National Institute of Pathology

Introduction: Patients satisfaction regarding medical care organizations like tertiary care hospital is important in the provision of services to patients. Patient satisfaction is a measure of how happy a patient is with their healthcare. Although “patient satisfaction” and “patient experience” are sometimes used interchangeably, they're actually two separate concepts. This effort has a positive impact on health and education sector in Bangladesh. Every year the demand of health care is increasing and health sector facing difficulties to maintaining the principle of high-quality health care delivery system. Objective: To analyze the level of satisfaction of patients attending the eye department of National institute of ophthalmology & Hospital, utilize the hospital service and determine the factors related to their satisfaction. Methodology: The present study was descriptive, cross sectional carried out in the outdoor, indoor and emergency of National institute of Ophthalmology Hospital, Dhaka from January 2021 to July 2021. Quantitative data has been collected. A sample population 384 patient using random sampling technique through face-to-face interview by using pretested semi structured questionnaire. The An ethical approval was obtained from the North South university public health department. Result: The patients were asked to evaluate the overall performance of the hospital. The majority (60.5%) said average and 39.5% said good. Conclusion: the patient satisfaction is very important to increase the flow of patient and reduce the burden of eye related service. Quality of care, doctor and staff attitude and behavior need to improve to enhance the satisfaction level of patient. Hospital general hygiene facility also need to improve. J.Natl.Inst.Ophthalmol.2024;7(2): 39-46

Acne vulgaris (Buthūr Labaniyya) is a prevalent chronic inflammatory disorder of the pilosebaceous unit, commonly affecting adolescents and young adults. The condition often leads to significant psychosocial distress and impaired quality of life. In the Unani system of medicine, Buthūr Labaniyya is attributed to humoral imbalance and disturbances in Asbāb-e-Sitta Ḍarūriyya, the six essential prerequisites for maintaining health. Classical Unani scholars emphasize disease prevention through regulation and moderation of these factors before initiating pharmacological treatment, aiming to restore systemic balance and limit drug dependency. This narrative review examines the role of alterations in Asbāb-e-Sitta Ḍarūriyya in the prevention and management of acne vulgaris by integrating evidence from classical Unani texts with contemporary understanding of acne pathophysiology. The review highlights lifestyle and dietary modifications as supportive, non-pharmacological strategies that may complement conventional acne management and contribute to a holistic therapeutic approach. Keywords: Acne vulgaris; Buthūr Labaniyya; Unani medicine; Asbāb-e-Sitta Ḍarūriyya; Lifestyle modification

Tuberculosis (TB) remains a global health burden, particularly because of the limited efficacy of the Bacillus Calmette-Guérin (BCG) vaccine against adult pulmonary TB. To improve immunogenicity, we developed a recombinant BCG strain expressing the M. tuberculosis -specific antigen Rv1507A (rBCG_Rv1507A) and evaluated its immune-enhancing potential. rBCG_Rv1507A-infected human PBMCs and murine macrophages exhibited enhanced co-stimulatory marker expression and Th1-skewed cytokine profiles invitro. The vaccine stimulated the expansion of T follicular helper (TFH) cells and both central and effector memory T cells. Intratracheal immunisation induced systemic and mucosal antibody responses, localized memory B cell formation, and enrichment of lung-resident memory T cells invivo. Importantly, rBCG_Rv1507A promoted macrophage apoptosis and suppressed autophagy, which may support cross-antigen presentation. Furthermore, it induces features of trained immunity, including hematopoietic progenitor expansion and metabolic reprogramming of macrophages. These immunological enhancements were compartmentalized to the lungs, the primary site of TB infection, due to mucosal delivery. Collectively, rBCG_Rv1507A demonstrated potential as a next-generation TB vaccine by integrating durable adaptive memory with innate immune training. However, further studies are required to confirm its protective efficacy.

Monensin (MON) is a polyether ionophoreantibioticof natural origin and is an FDA-approved drug for veterinary use.Recent studies have highlighted its potential anticancer activityin various in vitro and in vivo models.In this study, we evaluated the anti-breast cancer activity of MON and 37 synthetic analog compounds using cell monolayerand organoid models. Through a mini-ring cell viability assay, severalcompounds were identified that were more potent and selective againstbreast cancer cells compared to non-cancerous cells, surpassing theactivity of parent MON. MON and these compoundsinduced significant DNA fragmentation, reduced cell migration, anddownregulated SOX2 expression. Furthermore, MON and themost potent analog, compound 12, reduced the percentageof CD44+/CD24–/low stem-like cells anddiminished colony formation properties. Proteomics analyses revealedthat several pathways, including extracellular matrix organization,were significantly dysregulated by MON and compound 12 in breast cancer cells. Among these, TIMP2, a protein associatedwith the suppression of tumor growth and metastasis, was identifiedas one of the most prominently upregulated proteins by MON and compound 12 in MDA-MB-231 cells. This finding wasalso validated in other breast cancer and melanoma cell lines. Tosimulate breast cancer metastasis to the brain, a human hybrid organoidsystem: tumor in brain organoid (HOSTBO) model was developed. MON and compound 12 significantly reduced Ki-67expression within the HOSTBOs, and compound 12 significantlydownregulated SOX2 expression. Collectively, MON andcompound 12 significantly reduced the proliferation ofbreast cancer stem-like cells in the organoid models, inhibited theirmigration, and dysregulated markers associated with stemness, demonstratingtheir potential as anti-metastatic agents and warranting further clinicaldevelopment.

