A clinicopathological study of leprosy: a study of skin biopsies

Background: Leprosy is a chronic infectious granulomatous disease caused by Mycobacterium leprae. The disease mainly affects peripheral nervous system, the skin and other tissues such as the muscles, bones and joints, eyes, reticuloendothelial system, testis etc. To reduce global load of leprosy, it is essential to have an early and proper diagnosis by clinical and histopathological correlation followed by proper and complete treatment. Aims and Objectives were 1) to study histopathological spectrum of various subtypes of leprosy, 2) to study the age and gender wise incidence of different subtypes of leprosy, and 3) to assess the concordance between clinical and histological diagnosis in cases of leprosy using Ridley-Jopling scale.Methods: A retrospective observational study of 126 skin biopsies diagnosed as leprosy over a period of one year from August 2020 to July 2021 at P. D.U. Medical College and Hospital, Rajkot, Gujarat.Results: In this study, most of cases occurred in age group (21-40) years (50.8%) and showed marked male predominance with M:F ratio=2.7:1. Lepromatous leprosy (40.5%) was the most common histopathological type of leprosy. Maximum clinicopathological correlation seen in HL (100%), LL (90%) and TT (71.4%).Conclusions: Histopathological examination of skin biopsies and clinicopathological correlation both are essential for early and accurate diagnosis and typing of leprosy which is helpful in prevention of deformities and drug resistance by early and appropriate treatment

Histopathological evaluation of endometrial curettage in cases of abnormal uterine bleeding and its correlation with age of patient

Background: Abnormal uterine bleeding (AUB) is defined as a pattern of bleeding that does not correspond with the duration, amount and frequency of the flow of a normal menstrual cycle. The cause of AUB varies according to the age, endometrial response to hormones and its variations and other structural lesions. Endometrial sampling by endometrium curettage is safe and easy technique and its histopathological analysis is considered the gold standard for diagnosis of the etiology of AUB. Aims and objective was to evaluate the spectrum of endometrial histology in cases of AUB, to find out age wise incidence of AUB, and to find out age wise incidence of various histological pattern of endometrium in AUB.Methods: An observational study was conducted on dilatation and curettage material which were obtained from 110 women with a complaint of AUB attending the gynecology outpatient department (OPD) at tertiary care hospital, Rajkot, Gujarat during one year (August 2020 to July 2021).Results: Maximum number of cases of AUB were noted in the age group of (31-40) years (44 cases, 40%). Most common observed histopathological pattern in this study was normal cyclical patterns including proliferative endometrium (34.5%) and secretory endometrium (21%).Conclusions: Histopathological evaluation of endometrium is indicated in women over the age of 35 years presenting with AUB to rule out preneoplastic lesions and malignancies

Women and Informal Employment: An Analysis of Socio-Economic and Health Conditions of Women Home-Based Workers in Chennai, India

This study seeks to analyse the socio-economic and health status of women workers in the informal sector in Chennai, India. Informal employment consists of various kinds of micro-enterprises offering commodities and services and home-based work. Of all these different types of work in the informal sector, home-based work is associated with women because of its nature and characteristic features. Home-based work is piecework for remuneration that is completed in the premises of the worker’s choice rather than the workplace of the employer. Women homeworkers face many issues such as long hours of work, low wages, meagre rates per piece, lack of social security and lack of union or organizational support. More importantly, their conditions of work and health are deplorable. The present study has followed the descriptive research method to carry out the survey. The data for this study has been collected directly using the field survey method. A formally structured questionnaire was prepared and circulated among the target sample for this purpose. The questions were formulated using the variables taken from the literature review and research gap. A stratified random sampling method was adopted for the survey. The sample size was justified on the calculation of secondary data and by applying the appropriate formula to collect data from 150 sample respondents in the study area. As the study focuses on female home-based workers, a direct survey was conducted among women workers. The data collected relates to the socio-economic and work conditions of women workers. The findings reveal that 59.2 percent of the home-based women workers are in the age group 25 to 35 years, and the average wage is low at Rs.164.7 per day, based on a fixed piece rate. Further analysis of the data shows that 35.5 percent of the respondents earn Rs.100 per day, which is significantly below the minimum wage. Therefore, the findings reveal that female home-based workers are subject to multiple forms of exploitation such as low wages, delayed and irregular payments and sporadic work. In conclusion, the researcher states that despite these problems, home-based work is the most suitable avenue for poverty alleviation and employment generation among urban women. However, low wages, lack of micro-capital for entrepreneurial ventures and non-payment of dues on time are serious issues that these workers face

Antimicrobial resistance in bacteria causing ventilator-associated pneumonia in a tertiary care hospital: one year prospective study

