Study of Correlation of High-Resolution Ultrasonography and Ultrasonography Guided Fine Needle Aspiration Cytology in Diagnosis of Pure Neuritic Leprosy in a Tertiary Care Hospital

This study assesses the features of high-resolution ultrasonographic and ultrasound-guided FNAC of peripheral nerves and correlates the findings in clinically suspected cases of pure neuritic leprosy (PNL). As per the study protocol, clinically screened pure neuritic leprosy cases from January 2017 to June 2018 were subjected to high resonance ultrasonography and ultrasonography-guided FNAC. The aspirated material was stained with modified ZN stain for AFB. Nerves showed hypoechogenicity, loss or distorted echogenic rim, and fibrillary echotextures in ultrasonography. Epithelioid cells, epithelioid cell granuloma was found in the histopathology sections of FNAC specimens with the presence of AFB in some cases. From these findings it may be concluded that HRUS and ultrasound-guided FNAC could be incorporated as rapid and reliable diagnostic tools for PNL. It may enlighten the future path as an early indicator of neural damage and be critical and useful to prevent the disabilities.

Histomorphological study of prostatic adenocarcinoma and its mimics

Context: Prostate adenocarcinoma (PC) is one of the common cancers in India and world over. Numerous prostatic, nonprostatic lesions, and normal structures can be very similar to adenocarcinoma. A pathologist's awareness of the benign mimics is important for the diagnosis of PC. Aim: The aim of this study was to determine the prevalence, clinical, and histopathological features of PC, and its common mimics, and to study the criteria for their distinction from PC. Materials and Methods: A prospective study of histopathological features of radical prostatectomy and transurethral resection of the prostate specimens, sent to the department of pathology in a medical college, for a period of 2 years was done. A brief clinical history followed by a clinical examination, including per-rectal findings and serum prostate-specific antigen (PSA) levels, was noted. Results: After excluding all the cases of benign hyperplasia of prostate without any associated findings, 50 cases of operated surgical specimens of prostate were studied. PC was the most frequent diagnosis in 28 patients of 50 cases (56.0%). Basal cell hyperplasia formed the predominant mimic (26.0%), followed by prostatic intraepithelial neoplasia (8%), prostate atrophy (4%), clear-cell cribriform hyperplasia(4%),, and one case of atypical adenomatous hyperplasia (2%). Serum PSA was >4 ng/mL in all the cases of PC. In three of the mimics, PSA was >4 ng/mL and in the rest it was <4 ng/mL. Immunohistochemistry (IHC) was not applied in our study. Conclusion: Biopsy still remains a gold standard for diagnosis of PC and its mimics. All the lesions in the above study were diagnosed on routine hematoxylin and eosin staining. IHC is useful especially for lesions in the grey zone but not in routine histopathological study and should not be used as a screening test but should be applied in specific selected cases only.

Mullerian adenosarcoma (heterologous) of uterine cervix with sarcomatous overgrowth: A case report with review of the literature

Mullerian adenosarcoma is a rare biphasic malignant neoplasm of cervix characterized by an admixture of benign epithelial elements and a malignant sarcomatous stromal component, which may be either homologous or heterologous. Mullerian adenosarcoma with stromal overgrowth (MASO) in an aggressive variant of adenosarcoma, which is extremely rare with only two such cases reported till date. In this report, we present a case of MASO of cervix with heterologous elements in a 55/F presenting with postmenopausal bleeding. As it commonly simulates clinically and radiologically as benign cervical polyp, the gynecologists and pathologists should be aware of this extremely rare entity presenting with aggressive clinical course.

Development of Buccal Patches for Delivery of Darifenacin from Beta-Cyclodextrin Complexes / Development of Buccal Patches for Delivery of Darifenacin from Beta-Cyclodextrin Complexes

Drug-cyclodextrin complexes improve aqueous solubilityand dissolution rate of poorly water-soluble drugs.Solubilisation followed by buccal delivery of poorlywater-soluble drugs can be advantageous for increasingdrug absorption. Darifenacin is an antispasmodic usedagainst urinary incontinence and specifically blocksM3 muscarinic acetylcholine receptors in smoothmuscle. M3 receptors are mainly located in exocrineglands, smooth muscle and vascular endothelium. Theoral absorption of darifenacin is poor owing to its lowsolubility. It also has poor bioavailability (15-19%) dueto a high rate of first-pass metabolism. Complexationwith beta-cyclodextrin was carried out to enhancesolubility. The best results were obtained by co-grindingin a 1:1 molar ratio of drug: ?-cyclodextrin. The solidinclusion complexes were characterized by DSC, X-raydiffractometry and FTIR. Inclusion complexes showedhigher dissolution rates than the pure drug. Controlledreleasemucoadhesive patches were prepared with twohydroxypropyl methylcellulose (HPMC) polymers,K100M CR and K15. The patches were assessed forsurface pH, folding endurance, swelling, mucoadhesiveproperties, in-vitro residence time, vapor transmissiontest and in-vitro (cellophane, egg membrane) and exvivo(goat buccal mucosa) release. Formulations Ha2(2%) HPMC K100M CR and Pa4 (4%) HPMC K15showed good mucoadhesive strength, in-vitro and exvivoresidence times, with controlled release for 10hours.

