Monotypic angiomyolipoma of the nasal cavity: An extremely rare cause of nasal mass with recurrent epistaxis

Monotypic angiomyolipoma is usually found in the kidneys and is composed predominantly of epithelioid cells which show positivity for melanocyte and smooth muscle markers. It can pose a diagnostic challenge due to a range of differential diagnosis. We report the second case of monotypic angiomyolipoma of nasal cavity and first from India in a 54-year-old male who presented with a nasal polyp. Grossly the tumor was well circumscribed and un-encapsulated. Microscopy showed a large number of epithelioid cells mixed with a few spindle cells, varying sized blood vessels, and focal areas of adipose tissue. Immunohistochemistry was positive for smooth muscle actin (SMA) and human melanoma black (HMB-45) stains. It is important to identify this tumor as it can sometimes be mistaken for malignancy and only needs endoscopic resection.

Variability in Colletotrichum infecting chilli plants of Andaman and Nicobar Islands, India

Aim: The aim of the present study was to understand the basic pathogen dynamics of Colletotrichum species infecting chilli crop in the Andaman and Nicobar Islands for disease management practices. Methodology: Twenty fungal isolates associated with chilli (Capsicum annuum) anthracnose disease from diverse locations of tropical Andaman, India were characterized using polyphasic approaches. Results: Upon morphological studies, out of twenty isolates, fourteen isolates were found chromogenic and eleven showed concentric ring pattern of mycelial growth. Based on conidial morphology, the isolates were grouped into two species (C. capsici and C. gloesporioides). The pathogenicity tests on three chilli varieties revealed difference in the pathogenic potential among the collected isolates. The sequence analysis using internal transcriber spacer (ITS) region revealed the presence of two other species C. siamense and C. plurivorum, in addition to C. gloesporioides and C. capsici. Interpretation: The present study revealed the presence of high level of genetic and pathogenic variability among the Colletotrichum isolates infecting chilli in Andaman Islands.

A prospective study for the assessment of thyroid function by pre and post supervised exercise protocol in newly diagnosed patients of subclinical hypothyroidism

Background: The presence of raised serum TSH with serum free T4 and T3 within the reference range falls in subclinical hypothyroidism. It is a well-known fact that exercise affects the activity of thyroid glands and the production of their hormones. Author studied the effect of regular exercise in patients of newly diagnosed subclinical hypothyroidism. Pre and post-exercise thyroid function tests were evaluated to decide about the necessity to start thyroid replacement therapy or to adopt wait and watch policy.Methods: Study enrolled 100 newly diagnosed subclinical hypothyroidism patients attending this tertiary care hospital and randomised them in two groups, one group was subjected to regular physical exercise of 45-60 minutes daily along with supervised treadmill exercise stage 0 for 45-60 minutes once weekly followed by re-evaluation of thyroid function test after 30 days and second group was re-evaluated for thyroid function test without exercise after 30 days.Results: Thyroid profile parameters were compared and analysed by paired ‘t’ test, statistically significant increase in serum T3 (p value <0.05) and serum T4 (p value <0.05), along with significant reduction in TSH level (p value <0.05) were found in exercise group, while in non-exercise group changes in thyroid profile parameters were statistically not significant. There was significant reduction in mean weight in exercise group (p value <0.05), while in non-exercise group changes in weight were not significant.Conclusions: Present study concluded that regular physical exercise can improve thyroid function in patients of newly diagnosed subclinical hypothyroidism and convert them to euthyroid state.

Spermatocytic seminoma with rhabdomyoblastic differentiation: Case report and review of literature

Spermatocytic seminoma (SCS) is an indolent germ cell tumor of the testis. It has an excellent prognosis and orchidectomy is generally curative. Very rarely, it can be complicated by a sarcomatous transformation which is associated with a very aggressive behavior and requires adjuvant therapy. SCS with sarcomatous component is a very rare occurrence with <20 cases described in the world literature of which eight showed rhabdomyoblastic differentiation. We report a case of SCS with rhabdomyosarcomatous differentiation in a 60-year-old male along with a short review of literature.

Formulation and evaluation of olanzapine loaded chitosan nanoparticles for nose to brain targeting an in vitro and ex vivo toxicity study.

