Epithelial iris cyst after cataract surgery

We report a case of an epithelial inclusion cyst of the iris following cataract surgery that was successfully treated with en bloc excision, after an unsuccessful attempt with Neodymium-doped Yttrium Aluminium Garnet (Nd YAG) Laser. A 60-year-old man had undergone cataract surgery two years back. One year later, he developed a pigmented epithelial inclusion cyst of the iris which progressively increased in size. His vision reduced to finger counting close to face as the cyst grew over the pupil. We performed Nd YAG laser cystotomy of the cyst wall initially, but the treated lesion recurred. So we performed an en bloc iris excision of the cyst with sector iridectomy. There was no recurrence as determined by slit lamp examination at six months after treatment. Hence, we conclude that en bloc excision can be used to effectively treat epithelial inclusion cyst of the iris.

A comparative study for selectivity of micronuclei in oral exfoliated epithelial cells

BACKGROUND

Micronucleus (MN) represents small, additional nuclei formed by the exclusion of chromosome fragments or whole chromosomes lagging at mitosis. MN rates, therefore, indirectly reflect chromosome breakage or impairment of the mitotic apparatus. During the last few decades, micronuclei ("MNi") in oral exfoliated epithelial cells are widely used as biomarkers of chromosomal damage, genome instability and cancer risk in humans. However, until now only little attention has been given to the effect of different staining procedures on the results of these MN assays.

AIM

To compare the MNi frequencies in oral exfoliated epithelial cells using three different stains, i.e.,Feulgen stain, Papanicolaou stain (Pap) and hemotoxylin and eosin stain (H and E).

MATERIALS AND METHODS

Oral exfoliated cells from 45 cases of potentially malignant disorders (15 oral submucous fibrosis, 15 lichen planus and 15 leukoplakia) and 15 controls with healthy mucosa, were taken and MNi frequencies (No. of MNi/1000 cells) were compared using three different stains.

RESULTS

Mean MNi frequency in cases was found to be 3.8 with Feulgen stain, 16.8 with PAP and 25.9 with H and E. In controls, mean MNi frequency was 1.6 with Feulgen stain, 7.7 with PAP and 9.6 with H and E stain. Statistically significant value (P < 0.01) were observed when the three stains were compared together using Kruskal Walli's ANOVA test.

CONCLUSION

Feulgen being a DNA-specific stain gave the least counts, although statistically significant results from the comparison of MNi frequency between cases and controls were obtained with all the three stains.

Perceptions among primary caregivers about the etiology of delirium: a study from a tertiary care centre in India

OBJECTIVE

To study caregivers' perceptions about the cause of delirium and their distress caused by symptoms of delirium.

METHOD

Adult caregivers of patients with delirium, who gave consent, were asked about their perceptions of the cause of delirium. Patients were assessed for delirium by using the delirium rating scale-revised version (DRS-R-98).

RESULTS

The study included 72 primary caregivers of patients with delirium. About one-third of the caregivers (36.11%) attributed the symptoms of delirium to non-organic causes like supernatural beliefs, emotional stress resulting from physical illness or various social factors, attention seeking behaviour, or a result of religious disobedience. Approximately eight percent of the caregivers couldn't give any reason for the altered mental state of the patient. Others attributed the symptoms to medical-surgical causes.

CONCLUSION

A significant proportion of caregivers attribute delirium to non-organic causes in this context.

Prevalence and type of functional somatic complaints in patients with first-episode depression

OBJECTIVE. To study the prevalence and type of functional somatic complaints in patients with first-episode depression. METHODS. A total of 164 patients attending the outpatient department of a general hospital psychiatric unit were evaluated using the Patient Health Questionnaire-15 (PHQ-15) and Hamilton Depression Rating Scale (HDRS). RESULTS. More than half of the sample were male (n = 85; 52%) and most of the subjects were married (n = 128; 78%). The mean (standard deviation) HDRS score was 19.9 (5.4). All patients had at least 1 functional somatic complaint, and that the mean (range) number of functional somatic complaints per patient on the PHQ-15 was 8 (1-15). The most common functional somatic complaints included feeling tired or having little energy (93%); trouble sleeping (80%); nausea, gas and indigestion (68%); headache (68%); pain in arms, legs, or joints (66%); and feeling the heart racing (65%). Total PHQ-15 scores indicated the presence of moderate-to-severe severity of functional somatic complaints. Back pain, as well as pain in arms, legs, or joints, were found to be more common in females. The number and severity of functional somatic complaints did not differ significantly in relation to other socio-demographics (locality, marital status, age, education, income) and clinical variables (duration, physical co-morbidity, and atypical features). CONCLUSIONS. Functional somatic complaints are quite prevalent in subjects with first-episode depression. Hence, clinicians should routinely evaluate patients with depression for these symptoms.

