Correlation of fine needle aspiration cytology and cell block study of category III, IV, and V (TBSRTC-2017) thyroid lesions with special reference to cytokeratin-19 immunohistochemical staining

Context: Ascertaining the role of cytokeratin-19 (CK19) and its staining pattern helps to differentiate papillary carcinoma from other thyroid lesions. Aims: To correlate fine needle aspiration cytology (FNAC) and cell block study of equivocal cases (Category III, IV, and V) with the role of CK19 staining in it. Settings and Design: A hospital-based cross-sectional observational study was designed and conducted at North Bengal Medical College and Hospital, Shusrutnagar, Darjeeling. Methods and Material: The FNAC performed and reported as per TBSRTC-2017.50 cases of Category III, IV, and V was selected for cell block study and CK19 staining followed by immunohistochemical scoring. Results: Out of 50 cases, 17 were follicular neoplasm, 21 papillary carcinoma, 6 lymphocytic thyroiditis, 1 Hürthle cell adenoma, 1 medullary carcinoma, 1 lymphoma, and 3 undifferentiated carcinomas. Among cases of papillary carcinoma, 10 showed 4+ positivity, 9 showed 3+ positivity, 2 showed focal 1+ and 2+ positivity. In the case of follicular neoplasm, 1 showed 3+ positivity, 3 cases had 1+ 2+ positivity, and 13 cases revealed negative staining. Conclusion: Role of CK19 in distinguishing papillary carcinoma of thyroid from other lesions in cytologically diagnosed Category III, IV, and V (TBSRTC-2017) cases can be demonstrated.

Zero Budget Natural Farming in India: Aiming Back to the Basics

Crisis of Indian agriculture is very pertinent at this moment as green revolution is gradually losing its hope. Excessive, pointless exploitation of broods of green revolution has left bad footprints on country’s food security and environmental safety. With the motto to ensure food security by reviving Indian agriculture in environmentally safe way as well as to release farmers from debt cycle and suicides, zero budget natural farming (ZBNF) has come in the picture, which discards uses of all the chemical farming inputs and relies on natural way of farming i.e. rejuvenating soil and crop health through its own practices (Jivamrita, Bijamrita, mulching, soil aeration, intercropping, crop diversification, bunds, bio-pesticides etc.). ZBNF movement right now is the most popular agrarian movement which begun in 2002 in Karnataka and later successfully spread in many states (specially, of South India) of the nation through numbers of trainings, demonstrations and various promotional activities. Successful outcomes from farmers’ fields of south Indian states like Andhra Pradesh, Karnataka etc. are encouraging and grabbing attention of farmers, public and private organisations towards ZBNF in recent times. Yet, various controversies regarding its transparency, inadequate information, efficacy, practices, idealisms, even the term ‘zero budget’ etc. have agglutinated around ZBNF over the years since it debuted. Critics in fact have cited several references of drastic yield reductions with ZBNF practices in many places. Adequate scientific evaluation or monitoring of ZBNF’s successes or failures through multi-locational trials is now therefore the needful before allowing or restraining its run in Indian agriculture.

Prospects and Constraints of Transplanted Maize, Wheat, Sorghum and Pearl Millet: A Review

Cereal crops such as maize, wheat, sorghum and pearl millet are important for human consumption due to their nutritional benefits. These cereals play pivotal roles to meet world’s food demand. However, maintenance of food security particularly in the circumstance of changing climate, constantly urges for modification of agro-techniques and one such modification is the incorporation of transplanting technique in these cereals as an alternative under a non-practicable situation of direct sowing. Transplanting is a method of transferring seedlings grown in nursery or others to the field. It has been already found to shorten the crop duration and improve germination, plant stand, seed and seedling quality parameters, growth, yield and economic profitability of these cereals. Besides, research findings are also available stating that transplanting helps these cereals to cope up with vagaries of weather and to exhibit greater radiation and water use efficiencies and suppression of weeds. Outcomes of transplanting are however dependent on various factors like methods of nursery raising, the variety used, mode of planting, age of seedlings etc. In spite of these prospects, transplanting technique is not so popular in these cereals due to poor dissemination, discouraging research findings, pest and disease problems, lack of suitable package of practices etc. Therefore, focuses are to be given in conducting more and more research trials to confirm its location and situation wise efficacy and also in developing and disseminating a suitable package of practices of transplanting accordingly.

