Histopathological changes of pancreas in patients with fibrocalculous pancreatopathy

A total of 20 pancreatic biopsy samples taken from Fibrocalculous Pancreatopathy previously known as Fibro Calculus Pancreatic Diabetes (FCPD) patients, a variant of Malnutrition Related Diabetes Mellitus (MRDM) or under 30 young diabetes attending hepatobiliary, surgical and out patient department of Bangladesh Diabetes, Endocrine and Metabolic (BIRDEM) hospital were processed for light microscopic examination. Four samples were subjected to Immunohistochemistry (IHC) staining using antibodies to T cell marker (CD3), B cell marker (CD20), anti apoptotic markers (bcl-2) and tumour suppressor gene marker p53. Light microscopic findings and IHC indicate an immune mediated injury of pancreatic tissue and increased evidence of apoptosis which possibly results in the development of diabetes in these patients.     

Dentists'' preferences of anterior tooth proportion—a Web-based study

PURPOSE: This study aimed to determine dentists' esthetic preferences of the maxillary anterior teeth as influenced by different proportions. The goal was to link choices to demographic data as to the experience, gender, and training of the dentist. METHOD AND MATERIALS: Computer-manipulated images of the 6 maxillary anterior teeth were generated from a single image and assigned to 5 tooth-height groups (very short, short, normal height, tall, and very tall). For each group, 4 images were generated by manipulating the relative proportion of the central incisors, lateral incisors, and canines according to the proportions 62% (or "golden proportion"), 70%, 80%, and "normal" or not further altered. The images were randomly ordered on a web page that contained a form asking for demographic data and fields asking for a ranking of the images. Dentists were asked via e-mail to visit the web page and complete the survey. The responses were tabulated and analyzed with repeated measures logistic regression with the alpha at 0.05. A subset of North American respondents was chosen for further analysis. RESULTS: A total of 549 valid responses were received and analyzed from dentists in 38 countries. There were statistically significant differences in all groups for the variables of proportion, group (tooth height), and their interaction. The 80% proportion was judged best for the Very Short and Short groups. Three of the choices were almost equally picked for the Normal Height and Tall groups, and the golden proportion was judged best for the Very Tall group. The variables of year of graduation, gender, professional activity, generalist or specialist, or number of patients were not significantly correlated with the choices for the North American respondents. CONCLUSIONS: Dentists preferred the 80 percent proportion when viewing short or very short teeth and the golden proportion when viewing very tall teeth. Golden proportion was worst for normal height or shorter teeth and the 80% proportion for tall or very tall teeth. They picked no clear-cut best for normal height or tall teeth, and their choices could not be predicted based on gender, specialist training, experience, or patient load.     

Consanguinity: A blessing or menace at population level?

Consanguinity has highly complex and multifaceted aspects with sociocultural as well as biological debates on its pros and cons. The biological upshot of consanguinity includes the increased homozygosity, which results in manifold increased risk of genetic disorders at family and population levels. On the other hand, in addition to social, cultural, political, and economic benefits, consanguineous marriages have biological advantages at the population level. The consequence of consanguineous marriages is an upsurge in the number of homozygous diseased individuals with fewer chances of mating and reduced chances of survival, therefore evolutionarily confining the transmission of disease alleles to future generations and encouraging its elimination from a population. Protective effects of consanguinity have also been observed in a few diseases in different populations. Although attractive for many reasons, nonconsanguineous marriages will cause risk alleles to spread throughout the population, making most individuals carriers, and ultimately will resume the production of recessive diseases in subsequent generations. Although consanguinity, from an evolutionary point of view, is beneficial at the population level, it increases the risk of diseases in the very next generation. Presently, there is no treatment for most of the genetic disorders; we cannot opt for consanguinity for long‐term benefits. Nonconsanguineous marriages are a better strategy by which we may delay disease manifestation for some generations until science offers a viable solution.     

Incidence of Fractures Before and After Dialysis Initiation

Fractures are common in dialysis patients, but little is known about the trajectory of incidence rates of different types of fractures before and after dialysis initiation. To address this, we investigated the incidence of major fractures before and after dialysis initiation. We performed a retrospective statistical analysis using the Swedish Renal Registry of 9041 incident dialysis patients (median age 67 years, 67% men) starting dialysis 2005 through 2015 to identify major fractures (hip, spine, humerus, and forearm) occurring during the dialysis transition period from 1 year before until 1 year after dialysis initiation. Using flexible parametric hazard models and the Fine-Gray model, we estimated adjusted fracture incidence rates and predictors of major fractures. We identified 361 cases with primary diagnosis of major fracture, of which 196 (54%) were hip fractures. The crude incidence rate of major fractures before dialysis initiation was 17 per 1000 patient-years (n = 157) and after dialysis initiation it was 24 per 1000 patient-years (n = 204). The adjusted incidence rate of major fractures began to increase 6 months before dialysis initiation, and then stabilized at a higher rate after 1 year. The adjusted incidence rate of hip fractures started to increase sharply 3 months before dialysis initiation, peaked at initiation, and declined thereafter. In contrast, the adjusted incidence rate of non-hip fractures was stable during the transition period and gradually increased over time. Higher age, female sex, and history of previous major fractures were associated with increased fracture incidence both before and after dialysis initiation. We conclude that the incidence of major fractures, especially hip fractures, start to rise 6 months before initiation of dialysis therapy, indicating that heightened surveillance with implementation of preventive measures to avoid fractures is warranted during the transition period to dialysis. © 2020 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).