Environment Friendly Rehydrants for Air-Dried Oral Buccal Smears - A Comparative Study with Conventional Method.

Background: Cytopathology is defined as a branch of pathology which involves studying diseases and their diagnosis. The conventional method involves fixing the cells in alcohol, but its poor availability in ill-equipped areas can pose problems. One solution to this problem is air-drying of smears followed by rehydration. In this study, we intend to assess the cytomorphologic changes in air-dried smears rehydrated using various agents and to correlate them with the smears prepared using conventional wet technique. Also, we attempt to find the alternative to alcohol which can be used in less equipped areas. Materials and Methods: Three smears each were prepared from 24 patients (12 healthy and 12 with habits). A total of 72 smears were prepared. One smear from each patient was used as control group (alcohol fixation - total number: 24 smears). The remaining two smears were air-dried and rehydrated and were taken as the test group (test group A - rehydrated with aq. glycerine; total number: 24 smears, test group B - rehydrated with coconut oil; total number: 24 smears) for 5-10 minutes. Then, all 72 slides were stained by standard Papanicolaou stain. The slides were examined for cytomorphologic changes and a score was assigned from 0 to 3. Conclusion: Our study proved aq. glycerine to be a superior rehydrant in comparison to conventional wet fixed smears or coconut oil. Also, in studies where cytoplasmic evaluation is required, coconut oil can be used due to its superior quality.

Tooth decalcification using different decalcifying agents - A comparative study.

Background: In microscopic assessment of mineralized tissue, decalcification is an important step during tissue processing. The present study was attempted to compare the efficacy of various decalcifying agents and to evaluate the most efficacious decalcifying agent. Aims and Objectives: The aim was to study and compare the time taken for complete decalcification of the specimen by six different chemical agents; to study and compare the effect of various decalcifying agents on cellular and nuclear changes of hard and soft tissues; to study and compare the effect of various decalcifying agents used on the staining intensity with Ehrlich's Hematoxylin and Eosin stain and to determine the ideal decalcification technique. Materials and Methods: The six decalcifying agents, namely 5% nitric acid, 8% formic acid, formalin-nitric acid, 5% trichloroacetic acid, neutral ethylenediaminetetraacetic acid (EDTA) and Perenyi's fluid were used to decalcify 30 human permanent teeth (5 teeth in each solution). The endpoint of decalcification was evaluated by chemical (calcium oxalate test) as well as radiographic methods. The specimens were then subjected to processing, sectioning and staining with hematoxylin and eosin. The stained sections were observed under a light microscope and grading was done. Results: The results in the present study confirmed the fact that the time required for complete decalcification process was least in Perenyi's fluid, 5% trichloroacetic acid and highest in 14% EDTA. Teeth decalcified in 5% trichloroacetic acid, 8% formic acid, formalin-nitric acid and 5% nitric acid were easy to section. Sectioning was most difficult for teeth decalcified in Perenyi's fluid and 14% EDTA. The overall structure details as well as staining characteristics were best in teeth decalcified by 5% trichloroacetic acid and neutral EDTA and worst in teeth decalcified by Perenyi's fluid. Conclusion: Five percent trichloroacetic acid was showing the most efficient result as it balances both tissue integrity and time factor suggesting that it can be used as a stable decalcifying agent for routine histopathological diagnosis.

Dentinogenic ghost-cell tumor of the maxilla: A case report and review of literature.

Dentinogenic ghost-cell tumor (DGCT) is a rare, odontogenic neoplasm which is considered to be a solid variant of the calcifying odontogenic cyst (COC) with locally aggressive behavior and is characterized by ameloblastoma-like epithelial islands, ghost cells and dentinoid. It accounts for only 2%-14% of all COCs. Herewith, we report the case of DGCT in a 40-year-old male patient with clinical presentation as swelling on the right side of the face.

Anaplastic lymphoma kinase negative anaplastic large cell lymphoma of hard palate as first clinical manifestation of acquired immune deficiency syndrome.