Growth, Yield, Seed and Seedling Quality Parameters of Rapeseed-mustard Varieties under Different Seed Priming Options

Rationale: Crop production and quality of produce get affected by drought, stand establishment and low availability of nutrients. Apart from various prevailing methods, seed treatment through priming now-a-days has been found to noticeably improve crop establishment for increasing seed yield and quality. Aim: To study the effect of various seed priming options on rapeseed-mustard varieties. Place of Study: A field experiment was conducted at AB Block Farm, Bidhan Chandra Krishi Viswavidyalaya, Kalyani, Nadia, West Bengal, India during winter season of 2017-2018. Methodology: Experiment comprised six rapeseed-mustard varieties (Anushka, Sanchita, TBM-143,TBM-204, Kranti and Pusa Bold) in main plot and five seed priming options (KH2PO4 @ 0.15 mol 100 ml water-1 5 g seeds-1, KNO3 @ 0.1 mol 100 ml water-1 5 g seeds-1, PEG 6000 @ -0.3 MPa 100 ml water-1 5 g seeds-1, hydro priming @ 100 ml 5 g seeds-1 and control) in subplot, replicated thrice in a split plot design. Observations on growth and yield contributing parameters were recorded from the field. Further, various quality parameters of seed and seedlings were evaluated in the laboratory. Data on all the parameters were finally statistically analyzed. Results: Among the varieties, Pusa Bold performed better in terms of growth, yield contributing parameters and seed yield under seed priming through either KH2PO4 @ 0.15 mol 100 ml water-1 5 g seeds-1 or PEG 6000 @ -0.3 MPa 100 ml water-1 5 g seeds-1. Seed and seedling quality parameters such as root and shoot lengths, seedling fresh and dry weights, germination % and vigour index were also improved under the same. Conclusion: Cultivation of mustard variety, Pusa Bold by seed priming through any of those two chemicals (KH2PO4 or PEG 6000) can be recommended for New alluvial zone of West Bengal, India.

Evaluation of trans thoracic invasive diagnostic procedures in 50 adult patients of mediastinal diseases

Introduction: Mediastinum is a “Pandora’s box” with many neoplastic and nonneoplastic lesions. Clinico-radiological pattern of mediastinal diseases depends on the size, location and etiology. Hence, non-invasive approach to these cases sometimes leads to diagnostic dilemma. Aims: A prospective study was performed over a 1-year period with the objective of evaluation of diagnostic yields and risk of trans thoracic ultra sound (TTUS) and computed tomography (CT) guided fine‑needle aspiration cytology (FNAC) and Tru-cut biopsy along with comparison of cost-effectiveness among mediastinal diseases where clinical and non-invasive imaging could not conclude the diagnosis. Materials and Methods: A prospective study of mediastinal diseases of the adult population without having any diagnosis admitted in a tertiary care hospital in Eastern India was performed after clearance of the ethical committee of the institute. Fifty cases of mediastinal diseases were seen during the study period. One patient sometimes had undergone more than one procedure. The choice of a procedure depended upon the location of the lesion, nature of disease and complication and cost effectiveness ofthe procedures. During the calculation of diagnostic yield of procedure, conclusive results and concordant results to more invasive procedures were considered. Results: Among 50 patients diagnostic yield of TTUS guided FNA and Tru-cut biopsy were 60% and 63.6% respectively. Diagnostic yield of Thoracic CT guided FNA and Tru-cut biopsy were 85% and 92.3% respectively. As a whole TTUS guided invasive procedure and Thoracic CT guided invasive procedure had a diagnostic yield of 61.5% and 87.9% respectively. Complication is less in CT guided invasive procedures (9.1%) compared to Transthoracic USG guided invasive procedures (11.5%) and complication is more common in Tru-Cut biopsy (16.7%) than fine needle aspiration (5.7%). Conclusion: Tru-cut biopsy if applicable is much superior to FNAC for a definite diagnosis of the mediastinal diseases. TTUS guided invasive procedures are very much cost-effective and have added advantage of real time guidance and is comparable with CT guided invasive procedures in respect to risk and diagnostic yields.

