Journal of clinical and diagnostic research

Potential Use Of Blood, Buccal And Urine Cells For Rapid Noninvasive Diagnosis Of Suspected Aneuploidy Using Fluorescence In Situ Hybridization (FISH)

HALDER A, FAUZDAR A

Objective: The objective of the study was to determine whether noninvasive and readily available cells could be used for rapid diagnosis of specific chromosomal abnormality to facilitate management of patients in acute/specialized situation. Methods: In the present study we analyzed blood, buccal & urine cells from 3 patients with pure trisomy 21 with locus specific FISH probes for chromosome 21. Three normal subjects were included for comparison. The clinical cases were confirmed with conventional cytogenetic studies of peripheral lymphocytes before inclusion in the study. Result: Average frequencies for 1, 2 and 3 hybridization signals were 2.2%, 6% and 91% for blood cells, 2.5%, 7% and 89.8% for buccal cells and 2%, 9.3% and 87.4% for urine cells, respectively in the cases. False trisomic cells were less than 1% in all type of cells in controls. False monosomic cells were 3.6%, 4.5% & 9.8% for blood, buccal & urine cells in controls which was quite similar to alphoid FISH probes (chromosome 1 & 18). Conclusion: This study suggests DNA locus specific FISH probes can be used in blood/buccal/urine cells for rapid noninvasive diagnosis, but because of high rates of false monosomy, it may not be accurate to diagnose low (<10%) level of mosaicism. The test is suitable for medically urgent situations for management guidance.

Status of Lipid Peroxidation, Glutathione, Ascorbic Acid, Vitamin E and Antioxidant Enzymes in Schizophrenic Patients

SURAPANENI K M

The exact pro- and antioxidant status in schizophrenic patients is still not clear. To add a new insight to the question, changes in the erythrocyte lipid peroxidation products (MDA), levels of glutathione (GSH), ascorbic acid and plasma vitamin E (non-enzymatic antioxidant parameters) and activities of antioxidant enzymes superoxide dismutase (SOD), glutathione peroxidase (GPX) and catalase in erythrocytes were studied in 48 schizophrenic patients and 48 healthy subjects. It was observed that there was a significant increase in erythrocyte MDA levels and activities of SOD and GPX and a significant decrease in erythrocyte GSH, ascorbic acid, plasma vitamin E levels and catalase activity in patients with schizophrenia, when compared to controls. The results of our study have shown higher oxygen free radical production, evidenced by increased levels of MDA and decreased levels of GSH, ascorbic acid, vitamin E and catalase activity, which supports the oxidative stress in schizophrenic patients. The increased activities of antioxidant enzymes may be a compensatory regulation in response to increased oxidative stress. The decreased concentrations of the glutathione and antioxidant vitamin status support the hypothesis that lipid peroxidation is an important causative factor in the pathogenesis of schizophrenia. These data reveal that antioxidant defence mechanisms might be impaired in schizophrenic patients. These findings also provide a theoretical basis for the development of novel therapeutic strategies, such as antioxidant supplementation. This may suggest the hope for use of antioxidants in clinical trials to prevent and treat schizophrenic patients.

Benefit Of Vasectomy Using Cautery In Comparison With Excision And Ligation

MOUSAVI SMN, FANAIE SA , ZIAEE SA

Background: The data from a lot of comparatives analyses provided a strong hypothesis that the use of cautery is a very effective method. The main objectives of this study were to evaluate the cautery occlusion method against ligation and excision in terms of complications. The other objectives were to estimate the time of the procedure and the failures of cautery versus ligation and excision. Methods: A prospective, comparative observational study was conducted at a referral center in Iran. One hundred men who chose vasectomy were enrolled and observed for 48 weeks. More frequent than normal semen analysis (12, 18, and 48 weeks after vasectomy) were performed. Planned outcome included early and late complication, early scrotal pain, consuming time and effectiveness (based on semen analysis). Results: A total of 98(98%) participants in both groups completed a follow up. Significantly, the cautery technique took less time than ligation excision (7.56±1.08 min versus 9.88±1.24 min respectively).Early post-vasectomy scrotal pain based on VAS score in cautery group was significantly lower than ligation and excision (1.61±0.88 versus 2.39±1.40 respectively) .Among complications, the incidence of granuloma and epididymitis in the cautery group is significantly less than ligation and excision. The overall failure rate based on semen analysis was 0.9% in the cautery group versus 4.7% in ligation and excision. (OR=4.8 CI=95%, 1.6-14.3) Conclusions: Cautery is a very effective method for occluding the Vas deferensDespite the reduction in failure rate, it takes less time, and risk of the complications is acceptable compared to the ligation-excision technique

