Acantholytic oral squamous cell carcinoma with clear cell change - a rare amalgamated variant

ABSTRACT Background Acantholytic squamous cell carcinoma (ASCC) is an uncommon histological variation of oral squamous cell carcinoma (OSCC), accounting for fewer than 4% of all occurrences. The tumor shows a slight masculine predisposition, with the lower lip being the most commonly affected location. ASCC is reported to have a diverse biologic behavior, which explains its ability to metastasize to distant places and, thus, its poor prognosis. Similarly, clear cell change in OSCC is a rare occurrence with an unknown etiology that suggests its aggressive nature. Method and Results Histopathology reveals central acantholytic cells with numerous duct-like features. The presence of distinct cytological atypia contributes to the diagnosis of SCC. Special stains and IHC aid in distinguishing tumor from other histopathologically similar entities. Conclusion The case of a 29-year-old male presented here with an updated literature review highlights the need for histological study of the unique and seldom seen oral ASCC with clear cell change, which can be ignored because of similarities with other entities. Because recurrence rates are so high for ASCC, amalgamated clear cell change makes it critical for proper treatment initiation with a definite diagnosis. To the best of our knowledge, this is the first documented occurrence. Our experience with the present case suspected a more aggressive behavior due to a high Ki-67 index, anticipating a poorer prognosis in the oral cavity considering the patient's young age.

Inclusion complexes of atorvastatin calcium–sulfobutyl ether β cyclodextrin with enhanced hypolipidemic activity

The aim of present study was to explore the impact of Atorvastatin (ATR) Sulfobutylether beta-cyclodextrin complex(ATR-SBE-β-CD) on ATR dissolution behavior. Various batches of inclusion complexes were formulated usingvarious drug: polymer ratios (1:1, 1:3, and 1:5); using β-CD and SBE-β-CD and using two methods (freeze dryingand kneading method). Phase solubility studies were carried out of all the complexes and ratio 1:5 (ATR-SBE-β-CD)prepared by freeze-drying yield maximum solubility enhancement (30-fold in comparison to pure drug). Fouriertransformation infrared spectroscopy, Powder X-ray diffraction, Scanning electron microscopy (SEM), Differentialscanning calorimetry (DSC) studies was also carried out. FTIR studies showed no drug polymer interaction. DSCand SEM studies suggested incorporation of drug into inclusion complexes of cyclodextrin. Solid dispersion viaFreeze drying technique using SBE-β-CD (1:3 ratio of drug to polymer) produces better dissolution characteristics incomparison to kneading method. The results revealed superiority of SBE-β-CD over β-CD for solubility enhancementof poorly soluble drugs (owing to amorphous nature and more stable form of SBE β-CD). No significant drug losswas observed in solid dispersion batch (as per results of drug content analysis) during storage for 3 months underaccelerated conditions. Further in vivo pharmacodynamics studies of selected batch were carried out by inducingobesity in rats by feeding them with a high-fat diet. Group I (normal control group) received normal chow diet andgroup II, group III, group IV (High fat diet group, optimized formulation group and disease control group) receivedHFD for 1 month and were further evaluated for BMI, Blood glucose, lipid profile, liver profile, and histopathologicalexamination. The results so obtained depicted that optimized formulation of Atorvastatin (10 mg/kg, p.o.) showedbetter results in comparison to pure Atorvastatin Calcium (10 mg/kg, p.o.).

Comparison of Automated Analyzer Generated Red Blood Cell Parameters and Histogram with Peripheral Smear in the Diagnosis of Anaemia

Introduction: Red blood cell (RBC) indices and histogramobtained from automated analyzer give an idea aboutmorphological changes in anaemia. Along with the peripheralsmear, they can be used to interpret the cause of anaemia.The aim of the present study was to correlate typing ofanaemia based on RBC indices and histograms obtained fromautomated analyzer with peripheral smear examination and togive a better approach in the diagnosis of anaemia and analysetheir limitations.Material and methods: Blood samples collected from1575 anaemic patients, over a period of one year, in theHematology laboratory, were typed for anaemia, first byparameters obtained by haematology analyzer (RBC indiceswith red cell distribution width) and then by peripheral bloodsmear findings. The correlation between the diagnosis madeby peripheral smear versus RBC indices and histogram wereanalysed to find out the significance of the mean difference invarious parameters.Results: Microcytic hypochromic anaemia (50.86%) wasthe most common followed by normocytic normochromic(25.14%), macrocytic (2.29%), dimorphic (15.43%) andhaemolytic anaemia (6.29%) as diagnosed on peripheralsmear examination. Analysis by RBC indices showed 59.43%,32%, 3.43%, 2.86% and 2.29% of microcytic hypochromic,normocytic normochromic, macrocytic, dimorphic andhaemolytic anaemia respectively. Out of 801 (50.86%) casesof microcytic hypochromic anaemia on smear, 513(32.5%)revealed left shift while 288 (18.3%) showed broad-basedcurve on the histogram. In normocytic normochromic anaemia,anormal bell-shaped curve was seen in 378 cases (25%)while 18 cases (1.1%) showed the broad curve. Histogramsin macrocytic anaemia show a right shift in 27 cases (1.7%)while 9 cases (0.6%) showed left shift. In dimorphic anaemia,the histogram was bimodal only in 2.9% of cases whereas amajority (11.4%) showed broad-base histogram.Conclusion: Histogram and RBC indices give valuableinformation, but peripheral smear examination remains theimportant diagnostic tool in haematological disorders.

