Hydroxychloroquine pleiotropic benefits: is there any evidence beyond rheumatological diseases?

Once used as an antimalarial medication, hydroxychloroquine (HCQ) is now widely used to treat a variety of rheumatic diseases, including rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). HCQ has shown benefits in rheumatic diseases because of its anti-inflammatory and immunomodulatory properties. HCQ has demonstrated cardioprotective effects in rheumatic disorders, including SLE and RA. Recently, the role of inflammatory mediators has drawn a lot of attention in the pathophysiology of prediabetes, type 2 diabetes (T2D), diabetic complications and atherosclerotic cardiovascular diseases (ASCVD). In a prospective observational study of RA patients, taking HCQ for longer than four years, the incidence of diabetes has been found to be substantially decreased. In a mechanistic human pharmacodynamic study of T2D patients, HCQ showed improvements in insulin resistance and beta-cell function. These outcomes are associated with reductions in inflammatory markers such as interleukin 6 (IL6) and high-sensitivity C-reactive protein (hs-CRP). With its anti-hyperglycemic potential, anti-inflammatory, and pleiotropic effects (lipid-lowering, antiplatelet, antithrombotic) HCQ stands out as a therapeutic option that is affordable for patients with uncontrolled T2D who are at risk for complications. The pleiotropic benefits of HCQ extend beyond rheumatic diseases with potential in prediabetes, T2D and ASCVD

An unusual case of pseudoxanthomatous salpingitis

Pseudoxanthomatous salpingitis (PXS) is a rare condition which is characterized by the presence of pigment-laden histiocytes within the lamina propria of the fallopian tube. Till date, less than 30 cases of have been reported in the literature.  Herein, we report an incidentally detected case of PXS. PXS has been linked with ovarian endometriosis. The pathogenesis of PXS is unclear but it might be a response by the macrophages to haemorrhage in the lumen of the fallopian tube. The importance of knowing about this entity lies in the fact that it can be preoperatively diagnosed as adnexal neoplasm sometimes mistakenly.

Thanatophoric skeletal dysplasia: a rare case report

A diverse range of bone growth disorders known as skeletal dysplasias are brought on by new mutations in the FGFR3 gene, which cause abnormalities in the size and shape of the skeleton. We present a case of thanatophoric dysplasia diagnosed antenatally on ultrasound. G2P1L0, a 30-year-old woman, came to our radiodiagnosis department for her first pregnant ultrasound examination. The results showed a single live intrauterine baby with a head that was considerably bigger than the rest of the body, a hypoplastic nasal bone, an exceedingly thin fetal thorax, thicker soft tissue in the hands and feet, as well as bent long bones that resemble telephone receiver handles, along with bilateral club feet and trident hands.

Impact of dietary habit on the mental wellbeing of adolescents: a Bangladeshi perspective

Background: Adolescent mental health is a critical public health issue, significantly influenced by dietary habits. This study aims to explore the relationship between dietary patterns and mental well-being among adolescents in Dhaka, Bangladesh. Methods: This cross-sectional observational study was conducted with 600 students from Grades 9 and 10 across multiple schools in Dhaka. Data were collected using a structured questionnaire covering demographic information, dietary habits, and mental health assessed using the generalized anxiety disorder 7-item (GAD-7) scale. Result: The majority of participants were aged 15 years (37.83%) and 16 years (28.33%), with 61.33% being female. BMI classification revealed that 28.83% were underweight, 54.67% had a normal BMI, and 16.50% were overweight or obese. Dietary analysis showed that 56.17% had a mixed diet, 48.33% consumed fruits weekly, and 59.83% consumed vegetables regularly. Significant correlations were found between dietary habits and anxiety levels, with positive correlations between fruit and vegetable intake (r=0.143, p<0.001) and negative correlations between skipping breakfast and fruit intake (r=-0.172, p<0.001). Conclusion: This study highlights the significant impact of dietary habits on the mental well-being of adolescents in Dhaka. Regular consumption of fruits and vegetables is associated with lower anxiety levels, while poor dietary practices, such as skipping breakfast and high fast-food intake, are linked to higher anxiety. These findings underscore the need for targeted nutritional education and mental health interventions to improve adolescent health outcomes

Bartter’s syndrome type II due to a novel mutation in KCNJ1 gene presenting in adulthood as recurrent hypokalaemic periodic paralysis

Bartter’s syndrome affects salt reabsorption transporters in Henle's loop's thick ascending limb (TAL). Bartter’s syndrome type II begins in antenatal/neonatal period with an autosomal recessive pattern of inheritance due to mutation in the KCNJ1 gene. Renal disorder begins early. It is a disorder which usually presents in infancy but not in adulthood. We report a case of late onset Bartter’s syndrome type II due to a novel mutation in the KCNJ1 gene manifesting with bilateral medullary nephrocalcinosis and recurrent hypokalaemic periodic paralysis

Pinna reconstruction in a 2-year-old: a case report

Pediatric age group is one of the most vulnerable groups to trauma and morbidity occurring thereby. And that too requiring reconstruction of ear pinna is in itself a challenge. Confronted with such situation is not an easy situation for any trauma team. Successful outcomes in auricular reconstruction rely on the surgeon's careful analysis of the defect as well as knowledge of the different reconstructive options available. We present one such case and discuss the relevant anatomy and operative options for surgeons

Clinical study of effect of low dose atropine drops on progression of myopia in children

