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C Sundaram

Publications and source records attributed to C Sundaram.

At least 19 recordsLinked to original sources
PubMed2006

Pathology of fungal infections of the central nervous system: 17 years' experience from Southern India.

AIMS: To describe the pathology of central nervous system (CNS) fungal infections with particular reference to India. METHODS AND RESULTS: This was a retrospective study from 1988 to 2004 constituting 130 cases. The diagnosis was based on morphology of biopsy/autopsy material. These included aspergillosis (n=73), zygomycosis (n=40), cryptococcosis (n=2), rhodotorulosis (n=1), candidiasis (n=5), maduramycosis (n=1), pheohyphomycosis (n=3) and mixed infections (n=5). Predisposing risk factors were present in 49 (38%) patients only. The majority of the patients were immunocompetent. The commonest risk factor was diabetes mellitus, the commonest route of infection was from a contiguous site and the commonest pathology was granuloma. Culture positivity was seen in only 31%. CONCLUSION: Environmental factors in tropical countries such as India play a significant role in the pathogenesis of CNS fungal infections.

Adolescent↗
PubMed2006

Pathogenesis and pathology of brain abscess.

Brain abscess continues to be a serious medical problem with increasing incidence despite advances in diagnostic and surgical methods, and advent of new antibiotics. This is due to increase in immune suppressed individuals, opportunistic pathogens and resistance to antibiotics. The morbidity, mortality and long term sequelae of brain abscess like cognitive impairment and poor neurological outcome are due to persistent release of proinflammatory mediators by activated microglia, astrocytes and infiltrating inflammatory cells, along with disruption of blood brain barrier. Anti-inflammatory drugs along with specific antimicrobial agents help in minimizing damage to the adjacent brain parenchyma. Identification of microorganisms in the aspirated material or the excised specimen help decide the optimal antimicrobial therapy. Prompt examination of smear and meticulous culture techniques to identify aerobes, anerobes, mycobacteria, actinomycetes, parasites and fungi are of utmost importance in choosing antibiotics. Histology complements culture and plays a key role especially in specific infections. Use of appropriate histochemical stains along with tissue reaction helps in diagnosis. The route of spread, the type and virulence of the organism, thickness of the capsule, location and number of abscesses in the brain, and immune status of the host are important determinants of outcome. Identification of microorganisms and insights into pathogenesis allow appropriate therapeutic interventions to improve outcome.

Actinobacteria↗
PubMed2005

Protective effect of CardiPro against doxorubicin-induced cardiotoxicity in mice.

The effect of CardiPro, a polyherbal formulation, with an antioxidant property, has been studied on doxorubicin (DXR)-induced cardiotoxicity in mice. CardiPro (150 mg/kg b.w., twice daily was administered orally for 7 weeks along with four equal injections (each containing 4.0 mg/kg b.w., DXR) intraperitoneally, once weekly (cumulative dose 16 mg/kg). After a 3-week post DXR treatment period, cardiotoxicity was assessed by noting mortality, volume of ascites, liver congestion, changes in heart weight, myocardial lipid peroxidation, antioxidant enzymes and histology of heart. DXR-treated animals showed higher mortality (50%) and more ascites. Myocardial SOD and glutathione peroxidase activity were decreased and lipid peroxidation was increased. Histology of heart of DXR-treated animals showed loss of myofibrils and focal cytoplasmic vacuolization. CardiPro significantly protected the mice from DXR-induced cardiotoxic effects as evidenced by lower mortality (25%), less ascites, myocardial lipid peroxidation, normalization of antioxidant enzymes and minimal damage to the heart histologically. Our data confirm the earlier reports that DXR cardiotoxicity is associated with the free radical-induced tissue damage. Administration of CardiPro, with an antioxidant property, protected the DXR-induced cardiotoxicity in mice.

Animals↗
PubMed2005

Cerebral zygomycosis.

