurate results.

Clustering of cardiovascular disease risk factors – Syndemic approach: Is sit a time to shift toward integrated noncommunicable disease clinic?

Background: The concurrent occurrence of many noncommunicable disease (NCD) risk factors is common, and it can play a synergistic role in occurrence of NCDs. Objectives: This study aimed to identify the magnitude of clustering of NCD risk factors, patterns of risk factors emerged in clustering, and variations in clustering of risk factors based on socioeconomic factors. Methods: A cross-sectional survey was undertaken in an urban area of Puducherry among 2399 adults during 2014–2015. Sociodemographic and behavioral risk factors were assessed through a validated STEPS survey tool. Individuals with three or more risk factors were classified to have clustering of NCD risk factors. Socioeconomic positions in relation to clustering were identified through Chi-square analysis followed by multiple logistic regression where clustering at family and area was adjusted through multilevel modeling techniques. Results: Of the 2399 adults, 1741 (73%) had clustering of NCD risk factors. Inadequate consumption of fruits and vegetables, high salt intake, and high waist circumference are the three predominant risk factors across all subgroups. Adults belonging to Christian religion (adjusted odds ratio [adjOR]: 2.8, 95% confidence interval [CI]: 1.5–5.2), aged 35 years and over (adjOR: 2.0, 95% CI: 1.4–6.0), and illiterates (adjOR: 1.8, 95% CI: 1.1–5.5) are more likely to have clustered NCD risk factors compared to others. Conclusions: Clustering of NCD risk factors is highly prevalent in this region and mainly driven by dietary practices and obesity measures. There is an urgent need to reorient the health system toward integrated approach with mandated inclusion of nutritionist in NCD health service delivery.

Student-centred learning in Community Medicine: An experience from Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry.

Background. Student-centred learning (SCL) places the student at the centre of policies, practices and decision-making in the teaching–learning process. SCL methodology also advocates active involvement of students in the curriculum planning, selection of teaching–learning methods and assessment process. We planned an education innovation project to assess the perception of fifth semester undergraduate medical students towards implementation of an SCL methodology. Methods. The study was done among 87 fifth semester undergraduate medical students (batch of 2010–11) in the noncommunicable disease epidemiology section of Community Medicine at the Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry. The students divided themselves into seven groups and developed the learning objectives, selected teaching–learning methods and assessment process for each session. The facilitators had 3–5 rounds of interaction with each group before the session. Qualitative analysis of feedback collected from students and external faculty after each session was done. The effect of implementing the SCL methodology was assessed by the reaction level of Kirkpatrick’s training evaluation model by using a rating scale. Results. Of the 87 eligible students, 73 (83.9%) returned the forms for evaluation. All seven groups were able to formulate the learning objectives. Most of the groups had used PowerPoint slides and videos as a teaching–learning tool. Innovative assessment methods such as crosswords and ‘chocopati’ were used by some groups. In general, the perception of students was favourable towards SCL compared to conventional methods and they felt that this methodology should be adopted more often. Time management and organization of sessions were the main problems encountered by the students. The mean (SD) score for the items ‘sessions were useful’, ‘sessions were enjoyable’ and ‘sessions improved my knowledge’ were 6.2 (1.8), 7.1 (1.8) and 6.3 (1.9), respectively. Conclusion. The majority of students found the sessions on innovative teaching–learning and assessment techniques enjoyable, useful and informative. The sessions showed that students took an active part in curriculum planning, execution and evaluation.