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We here report a case of 9 years old girl presented in casualty with an acute abdomen and small bowel obstruction and on laprotomy a large trichobezoar was revealed extending into small intestine along with intussuception. Rapunzel syndrome is a rare but potentially fatal trichobezoar. Trichobezoar, an underdiagnosed entity, has to be considered in the differential diagnosis of abdominal pain and a nontender abdominal mass even in young children.

Herbal medicines are in great demand for preliminary health care due to their wide medicinal value, with no side effects. Since many species are used in the system of traditional medicine, scientists have great opportunities to develop appropriate packages of practices for their multiplication and conservation. Abrus precatorius is the native plant of India and used in many ways in the Indian Ayurvedic system of medicine. This seeds of the species is dormant due to hard seed coat. So the aim of the study is to remove seed dormancy and enhance germination capacity within a short period. To overcome the problem of dormancy, seeds were scarified by seed scarifier and sand paper and also treated with acid (H2SO4) and hot water just before sowing. 60-95% germination was achieved under different treatment conditions while the seeds without any treatment fail to germinate. The highest (95%) germination was observed just 12 days after sowing in seeds treated with concentrated H2SO4 for 120 minutes. 70-75% germination was achieved when the seeds were treated with acid for 105 and 135 minutes. Seeds treated with con. H2SO4 for 150, 90 and 60 minutes and also scarified by sand paper showed similar results with 60-65% germination. The seeds scarified by a mechanical scarifier and treated with hot water did not show more than 32.5% germination.

Peutz-Jeghers Syndrome (PJS) is a rare autosomal dominant syndrome characterised by the familial occurrence of gastrointestinal hamartomatous polyps in association with mucocutaneous hyperpigmentation. We here report a case of 6 yr old female child presented with colicky abdominal pain, nausea and vomiting. The patient underwent laparotomy due to small bowel intussusception secondary to a jejunal polyp. Histological examination showed the characteristic features of Peutz-Jeghers Polyp (PJP), but no other features of (PJS) as laid down by WHO were seen. Solitary PJP is an extremely rare condition, with an estimated incidence of 1:1,20,000 and all previously reported patients were older than this patient.

High altitude medicinal plants are facing problem due to their unsustainable utilization. So, the cultivation of these plants with appropriate technology may fulfill the demand of pharmaceutical industry and may also promote the conservation at their natural habitat. Highly important two species of Aconitum were studied for the enhancement of net profit by applying protected farming system. Both the experimental species were grown under natural and greenhouse conditions. Very positive results were obtained in plants of both Aconitum species grown under greenhouse as compared to natural conditions. Enhancement in yield was 12 and 9 times high in Aconitum heterophyllum Wall. ex Royle and Aconitum balfourii Stapf. respectively grown under greenhouse as compared to natural condition. Pseudoaconitine and aconitine were also observed high in greenhouse grown (0.51% and 0.42% respectively) than naturally grown plants (0.49% and 0.40% respectively). The quantity of atisine and aconitine was also found high (0.35% & 0.27% respectively) in greenhouse than naturally grown plants (0.19% & 0.16% respectively). It was noticed that plant height, leaf number, and average length of tubers were high in plants grown inside greenhouse in contrast to natural habitat. Almost five and two folds more tubers were found in A. balfourii and A. heterophyllum respectively in plants grown under greenhouse in comparison to natural conditions.

Background: Menstrual hygiene and management will directly contribute to MDG-2 and MDG-3. This study was conducted to know the awareness about menstruation before menarche and the source of information; to compare menstrual pattern and menstrual hygiene among adolescent girls from slum and non-slum area and also to find some socio-demographic determinants of menstrual hygiene. Methods: A cross sectional study was conducted among 324 late adolescent girls, 200 from slum and 124 from non-slum. House to house survey was done. Results: Awareness of menstruation before menarche was seen in 56.48% girls. Friends [38.8%] and mothers [38.25%] were the main informant. The difference in mean age of menarche [12.85±1.13 in slum and 13.12±1.15 in non-slum] and regularity of cycles [126(63%) in slum and 102(82.26%) in non-slum] was statistically significant, p

