Boerhavia diffusa attenuates podocyte injury in rats with adenine induced chronic kidney disease by enhancing nephrin expression.

Nephrin is a transmembrane protein that maintains the slit diaphragm of renal podocyte. In chronic kidney disease (CKD), podocyte effacement causes damage to glomerular basement membrane barrier leading to proteinuria. Boerhavia diffusa, (BD), an Ayurveda herb, is used in treatment of various diseases particularly in relation to the urinary system. This study attempts to evaluate the effect of ethanolic extract of BD on the expression of nephrin in adenine induced CKD rats. CKD was induced in Wistar albino rats using adenine (600/mg/kg, orally for 10 days). CKD rats were treated with BD (400/mg/kg) and pirfenidone (500/mg/kg) orally for 14 days. The kidneys were harvested from euthanized animals and processed for histopathology, electron microscopy and immunohistochemistry, gene and protein expression of nephrin. Diseased rats treated with BD and pirfenidone showed reduction in the thickening of renal basement membranes and reduced haziness in brush border of PCT and glomeruli. Nephrin gene and protein expressions were higher in BD and pirfenidone treated group when compared to the disease control group. The structural and functional damage brought on by adenine-induced nephrotoxicity was countered by protective action of BD by up regulating the expression of nephrin. Therefore, BD can be utilized as a nutraceutical for the prevention and treatment of CKD.

Xanthogranulomatous oophoritis with Leydig cell hyperplasia masquerading as ovarian neoplasm - A case report.

ABSTRACT: Xanthogranulomatous oophoritis is an uncommon form of chronic inflammation of the ovary. Its clinical manifestations, imaging findings, and gross picture can mimic an ovarian neoplasm. Hilar cells, which are morphologically difficult to distinguish from testicular Leydig cells, secrete testosterone and they are mostly seen in the ovarian hilum. They can undergo hyperplasia or can transform into a tumor. We present a case of xanthogranulomatous oophoritis with Leydig cell hyperplasia, which mimicked an ovarian neoplasm.

Salivary Gland Choristoma in External Auditory Canal: A Case Report.

INTRODUCTION: Salivary gland choristomas have been described in the middle ear but tend not to involve the external auditory canal. CASE PRESENTATION: A 6-year-old boy with situs inversus totalis presented with congenital hearing loss in the left ear due to external auditory canal atresia. High resolution computed tomography of the temporal bone demonstrated a soft tissue obstruction of the external auditory canal with a normal middle ear. Histopathologically, this was a salivary gland choristoma. Post operatively the patient had a facial nerve palsy. CONCLUSION: Salivary gland choristomas of middle ear have been reported, but have not been described with external auditory canal atresia and situs inversus totalis.

Pineal Anaplastic Ependymoma - A Rare Entity.

Anaplastic ependymoma in the pineal region is rare. Here, we present a rare case of anaplastic ependymoma of the pineal region on a 42-year-old woman who came to our hospital with headache associated with blurring of vision since one month. MRI brain showed a contrast enhancing mass lesion measuring 30 × 30 × 35 mm in the pineal region with obstructive hydrocephalus. Initially, the ventriculoperitoneal (VP) shunt was done, followed by total tumor excision by the infratentorial supracerebellar approach. Histopathological and immunohistochemistry examinations of the tumor showed the features of anaplastic ependymoma (WHO Grade III). Patient made uneventful recovery and underwent radiotherapy. Only 12 cases of pineal ependymoma have been reported so far, of which only three have been anaplastic ependymoma.

A Correlative Study between Platelet Count, Mean Platelet Volume and Red Cell Distribution Width with the Disease Severity Index in Psoriasis Patients.

INTRODUCTION: Platelet activation is presumed to play an important role in the immunoinflammatory reactions. Several recent studies on a variety of inflammatory disorders have used Mean Platelet Volume (MPV) as a marker for platelet activation. AIM: To determine the relationship between haematological parameters and disease severity index in psoriasis patients. MATERIALS AND METHODS: A Case control study was carried out on 50 psoriatic patients and 50 healthy control subjects. Ten haematologic parameters were compared between patients and control subjects. These parameters were also correlated in patients with PASI (Psoriasis Area and Severity Index) score. The data was statistically analysed using IBM SPSS software (Version 21). Spearman Rank Correlation was used to find the correlation between PASI and haematological parameters. RESULTS: When all the patients were considered together, mean values for MPV, Platelet Count (PLT) and Red Cell Distribution Width (RDW) were significantly different between the two groups (Control and Patients). While MPV and RDW were raised, PLT was reduced in patients of both sexes when compared with controls. In Male patients the MPV and RDW showed statistically significant correlation with Psoriasis Area And Severity Index (PASI) (MPV <0.01; RDW<0.05), whereas PLT though reduced in both sexes when compared with controls, it showed significance in female patients alone (p <0.01). CONCLUSION: The mean values for MPV and RDW were higher and mean platelet values were lower in patients than controls. The MPV values in male patients and Platelet counts in female patients showed strong positive and negative correlation respectively with the PASI score. It can be concluded that rising MPV and decreasing PLT could be good indicators of disease severity and progression. These indicators could also help in assessing the treatment course of the disease.

