Extreme Peripheral Blood Plasmacytosis Mimicking Plasma Cell Leukemia as a Presenting Feature of Angioimmunoblastic T-Cell Lymphoma (AITL).

Angioimmunoblastic T-cell lymphoma (AITL) is one of four major subtypes of nodal peripheral T cell lymphoma, characterized by its cell of origin, the follicular helper T-cell (TFH). Patients typically present with prominent constitutional (B) symptoms, generalized lymphadenopathy, hepatosplenomegaly, cytopenias, and rash. Here we present a case of a 62-year-old male with progressive cervical adenopathy, fevers and weight loss presenting with extreme polyclonal plasmacytosis and high plasma EBV viral load. While the initial presentation appeared to mimic plasma cell leukemia or severe infection, lymph node biopsy and bone marrow biopsy confirmed a diagnosis of AITL. This case highlights the heterogeneity of the clinical presentation of AITL to enable physicians to more promptly recognize, diagnose and initiate treatment

Cholestenoic acid, an endogenous cholesterol metabolite, is a potent γ-secretase modulator.

BackgroundAmyloid-β (Aβ) 42 has been implicated as the initiating molecule in the pathogenesis of Alzheimer's disease (AD); thus, therapeutic strategies that target Aβ42 are of great interest. γ-Secretase modulators (GSMs) are small molecules that selectively decrease Aβ42. We have previously reported that many acidic steroids are GSMs with potencies ranging in the low to mid micromolar concentration with 5β-cholanic acid being the most potent steroid identified GSM with half maximal effective concentration (EC50) of 5.7 μM.ResultsWe find that the endogenous cholesterol metabolite, 3β-hydroxy-5-cholestenoic acid (CA), is a steroid GSM with enhanced potency (EC50 of 250 nM) relative to 5β-cholanic acid. CA i) is found in human plasma at ~100-300 nM concentrations ii) has the typical acidic GSM signature of decreasing Aβ42 and increasing Aβ38 levels iii) is active in in vitro γ-secretase assay iv) is made in the brain. To test if CA acts as an endogenous GSM, we used Cyp27a1 knockout (Cyp27a1-/-) and Cyp7b1 knockout (Cyp7b1-/-) mice to investigate if manipulation of cholesterol metabolism pathways relevant to CA formation would affect brain Aβ42 levels. Our data show that Cyp27a1-/- had increased brain Aβ42, whereas Cyp7b1-/- mice had decreased brain Aβ42 levels; however, peripheral dosing of up to 100 mg/kg CA did not affect brain Aβ levels. Structure-activity relationship (SAR) studies with multiple known and novel CA analogs studies failed to reveal CA analogs with increased potency.ConclusionThese data suggest that CA may act as an endogenous GSM within the brain. Although it is conceptually attractive to try and increase the levels of CA in the brain for prevention of AD, our data suggest that this will not be easily accomplished

Epidural analgesia during labour: its influences on pain relief, progress of labour, mode of delivery, maternal and foetal

Background: Today, the availability of regional anaesthesia for labour is considered a reflection of standard obstetric care. This study is to be conducted in a tertiary care centre with all facilities available for proposed end of proving that epidural analgesia is a safe and effective method for both parturient and the foetus in abolishing pain during labour.Methods: A total of 60 parturients were studied. they were randomly divided into two groups Group 1 includes 30 parturients. In this group parturient received epidural analgesia. The loading dose consisted of 10 ml of Bupivacaine 0.1% and Fentanyl 0.0002% (20 mcg). The top up doses were 10 ml of 0.1% Bupivacaine and Fentanyl 0.0002%, administered whenever the parturient complained of pain. When parturients enters into second stage a further 12-15 ml was injected with parturient in sitting position or semi-sitting position. Group 2 - (control group) Includes 30 parturients. In this group parturient was monitored without any analgesia.Results: This prospective study was done to assess the effect of epidural analgesia on the progress of labour and its outcome, to evaluate its efficacy as an analgesic technique and to study the maternal and fetal outcome. The total number of 60 parturients were selected and randomly categorized into two groups. CASE-Those who received epidural analgesia, CONTROL-Those who did not receive any analgesia.Conclusions: Epidural analgesia provides a versatile method of administering effective and satisfactory pain relief to parturient women. The technique should not be considered as a single entity, because the type and the dose of epidural medication can be altered as needed

Performance Evaluation of Advanced PLL Techniques For Accurate FFPS Component Extraction

