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By: Vinay Kumar, MBBS, MD, FRCPath

  • Donald N. Pritzker Professor and Chairman, Department of Pathology, Biologic Sciences Division and Pritzker School of Medicine, The University of Chicago, Chicago, Illinois

https://en.wikipedia.org/wiki/Vinay_Kumar_(pathologist)

Study the protective effect of Matricaria chamomilla flower extract against the toxicity of Entamoeba histolytica induces liver and renal dysfunctions in adult albino male rats man health report garcinia testvol usx buy casodex 50mg free shipping. Extracellular biosynthesis of silver nanoparticles using the fungus Fusarium oxysporum mens health zucchini carbonara safe casodex 50mg. Preparation and characterization of fruit-mediated silver nanoparticles using pomegranate extract and assessment of its antimicrobial activity mens health november 2013 buy casodex 50mg on line. A study of the Cisplatin effect on testis of Infected mice with Echinococcus granulosus man health kick buy generic casodex from india. Evaluation of inhibition activity of silver nanoparticles activity against pathogenic bacteria. Silver nanoparticles as free radical scavengers for protection from nuclear radiation hazards. Methodology: this is a case series descriptive study of one hundred pregnant female in Thiqar province in Iraq complaining from lower back pain in different stages of their pregnancies. Results: in our study seventy one patients experience back pain in different stages of pregnancy giving a (71%) as frequency of back pain in the studded group. Most of the patients Seventy four patients (74%) developed the pain during the first trimester of pregnancy and (22%) experience the pain during the second trimester. One patient underwent cesarean section for sever back pain dueto lumbar disc prolapse at the end of the pregnancy period (non-gynecological indication for cesarean section). Conclusion: lower back pain is a common problem during pregnancy,and it shows some common epidemiological characteristics. Keywords: Thiqar-Iraq; back pain; pregnant ladies Introduction Low back pain is a common complaint among pregnant women. It is estimated that about 50% of pregnant women complain of some form of back pain at some point in pregnancy or during the postpartum period (1). Pregnancy has a profound effect on the human body, particularly the musculoskeletal system. Hormonal changes cause ligamentous joint laxity, weight gain, and a shift in the center of gravity that leads to lumbar spine hyperlordosis and anterior tilting of the pelvis. In addition, vascular changes may lead to compromised metabolic supply in the low back. The most common musculoskeletal complaints in pregnancy are low back pain and/or pelvic girdle pain. They can be diagnosed and differentiated from each other by history taking, clinical examination, provocative test maneuvers, and imaging. Management ranges from conservative and pharmacologic measures to surgical treatment. Depending on the situation, and given the unique challenges pregnancy places on the human body and the special consideration that must be given to the fetus, an orthopedic surgeon and the obstetrician may have to develop a plan of care together regarding labor and delivery or when surgical interventions are indicated (2). Risk factors that contribute to the development of low-back pain during pregnancy have been examined in several studies. The results consistently suggest that the major predictors of back pain during pregnancy are back Medico-legal Update, January-March 2020, Vol. Two major subtypes of back pain occurs during pregnancy; (Lumbar and pelvic pain) lumbar pain located at and above the waist in the center of the back. But what is most common is the posterior pelvic pain which 5 times more common than lumbar pain and experience below the west on either sides (4). Usually the treatment is conservative by rest, sleeping on the side, physiotherapy, lifting in proper way without bending, acetaminophen may be sufficient to relieve the pain. But; the managing doctor should remember the fact that Bach pain during pregnancy may be a sign of premature labor or urinary tract infection. Sever back pain during pregnancy lasting more than one week is dangerous sign and need physician consultation (5). Patients, material and method this is case series of One hundred pregnant in Thiqar province in the south of Iraq were studied, all patients were selected randomly from the outpatients clinic of Bint Alhuda teaching hospital during their antenatal care visits and history of back pain were recorded; patients with positive history of lower back pain were evaluated by gynecologist firstly to exclude non-musculoskeletal back pain like preterm labor, urinary tract infection or other rare cause like ectopic pregnancy, such patients were excluded from the study, all patients then were referred to orthopedic out patient in Alhusein teaching hospital and evaluation done by orthopedic surgeon by history taking according to special questioner. Some patient were sent to x-ray examination for lumbosacral spine and the data from the were collected aiming to study the demographic and epidemiological characteristic of back pain problem in Thiqar province-Iraq. Our study show association between multiparity, striae gravidarum and the problem of back pain and this association is well studied by Kokanali D which showed a an association between presence and severity of striae gravidarum and back pain (7). Our study shows that most of pregnant female developed the back pain during second trimester of pregnancy (81. Ethical Clearance: the Research Ethical Committee at scientific research by ethical approval of Results Our study include 100 pregnant women. Back pain in pregnancy among office workers: risk factors and its impact on quality of life. Hidden association between the presence