FNAC as a diagnostic tool for Tuberculouslymphadentitis at peripheral health institutions

Background:Tuberculosis is a common and important public health problem in India. Fine Needle Aspiration Cytology (FNAC)is very easy, simple, quick,cheap and specific method for diagnosis of Tuberculous Lymphadenitis. The objective of this studywas to study the diagnostic yield of FNAC for diagnosis of Tuberculous Lymphadenitis by ZN staining and Cytopathologicalcharacteristics.Material and Methods: Present study was a retrospective study. FNAC/ aspiration was done in cases of superficiallymphnodes / abscess were analysed for diagnostic yield of Tuberculous etiology by ZN staining and cytopathologicalcharacteristics.Results: A total of 136 cases of superficial lymphadenitis presenting as solid swelling or abscess were subjected toFNAC examination. Smears were prepared from the aspirated material. Two separate slides prepared, stained with Giemsa and ZNstain. Total of 73 cases (53.67%) slides showed evidences suggestive of Tuberculous etiology out of which 33 (45.2%) were foundAFB positive on ZN stain. One AFB positive (not included as AFB positive in the analysis of results) slide was suggestive ofMycobact.leprae as confirmed by Fite stain.Conclusion: FNAC is a simple, safe, quick and cheap method to establish thediagnosis. Procedure is very safe, easy and can be performed by any doctor of PHI. Demonstration of AFB in the smear gives abacterilogically confirmed diagnosis very quickly. Cytological examination can further improve the diagnostic yield withoutbacteriological confirmation.

Photographic appraisal of crystal lattice growth technique.

Concept of creating mechanical retention for bonding through crystal growth has been successfully achieved in the present study. By using polyacrylic acid, sulphated with sulphuric acid as etchant, abundant crystal growth was demonstrated. Keeping in view the obvious benefits of crystal growth technique, the present SEM study was aimed to observe and compare the changes brought about by different etching agents (phosphoric acid, polyacrylic acid and polyacrylic acid sulphated) and to evaluate their advantages and disadvantages in an attempt to reduce iatrogenic trauma caused due to surface enamel alteration. Control and experimental groups were made of 24 and 30 premolars, respectively, for scanning electron microscopic appraisal of normal unetched and etched enamel surface and fracture site and finished surface evaluation. When compared with conventional phosphoric acid and weaker polyacrylic acid, investigations indicated that crystal growth treatment on enamel surface caused minimal iatrogenic trauma and surface alteration were restored to the original untreated condition to a large extent.

Epileptic seizures in supratentorial gliomas.

Two hundred patients with supratentorial glioma; astrocytoma (pilocytic, fibrillary, gemistocytic) 82, mixed glioma (oligoastrocytoma) 46, oligodendroglioma 8, malignant (anaplastic) astrocytoma 33 and glioblastoma multiforme 31, surgically treated for the tumours and followed up for one to sixteen years, were retrospectively analysed for the incidence of pre and postoperative epileptic seizures. 122 patients (61%) had seizures preoperatively. 62 (50.8%) of them had at least one or more seizures during follow up. Seizures were persistent in 22 patients. Doubtful, or one or two minor seizures occurred in 19 cases. Six patients in this group had seizure only at the time of CT confirmed recurrence, after a seizure free interval of one to nine years. Amongst 78 patients who did not have seizures preoperatively, 24 (30.6%) developed seizures during the postoperative follow up period. Recurrent attacks were reported only by 5 patients while 15 patients had seizure(s) only at the time of recurrence of tumour. Two patients had a few seizures in the early postoperative period and none thereafter, while doubtful seizures were reported by two patients.

Acute subdural haematoma : a reappraisal.

Acute subdural haematoma is a well-entrenched nosological entity implying subdural collection of blood following acute head injury. Pathologically, it is usually associated with or, for that matter, secondary to cerebral contusion and laceration. Based on cumulated experience, clinical and pathological studies it is proposed that, for too long the neurosurgeons have put emphasis on the clot rather than the totality of the pathological anatomy and that they have focused their therapeutic strategy on removal of the accumulated blood, unmindful of the associated parenchymatous lesion. Not surprisingly, such attempts have been associated with a very high mortality. On the basis of nearly four decades of personal experience and critical review of the literature, evidence has been provided that to reduce the mortality associated with this condition, it is necessary to evolve a strategy, not only to evacuate the blood but comprehensively deal with the associated parenchymatous lesions and the cascade of secondary insult to the underlying brain.

The decade of the brain: a brief review.

Recognising the huge burden of neurological and psychiatric disorders and prompted by the potentials of new techniques of molecular biology, biotechnology, genetics and imaging to study these, the 1990s were declared the 'decade of the brain'. This stimulated global scientific efforts to understand the human brain in health and disease. This review summarises some of the major research achievements during the decade. While it is impossible to provide a comprehensive summary of the voluminous data that has been generated, it was decided to provide a bird's eye view of the recent advances in the fields of developmental neurobiology, neurogenetics, neurochemistry and imaging of the brain, which have direct relevance for the clinicians.

