The Role of Novel Tiered Reporting System in Serous Fluid Cytology and Risk of Malignancy Assessment: A Retrospective Study in a Tertiary Care Center.

Background: Serous effusion cytology (SEC) reporting is important for the management of the cancer patient. The International System for Reporting Serous Fluid Cytology (ISRSFC) provides tiered reporting terminology to standardize practice, looking into the risk of malignancy (MAL) for each category. In this study, we have assessed the utility of the ISRSFC and reported our experience at a tertiary cancer center. Materials and Methods: Serous fluid cytology reported from January 2019 to December 2020 was categorized according to ISRSFC diagnostic categories: nondiagnostic (ND), negative for MAL (NFM), atypia of undetermined significance (AUS), suspicious for MAL (SFM), and MAL. The risk of MAL (ROM) and performance parameters were calculated. Results: A total of 2150 serous effusions including 1160 pleural, 929 peritoneal, and 61 pericardial effusions from 2071 patients were reported. There were 742 males and 1329 females. The patient's age ranged from less than 1 yr to 95 years. The volume of the sample ranged from 0.5 ml to 2000 ml. There were 114 ND (5.32%), 1068 NFM (49.67%), 144 AUS (6.69%), 82 SFM (3.81%), and 742 MAL (34.51%) cases. Adenocarcinoma was the most common MAL involving serous fluids (91.50%). The calculated ROM was 15.38% for ND, 24.26% for NFM, 62.96% for AUS, 79.16% for SFM, and 100% for MAL. Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were, respectively, 68.04%, 96.96%, 96.35%, 72.07%, and 81.33%. Conclusion: ISRSFC provides consistent reporting terminology and the ROM for each category aids in clinical correlation and management.

Green synthesis of silver nanoparticles using canthaxanthin from Dietzia maris AURCCBT01 and their cytotoxic properties against human keratinocyte cell line.

AIM: Nano-biotechnologically synthesizing silver nanoparticles via canthaxanthin pigment extracted from Dietzia maris AURCCBT01 and assessing their cytotoxic therapeutic potential against human keratinocyte cell line (HaCaT) were the key objectives of this study. METHODS AND RESULTS: The pigment extracted from D. maris AURCCBT01 was identified as canthaxanthin using UV-VIS spectroscopy, FTIR, NMR (1 H NMR and 13 C NMR) and MS. Canthaxanthin, treated with silver nitrate solution, produced canthaxanthin-mediated silver nanoparticles and they were characterized by UV-VIS spectroscopy, FTIR, XRD, FESEM-EDX and TEM-SAED techniques. UV-VIS spectroscopy pointed out an absorption band at 420 nm, relating to the surface plasmon resonance of silver nanoparticles. FTIR findings suggested that the diverse functional groups of canthaxanthin bio-molecules played a significant task in capping the silver nanoparticles. XRD analysis exhibited 40·20 nm for the crystal size of nanoparticles. FESEM and TEM exhibited that the biosynthesized silver nanoparticles were spherical in shape with crystalline nature and the particle size was 40-50 nm. Moreover, the cytotoxicity assessment of the synthesized nanoparticles in HaCaT revealed significant cytotoxicity in the cultured cells with an IC50 value of 43 µg ml-1 . CONCLUSION: Stable silver nanoparticles synthesized using canthaxanthin from D. maris AURCCBT01 were found effective for application in wound healing activity. SIGNIFICANCE AND IMPACT OF THE STUDY: Biosynthesized silver nanoparticles via canthaxanthin bacterial pigment exhibited their cytotoxicity effect in HaCaT and testified their eventual therapeutic potential in the wound healing activity with no side effects in a cost effective and eco-friendly process.

The ignitability, fuel ratio and ash fusion temperatures of torrefied woody biomass.

