The Effects of Lavandula Angustifolia Mill Infusion on Depression in Patients Using Citalopram: A comparison Study

Background: Many herbs have been used to treat psychiatric disorders including anxiety and depression in traditional medicine. Objectives: This study was carried out to determine the effect of using Lavandula angustifilia infusion on depression in patients taking Citalopram. Patients and Methods: Among all patients referred to the Hajar Hospital psychiatric clinic, Shahrekord, Iran, 80 patients who met the criteria of major depression according to the structured interviews and the Hamilton questionnaire for Depression were included in the study. They were randomly assigned into two groups of experimental treatment group and standard treatment group at this study. In standard treatment group, the patients were given Citalopram 20 mg. In experimental treatment group, the patients took 2 cups of the infusion of 5 g dried Lavandula angustifilia in addition to tablet Citalopram 20 mg twice a day. The patients were followed up for four and eight weeks of the study onset using Hamilton Scale questionnaire and treatment side effects form. Data were analyzed using student t-test, pair t-test and chi square. Results: After four weeks of the trial onset, the mean depression score according to the Hamilton Scale for Depression was 17.5 +/- 3.5 in the standard treatment group and 15.2 +/- 3.6 in the experimental treatment group (P < 0.05). After eight weeks, it was 16.8 +/- 4.6 and 14.8 +/- 4 respectively (P < 0.01). In addition, the most commonly observed adverse effects were nausea (12.8 %) and confusion (10%). In terms of side effects, there were no significant differences between two groups. Conclusions: Considering the results of this study, Lavandula angustifilia infusion has some positive therapeutic effects on depressed patients most importantly decreases mean depression score and might be used alone or as an adjunct to other anti-depressant drugs

New diagnostic criteria for inguinal hernia based on ultrasound examination

Background: According to increasing use of ultrasound in the diagnosis of inguinal herniation, this study was designed to evaluate the cross-sectional area of the inguinal canal in patients with inguinal herniation and its increase with Valsalva maneuver. We also compared the obtained values with those of normal population. Methods: a cross-sectional study, 52 normal persons and 35 cases with inguinal hernia were assessed. The cross-sectional area of the inguinal canal was measured in all subjects and data was analyzed using Student's t-test and Pearson's correlation tests in SPSS. Receiver operator characteristic (ROC) curves were traced to define cut-off points. Findings: Valsalva maneuver caused significantly greater increase in the cross-sectional area of the inguinal canal among patients than in the normal group. The cut-off point of the cross-sectional area of inguinal canal was 63.5 mm2 in neutral state and 72.5 mm2 with Valsalva maneuver (increase rate: 34 mm2). In the absence of Valsalva maneuver, a cross-sectional area of the inguinal canal of greater than 63.5 mm2 is predictive of inguinal hernia (with 91 sensitivity and 98 specificity). Otherwise, values greater than 72.5 mm2 will be predictive of inguinal hernia (with 100 sensitivity and 98 specificity). Inguinal hernia will also be suspected if Valsalva maneuver increases the cross-sectional area of the inguinal canal by more than 34 mm2 (with 91 sensitivity and 100 specificity). Conclusion: The following diagnostic criteria are suggested for diagnosis of inguinal hernia through ultrasound examination: the presence of bowel loop within the inguinal canal, a cross-sectional area of the inguinal canal > 63.5 mm2 without Valsalva maneuver and > 72.5 mm2 with Valsalva maneuver, an increase of > 34 mm2 in the cross-sectional area of the inguinal canal with Valsalva maneuver, and a > 0.5 cm movement of the spermatic cord with Valsalva maneuver

A combined spatial score of granzyme B and CD68 surpasses CD8 as an independent prognostic factor in TNM stage II colorectal cancer.

BACKGROUND Previous assessments of peritumoral inflammatory infiltrate in colorectal cancer (CRC) have focused on the role of CD8+ T lymphocytes. We sought to compare the prognostic value of CD8 with downstream indicators of active immune cell function, specifically granzyme B (GZMB) and CD68 in the tumour microenvironment. METHODS Immunohistochemical (IHC) staining was performed for CD8, GZMB, CD68 and CD163 on next-generation tissue microarrays (ngTMAs) in a primary cohort (n = 107) and a TNM stage II validation cohort (n = 151). Using digital image analysis, frequency of distinct immune cell types was calculated for tumour proximity (TP) zones with varying radii (10 μm-100 μm) around tumour cells. RESULTS Associations notably of advanced TNM stage were observed for low density of CD8 (p = 0.002), GZMB (p < 0.001), CD68 (p = 0.034) and CD163 (p = 0.011) in the primary cohort. In the validation cohort only low GZMB (p = 0.036) was associated with pT4 stage. Survival analysis showed strongest prognostic effects in the TP25μm zone at the tumour centre for CD8, GZMB and CD68 (all p < 0.001) in the primary cohort and for CD8 (p = 0.072), GZMB (p = 0.035) and CD68 (p = 0.004) in the validation cohort with inferior prognostic effects observed at the tumour invasive margin. In a multivariate survival analysis, joint analysis of GZMB and CD68 was similarly prognostic to CD8 in the primary cohort (p = 0.007 vs. p = 0.002) and superior to CD8 in the validation cohort (p = 0.005 vs. p = 0.142). CONCLUSION Combined high expression of GZMB and CD68 within 25 μm to tumour cells is an independent prognostic factor in CRC and of superior prognostic value to the well-established CD8 in TNM stage II cancers. Thus, assessment of antitumoral effect should consider the quality of immune activation in peritumoral inflammatory cells and their actual proximity to tumour cells

Oxford-MEST classification in IgA nephropathy patients: A report from Iran.

