Cold spot assessment in Epithelial-Mesenchymal Transition: a histological predictor of tumor recurrence in oral cavity squamous cell carcinoma

Objectives: To investigate clinical implications of epithelial mesenchymal transition (EMT) expression in oral cavity squamous cell carcinoma (OSCC). Materials and Methods: E-cadherin and vimentin expression was studied in 50 newly diagnosed cases of OSCC who underwent surgical excision. EMT expression at non cold spot infiltrative margin and cold spot was studied and correlated with prognostic factors and disease-free survival (DFS). Results: EMT expression at the cold spot and non-cold spot infiltrative margin showed significant results with nodal status (P < 0.001, P < 0.009 respectively). On multivariate analysis, only EMT at the cold spot correlated significantly with prognostic factors (P < 0.030). The factors affecting DFS on Kaplan Meier index were EMT expression and differentiation (P < 0.002, P < 0.016 respectively) which proved significant in cox regression analysis. Conclusion: The study reveals that EMT expression at the cold spot is a significant biomarker for predicting lymph-node metastasis and tumor recurrence in OSCC.

Ultrasound-guided fine-needle aspiration cytology of gallbladder masses – A solution to diagnostic dilemmas

Background: Advances in medical technology has revolutionized patient care. Ultrasound (USG)-guided fine-needle aspiration cytology (FNACs) is enlarging the realm of diagnostic cytology. This merger has increased the diagnostic accuracy especially in inaccessible body sites like the gall bladder (GB) masses. Impalpable, deep, and small lesions are now no longer a dilemma, thanks to image-guided FNACs. Objectives: The objective of the study was to study the ultrasound-guided FNACs of GB masses for a 10 year period and evaluate the efficacy of ultrasound-guided FNACs in GB lesions. Materials and Methods: USG-guided FNACs were collected and analyzed over a 10 year period (2007–2016) in the Department of Pathology North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong. This is a retrospective study and is in accordance with the ethical standards as laid by the Helsinki Declaration, 2000. Descriptive statistics were used for analysis. Results: The age ranges from 27 to 83 years and the mean age was 53.2 years. The majority were females which constituted around 94.3% (50) and males constituted around 5.7% (3). Out of all the adequate cases (42 in number) that were evaluated, 37 (88%) were malignant and 5 (12%) were benign and inflammatory; 11 out of 53 cases (20.8%) were inadequate. Conclusion: Although FNAC is established as a reliable diagnostic method, our study of 10 years has further proven that this test has stood the test of time, and with our high diagnostic yield and in the hands of a dedicated radiologist and cytopathologist, it will prove to surpass its expectations.

Irlen syndrome: systematic review and level of evidence analysis / Síndrome de Irlen: revisão sistemática e análise do nível de evidência

ABSTRACT Background: Scotopic sensitivity syndrome, later called Meares-Irlen syndrome or simply Irlen syndrome (IS) has been described as symptoms of poor reading ability due to poor color matching and distorted graphic images. Individuals with this syndrome are considered slow, ineffective readers with low comprehension and visual fatigue. It is still uncertain whether the disease pathophysiology is an independent entity or part of the dyslexia spectrum. Nevertheless, treatments with lenses and colored filters have been proposed to alleviate the effect of the luminous contrast and improve patients' reading performance. However, no evidence of treatment effectiveness has been achieved. Objective: The aim of the present study was to obtain evidence about IS etiology, diagnosis and intervention efficacy. Methods: A systematic review was performed covering the available studies on IS, assessing the available data according to their level of evidence, focusing on diagnostic tools, proposed interventions and related outcomes. Results: The data showed high heterogeneity among studies, and lack of evidence on the existence of IS and treatment effectiveness. Conclusion: The syndrome as described, as well as its treatments, require further strong evidence.

RESUMO Background: A síndrome da sensibilidade escotópica, posteriormente denominada síndrome de Meares-Irlen ou simplesmente síndrome de Irlen (SI), foi descrita como indivíduos com sintomas de baixa capacidade de leitura devido à combinação de cores e distorções nas imagens. Indivíduos com essa síndrome podem apresentar leitura lenta e ineficaz, com baixo nível de compreensão e fadiga visual. A fisiopatologia da doença ainda é incerta como uma entidade independente ou como parte do espectro da dislexia. No entanto, tratamentos com lentes e filtros coloridos foram propostos com o objetivo de aliviar o efeito do contraste luminoso e melhorar o desempenho de leitura dos pacientes. Outrossim, nenhuma evidência de eficácia do tratamento foi alcançada. Objetivos: Obter evidências sobre a etiologia, eficácia diagnóstica e intervenção da SI. Métodos: Foi realizada uma revisão sistemática, cobrindo os estudos disponíveis sobre a SI, avaliando os dados disponíveis de acordo com seu nível de evidência, com foco em ferramentas de diagnóstico, intervenções propostas e desfechos relacionados. Resultados: Os dados mostram alta heterogeneidade, falta de evidência sobre a existência da SI e eficácia do tratamento. Conclusões: A síndrome descrita e seus tratamentos exigem evidências mais robustas.

Tuberculosis of nose and palate with vanishing uvula.

During the past two decades, tuberculosis - both pulmonary and extrapulmonary - has re-emerged as a major health problem worldwide. Nasal tuberculosis - either primary or secondary to pulmonary tuberculosis or facial lupus - is rare, but it should be considered in the differential diagnosis of nasal granulomas. We describe a case of tuberculosis in an adult male who presented with palatal perforation with vanishing uvula and arch deformity of the palate. The diagnosis was based on histopathology and patient's successful response to antituberculous drug treatment.