and severity of striae gravidarum and low back pain in pregnancy. Aim: this study designed to identify the prevalence of thyroid dysfunction in Iraqi patients with acromegaly,to identify the factors responsible for thyroid dysfunction in patients with acromegaly. Study design: A cross sectional case control study Patients and Method: seventy patients with acromegaly were enrolled from 2 different tertiary centers of endocrinology from Jan. The Age and diastolic blood pressure are independent risk factors of thyroid dysfunction. Key-words: thyroid dysfunction,acromegaly,hypothyroidism,central hypothyroidism, secondary hypothyroidism, hyperthyroidism. However it may be responsible for pathogenesis of different thyroid related diseases. The thyroid gland is an endocrine organ present at the front and sides of the neck, anterior to the trachea. The thyroid gland produces thyroid hormones that are 542 Medico-legal Update, January-March 2020, Vol. Also, acromegaly can cause panhypopituitarism because of compressing effect of the tumor mass on the surrounding tissue, therefore there may be secondary thyroid or adrenal failure hypogonadism or amenorrhea[15,16]. An informed consent have been obtained from all patients and control counterparts,signed and dated before participation in this study. The enrolled subjects were already diagnosed as acromegaly clinically,biochemically and radiologically. Patients and method this is a cross sectional case control study in which seventy patients with acromegaly were enrolled in this study compared with 70 non-acromegalic subjects from Medico-legal Update, January-March 2020, Vol. A growth hormone producing macroadenoma was the cause of acromegaly in 62 patients (88. The control group was composed of 70 nonacromegalic subjects (50% males) with a mean age of 43. The systolic blood pressure was higher in patients with acromegaly compared to control subjects (132. The diastolic blood pressure was also higher in patients with acromegaly compared to control subjects (86. There is significant thyroid dysfunction in patients with acromegaly compared to control subjects (p value <0. Then the analysis of variance in between subgroups conducted to identify the differences in variables of general clinical characteristics which shows that the age is significant risk factor (p=0. In table 3 the analysis of variance conducted to the subgroups of patients with acromegaly that were already classify according to their thyroid status to identify the Medico-legal Update, January-March 2020, Vol. Discussion Most of our patients with acromegaly were in euthyroid status (51%) while there is 20% had primary hypothyroidism, in addition to 15. As well as we can accept our result regarding hyperthyroidism if we compared it with other study that found in 3. Hyperthyroidism should be taken into consideration in diagnosing a patient with acromegaly and weight loss, after excluding cancer [19]. Normal physiology of the hypothalamic pituitary-thyroidal system and relation to the neural system and other endocrine gland. Conclusion Thyroid dysfunction is more prevalent in patient with acromegaly whether hypothyroidism (both primary and secondary) and hyperthyroidism. The Age and diastolic blood pressure are significant risk factors of thyroid dysfunction. Ethical Clearance: the Research Ethical Committee at scientific research by ethical approval of both environmental and health and higher education and scientific research ministries in Iraq 8. Functional connections between the suprachiasmatic nucleus and the thyroid gland as revealed by lesioning and viral tracing techniques in the rat.

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N 64 82 58 34 31 23 49 8 2 87 80 66 16 3 47 45 35 100 46 22 36 33 4 3 2 132 14 108 10 8 2 2 2 % 43 mens health deltafit review purchase cheap casodex. Table 1: General characteristics of subjects Less than a month 1-6 Months How long have you had your parttime job? There are a lot of them Appropriate Time Management Method the psychological well-being of social relations What did you get from your part-time job? Positive interpersonal relationship Appropriate actions for a given environment Etc prostate vs breast cancer cheap 50 mg casodex with mastercard. Mean value on Major Satisfaction prostate 5k greensboro order generic casodex online, Career Resilience and Career Decision-Making Level Major satisfaction prostate cancer and back pain generic casodex 50mg on-line, Career resilience and Career decision-making level are shown in Table 2. Table 2: Mean value on Major satisfaction, Career resilience and Career decision-making level Major satisfaction Career resilience Self-confidence Achievement fervor Career self-reliance Transformation counterparty Relationship utilization Career decision-making level M 3. Differences in Major Satisfaction according to sociodemographic characteristics According to general characteristics, the results of comparing the choice satisfaction level of majors showed that there are differences between sex, motivation for applying for college entrance, and the level of study you think of. Differences in Career Resilience according to sociodemographic characteristics Cognitive attitudes toward donating cornea have been shown to vary according to gender, presence of chronic and incurable patients in the family, your wish to donate organs, recommended that family donate their 1650 Medico-legal Update, January-March 2020, Vol. Differences in Career Decision-Making Level according to sociodemographic characteristics Behavioural attitudes toward donating cornea have been shown to vary according to your wish to donate organs, recommended that family donate their organs, presence of information about organ donation organizations, wish to participate in training on organ donation, Information on organ donation registration procedure