T-cell lymphomas in a tertiary care center of Mangalore

Background: The clinicomorphology and immunohistochemical features of T-cell lymphomas have been documented. Aim: The aim of the study was to evaluate the spectrum of clincopathological features of T-cell lymphoma with immunohistochemistry correlation in a tertiary care center. Materials and Methods: The present study was conducted on 19 biopsy specimens received from the Department of Pathology, Kasturba Medical College, from referral hospitals of Mangalore city. Cases of nodal and extranodal T-cell lymphomas diagnosed between January 2012 and December 2015 were selected with evaluation of clinical data, histomorphological features, and immunophenotyping. Appropriate panel of antibodies was chosen after morphological evaluation of the cases. Results: Of the 19 cases of T-cell lymphomas, 14 were nodal disease and 5 were extranodal disease. Among the nodal lymphomas, five were primary peripheral T-cell lymphoma-not otherwise specified (PTCL-NOS), four were cases of lymphoblastic lymphoma, three were cases of angioimmunoblastic T-cell lymphomas, and two were cases of anaplastic large-cell lymphoma anaplastic lymphoma kinase (ALK) negative. In extranodal disease, two were mycosis fungoides of skin, one case each of subcutaneous panniculitis-like T-cell lymphoma, T-cell lymphoblastic lymphoma of tonsil, and T-cell lymphoma of the stomach. Conclusions: The diagnosis and subclassification of PTCLs is necessary for therapeutic and prognostic purposes

Thyrotoxic Hypokalemic Periodic Paralysis – A Case Report.

Thyrotoxic hypokalemic periodic paralysis is a medical emergency which presents with muscular weakness, hypokalemia and features of thyrotoxicosis. Urgent treatment is very important; since, very low potassium levels can lead to cardiac complications. Here, we present a case where features of hyperthyroidism were missed on initial assessment and were picked up subsequently in the second presentation of paralysis. This emphasizes the importance in recognizing the subtle features of hyperthyroidism from both history and clinical examination. Acute management consisted of administering intravenous potassium chloride and then treatment of thyrotoxicosis.

Comparative study of quality of life in breast cancer patients receiving two different chemotherapy regimens using European Organization for Research and Treatment of Cancer Quality of Questionnaire-Core 30 questionnaire module; for tolerability and safety.

Background: Breast cancer is one of the most frequent occurring cancers in women and burgeoning worldwide. It is the second most common malignancy in India after carcinoma of the uterine cervix. In clinical trials, quality of life (QOL) outcome measurements is an important as endpoints with improving subjects physical, emotional, and social well-being. Methods: In this study, we were evaluated the comparison of the QOL in breast cancer patients on anthracycline-based regimen (six cycles of 5-fluorouracil, adriamycin, and cyclophosphamide [FAC] for a period of 18 weeks) and taxane-containing regimen (four cycles of adriamycin and cyclophosphamide [AC] followed by four cycles of paclitaxel [PTX] for a period of 24 weeks) using European Organization for Research and Treatment of Cancer Quality of Questionnaire-Core 30. Results: During first 3 months of therapy, both treatment groups exhibited a reduction in health-related QOL (HRQOL) with no clinically significant difference between them. The effect on HRQOL was less evident 3 weeks after completing chemotherapy with HRQOL of both groups returning to near baseline scores. Conclusions: Both treatment regimens (FAC and AC → PTX [AC followed by PTX]) were equally tolerated in patients.

Comparative study to evaluate the accuracy of polyether occlusal bite registration material and occlusal registration wax as a guide for occlusal reduction during tooth preparation.

Introduction: The use of different materials and techniques has been studied to decide the safest quantum of reduction of the occlusal surfaces. However, these methods provide limited information as to the actual amount of reduction with limitations in accuracy, accessibility and complexity. Objective: The objective of this study was to compare and evaluate the reliability of the most commonly used occlusal registration wax that with polyether bite registration material as a guide for occlusal reduction required during tooth preparations. Materials and Methods: For the purpose of this study, 25 abutment teeth requiring tooth preparation for fixed prosthesis were selected and tooth preparations carried out. Modeling wax strips of specific dimensions were placed onto the cast of prepared tooth, which was mounted on maximum intercuspation on the articulator and the articulator was closed. The thickness of the wax registration was measured at three zones namely two functional cusps and central fossa. Similar measurements were made using the polyether bite registration material and prosthesis at the same zones. The data was tabulated and was subjected to statistical analysis using anova test and Tukey honestly significant difference test. Results: The differences in thickness between wax record and prosthesis by 0.1346 mm, whereas the difference between polyether and prosthesis was 0.02 mm with a P value of 0.042, which is statistically significant. This means that the wax record was 8.25% larger than the prosthesis while polyether was just 1.27% larger than the prosthesis. Conclusion: The clinical significance of the above analysis is that Ramitec polyether bite registration material is most suitable material when compared with commonly used modeling wax during the tooth preparation.

A study to correlate the incidence of cross arch balance and working side occlusal wear facets among different age groups: An in vivo study.

