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Ge–Sb–Se–Te chalcogenides, namely Se-substituted Ge–Sb–Te, have been developed as an alternative optical phase change material (PCM) with a high figure-of-merit. A need for the integration of such new PCMs onto a variety of photonic platforms has necessitated the development of fabrication processes compatible with diverse material compositions as well as substrates of varying material types, shapes, and sizes. This study explores the application of chemical solution deposition as a method capable of creating conformally coated layers and delves into the resulting modifications in the structural and optical properties of Ge–Sb–Se–Te PCMs. Specifically, we detail the solution-based deposition of Ge–Sb–Se–Te layers and present a comparative analysis with those deposited via thermal evaporation. We also discuss our ongoing endeavor to improve available choice of processing-material combinations and how to realize solution-derived high figure-of-merit optical PCM layers, which will enable a new era for the development of reconfigurable photonic devices. [ABSTRACT FROM AUTHOR]

Background: Amputation of the lower limb leads to marked physical disability and brings a significant and dramatic alteration to the patient's life. Life with a sudden disability after discharge at home is not easy for a patient who had undergone amputation both physically as well as psychologically. But how the patients perceive the period of discharge is still an untouched area in literature. Objective: To explore the concerns of the patients with lower limb amputation during transition from hospital to home. Methods: A phenomenological research study was conducted in the amputation clinic of a tertiary care center in North India. Participants were the patients who had undergone lower limb amputation after sudden trauma. The tool used was an interview schedule, which comprised of(a) personal profile of the patients and (b) in-depth interview topic guide. In-depth interviews were conducted until data saturation. After 14 interviews, no fresh responses were received, and therefore, data collection was stopped after 16 interviews. Data were analyzed using Colaizzi's method of data analysis. Results: Based on the participants' verbatim, a total of three themes and eight subthemes were extracted after data analysis. The main theme that emerged was different emotions at the time of discharge, and the subthemes extracted under this theme were "want to leave stressful environment of hospital," "feeling more secure at hospital," and "not willing for discharge--anxiety of facing society." The second theme was "unexpected hardships in the home after discharge," and subthemes extracted under this theme were "reactions of closed ones," "facing reality of practical life-unimagined difficulties," and "immediate comparison to previous healthy life." The third theme that emerged was "the bright side of amputation," and subthemes extracted under this theme were "understood the uncertainty of life" and "positive transformation in life." Conclusion: The study findings highlighted that experience of each individual is unique. Therefore, an individualized and patient-tailored approach must be used while handling such patients. Furthermore, the life at home after amputation comes with multifaceted challenges. Hence, there is a need of rendering detailed discharge information and need-based counseling at the time of discharge. [ABSTRACT FROM AUTHOR]

Histoplasmosis is an invasive mycosis caused by inhalation of the spores of dimorphic fungi Histoplasma capsulatum. The disease manifests in the lung as acute or chronic pulmonary histoplasmosis and in severe cases gets disseminated in multiple organs like skin, adrenal gland, central nervous system, lymph node, liver, spleen, bone marrow, and gastrointestinal tract. It occurs most commonly in immunodeficient patients like HIV-positive patients and transplant recipients, while immunocompetent hosts are affected rarely. In cases of gastrointestinal histoplasmosis, the samples are collected for culture and biopsy should be sent for histopathological examination for definitive diagnosis. We conducted a retrospective study of colonic biopsies performed in the department of gastroenterology in a tertiary care hospital of north India from January 2014 to December 2015. Five cases of colonic histoplasmosis were diagnosed on histopathology out of which 4 patients were from north India while 1 patient was from Myanmar. The patients presented with various complaints, including loose stools, diarrhea, altered bowel habits, and gastrointestinal bleeding. The prognosis is very good after early and aggressive treatment while the disease is fatal if it remains untreated. In our study, 2 patients died within few days of diagnosis due to delay in the diagnosis, dissemination, and associated complications. Other patients were started on amphotericin B deoxycholate and are under follow-up. An early diagnosis of gastrointestinal histoplasmosis is important as appropriate treatment leads to long-term survival while untreated cases are almost fatal. [ABSTRACT FROM AUTHOR]

