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Aim: Determination of the plane of occlusion in completely edentulous patients with the help of the ala-tragus line (Camper′s plane) may be questioned. An attempt to devise an alternative method to determine the orientation of the plane of occlusion was made. Materials and Methods: Cephalometric analysis was used to identify whether a correlation exists between the plane of occlusion of dentulous Indian individuals and other stable cranial landmarks. Results: A negative correlation was found to exist between the occlusal Plane-FH plane angle and the porion-nasion-anterior nasal spine (PoNANS) angle. Conclusions: From the derived mathematical correlation, it was concluded that the angulation of the occlusal plane in completely edentulous subjects may be determined by taking a cephalogram at the diagnostic stage. Further, the clinical applicability of the derived mathematical formula (while determining the plane of occlusion) was tested on completely edentulous patients.

Partial discharge (PD) occurring in the insulation systems of the transformer is an important indicator of their deterioration. Insulation degradation is a well-known source of power transformer failure. Many methods have been realized for detection and localization of PD source in the transformer. In this paper sensor based acoustic emission technique has been implemented for PD detection. To repair site of PD after detection it is very important to find the exact location of PD sources in the equipment. This paper proposed adaptive grey wolf optimizer (AGWO) algorithm for localization of PD source using acoustic emission technique. A novel bio-inspired optimization algorithm based on the hunting process of wolves in nature called the grey wolf optimizer (GWO) Algorithm. In contrast to meta-heuristics; the main feature is randomization having a relevant role in both exploration and exploitation in the optimization problem. A novel randomization technique termed adaptive technique is integrated with GWO and exercised on unconstrained test benchmark function and optimum location of PD in the transformer. Integration of new randomization adaptive technique provides potential to AGWO algorithm to attain global optimal solution and faster convergence with less parameter dependency. AGWO solutions are evaluated and a result shows it’s competitively better performance over other optimization algorithms.

Introduction: Meningiomas comprise 24-30% of all tumours occurring in the central nervous system. Conventional morphologic critera as studied in routine Haematoxylin and Eosin stained sections (H & E) may not be accurate in grading and assessing prognosis in small stereotactic biopsy specimens. Thus, arises the need for objective methods for assessing tumour biology. Angiogenesis is a key event in the spread of tumours and denotes a poor prognosis. Intratumoural Microvessel Density (MVD) helps in quantification of angiogenesis. Aim: To measure the proliferative index by MIB-1 and correlate it with the WHO grading of meningiomas. Also to assess the expression of CD34 in various grades of meningioma and evaluate their angiogenic potential by calculating MVD. Materials and Methods: Paraffin blocks of 30 surgically resected cases, 10 each of grade I, II and III meningiomas were reviewed. Tumours were graded and subtyped as per WHO criteria. Immunohistochemical staining was done with MIB-1 and CD 34 antibodies. Statistical analysis was performed using Mann – Whitney U test. p-value of < 0.05 was considered significant. Results: The male to female ratio overall was 1:1. The age of the patients ranged from 18-81 years. A 73% of patients had raised intracranial pressure and 18.4% of patients presented with seizures. The mean ± SD MIB-1 LI was 1.14 ± 0.84, 8.94 ± 2.73 and 35.62 ± 4.44 in grade I, II and III tumours respectively which was statistically significant. (p< 0.01). The mean ± SD MVD was 49.67 ± 22.35, 41.37 ± 7.45 and 47.86 ± 10.77 respectively in grade I, II and III tumours (p NS). Conclusion: MIB-1 LI is an important complementary tool to accurately grade meningothelial tumours and assess tumour biology. Specific cycling endothelial markers along with CD 34 & MVD could be used to assess the prognosis of these tumours.

Background: Transthoracic fine needle aspiration cytology (FNAC) is an established and safe technique for diagnosis of thoracic mass lesions. Computed tomography (CT) scan depicts clear anatomical details and provides access to any area of the body. It is, however, expensive and the needle is not passed in real time. Ultrasound is cheaper, radiation free, and allows real time monitoring. Its limitations are obscurement of lesions by aerated lung, smaller, deep seated, and cavitary lesions. Aims: This study aims to compare sensitivity and specificity of CT scan and ultrasonography (USG) in thoracic FNAC. Materials and Methods: The study was conducted on patients who presented with thoracic mass lesions in lungs, mediastinum, hilar lymph nodes, thoracic vertebrae, paraspinal soft tissue, and pleura. One hundred and twenty patients were studied. Only those cases in which sonographic guidance was not possible were taken up for CT guided FNAC. The lesions were assigned to benign and malignant categories and into specific diagnoses where possible. Biopsy correlation was available in 113 cases. Patients were lost to follow-up in five lung and two mediastinal masses. Statistical Analysis: Statistical tests applied included diagnostic tests for sensitivity and specificity. Results: An accuracy of 70.8% was found for image guided FNACs with a sensitivity and specificity of 92.2% and 100%, respectively. CT had a sensitivity of 93.2% and specificity of 100%. For USG guidance, the same was 91.3% and 100%, respectively. Conclusions: Precision of USG and CT scan is comparable for guidance in FNAC from thoracic mass lesions.

Paragonimiasis is a food-borne parasitic zoonosis caused by the genus Paragonimus. Fresh water snails, crabs, and crayfish are the first and second intermediate hosts, respectively. Humans acquire this infection by ingesting uncooked/undercooked crustaceans. Laboratory diagnosis of Paragonimiasis is done by demonstration of ova in the sputum/feces/pleural fluid or by serology. A case of pulmonary Paragonimiasis is presented herewith; the patient having been diagnosed with pulmonary tuberculosis earlier. The aim of this presentation is to highlight this entity so that it is considered in the differential diagnosis in a case of hemoptysis.

