Stanley Medical College (SMC) is a government medical college with hospitals located in Chennai, Tamil Nadu, India. Though the original hospital is more than 200 years old, the medical college was formally established on 2 July 1938.The medical college and the hospital include a Centre of Excellence for Hand and Reconstructive Microsurgery and a separate cadaver maintenance unit, the first in the country.[citation needed] By legacy, the hospital's anatomy department receives corpses for scientific study from the Monegar Choultry from which the hospital historically descended.
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.
Background:Adrenal insufficiency is characterized by inadequate cortisol production, with or without aldosterone and adrenal androgen precursor deficiencies. This can make it difficult for the body to respond to stress and maintain essential functions. The symptoms of adrenal insufficiency are often non-specific, leading to delayed diagnosis and frequent misinterpretation. Case illustration:We report three cases of adrenal insufficiency: (1) a 61-year-old male with autoimmune polyendocrine syndrome II (cortisol 4.76 μg/dl baseline →10.6/12.2 post-adrenocorticotropic hormone; thyroid-stimulating hormone 369 IU/ml); (2) a 55-year-old female with secondary adrenal insufficiency due to partial empty sella syndrome (free T4 0.03 ng/dl; luteinizing hormone/follicle-stimulating hormone/prolactin ↓91-97%; and (3) a 37-year-old male with adrenal tuberculosis (bilateral enlargement on CT). In all the cases, the diagnosis is established through clinical evaluation and imaging followed by effective management with hormone replacement therapy. Conclusion:Atypical presentations of adrenal insufficiency require a high degree of clinical suspicion to ensure timely diagnosis and effective management.
Introduction: Colorectal carcinoma is one of the most common malignancies worldwide. The development of carcinoma occurs as a multistep process involving a wide variety of genetic alterations, among which Kirsten Rat Sarcoma (KRAS) mutations play a pivotal role in increasing proliferation and decreasing apoptosis of tumour cells. Aim: To determine the incidence of KRAS mutations in colorectal carcinomas and establish associations with age, histopathological findings such as tumour site, size, angiolymphatic invasion, lymph node status, and staging of carcinoma. Materials and Methods: A cross-sectional analytical observational study was conducted in the Pathology Department of Rajiv Gandhi Government General hospital, Chennai in Tamil Nadu, South India, on colorectal carcinoma biopsy samples. Over a study period of two years, from January 2022 to December 2024, 30 tissue samples of colorectal carcinoma were collected. Formalin-fixed paraffin-embedded blocks of these samples were subjected to molecular KRAS mutational analysis at codons 12 and 13 of exon 2 through Polymerase Chain Reaction (PCR), followed by Sanger sequencing. The incidence of KRAS mutations and their concurrent association with histopathological variables such as age, tumour site, size, angiolymphatic invasion, lymph node status, and staging of carcinoma were studied. Statistical evaluations were performed using International Business Machine (IBM)-Statistical Packages for Social Sciences (SPSS) version 20.0. Pearson’s Chi-squared test was utilised to analyse the association between variables. Results: The mean age of presentation in the study was 55.2±13.95 years. Out of 250 colorectal adenocarcinoma biopsy samples examined, 30 adequate samples were extracted. Of these, 27 were conventional adenocarcinomas and 3 were mucinous carcinomas with moderate differentiation. The sample included 17 males and 13 females. KRAS mutations were seen in 5 (16.7%) samples of patients older than 50 years. There was no statistically significant association between the incidence of KRAS mutations and age (p=0.686), gender (p=0.410), histopathological findings such as tumour site (p=0.807), size (p=0.828), angiolymphatic invasion (p=0.787), lymph node status (p=0.640), and staging of carcinoma (p=0.730); nevertheless, their importance should not be undermined. Conclusion: The KRAS mutations, commonly observed in codons 12 and 13 of exon 2, are involved in the multistep tumourigenesis of colorectal carcinoma. These mutations contribute to tumour aggressiveness, favoring metastasis and reducing apoptosis, thereby being associated with poor survival outcomes for patients. KRAS mutations are predictive of resistance to anti-EGFR targeted therapies, highlighting the necessity of analysing them in all cases of colorectal carcinoma to develop effective screening strategies and management plans.
