Role of Dietary Antioxidant Supplements in Male Infertility: A Review.

Infertility, which affects around 70 million couples globally, is the inability to conceive after at least a year of continuous, unprotected sexual activity. Male-related elements are involving half of all infertility cases globally. Male infertility has various characteristics, including oligospermia, asthenozoospermia, and teratozoospermia. The purpose of this study was to assess the impact of antioxidant-rich food supplements on the properties of semen, like concentration of sperm, morphology, motility, fertility rate, and damage of DNA. Terms such as coenzyme Q10, antioxidants, folic acid, vitamin C, vitamin E, male infertility, selenium and others, were used to search for relevant research papers in the PubMed database. The findings of this study demonstrated beneficial improvements in semen parameters among infertile men who consumed dietary supplements, particularly combining antioxidants like coenzyme Q10, vitamin C, and vitamin E.

Askin's Tumour: A Report of a Rare Case.

Primitive neuroectodermal tumours (PNETs) are rare, malignant tumours arising from primitive nerve cells. PNET of the chest wall is rare and is observed in children and young adults. Askin defined Askin's tumour as a PNET of the thoracopulmonary area. It develops from the soft tissues of the chest wall, particularly in the paravertebral region. Here, we report a case of Askin's tumour, a rare neoplasm occurring in the thoracopulmonary region in a 13-year-old girl. She came with complaints of fever, cold, cough with mucoid expectoration, breathlessness for 15 days, and generalized weakness for three months. A high-resolution computed tomography (HRCT) thorax scan was also done, which suggested a large right pleural-based mass with vertebral metastasis. Through diligent diagnostic evaluation involving imaging studies and histopathological examination, the tumour was accurately identified.

Sinonasal Carcinoma Presenting with Proptosis and Visual Impairment: A Case Report.

Sinonasal carcinoma is a rare but aggressive malignancy arising from the nasal cavity and paranasal sinuses. We present a case of a 40-year-old female who presented with a three-month history of headache, diminution of vision, and proptosis. Imaging studies revealed soft tissue density with bony erosion and extraconal extension in the left orbit. Histopathological examination confirmed sinonasal carcinoma with anaplastic changes. The patient underwent surgical excision of the tumor and received post-operative care in the neuro-ICU. Her visual acuity improved post-surgery, and she was discharged with stable neurological status. This case highlights the challenges in the diagnosis and management of sinonasal carcinoma and underscores the importance of multidisciplinary care for optimal outcomes. Early diagnosis and intervention are crucial in preventing complications and achieving favorable outcomes in patients with this aggressive malignancy.

Unmasking the Rarity: A Case Report on Type B Lactic Acidosis in Pediatric Acute Lymphoblastic Leukemia.

Acute lymphoblastic leukemia (ALL) is the most prevalent pediatric malignancy, accounting for approximately 25% of childhood cancers. Despite significant advancements in treatment protocols, ALL remains a complex disease, often presenting with various complications, including the rare metabolic disturbance of type B lactic acidosis. This case report details the clinical journey of a 14-year-old female with ALL who developed type B lactic acidosis during treatment. The patient presented with intermittent fever, abdominal pain, jaundice, and hepatosplenomegaly, accompanied by severe anemia and thrombocytopenia. Initial management included supportive care and chemotherapy initiation. Despite aggressive interventions, the patient's condition deteriorated, with escalating lactic acidosis and respiratory distress, leading to a critical need for tailored management strategies. This report underscores the importance of early recognition and comprehensive management of type B lactic acidosis in pediatric ALL, highlighting its multifactorial etiology and potentially life-threatening consequences. Enhanced clinical awareness and a multidisciplinary approach are crucial for improving outcomes in such complex cases.

Navigating the Diagnostic and Therapeutic Challenges of Central Neurocytoma: A Case Report.

