Abdominal wall calcification in a peritoneal dialysis patient.

Abdominal wall calcification in a peritoneal dialysis patient has not previously been reported. We describe a 40-year-old lady, a type 2 diabetic and hypertensive for the past 14 years, who did not have any history, clinical features or laboratory results suggesting autoimmune disease, and had not suffered from tuberculosis in the past, but who had been diagnosed with chronic kidney disease in 2016. She had initiated peritoneal dialysis in December 2018.

Relationship Between Central Auditory Processing Abilities and Working Memory During Adolescence.

Purpose: Adolescence is a period of transformation in humans with changes in the neural physiology at subcortical and cortical levels. However, its significance on auditory processing skills and working memory skills and their association is yet to be well understood. Hence, the current study was designed to evaluate and establish the association between auditory processing skills and working memory abilities in adolescents. Method: A total of 125 adolescents within the age range of 10 to 15 years participated in the current study. All of them had normal hearing sensitivity and no associated obvious peripheral or central deficits. All the participants underwent auditory closure ability assessment using quick speech perception in noise test in Kannada, binaural integration ability assessment using dichotic CV test, and temporal processing assessment using gap detection test. Auditory working memory abilities were assessed using auditory digit span and digit sequencing. Results: Spearman correlation was done to assess the correlation between auditory processing skills and working memory abilities. Results revealed a significant negative correlation between most of the central auditory processing abilities and all the working memory spans. Conclusions: Findings of the current study indicate that individuals with poor working memory abilities have difficulty in auditory processing abilities.

Determination of Barr bodies in Transgender Patients in India - A comparative study.

Sex determination in forensic medicine is considered one of the first and foremost steps in personal identification. The need for identifying the exact sex of the individual arises when deciding whether a person can exercise certain civil rights reserved for one particular sex, for competing in sex-specific athletic and sports events, legitimacy, divorce, paternity disputes and also to some criminal offenses. Nuclear sexing by Barr body examination can be done using buccal smears to establish the sex of the individual when routine methods fail to disclose the exact gender of the individual. Aim: To determine and compare the Barr bodies present in exfoliated buccal epithelial cells in males, females and transgender populations using light and fluorescence microscopy. Materials and Methods: A total of 90 patients were recruited for the study. Group I consisted of 30 female patients. Group II consisted of 30 male patients and group III consisted of 30 transgender patients. The buccal mucosa was then scraped using a wooden spatula and the cells obtained were fixed in 95% ethanol. Two smears per individual were made and stained. One smear was stained with papanicolaou (PAP) stain and the other with Acridine orange and viewed under light microscopy and fluorescent microscopy, respectively. Results: When PAP stained slides were examined, the percentage of Barr-bodies in females ranged from 3% to 5% and in males it was 0% and in transgenders, it ranged from 0% to 5%. In Acridine orange stained smears, the percentage of Barr bodies in females ranged from 1% to 3% and in males it was 0% and in transgenders, it was 0%. Kruskal-Wallis test to study the relation of Barr body percentage in females, males and transgender subjects demonstrated significant differences between the groups (P < 0.001). Wilcoxon signed rank test was done for pairwise comparison, which showed that the distribution of percentage of positive cells in females are statistically significant from males and transgenders (P < 0. 001). Conclusion: Nuclear sexing using Barr bodies offers a simple yet effective method for determining the sex of transgender patients which could help them in understanding their gender identity better and diagnose any underlying chromosomal aberration.

Relationship Between Peripheral and Central Auditory Abilities and Iron Deficiency Anemia in Adolescent Girls.

