Histologic scoring of liver biopsies for the prognosis of chronic liver disease at a tertiary care hospital in South India.

OBJECTIVES: The study aimed to evaluate the role of histologic scoring of liver biopsies using Ishak-modified histological activity index (HAI) and Laennec's scoring system in predicting chronic liver disease (CLD) prognosis in South India. METHODS: A retrospective analysis of liver biopsy samples was conducted at a tertiary care hospital. The samples were scored using the Ishak-modified HAI and Laennec's scoring system for staging and grading CLD. Patient clinical data were retrieved and assessed using the Child-Pugh scoring system. Chi-squared test was used to test the association between categorical variables and the association with multiple categories was reported using Cramer's V correlation coefficient. A p-value < 0.05 was considered significant. RESULTS: Out of 43 samples included in the study, 65.12% were male patients, with a mean age of 43.3 ± 13.9 years. Cirrhotic cases accounted for the highest proportion (65.12%, n = 28), followed by hepatitis cases (30%, n = 13). The predominant etiology was alcohol-related (44.19%, n = 19). Percutaneous liver biopsies constituted most of the samples (48.84%, n = 21), followed by transjugular (37.21%, n = 16) and ultrasonography-guided (11.63%, n = 6) biopsies. The correlation between Ishak-modified HAI stages and Child-Pugh scores was weak and insignificant (p = 0.71), while Laennec's scores showed a moderate but insignificant correlation with Child-Pugh scores (p = 0.066). CONCLUSION: Histologic scoring of liver biopsies using the Ishak-modified HAI and Laennec's scoring system can provide valuable prognostic information for CLD. However, further research is needed to establish stronger correlations with clinical outcomes.

Eyeball simulator for extraocular muscles.

Learning about human eye movements broadens our comprehension of the visuomotor system and aids in the effective management of strabismus. One's clinical practice is improved by a dynamic simulation of human eye movements using physical models of the extraocular muscles (EOMs). We use our eyeball model to teach the basics of strabismus to undergraduate students and ophthalmology residents. In Listing's plane, extraocular movements of each muscle and the angle demonstration are being used to familiarize students with their knowledge. The degree of the residents' understanding of strabismus is significantly influenced by the eyeball strabismus simulator. This model is an inexpensive, Do It Yourself (DIY) model that is simple to build.

COX-2, aspirin and metabolism of arachidonic, eicosapentaenoic and docosahexaenoic acids and their physiological and clinical significance.

Polyunsaturated fatty acids (PUFAs) are vital for normal growth and development and physiological function of various tissues in humans. PUFAs have immunomodulatory actions in addition to their ability to modulate inflammation, vascular reactivity, neurotransmission and stem cell biology. PUFAs and their metabolites possess both pro- and anti-inflammatory properties that underlie their actions and involvement in several diseases. Aspirin, a non-steroidal anti-inflammatory drug (NSAID), possesses both cyclo-oxygenase (COX) and lipoxygenase (LOX) inhibitory action and enhances the production of anti-inflammatory lipoxin A4 {(called as epi-lipoxin A4, aspirin-triggered lipoxins (ATLs))}. In addition, at low doses aspirin may not interfere with the production of prostacyclin (PGI2). Both lipoxin A4 and PGI2 have vasodilator, platelet anti-aggregator and anti-inflammatory actions that may underlie the beneficial actions of aspirin. Paradoxically, other NSAIDs may not have the same actions as that of aspirin on PUFA metabolism. Similar anti-inflammatory compounds are formed from eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) by the action of aspirin termed as resolvins (from EPA and DHA) and protectins and maresins from DHA. PUFAs: arachidonic acid (AA), EPA and DHA and their various products modulate not only inflammation and immune response but also possess actions on various genes, nuclear factors, cyclic AMP and GMP, G-protein coupled receptors (GPRs), hypothalamic neurotransmitters, hormones, cytokines and enzymes, and interact with nitric oxide, carbon monoxide, and hydrogen sulfide to regulate their formation and action and to form new compounds that have several biological actions. These pleiotropic actions of PUFAs and their metabolites may explain their ability to play a role in several physiological actions and diseases. The big challenge is to harness these actions to prevent and manage clinical conditions.