Papillary cystic acinic cell carcinoma: report of a rare lesion with unusual presentation

Introduction: Acinic cell carcinoma is an uncommon low grade tumour of the salivary glands that constitutes 2.5 to 4% of parotid gland tumours. Acinic cell carcinoma -Papillary cystic variant (ACC-PCV) is histologically composed of tumor with papillary and cystic growth patterns, with varying proportions of one or more cell types. It has been conferred significance because it has a poorer prognosis and is reported to be universally fatal in ten years. Case Report: We present a case of ACC-PCV in a sixteen year old male with unusual unicystic gross appearance, benign cytological picture and characteristic histopathological features .Cystic areas with papillary projection of surrounding cells showing characteristic tombstone or hobnail arrangements were seen. Discussion: The histogenesis and myriad architectural and cellular variations of ACC-PCV have been discussed along with its variegated cytomorphology which may lead to pitfalls in cytodiagnosis. The tumor may pose difficulty in histodiagnosis due to its resemblance to papillary carcinoma of the thyroi

(5,7-Dimethyl-2-oxo-2H-chromen-4-yl)methyl diethyl­dithio­carbamate

In the title compound, C17H21NO2S2, the coumarin ring system is nearly planar, with a maximum deviation of 0.080 (2) Å from the mean plane. An intra­molecular C—H⋯S hydrogen bond occurs. The crystal structure features C—H⋯S hydrogen bonds and weak π–π inter­actions with a centroid–centroid distance of 3.679 (1) Å

Bis[N,N-dimethyl-1-(10H-pyrido[3,2-b][1,4]benzothia­zin-10-yl)propan-2-aminium] tetrakis­(thio­cyanato-κN)cobaltate(II)

The asymmetric unit of the title salt, (C16H20N3S)2[Co(NCS)4], comprises one monovalent isothio­pendylium cation and one-half of a divalent thio­cyanatocobaltate(II) anion (2 symmetry). The central thia­zine ring of the cation is slightly twisted in a boat-like fashion, with r.m.s. deviations from the mean plane of 0.272 (1) and 0.2852 (8) Å for the N and S atoms. The mol­ecular structure of the cation is stabilized by an intra­molecular N—H⋯N hydrogen bond. Within the complex anion, the CoII atom is tetra­hedrally surrounded by four N atoms of the thio­cyanate ligands. π–π stacking, with a distance of 3.7615 (10) Å between the centroids of benzene and pyridine rings, helps to consolidate the packing

Inducing remission of Type 2 diabetes in the Caribbean: findings from a mixed methods feasibility study of a low-calorie liquid diet-based intervention in Barbados.

AIM: In a high proportion of people with recently diagnosed Type 2 diabetes, a short (2-3-month) low-calorie diet is able to restore normal glucose and insulin metabolism. The aim of this study was to determine the feasibility of this approach in Barbados. METHODS: Twenty-five individuals with Type 2 diabetes diagnosed within past 6 years, not on insulin, BMI ≥ 27 kg/m2 were recruited. Hypoglycaemic medication was stopped on commencement of the 8-week liquid (760 calorie) diet. Insulin response was assessed in meal tests at baseline, 8 weeks and 8 months. Semi-structured interviews, analysed thematically, explored participants' experiences. 'Responders' were those with fasting plasma glucose (FPG) < 7 mmol/l at 8 weeks. RESULTS: Ten men and 15 women (mean age 48, range 26-68 years) participated. Mean (sd) BMI was 34.2 kg/m2 (6.0); FPG 9.2 mmol/l (2.2). Mean weight loss at 8 weeks and 8 months was 10.1 kg [95% confidence interval (CI) 8.1, 12.0] and 8.2 kg (95% CI 5.8, 10.6); FPG was lower by 2.2 mmol/l (95% CI 1.2, 3.2) and 1.7 mmol/l (95% CI 0.8, 2.7) respectively. Nine of 11 (82%) of those who lost ≥ 10 kg were 'responders' compared with 6 of 14 (43%) who lost < 10 kg (P = 0.048). The 30-min insulin increment was higher in responders at baseline and follow-up (P ≤ 0.01). A food culture based on starchy foods and pressures to eat large amounts at social events were among the challenges identified by participants. CONCLUSIONS: The feasibility of this approach to weight loss and diabetes remission in a predominantly black population in Barbados was demonstrated

Feasibility of store-and-forward teledermatology in out-patient care: A prospective study from rural India utilising specialist referral services through an instant messaging platform - "WhatsApp"

Objectives: The COVID-19 pandemic has placed unprecedented demands on the delivery of health care in rural areas of India. We examined the feasibility of store-and-forward mobile teledermatology for outpatient access to specialist dermatologic care in underserved areas in India. Methods: We conducted a prospective study using smartphone-based teledermatology, connecting six underserved clinics manned by primary care physicians (PCP) to three dermatologists, using the instant messaging platform WhatsApp. We assessed the concordance between PCPs and dermatologists (using prevalence adjusted bias adjusted kappa), consultation time, the spectrum of conditions, and the outcome. Results: Of the 730 dermatology patients screened in the clinics, 95 (13%) (36 males and 59 females) required teleconsultation, among which 61.1% were non-infective, 34.7% were infective, and the diagnosis could not be ascertained in 4.2 %. The mean time taken for the first response was 13.5\ub118.4 minutes. Twenty per cent (n=19) required referral, and 80% (n=76) of consultations could be resolved at the clinic, of whom 36.8 % were cured, 38.2% had moderate, 4% had minimal improvement, 13% were lost to follow-up, and 8% refused treatment. Cure was observed in viral infections and eczema. The diagnostic concordance ranged from low values [0.38 (95% CI: 0-0.68)] in infective to moderate [0.66 (95% CI: 0.42 -0.83), p=0.033] in non-infective disorders. Conclusion: Asynchronous mobile teledermatology, using specialist referral via instant messaging platforms, is a powerful modality for providing real-time dermatologic care, while offering a very promising alternative for decreasing healthcare disparities and continuity of services even in adverse situations like the Covid-19 pandemic

Expression profile of microRNAs in young stroke patients

10.1371/journal.pone.0007689PLoS ONE41

Leukocyte ADAM17 Regulates Acute Pulmonary Inflammation

The transmembrane protease ADAM17 regulates the release and density of various leukocyte cell surface proteins that modulate inflammation, including L-selectin, TNF-α, and IL-6R. At this time, its in vivo substrates and role in pulmonary inflammation have not been directly examined. Using conditional ADAM17 knock-out mice, we investigated leukocyte ADAM17 in acute lung inflammation. Alveolar TNF-α levels were significantly reduced (>95%) in ADAM17-null mice following LPS administration, as was the shedding of L-selectin, a neutrophil-expressed adhesion molecule. Alveolar IL-6R levels, however, were reduced by only ≈25% in ADAM17-null mice, indicating that ADAM17 is not its primary sheddase in our model. Neutrophil infiltration into the alveolar compartment is a key event in the pathophysiology of acute airway inflammation. Following LPS inhalation, alveolar neutrophil levels and lung inflammation in ADAM17-null mice were overall reduced when compared to control mice. Interestingly, however, neutrophil recruitment to the alveolar compartment occurred earlier in ADAM17-null mice after exposure to LPS. This decrease in alveolar neutrophil recruitment in ADAM17-null mice was accompanied by significantly diminished alveolar levels of the neutrophil-tropic chemokines CXCL1 and CXCL5. Altogether, our study suggests that leukocyte ADAM17 promotes inflammation in the lung, and thus this sheddase may be a potential target in the design of pharmacologic therapies for acute lung injury