Ambulatory Blood Pressure Monitoring

Hypertension is a major health care concern. With office and home blood pressure monitoring giving insufficient information, ambulatory blood pressure monitoring has emerged as the investigation of choice for hypertension

Microfluidic Devices: Applications and Role of Surface Wettability in Its Fabrication

Microfluidic devices are based upon the behavior of fluids at the microenvironment level. They offer innumerable applications in the field of science and technology. Their scope is not limited to single field and now have applications in various fields such as biomedical, energy, chemicals and environment as well. Their major advantages are low experiment to cost ratio, and fast response time. Surface wettability is one of the factors contributing to the working of microfluidic devices. Surface wettability measurement is a very critical technique to measure the flow of micro fluids in microfluidic applications. In microfluidic devices the detection of small volume change with change in fluid properties is very minor because of the micrometer range. In order to detect this small change in micrometer range, an in situ wetting measurement is required. In this chapter, we have discussed about types of taxis, microfluidic devices: an application of taxis, microfluidic applications and role of surface wettability in microfluidic devices

Assessing pedestrian thermal comfort to improve walkability in the urban tropical environment of Nagpur city

Walking can be an efficient and sustainable mode of transportation for "last mile" connectivity. However, the willingness to walk largely depends on the availability of infrastructure, safety, and comfort. Improving thermal comfort on streets connected to transit stations is crucial for encouraging walking and public transit use. This study assesses seasonal and spatiotemporal variations in pedestrian thermal comfort (PTC) on an N-S-oriented street in Nagpur (India). Thermal walk surveys simultaneously monitored environmental conditions and human thermal perception (thermal sensation vote-TSV). The findings revealed that urban geometry significantly influences PTC and TSV, and the level of influence varied spatiotemporally in both seasons. This study shows the relationship between urban street geometry, microclimate, and PTC, emphasizing the necessity of a multidimensional assessment approach

Значение специфических инфекций у беременных в развитии хронической плацентарной недостаточности

ПЛАЦЕНТАРНАЯ НЕДОСТАТОЧНОСТЬБЕРЕМЕННОСТИ ОСЛОЖНЕНИЯПОЛОВЫМ ПУТЕМ ПЕРЕДАВАЕМЫЕ БОЛЕЗНИИНФЕКЦИ

Computed tomography- guided percutaneous core needle biopsy for diagnosis of intathoracic mass lesions: experience at a tertiary care centre of North India

Background: CT guided core needle biopsy is a less invasive method for initial diagnostic workup in the assessment of intrathoracic masses. This study was conducted to evaluate the diagnostic yield of the procedure as well as to demonstrate the spectrum of various disease in our population.Methods: Present study was conducted in a tertiary care hospital for a study period of two years. Patients with intrathoracic mass were included and CT guided biopsies were performed following a protocol. The CT guided biopsies received were examined for histological diagnosis. Immunohistochemistry was carried out where ever routine histopathology was not sufficient for diagnosis. Relevant immunohistochemical panels were applied for lung, mediastinal and pleural tumours according to the histological differential diagnosis. Detailed demographic and clinical profiles along with radiological findings were noted.Results: Total of 138 cases were taken for CT guided FNAC procedure and 123 (89.1%) cases yielded diagnostic biopsy. Lung was the most commonly involved organ followed by mediastinum. Bronchogenic carcinoma was the most common lesion reported in lung and Non-Hodgkin Lymphoma was the most common mediastinal lesion. Lung collapse was most common radiological feature.Conclusions: CT guided percutaneous biopsy is a valuable diagnostic technique providing for early accurate diagnosis and being minimally invasive procedure. Care should be taken while tissue processing and section cutting of intrathoracic biopsies as the biopsies are small and tissue loss should be prevented so that sufficient material is available for immunohistochemistry

Prevalence of diabetes distress and its psychosocial determinants among Indian population with type II diabetes

Background: Diabetes distress (DD) refers to the negative emotional or affective experience resulting from the challenge of living with the demands of diabetes, regardless of the type of diabetes. In addition to the chronic treatment of diabetes, patients with type 2 diabetes mellitus (T2DM) often experience psychosocial difficulties which can go unnoticed. Hence, it is necessary to identify DD at an early stage to prevent its effect on the patients’ long-term self-care and management plan. This study was conducted to assess the prevalence of DD and its psychosocial determinants among T2DM at a tertiary care centre. Methods: This was a cross sectional, observational study which included patients of either gender, who were between 18-65 years of age with T2DM for more than 3 months to 12 years. DD was assessed using the diabetes distress scale (DDS17) scale. In addition, association between the level of DD with the sociodemographic and clinical characteristics of the patients was assessed. Results: The prevalence of DD in type II diabetic patients in suburban population was found to be 17.69%. The psychosocial determinants which influence DD were found to be age, treatment modality, hypothyroidism, hypertension, and smoking. Conclusions: This study signifies the importance of identifying DD by the primary care physician which often remain unrecognized in clinical practice and to implement the interventions at early stages to improve the quality of life of diabetic patients

Cytological spectrum of granulomatous mastitis: diagnostic and treatment challenges

