Histopathological study of nasal masses, a one year retrospective study in a tertiary care centre of Assam

Background: Prolapsed lining of the nasal sinuses are defined as nasal polyp. Diseases of the nasal cavity include viral, bacterial and fungal infections, nasal cavity tumors (benign and malignant) as well as inflammations of the nasal mucosa. This study was undertaken to note the various histopathological patterns of nasal masses, their classification and relative distribution of various lesions with regard to age and sex in our setting.Methods: The study is done for a period of 1 year (July 2018 to June 2019). In this study, 30 patients are selected who presented in our hospital with nasal masses and having multiple types of clinical presentations.Results: Total 30 cases presented as nasal mass. Overall male to female ratio was 2.3:1. Nonneoplastic nasal masses formed the largest group of lesions; 24 cases (80%), followed by 6 cases (20%) of neoplastic nasal masses. Inflammatory polyp was the commonest non neoplastic lesion constituting 22 cases followed by rhinosporidiosis with 2 cases. Out of the 6 neoplastic nasal masses, 5 were benign and 1 was malignant. Out of the benign neoplastic masses, inverted papilloma constituted 3 cases and nasopharyngeal angiofibroma constituted 2 cases. Malignant neoplastic mass was embryonal rhabdomyosarcoma.Conclusions: Nasal obstruction and rhinorrhea are the most common symptoms of presentation. Simple inflammatory nasal polyps are the most common histological pattern seen in our environment, and surgery is the best modality of treatment

Implementation of Continuous Capnography Is Associated With a Decreased Utilization of Blood Gases

Background Capnography provides a continuous, non-invasive monitoring of the CO2 to assess adequacy of ventilation and provide added safety features in mechanically ventilated patients by allowing for quick identification of unplanned extubation. These monitors may allow for decreased utilization of blood gases. The objective was to determine if implementation of continuous capnography monitoring decreases the utilization of blood gases resulting in decreased charges. Methods This is a retrospective review of a quality improvement project that compares the utilization of blood gases before and after the implementation of standard continuous capnography. The time period of April 2010 to September 2010 was compared to April 2011 to September 2011. Parameters collected included total number of blood gases analyzed, cost of blood gas analysis, ventilator and patient days. Results The total number of blood gases after the institution of end tidal CO2 monitoring decreased from 12,937 in 2009 and 13,171 in 2010 to 8,070 in 2011. The average number of blood gases per encounter decreased from 20.8 in 2009 and 21.6 in 2010 to 13.8 post intervention. The blood gases per ventilator day decreased from 4.94 in 2009 and 4.76 in 2010 to 3.30 post intervention. The total charge savings over a 6-month period was $880,496. Conclusions Continuous capnography resulted in a significant savings over a 6-month period by decreasing the utilization of blood gas measurements

Cardiovascular disease risk factors among school children of Bangladesh: A cross-sectional study

Objective: Primarily, we assessed the distribution of cardiovascular disease (CVD) risk factors among school children living in urban and rural areas of Bangladesh. In addition to this, we sought the association between place of residence and modifiable CVD risk factors among them. Design, setting and participants: This cross-sectional study was conducted among 854 school children (aged 12&ndash;18 years) of Bangladesh. Ten public high schools (five from Dhaka and five from Sirajgonj district) were selected randomly and subjects from those were recruited conveniently. To link the family milieu of CVD risk factors, a parent of each children was also interviewed. Primary and secondary outcome measures: Distribution of CVD risk factors was measured using descriptive statistics as appropriate. Again, a saturated model of binary logistic regression was used to seek the association between place of residence and modifiable CVD risk factors. Results: Mean age of the school children was 14.6&plusmn;1.1 years and more than half (57.6%) were boys. Overall, 4.4% were currently smoker (urban&mdash;3.5%, rural&mdash;5.2%) with a strong family history of smoking (42.2%). Similar proportion of school children were identified as overweight (total 9.8%, urban 14.7%, rural 5%) and obese (total 9.8%, urban 16.8%, rural 2.8%) with notable urban-rural difference. More than three-fourth (80%) of them were physically inactive with no urban-rural variation. Only 2.4% consumed recommended fruits and/ or vegetables (urban&mdash;3.1%, rural&mdash;1.7%). In the adjusted model, place of residence had higher odds for having several modifiable CVD risk factors: current smoking (OR: 1.807, CI 0.872 to 3.744), inadequate fruits and vegetables intake (OR: 1.094, CI 0.631 to 1.895), physical inactivity (OR: 1.082, CI 0.751 to 1.558), overweight (OR: 3.812, CI 2.245 to 6.470) and obesity (OR: 7.449, CI 3.947 to 14.057). Conclusions: Both urban and rural school children of Bangladesh had poor CVD risk factors profile that demands further nation-wide large scale study to clarify the current findings more precisely.</jats:sec

Spectrum of pigmented lesions of skin: a retrospective study in a tertiary health care of Southern Assam

