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Lymphoepithelial carcinoma (LEC) is an entity mostly frequent in the nasopharynx, which represents 40% of all neoplasms. The incidence’s not exclusive of a geographic area; however, it has an endemic distribution in Southeast Asia and Eskimos. LEC is not exclusive of the nasopharynx, has also been reported in other anatomical areas, such as the sinonasal tract, nasolacrimal duct, oral cavity, oropharynx, salivary glands, thymus, hypopharynx, oesophagus, stomach, trachea, lung and others. Non-nasopharyngeal and nasopharyngeal LEC have the same microscopic features, but the nasopharyngeal is more likely associated with Epstein-Barr virus. LEC has been approved by the WHO. LEC located in the larynx is quite rare and worthy of attention for its implication in the treatment and prognosis. We present a case of LEC treated in our ENT department in a middle-aged man.

Kikuchi disease is a rare, benign condition of unknown aetiology, which usually involves young women and is characterised by cervical lymphadenopathy and fever. Herein, we are reporting a case of a young Asian woman, who presented with fever and lymphadenopathy raising possibility of either infection or malignancy but after appropriate clinical investigations including lymph node biopsy, it turned out to be Kikuchi disease. She made an uneventful complete recovery with only symptomatic treatment.

BACKGROUND Vitamin A deficiency (VAD) and anemia are the most prevalent nutritional deficiency in children globally. The dried blood spot (DBS) method has been used in prevalence studies of VAD and anemia in different age groups. However, it has not yet been validated for children. OBJECTIVES This study aimed to assess the reproducibility and validity of DBS in the diagnosis of VAD and anemia in preschoolers. METHODS Venous and capillary blood samples were collected from a representative sample of children

Проведено комплексне обстеження 30 дітей, хворих на позалікарняну пневмонію, віком від 2 місяців до 3 років, серед яких у 18 дітей захворювання було викликано Streptococcus pneumoniae, а в інших 12 пацієнтів — грамнегативною флорою. Всім дітям проводилася оцінка тяжкості стану за шкалою PRESS, за результатами якої встановлено, що перебіг пневмонії пневмококової етіології в більшості випадків був тяжким. Проведений аналіз показав, що розвиток пневмококової пневмонії у дітей на відміну від пневмоній, етіологічним чинником яких були грамнегативні патогени, відбувався на фоні зниження вмісту в сироватці крові метаболітів вітаміну D та активності антимікробних пептидів. В сироватці крові дітей з пневмококовою пневмонією встановлено зниження вмісту β1-дефензину в 2,6 раза, LL-37 — в 3,7 раза та hBPI — в 2,8 раза порівняно з контрольною групою (р < 0,05). Доведено, що недостатня активація антимікробних пептидів на фоні дефіциту метаболітів вітаміну D у дітей раннього віку, хворих на пневмонію, викликану Streptococcus pneumoniae, є однією з патогенетичних ланок, що призводить до тяжкого перебігу захворювання.

В данном обзоре представлены результаты изучения проблемы сочетанной патологии желудочно-кишечного тракта и щитовидной железы, возможные механизмы развития и перспективы последующего использования полученных результатов. Вопрос сочетанной гастротиреоидной патологии активно изучается как отечественными, так и зарубежными исследователями. Приведены результаты мета­анализов и собственных исследований, которые подтверждают возможную взаимообусловленность и взаимозависимость развития сочетанной патологии желудочно-кишечного тракта и щитовидной железы.

Blue nevus (BN) is a blue- or black-colored benign melanocytic proliferation that commonly occurs on the dorsal surface of the hands and feet or in the head and neck region. However, BN arising from the sinonasal mucosa is extremely rare. BN is usually asymptomatic and small in size. Based on the pigmentation of BN, sinonasal malignant melanoma should be considered in the differential diagnosis of BNs in this region. We herein report a case of BN of the nasal septum. Histopathologic examination revealed the presence of heavily pigmented, spindle-shaped melanocytic cells within the stromal tissue. On immunohistochemical analysis, BN cells were positive for S-100 and HMB-45. Due to the few reported cases of sinonasal BN and challenging location, complete resection, biopsy, and adequate follow-up are recommended.

Cervical cancer is second most frequent cancer of women in the world. HPV infection is now a well established cause of cervical cancer . Currently used screening programmes are detecting cases in which only 15-20 percent of women found to have an abnormality signicant enough to need treatment, other 80-85 percent were probably false alarms. The oncogenic process in cervical cancer is initiated and mediated by upregulation of E6/E7 mRNA proteins and their over expression. So HPV E6 mRNA detection as a triage test could actually detect a neoplastic transformation and may help to reduce the false alarms. To compare the expression of HPV E6 mRN AIMS AND OBJECTIVES : A verses the HPV DNA as a biomarker in the screening of cervical cancer .Biopsy is used as gold standard for screening. This a prospective MATERIALSAND METHODS: study conducted in Institute of Social Obstetrics and Govt. Kasturba Gandhi hospital, Madras medical college, 41 cases positive for VIA/VILI in colposcopy were selected and subjected to conventional cytology and cervical biopsy ,part of biopsy was collected in RNA later solution and were typed for HPV DNA 16& 18,HPV E6mRNA Expression.the results of above test are compared with histopathology as gold standard. RESULTS: The specicity of E6 mRNA was 100% for both high grade and low grade lesions.But the sensitivity was less than HPV DNA and cytology for both low and high grade lesions.With increasing severity of lesion expression of E6 mRNA was found to increase. Low positivity CONCLUSION: rate and the high specicity makes E6 mRNA better biomarker in a screening of cervical cancer.

Invasive meningococcal infection is a significant cause of death, reaching 80% in septic shock. The Pediatric Research and Clinical Center for Infectious Diseases (PRCCID) has developed an algorithm for the treatment of children with invasive meningococcal infection with refractory septic shock and multiple organ failure syndrome, which includes basic drug therapy with polymyxin hemoperfusion in combination with extended methods of extracorporeal hemocorrection.Purpose: to evaluate the effectiveness of extracorporeal hemocorrection operations in children with invasive meningococcal infection with refractory septic shock and multiple organ failure syndrome.Materials and research methods: to the intensive care unit of the PRCCID for the analyzed period 2006—2020 34 children were hospitalized with invasive meningococcal infection with refractory septic shock and multiple organ failure syndrome. Two groups were formed: Group 1 — children admitted to the PRCCID in the period 2014—2020 (n = 23), who underwent polymyxin hemoperfusion simultaneously with extended methods of extracorporeal hemocorrection, group 2 — children hospitalized in 2006—201 3 (n = 1 1), methods of extracorporeal hemocorrection were not performed. The Mann-Whitney U-test and ANOVA were used to evaluate the results.Results and discussion: the use of extracorporeal hemocorrection operations in the complex therapy of invasive forms of meningococcal infection with refractory septic shock and multiple organ failure syndrome in children provides stabilization of central hemodynamics, reduces clinical and laboratory inflammatory reactions, helps to reduce the dose of vasopressor drugs and parameters of respiratory support, and also increases patient survival rate by 82.6%.