Selection of suitable reference genes for quantitative gene expression studies in milk somatic cells of lactating cows (Bos indicus)

We assessed the suitability of 9 internal control genes (ICG) in milk somatic cells of lactating cows to find suitable reference genes for use in quantitative PCR (qPCR). Eighteen multiparous lactating Sahiwal cows were used, 6 in each of 3 lactation stages: early (25 ± 5 d in milk), mid (160 ± 15 d in milk), and late (275 ± 25 d in milk) lactation. Nine candidate reference genes [glyceraldehyde 3-phosphate dehydrogenase (GAPDH), protein phosphatase 1 regulatory subunit 11 (PPP1R11), β-actin (ACTB), β-2 microglobulin (B2M), 40S ribosomal protein S15a (RPS15A), ubiquitously expressed transcript (UXT), mitochondrial GTPase 1 (MTG1), 18S rRNA (RN18S1), and ubiquitin (UBC)] were evaluated. Three genes, β-casein (CSN2), lactoferrin (LTF), and cathelicidin (CAMP) were chosen as target genes. Very high amplification was observed in 7 ICG and very low level amplification was observed in 2 ICG (UXT and MTG1). Thus, UXT and MTG1 were excluded from further analysis. The qPCR data were analyzed by 2 software packages, geNorm and NormFinder, to determine suitable reference genes, based on their stability and expression. Overall, PPP1R11, ACTB, UBC, and GAPDH were stably expressed among all candidate reference genes. Therefore, these genes could be used as ICG for normalization of qPCR data in milk somatic cells through lactation.

Effect of exercise in reducing breast and chest-wall pain in patients with breast cancer: a pilot study

BACKGROUND

Breast or chest-wall pain (BCP) is prevalent in 20%-50% of breast cancer survivors, and it affects quality of life (QOL). To determine the feasibility and potential efficacy of an exercise program to improve patient QOL and BCP, such a program was offered to breast cancer patients suffering from BCP.

METHODS

The study enrolled 10 breast cancer patients with moderate-to-severe BCP at 3-6 months after completion of all adjuvant treatments. These patients participated in a 12-week comprehensive health improvement program (CHIP). Intensity was adjusted to reach 65%-85% of the patient's maximal heart rate. Before the CHIP and at 1 and 6 months after completion of the CHIP, QOL and pain were measured using questionnaires [European Organisation for Research and Treatment of Cancer Quality of Life core and breast cancer modules (QLQ-C30, -BR23) and the McGill Pain Questionnaire short form] completed by the patients. Results were compared with those from case-matched control subjects from another study at McGill University.

RESULTS

After the CHIP, patients reported significant and clinically important improvements in QOL and symptoms. At 1 and 6 months post-CHIP, patients in the study felt, on average, better in overall QOL than did historical control subjects.

CONCLUSIONS

Our study suggests that patients who experience chronic bcp may benefit from an exercise program. A randomized controlled trial is warranted.

Scale for positive aspects of caregiving experience: development, reliability, and factor structure

OBJECTIVE. To develop an instrument (Scale for Positive Aspects of Caregiving Experience [SPACE]) that evaluates positive caregiving experience and assess its psychometric properties. METHODS. Available scales which assess some aspects of positive caregiving experience were reviewed and a 50-item questionnaire with a 5-point rating was constructed. In all, 203 primary caregivers of patients with severe mental disorders were asked to complete the questionnaire. Internal consistency, test-retest reliability, cross-language reliability, split-half reliability, and face validity were evaluated. Principal component factor analysis was run to assess the factorial validity of the scale. RESULTS. The scale developed as part of the study was found to have good internal consistency, test-retest reliability, cross-language reliability, split-half reliability, and face validity. Principal component factor analysis yielded a 4-factor structure, which also had good test-retest reliability and cross-language reliability. There was a strong correlation between the 4 factors obtained. CONCLUSION. The SPACE developed as part of this study has good psychometric properties.