The chromosomes of multicellular animals are organized into a series of topologically independent looped domains. This domain organization is critical for the proper utilization and propagation of the genetic information encoded by the chromosome. A special set of architectural elements, called boundaries or insulators, are responsible both for subdividing the chromatin into discrete domains and for determining the topological organization of these domains. Central to the architectural functions of insulators are homologous and heterologous insulator:insulator pairing interactions. The former (pairing between copies of the same insulator) dictates the process of homolog alignment and pairing in trans, while the latter (pairing between different insulators) defines the topology of looped domains in cis. To elucidate the principles governing these architectural functions, we use two insulators, Homie and Nhomie, that flank the Drosophila even skipped locus. We show that homologous insulator interactions in trans, between Homie on one homolog and Homie on the other, or between Nhomie on one homolog and Nhomie on the other, mediate transvection. Critically, these homologous insulator:insulator interactions are orientation-dependent. Consistent with a role in the alignment and pairing of homologs, self-pairing in trans is head-to-head. Head-to-head self-interactions in cis have been reported for other fly insulators, suggesting that this is a general principle of self-pairing. Homie and Nhomie not only pair with themselves, but with each other. Heterologous Homie-Nhomie interactions occur in cis, and we show that they serve to delimit a looped chromosomal domain that contains the even skipped transcription unit and its associated enhancers. The topology of this loop is defined by the heterologous pairing properties of Homie and Nhomie. Instead of being head-to-head, which would generate a circular loop, Homie-Nhomie pairing is head-to-tail. Head-to-tail pairing in cis generates a stem-loop, a configuration much like that observed in classical lampbrush chromosomes. These pairing principles provide a mechanistic underpinning for the observed topologies within and between chromosomes.

Onychomycosis constitutes the most common fungal infection of the nail (skin beneath the nail bed) that affects the finger as well as toe nails. It is an infection that is initiated by yeasts, dermatophytes, and nondermatophyte molds. Nail lacquers are topical solutions intended only for use on fingernails as well as toenails and have been found to be useful in the treatment of onychomycosis. Thus, in the present review an attempt has been made to focus on the treatment aspects of onychomycosis and the ungual delivery of antifungals via nail lacquer. Several patents issued on nail lacquer till date have also been discussed. Penetration efficiency was assessed by several researchers across the human nail plate to investigate the potentiality of nail lacquer based formulations. Various clinical trials have also been conducted in order to evaluate the safety and efficacy of nail lacquers in delivering antifungal agents. Thus, it can be concluded that nail lacquer based preparations are efficacious and stable formulations. These possess tremendous potential for clinical topical application to the nail bed in the treatment of onychomycosis.

Introduction: The study of the epidermal ridges on the volar aspect of the hands and feet which form a variety of pattern configurations is called “DERMATOGLYPHICS”. All configurations are laid down permanently from the 3rd month of the intra-uterine life and they remain unchanged throughout the life. A positive association of the dermatoglyphic features with different diseases like diabetes, mongolism, schizophrenia and leprosy have been well documented in recent years. Methods: In the present study, 50 diabetic cases and 50 controls were selected from the SMS Hospital, Jaipur, India for the establishment of the correlation between the two groups by checking for the presence and absence of any dermatoglyphic pattern. Hand prints were taken by Indian ink methods and examined for Total Finger Ridge Count (TFRC), Absolute Finger Ridge Count (AFRC), (a-b) ridge count , distal and lateral deviation (quantitative parameter) and digital and palmer pattern frequency, lateral deviation, angles and the C- line pattern frequency (qualitative parameter). Aim: The aim of the present was to evaluate the dermatoglyphic features and the specific variations which were to be used as diagnostic tools for an economic and early detection of diabetes. Results and Conclusion: The TFRC, AFRC, and the (a-b) ridge count were higher in all the patients but they were statistically insignificant. The ‘atd’ angles in the hands of both sides in the patients were increased in all the groups, except in males (left side), but they differed significantly on the right side (overall, p

