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Xanthomas are characterized by the presence of foamy lipid-laden macrophages. The gastrointestinal tract is an uncommon site for xanthoma, with the stomach being the most favored location. They have been associated with various premalignant and malignant conditions of the stomach. We present a case of a 21-year-old female patient with dyspepsia of 4 months duration. Her lipid profile was mildly altered. On upper gastrointestinal endoscopy, multiple discrete yellow patches were found in the antrum, diagnosed as gastric xanthoma on microscopy. Various published literature has emphasized the frequent association of gastric xanthomas with gastritis, gastric atrophy, intestinal metaplasia, and gastric cancer. Hence, there is a necessity for early recognition, treatment of any coexistent pathology, and close clinical follow-up. [ABSTRACT FROM AUTHOR]

Gout is a metabolic disease that occurs either because of increased uric acid production or decreased uric acid secretion. It most commonly affects middle‑aged to elderly men and postmenopausal women. Chronic tophaceous gout frequently occurs after 10 years or more of recurrent polyarticular gout. Gouty tophi are deposition of monosodium urate (MSU) crystals in and around joints as well as soft tissues. We present a case of chronic tophaceous gout in a 21‑year‑old male, which occurred after 4 years of onset of gouty arthritis. The patient presented with tophaceous gout in four forms, that is, periarticular subcutaneous tophi, disseminated intradermal tophi, ulcerative form, and miliarial tophi along with multiple sinuses discharging chalky white material. The case was diagnosed as chronic tophaceous gout on the basis of raised serum uric acid, imprint smear showing needle‑shaped crystals and negatively birefringent crystals on polarized microscopy. The case is interesting for varied morphological forms of tophaceous gout in a patient at an early age and shorter interval between onset of gouty arthritis and tophaceous gout. [ABSTRACT FROM AUTHOR]

Teratomas are nonseminomatous germ cell tumors composed of elements derived from more than one germinal layers (endoderm, mesoderm, and ectoderm). Malignant transformation of teratoma in the testis is well known; however, benign somatic neoplasm arising in a testicular teratoma is a rare occurrence. We report a case of meningothelial variant of meningioma arising in a pure and mature teratoma of the testis in a 5-year-old boy. Immunohistochemistry was positive for epithelial membrane antigen and vimentin. To our knowledge, this is the first report of meningothelial meningioma in a prepubertal testicular teratoma. [ABSTRACT FROM AUTHOR]

Introduction: Leprosy also known as Hansen's disease is one of the oldest disease known to mankind. It is a chronic infectious disease caused by Mycobacterium leprae. It still remains as a major public health problem facing India. Nearly, 60% of all world leprosy cases are reported from India. The spectrum of presentation of leprosy is very wide. Histopathology is an important tool in making a definitive diagnosis. The objective of the study is to describe the histopathological profile of leprosy in the state of Bihar. Aim: To study the histopathological spectrum of leprosy at a tertiary care centre of Bihar. Materials and Methods: A retrospective hospital-based study of clinically diagnosed leprosy cases was conducted over a period of 28 months (January 2015 to April 2017). Lesional skin biopsies obtained were fixed, processed and stained with Haematoxylin and Eosin (H&E) followed by Ziehl-Neelsen (ZN) staining. The lesions were classified on microscopy as per Ridley-Jopling classification. Results: A total of 200 cases were studied. Highest incidence was in the 11 to 30 years age group for both males and females. Males were more affected (M:F=2.4:1). Most common clinical feature was loss of sensation. The commonest reported histopathological type was borderline lepromatous (43%) followed by borderline (17%). Overall ZN staining was positive in 56 (28%) cases. Conclusion: The spectrum of presentation of leprosy is very wide and there is clinical overlap between different types of leprosy. Histopathology still remains the gold standard for early diagnosis and classification of the disease. Accurate diagnosis forms the backbone for appropriate treatment and preventing deformities and drug resistance. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: To expose the rarity of the phenomena of congenital laryngeal cysts. Additionally, a discussion is presented in support of the basic similarities between laryngeal duplication cyst and bronchogenic cyst and a proposal to use the term ‘bronchogenic cyst’ (appended by the location) is put forth. Materials and methods: Three cases of cysts of the larynx, two in the neonate and one, in a child were discovered in the pediatric age group from the archives of the Department of Pathology, Kasturba Medical College, Mangalore. Observations: Laryngeal duplication cyst/bronchogenic cyst in a 6-day-old male infant was lined by predominantly respiratory with focal squamous epithelium. The wall contained fibromuscular bundles within a myxoid stroma studded with seromucinous glands. The fibromuscular bundles were positive for smooth muscle actin (SMA) and negative with desmin. A 3-year-old male child diagnosed of laryngocele had the cyst lined by respiratory epithelium and the wall densely infiltrated with lymphoid cells. A 20-day-old male neonate with laryngomalacia had a small arytenoid cyst lined by squamous epithelium. Conclusion: On morphological grounds, a laryngeal duplication cyst may be called a bronchogenic cyst and published reports do not deny that both these entities are cognate. Hence, pathologists should enjoy the freedom to write ‘bronchogenic cyst’ as the final impression if the histological features should so indicate. Otolaryngologtists however might term the congenital cyst as Type 1, 2a or 2b (according to Forte's classification) taking into account the laryngoscopic, radiologic, intraoperative and pathological findings. [Copyright &y& Elsevier]

