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Ovarian pathology ranges from innocuous non-neoplastic lesions to malignant neoplastic entities. The incidence, clinical appearance and the behaviour of the different types of ovarian tumour is extremely variable. In order to have a better understanding of frequency and histomorphological patterns of different ovarian lesions study was encountered in our tertiary care hospital.To study the histopathology of ovarian non-neoplastic and neoplastic lesions and to study the distribution of ovarian lesions with respect to various parameters like age, bilaterality, gross and microscopic features.This is a prospective study of 125 ovarian specimens received in department of pathology, G.K. General Hospital, Bhuj during August 1, 2018 to July 31, 2020. Total 125 cases of ovarian specimens were studied, amongst them 58 were non-neoplastic and remaining 67 were neoplastic. The most common non-neoplastic lesion seen was follicular cysts 12 cases (21%), followed by endometriosis 9 cases (16%). Among 67 neoplastic ovarian lesions 58(87%) cases were benign, 3(4%) cases were borderline and 6 (9%) cases were malignant. In benign ovarian neoplasm, most commonly seen lesions were serous cystadenoma 24 cases (36%) followed by 13 cases (20%) of mature cystic teratoma. In malignant cases, maximum was of high-grade serous cystadenocarcinoma.Ovarian epithelial tumours are the most common type, while serous cystadenocarcinoma was the most common malignancy. Histological examination is gold standard and in certain difficult cases require immunohistochemistry.Ovary is an important reproductive organ with involvement in production of progeny.Ovarian pathology ranges from innocuous non-neoplastic lesions to malignant neoplastic entities. Ovarian neoplasms have become increasingly important not only because of the wide range of neoplasms, but also because they have gradually increased the mortality rate. The incidence, clinical appearance and the behaviour of the different types of ovarian tumour is extremely variable.

Acute respiratory distress syndrome (ARDS) is a highly heterogeneous clinical condition. Shock is a poor prognostic sign in ARDS, and heterogeneity in its pathophysiology may be a barrier to its effective treatment. Although right ventricular dysfunction is commonly implicated, there is no consensus definition for its diagnosis, and left ventricular function is neglected. There is a need to identify the homogenous subgroups within ARDS, that have a similar pathobiology, which can then be treated with targeted therapies. Haemodynamic clustering analyses in patients with ARDS have identified two subphenotypes of increasingly severe right ventricular injury, and a further subphenotype of hyperdynamic left ventricular function. In this review, we discuss how phenotyping the cardiovascular system in ARDS may align with haemodynamic pathophysiology, can aid in optimally defining right ventricular dysfunction and can identify tailored therapeutic targets for shock in ARDS. Additionally, clustering analyses of inflammatory, clinical and radiographic data describe other subphenotypes in ARDS. We detail the potential overlap between these and the cardiovascular phenotypes.

ARDS is the major cause of mortality in patients with SARS-CoV-2 pneumonia. We report a single-centre study comparing the characteristics of ARDS patients with and without SARS-CoV-2. A greater proportion of SARS-CoV-2 patients were from an Asian ethnic group (p=0.002). SARS-CoV-2 patients had lower circulating leukocytes, neutrophils and monocytes (p

Supplemental Digital Content is available in the text., Objectives: Vitamin D deficiency has been implicated as a pathogenic factor in sepsis and ICU mortality but causality of these associations has not been demonstrated. To determine whether sepsis and severe sepsis are associated with vitamin D deficiency and to determine whether vitamin D deficiency influences the severity of sepsis. Design, Setting, and Patients: Sixty-one patients with sepsis and severe sepsis from two large U.K. hospitals and 20 healthy controls were recruited. Murine models of cecal ligation and puncture and intratracheal lipopolysaccharide were undertaken in normal and vitamin D deficient mice to address the issue of causality. Measurements and Main Results: Patients with severe sepsis had significantly lower concentrations of 25-hydroxyvitamin D3 than patients with either mild sepsis or age-matched healthy controls (15.7 vs 49.5 vs 66.5 nmol/L; p = 0.0001). 25-hydroxyvitamin D3 concentrations were significantly lower in patients who had positive microbiologic culture than those who were culture negative (p = 0.0023) as well as those who died within 30 days of hospital admission (p = 0.025). Vitamin D deficiency in murine sepsis was associated with increased peritoneal (p = 0.037), systemic (p = 0.019), and bronchoalveolar lavage (p = 0.011) quantitative bacterial culture. This was associated with reduced local expression of the cathelicidin-related antimicrobial peptide as well as evidence of defective macrophage phagocytosis (p = 0.029). In the intratracheal lipopolysaccharide model, 1,500 IU of intraperitoneal cholecalciferol treatment 6 hours postinjury reduced alveolar inflammation, cellular damage, and hypoxia. Conclusions: Vitamin D deficiency is common in severe sepsis. This appears to contribute to the development of the condition in clinically relevant murine models and approaches to correct vitamin D deficiency in patients with sepsis should be developed.

To study neurological outcome of Moya Moya disease treated surgically with Encephaloduroarteriosynengopsis (EDAS).Prospective observational study.Community and General with tertiary care facility.Eight children diagnosed with Moya Moya disease by Magnetic Resonance Angiogramover 4 years of period were selected for EDAS. Children who were not able to sustain surgery excluded from study.Treatment modality selected were surgery in form of EDAS. After surgery subjects were followed up for minimum of 2 year period to know neurological out come. Outcome was reported as poor, fair, good and excellent. No statistical analysis performed due to small sample size.After surgery no episode of stroke or TIA was observed in any patient during 2 year follow up period and all patients are living without any new neurological deficit.Long term outcome of EDAS is promising.