Background: Pigmented lesions are one of the most common cause for dermatological consultation.  Most of them are benign, while a majority of them have malignant transformation and are called as melanoma. A careful histopathological interpretation by the pathologist is needed in the diagnosis and management of these lesions. Aims and objectives of the study were- 1. To study the spectrum of various pigmented skin lesions.  2.  To establish the correlation between the microscopic pathological findings of various skin lesions with the presenting clinical features.Methods: A 3-year study was conducted in the pathology department of tertiary care centre on all skin biopsy tissue which came as pigmented lesion. The entire skin biopsy is submitted for routine processing and embedded in paraffin wax. 3-5 mm thick paraffin sections of the skin biopsy are stained with H and E.Results: Out of 432 skin biopsies studied during this period, 58 cases were diagnosed as pigmented skin lesions. Of these, the biopsy tissue was inadequate in 5 cases while five cases presented with non-specific findings. Of the remaining cases, 15 were malignant and 33 were benign lesions. Only 18 of these were of melanocytic origin with 8 cases of malignant melanoma and 10 nevi. In the present study an analysis of the clinical diagnosis with the histopathological diagnosis revealed a positive correlation in 54% cases.Conclusions: A good clinical correlation and biopsy with histopathological diagnosis is necessary for the accurate diagnosis and definite treatment of patients with pigmented skin lesions

Comparison between chloral hydrate and propofol-ketamine as sedation regimens for pediatric auditory brainstem response testing

Introduction The use of diagnostic auditory brainstem response testing under sedation is currently the “gold standard” in infants and young children who are not developmentally capable of completing the test. Objective The aim of the study is to compare a propofol-ketamine regimen to an oral chloral hydrate regimen for sedating children undergoing auditory brainstem response testing. Methods Patients between 4 months and 6 years who required sedation for auditory brainstem response testing were included in this retrospective study. Drugs doses, adverse effects, sedation times, and the effectiveness of the sedative regimens were reviewed. Results 73 patients underwent oral chloral hydrate sedation, while 117 received propofol-ketamine sedation. 12% of the patients in the chloral hydrate group failed to achieve desired sedation level. The average procedure, recovery and total nursing times were significantly lower in the propofol-ketamine group. Propofol-ketamine group experienced higher incidence of transient hypoxemia. Conclusion Both sedation regimens can be successfully used for sedating children undergoing auditory brainstem response testing. While deep sedation using propofol-ketamine regimen offers more efficiency than moderate sedation using chloral hydrate, it does carry a higher incidence of transient hypoxemia, which warrants the use of a highly skilled team trained in pediatric cardio-respiratory monitoring and airway management

Intensivist-based deep sedation using propofol for pediatric outpatient flexible bronchoscopy

AIM To evaluate the safety and efficacy of sedating pediatric patients for outpatient flexible bronchoscopy. METHODS A retrospective chart review was conducted for all children, age 17 years or under who underwent flexible bronchoscopy under deep sedation in an outpatient hospital-based setting. Two sedation regimens were used; propofol only or ketamine prior to propofol. Patients were divided into three age groups; infants (less than 12 mo), toddlers (1-3 years) and children (4-17 years). Demographics, indication for bronchoscopy, sedative dosing, sedation and recovery time and adverse events were reviewed. RESULTS Of the total 458 bronchoscopies performed, propofol only regimen was used in 337 (74%) while propofol and ketamine was used in 121 (26%). About 99% of the procedures were successfully completed. Children in the propofol + ketamine group tend to be younger and have lower weight compared to the propofol only group. Adverse events including transient hypoxemia and hypotension occurred in 8% and 24% respectively. Median procedure time was 10 min while the median discharge time was 35 min. There were no differences in the indication of the procedure, propofol dose, procedure or recovery time in either sedative regimen. When compared to other age groups, infants had a higher incidence of hypoxemia. CONCLUSION Children can be effectively sedated for outpatient flexible bronchoscopy with high rate of success. This procedure should be performed under vigilance of highly trained providers

Enhancing Physical Layer Secrecy Performance for RIS-assisted RF-FSO Mixed Wireless System

Peer reviewedPublisher PD

The tip-link antigen, a protein associated with the transduction complex of sensory hair cells, is protocadherin-15

Sound and acceleration are detected by hair bundles, mechanosensory structures located at the apical pole of hair cells in the inner ear. The different elements of the hair bundle, the stereocilia and a kinocilium, are interconnected by a variety of link types. One of these links, the tip link, connects the top of a shorter stereocilium with the lateral membrane of an adjacent taller stereocilium and may gate the mechanotransducer channel of the hair cell. Mass spectrometric and Western blot analyses identify the tip-link antigen, a hitherto unidentified antigen specifically associated with the tip and kinocilial links of sensory hair bundles in the inner ear and the ciliary calyx of photoreceptors in the eye, as an avian ortholog of human protocadherin-15, a product of the gene for the deaf/blindness Usher syndrome type 1F/DFNB23 locus. Multiple protocadherin-15 transcripts are shown to be expressed in the mouse inner ear, and these define four major isoform classes, two with entirely novel, previously unidentified cytoplasmic domains. Antibodies to the three cytoplasmic domain-containing isoform classes reveal that each has a different spatiotemporal expression pattern in the developing and mature inner ear. Two isoforms are distributed in a manner compatible for association with the tip-link complex. An isoform located at the tips of stereocilia is sensitive to calcium chelation and proteolysis with subtilisin and reappears at the tips of stereocilia as transduction recovers after the removal of calcium chelators. Protocadherin-15 is therefore associated with the tip-link complex and may be an integral component of this structure and/or required for its formatio