Correlation of Cervical Pap Smear with Histopathological Diagnosis in Cervical Lesions: A 2 Years Retrospective Study

Introduction: Cervical cancer is one of the most commonforms of cancer worldwide. In developing countries, cancerof uterine cervix is ranked second with a relative frequency of15% of all cancers in women. Screening women with regularPap smears allows diagnosis of treatable pre-invasive lesions.The objective of the study was to correlate the Pap smeardiagnosis with histopathology and to know the accuracy ofPap smears, so as to assess the efficacy of Pap smears indiagnosing cervical lesions.Material and methods: This two year retrospective study wasdone in the department of Pathology in a tertiary care centre,which includes 250 Pap smears for which histopathologicaldiagnosis was also done. Detailed clinical history of patientswas taken from requisition forms received in cytologydepartment along with Pap smears. The cervical biopsies orhysterectomies received from the same patients were alsostudied and then correlated with the diagnosis of Pap smears.Results: Out of 250 Pap smears, maximum patients (32%)belonged to the age group of 41-50 years and were multipara.Maximum cases were reported as NILM (59%),followedby ASCUS (16%), LSIL (15%), HSIL (7%), squamous cellcarcinoma (1.6%) and 0.8% cases of adenocarcinoma werediagnosed. On histopathology, 41.2% cases were diagnosedas chronic cervicitis, 27.2% cases as chronic cervicitis withsquamous metaplasia, CIN I (22.4%),CIN II (4.0%),CIN III(2.8%), squamous cell carcinoma (1.6%) and (0.8)% casesof adenocarcinoma. Overall sensitivity, specificity, positivepredictive value, negative predictive value and diagnosticaccuracy was 75.24%, 97.98%, 96.20%, 85.38% and 88.8%.Conclusion: As per our study, maximum number of casesdiagnosed on Pap smears correlated on histopathology,thereby concluding that Pap smears have an important role indiagnosis of cervical lesions.

Association Between Body Image Dissatisfaction and Body Mass Index, Eating Habits and Weight Control Practices among Mauritian Adolescents

Adolescence is a nutritionally vulnerable period owing to rapid physical and psychological changes. The objective of the study was to determine the prevalence of body image dissatisfaction and its association with body mass index (BMI), eating habits and weight control practices among Mauritian adolescents. Methods: A total of 200 adolescents aged 14-17 years who fulfilled the inclusion criteria were conveniently recruited from public places. Height and weight measurements were taken to determine BMI. The respondents completed a self-administered questionnaire on demographics, eating behaviour, Figure Rating (Stunkard Scale with silhouettes 1 to 9 indicating from the most lean to the most heavy figure), and attempts to manage weight. Results: Overall, 73.5% of respondents had normal BMI, with more males being overweight (12.5%) and obese (3.1%) than females. Body image dissatisfaction (BID) was higher among the males (76.0%) while BMI showed a significant influence on the body image of both genders. Males perceived silhouette 4 as an ideal body figure while females desired silhouette 3. Previous dieting was reported by all categories of body weight. Adolescents with satisfied body image tended to eat more fruits and vegetable. Adolescents with BID showed a higher likelihood of skipping breakfast (41.6%) and dinner (20.8%) and had a higher snacking frequency (72.0%). Almost all (96.1%) consumed fast food. Conclusion: BID appears to be a matter of concern among Mauritian adolescents. The findings emphasise the need for nutrition education programs promoting healthy weight management among adolescents.

Superporous Hydrogel Composites of Acrylamide Using Starch-silicone Dioxide Coprecipitate as Composite Agent.