Central neurocytoma, a rare intracranial tumor predominantly located in the lateral and third ventricles, presents a diagnostic and therapeutic challenge due to its varied clinical manifestations. We report the case of a 53-year-old male presenting with right upper and lower limb weakness, headaches, blurred vision, and tingling sensations, leading to the diagnosis of central neurocytoma with associated hydrocephalus. Initial evaluation, including magnetic resonance imaging (MRI) and subsequent computed tomography (CT) scans, revealed characteristic features of the tumor. The patient underwent a two-stage surgical intervention, including tumor excision and ventriculoperitoneal shunting, followed by a tracheostomy due to respiratory complications post-surgery. Histopathological examination confirmed the diagnosis of central neurocytoma, prompting multidisciplinary management and further referral for long-term follow-up. This case underscores the importance of comprehensive evaluation, multidisciplinary collaboration, and continued research in optimizing the diagnosis and management of central neurocytomas.

Insights Into Colorectal Carcinoma: A Comprehensive Review of MicroRNA Expression Patterns.

Colorectal carcinoma (CRC) remains a significant contributor to cancer-related morbidity and mortality worldwide. MicroRNAs (miRNAs) have emerged as crucial regulators of gene expression and play critical roles in various biological processes, including carcinogenesis. This comprehensive review aims to elucidate the role of miRNAs in CRC by analyzing their expression patterns and functional implications. An extensive literature review identified dysregulated miRNAs associated with different stages of CRC progression, from initiation to metastasis. These miRNAs modulate key signaling pathways in tumor growth, invasion, and metastasis. Furthermore, we discuss the potential of miRNAs as diagnostic biomarkers and therapeutic targets in CRC management. Future research directions include elucidating the functional significance of dysregulated miRNAs using advanced experimental models and computational approaches and exploring the therapeutic potential of miRNA-based interventions in personalized treatment strategies for CRC patients. Collaboration among researchers, clinicians, and industry partners will be essential to translate these findings into clinically impactful interventions that improve patient outcomes in CRC.

Navigating the Future: A Comprehensive Review of Artificial Intelligence Applications in Gastrointestinal Cancer.

This comprehensive review explores the transformative role of artificial intelligence (AI) in the realm of gastrointestinal cancer. Gastrointestinal cancers present unique challenges, necessitating precise diagnostic tools and personalized treatment strategies. Leveraging AI, particularly machine learning and deep learning algorithms, has demonstrated remarkable potential in revolutionizing early detection, treatment planning, prognosis, and drug development. The analysis of current research and technological advancements underscores the capacity of AI to unravel intricate patterns within extensive datasets, providing actionable insights that enhance diagnostic accuracy and treatment efficacy. The transformative impact of AI on the landscape of gastrointestinal cancer is emphasized, signaling a paradigm shift towards more precise and targeted cancer care. The conclusion emphasizes the need for sustained research efforts and collaborative initiatives among AI researchers, healthcare professionals, and policymakers. By fostering interdisciplinary collaboration, we can navigate the evolving field of gastrointestinal cancer care, embracing the potential of AI to improve patient outcomes and contribute to a more effective and personalized approach to cancer management.

Advances in Understanding and Treating Amyotrophic Lateral Sclerosis (ALS): A Comprehensive Review.

Amyotrophic lateral sclerosis (ALS) is a deadly CNS neurodegenerative disease. The way ALS is now managed, from diagnosis to prognosis, is still not ideal despite many studies. Early diagnosis can help ALS patients live longer since prompt treatment can halt the disease's development. Two medications, riluzole and edaravone, have recently been licensed for use in therapy, and they very slightly increase life expectancy. Still, a lot of cutting-edge experimental medications are being developed. In the following article, we give a synopsis of the innovative medications and genetic remodeling that have emerged recently and help to halt the course of the illness. Studies have also been conducted on a few symptomatic and rehabilitative therapies that enhance the quality of life for ALS patients.

Guiding Mothers About Early Detection and Addressing Speech Delay and Disorders Among Children in a Rural Setup.