The impact of torrefaction temperature on the ignitability, fuel ratio and ash fusion temperatures of two tropical deciduous woods (Teak and Melina) were investigated in a setup of tubular furnace. The properties considered are calorific value, fuel ratio, ignitability index, ash compositions and ash fusion temperatures of the biomass. Six different temperatures (220, 240, 260, 280, 300 and 320 °C) at 60 min reaction time were considered. The results indicated that as torrefaction temperature increased, the calorific value, fuel ratio and ignitability index of the biomass also increased. The ignitability index of biomass (40-63) was better than the value (35) recommended for fuel applicable in thermal plants for power generation. The ash compositional analysis revealed that there was no variation in the quantity of SiO2, Al2O3, CaO along with other minerals for the raw and torrefied biomass. This implied that the temperature up to 320 °C has no significant impact on the compositions of biomass ash during torrefaction. The ash fusion temperature test showed that the biomass ash softens at ≈ 1200 °C and finally fused at ≈ 1300 °C. The study concluded that an increase in torrefaction temperature increases the thermal properties of the torrefied biomass without affecting the compositions of biomass ash or lowering the ash fusion temperatures.

Densification of coal fines and mildly torrefied biomass into composite fuel using different organic binders.

Coal processing industries generate millions of tons of fines (<3 mm) during mining operation and are often considered as wastes. These wastes have enormous potential in serving as energy and metallurgical operation feedstock. One avenue for its use is densification into briquettes or pelletizes. Various briquetting techniques have been adopted in the past few decades; however, the main issues upfront in commercializing these techniques are significant binder cost and poor mechanical integrity. Therefore, the present study concentrates on utilizing commonly available organic binder along with pretreated biomass in developing coal fine briquettes. Briquettes were produced after initial pretreatment of the raw materials under a load of 2 tons. Briquettes were cured in an inert environment and eventually characterized for its main litmus requirements (physical properties). It was observed that pitch-molasses bonded briquettes have better physical properties leading to good mechanical integrity than briquettes produced from individual binder. The proximate, ultimate and calorific value analyses of the briquettes do not deteriorate but mildly improved compared to the raw coal fines. With a density of 1.18-1.32 g/cm3, drop to fracture that is greater than 100 (times/2 m), impact resistance index well above 6000, water resistance index of 99% and cold crushing strength of 9 MPa, pitch-molasses bonded briquettes clearly surpassed recommended physical properties benchmarked for briquettes of industrial and domestic end use. The physical properties of the briquettes favorably meet requirements as feedstock for rotary kiln direct reduced iron and COREX iron-making processes as well as fuel for thermal operations.

Brain Tumour Segmentation Using Convolutional Neural Network with Tensor Flow.

Introduction: The determination of tumour extent is a major challenging task in brain tumour planning and quantitative evaluation. Magnetic Resonance Imaging (MRI) is one of the non-invasive technique has emanated as a front- line diagnostic tool for brain tumour without ionizing radiation. Objective: Among brain tumours, gliomas are the most common aggressive, leading to a very short life expectancy in their highest grade. In the clinical practice manual segmentation is a time consuming task and their performance is highly depended on the operator's experience. Methods: This paper proposes fully automatic segmentation of brain tumour using convolutional neural network. Further, it uses high grade gilomas brain image from BRATS 2015 database. The suggested work accomplishes brain tumour segmentation using tensor flow, in which the anaconda frameworks are used to implement high level mathematical functions. The survival rates of patients are improved by early diagnosis of brain tumour. Results: Hence, the research work segments brain tumour into four classes like edema, non-enhancing tumour, enhancing tumour and necrotic tumour. Brain tumour segmentation needs to separate healthy tissues from tumour regions such as advancing tumour, necrotic core and surrounding edema. This is an essential step in diagnosis and treatment planning, both of which need to take place quickly in case of a malignancy in order to maximize the likelihood of successful treatment.