Background: As an eye condition, myopia is prevalent and often confusing. In modern times, a higher risk of many eye illnesses is linked to myopia, even at modest levels. Improving eye health and quality of life may be possible by halting the development of myopia. Methods: It was a prospective, experimental study, designed to look at the effect of 0.01% atropine eye drop on myopia progression, conducted in outpatient tertiary medical centre, total 66 patients were enrolled. Inclusion criteria include having age of ≥6 years and ≤15 years with myopia or myopic astigmatism and whose parents have given consent to participate in the study. Exclusion criteria include children with congenital/developmental delay or systemic diseases, ocular pathology like amblyopia, strabismus, cataract, allergy to atropine were not included. Results: The result showed that the comparison of spherical equivalent between the baseline measurements and the follow-up measurements after the use of low dose atropine drops indicates that a significant correlation is found between the baseline and follow-up of 12 months (p=0.043) and 18 months (p=0.038). The 6-month follow-up comparison does not show statistically significant association. Conclusions: We concluded that the low dose atropine should be considered as one the myopia progression control remedy. Recommendation of carry out further research in the similar population of a longer duration of three years and above to better understand the effect of low dose atropine in myopia progression should be considered. 

Addressing substance abuse among healthcare professionals in a tertiary healthcare facility in Nigeria: a case study of Nnamdi Azikiwe university teaching hospital

Background: The use of psychoactive substances is prevalent worldwide, including among healthcare workers whose well-being, productivity, and effectiveness in addressing substance addiction in patients and the wider community can be significantly impacted. However, the extent of substance misuse among healthcare professionals in Nigeria, with its substantial social and public health implications, remains poorly understood. This research focused on the prevalence, attitudes, substances used, and influencing factors regarding substance misuse among staff at Nnamdi Azikiwe university teaching hospital (NAUTH) in Nnewi. Methods: A descriptive cross-sectional study was conducted involving 194 healthcare workers, using a multi-stage sampling method. Data were collected via a semi-structured self-administered questionnaire and analyzed with SPSS version 20. Results were presented in tables, considering p values less than 0.05 as significant. Results: Of the 197 respondents, 63.5% were female and 36.5% male, spanning various professions including doctors, nurses, and other healthcare specialists. Notably, 66% of participants had used substances in their lifetime. Alcohol was the most commonly abused substance, with significant percentages of moderate and high-risk users. Socialization and peer pressure were identified as the predominant factors influencing substance use, with significant statistical associations found between substance use and variables such as profession, sex, and duration of practice. Conclusions: The study highlighted a considerable prevalence of alcohol use among healthcare workers, who generally held a moderate view towards substance misuse and identified socialization and peer pressure as key factors. These findings underscore the pressing need for targeted training and intervention strategies for substance addiction among healthcare workers in Nigeria

Tumor budding in invasive breast carcinoma: an emerging prognostic factor

Background: Tumor budding refers to single or small cluster of tumor cells detached from the main tumor mass in histological sections. In colon cancer high tumor budding is associated with worse prognosis and correlates with metastatic lymph nodes. We studied tumor budding in modified radical mastectomy specimens to evaluate its utility as a prognostic factor by correlating high tumor budding score with known prognostic markers of breast cancer like axillary lymph nodal metastasis, clinical staging, tumor size, lymphovascular invasion, hormonal status and pathological grading. Aim was to evaluate tumor budding in invasive breast carcinoma and to describe clinical features and histopathological spectrum of Invasive Breast Carcinoma with/without lymph node metastasis on H&E slides. Secondly, to find association between grades of tumor budding and various clinical, gross, microscopic and immunohistochemical variables. Methods: The present study is a cross sectional study of 70 modified radical mastectomy specimens from June 2018 to Dec 2022. Along with tumor budding various prognostic parameters like hormonal markers, pathological grading and clinical grading were evaluated. Immunohistochemical marker Pancytokeratin was utilized for counting the tumor buds, wherever necessary. Statistical Analysis: Chi Square test was utilized to study significant differences between variables, p<0.05 was considered statistically significant. Results: A high tumor budding score (≥4/HPF) had significant association with axillary lymph node involvement and clinical staging. Conclusions: In our study we detected the association of high tumor budding, PTB in invasive breast carcinoma with axillary lymph node involvement and clinical staging. Hence our results highlight the importance of tumor budding as a prognostic factor and submit that this histological feature could be included in diagnostic protocols just as in carcinoma of the colon

Profile and outcome of treatment in non-small cell lung cancer with brain metastasis

Background: Brain metastasis is a common problem in patients with NSCLC. This study was done to study the risk factors associated with the development of brain metastasis and assess treatment response in NSCLC to improve patient survival. Methods: This was a retro-prospective study in which 126 patients with non-small cell lung carcinoma with brain metastasis were taken for the study. Results: The mean age in study group was 56.1±12.72 years. Adenocarcinoma was found in 57.1% and squamous cell carcinoma in 41.3% patients. 65.9% patients received chemotherapy for primary disease followed by targeted therapy in 34 (27.0%) patients. 53.9% patients received WBRT after diagnosis  of brain metastasis and 23% WBRT and systemic chemotherapy while as14.3% received WBRT and targeted therapy and 2.4%  received WBRT, systemic chemotherapy and targeted therapy, 1.6%  patients received systemic chemotherapy, WBRT and local RT to the primary site  and 0.8% each was treated with gamma knife therapy; surgery, WBRT and targeted therapy; SRS and WBRT. Median overall survival of patients with brain metastasis who received WBRT was 2.5 months and patients who received WBRT and systemic chemotherapy was 9.0 months while patients with brain metastasis who received WBRT and targeted therapy was 14.3 months. Conclusions: The median overall survival as per treatment received after diagnosis of brain metastasis was higher in patients who received WBRT and targeted therapy as compared to patients who received WBRT and systemic chemotherapy and patients who received WBRT only