Introduction Speech is one of the most important milestones to be achieved by a growing child. The significance of being informed about different pediatric speech abnormalities, especially to mothers, allows them to help their children in cases of irregularities in the maturation in this domain. Aim and objectives The study aimed to assess and educate mothers on the important milestones of speech delay in children and make them address the issue and be aware of various corrective measures to treat the underlying conditions of speech disorders in children. The objectives of the study include understanding the pre-acquired knowledge of the mothers regarding the delay in speech in children, imparting knowledge regarding different speech disorders and their management, spreading awareness on how to seek help for various underlying causes of speech irregularities or delay, and to train the mothers into approaching the challenges in an orderly manner. Methods A study was conducted to guide rural mothers visiting the Obstetrics and Gynecology and Pediatric out-patient departments and Neonatal wards in a rural tertiary care hospital situated in the Sawangi Meghe village of Wardha City, Maharashtra, India, about the detection and treatment of children with disabilities of speech as early as possible. The mothers' knowledge was assessed before and after the study with the help of questionnaires, and basic understandable information on different types, causes, symptomatology, and management of speech delay and disorders among children was explained with the help of group discussions and posters. Results The motive behind this study was to be aware of facts known by the rural mothers, their actions on coming across such presentations by their children, cues that they would pick up, and the need to ask for help at the appropriate time were assessed and elaborated if not known by them. The Relative Learning Gain and Normalized Gain were calculated to be 76.43% and 0.74 (high gain), respectively, and out of the total subjects, 97.16% of mothers voted that this study proved helpful, and six mothers (4.23%) benefited with the intervention and were referred to experts for evaluation of their children. Conclusion Awareness in this field is necessary to manage children's development, especially by their mothers. Knowing the prevalence of knowledge in mothers may build an association with the prevalence of the recognized cases of speech disorders in children. Evaluation at different community levels may be conducted to gauge the need to impart required knowledge about speech disabilities in children to the maternal population. Future research and the impartation of knowledge to caregivers are vital to promote vigilant and systematic action to be taken regarding the proper growth of their children.

Utility of CD34 in Assessing Microvessel Density and Its Correlation With Clinicopathological Parameters in Colorectal Carcinoma Patients.

Currently, the most commonly practiced method of reporting cases of colorectal carcinoma is done according to guidelines provided by the College of American Pathologists (8th edition) and the Royal College of Pathologists (UK). These guidelines include various histopathological parameters like tumor site, extent, histologic type, grade, margins, tumor budding, lymphovascular invasion, and perineural invasion. However, in the present guidelines, the immunohistochemistry-based marker of mean vessel density (MVD) has not been addressed as an important parameter. The present study gives an overview of the importance of MVD. MVD was statistically significant when correlated with tumor size, lymph node metastasis, grade, and vascular invasion. However, no statistical significance was observed when compared with age, perineural invasion, and stage of the tumor.

Review on Scrub Typhus: An Important Etiology of Acute Undifferentiated Fever Illness.

One of India's predominant public health issues is acute undifferentiated fever illness (AUFI), a typical response to an infectious agent. Diagnosis becomes challenging when the disease has been reported with fever as the primary symptom. Among the cases presenting at a tertiary care hospital in central India, 88% had an acute undifferentiated fever, the most common being dengue infection. In India, rural communities are at more risk from AUFI than cities. Most of those in danger are those who reside in remote areas, and one of the most significant risks is for those who reside close to forests. AUFI is a complex condition for physicians to deal with and is one of the most frequent clinical conditions for which empirical treatment is required. Nowadays, AUFI can be managed by a syndromic approach with the judicial use of antibiotics. Symptoms of AUFI, along with myalgia, headache, and anorexia, can be caused by various illnesses. Patients are recommended to undertake a battery of investigations, which may delay the therapy and increase expenses because many diseases may present with the same symptoms. In the developed world, viral illness is the primary cause of AUFI. However, in developing countries like India, it can also be brought on by potentially curable but life-threatening conditions such as malaria, leptospirosis, hantavirus infection, and Japanese encephalitis. Lack of knowledge of the locally prevalent illnesses, which might be the cause of AUFI, and lack of preliminary screening and diagnostics at the point of care to identify the etiologies make it difficult to control these generally curable causes of the burden of AUFI, especially in tropical and subtropical countries. A deeper understanding of AUFI is required to develop better diagnostics and cures for various etiologies, especially scrub typhus.

