Journal Of Clinical And Diagnostic Research[JOURNAL]
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200 papers
Effect of Cellular Mobile Phone Use and Cetrizine on Hand-Eye Coordination and Visual Acuity.
Gawit KG, Tiwari SA, Kasabe GH … +2 more , Deshpande PK, Ghongane BB
J Clin Diagn Res · 2017 Sep · PMID 29207727 · Full text
INTRODUCTION: Cellular mobile phones are a major cause of distraction especially while driving. The aggressive and inappropriate use of cellular mobile phones has increased the risk of accidents. Similar alerts are avail...
INTRODUCTION: Cellular mobile phones are a major cause of distraction especially while driving. The aggressive and inappropriate use of cellular mobile phones has increased the risk of accidents. Similar alerts are available in literature for certain substances and drugs (e.g. second generation anti H1 drug -Cetirizine) which also derange psychomotor performance and parameters of alertness. AIM: This study measured variations in hand-eye coordination and visual acuity due to use of cellular mobile phone in comparison to that of commonly used antihistaminic drug viz., single dose Cetirizine 10 mg. MATERIALS AND METHODS: It was a single blind, single dose, interventional study, 100 healthy human volunteers divided into two groups. Baseline readings of all volunteers were noted. Group-I (n=50) was Cetirizine group (10mg orally stat), Group -II (n=50) Cellular mobile phone user group. Alertness was tested on hand- steadiness tester (Reaction Time Index = RTI) and on Flicker-fusion apparatus (visual acuity - Critical Flicker Fusion Frequency per second= CFFF/sec). Baseline readings of all volunteers were noted before intervention. Baseline was compared with readings at three hour post-intervention and was analysed by paired t-test. Inter-group comparison of parameters was also done and was analysed by unpaired t-test. RESULTS: The baseline RTI (95.46±41.74, 85.11±39.05) and CFF low and high (40.07±9.970, 40.76±9.309 and 40.42±9.035, 40.48±9.863) respectively, in Cetirizine group and Mobile user group were comparable. The RTI increased significantly (116.4±51.46, 102.8±49.26) in both the groups after intervention. However, there is no significant change in CFF intensity from baseline in either group post-intervention. CONCLUSION: Concurrent use of mobile phone while performing tasks, showed significant impairment of hand-steadiness which was comparable to that produced by single dose Cetirizine 10 mg and this may be one of the factors contributing to their close association with road traffic accidents.
Pleiotropic Effects of Losartan in Hypertensive Patients with Dyslipidemia.
Sivasubramaniam S, Kumarasamy B
J Clin Diagn Res · 2017 Sep · PMID 29207726 · Full text
INTRODUCTION: In essential hypertension, the comorbidity of dyslipidemia is very common. In addition to hypertension, dyslipidemia is linked to cardiovascular disease, stroke and decline in renal function. Unlike other a...
INTRODUCTION: In essential hypertension, the comorbidity of dyslipidemia is very common. In addition to hypertension, dyslipidemia is linked to cardiovascular disease, stroke and decline in renal function. Unlike other angiotensin receptor blockers, Losartan has been claimed to have unique pleiotropic property and thereby decreasing the risk of future cardiovascular complications. AIM: The present study was done to assess on the pleiotropic effect of losartan in newly diagnosed hypertensive patients with dyslipidemia. MATERIALS AND METHODS: Fifty four hypertensive patients with dyslipidemia who fulfilled the eligible criteria and were willing to give informed consent were included in the study after getting Institutional Ethical Committee (IEC) approval. All the study participants were given tab. Losartan 50mg once daily for four weeks. At the end of 1st, 2nd, 3rd and 4th week, blood pressure control and compliance were monitored. At the end of 4th week all the baseline laboratory parameters like renal function test, liver function test, lipid prolife and random blood sugar were performed. The EQ-5D questionnaires were completed at two points during the study: at the patient's initial visit before enrollment in the study and after 4 weeks of Losartan therapy. Appropriate statistical methods were used to analyse the results.The primary endpoint was reduction in blood pressure and improvement in lipid profile and improvement in quality of life score from baseline after 4 weeks of losartan therapy. RESULTS: Four patients were withdrawn due to non-compliance and totally 50 patients completed the study. The mean systolic blood pressure was reduced from 154.54 mm Hg to 138.16 mm Hg with p<0.0001 and the mean diastolic blood pressure was reduced from 91.56 mm Hg to 82.44 mm Hg with p<0.0001. There was a significant reduction in the mean total cholesterol from 189.52 to 180.46 mg/dl, mean LDL from 110.50 to 101.32 mg/dl and mean triglygeride from 135.68 to 127.70 mg/dl with p<0.0001. Improvements in anxiety and depression, as well as other dimensions in the QOL questionnaire, paralleled with improvement of the clinical picture. CONCLUSION: Based on the results of this study, Losartan is safe and effective in treating hypertensive patients with dyslipidemia in addition to its antihypertensive effect and it also has benefits of reducing serum glucose, lipid levels; and improvement in the quality of life.
