Adesh Institute of Medical Science and Research (AIMSR) is a private medical college associated with a 750-bed tertiary care teaching hospital. It has 150 M.B.B.S. annual seat intake. The college is located on the Barnala Bathinda Highway in the district Bathinda of Punjab, India. The campus is spread out on 100 acres (40 ha). The college was established in 2006 under Adesh Institutions. AIMSR is approved by Medical Council of India and permitted by Ministry of Health & Family Welfare. It was affiliated to Baba Farid University of Health Sciences, Faridkot from 2006 to 2011 MBBS Admissions Batch and is affiliated to Adesh University, Bathinda starting 2012 MBBS Admissions Batch.
BACKGROUND:Jejunal carcinoid tumors are rare neuroendocrine neoplasms that often present with nonspecific abdominal symptoms, resulting in delayed diagnosis. Intussusception is an uncommon complication in adults, and skeletal metastases at initial presentation are exceedingly rare. To our knowledge, this is the first reported case of a jejunal carcinoid tumor presenting simultaneously with jejuno-jejunal intussusception and skeletal metastases involving the axial skeleton. CASE PRESENTATION:A 48-year-old man presented with one week of recurrent colicky abdominal pain, bilious vomiting, and constipation. His medical history was significant for chronic low back pain progressing to paraplegia, with imaging evidence of vertebral metastases identified two years earlier. Contrast-enhanced computed tomography demonstrated jejuno-jejunal intussusception with proximal bowel dilatation and mixed sclerotic-lytic lesions of the axial skeleton. After preoperative stabilization, laparoscopic localization followed by laparotomy was performed, with resection of a 40-cm jejunal segment containing a circumferential mass acting as the lead point. A side-to-side stapled anastomosis was fashioned. The postoperative course was uneventful. Histopathological examination revealed a high-grade neuroendocrine neoplasm with a mitotic index >20 per high-power field. Postoperative PET imaging showed no residual disease at the primary site but confirmed skeletal metastases. Systemic therapy with somatostatin analogues and multidisciplinary oncologic follow-up were recommended. CONCLUSIONS:This case illustrates an unusual presentation of a jejunal carcinoid tumor complicated by jejuno-jejunal intussusception and skeletal metastases. Recognition of such atypical metastatic patterns may facilitate earlier diagnosis and more appropriate management. Jejunal neuroendocrine tumors should be considered in the differential diagnosis of adult intussusception, particularly in the presence of unexplained skeletal lesions, with surgical resection remaining central to management.
OBJECTIVE:Blood group antigen frequencies vary across populations and influence transfusion compatibility and alloimmunization risk; data on minor systems in northern Saudi Arabia are limited. This study determined Kidd (Jk), Lutheran (Lu), and Duffy (Fy) antigen and phenotype frequencies among Al-Qurayyat blood donors and compared them with other populations. METHODS:In this cross-sectional study, 240 healthy blood donors were serologically typed for Kidd (Jka, Jkb), Lutheran (Lua, Lub), and Duffy (Fya, Fyb) antigens. Using the chi-square test, Phenotype frequencies were compared with published. RESULTS:Jka and Jkb antigens were observed in 94.2% and 50.8%, respectively. Kidd phenotypes were predominantly Jk(a+b-) (49.2%), followed by Jk(a+b+) (45.0%). Lub was the predominant Lutheran specificity (99.2%), and Lua was rare (0.8%). The main Lutheran phenotype was Lu(a-b+) (99.2%). Duffy antigens Fya and Fyb were found in 38.3% and 45.0%, respectively. Duffy phenotypes were predominantly Fy(a-b+) (35.0%), followed by Fy(a+b-) (28.3%), Fy(a-b-) (26.7%), and Fy(a+b+) (10.0%). Duffy distribution differed significantly from Caucasian, Asian, and other regional populations (p<0.001). CONCLUSIONS:This first profile of the Kidd, Lutheran, and Duffy systems in Al-Qurayyat reveals wide regional differences, especially for Duffy; this underscores the value of population-based databases to guide transfusion practice and directed searches for compatible donors.
Background: Dyslipidemia, characterized by an imbalance in lipid profiles, is a recognized factor in the development of atherosclerosis and cardiovascular diseases. Current evidence suggests that non-traditional serum lipid ratios are more effective than traditional serum lipid parameters in predicting vascular diseases. Therefore, this study aims to investigate the relationship between atherogenic index of plasma (AIP; logarithm TG/HDL-c), Castelli risk index I and II (TG/HDL-c and LDL-c/HDL-c, respectively), and atherogenic coefficient (AC; non-HDL-c/HDL-c) using traditional serum lipid parameters (triglyceride (TG), total cholesterol (TC), LDL cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c)) with TSH in subclinical hypothyroidism. Material and Methods: The study was designed as a hospital-based cross-sectional observational study conducted for a period of four months from January–April 2026, in Central Clinical Laboratory and Department of Medicine of Adesh Institute of Medical Sciences and Research, Bathinda, a tertiary care teaching hospital in Punjab. A total of 200 subjects (100 cases and 100 controls) were enrolled in the study.Results: Lipid parameters including total cholesterol (p=0.001), triglycerides (p=0.001), HDL (p=0.049), LDL (p=0.001), and VLDL (p=0.001) were significantly higher in cases. Atherogenic indices such as AIP, Castelli Risk Index I, Castelli Risk Index II and AC were also significantly elevated (p<0.001), indicating increased cardiovascular risk among SCH patients. ROC curve analysis demonstrated that AIP showed the highest area under the curve (AUC=0.751), followed closely by CRI-I (AUC=0.748), CRI-II (AUC=0.744) and AC (AUC=0.656) while LDL cholesterol showed comparatively lower discriminatory ability (AUC=0.615). There was a significant difference (p=0.011) in area under curve for AIP and LDL when compared together.Conclusion: AIP correlated significantly (p=0.005) with serum TSH levels and showed a superior diagnostic performance (z=-2.542, p=0.011) (AUC for AIP=0.751) compared to LDL (AUC for LDL=0.651), suggesting that it may serve as a sensitive marker of cardiovascular risk in SCH patients as compared to traditional lipid markers.
The Ziehl–Neelsen (ZN) staining technique, first developed in the late 19 th century, remains a cornerstone in microbiological identification of acid–fast bacilli (AFB). This review explores the historical development, principle, and procedure of the ZN staining method and also highlights its role in diagnosing tuberculosis (TB) and related infections. In addition to standard (hot) ZN staining, numerous modifications have been introduced to accommodate diverse clinical specimens and organisms. The review also discusses alternative techniques such as auramine fluorochrome staining and their comparative advantages. A significant recent advancement is the integration of artificial intelligence (AI) into AFB detection workflows, offering improved accuracy, reduced workload, and faster diagnostics through automated image analysis. Studies demonstrate high sensitivity and specificity of AI-based tools in identifying AFB in ZN-stained slides, suggesting strong potential for implementation in resource-limited settings. As global health efforts intensify against TB and related diseases, the ZN staining method, accompanied by digital innovation, continues to evolve as a pivotal diagnostic tool.
