Correlation between ischemic heart disease and coronary atherosclerosis: an autopsy based cross-sectional study in a tertiary care hospital

Background: The most common cause of ischemic heart disease (IHD) is reduced blood flow due to obstructive lesions in the coronary arteries. In adults, IHD associated with coronary atherosclerosis and acquired forms of cardiomyopathy are the most common findings of autopsies. Aim and objectives were to study age and gender related prevalence of IHD in population of Sonepat district of Haryana and its association with coronary atherosclerosis in autopsy cases. Methods: A cross sectional study was conducted from April 2019-March 2020 for a duration of one year on 140 post-mortem heart specimens received in the department of pathology at Bhagat Phool Singh government medical college for Women, Khanpur Kalan, Sonepat, Haryana. Sections from various parts of heart and from three main coronary arteries were processed and examined. Results: In our study, 22 cases (15.71%) of chronic IHD (CIHD) and 7 cases (5%) of myocardial infarction (MI) was observed. The overall prevalence of IHD was 20.7%. All 7 cases (100%) of MI and 95.46% of CIHD revealed atherosclerosis in their coronary arteries. A highly significant statistical correlation was observed between IHD and atherosclerosis p<0.05 (p=0.001). All the cases of MI and 81.82% of CIHD were observed in more than or equal to 40 years age group. Conclusions: The awareness regarding atherosclerosis and various preventive and screening of cardiovascular risk factors should be initiated in young population as early as second decade

Cervical polyp: histomorphological spectrum of ninety-two cases a five-year study

Background: Cervix is vulnerable to many pathological changes ranging from inflammation to malignancy. Cervical polyp is one of the commonest cervical lesion seen in about 2-5% of women. They are more frequent in parous women and are mostly asymptomatic. Symptomatic polyps are frequent in the premenopausal women with most common clinical presentation of AUB(abnormal uterine bleed). Usually they are benign but there are chances of malignant transformation. This study was done to analyse the clinico-pathological spectrum of cervical polyp at a tertiary care institute Methods: A retrospective study was conducted in department of Pathology, BPS GMC for Women Khanpur Kalan, Sonepat over a period of 5 years. All patients who had been diagnosed with cervical polyp clinically and underwent subsequent histopathological sampling were included. Results: A total of 92 cases were included in the study. AUB was the most common clinical presentation of these patients with cervical polyp. Most common age group was 30 to 55 years. Out of 92 cases 47 were of endocervical type polyp, followed by 20 cases of leiomyomatous polypConclusions: To conclude in this study we found that the most common type of cervical polyp is endocervical type. Keeping in view the malignant transformation histopathological sampling of polyp is essential

Factors Important to Older Adults Who Disagree With a Deprescribing Recommendation.

IMPORTANCE Little is known about why older adults decline deprescribing recommendations, primarily because interventional studies rarely capture the reasons. OBJECTIVE To examine factors important to older adults who disagree with a deprescribing recommendation given by a primary care physician to a hypothetical patient experiencing polypharmacy. DESIGN, SETTING, AND PARTICIPANTS This online, vignette-based survey study was conducted from December 1, 2020, to March 31, 2021, with participants 65 years or older in the United Kingdom, the US, Australia, and the Netherlands. The primary outcome of the main study was disagreement with a deprescribing recommendation. A content analysis was subsequently conducted of the free-text reasons provided by participants who strongly disagreed or disagreed with deprescribing. Data were analyzed from August 22, 2022, to February 12, 2023. MAIN OUTCOMES AND MEASURES Attitudes, beliefs, fears, and recommended actions of older adults in response to deprescribing recommendations. RESULTS Of the 899 participants included in the analysis, the mean (SD) age was 71.5 (4.9) years; 456 participants (50.7%) were men. Attitudes, beliefs, and fears reported by participants included doubts about deprescribing (361 [40.2%]), valuing medications (139 [15.5%]), and a preference to avoid change (132 [14.7%]). Valuing medications was reported more commonly among participants who strongly disagreed compared with those who disagreed with deprescribing (48 of 205 [23.4%] vs 91 of 694 [13.1%], respectively; P < .001) or had personal experience with the same medication class as the vignette compared with no experience (93 of 517 [18.0%] vs 46 of 318 [12.1%], respectively; P = .02). Participants shared that improved communication (225 [25.0%]), alternative strategies (138 [15.4%]), and consideration of medication preferences (137 [15.2%]) may increase their agreement with deprescribing. Participants who disagreed compared with those who strongly disagreed were more interested in additional communication (196 [28.2%] vs 29 [14.2%], respectively; P < .001), alternative strategies (117 [16.9%] vs 21 [10.2%], respectively; P = .02), or consideration of medication preferences (122 [17.6%] vs 15 [7.3%], respectively; P < .001). CONCLUSIONS AND RELEVANCE In this survey study, older adults who disagreed with a deprescribing recommendation were more interested in additional communication, alternative strategies, or consideration of medication preferences compared with those who strongly disagreed. These findings suggest that identifying the degree of disagreement with deprescribing could be used to tailor patient-centered communication about deprescribing in older adults

Patient satisfaction for telemedicine health services in the era of COVID-19 pandemic: A systematic review