Objectives Knowledge of possible drug-laboratory test interactions (DLTIs) is important for the interpretation of laboratory test results. Failure to recognize these interactions may lead to misinterpretation, a delayed or erroneous diagnosis, or unnecessary extra diagnostic tests or therapy, which may harm patients. The aim of this multicentre survey was to evaluate the clinical value of DLTI alerts. Methods A survey was designed with six predefined clinical cases selected from the clinical laboratory practice with a potential DLTI. Physicians from several departments, including internal medicine, cardiology, intensive care, surgery and geriatrics in six participating hospitals were recruited to fill in the survey. The survey addressed their knowledge of DLTIs, motivation to receive an alert and opinion on the potential influence on medical decision making. Results A total of 210 physicians completed the survey. Of these respondents 93% had a positive attitude towards receiving DLTI alerts; however, the reported value differed per case and per respondent’s background. In each clinical case, medical decision making was influenced as a consequence of the reported DLTI message (ranging from 3 to 45% of respondents per case). Conclusions In this multicentre survey, most physicians stated DLTI messages to be useful in laboratory test interpretation. Medical decision making was influenced by reporting DLTI alerts in each case. Alerts should be adjusted according to the needs and preferences of the receiving physicians.

POINTS CLES Un homme de 24 ans a consulte son medecin de famille parce qu’il presentait depuis la veille des symptomes subjectifs de fievre, des frissons, une cephalee, une myalgie, une arthralgie et une diarrhee legere; le medecin lui a conseille de se rendre au service des urgences

Background: Pleural fluid cytology is a useful diagnostic test to detect metastasis to pleura. Among the metastatic neoplasms to pleural cavity adenocarcinoma is the most common. However there are other neoplasms which rarely infiltrate pleura and produce effusion. The aim of this study is to analyse the spectrum of these unusual malignancies involving pleural fluid with cytomorphology and ancillary studies. Materials and Methods: This is a retrospective study which includes the pleural fluid samples submitted to the cytology section of our institute between 2015 to 2018. A total of 1510 samples are reviewed. Cases with diagnosis other than adenocarcinoma are selected and their cytomorphological details are analysed with ancillary tests wherever available. Results: Out of 1510 samples analysed, 468 are positive for malignancy. Out of 468, 42 cases are uncommon malignancies. These are classified into hematolymphoid (33/42 cases) which includes Nonhodgkin lyphoma, acute lymphoblastic leukemia, chronic myeloid leukemia, multiple myeloma and nonhematolymphoid neoplasms (9 /42) which includes small round cell tumours, squamous cell carcinoma, small cell carcinoma, germ cell tumor and granulosa cell tumour. Conclusion: There are certain uncommonly encountered malignancies in pleural fluid. Cytomorphology plays a key role in diagnosing them with certain cases requiring ancillary studies to confirm the diagnosis. Keywords: Pleural fluid, Uncommon malignancies, Adenocarcinoma, Cytomorphology.

Objectives We review how the pandemic-related education disruption may interplay with pathology manpower worldwide and shifts in disease burden to identify workable solutions. Methods Literature related to pathology education, pathology services in low-resource settings, and application of digital tools to pathology education was reviewed for trends and training gaps. Publications covering pathology manpower and cancer incidence worldwide were also included to assess needs. Results Pandemic-related virtual teaching has produced abundant online training materials. Pathology learning resources in low- to middle-income countries remain considerably constrained and dampen pathology manpower growth to meet current needs. Projected increases in disease burden toward the developing world thus pose a major challenge. Digital pathology resources have expanded and are beginning to appear beyond the developed countries. Conclusions This circumstance offers a unique opportunity to leverage digital teaching resources to enhance and equitize training internationally, potentially sufficient to meet the rising wave of noncommunicable diseases. We propose four next steps to take advantage of the current opportunity: curate and organize digital training materials, invest in the digital pathology infrastructure for education and clinical care, expand student exposure to pathology through virtual electives, and develop further competency-based certification pathways.

Author(s): Finnin, Daniel; Hanowitz, Christopher | Abstract: Introduction: Human granulocytic anaplasmosis is a tick-borne disease with an increasing incidence associated with morbidity and mortality. Uncertainty remains whether a prophylactic dose of doxycycline is effective in prevention.Case Report: We present a case of an 80-year-old female with syncope, resultant facial trauma, and fever two weeks after a tick bite for which she received prophylaxis. Workup revealed anaplasmosis, and treatment led to symptomatic improvement.Conclusion: We review the presenting symptoms, laboratory findings, and treatment of anaplasmosis, as well as give caution about the limitations in prescribing a prophylactic dose of doxycycline following a tick bite.

Background Atypical cellular features are commonly encountered in patients with indeterminate biliary strictures, which are nondiagnostic of malignancy yet cannot rule it out. This study aims to identify clinical features that could discriminate patients with indeterminate biliary strictures and atypical biliary cytology who may harbor underlying malignancy. Methods All patients with an indeterminate biliary stricture and an atypical brush cytology obtained during endoscopic brushings were identified in a large tertiary-care center. Demographical information, clinical data and the final pathological diagnosis were collected. The study cohort was divided based on the final diagnosis into benign and malignant groups. Descriptive and multivariable analyses were performed. Results A total of 151 patients were included in the analysis. Of these, 62.9% were males with mean age of 61.7 ± 16.4 years. Overall, there was an almost equal distribution of patients in the benign and malignant groups. Older age (≥65 years), jaundice, weight loss, intrahepatic biliary and pancreatic duct dilation, double-duct sign and presence of a mass were associated with malignancy in the univariate analysis. However, only older age (odds ratio [OR] 1.02, 95% confidence interval [CI] 1.00 to 1.03), jaundice (OR 3.33, 95% CI 1.11 to 9.98) and presence of a mass (OR 12.10, 95% CI 4.94 to 29.67) were significantly associated with malignancy in the multivariate analysis. High CA19-9 was associated with malignancy only in patients with primary sclerosing cholangitis. Conclusion In patients with indeterminate biliary stricture and atypical brush cytology, older age, jaundice and presence of a mass are significant predictors of malignancy. Patients with such characteristics need prompt evaluation to rule out underlying malignancy.

Lung cancer is the biggest challenge in the research world. Blood samples for lung cancer patients are significant for the prediction method in the research environment. Accurate prediction is essential to increase the survival period and may help to take proper medication. The feature selection is an essential part of this prediction system. In this method, the essential features are analyzed from lung cancer patient’s blood. Biomarkers can be identified from blood and other tests. Biomarkers are used in many scientific fields. The Serum CKAP4 levels were analyzed from lung cancer patient’s blood at the TNM stages. White blood counts and Hemoglobin are viewed as an analysis of immunity, and CKAP4 is located at an immunity level that has been recognized in the body fluid of patients with lung cancer. The system is analyzed immunity from collected real health information by a proposed Gaussian Kb Ensemble Weighting Classifier method. The novel attributes are composed of a cancer research center and cancer sanatoriums. The measurement of weighting value {low = 0, high = 1} of blood in Serum CKAP4, Hemoglobin, and the WBC are classified by immunity range. High immunity people’s survival rate is high at TNM stage 1. If not, high immunity was survival rate is low at TNM stage 1. Lung cancer patient’s survivability classification was performed by various supervised machine learning models such as Ada boost, neural networks, and SVM model. The Gaussian Kb Ensemble Weighting Classifier method helped to improve the classification accuracy by feature selection and the algorithm was implemented in the MATLAB environment. Kaplan–Meier curve method used to analyzes results. The classified labels are compared with existing results. The area proved the Gaussian Kb Ensemble weighting classifier algorithm under the Curve through the ROC method.

