Comparative Assessment of E-cadherin's Expression between the Metastatic and Non-metastatic Oral Squamous Cell Carcinoma: An Immunohistochemical Study

ABSTRACT Objective: To identify the clinicopathological correlation of E-cadherin expression in metastatic and non-metastatic oral squamous cell carcinoma (OSCC). Material and Methods: A total of 90 paraffin-embedded tissue sections of OSCC were retrieved from the registry. The total selected samples were 45 cases each from the primary lesions of metastatic and non-metastatic OSCC. One section was subjected to routine Hematoxylin and eosin stain and another to immunohistochemical analysis for E-cadherin expression. Results: A non-significant (p˃0.05) increased expression is seen in the non-metastatic group compared to the metastatic group, with predominantly membrane as the staining site in either group. However, the expression of E-cadherin did not reveal any statistically significant association with independent variables such as age, gender, and adverse habits of the patients (p>0.05). On the other hand, with respect to the histological differentiation of OSCC, a significant association (p<0.001) was observed with the well-differentiated type of metastatic OSCC. Conclusion: E-cadherin was useful to some extent in predicting regional metastasis. However, further studies using a panel of biomarkers with increased sample size may help us understand the process involved in metastasis.

Misplaced PPIUCD, Uncommon Complication in Common Procedure.

An ideal contraceptive is the one having features like being safe, effective, acceptable, inexpensive, reversible, simple to administer, independent of coitus, long lasting and requires little or no medical supervision.(1) Couple protection rate (CPR) of India currently is 54.8% among the eligible couples in the age group of 15-44 years.(2)In view of low CPR, National Health Mission has intensified the PPIUCD program. According to India’s Vision FP 2020’, emphasis is laid on training of more nurses to deliver the service in a 24 hour mode to the women opting for the method. In addition to this, women are highly motivated and most receptive towards family planning during the postpartum period but dilemma and conflict begins if any complication is met with, as in this case scenario.Intra-Uterine Copper Device (IUCD) is a safe, reversible and a cost-effective long-term contraceptive method. According to the WHO Eligibility criteria, post-placental and immediate Postpartum Intra uterine Copper Device insertion is done immediately after delivery of the placenta, within ten minutes to 48 hours respectively.(3) In a study, it was shown that IUCD insertion rate was as high as 95% in patients willing for immediate postpartum insertion, as compared this rate declined to only 45% in those consenting for a later insertion.(4)Although this method provides effective contraception, it is associated with complications, with uterine perforation being the rare but potentially devastating complication that can cause severe morbidity.(5) There are many incidences reported of uterine perforation due to postpartum IUCD insertion after interval IUCD technique, but none reported after post-placental or immediate postpartum IUCD insertion. We present a case report of uterine perforation after post-placental IUCD insertion.

Successful IVF Pregnancy in a Young Patient with Stromal Leydig Cell Tumour and Adenofibroma Simultaneously.

Sertoli Leydig cell tumour of ovary belonging to the category of sex cord stromal tumours is an extremely rare neoplasm accounting for <0.5% of all primary ovarian neoplasms. The tumour has varied clinical and histopathological presentations often overlapping with other common entities making the diagnosis difficult.Adenofibroma belong to the category of surface epithelial tumours of ovary. Serous adenofibroma are lesser known variants of this class of surface epithelial tumours. They are relatively benign and usually bilateral that contains both epithelial and fibrous stromal components. We present a case of 27 years old nulliparous woman with complains of pain in abdomen in right iliac fossa and irregular periods with histopathological examination revealing stromal Leydig cell tumour with adenofibroma..