Olanzapine is an atypical antipsychotic drug shows low bioavailability due to extensive first pass metabolism and results in numerous side effects due to non targeted delivery. The present study was aimed to prepare and characterize olanzapine loaded chitosan nanoparticles for nose to brain targeting. The olanzapine loaded chitosan nanoparticles were prepared by ionic gelation of chitosan with tripolyphosphate anions. The formulated nanoparticles showed mean particle size, polydispersity index and zeta potential to be 183.1±8.42 nm, 0.122±0.08, +52.1±2.4 mV respectively. The entrapment efficiency and drug loading was found to be 72.42 ±3.65% and 26 .04± 2.12. In vitro drug release was showed a biphasic release pattern with initial burst release followed by sustained release of formulated nanoparticles. In vitro toxicity studies were carried out on RPMI 2650 human nasal epithelial cell line by MTT assay. The obtained result shows lower toxicity (high IC50 value) of nanoformulation as compared to free drug. Ex vivo histopathological studies were carried out by using excised goat nasal mucosa and the microscopic structure of nasal mucosa shows no significant harmful effects of formulated nanoparticles. These results illustrate that olanzapine loaded chitosan nanoparticles is a potential new delivery system for treatment of depressant when transported via olfactory nasal pathway to the brain.

Evaluation of oral health status among drug addicts in rehabilitation centre

Background: The present study was conducted to investigate the attitude of drug addicts under withdrawal treatment towards oral health so that required interventions can be planned for the good health of those who are in rehabilitation phase of life. Materials and methods: The present study comprised of 30 drug addicts (all males) admitted in the rehabilitation centre in Punjab, India. Data so obtained was subjected to analysis using SPSS version 16. Percentage and mean ± standard deviation was calculated and Chi-square test was used for statistical analysis. Results: Most of the participants (97%) were involved in more than one type of drug abuse and most of them used more than one type of route of drug substance administration. Regarding brushing frequency, about 17% not brushed their teeth regularly and 83% once a day and regarding the use of mouthwashes, 38% never used mouthwash, 59% used occasionally, 3% reported once a day. Most of the participants 92% never used floss to clean their teeth. Significant p value (<0.05) was found on statistical analysis of periodontal status, carious and fractured teeth in relation to oral hygiene practices among drug addicts. Conclusion: The result of the present study emphasis for more attention in designing and implementing oral health programs for addicts.

A comparative study of oral manifestations of HIV among pediatric patients

Introduction: The HIV pandemic has become a human, social as well as economic disaster, with far reaching inferences for individuals, communities and countries. The distribution of some of the specific oral manifestations is reported to differ between adults and children. Thus, the present study was carried to compare the oral manifestations in HIV positive children and HIV negative children. Materials and methods: The present study comprised a total of 90 subjects, divided into 3 groups, 30 HIV positive pediatric patients with HAART, 30 HIV positive pediatric patients without HAART and 30 healthy controls (HIV negative patients). The present study was conducted in the ART centre in Ranchi, Chattisgarh, India. The details to be taken from these children for subsequent analysis include age, CD4+ T cell count and oral lesions. Chi- square test was used to compare the lesions with Pvalue of 0.05 or less was considered for statistical significance and a P-value of 0.02 or less was considered for statistical highly significance. Results: Statistical analysis showed that patients with low CD4+ T cell counts (Group IA) had more number of lesions when compared to the patients with higher CD4 T cell count (Group IB). Dutta N, Gupta VK, Shetty R, Roy A, Dani G, Pandey V. A comparative study of oral manifestations of HIV among pediatric patients. IAIM, 2016; 3(5): 46-52. Page 47 According to individual lesion percentage distribution, it was observed that except hyperpigmentation most of the other lesions where more prevalent in group II than in group I. Mucocele was seen in group III and was not seen in group I and II. Dental caries was prevalent in all the three groups. Conclusion: HIV infected patients receiving HAART, had a significantly lower prevalence of oral lesion as compared to patients without HAART therapy

Cytomorphometric analysis of oral squames Tobacco Smokers using oral brush biopsy: An exfoliative cytological study

Background: Tobacco is mostly regarded as one of the primary etiologic factor in causing oral cancer. Literature quotes studies have depicted the alteration of nuclear (NA) and cytoplasmic area (CA) induced by tobacco smoking and chewing. Also some authors have stressed on quantifying the role of cytomorphometric analysis in analysing these cellular alterations. Therefore, we evaluated the cytological and cytomorphometric changes in the oral squames using brush biopsy from buccal mucosa of tobacco users. Materials and methods: 200 patients of age group of 40-65 years attending the hospital OPD with history of smoking were included in the study. The patients were broadly divided into two groups; Shetty R, Mukherjee S, Dutta N, Bhagat DK, Sushma K N, Pandey V. Cytomorphometric analysis of oral squames Tobacco Smoker’s using oral brush biopsy: An exfoliative cytological study. IAIM, 2016; 3(5): 14-19. Page 15 smokers (n=150) and Non-smokers (n=50). The cytological samples were taken from clinically normal appearing oral mucosa, stained and analysed using Image analysing software. IndependentSamples T Test and One-Way ANOVA were used to assess the level of significance. Results: significant increase in Mean NA was observed in smokers as compared to non-smokers. Also, Mean CA decreased in smoker’s group as compared to non-smokers. Likewise, N/C ratio was found to be significantly elevated in smokers group. Cytomorphometric parameter changes showed significant alteration with increasing duration of smoking. Conclusion: Cytomorhometric analysis can be used to analyse the alterations occurring in cellular and nuclear level.

