Idiopathic arterial calcification of infancy : a case report

Idiopathic arterial calcification of infancy is a rare condition characterized by extensive calcification and stenosis of large and medium sized arteries. A ten day old female baby developed sudden shortness of breath and was treated with oxygen and antibiotics. Antenatal echocardiography showed calcification of the aorta and pulmonary arteries. Autopsy examination revealed extensive calcification in the walls of major arteries and vessels of several organs. The baby was found to have a karyotype of 47 chromosomes.peer-reviewe

Outcome of combination of methods of educational interventions in physiology for first-year MBBS students

Background: This comparative, before and after study (without controls) was conducted in a municipal medical college to compare the cognitive domain scores obtained by first-year MBBS students after didactic lectures with that obtained after an educational intervention that combined integrated teaching with clinical scenarios.Methods: After obtaining prior permissions, the purpose of the study was explained to first-year MBBS students and written informed consent was obtained. After attending curriculum-based didactic lectures on the alimentary system, the students (n=62, females: n=29, 46.77% and males: n=33, 53.23%) took a pre-test comprising ten questions (total 20 marks). After the pre-test, the participants attended an educational intervention that combined integrated teaching with clinical scenarios on the same topic. Subsequently, the post-test was administered using a questionnaire that was identical to that of the pre-test.Results: The mean overall marks obtained in the pre-test was 14.73±1.87 (95% CI: 14.26-15.19), while that obtained in the post-test was 17.16±1.73 (95% CI: 16.73-17.59), exhibiting highly significant (p <0.00001) difference. The gender difference in scores was significant (p=0.011) for only question no. 1 in the pre-test and there was no significant gender difference in the post-test.Conclusions: A combined method of educational intervention was found to enhance the cognitive domain scores of students. Though a larger study would be needed to generalize the findings, male students seem to need an additional educational intervention to improve their cognitive domain scores. Despite time limitations in the teaching schedule for the first-year MBBS course, integrated teaching with case scenarios can be implemented to impart early clinical exposure

Analysis of MUC4 expression in the prostatic adenocarcinoma and its pathological implications

Background: Expression of various types of mucins has been documented in several malignancies and seems to play a sentinel role in some epithelial malignancies. MUC1 and MUC4 are two transmembrane mucins that are involved in cell signalling events that drive the proliferation of cells. Therefore, mucins may be important biomarkers for early diagnosis and targeted therapy due to their frequently altered expression pattern in carcinomas. The objective of the study was to determine the expression pattern of MUC-4 in prostate cancer and to correlate the expression with clinicopathological parameters.Methods: Thirty cases of prostate carcinomas of different grades were selected from the case files of our institute for the study. Immunohistochemistry was done on all cases using monoclonal antibodies against MUC- 4 by the avidin biotin technique. The expression and pattern of staining were analyzed .Staining pattern in the adjacent benign areas were also noted.Results: Our study showed that expression of MUC4 was considerably down regulated in prostate cancer tissues when compared to normal or benign prostatic tissue. Few cases of prostate cancer showed a moderate staining while majority cases of adjacent normal areas were moderate to strongly positivity.Conclusions: The results of our study implies that MUC4 is down regulated in prostate cancer and this may be of significance for diagnostic application and tumor progression in prostate cancer. Since MUC4 is known to modulate HER2/ErbB2 signalling it may prospectively prove to be useful in prostate cancer therapy

Exploring evidence-policy linkages in health research plans: A case study from six countries

The complex evidence-policy interface in low and middle income country settings is receiving increasing attention. Future Health Systems (FHS): Innovations for Equity, is a research consortium conducting health systems explorations in six Asian and African countries: Bangladesh, India, China, Afghanistan, Uganda, and Nigeria. The cross-country research consortium provides a unique opportunity to explore the research-policy interface. Three key activities were undertaken during the initial phase of this five-year project. First, key considerations in strengthening evidence-policy linkages in health system research were developed by FHS researchers through workshops and electronic communications. Four key considerations in strengthening evidence-policy linkages are postulated: development context; research characteristics; decision-making processes; and stakeholder engagement. Second, these four considerations were applied to research proposals in each of the six countries to highlight features in the research plans that potentially strengthen the research-policy interface and opportunities for improvement. Finally, the utility of the approach for setting research priorities in health policy and systems research was reflected upon. These three activities yielded interesting findings. First, developmental consideration with four dimensions – poverty, vulnerabilities, capabilities, and health shocks – provides an entry point in examining research-policy interfaces in the six settings. Second, research plans focused upon on the ground realities in specific countries strengthens the interface. Third, focusing on research prioritized by decision-makers, within a politicized health arena, enhances chances of research influencing action. Lastly, early and continued engagement of multiple stakeholders, from local to national levels, is conducive to enhanced communication at the interface. The approach described has four main utilities: first, systematic analyses of research proposals using key considerations ensure such issues are incorporated into research proposals; second, the exact meaning, significance, and inter-relatedness of these considerations can be explored within the research itself; third, cross-country learning can be enhanced; and finally, translation of evidence into action may be facilitated. Health systems research proposals in low and middle income countries should include reflection on transferring research findings into policy. Such deliberations may be informed by employing the four key considerations suggested in this paper in analyzing research proposals