Association between body mass index, lipid peroxidation and coronary lipid risk factors in hypothyroid subjects.

Background: Thyroid hormones plays an important role in control of metabolism in human. Hyperlipidaemia particularly hypercholesterolemia, is a well-documented significant health consequence associated with hypo-thyroidism. Oxidative stress is a common factor associated with several clinical conditions including hypothyroidism. Aims & Objective: To evaluate the association between BMI, Hyperlipidaemia, Lipid Peroxidation and Atherogenic risk in newly diagnosed hypothyroid patients. Material and Methods: 85 newly diagnosed hypothyroid cases and 41 euthyroid controls were studied for their Thyroid profile [TSH, T4 andT3], Lipid profile , Oxidative stress marker, Malondialdehyde {MDA} Lipid risk ratios, [TC/HDL-C and LDL-C / HDL-C ratio] , Atherogenic index [AIP] - log TG/HDL-C and Body Mass Index [BMI]. Results: Hypothyroid patients had hyperlipidaemia, especially hypercholesterolemia [224 ± 43.8 mg/dl], increased LDL-C level [150.4 ± 42.3 mg/dl] when compared to controls [169.5 ± 25.1 and 97 ± 25.5 respectively]. MDA was significantly increased [p< 0.0001] in hypothyroid subjects [6.14± 1.83μ mol/L] versus the controls [2.9 ± 0.86 μmol/L] .BMI had positive correlation with TSH [r =4.421; p<0.0001]. Conclusion: Hypothyroidism leads to hyperlipidaemia enhancing risk for cardiovascular diseases, the connecting link being oxidative stress. It was found that TSH had positive significant correlation with BMI, Lipid profile and oxidative stress in hypothyroid patients when compared to the controls making them more prone for coronary artery diseases.

Clinicoepidemiological profile of 590 cases of beetle dermatitis in western Orissa.

BACKGROUND: Beetle dermatitis is a very common condition in western Orissa. It is often misdiagnosed and causes significant morbidity among the rural population. AIM: This study was conducted to determine the epidemiological and clinical profile of beetle dermatitis in western Orissa. METHODS: All clinically diagnosed cases of beetle dermatitis were included in the study. Detailed history was taken and thorough clinical examination was conducted in all the cases. One urban and three rural localities were visited regularly to detect the epidemiological trends of the disorder. RESULTS: A total of 590 cases were studied: 486 males and 104 females. The age of the patients ranged from 2 to 65 years. Forty-four percent of the patients belonged to the pediatric age group. Majority of the cases (85%) presented during the months of March to July, indicating a distinct seasonal trend. The disorder was prevalent in the localities nearer to paddy and sugarcane fields and grasslands with stagnant water. The clinical lesions included papules, erosions, crusted lesions, urticarial plaques and vesiculobullous lesions. Distribution was mainly linear, but kissing lesions were also observed. Head, neck and upper extremities were the most commonly involved sites. Lymphadenopathy and systemic features such as fever and malaise were observed in 24% and 15% of the cases, respectively. CONCLUSION: Beetle dermatitis should be included in the differential diagnosis of the acute onset of vesiculobullous lesions in the endemic areas.

Kinetics and mechanism of reduction of ferricytochrome c by glutathione and L-cysteine: a comparative study.

The kinetics and mechanism of the reduction of ferricytochrome c [Cyt c(III)] by substrates namely glutathione (GSH) and L-cysteine (L-cys) have been investigated spectrophotometrically employing [substrate]T > [Cyt c(III)]T. The reaction exhibits first order dependence in [substrate]T and [Cyt c(III)]T. The pseudo-first order rate constant increases with an increase in pH, indicating that the conjugate base form of the HCyt c(III) is a better oxidant than the parent HCyt c(III). The electron transfer rate constants between the oxidants and GSH for both the k1 and k2 paths are found to be greater than that with L-cysteine. Hence, GSH is a better reductant of Cyt c(III) as compared to L-cysteine. A suitable mechanism has been proposed on the basis of experimental findings. The deprotonation constant for HCyt c(III) and the second order rate constants of k1 and k2 paths for the present reaction at 25 degrees C have been determined.

Integrated management of childhood illness (IMCI) follow-up of basic health workers.

