Primary systemic amyloidosis is an uncommon disease which presents with involvement of the kidney, heart, peripheral nervous system and liver. The involvement of skeletal muscles called amyloid myopathy is uncommon. We report a 74-year-old male who presented with progressively drooping shoulders followed by other muscular involvement without other organ involvement as a manifestation of amyloidosis. The patient was managed with melphalan, prednisolone and thalidomide with clinical improvement.
. Tumours of the eyelid are a rare subgroup of neoplasms with varied histology and inherent differences in clinical behaviour. Surgery is the standard of care, and adjuvant radiation therapy (RT) is given in the presence of features suggesting a high risk of local recurrence. The treatment of lymph nodes in the neck is debatable. We reviewed the utility of RT for lymph nodes in the neck in patients with malignant tumours of the eyelid.

. We reviewed medical records of all patients with tumours of the eyelid treated at our centre from July 2006 to December 2014 for their demographic, clinical profile, treatment details and outcome.

. The records of 37 patients were included for analysis, of these 34 underwent surgery and 21 received adjuvant RT. Their median age was 60 (range 30-85) years. Sebaceous cell carcinoma was the most common (50.4%). The median disease-free survival (DFS) was 35 months (95% CI 17.9-52.0). The 1- and 3-year DFS were 82.7% and 45%, respectively. Univariate analysis showed a superior outcome with early stage (T1) tumours (p=0.01), RT dose of ≥60 Gy and those underwent lymph node dissection (p=0.03). The presence of high-risk factors including close or positive margin had an inferior outcome with a trend towards statistical significance (p=0.06).

. We found a favourable outcome with early T stage, RT dose of ≥60 Gy and lymph node dissection. High-risk histopathological features including close margins and positive lymph nodes merit adjuvant RT including regional lymph nodes.
. We found a favourable outcome with early T stage, RT dose of ≥60 Gy and lymph node dissection. High-risk histopathological features including close margins and positive lymph nodes merit adjuvant RT including regional lymph nodes.
. Doctors are called to courts to give evidence as experts. This is time-consuming and impedes routine patient care. The court ordered the state to instal a video conferencing system for the benefit of doctors in hospitals for this purpose. We aimed to quantify the costs and benefits of the video conferencing system for doctors to give evidence as expert witness in courts.

. We analysed the tele-evidence system at our institution from the societal point of view examining whether the arrangements were positive for the taxpayers and second from the point of view of a cost-break-even analysis.

. Over a period of 1 year, 482 tele-evidences were recorded from our site. Most of the doctors appearing for court evidence were males (84%) and the majority were in government health services (84.4%). These expert witnesses included specialists (83.8%), followed by super-specialists (10.4%) and non-specialists (5.8%). The subject experts who were called the most were radiologists (19.5%), forensic experts (18.3%), surgeons (18.0%), orthopaedic surgeons (12.4%) and neurosurgeons (6.6%). Average savings per tele-evidence were ₹2620; 181 km of travel was prevented and 4 hours and 12 minutes of time was saved.

. Given our limited resources, video conferencing saves costs, time and travel.
. https://www.selleckchem.com/TGF-beta.html Given our limited resources, video conferencing saves costs, time and travel.
. Infection-related glomerulonephritis (IRGN) in adults is witnessing a dramatic shift in its epidemiology and outcome. Adult IRGN studies are all retrospective in nature, and Indian studies are scarce.

. We did this prospective study (September 2016-April 2018) on all patients with biopsy-proven IRGN and age ≥18 years satisfying three of five diagnostic criteria. Patients with persistent hypocomplementaemia (>3 months) were excluded. We did electron microscopy in those without a minimum of three diagnostic criteria and did an extensive search for any occult infection in every patient.

. Forty-five patients were studied with a mean (SD) follow-up of 45.7 (20) weeks. Their mean age was 41.5 years (18-70 years), with a female preponderance (11.25). At presentation, the majority had oedema (100%), oliguria (84.4%), hypertension (80%) and haematuria (77.8%). Of them, 86.7% had renal insufficiency and 35.6% required dialysis. Only 53.3% of them had evidence of antecedent/ current infection, with skin/subcutaneous focus being the most common site. Hypocomplementaemia was present in 82.2% of patients. Salient pathological features were endocapillary proliferation (93.3%), neutrophilic infiltration (88.9%), presence of crescents (17.8%), interstitial infiltration (24.4%), moderate-to-severe interstitial fibrosis with tubular atrophy (IFTA; 15.5%) and underlying diabetic glomerulosclerosis (8.9%). Only 66.7% of patients made complete renal recovery. By logistic regression analysis, the predictors of poor outcome were a requirement for dialysis at presentation (p=0.04) and presence of IFTA (p = 0.03).

. A proportion of adult IRGN patients progress to chronic kidney disease.
. A proportion of adult IRGN patients progress to chronic kidney disease.
Human exposure to infrasound is increasing due to man-made factors, such as occupational conditions, wind farms and transportation. The concern among the public regarding the safety of infrasound exposure is growing.

To evaluate whether exposure to infrasound interferes directly with human cardiac function and contributes to pathological processes.

The University Hospital of Mainz, Germany.