We report a case of a 9-year-old girl presented to the outpatient department with abdominal pain and diagnosed as solid pseudopapillary neoplasm (SPN) with urogenital anomalies. SPN can occur in children with extrapancreatic abnormalities, especially urogenital abnormalities, so these anomalies should be looked for in children diagnosed with SPN and vice versa. [ABSTRACT FROM AUTHOR]

Objective: Histoplasmosis is an infectious disease caused by the dimorphic fungus Histoplasma capsulatum, endemic in central and eastern states of United States, South America and Africa. India is considered to be non-endemic area for histoplasmosis. Disseminated histoplasmosis may affect almost all systems. Disseminated histoplasmosis with asymptomatic adrenal involvement has been described in immunocompromised patients; whereas isolated adrenal involvement with adrenal insufficiency as the presenting manifestation of the disease is rare. Material and Method: Twelve patients from a non-endemic area with adrenal histoplasmosis, who were immunocompetent and diagnosed as adrenal histoplasmosis by cytology/histopathology between January 2012 to December 2014 were studied. 18F-FDG PET/CT (fluorodeoxyglucose positron emission tomography/computed tomography) was used to assess the extent of involvement. Results: There were a total of 12 immunocompetent males (mean age: 56.9 years). Ten patients had bilateral adrenal involvement and two had a unilateral left adrenal mass. All the patients had histopathologically/cytologically proven adrenal histoplasmosis. Two patients had simultaneous histoplasmosis of other sites, one in the epiglottis and the other in the alveolus. 18F-FDG PET/CT was performed in 10 patients showing high FDG uptake in the adrenals. All these patients received Amphotericin B and/or Itraconazole treatment that led to symptomatic improvement. Conclusion: A diagnosis of invasive fungal infection requires a high index of suspicion, especially in immunocompetent patients who present with nonspecific symptoms, clinical signs, laboratory and radiological features that can resemble adrenal neoplasms. Clinical specimens must be sent for cytopathology/histopathology together with fungal culture for a definite diagnosis and appropriate management. [ABSTRACT FROM AUTHOR]

Introduction: Collagen degradation is important both for carcinogenesis and in its progression. Research regarding the co-relation of collagen with Oral Epithelial Dysplasia (OED) and Oral Squamous Cell Carcinoma (OSCC) is less explored. Aim: To elucidate the nature of collagen in Oral Epithelial Dysplasia (OED) and Oral Squamous Cell Carcinoma (OSCC) using Picrosirius Red Stain (PSR) under polarizing microscopy. Materials and Methods: The study consisted of a total 40 samples which were divided into three groups. Group I included buccal mucosa as negative and irritation fibroma as positive control, group II consisted of OED and group III consisted of Oral Squamous Cell Carcinoma (OSCC). A histochemical analysis was conducted using PSR-polarization method by two independent observers. Results: The control group shows predominantly reddish-orange birefringence. In OED with the advancement of grades, the colour changed from yellowish-orange colour to yellowgreenish with progressive increase in greenish hue. As OSCC regresses from well to poorly differentiated, the colour changed from reddish-orange to yellowish orange to greenish-yellow suggesting a transition from mature to immature collagen. Conclusion: An observable gradual change in collagen of both OED and OSCC was noted as they were proceeding from benign to critical step. Thus, PSR is a useful tool for studying stromal changes as supporting collagen shows the transition in the form besides the alterations in epithelial cells. [ABSTRACT FROM AUTHOR]