A Comparative Analysis of Rapid Immunochromatographic Card Test with MAC –ELISA Used in Detection of Dengue at a Tertiary Care Hospital in Jamshedpur, Jharkhand

Introduction: Dengue virus transmitted by mosquitoes iswidely distributed throughout the tropics and subtropics. It isone of the most rapidly spreading mosquitos borne viraldisease in the world. In India specially, dengue has emergedas a matter of major concern because of its epidemicproportions. Therefore, early diagnosis for dengue is called for,to reduce the mortality and morbidity attributed to it.Aims and Objective: There are numerous methods for thediagnosis of dengue of which the serological tests play asignificant role. Various rapid ICT tests are being used in thelaboratories for the early diagnosis of dengue these days. Thepresent study aims to evaluate the performance of rapid ICTwith reference to MAC-ELISA for its role in diagnosis ofdengue.Methods and Materials: In the present study 305 suspectedsamples of dengue were collected during the month of October2017 to December 2017. All the samples were collected byaseptic techniques.Results: 92 samples were positive by Mac Elisa IgM Ab test.The prevalence of the disease was 30.16 %. When ICT IgM Abtest was compared with Elisa IgM capture Ab test a sensitivityof 95.65 % and specificity of 98.59 % was observed.Conclusion: The high sensitivity and specificity makes itsuitable to be used in acute diagnosis of dengue but Mac ElisaIgM capture Ab test combination will make it more reliable andconfirmatory.

Quality indicators for eye bank

Purpose: The aim of this study is to identify quality indicators of the eye bank and validate their effectivity. Methods: Adverse reaction rate, discard rate, protocol deviation rate, and compliance rate were defined as Quality Indicators of the eye bank. These were identified based on definition of quality that captures two dimensions – “result quality” and “process quality.” The indicators were measured and tracked as part of quality assurance (QA) program of the eye bank. Regular audits were performed to validate alignment of standard operating procedures (SOP) with regulatory and surgeon acceptance standards and alignment of activities performed in the eye bank with the SOP. Prospective study of the indicators was performed by comparing their observed values over the period 2011–2016. Results: Adverse reaction rate decreased more than 8-fold (from 0.61% to 0.07%), discard rate decreased and stabilized at 30%, protocol deviation rate decreased from 1.05% to 0.08%, and compliance rate reported by annual quality audits improved from 59% to 96% at the same time. In effect, adverse reaction rate, discard rate, and protocol deviation rate were leading indicators, and compliance rate was the trailing indicator. Conclusion: These indicators fulfill an important gap in available literature on QA in eye banking. There are two ways in which these findings can be meaningful. First, eye banks which are new to quality measurement can adopt these indicators. Second, eye banks which are already deeply engaged in quality improvement can test these indicators in their eye bank, thereby incorporating them widely and improving them over time.

Crop Co-efficient Values of Sunflower for Different Growth Stages by Lysimeter Study.

The experiment was conducted on sunflower (variety BARI Surjomukhi-2) crop during the month of mid-November, 2014 to mid-March, 2015, in a lysimeter (dimension:1 m X 1 m X 1 m size) to measure crop evapotranspiration (ETc) and determine crop coefficient (kc) values at Irrigation and Water Management Division, Bangladesh Agricultural Research Institute, Gazipur. The study was examined by applying four irrigation at an interval of 10, 15, 20, and 25 days allowing drainage within and adjacent the tank. Results reveals that irrigation at 15 days interval produced the highest yield and was considered suitable for estimating ETc and kc. Seasonal total ETc was found as 270.89 mm. The kc values of sunflower under different ET0 methods for initial, development, mid-season and late season ranged from 0.34 to 0.48, 0.80 to 1.10, 1.06 to 1.55, and 0.27 to 0.36, respectively. Among different methods, P-M method gave relatively higher value than those of other methods and also FAO recommended value. Therefore, this information would be a helpful tool for crop water requirement and irrigation scheduling for similar semi-arid climates.