Skin tags / acrochordons also known as fibroepithelial polyps are small benign tumors that form primarily in areas where the skin forms creases, such as neck, armpit and groin. They are harmless and typically painless, and do not grow or change over time. Giant skin tags at unusual locations have been rarely reported in literature. We present here the case of giant skin tag at labium majus which is a rare site for skin tags. To the best of our knowledge, it is one of the few largest skin tags reported over vulva. [ABSTRACT FROM AUTHOR]

The article discusses the need for social work practice in police stations. The first part presents the current state of the Indian Criminal Justice System (CJS). The next section situates CJS within the mandate of a welfare state. The issues related to policing and corrections in the country precede the section elucidating the role of and challenges faced by a social worker in the police station. It suggests that Social Work practice within the CJS would facilitate a tactical shift in its approach to address the domain of civil and political rights. The article concludes that while there is need for a partnership between social workers and police, the divergent cultures and mandates of the two professions makes it difficult, even though both have a commitment to protection. [ABSTRACT FROM AUTHOR]

The current study examines how using a multidimensional battery of predictors (high-school grade point average (GPA), SAT/ACT, and biodata), and weighting the predictors based on the different values institutions place on various student performance dimensions (college GPA, organizational citizenship behaviors (OCBs), and behaviorally anchored rating scale (BARS)), can increase the proportion of some ethnic subgroups often disadvantaged by the use of only traditional measures such as the SAT/ACT. The sample consisted of 836 students from 10 universities across the United States. Results show that meaningfully different proportions of groups would be admitted to universities when the predictors included noncognitive measures and the weights for the various components in the battery were based on performance dimensions other than first-year GPA. These dimensions should reflect institutional values. [ABSTRACT FROM AUTHOR]

Human performance applications of mindfulness-based training have demonstrated its utility in enhancing cognitive functioning. Previous studies have illustrated how these interventions can improve performance on traditional cognitive tests, however, little investigation has explored the extent to which mindfulness-based training can optimise performance in more dynamic and complex contexts. Further, from a neuroscientific perspective, the underlying mechanisms responsible for performance enhancements remain largely undescribed. With this in mind, the following study aimed to investigate how a short-term mindfulness intervention (one week) augments performance on a dynamic and complex task (target motion analyst task; TMA) in young, healthy adults (n = 40, age range = 18–38). Linear mixed effect modelling revealed that increased adherence to the web-based mindfulness-based training regime (ranging from 0–21 sessions) was associated with improved performance in the second testing session of the TMA task, controlling for baseline performance. Analyses of resting-state electroencephalographic (EEG) metrics demonstrated no change across testing sessions. Investigations of additional individual factors demonstrated that enhancements associated with training adherence remained relatively consistent across varying levels of participants' resting-state EEG metrics, personality measures (i.e., trait mindfulness, neuroticism, conscientiousness), self-reported enjoyment and timing of intervention adherence. Our results thus indicate that mindfulness-based cognitive training leads to performance enhancements in distantly related tasks, irrespective of several individual differences. We also revealed nuances in the magnitude of cognitive enhancements contingent on the timing of adherence, regardless of total volume of training. Overall, our findings suggest that mindfulness-based training could be used in a myriad of settings to elicit transferable performance enhancements. [ABSTRACT FROM AUTHOR]

