Clinico-pathological study of ovarian tumors at tertiary care hospital, Udaipur

Background: Diagnosis of malignancy in ovarian tumour is always questionable clinically as well as by investigation. Ovarian tumour arise in any age group and any type of body tissue present in tumour like epithelial tissues, germ cells, embryonic cells due to varied histology of ovary and metastatic non ovarian tumours. Aim and objective of the study was to study the correlation ovarian masses regarding their clinical presentation investigation and histo-pathological report.Methods: All the women who presented with lump and/or pain or menstrual problem attending Gynecology, Surgery and oncology OPD of GMCH, Udaipur. Our study design is prospective hospital based study. The statistical analysis was performed using IBM statistical for social sciences (SPSS).Results: In our study, 85.43% were benign tumour and 12.67% were malignant tumour. Among this, 70.87% were cystic, 14.56% were solid and 14.56% were mixed tumours. Mostly they were epithelial tumours (85.43%). Main surgery was total hysterectomy with bilateral salpingoopherectomy. In malignant tumours 61.53% also had Chemotherapy and 0.97 % had debulking.Conclusions: There is strong correlation of ultrasonography finding with histopathology report. Though clinically it was 55 % only. Specificity of the Ultrasonography was 73.33% but sensitivity was 100%. Positive predictive value was 95.65% and negative predictive value was 100%

Growth, yield and nutrient uptake of guava (Psidium Guavaja L.) affected by soil matric potential, fertigation and mulching under drip irrigation

Our objective was to examine the effect of plastic mulching, three soil matric potentials (SMP) treatments    {I1(-20 kPa), I2(-40 kPa), and I3(-60 kPa)} and three fertigation levels {F1(100%), F2(80%), and F3(60%) recommended dose of fertilizer} under drip irrigation conditions for nutrient uptake, growth parameters and yield in guava plants.  The experiments were set up in factorial randomized block design with eighteen treatment combinations.  The experiments were conducted during the year 2012-13.  The investigation indicated that the plant canopy spread in (N/S and E/W) directions was greatly affected by different treatments.  However, non-significant effects of interaction parameters were found on plant height, crop volume and plant girth.  The maximum yield was obtained in MI2F2 (68.66 kg per plant and 22.86 t ha-1) followed by NMI2F2 (66.50 kg per plant and 22.14 t ha-1) treatments.  The maximum percentage of high quality (fruit levels A and B) were 48.2% and 50.1% in -40 kPa  irrigation treatment for mulch and no mulch conditions under 100% application of recommended dose of fertilizers.  The varying range of leaf nutrients observed for different treatments of irrigation, fertigation and mulch is  1.26-1.74% N, 0.14-0.26% P, 0.44-0.88% K, 36.33-74.23 ppm Zn, 11.33-32.76 ppm Cu, 415.6- 557.3 ppm Fe, 26.80- 39.06 ppm Mn, 0.533-0.762 % Mg and 3.42-5.06% Ca.  Based on the results above, it is recommended that controlling SMP between -40 kPa to -45 kPa at 0.2 m depth immediately under the drip emitter and fertilizer dose of 80% recommended dose of fertilizer can be used as an indicator for drip irrigation scheduling in semi-arid region of northwest India.   Keywords: fertilizer application, irrigation strategies, pressure head, tensiometer, leaf uptak

Clinically Actionable Hypercholesterolemia and Hypertriglyceridemia in Children with Nonalcoholic Fatty Liver Disease

OBJECTIVE: To determine the percentage of children with nonalcoholic fatty liver disease (NAFLD) in whom intervention for low-density lipoprotein cholesterol or triglycerides was indicated based on National Heart, Lung, and Blood Institute guidelines. STUDY DESIGN: This multicenter, longitudinal cohort study included children with NAFLD enrolled in the National Institute of Diabetes and Digestive and Kidney Diseases Nonalcoholic Steatohepatitis Clinical Research Network. Fasting lipid profiles were obtained at diagnosis. Standardized dietary recommendations were provided. After 1 year, lipid profiles were repeated and interpreted according to National Heart, Lung, and Blood Institute Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction. Main outcomes were meeting criteria for clinically actionable dyslipidemia at baseline, and either achieving lipid goal at follow-up or meeting criteria for ongoing intervention. RESULTS: There were 585 participants, with a mean age of 12.8 years. The prevalence of children warranting intervention for low-density lipoprotein cholesterol at baseline was 14%. After 1 year of recommended dietary changes, 51% achieved goal low-density lipoprotein cholesterol, 27% qualified for enhanced dietary and lifestyle modifications, and 22% met criteria for pharmacologic intervention. Elevated triglycerides were more prevalent, with 51% meeting criteria for intervention. At 1 year, 25% achieved goal triglycerides with diet and lifestyle changes, 38% met criteria for advanced dietary modifications, and 37% qualified for antihyperlipidemic medications. CONCLUSIONS: More than one-half of children with NAFLD met intervention thresholds for dyslipidemia. Based on the burden of clinically relevant dyslipidemia, lipid screening in children with NAFLD is warranted. Clinicians caring for children with NAFLD should be familiar with lipid management