Active Contour Based Segmentation and Classification for Pleura Diseases Based on Otsu's Thresholding and Support Vector Machine (SVM)

Objective: Generally, lung cancer is the abnormal growth of cells that originates in one or both lungs. Finding the pulmonary nodule helps in the diagnosis of lung cancer in early stage and also increase the lifetime of the individual. Accurate segmentation of normal and abnormal portion in segmentation is challenging task in computer-aided diagnostics. Methods: The article proposes an innovative method to spot the cancer portion using Otsu's segmentation algorithm. It is followed by a Support Vector Machine (SVM) classifier to classify the abnormal portion of the lung image. Results: The suggested methods use the Otsu's thresholding and active contour based segmentation techniques to locate the affected lung nodule of CT images. The segmentation is followed by an SVM classifier in order to categorize the affected portion is normal or abnormal. The proposed method is suitable to provide good and accurate segmentation and classification results for complex images. Conclusion: The comparative analysis between the two segmentation methods along with SVM classifier was performed. A classification process based on active contour and SVM techniques provides better than Otsu's segmentation for complex lung images.

Effect of Interaction Between Duration of Alcohol Consumption and Alcohol Dependence on Thyroid Function Test: Cross Sectional Observational Study.

Dependence on alcohol, nicotine and duration of alcohol consumption are known to alter thyroid function tests. This study was conducted to assess the effect of interaction between the duration of alcohol consumption and alcohol dependence on TFT. The subjects consisted of 38 male patients with alcohol dependent syndrome co morbid with nicotine dependent syndrome, 33 male patients with alcohol dependent syndrome and 30 male normal healthy volunteers. Liver function tests, haematological parameters and thyroid function tests were assayed. Two way multivariate ANOVA was used to assess the interaction effect by SPSS 21 package. Multivariate analysis of combined TFT levels revealed no significant (P = .078) difference amongst groups based on alcohol dependence, significant difference (P = .001) amongst groups based on duration of alcohol consumption and no significant (P = .604) interaction effect between duration of alcohol consumption and alcohol dependence. Tests of between subject effects for individual TFT revealed significant (P = .014) difference in T3 between groups based on alcohol dependence, significant difference in the levels of fT4 (P = .001), T3 (P = .07) and T4 (P < .001) between groups based on duration of alcohol consumption was observed. Interaction between the effect of duration of alcohol consumption and alcohol dependence for individual TFT did not reveal any significance. fT4, TSH and T4 levels were significantly low in persons consuming alcohol for more than 20 years. TSH levels were significantly low in ADS compared to controls. Significant decrease in the levels of thyroid hormones was observed as the duration of alcohol consumption increased.

Degradation of organic pollutants by Ag, Cu and Sn doped waste non-metallic printed circuit boards.

The disposal and reuse of waste printed circuit boards have been the major global concerns. Printed circuit boards, a form of Electronic waste (hereafter e-waste), have been chemically processed, doped with Ag+, Cu2+ and Sn2+, and used as visible light photocatalysts against the degradation of methylene blue and methyl violet. The elemental analyses of pristine and metal doped printed circuit board were obtained using energy dispersive X-ray fluorescence (EDXRF) spectra and inductively coupled plasma optical emission spectroscopy (ICP-OES). The morphology of parent and doped printed circuit board was obtained from scanning electron microscopy (SEM) measurements. The photocatalytic activity of parent and metal doped samples was carried out for the decomposition of organic pollutants, methylene blue and methyl violet, under visible light irradiation. Metal doped waste printed circuit boards (WPCBs) have shown higher photocatalytic activity against the degradation of methyl violet and methylene blue under visible light irradiation. Scavenger experiments were performed to identify the reactive intermediates responsible for the degradation of methylene blue and methyl violet. The reactive species responsible for the degradation of MV and MB were found to be holes and hydroxyl radicals. A possible mechanism of degradation of methylene blue and methyl violet is given. The stability and reusability of the catalysts are also investigated.

Effect of Oestrogen on Altering the Serum and Urinary Levels of Calcium, Phosphate and Magnesium in Hysterectomised Women Compared to Natural Menopausal South Indian Women: A Case Control Study.

