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Multivariate examination regarding precious metals items inside spices frequently ingested in republic associated with Korea.
Light-matter quantum character regarding complicated laser-driven systems.
Thyroid paragangliomas are distinctly rare primary thyroid neoplasms with nearly 75 cases reported worldwide. Due to their similar embryological origin and cytohistomorphology with other thyroid neoplasms, they may pose great diagnostic challenges for pathologists, radiologists, endocrinologists, as well as surgeons leading to unnecessary aggressive therapy. link= Veliparib in vivo With recent advances in molecular genetics, the prognostic significance of such seemingly innocuous thyroid neoplasms has been better understood. In this manuscript, we describe such a case and present a systematic review of all reported cases till date giving an update on our current knowledge regarding their diagnostic pitfalls, pathology, and molecular genetics.Mucositis is a frequent, severe consequence of radiation therapy among patients undergoing radiotherapy for the head-and-neck cancer, often requiring hospitalization and even breaks or discontinuity in treatment. Mouth rinsing with various agents has demonstrated effectiveness in the prevention and treatment of radiation-induced mucositis (OM), but evidence for the same is lacking. This systematic review is therefore conducted with the aim of assessing the evidence for the effectiveness of mouthrinses in prevention and treatment of OM. Joanna Briggs Institute guidelines were followed to conduct this review. Six databases were searched and a total of 25 randomized clinical trials published over a period of the past 31 years were included for qualitative synthesis. Analysis of 25 studies revealed that 1299 participants, aged 46-69 years were assigned to the test groups and control groups. A total of 16 different formulations were studied among patients over a duration of 6 days to 1 year in varying dosages. The overall preventive fraction ranged from 1.9% to 77.8% for a reduction in clinical grades of mucositis, 7.6%-83.3% for a reduction in pain and 20%-50% for a reduction in bacterial counts. Adverse effects such as mouth burning, altered taste, sore throat, have been reported, especially with chlorhexidine and benzydamine hydrochloride. Evidence for the included studies is IC and ID. Studies using herbal based products and tissue regenerating agents revealed comparatively better effectiveness with lesser side effects. However, the number of studies to support such a claim is very limited.
The choice of a postgraduate specialization in medicine is influenced by many factors. What motivates students to take up pathology as a career option or to reject the same remains unexplored. This study aimed to understand the perceptions of medical students from a college in southern India regarding the role played by pathologists in clinical practice and how this influenced their choice of pathology as a career.
This qualitative study conducted personal interviews with 15 participants (13 undergraduates and 2 postgraduates in pathology) using a semi-structured interview guide. The data were transcribed and thematically analysed.
Although most of the participants acknowledged that pathologists play an important role in diagnosis, they were of the view that pathologists have minimal patient contact and do not play the main role in treating patients. They were also of the opinion that the undergraduate course and curriculum in pathology was inadequate in exposing them to the actual practice of pathology. link2 Lower social status and earning potential were also stated as deciding factors in choosing a career in pathology. Pathology residents cited stress-free lifestyle as a motivating factor in choosing pathology as a career.
A career in pathology can be rewarding and intellectually stimulating. The fact that a pathologist plays an important role in diagnosis and also patient management must be emphasized in the undergraduate medical curriculum. The medical student will then be able to take an informed decision about his or her career.
A career in pathology can be rewarding and intellectually stimulating. The fact that a pathologist plays an important role in diagnosis and also patient management must be emphasized in the undergraduate medical curriculum. The medical student will then be able to take an informed decision about his or her career.Postgraduate medical education in India is beset with many problems including lack of a uniform national syllabus, nonexistence of an accepted list of competencies across disciplines, lack of uniformity in teaching/learning methods between different institutions, a poor evaluation system which focuses on a day's performance rather than the whole course and lack of attention to attitude and professionalism both in the training and evaluation processes. Since there is no national-level quality control of the outgoing postgraduates, there is no uniformity either in knowledge or skill level among them. Regulatory control over the whole process inhibits institutions from making any changes. Furthermore, the summative examination process is entirely under regulatory guidelines, with little or no option to universities and institutions to change the same. In this scenario, Sri Balaji Vidyapeeth, Puducherry, introduced and implemented a competency-based training programme for medical postgraduates, which is now in the 4th year. This model is suitable for the Indian milieu as it can be implemented within the regulatory guidelines. The model has been described with details of the processes involved in preparation, implementation, monitoring and overcoming possible hurdles and pitfalls in the Indian context.History of medicine is rich with the achievements and successes of years of research and development. Veliparib in vivo The Medical Council of India incorporated teaching 'History of Medicine' in