Arabinogalactan and lipoarabinomannan biosynthesis: structure, biogenesis and their potential as drug targets

Mycobacterium tuberculosis, the etiological agent of TB, remains the leading cause of mortality from a single infectious organism. The persistence of this human pathogen is associated with its distinctive lipid-rich cell wall structure that is highly impermeable to hydrophilic chemical drugs. This highly complex and unique structure is crucial for the growth, viability and virulence of M. tuberculosis, thus representing an attractive target for vaccine and drug development. It contains a large macromolecular structure known as the mycolyl-arabinogalactan-peptidoglycan complex, as well as phosphatidyl-myo-inositol derived glycolipids with potent immunomodulatory activity, notably lipomannan and lipoarabinomannan. These cell wall components are often the targets of effective chemotherapeutic agents against TB, such as ethambutol. This review focuses on the structural details and biosynthetic pathways of both arabinogalactan and lipoarabinomannan, as well as the effects of potent drugs on these important (lipo)polysaccharides.

Dental anxiety among patients visiting a dental institute in Faridabad, India

Despite advances in dentistry, anxiety about dental treatment and the fear of pain remains widespread among patients and is a significant barrier to dental treatment. This study would therefore provide information so as to minimize levels of anxiety and aid in planning stress-free treatment. The cross-sectional study utilizing a self-reported questionnaire based on Modified Corah's Dental Anxiety Scale (MDAS) framed in Hindi (local language) was performed on 1032 patients (aged 14-68 years). Around 1004 questionnaires were returned (response rate--97.3%). Overall, prevalence of dental anxiety was high (50.2%), but severe anxiety (phobia) was low (4.38%). The prevalence of anxiety was seen mostly in the 20-30-year age group (37.3%). Anxiety was also seen to be significantly higher in females (mean - 11.79) than in males [mean - 9.47] (p < 0.0000). Patients anxious about dental procedures are often more difficult to treat. Anxious patients should be identified and managed appropriately by behavioural/pharmacological measures.

An Indian adaptation of the Involvement Evaluation Questionnaire: similarities and differences in assessment of caregiver burden

OBJECTIVES

The Involvement Evaluation Questionnaire (IEQ) is a comprehensive, conceptually valid and reliable means of assessing caregiver burden. However, its psychometric properties have rarely been examined in non-European settings. The aim of the present study was to evaluate the psychometric properties of an Indian translation of the IEQ (Hindi-IEQ).

METHODS

The European Union (English) version of IEQ was translated into Hindi and reviewed by a group of experts and caregivers for translation accuracy, cultural appropriateness, and for relevance and acceptability of items and constructs. The Hindi-IEQ was then administered to 162 primary caregivers of patients with severe mental illnesses. Eighteen caregivers completed both the English and Hindi versions to check the level of agreement between them. Another 27 completed the Hindi-IEQ twice, a week apart, to evaluate its test-retest reliability. Factor structure of the Hindi-IEQ was examined using an exploratory, principal components and factor analysis.

RESULTS

Pearson's correlation coefficients were significant for 24 items, while intraclass correlation coefficients were significant for 28 of the 31 items (P < 0.05), indicating a satisfactory level of agreement between the Hindi and English versions. Test-retest reliability for all items of the Hindi-IEQ was adequate, with kappa values ranging from 0.46 to 0.95 and intraclass correlation coefficients from 0.76 to 1.00. Internal consistency (Cronbach's alpha = 0.89) and the split-half reliability (Spearman-Brown coefficient = 0.68) of the Hindi-IEQ were also satisfactory. However, several differences were noted in the factor structure and distribution of scores of the Hindi-IEQ, which were quite unlike that of the European Union version.

CONCLUSIONS

The similarities and differences between the 2 versions of the IEQ indicated that sociocultural factors could influence assessment of caregiver burden across different cultures.