The aim of the present review was to elaborate on the surface modifications of biomaterials which are used in implant dentistry. The ongoing studies on the clinical and laboratory phases and on the biomaterial sciences have largely aimed at invoking a stronger bone response and an earlier and longer functional loading. Surgical grafting procedures to improve the bone bed are used to create an ideal environment for the implant functioning. The implant selection which is based on the available bone, is also an important determiner of the long term clinical success. The interfacial zone between the implant and the bone is composed of a relatively thin layer (

Introduction: Nitrate is a common pollutant in the drinking water of Rajasthan as well as in the rest of India. The maximum permissible limit for the nitrate ion in drinking water has been set at 50 mg/l by the WHO and at 45 mg/ l by the Bureau of Indian Standards. In the body, nitrate is reduced to nitrite and the absorption of nitrite leads to methemoglobinaemia. Nitrate toxicity has been observed frequently in ruminants which has been fed on a variety of plant materials which had high nitrate content. Aim: The present study examined a possible correlation between the nitrate concentration in drinking water and the blood profile changes in rabbits. Materials and Methods: Rabbits were selected for the study because the pH of their stomachs was similar to that of human beings. We included 5 groups of rabbits, with 2 rabbits in each group. The groups were named A, B, C, D and E respectively. The nitrate concentrations in the drinking water were 45 mg/l, 100 mg/ l,200 mg / l,400 mg / l and 500 mg/ l in the groups A to E respectively. The group A was considered as the control group. After 120 days of the ingestion of sodium nitrate in drinking water, blood samples were collected from the rabbits of each group and were observed. Results and Conclusion: The maximum haematological parameters such as WBC, lymphocytes, MCHC, RBC, Hb and basophills showed decreased values in the higher groups as compared to the values of the control group. The PCV and MCV showed increased values in the higher groups as compared to the values of the control group. The present study indicated that the symptoms of nitrate toxicity were associated with the low oxygen carrying capacity of blood in the affected animals. Nitrate toxicity is a potential health hazard and the scarcity of data on the nitrate toxicity in blood created an interest in attempting the present study.

Introduction : HER2/neu gene status in breast cancers can be evaluated by targeting protein and gene - immunohistochemistry (IHC) and fluorescence in-situ hybridization (FISH). Recent studies have shown chromogenic in-situ hybridization (CISH) as a relatively cheaper alternative. Materials and Methods : Forty-three nonconsecutive, randomly selected primary invasive breast cancer cases were evaluated for c-erbB-2 (HER2 protein) by IHC and gene amplification by FISH and CISH. Results of each of the same were compared. Results : CISH showed approximately 90% and 100% concordance for IHC negative and positive cases, respectively; while approximately 94.4% and 91% concordance with FISH amplified and non-amplified cases, respectively. Conclusion : This study showed feasibility of incorporation of CISH as a low cost option in routine management of breast carcinoma in the Indian setting. Secondly, reconfirmation of IHC negative and positive cases can be done by CISH.

We explored fish fauna Ganga and Yamuna river in Uttarkashi district of Uttarakhand, to establish the molecular taxonomy database. A total of 133 samples were collected from various sampling sites along the entire stretch of rivers in district Uttarkashi. A region of cytochrome c-oxidase unit I (COI) gene (655 bp) was amplified using PCR and sequenced (DNA Barcoded). All the sequences have been uploaded into the NCBI GenBank (accession number assigned). Analysis of data generated showed that these 133 samples belonged to 22 species of 4 orders, 14 genera and 8 families. The genetic variability (K2P distance) distribution analysis was also carried out. The average mean distance of 22 species is 0.219 with 0.014 standard error. The mean genetic distance between 22 species ranged from 0.010%-0.362% while the mean genetic distance within the species ranged from 0.0006%- 0.0048%. The lowest pairwise genetic distance observed in Schizothorax sinuatus and Schizothorax progastus i.e. 0.010% with 0.003 standard error indicating a closer phylogenetic relationship between Schizothorax sinuatus and Schizothorax progastus than other species which was confirmed by the genetic distance data. Maximum divergence were observed between Danio devario and Channa gachua i.e. 0.362% with 0.028 standard error. The maximum sequence divergence within the species is observed in Barilius bendelisis with 0.0048% while minimum sequence divergence is observed in Tor putitora with 0.0006 of cyprinidae family. Our data suggests that there is high inter-specific sequence divergence as compared to intra-specific sequence divergence and also conclude that COI sequencing (barcoding) was found to be suitable for the identification of fresh water fish species.