Increasing sustainability demands of stakeholders and government regulators are driving Food Manufacturing Companies (FMCs) towards embedding sustainability practices across the entire food value chain. This is most relevant in emerging economies such as India, as the sustainable growth of the food supply chain (SC) is predominantly dependent upon its multiple tiers of suppliers. Regrettably, the most impactful tier of suppliers, which are the grass-root suppliers, lie outside the reach of the sustainable efforts of the FMC. Significantly, the incorporation of the sustainability initiatives needs consistent and coordinated efforts of all the tiers of suppliers and stakeholders, especially in the current situation where a global pandemic badly hits farmers. This can be achieved by adopting Collaborative Sustainable Practices (CSPs) for channelization of joint efforts of FMC and stakeholders towards sustainability of grass-root suppliers using supply chain practice view. However, minimal documentation exists regarding the same, and the present study intends to fill this gap. Based on a case study of an Indian flour milling company, the focus of the research work is (1) identifying CSPs that FMC can adopt, (2) ascertaining the role of interim suppliers for ensuring sustainability up to the last tier of suppliers, and (3) developing a structural model utilizing combined efficiencies of Total Interpretive Structural Modeling technique and Fuzzy-MICMAC analysis, which the FMC can adopt for effectively implementing both the traditional practices as well as the CSPs. Through the result findings, decision-makers can visualize the impact and strength of each CSP and its interactions with other CSPs. It can enable them to cascade effective managerial responses into the respective tiers of SC for successful implementation of the CSPs and transmission of sustainability benefits to include the grass root suppliers. The study provides significant theoretical implications contributing to the existing literature on sustainability in a multi-tier food SC. Further, inputs to policy formulators for enhancing sustainability of farmers are outlined. [ABSTRACT FROM AUTHOR]

Enyne diesters derived from biaryls and related substrates undergo intramolecular [2+2]‐cycloaddition and concomitant cyclo‐reversion when treated with 10 mol% In(OTf)3 in 1,2‐dichloroethane. This enyne metathesis type cycloisomerization reaction enables the synthesis of phenanthrene, benzophenanthrene, benzotetraphene and other polycyclic (hetero)aromatic compounds bearing a synthetically useful diethyl β‐(hetero)arylidene malonate moiety in a step‐ and atom‐economic manner. In(OTf)3‐catalyzed two independent intramolecular cycloisomerization on substrates 5 a and 5 b provides direct access to benzotetraphenes 6 a and 6 b containing bis(diethyl β‐phenylmethylene malonate) moiety. Tetrasubstituted vinylidene malonate 4 a, substiututed by two different aromatic groups, is stereoselectively converted into E‐ and Z‐isomer of triaryl group containing all carbon tetrasubstituted olefins (8 a, 8 a′ and 8 b) via Pd‐catalyzed stereoselective decarboxylative arylation reaction. [ABSTRACT FROM AUTHOR]

A series of 0-(4-nitrophenyl)hydroxylamines were synthesized from their respective oximes using a pulsed addition of excess NaBH3CN at pH 3 in 65--75% yield. Steric hindrance near the oxime functional group played a key role in both the ease by which the oxime could be reduced and the subsequent reactivity of the respective hydroxylamine. Reaction of the respective hydroxyiamines with pyruvic add derivatives generated the desired amides in good yields. A comparison of phenethylamine systems bearing different leaving groups revealed significant differences in the rates of these systems and suggested that the leaving group ability of the N--OR substituent plays an important role in determining their reactivity with pyruvic add. Competition experiments (in 68% DMSO/phosphate buffered saline) using 1 equiv of N-phenethyl-0-(4-nitrophenyl)hydroxylamine and 2 equiv of pyruvic acid in the presence of other nucleophiles such as glycine, cysteine, phenol, hexanoic add, and lysine demonstrated that significant chemoselectivity is present in this reaction. The results suggest that this chemoselective reaction can occur in the presence of excess α-amino acids, phenols, acids, thiols, and amines. [ABSTRACT FROM AUTHOR]

Abstract: Understanding housing submarket structure is of crucial importance to both public and private agencies. It can also help current and future homeowners make informed decisions on their residential choices. Current research on submarket focuses on comparative analyses of different classification techniques. Few studies, however, have examined the function of spatial contiguity on housing submarket classification. To address this issue, this paper developed a spatially constrained data-driven submarket classification methodology to obtain spatially integrated housing market segments. Specifically, a data-driven model based on principal component analysis and cluster analysis was developed for delineating housing submarkets. Within the model, a number of location attributes were used for principal component analysis, and the geographic locations of houses were also incorporated in the cluster analysis. The performance of this method was compared with other unconstrained data-driven techniques and a priori classifications using three measurements: substitutability, spatial integrity, and similarity. Results indicate that spatially contiguous submarkets can be obtained without compromising housing hedonic model accuracy and attribute homogeneity. [Copyright &y& Elsevier]