OBJECTIVE: To assess the practice of skills learnt by basic health workers for 4 - 8 weeks and one year after IMCI training, and to identify the gaps in practices due to various constraints. METHODS: The Anganwadi Workers (AWWS) and the supervisory staff were given 5 days IMCI training using WHO package. The supervisors gave follow up visits to AWWs using standardized follow up forms adapted from WHO material. The supervisors gave follow up visit to the 1st batch of AWWs 1 year after training in IMCI and a second visit was given 4-8 weeks after the 1st visit. The 2nd batch of AWWs was followed up 4-8 weeks after training in IMCI. RESULTS: The performance on correct treatment of cases by AWWs weeks were trained 4-6 weeks prior to follow up was better than group followed up one year after the completion of training (81.8% and 47.9% respectively). At the same time, the performance on correct treatment showed significant improvement during the second follow up (47.9% and 83.8% respectively). Performance on counseling improved from 15.6% during 1st follow up to 52.1% during 2nd follow up visit. The average number of cases seen by AWWs increased from 6.6 in 1st follow up to 9.3 during second follow up of the same AWWs. CONCLUSION: The basic health workers (AWWs) are capable of correct case management of sick children using the IMCI guidelines. The first follow up visit should not be delayed as delay leads to loss of skills. The health workers benefit from frequent and regular follow up by supervisors. Provision of requisite supplies is essential for practice of skills after training in IMCI by basic health worker.

Characterization of high temperature induced stress impairments in thylakoids of rice seedlings.

Exposure of isolated thylakoids or intact plants to elevated temperature is known to inhibit photosynthesis at multiple sites. We have investigated the effect of elevated temperature (40 degrees C) for 24 hr in dark on rice seedlings to characterize the extent of damage by in vivo heat stress on photofunctions of photosystem II (PSII). Chl a fluorescence transient analysis in the intact rice leaves indicated a loss in PSII photochemistry (Fv) and an associated loss in the number of functional PSII units. Thylakoids isolated from rice seedlings exposed to mild heat stress exhibited >50% reduction in PSII catalyzed oxygen evolution activity compared to the corresponding control thylakoids. The ability of thylakoid membranes from heat exposed seedlings to photooxidize artificial PSII electron donor, DPC, subsequent to washing the thylakoids with alkaline Tris or NH2OH was also reduced by approximately 40% compared to control Tris or NH2OH washed thylakoids. This clearly indicated that besides the disruption of oxygen evolving complex (OEC) by 40 degrees C heat exposure for 24 hr, the PSII reaction centers were impaired by in vivo heat stress. The analysis of Mn and manganese stabilizing protein (MSP) contents showed no breakdown of 33 kDa extrinsic MSP and only a marginal loss in Mn. Thus, we suggest that the extent of heat induced loss of OEC must be due to disorganization of the OEC complex by in vivo heat stress. Studies with inhibitors like DCMU and atrazine clearly indicated that in vivo heat stress altered the acceptor side significantly. [14C] Atrazine binding studies clearly demonstrated that there is a significant alteration in the QB binding site on D1 as well as altered QA to QB equilibrium. Thus, our results show that the loss in PSII photochemistry by in vivo heat exposure not only alters the donor side but significantly alters the acceptor side of PSII.

Multiple cutaneous malignancies in xeroderma pigmentosum.

A case of xeroderma pigmentosum with multiple cutaneous malignancies is being reported. The case presented with freckles, letigens, and keratosis, a non-tender ulcerated nodular lesion on the nose, a nodular ulcerated lesion on the right outer canthus of the conjunctiva, and a nodular growth which developed on the right cheek which on histopathology was found to be squamous cell carcinoma, basal cell carcinoma and malignant melanoma respectively.

Low dose UV-B induced modification of chromophore conformation and it's interaction with microenvironment in cyanobacterial phycobilisomes.

Phycobilisomes (Pbsomes) are the supra macromolecular pigment protein complexes of cyanobacteria. Synechococcus Pbsomes are comprised of phycocyanins (PC) and allophycocyanins (APC). Pbsomes are major light harvesting antennae and also absorb ultraviolet-B (UV-B) radiation (280-320 nm). Synechococcus Pbsomes, upon exposure to low dose of UV-B (0.28 mW cm-2) for different time intervals showed profound alteration in their steady state absorption, fluorescence excitation and emission characteristics (Sah et. al. Biochem. Mol. Biol.Int., Vol. 44, No. 2, 245-247). In the present study, we investigated the effect of low dose of UV-B on isolated Pbsome of Synechococcus. Our results demonstrate the following alterations. Absorbance at 623 nm initially showed a sharp decrease with increasing exposure time to UV-B radiation. The changes in the visible to near ultraviolet absorption and excitation ratio indicated a change in chromophore conformation, upon prolonged exposure of Pbsomes to UV-B radiation. This modification of chromophore conformation appeared to be associated with the loss of energy transfer from PC to APC. Circular dichroism spectra in the amide region showed a significant loss of the alpha helical content of Pbsomes when exposed for longer duration to UV-B. CD spectra in the visible region revealed a marked decrease in the rotational strength at 620 nm. Close monitoring of CD signals emanating in the 500 to 700 nm range further revealed that the decrease in the rotational strength was closely associated with an initial red shift in the positive CD band of Pbsomes when exposed to UV-B for short duration. However, the peak became constant over prolonged exposure to UV-B radiation and accompanied a prominent blue shoulder in the positive CD band which suggests the modification and uncoupling of the various phycocyanobilin (PCB) chromophores of the Synechococcus Pbsomes.

