Natural antioxidant products are increasingly being used to treat various pathological liver injuries considering the role of oxidative stress in their pathogenesis. Auricularia polytricha has been used as food or medicine due to its antioxidant activity. The aim of the study was to evaluate the protective effect of the aqueous extract of the fruiting bodies of A. polytricha against paracetamol-induced liver toxicity in rats. Liver toxicity was induced in Sprague-Dawley rats by oral administration of 2g/kg paracetamol on the 15th day after the administration of aqueous extract and silymarin 100 mg/kg. Aqueous extract of A. polytricha was administered orally at 250 and 500 mg/kg doses, daily for a period of 14 days. Aspartate aminotransferase (AST), Alanine transaminase (ALT) and Alkaline phosphatase (ALP), Lactate dehydrogenase (LDH), Total bilirubin (TB), Total protein (TP), Triglycerides (TG) and cholesterol were measured to assess the effect of the extract on paracetamol-induced hepatic damage. The patent on Auricularia Polytricha (EP0413052A1) assisted in selecting the extraction procedure. The study also included histopathological examination of liver sections to assess hepatoprotective activity. Paracetamol significantly (P<0.001) increased the serum AST, ALT, ALP, LDH, TB, TG and cholesterol and decreased TP levels. Extract treatment significantly (P<0.001 to P<0.05) attenuated the paracetamol induced increase in AST, ALT, ALP, LDH, TB, TG and cholesterol and increased the diminished TP in a dose dependent manner. The standard drug, silymarin produced significant (P<0.001) decrease in AST, ALT, ALP, LDH, TB, TG and cholesterol and increase in TP. Histopathological examination of animals treated with paracetamol showed large areas of centrilobular necrosis with congestion and dilatation in both central and portal veins. These results indicate that the aqueous extract of A. polytricha has significant protective effect against paracetamol-induced liver toxicity in rats, due to its potent antioxidant activity.

BackgroundStudent perspectives of clinical preparedness have been studied in the literature, but the viewpoint of supervisors is limited. Hence, the aim was to examine the perspective of supervisors on the characteristics of health professional students important for preparedness for clinical learning.MethodsThis was a descriptive, questionnaire-based, cross-sectional study conducted at three higher education institutions in Malaysia. A previously published questionnaire with 62 characteristics was adopted with modifications after pre-testing. Descriptive analysis was completed for the demographic data. The sample was grouped based on health profession, clinical practice experience and teaching experience for further analysis. Non-parametric Kruskal-Wallis test was selected to evaluate differences in mean ranks to assess the null hypothesis that the medians are equal across the groups. Kruskal-Wallis post-hoc pair wise comparison was performed on samples with significant differences across samples.ResultsThe sample was comprised of 173 supervisors from medicine (55, 32%), pharmacy (84, 48%) and nursing (34, 20%). The majority (63%) of the supervisors were currently in professional practice. A high percentage (40%) of supervisors had less than 4 years of teaching experience. The highest theme ratings were for willingness (6.00) and professionalism (5.90). There was a significant difference (p < 0.05) in the medians, among medicine, pharmacy and nursing professional speciality for willingness (5.70, 6.00 and 6.00), professionalism (5.70, 5.90 and 6.15), communication and interaction (5.42, 5.67 and 6.00), personal attributes (5.42, 5.71 and 6.02) and the professional and interpersonal skills (5.50, 5.63 and 6.00) themes. Post-hoc analysis showed a significant difference (p < 0.05) between medicine and nursing groups in the willingness (5.70 and 6.00), professionalism (5.70 and 6.15) and personal attributes (5.42 and 6.02) themes. Supervisors who are currently in practice had given high ratings compared to other groups. There were no significant differences observed within groups with different level of teaching experiences.ConclusionsAll supervisors rated professionalism and willingness as the most important characteristics followed by personal attributes. Further strengthening learning opportunities related to these characteristics in the curriculum may improve the students’ preparedness in clinical learning.Electronic supplementary materialThe online version of this article (doi:10.1186/s12909-017-0966-4) contains supplementary material, which is available to authorized users.