BACKGROUND There is a limited knowledge about the morphological features of IgA nephropathy (IgAN)in the middle east region. OBJECTIVES The objective of this study was to evaluate the spectrum of histopathological findings in IgAN patients at our laboratory. PATIENTS AND METHODS At this work, an observational study reported which was conducted on IgAN patients using the Oxford-MEST classification system. RESULTS In this survey, of 102 patients 71.6 % were male. The mean age of the patients was 37.7 ± 13.6 years. Morphologic variables of MEST classification was as follows; M1: 90.2 %, E: 32 %, S: 67 % also,T in grads I and II were in 30% and 19% respectively, while 51% were in grade zero. A significant difference was observed in segmental glomerulosclerosis (P=0.003) and interstitial fibrosis/tubular atrophy frequency distribution (P= 0.045), between males and females . Furthermore, it was found that mesangial hypercellularity was more prevalent in yonger patients. Moreover, there was a significant correlation between serum creatinine and crescents (P<0.001). There was also significant correlation of serum creatinine with segmental glomerulosclerosis (P<0.001). CONCLUSIONS Higher prevalence of segmental glomerulosclerosis and interstitial fibrosis/ tubular atrophy, as the two of, four variables of Oxford-MEST classification of IgAN in male patients further attests that male gender is a risk factor in this disease.In this study the significant correlation between serum creatinine and crescent was in an agreement with previous studies and suggests for the probable accomodation of extracapillary proliferation as a new variable in MEST system

What is New in the 2019 World Health Organization (WHO) Classification of Tumors of the Digestive System Review of Selected Updates on Neuroendocrine Neoplasms, Appendiceal Tumors, and Molecular Testing

Context.-The 5th edition of the World Health Organization classification of digestive system tumors discusses several advancements and developments in understanding the etiology, pathogenesis, and diagnosis of several digestive tract tumors. Objective.-To provide a summary of the updates with a focus on neuroendocrine neoplasms, appendiceal tumors, and the molecular advances in tumors of the digestive system. Data Sources.-English literature and personal experiences. Conclusions.-Some of the particularly important updates in the 5th edition are the alterations made in the classification of neuroendocrine neoplasms, understanding of pathogenesis of appendiceal tumors and their precursor lesions, and the expanded role of molecular pathology in establishing an accurate diagnosis or predicting prognosis and response to treatment

Uncommon Benign Neoplasms and Pseudotumors of the Liver

Context.— The most common benign hepatic mass-forming lesions often display fairly specific imaging characteristics, whereas less familiar, rarer benign neoplasms and pseudotumors may pose a diagnostic challenge in clinical, radiology, and pathology practice because of either their rarity or their unusual features. Objective.— To review a selection of pseudotumors and unusual benign hepatic neoplasms encountered in consultation practices with a focus on nonepithelial tumors. Data Sources.— Sources include English-language literature and personal experiences. Conclusions.— Several benign conditions (namely, segmental atrophy, infections, immunoglobulin G4 [IgG4]–related sclerosing disease, angiomyolipoma, mesenchymal hamartoma, and various vascular lesions) can lead to formation of hepatic masses. Because of their rarity and underrecognition, such lesions are often diagnostically challenging. Awareness of hepatic pseudotumors and various rare hepatic neoplasms and their potential mimics can forestall misdiagnosis and inappropriate management

Perianal Paget's disease as spread from non-invasive colorectal adenomas

Paget's disease of the perianal skin is a rare form of extramammary Paget's disease, and may be a primary intraepithelial adnexal neoplasm or secondary due to spread from an underlying colorectal lesion, nearly always colorectal adenocarcinoma. Secondary perianal Paget's disease associated with non-invasive colorectal adenomas is exceedingly uncommon, with only a few reported cases. Herein, we present the clinical and pathological features of the largest series of secondary perianal Paget's disease arising in association with colorectal adenomas. There was gender parity and the median age was 72 years (range = 68-76 years). In all cases, perianal Paget's disease was associated with colorectal adenomas, including three (75%) conventional tubular adenomas and one (25%) tubulovillous adenoma with serrated foci. All adenomas had high-grade dysplasia and one had intramucosal adenocarcinoma (lamina propria invasion; Tis), but all lacked submucosal invasion. The intraepithelial Paget's cells showed a colorectal phenotype by immunohistochemistry in all cases. At follow-up, two patients had no evidence of disease at 6 and 87 months, one had residual perianal Paget's disease at 8 months and one developed invasive adenocarcinoma of the perianal tissue at 36 months. Similar to its mammary analogue, secondary perianal Paget's disease may arise in association with invasive and/or in-situ colorectal lesions. Although the latter is an uncommon presentation of a recognised rare disease, knowledge of this phenomenon is important to forestall overdiagnosis of invasion and potential overtreatment. The clinical course is variable, such that close follow-up is required