Age dependent alterations in photosystem II acceptor side in Cucumis sativus cotyledonary leaf thylakoids: analysis of binding characteristics of herbicide [14C]-atrazine.

Senescence induced temporal changes in photosystems can be conveniently studied in cotyledonary leaves. We monitored the protein, chlorophyll and electron transport activities in Cucumis sativus cv Poinsette cotyledonary leaves and observed that by 20th day, there was a 50%, 41% and 30-33% decline in the chlorophyll, protein and photosystem II activity respectively when compared to 6th day cotyledonary leaves taken as control. We investigated the changes in photosystem II activity (O2 evolution) as a function of light intensity. The photosystem II functional antenna decreased by 27% and the functional photosystem II units decreased by 30% in 20-day old cotyledonary leaf thylakoids. The herbicide [14C]-atrazine binding assay to monitor specific binding of the herbicide to the acceptor side of photosystem II reaction centre protein, D1, showed an increase in the affinity for atrazine towards D1 protein and decrease in the QB binding sites in 20th day leaf thylakoids when compared to 6th day leaf thylakoids. The western blot analysis also suggested a decrease in steady state levels of D1 protein in 20th day cotyledonary leaf thylakoids as compared to 6th day sample which is in agreement with [14C]-atrazine binding assay and light saturation kinetics.

Action of K-crown ether on photosystem II electron transport: characterization of the site of action.

We have investigated the inhibitory effect of K-crown (18-crown-6 potassium picrate) on photosystem II (PSII)-enriched membrane fragments and O2-evolving core complexes. K-crown at 2-4 microM inhibits about half the control level of O2-evolution activity in both types of PSII samples. Oxygen-evolution studies demonstrated that the ether works by inactivating the centres and not by interfering with antenna function or energy transfer to the reaction centre. K-crown does not disrupt binding of the extrinsic proteins associated with O2 evolution nor complex with bound Ca2+ or Cl- cofactors, but rather it directly inhibits electron transfer after the tetrameric Mn cluster. Fluorescence studies on active and Tris-treated samples showed that K-crown does not prevent artificial donors from transferring electrons to PSII but like DCMU inhibits on the acceptor side after QA, the primary quinone acceptor. However, the ether is a leaky inhibitor and may also act as a weak donor when the Mn cluster is not present. Oxygen-production experiments using silicomolybdate as an artificial acceptor (which accepts from both pheophytin and QB in PSII membranes) demonstrated that the inhibition is at or near the DCMU site.

Studies on electron donation to photosystem I sites by exogenous donors in Spirulina thylakoids.

The kinetic parameters of different sites of electron donation to photosystem I (PS I) were evaluated in Spirulina platensis thylakoids. Reduced 2,6-dichlorophenolindophenol (DCIPH2) exhibited two sites of electron donation, with apparent K(m) values of 8 and 40 microM each. The corresponding value for reduced N-tetramethyl-p-phenylenediamine (TMPDH2) and diaminodurene (DADH2) which donate electrons at a single site to PS I were 103 and 48 microM, respectively. The electron donation by these three exogenous donors were differentially inhibited by KCN (70 mM) affecting the apparent K(m) and Rmax values to varying extent. This cyanide inhibition of PS I catalyzed electron transport suggests the presence of plastocyanin in the photosynthetic electron transport chain of Spirulina platensis.

Characterization of aliphatic amine 1,4-diazobicyclo (2,2,2) octane-induced stimulation of beet spinach thylakoid electron transport.

Electron transport activity of beet spinach thylakoids was enhanced in the presence of aliphatic amine, DABCO (1,4-diazobicyclo (2,2,2) octane), a hydrophilic proton trapping agent. The extent of stimulation was pH-dependent and similar to the effect of the uncoupler ammonium chloride on electron transport. The stimulation of whole-chain (H2O-->MV) electron transport activity was observed only at high (rate-saturating) light intensity. The light-induced proton uptake coupled to electron transport of thylakoid was also arrested by DABCO, suggesting that DABCO uncouples thylakoid phosphorylation by proton trapping.