The Armed Forces Medical College (AFMC) is a leading medical training institute in Pune, India, in the state of Maharashtra. The college is managed by the Indian Armed Forces.Established in May 1948 as a post-graduate teaching institution after World War II on the recommendation of the BC Roy Committee, remnants of various Indian Army Medical Corps units were amalgamated to create the Armed Forces Medical Services. The AFMC undergraduate wing was established on 4 August 1962, which is also celebrated annually as AFMC Day by its alumni.The institution primarily imparts training to medical undergraduates and postgraduates, dental postgraduates, nursing cadets and paramedical staff. Patient care forms an integral part of its training curriculum and the attached hospitals benefits from the expertise available at AFMC. The institution is responsible for providing the entire pool of specialists and super specialists to the Armed Forces. The college is also involved in conducting research in various medical subjects as well as those aspects which would affect the morale and performance of the Armed Forces both in war and peace.
This study aims to evaluate and compare the morphometric parameters of megakaryocytes (MKs) in bone marrow (BM) sections of various myeloproliferative neoplasms (MPNs) disorders, along with a normal histology case. Whole slide scanned microscopic images of hematoxylin and eosin stained two micron thick sections of thirty-one BM biopsy cases were used for the evaluation of: BM cellularity, megakaryocyte (MK) density in BM area, MK density in cellular BM area, MK nuclear area, coefficient of variations (CV) of MK nuclear area, MK nuclear circularity, space occupied by MK nuclei in BM, MK cell area, CV of MK cell area, MK cell circularity, space occupied by MKs in BM, and MK nuclear to cell area ratio. BM cellularity, MK density in the BM area, MK nuclear circularity, space occupied by MK nuclei, and space occupied by MKs in the BM were found significantly higher in MPNs than in the normal histology group. Within the MPNs, the MK nuclear area and space occupied by MK nuclei in BM showed remarkable differences between the groups. The morphometric features of megakaryocytes in hematological neoplasms provide quantitative information that will be helpful for precise diagnosis and understanding of disease progression.
Periodontitis is a chronic inflammatory disorder that has been recognized as a significant public health concern worldwide. An imbalance between the protective oral microbiota and numerous oral pathogens has been implicated in its pathogenesis. Periodontitis not only impacts an individual's oral health but also has systemic implications. The pathogenesis of periodontitis and these respiratory infections has been shown to be intricately linked. Numerous clinical research and animal studies have highlighted that the oral health of a population is closely related to their systemic health. It has been suggested that the periodontal pockets can act as a reservoir for oral pathogens, which can later migrate into the respiratory tract through aspiration or systemic circulation. This is a narrative review conducted after a wide literature search on databases such as PubMed, Cochrane, and Google Scholar with keywords including "Periodontitis," "Respiratory," "Infections," "Tuberculosis," 'COVID-19', "Pneumonia," "Asthma," and "COPD" published in the last 15 years. The cornerstone of this comprehensive review lies in deciphering the pathogenesis and epidemiology of periodontitis and how these periodontal bacteria contribute to respiratory infections through numerous biological mechanisms, inflammatory pathways, and the potential pathways of infection transmission. We also explore the empirical evidence through research studies supporting the periodontitis-respiratory infections link and also studies with conflicting or inconclusive results. By connecting the dots between this crucial oral-systemic link, we hope to uncover the gaps in the current research and find new avenues for developing cost-effective, targeted, transformative preventive and therapeutic strategies that will not only improve oral health but will also support respiratory health and help reduce the global burden of respiratory infections. Strengthening oral hygiene programs could reduce the burden of respiratory diseases, particularly in elderly and high-risk populations.
