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Background: During Middle Ear Surgeries (MES) done under Local Anesthesia (LA), patients may feel discomfort due to noise of suction, manipulation of instruments, positioning of head-neck and sometimes due to pain. A bloodless microscopic field is also essential to facilitate surgical exposure in MES. Various combinations of analgesics and sedatives have been tried to alleviate apprehension of the patients and improve microscopic field which may result into reduction in surgical time. In the present study, we have compared Dexmedetomedine (Dex) with Midazolam-Fentanyl (MF) and PentazocinePromethazine (PP) combinations for their sedoanalgesia, anxiolysis and other pharmacological effects when administered during MES, not lasting for more than 60 min. Material and Methods: Ninety American Society of American Society of Anesthesiologists (ASA) group I /II patients admitted in either of the three hospitals during May 2014 to January 2015 for MES under LA were randomly divided into three groups by an independent observer. Group D received intravenous bolus of Injection Dexmedetomidine 1 µg/ kg over 10 min. Group MF received Injection Midazolam 0.06 mg/ kg + Inj. Fentanyl 1 µg/ kg and Group PP received Injection Pentazocine 0.3 mg/kg + Injection Promethazine 0.5mg/kg given intravenously followed by LA before taking incision for the surgery. Need of a rescue sedoanalgesic dose of (Midazolam 0.01 mg/kg + Fentanyl 0.5 µg/kg) during the surgery was noted. All the patients received 500 ml of normal saline infusion till the end of the surgery. All surgeries were finished within 60 min. Vital parameters and Ramsay Sedation Score (RSS) of the patients were noted from the time of administration of sedative till the end of the surgery. Patient and surgeon satisfaction scores were recorded immediately after the surgery. Drug combinations of three groups were compared for their effectiveness, adverse effects and satisfaction scores in given doses. Children, mentally unstable patients, uncooperative patients, patients requesting general anesthesia, patients with known sensitivity to local anesthetic drug Lignocaine, and allergy to study drugs, pregnant and lactating females were excluded from the study. Results: RSS were satisfactory in Group D and Group MF but not in Group PP. Percentage of patients requiring rescue sedoanalgesic dose of (Midazolam 0.01 mg/kg + Fentanyl 0.5 µg/kg) was the highest (20%) in Group PP. It was the least in Group D. Intraoperative heart rate and mean arterial pressure in Group D were significantly lower than the baseline values and the corresponding values in Group MF and Group PP. Incidence of postoperative nausea was higher in Group PP. One patient in Group D had significant bradycardia with hypotension while one patient in Group MF got desaturated needing Oxygen therapy. Statistically significant number of patients from Group D had bloodless microscopic field compared to Group MF and Group PP. Surgeon satisfaction scores which showed statistically significant correlation with type of microscopic field were better in Group D. Patient satisfaction scores were better in Group D than Group MF and Group PP. Conclusion: Out of the sedoanalgesics tested, Dexmedetomidine was found to be the best drug for MES patients performed under local anaesthesia. It produced near bloodless microscopic surgical field with better surgeon and patient satisfaction.

Purpose: Our objective was to study the pressor response to endotracheal intubation through laryngeal mask airway C-Trach and compare it to the hemodynamic response to intubation with direct laryngoscopy (DL). Materials and Methods: After obtained approval from institutional ethical committee, 100 patients of American Society of Anesthesiologists physical Status I, aged 14-65 years, posted for elective surgery were enrolled in the trial. They were randomly divided into two groups of each 50 patients. Anesthesia technique was standardized and patients of Group I were intubated using DL, while patients of Group II were intubated with the help of C-Trach assembly. Hemodynamic parameters, systemic blood pressure (systolic and diastolic) and heart rate were recorded before and after induction of anesthesia and every minute up to 5 min after intubation. Results: Patients of Group II recorded a minimal rise in peak systolic blood pressure (SBP) (1.8%) and diastolic blood pressure (10.6%). In comparison patients of Group I recorded a significant sustained rise in peak SBP (20.3%) and diastolic blood pressure (21.4%). However heart rate changes recorded in the two groups were of equal measure (peak rise of 22.9% in Group I vs. 22.4% in Group II). Conclusion: We conclude that intubation through C-Trach generates a lower pressor response to intubation in comparison to intubation using DL.