Multi-factorial risk stratification in Acute Coronary Syndrome

Background: ST elevated myocardial infarction (STEMI), non-ST elevated myocardial infarction (NSTEMI) and unstable anginas (UA) are continual spectrum of coronary artery disease (CAD).These are terminal events arising as a result of coronary artery atherosclerosis and superimposed thrombosis.Materials and methods: A prospective study in which a total of 91 patients of either sex aged 20 to 60 years were recruited, of which 30 were STEMI, 31 were NSTEMI/ unstable angina and 30 were age and sex matched healthy controls. Patients with following complaints of maximum 24 hours duration were registered in the emergency department and were included in the study (ACC/AHA Guidelines, 2002).Results: In the present study, 91 subjects were recruited from medical emergency department. All of the subjects were meeting the inclusion criteria. Of the total 91 subjects 30 were of STEMI (Group 1),15 were of NSTEMI (Group 2), 16 were of unstable angina (Group 3) and 30 were controls (Group4).Conclusion: In patients of ACS, MPO is raised as compared to controls. Also in complicated ACS,irrespective of other risk factors, MPO was significantly raised as compared to controls and can beused to predict immediate clinical complication. There is no significant association between MPO, hs Chowdhury P, Pandey V, Avasthi R, Kandukuri MK, Giri S, Sharma S. Multi-factorial risk stratification in Acute Coronary Syndrome. IAIM, 2016; 3(1): 36-45.Page 37 CRP and CK-MB when taken together to predict complications. TIMI risk score is a simple prognostication scheme that categorizes a patient's risk of death and ischemic events and provides a basis for therapy.

Pediatric caecal lymphoma involving ovary in a 12 year old girl – A bad prognostic sign: A rarity.

Primary caecal lymphoma or the colonic lymphoma is a rare tumor of the gastrointestinal (GIT) tract and comprises only 0.2-1.2% of all colonic malignancies, both in adults and pediatric age group. The most common variety of colonic or caecal lymphoma is a on-Hodgkin’s Lymphoma (NHL) which arises from the lymphoid elements of the intestine. GIT is the most frequently involved site, accounting for 50-60% of all extra nodal lymphomas, and most of them are NHL. In adults, the stomach is the most common location of GIT lymphomas, followed by the small intestine, but the most common GI site of NHL in children is the terminal ileum and the ileo-caecal region. Diagnosis is difficult since lymphoma presents with vague abdominal pain with loss of weight and appetite. It may present as lump abdomen with complications such as intestinal obstruction, bleeding, perforation and peritonitis and intussusseption. Histologically it is B or T cell type with small or large cell variation, but frequently encountered is diffuse large B-cell cell lymphoma (DLBCL). DLBCL has low incidence but favorable outcome in young adults, lesions localized to one area or organ and children below 5 years of age, but has an aggressive course in children between 10-15 years of age and also in adults above 55 years of age. DLBCL or GIT Lymphomas in general have male preponderance. We present a rare case of caecal lymphoma (DLBCL) involving appendix and right ovary in a 12 year old girl who presented with vague symptoms of abdominal pain and abdominal mass. Clinically and radiologically, provisional diagnosis of Ileo-caecal tuberculosis with possibility of adhesions leading to a mass lesion was considered. Histopaththological examination (HPE) revealed the diagnosis and prognosis of the case.

Effect on free radical generation with different anaesthesia.

Reactive oxygen species are a part of the normal physiology of the biological system but their subsequent defence undergoes alteration during diseased conditions. Administration of anaesthesia for surgery may also alter the formation of reactive oxygen species. The present work deals with the comparative status of oxidative stress (lipid peroxidation) and anti-oxidant defence markers (superoxide dismutase and catalase) in blood in 3 groups of 15 patients each receiving halothane, relaxant vecuronium and spinal form of anaesthesia with lignocaine 5% heavy. The results obtained depict that the formation of malonyl dialdehyde as well as decrease in superoxide dismutase and catalase activities was highest in spinal anaesthesia followed by halothane and then relaxant group. Therefore, it seems important to consider the pre-operative anti-oxidant status while administering anaesthesia to such patients in order to provide biologically safe anaesthesia.