The purpose of the study was to determine the effect of Yersinia pestis EV NIIEG on the process of neutrophil extracellular traps formation in vivo when modeling plague infection and assess their contribution to antiplague protection.Materials and methods. BALB/c mice, which were immunized subcutaneously with the Y. pestis EV NIIEG vaccine strain, were used in the study. Animals were infected with a virulent strain Y. pestis 231 at a dose of 20 LD50 (103 CFU). To evaluate the contribution of neutrophil extracellular traps (NETs) to antibacterial protection, an experimental model was used based on fermenting NETs in the abdominal cavity of mice with nuclease. To calculate the number of NETs in peritoneal exudate (PE) fluorescent microscopy was applied. Phagocytic activity of PE cells was determined by flow cytometry. Bactericidal effect of NETs was recorded using bacteriological method.Results and discussion. In pre-immunized mice, the process of NETs formation in response to the reintroduction of plague microbe living cells was 5 times more intense than in intact animals and was accompanied by a significant increase in the killing of Y. pestis cells in PE. The use of micrococcus nuclease in the experiment for fermentation of the NETs, produced in the body of immunized animals, provided evidence of NET participation in conferring anti-infective protection against plague infection. Thus, the established fact of the NET formation in case of Y. pestis infection of mice immunized with Y. pestis EV NIIEG vaccine strain and the influence of this process on the effectiveness of protection against plague is the basis for further clarifying the immunopathogenetic role of neutrophil granulocytes in plague.

The use of the cell block in the cytology laboratory can be a routine procedure, having an important role in establishing the diagnosis and also in performing additional tests without the need for additional sampling of biological material. Numerous attempts have been made to modify and improve the cell block over the years, however, obtaining a cell block from a fluid biological product is a current challenge because lack of cell adhesion to a tissue remains the most common reason for dissatisfaction among cytopathologists. Although various methods for obtaining cell blocks have been proposed and described in the literature, it is noted that each of them has a disadvantage, in addition to advantages. Thus, in this study we propose a new method that eliminates in turn the disadvantages of other methods, obtaining an increase in cell densities, can apply additional testing applications, while minimizing laboratory costs.

We examined 66 women who were 22-40 weeks pregnant and their newborns. Of these, 15 women with moderate PE were in group 1, 22 women with severe PE were in group 2, and 55 women with uncomplicated pregnancy without hypertensive disorders were in the control group. Blood was taken from women when they were admitted to the clinic, and newborns ‘ blood was taken for 3-5 days of life. Free radical oxidation and antioxidant activity were evaluated by induced chemiluminescence. It was found that in patients with severe and moderate preeclampsia, the development of oxidative stress is accompanied by a weakening of antioxidant activity. In newborns born to mothers with preeclampsia, oxidative stress is accompanied by a compensatory increase in antioxidant activity.

Context.— The College of American Pathologists surveys provide national benchmarks of pathology practice for laboratories. Objective.— To investigate breast fine-needle aspiration (FNA) biopsy practice in domestic and international laboratories in 2019. Design.— We analyzed data from the College of American Pathologists Breast FNA Practice Supplemental Questionnaire that was distributed to laboratories participating in the 2019 College of American Pathologists Non-Gynecologic Cytopathology Education Program. Results.— Sixty-one percent (499 of 816) of respondent laboratories routinely evaluated breast FNAs. Cystic lesions were the most common indication, and radiologists primarily performed FNAs in most settings. Forty-five percent (220 of 491) of laboratories performed ancillary studies on breast FNA samples, but 33.8% (70 of 207) did not report fixation time for breast biomarker studies. Only 54.5% (271 of 497) of laboratories had a standardized reporting system and only 16.8% (82 of 488) were aware of the International Academy of Cytology Yokohama Breast FNA Biopsy Cytology Reporting System. There were significant differences among different types of institutions in several aspects of breast FNA practice, including frequency of concurrent FNA and core needle biopsy for the same lesion, primary personnel who performed the FNA, etc. Significant differences existed between domestic and international laboratories in slide preparation, ancillary studies, fixation time reporting, standardized/descriptive diagnosis, and International Academy of Cytology Yokohama Reporting System awareness. Conclusions.— This is the first survey from the College of American Pathologists Cytopathology Committee to investigate breast FNA practices. The data reveal significant differences in breast FNA practice among different types of institutions and between domestic and international laboratories, and provide a baseline for future breast FNA studies in a variety of practice settings.

Spindle cell carcinoma of the salivary gland is very rare. Spindle cell carcinoma is a variant of squamous cell carcinoma with an aggressive course. We present a rare case of spindle cell carcinoma of the parotid in a 54-year-old male, who presented with a rapidly enlarging mass in the right parotid gland. Histopathologically, the tumour was composed of foci of squamous cell carcinoma with sheets of malignant squamoid cells and spindle cell sarcoma with scattered pleomorphic, plump to spindle- shaped cells with foci of bone formation. Immunohistochemical studies revealed cytokeratin positivity and vimentin negativity in the squamous cell carcinoma component with focal positivity for epithelial membrane antigen and negative expression of cytokeratin and vimentin positivity in the sarcomatoid component. A final diagnosis of primary spindle cell carcinoma of the parotid gland was given. Our patient is alive and well with no clinical or radiological evidence of recurrence or metastatic disease after 12 months of follow up period. Keywords: Salivary gland, Spindle cell carcinoma, Histopathology, Immunohistochemistry.

The main reason for the development of neonatal hypoxic-ischemic encephalopathy is inadequate oxygen supply to brain tissue, due to a combination of hypoxemia and ischemia. Hypoxia leads to disruption of oxidative processes and the development of acidosis, decreased energy balance of the cell, an excess of excitatory neurotransmitters, impaired metabolism of glia and neurons. Excess homocysteine can also induce a cascade of events in hippocampal neurons, producing in response to acute bacterial meningitis and accumulating in the central nervous system, reaching neurotoxic levels. Understanding the pathological mechanisms of neonatal ischemic Brain injury will help optimize treatment and reduce the degree of hypoxic-ischemic damage. The purpose of the study was to assess the level of homocysteine in the blood serum as a predictor of the development of meningitis in newborns with hypoxic-ischemic lesions of the central nervous system using mathematical analysis. Material and methods. The following research methods were used in the course of work: clinical-anamnestic (subjective and objective examination data), laboratory (biochemical, immunological method, enzyme-linked immunosorbent assay method), instrumental (neurosonography), methods of mathematical statistics. Statistical processing of all obtained results performed on a personal computer using the license software package Statistics 13.0 (StatSoftInc, serial number JPZ8041382130ARCN10-J) and MS Excel. We used the following methods of statistical analysis in the study: descriptive statistics, parametric and nonparametric methods of comparison of mean groups, correlation analysis, multiple linear and logistic regression analysis, utility statistics: odds ratio, relative risk, ROC analysis. Results and discussion. The relationship between homocysteine and hemoglobin and gestational age was found to be direct and reversed with bilirubin. The use of linear regression analysis allowed predicting the value of homocysteine by known values of one or more predictor variables. A ROC analysis was performed to assess the diagnostic significance of homocysteine levels as an indicator of oxidative stress and to express it in some integral indicators. Conclusion. The analysis showed that high levels of homocysteine in newborns can be considered as a statistically significant indicator of oxidative stress and a predictor of meningitis in premature infants. The probability of developing meningitis in premature infants with high homocysteine levels is 1.15 times higher than in full-term infants with central nervous system lesions (p> 0.05) and 8 times higher (p

The taphonomy of human remains and associated funerary textiles are inevitably linked. The interplay among burial clothes, human remains, insects, rodents, and preservation is explored through study of a group of postmedieval burials in Finland. These burials have been either archaeologically excavated or inventoried beneath wooden church floors. Decay and preserving factors for various conditions are studied, allowing in-depth study of individual garments and identification of the burial season. In addition, research has revealed different factors that have an effect on future preservation of the burials under church floors.