Given the paucity of studies conducted to know the effect of suddenness and earlier onset of endocrinological changes associated with hysterectomy, on the serum and urinary levels of calcium, magnesium and phosphate the present study was conducted to compare the levels of calcium, magnesium and phosphate in serum and urine of hysterectomised and natural menopausal south Indian women. This is a cross-sectional observational study. The study included three groups of 30 healthy premenopausal, 30 early surgical menopausal and 30 natural post menopausal women. Women suffering from any endocrine disease were excluded. Analysis was performed in serum and urine sample. The levels of calcium, magnesium and phosphate in serum and calcium/creatinine, magnesium/creatinine and phosphate/creatinine ratio were estimated in urine by spectrophotometric method. Hysterectomised women (serum calcium: 8.7 ± 0.09 mg/dl; urine calcium/creatinine: 0.16 ± 0.02) have significantly low serum calcium (p < 0.001) and high urinary calcium/creatinine (p = 0.002) ratio and post menopausal women (serum magnesium: 2.1 ± 0.03; serum phosphate: 4.4 ± 0.16; urinary calcium/creatinine: 0.17 ± 0.02; urinary magnesium/creatinine: 0.09 ± 0.01) have significantly high serum magnesium (p = 0.016), serum phosphate (p = 0.043) and high urinary calcium/creatinine (p = 0.002), magnesium/creatinine ratio (p = 0.025) compared to healthy pre menopausal women. Post menopausal women (serum calcium: 9.1 ± 0.08) have significantly high serum calcium and phosphate compared to hysterectomised women (serum phosphate: 3.93 ± 0.11). Hysterectomised women have significantly low serum calcium, oestrogen and high urinary calcium/creatinine ratio compared to healthy premenopausal women and low serum calcium and low serum phosphate compared to natural postmenopausal women. Natural postmenopausal women had low serum oestrogen and high serum magnesium, serum phosphate, urinary calcium creatinine ratio and urinary magnesium creatinine ratio compared to healthy premenopausal women.

Trier social stress test in Indian adolescents.

OBJECTIVE: To test the Trier Social Stress Test for children (TSST-C) in a cohort of Indian adolescents. DESIGN: Cohort study. SETTING: Holdsworth Memorial Hospital, Mysore, India. PARTICIPANTS: Adolescent children (N=273, 134 males; mean age 13.6 yrs) selected from an ongoing birth cohort; 269 completed the test. INTERVENTION: Performance of 5-minutes each of public- speaking and mental arithmetic tasks in front of two unfamiliar 'evaluators'. OUTCOME MEASURES: Salivary cortisol concentrations were measured at baseline and at regular intervals after the TSST-C. Continuous measurements of heart rate, finger blood pressure, stroke volume, cardiac output and systemic vascular resistance were carried out before, during and for 10 minutes after the TSST-C using a finger cuff. RESULTS: Cortisol concentrations [mean increment (SD): 6.1 (6.9) ng/mL], heart rate [4.6 (10.1) bpm], systolic [24.2 (11.6) mmHg] and diastolic blood pressure [16.5 (7.3) mmHg], cardiac output [0.6 (0.7) L/min], stroke volume [4.0 (5.6) mL] and systemic vascular resistance [225 (282) dyn.s/cm5] increased significantly (P<0.001) from baseline after inducing stress. CONCLUSIONS: The TSST-C produces stress responses in Indian adolescents of a sufficient magnitude to be a useful tool for examining stress physiology and its relationships to disease outcomes in this population.

An unusual case of pulmonary granulocytic sarcoma treated with combined chemotherapy and radiation.

We report an unusual case of a 6-year-old male child who presented with fever and a cough of one month's duration. A bone marrow aspiration and cytogenetics were suggestive of acute myeloid leukaemia with t(8;21)(q22;q22). A chest x-ray and computed tomography of the thorax showed a soft tissue lesion in the right lung. The fine needle aspiration cytology (FNAC) of this lesion was suggestive of pulmonary granulocytic sarcoma. The patient was successfully treated with induction chemotherapy (cytosine arabinoside + daunomycin), followed by consolidation with high-dose cytosine arabinoside. In view of the persistent lesion in the right lung, the patient was given external beam radiotherapy (EBRT), which resulted in near total resolution of the lung granulocytic sarcoma. We report this case in view of its rarity and clinical importance, and to highlight the treatment options in this scenario.

