Ultrasound guided fine needle aspiration cytology in deep seated lesions: an effective diagnostic tool

Background: Fine needle aspiration cytology (FNAC) is a diagnostic method used to assess various masses in the body with minimal invasion. FNAC alone has a lower yield as compared to biopsy for diagnosing deep-seated lesions. Radiological guidance improves the yield of FNAC. The aim of the study was to evaluate the diagnostic efficacy of Ultrasound (USG) guided FNAC in various deep-seated lesions in the body. We conducted a cross-sectional analytical study at the cytology section of pathology department of our hospital for indoor patients.Methods: It was a retrospective study done over a period of five years, which included 334 aspirates suspected to be of inflammatory or neoplastic origin obtained from deep-seated lesions. After a thorough clinical and radiological evaluation, USG guided FNACs were performed. Experienced pathologists processed the smears, prepared thereby, for cytological evaluation and diagnosis.Results: A total of 334 samples were collected using USG-guided FNAC. The most common site was lungs (36.5%) followed by liver (13.77%). The most common type were malignant lesions (57.19%) which were either primary malignancies or metastatic carcinomas. 29 samples were found to be acellular or had inadequate material, thus a diagnosis couldn’t be made. Out of the various lung masses, non-small cell carcinoma was the most common (66.39%). The most common liver mass was metastatic carcinoma (54.35%).Conclusions: USG guided FNAC is a relatively simple, safe, fast, minimally invasive and cost effective procedure, which provides quite a high rate of adequacy and diagnostic efficacy. It is useful for making a pre-operative diagnosis and guiding the choice of treatment.

Slum Health: From Understanding to Action

The defining physical and legal characteristics of slums profoundly affect the health of these communities and may also serve as potential targets for immediate intervention

Guidelines for Diagnosis and Management of Infective Endocarditis in Adults: A WikiGuidelines Group Consensus Statement.

IMPORTANCE Practice guidelines often provide recommendations in which the strength of the recommendation is dissociated from the quality of the evidence. OBJECTIVE To create a clinical guideline for the diagnosis and management of adult bacterial infective endocarditis (IE) that addresses the gap between the evidence and recommendation strength. EVIDENCE REVIEW This consensus statement and systematic review applied an approach previously established by the WikiGuidelines Group to construct collaborative clinical guidelines. In April 2022 a call to new and existing members was released electronically (social media and email) for the next WikiGuidelines topic, and subsequently, topics and questions related to the diagnosis and management of adult bacterial IE were crowdsourced and prioritized by vote. For each topic, PubMed literature searches were conducted including all years and languages. Evidence was reported according to the WikiGuidelines charter: clear recommendations were established only when reproducible, prospective, controlled studies provided hypothesis-confirming evidence. In the absence of such data, clinical reviews were crafted discussing the risks and benefits of different approaches. FINDINGS A total of 51 members from 10 countries reviewed 587 articles and submitted information relevant to 4 sections: establishing the diagnosis of IE (9 questions); multidisciplinary IE teams (1 question); prophylaxis (2 questions); and treatment (5 questions). Of 17 unique questions, a clear recommendation could only be provided for 1 question: 3 randomized clinical trials have established that oral transitional therapy is at least as effective as intravenous (IV)-only therapy for the treatment of IE. Clinical reviews were generated for the remaining questions. CONCLUSIONS AND RELEVANCE In this consensus statement that applied the WikiGuideline method for clinical guideline development, oral transitional therapy was at least as effective as IV-only therapy for the treatment of IE. Several randomized clinical trials are underway to inform other areas of practice, and further research is needed

Regenerative Early Educational Facility for Underrepresented Children in Pratiksha Nagar, Mumbai

Thesis (Master's)--University of Washington, 2016-12Children of all age, class, sex and region deserve an equal opportunity to good quality education. Research shows that investing in early education reaps long term socio-economic benefits for a country. This makes early education all the more important for sub-developed countries. Studies show that the primary reason for high drop-out rate in India is due to the lack of good quality educational facilities for the lower income groups. This thesis studies an existing not-for-profit educational facility, working towards providing equal opportunities for low-income group families of the nearby informal settlements. While the social impact is large, due to shortage on space, the outreach has plateaued. This calls for a need to grow in size and quality, to match the ever-growing demand for services and psychological needs of its users. The physical environment of a learning space has an impact on students’ achievements. This thesis questions ‘what makes good quality educational facilities in sub-developed countries’ and through travel research in India and South-East Asia, charts out factors that contribute to making successful spaces for children. Using these factors as core requirement, the design approach involves a back and forth process between psychological, cultural, social, economic and environmental considerations. It strives to be regenerative not just in terms of green building technologies but also in terms of regenerating the social standing of its occupants

MCK1 is a novel regulator of myo-inositol phosphate synthase (MIPS) that is required for inhibition of inositol synthesis by the mood stabilizer valproate.

Myo-inositol, the precursor of all inositol compounds, is essential for the viability of eukaryotes. Identifying the factors that regulate inositol homeostasis is of obvious importance to understanding cell function and the pathologies underlying neurological and metabolic resulting from perturbation of inositol metabolism. The current study identifies Mck1, a GSK3 homolog, as a novel positive regulator of inositol de novo synthesis in yeast. Mck1 was required for normal activity of myo-inositol phosphate synthase (MIPS), which catalyzes the rate-limiting step of inositol synthesis. mck1Δ cells exhibited a 50% decrease in MIPS activity and a decreased rate of incorporation of [13C6]glucose into [13C6]-inositol-3-phosphate and [13C6]-inositol compared to WT cells. mck1Δ cells also exhibited decreased growth in the presence of the inositol depleting drug valproate (VPA), which was rescued by supplementation of inositol. However, in contrast to wild type cells, which exhibited more than a 40% decrease in MIPS activity in the presence of VPA, the drug did not significantly decrease MIPS activity in mck1Δ cells. These findings indicate that VPA-induced MIPS inhibition is Mck1-dependent, and suggest a model that unifies two current hypotheses of the mechanism of action of VPA-inositol depletion and GSK3 inhibition

Rate of synthesis of inositol-3-phosphate and inositol is decreased in <i>mck1Δ</i> cells.

<p>Cells were cultured in SC medium supplemented with 75 M inositol to the mid log phase and transferred to SC inositol free medium for 3 h. [¹³C₆]glucose was added at a final concentration of 0.2% and cells were incubated for 15 min. Levels of ¹³C labeled inositol-3-phosphate (A) and inositol (B) in cell extracts were determined by LC-MS (6 independent experiments). Values shown are mean ± SEM.</p

Rate of inositol synthesis

Fig. 2<div>Cells were cultured in SC medium supplemented with 75 M inositol to the mid log phase and transferred to SC inositol free medium for 3 h. [¹³C₆]glucose was added at a final concentration of 0.2% and cells were incubated for 15 min. Levels of ¹³C labeled inositol-3-phosphate (A) and inositol (B) in cell extracts were determined by LC-MS.<br></div