The effect of mesodiencephalic modulation on the metabolism of carbohydrates and lipids, insulin and cortisol secretion, the severity of neurological disorders and pain syndrome has been studied in patients with diabetic polyneuropathy. It has been established that the addition of a standard therapeutic complex with MDM-therapy reduces the neurological symptoms of the disease and the severity of the pain syndrome by half, as well as significantly improves the insulin regulation of carbohydrate and lipid metabolism. It has been proven that MDM-therapy reduces the body’s insulin resistance, which makes it possible to recommend this physical factor for the treatment of diseases associated with metabolic syndrome. The hypothesis of the systemic nature of MDM-therapy and its effect on the formation of adaptive responses is considered.

BACKGROUND Transitional cell carcinoma also known as urothelial carcinoma accounts for more than 90 % of all primary tumours of urinary bladder. It is the 4 th most common cancer in men and 8 th most common cancer in women in the western world. Nearly 80 % of patients initially present with bladder tumours confined to mucosa or submucosa. Not grading but detection of infiltration is of much value when dealing with invasive urothelial malignancy. When it invades muscle, it dictates more aggressive treatment. This study was undertaken to correlate the clinical, radiological, and pathological findings in the grading and staging of carcinoma bladder. METHODS This prospective study was conducted in the Department of Pathology for a period of two years. 55 patients with clinical features suggestive of carcinoma bladder were included in the study. Radiological and cystoscopic findings were combined to obtain a clinical staging. Materials included were H&E stained sections of biopsies, TURBT and Cystectomy. Special stains were done in indicated cases. Grading was done using WHO / ISUP grading system and staging using AJCC / UICC staging system. RESULTS 55 cases were studied. Most common age group was 60 - 69 years (40 %) with male preponderance (94.5 %). 100 % of patients presented with haematuria. Cystoscopically most common appearance was fronds (69.1 %) involving right lateral wall (40 %). Of the clinically invasive cases 29 (52.7 %), 19 (65.50 %) were pathologically invasive, 3 (10.3 %) were pathologically noninvasive, 7 (24.10) were insufficient for opinion. Of the clinically noninvasive cases (26), 5 (19.20 %) were pathologically invasive 13 (50 %) were noninvasive and rest were insufficient for opinion. CONCLUSIONS Bladder carcinomas are more common in elderly males. All patients presented with haematuria. Most common site of involvement was lateral walls. Clinicopathological correlation was more in highly advanced cases. KEYWORDS Urothelial Carcinoma, Grading, Staging

Introduction: The Cyclin D1 gene (CCND1) located on chromosome 11q13 is a positive regulator of the cell cycle. It encodes a nuclear protein that plays an important role in the tumorigenesis of human cancers. Aim: The aim of the study is to evaluate numerical aberration of Cyclin D1 gene by using Fluorescence in Situ Hybridization (FISH) in Oral Squamous Cell Carcinoma (OSCC). Materials and Methods: Formalin-fixed paraffin embedded tumor section obtained from histological confirmed 50 OSCC patients from Department of Oncology, ENT and Pathology, S.M.S. Medical College, Jaipur. The FISH technique was used to detect the numerical aberrations of Cyclin D1 using the Vysis protocol. Results: The CCND1 numerical aberration was found positive in 18(36.0%) of 50 patients of OSCCs. Low level amplification was found in 9(11.3%), Cluster amplification 6(7.5%), polysomy 2(2.5%) and deletion of Cyclin D1 1(1.3%) respectively. There was not statistically significant association of histopathological differentiation, site of carcinoma, lymph node metastasis with gender. A significant association (P=0.004) was present between stage of carcinoma and types of numerical aberration of Cyclin D1 gene. Cyclin D1 aberration showed a significant association with lymph node metastasis (P=0.038). We have found no significant association between risk factors (tabacco chewing, smoking and alcohol consumption) to aberration of Cyclin D1 gene. Conclusions: Analysis of the CCND1 numerical aberration using FISH on paraffin embedded tumor section may be a useful and practical method for predicting aggressive tumors, recurrence and clinical outcome in patients with OSCCs. Keywords: Amplification, Cyclin D1, FISH, Numerical Aberration.

Objective: Although transcriptomic assessments of small samples using high-throughput techniques are usually performed on fresh or frozen tissues, there is a growing demand for those performed on stained cellular specimens already used for diagnostic purposes. Study Design: The possibility of detecting mRNAs and microRNAs (miRNAs) from routinely processed cytological samples using nCounter® technology was explored. Fresh samples from pleural and peritoneal effusions were analyzed using 2 parallel methods: samples were smeared and routinely stained using the May-Grünwald-Giemsa or Diff-Quik® method and mounted using conventional methods, and they were also studied following a snap freezing method, in which samples were maintained at −80°C until use. mRNAs and miRNAs were assessed and compared after total RNA extraction from both routinely processed samples and their matched frozen controls. Results: A good concordance was found between the gene expression measured in routinely processed samples and their matched frozen controls for the majority of mRNAs and miRNAs tested. However, the standard deviation of low-expressed miRNA was high. Conclusions: Although nCounter® technology is a robust method to measure and characterize both mRNAs and miRNAs from routinely processed cytological samples, caution is recommended for the interpretation of low-expressed miRNA.

Coronary artery disease progression involves a slow process of abnormal accumulation of lipid deposits to the inner walls of the arteries followed by an immune system response. It is known that an increase in lipid concentration could trigger cholesterol crystals deposition, thus starting a vicious cycle that could also progress into intra-arterial plaque formation, the hallmark of mature atheromas. The purpose of this manuscript is to introduce a proposed mechanism for the genesis of coronary artery disease; whereby the actual act of lipids crystallization starts a cycle demonstrated to induce additional crystallization via dehydration. Experiments demonstrate for the first time via images and video-recordings showing that when the onset crystallization occurs near the tissue (≅ 1 mm) a dehydration triggered backward hydrodynamic suction or vacuum ensues with enough force to withdraw lipid molecules from human tissue; these molecules are shown to adhere to the crystals.

