Endometrial stromal sarcoma together with leiomyosarcoma in a single patient: a rare case report

Uterine sarcomas are relatively rare tumors of mesodermal origin. The three most common histological variants of uterine sarcoma are Leiomyosarcomas, Endometrial stromal sarcomas, and Carcinosarcomas. It is extremely uncommon to find the 2 variants in a single patient. Given the rarity of these tumors there are limited reports in the literature referring to the clinical management and final outcome of these cases. Our patient was a 60 year old post-menopausal women presented in the opd with post-menopausal bleeding. Ultrasound report showed a fibroid of around 8 by 8 cm fundal fibroid. Endometrial biopsy report showed low grade endometrial sarcoma while the CECT report showed leiomyosarcoma creating a dilemma in the diagnosis. Patient was then taken up for surgical exploration. The biopsy report confirmed the existence of both the types of tumor, a very rare finding

Case control study of supervised and unsupervised medical abortion in first trimester of pregnancy

Background: The MTP act of India 1971 provides for the termination of pregnancy up to 20 weeks of gestation, by a registered medical practitioner, provided all the prerequisites are fulfilled. The objective of this study was to conduct case control study of supervised and unsupervised medical abortion in first trimester of pregnancy.Methods: A case control study was conducted with two groups of patients with period of gestation <9 weeks. Case group consist of 30 patients presenting to emergency department with unsupervised intake of medical abortion pill. Control group consist of 30 patients presenting to family planning outpatient department want medical abortion pill under supervision. The main outcome variables were comparison of success rate, failure rate, complications like pain, fever, heavy bleeding, shock, requirement of blood transfusion. Interventions required were compared in both the groups in terms of medical management, surgical evacuation and laparotomy.Results: In our study, the success rate achieved in terms of complete abortion was 66.7% in the supervised and 13.3% in the unsupervised group with (p value <0.001). The complication rate was 60% in the supervised group in contrast to 93.3% in the unsupervised group. 56.7% patients in unsupervised group required blood transfusion which was nil in supervised groups. 71.4% patients in the supervised group did not require intervention. In the unsupervised group, 13.8% required medical management, 65.5% required surgical evacuation and 6.7% had to undergo laparotomy for ectopic pregnancy.Conclusions: In present study we conclude that first trimester medical abortion under supervision is more effective, safe and convenient as compared to unsupervised medical abortion. We recommend that government must stop over the counter sell of medical abortion pills

A rare case of myiasis in a woman with genital prolapse

Myiasis is an infestation by dipterous larva that thrives on host’s living or necrotic tissue and cause massive tissue infection. We present a case of myiasis in a 65-year-old multiparous lady with procidentia. Her examination revealed a big excavatory ulcer on dependent part and cervix indwelled with maggots. About 40 to 50 such maggots were subsequently manually removed with a forceps. After conservative management, definitive surgical treatment for prolapsed uterus was done after healing of the ulcer, within three months. It is a very rare case as only a few reports have been previously published in literature

Ruptured caesarean scar ectopic pregnancy: a rare case report

Caesarean scar pregnancy is a rare type of ectopic pregnancy. Little is known about its incidence and natural history. With increasing incidence of caesarean section worldwide, more and more cases are diagnosed and reported.  We report a case of caesarean scar site ruptured ectopic pregnancy presented to emergency department with hypovolemic shock. Decision for emergency laparotomy was taken on the basis of clinical findings and ultrasonography. Hemoperitoneum of 2 litres with scar site rupture ectopic was seen. Evacuation of products along with repair of uterus in 2 layers with bilateral tubal ligation was done. It is the rarest kind of ectopic pregnancy and may lead to severe life threatening complications such as uterine rupture and severe hemorrhage or may have adverse effect on future fertility.