It is very necessary to adopt fundamental frequency positive sequence (FFPS) element extraction methods in order to maximise the efficiency of integrating and handling the use of renewable energy sources (RES). The decision to act in this manner is made with the purpose of contributing to the accomplishment of the aforementioned aim. The capability of the synchronous references frame phase-locked loop to reject variations over a broad variety of grid conditions is enhanced as a result of this. This is particularly true for voltage sags and surges that are accompanied by harmonics, irrespective of whether the harmonics are the result of balanced or unbalanced electrical current fluctuations. The accuracy of the extraction of FFPS components is significantly influenced by the frequency deviation in SRF-PLL systems. The frequency deviation is another critical component. This is a result of the frequency deviation not remaining constant. An investigation is being conducted to ascertain the effectiveness of a various advanced PLL techniques, such as the cascaded delayed signal cancellation (CDSC), the dual second-order generalized integrator (DSOGI) and the multiple delayed signal cancellation (MDSC). The objective of conducting this assessment is to facilitate the evaluation of the efficacy of these strategies, which is the reason for its implementation. The CDSC and MDSC PLL have been demonstrated to be preferable to other PLLs due to their ability to distinguish between even and odd harmonics. This is due to the fact that each of these harmonics possesses its own distinctive characteristics. This may be attributable to its capacity to independently identify either harmonic. The MATLAB simulation results is provided to demonstrate the exceptional performance of these highly advanced PLLs

Use of Intense Pulse Light Technology for Various Dermatological Conditions on Indian Skin: A Descriptive study

INTRODUCTION : The use of light in the treatment of various dermatological conditions is known to human beings since ancient times. Light was used by Hindu and Greek physicians along with plant extracts in the treatment of Vitiligo. Neils Finsen was awarded the 1903 Nobel Prize in Medicine for establishing the scientific basis of using light to treat skin disease. Since then light therapy has advanced in leaps and bounds with the advent of lasers, photodynamic therapy and phototherapy. Lasers were first conceived in 1917 through the vision of Albert Einstein, when he hit upon the possibility of stimulated emission of radiation. The world had to wait another ten years for the first laser –the RUBY laser to be built by T.Maiman. Lasers expanded into medicine in the early 1960s with focus on the skin and eye, as they were easily accessible. Lasers have now revolutionized the practice of dermatology, promising innovative treatment for a host of skin conditions including vascular and pigmented birthmarks, tattoos, scars, rhytids and unwanted hair. Intense Pulsed Light (IPL) technology burst into the scene in the mid 1970s. They were first introduced for the treatment of vascular disorders, but are now popular among both cosmetologists and physicians for the treatment of unwanted hair, pigmented blemishes and more. Unlike lasers, they use broad band non coherent light: Like lasers, they work on the principle of selective photothermolysis of target chromophores. In spite of their extreme popularity, they do have limitations, which has to be kept in mind .They are not a panacea for all cosmetological skin conditions. Most studies based on IPL published in the literature stem from the western world and use patients with Caucasian skin types. There are a few reports on Asian skin from the Far East. Unfortunately, there are almost no published studies of IPL done on Indian skin types. Even as the popularity of IPL increases, lack of such vital data is of concern to all. This study aims to be a preliminary study gauging the effect of these light systems on Indian skin. It aims to ascertain the efficacy, the tolerability and the adverse effects of IPL when used for patients of Indian skin types. We hope to obtain preliminary data, comparing the study results with western data. IPL is becoming extremely popular and widely used in India these days. Hence the knowledge of this data is essential to Indian Dermatologists. AIMS OF THE STUDY : 1. To study the effect of broad band intense pulse light source for various dermatological indications. 2. To study the efficacy of the intense pulsed light in patients with dark skin types (Fitzpatrick 3 – 5) 3. To study the incidence of side effects in dark skinned patients following the IPL treatment procedure. CONCLUSIONS : 1. IPL is an effective and versatile tool in the treatment of different dermatological problems. 2. Efficacy was noted to be highest in the treatment of unwanted hair followed by acne vulgaris and pigmentary disorders in that order. 3. Average number of sessions required for excellent response in hair removal was 2.9. 4. In the treatment of acne vulgaris inflammatory lesions responded the best. Poor response was seen in the removal of comedones. An average of 3.4 treatment sessions was used. 5. An average of 3.3 treatment sessions was used in treatment of pigmentary disorders. Good results were seen in lentigenes, freckles, post acne hyper pigmentation and melasma. 6. Results close to that obtained in Caucasian skin can be obtained in Asians through proper patient selection and strict adherence to pre treatment and post treatment therapeutic protocol. 7. Adverse effects with IPL were minimal and transient. Hence IPL appears to be safe for use on Indian skin

Evaluation of nootropic activity of Curcuma longa leaves in diazepam and scopolamine-induced amnesic mice and rats