PURPOSE: This study evaluated the peripheral hearing and central auditory processing abilities in Indian adolescent girls with iron deficiency anemia (IDA). METHOD: The participants consisted of 75 adolescent girls with IDA, 50 adolescent girls without IDA, and 50 adolescent boys without IDA. Participants underwent a test battery to evaluate auditory processing and peripheral hearing assessment. In this study, central auditory processing abilities were assessed using Speech Perception in Noise test in Kannada (SPIN-K) and quick speech perception in noise tests in Kannada, dichotic consonant-vowel test, gap detection threshold (GDT), and auditory digit sequencing and auditory digit span tests. RESULTS: Results showed that the hearing thresholds at extremely low and high frequencies (250 and 8000 Hz), although within clinically normal limits, were poorer in girls with IDA than in the control groups. Also, girls with IDA performed poorly in SPIN-K of the right ear, GDT, and auditory backward digit span tests. CONCLUSION: These subtle auditory deficiencies may be attributed to the compromised blood supply to the central auditory nervous system, as observed in the current study.

Narrow-band chirp and tone burst auditory brainstem response as an early indicator of synaptopathy in industrial workers exposed to occupational noise.

This study aims at characterizing and comparing the findings of auditory brainstem response (ABR) using narrow-band chirp (NB-chirp) and tone burst (TB) for both latency and amplitude parameters among those exposed to occupational noise and to determine which among the two serves as a better indicator of noise-induced cochlear neuropathy. Forty adult males in the age range of 20-35 years were considered, wherein 20 of them were exposed to noise > 80 dB (A) for 8 hours per day constituting Noise-exposed group; and Control group consisted of 20 individuals without occupational noise exposure. ABR was recorded using NB-chirp and TB for four frequencies at 80 dB nHL through Etymotic Research - 3A (ER-3A) Insert phones using Interacoustics Eclipse EP-25 in individuals with and without noise exposure. MANOVA was performed to compare between TB ABR and NB-chirp ABR between the two groups. Statistical analysis revealed a notable difference for NB-chirp comparisons between the two groups at three frequencies: 500 Hz, F(1, 38) = 10.6; 1000 Hz, F(1, 38) = 7.91; and 2000 Hz, F(1, 38) = 6.64. Whereas, the difference was evident at only 500 Hz: F(1, 38) = 4.98 in case of TB ABR. However, there was no significant difference seen at any of the frequencies for amplitude parameters in both TB and NB-chirp ABR. Latency of wave V using NB-chirp was considered to be a better indicator compared to TB, acting as a better clinical tool in early identification, diagnosis, and monitoring of noise induced hearing loss (NIHL).

Protected carotid artery stenting in patients at high risk for carotid endarterectomy.

OBJECTIVES: To compare the 30-day, six-month, and one-year outcomes of carotid artery stenting (CAS) and carotid endarterectomy (CEA) in male veterans, and to identify any predictors of adverse outcomes. CAS has been shown to be non-inferior to CEA in patients at high-risk for CEA. The outcome of CAS compared to low-risk CEA is less clear. METHODS: Retrospective analysis of 96 consecutive patients who underwent CAS (N = 31) or CEA (N = 65). The cumulative 30-day, six-month, and one-year incidence of ipsilateral transient ischemic attack (TIA) or stroke, restenosis or reocclusion, need for target vessel revascularization, non-fatal myocardial infarction (MI), and death were compared. RESULTS: All patients in the CAS group were at high risk for CEA. Among the CEA group, 50 (76.9%) were at high risk and the remaining 15 (23.1%) were considered to be at low risk. The cumulative incidence of adverse outcomes with CAS and CEA, respectively, at 30 days (3.2% vs 9.2%, P = ns), six months (3.2 vs 18.5%, P = 0.047), and one year (9.7% vs 18.5%, P = ns) favored CAS. This difference was primarily due to adverse events in the high-risk CEA patients. There was no significant difference in outcome between the CAS and low-risk CEA groups. The independent significant predictors for adverse outcomes within six months were the group (P = 0.047) and number of risk factors (P = 0.01). Interestingly, the use of angiotensin-converting enzyme inhibitors (ACE-I) predicted adverse outcomes within one year (P = 0.01). CONCLUSION: CAS may be superior to high-risk CEA with better six-month outcomes. The outcomes with CAS were not significantly different compared to low-risk CEA, suggesting that CAS may be non-inferior to low-risk CEA.