Objective: Few studies have investigated the reasons for alcohol initiation and continuation. The present study examined reasons for trying alcohol for the first time and its subsequent use. Furthermore, the study attempted to discover the possible predictors that make an individual vulnerable to alcohol use. Methodology: A total of 280 first-year college students from six different colleges were contacted. Using the method of equal probability, every third subject from each class was selected. All the selected subjects were interviewed and administered semi-structured questionnaire for gathering information regarding their experience with alcohol. Results: In our study, experimentation and peer pressure were found to be the main reasons for both alcohol use and its re-use. The first time drinkers differed a lot from those with multiple users in terms of reasons for trying alcohol, the effect of alcohol, family history of alcohol use, and self-view about alcohol use. The results depicted that the gender, educational stream, and family history of alcohol use are the factors that make an individual vulnerable to alcohol use. Conclusion: First-year of college is a unique transitional period. First-year students with high levels of sensation seeking may be especially at high-risk to begin or escalate heavy drinking. Studying the nature of alcohol initiation may not only be helpful in planning awareness programs but also in preventing underage drinking and alcohol abuse.

Context.--Human epidermal growth factor (HER2/neu) gene amplification, a poor prognostic factor in invasive breast cancer, has shown substantial utility as a predictive marker, with significantly improved survival following anti-HER2 therapies like trastuzumab. Dual-color dual in situ hybridization (D-DISH), a recently introduced fully automated assay for HER2/neu evaluation on light microscopy, has several advantages over fluorescence in situ hybridization (FISH). Objective.--To standardize and validate the D-DISH assay using FISH as the gold standard and assess interobserver reproducibility in interpreting the D-DISH assay. Design.--D-DISH was performed using the latest HER2 Dual ISH DNA Probe Cocktail assay (Ventana Medical Systems Inc, Tucson, Arizona) in 148 cases of invasive breast cancer. The same block was used for performing immunohistochemistry by Ventana PATHWAY anti-HER2/neu (4B5) antibody and FISH assay by ZytoLight SPEC ERBB2/CEN17 Dual Color Probe. D-DISH was separately interpreted by 4 pathologists blinded to FISH results. Results.--Concordance of 98.65% and a Cohen [kappa] value of 0.97 were observed between FISH and D-DISH. Intraclass correlation coefficient (0.93-0.97) and [kappa] values (0.98-1.0) for interobserver reproducibility showed almost perfect agreement by D-DISH. Interobserver reproducibility was also evaluated for genomic heterogeneity, HER2 group categorization, and polysomy (k values 0.42-0.74, 0.89-0.93, and 0.98-1.0, respectively). Conclusions.--We successfully validated the latest version of D-DISH assay as a substitute for FISH in predicting HER2 gene status with significant interobserver reproducibility, concluding that this D-DISH assay may be introduced in routine diagnostic services as a reflex test to ascertain HER2 gene status. doi: 10.5858/arpa.2022-0543-0A, The human epidermal growth factor (HER2/neu) gene, located on the long arm of human chromosome 17 (17q12), is associated with aggressive tumor behavior and has emerged as an independent prognostic [...]

A good dressing is mandatory to an uncomplicated wound healing, especially when foreign particles contaminate the wound. Various forms of dressing preparations are available for use and differ in chemical composition and efficacy. Silver has been a known agent with good antimicrobial and healing properties and recent times has seen an upsurge in various silver-based dressing supplements. We describe our report of use and efficacy of a silver nanoparticle- based gel dressing in the healing of multiple superficial firearm pellet wounds.