Breast cancer (BC) represents the most common type of cancer in females worldwide. Endocrine therapy evolved as one of the main concepts in treatment of hormone-receptor positive BC. Current research focuses on the elucidation of tumour resistance mechanisms against endocrine therapy. In a translational in vitro approach, potential regulatory effects of clinically implemented BC anti-oestrogens on ERα, its coactivators DDX5, DDX17 and other DEADbox proteins as well as on the proliferation markers cyclin D1 and Ki67 were investigated on both the RNA and protein level. BC in vitro models for hormone-receptor positive (MCF-7, T-47D) and hormone-receptor negative cells (BT-20) were subjected to endocrine therapy. Anti-oestrogen-dependent expression regulation of target genes on the transcriptional and translational level was quantified and statistically assessed. Endocrine therapy decreases the expression levels of Ki67, cyclin D1 and ERα in hormone-receptor positive cells. In the hormone-receptor negative cells, the three parameters remained stable after endocrine therapy. Endoxifen triggers a downregulation of DDX5 and DDX23 in MCF-7 cells. Fulvestrant treatment downregulates the expression levels of all investigated DEADbox proteins in MCF-7 cells. In T-47D cells, endoxifen and fulvestrant lead to a decrease of all target gene expression levels. Interestingly, endocrine therapy affects DEADbox RNA expression levels in BT-20 cells, too. However, this result could only be confirmed for DDX1, immunocytologically. The investigated DEADbox proteins appear to correlate with the oestrogen-dependent tumourigenesis in hormone-receptor positive BC and show expression alterations after endocrine treatment.

Introdução: O envelhecimento da população se torna notório a partir do século XX alcançando vários países do mundo. Os dados do Boletim Epidemiológico de 2019 do ministério da saúde informam um aumento na incidência de casos de aids entre idosos do sexo masculino no período de 2008 a 2018 de 9,7 % e uma redução de 5% entre as mulheres. O comprometimento do sistema imunológico favorece o surgimento de doenças consideradas oportunistas sendo a Tuberculose (TB) a maior causa de morte entre os indivíduos com aids. Umas das medidas para prevenção da coinfecção TB/HIV em adultos jovens e idosos, segundo a Organização Mundial de Saúde, é o tratamento com o medicamento isoniazida, que tem por objetivo a redução do risco de adoecimento pelo Mycobacterium tuberculosis e consequentemente a manifestação da TB. Em relação a isoniazida, a hepatotoxicidade é uma reação adversa potencialmente grave que pode resultar até em morte. Objetivo: Avaliar o risco de hepatotoxicidade ao uso de isoniazida medida através dos resultados de exames laboratoriais através das enzimas hepáticas. METODO: Estudo transversal retrospectivo descritivo e analítico com pacientes idosos com HIV/aids em uso de isoniazida em acompanhado em Serviço Especializado em HIV/aids de 2008 a 2011. Foram analisados resultados laboratoriais de transaminases hepáticas (AST e ALT) e gama glutariltranferase de uma base de dados secundária em 3 momentos específicos (pré tratamento, concomitante ao tratamento e pós tratamento com isoniazida) e características dos sujeitos (idade, sexo, tempo de infecção pelo HIV). Os dados foram analisados em Programa Estatístico SPSS 20. Resultado: Foram analisados 12 sujeitos com idade igual ou superior a 60 anos sendo 75% (9) homens, idade média de 63 anos e 25% (3) mulheres, idade média de 68 anos. Os sujeitos apresentavam em média 15 anos de infecção pelo HIV. Houve um aumento de 20,9 % da AST, e 11,5% da Gama Gutamiltransferase concomitante ao tratamento em relação aos valores pré tratamento. Conclusão: Os resultados laboratoriais ao uso de isoniazida apresentaram elevação indicado uma leve hepatotoxicidade sem necessidade de suspensão do tratamento preventivo com isoniazida, no entanto, acompanhamento por equipe multiprofissional e farmacêutico se faz necessário.

Introduction: The aging of the population becomes notorious from the twentieth century reaching several countries of the world. Data from the 2019 Epidemiological Bulletin of the Ministry of Health report an increase in the incidence of AIDS among elderly males in the period 2008 to 2018 of 9.7% and a 5% reduction among women. The impairment of the immune system favors the emergence of diseases considered opportunistic and Tuberculosis (TB) is the leading cause of death among individuals with AIDS. One of the measures to prevent TB/HIV co-infection in young and elderly adults, according to the World Health Organization, is treatment with the drug isoniazid, which aims to reduce the risk of illness from Mycobacterium tuberculosis and consequently the manifestation of TB. Regarding isoniazid, hepatotoxicity is a potentially serious adverse reaction that can even result in death. Objective: To evaluate the risk of hepatotoxicity to the use of isoniazid measured through laboratory test results through liver enzymes. METHOD: Descriptive and analytical retrospective cross-sectional study with elderly patients with HIV/AIDS using isoniazid in a specialized HIV/AIDS Service from 2008 to 2011. Laboratory results of hepatic transaminases (AST and ALT) and glutaryltranferase range from a secondary database at 3 specific moments (pre-treatment, concomitant treatment and post-treatment with isoniazid) and subjects’ characteristics (age, gender, time of HIV infection) were analyzed. The data were analyzed in statistical program SPSS 20. Result: We analyzed 12 subjects aged 60 years or older, 75% (9) men, mean age 63 years and 25% (3) women, mean age 68 years. The subjects had an average of 15 years of HIV infection. There was an increase of 20.9% in AST, and 11.5% in the Range Gutamiltransferase concomitant with the treatment in relation to the pre-treatment values. Conclusion: Laboratory results for the use of isoniazid showed a slight hepatotoxicity elevation without the need to discontinuation of preventive treatment with isoniazid, however, follow-up by a multidisciplinary and pharmaceutical team is necessary.

To explore the potential of distributed training on deep neural networks, we implement several distributed algorithms with the basis of swFlow on the world-leading supercomputer, Sunway TaihuLight. Based on two naive designs of parameter server and ring all-reduce, we present the limitation of the communication model and discuss the optimizations for adapting the five-level interconnect architecture of Sunway system. To reduce the communication bottleneck on large scale system, multi-severs and hierarchical ring all-reduce models are introduced. With a benchmark from deep learning-based cancerous region detection algorithm, the average parallel efficiency obtains over 80% for at most 1024 processors. It reveals the great opportunity for joint combination of deep learning and HPC system.

Introduction: Inactivating mutations of the SMARCA4 (SWI/SNF-related, matrix-associated, actin-dependent regulator of chromatin, subfamily A, member 4) gene and/or loss of the BRG1 (brahma-related gene 1) protein defines SMARCA4-deficient thoracic sarcoma (SMARCA4-dTS), an aggressive neoplasm with a usually fatal outcome. Similar SMARCA4 mutations/BRG1 loss is also seen in a subset of non-small cell lung carcinomas (NSCLCs; SMARCA4-dNSCLCs) that lack alterations in currently targetable oncogenic drivers, that is, EGFR, ALK, and ROS1. There is limited knowledge on the cytomorphological features of these SMARCA4-deficient thoracic neoplasms. Methods: We retrospectively analysed the cytology of 2 cases each of SMARCA4-dNSCLC and SMARCA4-dTS to understand their cytomorphological overlap, if any, and identify features that would prompt testing for BRG1 loss. Results: All 4 patients were males presenting with advanced disease, with a mean age of 41.5 years (SMARCA4-dTS) and 58.5 years (SMARCA4-dNSCLC) at presentation. The cytology of the 2 SMARCA4-dTSs was strikingly similar, showing predominantly singly dispersed rhabdoid phenotype tumour cells with perinuclear cytoplasmic condensations in an inflammatory or necrotic background. The cytology raised suspicion for a wide range of differentials, including melanoma, high-grade lymphoma, germ cell tumour, undifferentiated carcinoma, and undifferentiated sarcoma. SMARCA4-dNSCLCs, on the other hand, were recognizable as poorly differentiated (adeno)carcinomas and were easily distinguished from SMARCA4-dTSs, with both cases showing cohesive clusters of frequently large tumour cells with abundant pale cytoplasm. Conclusion: A diagnosis of SMARCA4-dTS is possible on cytology with appropriate ancillary testing and a high index of suspicion. The cytology of SMARCA4-dNSCLCs does not overlap with SMARCA4-dTS; rather, it resembles that of any poorly differentiated (adeno)carcinoma in the limited numbers analysed in this study.