Hidradenoma papilliferum (HP) is a rare benign tumor of the apocrine gland and is commonly seen at the anogenital region. A 32-year-old post-hysterectomy woman presented with excessive vaginal discharge and itching. Small polypoidal mass was noted at vault. Excision of the lesion was done, and histopathology confirmed HP. The patient is symptom free following excision. This case report highlights the presence of pluripotent cells in the vagina and their differentiation into any cell lineage. [ABSTRACT FROM AUTHOR]

Unicornuate uterus with rudimentary horn is an uncommon type of mullerian duct malformation associated with various gynecological and obstetrical complications. Rudimentary horn pregnancy is a rare entity and the majority have rupture of gravid horn leading to maternal and fetal morbidity and mortality. A case of rudimentary horn pregnancy at 32 weeks and 6days with pregnancy induced hypertension is reported where proper management results in successful pregnancy outcome. [ABSTRACT FROM AUTHOR]

Since its discovery in Wuhan, China, in December 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread rapidly around the world with being declared a pandemic in March 2020 by the World Health Organization (WHO). Comorbidities are one of the most concerning clinical considerations for mortality. Materials and Methods: This was a retrospective observational study conducted at the All India Institute of Medical Sciences in Patna, Bihar, from June 2020 to December 2020. It included adult patients who succumbed to coronavirus disease 2019 (COVID-19) during this period, and their relevant information, such as demographic information hospital stay duration, haematological parameters and comorbidities, was gathered. Results: The mean age of the study group was 63.5 (11.8) years. Of 150 cases, 126 men (about 84 per cent) and 24 women were involved (16 per cent). In our study, hypertension (HTN) was shown to be the most frequent comorbidity at 68.7% (103/150), followed by diabetes mellitus (DM) at 61.3% (92/150). The most prevalent haematological disorder identified in our investigation was anaemia and leucocytosis. Conclusion: The categorisation of patients who would need extra measures including early hospitalisation, heightened monitoring and intense therapy would be made easier by identifying patient traits and conditions. [ABSTRACT FROM AUTHOR]

Pleomorphic adenoma is the most common salivary gland neoplasm, which affects both major and minor salivary glands. It is also the most common neoplasm arising in the parotid. In minor salivary glands, it most commonly involves the palate and rarely involves the lips, cheek, and gingiva. It is also called Benign Mixed Tumour (BMT) since it is composed of a variable amount of epithelial and mesenchymal elements. Diagnostic modalities include Ultrasonography (USG), Computed Tomography (CT), and Magnetic Resonance Imaging (MRI). MRI provided the most precise structural information of the tumour as well as surrounding structures. A 60-year-old female presented with a massive right-sided infra-auricular swelling since 20 years. On Contrast Enhanced Computed Tomography (CECT), a huge lobular exophytic lesion with thin enhancing septation and few calcific foci was visualised in the right parotid region. The Fine Needle Aspiration Cytology (FNAC) yielded the diagnosis of Pleomorphic Adenoma (PA). Giant PA with an indolent course is a rare entity in itself. This is a case of giant PA of the parotid gland growing insidiously over a period of 20 years. [ABSTRACT FROM AUTHOR]

Hidradenoma papilliferum (HP) is a rare benign tumor of the apocrine gland and is commonly seen at the anogenital region. A 32-year-old post-hysterectomy woman presented with excessive vaginal discharge and itching. Small polypoidal mass was noted at vault. Excision of the lesion was done, and histopathology confirmed HP. The patient is symptom free following excision. This case report highlights the presence of pluripotent cells in the vagina and their differentiation into any cell lineage. [ABSTRACT FROM AUTHOR]