Introduction: The prevalence of group function and canine guided occlusion is common in natural dentition, but cross arch balance is not often seen. Hence, a study was carried out with following objectives: Analysis of incidence of cross arch balance in different age groups and working side occlusal wear facets in following subjects. Materials and Methods: A total of 200 patients with natural dentition were included in the study. Subjects with cross arch balance were analyzed for working side occlusal wear facets. Data were analyzed statistically by Chi-square test. Results: The incidence of cross arch balance in the study group was 0.7%. On examination, subjects with group function on the working side and cross arch balance on the non-working side had more occlusal wear facets. Conclusion: From the study, it was observed that there was no significant variation in the number and extent of wear facets between the cross arch and without cross arch subjects due the smaller sample size hence it was difficult to conclude the relationship non-working side contact as interference and its influence in wearing of dentition in this study.

An in vivo study to determine the range of posterior teeth disclusion on working side in canine-guided occlusion.

Background and Objectives: This study was done with the objectives to determine the range of functional zone between the intercuspal positions and edge to edge position, the range of incomplete and complete disclusion of posterior teeth in canine-guided occlusion, and to have a gender comparison and comparison between right and left sides of the obtained values. Materials and Methods: Thirty-five subjects showing canine-guided occlusion and Angle's class I canine and molar relation were chosen for the study. Maxillary midline and a corresponding line on the mandible were marked in maximum intercuspation with marker pen in the patient's mouth. Lines from 1 to 5 mm were marked on maxillary central incisor with marker pen. A dental floss was looped around the distal surface of mandibular last molar and the subject was asked to make left lateral movement (working side) at 1-mm intervals. The point at which floss was freed posteriorly was considered as initial disclusion and the point at which edges of maxillary and mandibular canines contacted was considered as complete disclusion. Results: Most of the male and female subjects in the study showed progressive disclusion on right side and delayed disclusion on left side. The range of complete disclusion was 3-4 mm in males and 2-3 mm in females irrespective of the side. The range of functional zone was 1-4 mm irrespective of side or gender. Interpretation and Conclusion: There is a need to redefine canine guidance in terms of immediate disclusion, delayed disclusion, and progressive disclusion.

Single rooted maxillary first molar: A rare case.

Adequate knowledge of the root canal morphology and its variations is essential for successful endodontic treatment. Of all the permanent teeth, maxillary first molar has a wide variety of variations in the root canal morphology. One among the rarest variation is to have a single root with a single canal. This case report presents one such unusual variation in maxillary first molar.

Rare association of papillary carcinoma of thyroid with adult T-cell lymphoma/leukemia.

Papillary carcinoma is the most common malignant tumor of the thyroid, especially in countries with adequate or excess iodine in diet. Many studies indicate that a sizable number of papillary cancer cases occur in a setting of chronic thyroiditis. But the tumor that arises more frequently in thyroiditis is malignant lymphoma. We report a rare association of papillary carcinoma of thyroid in an elderly lady with adult T-cell lymphoma/leukemia. Fine needle aspiration of the thyroid, neck nodes and evaluation of the bone marrow and peripheral blood helped in the diagnosis of papillary cancer coexisting with adult T-cell lymphoma/leukemia.

An in vitro study to evaluate the effect of storage time and application of subsequent layers on the variation in thickness of three commercially available die spacers.

Aims : The application of a paint-on die spacer onto the dies prior to the fabrication of cast crowns is an acceptable procedure to improve the fit of the restoration. The primary purpose of this study was to evaluate the variation in thickness of different brands of die spacer based on the effect of storage time and application of additional layers. Materials and Methods: Dies were duplicated from a master model of ivorine teeth, with a full ceramic preparation. Dies obtained were then painted with one, two, and three coats of each brand of die-spacers separately. These dies were embedded in die stone and sectioned bucco-lingually. The same procedure was done after three and six months. The thickness of the paint on die spacer was measured at five points on the die using an optical microscope, and the data were statistically analyzed. Results and Conclusion : There was a definite variation in the thickness of the die spacer with all the three brands and at various points on the die. Two coat thicknesses were found to be in the range of tolerance of 20-40 microns. Thickness at occlusal groove was noted to be the maximum with least at occlusoaxial line angles. Thickness also showed a very significant increase when bottles were stored for a period of three to six months and then applied.

Evaluation of total plasma homocysteine in Indian newborns using heel-prick samples.

OBJECTIVE: To estimate total plasma homocysteine levels in Indian newborns by modifying the existing SBD-F based High performance liquid chromotography (HPLC) method in order to enable analysis in newborn heel-prick samples and assess the prevalence of hyperhomocysteinemia in Indian newborns who are exclusively breast-fed. METHODS: Reverse-phase HPLC with fluorescence detection for plasma homocysteine estimation and statistical analysis using student t-test. RESULTS: SBD-F based HPLC method was modified and Bland and Altman analysis was carried out to assess agreement between original and modified methods. The correlation co-efficient was 0.994. The limits of agreement (-5.9, 6.3) were small enough to apply new method in place of the old for heel-prick sample analysis. Total plasma homocysteine analysis was carried out on heel-prick samples of 607 randomly selected newborns (331 males and 276 females). The mean plasma homocysteine estimated by this method in Indian newborns was 6.99 (95% CI: 6.48-7.49) with no appreciable gender effect (P=0.74). Elevated homocysteine levels were observed in 31 males and 21 females. CONCLUSIONS: Modified HPLC method is validated and can be used for homocysteine analysis on newborn heel-prick samples. Using this method, the prevalence of hyperhomocysteinemia in Indian newborns is 8.6%.