Malignant pleural mesothelioma (MPM) is a rare and deadly disease. A precursor in situ lesion, malignant pleural mesothelioma in situ (MPMIS), has recently been proposed. On cytological examination, the distinction between reactive and malignant mesothelial cells is often challenging, and sometimes even impossible without ancillary methods. Fluorescence in situ hybridization (FISH) for detection of 9p21 deletion is a powerful diagnostic tool in this context, both in histological and in cytological specimens. Here, we present a case of MPM with initial presentation as a putative MPMIS with disomic chromosomal pattern and homozygous 9p21 deletion with subsequent development of an aneuploid pattern after whole genome duplication during tumor progression.

Introduction: High-risk human papillomavirus (HR HPV) is found to be responsible for 4.5% of cancer in general, primarily cervical cancer. We aim here to highlight the prevalence and genotypes of HR HPV and correlate its association with Pap tests’ results, which are still not well known in the Eastern Province of Saudi Arabia. Methods: Over 7 years (2013–2019), the results of 164 Saudi women coinvestigated for HR HPV along with Pap tests were collected from the archive of King Fahd University Hospital. Only women who had atypical squamous cells of undetermined significance (ASCUS) on the Pap test and those at elevated risk of infection were cotested for HR HPV; otherwise, the Pap test was the only screening modality for cervical cancer. Data were organized and statistically analyzed using IBM SPSS v26. Results: Out of 164 Saudi women, 14.5% (n = 24/164) showed positive results for HR HPV (8 patients had HPV16 and 2 had both HPV16 and HPV18/45, while the remaining 14 had other HR HPV); among them, 41.5% (n = 10/24) had an abnormal Pap test (5 ASCUS and 5 LSIL), while 58.5% (n = 14/24) had a negative Pap test. On the other hand, 21% (n = 35/164) of patients, in the study, had an abnormal Pap test (24 ASCUS, 8 low-grade squamous intraepithelial lesion [LSIL], and 3 atypical glandular cell [AGC]). In 80% (n = 19/24) of ASCUS cases, HR HPV was not detected; however, 20% (n = 5/24) were positive for other HR HPV. Concerning LSIL cases, 62.5% (n = 5/8) were positive for HR HPV (1 case showed HPV16 and HPV18/45, 2 cases showed HPV16, and 2 cases showed other HR HPV), while in the remaining 37.5% (n = 3/8) LSIL cases, HR HPV was negative; similarly, all AGC cases were negative for HR HPV. Statistical analysis showed a significant correlation between HPV status and Pap test findings (p value Discussion/Conclusion: HR HPV frequency and genotype distribution, in this study, might reflect a different regional infection pattern. The high association of HR HPV with negative cytology emphasizes the need to add the HR HPV test to screening modalities of cervix cancer.

The use of psychoactive substances for several reasons by commercial vehicle drivers has been documented as a major cause of increased incidences of traffic accidents globally. The study aimed at determining the prevalence of psychoactive substance use among Nigerian male commercial vehicle drivers randomly selected from the three major ethnic groups in Nigeria (Igbo, Hausa and Yoruba). A structured questionnaire which included data on sociodemographic status and psychoactive drug use history was introduced to all participants. Generic Multi-Drug Urine Dip Card Test Kit and Shimadzu chromatograph system (Shimadzu Corporation, Kyoto, Japan) were used for toxicological analyses. Out of the 264 Nigerian male commercial vehicle drivers who participated in this study, 111(42.0 %) had used illicit drugs in recent times, 55(20.8 %) took drugs for improved energy and 90(34.1 %) felt high after using illicit drugs. Marijuana was the most abused substance; 77(29.2 %) followed by benzodiazepine; 34(12.9) across all ethnicities studied. Across all ethnicities, HPLC revealed that the Hausa drivers had the highest concentration of psychoactive substances in their urine samples. These findings, reiterates the need for the Nigerian anti-drug agency to develop new strategies in conducting a repressive drug war and extending the same to bus stations.

Resumen El carcinoma sebaceo de mama (CSM) es una neoplasia muy poco frecuente. De acuerdo con la clasificacion actual de la OMS, el CSM se define como un carcinoma de la mama en el que sus celulas presentan diferenciacion sebacea en al menos el 50% de las mismas y no existe ninguna relacion con las glandulas sebaceas de los anejos de la piel. Acorde con esta definicion tan solo encontramos 21 casos descritos en la literatura. Presentamos un nuevo caso de CSM junto a una revision de caracteristicas clinicas, anatomopatologicas y terapeuticas de esta rara estirpe tumoral de mama.

Over the last decade, cytopathology laboratories wishing to achieve an automated and seamless workflow process, to diminish turnaround times and to improve their diagnostic accuracy have successfully adopted information technologies and automation. New types of cameras and microscopes, connected to computers, have made possible image capture and transmission (telecytology). New innovative information technologies, including e-health and telemedical applications, constitute a valuable tool for interlaboratory collaboration and quality improvement. New applications are expected to enhance the opportunities for improvement in the field of cytological data management and sharing. In this article, we emphasize on the possible use of short videos captured by static telecytology applications in a modern cytopathology laboratory wishing to establish an effective interlaboratory comparison system and obtain expert opinions in diagnostically challenging cases from distant consultants with well recognized diagnostic competence and experience in the field of thyroid cytology.

Introduction: Staphylococcus aureus (S. aureus) is one of the prominent gram positive human pathogen secretes many surface and secretary proteins including various enzymes and pathogenic factors that favour the colonization and infection of host tissue. Alpha-amylase is one of the enzymes secreted by S.aureus which catalyses the breakdown of complex sugars to monosaccharides, which are required for colonization and survival of this pathogen. Materials and Methods: In the present study we have cloned, sequenced, expressed and characterized a-amylase from the clinical isolate of S.aureus resistant to vancomycin (VRSA). The 25kb plasma DNA was isolated from the clinical isolate of S.aureus and a 600bp PCR amplified product was obtained. Results: The SDS-PAGE analysis of induced and un-induced clone SB3 indicates that a-amylase has a M.W. of 22KD. The ra-amylase was eluted from the gel and enzymes assay was performed. The Km was found to be close to Km of native a-amylase identified in the extracellular and in the cytosolic fraction of S.aureus resistant to vancomycin. Conclusion: The current study clearly indicate that there is clear distinction between the a-amylase of human and different prokaryotes, particularly S.aureus which made this enzyme an ideal target in the development of drugs against infections of tooth and oral cavities. Keywords: Staphylococcus aureus, Alpha-amylase, Cloning, Vancomycin.