Fine-needle aspiration (FNA) cytology of the thyroid is usually performed on an outpatient basis. The results of FNA are operator dependent and may be affected by the lesion characteristics and the aspiration technique. In current practice ultrasound (US) is widely used to guide the needle for aspiration of nondominant nodules. Our study aimed to compare the free-hand FNA with US-guided FNA in the evaluation of thyroid nodules. A total of 91 cases of thyroid lesions were studied at the Department of Pathology, Karnataka Institute of Medical Sciences, Hubli, India. All the cases underwent free-hand and US-guided FNA. The cytological samples from both procedures were analyzed for adequacy, cytological features, and possible diagnosis. The results were correlated with histopathological diagnosis whenever possible. Of 91 aspirates, 89 were satisfactory and 2 were unsatisfactory on US-guided FNA, whereas 85 were satisfactory and 6 were unsatisfactory in free-hand FNA. Of 91 cases 68 (74.7%) were nonneoplastic lesions and 21 (23.1%) were neoplastic lesions in US-guided FNA, whereas 67 cases (73.6%) were nonneoplastic and 18 cases (19.8%) were neoplastic in free-hand FNA. Histopathological study was possible in 25 patients, among whom 15 lesions were nonneoplastic and 10 were neoplastic. Sensitivity and specificity of US-guided FNA to detect neoplastic lesions were 81.81% and 92.85%, respectively, compared with free-hand FNA, for which the sensitivity and specificity were 54.54% and 92.85%, respectively. The diagnostic accuracy of guided FNA was 88% against the 76% accuracy rate of free-hand FNA. US-guided FNA provides a better representative sample and has a higher diagnostic rate in the evaluation of thyroid lesions.

BackgroundCervical cancer is one of the most common cancers affecting women worldwide. It is well established that human papilloma virus (HPV) infection is the prime risk factor in the development of cervical cancer. The current screening and diagnostic tests have limitations in identifying the range of lesions caused by HPV. The current study aims to evaluate the diagnostic value of p16 immunohistochemical (IHC) investigation in high-risk human papillomavirus (HR-HPV) related lesions of the uterine cervix in Hospital Tuanku Jaafar, Seremban, Malaysia.MethodsA total of 75 cases were selected from the records of Pathology services, Hospital Tuanku Ja’afar, Seremban. The samples were collected in three separate groups (n = 25 per group) as Carcinoma cervix, Carcinoma in situ and Chronic cervicitis. The demographic data of the patients and the representative paraffin blocks were retrieved from Hospital Tuanku Ja’afar, Seremban. The immunohistochemical staining with p16 and HPV 16 L1 were done on all cases. The staining intensity and density were observed and compared among the three groups of cases.ResultsImmunohistochemistry of p16INK4A staining shows nil (0/25) expression in the cervicitis patients, 72% (18/25) in CIN patients and 100% (25/25) in cervical carcinoma. HPV 16 L1 was positive in 100% (25/25) of cervicitis patients, 96% (24/25) of CIN patients and 40% (10/25) of cervical cancers patients. A chi square test was used to analyze the result and the obtained p value was <0.05.Conclusionp16 expression was strongly observed in cervical cancer and minimally observed in cervicitis. Thus indicating p16 immunohistochemistry investigations can aid in diagnosing the different categories of cervical lesions into benign, insitu and malignant.Virtual SlidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/13000_2014_202

The antidiabetic effects of quercetin and metformin are well known. However, their synergistic effect in reversing the symptoms of diabetes-induced endothelial dysfunction remains unknown. In this study, we have investigated their synergistic effect in streptozotocin (STZ)-nicotinamide induced diabetic rats. Seventy-five rats were divided into five groups; normal control, diabetic control, treatment groups (10 mg/kg quercetin, 180 mg/kg metformin, and combined). The plasma glucose and lipid levels, liver enzymes, ex-vivo studies on aortic rings, histology of liver, kidney, pancreas, abdominal aorta and thoracic aorta, and immunohistochemical studies were carried out. The findings revealed that the combination of quercetin and metformin showed a greater antidiabetic effect than either drug, and rendered protection to the endothelium. The combination effectively reversed the hyperglycemia-induced endothelial dysfunction in diabetic rats. Furthermore, it also reversed the dysregulated expression of eNOS, 3-nitrotyrosine, VCAM-1, CD31 and SIRT-1. Overall, the present study's findings demonstrate that quercetin potentiates the activity of metformin to control the complications associated with diabetes.