Background: Ventilator-associated pneumonia (VAP) is the most common infection diagnosed in intensive care units (ICUs). The causative organisms of VAP vary among different populations and are increasingly associated with resistance against various antimicrobial agents. Objective of current study was to determine the bacteriological etiology of VAP, antimicrobial susceptibility pattern of the isolates and detect the presence of extended-spectrum b-lactamases (ESBL), metallo β-lactamases (MBL) and AmpC b-lactamases in multidrug resistant isolates causing VAP in the medical ICU.Methods: A prospective study was carried out over a year to know the various etiological agents of VAP and their drug susceptibility patterns. ESBL, MBL and AmpC b-lactamases were detected in various isolates by combination disk method, imipenem-EDTA combined disk method and AmpC disk method respectively.Results: The majority of bacterial isolates causing VAP were found to be gram negative bacilli. Acinetobacter spp accounted for 34.28% of VAP cases followed by Pseudomonas aeruginosa which was responsible for 25.71% cases. Other gram negative bacilli isolated were Klebsiella pneumoniae, Citrobacter freundii, Enterobacter spp, and Escherichia coli. Out of the total 70 isolates, 67 (95.7%) were multidrug resistant and not even a single isolate was sensitive to all the drugs tested.Conclusions: Most of the pathogens causing VAP in our institute were multidrug resistant and in many isolates this resistance was due to production of ESBL, MBL, and AmpC β-latamases. Polymixin-B and colistin were found to be highly effective against multidrug resistant Acinetobacter spp and P. aeruginosa.

Derivative moments in turbulent shear flows

We propose a generalized perspective on the behavior of high-order derivative moments in turbulent shear flows by taking account of the roles of small-scale intermittency and mean shear, in addition to the Reynolds number. Two asymptotic regimes are discussed with respect to shear effects. By these means, some existing disagreements on the Reynolds number dependence of derivative moments can be explained. That odd-order moments of transverse velocity derivatives tend not vanish as expected from elementary scaling considerations does not necessarily imply that small-scale anisotropy persists at all Reynolds numbers.Comment: 11 pages, 7 Postscript figure

Analog Computer Simulation of the Runoff Characteristics of an Urban Watershed

In the syntheses of hydrograph characteristics of small urban watersheds, the distribution of water among the various phases of the runoff process is attempted by the concept of equivalent rural watershed. The urban parameters considered in the study are percentage impervious cover and characteristic impervious length factor. A mathematical model is developed for the equivalent rural watershed with precipitation as input. The hydrograph of outflow is obtained by chronologically deducting the losses due to interception, infiltration, and depression storages from precipitation and then routing through the watershed storage. This mathematical procedure is programmed on an analog computer and is tested with data from the Waller Creek watershed, at Austin, Texas. In the verification process, watershed coefficients representing interception, infiltration, and depression storage are established by trial and error such that the simulated and observed hydrographs are nearly identical with a high statistical correlation. Sensitivity studies indicate the relative influence of the watershed coefficients on the runoff process. The watershed coefficients determined by model verification for each year of study are related to corresponding urban parameters

Vitamin D receptor gene polymorphisms and prognosis of breast cancer among African-American and Hispanic women.

BackgroundVitamin D plays a role in cancer development and acts through the vitamin D receptor (VDR). Although African-Americans have the lowest levels of serum vitamin D, there is a dearth of information on VDR gene polymorphisms and breast cancer among African-Americans and Hispanics. This study examines whether VDR gene polymorphisms are associated with breast cancer in these cohorts.MethodsBlood was collected from 232 breast cancer patients (Cases) and 349 non-cancer subjects (Controls). Genotyping for four polymorphic variants of VDR (FokI, BsmI, TaqI and ApaI) was performed using the PCR-RFLP method.ResultsAn increased association of the VDR-Fok1 f allele with breast cancer was observed in African-Americans (OR = 1.9, p = 0.07). Furthermore, the FbTA, FbtA and fbtA haplotypes were associated with breast cancer among African-Americans (p<0.05). Latinas were more likely to have the VDR-ApaI alleles (Aa or aa) (p = 0.008). The VDR-ApaI aa genotype was significantly associated with poorly-differentiated breast tumors (p = 0.04) in combined Cases. Kaplan-Meier survival analysis showed decreased 5-year disease-free-survival (DFS) in breast cancer patients who had the VDR-Fok1 FF genotype (p<0.05). The Cox regression with multivariate analysis revealed the independent predictor value of the VDR-FokI polymorphism for DFS. The other three variants of VDR (BsmI, TaqI and ApaI) were not associated with disease outcome.ConclusionsVDR haplotypes are associated with breast cancer in African-Americans, but not in Hispanic/Latinas. The VDR-FokI FF genotype is linked with poor prognosis in African-American women with breast cancer

Statistical Relationships Between Storm and Urban Watershed Characteristics

Because of the rapid urban development in recent years, hydrologic problems associated with urban watersheds have gained importance. Large sums of money are being spent for the design of urban drainage systems based upon inadequate procedures for predicting peak runoff rates. In this report a procedure is proposed for predicting peak runoff rates from small urban and rural watersheds based upon measurable storm and watersheds characteristics. The technique was tested for a number of runoff events on the Boneyard Creek watershed at Urbana, Illinois, and the results of this test are included. The procedure will be particularly useful for estimating runoff rates from small ungaged drainage areas, and thus will be directly applicable to both design and water management problems