Glucose transport in cerebral microvessels during Plasmodium yoelii nigeriensis infection in mice.

Plasmodium yoelii infected cerebral micro vessels of mice registered a significant increase in D-[U-14C] Glucose transport as compared to normal microvessels which was found to be time, temperature and concentration dependent. Metabolic inhibitors galactose, manose, 2-deoxy glucose and D-glucose showed noticeable inhibition of the same.

Status of urea and related enzymes during Plasmodium yoelii infection and pyrimethamine treatment in mice.

Plasmodium yoelii infection alters the hepatic levels of key enzymes of urea cycle, viz.carbamoyl phosphates synthetase (EC 6.3.4.16) and ornithine transcarbamoylase (EC 2.1.3.3) and urea levels in mice. The urea level was found elevated in liver, brain and plasma during P. yoelii infection. However, carbamoyl phosphate synthetase and ornithine transcarbamoylase were noticeably decreased during P. yoelii infection. Pyrimethamine treatment (10 mg/kg body weight for 4 days) brought back the altered parameters to normal a week after cessation of drug treatment.

Status of ammonia, glutamate, lactate and pyruvate during Plasmodium yoelii infection and pyrimethamine treatment in mice.

Ammonia, lactate, glutamate and pyruvate levels in blood, liver, brain, spleen and kidney were determined during Plasmodium yoelii infection and pyrimethamine treatment in mice. Ammonia and lactate levels showed significant increase with rise in parasitaemia except in spleen where decrease in the lactate levels was observed. The glutamate level displayed a marked decrease in blood, liver and splenic tissues, whereas, significant increase in glutamate level in kidney was observed, although its level in cerebral tissue remained unaltered. The pyruvate level in blood and liver showed a noticeable decrease but brain, spleen and kidney registered an elevation of the same due to the parasitic infection. Pyrimethamine (oral) treatment (10 mg/kg body weight) to infected mice (5-10%) for four days brought back the altered levels of the above cellular constituents in different tissues to normal, a week after cessation of drug treatment.

Effect of sodium stibogluconate on hepatic mixed function oxidase system and marker enzymes of golden hamsters during Leishmania donovani infection.

During L. donovani infection in golden hamsters, tremendous hepatic damage was observed as apparent from increased activities of glutamate oxaloacetate transaminase, glutamate pyruvate transaminase, succinate dehydrogenase, glucose-6-phosphatase and acid ribonuclease. The levels of cytochrome P-450 and related monooxygenases, viz. aniline hydroxylase and aminopyrine-N-demethylase registered significant decrease in infected animals. Sodium stibogluconate, a standard antileishmanial drug, though caused the removal of parasites from infected tissues, but did not help in the recovery of deranged hepatic markers. The results explain the higher mortality of stibanate treated infected animals as compared to untreated animals infected with L. donovani.

An invertase with unusual properties secreted by sucrose-grown cells of Corynebacterium murisepticum.

The mode of sucrose utilisation by Corynebacterium murisepticum cells growing on M9 minimal medium supplemented with 0.4% sucrose as the carbon source was studied. It was observed that during growth of this organism, sucrose in the medium is hydrolysed to glucose and fructose, suggesting the formation of an extracellular invertase. Unlike in other microorganisms (e.g. Saccharomyces cerevisiae) the invertase formation is not repressed by the presence of glucose in the medium. The invertase was found to be the only predominant extracellular protein in the culture broth and could be purified in a single step by precipitation at 90% ammonium sulphate saturation. The purified protein had a molecular mass of 70,000 daltons. It not only showed invertase activity, but also a fructosyltransferase activity as it could convert sucrose to beta-1,2-difructose, as well as to glucose and fructose.

Hydrolytic enzymes of rhesus placenta during Plasmodium cynomolgi infection: ultrastructural and biochemical studies.

Placenta in monkey demonstrated altered pathophysiology after P cynomolgi infection. The electronmicroscopic observations showed slight complete focal necrosis of the placental tissue, besides alterations in total protein, phosphatases and proteinases. These changes in cellular constituents of placenta during malaria infection may be responsible for malfunctioning of the organ and in turn, abnormal development of foetus.

Partial purification of acid phosphomonoesterase in axenically grown Entamoeba histolytica NIH-200.

Entamoeba histolytica possesses significant acid phosphatase activity as compared to alkaline phosphatase activity. The acid phosphatase activity in the amoebic cells eluted at higher saline concentration as three distinct peaks at 200, 300 and 400 mM sodium chloride.