Computed tomographic abdominal fat volume estimation - a handy tool to predict the risk of metabolic syndrome.

Purpose: Abdominal obesity plays a significant role in the development of metabolic syndrome, with individual metabolic risk profiles for visceral and subcutaneous adipose tissues. This study aimed to calculate and correlate the subcutaneous, visceral, and total fat compartment volume in metabolic and non-metabolic syndrome patients. Material and methods: This was a cross-sectional study conducted on 112 patients categorized into Group A (with metabolic syndrome) and Group B (without metabolic syndrome). They were subjected to computed tomography (CT) study of the abdomen using a 128-slice MDCT scanner. Body mass index (BMI), visceral fat volume (VFV), subcutaneous fat volume (SFV), and total fat volume (TFV) were calculated and correlated with biochemical evidence of metabolic syndrome. Results: The mean age of patients in Group A was 60.91 ± 12.23 years as compared to Group B, which was 50.12 ± 16.30 years. Overall, a male predominance was observed, i.e. 69 cases (61.6%). BMI was proven to be an inaccurate risk predictor. However, mean VFV, SFV, and TFV was statistically higher in patients with metabolic syndrome (p = 0.001), with visceral fat volume predicting a higher risk in females (p = 0.026). Conclusions: Abdominal CT is a commonly performed yet unexplored tool for the risk assessment of metabolic syndrome. Through the results obtained in this study, we have proven the need for calculating SFV, VFV, and TFV as predictors of metabolic syndrome in comparison to the conventional practice of BMI assessment. The radiologist can thus work with the clinician to effectively detect and treat this health condition.

Spectrum of salivary gland diseases: A 24-year single-institution retrospective study.

Introduction: Salivary glands are exocrine glands and are classified as major and minor salivary glands. Salivary gland pathologies are classified as neoplastic and non-neoplastic. The neoplasms of salivary glands can be benign or malignant. Aim: The aim of the study was to describe the frequency of various salivary gland diseases reported in our institution from 1997 to 2021. Methodology: This was a 24-year retrospective study of salivary gland lesions processed and reported by the Department of Oral Pathology and Microbiology. Data regarding age, gender, site, and diagnosis were obtained and studied. Results: Amongst the total 5928 biopsied cases reported, 6% were salivary gland pathologies. Two hundred sixty-six were non-neoplastic lesions and 81 were neoplastic. The most common non-neoplastic lesion was mucous extravasation cyst. The most common neoplastic lesion was pleomorphic adenoma. Conclusion: The frequency of occurrence of salivary gland lesions in the last 24 years of this institution is almost similar to that stated in other published studies.

Acute Myeloid Leukemia with Concurrent Inversion 16 and Trisomy 9: A Case Report.

Acute myeloid leukemia (AML) are a diverse group of hematological malignancies, each with a distinct clinical, morphological, immunophenotypic, and molecular profile. The World Health Organization (WHO) classifies AML into various subtypes based on recurrent genetic abnormalities, each of which has clinico-pathological and prognostic significance. Inversion(16)(p13q22) or t(16;16)(p13q22) is a balanced structural chromosomal abnormality associated with complete remission and a favorable response to treatment. Trisomy 9 is a numerical chromosomal abnormality with an intermediate risk and is often seen in association with other cytogenetic abnormalities. We describe a case of a 36-year-old female patient who was diagnosed as AML-M4 on peripheral smear and bone marrow evaluation. Cytogenetic studies revealed concurrent presence of inv(16) and trisomy 9. To the best of our knowledge, this is the first case in published literature with simultaneous presence of inv(16)(p13q22) and trisomy 9 in de novo AML.

Overexpression of deubiquitinase (usp 36) in oral squamous cell carcinoma.

Aim: Oral cancer is one of the top three types of cancer and is of significant public health importance in India. A common post-translational modification in cells is ubiquitination/deubiquitination, and its dysregulation is closely associated with the development of cancer. Studies on the role of ubiquitination in oral squamous cell carcinoma (OSCC) are lacking. Increased expression of usp36 has been observed in various types of cancer, and this study aimed to check the gene expression of usp36 in OSCC patients. In this study, we analyzed the expression of ubiquitin-specific proteases (USPs) 36 in OSCC. Materials and Methods: A total of 15 OSCC patients at different stages of tumor differentiation and age- and sex-matched controls were recruited for the study. The patients were categorized based on their differentiation patterns. RNA was extracted from the tissues, and usp36 gene expression was checked in these samples using a quantitative real-time PCR technique. Results: Our study showed increased expression of usp36 gene in OSCC patients. The usp36 mRNA was 231.8 ± 137.94 folds higher in well-differentiated squamous cell carcinoma patients, 38.18 ± 3.77 folds higher in moderately differentiated squamous cell carcinoma patients, and 25.49 ± 7.30 folds higher in poorly differentiated squamous cell carcinoma patients compared to control tissues. Conclusion: Our study reports, for the first time, an increased gene expression of usp36 in OSCC tissues.