is available, the one I want to receive when I donate my organs, Opinion on the absence of a price for an organ donor, and want to pay for organ donation. Relation between Major satisfaction, Career resilience and Career decision-making level the correlation between Major satisfaction, Career resilience and Career decision-making level has shown that all three variables have significant correlation<Table 3>. The degree of satisfaction with the major and career resilience were correlated, and the level of career resilience and career decision-making level were found to be very closely related. Table 3: Relation between Major satisfaction, Career resilience and Career decision-making level Major satisfaction Major satisfaction Career resilience Career decisionmaking level *p<0. Comparing the satisfaction level of choice of majors according to the general characteristics, the results show that there are differences in gender and motivation for applying for college entrance and those male students are higher than female students, which are why the nature of the health category requires a sense of mission and has a clear path to professional work. The lower the economic level and experience of part-time work experience, period, and experience of society, the higher the resilience of career. It is believed that the active attitude to overcome the work atmosphere and economic difficulties of society through part-time work may have influenced the work atmosphere of society. The level of career decision was found to differ only depending on the length of a part-time job, but the shorter the part-time period, the less experienced the society will be and the less judgment will be available to consider the career decision more. The correlation between each variable showed that the higher the degree of satisfaction in the major, the higher the level of career decision, the clearer the decision on career path and the higher the interest in the profession related to the major. Conclusion the factors that determine a satisfactory career path are based on not only individual interest and ability, but also job appreciation, and the more satisfied a university student is with his or her major and the more satisfied he or she is with his or her major professors and majors, the more active she is in collecting information for employment and the more self-identity she can improve her career resilience as well. In particular, health care students need not only aptitude or personality but also a process of value recognition such as calling when choosing their careers. Therefore, universities need to develop programs to improve their belief that students can overcome difficulties in career selection and preparation, and provide appropriate counseling for developing career plans that meet their goals, interests, personalities, and talents to improve their professional satisfaction. Ethical Clearance: Not required 1 Discussion this study was conducted as a basic data for developing a program to develop a society that can flexibly adapt to the rapidly changing employment market after graduation by identifying differences in major selection satisfaction of college students in the health category, as it was determined that their major selection satisfaction would be affected by Source of Funding: this research was supported Medico-legal Update, January-March 2020, Vol. Analysis of Structural Relationships Among Predictors of Employment Anxiety of College Students. The Effects of Work Hope and Career Motivation on College Students` Career Stress. Career management and survival in the workplace: Helping employees make tough career decisions, stay motivated, and reduce career stress. A Theoretical Review on the Concepts of Career Resilience and the Implications for Adult 9. The Relationship between Major Satisfaction, Learning Attitude, and Course Satisfaction of University Students Majored in Special Education. Structural Relationship between Myongri Occupational Apriority, Career Resilience and Career Decision Level. Methods/Statistical analysis: Based on the modeling, pectoralis major muscles and mammary glands were printed; in order to express the soft material of the breast, we used the molding method. Improvements/Applications: After accessing the manufactured phantom at the clinical level, all of the evaluators concluded that the phantom may be applied for education. Therefore women are regularly receiving mammograms, leading to a steady increase in the number of mammogram screening cases. A growing desire for a healthy life has triggered an increase in awareness and needs for screening for early detection of breast cancer. In accordance with this trend in Korea, the national health screening center has designated a mammogram as one of the essential tests and is recommended for those over 40 years old. The most important thing in mammography is the fact that the use of radiation for medical purposes carries both significant medical benefits and the risk of radiation exposure; hence, improper care can lead to fatal side effects for the patients [1-4]. For this reason, radiographers should refrain from having the patients retake a mammogram and exposing them to unnecessary radiation. It is also advisable that radiographers are fully trained in mammography and improve their practice skills before performing mammography in a real clinical setting. Mammography is the most optimized test for early detection and diagnosis of breast cancer. Therefore, radiographers should be fully aware of all screening methods for mammography and practice for a variety of patients in advance. The main purpose of screening mammography is to detect any symptoms of diseases in advance by minutely screening the shape and size of breast masses, mammary gland expansion, and calcification. It can possibly detect lesions, but high-quality images