Background: Granulomatous mastitis (GM) is an inflammatory disease of the breast which clinico- radiologically mimics both inflammatory and malignant lesions. This leads to diagnostic dilemmas and delay in treatment. The aim of the present study was to review the cases diagnosed as granulomatous mastitis on Fine Needle Aspiration Cytology (FNAC) with an objective to co-relate their clinico-radiological findings, histology review where available and follow up treatment received to establish etiology and study the treatment outcome.Methods: Cytologically diagnosed cases of granulomatous mastitis were retrieved and reviewed from August 2015 - July 2017 records. Clinico-radiological co-relation, histology review where available and follow up treatment records were sought for.Results: Around 31.7% (530/1670) cases were reported as malignant, 60.3% (1009/1670) as benign proliferative and 7.9% (131/1670) as inflammatory lesions by breast FNA. 3.1% (51/1670) cases were reported as GM of all breast FNAC and 38% (51/131) of all inflammatory lesions. Follow up was available for 47 cases. Of which 26 (55.3%) cases were diagnosed as Tubercular Granulomatous mastitis (TGM) and 21(44.7%) were idiopathic granulomatous mastitis (IGM).Conclusions: Countries where tuberculosis is endemic, high degree of clinical suspicion and detailed work-up to rule out TGM is essential for all cases of granulomatous mastitis. Authors recommend a multidisciplinary workup with microbiological culture and molecular based tests on FNA material. This retrospective study illustrates that the cause of GM needs to be determined accurately for timely treatment, to avoid unnecessary delays and treatment dilemma in these patients

Clinicopathological and immunohistochemical analysis of Sarcomatoid carcinoma of head and neck mucosal region: a retrospective analysis

Background: Sarcomatoid carcinoma is a biphasic tumour comprising both of malignant epithelial and mesenchymal elements derived monoclonally from same stem cells. These are unusual variants of squamous cell carcinoma and constitute less than 1% of the head and neck mucosal tumors. Only few studies have been published and needs more understanding to establish treatment guidelines. The aim of this study was to review the cases of carcinosarcoma arising from mucosal sites of head and neck and study their clinical, histological and Immunohistochemical features.Methods: Retrospective data and slides of histologically proven sarcomatoid carcinoma over a period of thirty -four months between January 2016 - October 2018 were retrieved and evaluated for various clinical and histopathological parameters.Results: Total of 22 cases were included in the study and the mean age of presentation was 58years with male: female ration 2:1. Most of the patients (81.8%) presented with a mass lesion of less than 6 months duration. The most common site was oral cavity (68.1%) followed by larynx (22.7%). Clinical stage was known in eleven cases. One case presented with pulmonary metastasis. Histopathologically, epithelial differentiation was identified in nine cases (41%) on morphology and in thirteen cases could be highlighted by cytokeratin positivity. The Mesenchymal component was arranged in sheets (63.7%) and fascicles (31.8%). Marked anaplasia and brisk mitosis wereseen in 54.5% and 19.3% respectively.  On immunohistochemistry all 22 cases were positive for Vimentin, twenty cases were positive for cytokeratin/EMA and aberrant mesenchymal markers were expressed in 10% of cases.  Follow up was available in eighteen cases out of which fourteen cases died within one year of diagnosis.Conclusions: Diagnosis of sarcomatoid carcinoma is challenging especially on small biopsy because of overlapping features with other spindle cell tumors. Understanding the clinicopathological features facilitates their diagnosis and effective clinical management

Dopamine induces functional extracellular traps in microglia

Dopamine (DA) plays many roles in the brain, especially in movement, motivation, and reinforcement of behavior; however, its role in regulating innate immunity is not clear. Here, we show that DA can induce DNA-based extracellular traps in primary, adult, human microglia and BV2 microglia cell line. These DNA-based extracellular traps are formed independent of reactive oxygen species, actin polymerization, and cell death. These traps are functional and capture fluorescein (FITC)-tagged Escherichia coli even when reactive oxygen species production or actin polymerization is inhibited. We show that microglial extracellular traps are present in Glioblastoma multiforme. This is crucial because Glioblastoma multiforme cells are known to secrete DA. Our findings demonstrate that DA plays a significant role in sterile neuro-inflammation by inducing microglia extracellular traps

Biochemical Properties of Highly Neuroinvasive Prion Strains

Infectious prions propagate from peripheral entry sites into the central nervous system (CNS), where they cause progressive neurodegeneration that ultimately leads to death. Yet the pathogenesis of prion disease can vary dramatically depending on the strain, or conformational variant of the aberrantly folded and aggregated protein, PrPSc. Although most prion strains invade the CNS, some prion strains cannot gain entry and do not cause clinical signs of disease. The conformational basis for this remarkable variation in the pathogenesis among strains is unclear. Using mouse-adapted prion strains, here we show that highly neuroinvasive prion strains primarily form diffuse aggregates in brain and are noncongophilic, conformationally unstable in denaturing conditions, and lead to rapidly lethal disease. These neuroinvasive strains efficiently generate PrPSc over short incubation periods. In contrast, the weakly neuroinvasive prion strains form large fibrillary plaques and are stable, congophilic, and inefficiently generate PrPSc over long incubation periods. Overall, these results indicate that the most neuroinvasive prion strains are also the least stable, and support the concept that the efficient replication and unstable nature of the most rapidly converting prions may be a feature linked to their efficient spread into the CNS