Double Philadelphia Chromosomes- A Rare, Yet an Important Cytogenetic Phenomenon of Prognostic Significance in De Novo Acute Lymphoblastic Leukemia.

Presence of additional copies of Philadelphia chromosome (Ph) is characteristic of chronic myeloid leukemia in blast crisis, very rarely observed in de novo acute lymphoblastic leukemia (ALL). Ph positive (Ph+ve) ALL and CML in lymphoid blast crisis (CML-LBC) are biologically different with divergent clinical course. Double Ph+ve ALL has little data available as to its incidence and prognostic significance. We studied five cases of Ph+ve precursor B-cell ALL having an extra copy of Ph chromosome with regard to their clinical and laboratory features. An extensive review of literature was done on prognostic significance and molecular aspects of double Ph in ALL. The study confirms that double Ph was a rare phenomenon in precursor B-cell ALL. It is observed that molecular basis of double Ph positive ALL is less understood compared to CML in blast crisis. The study highlights fundamental role of cytogenetic and molecular studies in diagnosis and management of these patients. Long-term follow-up studies on a larger group of patients are required to understand the prognostic impact of extra Ph in Ph+ve ALL, which is usually resistant to standard chemotherapeutic regimen and often requiring bone marrow transplantation. Supplementary Information: The online version contains supplementary material available at 10.1007/s12288-022-01525-1.

Doing More with Less: Fine Needle Aspiration Cytology in Pediatric Neoplasms.

BACKGROUND: Cancer is one of the leading causes of death in the pediatric age group following infections. Among the diagnostic modalities, fine needle aspiration cytology (FNAC) is increasingly recognized as it permits rapid diagnosis with low cost and complication. In this study, we emphasize the diagnostic value of FNAC and describe the cytomorphological spectrum of tumors diagnosed on FNAC in pediatric patients with or without the aid of ancillary tests. MATERIALS AND METHODS: This retrospective study included a total of 614 patients under the age of 15 years for whom fine needle aspiration (FNA) was done during a period of 3 years with or without guidance. The cytology smears were reviewed, and the morphological spectrum was analyzed with the ancillary studies. RESULTS: Aspirates from children constituted around 3.5% of the total FNAC performed in our Institute. Of the 614 cases, 336 were male, and 278 were female with age under 15 years. Neoplastic cases constituted around 72%, which included benign (2%) and malignant (98%) tumors. The spectrum include hematolymphoid neoplasms in 39.3%, small round cell tumors (SRCT) in 24.9%, Wilms tumor in 9.2%, germ cell tumors in 4.8%, spindle cell neoplasms in 4.8%, hepatoblastoma in 3.2%, and osteosarcoma in 3% of the cases. The metastatic lesions constituted 8.1% of the cases diagnosed by FNA. CONCLUSION: FNA proves to be a reliable and efficien modality in diagnosing pediatric neoplasms in the hands of a skilled cytopathologist.

Diagnosis of solid tumors in infants by fine-needle aspiration cytology: 5 years retrospective study from a tertiary care oncology center in South India.

INTRODUCTION: Neuroblastoma (NB), Wilms tumor (WT), hepatoblastoma (HBL), germ cell tumors (GCT), rhabdomyosarcoma (RMS), and so forth are the commonly identified solid tumors in infants. Invasive diagnostic techniques are more challenging in infants than older children. fine needle aspiration cytology (FNAC) is a safe, minimally invasive and outpatient procedure which is time and cost-effective for solid tumor diagnosis. This study aims to evaluate the role of FNAC in the diagnosis of various infantile solid tumors. METHODS: In this retrospective study, 61 cases of FNA of infant solid tumors were retrieved from the cytology archives over a period of 5 years from January 2013 to December 2017. Cytomorphology was studied and immunohistochemistry on cell block was performed wherever feasible. Histopathological correlation was done in 19 cases. RESULTS: Of the 61 cases studied, 60 cases were included in the study of which 35 were male and 25 were female. Infantile solid tumors constituted 7.3% of all pediatric solid tumors reported in cytopathology division of our Institute. The most common final diagnosis was NB (15, 25%) followed by HBL (13, 21.6%), WT (10, 16.6%), RMS (nine, 15%) and GCT (nine, 15%). The commonest site was abdominal-pelvic (42, 70%). A definitive independent diagnosis could be made on FNA in 48 cases (80%). Follow-up was done for 1.5 to 4 years (mean 26 months). The highest and lowest mortality was noted in NB (64.3%) and WT (12.5%) respectively. CONCLUSION: This study concludes that FNAC can be adopted as a diagnostic modality in infant solid tumors.