Winchester syndrome (WS) is a rare genetic disorder with a handful of cases reported to date. We report a 14‐year‐old male who presented with growth retardation, contracture of left lower limb due to thick indurated skin, hypertrichosis, and bilateral corneal opacity. There was complete improvement in joint contracture with oral betamethasone pulse and weekly oral methotrexate. [ABSTRACT FROM AUTHOR]

The rapidly growing body of research on the effect of emotional expressions in negotiation has been the subject of several narrative reviews. Through meta-analysis, we combine relevant findings, compare and integrate moderators, and examine the mediating mechanisms quantitatively. The analysis incorporates 64 published and unpublished studies conducted over three decades. The findings suggest that, generally, negotiators expressing negative emotions will increase counterparts' concession-making, which presumably enables them to claim more individual value. Expressing negative emotions diminishes trust and other subjective outcomes. Relationships between negative emotions and negotiation outcomes are moderated by factors that are both theoretical (i.e., power, culture, emotion regulation) and methodological (i.e., characteristics of research design, phases of negotiation). Additionally, we tested theoretical frameworks from Emotions as Social Information theory, which describes the processes through which negative emotions influence negotiation outcomes. The effects for concessions are mediated by inference of limits, inference of toughness, and affective reactions. The effect of negative emotions on individual outcomes is mediated by complementary affective reactions. Based on the existing body of work, we make specific calls for further research. [ABSTRACT FROM AUTHOR]

Primary melanoma is an extremely rare tumour of the spinal cord. We are reporting a case of primary melanoma of the spinal cord in a 55-years-old male patient. Magnetic resonance imaging showed an extradural intraspinal lesion opposite the L4 vertebral body. The lesion was completely resected and a microscopic diagnosis of melanoma was made. Thirty eight months later, the patient is alive, with no evidence of any tumour recurrence. [ABSTRACT FROM AUTHOR]

We present a case of 20-year-old woman who presented with a large pedunculated skin covered mass lesion arising from the left thigh, measuring 40 × 25 cm, with no history of pain or skin ulceration and a feeling of a lump with dragging pain in the left side of the abdomen for about 7 years. Subsequently, ultrasound, contrast-enhanced computed tomography, and magnetic resonance imaging of abdomen and left thigh region were carried out. The lesion was broad-based toward the left upper thigh with a central core of interspersed fat supplied by branches of the superficial and deep femoral arteries. Another lesion was seen in the left retroperitoneum anterior to the psoas muscle in a left paravertebral location encasing the left common iliac vessels extending into the left pelvic cavity and inguinal region inferiorly. The lesion showed dense post-acoustic shadowing on ultrasound, mild enhancement on contrast-enhanced computed tomography, and appeared hypointense on T1- and T2-weighted images. A left thigh lesion was excised, whereas incisional biopsy was done for the left retroperitoneal lesion. The diagnosis of a giant fibroepithelial polyp arising from the left thigh and left retroperitoneal fibromatosis was made. This is the first report of such a giant fibroepithelial polyp arising from the thigh with associated retroperitoneal fibromatosis. [ABSTRACT FROM AUTHOR]

Introduction: Salivary gland neoplasms account for approximately 5% of head and neck tumours. The cytomorphology of fine needle aspiration material helps determine the preoperative assessment and risk stratification. The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) was developed to improve communication between the laboratory and treatment provider. Aims and objective: In the present study, we stratified all salivary gland lesions according to the MSRSGC and evaluated each category's concordance and risk of malignancy (ROM). Materials and methods: This was a 5 year retrospective study. First, all cases were assigned to one of the six MSRSGC categories. Then, following cytohistological correlation, the concordance rates and ROM were calculated based on the final histopathology report. Results: A total of 354 cases were identified, with ages ranging from 2 to 88 years and the commonest age group was the 3rd to 4th decades. Categories I, II, III, IVA, IVB, V, and VI comprised 5.37% (19/354), 26.84% (95/354), 1.13% (04/354), 51.41% (182/354), 1.98% (07/354), 1.13% (04/354), and 12.15% (43/354) of the cases, respectively. The overall concordance rate between the cytological and histopathological diagnoses was 81.25% (65 out of 80 cases), with the sensitivity, specificity, positive predictive value, and negative predictive value at 43.48%, 96.49%, 83.33%, and 80.88%, respectively. Conclusion: The MSRSGC provides a better objective and structured way to communicate with the health care provider. In our study, the overall concordance rate was observed in 62/80 cases, with maximum concordance seen in categories III, IVB, and V of the MSRSGC. [ABSTRACT FROM AUTHOR]