Anaplastic large cell lymphoma (ALCL) is an uncommon disease, accounting for <5% of all cases of non-Hodgkin's lymphoma. We report a case of 48-year-old male who presented a clinically benign swelling in the right anterior palatal region since last 2 months. Radiographic evaluation showed no bone loss in palatal area. Histological and radiological examination was in favor of a peripheral reactive lesion like pyogenic granuloma or a benign salivary gland tumor. Immunohistochemistry confirmed the diagnosis of anaplastic lymphoma kinase-negative (ALK(-)) ALCL. Further laboratory tests ELISA for human immunodeficiency virus (HIV) and CD4 cell count was done which showed positivity for HIV. To the best of our knowledge, it is the first case of ALK(-) ALCL in the hard palate presenting as the first clinical manifestation of acquired immune deficiency syndrome.

Mandibular plasmacytoma of jaw - a case report.

The plasma cell neoplasm may present as Extramedullary Plasmacytoma (EMP) in soft tissues in bone as a Solitary Plasmacytoma of bone (SPB) or as a part of multi focal disseminated disease Multiple Myeloma (MM). The majority of 80% occurs in head and neck region. In our case, a 62-year-old male patient presented with a non tender swelling of short duration. The swelling was noted obliterating the vestibular depth in right lower mandibular region. The radiological features were non specific.

Odontogenic myxoma.

Odontogenic myxoma is a rare intraosseous neoplasm, which is benign but locally aggressive. It rarely appears in any bone other than the jaws. It is considered to be derived from the mesenchymal portion of the tooth germ. Clinically, it is a slow-growing, expansile, painless, non-metastasizing, central tumor of jaws, chiefly the mandible. Here we report the case of a typical odontogenic myxoma in a 26-year-old female patient, which had acquired large dimensions and involved the entire left half of the mandible including the ramus, resulting in a gross facial deformity, within a span of one and a half years.

Lymphocytic thrombophilic arteritis presenting as localized livedo racemosa.

A 28-year-old Costa Rican woman presented with a 6-year history of an asymptomatic progressive localized livedo racemosa on her limbs. Histological examination revealed a lymphocytic vasculitis targeting the arterioles in the deep dermis. In addition, a distinct hyalinised fibrin ring was noted at the periphery of the vessel lumen. These findings were consistent with the recently described entity known as lymphocytic thrombophilic arteritis. An extensive array of investigations did not show any underlying systemic disease, and the patient has remained in good health without treatment.

Prediction of mortality and morbidity by simplified acute physiology score II in obstetric intensive care unit admissions.

BACKGROUND: Critical care in obstetrics has received much attention in recent times. Despite progress in medical field and improvement in health facilities provided, maternal mortality is still very high in most of the developing countries. AIM: To study and analyze records of patients requiring intensive care in obstetrics and to assess utility of simplified acute physiology score (SAPS II) for predicting maternal mortality. SETTING: A multidisciplinary intensive care unit (ICU) at a tertiary care center. DESIGN: Retrospective review. MATERIALS AND METHODS: Fifty-seven consecutive obstetric patients' records requiring ICU admissions were studied for clinical picture, diagnosis, complications, morbidity and mortality over a period of 21/2 years - from 1st May 2002 to 31st Oct. 2004. SAPS II score was calculated according to the different variables for predicting mortality. STATISTICAL ANALYSIS: SAPS II scores were regressed on mortality status using logistic regression analysis. The predictability was assessed by goodness-of-fit test and receiver operated characteristic curve. RESULTS: Maternal mortality in obstetric ICU admissions was 1.15/1,000 deliveries, amounting to 40.35% of obstetric ICU admissions. The mean SAP II score was significantly higher (40.04 +/- 12.97 vs. 22.6 +/- 7.31) in those patients who died compared to survivors (P < 0.001%). CONCLUSIONS: The SAPS II accurately predicted mortality in obstetric patients admitted to ICU. Computation of the score as a routine in ICU may help in identifying those at high risk of mortality and then to reduce this risk.