FOXP3+ natural regulatory T cells (nTregs) promote resolution of inflammation and repair of epithelial damage following viral pneumonia–induced lung injury, thus representing a cellular therapy for patients with severe viral pneumonia and the acute respiratory distress syndrome. Whether in vitro–induced Tregs (iTregs), which can be rapidly generated in substantial numbers from conventional T cells, also promote lung recovery is unknown. nTregs require specific DNA methylation patterns maintained by the epigenetic regulator ubiquitin-like with PHD and RING finger domains 1 (UHRF1). Here, we tested whether iTregs promote recovery following viral pneumonia and whether iTregs require UHRF1 for their pro-recovery function. We found that adoptive transfer of iTregs to mice with influenza virus pneumonia promotes lung recovery and that loss of UHRF1-mediated maintenance DNA methylation in iTregs leads to reduced engraftment and a delayed repair response. Transcriptional and DNA methylation profiling of adoptively transferred UHRF1-deficient iTregs that had trafficked to influenza-injured lungs demonstrated transcriptional instability with gain of transcription factors that define effector T cell lineage. Strategies to promote the stability of iTregs could be leveraged to further augment their pro-recovery function during viral pneumonia and other causes of severe lung injury.

Brain metastasis (BRM) of pancreatic ductal adenocarcinoma (PDAC) is rare. The clinicopathological characteristics of BRM have not been defined. We reviewed the clinicopathologic and molecular features of 18 PDAC patients who underwent resection of primary tumor (RPT) and developed BRM, along with 2 patients who had BRM resection without RPT and compared with 679 patients without BRM who received neoadjuvant therapy (NAT) and pancreatectomy. There were 11 males and 9 females (median age: 60.7y). The median intervals to BRM were 47.0, 44.4, and 31.6 months from dates of diagnosis, surgery, and first metastasis to other sites, respectively. Five patients underwent resection for BRM and showed unique cystic papillary growth patterns with detached cell clusters. All BRMs had mutant p53 staining, 4 had retained SMAD4, and 3 were focally positive for CK17. Among 18 patients who underwent RPT, 12 received NAT. Patients with BRMs have lower tumor stage ( P <0.001) and better tumor response ( P =0.01) at RPT. The median overall survival (OS) for 18 patients with BRM after RPT was 62.3 months compared with 42.4 months for those without BRM (n=679, P =0.59). The median survival was 3.3 months from BRM diagnosis for all patients and 6.9 months for 5 patients who underwent brain surgery. In summary, BRM represents a late event in PDAC patients, occurs after patients developed metastasis to other organs, and has distinct cystic papillary growth pattern. The prognosis for patients who underwent RPT and developed BRM is similar to those who underwent RPT without BRM.

Abstract Hydrogen sulfide (H₂S), generated by cystathionine γ-lyase (CSE), exerts protective effects against aortic aneurysm/dissection (AAD). Proteoglycans, major extracellular matrix (ECM) components synthesized by vascular smooth muscle cells (VSMCs), preserve aortic wall integrity but also contribute to AAD pathogenesis. The mechanisms linking VSMC-derived CSE/H₂S to proteoglycan regulation in AAA remain undefined. Here, we identified reduced CSE expression in VSMCs (α-SMA⁺) from human AAD tissues and murine models. VSMC-specific CSE deletion (CSESMCKO) exacerbated AngII-induced AAD, with increased ADAMTS4 expression and versican degradation. Mechanistically, CSE loss suppressed CBX3, releasing Adamts4 transcriptional repression. Conversely, CBX3 overexpression ameliorated AAD in CSESMCKO mice. CBX3 formed an epigenetic complex with SUV39H1, KDM2A, HDAC1, and RING1, regulating H3K9/H3K4 methylation/acetylation, thereby modulating ECM remodeling, apoptosis, and inflammation. Therapeutically, AAV-mediated CSE or CBX3 delivery via extravascular carrier reduced AAD incidence and progression. Thus, VSMC-derived CSE/H₂S–CBX3 signaling restrains AAD through epigenetic regulation of the ADAMTS4–versican axis.

Cite this article as: Malkoç B, Bilgili YD, Kutlu F, Güvenç BH. Massive cystic nephroma in a 13-month-old girl: case report and differential diagnostic outcome. Turk Arch Pediatr. 2025;60(5):543-545.

Radiation-induced lymphopenia (RIL) remains a challenging side effect of radiation therapy that is often associated with poor prognosis and reduced overall survival. Although CD8+ T cells are highly radiosensitive, the dynamics of quantitative and qualitative changes to the CD8+ T cell pool following exposure to high doses of ionizing radiation (IR) remain understudied. Herein, we sought to determine the long-term impact of sublethal whole body irradiation (WBI) on the antigen-inexperienced (Ag-inexperienced) CD8+ T cell pool, comprising naive (TN) and virtual memory (TVM) CD8+ T cells. We show that although both TN and TVM cells gradually regenerated after WBI-induced loss, TN recovery occurred only through de novo thymic production. Despite the numerical restoration, the subset and phenotypic composition of postrecovery Ag-inexperienced CD8+ T cells did not qualitatively recapitulate the pre-WBI state. Specifically, the frequency of TVM cells is increased, especially during the early stages of recovery. Within the TN subset, a lasting overrepresentation of Ly6C+CD122+ cells and an altered TCR clonotype diversity are also observed. Overall, our data highlight the dynamic changes to the Ag-inexperienced CD8+ T cell pool upon recovery from RIL.