with an appropriate amount of radiation are still required. As patients have different shapes and sizes of breasts, it is necessary for radiographers to practice on various types of breasts. However, less than half of medical schools in Korea do not have a regular mammography curriculum for radiology majoring students. The reason is that breasts are a private part of the human body, and there are few phantoms available for practice. Mammography phantoms made in Japan are expensive and lose their shape after several practices. Moreover, it does not show parenchymal tissues in the breasts, and thus, radiographers cannot judge whether they are screening the object in a right position. Therefore, most of the current radiographers strive for mammography practice and training. It makes a product from various materials by various methods according to a modeled design map [12]. In the case of breasts, as it is impossible to use hard materials, mammography phantoms should be manufactured with different or new materials. In a prior study, a phantom was manufactured with soft materials which led to a discovery of a transparent material which enables the internal structure to be identified. Therefore the purpose of this study is to manufacture a new phantom in this material and evaluate its usefulness. The pectoralis minor muscle when modeled for the first time was manufactured without any differentiation from pectoralis major muscles and modeling was processed with pectoralis major muscle as the main object. The molding method is to model and print the outer surface of the breast and fill the inside with silicone, which needs to be done carefully to prevent air bubbles. In addition, as seen in Figure 2, after mammography, contrast agents were mixed and printed to identify pectoralis major muscles and mammary glands in the images. Spheres of 1 cm in diameter were also printed to see how much compression has been applied when screening. Useful evaluation To assess the usefulness of mammography training phantom manufactured using a 3D printer, various assessments were conducted with mammography device currently used in hospitals. The following were assessed: whether pectoralis major muscle and mammary glands are clearly distinguished from each other in mammogram images; whether they show the appropriate concentration; whether the spheres were useful to check the degree of compression; and whether the quality of the materials were similar to actual breasts during mammography. The assessment was conducted by 3 radiographers who have been in real clinical settings for more than five years. The spherical prints which enable radiographers to see the degree of compression were manufactured using a sponge material, and they were also printed by using the same method. The amount of silicone was readily controlled to be hardened while regulating the location of each component, and this was done repeatedly as this must be done at the final stage and all the tissues, pectoralis major muscles, mammary glands, and the spheres for checking compression should be placed inside the breast tissue. To achieve this, the outer surface of the breast was modeled and printed for 14 hours in the additive manufacturing method and made it 2 cm thick to support the weight of silicone. To enhance the reality of the muscle, the comp pattern was modeled and printed at its top. Two were printed to place each on the left and right sides, and to reflect the end of the muscle as being adjacent to the humerus according to bone anatomy, the part of the bone was modeled and printed. To express the mammary tissue, the duct connecting the acini to the nipple was printed together, and as it may fall back during 1656 Medico-legal Update, January-March 2020, Vol.

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The brain was the most common site for secondary and tertiary metastatic recurrences prostate lesion cheap casodex 50mg visa. This was attributed to prostate cancer hormone injections buy generic casodex line the rather low mortality observed in patients to mens health quick adjust resistance band buy casodex 50 mg cheap the vigorous multimodal treatment offered prostate knowledge casodex 50mg without prescription. The reported probability for survival has been 60-99% at 5 years, 50-97% at 10 years, 35-95% at 20 years and 78-93% at 30 years. Probability of survival of papillary cancers who present with thyroid nodules, nodal or distal metastases. However, as these tumours grow very rapidly, it is likely that they have become less differentiated resulting in reduced capacity for 131I uptake. In this series, the 5 and 10 year survival rate in metastases concentrating 131I was 93. The survival for patients in intra-thyroidal and nodal disease is believed to be excellent as evident by overall survival rates of 96-98% and recurrence rate of less than 10% [16. Shows recurrence rate in follicular cancer when presented with thyroid nodule, nodal and distal metastases. In fact in one study, it has been shown as an independent predictor for adverse outcome [16. Survival rate of follicular cancers when presenting with thyroid nodules, nodal or distal metastases. The 10 and 15 year survival for patients with pulmonary metastasis in this series was 74. When matched for age and sex, the mortality in follicular and papillary types of the tumour has been comparable. There was no significant difference in the mortality rate when the intra-thyroidal disease was matched for both types of histology. The lung metastasis had a better prognosis as compared to skeletal metastases as observed by us and reported by others (Table 16. Radioiodine therapy is known to produce chronic side effects and these have to be carefully assessed at the time of the follow­up. This could be transient or permanent in nature requiring frequent administration of calcium (Ca2+) along