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Biomedical subjects

D K Das

Publications and source records attributed to D K Das.

At least 361 records · Page 20Linked to original sources
PubMedDate not supplied

An analysis of long-term venous access catheters in cancer patients:experience from a tertiary care centre in India.

BACKGROUND: Venous access is crucial for cancer management for administration of drugs blood products, antibiotics and periodic sampling. AIMS: To review our experience of long-term venous access devices used over a ten-year period and to analyse the outcome in cancer patients in Indian setting. SETTING AND DESIGN: A retrospective analysis of data in a tertiary care Regional cancer centre. PATIENTS AND METHODS: A total of 110 patients with various malignancies requiring long-term venous access were included in the study. A uniform open cut down procedure under local anaesthesia was used and silastic Hickman catheters were inserted in the cephalic or external jugular or internal jugular veins. A record of all complications and catheter loss and final out come were analysed. RESULTS: A total of 111 catheters were used in 110 patients. Sixty-nine catheters were placed in cephalic, 40 in external jugular, and 2 in internal jugular vein. Duration of catheter indwelling period ranged from 7 to 365 days with a median of 120 days. In 90% of the cases the catheter tip was located either in superior vena cava or in right atrium. Total catheter related complications were observed in 37 (34.54%) patients and catheter loss rate due to complications was 15.4% (17/111). CONCLUSIONS: Long-term venous access using Hickman catheter insertion by open cut down method is a simple, safe and reliable method for administration of chemotherapeutic agents, antibiotics and blood products. The incidence of various complications and catheter loss was acceptable and overall patient satisfaction was good.

Adult↗
PubMedDate not supplied

Colloid carcinoma of the breast with concomitant metastasis and a tuberculous lesion in the axillary lymph nodes. A case report.

A 30-year-old woman presented with a lump in the left breast and left axillary lymphadenopathy that, on fine needle aspiration cytology (FNAC), proved to be duct cell carcinoma with metastasis. Histology of the radical mastectomy specimen showed a mixed colloid carcinoma. Axillary lymph nodes revealed a variety of pathologic changes consisting of reactive hyperplasia, tuberculosis and metastasis. A combination of a tuberculous lesion and metastasis in the same lymph nodes was also found. During follow-up, after radiotherapy, the patient developed left supraclavicular and right cervical lymphadenopathy that, on FNAC, revealed a tuberculous lesion and metastasis, respectively. The rarity of this condition with double pathology is highlighted, and the reason behind the limitations of FNA in subtyping the primary malignancy and its failure to detect the tuberculous lesion in the axillary lymph node are discussed.

Adenocarcinoma, Mucinous↗
PubMedDate not supplied

Status of maternal and new born care at first referral units in the state of West Bengal.

A study was conducted in 12 First Referral Units (FRUs), selected through multistage sampling, from 6 districts of West Bengal. Infrastructure facilities, record keeping, referral system and MCH indicators related to newborn care were documented. Data was collected by review of records, interview and observation using a pre-designed proforma. Inadequate infrastructure facilities (e.g. no sanctioned posts of specialists, no blood bank at rural hospitals declared as First Referral Units etc.); poor utilization of equipment like neonatal resuscitation sets, radiant warmer etc, lack of training of the service providers were evident. Records/registers were available but incomplete. Referral system was found to be almost nonexistent. Most of the deliveries (86.1%) were normal delivery. Deliveries (87.71%) and immediate neonatal resuscitation (94.9%) were done mostly by nursing personnel. Institution based maternal, perinatal and early neonatal mortality rates were found to be 5.6, 62.4 and 25.2 per 1000 live births respectively. Eclampsia (48.9%), hemorrhage (17.7%), puerperal sepsis (7.1%) were reported to be major causes of maternal mortality. Common causes of early neonatal mortality were birth asphyxia (54.3%), sepsis (14.6%) and prematurity/LBW (12.4%).

Documentation↗
PubMedDate not supplied

Fine needle aspiration cytology diagnosis of tuberculous thyroiditis. A report of eight cases.