OBJECTIVE:To explore the value of machine learning methods for predicting multiple sclerosis disease course. METHODS:1693 CLIMB study patients were classified as increased EDSS≥1.5 (worsening) or not (non-worsening) at up to five years after baseline visit. Support vector machines (SVM) were used to build the classifier, and compared to logistic regression (LR) using demographic, clinical and MRI data obtained at years one and two to predict EDSS at five years follow-up. RESULTS:Baseline data alone provided little predictive value. Clinical observation for one year improved overall SVM sensitivity to 62% and specificity to 65% in predicting worsening cases. The addition of one year MRI data improved sensitivity to 71% and specificity to 68%. Use of non-uniform misclassification costs in the SVM model, weighting towards increased sensitivity, improved predictions (up to 86%). Sensitivity, specificity, and overall accuracy improved minimally with additional follow-up data. Predictions improved within specific groups defined by baseline EDSS. LR performed more poorly than SVM in most cases. Race, family history of MS, and brain parenchymal fraction, ranked highly as predictors of the non-worsening group. Brain T2 lesion volume ranked highly as predictive of the worsening group. INTERPRETATION:SVM incorporating short-term clinical and brain MRI data, class imbalance corrective measures, and classification costs may be a promising means to predict MS disease course, and for selection of patients suitable for more aggressive treatment regimens.

Acid catalysis is quite prevalent and probably one of the most routine operations in both industrial processes and research laboratories worldwide. Recently, “graphene”, a two dimensional single-layer carbon sheet with hexagonal packed lattice structure, imitative of nanomaterials, has shown great potential as alternative and eco-friendly solid carbocatalyst for a variety of acid-catalyzed reactions. Owing to their exceptional physical, chemical, and mechanical properties, graphene-based nanomaterials (G-NMs) offer highly stable Brønsted acidic sites, high mass transfer, relatively large surface areas, water tolerant character, and convenient recoverability as well as recyclability, whilst retaining high activity in acid-catalyzed chemical reactions. This comprehensive review focuses on the chemistry of G-NMs, including their synthesis, characterization, properties, functionalization, and up-to-date applications in heterogeneous acid catalysis. In line with this, in certain instances readers may find herein some criticisms that should be taken as constructive and would be of value in understanding the scope and limitations of current approaches utilizing graphene and its derivatives for the same.

Aim: This study was conducted to evaluate the efficacy of the combination therapy i.e. inverted periosteal graft (IPG) with autogenous bone used alone and in conjunction with an osteoclast inhibitor - 1% alendronate (ALN) sodium gel, in the treatment of mandibular buccal degree II furcation defects. Materials and Method: A total of 28 buccal degree II furcation defects in 14 patients were selected and randomly divided into Group A and Group B. Experimental sites in Group A were treated using inverted periosteal graft and autogenous bone mixed with 1% alendronate gel and experimental sites in Group B were treated with inverted periosteal graft and autogenous bone only. Results: Both the experimental groups showed significant reduction in probing pocket depth, gain in clinical attachment level and mean percentage of horizontal defect fill (41.82% vs 49.09%) at 6 months. Experimental sites in group B showed a significant loss in mean vertical defect height compared to experimental group A (1.52% Vs -1.59%). Conclusion: It can be suggested that bisphosphonates such as alendronate sodium have the potential to inhibit the surgery induced bone loss.

The anti-microbial efficacy of aqueous extracts of Indian chewing sticks against different kinds of plaque bacteria in vitro was investigated. Supra-gingival plaque is cultured and subjected to the antibacterial activity of the aqueous extracts of chewing sticks (Neem, Acacia, Pongamia glabra, Achyranthes aspera, Streblus asper) separately. The results of the study demonstrate that all the five chewing sticks under study possess inhibitory potential against bacteria present in dental plaque mainly on aerobes. The antibacterial efficacy of aqueous extracts has antibacterial effects and could be used as a therapeutic agent and therefore, it appears to be potent anti-microbial agents that could be considered as a medicinal plant. Results of this study showed chewing sticks contained antibacterial agents, but the concentration and composition of the active substances differed among the plants.

