A Prospective and Retrospective Study of Bone Marrow in Patients with Pancytopenia– A Study of 150 Cases

BACKGROUND : The bone marrow is widely distributed organ and is the principle site for blood cells forma?on. The broad spectrum of disorders affects the marrow primarily or secondarily with presenta?on of peripheral pancytopenia. Hence, bone marrow examina?on is extremely helpful in evalua?on of pancytopenia. This study emphasizes the different causes of pancytopenia and bone marrow morphology in cases of pancytopenia. MATERIALS & METHODS: The present study is a retrospec?ve and prospec?ve study done in the department of Pathology, for a period of two years. All the relevant history, clinical details, radiological details, and biochemistry parameters were considered. RESULTS: Out of 150 cases,96 were males and 54 were females. Majority of the pa?ents were in the age group of 41-60 years (54%) amongst whom Megaloblas?c anaemia was the most important cause of pancytopenia. CONCLUSION: Bone marrow aspira?on is rela?vely a very safe invasive procedure and primarily permits cytological assessment since the underlying pathology determines the management and prognosis of the pa?ents.

Schoolbag weight limit: should there be a cut off?

Background: School children are at a development age and it is important that they do not carry excessive loads. Heavy school bags can change the body posture and the musculoskeletal system must react appropriately in order to compensate for this stress. There is still no consensus about a guideline for weight of school bags. The objective of the present study was to asses the bag weight in school going children, Compare the bag weight with the whole-body weight of children, Percentage of bag weight to whole body weight at different age groups.Methods: 727 children (413 males and 314 girls) were examined from different schools in Davangere. Descriptive analyses and measures of central tendency were performed on the demographic data to describe the sample.Results: Overall 21.7% of children carry a bag which is >25% of their body weight, 46.5% children are carrying a bag >20% of their body weight and 74.7% of children carry a bag of >15% of their body weight. 40.9% children between 8-10 years carry bag of >25% and 39.8% of them between 11 -13 years carry bag of >20% and this is statistically significant (p = 0.000).Conclusions: The weight of schoolbags of school children were higher than the internationally acceptable standards in majority of school children. The school authorities and ministry of health should further evaluate and take the necessary steps to rectify the situation. Early intervention and good regulation can prevent long term complication.

A Study On Utility Of Pap Smear Screening For Prevention Of Cervical Cancer In North Telangana

Background:Cancer cervix is a leading cause of mortality and morbidity among women worldwide. According to National Cancer Registry Program of India, cancers of cervix and breast are leading malignancies in Indian women. Themorbidity and mortality could be significantly reduced with an active cervical smear screening programme.Materials & Methods:The present study is a retrospective and prospective study conducted in department of Pathology. Atotal of one hundred Pap smears were examined for a period of one year. All the pap smears were examined and reported .Detailed history was taken for the required cases. Results:Out of total 100 cases inflammatory smear was the most common abnorrmality followed by normal study. Only 4 cases were diagnosed as unsatisfactory and 06 cases were diagnosed as Squamous cell carcinoma (SCC).Conclusion : Incidence of malignancy can be prevented by pap screening programmes. Pap smear helps in early detection and management of malignancies hence reducing mortality and morbidity. Pap smear studies are cost effective, doesn't need experts and specialists for collection. Therefore, till today it is the most useful screening procedure for malignant and pre-malignant conditions.

Histopathological Study Of Endometrial Lesions In Patients In A Tertiary Care Hospital In North Telangana

Introduction:Abnormal uterine bleeding (AUB) is considered one of the most common and challenging problems presenting to the gynecologist. Histopathological examination of endometrial biopsy is gold standard diagnostic tool in evaluation of AUB. Our study is aimed at determining the spectrum of endometrial pathologies in different age group patients presenting with AUB at our hospital which caters largely to women living in rural area. Materials & Methods : The present study is a retrospective and prospective study done for a period of one year in department of Pathology. All hysterectomy cases and endometrial biopsy cases were considered in the present study. Complete patient history, clinical and radiological findings were considered. Results: A total of 100 cases were included in our study and out of them the most common lesion was proliferative phase constituting upto 33 cases followed by secretory phase.The most common age group was in between 31-40 years. The most common complaint was abnormal uterine bleeding. Conclusion: Histopathological examination of endometrium is gold standard diagnostic tool in evaluation of AUB and there is an age specific association of endometrial lesions.