Human myocardial tissues, obtained from patients undergoing cardiac surgery, were prepared in small muscle samples and stimulated electrically in-vitro for a period of almost two hours under physiological conditions to induce continuous pulsatile contractions and simulating a working human heart. Two samples were obtained from each donor one was subjected to infrasound for 60 min and the other served as a control. Their contraction forces (CF) and durations (CD) were measured before and after each testing period and their relative changes (CF
and CD
) were calculated and introduced in a multilinear regression model.
Primary systemic amyloidosis is an uncommon disease which presents with involvement of the kidney, heart, peripheral nervous system and liver. The involvement of skeletal muscles called amyloid myopathy is uncommon. We report a 74-year-old male who presented with progressively drooping shoulders followed by other muscular involvement without other organ involvement as a manifestation of amyloidosis. The patient was managed with melphalan, prednisolone and thalidomide with clinical improvement. . Tumours of the eyelid are a rare subgroup of neoplasms with varied histology and inherent differences in clinical behaviour. Surgery is the standard of care, and adjuvant radiation therapy (RT) is given in the presence of features suggesting a high risk of local recurrence. The treatment of lymph nodes in the neck is debatable. We reviewed the utility of RT for lymph nodes in the neck in patients with malignant tumours of the eyelid. . We reviewed medical records of all patients with tumours of the eyelid treated at our centre from July 2006 to December 2014 for their demographic, clinical profile, treatment details and outcome. . The records of 37 patients were included for analysis, of these 34 underwent surgery and 21 received adjuvant RT. Their median age was 60 (range 30-85) years. Sebaceous cell carcinoma was the most common (50.4%). The median disease-free survival (DFS) was 35 months (95% CI 17.9-52.0). The 1- and 3-year DFS were 82.7% and 45%, respectively. Univariate analysis showed a superior outcome with early stage (T1) tumours (p=0.01), RT dose of ≥60 Gy and those underwent lymph node dissection (p=0.03). The presence of high-risk factors including close or positive margin had an inferior outcome with a trend towards statistical significance (p=0.06). . We found a favourable outcome with early T stage, RT dose of ≥60 Gy and lymph node dissection. High-risk histopathological features including close margins and positive lymph nodes merit adjuvant RT including regional lymph nodes. . We found a favourable outcome with early T stage, RT dose of ≥60 Gy and lymph node dissection. High-risk histopathological features including close margins and positive lymph nodes merit adjuvant RT including regional lymph nodes. . Doctors are called to courts to give evidence as experts. This is time-consuming and impedes routine patient care. The court ordered the state to instal a video conferencing system for the benefit of doctors in hospitals for this purpose. We aimed to quantify the costs and benefits of the video conferencing system for doctors to give evidence as expert witness in courts. . We analysed the tele-evidence system at our institution from the societal point of view examining whether the arrangements were positive for the taxpayers and second from the point of view of a cost-break-even analysis. . Over a period of 1 year, 482 tele-evidences were recorded from our site. Most of the doctors appearing for court evidence were males (84%) and the majority were in government health services (84.4%). These expert witnesses included specialists (83.8%), followed by super-specialists (10.4%) and non-specialists (5.8%). The subject experts who were called the most were radiologists (19.5%), forensic experts (18.3%), surgeons (18.0%), orthopaedic surgeons (12.4%) and neurosurgeons (6.6%). Average savings per tele-evidence were ₹2620; 181 km of travel was prevented and 4 hours and 12 minutes of time was saved. . Given our limited resources, video conferencing saves costs, time and travel. . https://www.selleckchem.com/TGF-beta.html Given our limited resources, video conferencing saves costs, time and travel. . Infection-related glomerulonephritis (IRGN) in adults is witnessing a dramatic shift in its epidemiology and outcome. Adult IRGN studies are all retrospective in nature, and Indian studies are scarce. . We did this prospective study (September 2016-April 2018) on all patients with biopsy-proven IRGN and age ≥18 years satisfying three of five diagnostic criteria. Patients with persistent hypocomplementaemia (>3 months) were excluded. We did electron microscopy in those without a minimum of three diagnostic criteria and did an extensive search for any occult infection in every patient. . Forty-five patients were studied with a mean (SD) follow-up of 45.7 (20) weeks. Their mean age was 41.5 years (18-70 years), with a female preponderance (11.25). At presentation, the majority had oedema (100%), oliguria (84.4%), hypertension (80%) and haematuria (77.8%). Of them, 86.7% had renal insufficiency and 35.6% required dialysis. Only 53.3% of them had evidence of antecedent/ current infection, with skin/subcutaneous focus being the most common site. Hypocomplementaemia was present in 82.2% of patients. Salient pathological features were endocapillary proliferation (93.3%), neutrophilic infiltration (88.9%), presence of crescents (17.8%), interstitial infiltration (24.4%), moderate-to-severe interstitial fibrosis with tubular atrophy (IFTA; 15.5%) and underlying diabetic glomerulosclerosis (8.9%). Only 66.7% of patients made complete renal recovery. By logistic regression analysis, the predictors of poor outcome were a requirement for dialysis at presentation (p=0.04) and presence of IFTA (p = 0.03). . A proportion of adult IRGN patients progress to chronic kidney disease. . A proportion of adult IRGN patients progress to chronic kidney disease. Human exposure to infrasound is increasing due to man-made factors, such as occupational conditions, wind farms and transportation. The concern among the public regarding the safety of infrasound exposure is growing. To evaluate whether exposure to infrasound interferes directly with human cardiac function and contributes to pathological processes. The University Hospital of Mainz, Germany. Human myocardial tissues, obtained from patients undergoing cardiac surgery, were prepared in small muscle samples and stimulated electrically in-vitro for a period of almost two hours under physiological conditions to induce continuous pulsatile contractions and simulating a working human heart. Two samples were obtained from each donor one was subjected to infrasound for 60 min and the other served as a control. Their contraction forces (CF) and durations (CD) were measured before and after each testing period and their relative changes (CF and CD ) were calculated and introduced in a multilinear regression model.
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