The Netflix Obsession

This paper investigates how long it would take an individual to watch all newly added movies and documentaries to the UK Netflix in 2017, whilst maintaining normal daily activities which include eating, sleeping and drinking. For the purposes of this investigation it was assumed the individual had no other commitments apart from watching Netflix. It was calculated that an individual would require 236.5 days to watch all newly added movies and documentaries in 2017

How much comfort can you get from a chocolate bar?

The purpose of this paper was to explore a hypothetical experiment to identify a correlation between the change in blood serotonin levels and mood in an individual after a fixed quantity of chocolate is ingested. Blood levels would be taken 0, 1 and 2 hours and expressed as nano-grams per millilitres (ng/ml) of serotonin. Mood changes would be assessed using the Bond-Lader Visual Analogue Scales

Analysis of spectrum of ovarian tumours: a study of 55 cases

Background: Malignant epithelial tumours are the most common ovarian cancers and also the most lethal gynaecological malignancies. This study was undertaken to analyse histomorphological spectrum and clinicopathological correlation of ovarian tumours.Methods: This retrospective study was done for the period of one year at Department of Pathology, New Civil Hospital, Surat, which is a tertiary health care center. Here we studied 55 cases of ovarian mass received in formalin, which were subjected to histopathological examination and immunohistochemistry as and when required.Results: In total, 55 ovarian tumour specimens were examined. Out of which 28 cases (51%) were benign, 3 cases (5%) were borderline and 24 cases (44%) were malignant. Most common histological type was surface epithelial tumours (60%) followed by germ cell tumours (13%). The commonest benign tumour was mucinous cystadenoma and commonest malignant tumour was serous adenocarcinoma. Malignancy was quite common in ovarian masses in our institute.Conclusions: Ovarian tumours are quite common in our set up and epithelial tumours are the commonest variety of ovarian tumours. The histological type of ovarian tumour correlates with the prognosis of the tumour.

Role of immunohistochemistry in the differential diagnosis of malignant small round cell tumor: a study of 38 cases

Background: : Immunohistochemistry play a very important role in modern surgical pathology especially for identification of tumors lacking the evidence of lineage differentiation on the basis of routine Hematoxylin and Eosin (H&E) stain alone. More than 90% of the tumor with diagnostic difficulties by routine H & E stain could be very well classified by using IHC. The aim of present study is to classify and identify MSRCT.Methods: The study was carried out in Department of Pathology, Government Medical College in a period from August 2008 to November 2011. Total 38 cases of MSRCT are selected for Immunohistochemical staining (IHC) and they are classified and categorized accordingly after IHC.Results: Out of 38 cases of  MSRCT, there are 18 cases (47.36%) of non-Hodgkin lymphoma, 3 (7.89%) cases of Neuroblastoma,  3 (7.89%) cases of Synovial Sarcoma, 2 (5.26%) cases of Ewing Sarcoma, 2 (5.26%) cases of Undifferentiated neuroendocrine carcinoma,  2 (5.26%) case of Desmoplastic Small Round Cell Tumor, 1 (2.63%) case of  Primitive Neuroectodermal Tumor, 1 (2.63%) case of Amelanotic Melanoma (Small cell variant), 1 (2.63%)  case of  Anaplastic Dysgerminoma, 1 (2.63%)  case of Osteosarcoma, 1 (2.63 %) case of Wilm's tumor, 1 (2.63%)  case of  Dendritic cell Tumor Testis, 1 (2.63%) case of Undifferentiated Nasopharyngeal Carcinoma, 1 (2.63%) case of  Embryonal rhabdomyosarcoma.Conclusions: IHC is very valuable tool for adequate and accurate categorization of MSRCT.

Shifting trends of lung tumours and its diagnosis by lung biopsy: a study of 78 cases

Background: The objective of the study was to study the spectrum of pathological lesions in patients with lung mass and to study correlation between clinical findings, histopathological pattern and immunohistochemical stains in various biopsy specimen for differentiation and typing of tumors.Methods: This retrospective study was done for the period of three years at Department of Pathology, New Civil Hospital, Surat, India, which is a tertiary health care Centre. Here we studied 78 cases of lung biopsy received in formalin, which were subjected to histopathological examination. Immunohistochemistry was performed as and when required.Results: Total 78 lung biopsy specimens were examined. Out of which, 59 cases (75.6%) were neoplastic, 12 cases(15.4%) were non-neoplastic and 7 cases (9%) were inconclusive. The commonest histological type of malignancy was adenocarcinoma which is associated with peripheral mass lesion, female gender and in non-smokers. Commonest non-neoplastic lesion was tuberculosis.  Malignancy was seen quite common in patients presented with lung masses in our institute.Conclusions: Lung tumours are quite common in patients presented with mass lesion. Similar to global trend, adenocarcinoma is the commonest histological type now and associated with change in incidence among women, in non-smokers, molecular alteration and prognosis which need further investigation. Immunohistochemistry is helpful in cases which are not accurately subtyped by histomorphology alone.