Association between anthropometry, cardiometabolic risk factors, & early life factors & adult measures of endothelial function: Results from the New Delhi Birth Cohort.

Background & objectives: Abnormal endothelial function represents a preclinical marker of atherosclerosis. This study was conducted to evaluate associations between anthropometry, cardiometabolic risk factors, and early life factors and adult measures of endothelial function in a young urban Indian cohort free of clinical cardiovascular disease. Methods: Absolute changes in brachial artery diameter following cuff inflation and sublingual nitroglycerin (400 μg) were recorded to evaluate endothelium-dependent and -independent measures of endothelial function in 600 participants (362 men; 238 women) from the New Delhi Birth Cohort (2006-2009). Data on anthropometry, cardiometabolic risk factors, medical history, socio-economic position, and lifestyle habits were collected. Height and weight were recorded at birth, two and 11 yr of age. Age- and sex-adjusted linear regression models were developed to evaluate these associations. Results: The mean age of participants was 36±1 yr. Twenty two per cent men and 29 per cent women were obese (BMI > 30 kg/m2). Mean systolic blood pressure (SBP) was 131±14 and 119±13 mmHg, and diabetes prevalence was 12 and 8 per cent for men and women, respectively. Brachial artery diameter was higher for men compared with women both before (3.48±0.37 and 2.95±0.35 cm) and after hyperaemia (3.87±0.37 vs. 3.37±0.35 cm). A similar difference was seen before and after nitroglycerin. Markers of increased adiposity, smoking, SBP, and metabolic syndrome, but not early life anthropometry, were inversely associated with endothelial function after adjustment for age and sex. Interpretation & conclusions: The analysis of the current prospective data from a young urban Indian cohort showed that cardiometabolic risk factors, but not early life anthropometry, were associated with worse endothelial function.

articleClinico-pathological study of 273 cases of rhinosporidiosis over a period of ten years in a tertiary care institute catering predominantly rural population of tribal origin.

Introduction: Rhinosporidiosis is a chronic granulomatous infection caused by Rhinosporidium seeberi, an organism whose taxonomy is still debated. The present study was aimed to document the clinico-pathological presentation of rhinosporidiosis in different parts in reference to caste, age and gender. Evaluation of diagnostic role of cytology in the diagnosis of rhinosporidiosis was also explored. Materials and Methods: All histology confirmed rhinosporidial cases were included in the study. Detailed clinical history and examination findings including previous hematological and cytological reports, if available, were collected and tabulated. Periodic Acid Schiff (PAS) and Mucicarmine stains were used over cyto- and histological slides, if necessary. Observations: Male cases were more frequent in these series though this sex difference is less pronounced among tribal population. Majority of the cases belonged to 21-40 years age group. Nose and nasopharynx was the commonest site of infection and polypoid mass lesions were the commonest presentation. Both scrape and aspiration cytology could successfully detect rhinosporidiosis in 100% cases. Discussion: Most of the cases are among poor-socioeconomic status and probably out-door activities and pond bathing habit. Haematological data correlation did not revealed any significant association. Histology is the preferred method for confirmed diagnosis of rhinosporidiosis. Rare cases of misdiagnosis can be avoided by use of special stains. Conclusion: Rhinosporidiosis commonly presents as polypoidal lesions in nose and extra-nasal sites. Histopathology is the standard method for confirmation of diagnosis. Cytology can be used as an adjunct for pre-operative diagnosis of extra-nasal rhinosporidiosis. We recommended use of special stains for diagnosis of difficult cases

Comparison of isolates and antibiotic sensitivity pattern in pediatric and adult cancer patients; is it different.

