Isolated hydatid cyst of adrenal gland with hypertension mimicking Conn’s syndrome: a very rare case

Hydatid cyst of the adrenal gland is one of the rare conditions caused by the larval stage of Echinococcus granulosus. The incidence of adrenal gland involvement is less than 1% of all hydatid disease in humans and isolated adrenal involvement is extremely rare. Hydatid disease is frequent in endemic regions and sheep farming areas with equal sex distribution. Here, a case of 23 year old female with isolated adrenal gland hydatid cyst is presented, that was evaluated clinically, investigated radiographicaly and by blood investigations and finally histopathology confirmed the diagnosis. No complications occurred at peri and postoperative period. The patient was given 6 cycles of albendazole (10 mg/kg in two divided doses), each for a period of four weeks followed by a week’s rest. The patient is on regular follow-up without recurrence in last 1 year

CLINICO - HISTOPATHOLOGICAL SPECTRUM OF CUTANEOUS VASCULITIS: A RETROSPECTIVE STUDY OF 62 CASES

Context: Cutaneous Vasculitis is the inflammation of vessel walls which leads to hemorrhagic or ischemic events. The histopathological classification of cutaneous vasculitis depends on the vessel size and the dominant immune cell mediating the inflammation. Object: We studied the etiological factors and clinico-pathological spectrum of patients with cutaneous vasculitis at a tertiary referral centre of north India. Design: Skin biopsies of all patients with clinically suspected cutaneous vasculitis presenting over 5 years, between 2009-2014 were reviewed. Cutaneous vasculitis was classified on the basis of etiology (primary or secondary), on the basis of size of vessel wall as well as on the dominant inflammatory cell infiltrating the vessels. Results: Over 5 years, 62 / 103 patients evaluated for vasculitic syndromes had histologically proven vasculitis. Clinically, vasculitis was primary (77.4%) or secondary (22.5%) to drugs, infections, underlying connective tissue diseases and malignancy. Neutrophilic (n=30), lymphocytic (n=18), eosinophilic (n=10), and granulomatous (n=4) vasculitis were the major histopathological groups. Small vessel involvement was seen in 97% cases. Conclusion: Skin biopsy remains the gold standard for diagnosing cutaneous vasculitis. Small vessel vasculitis was the most common type of cutaneous vasculitis with the dominant cell type being neutrophilic. Eosinophilic infiltrate was exclusively associated with primary vasculitis. KEYWORDS: Cutaneous vasculitis; Small vessel vasculitis; Skin biopsy

CLINICO - HISTOPATHOLOGICAL SPECTRUM OF CUTANEOUS VASCULITIS: A RETROSPECTIVE STUDY OF 62 CASES

Context: Cutaneous Vasculitis is the inflammation of vessel walls which leads to hemorrhagic or ischemic events. The histopathological classification of cutaneous vasculitis depends on the vessel size and the dominant immune cell mediating the inflammation. Object: We studied the etiological factors and clinico-pathological spectrum of patients with cutaneous vasculitis at a tertiary referral centre of north India. Design: Skin biopsies of all patients with clinically suspected cutaneous vasculitis presenting over 5 years, between 2009-2014 were reviewed. Cutaneous vasculitis was classified on the basis of etiology (primary or secondary), on the basis of size of vessel wall as well as on the dominant inflammatory cell infiltrating the vessels. Results: Over 5 years, 62 / 103 patients evaluated for vasculitic syndromes had histologically proven vasculitis. Clinically, vasculitis was primary (77.4%) or secondary (22.5%) to drugs, infections, underlying connective tissue diseases and malignancy. Neutrophilic (n=30), lymphocytic (n=18), eosinophilic (n=10), and granulomatous (n=4) vasculitis were the major histopathological groups. Small vessel involvement was seen in 97% cases. Conclusion: Skin biopsy remains the gold standard for diagnosing cutaneous vasculitis. Small vessel vasculitis was the most common type of cutaneous vasculitis with the dominant cell type being neutrophilic. Eosinophilic infiltrate was exclusively associated with primary vasculitis. KEYWORDS: Cutaneous vasculitis; Small vessel vasculitis; Skin biopsy