the undergraduate medical curriculum in India nearly a decade ago. Despite being included in the medical curriculum by the Medical Council of India, it is not yet a part of the teaching curriculum in the top-ranking medical institutions. link2 Teaching 'History of Medicine' to undergraduate medical students may be a good divergence from the fact-based teaching of undergraduate medical curriculum. It will also help students cherish medical achievements of the past and inculcate in them a sense of pride and belongingness to the medical fraternity.Acute pancreatitis (AP) is a common emergency in gastroenterology. After gallstone disease and alcoholism, hypertriglyceridaemia (HTG) is the next common cause for AP. link3 The role of intensive insulin therapy (IIT) and plasma exchange (PE) in hypertriglyceridaemic acute pancreatitis (HTG-AP) is still debatable. We report a 56-year-old farmer with HTG-AP who presented with a recurrence of AP. On admission, his plasma triglycerides were 4773 mg/dl with a wide range of laboratory abnormalities. Over the course of his illness, he developed multiple organ failure. He received early IIT initially, and PE once haemodynamic stability was achieved. This approach improved the functioning of the organs. link3 In haemodynamically unstable patients with HTG-AP, we suggest early initiation of IIT, followed by adjuvant PE after the resolution of shock, to ameliorate organ dysfunction and improve overall outcome.Cogan syndrome (CS) is a rare vasculitis seen primarily in young adults. It predominantly affects eyes, ears and the heart with characteristic findings of interstitial keratitis, sensorineural hearing loss and vestibular dysfunction. A high index of suspicion is required to diagnose this rare disorder. Veliparib in vivo It is one of the few vasculitis which can involve vessels of all sizes small, medium and large. Coexistence of inflammatory bowel disease (IBD) in Cogan syndrome has been described in the literature. Immunosuppressive agents such as corticosteroids with or without steroid sparing agents are the standard of care. Early diagnosis and treatment are the cornerstone of treatment to prevent permanent damage to the ears and eyes. We describe a patient with Cogan syndrome with large vessel vasculitis and IBD. Our patient was treated with glucocorticoids and methotrexate.Chronic lymphocytic leukaemia (CLL) is a heterogeneous disease with uncertain course. Treatment should be tailored to the patient's disease as well as the prognostic subgroup. With the increased use of rituximab as well as other selective and non-selective immunomodulatory agents, the incidence of infectious complications and second malignancies has also increased. Progressive multifocal leucoencephalopathy (PML) is a complication of rituximab in HIV-negative patients. A 56-year-old male with CLL had been treated and relapsed four times in 6 years. Rituximab was added to the combination after the second relapse and repeated in the third relapse in combination with bendamustine. In the seventh year of diagnosis, relapse of CLL and an ulcerated tumorous lesion was observed in the left index finger, which progressed in 3 months and was later diagnosed as angiosarcoma. The cancer was treated with local radiotherapy and combination chemotherapy. One year after the last rituximab exposure, progressive muscle weakness developed and polyoma JC virus DNA was observed with increased titres in the cerebrospinal fluid, and the patient was diagnosed as having PML. The patient died 2 months later. Our patient had an unusual course of CLL over 8 years, with relapses, complicated with a secondary malignancy and an infectious complication.
Sexual assault is said to be an under-reported and under-researched crime worldwide. The high number of cases of sexual assault reported in India is the tip of the iceberg. We did this study to understand various factors associated with this crime.
We did a retrospective analysis of 312 forensic examination reports of alleged sexual offenders, available from a tertiary care hospital of Delhi from January 2014 to December 2016.
Of the 312 victims of sexual assault, 62.9% were adults and 37.1% minors. The time of assault was mentioned in only 73 cases. Among these, about two-thirds of cases (60.3%) occurred during daytime. Among the 213 cases where the reporting time of the crime was mentioned, only 35.7% of cases were reported within 24 hours of the crime. Around 92% offenders were known to the victims.
More than one-third of sexual assaults were against minors and in a majority of instances the alleged offenders were known to the victims. A major delay in reporting the crime was observed when the victim was known to the perpetrator.
More than one-third of sexual assaults were against minors and in a majority of instances the alleged offenders were known to the victims. A major delay in reporting the crime was observed when the victim was known to the perpetrator.
Management of tumour bleeding remains a challenge in oncology. With a number of methods available, radiotherapy still holds a crucial place. There are no standard guidelines for dose fractionation of haemostatic radiotherapy (HRT), and it varies from case to case. We aimed to study the effectiveness of HRT.
We retrospectively analysed the effectiveness of HRT in 70 patients in terms of control of bleeding and overall survival, who presented to us with advanced cancers from July 2014 to June 2017.
The median age was 48 (range 23-76) years, and male to female ratio was 2.181. The most common malignancy encountered was lung and gynaecological (both 17.1%). Stage IV was the most common stage (48.6%) of the primary tumour. The site of bleeding was the primary tumour in 50 (71.4%) patients, whereas fungating regional nodes were the cause in the remaining. The median duration between initial diagnosis and HRT was 5 (range 0-19) months. Seventeen patients (24.3%) had a history of prior radiotherapy. Fifty-one patients (72.
