Multiportal Combined Transorbital and Transnasal Endoscopic Resection of Fibrous Dysplasia

Introduction Historically, access to the anterior skull base was achieved with open procedures. The paradigms to this approach were challenged with the advent of minimally disruptive endoscopic surgical techniques and supporting technology. The next step in the evolution of minimally disruptive surgery was the combination of multiportal endoscopic surgery. Results The patient was an 18-year-old man who presented with right-sided proptosis. Further diagnostic tests revealed a fibrous dysplasia (FD) occupying the skull base and orbit. The lesion was successfully resected. Conclusions The location of the tumor in this case was challenging, in which surgeons at some centers would have opted to have performed as an open procedure instead of endoscopically. The combined transnasal/transorbital approach is an uncommonly used technique that we have used to remove this tumor successfully. The patient also had a unique disease (FD) in a unique location that was treated without complications. This case report highlights how surgeons may use an expanded armamentarium in dealing with complex pathologies

IMPACT OF TEACHERS' MINDFULNESS AND PROFESSIONAL SKILLS TOWARDS CLASSROOM CLIMATE ON STUDENT OUTCOMES WHILE LEARNING ENGLISH AS A SECOND LANGUAGE IN SRI LANKA

Public education system of Sri Lanka suffers from poor education outcomes and wide disparities in academic achievement across schools, and studies reveal that students’ outcomes are best when the teachers are qualified in both subjects, they are assigned to teach and in pedagogy. At present teacher stress has become a critical issue in the educational field which affects negatively towards classroom climate; teacher student relationship, teacher creativity, teaching methodologies and student outcomes, while a positive classroom climate results in better academic, social, and emotional outcomes for students. Though the studies have revealed that teacher can improve their well-being, as well as the classroom climate and the student outcomes through the use of mindfulness practices which was taught by the Buddha 2600 years ago, any convincing evidence of the influence of both, teachers’ mindfulness and professional skills on classroom climate towards student outcomes in Sri Lanka or any other country cannot be found. To fulfil that gap, this study explored the influence of teachers’ mindfulness and professional skills on classroom climate towards student outcomes in the government schools in Sri Lanka, using pre-test and post-test experimental design. Data was collected before and after 8-week intervention period, from a sample consisted of 230 students and nine teachers of English, that were observed quantitatively. Findings revealed that teachers’ mindfulness and professional skills as two of the most influential factors that decide the student outcomes directly and via classroom climate of a school, that offer valuable recommendations to the education system in Sri Lanka, in order to enhance student academic and behavioural outcomes by taking steps to improve the professional skills of teachers and the mindful living of both teachers and students.  Article visualizations

IMPACT OF TEACHERS’ PROFESSIONAL SKILLS ON STUDENT ACHIEVEMENT WHILE LEARNING ENGLISH AS A SECOND LANGUAGE IN SRI LANKA

The public education system of Sri Lanka suffers from poor education outcomes and wide disparities in academic achievement across schools, and studies have revealed that students’ outcomes are best when the teachers are qualified in both, the subjects they are assigned to teach and in pedagogy. Though the studies have revealed that student outcomes can be improved by improving the professional skills of teachers, any convincing evidence of the influence of teachers’ professional skills on student outcomes in Sri Lanka cannot be found. To fulfil that gap, this study explored the influence of teachers’ professional skills on student outcomes in government schools in Sri Lanka, using the pretest, posttest experimental design. Data were collected before and after the 8-week intervention period, from a sample consisting of 102 students and four teachers of English, that were observed quantitatively. Findings revealed that teachers’ professional skills as one of the most influential factors that decide the student outcomes directly of a school, which offer valuable recommendations to the education system in Sri Lanka, in order to enhance student outcomes by taking steps to improve the professional skills of teachers.  Article visualizations

CPB1 of Aedes aegypti Interacts with DENV2 E Protein and Regulates Intracellular Viral Accumulation and Release from Midgut Cells