Mural Unicystic Ameloblastoma mimicking Odontogenic Cyst.

Unicystic ameloblastoma is considered a less aggressive variant of ameloblastoma with clinical and radiographic features mimicking a cyst. Herein, we present a case of unicystic ameloblastoma in a 20-year-old female who was clinically and radiographically diagnosed as an odontogenic cyst. Unicystic ameloblastoma and its subtypes are reviewed with special emphasis on the mural variant. The main aim of this case report is to highlight (1) the need of including an odontogenic tumor in the differential diagnosis of the unilocular, well-circumscribed radiolucent lesion by the clinicians (2) importance of serial sectioning of the specimen to identify the mural component if any present, and (3) following resection as the mode of treatment.

Comparison of cytokeratin expressions among orthokeratinized odontogenic cysts, epidermoid cysts and odontogenic keratocysts: An immunohistochemical study.

BACKGROUND: Orthokeratinized odontogenic cysts are keratinizing jaw cysts and due their association with impacted teeth and keratinaceous content, they resemble odontogenic keratocysts but differ in regards to biological behaviour, being less aggressive. To unravel the nature of OOCs, as they resemble epidermoid cysts histologically and due to their developmental resemblances to OKCs, this study was conducted. AIM AND OBJECTIVE: To compare the cytokeratin expressions of CK 10 and CK 19 among orthokeratinized odontogenic keratocysts, epidermoid cysts and odontogenic keratocysts by immunohistochemical study. MATERIALS AND METHODS: 30 cases of all three cysts were collected, 10 cases in each of these cysts (OOCs, EDCs and OKCs) were incubated with CK 10 and CK 19 markers respectively. IHC staining was performed and assessed all layers of epithelium. All the data were analyzed using SPSS software, P values were obtained by the Chi-square test and Fisher's test. RESULTS: The expression pattern of CK10 showed 100% positive in both OOCs and EDCs with significant difference in OKCs. CK19 expression, between EDCs and OKCs was significant but between OOCs & EDCs and OOCs & OKCs was found to be statistically insignificant. CONCLUSION: CK 10 expressions in both OOCs and EDCs were near identical both in terms of expression and patterns of expression in surface and spinous layers. OOCs may not be distinguished from EDCs both histologically and with CK 10 expression. CK19 expression between OOCs & EDCs and OOCs & OKCs was statistically insignificant. Thus, based upon CK 19 expression, no significant differences were found between OOCs & EDCs and OOCs & OKCs, implying that OOCs resemble both EDCs and OKCs.

Salivary cortisol and dehydroepiandrosterone as oral biomarkers to determine stress in patients with recurrent aphthous stomatitis.

BACKGROUND: Recurrent aphthous stomatitis (RAS) is one of the most common oral ulcerative diseases with a multifactorial etiology. Although psychological stress is an exacerbating factor, the role of salivary stress hormones, cortisol, and dehydroepiandrosterone (DHEA) in this oral disease has not been extensively reported. The study aimed to estimate and compare the salivary cortisol and DHEA levels in RAS patients and healthy control group with the aid of ELISA microplate reader. SUBJECTS AND METHODS: Sixty patients were enrolled in our study, which included 30 patients with clinically diagnosed RAS and 30 healthy controls. Two mL of unstimulated whole saliva was collected and salivary cortisol and DHEA levels were measured using ELISA kit, and the values were read by microplate ELISA reader and recorded in both groups. RESULTS AND CONCLUSION: The mean salivary cortisol and DHEA levels were elevated in the RAS patients compared to the healthy controls and were statistically significant. Salivary cortisol and DHEA can serve as oral biomarkers to determine stress in patients with RAS. However, the present study necessitates further studies with larger sample size and an improved protocol to ascertain the actual role of these presumed oral biomarkers as well as anxiety and stress as triggers in the pathogenesis of RAS.

Electrochemical detection and quantification of Reactive Red 195 dyes on graphene modified glassy carbon electrode.