Introduction: Breast lesions are leading cause of morbidity and mortality in women worldwide. Fine Needle Aspiration (FNA) is an affordable, minimally invasive and rapid method. It is gaining importance as a preoperative procedure to distinguish benign and malignant breast lesions. Thus unnecessary invasive procedures can be avoided. This study is undertaken to explore utility and accuracy of FNA in various breast pathologies. Objectives: 1) To study cytology of various breast lesions, 2) To correlate cytological diagnosis with histopathological diagnosis wherever possible, 3) To study sensitivity, specificity and accuracy of FNA in breast lesions Materials and Methods: A two year prospective study was carried out from November 2017 to November 2019 at Department of Pathology, JJM Medical College – Davangere. This study included patients with breast lesions referred for FNA. FNA was done. Cytomorphological features were studied. Cytomorphological diagnosis was correlated with histopathological diagnosis wherever possible. Results: Out of 425 patients with suspected breast lesions, cyto-histo morphological correlation was possible in 331 cases. Cytology histology concordance was 94.4%. This study has sensitivity of 90.1%, specificity of 96.5% and accuracy of 94.1%. Conclusion: FNA is highly simple, safe and effective technique. It should be an essential component in preoperative diagnosis of breast lesions. Keywords: Breast, Fine Needle Aspiration Cytology, Classification.

Fine Needle Aspiration Cytology is the preliminary investigation employed for superficial and deep swelling in the body. It provides early information regarding the lesions before performing biopsy and aid in the treatment plan of the patient. However sample inadequacy from representative lesion may render patients to repeat aspirations and may also cause delay in reports. There is an ever increasing demand for rapid diagnosis in cytology. The present study was conducted to assess the utility of brilliant cresyl blue as a rapid stain in fine needle aspiration cytology. Objective: To assess the utility of rapid Brilliant cresyl blue (BCB) stained wet mount preparation in routine fine needle aspiration cytology. Materials and Methods : The study was carried out in the Cytology laboratory, Govt. Medical College Thiruvananthapuram and PG Pathology Lab, Department of MLT, Govt. Medical College Thiruvananthapuram for a period of six months. A total of 50 cases referred to cytology laboratory for FNAC were included in this study. A wet mount preparation with Brilliant cresyl was prepared immediately after aspiration and examined for cellular adequacy and cytomorphology, which was then compared with the routine Papanicolau stained smear . Results & Conclusion: In situations for rapid diagnosis, and to assess the cellular adequacy of a lesion Brilliant cresyl blue staining method is very helpful. Most of the cases diagnosed as malignant on Brilliant cresyl blue staining correlate with the Pap stain. All the cases diagnosed as benign on rapid brilliant cresyl blue stain were also diagnosed as benign with Pap stain. The result clearly indicate that the brilliant cresyl blue stained wet mount preparation can be used as a rapid supplementary diagnostic procedure in FNAC at least for urgent reporting and sample adequacy assessment. Keywords: FNAC, Papanicolaou stain, Brilliant cresyl blue supravital stain, Cytology

Introduction: Fine needle aspiration cytology (FNAC) was described and practiced by Martin and Ellis in 1930. It is a well-accepted procedure and is a valuable tool in the diagnosis and patient management of breast lesions. The sensitivity and specificity of FNAC as a diagnostic tool for palpable breast lumps are 65-99% and 96-100% respectively. Therefore, the study aimed to access the cytomorphological spectrum of breast lesions. Materials and Methods: The present study included thirty-seven consecutive female patients of palpable breast lesions who underwent fine needle aspiration cytology (FNAC). After obtaining a detailed history followed by clinical examination, the FNAC procedure was performed. All the slides were stained with Hematoxylin and Eosin (H & E). The stained smears were viewed under microscope and cytological findings were interpreted accordingly. Results: The most common affected age group was 40-49 years with preponderance on right side. Considering the Cytomorphological spectrum, the most common lesion was Fibroadenoma followed by Ductal carcinoma, fibrocystic disease, acute suppurative inflammatory lesion, benign breast lesion, granulomatous mastitis and atypical ductal hyperplasia. The ductal carcinomas were more commonly seen in the age group of 40-49 years and Fibroadenoma were more common in age group of 20-29 years. Conclusion: Fine needle aspiration cytology of breast lesions is a valuable, cost effective, minimally invasive and a rapid investigation. Majority of the lesions in the younger age group are benign in nature and malignant in older age groups. Despite its high accuracy, some pitfalls may lead to confusion and misdiagnosis of breast lesions. Therefore, accuracy of diagnosis increases when aided with radiological investigations. Keywords: Fine needle aspiration cytology (FNAC) breast lesions Cytomorphology

Objectives The 2014 Bethesda System (TBS 2014) guidelines for reporting cervical cytology revised the age for reporting benign endometrial cells (BECs) from 40 years or older to age 45 years or older. We evaluated this change and further investigated if extending the reporting age to 50 years or older may be acceptable. Methods We reviewed cases with BECs reported on Papanicolaou tests in women age 40 years or older and 45 years or older before and after implementation of TBS 2014. Follow-up endometrial biopsy/curettage results were categorized as benign, endometrial hyperplasia with or without atypia, or malignant. Hyperplasia and malignant follow-up were considered clinically significant. Clinical data were documented. Results were compared for women age 40 to 44, 45 to 49, and 50 years or older. Results Follow-up in 15 (100%) women age 40 to 44 years was benign. In women age 45 to 49 years, 61 (96.8%) had benign follow-up, one (1.6%) had atypical hyperplasia, and one (1.6%) had malignant follow-up. In women age 50 years or older, 57 (86.5%) had benign follow-up, four (6%) had malignant follow-up, and seven (7.5%) had atypical or nonatypical hyperplasia. There was a significant difference in follow-up between the age groups of 40 to 49 and 50 or older (P = .023). Conclusions We conclude that the TBS 2014 revision was justified. Our data suggest that age 50 years or older rather than age 45 years or older may be an acceptable cutoff for reporting BECs.

The present study was undertaken to evaluate if any signifi cant hematological and biochemical changes occur in dogs with chronic heart failure (CHF), that will help in the diagnosis and prognosis of CHF. According to the obtained data, neutrophil leukocytosis was found in 22.2% of the animals in the experimental group, and anemia was found in 50.0%. Among them the 77,8 % of animals had nonregenerative anemia, the 77,8 % – hypochromic anemia, 38,9 % of – microcytic anemia. Neutrophil leukocytosis was registered in dogs with regenerative shift of the nucleus to the left (13.8%) and to the right (5.6%), and without changes in the leukogram (2.8%). It should be noted that 55.6% of animals with signs of CHF were also diagnosed with changes in the ratio of segmented neutrophils (degenerative shift of the nucleus to the left) in the absence of leukocytosis. Hypoproteinemia was found in 8,3% of animals, hypoalbuminemia in 13,8%, urea and creatinine concentrations were increased in 16,7 % and 19,4%, respectively. Hypocalcaemia was observed in 5,6% of dogs, inorganic phosphorus content was higher in 13,9%, slight hyponatremia was observed in 19,4%. The activity of enzymes in the serum of dogs in the experimental group ranged widely and was higher in ALT (p

