Pre Renal Assessment For A Successful Kidney Transplant

Introduction:Living donor kidney transplantation is the treatment of choice for patients with end stage kidney disease, which prevents chronic dialysis and its long term side effects. In addition to the detailed clinical history and thorough laboratory testing, anatomical assessment of kidneys, pre donation kidney volume and its function before transplantation are important factors to assess post transplant outcome. Materials and methods: Patients undergoing first renal transplant and those between age group of 18 to 60 years were included in the study. Donor kidney volume was measured ultrasonographically, from which donated kidney volume was calculated to evaluate GFR of the donated kidney from the total GFR of the donor. Estimation of recipient graft function was done using four variable abbreviated MDRD equation at 3, 6, 9 and 12 months post transplant. Results :Correlation of the donor age and donor kidney volume with recipients eGFR was done and the results were tabulated. Statistical analysis was done and correlations were seen with Pearson’s correlation coefficient. Statistical significance was defined as p value 0.05. Conclusion: Living donor kidney transplantation remains one of the vitally important treatment option for the end stage renal disease patients. Estimation of donor kidney volume, eGFR and donor age all together play an important role in post transplant graft survival and also better renal outcomes and functioning

Comparative evaluation of non enzymatic antioxidants, vitamin C and albumin in patients suffering from different grades of periodontitis: a retrospective observational study

Background: Rate of degree of destruction of periodontium may be associated with the oxidative stress due to the imbalance of different serum antioxidants. The objective of this study is to compare the evaluated concentrations of non enzymatic antioxidants like vit-C, albumin levels and total antioxidant status, from the available data of patients with slowly and rapidly progressive periodontitis (RPP). Methods: This retrospective observational study was confined to a study population, which include; 42 patients with RPP, 42 patients with slowly progressive periodontitis (SPP) and 86 healthy controls, in whom the required data were available. The levels of non enzymatic antioxidants like albumin, vitamin C and total antioxidant capacity (TAC) of patients, suffering from RPP, are compared with SPP and healthy controls. Results: The values of serum albumin and vitamin-c levels in RPP even remaining within the normal ranges were found to be on the lower side, when compared with healthy controls. The systemic TAC levels were found to be at a lower side in both SPP and RPP, when compared with the healthy control group.   Conclusions: The systemic levels of non enzymatic antioxidants, vit C and albumin, in RPP were found to be on the lower side, even remaining within the normal ranges, when compared with the healthy controls. The TAC in SPP and RPP is also found to be on lower side, consistent with previous studies.

Understanding pelvic floor in women

Change from quadruped to erect posture has resulted in changes in the human pelvis. This has resulted in pelvis supporting the abdominal viscera. The bony pelvis is deficient on inferior aspect. Muscles covered by fascia on superior and inferior aspect. A good knowledge of pelvic floor is very basic and mandatory for any gynecologist as pelvic floor is crucial to support the pelvic organs and is required to maintain urinary and fecal continence

Expression analysis of E-cadherin, Slug and GSK3β in invasive ductal carcinoma of breast

<p>Abstract</p> <p>Background</p> <p>Cancer progression is linked to a partially dedifferentiated epithelial cell phenotype. The signaling pathways Wnt, Hedgehog, TGF-β and Notch have been implicated in experimental and developmental epithelial mesenchymal transition (EMT). Recent findings from our laboratory confirm that active Wnt/β-catenin signaling is critically involved in invasive ductal carcinomas (IDCs) of breast.</p> <p>Methods</p> <p>In the current study, we analyzed the expression patterns and relationships between the key Wnt/β-catenin signaling components- E-cadherin, Slug and GSK3β in IDCs of breast.</p> <p>Results</p> <p>Of the 98 IDCs analyzed, 53 (54%) showed loss/or reduced membranous staining of E-cadherin in tumor cells. Nuclear accumulation of Slug was observed in 33 (34%) IDCs examined. Loss or reduced level of cytoplasmic GSK3β expression was observed in 52/98 (53%) cases; while 34/98 (35%) tumors showed nuclear accumulation of GSK3β. Statistical analysis revealed associations of nuclear Slug expression with loss of membranous E-cadherin (p = 0.001); nuclear β-catenin (p = 0.001), and cytoplasmic β-catenin (p = 0.005), suggesting Slug mediated E-cadherin suppression via the activation of Wnt/β-catenin signaling pathway in IDCs. Our study also demonstrated significant correlation between GSK3β nuclear localization and tumor grade (p = 0.02), suggesting its association with tumor progression.</p> <p>Conclusion</p> <p>The present study for the first time provided the clinical evidence in support of Wnt/β-catenin signaling upregulation in IDCs and key components of this pathway - E-cadherin, Slug and GSK3β with β-catenin in implementing EMT in these cells.</p

Dermatofibrosarcoma Protuberans at Unusual Sites: A Case Series

Dermatofibrosarcoma Protuberans (DFSP) is a rare, locally aggressive malignant subcutaneous soft tissue tumour that often goes undiagnosed due to its indolent nature and non protuberant growth. Recurrences after surgical excision are a common issue. While the trunk and extremities are commonly affected sites, rarer locations such as the genitalia and breast have been reported. The rarity of the lesion, its occasional unusual presentation sites, the indolent yet locally aggressive nature, and the diagnostic and therapeutic challenges are the distinctive features of this tumour. This study presents three unusual sites of DFSP: scrotum, vulva, and pubic region, one of which is an uncommon variant known as pigmented DFSP (Bednar tumour)

An Assembly of Anomalous Extensor Tendons of the Hand – Anatomical Description and Clinical Relevance

Innumerable descriptions about variations in the pattern of extensor tendons are recorded in the literature. The dorsum of the hand in an adult male cadaver revealed an unusual pattern of extensor arrangement during a gross anatomical practical session. The extensor digitorum, extensor indicis and extensor digiti minimi tendons displayed a variant pattern. Extensor digitorum contributed tendons only to the middle and ring fingers, with junctura tendinum present between the extensor digitorum for the ring finger and extensor digiti minimi. Interestingly, an accessory muscle was observed arising from the common extensor origin passing to the index finger, in addition to the usual extensor indicis. The origin and insertion of extensor digiti minimi was as usual with an accessory slip contributed from the extensor carpi ulnaris to the proximal phalanx of the fifth finger. The plethora of variations in this region is of paramount importance for the reconstructive surgeon, who may utilize the accessory tendons to restore functional capacity of the fingers

Unilateral Anomalous Arterial Pattern of Human Upper Limb: Anatomical Description and Clinical Implications

A unilateral case of variations in the brachial and antebrachial arterial branching pattern of a human upper limb is reported. A high bifurcation of brachial artery along with superficial course of ulnar artery was observed. Additionally, the profunda brachii and common interosseous artery originated from the radial artery instead of brachial and ulnar arteries respectively. An atypical branching pattern of arteries in an upper limb could pose a challenging problem to vascular surgeons while performing reconstructive procedures