Reactive Red 195 was detected from industrial waste samples electrochemically on graphene modified glassy carbon electrode (GCE), using both bare and surface changed GCE at different pH media from 1.0 to 13.0. The optimum pH was determined to be 4.0. RR 195 exhibited good linear responds at pH 4.0 on both electrode surfaces. Other parameters, such as accumulation potential, accumulation time, initial scan potential, pulse height, pulse width, and potential scan increment and scan rate are optimized and calibration plot was also derived on different concentrations of the dye. The stripping voltammetric behavior of dye exhibits very low limit of detection on graphene coated electrode (30 ppb). The adsorption of compound on GCE and graphene coated GCE are confirmed using atomic force microscopy studies.

Carcinoma Cuniculatum of the Alveolar Mucosa: A Rare Variant of Squamous Cell Carcinoma.

Carcinoma cuniculatum is one of the variants of squamous cell carcinoma. It is significantly rare with an incidence rate < 1% compared to other histological variants of squamous cell carcinoma. Various etiologic factors implicated are trauma, HPV, chronic inflammation and alcohol consumption but real causative agent still remains unclear. Initially it resembles plantar wart which slowly progress to bulky exophytic mass in the sole of the foot, where cases have been reported first. In the oral cavity it presents clinically as an exophytic growth and slowly invades the jaw and destroys the underlying bone. Microscopically it exhibits as both exophytic and endophytic epithelial masses along with well differentiated and pronounced hyperkeratosis. Treatment includes surgical resection alone unlike other variants which are treated by radiation with or without chemotherapy. Here we present a case of carcinoma cuniculatum occurred in alveolar mucosa of a 47 years old female. It presented as an exophytic growth in mandibular alveolar region, with histological features consistent with carcinoma cuniculatum.

Effects of bilateral superficial cervical plexus block on sevoflurane consumption during thyroid surgery under entropy-guided general anesthesia: a prospective randomized study / 대한마취과학회지

BACKGROUND: Bilateral superficial cervical plexus block (BSCPB) provides good postoperative analgesia, but its effect on anesthetic consumption is unknown. This study evaluated the effects of BSCPB on sevoflurane consumption during thyroid surgery. METHODS: Fifty patients were randomly allocated into groups A and B of 25 each in this prospective double-blind study. Group A received BSCPB with 20 ml 0.25% bupivacaine, whereas group B received 20 ml saline immediately before entropy-guided general anesthesia. Intraoperative hemodynamic parameters, end-tidal sevoflurane concentration, minimum alveolar concentration, and sevoflurane consumption were recorded. Postoperative pain was assessed using a visual analog scale, and the time of the first request for analgesia was noted. All side effects were recorded. RESULTS: Demographics were comparable. Mean sevoflurane consumption [for 30 min: group A = 7.2 (1.1) ml, group B = 8.8 (2.0) ml, P = 0.001; for 60 min: group A = 13.5 (1.7) ml, group B = 16.5 (3.9) ml, P = 0.002] and mean end-tidal sevoflurane concentration [for 30 min: group A = 1.2% (0.2%), group B = 1.4% (0.2%), P = 0.008; for 60 min: group A = 1.2% (0.1%), group B = 1.4% (0.2%), P = 0.010] were significantly lower in group A. Patients in group A had a longer duration of analgesia [361.6 (79.5) min vs. 151.0 (60.2) min, P < 0.001] compared to those in group B. CONCLUSIONS: Preinduction BSCPB during thyroid surgery significantly reduced sevoflurane consumption and increased the duration of postoperative analgesia.

Chronic bovine fasciolosis associated cholangiolithiasis: a case report.

Cholangiolithiasis is a rare condition in animals wherein the choleliths are formed in the biliary tracts causing chronic inflammation. In the current study, choleliths which were firm and friable concretions of approximately 3-4 cm in diameter were found in the bile ducts of the liver of an adult cattle infected with Fasciola gigantica. Two such irregularly shaped concretions were encountered in the two biliary tracts leading to common bile duct in the liver. There were localized irregular saccular dilatation and numerous liver flukes in the bile ducts. Further, several small hard concretions of varying sizes were also present in the ducts. The histological investigation revealed chronic cholangitis with bile duct hyperplasia and cirrhosis. The co-existence of F. gigantica and choleliths indicated the physical pre-disposition for the formation of bile concretions in the bile duct which is not a common site for the occurrence of gall stones.

A rare case of translocation (12;22) (p13;Q) in Ewing's sarcoma.