Cytology of Collagenous Spherulosis: A Case Series.

Collagenous Spherulosis (CS) is an uncommon benign entity characterized by the presence of pink hyaline globules composed of basement membrane like material. Although they are known to occur independently, they are more often found as incidental findings in association with benign pro iferative breast lesions. As morphologically similar hyaline globules also occur in certain malignant lesions such as Adenoid Cystic Carcinoma (ACC) and adenomyoepithelial carcinoma, their presence may pose diagnostic problems. The present series is a retrospective analysis of six cases of CS reported cytologically over a period of three years from 2013 to 2016 at Chettinad Hospital and Research, Tamil Nadu, India. The cytopathologist should be aware of this benign entity to distinguish it from similar looking malignant lesions to avoid inappropriate management.

Relevance of Haematologic Parameters in Obese Women with or without Metabolic Syndrome.

INTRODUCTION: Obesity is rapidly growing problem worldwide. It predisposes to a variety of serious ailments including heart disease, diabetes mellitus, degenerative joint disease, atherosclerosis, etc. This is probably related to proinflammatory state associated with obesity due to release of several inflammatory mediators by the adipose tissue. The mediators are also probably responsible for metabolic syndrome associated with obesity. Besides, they may also induce significant changes in haematological parameters associated with inflammation. AIM: Present study was undertaken to ascertain the relationship between obesity and leucocyte counts (particularly TLC and ANC) and find out if the changes induced in them are significant enough to be used as predictors of metabolic syndrome. MATERIALS AND METHODS: This case-control study was carried out on 243 female subjects allocated to four groups based on WHO and IDF criteria: Control, Overweight, Obese and Obese with Metabolic Syndrome. From all the subjects, data pertaining to obesity related anthropometric measurements, lipid profile, fasting plasma glucose levels and complete blood counts were collected. These were analysed statistically. RESULTS: There was a strong positive correlation between obesity related anthropometric measurements (BMI, BF, WC) and leucocyte counts - TLC and ANC - which were statistically highly significant; TNC and ANC also showed strong positive correlation with FPG. Mean values for TLC and ANC showed statistically significant difference between each and every group. The difference in the mean values of these parameters between obese and metabolic syndrome was highly significant. Both elevated FPG and BMI were independently associated with relative leucocytosis; when both of them were elevated simultaneously, the effect appeared to be potentiating. CONCLUSION: Increase in obesity associated anthropometric measurements (BMI, WC, BF) is associated with relative leucocytosis within the physiological range. The changes in TLC and ANC are significant enough to be used as predictors of onset of metabolic syndrome in obese subjects.

Downregulation of involucrin in psoriatic lesions following therapy with propylthiouracil, an anti-thyroid thioureylene: immunohistochemistry and gene expression analysis.

BACKGROUND: Propylthiouracil (PTU), an anti-thyroid thioureylene, has been shown to be effective in chronic plaque psoriasis. Involucrin is a precursor protein that is upregulated in psoriasis. OBJECTIVES: This study evaluated the expression of involucrin in the epidermis of skin in psoriatic plaques before and after treatment with PTU. METHODS: This was an open-label, prospective study in which 25 psoriasis patients underwent skin biopsies prior to treatment with oral PTU 100 mg three times per day for 12 weeks. Patients were assessed at 2, 6, and 12 weeks. Skin biopsies were repeated at the same sites at 12 weeks. Pre- and post-treatment specimens were subjected to immunohistochemical staining and real-time polymerase chain reaction for involucrin. RESULTS: Mean ± standard deviation (SD) scores on the Psoriasis Area and Severity Index reduced significantly from 17.86 ± 9.9 at baseline to 4.63 ± 4.1 at week 12 (P < 0.001). Histomorphometric analysis revealed marked decreases in numbers of positively stained cells and intensity of staining. Staining became localized to the upper granular layers after therapy. Immunohistochemical scoring for involucrin reduced from a mean ± SD of 9.00 ± 0.67 at baseline to 3.90 ± 0.88 at week 12 (P < 0.0001). CONCLUSIONS: In psoriasis, there is increased expression of involucrin, which leads to abnormal keratinocyte differentiation and hence to the formation of psoriatic plaques. The therapeutic effect of PTU in psoriasis may be attributable to the downregulation of involucrin. Larger trials should further elucidate the mechanism and therapeutic potential of PTU in psoriasis.