Effects of chemical injuries on the cornea and limbus have been widely studied; however, little is known about glaucoma after ocular chemical injuries. We herein investigated the incidence, risk factors, and outcome of glaucoma in patients with ocular chemical burns. Medical records were reviewed of patients who visited our clinic for chemical injuries to the ocular surface. Patients were divided into glaucoma and non-glaucoma groups based on high intraocular pressure (IOP) readings. Clinical characteristics, treatment method, and therapeutic and visual outcomes were compared between the two groups. Of 29 patients (40 eyes), 9 patients (15 eyes, 37.5%) were diagnosed with glaucoma at 2.64 ± 2.92 months after injury. Factors associated with glaucoma included male gender (p = 0.0114), bilateral ocular involvement (p = 0.0478), severe ocular surface involvement (Dua grades IV-VI, p = 0.0180), poor initial visual acuity (p = 0.0136), high initial IOP (p

Background: Evidence for tranexamic acid (TXA) in the pharmacologic management of trauma is largely derived from data in adults. Guidance on the use of TXA in pediatric patients comes from studies evaluating its use in cardiac and orthopedic surgery. There is minimal data describing TXA safety and efficacy in pediatric trauma. The purpose of this study is to describe the use of TXA in the management of pediatric trauma and to evaluate its efficacy and safety end points. Methods: This retrospective, observational analysis of pediatric trauma admissions at Hennepin County Medical Center from August 2011 to March 2019 compares patients who did and did not receive TXA. The primary end point is survival to hospital discharge. Secondary end points include surgical intervention, transfusion requirements, length of stay, thrombosis, and TXA dose administered. Results: There were 48 patients aged ≤16 years identified for inclusion using a massive transfusion protocol order. Twenty-nine (60%) patients received TXA. Baseline characteristics and results are presented as median (interquartile range) unless otherwise specified, with statistical significance defined as P < .05. Patients receiving TXA were more likely to be older, but there was no difference in injury type or Injury Severity Score at baseline. There was no difference in survival to discharge or thrombosis. Patients who did not receive TXA had numerically more frequent surgical intervention and longer length of stay, but these did not reach significance. Conclusions: TXA was utilized in 60% of pediatric trauma admissions at a single level 1 trauma center, more commonly in older patients. Although limited by observational design, we found patients receiving TXA had no difference in mortality or thrombosis.

Introduction: The CytoRich Red fixative system for red blood cell lysis in liquid based cytology technique is quite effective in hemorrhagic cervical PAP smears. However, its role in fine needle aspiration cytology needs to be explored. Aims and Objectives: (1). Highlight the role of CytoRich Red fluid as fixative media. (2). To compare CytoRich Red fixed smear with conventional smear. (3). To compare CytoRich Red fixed smear with liquid based cytology (LBC) smear. Material and Methods: Thirty hemorrhagic smears from breast (16 ) , thyroid (08), lymph node (04) and soft tissue (02) lesions were included in the study. The fine needle aspirate was divided into two parts. First part was used for conventional smears and CytoRich Red treated smears. An unstained smear was stored in cold acetone for immunocytochemistry, which was applied on relevant cases. The second part was used for Liquid-Based cytology (LBC). All smears were compared for cytomorphological features and background material. The smears were classified into 3 groups based on the percentage of hemorrhage that is 25-50% and >50%. Statistical analysis was done by SPSS version 24. A p value of 0.05 was considered as significant. Results: Red blood cells were significantly reduced without hindering staining with a statistically significant difference between background haemorrhage in conventional smears and CytoRich Red treated smears (p value smears and LBC. The Diagnostic utility of CytoRich Red treated smears was more than that of LBC alone (p value Conclusion: Cytorich red fixative system can be used in case of hemorrhagic fine needle aspiration slide which provides a clear background without compromising the cellularity of the smears. Keywords: Hemorrhagic smears, CytoRich Red, Fine needle aspiration cytology, Liquid-Based cytology, Immunocytochemistry

Background & Objective: Modified Ultra-fast Papanicolaou (MUFP) stain has been developed from Papanicolaou stain (PAP) with the goal to improve staining quality, minimize staining time for obtaining immediate cytological diagnosis and to check specimen adequacy during Ultrasound guided Fine needle Aspiration Cytology (US guided FNAC). The aim of this research was to study the cytomorphological features of intra-abdominal lesions with help of US guided FNAC and to assess the diagnostic utility of Modified Ultrafast Papanicolaou stain in cytological diagnosis. Methods: ​This cross-sectional study enrolled consecutive 100 subjects in N.K.P Salve Institute of Medical Sciences and Research Centre, Nagpur, which is a tertiary teaching hospital in India, from July 2015 to June 2017 who underwent US guided FNAC for Intra-abdominal lesions. Fine needle aspiration was done under ultrasound guidance and the smears were divided into two groups. Wet smears were fixed in 95% ethyl alcohol for conventional PAP staining and air dried for MUFP. After staining, results were evaluated on basis of the cytological features. Scores were given according to four parameters namely background of smears, staining pattern, cell morphology and nuclear staining. Quality index was calculated from the ratio of score achieved to the possible maximum score. Result: The most common organs involved were ovaries (46 %) followed by liver (11%) and most common lesions were malignant (68 %). The cytological characteristic showed significant difference in all four parameters (P

Objective: To investigate the clinical features and imaging characteristics of mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes (MELAS).Methods: Seventeen patients wi...

Background: Cervical cancer is the fourth most common cancer in the world. A raised incidence and mortality parallel a low participation rate in screening, namely screening in poor countries and among specific populations of developed countries. Cervical or vaginal self-sampling may increase adherence to screening due to its low costs and elevated sensibility and specificity. Our main goal was to compare self-sampling with physician sampling and to evaluate the participation rate of women formerly non-adherent to cervical cancer screening. Study Design: We identified relevant studies from PubMed. Studies were eligible for inclusion if they fulfilled the following criteria: women aged between 16 and 80 years, poor and developed countries that use self-sampling, women with a low participation rate in screening and studies published since 2013. After fully reading the articles, data were extracted to an Excel sheet to ­display all relevant information in an organized manner. ­Results: We identified 18 studies, which altogether enrolled 22,118 women. Self-sampling and physician sampling are quite similar regarding the HPV detection rate. Women have a low participation rate mainly because of limited access to health services, religious and culture beliefs, and lack of time due to several demanding tasks in daily life. Self-sampling shows a significant increase in acceptability and preference compared to physician sampling. Conclusion: Self-sampling is a reliable method to involve women in opportunistic or organized screening programs for cervical cancer prevention.

Background: Metastases to axillary lymph nodes are commonly and readily confirmed by fine needle aspiration cytology (FNAC). Most likely, these arise from breast primaries. However, the diagnosis can become complicated when unusual cytomorphology is encountered. Case: We report a 60-year-old woman presenting with bilateral axillary lymphadenopathies but without breast lesions. History showed increasing CA-125 levels. FNAC yielded carcinoma cells showing prominent papillary pattern, being composed of mild to moderately differentiated malignant cells, with focal abortive glandular formation and squamous metaplasia. IHC stains were done and the tumor cells were PAX-8 positive, but GATA-3 and GCDFP-15 negative. Coupled with the clinical history, a diagnosis of metastatic endometrioid adenocarcinoma was made. Conclusion: Nodal metastases with papillary cytomorphology can rarely arise from nonbreast primaries. The presence of papillary pattern, particularly in the absence of a clinically detectable breast lesion, should raise the possibility of a metastasis. Correlation with patient history, imaging findings and judicious use of IHC studies are crucial for a correct diagnosis.