BACKGROUND: Infection is a common cause of mortality and morbidity in cancer patients. Organisms are becoming resistant to antibiotics; age appears to be one of the factors responsible. We analyzed common organisms and their antibiotic sensitivity pattern in the correlation with age. METHODS: This is a single institutional, retrospective analysis of all culture positive adult and pediatric cancer patients from January 2007 to December 2007. For statistical analysis, Chi‑square test for trend was used and P values were obtained. Of 1251 isolates, 262 were from children <12 years of age and 989 were from adolescents and adults (>12 years of age). Gram‑negative organisms were predominant (64.95) while Gram‑positive constituted 35.09% of isolates. RESULTS: The most common source in all age groups was peripheral‑blood, accounting to 47.8% of all samples. The most common organisms in adults were Pseudomonas aeruginosa (15.3%) while in children it was coagulase negative Staphylococcus aureus (19.8%). Antibiotic sensitivity was different in both groups. In pediatric group higher sensitivity was seen for Cefoparazone‑sulbactum, Cefipime, Amikacin, and Tobramycin. No resistance was found for Linezolid. CONCLUSIONS: The isolates in both children and adults were predominantly Gram‑negative though children had proportionately higher Gram‑positive organisms. High‑dose cytarabine use, cotrimoxazole prophylaxis, and frequent use of central lines in children especially in hematological malignancies could explain this observation. Children harbor less antibiotic resistance than adults; Uncontrolled, cumulative exposure to antibiotics in our community with increasing age, age‑related immune factors and variable bacterial flora in different wards might explain the higher antibiotic resistance in adults. Thus age is an important factor to be considered while deciding empirical antibiotic therapy.

Frequency of bacterial isolates and pattern of antimicrobial resistance in patients with hematological malignancies: A snapshot from tertiary cancer center.

BACKGROUND: Infections are the most important cause of mortality in patients with high‑risk febrile neutropenia. Emergence of multi‑drug resistant organisms (MDROs) has become a major challenge for hemato‑oncologists. Knowledge of the prevalent organisms and their antimicrobial sensitivity can help deciding the empirical therapy at individual centers and allows timely measures to reduce the risk of antimicrobial resistance. AIMS: To evaluate the frequency of bacterial isolates from all the samples and the pattern of bacterial bloodstream infections and incidence of MDROs. SETTINGS AND DESIGN: This is a retrospective analysis from a tertiary care cancer center. MATERIALS AND METHODS: From January to June 2014 information on all the samples received in Department of Microbiology was collected retrospectively. The data from samples collected from patients with hematological cancers were analyzed for types of bacterial isolates and antimicrobial sensitivity. RESULTS: A total of 739 isolates were identified with 67.9% of isolates being Gram‑negative. The predominant Gram‑negative organisms were Escherichia coli, Psuedomonas spp. and Klebsiella spp. Among the bacterial bloodstream infections, 66% were Gram‑negative isolates. MDROs constituted 22% of all isolates in blood cultures. Incidence of resistant Gram‑positive organisms was low in the present dataset (methicillin resistant Staphylococcus aureus and vancomycin‑resistant enterococci‑1.3%). CONCLUSIONS: The analysis reconfirms the Gram‑negative organisms as the predominant pathogens in bacteremia seen in patients with hematological cancers. The high frequency of multi‑drug resistance in the dataset calls for the need of emergency measures to curtail further development and propagation of resistant organisms.

Alarming prevalence of community-acquired multidrug-resistant organisms colonization in children with cancer and implications for therapy: A prospective study.