Co-Existence of Chronic Lymphocytic Leukaemia and Malignancy of Uterine Cervix

Chronic Lymphocytic Leukaemia (CLL) is the most common variety of leukaemia. In this disease B-lymphocytes which would normally respond to antigens by transformation and forming antibodies, fail to do so. Patients with chronic lymphocytic leukaemia have up to a threefold risk of site specific secondary cancers. However, the co-existence of chronic lymphocytic leukaemia with gynaecological cancers is a rare phenomenon. Expert clinical and pathological review is warranted for proper diagnosis and management. Here we report a case of 57 year old patient with co-existent CLL and squamous cell carcinoma of the uterine cervix.Chronic Lymphocytic Leukaemia (CLL) is the most common leukaemia affecting the western world. It occurs mostly in the elderly.[1] It is less frequent in the Asian population. CLL is characterized by clonal proliferation and accumulation of mature, typically, CD5 positive B-cells within the bone marrow, spleen, blood and lymph nodes.[2]

Diagnostic Dilemma in a Case of Genital Tuberculosis.

Extrapulmonary tuberculosis accounts for a significant proportion of tuberculosis cases worldwide. Nevertheless, the diagnosis is often delayed or under dilemma or even missed due to insidious clinical presentation and unpredictable sensitivity of diagnostic tests. Here we describe a case of a 30-year-old woman of secondary amenorrhoea who was evaluated and posted for diagnostic hysterolaparoscopy and endometrial biopsy. The tubercular lesions identified on laparoscopy and endometrial tissue sampled was sent for TB-PCR, AFB culture and histopathology. TB-PCR and AFB culture reports were negative for tuberculosis, while her histopathology report was positive. She was started on category 1 anti-tubercular therapy. Her further course was uneventful and she started having normal menstrual cycles 9 months later.

Assessment of platelet indices in pregnancy induced hypertensive patients versus normotensive pregnant patients

Background: Hypertensive disorders of pregnancy (HDP) represent a group of conditions associated with high blood pressure during pregnancy, proteinuria and in some cases convulsions. The most serious consequences for the mother and the baby result from pre-eclampsia and eclampsia. These are associated with vasospasm, pathologic vascular lesions in multiple organ systems, increased platelet activation and subsequent activation of the coagulation system in the micro-vasculature. It is a multisystem disease and many theories are proposed for pathophysiology. So there is a constant search for better prognostic factors to predict the progression and severity of disease. The fall in platelet count is most frequently found in preeclampsia and is probably due to consumption during low grade intravascular coagulation. The major adverse outcomes of pre-eclampsia and eclampsia include central nervous system injuries such as seizures (eclampsia), ischemic heart disease, stroke, type II diabetes, and venous thromboembolism hemorrhagic and ischemic strokes, hepatic damage, HELLP syndrome, renal dysfunction as well as increased frequency of cesarean delivery, preterm delivery, and abruptio placenta, in comparison with women without history of the disease.Methods: Total 100 subjects, 50 control and 50 cases were taken for study. Samples for platelet count were collected and estimation was carried out by the auto-analyzers. The statistical evaluation is done using SPSS version 22 along with Anova and student t-test.Results: There was a significant difference in platelet count in patients with preeclampsia as compared to control group. Mean platelet diameter was significantly increased in cases with preeclampsia.Conclusions: Thrombocytopenia is directly proportional to the severity of PIH. Platelet count less than 1 lakh/cumm indicate increasing risk of DIC and HELLP syndrome. In this study we noted significant association was established when the platelet counts of PIH cases were compared with the normotensive control patients. Strong association was made out between the platelet count and MPD and MPV and the severity of PIH.

Effective Reduction of Mental Trauma with a Multidisciplinary Approach to Treatment of Dental Trauma

The purpose of this case report and review is to present the successful management of complicated crown-root fracture of maxillary central incisor with a multidisciplinary approach. A 57-year-old male patient reported with a complaint of unpleasant appearance due to a broken 21. Clinical and radiological examination revealed a complicated oblique crown-root fracture extending below the gingival margin. The tooth was endodontically treated. Surgical crown lengthening with osseous recontouring was performed. After 7 days prefabricated temporary crown was cemented, 6 weeks after surgery fiber post was placed followed by composite core build up. The tooth was restored with a permanent restoration of porcelain fused to the metal crown with gingival porcelain. Examination after 3 months revealed the good periodontal health, esthetic, normal function and patient satisfaction. The key factor in the successful functional and esthetic rehabilitation of a complicated crown-root fracture is weighing of all the available options with a multidisciplinary approach.