Search

Total anomalous pulmonary venous connection (TAPVC) is a rare cyanotic congenital heart disease and their survival into adulthood is even rarer. Here, we present the case of a 26-year-old female who was incidentally diagnosed with a case of supracardiac TAPVC during her pregnancy. All four pulmonary veins were joining to form a common venous confluence which drained into a left-sided vertical vein which drained into the innominate vein. [ABSTRACT FROM AUTHOR]

Context: Organ transplantation can save thousands of lives as it is one of the greatest advancements of modern medical science but the process of organ donation and transplantation is very complex and multi-factorial, interplaying with- medical, legal, ethical, organizational and above all social factors. The future doctors can take up the role of promoting organ donation activity, especially the heart. Settings and Design: This cross-sectional questionnaire based survey study was conducted amongst the undergraduate medical students of our Institute, to ascertain their knowledge and ethical perception regarding orthotropic heart transplantation. Methods and Material: Students were approached in lecture halls and were asked to fill the questionnaire after explaining them the importance of this study in brief. Written consent for participation was taken from all of them. A total of 197 undergraduate students gave consent and filled the questionnaire. Statistical Analysis Used: All the quantitative variables were analyzed using mean and standard deviation and all the qualitative variables were described as numbers and percentages. Results: Nearly all the students knew the term organ donation and heart transplantation but in-depth knowledge of medical students on this topic was not good enough. Most participants (75%) considered "Internet" as their major source of information, while only 01% regarded academic books as their source of information. This strongly highlights the point that the undergraduate medical books with curriculum is largely lacking in basic aspects of organ donation and heart transplantation. Very few medical students (4.5%) knew about the Non-Governmental Organization (NGOs) working for transplant activity and also majority (82.2%) are unaware of legal aspects related to organ donation. Conclusions: Currently heart transplantation is a totally neglected topic in undergraduate medical curriculum. Inclusion of this complex but interesting topic by a short lecture or interactive seminar for undergraduate medical students may be the most cost-effective and durable innovation for the future. [ABSTRACT FROM AUTHOR]

Background: The histological spectrum of explant liver pathology and their prevalence has not previously been reported from the Indian subcontinent. (1) The study was performed to provide new insight into the prevalence of explant liver pathologies in this part of the world by retrospective analysis of the spectrum of histological changes, (2) to study the etiopathological association of cirrhosis, (3) to study the etiopathogenesis for development of hepatocellular carcinoma (HCC), and to analyze whether there is any association of macroregenerative and dysplastic nodule with HCC. Materials and Methods: Written records of all explant liver pathology service were entered into an electronic database. Retrospective analysis of the liver explants was performed from May 2015 to July 2016 at a tertiary-care center in India. Results: Maximum (97.2%) number of liver explants showed cirrhosis. Hepatitis C virus (HCV)-related chronic liver disease was the most common etiological factor for the development of cirrhosis in this part of the world followed by HBV and alcohol. The association between HCC and HBV was found to be statistically significant with a value of P = 0.009. The association between dysplastic nodules and HCC was also found to be significant. Conclusion: This is the first study to describe the histological spectrum of explant liver pathology from India. HCV forms the major disease burden for the chronic liver disease. There is a significant association of dysplastic nodules with HCC postulating their role as a precursor lesion in HCC. [ABSTRACT FROM AUTHOR]

