Comparison of various decalcifying agents to evaluate their efficacy

Background: Bone is a biological complex structure primarily comprising collagen and minerals. It is important to demineralize these mineralized tissues to remove their calcium apatite crystals for analysing the sub-cellular, cellular, and fibrillar architecture. Six demineralizing agents’ efficacy was examined by assessing their duration, ease of handling tissue, staining, and histological criteria. The present study aimed to evaluate six commonly used demineralizing agents to identify the best decalcifying agent. Methods: Twenty resected hard tissue specimens (1 cm × 1 cm x 1 cm) from the archives were used in the study. These segments were decalcified by solutions namely 10% nitric acid, 10% formic acid, 14% ethylene di amine tetra acetic acid (EDTA), a mixture of formic acid and hydrochloric acid (formic + HCL) 4% each, and a mixture of formic acid and nitric acid 4% each (formic + HNO3), 10% formal nitric acid further subjected to radiographic endpoint test. Results: The present study confirmed the fact that samples treated with EDTA showed the best overall impression in terms of tissue integrity and histology followed by 10% formal nitric acid which gave fairly good cellular details and was also rapid in the action. Conclusions: Based on the present study findings, we suggest that 10% formal nitric acid is the better decalcifying agent available, considering time and tissue integrity as two main factors

A Study on Evaluation of Various Tongue Patterns in North Indian Population and a Working Classification System for These Tongue Print Patterns

INTRODUCTION: Tongue is a vital internal organ enclosed within the oral cavity and is well protected from the external environment. The color, shape, and surface features are characteristic of every individual, and this serves as a tool for identification. The search for a new personal identification method secure has led to the use of the tongue print as a method of biometric verification.AIM AND OBJECTIVE: To analyze the shape, margins, texture of tongue prints and compare these between males and females. Also, formulate a working classification system for these tongue prints.MATERIAL AND METHODS: Subjects were asked to protrude tongue in relaxed position. After this tongue images were captured using Nikon digital camera to evaluate the shape, texture, margins, and papillations of tongue patterns.RESULT: The most common pattern seen in males and females was Patternless, with majority of subjects showing scalloped lateral margins, prominent papillations with short and broad tongue. Mostly female patients had pointed tip of tongue. Also, we in this paper have formulated a working classification system for easily categorizing the tongue print patterns in individuals.CONCLUSION: The human tongue is unique and delivers relevant information about shape, size, color, texture, margins and is suitable for forensic case identification

Identifying public preferences using multi-criteria decision making for assessing the shift of urban commuters from private to public transport: A case study of Delhi

Shifting urban commuters to public transport can be an effective strategy to deal with the energy and environmental problems associated with the transport sector. In order to enhance public transport the mode of choice for urban commuters, public expectations and requirements should be at the centre of the policy-making process. This study uses pair-wise weighing method (i.e. Analytical Hierarchy Process) to derive priorities for different criteria for shifting urban commuters to the public transport system based on their opinion. The primary survey has been conducted to collect the data for identifying public preferences for public transport characteristics under four parent criteria: reliability, comfort, safety and cost, identified based on literature review and expert opinion. This information was collected using questionnaire based surveys between January 2013 and July 2013 from nearly 50 locations using a stratified random sampling technique from nine districts of Delhi. Our results suggest safety as the most important criteria (36% of total) for encouraging the urban commuters to shift from private vehicles to public transport and then reliability (27%), cost (21%) and comfort (16%). Based on above four criteria, commuters were found to be happy with Delhi metro services compared to buses and other mode of public transport due to more frequency, adherence to schedule, less travel time, comfort and safety. Commuters were willing to pay more for better public transport service since the travel cost was not considered to be one of the important criteria. The results also showed that 96% commuters are willing to shift to public transport if above criteria or services are considered for providing an efficient public transport system. These results can assist transport planners to integrate public preferences with the available technical alternatives for the wise allocation of the available resources