BACKGROUND: Infection or colonization with multidrug‑resistant organisms (MDRO) is associated with high mortality and morbidity. Knowledge of MDRO colonization may help in planning empirical antibiotic approach in neutropenic patients, which is known to improve patient outcomes. While routine cultures are positive and may help direct antibiotic therapy in only up to 15% neutropenic patients, surveillance cultures are positive in more than 90% of cancer patients. AIMS: To assess the rate of MDRO carrier status at presentation and rate of conversion to MDRO during the treatment. MATERIALS AND METHODS: Rectal swabs of all the outpatients presenting to pediatric oncology unit were sent within 7 days from date of registration from January 2014 to December 2014. Furthermore, stool cultures/rectal swabs of all patients who got directly admitted to the pediatric ward at presentation were sent within 24 h. Repeat rectal swabs were sent again for patients from this cohort when they got readmitted to the ward at least 15 days after last discharge or when clinically indicated. RESULTS: Baseline surveillance rectal swabs were sent for 618 patients, which included 528 children with hematological malignancies and 90 children with solid tumors. Forty‑five (7.3%) showed no growth. Of the remaining 573, 197 (34.4%) patients were colonized by two organisms and 30 (5.2%) by three organisms. Three hundred and thirty‑four (58.4%) showed extended spectrum beta‑lactamase (ESBL) Enterobacteriaceae, of which 165 (49.5%) were ESBL sensitive to beta‑lactam with beta‑lactamase inhibitors combinations and 169 (50.5%) were resistant to combinations. One hundred and sixteen (20.2%) were carbapenem‑resistant Enterobacteriaceae (CRE) and 65 (11.4%) had vancomycin‑resistant enterococci in baseline cultures. Only 63 (21%) patients were colonized by a sensitive organism in their baseline surveillance cultures. Morbidity (Intensive Care Unit stay) and mortality was higher in patients colonized by MDR organisms. There was a significant correlation between the place of residence and CRE colonization status with the highest rate (60%) of CRE colonization observed in children from East India. The repeat cultures showed the further conversion of sensitive isolates to MDRO in 80% of these children, of which 40% each converted from non‑ESBL and non‑CRE to ESBL and CRE, respectively. CONCLUSION: This is the first study illustrating the alarming high prevalence of community‑acquired MDRO colonization, especially CRE, which has grave implications for therapy for children with cancer potentially compromising delivery of aggressive chemotherapy and affecting outcomes. This incidence further increases during the course of treatment. Knowing the baseline colonization also guides us for the planning of chemotherapy as well as antibiotic approach and infection control strategies. Local antibiotics stewardship including education of the healthcare workers as well as national level interventions to prevent antibiotic misuse in the community is critical to minimize this problem.

Epidemiology of blood stream infections in pediatric patients at a tertiary care cancer centre.

BACKGROUND: Blood stream infections (BSI) are among the most common causes of preventable deaths in children with cancer in a developing country. Knowledge of its etiology as well as antibiotic sensitivity is essential not only for planning antimicrobial policy, but also the larger infection prevention and control measures. AIMS: To describe the etiology and sensitivity of BSI in the pediatric oncology unit at a tertiary cancer center. MATERIALS AND METHODS: All the samples representative of BSI sent from pediatric oncology unit during the period of January to December, 2013 were included in the study, and analyzed for microbiological spectrum with their antibiotic sensitivity. RESULTS: A total of 4198 samples were representative of BSI. The overall cultures positivity rate was 6.97% with higher positivity rate (10.28%) from central lines. Of the positive cultures, 208 (70.9%) were Gram‑negative bacilli (GNB), 71 (24.2%) were Gram‑positive organisms, and 14 (4.7%) were Candida species. Lactose fermenting Enterobacteriaceae i.e., Escherichia coli (28.4%), Klebsiella pneumoniae (22.1%), and Enterobacter (4.8%) accounted for 55.3% of all GNB. Pseudomonas accounted for 53 (25.5%) and Acinetobacter 19 (9.1%) of GNB. Among Gram‑positive isolates, staphylococci were the most frequent (47.8%), followed by Streptococcus pneumoniae 17 (23.9%), beta‑hemolytic streptococci 11 (15.5%), and enterococci 9 (12.68%). Of GNB, 45.7% were pan‑sensitive, 24% extended spectrum beta–lactamase (ESBL) producers, 27% were resistant to carbapenems, and 3.4% resistant to colistin. Pseudomonas was most sensitive, and Klebsiella was least sensitive of GNB. Of the staphylococcal isolates, 41.67% were methicillin-resistant Staphylococcus aureus (MRSA) and 10% of Coagulase Negative Stapylococci (CONS) were methicillin. CONCLUSION: A high degree of ESBL producers and carbapenem‑resistant Enterobacteriaceae is concerning; with emerging resistance to colistin, raising the fear of a return to the preantibiotic era. An urgent intervention including creating awareness and establishment of robust infection control and antibiotic stewardship program is the most important need of the hour.