Background: Organophosphate compound (OPC) poisoning with suicidal intent is common in Indian ICUs. These compounds are the organic derivatives of phosphorous containing acids and their effect on neuromuscular junction and autonomic synapses is clinically important. Organophosphate poisoning can present as acute cholinergic syndrome, intermediate syndrome and delayed neuropathy. Case Presentation: Intermediate syndrome secondary to organophosphate poisoning is a serious health problem leading to increased morbidity and mortality. The incidence of problem varies and ranges from 8%-84% of OPC poisoning cases. After initial recovery from cholinergic crisis, some patients have resurgence of respiratory muscle paralysis requiring continued ventilatory support. This is termed intermediate syndrome (IMS). The factors accounting for this difference is the nature of organophosphate compound, severity of poisoning and inadequate oxime therapy. The recognition of this syndrome is important as if this entity is overlooked it can have disastrous effects. Discussion: Our patient had developed respiratory muscle weakness as evidenced by inadequate respiratory efforts, drop in oxygen saturation, retention of CO2 and need for ventilatory support. There was no evidence of weakness in ocular, neck, bulbar muscles but he had weakness in all 4 limbs more pronounced in proximal muscles. Conclusion: We presented this case of OPC poisoning with intermediate syndrome, which remained for a prolonged time and required mechanical ventilation for 16 days. This case highlights how the timely intervention can save the patient’s life.

Dengue is the most rapidly spreading viral disease transmitted by the bite of infected Aedes mosquitos. The pathogenesis of dengue is still unclear; although host immune responses and virus serotypes have been proposed to contribute to disease severity. In this study, we examined the circulating dengue virus (DENV) and measured plasma levels of inflammatory mediators. Ninety-eight patients during a dengue outbreak in eastern India in 2016 were included in the study. The presence of DENV was demonstrated by detecting NS1 antigen; IgM capture ELISA and serotypes were discriminated by type-specific RT-PCR and/or sequencing. Plasma samples were assayed for 41-plex cytokine/chemokines using multiplex Luminex assay. Eighty-five (87%) samples were positive by NS1/IgM capture ELISA/RT-PCR. All four serotypes of DENV were detected in this outbreak, with DENV-2 as the predominant type, seen in 55% of cases. Mixed infections were seen in 39% of subjects. Among the host inflammatory biomarkers, GM-CSF, IFN-γ, IL-10, IL-15, IL-8, MCP-1, IL-6, MIP-1β, and TNF-α levels were significantly increased in dengue with and without warning signs, in severe dengue patients in comparison to healthy controls. Four cytokines IFN-γ, GM-CSF, IL-10, and MIP-1β correlated significantly with disease severity and could serve as potential predictor for disease severity. Information on the host biomarkers and the dengue serotype may help guide in optimizing effective intervention strategies.

The branching of axons is a fundamental aspect of nervous system development and neuroplasticity. We report that branching of sensory axons in the presence of nerve growth factor (NGF) occurs at sites populated by stalled mitochondria. Translational machinery targets to presumptive branching sites, followed by recruitment of mitochondria to these sites. The mitochondria promote branching through ATP generation and the determination of localized hot spots of active axonal mRNA translation, which contribute to actin-dependent aspects of branching. In contrast, mitochondria do not have a role in the regulation of the microtubule cytoskeleton during NGF-induced branching. Collectively, these observations indicate that sensory axons exhibit multiple potential sites of translation, defined by presence of translational machinery, but active translation occurs following the stalling and respiration of mitochondria at these potential sites of translation. This study reveals a local role for axonal mitochondria in the regulation of the actin cytoskeleton and axonal mRNA translation underlying branching.

Endometriosis is a common benign disease of reproductive age women, and can involve the intestinal tract. Inconsistent clinical presentation, similar features on radiological imaging and colonoscopy with other inflammatory and malignant lesions of the bowel makes the preoperative diagnosis of bowel endometriosis difficult. We present a case of a 42-year-old perimenopausal female clinically presented, investigated and managed in the lines of carcinoma of sigmoid colon. She underwent terminal ileac resection with end to end anastomoses, Hartmann′s procedure and total hysterectomy with bilateral salpingoophorectomy. The histopathological report revealed endometriosis of small intestine, large intestine, mesentery, right ovary and adenomyoma of uterus. Thus, bowel endometriosis should also be considered as differential diagnosis in reproductive age women with gastrointestinal symptoms or intestinal mass of uncertain diagnosis.