Introduction: Adnexal masses are a common diagnosis in Gynaecology out-patient department. It can be benign or malignant. To arrive on a diagnosis, patient should be subjected to clinical examination and a variety of investigations. Management is tailored according to the diagnosis, age of the patient and the reproductive goal of the patient in future. Aim: To evaluate the proportion of benign and malignant aetiology in patients presented with adnexal mass and secondarily to correlate preoperative diagnosis with the histopathological diagnosis. Materials and Methods: A prospective observational study was conducted, where patients with adnexal masse presented during one year were included. After work-up for all the patients, appropriate case based management was done. Clinical diagnosis of benign or malignant as pre-operative was co-related with histo-pathology and proportion of benign and malignant cases were noted. Results: Total 81 cases with the diagnosis of adnexal mass were included in the study. Mean age of presentation was 36.26 years. Most common presentation was pain in abdomen; 70 (86.4%) patients had benign masses, while 11 (13.6%) masses were malignant including two cases of borderline variety. Both patients underwent exploratory laparotomy with peritoneal lavage with total abdominal hysterectomy with bilateral salpingo-oophorectomy with infracolicomentectomy. Conclusion: All Adnexal masses need to be evaluated clinically and radiologically. All investigations should aim at to differentiate benign and malignant masses. Preoperative diagnosis of benign or malignant mass is very important to plan optimum management of the case. [ABSTRACT FROM AUTHOR]

Coinfection of Strongyloides stercoralis and aspergillus found in bronchoalveolar lavage fluid from a patient with stubborn pulmonary symptoms. Strongyloides stercoralis is responsible for a significant human parasitic infection known as strongyloidiasis. Parasitic larvae in bronchoalveolar lavage fluid in a non-immunocompromised patient. [Extracted from the article]

Background: Clinical practice guidelines (CPGs) aim to standardize clinical care. Increasingly, hospitals rely on locally produced guidelines alongside national guidance. This study examines variation between national and local CPGs, using the example of acute paediatric asthma guidance from the United Kingdom and the Netherlands. Methods: Fifteen British and Dutch local CPGs were collected with the matching national guidance for the management of acute asthma in children under 18 years old. The drug sequences, routes and methods of administration recommended for patients with severe asthma and the tone of recommendation across both types of CPGs were schematically represented. Deviations from national guidance were measured. Variation in recommended doses of intravenous salbutamol was examined. CPG quality was assessed using the Appraisal of Guidelines for Research and Evaluation (AGREE) II. Results: British and Dutch national CPGs differed in the recommended drug choices, sequences, routes and methods of administration for severe asthma. Dutch national guidance was more rigidly defined. Local British CPGs diverged from national guidance for 23% of their recommended interventions compared to 8% for Dutch local CPGs. Five British local guidelines and two Dutch local guidelines differed from national guidance for multiple treatment steps. Variation in second-line recommendations was greater than for first-line recommendations across local CPGs from both countries. Recommended starting doses for salbutamol infusions varied by more than tenfold. The quality of the sampled local CPGs was low across all AGREE II domains. Conclusions: Local CPGs for the management of severe acute paediatric asthma featured substantial variation and frequently diverged from national guidance. Although limited to one condition, this study suggests that unmeasured variation across local CPGs may contribute to variation of care more broadly, with possible effects on healthcare quality. [ABSTRACT FROM AUTHOR]