A 36-year-old lady presented with redness and decreased vision in right eye since 6 months. She was earlier diagnosed of cavitary lung lesion, presumed secondary to tuberculosis and treated with anti-tubercular treatment for 4 months. Examination of affected right eye revealed nil light perception, conjunctival congestion with an exuberant mass in the inferotemporal bulbar conjunctiva, proptosis, iris neovascularization, 360° closed angles, intraocular pressure of 48 mm Hg, exudative retinal detachment, uveal mass and orbital extension. A diagnostic needle biopsy of uveal mass revealed malignant cells. Computed tomography-guided lung biopsy revealed squamous cell carcinoma (SCC), indicating metastatic spread from the orbit. She underwent lid-sparing exenteration of the right eye. Histopathological examination of the orbital tissue revealed mucoepidermoid carcinoma arising from the conjunctiva with extensive invasion into the orbital tissue, muscle fibers, sclera, choroid and optic nerve. Multiple tumor emboli were seen in the lumen of orbital blood vessels. In conclusion, mucoepidermoid carcinoma of the conjunctiva is a rare, aggressive variant of SCC. Early intervention is essential to prevent intraocular invasion and systemic metastasis. [ABSTRACT FROM AUTHOR]

An etching process is demonstrated for removing noble metal from microstructures to restore their original function after being characterized by scanning electron microscopy (SEM). Using neither aggressive acids nor high temperatures, the etching method gently removes gold/palladium alloys from complex three-dimensional microstructures, preserving their structural form. To explore the efficacy of the etching process, polymeric photonic crystals and monolithic microstructures were fabricated, metal coated, etched, and then structurally and optically characterized. Metal coating substantially diminishes the optical functional and transmission of the microstructures. SEM imaging performed throughout a series of metal sputtering, etching, and resputtering shows that the etching process does not significantly alter the form of a microstructure. Measurements of optical transmission using a scanned-optical-fiber system confirm that the etchant removes the metal and restores the optical properties of the microstructures. [ABSTRACT FROM AUTHOR]

Electrically tunable optical devices present diverse functionalities for manipulating electromagnetic waves by leveraging elements capable of reversibly switching between different optical states. This adaptability in adjusting their responses to electromagnetic waves after fabrication is crucial for developing more efficient and compact optical systems for a broad range of applications, including sensing, imaging, telecommunications, and data storage. Chalcogenide‐based phase‐change materials (PCMs) have shown great promise due to their stable, nonvolatile phase transition between amorphous and crystalline states. Nonetheless, optimizing the switching parameters of PCM devices and maintaining their stable operation over thousands of cycles with minimal variation can be challenging. Herein, the critical role of PCM pattern as well as electrical pulse form in achieving reliable and stable switching is reported on, extending the operational lifetime of the device beyond 13000 switching events. To achieve this, a computer‐aided algorithm that monitors optical changes in the device and adjusts the applied voltage in accordance with the phase transformation process is developed, thereby significantly enhancing the lifetime of these reconfigurable devices. The findings reveal that patterned PCM structures show significantly higher endurance compared to blanket PCM thin films. [ABSTRACT FROM AUTHOR]