with calciotropic substances. These patients were followed up from a minimum of 2-3 years, to a maximum of 15-20 years, and calcemic status was ascertained at varying times following their surgery and radioiodine therapy. The minimum period of ascertaining Ca2+ status varied from 4-6 weeks after surgery, to at times several years later. They were investigated for the circulating levels of Ca2+ before 131I treatment and further on every follow-up examination and evaluation. Regular monitoring, preferably at 3-6 months intervals is necessary to detect any spontaneous changes which some times occur, besides controlling the patient at a satisfactory level of serum Ca2+ [16. Calcium supplements are generally used, and it is essential that a regular diet must be fortified with at least 1 g/day of elemental calcium, preferably in 2-3 divided doses on an empty stomach to facilitate its increased absorption. These help in the increased mobilization of Ca2+ from intestine and bone, particularly Calcitriol. The decision to treat hypocalcemic patients, further rests upon both the degree of hypocalcemia and the rate at which the condition develops. The per cent uptake and excretion of 99mTcO4- by the salivary glands in controls (only thyrodectomized) and the 131I treated patients is shown in Table 16. Reports indicate that chronic sialadenitis with xerostomia can occur in 12% of subjects. Reserpine has been used to protect glands, however, the benefits are doubtful [16. In this study of 15 males younger than 21 years, treated with 131I dosages varying from 100500 mCi (3. To reduce gonadal irradiation it is advised that the patient should drink plenty of water and void frequently for the first 72 hours after 131I administration. Ovarian function and fertility Female gonadal function and fertility has been documented in a few reports [16. Over the years data has been published on a large series of women treated with 131I with no demonstrable effects on fertility or on the incidence of congenital abnormalities in children borne by these women (Table 16. In this series it was seen that 66 subjects (51 females, 15 males) treated with 131I had later married and had children. Chromosomal aberrations are known to occur at a higher frequency after 131I treatment in peripheral lymphocytes of treated patients as compared to controls [16. There are only a few reports on pregnancy and foetal risks in patients treated with 131I [16. In one series only one case of severe cardiac malformation among 73 new born children was observed. In this mother the calculated gonadal dose was not higher than in other mothers [16. It was presumed that high suppressive doses of thyroxin may have been an important factor in the low birth weight of neonates [16. The mild exogenous hyperthyroidism was probably responsible for the two spontaneous abortions which were recorded in this series. On the basis of the data it appears irrational to dissuade young females treated with 131I from considering pregnancy. Overall the problems faced are not due to 131I but to the hormonal therapy which needs more stringent monitoring [16. The cancer patients are probably an increased risk of developing the second malignancies compared to general population rather than a consequence of 131I therapy. The long survival time of patients would predispose them to development of another malignancy which occurs with the same frequency as those in an untreated population. Thirty one per cent presented with second concurrent malignancies at the time of treatment, while 41% developed a second malignancy after 5 or more years. External radiation treatment was given to more than half of them primarily as a mode of therapy for the second malignancy. In one review of 13 large series of 2753 patients treated with 131I the incidence of leukaemia was 0. It was suggested that an incidence of 5 per 1000 cases is more than expected in the general population. However, studies at Memorial Hospital have not reported any temporary or permanent marrow suppression following the use of 75 mCi (2. To determine whether the radiation dose delivered to the kidneys during 131I treatment caused any renal impairment, urinary albumin was used as an index. Microalbuminuria indicates slightly elevated urinary albumin excretion and is a marker for glomerular damage. Tubular dysfunction with impaired protein reabsorption may also play a minor role in the excretion of elevated urinary albumin. Seventy-three patients were treated once, the remainder being treated two to six times. They also stated that such therapy may lead to the development of acute or chronic radiation nephritis which causes proteinuria. Other complications of this therapy include benign or malignant hypertension and interstitial fibrosis. This is true in the case of intact thyroid gland, but where the thyroid tissue is not intact, the renal dose will be higher. However, the incidence of microalbuminuria was not suggestive of renal damage after treatment with 30-268 mCi (1. Radiation pneumonitis and pulmonary fibrosis Patients with extensive diffuse pulmonary metastases that concentrate a high percentage of administrated 131I may develop fatal radiation pneumonitis or pulmonary fibrosis. To avoid this complication, the treatment dosage administered is such that no more than 80 mCi (2. The effect of large dosages of 131I on the pulmonary alveolar-capillary membrane integrity as an index of pulmonary damage in 35 patients of thyroid carcinoma with pulmonary metastases was studied. The observation was a significant loss of bone calcium in those on T4 and this was more evident in postmenopausal women. However, interpretation of images can pose difficulties due to distortion of anatomy after surgery. The sensitivity of detection of the primary and metastatic lesions in the nodes, lungs and bones, was about 75% in this series.