Carcinosarcoma (CS) or Sarcomatoid carcinoma (SC) of the prostate is a very rare malignant tumor of the prostate having an aggressive clinical course and dismal prognosis. The adenocarcinomatous element is usually of the acinar type and closely admixed with a sarcomatous component. We report a case of α-methyl-CoA-racemase (AMACR)-negative pseudohyperplastic variant of adenocarcinoma in CS. To the best of our knowledge, there have been no published case reports of this variant in CS till date. An accurate diagnosis is essential as this uncommon, aggressive cancer has limited therapeutic options

Background: Celiac disease is an autoimmune disorder caused by the ingestion of wheat gluten and related proteins in genetically susceptible individuals. It is characterized by anti-tissue transglutaminase (anti-tTG) antibodies. Duodenal biopsy is the gold standard for diagnosis. Correlation of clinical, serologic, and histological features is essential for a definitive diagnosis. The ratio of diagnosed versus undiagnosed cases is quite high. Aims: This study aimed to correlate the degree of mucosal damage with anti-tTG levels, mean baseline hemoglobin and endoscopic findings. Setting and Design: Two hundred twenty six adults suspected to have celiac disease were studied. Marsh grades were compared with anti-tTG levels, hemoglobin, endoscopy, and clinical presentations. Materials and Methods: Esophagogastroduodenoscopy, serum levels of anti-tTG, complete hematologic work-up, and duodenal biopsy were performed in all 226 cases (including three siblings of confirmed patients) with well-defined symptom groups. Histopathological grading was done as per modified Marsh system. Correlation of all the parameters was performed with Marsh grades. Statistical Analysis : Performed on SPSS version 15.0. Tests applied include one way ANOVA, Chi-square test, repeated measure analysis, and Bonferroni′s method for comparison. Results were considered significant when P

Background : Breast carcinoma is the most common malignancy globally. Cytological evaluation in breast lesions is largely subjective. Gradual progression of cells from normal to invasive involves nuclear changes that need to be viewed objectively. Aims : This study aims to apply nuclear morphometry on cytological breast aspirates. It evaluates its utility in differentiating benign vs. malignant lesions and correlates it with cytologic grading in malignant cases. Setting and Design : Nuclear morphometric parameters of malignant and benign cases were compared. Parameters of malignant cases were correlated with cytologic grading. Materials and Methods : Cytology was used to categorize aspirates from breast lumps into malignant (53 cases) and benign (29 cases). One hundred cells per case in both groups were mapped on DEBEL Cytoscan and six geometrical and three textural parameters obtained were compared. In malignant cases, morphometry was correlated with Robinson′s cytologic grading, which was further correlated in tissue sections (45 cases) with modified Scarff-Bloom-Richardson histologic grading. Statistical Analysis : Students "t"-test was applied for comparison between benign and malignant cases. One-way ANOVA followed by Bonferroni′s post hoc comparison was applied to compare the three cytologic grades. Results were considered significant when PResults : Nuclear morphometry successfully differentiated between benign and malignant aspirates and correlated significantly with cytologic grades. Morphometry was especially useful in the diagnosis of atypical ductal hyperplasia and ductal carcinoma in situ. Useful parameters were mean nuclear area, long axis, short axis and total run length. Cytohistologic correlation was 83.3%, 88.9% and 88.9% for cytological grades 1, 2 and 3 respectively. Conclusions : Nuclear morphometry was thus a useful objective tool in the evaluation of breast masses.

The systemic immune-inflammation index (SII) is a novel parameter and its role in the prognosis of sepsis has never been explored previously. We retrospectively assessed 267 patients with blood-culture confirmed sepsis. Clinical and laboratory data recorded at intensive care unit (ICU) admission were analyzed. Outcomes of interest included in-hospital mortality and length-of-stay (LOS) in the ICU. Sequential Organ Failure Assessment (SOFA) scores, SII, neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) were calculated. Multivariable regression analysis was used to identify independent predictors of LOS and mortality. Area under receiver operator characteristic (AUROC) curves were used to determine optimum cutoffs, and the incremental effect of SII on the SOFA score was assessed using model discrimination and calibration properties. There were 76 (28.5%) non-survivors. SII, NLR, and PLR were independent predictors of sepsis mortality, with adjusted odds ratios of 1.51 (1.24–1.84), 1.67 (1.30–2.13) and 1.24 (1.11–1.39). SII and SOFA score were independent predictors of LOS. SII had an AUROC of 0.848, and the optimum cutoff was 564 with a sensitivity and specificity of 85.5% and 71.2%. The addition of SII to the model had a significant incremental effect on the predictive ability of SOFA score (Net Reclassification Index = 0.084, P = 0.025; Integrated Discrimination Index = 0.056, P = 0.001). The SII is an inexpensive parameter that can be used in addition to clinical sepsis scores to improve the accuracy of patient assessment. [ABSTRACT FROM AUTHOR]

Preservation of fertility is an important issue in the management of young cancer patients. Though embryo cryostorage is a well-established procedure, it can only be availed by couples. Recent studies have indicated increasing success rates with mature and immature oocyte cryopreservation. Cryostorage induces injuries on the human oocytes which can be minimized by slow freezing and vitrification. Selection of candiidates is crucial so that the most suitable technique can be offered without any delay in initiation of cancer therapy. Factors affecting suitability are age of patient, assessment of ovarian reserve, hormonal status and type and stage of neoplastic disease. Encouraging results have been obtained with oocyte in vitro maturation (IVM) followed by vitrification for cryostorage. Data on the use of vitrified eggs in routine in vitro fertilization (IVF) show that pregnancy rates can be comparable to those achieved with fresh oocytes.

Adenomatous polyps of the stomach are rare tumors and comprise