ABSTRACT
Background: According to Darwin's theory of evolution, complex creatures evolve from more simplistic ancestors. Dollo's law of irreversibility states that evolution is irreversible. However, cancer cells tend to follow anti-Dollo's law. Unfavorable conditions such as hypoxia, acidic pH and low nutrients cause the cancer cells to switch their lifestyle atavistically in order to survive. They start behaving like a unicellular organism. There is a switch from normal metabolism to Warburg effect and finally cannibalism. Cannibalism is a cell eating cell phenomenon. It is defined as a large cell enclosing a smaller one within its cytoplasm and is known by odd names such as “bird's eye cells” or “signet ring cells.” Smaller tumor cells are found in the cytoplasm of larger tumor cells with crescent-shaped nucleus. Cannibalistic cells (CCs) are a feature of aggressive tumors. These cell types are vulnerable to metastasis. Aim: The aim of this study is to identify CCs in various histological grades of oral squamous cell carcinoma (OSCC) and to relate them with the pattern of invasion, lymphocytic response (LR), and mitotic figures (Mfs). The purpose of the article is to establish it as a marker of aggressiveness and metastasis and as an evidence of de-evolution and retroversion of multicellularity. Materials and Methods: Sixty-five histologically confirmed cases of OSCC were studied. Pattern of invasion, LR, number of CCs, and Mfs were recorded on 5 μ hematoxylin and eosin-stained tissue sections. ANOVA and t-test were applied; P < 0.05 was considered statistically significant. Results: CCs were more in sections with patchy LR, increased Mfs, and grade IV pattern of invasion. Conclusion: With increase in dedifferentiation, tumor cells start behaving like unicellular organisms with cell eating cell characteristics
ABSTRACT
Background: Study was conducted to assess awareness of leprosy and its treatment among leprosy patients presenting at a tertiary care hospital in Lucknow (UP), India. Methods: The study was conducted by a qualified interviewer using a 12-point self-prepared questionnaire on 78 leprosy patients turning up at the Dermatology Out-Patient Department of I.I.M.S & R and Hospital in Lucknow (UP) from January 2015 to June 2016. Results: Around 73% patients had heard about leprosy, while remaining 27% patients were either unaware or not sure. About 33% of the total 78 patients thought leprosy to be a type of infection, 21.7% said it was due to bad blood, 20.5% said it was exclusively a skin disease, 10% attributed it to supernatural phenomenon and rest of the 14% patients were unsure about its cause. Nearly 43.5% patients believed that they got the disease by coming in direct contact with some infected individual and 25.6% patients believed it to be as a result of some alteration in the blood. About 56.4% patients believed that leprosy was a communicable disease. Only 30.7% patients were confident that leprosy was curable. Approximately 72% patients knew one or more sign/symptom of leprosy. Only 23% patients were well aware of multidrug therapy (MDT) for leprosy while even a further lower percentage had knowledge of its free availability at government hospitals or centres. More than 90% patients did not know about the duration of treatment. Only about 27% patients believed that allopathic medications would be best for curing leprosy while remaining 63% patients were either not sure or believed that alternate medicine (unani, homeopathy or auyurveda) could cure leprosy better. Literacy influenced the answer for many of the questions although in few areas it had less or no effect at all. Conclusion: Awareness of leprosy is still not adequate among the masses. Further steps are needed to ensure that basic knowledge of leprosy, its signs & symptoms, MDT and its availability is conveyed more to the general population by educating them at the grass root level through various literacy programme and other innovative ideas.
ABSTRACT
Pemphigus is a life-threatening autoimmune blistering disease targeting skin and mucous membranes. It is clinically characterized by flaccid blisters and erosions, while histologically shows intraepithelial acantholysis. The disruption of desmoglein-dependent cell adhesion by autoantibodies is the basic pathophysiology in blister formation of pemphigus. The clinical and histological spectrum of pemphigus is complex and differs in various variants of pemphigus. This review offers an answer to why the splits associated with pemphigus foliaceus occur in the superficial layer of the epidermis, while those of pemphigus vulgaris occur deep in the epidermis. With the help of desmoglein compensation theory, it logically explains why oral erosions develop in patients with pemphigus vulgaris, but not in patients with pemphigus foliaceus and why some patients with pemphigus vulgaris have only oral involvement, but others have extensive lesions on both skin and mucous membranes. Learning objective: After completing this article, readers shall be familiar with the clinical presentations, histologic findings, immunopathology of classical pemphigus and its variants. It discusses the desmoglein compensation theory of pathogenesis. along with the management of pemphigus.