Correlation of microvessel density with histopathological parameters of carcinoma breast.

BACKGROUND OBJECTIVES: Microvessel density (MVD) is a surrogate measure of tumour angiogenesis, and is well known for over two decades to identify individuals with a high risk of recurrence with greater prevision than traditional markers. This study aims to assess the utility of MVD and its correlation with the Nottingham Prognostic Index (NPI) and other routine histopathological parameters in carcinoma breast. METHODS: This two year retrospective, cross-sectional and analytical study evaluated 143 women with breast cancer presenting to rural tertiary hospital in central India. These women were graded histopathologically, the immunophenotype was determined using ER (estrogen receptor), PR (progesterone receptor), Her2 neu (human epidermal growth factor receptor 2 neu) and Ki-67 proliferation index (Kiel-67) immunohistochemical markers and anti-CD34 antibody to stain the endothelial cell clusters displaying the microvessels. The NPI was generated for each participant based on the tumour size, histologic grade and involvement of lymph node. The parameters were compared with the CD34 scores. Differential and inferential statistics, including the independent t test, analysis of variance, Pearson's correlation coefficient, Spearman's rank correlation coefficient and point biserial correlation coefficient, were used for statistical analysis. RESULTS: This study showed that CD34 values ranged from 6-36 microvessels/hpf, with 24.16±6.77 microvessels/hpf as the mean. The mean microvessel counts showed a significant positive correlation with the Bloom-Richardson histological grade, vascular invasion, LN (lymph node) positivity and NPI. However, there was no significant correlation of CD34 values with the participant's age, tumour size neither any significant association of CD34 values with the individual's immunophenotype. INTERPRETATIONS CONCLUSIONS: A positive linear correlation of the microvessel counts and the NPI scores suggest that with an increase in tumour angiogenesis, there was increased proliferative potential. Based on the significant correlation between the microvessel counts and the vascular invasion of the tumour masses in this study, it can be assumed that there will be vascular invasion if the microvessel count is higher and vice-versa. Although it is established that angiogenesis and neovascularization are required for the expansion of the solid tumour tissue, the heterogeneous nature of this entity makes it difficult for obtaining a linear correlation. Hence, it is suggested that though neovascularization permits advanced tumour spread it, however, does not guarantee it.

Endodermal Sinus Tumor of the Neck: A Rare Presentation.

Germ cell tumors usually occur in the gonads. Extragonadal germ cell tumors (EGCTs) are uncommon, and the head and neck region is a rare primary location. In this region, endodermal sinus tumors are relatively uncommon; they are typically recorded alongside teratomas and infrequently by themselves. When an endodermal sinus tumor arises in the neck, it can present with unique clinical and radiographic features and can be challenging to diagnose and manage. We report the peculiar case of a 25-year-old young adult who was suffering from a painful left-sided neck swelling for a year. Fine needle aspiration cytology (FNAC) of neck mass was performed and the cytomorphological features were suggestive of germ cell tumor. After the diagnosis, the patient received chemotherapy and was posted for wide local excision of the tumor. On microscopic examination, the tumor mass showed histopathological features suggestive of an endodermal sinus tumor.

Thyrolipoma: A Rare Presentation of the Thyroid Gland.