Introduction: Intercondylar humerus fractures are uncommon in orthopaedic practice. The treatment for the same has been described in the literature and include paragonal and orthogonal fixation by using plates. Tension band wiring as a treatment for the same is sparsely described in the literature. Aim: To evaluate the effectiveness of "Double Tension Band wiring" method for the treatment of intercondylar fractures of humerus and compare the results with studies involving treatment with locked plates. Materials and Methods: Twenty patients, all presenting with fresh fractures of the distal humerus, treated with double tension band wiring were retrospectively evaluated over a period of three years. Fractures were classified according to Jupiter classification of distal humeral fractures. There were 5 high T fractures, 13 low T fractures and 2 Y fractures. According to AO classification, all were C1 fractures. Average age of the patients was 56.20 years (32-70 years). There were 13 males and 07 females. Results: Out of 20 cases treated with this method, rigid fixation and union was achieved in all of them. The average tourniquet time was 69 minutes with minimum of 50 minutes and maximum of 120 minutes. Radiological union was achieved at an average of 10.8 weeks (8-14weeks). Average range of motion was 104.5 degrees with maximum range of motion 120 degrees (10-130) and minimum of 70 degrees (30-100). Excellent or good results were obtained in 80% of the patients in our study. Conclusion: Double tension band is a reliable, less demanding and cost effective method of fixation of intercondylar fractures of humerus.

Quercus semecarpifolia Sm. is a temperate, timberline, multipurpose oak species. It plays an important role in the Himalayan ecosystem. Human pressure, predation, short-lived acorns, failure of good seed crop every year, poor regeneration, desiccation, frost sensitivity and climate change may lead to complete extinction of the species in a near future. Immediate attention to conservation and restoration measures of the Himalayan ecosystem, in which this species grows, is required. Thus, an experiment was designed to analyze the role of planting stock and micro-sites for the regeneration of Q. semecarpifolia in-situ. For that purpose, 16 microsites with presence/absence of litter, canopy and sunlight were identified, where seeds/propagules were planted. The presence of litter, canopy and sunlight influenced the seedling production, mainly impairing the processes, leading to the expansion in diameter of the radicle, causing shoot/root emergence. Radicle emergence took place in all the seeds immediately after shedding but only 20% of seedlings recovered; however, when the stored seeds were sown as soon as the emerging radicle attained 10-15cm in length and 2-3cm in diameter, 80% of seedlings were recovered. Surprisingly, after being detached from the seed the swollen radicle acted as a propagule and produced 80% seedlings irrespective of the microsites; however, radicles detached prior to diameter expansion failed to produce seedlings which is a crucial insight for promoting seedling production.

Fast disintegrating tablets (FDTs) have received ever-increasing demand during the last decade, and the field has become a rapidly growing area in the pharmaceutical industry. Oral drug delivery remains the preferred route for administration of various drugs. Recent developments in the technology have prompted scientists to develop FDTs with improved patient compliance and convenience. Upon introduction into the mouth, these tablets dissolve or disintegrate in the mouth in the absence of additional water for easy administration of active pharmaceutical ingredients. The popularity and usefulness of the formulation resulted in development of several FDT technologies. FDTs are solid unit dosage forms, which disintegrate or dissolve rapidly in the mouth without chewing and water. FDTs or orally disintegrating tablets provide an advantage particularly for pediatric and geriatric populations who have difficulty in swallowing conventional tablets and capsules. This review describes various formulations and technologies developed to achieve fast dissolution/dispersion of tablets in the oral cavity. In particular, this review describes in detail FDT technologies based on lyophilization, molding, sublimation, and compaction, as well as approaches to enhancing the FDT properties, such as spray drying and use of disintegrants. In addition, taste-masking technologies, experimental measurements of disintegration times, and dissolution are also discussed.