Trichomoniasis: How do we diagnose in a resource poor setting?

BACKGROUND: Diagnosis of Trichomonas vaginalis vaginalis infection based solely on clinical symptoms and signs is unreliable because the spectrum of infection is broad and other sexually transmitted pathogens cause similar signs and symptoms. AIMS: Our study was undertaken to study the frequency of T. vaginalis infection in women presenting with vaginal discharge, to characterize the clinical features, and to study the sensitivity and specificity of microbiological investigations in the diagnosis of the same. MATERIALS AND METHODS: This was a hospital-based descriptive study done on 400 female patients with vaginal discharge attending the Gynecology out-patient department (OPD) of JIPMER, Puducherry, from May 2010 to July 2011. Women of age between 20 years and 50 years presenting with vaginal discharge irrespective of marital status, were included, and detailed history was elicited and thorough examination was performed. RESULTS: In 400 women presenting with vaginal discharge from Gynecology out-patient department (OPD) included in the study, T. vaginalis infection was found in 27 (6.75%) women. The risk factors for trichomoniasis included history of pre- or extramarital sexual contact in the woman or her partner, symptomatic partner, and alcohol consumption. A positive association with pelvic inflammatory disease was also observed. The most frequent symptoms included lower abdominal pain, dysuria, and dyspareunia. Combining of Whiff test, pH > 4.5, and pus cells in Gram-stained smear, the specificity in diagnosing the infection (97.3%) approached that of the reference standard, i.e., culture. On combining wet mount with Papanicolaou smear, the sensitivity increased to 92.6%, which was higher than that individually done. CONCLUSION: To conclude, diagnosis of T. vaginalis infection based solely on clinical symptoms and signs is unreliable, and combination of simple laboratory tests increases the diagnostic performance close to the reference standard (culture), especially in resource poor settings.

Spectrum of vaginal discharge in a tertiary care setting.

INTRODUCTION: Vaginal discharge is one of the common reasons for gynecological consultation. Many of the causes of vaginitis have a disturbed vaginal microbial ecosystem associated with them. Effective treatment of vaginal discharge requires that the etiologic diagnosis be established and identifying the same offers a precious input to syndromic management and provides an additional strategy for human immunodeficiency virus prevention. The present study was thus carried out to determine the various causes of vaginal discharge in a tertiary care setting. MATERIALS AND METHODS: A total of 400 women presenting with vaginal discharge of age between 20 and 50 years, irrespective of marital status were included in this study and women who had used antibiotics or vaginal medication in the previous 14 days and pregnant women were excluded. RESULTS: Of the 400 women with vaginal discharge studied, a diagnosis was established in 303 women. Infectious causes of vaginal discharge were observed in 207 (51.75%) women. Among them, bacterial vaginosis was the most common cause seen in 105 (26.25%) women. The other infections observed were candidiasis alone (61, 15.25%), trichomoniasis alone (12, 3%), mixed infections (22, 5.5%) and mucopurulent cervicitis (7 of the 130 cases looked for, 8.46%). Among the non-infectious causes, 72 (18%) women had physiological vaginal discharge and 13 (3.3%) women had cervical in situ cancers/carcinoma cervix. CONCLUSION: The pattern of infectious causes of vaginal discharge observed in our study was comparable with the other studies in India. Our study emphasizes the need for including Papanicolaou smear in the algorithm for evaluation of vaginal discharge, as it helps establish the etiology of vaginal discharge reliably and provides a valuable opportunity to screen for cervical malignancies.

Lipid peroxidation and antioxidant vitamin status in oral cavity and oropharyngeal cancer patients.

