Histological pattern of focal segmental glomerulosclerosis and its clinical correlation

Background: Focal segmental glomerulosclerosis (FSGS) is a pattern of injury and it has five histological subtypes with varying prognosis and therapeutic response. Our aim was to study the pattern of primary FSGS in our population along with their clinicopathological characteristics.Methods: This is a 2-year retrospective, single centre cohort, observational study. All adult patients with primary FSGS were identified.Results: There were 51 patients of primary FSGS. The mean age of patients was 37.2±15.3 years with overall male dominance. The clinical presentations were nephrotic syndrome (88.2%), proteinuria with hematuria (11.7%), hypertension (47.05%) and renal insufficiency (60%). FSGS-NOS were seen in 26 patients, tip variant in 11, perihilar in 6, cellular variant in 6 and collapsing variant in 2 patients. The mean age of collapsing variant was significantly less than others (20.5±9.1 years vs 37.2±15.3 years). Massive proteinuria was seen in collapsing and tip variant significantly higher than rest of the variants and tip variant had the least degree of interstitial fibrosis and tubular atrophy.Conclusions: FSGS is a pattern of injury which shows histological variations. Although it most commonly affects males, tip and cellular variants show female preponderance. Massive proteinuria was mostly seen in collapsing and tip variants and the features of chronicity were mostly seen in tip variant. Larger studies are required for the differences in treatment protocols and prognosis of different variants.

The Bleeding and Burning Kashmir: Violence, Terrorism and Freedom Struggle

Efforts have been made to discuss various issues which Kashmir Valley had faced in the past six decades –Violence, Terrorism, Aggression and Bloodshed. Political conflict in the valley have marked a high degree of militarization and the presence of herse laws giving special powers to military forces makes Kashmiri people victims of violence. This article puts a view that how India and Mainstream parties of Jammu and Kashmir had and are trying to suppress the slogans and voices Kashmiri people and Separatists that are demanding nothing but Freedom. Keywords: Freedom, Jamat-I –islami, Kashmiri pundits, Ragdo Ragdo, Violence etc

Breeding approaches for improvement of temperate fruit crops and nuts - a review

Fruit breeding is an ancient technology with dynamic current technology and an exciting future (Janick and Moore, 1975, 1996).  In its broadest sense, fruit breeding refers to the purposeful genetic improvement of fruit crops through various techniques including selection, hybridization, mutation induction, and molecular techniques. Its origins trace to the domestication process in prehistory and antiquity, where useful species were chosen and cultivated, and improved by continuous selection (Janick, 2005, 2011). Much of the world fruit industry is still based on grower selection from chance seedlings as well as mutations (sports) and as a result many fruit species are characterized by a narrow germplasm base. Spontaneous hybridization between wild plants and cultivated clones was critical to the early domestication of fruits. The lengthy juvenile period and the large field space required to grow temperate fruits have imposed major limitations on conventional breeding and various molecular biological techniques have been employed to make fruit breeding easier. (Igarashi et al.2016). Marker-assisted selection (MAS) uses DNA markers to provide an early DNA-based evaluation of genetic performance potential of seedlings, with the aim of improving cost and/or genetic efficiency of seedling selection (Ru, et al., 2015). Transgenic technology has facilitated the development of fruit trees with resistance to fungal or bacterial diseases, improved fruit quality, or root stocks with better rooting or dwarfing ability. In recent years, new technologies for genetic improvement, such as transgrafting, and genome-editing, have emerged. (Mudge, et al. 2009; Jia and Wang 2014). Using these techniques, no foreign genes are present in the final product, and some of them show considerable promise for application to apple breeding. Furthermore, genome editing, by which only the target gene can be accurately modified, is emerging as a novel breeding technology. These new technologies will undoubtedly facilitate fruit breeding, and yield novel and attractive fruit cultivars

Carotid intima-media thickness as a marker for assessing the severity of coronary artery disease on coronary angiography