Spectrum of cervical lesions observed in 500 cases: Carcinoma cervix the leading cause of death in females.

INTRODUCTION: The present study was done to know the various histopathological variants in cervical lesions, to know the age incidence and to know the preventive measures and early detection of cervical cancer. MATERIALS AND METHODS: This is a retrospective and prospective study done on all the hysterectomy specimens and on punch biopsy samples sent for histopathology. We studied a total of 500 cases for a period of 3 years. RESULTS: Out of the 500 cases, 395 cases were non‑neoplastic and 105 cases were neoplastic lesions. Chronic cervicitis was the most common non‑neoplastic lesion and large cell non‑keratinizing squamous cell carcinoma was the most common malignant lesion. CONCLUSION: The main aim of presenting this study is to highlight the various histopthological variants, age incidence and to educate about the preventive measures and early detection of cervical cancer.

Enhancing retention of partial dentures using elastomeric retention rings.

This report presents an alternative method for the retention of partial dentures that relies on the engagement of tooth undercuts by a lining material. The lab procedures are also presented. A new maxillary and mandibular acrylic partial dentures were fabricated using elastomeric retention technique for a partially dentate patient. A partially dentate man reported difficulty in retaining his upper removable partial denture (RPD). The maxillary RPD was designed utilizing elastomeric retention technique. During follow‑up, it was necessary to replace the retention rings due to wear. The replacement of the retention rings, in this case, was done through a chairside reline technique. Elastomeric retention technique provides exceptionally good retention can be indicated to stabilize, cushion, splint periodontally involved teeth, no enough undercut for clasps, eliminate extractions, single or isolated teeth.

A comparative study of fine‑needle aspiration and fine‑needle non‑aspiration techniques in head and neck swellings.

AIMS AND OBJECTIVE: The present study was undertaken to compare the fine‑needle aspiration cytology (FNAC) and the fine‑needle non‑aspiration cytology (FNNAC) techniques in head and neck swellings and to study the cytology features of various head and neck swellings. MATERIALS AND METHODS: A total of 138 cases of head and neck swellings were sampled by a single operator, using both FNAC and FNNAC techniques. The two techniques were compared for the five objective parameters, amount of background blood or clots, amount of cellular material present, retention of appropriate architecture, degree of cellular degeneration and degree of cellular trauma, using Mair’s point scoring system. RESULTS: Blood contamination was similar in FNNAC as compared to FNAC in all cases. The difference was not statistically significant. Cellular yield was more in FNNAC in Thyroid and salivary gland lesions, with a significant statistical difference being noted in both. Better retention of architecture with a statistically significant difference was seen in FNNAC smears from lymph node lesions. There was no significant difference between the two techniques in degree of background blood. More number of FNNAC smears was diagnostically superior. CONCLUSION: The FNNAC technique provides an adequate cellular yield for a definite diagnosis in all head and neck swellings, except in cystic and fibrotic swellings where FNAC is a better technique.

Analytical profile of raw material and finished product of cefuroxime axetil.