Cytogenetic or immunohistochemical studies are often required to differentiate Ewing's sarcoma (ES) from other small round cell tumors. Herein we report a case of 13-year-old boy who presented with a large presacral lesion. Hemogram and biochemical parameters were normal except lactate dehydrogenase showing value of 96.40/IU/L, magnetic resonance imaging of the spine showed a large mass in presacral lesion (8 cm × 7 cm × 9 cm), with destruction of the sacrum (S2 S3 and S4) with interspinal extension. Bone scan showed multiple pelvic bone lesions, radiograph of chest, ultrasound of abdomen, pelvis and electrocardiogram were within normal limits. Bone marrow was not involved. Cells from the fine needle aspirate were cultured for short term using RPMI medium and karyotype obtained showed a t(12;22)(p12;q12) instead of the classic t(11;22). Diagnosis of ES was also confirmed by studies using immunohistochemistry for MIC2 which was positive, synaptophysin was inconclusive and leukocyte common antigen, desmin negative. This case provides evidence of the importance of chromosome 22, in the etiology of the disease.

Hormonal changes in exfoliated normal buccal mucosal cells.

AIMS: The present study was undertaken as a baseline study to evaluate the nuclear diameter (ND), cell diameter (CD) and nuclear-cytoplasmic ratio (N:C) and their variation with age in normal buccal smears of female subjects. MATERIALS AND METHODS: Buccal smears were collected from 400 apparently healthy individuals. After fixation in 95% alcohol, the smears were stained using the standard Papanicolaou laboratory procedure. The CD and ND were measured using a stage micrometer and an ocular micrometer. Statistical analysis of the data was performed using the one-way analysis of variance to evaluate the difference in the ND, CD and N:C with age in females. Multiple range tests by Tukey-honestly significant difference procedure were performed to evaluate the significance between various age groups. RESULTS: The results showed an increase in ND and CD from the 5-10 age groups to 15-35 age groups. In the 15-35 age groups, there was a decline in ND and CD when comparing the first and the second half of the menstrual cycle, but the difference was not significant. There was further decline in ND and CD in the 45-60 age groups. Variations were also seen in ratio N: C. Pattern of exfoliation also varied in each age group. CONCLUSION: Age-related alterations are observed in buccal smears.

Comparative study of Candida by conventional and CHROMagar method in non-denture and denture wearers by oral rinse technique.

INTRODUCTION: Candidal species colonizes the oral cavities of healthy individuals without dentures and also of denture wearers. Soft liners and tissue conditioning materials have been found to support the growth of Candida albicans which may predispose to lesions. The most important and common candidal species are C. albicans, C. tropicalis, and C. glabrata. C albicans is usually isolated from both the fitting surface of the denture and the denture-bearing mucosa of the affected patients. The aim of this study was to isolate, quantify, and speciate candidal species in non-denture wearers (controls) and denture wearers (study group) by the oral rinse technique. Isolation was done using Sabouraud dextrose agar (SDA). Speciation was done using conventional methods like the germ tube test, carbohydrate fermentation test, urease test, as well as the CHROMagar method. AIMS AND OBJECTIVE: 1) To assess the prevalence of Candida in non-denture wearers and in denture wearers by oral rinse technique, with isolation on SDA; 2) to speciate and quantify Candida in non-denture wearers and denture wearers by using conventional methods (germ tube test, carbohydrate fermentation test, urease test) and the CHROMagar method; 3) to assess the influence of smoking and diabetes on candidal species among the denture wearers; and 4) to assess the sensitivity and specificity of SDA and CHRO Magar. MATERIALS AND METHODS: Salivary samples for Candida evaluation were collected from the subjects in sterile sample containers, using the oral rinse technique. RESULTS: C glabrata was the most commonly found species among denture wearers and non-denture wearers both by conventional and CHROMagar methods. In males, C. albicans was the predominant species, whereas C. glabrata was the predominant species in females. Candidal colonization was higher in denture wearers compared to non-denture wearers, especially among females. The CHROMagar method was more rapid compared to conventional methods. In the present study, CHROMagar Candida showed 100% specificity and 100% sensitivity when compared to SDA and conventional methods.

Electrocardiographic enigma of a classical disease: pellagra.

Pellagra is caused by a deficiency of niacin. It is endemic in Africa and Asia where the staple diet of the many refugees or displaced people is corn-based and, therefore, nicotinic acid-deficient. It is also frequently seen in developed countries among chronic alcoholics or, occasionally, those suffering from anorexia nervosa. The usual manifestations are diarrhoea, dementia and dermatitis (the 3Ds), which if left untreated may lead to death. Cardiac manifestations and electrocardiographic changes are rarely seen in those suffering from pellagra. We present a case of pellagra in an alcoholic who presented with the classical rash over the upper limbs along with electrocardiographic changes but without any cardiac symptoms, both of which resolved dramatically after he had been given niacin supplements.