Background: It cannot be emphasized enough that a solid understanding of pathology is the foundation for a good clinical practice. And, Pathology, being a vast subject with the number of lecture hours being limited, understanding the students' perspective is essential for generating interest in the subject and for gaining essential knowledge and skills during those limited hours assigned. Aim: This study was aimed at understanding the students' perspective regarding pathology as a subject and about the effectiveness of the various teaching-learning methods currently used by the faculty of our department. Materials & Methods: This study was carried out on 81 2 nd MBBS students (regular batch) who have completed 3 semesters of pathology using a predesigned questionnaire with questions pertaining to students' perception of pathology and the various teaching learning methods currently used by the faculty. Results: A vast majority of the students, 96.6%, found pathology to be an interesting subject. About 95% of them agreed that a sound knowledge of pathology was useful during their clinical postings and for their clinical practice. Majority of the students, 76.6%, were satisfied with content of the lectures taken. 93.3% of them felt that enough stress has been laid on important topics during the lecture classes and important points have been highlighted adequately. Popular modes of teaching learning were casebased discussions and group discussion (96.6%), Powerpoint presentations (88%), black board teaching (78.3%), integrated teaching (83.3%). 96.65% of the students agreed that written exams were a very effective assessment tool. Among the changes suggested by the students, the point most mentioned was that more practical exams and monthly tests need to be conducted because pathology was perceived as a vast subject. Lack of effective teacher-student communication was also mentioned in 6% of the feedback forms. Conclusion: Our study showed that most students had a positive attitude towards pathology as a subject as well as the various teaching learning methods employed by the faculty of our department. Most students felt case based discussions and integrated teaching to be among the most effective ways of gaining knowledge.

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Background: Chronic kidney disease (CKD) is recognized as a global health issue having high mortality and morbidity rates putting a substantial burden on global resources. CKD has become a recognised independent risk factor for several adverse health outcomes including cardiovascular disease (CVD). Anaemia is an anticipated consequence as renal function declines, and can develop at any stage of CKD. There is a strong association between anemia and cardiovascular complications in CKD patients and many studies have proven that anemia plays a key role in worsening CVD in CKD patients. The objective of this study was to study the prevalence of anemia and cardiovascular diseases in CKD patients and establish an association between them. Methods: This study was conducted between January 2008 and June 2008 for a period of six months at a Government tertiary referral institution in south India. During this period, all newly diagnosed cases of chronic kidney disease based on the National Kidney foundation definition were included in this study. All the patients were evaluated based on detailed history taking, clinical examination and laboratory investigations after an informed consent was obtained from them. Staging of CKD was done based on the national kidney foundation (NKF/KDIGO) staging system. GFR was estimated using the abbreviated MDRD (Modification of Diet in Renal Disease) formula. Results: Of the 333 newly diagnosed CKD patients, a large majority (264, 79.28%) of the patients in the study presented in stage 5 CKD. The mean Hb in the study was 8.42±2.20 g/dl. Anemia was present in 90.39% while 25.53% had an Hb of <7g/dl. The prevalence of anemia increased from stage 3 (66.6%) to stage 5 (94.7%) and this correlation was statistically significant (p<0.0005). 167 (50.15% ) were found to have some form of cardiovascular disease, of which 120 (71.86%) were males and 47 (28.14%) were females. 83.93% had left ventricular hypertrophy, 16.17% had ischemic heart disease and 7.78% had congestive heart failure. 56.3% of patients in the age group 41-60 years had cardiovascular disease. The correlation between cardiovascular disease and age was statistically significant (p = 0.04139). And it was found that cardiovascular disease was more common when the cause of CKD was Diabetic nephropathy (65.8%) and hypertensive nephrosclerosis (84.6%). The correlation between the cardiovascular disease and etiological diagnosis of CKD was statistically significant. (p<0.0005).Cardiovascular disease was present in 61.2 % of the study population with diabetes mellitus and in 56.4% of the study population with hypertension. The correlations between CVD and diabetes and hypertension were statistically significant. Cardiovascular disease was present in 61.2% of the study population with Hemoglobin <7 gm/dl, 41.7% with Hb between 7-11 gm/dl and the correlation between cardiovascular disease and the level of Hb was highly significant in CKD patients. Conclusions: Thus there is a strong association between the clinical trial of anemia, CK...