The design of multiphase optical nanocomposites necessitates the understanding of coexisting phases' morphology and chemistry which have deterministic impacts on light–matter interaction. A prominent example is gradient refractive index (GRIN) materials proposed to realize an arbitrarily shaped, single optical component with minimal chromatic aberration. Ge‐As‐Pb‐Se materials are promising for GRIN due to their ability to exhibit spatially varying volume fraction of high‐index Pb‐rich phases in low index matrices. These materials are characterized to date, exclusively using transmission electron microscopy to reveal their phase separation and induced crystalline phase(s). It is found in the study that the intrinsic 2D perspective of the technique has hindered the identification of true morphology. To clarify this ambiguity, atom probe tomography (APT) is utilized to gain the first‐ever observation of the nanocomposites' microstructure and its evolution upon heat treatment in a 3D space. The APT‐quantified geometry and chemistry of coexisting phases are considered to predict the effective media's optical behaviors which closely match experimental data, enabling the establishment of the material's predictive and accurate process–structure–property relationship. Findings in the study demonstrate the robustness and advantage of the APT‐assisted characterization in the design and realization of GRIN materials. [ABSTRACT FROM AUTHOR]

Alzheimer's Disease (AD) patients experience diverse symptoms, including memory loss, cognitive impairment, behavioral abnormalities, mood changes, and mental issues. The fundamental objective of this review is to discuss novel therapeutic approaches, with special emphasis on recently approved marketed formulations for the treatment of AD, especially Aducanumab, the first FDA approved moiety that surpasses the blood-brain barrier (BBB) and reduces amyloid plaques in the brain, thereby reducing associated cognitive decline. However, it is still in the phase IV trial and is to be completed by 2030. Other drugs such as lecanemab are also under clinical trial and has recently been approved by the FDA and is also discussed here. In this review, we also focus on active and passive immunotherapy for AD as well as several vaccines, such as amyloid-beta epitope-based vaccines, amyloid-beta DNA vaccines, and stem cell therapy for AD, which are in clinical trials. Furthermore, ongoing pre-clinical trials associated with AD and other novel strategies such as curcumin-loaded nanoparticles, Crispr/ cas9, precision medicine, as well as some emerging therapies like anti-sense therapy are also highlighted. Additionally, we discuss some off-labeled drugs like non-steroidal anti-inflammatory drugs (NSAID), anti-diabetic drugs, and lithium, which can manage symptoms of AD and different non-pharmacological approaches are also covered which can help to manage AD. In summary, we have tried to cover all the therapeutic interventions which are available for the treatment and management of AD under sections approved, clinical phase, pre-clinical phase or futuristic interventions, off-labelled drugs, and non-pharmacological interventions for AD, offering positive findings and well as challenges that remain. [Display omitted] • Alzheimer's Disease (AD) is a burden that might affect 150 million people by 2050. • This review focuses on AD interventions with examples of successes and setbacks. • Aducanumab and Lecanemab may be the next likely drugs for AD. • Use of immunotherapy, stem cells, CRISPR, and nanoparticles for AD, is reviewed. • AD strategies include treatment with drugs and without drugs (precision medicine). [ABSTRACT FROM AUTHOR]

The article discusses the case of a 61-year-old male with multiple myeloma as an unusual cause of extensive bone marrow necrosis.

Background: The assessment of lung function, particularly lung volumes and gas transfer, recorded initially upon patient presentation and subsequent follow-up evaluations, along with high-resolution computed tomography (HRCT) of the chest, can facilitate the evaluation of the natural history of the disease or provide insights to guide therapy in interstitial lung disease (ILD). The utilization of available data related to connective tissue-related ILD (CTD-ILD), gastroesophageal reflux disease (GERD), smoke exposure, as well as any potential correlation of treatment with changes in lung functions, can offer valuable insights. Objectives: The main aim of this study was to study the changes in lung functions of ILD patients over one year apart, and whatever observations could be noticed based on case record form. Methodology: The study was conducted in a Tertiary Care Centre to evaluate changes in lung functions in patients with Interstitial Lung Disease (ILD) over one-year period, specifically assessing increases or decreases in lung function values. The data was collected on ILD patients over 18 years of age who had undergone two Pulmonary Function Tests (PFTs) one year apart, between 2013 and 2015, from the PFT register available in the Centre's PFT lab. Results: This study revealed that 81.25% of patients fell within the age range of 40-70 years. Furthermore, it was found that 77.5% of the patients experienced lung function restrictions. In fact, 95% of the patients exhibited HRCT chest images consistent with Nonspecific Interstitial Pnuemonia (NSIP), while 5% displayed Usual Interstitial Pnuemonia (UIP) patterns. Additionally, within the study group, 47.75% were diagnosed with connective tissue related ILDs. Notably, patients with a history of GERD experienced a median fall in FVC of 130ml/year, compared to 170ml/year in 15 patients without GERD. Conclusion: Thus the findings of the study hold the potential to improve the clinical care and outcomes of interstitial lung disease patients. [ABSTRACT FROM AUTHOR]