Trans-differentiation of follicular lymphoma (FL) into a histiocytic sarcoma (HS) is a rare event and usually occurs as a sequential event. We report a case where in the same node with two distinct areas one of low-grade FL and another with HS was observed. This patient was a 58 years old with generalized lymphadenopathy and Ann Arbor Stage III disease. The cervical node biopsy on histological examination revealed two distinct areas, firstly a FL with nodular architecture and the other a smaller focus of sheets of pleomorphic histiocytic cells diffusely arranged at the edge of the section contiguous with FL with few cells in transiting phase. On immunohistochemistry the FL was positive for CD20, CD10, PU.1, PAX5 and Bcl2, while the large histiocytic cells were positive for CD163, CD68, LCA, and PU.1, weakly for PAX5 and negative for CD20, CD10, CD30, CD3, CD1a, Bcl2, S100, and Alk-1. The therapeutic implications of this diagnosis and postulated theories on trans-differentiation are discussed.

BackgroundWe previously reported an association between household chemical exposures and an increased risk of paediatric-onset multiple sclerosis.MethodsUsing a case-control paediatric multiple sclerosis study, gene-environment interaction between exposure to household chemicals and genotypes for risk of paediatric-onset multiple sclerosis was estimated.Genetic risk factors of interest included the two major HLA multiple sclerosis risk factors, the presence of DRB1*15 and the absence of A*02, and multiple sclerosis risk variants within the metabolic pathways of common household toxic chemicals, including IL-6 (rs2069852), BCL-2 (rs2187163) and NFKB1 (rs7665090).Results490 paediatric-onset multiple sclerosis cases and 716 controls were included in the analyses. Exposures to insect repellent for ticks or mosquitos (OR 1.47, 95% CI 1.06 to 2.04, p=0.019), weed control products (OR 2.15, 95% CI 1.51 to 3.07, p

The present day school system curtails children's natural growth and interferes with their freedom to explore. It is here that teachers have an opportunity to engage meaningfully with the student community, and make them and society aware of the importance to explore and become self-determined and autonomous learners. Sustained engagement of students in an online class is only possible with continuous efforts from teachers. Constructivist Digital Learning Heutagogy could be the effective solution to break the monotony in online classes, and also to break away from teacher-centric classes and to bring about constructive engagement among the learners in online classes. Online education has very much changed the needs of education. Today we need an education system which is self-driven and facilitated by a teacher or a more knowledgeable other. The study throws light on CDLH (Constructivist Digital Learning Heutagogy) Model. Four-week training (how to teach with the use of the CDLH Model) was given to TGT mathematics teachers and then an intervention at six months will be provided by the same mathematics teachers to their students to assess the psychological indicators like Positive Emotions (Expression, Emotion Management, Expressing Gratitude), Academic Achievement (Focus and Persistence), Learning Engagement (Love of Learning) and Positive Relationship (Peer Relationships and Empathy) taught by the CDLH Model. CDLH model has been validated and tested for reliability (PLS SEM software) in the pilot test conducted. Results revealed that learning through constructivist Digital Learning Heutagogy supported academic achievement, learning engagement and positive emotions, whereas it also showed that the peer relationship was not supported by the intervention. Very importantly it helped to break the monotony of the class.