Among 1,283 cases of thyroid lesions subjected to fine needle aspiration cytology (FNAC) over a period of two years, 8 cases (0.6%) were found to be having cytologic features consistent with tuberculous thyroiditis. The ages of the patients ranged from 14 to 65 years, with a median of 30. The male:female ratio was 4:4. Six cases clinically presented with solitary nodules of the thyroid and two cases as abscesses in the thyroid region. Three patients had concomitant cervical lymphadenopathy, and only two patients were known cases of tuberculosis on treatment. Ultrasonography, done in seven cases, confirmed solitary nodules in four; in one case the differentiation between an extrathyroid nodule and cystic isthmic nodule was difficult, and in the remaining two cases the lesions were found to be extrathyroid. Fine needle aspirates from thyroid swellings showed epithelioid granuloma with necrosis in five cases and necrosis without epithelioid granuloma in three cases. The number of cases positive for acid-fast bacilli in these two groups were two and three, respectively. Lymph node aspiration, done in three cases, revealed necrotic material in two; both were positive for acid-fast bacilli, and the third case showed epithelioid granuloma without necrosis.

Adult↗
PubMedDate not supplied

Iodine deficiency disorders among school children of Dakshin Dinajpur District, West Bengal.

Iodine deficiency disorders (IDD) are major public health problems in India, including West Bengal. Existing programme to control IDD needs to be continuously monitored through recommended methods and indicators. Thus we undertook the study to assess the prevalence of goiter, status of urinary iodine excretion (UIE) level and to estimate iodine content of salts at the household level in Dakshin Dinajpur district, West Bengal. We conducted a community-based, cross-sectional study in 2004; among 2250 school children, aged 8-10 years. The '30 cluster' sampling methodology and indicators for assessment of IDD, as recommended by the joint WHO/UNICEF/ICCIDD consultation, were used for the study. Goitre was assessed by standard palpation technique, UIE was analyzed by wet digestion method and salt samples were tested by spot iodine testing kit. Of the 2250 children, 419 (18.6%) had goitre (95% CI = 17.0 - 20.2%). Total goitre rate (TGR) was not significantly different in respect of gender, age and religion. Visible goitre rate was 2.5%. Median urinary iodine excretion level was 16 mcg/dL (normal: > or = 10 mcg/dl.) and 16.5% children had value less than 5 mcg/dL. Only 67.4% of the salt samples tested had adequate iodine content of > or = 15 ppm, with significant difference between Hindus and Muslims (chi2 = 12.68, d.f. = 1, p < 0.01). TGR of 18.6% indicate the district is still endemic for IDD, but median urinary iodine within normal range reflects no current iodine deficiency. The district is in the transition phase from iodine-deficient to iodine-sufficient. Measures are to be sustained for successful transition towards elimination.

Child↗
PubMedDate not supplied

Agricultural practices and personal hygiene among agricultural workers in a rural area of Howrah district, West Bengal.

The study attempted to assess agricultural practices and personal hygiene among 100 agricultural workers in a rural area of West Bengal in 1999. 69% of the study population was marginal farmer with less than 2 acres of land. Organophosphorus group of pesticides were most commonly used pesticides (68%); spraying was irregular in nature (98%), through semiautomatic sprayer (99%) and only 5% used any special dress while spraying pesticides. 40% of workers used to store pesticides either in living room or in food storage area. 88% of them did not take any food during work with pesticides, only 37% used to take regular bath after working with pesticides but regular hand washing was practiced by all of them.

Adult↗
PubMedDate not supplied

Nuclear grooves. Valuable diagnostic feature in May-Grünwald-Giemsa-stained fine needle aspirates of papillary carcinoma of the thyroid.

Recent reports have indicated the usefulness of nuclear grooves (clefts or notches) as an additional criterion for the diagnosis of papillary thyroid carcinoma in fine needle aspirates; most of these studies were carried out on alcohol-fixed material stained with the Papanicolaou stain or with hematoxylin and eosin, which yield good nuclear details. In the present study air-dried thyroid aspirates stained with the widely used May-Grünwald-Giemsa stain were evaluated. Nuclear grooves were observed in 88% of the May-Grünwald-Giemsa-stained aspirates from papillary thyroid carcinoma, usually in substantial numbers. A few grooved nuclei were seen in a small percentage of the other thyroid aspirates studied. These results show that nuclear grooves can also be used as a possible marker of papillary carcinoma of the thyroid in May-Grünwald-Giemsa-stained aspirates.

Adenoma↗
PubMedDate not supplied

Fine needle aspiration cytology in the diagnosis of sinuses and ulcers of the body surface (skin and tongue).