Epstein-Barr virus positive B-cell lymphoproliferative disorder/polymorphous B-cell lymphoma of the urinary bladder: A case report with review of literature

We report an unusual case of a localized Epstein-Barr virus (EBV)-positive B cell lymphoproliferative disorder (LPD)/polymorphous B cell lymphoma of the urinary bladder in a 67 years old female patient. She had no known predisposing immunodeficiencies and presented with recent onset of hematuria. The CT and cystoscopic examination revealed a localized 2.5 cm polypoid or plaque-like mucosal mass on the right posterior and lateral wall of the bladder. The biopsy sample showed a diffuse and densely polymorphous atypical lymphoid infiltrate admixed with numerous small lymphocytes, histiocytes and occasional plasma cells and neutrophils. The large atypical cells were CD20+, CD79a+, CD30+, CD43+ and they were strongly positive for EBV by in situ hybridization using anti-EBER-1 probe. Polymerase chain reaction (PCR) for immunoglobulin heavy chain gene rearrangement study showed a clonal gene rearrangement. The findings indicated EBV+LPD of the bladder. Primary lymphoma of bladder is rare and primary EBV+LPD of the bladder has not been previously described. Potential misdiagnosis of poorly differentiated urothelial carcinoma can occur and accurate diagnosis depends on comprehensive immunohistochemical and molecular workups

Morphology to morphometry in cytological evaluation of thyroid lesions

Aim: To evaluate the cytomorphometric features in fine needle aspiration cytology (FNAC) of thyroid lesions. Materials and Methods: FNAC of 36 thyroid cases was reviewed. The study included 10 cases each of follicular lesion, adenomatous goiter, papillary carcinoma, 4 cases of medullary carcinoma and 2 cases of anaplastic carcinoma. Their ages ranged from 28 to 50 years, and there were nine females and one male. Morphometric analysis was done on aspiration smears from 36 thyroid lesions. Hematoxylin and Eosin stained smears were examined using image analyzer Proplus V software. Morphological parameters measured included mean nuclear diameter, mean nuclear perimeter, mean nuclear area, circular rate, largest to smallest dimension ratio (LS ratio) and coefficient of variation of nuclear area (NACV). Statistical Analysis: Statistical evaluation was carried out using the analysis of variance (ANOVA) test for the five variables, both within the group and in between the groups. The result was considered significant when P < 0.05. Results: The follicular carcinomas had higher LS ratio than patients with adenomatous goiters. Mean nuclear diameter and the mean nuclear perimeter were higher in anaplastic carcinomas when compared to other subtypes and were the least for follicular neoplasms. Conclusion: When correctly applied, quantitative estimation of cytological nuclear features can play an important role in preoperative assessment and can complement morphological features in thyroid lesions

Immuno-localization of glucose transporter 4 in healthy human gingiva

Background: The gingiva has been shown to be a target tissue for several hormones. Insulin induces uptake of glucose in the peripheral tissues by upregulating the Glucose transporter 4 expression. Little information is available on the expression of Glucose transporter 4 in human gingiva. Aim: In this regard, a pilot study was performed with the aim of determining the distribution pattern of Glucose transporter 4 in healthy human gingiva. Materials and Methods: Immuno-histochemistry was performed on 10 mounted sections of healthy human gingiva with the primary antibody Glucose Transporter 4 (GLUT 4). Appropriate positive and negative controls were used. Results: Glucose transporter 4 expression was observed in the basal and suprabasal layers of the gingival epithelium and fibroblasts of the gingival connective tissue. Conclusion: This may be the first study to demonstrate the expression of GLUT 4 in the healthy human gingiva. The results of this study raise the possibility that gingiva may serve as a target tissue for insulin action