Evaluation of downstaging in the detection of cervical neoplasia in Kolkata,India

Unaided visual inspection or "downstaging" has been suggested as a potential alternative method for cervical cancer screening in developing countries. Our study was designed to evaluate the accuracy of downstaging to detect cervical neoplasia in a low-resource setting. A total of 6,399 women aged 30-64 years were screened with downstaging by trained nonmedical health workers. Two thresholds were used to define positive downstaging: "low threshold" when any visible abnormality on the cervix was considered positive and "high threshold" when selected abnormalities such as bleeding on touch, bleeding erosion, hypertrophied oedematous cervix, congested stippled cervix and growth or ulcer constituted the positive test. All women underwent a colposcopy examination. Biopsies were directed when colposcopy revealed abnormal lesions. True disease status was defined as histologically proven moderate dysplasia and worse lesions. Since all the participants received a diagnostic (reference) investigation (biopsy and/or colposcopy), sensitivity, specificity and predictive values were estimated directly. Low- and high-threshold downstaging were positive in 1,585 (24.8%) and 460 (7.2%) women, respectively. The sensitivities of low- and high-threshold downstaging to detect high-grade precursors and invasive cancers were 48.9% and 31.9%, respectively. The specificities were 75.8% and 93.3%, respectively. These results indicate that downstaging is not suitable as an independent primary screening modality for cervical neoplasia.     

Neuropharmacological profile of Barleria lupulina Lindl. Extract in animal models

Barleria lupulina Lindl. is a popular medicinal plant distributed in mountains of southern and western India. In the present work, the effect of methanolic extract of aerial parts of B. lupulina on CNS activity has been evaluated. The CNS activity was tested in several experimental models, in mice and rats: general behavior, exploratory behavior, muscle relaxant activity, conditioned avoidance response and phenobarbitone sodium-induced sleeping time tests. The aerial parts of the plant B. lupulina was extracted with methanol and the solvent was removed by vacuum distillation. The methanol extract (100, 200 and 300 mg/kg) showed reduction in general behavioral pattern (spontaneous activity, alertness, awareness, pain response and touch response) in a dose dependent manner. The extract was found to produce a significant reduction of the exploratory behavioral profile (Y-maze test, head dip test) and conditioned avoidance response with all the tested doses. The methanolic extract showed significant motor incoordination and muscle relaxant activity. The extract also potentiated phenobarbitone sodium induced sleeping time. Preliminary investigation showed that the methanol extract of B. lupulina has significant psychopharmacological activity.     

Visual-field superiority as a function of stimulus type and content

The objective of this study was to examine whether hemispheric superiority is determined more by stimulus type (facial, lexical) or content (neutral, emotional). A split, visual-field experiment was designed using a computer-based program with bilateral presentation (left visual-field, right visual-field) for four sets of stimuli: face (neutral, emotional) x word (neutral, emotional), N = 40. The dependent measures were the frequency of correct response and response latency of correct responses. The visual-field effect was nonsignificant for correct responses; however, the interaction of stimulus type x content was found significant. The interaction of visual-field x stimulus type was significant with response time as the dependent measure. Facial stimuli were processed faster in the left visual-field (a right hemispheric function) and lexical stimuli were processed faster in the right visual-field (a left hemispheric function). No hemispheric effect was observed for stimulus content.     

Bilateral cryptorchidism with bilateral inguinal hernia and retrovesical mass in an infertile man: single-stage laparoscopic management

A 30-year-old married man presented with the complaint of inability to procreate. Examination revealed bilateral nonpalpable testes and bilateral inguinal hernia. Ultrasonography of the abdomen could not locate the testis; instead, a hypoechoic 5 x 5-cm mass was found behind the bladder. A CT scan of the abdomen revealed the right testis near the right inguinal canal. The left testis could not be identified beside the soft tissue mass. The patient was taken for diagnostic as well as therapeutic laparoscopy. The testis on the right was found just proximal to the internal inguinal ring, and right orchidopexy was done. The left testis was small and rudimentary; hence, orchidectomy was done. Bilateral laparoscopic herniorrhaphy was carried out with polypropylene mesh by fixing it intracorporeally to the pubic bone, Cooper's ligament, inguinal ligament, and conjoint tendon. Subsequently, the retrovesical mass was excised and retrieved by dilating the umbilical port site. The operative time was 3.5 hours with minimal blood loss. The postoperative period was uneventful, and the patient was discharged after 24 hours. The histopathology examination of the retrovesical mass showed an extragonadal germ cell tumor compatible with seminoma.     

Potential infection hazards of stethoscopes

This study was conducted to assess the bacterial flora carried on stethoscopes used by medical personnel and to study the effect of disinfection of stethoscopes on the flora. In the 106 stethoscopes sampled, Gram-positive organisms were the most (60%) frequently isolated. Among them, Staphylococcus aureus accounted for 15.8% of the flora of which 21% were resistant to methicillin. The rate of isolation of S aureus and methicillin resistant S aureus (MRSA) was higher in critical care units. Disinfection was found to significantly reduce the bacterial count.     

Prevalence of human immunodeficiency virus infection in and around Varanasi, Uttar Pradesh, India

Human Immunodeficiency Virus (HIV) infection is rising rapidly in the eastern Uttar Pradesh; however no data is available regarding its positivity rate. We have screened 1239 cases of various groups. HIV seropositivity rate of 0.28% was noted. These results suggest that HIV infection is spreading rapidly in this part of the country. M. tuberculosis was the commonest co-infection amongst them (29.5%). We recommend routine HIV screening of all patients of tuberculosis, especially if the persons frequent the cities, visit foreign countries where sex tourism is encouraged or stay away from their spouses for long periods as true history of sexual contact with commercial sex workers was difficult to obtain from them.     

Pleuropulmonary blastema with cystic nephroma — A rare presentation and surgical dilemma

Pleuropulmonary balstema with cystic nephroma is a rare dual pathology of pediatric age group. The etiopathogenesis of this entity is not known, still researches indicate towards a common genetic cause. We report a case of this dual pathology in a one and half year old male. Till now only 5 cases have been reported.     

Side-bias in alcohol and heroin addicts

Alcoholics, heroin addicts and normal controls were asked for their degree of preference for the two lateral (left, right) sides during their performance of unilateral activities involving one of the four paired organs, hand, foot, eye and ear. Side-bias was assessed by a questionnaire, with 22 items for hand preference, and five items each for foot, eye and ear preference. Group difference was assessed with a mixed-factorial design (Group x Side) for each form of side-bias. Unlike heroin addicts and normal controls, alcoholics exhibited a significant reduction in right side-bias for all four measures, which suggests an anomalous pattern of lateralization.     

Protective effect of leaf extract of Ficus hispida Linn. against paracetamol-induced hepatotoxicity in rats

The methanol extract of the leaves of Ficus hispida Linn. (Moraceae) was evaluated for hepatoprotective activity in rats by inducing acute liver damage by paracetamol (750 mg/kg, p.o.). The extract at an oral dose of 400 mg/kg exhibited a significant protective effect by lowering the serum levels of transaminase (SGOT and SGPT), bilirubin and alkaline phosphatase (ALP). These biochemical observations were supplemented by histopathological examination of liver sections. The activity of extract was also comparable to that of Liv-52 a known hepatoprotective formulation.