BACKGROUND: This study was conducted to determine levels of lipid peroxidation and antioxidant vitamin status in patients with oral cavity and oropharyngeal cancer. METHODS: The study group consisted of a total number of 80 subjects between the age 40-68 years, 40 with clinically and histopathologically proved cases of oral cavity and oropharyngeal cancer and 40 normal healthy, age and sex matched volunteers as controls. Levels of lipid peroxidation products as malondialdehyde (MDA) and antioxidant vitamins as vitamin A and vitamin C were estimated and compared between the two groups. RESULTS: There was a statistical significant difference in the mean MDA, plasma vitamin A and vitamin C in the oral and oropharyngeal cancer patients compared with the healthy controls (p<0.0001). CONCLUSIONS: Lipid peroxidation (MDA) is higher and plasma antioxidant vitamins like vitamin A and vitamin C were lower in oral cavity and oropharyngeal cancer patients than healthy controls.

Preparation, characterization and dielectric studies on carbonyl iron/cellulose acetate hydrogen phthalate core/shell nanoparticles for drug delivery applications.

A method to prepare composite colloidal nanoparticles, consisting of a magnetic core (carbonyl iron) and a biodegradable polymeric shell (cellulose acetate hydrogen phthalate) was described and also particle size was characterized by Optical Microscope and Scanning Electron Microscopy. Dielectric properties of Cellulose Acetate Hydrogen Phthalate (CAP) and carbonyl iron/CAP (core/shell) tablets were studied in the frequency range of 70 Hz-400 kHz at 300 K using LCR meter and compared the dielectric parameters of core/shell and ordinary phase of CAP tablets. From the dielectric results, the importance of core/shell nanoparticles in controlled drug delivery was discussed.

Laboratory-based dengue fever surveillance in Tamil Nadu, India.

Dengue fever and dengue haemorrhagic fever (DF/DHF) have become a serious public health problem in many parts of India in recent years. Several vertical national programmes for communicable diseases, which include vector-borne diseases such as malaria and filariasis have been in operation for over five decades in India. The remarkable increase in dengue fever and DHF related deaths during the last decade has necessitated an effective surveillance system to detect the cases and adopt appropriate control measures against dengue vectors. Although the existence of all the four serotypes of dengue virus was proved as early as in 1960s, it was only after 1990, several outbreaks of DF/DHF were reported in Tamil Nadu. Further, dengue, once considered as urban problem has now penetrated into rural areas also, due to various changes in the environment. The geographic spread, increase in number of cases, reporting system, laboratory diagnosis, monitoring of vector density and investigation of outbreaks in Tamil Nadu during the last decade are comprehensively documented and discussed here to further strengthen the surveillance network to prevent possible major outbreaks of DF/DHF.

Serological evidence for wide distribution of spotted fevers & typhus fever in Tamil Nadu.

BACKGROUND & OBJECTIVE: Although the re-emergence of spotted fevers and typhus was documented from southern India a few years ago, there was a paucity of community based data. Therefore a collaborative study was carried out in several districts of Tamil Nadu to understand the distribution of these infections. METHODS: Blood (3 ml) was collected from patients presenting to primary health centres (PHCs) with fever >10 days duration in 15 districts of Tamil Nadu during January 2004 to December 2005. Patients negative for malaria, were tested by Weil-Felix test. Clinical data were collected from patients visiting two hospitals. RESULTS: A total 306 samples were tested in 2004 and 115 (37.5%) had titres of >or=80 with OX K antigen, suggesting a diagnosis of scrub typhus. During 2005, 964 patients were tested and 89 (9.2%) were positive for scrub typhus. An additional 44 (4.6%) were positive for other rickettsial illnesses. In both years majority of scrub typhus occurred in individuals above 14 yr of age. Cases increased from August until the earlier part of next year. INTERPRETATION & CONCLUSION: This community based study from south India involving several districts in Tamil Nadu, showed that scrub typhus and rickettsial illnesses were widely distributed in the State. Measures to increase awareness and also to diagnose and treat this infection in the affected areas are essential.