Primary lymphoepithelioma-like carcinoma of the lung in an adolescent girl with unusual presentation

Primary lymphoepithelioma-like carcinoma (LELC) of lung is a rare tumour of lung mostly reported from south-east Asia. It occurs in middle aged persons of either sex and presents with the complaint of cough and haemoptysis.  We report a case of primary LELC of lung in a young girl with unusual presentation

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

A communal catalogue reveals Earth's multiscale microbial diversity

Our growing awareness of the microbial world's importance and diversity contrasts starkly with our limited understanding of its fundamental structure. Despite recent advances in DNA sequencing, a lack of standardized protocols and common analytical frameworks impedes comparisons among studies, hindering the development of global inferences about microbial life on Earth. Here we present a meta-analysis of microbial community samples collected by hundreds of researchers for the Earth Microbiome Project. Coordinated protocols and new analytical methods, particularly the use of exact sequences instead of clustered operational taxonomic units, enable bacterial and archaeal ribosomal RNA gene sequences to be followed across multiple studies and allow us to explore patterns of diversity at an unprecedented scale. The result is both a reference database giving global context to DNA sequence data and a framework for incorporating data from future studies, fostering increasingly complete characterization of Earth's microbial diversity.Peer reviewe

A communal catalogue reveals Earth’s multiscale microbial diversity

Our growing awareness of the microbial world’s importance and diversity contrasts starkly with our limited understanding of its fundamental structure. Despite recent advances in DNA sequencing, a lack of standardized protocols and common analytical frameworks impedes comparisons among studies, hindering the development of global inferences about microbial life on Earth. Here we present a meta-analysis of microbial community samples collected by hundreds of researchers for the Earth Microbiome Project. Coordinated protocols and new analytical methods, particularly the use of exact sequences instead of clustered operational taxonomic units, enable bacterial and archaeal ribosomal RNA gene sequences to be followed across multiple studies and allow us to explore patterns of diversity at an unprecedented scale. The result is both a reference database giving global context to DNA sequence data and a framework for incorporating data from future studies, fostering increasingly complete characterization of Earth’s microbial diversity

Rare coding variants in PLCG2, ABI3, and TREM2 implicate microglial-mediated innate immunity in Alzheimer's disease

We identified rare coding variants associated with Alzheimer’s disease (AD) in a 3-stage case-control study of 85,133 subjects. In stage 1, 34,174 samples were genotyped using a whole-exome microarray. In stage 2, we tested associated variants (P<1×10-4) in 35,962 independent samples using de novo genotyping and imputed genotypes. In stage 3, an additional 14,997 samples were used to test the most significant stage 2 associations (P<5×10-8) using imputed genotypes. We observed 3 novel genome-wide significant (GWS) AD associated non-synonymous variants; a protective variant in PLCG2 (rs72824905/p.P522R, P=5.38×10-10, OR=0.68, MAFcases=0.0059, MAFcontrols=0.0093), a risk variant in ABI3 (rs616338/p.S209F, P=4.56×10-10, OR=1.43, MAFcases=0.011, MAFcontrols=0.008), and a novel GWS variant in TREM2 (rs143332484/p.R62H, P=1.55×10-14, OR=1.67, MAFcases=0.0143, MAFcontrols=0.0089), a known AD susceptibility gene. These protein-coding changes are in genes highly expressed in microglia and highlight an immune-related protein-protein interaction network enriched for previously identified AD risk genes. These genetic findings provide additional evidence that the microglia-mediated innate immune response contributes directly to AD development

Mitochondrial physiology

As the knowledge base and importance of mitochondrial physiology to evolution, health and disease expands, the necessity for harmonizing the terminology concerning mitochondrial respiratory states and rates has become increasingly apparent. The chemiosmotic theory establishes the mechanism of energy transformation and coupling in oxidative phosphorylation. The unifying concept of the protonmotive force provides the framework for developing a consistent theoretical foundation of mitochondrial physiology and bioenergetics. We follow the latest SI guidelines and those of the International Union of Pure and Applied Chemistry (IUPAC) on terminology in physical chemistry, extended by considerations of open systems and thermodynamics of irreversible processes. The concept-driven constructive terminology incorporates the meaning of each quantity and aligns concepts and symbols with the nomenclature of classical bioenergetics. We endeavour to provide a balanced view of mitochondrial respiratory control and a critical discussion on reporting data of mitochondrial respiration in terms of metabolic flows and fluxes. Uniform standards for evaluation of respiratory states and rates will ultimately contribute to reproducibility between laboratories and thus support the development of data repositories of mitochondrial respiratory function in species, tissues, and cells. Clarity of concept and consistency of nomenclature facilitate effective transdisciplinary communication, education, and ultimately further discovery