Rapid and Accurate Diagnosis of Acute Pyogenic Meningitis Due to , Type b and Using A Multiplex PCR Assay.
Seth R, Murthy PSR, Sistla S … +2 more , Subramanian M, Tamilarasu K
J Clin Diagn Res · 2017 Sep · PMID 29207725 · Full text
INTRODUCTION: Acute bacterial meningitis is one of the major causes of morbidity and mortality in children and geriatric population, especially in developing countries. Methods of identification are standard culture and...
INTRODUCTION: Acute bacterial meningitis is one of the major causes of morbidity and mortality in children and geriatric population, especially in developing countries. Methods of identification are standard culture and other phenotypic tests in many resource poor settings. AIM: To use molecular methods for the improvement of aetiological diagnosis of acute pyogenic meningitis in patients. MATERIALS AND METHODS: CSF samples of 125 patients were included for the study. Gram staining and culture were performed according to standard procedures. Antigen was detected using commercial latex agglutination test kit. Multiplex PCR was performed using previously published primers and protocols. Fischer's exact test was used for finding association between presence of the disease and clinical/biochemical parameters, considering two tailed p<0.05 as statistically significant. Sensitivity, specificity, positive and negative predictive values were calculated using Graphpad QuicCalc software. RESULTS: A total of 39 cases (31.2%) were confirmed to be of acute pyogenic meningitis based on biochemical methods. Only 10/39 was positive for the three organisms tested. Multiplex PCR was able to detect one additional isolate each of and type b. When compared with multiplex PCR as the gold standard, culture and latex agglutination tests had same sensitivity (80%), specificity (100%), PPV (100%) and NPV (97.8%), whereas Gram stain had poor sensitivity (40%) and good specificity (95.6%). Detection rates were higher in multiplex PCR for the two organisms and type b. CONCLUSION: Multiplex PCR was more sensitive than culture or antigen detection, and employing this assay can significantly increase the speed and accuracy of identification of the pathogen.
Diagnosis of Lafora Disease by Skin Biopsy.
Sathiah P, Gochhait D, Dehuri P … +1 more , Subramanian H
J Clin Diagn Res · 2017 Sep · PMID 29207724 · Full text
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Papillary Renal Cell Carcinoma with Tubercular Paraaortic Lymphadenopathy: A Blessing in Disguise.
Sharma B, Malhotra P, Bhardwaj M
J Clin Diagn Res · 2017 Sep · PMID 29207723 · Full text
Incidental Renal Cell Carcinoma (RCC) can be found in a tubercular kidney; however, the vice versa i.e., finding tubercular lymphadenopathy after radical nephrectomy for cancer is exceptionally rare. To the best of our k...
Incidental Renal Cell Carcinoma (RCC) can be found in a tubercular kidney; however, the vice versa i.e., finding tubercular lymphadenopathy after radical nephrectomy for cancer is exceptionally rare. To the best of our knowledge, only two cases of coexistent renal cell carcinoma and tubercular paraaortic lymphadenopathy have been reported till date. Out of these, only one case was of papillary renal cell carcinoma. We hereby, report a rare case of papillary renal cell carcinoma with coexisting paraaortic tubercular lymphadenopathy, which was upstaged based on radiology findings. This case highlights the importance of considering the possibility of tuberculosis in cancer-associated lymphadenopathy. This can prevent unnecessary lymphnode dissection and inappropriate clinical upstaging in renal cancer patients.