Background: Coronary artery disease (CAD), the leading cause of death worldwide, has a huge area of primary prevention where patients at risk can be identified for more intensive, evidence-based medical interventions to reduce cardiovascular events. Whereas coronary angiography has stood the test of time to assess atherosclerotic burden, it is still unavailable to a huge population at risk of CAD. This study was devised in search of a cheap and simple tool to assess atherosclerotic burden. We aimed to investigate the relationship between Carotid Intima Media Thickness (CIMT) and Coronary Artery Disease (CAD) in patients evaluated by coronary angiography for suspected CAD and whether CIMT could predict the extension of CAD.Methods: This study was a cross-sectional study conducted from March 2013 to September 2015 in Department of Medicine, SMHS Hospital, J and K, India. A total of 100 patients admitted to for undergoing coronary angiography indicated for suspected coronary artery disease were enrolled. the risk factors evaluated in this study included age, body mass index, sex, dyslipidemia, hypertension, diabetes mellitus and smoking. CAD was assessed and classified by coronary angiography and CIMT was assessed by carotid doppler.Results: There was a positive relationship between CIMT and CAD. Risk factors like Age, smoking, BMI, cholesterol, hypertension, and diabetes had significant positive effect on CIMT; whereas gender, VLDL, triglycerides, HDL and LDL were statistically insignificant in affecting CIMT.Conclusions: CIMT is a cheap and simple tool to predict the extent of CAD

A study to assess knowledge and attitude of infertile Kashmiri couples

Background: Infertility is defined as the inability to conceive naturally after one year of regular unprotected sexual intercourse. The chance to conceive depends on multiple factors like the length of sexual intercourse, frequency of coitus and age of couples. This could be due to male as well as female factors and deficiencies.Methods: This is a cross sectional observational study conducted on infertility patients. A fertility questionnaire was designed for both the partners with questions covering knowledge and attitude towards infertility.Results: A total 100 couples were selected in which prevalence of primary and secondary infertility was 72% and 28% respectively. The mean duration of infertility was 3 years. On scoring their level of knowledge, 52% had inadequate knowledge, 44% had moderate knowledge and 4% had adequate knowledge. There was no statistically significant difference in the knowledge in relation to their educational qualification and type of infertility among participants.Conclusions: Infertility is common problem affecting 10-15% of the population. The knowledge about infertility and its risk factors is generally limited among the participants, in spite of their educational status

A prospective study of hearing impairment in school going children of Ghaziabad city attending a tertiary care hospital

Background:Overcrowding, poor hygiene, socio-economic status, climate, lack of resources to avail medical facilities, poor medical awareness have their bearing on the incidence of hearing loss. The family of each hearing-impaired child has its own cultural, social, educational, and financial background, and its own special needs. The aim of this study is to determine the percentage of hearing impaired school going children in Ghaziabad city.Methods:The material for the present study were a representative sample constituting 1000 school children selected from various localities of Ghaziabad city within age group of 6-12 years. The children belonged to all the strata of society and children from both sexes were evaluated for hearing loss and its underlying etiological factors. Children were subjected to detailed ENT examination in our OPD.  Results:In the present study sample the incidence of hearing loss is 9.3%. The maximum cases 60.22% belonged to the low socio-economic strata. A statistically significant difference of distribution by gender was noticed with a male preponderance (61.29%) as against 38.71% for females. The hearing loss in majority of cases was of a mild degree i.e., 26 to 45 dB (34.41%) of which majority of cases (87.10%) had conductive loss. Wax was the commonest cause of hearing loss (41.94%). CSOM was found in 21.50 % of all cases. Peak prevalence of hearing loss was found at 8 years of age, again declining after that from 20.43 % to 5.38 % by 12 years of age. Also it was observed that 59.14% children were living in crowded localities of city & 40.86% were living in non- crowded/open locality which is again statistically significant (P ≤0.05).Conclusion:The inferences drawn from the present study substantiates the view point of earlier workers that school screening is the most effective method of diagnosing deafness in school going children and should be extended to all schools in all the areas. Proper assessment and diagnosis of hearing loss in children at a very early age is important because an early diagnosis determines the efficacy of methods used for the correction of the hearing loss. Also early diagnosis of hearing impairment is a key to proper rehabilitation. The cases reporting to the hospital for treatment and rehabilitation can be regarded as the tip of the ice-berg and can have more management difficulties when compared to sub-clinical cases.