Objectives: Breast cancer is the most common cancer in women worldwide. The fine-needle aspiration biopsy (FNAB) may be used as the first-line pathological investigation for evaluation and early diagnosis of the breast lesion. The FNAB helps to differentiate malignant from benign lesions. In the present study, we categorized the breast FNAB cases according to the International Academy of Cytology Yokohama System (IACYS) for reporting breast FNAB cytology and to assess the risk of malignancy (ROM) for each category. Material and Methods: A retrospective data of breast lesions were retrieved from the archives of pathology department between January 2018 and December 2019. The study got approval from the Institutional Ethics Committee. Only 123 cases with cytology and histopathological correlation were included in this study. The cytological category was given according to IACYS for reporting breast FNAB cytology. Results: The FNAB results were include as insufficient material 3.25% (4/123), benign 46.34% (57/123), atypical 12.2% (15/123), suspicious for malignancy (SM) 4.88% (6/123), and malignant 33.33% (41/123). The ROM was 50%, 7.27%, 40.0%, 83.33%, and 97.5% for NS, benign, atypical, SM, and malignant, respectively. Conclusion: FNAB is an important tool in the diagnosis and management of breast lesions, especially in financial constrained developing countries like India with limited resources, where practice of core needle biopsy is limited. The 5-tier IACYS for reporting breast FNAB improves the reproducibility of cytology reports across the world and helps in triaging the breast lesion patients. [ABSTRACT FROM AUTHOR]

A case study of 10-day-old infant is presented with monkeypox viruses. Topics include examines monkeypox outbreak was declared to be a Public Health Emergency of lnternational Concern by the World Health Organization and considered that the young children are at risk for severe disease; therefore early recognition and prompt treatment are important.

Even in the 21st century, filariasis still remains one of the major health problems plaguing India. Filariasis usually presents as superficial swelling and lymphedema. It is uncommon for microfilaria to be seen during routine cytological examination. It is even rarer to find microfilaria coexisting with neoplastic lesions. Ninety-five percent of cases of lymphatic filariasis are caused by Wuchereria bancrofti and are rarely found in the thyroid gland. Here, we report a case of a 47-year-old male who presented with midline neck swelling, for which he underwent fine needle aspiration cytology which showed microfilaria coexisting with anaplastic carcinoma of the thyroid gland. [ABSTRACT FROM AUTHOR]

Bone marrow involvement by Hodgkin lymphoma is rare with an average incidence of 10%. However, the incidence of bone marrow involvement has been shown to be less than 1% in patients with clinical stage IA or IIA disease. The involvement of the marrow in a patient with Hodgkin lymphoma represents stage IV disease. We report our experience wherein three cases of marrow involvement were picked up on bone marrow aspirates/ -imprints and confirmed on trephine biopsy. In this paper we wish to highlight the significance of bone marrow examination in the initial diagnosis and staging of even clinically early stage Hodgkin lymphoma. Staging investigations performed at the time of diagnosis for patients with Hodgkin lymphoma are vital for determining the appropriate treatment and prognosis. [ABSTRACT FROM AUTHOR]

Introduction: Thyroid nodule is the prime indication for FNA, which is also a cheap and effective investigation. The current study seeks an association between benign goiter and aberrant thyroid function tests (TFTs). Can thyroid FNA anticipate overt morbidity resulting from thyroid function abnormalities? Materials and Methods: FNA records of 173 patients were studied along with the TFT results. A slide review was undertaken where the FNA impression did not correspond to the TFT. Results: The female:male ratio was 149:24. Two (1.15%) had inadequate cellularity. Nearly 95/173 cases had abnormal TFTs. Multinodular goiter (126), Hashimoto's thyroiditis (43), and two and one cases of granulomatous and unclassified thyroiditis, respectively, constituted our diagnostic profile. Abnormalities in TFT did not correlate with age group, gender, or FNA diagnoses. However, hypothyroidism (clinical and subclinical) was significantly observed in Hashimoto's thyroiditis (HT) cases. Further, scant colloid and hurthle cell change were significantly correlated with HT. A histological correlation was obtained in 46 cases. Four neoplastic cases among which three papillary carcinomas arising in small focal areas within cysts were seen. Conclusions: The major observation in this study is the subset of euthyroid and subclinically hypothyroid cases (23/43, 53.48%) of Hashimoto's thyroiditis (P = 0.0021). If treated with thyroxine replacement, overt hypothyroidism, particularly in pregnant women who are at risk of developing antithyroid antibodies, may be prevented. Besides, the inadequacy rate (1.15%) in the current study is low. False negatives 3/46 (6.5%), though available on a meager and selected subset of the patient population is still within the range of published data. [ABSTRACT FROM AUTHOR]