Thalassaemia Trait with Gaucher Disease: A Diagnostic Dilemma.
Kini JR, Sreeram S, Hegde A … +2 more , Kamath S, Pai RR
J Clin Diagn Res · 2017 Sep · PMID 29207722 · Full text
Gaucher Disease is an autosomal recessive disease caused by the accumulation of glucocerebrosidase due to deficiency in lysosomal glucocerebrosidase. Thalassaemia trait is asymptomatic and is usually an incidental diagno...
Gaucher Disease is an autosomal recessive disease caused by the accumulation of glucocerebrosidase due to deficiency in lysosomal glucocerebrosidase. Thalassaemia trait is asymptomatic and is usually an incidental diagnosis. Both thalassaemia and Gaucher disease can have similar haematologic manifestations and hence, their coexistence causes diagnostic dilemma. Our patient presented at one-and-a-half years with weakness, pallor, failure to thrive and massive hepatosplenomegaly. Clinical examination and history pointed to a lipid storage disease. Peripheral smear revealed microcytic hypochromic cells and nucleated red cells with haemolytic blood picture. Thalassaemia trait was indicated on haemoglobin variant analysis using High Performance Liquid Chromatography. Liver biopsy, bone marrow aspirate and therapeutic splenectomy revealed Gaucher-like cells. Type 1 Gaucher disease can be clinically asymptomatic as well as present with massive liver and spleen enlargement and involvement of bone marrow. Anaemia, splenomegaly and thrombocytopenia are the usual presentations at diagnosis, similar to the haemoglobinopathies. Gaucher-like cells with normal beta-glucocerebrosidase (pseudo-Gaucher cells) are seen in thalassaemia, leukaemia, mycobacterial infections and myeloma. Gaucher disease coexisting with thalassaemia trait is uncommon. We report the occurrence of thalassaemia trait and Gaucher disease in a child, which resulted in confusion regarding the haematological diagnosis. This report highlights the necessity of independent establishment of the diagnosis in every patient so that appropriate management decisions are taken.
Anorectal Melanoma: An Unusual Cause of Rectal Bleeding.
Kumar U, Singhal U
J Clin Diagn Res · 2017 Sep · PMID 29207721 · Full text
Anorectum is a rare site for primary melanoma. It is an aggressive cancer with poor prognosis. The diagnosis is often delayed due to non-specific signs and symptoms. Clinically, it is often misdiagnosed as hemorrhoids. T...
Anorectum is a rare site for primary melanoma. It is an aggressive cancer with poor prognosis. The diagnosis is often delayed due to non-specific signs and symptoms. Clinically, it is often misdiagnosed as hemorrhoids. The cytological diagnosis can be challenging especially when melanin pigment is sparse or absent. Herein, we present a rare case of anorectal melanoma which was initially misdiagnosed as hemorrhoids. A final correct diagnosis was made on cytology when later on the patient developed inguinal metastasis.
Locally Aggressive Primary Intraosseous Paraganglioma of Sacrum.
Srilatha PS, Rao L
J Clin Diagn Res · 2017 Sep · PMID 29207720 · Full text
Primary Intraosseous Paraganglioma (PGL) of sacrum is highly uncommon. Few of the spinal PGL reported were mostly intradural mass. Paraganglionic tissue is usually not present in the bone. So far, only seven cases of pri...
Primary Intraosseous Paraganglioma (PGL) of sacrum is highly uncommon. Few of the spinal PGL reported were mostly intradural mass. Paraganglionic tissue is usually not present in the bone. So far, only seven cases of primary intraosseous sacral PGL have been reported in the literature. There are no dependable prognostic histological features to differentiate benign from malignant PGL. The only unequivocal criterion for malignancy is metastasis to an organ where paraganglionic tissue is normally not present. However, an aggressive nature can be identified histologically by loss of architecture, decreased or absent sustentacular cells and Ki-67 index of >3%. We report a case of an elderly male who was admitted with complaints of swelling in the lower back with associated radiating pain and difficulty in sitting of two months duration. A diagnosis of sacral chordoma was made on Magnetic Resonance Imaging (MRI). No other mass was detected elsewhere in his body. The patient underwent surgical excision followed by radiotherapy. On histopathology and immunohistochemistry, a diagnosis of locally aggressive primary intraosseous PGL of sacrum was rendered. Hence, when evaluating a lytic sacral mass, PGL has to be considered as a differential diagnosis.