Background: The present study was undertaken to assess the nootropic activity of hydroalcoholic extract of Curcuma longa leaves (HAECL) in diazepam-induced amnesia in mice using Morris water maze method and scopolamine-induced amnesia in rats by using elevated plus maze behavioral paradigm and its effect on acetylcholinesterase (AChE) and reduced glutathione (GSH) level were carried out.Methods: Amnesia was induced by administration of diazepam (1 mg/kg i.p.) and scopolamine (0.4 mg/kg i.p.) and treatment groups received HAECL (200 and 400 mg/kg p.o) for 14 and 10 days in scopolamine and diazepam-induced amnesia model, respectively. The extent of improvement in memory was measured by behavioral paradigm. Finally, animals were sacrificed, and the whole brain was isolated for estimation of concentration of AChE and reduced GSH levels.Results: The oral treatment with HAECL with a dose 400 mg/kg has shown an enhancement in the memory function compared to 200 mg/kg.Conclusion: This could be by inhibiting the levels of cholinesterase concentration  of enzyme and thereby increasing the concentration of acetylcholine level in brain and improving cognition-memory performance

Effectiveness of structured teaching programme on knowledge and expressed practice regarding sanitary napkin among school girls those who attained menarche at a selected school in Kancheepuram district

A study to assess the effectiveness of structured teaching programme on knowledge and expressed practice regarding Sanitary Napkin among school girls those who attained menarche at a selected school in Kancheepuram District. OBJECTIVE: The objectives were, to assess the knowledge and expressed practice regarding sanitary napkin among school girls those who attained menarche, to evaluate the effectiveness of structured teaching programme on knowledge and expressed practice regarding sanitary napkin among school girls those who attained menarche and to associate the selected demographic variables and health related variables with the level of knowledge and expressed practice regarding sanitary napkin among school girls those who attained menarche. METHODOLOGY: A quantitative research approach of pre experimental with one group pre and post-test design was chosen for this study. By using purposive sampling technique a total of 50 samples were included for the study. The structured teaching programme was given by researcher. Pre and post test was conducted by structure questionnaire. Data were recorded and coded. The data analysis was done by using descriptive and inferential statistics. RESULT: The result revealed that there was a statistically significant difference between pre and post-test knowledge and expressed practice scores regarding sanitary napkin among school girls at level P<0.001. This study implied that creating awareness regarding sanitary napkin will prevent the occurrence of reproductive tract infection among school girls and promote their health

Apert syndrome (Acrocephalosyndactyly): a case report

Apert syndrome is named for the French physician. Eugene Apert in 1906 described the syndrome acrocephalosyndactylia. It is a rare autosomal dominant disorder characterized by craniosynostosis, craniofacial anomalies, and severe symmetrical syndactyly of the hands and feet (i.e. cutaneous and bony fusion refers to webbing of fingers and toes). Apert syndrome is characterized by the premature fusion of certain skull bones (craniosynostosis). This early fusion prevents the skull from growing normally and affects the shape of the head and face. In addition, a varied number of fingers and toes are fused together (syndactyly). Most cases of Apert syndrome are sporadic, may result from new mutations in the gene. The purpose of this paper is to report a case of Apert syndrome in a female fetus of 30 weeks with asymmetrical skull confirmed by prenatal ultrasonography. Pregnancy was terminated and fetus was submitted for detailed autopsy in anatomy dissection hall. The findings and review of literature were presented in this article

Cadaveric study of accessory renal arteries and its surgical correlation

A thorough knowledge of the accessory renal arteries has grown in importance with the increasing number of renal transplants and other uroradiological procedures. The literature indicates that multiple renal arteries are found in 9-75% cases. Normal anatomy describes each kidney receives irrigation from single renal artery which arises from abdominal aorta at the level L1-L2 vertebrae just below the superior mesenteric artery. Renal artery variations include their origin, number and course. The most common is the presence of additional vessels (accessory arteries) arising above the usual trunk is more frequent than one arising below. The accessory renal arteries are always end arteries. The kidneys may receive a single artery although each organ may equally be supplied by as many as six end arteries. The right and left renal arteries may arise from the aorta by a common stem or arise at lower point than usual in which case the kidneys lie below their usual position. There may be several renal arteries on each side or the renal artery may divide close to its origin into several branches. Current literature reports great variability in renal blood supply, the number of renal arteries mentioned being the most frequently found variation. Normal renal arterial information is useful not only for planning and performing of endovascular, laparoscopic uroradiological procedures and renal transplants. In order to facilitate the clinical approaches, we studied renal arterial pattern in 25 formalin fixed cadavers, on 50 kidneys during the period of one year. The purpose of this present study was to establish the incidence of accessory (aberrant) renal arteries in human cadavers and also discuss its surgical correlation during uroradiological procedures and angiographic interventions.

Важливе історико-географічне дослідження

Рец. на кн. Темушева В.Н. "Гомельская земля в конце XV первой половине XVI в. Территориальные трансформации в пограничном регионе". — М.: "Квадрига", 2009. — 190 с.Review of the book: Temushev V.N. "Gomel Land in the Late 15th — the 1st half of the 16th Centuries. Territorial Transformations in the Frontier Area". — Moscow: "Kvadriga", 2009. — 190 p