Evaluation Of The Cellular Immune Response In Patients With Head And Neck Cancer

GODEKMERDAN A ,KAYGUSUZ I ,SAKALLIOGLU O, ILHAN F,DEMIR N

Aim: The aim of the present study is to evaluate the cellular immune response in patients with head and neck cancer. Material-Method: Twenty volunteer healthy subjects as controls and 34 patients who have been diagnosed with squamous cell carcinoma at the Department of Ear Nose Throat in Firat University Firat Medical Center from June 2002 to January 2005 were included in the study. The ages of the patients ranged between 27 and 74 years (mean 56.8+/-10.3), and the ages of the controls ranged from 21 to 69 years (mean 53.4+/-12.7). There were squamous cell carcinoma (SCC) of larynx in 30 patients, SCC of hypo pharynx in three patients, and SCC of paranasal sinus in one patient. 18 of these patients were in the early stage, four patients in the advanced stage, and 14 patients in the metastatic stage. Histopathological diagnoses were carried out by biopsies in preoperative term and pathological examination of the specimens in postoperative term. The examination of lymphocyte sub groups was done by flow-cytometiric analysis. Results: In the flow cytometry of peripheral blood samples of head and neck cancer patients and controls, while the ratio of CD4+/CD8+ T cell significantly decreased, the ratio of B lymphocyte, NK cell and activated Tc cell increased in patients compared to the controls. When the patients were compared to each other, CD4+25+ cells were in high level in metastatic patients in comparison to patients in early stages. Conclusion: These results indicated that especially cellular immune response was activated in head and neck cancer, but it was not enough to prevent the cancer

Amniotic Membrane in Trabeculectomy: An Experimental Study

BISWAS NR, KHOKHAR S, RAJESH P, GOGOI M, SEN S, DAS TK, KUMAR H

Background: To assess the potential use of amniotic membrane graft (AMG) for augmenting trabeculectomy. Methods: Sixteen eyes of 8 rabbits were randomly divided into a study group that underwent trabeculectomy with AMG, and a control group that underwent trabeculectomy alone. Result: The mean duration of blebs was greater in the study group as compared to the controls (p=0.009). On day 1, the IOP was low in both groups (p<0.001). At 1 week, the study group IOP remained low but reached preoperative levels at 2 weeks and 1 month. In the control group the IOP reached preoperative levels at 1 week, 2 weeks and 1 month. Histologically, the early functioning bleb showed filtering spaces. There was subconjunctival fibrosis at 1 week in the controls and at 2 weeks in the study group. Conclusion: AMG had a short term augmenting effect on trabeculectomy in this animal model.

Solitary Plasmocytoma of Bone

CRASTA J, RAMESHKUMAR K

Within the plasma cell dyscrasias, solitary plasmacytoma is rare. Solitary plasmacytoma of bone (SPB) is defined as a single bony lesion caused by a monoclonal plasma cell infiltrate, with no evidence of myeloma elsewhere. All cases reported as multiple myeloma/plasmacytoma, from January 1999 to August 2002 at St. John’s Medical College and Hospital, were reviewed. After applying the diagnostic criteria, three cases conformed to the diagnosis of solitary plasmacytoma (7.5%). In the three cases of SPB, two occurred in males and one in female. The site of occurrence was in the thoracic vertebrae. Although radiotherapy alone is considered adequate, as two patients presenting in the vertebral region had neurological dysfunction, laminectomy was done in addition to radiotherapy. Light microscopy of all three cases showed a dense infiltrate of sheets of plasma cells. The present study highlights the salient features of SPB. The frustrating aspect in the management of the SPB is the development of peripheral neuropathy, which was present in all three cases and was the presenting symptom in two of the cases as part of POEMS syndrome. Careful microscopy is required in EMP, as it can be confused with other malignancies, particularly lymphomas.

Late Presentation Of Amniotic Band Syndrome A Case Report

VERMA A, MOHAN S, KUMAR S

Amniotic band syndrome is a term used interchangeably to Streeter’s dysplasia and refers to a continuous spectrum of manifestations occurring due to intrauterine rupture of amnion. The disease may be characterised by simple soft tissue constriction bands to amputation of digits or more severely of the whole limb due to dysplastic vasculature. Due to digital amputation the condition is also known as pseudo-ainhum. This is a rare condition. Therefore, we report a case wherein at the age of five years there are constriction bands in the right leg while amputation was noted in toes and in the right index and middle finger.