Background and Aim: Post-transplant liver biopsies form a critical part of management of complications arising post-transplant. The objective of this study was to analyze the Indian experience in pathologic diagnosis of liver biopsies after orthotopic liver transplantation (OLT) with special emphasis on cases presenting with intrahepatic cholestasis (IHC). Type, incidence, and timing of major complications were analyzed. All cases with IHC were retrospectively analyzed with clinical inputs to look for cryptic clues in subclassifying such cases. Materials and Methods: Forty-five post-transplant liver biopsies from 39 OLT patients were retrospectively analyzed from May 2015 to May 2016. All biopsies were stained with hematoxylin and eosin and Masson's Trichrome, and other stains were performed as required. Results: The number of liver biopsies performed for each patient ranged from 1 to 3. The timing of these biopsies varied from 5 days to >4 years post-transplant. Of the 39 patients who underwent post-transplant liver biopsies, most common etiology of a liver transplant was hepatitis C virus (HCV)-related chronic liver disease in 66.6% cases. The common complications post-transplant were acute cellular rejection (ACR) (33.3%), biliary stricture (13.3%), HCV recurrence (11.1%), plasma cell hepatitis (4.4%), chronic hepatitis (4.4%), IHC (22.2%), and others. On analysis of post transplant biopsy cases with IHC, we found that patients with high baseline HCV RNA levels had recurrences presenting only with prominent IHC without fibrosis and ballooning of hepatocytes. These changes might represent early stages of fibrosing cholestatic hepatitis (FCH). Conclusions: This study evaluated the types, incidence, and timing of major complications occurring after OLT. ACR remains major complication following transplant. The presence of IHC on biopsy, especially in HCV-positive patients, should prompt anti-HCV therapy even if other features of FCH were not found. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To evaluate the pharmacognostic characters of an important medicinal plant, Holoptelea integrifolia (H. integrifolia) Roxb. Methods: The pharmacognostic studies were carried out in terms of organoleptic, microscopic, macroscopic and fluorescence analysis. Results: The characteristic microscopic features of leaves were observed as trichomes, multicellular trichomes, xylem cells, phloem cells, collenchyma, vascular bundles, spongy parenchyma and palisade cells. The characteristic microscopic features of root bark included cork cambium, primary cortex, phloem fibers, medullary rays, endodermis, pericycle and lignified fibers in the transverse section and longitudinal section. The characteristic microscopy of root bark powder showed the presence of cortex cells, sieve tubes, calcium oxalate crystals and lignified fibers. Macroscopic study showed that leaf shape–oval, apex–acute, base–cordate and leaf margin was entire with glabrous surface, bitter taste and characteristic odour. The morphological features of root bark showed deep fissured, rough and firm surface with rhitydome and the periderm parallel to cambium. Conclusions: Various pharmacognostic characters observed in this study help in the identification and standardization of H. integrifolia. [Copyright &y& Elsevier]

Abstract: Objective: To perform the pharmacognostic study of Pongamia pinnata (L.) Pierre (P. pinnata) stem bark. Method: The pharmacognostic studies were carried out in terms of organoleptic, macroscopic, microscopic, fluorescence analysis and physicochemical parameters. Results: The bark consisting of channelled, recurved, slightly quilled, usually 0.2–1 cm thick, lenticellate pieces with outer surface ash-grey to greyish-brown and internal surface yellowish-white to cream coloured having unpleasant odour and bitter taste. The main microscopic characterstics of the bark include phellem (5–20 or more layers of cork), phellogen (2–3 layered) followed by 10–15 layered phelloderm. Among other microscopic components were phloem parenchyma, phloem fibre and stone cells, traversed by wavy medullary rays. Further, physicochemical analysis of the bark power showed total ash, water soluble ash, acid insoluble ash and sulphated ash as 10.94, 1.96, 1.47 and 15.8 % w/w respectively. The alcohol and water soluble extractives values of the stem bark were 9.6 and 18.4 %w/w respectively. Conclusions: Various pharmacognostic characters observed in this study helps in botanical identification and standardization of P. pinnata L. in crude form. [Copyright &y& Elsevier]

Abstract: The field of probiotics is an evolving field. Probiotics were first introduced to the world as a functional ingredient in dairy products, breakfast cereals and snacks. Unknown to many, probiotics offer health benefits that go beyond the scope of supporting digestive health. Research continues to emerge, supporting the use of different probiotic strains in a variety of conditions. The research now suggests that these “healthy” bacteria have beneficial effects on gastrointestinal dysfunctions, including diarrhea, as well as the immune system and conditions such as allergy, in children, adults, and in the oral cavity. Research on the horizon will develop a better understanding of the concepts of how colonizing microbes and probiotics can influence human health. [Copyright &y& Elsevier]