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Dopamine antagonists (eg prostate formula buy casodex with mastercard, antipsychotics) can cause galactorrhea due to prostate cancer xenografts effective 50mg casodex hyperprolactinemia prostate embolization generic casodex 50 mg online. Prolactin secretion from anterior pituitary is tonically inhibited by dopamine from tuberoinfundibular pathway of hypothalamus prostate 101 discount 50mg casodex amex. Prolactin in turn inhibits its own secretion by dopamine synthesis and secretion from hypothalamus. Secretion inhibited by glucose and somatostatin release via negative feedback by somatomedin. Act at cannabinoid receptors in hypothalamus and nucleus accumbens, two key brain areas for the homeostatic and hedonic control of food intake appetite. Calcium homeostasis Plasma Ca2+ exists in three forms: Ionized/free (~ 45%, active form) Bound to albumin (40%) Bound to anions (15%) in pH affinity of albumin (negative charge) to bind Ca2+ hypocalcemia (cramps, pain, paresthesias, carpopedal spasm). Common causes of Mg2+ include diarrhea, aminoglycosides, diuretics, alcohol abuse. Wolff-Chaikoff effect-excess iodine temporarily inhibits thyroid peroxidase iodine organification T3/T4 production. T4 is major thyroid product; converted to T3 in peripheral tissue by 5-deiodinase. Cushing disease is responsible for the majority of endogenous cases of Cushing syndrome. Hypertension, weight gain, moon facies A, abdominal striae B and truncal obesity, buffalo hump, skin changes (eg, thinning, striae), osteoporosis, hyperglycemia (insulin resistance), amenorrhea, immunosuppression. Screening tests include: free cortisol on 24-hr urinalysis, midnight salivary cortisol, and no suppression with overnight low-dose dexamethasone test. Alternatively, can use metyrapone stimulation test: metyrapone blocks last step of cortisol synthesis (11-deoxycortisol cortisol). No skin/mucosal hyperpigmentation, no hyperkalemia (aldosterone synthesis preserved due to intact renin-angiotensin-aldosterone axis). Seen in patients with chronic exogenous steroid use, precipitated by abrupt withdrawal. Hyperaldosteronism Primary hyperaldosteronism Secondary hyperaldosteronism Increased secretion of aldosterone from adrenal gland. Seen in patients with renovascular hypertension, juxtaglomerular cell tumors (renin-producing), and edema (eg, cirrhosis, heart failure, nephrotic syndrome). Occur in various organs (eg, thyroid: medullary carcinoma; lungs: small cell carcinoma; pancreas: islet cell tumor; adrenals: pheochromocytoma). Neuroblastoma A Most common tumor of the adrenal medulla A in children, usually < 4 years old. Most common presentation is abdominal distension and a firm, irregular mass that can cross the midline (vs Wilms tumor, which is smooth and unilateral). Can also present with opsoclonus-myoclonus syndrome ("dancing eyes-dancing feet"). Irreversible -antagonists (eg, phenoxybenzamine) followed by -blockers prior to tumor resection. May be hyperthyroid early in course due to thyrotoxicosis during follicular rupture. Fibrosis may extend to local structures (eg, trachea, esophagus), mimicking anaplastic carcinoma. Considered a manifestation of IgG4 -related systemic disease (eg, autoimmune pancreatitis, retroperitoneal fibrosis, noninfectious aortitis). Iodine deficiency E, goitrogens (eg, amiodarone, lithium), Wolff-Chaikoff effect (thyroid gland downregulation in response to iodide). Uncommon but serious complication that occurs when hyperthyroidism is incompletely treated/ untreated and then significantly worsens in the setting of acute stress such as infection, trauma, surgery. Presents with agitation, delirium, fever, diarrhea, coma, and tachyarrhythmia (cause of death). Thyrotoxicosis if a patient with iodine deficiency and partially autonomous thyroid tissue (eg, autonomous nodule) is made iodine replete. Most are nonfunctional ("cold"), can rarely cause hyperthyroidism via autonomous thyroid hormone production ("hot" or "toxic"). Most common histology is follicular A; absence of capsular or vascular invasion (unlike follicular carcinoma). Thyroid cancer Typically diagnosed with fine needle aspiration; treated with thyroidectomy. Complications of surgery include hoarseness (due to recurrent laryngeal nerve damage), hypocalcemia (due to removal of parathyroid glands), and transection of recurrent and superior laryngeal nerves (during ligation of inferior thyroid artery and superior laryngeal artery, respectively). Empty-appearing nuclei with central clearing ("Orphan Annie" eyes) A, psamMoma bodies, nuclear grooves (Papi and Moma adopted Orphan Annie). Invades thyroid capsule and vasculature (unlike follicular adenoma), uniform follicles; hematogenous spread is common. From parafollicular "C cells"; produces calcitonin, sheets of cells in an amyloid stroma (stains with Congo red B). Undifferentiated/ anaplastic carcinoma Lymphoma Older patients; invades local structures, very poor prognosis. Chvostek sign-tapping of facial nerve (tap the Cheek) contraction of facial muscles. May present with weakness and constipation ("groans"), abdominal/flank pain (kidney stones, acute pancreatitis), depression ("psychiatric overtones"). Osteitis fibrosa cystica-cystic bone spaces filled with brown fibrous tissue A ("brown tumor" consisting of osteoclasts and deposited hemosiderin from hemorrhages; causes bone pain). Secondary hyperparathyroidism Tertiary hyperparathyroidism Familial hypocalciuric hypercalcemia Defective G-coupled Ca2+-sensing receptors in multiple tissues (eg, parathyroids, kidneys). Nonfunctional tumors present with mass effect (bitemporal hemianopia, hypopituitarism, headache). Prolactinoma in women classically presents as galactorrhea, amenorrhea, and bone density due to suppression of estrogen. Treatment: dopamine agonists (eg, bromocriptine, cabergoline), transsphenoidal resection. Large tongue with deep furrows, deep voice, large hands and feet, coarsening of facial features with aging A, frontal bossing, diaphoresis (excessive sweating), impaired glucose tolerance (insulin resistance). If not cured, treat with octreotide (somatostatin analog) or pegvisomant (growth hormone receptor antagonist), dopamine agonists (eg, cabergoline). Clinical features include short height, small head circumference, characteristic facies with saddle nose and prominent forehead, delayed skeletal maturation, small genitalia. Correct slowly to prevent osmotic demyelination syndrome (formerly known as central pontine myelinolysis). Increased urine osmolality during water deprivation test indicates psychogenic polydipsia. Usually presents with failure to lactate, absent menstruation, cold intolerance Empty sella syndrome-atrophy or compression of pituitary (which lies in the sella turcica), often idiopathic, common in obese women Pituitary apoplexy-sudden hemorrhage of pituitary gland, often in the presence of an existing pituitary adenoma. Brain injury Radiation Treatment: hormone replacement therapy (corticosteroids, thyroxine, sex steroids, human growth hormone). Usually due to insulin noncompliance or insulin requirements from stress (eg, infection). Excess fat breakdown and ketogenesis from free fatty acids, which are then made into ketone bodies (-hydroxybutyrate > acetoacetate). Usually occurs in type 1 diabetes, as endogenous insulin in type 2 diabetes usually prevents lipolysis. Hyperkalemia, but depleted intracellular K+ due to transcellular shift from insulin and acidosis (therefore total body K+ is depleted). Life-threatening mucormycosis (usually caused by Rhizopus infection), cerebral edema, cardiac arrhythmias, heart failure. Symptoms: thirst, polyuria, lethargy, focal neurological deficits (eg, seizures), can progress to coma and death if left untreated. Labs: hyperglycemia (often > 600 mg/dL), serum osmolality (> 320 mOsm/kg), no acidosis (pH > 7. May see Whipple triad: low blood glucose, symptoms of hypoglycemia (eg, lethargy, syncope, diplopia), and resolution of symptoms after normalization of glucose levels. Symptomatic patients have blood glucose and C-peptide levels (vs exogenous insulin use). May present with diabetes/glucose intolerance, steatorrhea, gallstones, achlorhydria.

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Mean stature and nasal height were obtained by direct measurement; co-relation co-efficient were obtained and regression equation formulated for estimating stature prostate cancer metastasis to bone order generic casodex on line. Observations & Result: the study showed that in males mean values are significantly higher than females for both stature as well as nasal height; stature (males mens health and fitness magazine cheap 50mg casodex visa, 172 androgen hormone quizzes discount casodex 50mg without a prescription. These values can be employed in estimation of stature using the linear regression equation Y = 155 prostate cancer 6 gleason buy 50 mg casodex fast delivery. Also, accuracy in predicting sex when mean nasal height is taken as independent variable is more in females as compared to males (F=77. Conclusion: Nasal height can be used as a reliable tool in estimating stature, particularly in the males and in females it can be used for determination of sex with accuracy. Keywords: Nasal height, stature, identification, Introduction the branch of physical anthropology that deals with measurements of different body parts is known as Anthropometry. In archaeological procedures or in forensic examinations after mass disaster, estimation of height is done from rudiments or fragments of bones for the purpose of identification. A total of one hundred and fifty eight (158) subjects were involved which comprised of 79 males and 79 females. Those having any cephalo-facial defects or spinal deformity (kyphosis, scoliosis) were excluded from the study. A written informed consent was duly obtained from all the willing participants; procedure and purpose of study was explained in detail. The stature was measured using an anthropometer as the vertical distance between vertex and heel touching the floor or ground surface, with the person standing erect and head in a Frankfort plane. A vernier calliper was used for measuring nasal height; the distance between nasion to nasopinale of the nose i. It was taken on both sides; to minimise subjective errors, all these measurements were taken twice and an average was duly noted. Observations & Result Table 1: Mean Stature and nasal height Parameter Mean stature Total subjects (n= 158) Mean Nasal Height Mean stature Mean Nasal Height Mean stature Mean Nasal Height Mean 165. Also, in total subjects as well as individually in males and females, a weak positive co-relation was obtained with stature. Regression equation was formulated for total subjects as well as individually for males and females which can be used for calculating the estimated stature of that particular person once nasal height is known. This shows that statistically, sexual dimorphism exists among the study population having a percentage of 8. It was also observed that the findings are more accurate in females as compared