Pregnancy in chronic kidney disease is rare and is associated with high incidence of maternal and fetal morbidity. More women with chronic renal failure, due to better management and treatment modalities are able to conceive and carry on their pregnancy and delivery. The case report describes anesthesia for caesarean section in a parturient with chronic renal failure and reviews the literature.

Takayasu′s arteritis (TA) is a rare, chronic progressive panendarteritis involving the aorta and its main branches. Anaesthesia for patients with TA is complicated by their severe uncontrolled hypertension, end-organ dysfunction, stenosis of major blood vessels, and difficulties encountered in monitoring arterial blood pressure. In a patient with Cushing′s syndrome (CS), the anaesthesiologist needs to deal with volume overload, hyperglycaemia, hypokalaemia, difficult airway and ventilation. Anaesthetic management of a patient with concomitant TA and CS undergoing adrenalectomy has hardly ever been reported. We present the successful anaesthetic management of a 15-year-old child with coexisting TA and CS undergoing open adrenalectomy.

The Sturge-Weber Syndrome (SWS) is a neurocutaneous disorder characterized by leptomeningeal and facial angiomas, neurologic and ocular manifestations. We report a case of oophorectomy for ovarian dermoid in a 14 year -old girl who was a diagnosed case of Sturge-Weber Syndrome. General anaesthesia was given for the procedure. The perioperative anaesthestic management is discussed in the present report.

Visceral leishmaniasis (VL) is a multifactorial disease, where the host genetics play a significant role in determining the disease outcome. The immunological role of anti-inflammatory cytokine, Interleukin 10 (IL10), has been well-documented in parasite infections and considered as a key regulatory cytokine for VL. Although VL patients in India display high level of IL10 in blood serum, no genetic study has been conducted to assess the VL susceptibility / resistance. Therefore, the aim of this study is to investigate the role of IL10 variations in Indian VL; and to estimate the distribution of disease associated allele in diverse Indian populations.All the exons and exon-intron boundaries of IL10 were sequenced in 184 VL patients along with 172 ethnically matched controls from VL endemic region of India.Our analysis revealed four variations; rs1518111 (2195 A>G, intron), rs1554286 (2607 C>T, intron), rs3024496 (4976 T>C, 3' UTR) and rs3024498 (5311 A>G, 3' UTR). Of these, a variant g.5311A is significantly associated with VL (χ2=18.87; p =0.00001). In silico approaches have shown that a putative micro RNA binding site (miR-4321) is lost in rs3024498 mRNA. Further, analysis of the above four variations in 1138 individuals from 34 ethnic populations, representing different social and linguistic groups who are inhabited in different geographical regions of India, showed variable frequency. Interestingly, we have found, majority of the tribal populations have low frequency of VL ('A' of rs3024498); and high frequency of leprosy ('T' of rs1554286), and Behcet's ('A' of rs1518111) associated alleles, whereas these were vice versa in castes. Our findings suggest that majority of tribal populations of India carry the protected / less severe allele against VL, while risk / more severe allele for leprosy and Behcet's disease. This study has potential implications in counseling and management of VL and other infectious diseases.