Osteosarcoma: an immunophenotypic study for characterization and behavior.

Background: Osteosarcoma is the most common primary bone tumor occurring in second and third decades of life with a second peak later. Biopsy (needle or incision) is necessary for diagnosis along with imaging modalities (X-ray, CT scan etc) and serology. Due to diagnostic dilemma in certain cases and for prognosis of patients, immunohistochemistry is increasingly used. Aims: To assess the pathologic features and determinants of osteosarcoma in patients of the Indian subcontinent that would put an insight into its appearance and behavior. Methods and Material: Forty cases of biopsy proven osteosarcoma were selected over a period of three years. Histopathology was done for tumor typing, along with serology (pre and post-operative serum alkaline phosphatase). In all cases TNM staging and immunohistochemistry for antibodies to Osteonectin (ON) (diagnosis), S100 (differentiation), Ki 67 and Her2 (prognosis) was done. Results: Serum alkaline phosphatase was high in 37 (92%) cases initially and remained high in metastatic and recurrent lesions. Osteonectin was positive in 38 (95%) cases, S100 in 31 (77%), Ki 67 showed overlapping labeling indices between 4.8-18.8% and Her2 showed more positivity in higher stage tumors. Conclusions: Biopsy (along with imaging) is mandatory to diagnose osteosarcoma. Osteonectin is a good immunohistochemical marker to differentiate osteosarcoma from its mimics. For prognostication, serum alkaline phosphatase, post chemotherapy tumor necrosis (more than 90%), lack of Her2 expression are good parameters. S100 and Ki67 were found to have limited role in diagnosis and prognosis of osteosarcoma.

Checklist, Status and Role of Fish Diversity as a Measure of Alternative Livelihood in Dihing River Basin, Assam.

River Dihing, a tributary of mighty River Brahmaputra is serving as a potential fish habitat. Present investigation was done to identify the ichthyofaunal diversity and its utilization as alternative livelihood. A total 45 species belonging to 7 orders, 17 families and 29 genera were recorded. Among all these Cypriniformes had the majority occupying 40% and were recorded as dominated order. According to IUCN red list of threatened species 2013 (ver. 3.1), it was recorded that 35 were least concern, 5 were near threatened, 1 was vulnerable and 1 was endangered. Most of the people of Dihing River basin had been fruitful from the diversity of fish by fishing and adopting fish culture as an alternative livelihood. Different types of fishing techniques were studied along with the ichthyofaunal diversity.

Scedosporium apiospermum fungaemia: the ramification of broad spectrum antimicrobial treatments.

Scedosporium apiospermum is a cosmopolitan mycotic agent with unique characteristics. This is a case of a 65-year-old immunocompetent patient who presented with shortness of breath and fever. Consolidation was observed in both lung fields on chest X-ray. A diagnosis of aspiration pneumonia was made. Extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae was identified from his tracheal aspirate and imipenem was administered. Initial blood cultures were negative but after 10 days on imipenem, Candida glabrata was isolated. Amphotericin B was added to the treatment regimen, but after a week on this antifungal, Scedosporium apiospermum was cultured from the blood. The patient succumbed to illness before a change in the antifungal regimen. The case highlights the unwelcome consequence of using a broad spectrum antibiotic and later a broad spectrum antifungal agent.