Aim: Present study includes the development and evaluation of superporous hydrogel composites of acrylamide using starch silicone dioxide coprecipitate (SSC) as composite agent. Methodology: Gas blowing method was used for synthesis of superporous hydrogels. Different ingredients were mixed in specified amount in test tube and foaming agent was added at last. Simultaneous foaming and gelation lead to formation of porous hydrogel networks. Effect of different treatments (acetone dehydration and simulated gastric fluid (SGF) treatment) and drying conditions on the porous structure was evaluated. The prepared superporous hydrogels were evaluated for density, porosity, equilibrium swelling ratio, equilibrium swelling time, mechanical strength, scanning electron microscopy studies. The pure drug (Verapamil Hydrochloride) mixed with Carbopol 934 (1:0.5 and 1:1 ratio) was loaded into the selected batches of SPHC using in situ method of drug loading (drug added directly into the reaction mixture). The in vitro drug release was carried out using USP II dissolution apparatus. Results: Acetone dehydrated superporous hydrogel composites were observed as better floating devices due to least density and maximum porosity values. Maximum swelling ratio was found in case of oven dried conventional superporous hydrogel and superporous hydrogel composites with equilibrium swelling time of more than 25 min. On the other hand, acetone dehydrated SPH showed less equilibrium swelling ratio with equilibrium swelling time of 5-10 min. Minimum swelling ratio was observed in case of SGF treated hydrogels with equilibrium swelling time of 15-19 min. Mechanical strength was improved by addition of starch silicone dioxide coprecipitate as composite agent. SGF treatment also leads to enhanced mechanical strengthbut compromised swelling characteristics. SEM images showed uniformity in pore structure in case of acetone dehydrated hydrogels. Acetone dehydrated SPHC showed sustained drug release behavior with 71.14% and 57.84% of verapamil released in 12 h in the batches with Drug: Carbopol 934ratio of (1:0.5 and 1:1) respectively. Conclusion: Acetone dehydrated SPHC were found to be promising formulations with sufficient swelling and mechanical properties for achieving sustained drug delivery.

Co-positivity of anti-dengue virus and anti-Japanese encephalitis virus IgM in endemic area: co-infection or cross reactivity?

OBJECTIVE@#To report high co-positivity of anti-dengue virus (DV) and anti-Japanese encephalitis virus (JEV) IgM in an area endemic for both the viruses and to discuss the possibilities of co-infection.@*METHODS@#Serum samples from the patients who presented with fever, suspected central nervous system infection and thrombocytopenia, were tested for anti-DV IgM and anti-JEV IgM antibodies. Conventional reverse transcriptase polymerase chain reaction was done for detection of DV RNA and JEV RNA.@*RESULTS@#Of 1 410 patient sera tested for anti-DV and anti-JEV antibodies, 129 (9.14%) were co-positive for both. This co-positivity was observed only in those months when anti-JEV IgM positivity was high. Titers of both anti-DV IgM and anti-JEV IgM were high in most of the co-positive cases. Among these 129 co-positive cases, 76 were tested by conventional reverse transcriptase polymerase chain reaction for both flaviviruses, of which eight cases were co-positive for DV and JEV.@*CONCLUSIONS@#Co-infection with more than one flavivirus species can occur in hyperendemic areas.

Trend of dengue virus infection at Lucknow, north India (2008- 2010): A hospital based study.

Background & objectives: Dengue virus (DV) infection has emerged as a major health problem in north India. Here, we report the annual trend of dengue virus infection as seen in Lucknow, Uttar Pradesh, during 2008-2010. Methods: Blood samples from clinically suspected cases of dengue virus infection were collected and history was taken on structured clinical data sheet. All samples were tested for dengue IgM by antibody capture ELISA. Selected samples were tested by conventional RT-PCR for dengue virus RNA. Weather information was continuously recorded from website of world weather information service. Results: There was a gradual increase in number of dengue fever cases with increased occurrence in 2010. Cases referred in January - December 2008 were 398 (54.5% anti DV IgM positive), in January - December 2009 were 599 (51.9% anti DV IgM positive) and in January - December 2010 were 1602 (64.9% anti DV IgM positive). Serotypes circulating in years 2008, 2009 and 2010 were DV-2 & DV-3, DV -1, 2 & 3 and DV-1 and DV-2 respectively. There is no statistical significant correlation between weather data and increasing dengue positive cases. Interpretation & conclusions: Increased cases of dengue fever were seen in 2010, which was not correlated with any change in environmental factors. A change in circulating serotypes was noted.

In vivo model for dyslipidemia with diabetes mellitus in hamster.

Due to similarities in lipid metabolism to those in humans, hamster is considered as a good model for the study of regulatory mechanisms of plasma lipoproteins in response to cholesterol or fatty acid-enriched diet. This model of hyperlipidemia has been modified to produce dyslipidedmia with diabetes complexities by feeding with high fat diet added with 9% (w/w) fructose. Feeding this diet to hamster for 10 days markedly increases plasma levels of triglyceride, cholesterol, fatty acids followed by a significant increase in glycerol, beta lipoproteins, high density lipoprotein, glucose and glycosylated proteins. This model is being used for research and development of lipid lowering drugs with hypoglycemic activity in collaboration with Novo Nordisk, Denmark. The modified high fat diet formulation has now been prepared (Research diet D.99122211) and supplied by Research Diets Inc, Burnswick USA.