l-Dopa-induced dyskinesias (LIDs) are abnormal involuntary movements that develop with long term l-dopa therapy for Parkinson's disease. Studies show that nicotine administration reduced LIDs in several parkinsonian animal models. The present work was done to understand the factors that regulate the nicotine-mediated reduction in LIDs in MPTP-lesioned nonhuman primates. To approach this, we used two groups of monkeys, one with mild-moderate and the other with more severe parkinsonism rendered dyskinetic using l-dopa. In mild-moderately parkinsonian monkeys, nicotine pretreatment (300 μg/ml via drinking water) prevented the development of LIDs by ~75%. This improvement was maintained when the nicotine dose was lowered to 50 μg/ml but was lost with nicotine removal. Nicotine re-exposure again decreased LIDs. By contrast, nicotine treatment did not reduce LIDs in monkeys with more severe parkinsonism. We next determined how nicotine's ability to reduce LIDs correlated with lesion-induced changes in the striatal dopamine transporter and 3H-dopamine release in these two groups of monkeys. The striatal dopamine transporter was reduced to 54% and 28% of control in mild-moderately and more severely parkinsonian monkeys, respectively. However, basal, K+, α4β2* and α6β2* nAChR-evoked 3H-dopamine release were near control levels in striatum of mild-moderately parkinsonian monkeys. By contrast, these same release measures were reduced to a significantly greater extent in striatum of more severely parkinsonian monkeys. Thus, nicotine best improves LIDs in lesioned monkeys in which striatal dopamine transmission is still relatively intact. These data suggest that nicotine treatment would most effectively reduce LIDs in patients with mild to moderate Parkinson's disease.

Introduction: Within the last 20 years root demineralization has attracted attention as a periodontal regenerative technique. Topical tetracycline application has been widely reported for use as a conditioner, to decontaminate the root surface and to promote periodontal regeneration. The purpose of this scanning electron microscopic (SEM) study is to evaluate the surface characteristics of demineralized diseased and non-diseased dentine root surfaces using different concentrations of tetracycline hydrochloride (TTC-HCl). Material and Methods: This SEM study was carried out in 20 dentin samples obtained from non-diseased human premolars and 20 dentin samples obtained from diseased human premolars. Pure TTC-HCl was applied to the dentin surface at 50 mg/ml, 100 mg/ml and 150 mg/ml concentrations for 3 min in experimental groups while distilled (0 mg/ml) water was applied to the control groups. Statistical Analysis: Mean and standard deviation were estimated from the sample for each study group. Mean values were compared by either one-way ANOVA with Tukey-Honestly significant difference procedure or Kruskal - Wallis one way ANOVA with Mann-Whitney u-test. Further Student′s independent t-test/Mann-Whitney u-test was used appropriately to compare the mean values between two independent groups. Results: In the present study using 100 mg/ml tetracycline seems to be more effective on both diseased and non-diseased dentin surfaces. Conclusions: The results of this study confirm that pure TTC-HCl conditioning produced comparable surface characteristics on dentin of both diseased and non-diseased roots with 100 mg/ml concentration for 3 min.

Introduction: Attention Deficit Hyperactivity Disorder (ADHD) is characterized by a persistent pattern of inattention and/or hyperactivity-impulsivity. In view of the adverse effects associated with psycho-stimulants used for the treatment of this disorder, efficacy of Brāhmīghṛtam was evaluated in this condition. Materials and Methods: After following due ethical considerations, children of either sex between the age group of 6 and 12 years diagnosed to be suffering from mixed variety of ADHD as per The Diagnostic and Statistical Manual of Mental Disorders (DSM) IV criteria irrespective of other co-morbid psychiatric illnesses were recruited in the study. Initially a pilot study (n = 10) was carried out to confirm the efficacy of the identified dose of Brāhmīghṛtam. Using this dose, further therapeutic confirmatory study (n = 27) was carried out, wherein Brāhmīghṛtam was compared with methylphenidate. Effect on ADHD symptoms was assessed using the Dupaul ADHD rating scale and this was the main efficacy parameter. Results: In the pilot exploratory study, Brāhmīghṛtam showed 66% decrease in total ADHD score. In the therapeutic confirmatory study, only 16% improvement was seen with Brāhmīghṛtam, which was similar to methylphenidate, standard treatment for ADHD that was used as a comparator in the present study. No side-effects were reported in both studies. Conclusion: Our study thus has adequately demonstrated efficacy and safety of Brāhmīghṛtam in ADHD.