Giant Parapharyngeal Space Pleomorphic Adenoma Causing Acute Airway Obstruction

Primary parapharyngeal space (PPS) tumors are rare, representing only 0.5% of all head and neck neoplasms. About 80% of tumors of this space are benign, and 20% are malignant. They often pose therapeutic and diagnostic problems due to variable non-specific symptoms and the complex anatomy of this space. Pleomorphic adenoma is the most common benign tumor of this space. It presents as an asymptomatic mass causing mild bulging in the soft palate or tonsillar region, or fullness near the angle of the mandible in the neck. We report the case of a 60-year-old male admitted to the emergency department with breathing difficulty and acute stridor. He was unable to maintain oxygen saturation, and an emergency tracheostomy was performed. Radiological and cytological evaluation were performed, and the patient was diagnosed as having primary PPS pleomorphic adenoma. The tumor was excised via the transcervical approach. The rarity of tumor in this space and unusual life-threatening presentation prompted the authors to report this case. To our knowledge, this is the third case reported worldwide of a pleomorphic adenoma causing upper airway obstruction and acute respiratory failure

Training Professionalism Using Hidden Curriculum in an Internship Course: Account of Experiences of Undergraduate Students of Surgical Technology

Background: Medical students are in direct contact with patients due to their clinical situation, and one of the important goals of medical education is professional development of these students. Objectives: The purpose of this study was to explain students’ experiences regarding professionalism training using hidden curriculum. Methods: This study was carried out through content analysis, and data were collected through semi-structured interviews with 6th and 8th semester undergraduate students of surgical technology. The participants were entered into the study using the purposive sampling method and each individual interview lasted for about 35 - 45 minutes. Semi-structured questions were used to conduct the interviews and then follow-up and exploratory questions were used to clarify the concept and to deepen the interview process. Results: Overall, 358 primary codes and the two main themes of observing patient rights and professional accountability were extracted. The theme of observing patient rights includes three sub-themes, including observing patient privacy, respect for patient’s dignity and patient safety, and the theme of professional accountability comprised the three sub-themes of compliance with professional standards, professional communication and instructor as ethics teacher. Conclusions: Professors’ familiarity with the training and development of professionalism among medical students, and attention to the role of hidden curriculum in the formulation of values, norms and behaviors regarding professionalism is suggested. Keywords Professionalism Hidden Curriculum Explanation Studen

Optimasi Portofolio Resiko Menggunakan Model Markowitz MVO Dikaitkan dengan Keterbatasan Manusia dalam Memprediksi Masa Depan dalam Perspektif Al-Qur`an

Risk portfolio on modern finance has become increasingly technical, requiring the use of sophisticated mathematical tools in both research and practice. Since companies cannot insure themselves completely against risk, as human incompetence in predicting the future precisely that written in Al-Quran surah Luqman verse 34, they have to manage it to yield an optimal portfolio. The objective here is to minimize the variance among all portfolios, or alternatively, to maximize expected return among all portfolios that has at least a certain expected return. Furthermore, this study focuses on optimizing risk portfolio so called Markowitz MVO (Mean-Variance Optimization). Some theoretical frameworks for analysis are arithmetic mean, geometric mean, variance, covariance, linear programming, and quadratic programming. Moreover, finding a minimum variance portfolio produces a convex quadratic programming, that is minimizing the objective function ðð¥with constraintsð ð 𥠥 ðandð´ð¥ = ð. The outcome of this research is the solution of optimal risk portofolio in some investments that could be finished smoothly using MATLAB R2007b software together with its graphic analysis

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

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

Measurement of the top quark forward-backward production asymmetry and the anomalous chromoelectric and chromomagnetic moments in pp collisions at √s = 13 TeV

Abstract The parton-level top quark (t) forward-backward asymmetry and the anomalous chromoelectric (d̂ t) and chromomagnetic (μ̂ t) moments have been measured using LHC pp collisions at a center-of-mass energy of 13 TeV, collected in the CMS detector in a data sample corresponding to an integrated luminosity of 35.9 fb−1. The linearized variable AFB(1) is used to approximate the asymmetry. Candidate t t ¯ events decaying to a muon or electron and jets in final states with low and high Lorentz boosts are selected and reconstructed using a fit of the kinematic distributions of the decay products to those expected for t t ¯ final states. The values found for the parameters are AFB(1)=0.048−0.087+0.095(stat)−0.029+0.020(syst),μ̂t=−0.024−0.009+0.013(stat)−0.011+0.016(syst), and a limit is placed on the magnitude of | d̂ t| < 0.03 at 95% confidence level. [Figure not available: see fulltext.

Measurement of t(t)over-bar normalised multi-differential cross sections in pp collisions at root s=13 TeV, and simultaneous determination of the strong coupling strength, top quark pole mass, and parton distribution functions

Peer reviewe