The endeavour to understand human cognition has largely relied upon investigation of task-related brain activity. However, resting-state brain activity can also offer insights into individual information processing and performance capabilities. Previous research has identified electroencephalographic resting-state characteristics (most prominently: the individual alpha frequency; IAF) that predict cognitive function. However, it has largely overlooked a second component of electrophysiological signals: aperiodic 1/ƒ activity. The current study examined how both oscillatory and aperiodic resting-state EEG measures, alongside traditional cognitive tests, can predict performance in a dynamic and complex, semi-naturalistic cognitive task. Participants' resting-state EEG was recorded prior to engaging in a Target Motion Analysis (TMA) task in a simulated submarine control room environment (CRUSE), which required participants to integrate dynamically changing information over time. We demonstrated that the relationship between IAF and cognitive performance extends from simple cognitive tasks (e.g., digit span) to complex, dynamic measures of information processing. Further, our results showed that individual 1/ƒ parameters (slope and intercept) differentially predicted performance across practice and testing sessions, whereby flatter slopes and higher intercepts were associated with improved performance during learning. In addition to the EEG predictors, we demonstrate a link between cognitive skills most closely related to the TMA task (i.e., spatial imagery) and subsequent performance. Overall, the current study highlights (1) how resting-state metrics – both oscillatory and aperiodic - have the potential to index higher-order cognitive capacity, while (2) emphasising the importance of examining these electrophysiological components within more dynamic settings and over time. • Higher IAF is associated with faster adaptation to complex task requirements. • Flatter 1/ f slopes and high intercepts relate to better performance during learning. • Superior cognitive test scores do not reliably transfer to more dynamic contexts. • Highlights the importance of both oscillatory and aperiodic activity in EEG studies. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented about a case of gouty tophi diagnosed in a middle-aged man.

Malaria is a responsible for approximately 600 thousand deaths worldwide every year. Appropriate and timely treatment of malaria can prevent deaths but is dependent on accurate and rapid diagnosis of the infection. Currently, microscopic examination of the Giemsa stained blood smears is the method of choice for diagnosing malaria. Although it has limited sensitivity and specificity in field conditions, it still remains the gold standard for the diagnosis of malaria. Here, we report the development of a fluorescence in situ hybridization (FISH) based method for detecting malaria infection in blood smears and describe the use of an LED light source that makes the method suitable for use in resource-limited malaria endemic countries. The Plasmodium Genus (P-Genus) FISH assay has a Plasmodium genus specific probe that detects all five species of Plasmodium known to cause the disease in humans. The P. falciparum (PF) FISH assay and P. vivax (PV) FISH assay detect and differentiate between P. falciparum and P. vivax respectively from other Plasmodium species. The FISH assays are more sensitive than Giemsa. The sensitivities of P-Genus, PF and PV FISH assays were found to be 98.2%, 94.5% and 98.3%, respectively compared to 89.9%, 83.3% and 87.9% for the detection of Plasmodium, P. falciparum and P. vivax by Giemsa staining respectively. [ABSTRACT FROM AUTHOR]

Abstract: Data on the immunogenicity and memory induction of pneumococcal conjugate vaccines in very preterm infants is limited. We vaccinated 69 full term and 68 preterm infants (median gestational age (GA) 30 weeks) with a 7-valent pneumococcal conjugate vaccine (PCV7) at 2/3/4 months of age, followed by a plain polysaccharide booster at 12 months of age. IgG-GMC (ELISA) was significantly lower in preterm infants to six vaccine serotypes (ST) at 2 months and 5 months of age, to five ST at 12 months of age and to three ST at 13 months of age. A significantly lower proportion of preterm infants achieved IgG levels ≥0.35μg/ml to ST 4, 6B and 9V at 5 months and to ST 4, 6B, 18C, 19F and 23F at 12 months of age. Fold rises following the polysaccharide booster were comparable to those of term infants. At least 93% of both cohorts achieved IgG ≥0.35μg/ml to all STs following booster vaccination. Pneumococcal conjugate vaccine at an accelerated schedule of 2/3/4 months of age is likely to provide protection against pneumococcal disease for preterm infants. Antibody concentrations wane over the first year of life in both preterm and term infants and booster vaccination is therefore likely to be important. [Copyright &y& Elsevier]

