Clinicopathological spectrum of anterior mediastinal lesions with special reference to the role of cytology in diagnosis: A cross-sectional study

Background: Anterior mediastinal tumors comprise only 3% of all chest tumours. They are often of diagnostic challenge to both clinicians and histopathologists owing to their wide variety of clinical presentations and diversity in histomorphological appearance respectively. Hence, there is a need for elaborated studies to make the pathologists and clinicians aware of their diversity. Aim and Objectives: The present study was aimed to evaluate the diverse spectrum of clinical presentations and histomorphological appearances of anterior mediastinal lesions. In addition, cytological and radiological interpretations were correlated with histological diagnosis to assess their comparative role in diagnosis. Materials and Methods: It was a descriptive observational cross-sectional study. Patients diagnosed with anterior mediastinal mass on chest computed tomography (CT) scan were included in this study. Demographic details including clinical presentations and radiological interpretations were recorded. Patients underwent both CT guided Fine needle aspiration cytology (FNAC) and needle core/excisional biopsy. Histological diagnosis was correlated with radiological and cytological interpretations. Results: Of 659 patients presented with chest tumours, 19 were detected as having anterior mediastinal mass on chest CT scan indicating the prevalence of 2.88%. The most common presenting symptom was respiratory distress (73.68%), followed by chest pain (36.84%), superior vena cava syndrome (26.32%) and Myasthenic features (5.26%). About 50% of malignant tumours occurred at the 2nd decade of life. Thymic epithelial neoplasms comprise the major tumour type in this study (52.63%) followed by germ cell tumors (15.79%) and lymphomas (10.53%). Cytology was found to be more effective compared to radiology in diagnosis. Conclusion: Anterior mediastinal tumors are extremely heterogeneous in clinical presentation and histomorphological appearance. CT-guided FNAC can play an important role in their diagnosis along with radiology and histology.

Histopathological study of tumor budding in colorectal carcinoma and its correlation with clinicopathological parameters

Background: Colorectal cancer (CRC) is the third most common cancer worldwide. “Tumor budding,” defined by the presence of five or less tumor cell cluster in the invasive front of tumor, is a strong, reproducible, and independent prognostic marker of the biological aggressiveness of the tumor. Aim and Objective: The present study was conducted to assess the correlation of clinicopathological parameter with tumor budding in CRC. Materials and Methods: Sixty patients presenting with colectomy specimens with known histological diagnosis of colorectal adenocarcinoma were included in the study. Histological examination with hematoxylene and eosin stain and immunohistochemistry with pancytokeratin (Pan-CK) was performed in equivocal cases. Tumor budding was counted and scored as per international tumor budding consensus conference, 2016, recommended criteria. Tumor budding was correlated with other relevant clinicopathological parameters. Results: The age distribution ranged from 19 to 78 years with a peak incidence in the age group of 41–50 years (31.7%). Low-grade tumor budding was seen in 20%, intermediate grade budding in 16.7%, and high-grade tumor budding in 63.3%. No correlation could be established between age, sex, site, size of tumor, lymphovascular invasion, histological grade, and budding intensity. However, association between tumor budding and nodal involvement, perineural invasion and higher American Joint Committee on Cancer stage has been found to be statistically significant in this study. Conclusions: Tumor budding is emerging to be a promising and powerful predictor of nodal metastasis and a higher stage of the tumor. Immunohistochemistry with Pan-CK can aid in the grading of tumor budding and buid consensus.

Tribological Issues Related to the Use of Biofuels: A New Environmental Challenge.

The aim of the special issue “Interactions of Forests, Climate, Water Resources, and Humans in a Changing Environment” is to present case studies on the influences of natural and human disturbances on forest water resources under a changing climate. Studies in this collection of six papers cover a wide range of geographic regions from Australia to Nigeria with spatial research scale spanning from a tree leaf, to a segment of forest road, and large basins with mixed land uses. These studies clearly show the strong interactions among forests, global climate change, water quantity and quality, and human activities at multiple scales. Understanding the underlying processes of response of natural ecosystems and society to global climate change is essential for developing actionable science-based climate change mitigation and adaptation strategies and methodologies. Future research should focus on feedbacks among forests, climate, water, and disturbances, and interactions of ecohydrologic systems, economics and policies using an integrated approach.

Tribological Issues Related to the Use of Biofuels: A New Environmental Challenge.

Due to gradual depletion of world petroleum reserves and the impact of environmental pollution of increasing exhaust emissions, there is an urgent need for suitable alternative fuels for use in engines. The heightened awareness of green house gas emissions and global warming compels introduction of more stringent environmental regulations worldwide. Renewable biofuels are considered potential solution for these problems. But use of biofuel is creating tribology related new challenges world over. In this paper a critical analysis of tribology related issue of three main biofuels, namely Straight Vegetable Oil (SVO), biodiesel and alcohols are discussed. Many issues like lubricity of blends, carbon deposit, viscosity, corrosion of engine components, etc are discussed in detail. Quality control of biofuels, identified as a key factor for sustainable market growth of these fuels and can lead to many tribological issues. In this regard a dire need for global harmonized standards is also discussed. Different solutions for alcohol fuel related engine problems are discussed. Critical discussion in relation to the problems due to the use of SVO in engine, like engine performance decrease, injector choking, oil ring sticking, etc took place in this paper. Potential solutions to these problems found by academia as well as industry are discussed here.

A Silent Tsunami on Indian Road: A Comprehensive Analysis of Epidemiological Aspects of Road Traffic Accidents.