Development of neurogenic pulmonary edema at different grades of intracranial pressure in cats.

Development of neurogenic pulmonary edema (NPE) subsequent to increased intracranial pressure (ICP) was evaluated in an experimental model in cats. Experiments were conducted in chloralose anaesthetised animals, either on spontaneous respiration or on intermittent positive pressure ventilation. Hemodynamic parameters i.e., mean arterial pressure (MAP) and heart rate (HR) were continuously monitored. Pulmonary artery/right ventricular systolic pressure was recorded in cats on spontaneous respiration. Increase in ICP for 180 minutes caused an increase in extravascular lung water (EVLW) content in both spontaneously breathing and artificially ventilated animals. In spontaneously breathing animals EVLW to blood free dry weight ratio (EVLW/BFDW) was 3.95 +/- 0.16 and 4.96 +/- 0.16 at ICP 40 and 80 mm Hg respectively while in animals on artificial ventilation, at 40, 60, 80 and 100 mm Hg ICP, it was 3.88 +/- 0.11, 4.09 +/- 0.10, 4.50 +/- 0.13 and 5.03 +/- 0.17 respectively. These values were significantly greater (P < 0.05) as compared to that in sham operated animals (3.43 +/- 0.10). This was accompanied by rise in MAP, HR and pulmonary artery pressure. The study establishes the graded development of NPE, the severity of which is proportional to the levels of ICP.

Correlative study of histopathology and bacteriology in patients of tubercular lymphadenitis.

Histopathology as well as bacteriology of lymph node specimen are useful diagnostic tools for tuberculous lymphadenitis. In the present study, a total of 71 cases of lymphadenitis were selected for histopathological and bacteriological studies. Only 46 patients had caseating type and 4 had non-caseating type of tuberculous lymphadenitis while 21 patients revealed non-specific chronic lymphadenitis on histopathological examination. Only 6 lymph node smears were positive for acid fast bacilli (AFB), 19 cases were positive for mycobacterial culture growth. Thus, it is not necessary that the cases which are histopathologically positive will be positive for culture as well. Therefore, both bacteriology and histopathology are complimentary diagnostic tools for tuberculous lymphadenitis.

Dynamics of Met5- and Leu5-enkephalin and their receptor binding activity in relation to morphine.

A complete normal coordinate analysis of Met5- and Leu5-enkephalins using Wilson's GF matrix method and Urey Bradley force field has been carried out to understand the dynamical behaviour of enkephalins. In addition, the charge distributions on different atoms of the two enkephalins and morphine using CNDO/2 method are also reported. The similarity in the charge distribution on the part of these two molecules is indicative of the possible interactions at the same receptor site as that of morphine and its derivatives. Apart from the topographical features and charge distribution, binding onto receptor site is not a static but a dynamic process and low frequency modes must play an important role in the recognition process. The significance of the out-of-plane amide VII band and other skeletal modes as characteristic of conformational states of Met5- and Leu5-enkephalins are discussed.

Invasive thymoma: cytomorphological features on fine needle aspiration cytology.

Although thymomas are the commonest neoplasms of the anterior mediastinum, distinction between benign and malignant thymomas is controversial on Fine needle aspiration biopsy. We present cytomorphological features of a case of invasive thymoma on computed tomographic guided fine needle aspiration cytology and its basis is discussed in light of current concepts of thymic tumours.

Acute renal failure in lymphoma of the kidney.

Involvement of kidney by lymphomatous process occurs in 30-40% of cases of lymphoma, if the disease is left untreated. Incidence of renal involvement at initial presentation is 2.7%-6%. Mostly it is in the form of insidious renal failure. Acute renal failure as initial manifestation of the disease is very rare. A case of lymphomatous involvement of the kidney, with initial presenting manifestation of ARF is discussed, and the mechanisms responsible for rarity of this is analysed.

Conformational transitions and specific heat anomaly in poly(dG-dC) and its methylated analogue.

The Zimm and Bragg theory of the helix<-->coil transition has been modified to explain order<-->order transitions in polynucleotides, in particular B<-->Z<-->psi(-)<-->coil transitions in poly(dG-dC) and poly(dG-me5dC). Lambda anomalies in specific heat measurements around the transition point have also been explained by a further modification of the same theory. Theoretical results are found to be in good agreement with the experimental data. The nucleation parameter is consistent with the stabilization/destabilization of the ordered states (Z helix) under various environmental conditions, e.g. methylation of cytosine residue at C5 position or change in the cationic concentration of the solvent.

Benign non-traumatic inflammatory stricture of the common bile duct.

A case of isolated benign non-traumatic inflammatory stricture of the mid portion of the common bile duct presenting with recurrent jaundice and cholangitis is reported. The histological features suggested that this was not due to sclerosing cholangitis.