BACKGROUND: Mucoepidermoid carcinoma (MEC) is a malignant epithelial neoplasm characterized by the proliferation of epidermis, mucous, and intermediate cells in various proportions. This study evaluates the immunohistochemical expression of CD34 and D2-40 as marker of angiogenesis and lymphangiogenesis of MEC respectively and their correlation with the tumor grade and stage.

MATERIALS AND METHODS: We studied 22 salivary gland MEC tissue samples collected between 1972 and 2010. Age, sex, site, stage and histologic grades were reviewed. The samples were immunohistochemically stained with monoclonal antibodies against CD34 and D2-40.

RESULTS: The stage of MEC had a significant relationship with Brandwein grading system (P=0.039). The mean of microvessel density count by CD34 immunomarker was (10.74±5.97) with no significant relation to tumor grade or stage (P=0.579, P=0.438).The lymphatic vessel density expressed by D2-40 immunomarker was (18.15±15.92) which was also not significantly related to tumor grade or stage (P=0.573, P=0.773).

CONCLUSIONS: Microvessel density and lymph vessel density were not associated with tumor grade or stage. Thus, we found no correlation between the histological grade or tumor stage of MEC and angiogenesis or lymphangiogenesis.

OBJECTIVE: Problem-based learning (PBL) is an instructional method of hands-on active learning, centered on the investigation and resolution of simulated real-world problems. However, given that PBL has a significant social aspect to it, numerous factors may interplay in the dynamics of a small group and influence the overall learning process and outcomes. Since every aspect of the learning experience is influenced by the prevalent culture, we reviewed the influence of gender and ethnicity on the PBL system.

METHODS: A review of literature was carried out using the PubMed and Google Scholar databases for the terms “Gender and problem-based learning” and “Ethnicity and problem-based learning” on August 6^th, 2011. The results were filtered manually by the authors by reviewing abstracts for relevance to the topic. All relevant articles, since the inception of the electronic databases, were reviewed. The final filtered articles were then reviewed independently by the authors and evaluated for repetition and relevance, following which a narrative review on the topics was compiled. Suggestions for the improvement of the PBL process were then set by an evidence-based discussion between the authors.

RESULTS AND CONCLUSIONS: Gender and ethnicity, among other independent factors, influence the outcomes of PBL. Heterogeneity and diversity are proven factors, which have positive effects on outcomes of small group learning activities. In the short term these might seem to hamper learning outcomes; however, in the end heterogeneous groups lead to comparable or better performance. Hence, efforts should be made to promote ethnic and gender diversity while distributing students into PBL groups.

BACKGROUND: Inflammatory bowel disease, characterized by chronic relapsing immune-mediated inflammation of the gastrointestinal tract, is often associated with extra-intestinal manifestations affecting multiple organs. The aim of this study is to ascertain whether IBD is associated with atopy or not.

METHODS: The case group comprised of sixty newly diagnosed IBD patients; 51 with ulcerative colitis and 9 with Crohn’s disease, whereas the control group included 60 subjects (matched for age and gender) free from any gastrointestinal symptoms. They were all subjected to full history (including pulmonary and allergic symptoms, as well as personal and family history of atopy), skin prick test, serum total IgE, pulmonary function tests, and differential leukocytic count for eosinophils. Colon biopsies for histopathological scoring were taken from the patients.

RESULTS: IBD patients had significantly (p<0.05) greater frequency of pulmonary symptoms with evident pulmonary function test (PFT) abnormalities, allergic manifestations, personal and family history of atopy, skin prick test reactivity, blood eosinophilia and increased total serum IgE levels when compared with the matched controls. However, no statistically significant (p>0.05) relationship could be found between the skin prick test reactivity, serum total IgE levels and histopathological or clinical activity index.

CONCLUSION: IBD is significantly associated with atopy when compared with matched controls. 

Provision of efficient laboratory services is an essential aspect of a functioning healthcare system. However, as a result of paucity of funds, irregular power supply, limited equipments, administrative bottlenecks and few licensed medical laboratory scientists at rural medical laboratories, several rural healthcare facilities are without functioning medical laboratories. This article explores the training limitations of rural laboratory workforce and presents focus investigations that rural laboratories should carry out in accordance with WHO standards and recommendations. It also recommends methods that have been proven to be highly sensitive and specific, need minimal automation and training, could be easily controlled, and are reliable and reproducible. Laboratory health workforce in rural health facilities can aid safe motherhood by providing antenatal screening services for hemoglobin estimation using HemoCue method for early diagnosis of anemia. This article also recommends immunochromatographic testing methods for HIV, syphilis and malaria. Although a larger percentage of rural laboratories are ill-equipped to carry out tuberculosis screening, they can get involved by collecting, collating, storing and transporting the sputum samples to and from designated regional diagnostic facilities. With adequate exposure, provision of recommended diagnostics, retraining, quality control and assurance, laboratory officers in rural healthcare workforce can be trained to issue investigation reports that are not marred by the location of the laboratory, or circumstances in their health facilities.

The anatomical abnormalities of vermiform appendix are rarely observed. We report a case of appendicular duplication with gangrenous appendicitis in one of the appendixes. The operating surgeon should be vigilant of these rare anomalies to avoid serious clinical complications.

The aim of this paper is to report a case of orbital abscess, cellulitis and sinusitis secondary to infection originating from recently endodontically-treated maxillary teeth, and review the relevant literature. Appropriate treatment in this 33-year-old male patient was delayed due to lack of consent for dental extractions. Infectious orbital affliction of odontogenic origin is a rare and uncommon condition, comprising 1-3 % of all cases. Early recognition and prompt management of orbital infection of dental origin is of great importance, since failure to do so may lead to disastrous complications, including death. Depending on the progression of the inflammatory process, cooperation between specialties is essential. A brief review of the literature is also presented.

Dieulafoy’s lesion is an unusual cause of recurrent gastrointestinal (GI) bleeding, especially in the lower GI tract. This report describes a case of a bleeding Dieulafoy’s lesion of the cecum, in which the diagnosis was made by complete colonoscopy. In spite of encountering the most likely cause of lower GI bleed during colonoscopy, it was due to a resolve to do complete colonoscopy that the primary cause of the bleed was found. Three hemostatic metallic clips controlled the bleeding successfully. This case emphasizes a need for an open mind for the possible etiology of lower GI bleeding even when encountering more obvious and more common causative lesions.