Differentially expressed urinary biomarkers in children with idiopathic nephrotic syndrome.

Background: We performed a discovery phase of urinary proteomic profile in children with idiopathic nephrotic syndrome and validated selected biomarkers.

Methods: Urinary proteomic profile was performed using isobaric tags for relative and absolute quantitation labeling, coupled with liquid chromatography-matrix assisted laser desorption and ionization analysis. Validation of biomarkers apolipoprotein A1, alpha 2 macroglobulin, orosomucoid 2, retinol binding protein 4 and leucine-rich alpha 2-glycoprotein 1 was done by enzyme-linked immunosorbent assay.

Ostial atresia of left circumflex coronary artery arising from non-coronary sinus: a combination of rare anomalies.

Atresia of the left coronary artery ostium and right coronary artery ostium is a rare anatomic variant of the coronary circulation. Atresia of the left circumflex artery and its origin of from the non-coronary sinus have never been described. We report this unusual combination of rare anomalies for the first time.

Prompt Repair of Post Cholecystectomy Bile Duct Transection Recognized Intraoperatively and Referred Early: Experience from a Tertiary Care Teaching Unit.

Postcholecystectomy bile duct injuries are a cause of significant morbidity and occasional mortality. Intraoperative recognition and repair of complete biliary transection with hepaticojejunostomy is the recommended treatment; however, it is possible only in few patients as either the injury is not recognized intraoperatively or the center is not geared up to perform an urgent hepaticojejunostomy in these patients with a nondilated duct. Retrospective analysis of data from a tertiary care referral center over a period of 10 years from January 2000 to December 2009 to report the feasibility and outcomes of prompt repair was done (defined as repair within 72 h of index operation) of postcholecystectomy bile duct injury.

An Alternate Vista in Rehabilitation of Cranial Defects: Combining Digital and Manual Techniques to Fabricate a Hybrid Cranioplast.

The desired features of a cranioplast include providing an acceptable contour, continuity with the remaining skull (marginal adaptation), improvising the aesthetic outcome, providing a strengthened prosthesis to avoid fracture in case of repeat trauma, and protecting the remaining neurological structures. Combining digital and manual techniques to fabricate a hybrid polymethylmethacrylate cranioplast during the rehabilitation of a pediatric patient with cranial defect has been described. Utilization of digital techniques (rapid prototyping to obtain skull analog) and manual (hand) sculpting of the prosthesis strengthened with glass fiber enabled the authors to fabricate a hybrid cranioplast.

Are western guidelines good enough for Indians? My name is Borat.

Physicians in an attempt to give their patients the best possible care need to be updated on the evolving body of scientific research, trials, case reports, and combine this evidence with their own clinical experience keeping in mind each individual patient's circumstances and preferences. To address this felt need, guidelines are systematically developed statements designed to help clinicians make management decisions. While a multitude of guidelines are available from developed world they might not exactly fit into developing world context.

Endovascular Occlusion of Cervical Internal Carotid Artery Pseudoaneurysm in a Child Treated by N-Butyl Cyanoacrylate: A Rare Case Report.

We report a rare case of spontaneous extracranial cervical internal carotid artery (ICA) pseudoaneurysm in a female child aged 3 years who presented with a swelling in the neck which had bled following an attempted incision as it had been thought to be an abscess. A CT angiogram and an MR angiogram were not very conclusive to diagnose the exact site of origin and the morphology of the aneurysm. Digital subtraction angiography revealed a dissecting pseudoaneurysm of the right extracranial cervical ICA.

Composite pheochromocytoma masquerading as solid-pseudopapillary neoplasm of pancreas.

Pheochromocytoma and ganglioneuroma form rare composite tumours of the adrenal medulla comprising less than 3% of all sympathoadrenal tumours. We present a case of intraoperatively detected adrenal medullary tumour of composite pheochromocytoma and ganglioneuroma diagnosed on histopathology, in a normotensive patient. A 50-year-old male with a past history of chronic obstructive pulmonary disease presented with abdominal pain and significant weight loss since one month.

The cost of acute respiratory infections in Northern India: a multi-site study.

Background: Despite the high mortality and morbidity resulting from acute respiratory infections (ARI) globally, there are few data from low-income countries on costs of ARI to inform public health policy decisions We conducted a prospective survey to assess costs of ARI episodes in selected primary, secondary, and tertiary healthcare facilities in north India where no respiratory pathogen vaccine is routinely recommended.

Methods: Face-to-face interviews were conducted among a purposive sample of patients with ARI from healthcare facilities. Data were collected on out-of-pocket costs of hospitalization, medical consultations, medications, diagnostics, transportation, lodging, and missed work days.

Isolation of Mycobacterium tuberculosis from sputum of tribal, non-tribal pulmonary tuberculosis patients of Andaman & Nicobar islands by conventional culture method and assessment of first line anti-tuberculosis drug susceptibility patterns.

Background: Drug resistance surveys have not yet conducted in these Islands and as such no data exists on drug resistance currently.