A novel use of EP catheter in extraction of trapped intracardiac devices: Two case reports

The decision to retrieve chronically implanted abandoned leads and trapped intracardiac devices percutaneously has been difficult and highly controversial. We present two case reports in which electrophysiological ablation catheter was used to retrieve infected abandoned pacemaker lead and trapped permacatheter (permacath) in right ventricle. We could avert major cardiovascular surgeries in both the patients by simply modifying the traditionally used techniques for extraction of intracardiac devices

Management of coronary disease in patients with advanced kidney disease

BACKGROUND Clinical trials that have assessed the effect of revascularization in patients with stable coronary disease have routinely excluded those with advanced chronic kidney disease. METHODS We randomly assigned 777 patients with advanced kidney disease and moderate or severe ischemia on stress testing to be treated with an initial invasive strategy consisting of coronary angiography and revascularization (if appropriate) added to medical therapy or an initial conservative strategy consisting of medical therapy alone and angiography reserved for those in whom medical therapy had failed. The primary outcome was a composite of death or nonfatal myocardial infarction. A key secondary outcome was a composite of death, nonfatal myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest. RESULTS At a median follow-up of 2.2 years, a primary outcome event had occurred in 123 patients in the invasive-strategy group and in 129 patients in the conservative-strategy group (estimated 3-year event rate, 36.4% vs. 36.7%; adjusted hazard ratio, 1.01; 95% confidence interval [CI], 0.79 to 1.29; P=0.95). Results for the key secondary outcome were similar (38.5% vs. 39.7%; hazard ratio, 1.01; 95% CI, 0.79 to 1.29). The invasive strategy was associated with a higher incidence of stroke than the conservative strategy (hazard ratio, 3.76; 95% CI, 1.52 to 9.32; P=0.004) and with a higher incidence of death or initiation of dialysis (hazard ratio, 1.48; 95% CI, 1.04 to 2.11; P=0.03). CONCLUSIONS Among patients with stable coronary disease, advanced chronic kidney disease, and moderate or severe ischemia, we did not find evidence that an initial invasive strategy, as compared with an initial conservative strategy, reduced the risk of death or nonfatal myocardial infarction

Health status after invasive or conservative care in coronary and advanced kidney disease

BACKGROUND In the ISCHEMIA-CKD trial, the primary analysis showed no significant difference in the risk of death or myocardial infarction with initial angiography and revascularization plus guideline-based medical therapy (invasive strategy) as compared with guideline-based medical therapy alone (conservative strategy) in participants with stable ischemic heart disease, moderate or severe ischemia, and advanced chronic kidney disease (an estimated glomerular filtration rate of <30 ml per minute per 1.73 m2 or receipt of dialysis). A secondary objective of the trial was to assess angina-related health status. METHODS We assessed health status with the Seattle Angina Questionnaire (SAQ) before randomization and at 1.5, 3, and 6 months and every 6 months thereafter. The primary outcome of this analysis was the SAQ Summary score (ranging from 0 to 100, with higher scores indicating less frequent angina and better function and quality of life). Mixed-effects cumulative probability models within a Bayesian framework were used to estimate the treatment effect with the invasive strategy. RESULTS Health status was assessed in 705 of 777 participants. Nearly half the participants (49%) had had no angina during the month before randomization. At 3 months, the estimated mean difference between the invasive-strategy group and the conservative-strategy group in the SAQ Summary score was 2.1 points (95% credible interval, 120.4 to 4.6), a result that favored the invasive strategy. The mean difference in score at 3 months was largest among participants with daily or weekly angina at baseline (10.1 points; 95% credible interval, 0.0 to 19.9), smaller among those with monthly angina at baseline (2.2 points; 95% credible interval, 122.0 to 6.2), and nearly absent among those without angina at baseline (0.6 points; 95% credible interval, 121.9 to 3.3). By 6 months, the between-group difference in the overall trial population was attenuated (0.5 points; 95% credible interval, 122.2 to 3.4). CONCLUSIONS Participants with stable ischemic heart disease, moderate or severe ischemia, and advanced chronic kidney disease did not have substantial or sustained benefits with regard to angina-related health status with an initially invasive strategy as compared with a conservative strategy