Portal biliopathy: a study of 39 surgically treated patients

AbstractBackgroundPortal biliopathy (PBP) denotes intra- and extrahepatic biliary duct abnormalities that occur as a result of portal hypertension and is commonly seen in extrahepatic portal vein obstruction (EHPVO). The management of symptomatic PBP is still controversial.MethodsProspectively collected data for surgically managed PBP patients from 1996 to 2007 were retrospectively analysed for presentation, clinical features, imaging and the results of surgery. All patients were assessed with a view to performing decompressive shunt surgery as a first-stage procedure and biliary drainage as a second stage-procedure if required, based on evaluation at 6 weeks after shunt surgery.ResultsA total of 39 patients (27 males, mean age 29.56 years) with symptomatic PBP were managed surgically. Jaundice was the most common symptom. Two patients in whom shunt surgery was unsuitable underwent a biliary drainage procedure. A total of 37 patients required a proximal splenorenal shunt as first-stage surgery. Of these, only 13 patients required second-stage surgery. Biliary drainage procedures (hepaticojejunostomy [n= 11], choledochoduodenostomy [n= 1]) were performed in 12 patients with dominant strictures and choledocholithiasis. One patient had successful endoscopic clearance of common bile duct (CBD) stones after first-stage surgery and required only cholecystectomy as a second-stage procedure. The average perioperative blood product transfusion requirement in second-stage surgery was 0.9 units and postoperative complications were minimal with no mortality. Over a mean follow-up of 32.2 months, all patients were asymptomatic. Decompressive shunt surgery alone relieved biliary obstruction in 24 of 37 patients (64.9%) and facilitated a safe second-stage biliary decompressive procedure in the remaining 13 patients (35.1%).ConclusionsDecompressive shunt surgery alone relieves biliary obstruction in the majority of patients with symptomatic PBP and facilitates endoscopic or surgical management in patients who require second-stage management of biliary obstruction

Pseudocyst of Ectopic Pancreas of the Duodenal Wall Masquerading as Malignant Cystic Tumor of Pancreas

We report a patient who underwent pancreaticoduodenectomy for a cystic lesion in the region of the pancreatic head and duodenum. Preoperatively, we had suspected a malignant lesion; however, it turned out to be ectopic pancreatic tissue in the duodenal wall, with the changes of chronic pancreatitis and pseudocyst formation. With this report we seek to highlight the rarity of this particular pathologic combination and the difficulties in its correct preoperative diagnosis and management

Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): An update on 107 randomized trials and 19,805 patients, on behalf of MACH-NC Group.

The Meta-Analysis of Chemotherapy in squamous cell Head and Neck Cancer (MACH-NC) demonstrated that concomitant chemotherapy (CT) improved overall survival (OS) in patients without distant metastasis. We report the updated results. Published or unpublished randomized trials including patients with non-metastatic carcinoma randomized between 1965 and 2016 and comparing curative loco-regional treatment (LRT) to LRT + CT or adding another timing of CT to LRT + CT (main question), or comparing induction CT + radiotherapy to radiotherapy + concomitant (or alternating) CT (secondary question) were eligible. Individual patient data were collected and combined using a fixed-effect model. OS was the main endpoint. For the main question, 101 trials (18951 patients, median follow-up of 6.5 years) were analyzed. For both questions, there were 16 new (2767 patients) and 11 updated trials. Around 90% of the patients had stage III or IV disease. Interaction between treatment effect on OS and the timing of CT was significant (p < 0.0001), the benefit being limited to concomitant CT (HR: 0.83, 95%CI [0.79; 0.86]; 5(10)-year absolute benefit of 6.5% (3.6%)). Efficacy decreased as patients age increased (p_trend = 0.03). OS was not increased by the addition of induction (HR = 0.96 [0.90; 1.01]) or adjuvant CT (1.02 [0.92; 1.13]). Efficacy of induction CT decreased with poorer performance status (p_trend = 0.03). For the secondary question, eight trials (1214 patients) confirmed the superiority of concomitant CT on OS (HR = 0.84 [0.74; 0.95], p = 0.005). The update of MACH-NC confirms the benefit and superiority of the addition of concomitant CT for non-metastatic head and neck cancer