Introduction: Preeclampsia may lead to heart failure in late pregnancy and early puerperium. Diastolic dysfunction may be the cause of heart failure in these patients. There is paucity of data on diastolic dysfunction in patients with preeclampsia. Aim: To assess cardiac diastolic dysfunction in women with preeclampsia by Doppler echocardiography and to correlate severity of dysfunction with severity of preeclampsia. Materials and Methods: One hundred and fifty nulliparous women in age group of 20-35 years were recruited for the study. Among these, 120 women with preeclampsia were taken as cases and 30 normotensive women as controls. Doppler echocardiography was carried out between 28-36 weeks of gestation in both groups to assess and grade severity of diastolic dysfunction. Results: Of 120 women with preeclampsia, 61 had mild preeclampsia and 59 had severe preeclampsia. Diastolic dysfunction was seen in 25(20.8%) cases. Among these, grade I diastolic dysfunction was seen in 40% and the rest 60% had grade II diastolic dysfunction. In the mild preeclampsia group, only 2(3.3%) patients had diastolic dysfunction. Both had grade I dysfunction. Of severe preeclampsia patients, 8(13.6%) had grade I and 15(25.4%) had grade II diastolic dysfunction (p=0.001). None of these progressed to heart failure or pulmonary oedema. Systolic function assessed by left ventricular ejection fraction was normal in all cases. All controls had normal systolic and diastolic functions. Conclusion: Cardiac diastolic dysfunction occurred in one-fifth of women with preeclampsia. Grade of diastolic dysfunction correlated with the severity of preeclampsia.

Introduction: Body image is an essential aspect of young girls’ self-definition and individual identity which is influenced by various biological, psychological and social factors. Excessive concern about body image, body image misconception are leading to dissatisfaction, disturbed eating patterns, affecting the nutritional status and also leading to depression and anxiety disorders. This concept of body image has been less explored in Indian context, especially among young girls. Aims: The objectives of the study were to assess the body image perception among young college going girls, using a visual analog scale and to compare body image perception and satisfaction with their BMI levels and weight changing methods adopted. Materials and Methods: An exploratory cross-sectional study was conducted among 63 female students studying BBM course at a private commerce institution in Vijayapur city. Data was collected using a self administered questionnaire containing details of basic socio-demographic information and a validated visual analogue scale. Height was measured by Seca Stadiometer, weight was measured using Digital weighing machine and Body Mass Index levels were calculated. Percentages were calculated for descriptive variables. Chisquare test was applied for analysing categorical variables. Spearman Rank correlation test was applied for analysing ordinal data. Results: A 39.7% of participants were underweight and 15.9% were overweight/obese. Majority of underweight and overweight girls (72% and 89%, respectively) perceived themselves as normal weight. Body image satisfaction of participants was found to be significantly associated with their body image perception, mothers’ educational status and also with relatives’ and peer group’s opinions about their body weight. Unhealthy weight changing patterns like skipping meals (13%), increasing quantity and frequency of meals (17%) were reported among study participants. Conclusion: This exploratory study highlights the gap between young girls’ body image perception and their BMI levels, indicating body image misconception. Lower literacy level of mothers and opinions of relatives and friends significantly influenced body image satisfaction among study participants. Higher percentage of underweight (39.7%) coupled with unhealthy weight changing patterns reportedly adopted by participants (30%) indicates need for further research on this issue, to help inform public health nutrition programmes.

Aims: Cellulosic biomass is the only foreseeable sustainable source of fuels and is also one of the dominating waste materials in nature resulting from human activities. Keeping in view the environmental problems like disposal of large volumes of cellulosic wastes and shortage of fossil fuel in the world, the main aim of the present investigation was to characterize and study the cellulolytic activity of Streptomyces albospinus (MTCC 8768), isolated from municipal wastes, on natural cellulosic substrates viz. straw powder, wood powder and finely grated vegetable peels.Methodology and Result: Stanier’s Basal broth with 100 mg of each of the substrates was inoculated separately with S. albospinus (MTCC No. 8768) and incubated at 37 °C for 8 days. The cellulosic substrates were re-weighed at an interval of 2 days and the difference between the initial weight and the final weight gave the amount of substratesdegraded by the isolate. It was observed that maximum degradation was observed in the grated vegetable peels (64 mg) followed by straw powder (38 mg) and wood powder (28 mg) over a period of 8 days.Conclusion, significance and impact of study: By the selection of efficient cellulolytic microorganisms and cost-effective operational techniques, the production of useful end products from the biodegradation of the low cost enormous stock of cellulose in nature can be very beneficial.