Approach to a Pregnant Woman with Anti D + Anti C Reactivity Pattern: A Diagnostic Conundrum.
Rai P, Sharma G, Singh D … +1 more , Garg J
J Clin Diagn Res · 2017 Sep · PMID 29207719 · Full text
The Rhesus G antigen is present on all RBCs that are C+ and also on most D+ RBCs. Due to this co-distribution of G with either C or D antigen, it mimics a reactivity pattern of anti C + anti D on Indirect Antiglobulin Te...
The Rhesus G antigen is present on all RBCs that are C+ and also on most D+ RBCs. Due to this co-distribution of G with either C or D antigen, it mimics a reactivity pattern of anti C + anti D on Indirect Antiglobulin Test (IAT), though the role of Anti G in causing Hemolytic Disease of Newborn (HDN) is controversial. The differentiation of anti D, anti C, and anti G is essential particularly in pregnant females. We hereby report a rare case of anti G with anti D and anti C in a pregnant woman with emphasis on approach to identify anti D+C+G and its implications.
An Alpha Fetoprotein Producing Gastric Tumor with Yolk Sac, Hepatoid and Papillary Adenocarcinoma Components.
Lakshmanan A, Kurian A, Subramanyan A … +1 more , Srinivasan A
J Clin Diagn Res · 2017 Sep · PMID 29207718 · Full text
Alpha Fetoprotein (AFP) producing gastric carcinomas are very rare and have unique clinicopathological features and an extremely poor prognosis. Here, we report a case of AFP producing gastric carcinoma with three distin...
Alpha Fetoprotein (AFP) producing gastric carcinomas are very rare and have unique clinicopathological features and an extremely poor prognosis. Here, we report a case of AFP producing gastric carcinoma with three distinct histomorphologic patterns such as yolk sac like, hepatoid, tubular and papillary adenocarcinoma components. The uniqueness of this case is absence of metastases and associated findings such as fundic gland polyposis with varying degrees of dysplasia, gastric and duodenal well differentiated neuroendocrine tumour and rectal ganglioneuroma. The patient is symptom free as of two and half year's postoperative period. AFP producing gastric tumours although rare, need to be identified as it is known to carry poor prognosis.
Heterotopic Prostate at Autopsy- An Unusual Mass at the Dome of the Urinary Bladder.
Munde S, Fernandes G, Phadnis P
J Clin Diagn Res · 2017 Sep · PMID 29207717 · Full text
Heterotopic prostate in the dome of the urinary bladder is extremely rare and difficult to diagnose. It is often mistaken for neoplastic masses and histopathological examination is warranted for diagnosis. We report an a...
Heterotopic prostate in the dome of the urinary bladder is extremely rare and difficult to diagnose. It is often mistaken for neoplastic masses and histopathological examination is warranted for diagnosis. We report an autopsy case of an ectopic prostate at the dome of the bladder which mimicked a neoplasm on gross pathology.
Expression of p16INK4A Protein in Cervical Intraepithelial Neoplasia and Invasive Carcinoma of Uterine Cervix.
Kishore V, Patil AG
J Clin Diagn Res · 2017 Sep · PMID 29207716 · Full text
INTRODUCTION: Cervical cancer still ranks as the most frequent cancer among women in India. Infection with Human Papilloma Virus (HPV) results in precancerous lesions and invasive cervical cancer. Interaction of HPV onco...