to males i. Though, few of the authors18,19,20 found nasal height to be un-reliable in stature estimation. It is known that stature can be estimated either by multiplying the parameter with the derived multiplication factor or can be measured by employing regression equation, but most of the researchers considered that regression analysis is the best for stature estimation. This disparity could be due to lesser number of subjects being studied and thereby research needs to be extended to a larger population. In a study by Sagar S and Nath S 22 nasal height is not considered to be a reliable parameter for sex differentiation but findings by E O Ewunonu23 is consistent with the present study. The accuracy in predicting sex when mean nasal height is taken as independent variable is more in females as compared to males (F=77. Since, this study was conducted with intact soft tissue over the face, it is possible that the parameters may have insignificant correlation with bare bone measurements. These results can be of significance only in mutilated body with presence of some intact tissue or when isolated facial structure is brought for forensic examination. The regression equation thus obtained could prove to be beneficial in mass disasters as individuals that fall outside those limits can be easily excluded. Conclusion In circumstances where decomposed or mutilated body is bought for medico-legal examination, identification can be established by estimating stature by means of regression equation using nasal height. This produces a height range and individuals that fall outside 120 Medico-legal Update, January-March 2020, Vol. Prediction of sex is also possible to a greater extent which can be used as an identification tool. This method is not only reliable, relatively easy and quick to apply without involvement of any sophisticated techniques but also the anatomical landmarks measured are standard, much easier to locate and does not require difficult instrumentation. Conflict of Interest: None Source of Funding: Self Ethical Clearance: Obtained from the Institutional Ethical Committee of Shridev Suman Subharti Medical College 2015;37(3):253-7. Stature estimation from cephalometric parameters of young adults in five Nigerian ethnic groups. Estimation of stature from facial parameters in adult Abakaliki people of South ­ Eastern Nigeria. Estimation of stature from maxillofacial height measurements among Brahmins of Himachal Pradesh. Estimation of stature from cephalo-facial dimensions by regression analysis in Indo-Mauritian population. Estimation of stature from some selected cephalofacial parameters among teenage Indigenes of Ogoja local government area cross river state. Estimation of stature from maxillo-facial anthropometry in a central Indian population. Determination of sex by discriminant function analysis and stature by regression analysis: a lateral cephalometric study. Estimation of stature from some selected cephalofacial parameters among teenage Indigenes of Ogoja local government area Cross River State. Estimation of stature from cephalofacial dimensions by regression analysis in IndoMauritian population. Estimation of stature from cephalo-facial dimensions by regression analysis in Gujarati population. Determination of stature from cephalo-facial dimensions in a North Indian population. Width of sternum at suprasternal notch and at the level of fourth rib for determination of sex in the population of Delhi: A new & reliable tool for sex prediction. Estimation of stature from percutaneous measurement of upper limb length by linear regression equation. Estimation of stature using different facial measurements among Kabui Naga of Imphal valley, Manipur. Estimation of Stature from Cephalo-facial dimensions by regression analysis in Gujarati population. Estimation of stature from different head and face measurements among male and female Jatavs of Delhi. Nasal mophormetric pattern of the Abakaliki ethnic group of South Eastern Nigeria. Medical College, Baroda Abstract Introduction ­ Female deaths, especially young married females always arouse suspicions, but later age females who have crossed 30 years of age are not the cases which draws our attention. Material & Method ­ Of all cases coming for the postmortem examination, cases in which the victim is married female and above 30 years of age were taken for the study when there was suspicion regarding the cause of death. Conclusion ­ Education holds a very pivotal role in the prevention of unnatural deaths in females. Key-words ­ Married females, suspicious death Introduction In an autopsy whenever there is a case of married female for post-mortem examination, there is always suspicion raised by the family of the female. But married females who are more than 30 years in age, these cases do not attract our great attention. So, to identify profiles and patterns in suspicious deaths in married females who are more than 30 years in age, current study was designed. Hospital, Vadodara to study the profiles and patterns in suspicious deaths in married females of more than 30 years age group. Out of total cases coming from post-mortem examination total 48 cases were Corresponding Author: Dr. Material & Method An autopsy study of suspicious deaths in married females of above 30 years age was carried out in this Medical College from 1st August 2017 to 31st July 2018. A total 48 autopsy cases of unnatural deaths in married females with age more than 30 years were studied during the study period.

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