Aims: the present study was initiated with the objective of isolation and assessment of Drug resistance patterns of Mycobacterium tuberculosis isolates from sputum specimens collected from different categories of Tribal, Non-Tribal pulmonary tuberculosis patients treated under DOTS and Non-DOTS program by conventional culture and Proportion sensitivity (PST) method to detect patients with Multidrug resistant strains.

Methods: The investigation was hospital based laboratory surveillance study carried out for a period of 3 years at the selected hospitals of Andaman district (TB ward GB Pant Hospital at Port Blair, CHC Bamboflat at Port Blair and CHC Rangat at Rangat) and Nicobar district (CHC Nancowry at Nancowry groups of Islands), among the new cases and re-treatment cases of tuberculosis patient under DOTS program and Non-DOTS patients attended selected hospitals of Andaman & Nicobar districts chosen for the study.

Effectiveness of psycho-educational intervention in improving outcome of unipolar depression: results from a randomised clinical trial.

Objectives: Depressive disorders are one of the leading components of the global burden of disease with a prevalence of up to 14% in the general population. Numerous studies have demonstrated that pharmacotherapy combined with non-pharmacological measures offer the best treatment approach. Psycho-education as an intervention has been studied mostly in disorders such as schizophrenia and dementia, less so in depressive disorders.

Consensus Statement of HCV Task Force of the Indian National Association for Study of the Liver (INASL). Part II: INASL Recommendations for Management of HCV in India.

The estimated prevalence of hepatitis C virus (HCV) infection in India is between 0.5 and 1.5% with hotspots showing much higher prevalence in some areas of northeast India, in some tribal populations and in certain parts of Punjab.

Minimally invasive versus the conventional open surgical approach of a radical cholecystectomy for gallbladder cancer: a retrospective comparative study.

Background: Laparoscopic surgery has traditionally been contraindicated for the management of gall bladder cancer (GBC). This study was undertaken to determine the safety and feasibility of a laparoscopic radical cholecystectomy (LRC) for GBC and compare it with an open radical cholecystectomy (ORC).

Methods: Retrospective analysis of primary GBC patients (with limited liver infiltration) and incidental GBC (IGBC) patients (detected after a laparoscopic cholecystectomy) who underwent LRC between June 2011 and October 2013.

Juvenile Nasopharyngeal Angiofibroma: Case report with review on role of imaging in diagnosis.

Juvenile nasopharyngeal angiofibroma is a locally aggressive benign vascular neoplasm, composed of vasogenic and myofibroblastic elements, accounts for 0.05-0.5% of all the head and neck neoplasms.

Atypical presentation of calvarial metastasis of renal cell carcinoma in an adolescent: A rare case diagnosed on fine needle aspiration cytology with literature review.

Renal cell carcinoma (RCC) is a complex and challenging neoplasm both in terms of treatment as well as diagnosis. Its unpredictable biological behavior and many deceptive appearances can sometimes bewilder the pathologist. We hereby report a rare case of a 17 year old girl presenting with an occipital swelling and importantly no prior documents at the time of aspiration.

Sex cord tumor with annular tubules: an incidental finding in an endometriotic cyst--the first known cooccurrence.

Sex cord tumor with annular tubules (SCTATs) is a relatively rare ovarian neoplasm often having a syndromic association with Peutz-Jeghers syndrome (PJS). Other associations described with this rare neoplasm include adenoma malignum of cervix, Turners syndrome, dysgerminoma, gonadoblastoma, endometrial carcinoma, and endometriosis of fallopian tube. We describe for the first time to the best of our literature search the incidental detection of SCTAT coexisting with an endometriotic cyst of ovary.

Pathology of alcoholic liver disease, can it be differentiated from nonalcoholic steatohepatitis?

The liver involvement in alcoholic liver disease (ALD) classically ranges from alcoholic steatosis, alcoholic hepatitis or steatohepatitis, alcoholic cirrhosis and even hepatocellular carcinoma. The more commonly seen histologic features include macrovesicular steatosis, neutrophilic lobular inflammation, ballooning degeneration, Mallory-Denk bodies, portal and pericellular fibrosis. Nonalcoholic steatohepatitis (NASH) is a condition with similar histology in the absence of a history of alcohol intake.

Clinical Epidemiology of SIRS and Sepsis in Newly Admitted Children.

Objective: To assess the clinical and demographic profile of Systemic Inflammatory Response Syndrome (SIRS) and sepsis, among newly admitted children in different age groups in a hospital in North India.

Methods: This prospective study was conducted at a referral care centre in Northern India. All children, age group 0 to <18 y, admitted on days selected for study were screened and those with abnormal temperature and abnormal leukocyte count were included for further assessment.

Correlation of aspartate aminotransferase/platelet ratio index with hepatic venous pressure gradient in cirrhosis.

Background: Hepatic venous pressure gradient (HVPG) is a prognostic marker in cirrhosis, but is invasive. There is a need to validate a noninvasive marker to measure portal hypertension. Aspartate aminotransferase/platelet ratio index (APRI) is proposed as a good noninvasive estimator of hepatic fibrosis.