The article presents a case study of a 48-year-old lady presented with a palpable lump in left breast for the last two years. On examination, there was a large nontender, hard lump occupying entire breast with edema of the overlying skin and ulceration of the nipple-areola complex. Bilateral mammography showed a large, lobulated mass with indistinct margins involving the entire left breast. Ultrasonographic examination revealed solid cystic mass with increased vascularity in the solid areas.

Abstract: A randomised, modified, double-blind trial was conducted in children 2 to <5 years of age to evaluate immunogenicity and reactogenicity of a meningococcal (serogroups A, C, Y, W135) diphtheria toxoid conjugate vaccine (MCV-4) in healthy children previously vaccinated with a monovalent meningococcal C conjugate vaccine. Participants received one dose of either MCV-4 or Haemophilus influenzae type b vaccine (Hib vaccine, control group). Serum bactericidal antibodies (SBA) were determined in sera obtained before and approximately 28 days following vaccination. MCV-4 was highly immunogenic for serogroups A, C, Y and W135, the response to serogroup C being consistent with a booster response in participants primed with monovalent C conjugate vaccine. No major between-group differences in solicited local and systemic reactions or adverse events (AEs). [Copyright &y& Elsevier]

Problem: Decline in myeloid‐derived suppressor cells (MDSCs) and Th2 cytokines levels lead to early miscarriage (EM) but how the hormonal milieu of the body regulates MDSCs and Th1/Th2 cytokine balance is still a matter of investigation. Method of study: Peripheral blood and decidua samples were collected from 20 EM patients, and 20 healthy pregnant women opted for elective abortion. MDSCs and G‐MDSCs levels were analyzed in peripheral blood mononuclear cells, and Th1/Th2 cytokines levels were determined in serum via flow cytometry. Estrogen (E2), Progesterone (P4), and Testosterone levels were measured via ELISA. Further, proliferation and apoptosis in decidual samples were checked via immunoblot/immunohistochemistry of estrogen receptor ‐α (ER‐α), STAT‐3/pSTAT‐3, and caspase‐3, respectively. Results: Our results clearly indicate that in EM patients; decline in E2 and P4 significantly correlates with decline in MDSCs, particularly with subtype granulocytic MDSCs (G‐MDSCs) and skewness of the Th1/Th2 cytokines balance toward Th1 response. Downregulation of ER‐ α and increased caspase‐3 expression in endometrium decidua signifies poor endometrial receptivity in EM. STAT‐3 activation regulates proliferation, differentiation and suppressive potency of MDSCs. In decidua of EM, significantly lower expression of pSTAT‐3 indicates that these processes pertaining to MDSCs are compromised. Conclusion: Altogether, this unfavorable systemic milieu may drive toward early breakdown of maternal‐fetal tolerance in EM. Therefore, regulated crosstalk of E2, P4 with MDSCs and balanced Th1/Th2 cytokines is prerequisite for successful pregnancy. The main findings of our study are represented in the pictorial view, where estrogen and progesterone maintains Th1/Th2 cytokine balance and also helps in accumulation of MDSCs, specifically G‐MDSCs in the blood of pregnant women, that is, pre‐requisite for successful implantation and development of fetus against maternal immunity. On the other hand in EM cases decline in E2 and P4 leads to shifts of maternal immunity towards Th1 (inflammatory side) that is also accompanied by decline in MDSCs and G‐MDSCs levels. Lower E2 and P4 also caused decline in decidual neovascularization and development that ultimately brings rejection of fetus by maternal immune system and possibly triggers to miscarriage. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 23-year-old man with erythematous papules on face and trunk which was diagnosed to be generalized eruptive syringoma who was treated oral administration of isotretinoin.