Cefuroxime Axetil is the 1-acetoxyethyl ester of Cefuroxime. Chemically cefuroxime axetil is (RS)-1-hydroxyethyl (6R, 7R)-7-[2-(2-furyl) glyoxyl-amido]- 3-(hydroxymethyl)-8-oxo-5-thia-1-azabicyclo-Oct-2-ene-2-carboxylate, 72-(Z)-(O-me-thyl-oxime), 1-acetate-3-carbamate. Its molecular formula is C20H22N4O10S, and it has a molecular weight of 510.48. The cefuroxime raw material was identified by HPLC and IR Spectroscopy. The sample is tested for the solubility, diastereoisomer ratio, crystallinity and bulk density. The amount of cefuroxime axetil was estimated by HPLC assay method. The Cefuroxime axetil finished product was identified by HPLC and IR Spectroscopy. The average weight of tablets was calculated by taking the weights of 20 tablets. The content uniformity of the dosage units was calculated by weight variation method. The dissolution rate was calculated by HPLC method by using Paddle apparatus. The amount of Cefuroxime present in the sample was estimated by HPLC assay method. The known and unknown related substances present in the compound were estimated by HPLC method. Results obtained during the study were satisfactory and can be used for commercial purpose.

Dysmyelinating neuropathy in benign form of megalencephalic leukoencephalopathy with subcortical cysts: A novel observation from south India.

A 37-year-old gentleman presented with macrocephaly since early childhood and progressive impairment of motor and cognitive functions. Magnetic resonance imaging revealed extensive white matter involvement and frontotemporal subcortical cysts. Absent ankle jerk and abnormal nerve conduction study raised a possibility of associated peripheral neuropathy. Sural nerve biopsy was suggestive of dysmyelinating neuropathy. This report serves to expand the clinical spectrum of this rare leukodystrophy.

Neurological manifestations of Ehlers-Danlos Syndrome.

Ehlers-Danlos Syndrome (EDS) is more identified for its cutaneous features but its neurological manifestations have not received the focused attention. Four patients of Ehlers-Danlos Syndrome (EDS) with neurological manifestations were evaluated for phenotypic data. These four men were from three families and two had consanguineous parentage. The mean age at onset and presentation of neurological symptoms were 10.5 years and 19 years respectively. Patient 1 presented with bilateral optic atrophy, sensorineural deafness, cerebellar ataxia and neuropathy. Patient 2 had marfanoid habitus, chorea and cerebellar ataxia. Patient 3 had action and percussion myotonia, wasting and weakness of sternocleidomastoid and distal limb muscles. Patient 4 had action myotonia, mirror movements of both hands and neuropathy. MRI of brain showed right parietal polymicrogyria. Neuroaxis involvement at multiple levels in EDS may have prognostic significance.

A prospective study of reversible dementias: frequency, causes, clinical profile and results of treatment.

BACKGROUND: Dementia due to potentially reversible etiologies is an important group of dementias to be identified not only because of the number of such Patients encountered but also due to the potential for substantial improvement with treatment. AIMS: To prospectively investigate the frequency and causes of dementias with potentially reversible etiologies; to examine the clinical features of this subgroup with a view to identifying a signature profile and to determine if this potential reversibility translates into actual reversibility with appropriate treatment. SETTING AND DESIGN: A prospective longitudinal study of patients with dementia presenting to the outpatient services of a tertiary referral hospital. Methods: All Patients above 40 years referred for evaluation of cognitive complaints were serially enrolled and underwent clinical examination, various laboratory tests and neuroimaging. Patients were followed-up for one year. STATISTICAL ANALYSIS: One way analysis of variance for continuous variables followed by post hoc comparisons using Scheffe's procedure. RESULTS: A total of 129 patients met Diagnostic and Statistical Manual of Mental Disorders edition 4 (DSM IV) criteria for dementia and qualified for inclusion into the study. Twenty-four patients (18%), all with moderately severe cognitive [mean mini mental state examination (MMSE) score +/- SD = 17.9 +/- 4.8] and neuropsychiatric [mean neuropsychiatric inventory (NPI) score +/- SD = 30.7 +/- 8.7] dysfunction were diagnosed to have reversible causes - neuroinfections in 11 patients, normal pressure hydrocephalus in 8 patients and vitamin B12 deficiency in 5 patients. The majority of these patients had gait and urinary dysfunction reminiscent of subcortical dementias. These reversible causes were clinically suspected in only 58% of patients. In 20/24 patients in whom follow up was possible mean MMSE score had improved to 22.2 and mean NPI score had improved to 8.0, following 6 months of treatment. CONCLUSIONS: Reversible causes, especially neuroinfections and vitamin B12 deficiency accounted for 18% all dementias in this study. The majority of these conditions was not clinically suspected though resulting in moderate to severe cognitive and psychiatric dysfunction. Most of these patients had a subcortical pattern of dementia and showed substantial improvement with treatment.