Colorectal cancer (CRC) is one of the three leading causes for cancer mortality. CRC kills over 600,000 people annually worldwide. The most common cause of death from CRC is the metastasis to distant organs. However, biomarkers for CRC metastasis remain ill-defined. We compared primary and metastatic CRC cell lines for their angiogenesis-protein profiles and intracellular signaling profiles to identify novel biomarkers for CRC metastasis. To this end, we used primary and metastatic CRC cell lines as a model system and normal human colon cell line as a control. The angiogenesis profiles two isogenic CRC cell lines, SW480 and SW620, and HT-29 and T84 revealed that VEGF was upregulated in both SW620 and T84 whereas coagulation factor III, IGFBP-3, DPP IV, PDGF AA/AB, endothelin I and CXCL16 were downregulated specifically in metastatic cell lines. Furthermore, we found that TIMP-1, amphiregulin, endostatin, angiogenin were upregulated in SW620 whereas downregulated in T84. Angiogenin was downregulated in T84 and GM-CSF was also downregulated in SW620. To induce CRC cell metastasis, we treated cells with pro-inflammatory cytokine IL-6. Upon IL-6 treatment, epithelial-mesenchymal transition was induced in CRC cells. When DLD-1 and HT-29 cells were treated with IL-6; Akt, STAT3, AMPKα and Bad phosphorylation levels were increased. Interestingly, SW620 showed the same signal activation pattern with IL-6 treatment of HT-29 and DLD-1. Our data suggest that Akt, STAT3, AMPKα and Bad activation can be biomarkers for metastatic colorectal cancer. IL-6 treatment specifically reduced phosphorylation levels of EGFR, HER2 receptor, Insulin R and IGF-1R in receptor tyrosine kinase array study with HT-29. Taken together, we have identified novel biomarkers for metastatic CRC through the angiogenesis-antibody array and intracellular signaling array studies. Present study suggests that those novel biomarkers can be used as CRC prognosis biomarkers, and as potential targets for the metastatic CRC therapy.

There have been constant searches and researches which are taking place in the field of dental materials to best suit the ideal selection criteria to satisfy the functionality, biocompatibility, aesthetics as well as the durability as a maxillofacial material. Among all the different materials, Silicone is the most popularly used, but still studies are carried out to overcome their weaknesses and to come out with a material which can be labeled as the “ideal maxillofacial prosthetic material”. This article comprises the materials which were and are in use and the reason for their unpopularity. It also gives us a scope to understand the major fields where the materials lack and thus needs improvement to render an individual with the best maxillo-facial prosthesis.

Background: Thyroid disease is most common endocrine disorder and is different from other endocrine diseases because of its visible swelling and ease of diagnosis. If left untreated, thyroid disease makes a person more prone for heart disease, infertility and osteoporosis. In India, significant burden of thyroid diseases exist with an estimation of around 42 million cases. The thyroid status and autoimmune status of adult Indian population in the post iodinization phase is largely unknown. Aim: The main objective of this study was to generate valuable epidemiological data regarding the prevalence of thyroid disorders in rural population of Khanpur Kalan, Sonepat in the post-iodinisation era in India. To assess whether thyroid autoimmunity or goitrogens along with environmental factors play role in the development of thyroid.This paper is being presented in view that no such study has been carried out in the rural population of this region in Haryana. Materials and Methods: The present study was conducted in Department of Pathology, Bhagat Phool Singh Medical College for Women, Khanpur Kalan, Sonepat between August 2011 to July 2013. It included retrospective analysis of cytomorphology of fine needle aspiration cytology material of 206 patients presenting with thyroid nodule in the Department of Pathology. Results: The commonest age group affected was 31-40 yrs. The female patients (93.4%) outnumbered the male patients (6.6%). The cytomorphological analysis of 206 patients revealed 190 cases (92.2%) of neoplastic lesions, 10 cases (4.8%) were neoplastic and 6 cases (2.9%) had indeterminate cytomorphology. Maximum number (65.5%) of patients was suffering with goiter followed by lymphocytic thyroiditis (26.2%). Amongst the malignant cases three cases were of papillary carcinoma and one case of medullary carcinoma. Two out of the six cases of follicular neoplasm proved to be follicular adenoma on histopathology. Four patients with high T3 levels were under treatment with neomercazole. They showed change in cytomorphology from hyperplasia to colloid goiter. Only one case of acute suppurative thyroiditis was reported which shows rarity of its type. Conclusion: The increased prevalence of goiter in this post iodinisation era can be attributed to goitrogens, autoimmune thyroid disease and micronutrient deficiency of iron and selenium. Higher prevalence of autoimmune thyroiditis in females is linked with both genetic and environmental factors such as infection, stress.