Aedes aegypti is a principal vector responsible for the transmission of dengue viruses (DENV). To date, vector control remains the key option for dengue disease management. To develop new vector control strategies, a more comprehensive understanding of the biological interactions between DENV and Ae. aegypti is required. In this study, a cDNA library derived from the midgut of female adult Ae. aegypti was used in yeast two-hybrid (Y2H) screenings against DENV2 envelope (E) protein. Among the many interacting proteins identified, carboxypeptidase B1 (CPB1) was selected, and its biological interaction with E protein in Ae. aegypti primary midgut cells was further validated. Our double immunofluorescent assay showed that CPB1-E interaction occurred in the endoplasmic reticulum (ER) of the Ae. aegypti primary midgut cells. Overexpression of CPB1 in mosquito cells resulted in intracellular DENV2 genomic RNA or virus particle accumulation, with a lower amount of virus release. Therefore, we postulated that in Ae. aegypti midgut cells, CPB1 binds to the E protein deposited on the ER intraluminal membranes and inhibits DENV2 RNA encapsulation, thus inhibiting budding from the ER, and may interfere with immature virus transportation to the trans-Golgi network

Evaluation of the prognostic utility of the combination of platelet count with mean platelet volume as a prognostic indicator in head and neck cancer.

The combination of platelet count to mean platelet volume (COP-MPV) has been recently reported as a prognostic indicator of oral cavity cancer and other cancer sites. The aim of the present study was to validate the utility of the COP-MPV as a prognostic indicator in all head and neck cancer (HNC) sites. The clinicopathological characteristics of the COP-MPV with HNC were also investigated. This is a retrospective cohort study that recruited consecutively treated patients at a tertiary level academic hospital. Clinicopathological characteristics were recorded, including the COP-MPV scores. Survival was analyzed using Kaplan-Meier analysis, as well as multivariate Cox Proportional Hazards regression. COP-MPV was not associated with the survival outcome in univariate or multivariate analysis. In the multivariate model, tumor differentiation, tumor stage, nodal stage, surgical margins and hemoglobin were revealed to be significantly associated with survival. The results demonstrated that the COP-MPV is not a suitable prognostic factor for HNC

Randomised controlled trial of ranitidine versus omeprazole in combination with antibiotics for eradication of Helicobacter pylori.

This study compared high dose ranitidine versus low dose omeprazole with antibiotics for the eradication of H pylori. 80 patients (mean age 48 years, range 18-75) who had H pylori infection were randomised in an investigator-blind manner to either a two-week regime of omeprazole 20 mg daily, amoxycillin 500 mg tid and metronidazole 400 mg tid (OAM), or ranitidine 600 mg bd, amoxycillin 500 mg tid and metronidazole 400 mg tid (RAM), or omeprazole 20 mg daily and clarithromycin 500 mg tid (OC), or omeprazole 20 mg daily and placebo (OP). H pylori was eradicated in 6 of 19 patients in the OAM group (32%); 8 of 18 in the RAM group (44%), 4 of 15 in the OC group (27%); none of 18 in the OP group (0%). [< P0.005 for OAM, RAM, OC vs OP; P = N.S. between OAM, RAM, OC]. Overall metronidazole resistance was unexpectedly high at 58%. Eradication rates in metronidazole sensitive patients were 71% (5/7) and 100% (3/3) for OAM and RAM respectively. In conclusion, H pylori eradication rates using high dose ranitidine plus amoxycillin and metronidazole may be similar to that of low dose omeprazole in combination with the same antibiotics for omeprazole with clarithromycin. Overall eradication rates were low due to a high incidence of metronidazole resistance but were higher in metronidazole-sensitive patients. Even high dose ranitidine with two antibiotics achieves a relatively low eradication rate. These metronidazole-based regimens cannot be recommended in areas with a high incidence of metronidazole resistance