INTRODUCTION: Cervical cancer still ranks as the most frequent cancer among women in India. Infection with Human Papilloma Virus (HPV) results in precancerous lesions and invasive cervical cancer. Interaction of HPV oncogenic proteins with cellular regulatory proteins leads to upregulation of p16INK4A, a cyclin dependent kinase inhibitor. Therefore, p16INK4A overexpression is a surrogate biomarker of HPV infection making it useful in evaluating HPV associated premalignant and malignant lesions of gynaecological tract. AIM: This study was conducted to evaluate the usefulness of p16INK4A as a biomarker in dysplastic and malignant alteration of cervical epithelium. A total of 57 specimens diagnosed histopathologically as cervical dysplasia or malignancy were included in this prospective study of two year duration. Immunohistochemical (IHC) study of p16INK4A expression was performed on normal cervical tissue samples, Cervical Intraepithelial Neoplasia (CIN) 1, CIN 2, CIN 3, squamous cell carcinoma, adenocarcinoma. Expression was scored by two methods. One was simple positive versus negative p16INK4A staining and the other method was a semi-quantitative IHC scoring (0 to 8 points) according to the intensity of staining and the proportion of stained cells. The collected data was entered in excel sheet and analysed using Statistical Package For Social Science (SPSS) 16.0 software and the descriptive statistics, Chi-square test. The p-value of <0.05 was considered statistically significant. RESULTS: Nuclear and/or cytoplasmic p16INK4A immunoreactivity was absent in normal cervical tissue, while immunopositivity was 25% in CIN 1, 50% in CIN 2, 75% in CIN 3, 75% and 100% in squamous cell carcinoma and adenocarcinoma respectively. All normal cervical samples had low scores (0 to 2 points), while number of cases with high scores was proportional to the degree of cervical dysplasia or invasive carcinoma. p16INK4A immunostaining with higher expression (score>5) was observed in 75% cases of carcinoma cervix. CONCLUSION: IHC expression of p16INK4A is related to degree of histological dysplasia and malignancy, suggesting its prognostic and predictive value in the management of cervical cancers.
A Correlative Study between Platelet Count, Mean Platelet Volume and Red Cell Distribution Width with the Disease Severity Index in Psoriasis Patients.
Raghavan V, Radha RKN, Rao RK … +1 more , Kuberan A
J Clin Diagn Res · 2017 Sep · PMID 29207715 · Full text
INTRODUCTION: Platelet activation is presumed to play an important role in the immunoinflammatory reactions. Several recent studies on a variety of inflammatory disorders have used Mean Platelet Volume (MPV) as a marker...
INTRODUCTION: Platelet activation is presumed to play an important role in the immunoinflammatory reactions. Several recent studies on a variety of inflammatory disorders have used Mean Platelet Volume (MPV) as a marker for platelet activation. AIM: To determine the relationship between haematological parameters and disease severity index in psoriasis patients. MATERIALS AND METHODS: A Case control study was carried out on 50 psoriatic patients and 50 healthy control subjects. Ten haematologic parameters were compared between patients and control subjects. These parameters were also correlated in patients with PASI (Psoriasis Area and Severity Index) score. The data was statistically analysed using IBM SPSS software (Version 21). Spearman Rank Correlation was used to find the correlation between PASI and haematological parameters. RESULTS: When all the patients were considered together, mean values for MPV, Platelet Count (PLT) and Red Cell Distribution Width (RDW) were significantly different between the two groups (Control and Patients). While MPV and RDW were raised, PLT was reduced in patients of both sexes when compared with controls. In Male patients the MPV and RDW showed statistically significant correlation with Psoriasis Area And Severity Index (PASI) (MPV <0.01; RDW<0.05), whereas PLT though reduced in both sexes when compared with controls, it showed significance in female patients alone (p <0.01). CONCLUSION: The mean values for MPV and RDW were higher and mean platelet values were lower in patients than controls. The MPV values in male patients and Platelet counts in female patients showed strong positive and negative correlation respectively with the PASI score. It can be concluded that rising MPV and decreasing PLT could be good indicators of disease severity and progression. These indicators could also help in assessing the treatment course of the disease.
Paediatric Peripheral Primitive Neuroectodermal Tumour - A Clinico-Pathological Study from Southern India.
Rajendran R, Joseph LD, Johnson T … +3 more , Sneha LM, Scott JX, Srinivasan S
J Clin Diagn Res · 2017 Sep · PMID 29207714 · Full text
INTRODUCTION: Primitive Neuroectodermal Tumour (PNET)/Ewing Sarcomas (ES) are aggressive childhood malignancies with neuroectodermal differentiation. AIM: To study the clinical presentation, morphology, Immun-ohistochemi...