Thyrolipoma is a rare disorder marked by substantial adipose tissue growth inside the thyroid gland. Fatty tissue is frequently seen in salivary glands, thymus, breasts, and pancreas but rarely in the thyroid gland. The fascinating and unusual illness known as thyrolipoma presents challenging diagnostic and therapeutic issues. Due to the rarity of thyrolipoma, doctors must evaluate thyroid nodules with a high index of suspicion, especially those who are radiologically and clinically worrisome. We present a study of a 50-year-old female who came with the complaint of midline neck mass for one year. On clinical examination, a diagnosis of multinodular goiter was made. Computed tomography (CT) scan was suggestive of a heterogenous enhanced thyroid mass lesion. Thus, a total thyroidectomy was performed. On histopathological examination, a final diagnosis of thyrolipoma was made. The abstract aims to provide an overview of the clinical presentation, diagnosis, and treatment options of thyrolipoma, as well as highlight the importance of early recognition and appropriate management of this rare tumor.

Reviving medical education through teachers training programs: A literature review.

The art of teaching in undergraduate and post graduate medical curriculum was revised in last century with targeted programs to equip the medical faculty with advanced teaching technologies. Medical education units (MEUs) were established by the medical council to train the existing medical faculty of the country in teaching methodologies. This study aimed to evaluate the MEU's impact on teachers' training and compare the status of trained teachers before and after the MEU era. Published literature and statistics on the MCI website were compiled to compare teachers' training status over time empirically. MEU, R.C., and N.C. have been highly efficient in improving the proportion of teachers trained from 5.38 to 50.32% across the country, especially after the upgradation of MEU in 2009. Proportion of the teachers trained increased from 5.38% to 50.32% due to the programs organized by various MEU, regional and nodal centres, especially after the upgradation of MEU in 2009. Lack of trained resource persons and administrative support were the common challenges faced. Properly organized MEU and planned activities should be emphasized in every institute. for effective development of the faculties.

Pineal Parenchymal Tumors With Intermediate Differentiation to Pineoblastoma: A Transitional Neuroectodermal Tumor of the Pineal Gland.

Pineal tumors are quite rare and are fairly aggressive tumors seen in young adults and children. These tumors arise from the pineal region or recess from various types of cells in the gland and structures located in close propinquity to the gland. Pineal gland tumors have a heterogeneous spectrum that includes pineal parenchymal tumors (PPTs) and papillary tumors of the pineal region (PTPR). The PPTs are further subclassified into pineocytomas (Grade 1), PPTs of intermediate differentiation (grade 2 or 3), and pineoblastomas (grade 4) based on the World Health Organization (WHO) grades and histopathological features. We discuss the case of an 11-year-old male child who presented with complaints of headache for 15 days, vomiting for seven days, and diplopia for four days. On magnetic resonance imaging (MRI), a soft tissue density lesion was noticed in the posterior third ventricle region. Based on the location and the MRI findings, the differential diagnosis considered were a pineal lesion, a choroid plexus papilloma, or a meningioma. He underwent a right occipital ventriculoperitoneal shunt followed by total excision of the tumor, and the resected specimen was sent for histopathological examination. After pathologic examination, the diagnosis of pineoblastoma (grade 4) with features of a PPT of intermediate differentiation (grades 2-3) was revealed, and the same was confirmed on immunohistochemistry.

Malakoplakia of the Gallbladder: A Case Report.

Histiocytes are cells that are involved in the immune responses of the body. They are unable to properly break down the bacterial material in malakoplakia, a chronic granulomatous histiocytic disease that occurs in immunocompromised patients and autoimmune conditions. Very few reports of these lesions exist, as those that occur in the gallbladder. It typically affects the urinary bladder, alimentary tract, cutaneous, hepato-biliary, and male and female genital systems. These lesions are usually incidental findings that result in patients being misdiagnosed. A 70-year-old female presented with right lower quadrant abdominal pain, and malakoplakia of the gallbladder was diagnosed. Histopathology findings revealed malakoplakia of the gallbladder, and the same was confirmed with special stains such as periodic acid-Schiff (PAS). This case highlights the role of gross and histopathology findings as a clue to the diagnosis, which helps the surgeon with further management.

