Granular cell ameloblastoma: enigmatic cells in an unusual neoplasm.

An unusual granular variant of ameloblastoma presenting as a mandibular mass in a 43-year-old woman is described. These visually striking tumors display unusual and inconsistent immunohistochemical staining patterns although differential diagnosis from other granular cell lesions of the head and neck is usually not problematic.

Comparison of hearing outcome using a Nitinol versus Teflon prosthesis in stapedotomy.

CONCLUSION: The time-tested, readily available, and cost-effective Teflon® piston continues to have equivocal results to the newer Nitinol piston. OBJECTIVE: To compare hearing outcome using a Nitinol versus Teflon piston in stapes surgery and to ascertain the feasibility of using the Nitinol piston. METHODS: Forty patients between 18 and 45 years of age were selected and randomly allocated into two groups of 20 each and the study was conducted between September 2007 and March 2009 at Maulana Azad Medical College. RESULTS: There was no significant difference between the two groups in the postoperative air-bone gap and air-bone gap closure at 1, 2, 3, and 6 months.

Cost of medicines & their affordability in private pharmacies in Delhi (India).

BACKGROUND & OBJECTIVES: Medicines can account for up to 90 per cent of health care spending by poor people. High costs of medicines contribute to decreased access to healthcare. This study was conducted to assess the cost of medicines and their affordability in the private pharmacies in Delhi, India. METHODS: A survey was conducted to assess the costs of prescribed medicines and treatment of community acquired pneumonia (CAP), with medicines purchased from 27 private pharmacies, in Delhi. Affordability of medicines was assessed by comparing the costs of treatment (medicines) to the monthly per capita expenditure (MPCE) on food, minimum monthly and daily wages for different classes of workers. RESULTS: A large variability in the costs of prescriptions was observed (129.37 ± 217.99) The cost of treatment of CAP varied from Rs. 34.50- 244.75 with azithromycin and Rs.72.20- 277.30 with levofloxacin. The percentage of MPCE on food spent for a prescription was 17.64 per cent for urban and 23.4 per cent for rural population. The percentage of MPCE on food spent for treatment of CAP ranged from 10.11 to 13.42 per cent with azithromycin and 13.28 to 17.61 per cent with levofloxacin. The number of days a worker on minimum daily wages would have to work to enable him to purchase his prescription medicines ranged from 1-17 days, depending on the problem. The cost of treatment of CAP required 1-3 days of work by a daily wage earner, depending on the brand of medicine prescribed. INTERPRETATION & CONCLUSIONS: The findings of our study show that the costs of medicines are highly variable and not affordable for the economically poor in India. Modifications in National Pharmaceutical Policy need to be done urgently.

Cochlear implantation in India: a public health perspective.

Around 7% of the population of India suffers from profound deafness. More than a million children needs either hearing aid or cochlear implant surgery to restore their hearing power. Many of them had never heard a single word since their birth. Still only 5000 cochlear implant surgery has been conducted in the country, the first being nearly 20 years ago, and most of them in private health facilities where the patient paid out of their pocket. The main reason of such poor penetration of the surgery in masses is the inhibitory cost associated with cochlear implant surgery and the lack of trained man-power to conduct such surgeries. The other reason is being the government engagement with other pressing health needs of the society resulting in the shout of ear care falling on deaf ears. With the advent of National Program for Prevention and Control of Deafness (NPPCD) in 2006, there is renewed interest in tackling this public health disaster.

Progressive rise of c fos expression from premalignant to malignant lesions of oral cavity.

OBJECTIVES: Oral cancer is a worldwide phenomenon. It is thought to develop in a number of premalignant lesions. Protooncogene c fos is a known transformer of premalignant to malignant lesions. However, its role in oral carcinogenesis is not yet known. STUDY DESIGN: A total of 130 cases were studied comprising of premalignant lesions (n=50), squamous cell carcinoma (n=50) and controls (n=30). c fos expression was studied by immunohistochemistry. RESULTS: Premalignant lesions of oral cavity occurred at a lower age group (mean 39.2 years) compared to squamous cell carcinoma (mean 51.8 years), p <0.001. Mean c fos percentage positivity in squamous cell carcinomas (SCC), premalignant lesions and controls was 44.5+/-36.9%, 11.4+/-18.8% and 1.23+/-2.6% respectively, the differences were highly significant (p<0.001). c fos positivity also increased from mild (10.85+/-14.23%) to moderate dysplasia (19.64 +/-26.05%). CONCLUSIONS: The serially increasing c fos expression from normal mucosa to premalignant lesions to SCC and in dysplasias suggests that it could be an early gene to get activated and form transcription factor activator protein -1(AP-1).