INTRODUCTION: Primitive Neuroectodermal Tumour (PNET)/Ewing Sarcomas (ES) are aggressive childhood malignancies with neuroectodermal differentiation. AIM: To study the clinical presentation, morphology, Immun-ohistochemistry (IHC), management and outcome of all the cases of paediatric pPNET/ES reported in our tertiary care centre over a period of six years. MATERIALS AND METHODS: This was a retrospective study conducted at Sri Ramachandra Medical College and Research Institute, Chennai, India. All biopsy proven cases of peripheral PNET/ES, in patients less than 18 years of age for a period of six years were included in this study. The corresponding clinical details regarding initial presentation, treatment and follow up were retrieved from the case files and analysed. Survival rate was calculated and Kaplan-Meier survival curve was plotted. RESULTS: We describe eleven cases of paediatric peripheral PNET/ES. The mean age at presentation was 94.08 (±58.27) months with a male/female ratio of 1.2:1. About 27.3% cases, all male with a mean age of 140 months at presentation, had distant metastasis during initial diagnosis. Biopsy showed small round blue cell morphology on light microscopy. IHC revealed strong membranous staining for CD99 in all cases. All children were treated with neo-adjuvant chemotherapy and then surgery, followed by radiotherapy if indicated. The cases were followed up for a mean duration of 20.82 months (ranging from one to 66 months). Nine children are doing well on follow up (81.8% survival rate). Two cases with metastasis at initial presentation died. Patients with metastatic disease exhibited a mean duration of survival of 9.66 (±7.24) months and those with localized disease exhibited a mean duration of survival of 25 (±22.88) months. CONCLUSION: Metastasis at diagnosis is the single most important factor affecting prognosis. This was reflected in the present study where cases with metastasis exhibited a short mean duration of survival when compared to localized disease. It is likely that many cases of PNET/ES were not accurately identified in the past as IHC plays a vital role in the diagnosis of these small round blue cell tumours. IHC in adjunct with molecular studies has improved diagnostic accuracy. Multidisciplinary management and good supportive care when the lesion is localized has lead to improved survival.
Analysis of Patient's Satisfaction with Phlebotomy Services in NABH Accredited Neuropsychiatric Hospital: An Effective Tool for Improvement.
Gupta A, Dwivedi T, Sadhana … +1 more , Chaudhary R
J Clin Diagn Res · 2017 Sep · PMID 29207713 · Full text
INTRODUCTION: Patient's satisfaction is the need of the hour and one of the most important quality indicators in the laboratory medicine. AIM: To assess the patient's satisfaction with phlebotomy services in a neuropsych...
INTRODUCTION: Patient's satisfaction is the need of the hour and one of the most important quality indicators in the laboratory medicine. AIM: To assess the patient's satisfaction with phlebotomy services in a neuropsychiatric hospital by a structured questionnaire with grading scale. Also, identify the problems causing dissatisfactions and to undertake necessary Corrective and Preventative Action (CAPA). MATERIALS AND METHODS: Total 1200 patients were randomly selected over a period of two months (June and July 2016). A structured self designed questionnaire (feedback form) was devised in both Hindi and English languages containing ten questions with a grading scale for each question. It also included suggestions from the users. All the selected patients or their attendants filled up this questionnaire. At the same time, they were also interviewed by phlebotomy staff. A statistical analysis was conducted using SPSS version 16.0 software and Likert scale. RESULTS: A total of 94% of the patients were satisfied with the phlebotomy services. Almost 30.0% patients found the phlebotomy services to be very good, but the majority of them (40.5%) found it to be good and another 23.5% found it to be satisfactory while, 4% found the services to be poor and 2% found it to be very poor. The highest rate of satisfaction (4.21) was noted in case of parameter-ease to find collection sample room and lowest rate of satisfaction (3.92) was scored by the parameter-staff's wearing proper uniform. Depending upon the deficient areas some corrective actions were suggested such as strict compliance of personal protective equipments, regular training to improve technical skill, knowledge and behaviour with emphasis on cleanliness of work area. CONCLUSION: Even though the overall patient's satisfaction was high, there were areas which needed our attention such as waiting time for phlebotomy procedure, lack of proper sitting arrangement, techniques of sample collection, knowledge of universal precautions etc. Appropriate corrective and preventive actions were taken to solve the problems. Thereby, feedback proved effective in maintenance and improvement of phlebotomy services.
