Histopathological Approach To The Diagnosis Of Benign Peripheral Nerve Sheath Tumors At Uncommon Location

PARIPEX - INDIAN JOURNAL F RESEARCH |O December - 202Volume - 11 | Issue - 12 | 2 | PRINT ISSN No. 2250 - 1991 | DOI : 10.36106/paripex ABSTRACT Peripheral nerve sheath tumors are relatively common lesions that exhibit a wide morphological and biological spectrum. In the presence of classical morphological and immunohistochemical features, the histological diagnosis is usually straightforward, but they may represent diagnostic challenges. Schwannoma is a slow growing encapsulated tumor of neuroectodermal derivation that originates from the Schwann cells of the neural sheath. Most commonly presents as cerebellopontine angle mass but extracranial sites are known and needs to be considered in the differential diagnosis. Intraparotid and penile schwannomas are extremely rare. Their diagnosis could be missed on cytology due to cystic changes. Isolated plexiform neurofibroma of the tongue is again a rare tumor. Plexiform pattern recognition is important for the pathologist as these varients might show malignant transformation. Overall Fine needle aspiration cytology though inconclusive at times, help a lot initially to delineate between benign Vs malignant lesions. Moreover its minimally invasive so can be performed easily at the uncommon locations. Histopathology remains the gold standard. Clinicopathological and imaging correlation is must for definite diagnosis and treatment.

Screening and Characterization of Antimalarial Heme Polymerase Inhibitors from Garlic Cloves.

Aim: Garlic (Allium sativum L) aqueous extract was investigated to identify antimalarial compounds inhibiting heme polymerization. Methods: Solvent fraction of aqueous garlic extract was tested in heme polymerization assay and antimalarial assay to identify active factor. Mass spectroscopy, TLC and optical spectroscopy was used to characterize the active factor and mechanism of inhibiton. Results: Solvent fractionation and silica chromatography of aqueous garlic extract yields partially purified active constituent. The crude garlic extract has a high level of heme polymerization inhibition activity. Mass spectroscopy analysis of the high activity fraction indicates quercetin as a promising hit with an acceptable limit of error. Pure quercetin was found to inhibit heme polymerization and inhibit parasite growth in a dose dependent manner with an activity comparable to the activity present in the purified garlic aqueous fractions. Quercetin forms two distinct complexes with hemin as evident by TLC Chromatogram of hemin and quercetin mixture. ESI-MS analysis of quercetin-hemin reaction mixture gives two prominent peaks; 1st peak with m/z 929 (Hemin+Q+Li+3H) and 2nd peak with m/z 1244.7 (H+2Q+Na) with a clear indication of the formation of quercetin: hemin (1:1) and 2:1 complexes. The dissociation constant (Kd) of quercetin-hemin is 9.35 μM. Conclusions: In summary, aqueous garlic extract has heme polymerization inhibitor with high antimalarial activity. Quercetin is the main active constitution responsible for the activity and it inhibits heme polymerization by chelating free available hemin for polymerization.

Safety of acute normovolemic haemodilution with hydroxyethyl starch during intracranial surgery.

The effect of acute normovolemic haemodilution on haemodynamics, serum osmolality and coagulation parameters was studied in 20 patients undergoing intracranial surgical procedures. After induction of anaesthesia, 740+/-153 ml of blood was collected and the same was replaced with an equal volume of 6% hexaethyl starch. Heart rate (HR), blood pressure (BP), central venous pressure (CVP) and end tidal carbon dioxide tension (Et CO2) were monitored for 45 min. Haemoglobin concentration (Hb), haematocrit (Hct), serum osmolality (Osm), bleeding time (BT), prothrombin time (PT) and platelet count were determined before and 45 min after haemodilution. Hb and Hct were significantly lower following haemodilution (13.1+/-1.8 and 10.3+/-1.7 g/dL for Hb and 38.0+/-4.6%. and 30.1+/-4.5% for Hct). There was no significant change in the HR, BP and Et CO2 throughout the study period. CVP increased marginally from 35 to 45 min but was within normal limits. There was no significant change in serum osmolality, bleeding time and prothrombin time following haemodilution. Platelet count decreased following haemodilution but the values were within normal limits. The brain relaxation, as assessed by a semiquantitative scale, was satisfactory in all cases. None of the patients developed intraoperative brain swelling. In conclusion, acute normovolemic haemodilution with hexaethyl starch is tolerated well haemodynamically. It does not cause changes in serum osmolality which can increase brain oedema. It has no adverse effect on intraoperative haemostasis. It is a safe technique to decrease homologous blood transfusion during intracranial surgery.

Fasciolopsis buski (giant intestinal fluke)--a case report.

A girl, aged 20 years presented with diarrhoea, vomiting, pain abdomen and loss of weight, the routine Stool examination revealed Fasciolopsis buski (giant intestinal fluke) in large numbers. Despite treatment with Praziquantel, she died after three days.

Evaluation of thyroid hormones in chronic renal failure.

When chronic renal failure becomes advanced, the serum levels of most hormones are altered because of several interplaying mechanisms. This study was carried out to evaluate the level of total thyroxine (T4), triiodothyronine (T3) and thyrotropin (TSH) in 96 clinically euthyriod patient with chronic renal failure and 25 healthy individual as control. The patients were grouped into two groups, 62 patient on conservative management and 34 patients on chronic haemodialysis. The patient of both groups showed significant decrease in total T3 and T4 level as compared to normal control. Serum TSH level were similar in both groups as well as in control and were with in normal limit except 3 patients on conservative management which showed TSH level above normal chronic haemodialysis did not have positive effect in alteration of serum T3, T4 and TSH level.

Retroperitonial, teratoma as fetus in fetu--a case report.

We report a rare case of Retroperitonial teratoma containing Axial Skeleton long bone. Jaw, pelvis & scapula in a 27 yrs old male. Aberration in monozygotic twinning may rarely present as Fetus in Fetu. Rarer is presentation in Adult.