ObjectivesTo address the challenges of tuberculosis (TB) control in the United States post-COVID-19, focusing on high-risk populations, current diagnostic and treatment strategies, and the importance of addressing clinical and social determinants of health to achieve TB elimination goals.MethodsA review of the latest evidence-based guidelines and literature on TB diagnostics, treatment regimens, and latent TB infection (LTBI) management was conducted. Key public health challenges and interventions targeting socioeconomic disparities, stigma, and healthcare access among high-risk populations were analyzed.ResultsHigh-risk groups, including immigrants and ethnic minorities, continue to bear a disproportionate burden of TB due to socioeconomic disparities and comorbidities. Advancements in diagnostic modalities and treatment regimens offer promising outcomes, but gaps remain in LTBI screening and management. Addressing social determinants, such as healthcare access and stigma, is essential for enhancing TB control efforts.DiscussionEffective TB elimination requires collaborative efforts among healthcare professionals, policymakers, and communities to implement evidence-based strategies. Prioritizing both clinical precision and social interventions is critical for overcoming barriers and achieving national TB control and elimination goals.
Paroxysmal nocturnal haemoglobinuria (PNH) is a disorder of haematopoietic stem cells that arises when these cells acquire a somatic mutation in the X-linked PIGA gene, which is essential for producing the glycosylphosphatidylinositol (GPI) anchor. As a result, affected stem cells lack all GPI-anchored proteins(GPI-AP). Patients typically present with haemolytic anaemia, bone marrow dysfunction, and an increased risk of thrombosis. Diagnosis relies on flow cytometric detection of GPI-anchored protein expression on circulating blood cells, complemented by bone marrow assessment. PNH frequently coexists with aplastic anaemia (AA) and, to a lesser extent, with low-risk myelodysplastic neoplasms (MDS). Thrombotic events remain the leading cause of death and disability in affected individuals. Terminal complement inhibition is the standard therapy for controlling intravascular haemolysis and reducing thrombotic risk, though it does not correct the underlying marrow failure. This review focuses on identifying PNH clones in the setting of aplastic anaemia and outlines the current flow cytometric approach recommended in recent guidelines. Learning objectives: 1. Explain the biological link between PNH and aplastic anaemia. 2. Recognise clinical scenarios where PNH testing should be performed, especially in bone marrow failure. 3. Understand flow cytometry principles used in PNH diagnosis, including FLAER-based and multi-lineage strategies. 4. Apply guideline-based recommendations for reporting and monitoring PNH clones in AA.
Background:It is being increasingly realized that immunological dysregulation and alteration of levels of cytokines play an important role in the etiology of psychotic symptoms, particularly of first-episode psychosis (FEP). Earlier studies have theorized that disrupted levels of interleukin-6 (IL-6) and interleukin-10 (IL-10) and other cytokines like C-reactive protein and tumor necrosis factor-alpha (TNF-α) play a role in symptom development in FEP patients. The study was done to evaluate serum levels of IL-6, IL-10, and IL-10-to-IL-6 ratio in FEP patients versus a healthy control population. Methods:A case-control study was conducted with 120 individuals (60 FEP patients and 60 healthy controls age and sex matched) at a tertiary care facility in Western Maharashtra from January 2023 to December 2023. The serum levels of IL-6 and IL-10 were analyzed using enzyme-linked immunosorbent assay. Independent t-tests were used to analyze data for continuous variables and odds ratios (ORs) with 95% confidence intervals (CIs). Results:FEP patients exhibited IL-10 levels significantly higher than controls (6.39 ± 1.17 pg/mL vs 4.42 ± 0.58 pg/mL; p < 0.001) and lower IL-6 levels than controls (3.98 ± 0.56 pg/mL vs 4.31 ± 0.39 pg/mL; p < 0.001). The average IL-10-to-IL-6 ratio was also significantly different in FEP cases at 1.65 ± 0.46 and controls at 1.03 ± 0.11, with p <0.001. High IL-10 (OR = 2.85; 95% CI: 1.35-6.04) and high IL-10-to-IL-6 ratio (OR = 2.11; 95% CI: 1.02-4.39) were both significantly correlated with FEP, while high IL-6 levels were inversely correlated with FEP (OR = 0.41; 95% CI: 0.20-0.86). Mean body weight of FEP patients was also decreased significantly compared with controls (68.6 kg vs 72.7 kg; p < 0.001). Conclusion:FEP patients have increased levels of IL-10, reduced levels of IL-6, and an increased IL-10-to-IL-6 ratio. Change in concentration of these cytokines could be involved in pathophysiology. The reduced body weight among the FEP patients may suggest underlying constitutional or metabolic factors that predispose them to the illness.