Chronic myeloid leukemia (CML) is characterized by increased and unregulated proliferation of granulocytic lineage in the bone marrow and presence of these immature myeloid cells in the peripheral blood with presence of Philadelphia (Ph) chromosome. Tyrosine kinase inhibitors are the most important drugs in the CML therapy and provide long disease-free survival. Due to the increased survival of CML patients with continual administration of these drugs, the chance of development of secondary malignancies may increase. The most common secondary malignancies are prostate, colorectal and lung cancer, non-Hodgkin lymphoma, malignant melanoma, non-melanoma skin tumors and breast cancer. Herein, we are describing a rare case of Hodgkin lymphoma in a patient of CML after ten year of primary disease presentation. Hodgkin lymphoma in a known case of CML is very rare and further studies are also needed to know the pathogenic relationship between the two entities and to assess the risk of secondary Hodgkin lymphoma in CML patients treated with tyrosine kinase inhibitors. CML itself is a risk factor for development of solid cancers and hematologic malignancies. In addition, patients on chemotherapy are immune-compromised and may be at greater risk of neoplasm driven by infectious agents such as Epstein-Barr virus. [ABSTRACT FROM AUTHOR]

The reaction allows an efficient access to amides. [ABSTRACT FROM AUTHOR]

To deal with dynamic customer preferences and global competition, Medium, Small and Micro Enterprises (MSMEs) are striving to improve customer satisfaction by enhancing their process capability, optimising resource utilization and achieving cost effectiveness. Manufacturing line in MSMEs involves a number of complex processes and process variations lead to rejections of poor quality products resulting in monetary losses and customer dissatisfaction. Delivery of high quality product within constraints of manpower, machinery and other limited resources stipulates the need to improve the process performance of manufacturing line through quality management. With this perspective, the present work proposes a framework to identify and prioritize defects by integrating multicriteria decision making techniques- Fuzzy Decision Making Trial and Evaluation Laboratory and Fuzzy Analytic Network Process with Quality Management Practices. The integration filters out most influential defects prior to data collection and prioritize them to reach out to critical defects of manufacturing process. Additionally, it addresses challenges faced by management in terms of large number of defects, insufficient data on defects and dependency among selected criteria. The proposed framework is exhibited with the help of a real case study. It is practically relevant in deriving decision support solutions for improving performance of manufacturing line in MSME firms. By virtue of the results, key areas are identified to augment responsiveness to government policies and MSME's proficiency to overcome resource constraints. [ABSTRACT FROM AUTHOR]

The design of active optical devices integrating second‐order nonlinear (SONL) optical responses typically relies on the use of dielectric crystalline materials such as lithium niobate (LN) or semiconductors such as GaAs. Despite high SONL susceptibilities, these materials present important geometry constrains inherent to their crystalline nature limiting the complexity of the designed photonic systems. Conversely, amorphous materials are versatile optical media compatible with broad platform designs possessing a wide range of optical properties attributable to their composition flexibility. Demonstrated here for the first time in an amorphous inorganic material, a magnitude of SONL optical susceptibility (χ(2) = 29 pm V−1 at 1.06 µm) comparable to that of LN single crystal is reported. By using a thermo‐electrical imprinting process, fine control of the induced uniaxial anisotropy is demonstrated at the micrometer scale. This work paves the way for the future design of integrated nonlinear photonic circuits based on amorphous inorganic materials enabled by the spatially selective and high SONL optical susceptibility of these promising and novel optical materials. [ABSTRACT FROM AUTHOR]