Role of in Premalignant and Malignant Lesions of Uterine Cervix.
Bajpai S, Awasthi S, Dutta S … +3 more , Mittal A, Kumar A, Ahmad F
J Clin Diagn Res · 2017 Sep · PMID 29207712 · Full text
INTRODUCTION: In light of literature and controversy that exists in various cervical lesions, this prospective study was designed to explore the expression of Human Epidermal Growth Factor Receptor-2 ( in the cervical le...
INTRODUCTION: In light of literature and controversy that exists in various cervical lesions, this prospective study was designed to explore the expression of Human Epidermal Growth Factor Receptor-2 ( in the cervical lesions and its correlation with the histopathological grade and type of tumour. Immunohistochemistry (IHC) was performed to evaluate expression as it is the most reliable method of detecting overexpression of . AIM: To assess the role of expression in premalignant and malignant lesions of uterine cervix. MATERIALS AND METHODS: Seventy cases of premalignant and malignant cervical lesions received in our department from January 2015 to December 2016, were included in study and Polyclonal Rabbit Anti-Human c-erbB-2 oncoprotein from DAKO was used. Standard streptovidin-biotin peroxidase method of IHC was followed. A golden brown membrane and cytoplasmic staining was taken as a positive reaction and intensity of expression was graded according to the 2014 ASCO/CAP guidelines for reporting. RESULTS: Out of total 70 cases, expression scores were 0 in 64.3% {23 cases of Cervical Intraepithelial Neoplasia (CIN) and 22 of Squamous Cell Carcinoma (SCC)}, +1 in 22.9%, (04 cases of CIN and 12 of SCC) +2 in 10% (06 cases of SCC and 01 of adenosquamous carcinoma) and +3 in 2.9% (02 cases of adenocarcinoma) cases. overexpression rate was significantly higher in malignant (48.8%) as compared to pre malignant (14.8%) cases (p=0.004) and expression scores were higher (+2 and +3) in 20.9% of malignant cases as compared to none of pre malignant cases (p=0.020). Significant higher scores are seen (+2 and +3) in all the adenocarcinoma cases as compared to 15% cases of SCC (p<0.001). Among malignant cases, expression was statistically significantly higher in {Moderately Differentiated (MD) + Poorly Differentiated (PD)} 59.09% as compared to {Well Differentiated (WD)} 38.09% cases (p=0.090). CONCLUSION: Study shows that expression of is relatively lower in cervical lesions. However, the results of our study show that with shift from well to poorly differentiated lesions; the expression rate shows an incremental trend.
Universal Presence of Gene in Carbapenem-Resistant Gram-Negative Bacilli in an Indian Hospital in 2015.
Chatterjee B, Khanduri N, Kakati B … +1 more , Kotwal A
J Clin Diagn Res · 2017 Sep · PMID 29207711 · Full text
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A Case of Keratomycosis Caused by at Rural Tertiary Care Center.
Kulkarni VL, Kinikar AG, Bhalerao DS … +1 more , Roushani S
J Clin Diagn Res · 2017 Sep · PMID 29207710 · Full text
Keratomycosis is defined as invasive infection of corneal stroma caused by variety of fungi. Most of these cases occur in agricultural workers with history of corneal trauma with vegetative matter contaminated by fungi....
Keratomycosis is defined as invasive infection of corneal stroma caused by variety of fungi. Most of these cases occur in agricultural workers with history of corneal trauma with vegetative matter contaminated by fungi. species which causes keratomycosis receives occasional mention in literature. We report a case of a 27-year-old male, farmer by occupation presented with complains of foreign body sensation, itching and discharge from the right eye and developed white patch on cornea which was progressed gradually to size of diameter of pea which was later diagnosed as keratitis caused by species.
Isolation of the Rare Opportunistic Yeast from Clinical Samples-Experience from a Tertiary Care Hospital in Southern India and a Brief Review of the Literature.
Pamidimukkala U, Kancharla A, Sudhaharan S … +5 more , Gundeti S, Mandarapu S, Nagalla VK, Raju SB, Karanam SD
J Clin Diagn Res · 2017 Sep · PMID 29207709 · Full text
INTRODUCTION: (Teleomorph: ) is a ubiquitous yeast found in environmental sources such as soil, water, air, plants and dairy products. It is also a part of the normal microbial flora in humans. The yeast is being increa...