BackgroundPodocyte dysfunction is the main pathologic mechanism driving the development of FSGS and other morphologic types of steroid-resistant nephrotic syndrome (SRNS). Despite significant progress, the genetic causes of most cases of SRNS have yet to be identified.MethodsWhole-genome sequencing was performed on 320 individuals from 201 families with familial and sporadic NS/FSGS with no pathogenic mutations in any known NS/FSGS genes.ResultsTwo variants in the gene encoding regulator of calcineurin type 1 (RCAN1) segregate with disease in two families with autosomal dominant FSGS/SRNS. In vitro, loss of RCAN1 reduced human podocyte viability due to increased calcineurin activity. Cells expressing mutant RCAN1 displayed increased calcineurin activity and NFAT activation that resulted in increased susceptibility to apoptosis compared with wild-type RCAN1. Treatment with GSK-3 inhibitors ameliorated this elevated calcineurin activity, suggesting the mutation alters the balance of RCAN1 regulation by GSK-3β, resulting in dysregulated calcineurin activity and apoptosis.ConclusionsThese data suggest mutations in RCAN1 can cause autosomal dominant FSGS. Despite the widespread use of calcineurin inhibitors in the treatment of NS, genetic mutations in a direct regulator of calcineurin have not been implicated in the etiology of NS/FSGS before this report. The findings highlight the therapeutic potential of targeting RCAN1 regulatory molecules, such as GSK-3β, in the treatment of FSGS.

Genomic instability is one of the hallmarks of cancer, having a crucial role in cancer pathogenesis as well as tumor proliferation. This essential feature is secondary to dysregulation of DNA damage repair pathways. Homologous repair represents the most reliable double-strand break repair mechanism. Homologous recombination deficiency is responsible for generating and perpetuating DNA damage in cancer, posing an opportunity for targeting treatment with poly(ADP-ribose) polymerase inhibitors through ‘synthetic lethality’, as well as platinum-based agents. Comprehensive genomic analysis has made it possible to discover molecular biomarkers that assist in the identification of Homologous recombination deficient tumors, allowing for the expansion of such treatment strategies to various other malignancies. Leveraging the improvement of genomic analysis methods to be more efficient in identifying Homologous recombination deficiency is crucial in the advancement of cancer care. The current review highlights the current strategies for Homologous recombination deficiency detection, clinical implications, limitations, and applicability.

Background: Adnexal skin tumors are relatively rare and present diagnostic difficulties in view of the endless morphological spectrum, complex nomenclature and incomplete knowledge of their histogenesis. Since pathologists encounter these lesions rarely, accurate sub classification of these can be challenging. This study intends to study skin adnexal tumors with eccrine and apocrine differentiation with emphasis on their histomorphology.Materials and Methods:The present study is a five year retrospective study with comprehensive analysis of 40 cases of adnexal tumors of skin in a tertiary center in Karnataka, South India. These tumors were reclassified and subtyped according to WHO classification of skin tumors, 2006.Results and analysis:Out the 62 cases of adnexal tumors studied, 40 were tumors with eccrine and apocrine differentiation (77% benign and 23% malignant). Hidradenoma was the most common tumor comprising 37% of all tumors and 45% of the benign tumors followed byspiradenoma, cylindroma and chondroidsyringoma respectively. Head and neck region was the most common site of occurrence, and seventh decade was the most frequent age group of presentation. A definite female preponderance was noted. Pagets disease of the breast was the most common malignant tumor in this group comprising (10%). Conclusion: Histopathology is considered the gold standard in the diagnosis of these tumors and so a clear knowledge of the clinical presentation and histomorphology of these tumors is essential to make a correct diagnosis. A diagnostic logarithm based on histomorphology provides a logical approach in the subclassification of adnexal tumors.DOI:

Background: Atherosclerotic coronary artery disease is the modern pandemic and is said to be responsible for a major chunk of sudden cardiac deaths. However, in few cases; especially among the young, conduction system abnormalities were found to be the cause of death with absence of significant coronary lesions. These days, examination of the cardiac conduction system during autopsy has been abandoned as it is said to be a time consuming process. The present study was undertaken to highlight the importance of examining the cardiac conduction system in all sudden death cases.Materials and Methods: This study was a prospective one, conducted from June 2007 to June 2009 in the department of Pathology, Kasturba Medical College, Mangalore. Forty six hearts of persons who died suddenly were studied.Results: Our study showed that even though atherosclerotic coronary lesions were the most common cause of sudden death, cardiac conduction defects also contributed to a significant number of cases; especially in the young. In our study of 46 cases; 6 cases showed only conduction system abnormalities. These were young adults who had died suddenly. The predominant lesion identified in them was fibromuscular dysplasia of the nodal arteries.Conclusion: A detailed examination of the coronaries and the cardiac conduction system should be made mandatory in all sudden death cases, especially in the young as they will help to throw some light into the cause of death.Journal of Pathology of Nepal (2015) Vol. 5, 709-716

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