Fifty-six patients with cerebral zygomycosis (mucormycosis) were seen during the period 1971-2001 in two tertiary care hospitals located in south India with tropical climate and catering to neurological diseases. Forty-four patients had rhinocerebral and twelve patients had isolated central nervous system (CNS) zygomycosis. Of these, ten were culture proven (Rhizopus oryzae in eight and Mucor in two); 30 were diagnosed as probable and 16 were diagnosed possible; mixed infections were seen in three patients. Diabetes mellitus was the predisposing condition in a majority (31/44) of patients with the rhinocerebral form of zygomycosis. The tissue obtained at biopsy/autopsy in either form showed necrotic/infarcted tissue with neutrophilic infiltration with broad non-septate hyphae showing irregular branching. The outcome was poor despite surgical excision and antifungal therapy. The high concentration of spores in a mouldy environment, the bird population and improper disposal of hospital waste may facilitate healthy hosts presenting with primary CNS disease.

Adolescent↗
PubMed2005

Extramedullary myeloid cell tumours--the NIMS experience.

Extramedullary myeloid cell tumours are rare clinical entities, which often pose diagnostic problems. From the pathology record files of Nizam's Institute of Medical Sciences, Hyderabad, 16 cases of EMCTs were traced, over a period of 14 years. The clinical details, follow-up were noted and morphology re-evaluated, and immunohistochemistry with LCA was performed. Of the 16 cases, the distribution was as follows--skin and subcutaneous nodules, lymph nodes, extradural masses presenting with cord compression and one case each with eyelid, orbital and breast masses. The problems in diagnosis are presented and a panel of immunohistochemical markers suggested for proper diagnosis and treatment.

Academic Medical Centers↗
PubMed2004

Brain abscess due to Entamoeba histolytica.

A patient of cerebral amoebiasis due to Entamoeba histolytica with no evidence of disease elsewhere is described. He made a complete recovery after surgical excision of the abscess along with metronidazole therapy.

Animals↗
PubMed2003

Magnetic resonance imaging in rabies.

Rabies encephalitis has a classical clinical presentation and its diagnosis is unmistakable. In about a fifth of cases rabies occurs as its paralytic form, which lacks the classic symptoms and may mimic other diseases, especially acute disseminated encephalomyelitis (ADEM). Magnetic resonance imaging of the brain in rabies shows a distinct abnormal pattern that differentiates it from ADEM. Hence it may be a useful tool in diagnosis of paralytic rabies. Failure to administer post-exposure rabies immunoglobulin along with the rabies vaccine may result in vaccine failure.

Animals↗
PubMed2003

Hemangioblastoma: a study of radiopathologic correlation.

Computerized tomography (CT) scan and operative observations, and histolopathogical findings of 25 cases of intracranial hemangioblastoma were correlated. Solid hemangioblastomas showed a large number of thin-walled capillaries and abundant stromal cells with eosinophilic cytoplasm. Tumors with a cystic component and a mural nodule had a large number of stromal cells with vacuolated cytoplasm and microcysts.

Adolescent↗
PubMed2003

Hodgkin's lymphoma presenting as extradural spinal cord compression.

OBJECTIVES: Hodgkin's lymphoma presenting with spinal cord compression is rare. Reports estimate that only 5% of patients with Hodgkin's lymphoma have spinal cord compression. The objectives of this study were:- (1) To review the histology of all cases of Hodgkin's lymphoma causing spinal cord compression. (2) To correlate the findings with the clinical details- lymphadenopathy, hepatosplenomegaly, and marrow involvement. METHOD: This was a retrospective study, the period of study being between 1987-2002. All cases were taken from the histopathology record files, pathology department, NIMS, Hyderabad. The clinical profile of each case was noted and the histology reviewed. When necessary, immunohistochemistry with the necessary markers was performed. RESULT: There were 12 cases, of which 11 were males, and one was a female. The patients ranged from 8-62 years of age, with a median age of 32 years. The cord involvement was at different levels- thoracic(8), lumbar(2) and cervical(2). CONCLUSIONS: The histologic diagnosis of Hodgkin's lymphoma presenting as cord compression requires awareness of the condition. The close differential diagnoses include non-specific inflammation, non-Hodgkin's lymphoma, tuberculosis and eosinophilic granuloma. Detailed clinical evaluation is essential for interpreting the histology.

Adolescent↗
PubMed2003

Medulloepithelioma: a case report.

Histological, immunohistochemical, and CT morphological features of medulloepithelioma, a rare embryonal tumor of primitive neuroepithelium, are described.

Brain Neoplasms↗
PubMed2003

Clinicopathological study of thymomas--correlation of histologic subtype to myasthenia gravis and prognosis.