This paper aims to critically analyze the epidemiology of road traffic accident in India. It is noteworthy to mention that India already accounts for about 9.5% of the total 1.2 million fatal accidents in the world. In 2009, for every 4.14 minute and 1.13 minute one death and one injury took place in India from road accident, respectively. Between 1970 and 2009 the number of accidents has quadrupled (1.1 lakh in 1970 to 4.22 lakh in 2009) with nearly 6.5 fold increase in injuries (0.7 lakh in 1970 to 4.67 lakh in 2009) and nearly 9.5 fold increase in fatalities (0.14 lakh in 1970 to 1.27 lakh in 2009). During the period of 2004 to 2009, road accident rate, injury rate and casualty rate per 105 population have been increased by 8.5%, 4.7% and 29.8%, respectively. In 2009, total 1,08,409 male and 18,487 female died in road accident. It was also observed that in last five years (2005 to 2009) average 84.9% male and 15.1 % female died in road accident. In 2009, total 90,298 people, out of total 1,26,896 accident victims died from age group of (5-44 Yrs), which is the most productive age group for nation. Average percentage share of last five years (2005-2009) for the age groups (Up to 14 Yrs), (15–29 Yrs), (30–44 Yrs), (45–59 Yrs), and (Above 60 Yrs) were 6.35, 29.84, 35.05, 20.97 and 7.79, respectively. The month-wise distribution of ‘Road Accidents’ has also shown more accidents during May (38,928) and June (36,234) sharing 9.2% and 8.6% respectively. Maximum ‘Road Accidents’ (68,835) were reported during 3 p.m. to 6 p.m (16.3%), 64,191 cases during 9 a.m. to 12 noon (15.2%), and least number (28,984) of these accidents (6.9%) was reported during 1200 to 3 AM in the night. The causewise number of persons killed in road accidents indicates that almost three-fourths of the accidents were due to driver’s fault.

Critical Review of Trends in GHG Emissions from Global Automotive Sector.

Between 1906 and 2005, records show that global average air temperature near the earth’s surface increased by 0.74 ± 0.18°C. If emissions of greenhouse gases, and in particular CO2, continue unabated the enhanced greenhouse effect may alter the world’s climate system irreversibly. Total emissions of greenhouse gases, across all sectors, were 42.4 gigatonnes (Gt) of CO2-eq in 2005. Energy sector, accounts for 84% of global CO2 emissions and 64% of the world’s greenhouse-gas emissions. Energy-related CO2 emissions rise from 28.8 Gt in 2007 to 34.5 Gt in 2020 and 40.2 Gt in 2030. Global percapita emissions of energy-related CO2 in 2007 was 4.4 tonnes. Higher growth of automobiles and consumption of petroleum products is invariably attended by concerns of pollution and climate changes. Global fleet of passenger light-duty vehicles (PLDVs) is estimated to increase from 770 million in 2007 to 1.4 billion in 2030. Among all sectors that emit CO2, the transport sector is the fastest growing, representing from 22% to 24% of global GHG emissions from fossil fuel sources, second only to the industrial sector. World emissions of NOx were 82 Mt in 2007, of which Road transport was responsible for about one-third of NOx emissions. Only Road transport related CO2 emission is estimated to increase from 4.8 Gt in 2007 to 6.9 Gt in 2030. The increase in CO2 emissions is largely a result of increasing demand for individual mobility in developing countries. There are strong efforts and renewed investments by manufacturers and suppliers in providing solutions to the CO2 reduction challenge. Low-carbon vehicles, such as hybrid cars, plug-in hybrids and electric cars, have received widespread public attention recently. It is estimated that share of hybrids in the global fleet will reach about 5% by 2020 and almost 8% by 2030, up from just 0.15% in 2007. Plug-in hybrids and electric cars will constitute only 0.2% of the global fleet in 2030. But increase in electricity consumption in road transport in future due to increased penetration of plug-in hybrids and electric vehicles, sees transport sector CO2 savings partially offset by power generation emissions. An estimated increase of 880 TWh of electricity consumption in transport in 2030, of which 90% occurs in PLDVs, will result in about 250 Mt of additional CO2 emissions. Authors forecasted that the use of environmentfriendly and clean technologies is going to make all the difference between the winners and the losers of the industry. It is noted that current policies are insufficient to prevent a rapid increase in the concentration of greenhouse gases in the atmosphere. It is recommended that policy makers and researchers should give more emphasis on ‘cost-effectiveness as most important factor to reduce automotive GHG emission reduction’. It is also concluded that CO2 savings will be maximized if well-to-wheel impact is clearly addressed at all stages of the fuel and energy chain.

Hepatitis B virus genotype D infection among antenatal patients attending a maternity hospital in Calcutta, India: assessment of infectivity status.

A seroepidemiological study was conducted to determine the hepatitis B virus carrier rate and infectivity status among antenatal patients in Calcutta. Fifteen of 400 antenatal mothers (3.74%) were carriers of HBV genotype D. Four (1.0%) of them were positive for HBeAg with a high risk of transmitting infection to their babies. The presence of precore mutant HBV, which has been associated with transmission events from HBeAg mothers to their babies, was not detected in any of the HBeAg negative mothers.

The newer unconventional indications of permanent pacemakers.

In recent years, the indications for permanent pacemakers have expanded. The interest has focussed on hypertrophic cardiomyopathy, dilated cardiomyopathy and a new entity called hypertensive hypertrophy with cavity obliteration (HHCO). Pacemaker therapy is establishing itself for the prevention of atrial fibrillation. Pacing for neurocardiogenic syncope with newer pacing mode has encouraging datas. Pacemaker for long QT syndrome, after cardiac transplant and for haemodynamic improvement in occasional cases of first degree atrio-ventricular block is getting attention. The AHA and ACC guidelines updated in 1998 for implantation of cardiac pacemakers, now include several of these newer indications.