INTRODUCTION: (Teleomorph: ) is a ubiquitous yeast found in environmental sources such as soil, water, air, plants and dairy products. It is also a part of the normal microbial flora in humans. The yeast is being increasingly reported as an opportunistic pathogen, especially in patients in the haemato-oncology setting, the infection being often mistakenly diagnosed as invasive candidiasis. AIM: To review the epidemiological, clinical and microbiological features of six patients admitted in our hospital over a period of 10 years (from January 2007 to December 2016), from whom was isolated. MATERIALS AND METHODS: A retrospective study was conducted and the epidemiological, clinical, imaging and microbiological data of the six patients were collected and analysed. RESULTS: The age of the six patients ranged from 19 years to 65 years with a median age of 53 years. There were two males and four females. In three out of the six patients, the isolation of was considered clinically significant as the yeast was isolated repeatedly from blood and/or respiratory specimens and the clinical features could not be explained by any other alternative diagnosis. Haematological malignancy was the underlying disease in three out of the six patients while one patient was on triple immunosuppression following renal transplantation four years back. Three out of the six patients had severe neutropenia with Absolute Neutrophil Count (ANC) ≤ 500 at the time of isolation of Two patients with clinical features of fungal sepsis received antifungal therapy with Amphotericin B but succumbed within a short period of starting the therapy. The post renal transplant patient who presented with pneumonia recovered after treatment with a combination of Amphotericin B and Voriconazole. CONCLUSION: Awareness regarding the epidemiological, clinical and microbiological aspects of invasive infections caused by is essential for early recognition and appropriate management.
In Vitro Anti-Cariogenic Plaque Effects of Essential Oils Extracted from Culinary Herbs.
Wiwattanarattanabut K, Choonharuangdej S, Srithavaj T
J Clin Diagn Res · 2017 Sep · PMID 29207708 · Full text
INTRODUCTION: Cariogenic bacteria including mutans streptococci and lactobacilli are partly but significantly involved in dental caries development. An effective prevention strategy against dental caries is to decrease t...
INTRODUCTION: Cariogenic bacteria including mutans streptococci and lactobacilli are partly but significantly involved in dental caries development. An effective prevention strategy against dental caries is to decrease the accumulation of this microbiota either in planktonic or in biofilm form. AIM: To examine the antimicrobial and anti-plaque effects of some culinary herbs (spices), so the herbs are plausibly used as alternative and effective herbal plaque control supplements to promote good oral health. MATERIALS AND METHODS: Essential oils extracted from sweet basil , cinnamon bark , sweet fennel , kaffir lime , black pepper , peppermint , and spearmint were primarily examined for their antimicrobial activities against the cariogenic bacteria KPSK2 and using the agar disk diffusion and broth microdilution methods, respectively. These essential oils were then analysed for anti-plaque effects (retardation of biofilm formation and reduction of the in vitro established biofilm). This experimental study was performed at the Department of Oral Microbiology, Faculty of Dentistry, Mahidol University during June 2015 till August 2016. RESULTS: All selected essential oils showed different degrees of antimicrobial activity against the planktonic form of both cariogenic bacteria. Cinnamon bark essential oil expressed the strongest inhibitory effect against {MIC of 0.08% (v/v)} and {MIC of 0.16% (v/v)}, whereas the weakest effect was found in kaffir lime essential oil {MIC values of 2.5% and 5.0% (v/v) for and , respectively}. Up to 80% of biofilm was retarded to form on the substratum primed with these spice essential oils, especially cinnamon oil. The preventive effect of these oils was in dose- and exposure time-dependent manners. For reductive effect against the 24-hour pre-established biofilm, at least 50% of the biofilm mass was reduced when the biofilm was treated with each essential oil at the MIC for an hour. The reductive effect against the in vitro established biofilm of these culinary herb essential oils only depended on the exposure time. CONCLUSION: Cinnamon and sweet basil essential oils with impressive in vitro anti-cariogenic bacteria and anti-plaque effects may be proposed as alternative and effective supplements to promote oral health status.
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