Cytomorphological Spectrum of Head and Neck Lesions by Fine Needle Aspiration Cytology in a Tertiary Care Center.

Introduction: Fine needle aspiration cytology (FNAC) is considered the first line investigation of choice for evaluating head and neck swellings as it is a quick, safe, and rapid diagnostic procedure. Material and Methods: This is a retrospective study that included 242 cases of head and neck lesions in the Department of Pathology, Maharaja Agrasen Medical College, Agroha. FNAC was performed by aspiration and non aspiration techniques, and cytological diagnosis was given and correlated with clinical findings and investigations. Results: The most common age group affected was 21-30 years. Male to female ratio was 1:1.49. Out of 242 cases, maximum lesions were found in lymph nodes (128 cases), followed by thyroid gland in 81 cases, salivary gland in 23 cases, and miscellaneous group in 10 cases. Maximum number of cases reported were inflammatory (55.37%), followed by benign (29.33%) and malignant (11.15%) cases. Most swellings occurring in the head and neck region are inflammatory in nature. Conclusion: Our study concluded that FNAC is a simple, safe, and minimal invasive technique that differentiates between neoplastic and non neoplastic lesions and avoids unnecessary surgeries.

Phase III, two arm, multi-centre, open label, parallel-group randomised designed clinical investigation of the use of a personalised early warning decision support system to predict and prevent acute exacerbations of chronic obstructive pulmonary disease: 'Predict & Prevent AECOPD' - study protocol.

INTRODUCTION: With 65 million cases globally, chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death and imposes a heavy burden on patients' lives and healthcare resources worldwide. Around half of all patients with COPD have frequent (≥2 per year) acute exacerbations of COPD (AECOPD). Rapid readmissions are also common. Exacerbations impact significantly on COPD outcomes, causing significant lung function decline. Prompt exacerbation management optimises recovery and delays the time to the next acute episode. METHODS/ANALYSIS: The Predict & Prevent AECOPD trial is a phase III, two arm, multi-centre, open label, parallel-group individually randomised clinical trial investigating the use of a personalised early warning decision support system (COPDPredict) to predict and prevent AECOPD. We aim to recruit 384 participants and randomise each individual in a 1:1 ratio to either standard self-management plans with rescue medication (RM) (control arm) or COPDPredict with RM (intervention arm).The trial will inform the future standard of care regarding management of exacerbations in COPD patients. The main outcome measure is to provide further validation, as compared with usual care, for the clinical effectiveness of COPDPredict to help guide and support COPD patients and their respective clinical teams in identifying exacerbations early, with an aim to reduce the total number of AECOPD-induced hospital admissions in the 12 months following each patient's randomisation. ETHICS AND DISSEMINATION: This study protocol is reported in accordance with the guidance set out in the Standard Protocol Items: Recommendations for Interventional Trials statement. Predict & Prevent AECOPD has obtained ethical approval in England (19/LO/1939). On completion of the trial and publication of results a lay findings summary will be disseminated to trial participants. TRIAL REGISTRATION NUMBER: NCT04136418.

Responses of two cultivars of Trifolium repens L. to ethylene diurea in relation to ambient ozone.

Three ethylene diurea (EDU) concentrations (0, 150 and 300 mg/L) were used to evaluate the negative impact of ozone (O3) on two cultivars of Trifolium repens L. cv. Vardan and Bundel grown under natural field conditions in a suburban area of Varanasi, India. Mean O3 concentrations varied from 30.3 to 46.6 microg/L during the experimental period. Higher photosynthetic pigments and ascorbic acid concentrations were noticed in both EDU-treated cultivars over non-EDU-treated ones, but a reverse trend was found for lipid peroxidation. Growth parameters and biomass also showed increments under EDU treatment of both cultivars. The ratio of variable fluorescence to maximum fluorescence increased significantly in Vardan but not in Bundel upon EDU treatment. Results revealed that EDU concentration of 300 mg/L was more effective to combat the oxidative stress as well as protecting plants from O3 injury symptoms. The test cultivar Vardan is relatively sensitive to O3, thereby can be used as a bioindicator of O3 pollution in areas having higher O3 concentrations. Results also indicated that Bundel has more efficient antioxidant defense system than Vardan and hence was more tolerant to O3 stress.

Extended insertion of teres minor muscle: a rare case report

Teres minor is one of the muscles of the shoulder joint along with subscapularis, supraspinatus and infraspinatus forming rotator cuff. Variations of teres minor are relatively uncommon. A unique and extended insertion of this muscle is being reported in the present case. Knowledge of the anatomy of this muscle is important to avoid injury to the axillary nerve and posterior circumflex humeral vessels while surgically approaching the shoulder joint and inserting portals of the arthroscope in a posterior approach to the shoulder joint (AU)

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