IntroductionIn the year 2019, the whole world witnessed the COVID-19 pandemic. The pandemic has negatively impacted the health care delivery system. This has risen the necessity among health systems across the world to deliver health care services through telemedicine. This systematic review would assess the level of patient satisfaction with telemedicine health services during the time of the COVID-19 pandemic.MethodologyThe literature search was conducted in June 2022 using “PubMed” “Google Scholar” and “Embase” databases. A total of eight articles were included. ROBVIS Analysis was performed for the assessment of bias. Descriptive statistics were performed using Microsoft Excel.ResultsAll included studies were conducted in seven countries/states/cities: India (n = 2), Philippines (n = 1), Saudi Arabia (n = 1), UAE (n = 1), Los Angeles (n = 1), Iran (n = 1), and New York City (n = 1). Most used telemedicine tools were voice calls, video calls and messaging/email. Maximum patients used video for consultation (5 out of 9 studies) followed by voice call (4 out of 8 studies), messaging/emails (2 out of 8 studies) and other telemedicine Apps (2 out of 8 studies). Overall, the level of satisfaction was found highest amongst studies conducted in developed countries/states/cities such as New York City (94.9%), Los Angeles (82.7%), UAE (81%) and Saudi Arabia (77.9%) in contrast to studies conducted in developing countries which includes Philippines (82%), India (73.9; 51.3%) and Iran (43.4%).ConclusionMost of the participants were found to be satisfied with the quality of telemedicine they were offered. This systematic review will help to improve telemedicine services which will eventually improve the health care delivery system.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/#myprospero

Agro-morphological characterization of lentil germplasm of Indian National Genebank and Development of a core set for efficient utilization in lentil improvement programs

Lentil (Lens culinaris Medik.) is one of the major cool-season pulse crops worldwide. Its increasing demand as a staple pulse has led to the unlocking of diverse germplasm collections conserved in the genebanks to develop its superior varieties. The Indian National Genebank, housed at the Indian Council of Agricultural Research (ICAR)-National Bureau of Plant Genetic Resources, New Delhi, India, currently has 2,324 accessions comprising 1,796 indigenous and 528 exotic collections. This study was conducted to unveil the potential of lentil germplasm by assessing its agro-morphological characteristics and diversity, identifying trait-specific germplasm, and developing a core set. The complete germplasm set was characterized for two years, i.e., 2017-2018 and 2018-2019, and data were recorded on 26 agro-morphological traits. High phenotypic variability was observed for nine quantitative and 17 qualitative traits. A core set comprising 170 accessions (137 Indian and 33 exotic) was derived based on the characterization data as well as geographical origin using a heuristic method and PowerCore software. This core set was found to be sufficiently diverse and representative of the entire collection based on the comparison made using Shannon-Weaver diversity indices and χ2 test. These results were further validated by summary statistics. The core set displayed high genetic diversity as evident from a higher coefficient of variance in comparison to the entire set for individual traits and overall Shannon-Weaver diversity indices (entire: 1.054; core: 1.361). In addition, the total variation explained by the first three principal components was higher in the core set (70.69%) than in the entire collection (68.03%). Further, the conservation of pairwise correlation values among descriptors in the entire and core set reflected the maintenance of the structure of the whole set. Based on the results, this core set is believed to represent the entire collection, completely. Therefore, it constitutes a potential set of germplasm that can be used in the genetic enhancement of lentils

The performance analysis of Miniature finned tube J-T coolers

Joule –Thomson miniature coolers are widely known for his or her immediately cooling characteristics & dependable however simple operation. it has been skilled during the existing have a look at that the fine of the nitrogen gas for the cooler plays an essential position in offering requisite refrigeration within the stipulated time. Further higher ambient strain affects the refrigeration temperature. In this paper, an attempt has been made to examine those influences and feasible rationalization towards the determined performance variation due to those elements

Molecular Insights of MAP4K4 Signaling in Inflammatory and Malignant Diseases

Mitogen-activated protein kinase (MAPK) cascades are crucial in extracellular signal transduction to cellular responses. The classical three-tiered MAPK cascades include signaling through MAP kinase kinase kinase (MAP3K) that activates a MAP kinase kinase (MAP2K), which in turn induces MAPK activation and downstream cellular responses. The upstream activators of MAP3K are often small guanosine-5′-triphosphate (GTP)-binding proteins, but in some pathways, MAP3K can be activated by another kinase, which is known as a MAP kinase kinase kinase kinase (MAP4K). MAP4K4 is one of the widely studied MAP4K members, known to play a significant role in inflammatory, cardiovascular, and malignant diseases. The MAP4K4 signal transduction plays an essential role in cell proliferation, transformation, invasiveness, adhesiveness, inflammation, stress responses, and cell migration. Overexpression of MAP4K4 is frequently reported in many cancers, including glioblastoma, colon, prostate, and pancreatic cancers. Besides its mainstay pro-survival role in various malignancies, MAP4K4 has been implicated in cancer-associated cachexia. In the present review, we discuss the functional role of MAP4K4 in malignant/non-malignant diseases and cancer-associated cachexia and its possible use in targeted therapy

Epidermoid Cyst of Ovary - A Rare Case Report

Epidermoid cyst of ovary represents 1% of all surface epithelial tumors. Though we commonly see follicular cyst, simple serous cyst, hemorrhagic cysts in hysterectomy specimens of post menopausal females, epidermoid cyst is an incidental finding. It is necessary to differentiate epidermoid cyst from dermoid cyst and immature teratoma because of different line of treatment. We here report a case of epidermoid cyst in a 50 years old female who presented with pain in lower abdomen and increased bleeding per vaginum