Thymoma is the most common primary tumor of anterior superior mediastinum. Sixty cases of thymomas over a 12 year period were analysed and the histologic subtype, according to Marino and Muller-Hermilink, classification was correlated with presence or absence of myasthenia gravis (MG) and capsular invasion. Thirty four patients had myasthenia gravis associated with thymoma and there was one case of pure red cell aplasia. There were 3 (1) predominantly cortical, 28 (20) cortical, 12 (9) mixed, 16 (4) medullary thymomas and 1 (0) thymic carcinoma (Figures in parenthesis indicate number of cases associated with MG). Capsular invasion was seen in 25 cases. Association with myasthenia gravis and capsular invasion were seen predominantly in cortical and mixed thymomas which were also associated with aggressive behaviour.

Adolescent↗
PubMed2003

Diagnostic utility of squash (smear) technique in the inflammatory lesions of central nervous system.

Smears of histologically verified inflammatory lesions of central nervous system (CNS) during 12 years were analysed to determine the diagnostic utility and accuracy of squash (smear) technique. Two hundred and sixteen (216) lesions were analysed. Smears could not be interpreted in 72 lesions (33.33%) as the tissue could not be spread or not representative. Tuberculosis was the commonest etiology (70.83%) followed by bacterial, fungal and parasitic infections. To conclude, smear technique is a useful modality in establishing diagnosis in inflammatory lesions of CNS, but its usefulness is limited by difficulties in spreading tissue.

Bacterial Infections↗
PubMed2003

Cerebral sparganosis.

A 22 years male patient presented with recurrent seizures, CT and MRI diagnosis of tuberculoma was made and the patient was treated. When seizures persisted, a craniotomy was done and the excised mass revealed an abscess with a segment of broad solid non-cavitory body, wall with no scolex and loose stroma and smooth muscle fibers. A diagnosis of sparganosis cerebral abscess was made. The case is reported in view of the rarity of cerebral sparganosis in India and the need for awareness of the entity in India.

Adult↗
PubMed2002

Primary cutaneous nocardiosis with epidural abscess caused by Nocardia brasiliensis: a case report.

Dissemination of primary cutaneous nocardiosis is a rare event. An interesting case of a 20 year old female labourer with progressive weakness in both the lower limbs and large multiple subcutaneous abscesses over the back, since 4 years, is presented. MRI showed an epidural abscess compressing the cord. Histopathology of skin lesions suggested a chronic suppurative lesion. Microbiological tests on the aspirate from the skin lesion identified the causative organism as Nocardia brasiliensis.

Adult↗
PubMed2002

Protective effect of Gingko biloba extract against doxorubicin-induced cardiotoxicity in mice.

Doxorubicin (DXR) causes dose dependent cardiotoxicity in experimental animals and in humans. In chronic doxorubicin cardiotoxicity model mice, the role of G. biloba extract (Gbe) which has an antioxidant property, was investigated. Doxorubicin treated animals showed higher mortality (68%), increased ascites, marked bradycardia, prolongation of ST and QT intervals and widening of QRS complex. Myocardial SOD and glutathione peroxidase activity were decreased and lipid peroxidation was increased. Ultrastructure of heart of DXR treated animals showed loss of myofibrils, swelling of mitochondria, vacuolization of mitochondria. G. biloba extract significantly protected the mice from cardiotoxic effects of doxorubicin as evidenced by lowered mortality, ascites, myocardial lipid peroxidation, normalization of antioxidant enzymes, reversal of ECG changes and minimal ultrastructural damage of the heart. The results indicate that administration of G. biloba extract protected mice from doxorubicin-induced cardiotoxicity.

Animals↗
PubMed2001

Dual-organ ablative surgery using a hand-assisted laparoscopic technique. A report of four cases.

In clinical situations where more than one procedure is required, a properly positioned hand-assist device can be used to obviate the need for two large incisions. We present four cases of hand-assisted laparoscopic nephrectomy combined with a simultaneous second organ extraction. Each of the four primary procedures, as well as one of the four secondary procedures, was performed using a hand-assisted laparoscopic technique. In two cases, the secondary procedure was performed with an open surgical technique through the hand-assist incision. For the remaining secondary procedure, we used a laparoscopically assisted technique.

Aged↗