Objectives: In India, especially in Rajasthan, people drink water which contains high level of nitrates and the possibility of finding concentrations of up to 500 mg of nitrate ions per litre of water is not unusual. Excessive use of nitrate fertilisers and herbicides results in accumulation of nitrate in plants and methemoglobinaemia in cattle as consequences of nitrate poisoning. The ingested nitrate is converted to nitrite in the digestive system and it is absorbed in blood, thus causing methemoglobinaemia. Methaemoglobinaemia is not restricted to infants alone, but it is prevalent in higher age groups also. Methods: Therefore, an experimental study was conducted on 10 rabbits which were between three and a half months to four months of age, which had weights which ranged from 1.310 kg to 1.720 kg. Five groups A, B, C,D and E were formed, with two rabbits in each group. The control Group A was given water orally, which had 45 mg/litres of nitrate. Groups B to E (experimental groups) were administered water orally, which had concentrations of 100mg/litre, 200mg/litre, 400mg/litre and 500mg/litre of nitrate respectively, for 120 days. During experimental period, the differences in general behaviour of rabbits were noted. After this, rabbits were anaesthetised and sacrificed according to guidelines of ICMR and their livers were removed and processed for making paraffin sections,. Hematoxyllin and eosin staining was done for microscopic observations. Results: During experimental period, the animals were found to be lethargic on 75th day. Quantity of intake of food and water was not altered in the rabbits which were undergoing experiments in different groups. Rabbits of all groups i.e. A to E showed a continuous increase in heart rate (up to 218/minute in Group E) and respiration rate (up to 84/minute in Group E) respectively. The microscopic study showed mild necrosis of hepatocytes, with infiltration of inflammatory cells in between hepatocytes. In higher groups, the liver showed bridging necrosis and portal triditis. Dilatations of central vein with eosinophilic degeneration were observed in Group E only.

Tuberculous osteomyelitis after open fracture is uncommon. Early diagnosis of tubercular arthritis is difficult because of insidious onset, indolent process and mild or non specific local or systemic symptoms. This case report describes the fibrinous loose bodies in elbow joint of a patient who sustained a compound fracture presented with chronic non healing discharging sinus. Intra-operatively some suspected seed like bodies were removed and sent for histopathological examination which showed circumscribed homogenous fibrinous bodies with focal area of hyalinization and few embedded tiny osteolytic fragments. Acid Fast Bacilli staining was positive. The patient had a good recovery after treatment with anti-tuberculosis drugs.

ABSTRACT A 17 years old female presented with multiple asymptomatic cutaneous cysts all over body, sparing the head and neck region. The microscopic examination of the cysts showed the features of steatocystoma multiplex. This disorder, although it is asymptomatic, is a cosmetic threat to the patient . Only a few cases of the patients with an autosomal dominant mutation, who had keratin 17, have been reported. We are reporting here, a case of steatocystoma multiplex in a 17 years old female, along with its review of literature.

Retinoblastoma usually manifests before five years of age. Retinoblastoma in an adult is extremely rare. Twenty-three cases of retinoblastoma in adults 20 years or older have been reported in world literature. We report a case of adult onset retinoblastoma in a 29-year-old female. Our patient had unilateral endophytic retinoblastoma with vitreous seeds and calcification on ultrasonography. She underwent enucleation with silicone ball implantation and the diagnosis was confirmed histopathologically. The diagnosis of retinoblastoma should be kept in mind in cases presenting with a white mass lesion of unknown etiology, in the fundus of an adult.

Pathogenesis of hepatitis B virus (HBV) and hepatitis E virus (HEV) infection is as varied as they appear similar; while HBV causes an acute and/or chronic liver disease and hepatocellular carcinoma, HEV mostly causes an acute self-limiting disease. In both infections, host responses are crucial in disease establishment and/or virus clearance. In the wake of worsening prognosis described during HEV super-infection over chronic HBV hepatitis, we investigated the host responses by studying alterations in gene expression in liver cells (Huh-7 cell line) by transfection with HEV replicon only (HEV-only), HBV replicon only (HBV-only) and both HBV and HEV replicons (HBV+HEV). Virus replication was validated by strand-specific real-time RT-PCR for HEV and HBsAg ELISA of the culture supernatants for HBV. Indirect immunofluorescence for the respective viral proteins confirmed infection. Transcription profiling was carried out by RNA Sequencing (RNA-Seq) analysis of the poly-A enriched RNA from the transfected cells. Averages of 600 million bases within 5.6 million reads were sequenced in each sample and ∼15,800 genes were mapped with at least one or more reads. A total of 461 genes in HBV+HEV, 408 in HBV-only and 306 in HEV-only groups were differentially expressed as compared to mock transfection control by two folds (p