Megalencephalic leukoencephalopathy with subcortical cysts: MRI and proton spectroscopic features.

Megalencephalic leukoencephalopathy with subcortical cysts (MLC) is a rare, recently described disease. It is characterized clinically by a large head, mild neurological symptoms and a remarkably slow course of functional deterioration. The MRI is characterized by 'swollen white matter' and large symmetrical cystic changes in the cerebral hemispheres. MLC should be considered in the differential diagnosis of children with megalencephaly and leukoencephalopathy. We report a child with this disease and discuss the MRI and MRS features.

Functional MR imaging of hand motor cortex in a case of persistent mirror movement.

Persistent mirror movements are unwanted movements restricted to muscles homologous to those moved intentionally on the opposite body half. It is rarely observed and the functional MRI findings in a case of persistent mirror movement are described.

CT features of intracranial metastases of unknown primaries.

Intracranial metastases of central nervous system are relatively common in patients with systemic cancer. Computed tomography (CT) scans of 60 patients of intracranial metastatic disease of unknown primaries, at the time of surgery, were retrospectively analyzed. These patients primarily presented with neurological dysfunction. They were operated upon for various reasons and histopathological diagnosis was obtained. There were 39 male and 21 female patients, with age range of 18 to 74 years. The common clinical symptoms were raised intracranial pressure without lateralization, acute onset hemiplegia and seizures. Multiple cranial nerve palsies were observed in 4 patients. Histopathologically the intracranial lesions consisted of metastatic adenocarcinoma (32 cases) or metastatic squamous cell carcinoma (28 cases). Among cases of adenocarcinoma, CT revealed solitary lesions in 17 and multiple lesions in 13 cases. Two had extraaxial deposition in the region of petrous apex. Out of squamous cell carcinomas, 17 lesions were solitary, while 10 were multiple and one had extraaxial deposition in the region of petrous apex. This study is unique as it consisted of CT features of intracranial metastases of unknown primary malignant disease elsewhere in the body.

MRI in subacute combined degeneration of spinal cord: a case report and review of literature.

A 56 year old man presented with acute onset posterior column and lateral spinothalamic tract dysfunction over a period of 15 days. MRI showed diffuse hyperintensity on T2WI involving the posterior columns. A diagnosis of subacute combined degeneration (SCD) of the spinal cord was considered and confirmed by laboratory findings. The patient showed complete recovery on B12 therapy. MRI lesion also compeletely resolved.

Intracranial infective aneurysms: angiographic evaluation with treatment.

Infective intracranial aneurysms are relatively uncommon. They develop due to septic embolisation of the vasa vasorum or lumen of the artery, with resultant focal arteritis and necrosis, leading to aneurysm formation. They are an important cause for intracranial haemorrhage. Six cases of infective aneurysms are described. A focus of infection could be detected in all the patients. Surgery was done in three cases, out of which two patients made significant recovery, while one patient died in the immediate postoperative period. Out of the three cases, treated conservatively with antibiotic therapy, there was total resolution on follow up angiogram in two, while one patient was lost to follow up.

Open and minimally open lips schizencephaly.

Two patients with isolated schizencephaly, a very rare congenital anomaly of the brain, who presented with epilepsy are presented. According to imaging morphology, there are two types of schizencephaly, 'open lip' and 'minimally open lip'. These two cases emphasize that while MRI is superior to CT in the diagnosis of congenital brain anomalies, schizencephaly can be diagnosed by its characteristic CT features.