To study the utility of COX-2 as immunohistochemical prognostic marker in comparison to various histopathological parameters and TNM staging in breast carcinoma: an observational, cross-sectional study protocol.

Background: Breast cancer is the most prevalent cancer among women worldwide and is a well-known cause for cancer mortality in females. COX-2 (cyclooxygenase) plays a vital role in development of some human cancers such as lung, colon and breast. It is a potent enzyme that is important for the conversion of arachidonic acid into prostaglandins. These prostaglandins mediate cellular proliferation, apoptosis and angiogenesis which contributes to carcinogenesis. Overexpression of COX-2 has been detected in several malignancies including breast cancer. COX-2 overexpression is regarded as a poor prognostic marker of breast cancer.The present study will aim to study the immunohistochemical expression of COX-2 in breast cancer and compare it with known histopathological parameters thus assessing its prognostic value. Methods: This will be an observational study conducted in the Department of Pathology, JNMC, Wardha (Sawangi). Radical mastectomy specimens will be studied for COX-2 expression by immunohistochemistry in patients diagnosed with breast carcinoma. COX-2 expression will be quantified as immunohistochemical score and results will be correlated with various histopathological parameters. Results: The expected result of our study will suggest an association of COX-2 expression to the factors associated with poor prognosis in breast carcinoma. A positive correlation is expected between larger tumor size, positive lymph node status, higher T stage and N stage and lymphovascular invasion. Conclusions: Conclusions will be drawn from the obtained results of the immunohistochemical study by using COX-2- for detection of overexpression of COX-2 when evaluated with TNM staging, histological grading and molecular types of breast cancer.

Case Report: A Pathological Odyssey in Primary Cutaneous Apocrine Carcinoma.

Apocrine carcinoma is an extremely rare malignant cutaneous neoplasm that usually arises in areas with a high density of apocrine glands. Diagnosis can be challenging as tumours share histological and immunophenotypic characteristics with them. At first evaluation, the disease is often assumed to be benign. There have been approximately 100 reports of apocrine neoplasms in the literature. A 48-year-old male presented with a right axillary mass which increased in size over a period of 2 years. The patient was reported to have had ayurvedic therapy, but his swelling remained unchanged. Axillary lymph nodes were palpable. USG axilla suggested a well-defined fungating solid isoechoic lesion. USG neck did not reveal any abnormality. The mass was surgically excised as a whole by removing the overlying skin with margins and lymph node excision. The patient was diagnosed with primary apocrine carcinoma after surgical excision. The differentials include adenocarcinoma of breast and prostate and apocrine adenoma. There are no established standards for the care of this form of carcinoma due to its rarity and the absence of clinical studies. A literature evaluation and further reporting will aid in developing diagnostic standards and the most efficient treatment options.

Correlation of Morphological Findings of Endometrium With Concerned Hormone Levels in Patients With Abnormal Uterine Bleeding: A Narrative Review.

Abnormal uterine bleeding (AUB) is a distressing menstrual condition that continues to be one of the most common rationales for hysterectomy in underdeveloped countries. It can be either focal (breakthrough bleeding) or diffuse (bleeding throughout the body) (withdrawal bleeding). AUB has a negative impact on a female's physical, social, and emotional well-being. It is caused by chronic endometritis, micro erosions, or vascular fragility caused by micro-vessel structural anomalies. Polyps, submucosal leiomyoma, atrophy, and cancer can all produce endometritis and micro erosions in otherwise healthy endometrium (organic causes). In hyperplasia and endometrial cancers, especially type I, estrogen and progesterone hormones are also expressed. The level of these hormones gives prognostic information. They also provide amenability to hormonal therapy. Hormonal imbalance is the main component involved in the pathogenesis of dysfunctional uterine bleeding (DUB).