In Children with Nonalcoholic Fatty Liver Disease, Zone 1 Steatosis is Associated with Advanced Fibrosis

Background & Aims Focal zone 1 steatosis, although rare in adults with nonalcoholic fatty liver disease (NAFLD), does occur in children with NAFLD. We investigated whether focal zone 1 steatosis and focal zone 3 steatosis are distinct subphenotypes of pediatric NAFLD. We aimed to determine associations between the zonality of steatosis and demographic, clinical, and histologic features in children with NAFLD. Methods We performed a cross-sectional study of baseline data from 813 children (age <18 years; mean age, 12.8 ± 2.7 years). The subjects had biopsy-proven NAFLD and were enrolled in the Nonalcoholic Steatohepatitis Clinical Research Network. Liver histology was reviewed using the Nonalcoholic Steatohepatitis Clinical Research Network scoring system. Results Zone 1 steatosis was present in 18% of children with NAFLD (n = 146) and zone 3 steatosis was present in 32% (n = 244). Children with zone 1 steatosis were significantly younger (10 vs 14 years; P < .001) and a significantly higher proportion had any fibrosis (81% vs 51%; P < .001) or advanced fibrosis (13% vs 5%; P < .001) compared with children with zone 3 steatosis. In contrast, children with zone 3 steatosis were significantly more likely to have steatohepatitis (30% vs 6% in children with zone 1 steatosis; P < .001). Conclusions Children with zone 1 or zone 3 distribution of steatosis have an important subphenotype of pediatric NAFLD. Children with zone 1 steatosis are more likely to have advanced fibrosis and children with zone 3 steatosis are more likely to have steatohepatitis. To achieve a comprehensive understanding of pediatric NAFLD, studies of pathophysiology, natural history, and response to treatment should account for the zonality of steatosis

Physiological parameters for Prognosis in Abdominal Sepsis (PIPAS) Study : a WSES observational study

BackgroundTiming and adequacy of peritoneal source control are the most important pillars in the management of patients with acute peritonitis. Therefore, early prognostic evaluation of acute peritonitis is paramount to assess the severity and establish a prompt and appropriate treatment. The objectives of this study were to identify clinical and laboratory predictors for in-hospital mortality in patients with acute peritonitis and to develop a warning score system, based on easily recognizable and assessable variables, globally accepted.MethodsThis worldwide multicentre observational study included 153 surgical departments across 56 countries over a 4-month study period between February 1, 2018, and May 31, 2018.ResultsA total of 3137 patients were included, with 1815 (57.9%) men and 1322 (42.1%) women, with a median age of 47years (interquartile range [IQR] 28-66). The overall in-hospital mortality rate was 8.9%, with a median length of stay of 6days (IQR 4-10). Using multivariable logistic regression, independent variables associated with in-hospital mortality were identified: age > 80years, malignancy, severe cardiovascular disease, severe chronic kidney disease, respiratory rate >= 22 breaths/min, systolic blood pressure 4mmol/l. These variables were used to create the PIPAS Severity Score, a bedside early warning score for patients with acute peritonitis. The overall mortality was 2.9% for patients who had scores of 0-1, 22.7% for those who had scores of 2-3, 46.8% for those who had scores of 4-5, and 86.7% for those who have scores of 7-8.ConclusionsThe simple PIPAS Severity Score can be used on a global level and can help clinicians to identify patients at high risk for treatment failure and mortality.Peer reviewe

Altered PTEN expression as a diagnostic marker for the earliest endometrial precancerous changes

Introduction: Study was planned to investigate PTEN gene expression in endometrial hyperplasia and carcinoma as analyzed by immunohistochemistry. Material and Method: This study was conducted on 80 endometrial samples in the Department of Pathology, Gandhi Medical College, Bhopal (January 2012 to August 2016) Results: 5 out of 5 cases of proliferative endometrium, 3 out of 5 cases of secretory endometrium, 37 [84%] out of 44 cases of simple and complex endometrial hyperplasia without atypia, 8 out of 15 cases of simple and complex endometrial hyperplasia with atypia and 3 out of 11 cases of endometrial carcinoma showed positive PTEN expression. Conclusion: PTEN is a major gene involved in the pathogenesis of endometrial carcinoma. Our data suggest that decreased PTEN expression was a marker of earliest endometrial pre-cancer lesion and we propose that use of PTEN immunostaining in a clinical setting may be informative in identifying premalignant lesions that are likely to progress to carcinoma

Immunology of Edible Vaccines and its Veterinary Importance

&lt;p&gt;The greatest numbers of immune cells are associated with the gastrointestinal tract. At least 80% of all plasma cells are found in the intestinal lamina propria, and together they produce more IgA than all other immunoglobulin isotypes combined. IgA is found in enormous amounts in saliva, intestinal fluid, nasal, and tracheal secretions, tears, milk, colostrum, urine, and the secretions of the urogenital tract. When animals are vaccinated against organisms that invade the intestinal or respiratory tracts, it makes sense to stimulate a mucosal IgA response&lt;/p&gt