Context: Oral exfoliative cytology is a simple, nonaggressive technique that is well accepted by patients. Therefore, it is an attractive option, which aids in the diagnosis and observation of epithelial atypias associated with oral mucosal diseases. Aims: The aim of this study was to evaluate and compare the quantitative and qualitative alterations in exfoliative smears from type 2 diabetics and healthy individuals. Patients and Methods: The study includes 30 type 2 diabetics and 30 healthy persons of both sexes. PAP and hematoxylin and eosin (H and E) stained smears were prepared from buccal mucosa (BM), tongue (T), floor of the mouth (FOM), and palate (P). Under a light microscope, 50 clearly defined unfolded epithelial cells were quantitatively evaluated for cellular area (CA), nuclear area (NA), and cellular-to-nuclear area ratio (CA:NA) and assessed for morphological features. Statistical Analysis: Collected data was manually entered into the Statistical Package for the Social Sciences version 13.5 for analysis. Student's f-test was used at 95% confidence interval. Results: Quantitative assessment of the overall mean CA was less, mean NA was more, and mean CA:NA was less in diabetics than that in healthy persons at all the four sites. Diabetic oral cells showed qualiative cytoplasmic and nuclear alterations: cytoplasmic vacuoles, karyorrhexis, karyolysis, pyknosis, peri-nuclear halo, binucleation, nuclear vacuoles, inflammation, and microbial colonies. Conclusion: Oral cytology from type 2 diabetics is associated with detectable cytomorphological changes with alteration in size of the cell and nucleus, which is site specific, indicating epithelial cell degeneration in cytoplasm and nucleus. [ABSTRACT FROM AUTHOR]

Haematogones are benign B lymphoid precursors which may mimic neoplastic lymphoblasts and pose diagnostic difficulty especially when the percentage of haematogones exceeds 10% in the bone marrow. Flow cytometric analysis with combination of CD19/CD10/CD20/CD34/CD38/CD58 can be used to differentiate the two depending upon the difference in the fluorescence intensity between blasts and haematogones. We hereby present a case of CALLA positive ALL, in which patient presented with haematogone proliferation in bone marrow after 6 months of chemotherapy mimicking relapse. The distinction was made on flow cytometric immunophenotyping by using optimal antibody combination. Distinction of benign haematogones from neoplastic lymphoblasts is essential for disease management in cases of post chemotherapy or post marrow transplant, especially in patients of ALL. Flow cytometric immunophenotyping is reliable to distinguish haematogones from residual lymphoblasts in almost all cases when optimal antibody combinations are used. [ABSTRACT FROM AUTHOR]

Background: Cytological artifacts are important to learn because an error in routine laboratory practice can bring out an erroneous result. Aims: The aim of this study was to analyze the effects of delayed fixation and morphological discrepancies created by deliberate addition of extraneous factors on the interpretation and/or diagnosis of an oral cytosmear. Materials and Methods: A prospective study was carried out using papanicolaou and hematoxylin and eosin-stained oral smears, 6 each from 66 volunteer dental students with deliberate variation in fixation delay timings, with and without changes in temperature, undue pressure while smear making and intentional addition of contaminants. The fixation delay at room temperature was carried out at an interval of every 30 minutes, 1 day and 1 week and was continued till the end of 1 day, 1 week, and 1 month, respectively. The temperature variations included 60 to 70°C and 3 to 4°C. Results: Light microscopically, the effect of delayed fixation at room temperature appeared first on cytoplasm followed by nucleus within the first 2 hours and on the 4th day, respectively, till complete cytoplasmic degeneration on the 23rd day. However, delayed fixation at variable temperature brought faster degenerative changes at higher temperature than lower temperature. Effect of extraneous factors revealed some interesting facts. Conclusions: In order to justify a cytosmear interpretation, a cytologist must be well acquainted with delayed fixation-induced cellular changes and microscopic appearances of common contaminants so as to implicate better prognosis and therapy. [ABSTRACT FROM AUTHOR]