Menstrual Disorders and Menstrual Hygiene Practices in Higher Secondary School Girls

Objective

To study the menstrual problems and menstrual hygiene practices of adolescent girls in Thiruvananthapuram City Corporation.

Methods

Students of class XI and XII in the age group 15–19 years, belonging to ten Higher Secondary Schools within the Thiruvananthapuram City Corporation area were selected for the study by multistage sampling procedure and screened using a pretested self evaluation questionnaire.

Results

Menstrual disorders were reported in 21.1%. The most frequently reported problem during menstruation was dysmenorrhoea (72.4%) followed by oligomenorrhoea (11.3%). Only 11.5% of the girls who had menstrual problems sought treatment and majority from a gynecologist. Out of 81.5% girls who reported vaginal discharge, only 5.7% had abnormal discharge. Menstrual hygiene was adequate in the majority of girls.

Conclusions

Menstrual disorders are common in adolescence and can have significant consequences on future reproductive health.

     

Pleomorphic adenoma arising in an incidental midline isthmic thyroid nodule: a case report and review of the literature

Ectopic salivary gland tissue is common in the head and neck, usually associated with lymph nodes in lateral areas. It is rarely noted in the thyroid gland. Here we report the first case of a pleomorphic adenoma presenting as a midline nodule in the isthmus of thyroid in a 66-year-old man. We propose the possibility of origin in ectopic salivary gland tissue that may have aberrantly migrated with the median anlage from the foramen cecum in the base of the tongue during embryogenesis.     

Bioresolution of benzyl glycidyl ether using whole cells of Bacillus alcalophilus

The incubation of whole Bacillus alcalophilus cells grown on a mineral supplemented medium (MSM) containing 1% (w/v) sucrose as carbon source, 1.2% (w/v) tryptone as nitrogen source at pH 6.5 and temperature 30 °C in 24 h kinetically resolved benzyl glycidyl ether (1 mg/ml) to provide (S)-benzyl glycidyl ether with 30% ee and (R)-3-benzyloxypropane-1,2-diol with 40% ee.     

Thyroid follicular lesion of undetermined significance: Evaluation of the risk of malignancy using the two-tier sub-classification

The Bethesda 2007 Thyroid Cytology Classification defines follicular lesion of undetermined significance as a heterogeneous category of cases that are not convincingly benign nor sufficiently atypical for a diagnosis of follicular neoplasm or suspicious for malignancy. In our institution, we refer to these cases as indeterminate, and they are further sub-classified into two: (1) low cellularity with predominant microfollicular architecture and absence of colloid (IN(a)) and (2) nuclear features not characteristic of benign lesions (nuclear atypia) (IN(b)). We reviewed these indeterminate cases to document the follow-up trend using this two-tier classification. A search of the cytology records was performed for the period between January 2008 and June 2009. All thyroid fine-needle aspiration (FNA) cases were reviewed and the ones diagnosed as indeterminate were identified. Correlating follow-up FNA and/or surgical pathology reports were reviewed. The percentage of cases showing a malignancy was calculated. One hundred and seventy-one indeterminate cases were identified, representing 2.8% of the 6,205 thyroid FNA cases examined during the time under review (107 IN(a), 64 IN(b)). Records of follow-up procedures were available in 106 (61%) cases. Malignancy was identified in 27% of all indeterminate cases. This was disproportionately more in the IN(b) (56%) compared to the IN(a) (7%) cases. A diagnosis of "IN(a)" does not carry the same implication as that of "IN(b)". The IN(b) category needs a more aggressive follow-up than the IN(a) category and may justify an immediate referral for lobectomy. Despite the vague morphologic criteria for this diagnostic category, the indeterminate rate remains relatively low and falls within the NCI recommendation (<7%).     

Surface plasmon resonance analysis of free IgE in allergic patients receiving omalizumab (Xolair)

The diagnosis of human allergic disease involves an initial clinical history based association of allergic symptoms with an allergen exposure. This is followed by confirmation of sensitization (IgE antibody positivity) with skin test, serology or provocation testing. Once diagnosed, the allergic individual can be managed using one or several modalities that involve allergen avoidance, pharmacotherapy, allergen immunotherapy and anti-IgE therapy. This report examines Law of Mass Action considerations for the design of immunological methods which permit the quantification of free (non-Omalizumab bound) IgE in the serum of patients receiving anti-IgE therapy. The rationale for and design and performance of a surface plasmon resonance assay for the detection of "free" IgE (unbound with anti-IgE) is presented as an alternative to microtiter plate based ELISAs.     

Evaluation of the deformation and corresponding dosimetric implications in prostate cancer treatment

The cone-beam computed tomography (CBCT) imaging modality is an integral component of image-guided adaptive radiation therapy (IGART), which uses patient-specific dynamic/temporal information for potential treatment plan modification. In this study, an offline process for the integral component IGART framework has been implemented that consists of deformable image registration (DIR) and its validation, dose reconstruction, dose accumulation and dose verification. This study compares the differences between planned and estimated delivered doses under an IGART framework of five patients undergoing prostate cancer radiation therapy. The dose calculation accuracy on CBCT was verified by measurements made in a Rando pelvic phantom. The accuracy of DIR on patient image sets was evaluated in three ways: landmark matching with fiducial markers, visual image evaluation and unbalanced energy (UE); UE has been previously demonstrated to be a feasible method for the validation of DIR accuracy at a voxel level. The dose calculated on each CBCT image set was reconstructed and accumulated over all fractions to reflect the 'actual dose' delivered to the patient. The deformably accumulated (delivered) plans were then compared to the original (static) plans to evaluate tumor and normal tissue dose discrepancies. The results support the utility of adaptive planning, which can be used to fully elucidate the dosimetric impact based on the simulated delivered dose to achieve the desired tumor control and normal tissue sparing, which may be of particular importance in the context of hypofractionated radiotherapy regimens.     

Foreword

Proceedings of the National Academy of Sciences, India Section B: Biological Sciences -     

Severe hypoglycemia secondary to methimazole‐induced insulin autoimmune syndrome in a 16 year old African‐American male

Insulin autoimmune syndrome (IAS) or Hirata's disease is a rare disorder characterized by hypoglycemia secondary to insulin autoantibodies (IAb). Over 200 patients have been described from Japan with significantly less numbers being reported from outside the Orient. IAS is more common in patients older than 40 yr of age with reports in the pediatric age group being notably rarer. Exposure to sulfhydryl group containing medications is implicated in the pathogenesis of this syndrome. In this report, we describe a case of IAS in an African‐American adolescent. A 16‐yr‐old healthy African‐American male was diagnosed with Graves' disease and started on Methimazole. Four weeks later, he was found unconscious and hypoglycemic (blood sugar 1.5 mmol/L). Evaluation was negative for insulinoma. Insulin antibodies were positive. Oral glucose tolerance test revealed elevated free insulin concentrations with disproportionately elevated total insulin levels. The patient was started on prednisone, diazoxide, and propranolol for management of IAS and hyperthyroidism. Thyroid radio‐ablation was subsequently undertaken. The doses of prednisone and diazoxide were tapered and these medications discontinued after 9 months. The insulin antibody levels decreased gradually and became undetectable in 6 months with resolution of the hypoglycemia.