Background: In the administration of minimal flow anesthesia, traditionally a fixed time period of high flow has been used before changing over to minimal flow. However, newer studies have used "equilibration time" of a volatile anesthetic agent as the change-over point. Materials and Methods: A randomized prospective study was conducted on 60 patients, who were divided into two groups of 30 patients each. Two volatile inhalational anesthetic agents were compared. Group I received desflurane (n = 30) and group II isoflurane (n = 30). Both the groups received an initial high flow till equilibration between inspired (Fi) and expired (Fe) agent concentration were achieved, which was defined as Fe/Fi = 0.8. The mean (SD) equilibration time was obtained for both the agent. Then, a drift in end-tidal agent concentration during the minimal flow anesthesia and recovery profile was noted. Results: The mean equilibration time obtained for desflurane and isoflurane were 4.96 ± 1.60 and 16.96 ± 9.64 min (P < 0.001). The drift in end-tidal agent concentration over time was minimal in the desflurane group (P = 0.065). Recovery time was 5.70 ± 2.78 min in the desflurane group and 8.06 ± 31 min in the isoflurane group (P = 0.004). Conclusion: Use of equilibration time of the volatile anesthetic agent as a change-over point, from high flow to minimal flow, can help us use minimal flow anesthesia, in a more efficient way.

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 report three elderly patients with follicular lymphoma in situ (FLIS) each highlighting a unique pattern of disease presentation and progression. The first patient had incidentally detected FLIS with peripheral blood spill and yet had an 11-year uneventful follow up. The second patient with an overt follicular lymphoma (FL) developed high-grade transformation in jejunum with FLIS extensively involving the Payers patches. The third patient had a FLIS but that qualified as higher grade and was treated in spite of lack of overt FL mainly because of higher grade and patient subsequently did develop overt FL. The first case of typical FLIS confirms that peripheral blood spill does not connote poor prognosis in FLIS, the second case illustrates that FLIS may colonize mucosa-associated lymphoid tissue as part of homing in process of a disseminated FL and the third case validates the aggressive nature of high-grade FLIS.

Primary cutaneous marginal zone lymphomas (PCMZL) have a wide range of morphology from tumors with monocytoid B cells to those composed entirely of plasma cells and the T-cell rich variants. We report a 60-year-old male with a PCMZL rich in plasma cells of the foot with a lymphoepithelioid-like pattern of dissemination to the lymph nodes posing problems in the diagnosis. The patient had a lesion on the dorsum of the foot which histologically revealed dense perivascular collections of lymphoid cells and plasma cells amidst fibrous tissue. Though the plasma cells did show light chain restriction, CD20 and CD3 did not reveal an overwhelming B/T-cell population and hence a diagnosis of a reactive process was offered. Subsequently the patient developed inguinal nodes with diffuse loss of architecture and replacement by epithelioid histiocytes and reactive T cells with few large B cells (lymphoepithelioid-like pattern). On pathology review it was realized that the two lesions may be related and clonality studies were asked for. The skin lesion showed clonally rearranged IgH receptor while the T-cell receptor rearrangement was negative. The patient developed disseminated disease and received six cycles of chemotherapy with partial response and 6 years after the initial presentation was alive with nonprogressive disease. Thus, the polymorphous background in PCMZL is evolving and an immunocytoma-like tumor can show a T-cell rich or Lennert′s like growth pattern of spread and early recognition these odd patterns may aid in appropriate management of patients.