Pathomorphological effects of Alloxan induced acute hypoglycaemia in rabbits

AbstractAlloxan is one of the frequently used beta-cytotoxic agents for the induction of Type-1 diabetes mellitus in animal models and is the drug of choice in rabbits. Its beta-cytotoxic action results in a sudden release of insulin leading to severe hypoglycaemia and even mortality if glucose therapy is not given. In the present investigation the pathological effects of alloxan induced acute hypoglycaemia were studied in rabbits. New Zealand White rabbits, 1–1.5 kg body weight, were administered alloxan @100 mg/kg b.w., as a single intravenous dose. Blood glucose levels were monitored (0 h, 20 min, 1 h, and then hourly up to 5 h) and clinical signs noted. Rabbits dead due to hypoglycaemia were necropsied and histopathology performed. Severe histopathological changes were observed especially in the brain (neuronal degeneration and necrosis), kidneys (nephrosis, nephritis) and liver (hepatosis, hepatitis) and also, other organs. Histopathological observation of beta-cytolysis was suggestive that the drug induced hypoglycaemia is insulin mediated. It was concluded that acute hypoglycaemia causes severe pathological changes and the alloxan induced immediate hypoglycaemia if not managed in time, might exacerbate the pathological effects of hyperglycaemia in the induced diabetic models

Ocular morbidity among diabetics attending the preventive ophthalmic clinic of a tertiary care institute with special reference to diabetic retinopathy

Background: Non communicable diseases have taken over previously life threatening infections in the demographic transition. As the burden of NCDs including diabetes is increasing at an alarming rate the complications related to these diseases are also increasing leading to huge morbidity. Likewise, blindness/ visual impairment due to diabetic retinopathy is now slowly and steadily replacing refractive errors and cataracts as a cause of morbidity.Methods: This cross sectional study was carried over a period of one year in an ophthalmic unit of a tertiary health care institute in which known diabetic patients were screened for diabetic retinopathy besides various modifiable and non-modifiable risk factors.Results: Overall prevalence of diabetic retinopathy in our study population was found to be 29.0%. Among various risk factors duration of diabetes, hypertension, HbA1C >6.5% and serum creatinine >1.1 mg/dl were found to be significantly associated with diabetic retinopathy.Conclusion: Regular screening for diabetic retinopathy besides prevention and strict control of risk factors is key to prevention and progression of blindness/ visual impairment due to diabetic retinopathy

Open reduction and internal fixation in a case with transscaphoid perilunate dislocation 8 months after the injury: a patient with a 5-year follow-up

The management of perilunate dislocations diagnosed later than three months continue to elicit debate with literature being scarce. We report a 22-year-old male with transscaphoid perilunate dislocation who reported to our hospital 8 months after sustaining the injury. Open reduction was done along with bone grafting. Five years after the surgery the patient is symptom-free with an excellent range of motion

Diagnostic Relevance of Primary Investigations in Early Referral and Management of Colorectal Cancer Patients

Aim: Colorectal cancers are largely considered as curable yet the high mortality rates associated with it points out at deficiency in early management of the disease. The aim of this study was to analyze the diagnostic potential of routine primary investigations with an attempt to categorize symptoms for early referral of colorectal cancers patients.Methods: This study involved retrospective analysis of a cohort of 85 patients diagnosed with colorectal cancer that underwent surgery in a period of one year. The patients were arranged into different age-groups to analyze the relative incidence and prognosis of the disease with respect to generalized symptoms and clinicopathological details. Multinomial Logistic Regression analysis was employed to predict the most effective set of parameter combinations for primary prognosis of the diseased state.Results: Abdominal pain, rectal bleeding and change in bowel habits were predominantly reported symptoms; however, these were imprecise with age, sex or stage of cancer. Interestingly, almost 85% of the patients were reported anemic, with a majority of them (41.7%) having Hb 10. Anaemic patients showed significantly higher frequency of symptoms viz. change in bowel habits (p 0.023), rectal bleeding (p 0.035) and/or abdominal pain (p 0.039) compared to non-anaemic ones. The co-occurrence of any two of the symptoms further increased the likelihood of the disease in anaemic patients.Conclusion: A substantial decrease in hemoglobin count with concomitant change in bowel habits, rectal bleeding, and/or abdominal pain could be considered as potential referral markers for early management of suspected colorectal cancers patients