Juvenile dermatomyositis (JDM) is an immune-mediated inflammatory disease affecting the microvasculature of skin and muscle. CD4+ CD25+ FOXP3+ regulatory T cells (Tregs) are key regulators of immune homeostasis. A role for Tregs in JDM pathogenesis has not yet been established. Here, we explored Treg presence and function in peripheral blood and muscle of JDM patients. We analyzed number, phenotype and function of Tregs in blood from JDM patients by flow cytometry and in vitro suppression assays, in comparison to healthy controls and disease controls (Duchenne's Muscular Dystrophy). Presence of Tregs in muscle was analyzed by immunohistochemistry. Overall, Treg percentages in peripheral blood of JDM patients were similar compared to both control groups. Muscle biopsies of new onset JDM patients showed increased infiltration of numbers of T cells compared to Duchenne's muscular dystrophy. Both in JDM and Duchenne's muscular dystrophy the proportion of FOXP3+ T cells in muscles were increased compared to JDM peripheral blood. Interestingly, JDM is not a self-remitting disease, suggesting that the high proportion of Tregs in inflamed muscle do not suppress inflammation. In line with this, peripheral blood Tregs of active JDM patients were less capable of suppressing effector T cell activation in vitro, compared to Tregs of JDM in clinical remission. These data show a functional impairment of Tregs in a proportion of patients with active disease, and suggest a regulatory role for Tregs in JDM inflammation.

Background: Our patients are not well aware of the role of anesthetist and especially their knowledge is very poor regarding anesthetist commitments within and outside the operation theatre. The present study was conducted to know the awareness and knowledge of the patients about anesthesia and anesthetist. Methodology: The present study was a cross sectional study conducted using predesigned questionnaire containing questions related to the awareness and knowledge of anesthesia among the patients coming for a pre-anesthesia check-up after taking their voluntary informed consent. Results: Only 22% of the cases know correctly that anesthetist is the person who will resuscitate the patients if any mishap occurs in operation theatre. It was observed that 63% of the cases feel that the role of the anesthetist in operation theatre is to put the patient to sleep. The knowledge about the types of anesthesia was present among 170 (56.7%) of the participants. 52% believe that the role of anesthetist is equivalent to that of the surgeon. Significant association was observed between educational status and perception about the anesthetist as a doctor (p

As SARS-CoV-2 continues to spread and evolve, detecting emerging variants early is critical for public health interventions. Inferring lineage prevalence by clinical testing is infeasible at scale, especially in areas with limited resources, participation, or testing and/or sequencing capacity, which can also introduce biases1-3. SARS-CoV-2 RNA concentration in wastewater successfully tracks regional infection dynamics and provides less biased abundance estimates than clinical testing4,5. Tracking virus genomic sequences in wastewater would improve community prevalence estimates and detect emerging variants. However, two factors limit wastewater-based genomic surveillance: low-quality sequence data and inability to estimate relative lineage abundance in mixed samples. Here we resolve these critical issues to perform a high-resolution, 295-day wastewater and clinical sequencing effort, in the controlled environment of a large university campus and the broader context of the surrounding county. We developed and deployed improved virus concentration protocols and deconvolution software that fully resolve multiple virus strains from wastewater. We detected emerging variants of concern up to 14 days earlier in wastewater samples, and identified multiple instances of virus spread not captured by clinical genomic surveillance. Our study provides a scalable solution for wastewater genomic surveillance that allows early detection of SARS-CoV-2 variants and identification of cryptic transmission.