Pulmonary Sequestration: Case Report

AQRABAWI H E

Pulmonary sequestration is a rare congenital anomaly of the lung that has variable presentation. It can remain asymptomatic up to early adulthood. This condition is suspected when a shadow persists on a chest radiograph. Confirmatory diagnosis requires angiography or computed tomography (CT) angiogram. Treatment of choice remains surgical removal; however, embolisation of the feeder artery presents a recent advance. We present a case of a 4-month-old infant, with pulmonary sequestration found on a radiograph done incidentally.

Unusual Presentation Of Pediatric Myelodysplastic Syndrome: A Case Report

TONDON R, SINGH PA, MISRA V, SINGH M

Myelodysplastic syndrome (MDS) is a clonal hematological disorder characterized by dysplastic hematopoiesis and progression to leukemia. MDS is a rare childhood disorder presenting with nonspecific symptoms and has extremely variable prognosis. It should be considered in the differential diagnosis of all cytopenic disorders in children. The preleukemic phase is usually short and the disease rapidly evolves into overt leukemia. Marrow cellularity is normal or increased in MDS with hypocellular marrow being a rare feature. We report a case of MDS in a child with the rare finding of hypocellular bone marrow for that age.

Primary Idiopathic Osteolysis Syndrome: Case Report And Review Of Literature

VERMA A, MOHAN S, KATHURIA MK, PHADKE S, BAIJAL SS.

Primary idiopathic osteolysis (massive osteolysis, essential osteolysis, progressive atrophy of bone, spontaneous absorption of bone, phantom bone) is an extremely rare occurrence. This disorder is characterised by spontaneous or post traumatic bone resorption of uncertain etiology with unpredictable prognosis, and any effective therapy is largely unknown (1). We report the clinico-radiological features of a 10-year-old male patient with this condition, and present a short review of the available literature.

Idiopathic Degenerative Elongation of Extensor Pollicis Longus Tendon: Case Series

REZAEE Y, RAHIMNIA A, ZIAEE S A

Three cases of elongation and attrition of the extensor pollicis longus without detectable fracture after wrist injury or dislocations of carpal bones or radio carpal joint and any connective tissue disorders are reported. The average age of all patients was 20 years. With palmar flexion of wrist, patients were able to completely extend their thumb finger, but with dorsiflexion of wrist, the ability to extend the thumb was lost. Elongation and thinning of the extensor pollicis longus tendon have not been reported in the literature. No mechanisms have been proposed to account for this problem. The following cases, the first of its kind of which we are aware, may help to clarify the relationships between degeneration and tendon rupturing.

Varenicline: A Helping Hand for Smokers to Quit Smoking

JIMMY B, WADHWA T, KHERA K, JOSE J, SARAVU K.

Necrotising Enterocolitis: Newer Insights

GARG P

Necrotising enterocolitis is the most common gastrointestinal emergency of the neonates with high mortality and morbidity. Despite 3 decades of extensive research and animal studies etio-pathogenesis, early diagnosis, preventive strategies and management options remain controversial. The present article reviews the literature for recent advances and newer insights for changing epidemiological trends, pathogenesis, role of inflammatory cytokines and various preventive and management strategies.

Air bacterial isolations from operation theatres in a tertiary care hospital in India

KAUR N , HANS C

Peroperative bacterial contamination of the wound is known to be a major risk factorfor surgical wound infection. The microbiological quality of theatre air is one of the significant parameter for controlling surgical wound infection. The present study was conducted in seven operation theatres of a tertiary care teaching hospital of capital city of India with 1000 beds for a period of one year. Settle plate method was adopted using standard sized Blood agar plates. A total of 344 samples taken repeatedly from seven different operation theatres were processed and the isolates were Staph aureus (16%), Coagulase negative Staph(26.7%), Acinetobacter spp.(2.03%) and Klebsiella spp. (0.3%). Crowding of surgical theatres by surgical staff, trainees and students is an important issue along with design, ventilation problems and overuse of theatres. This is the first Indian study conducted in order to determine air bacterial isolates in operation theatres.More studies are warranted on quality of air in operation theatres.