Both fine needle aspiration (FNA) and conventional scraping were used to obtain cytodiagnostic samples from ulcers and sinuses of the skin (18 cases) and tongue (3 cases). These included 14 cases of tuberculosis, 5 squamous-cell carcinomas and 2 cases of nonspecific infection. The FNA smears contained characteristic tuberculous granulomas or epithelioid cells in 10 of the 14 tuberculosis cases and ample diagnostic material in 4 of the 5 carcinoma cases; in contrast the scraping smears predominantly contained necrotic material on which a diagnosis was not possible. Of the 19 cases of tuberculosis and malignancy, 12 were diagnosed only by FNA, 6 were diagnosed by both methods and the FNA sample was negative while the scrape was positive in 1 case. Hence, the diagnosis was made in 18 of 19 by FNA cytology, but in only 7 of 19 cases by scraping cytology, strongly indicating the diagnostic superiority of the former in diagnosing many lesions of the body surface.

Adolescent↗
PubMedDate not supplied

Fine needle aspiration cytodiagnosis of Hodgkin's disease and its subtypes. I. Scope and limitations.

The fine needle aspiration (FNA) smears and paraffin-embedded sections from 89 cases with a cytologic and histologic diagnosis of Hodgkin's disease (HD) and 27 cases with minor or major cytohistologic discrepancies were reviewed. The accuracy of the initial cytologic study was found to be 91.8% for diagnosing HD and 58.1% for classifying its subtypes. Following review, 87 of the 89 agreement cases remained classified as HD. Of the 27 cases with initial cytohistologic discrepancies, 12 were classified as HD and 10 were categorized as lymphocytic or non-Hodgkin's lymphoma by both cytology and histology upon review. Following review, the accuracy of FNA cytology for the diagnosis of HD improved to 98.0%, with 71.4% correct subtyping. The greatest limitation of cytologic subtyping was in cases of nodular sclerotic HD: only 3 of 17 cases could be subtyped even after review. The cytomorphologic features of the HD subtypes are described, and the difficulties encountered in the cytodiagnosis of HD are discussed at length. The results of this study indicate that FNA cytology is a useful tool not only for the diagnosis of HD, but also for its subtyping.

Adult↗
PubMedDate not supplied

Fine needle aspiration cytodiagnosis of Hodgkin's disease and its subtypes. II. Subtyping by differential cell counts.

Differential cell counts were performed on fine needle aspiration (FNA) smears from 96 cytologically diagnosed and subsequently biopsy-proven cases of Hodgkin's disease (HD). Reed-Sternberg cells and Hodgkin cells showed a definitely increasing trend in three major HD subtypes (as diagnosed on the smears): lymphocytic predominance (LP), mixed cellularity (MC) and lymphocytic depletion (LD). Lymphocytes, on the other hand, showed a decreasing trend between these subtypes. The differences in the percentages of Hodgkin cells, Reed-Sternberg cells and lymphocytes were highly significant (P less than .001). No trends (increasing or decreasing) were observed in the smear content of other reactive components (non-neoplastic histiocytes, eosinophils, plasma cells and neutrophils). In 88.0% to 95.0% of the cytologically diagnosed cases of LP, MC and LD subtypes, the percentages of Hodgkin cells plus Reed-Sternberg cells fell within a distinct range: less than 1.5% for LP, greater than or equal to 1.5% to less than 7.5% for MC and greater than or equal to 7.5% for LD. Analysis of the data based on histopathologic subtyping of the cases showed similar significant trends in the proportions of Hodgkin cells, Reed-Sternberg cells and lymphocytes, with 70.0% to 80.0% of the LP, MC and LD subtype cases within these ranges. These results demonstrate the validity of the subjective subtyping of HD on FNA smears in most cases.

Adult↗
PubMedDate not supplied

Burkitt-type lymphoma. Diagnosis by fine needle aspiration cytology.

Forty cases of lymphoma were categorized as Burkitt-type lymphoma in a study of fine needle aspiration (FNA) smears. These constituted 14.3% of all cases of non-Hodgkin's lymphoma diagnosed between 1974 and 1982. The median age was 22 years in these cases, 81.8% of which had extranodal tumors. The majority of the cells in the smears (59.8% +/- 8.32%) were in the 11 micron to 15 micron size range and 60.3% +/- 10.3% had noncleaved nuclei. An average 71% of the cells contained cytoplasmic and/or nuclear vacuolizations. Nonneoplastic macrophages were present in the smears in 87.5% of the cases. A study of paraffin-embedded sections in 17 cases revealed the characteristic "starry-sky" appearance in 11; in 5 it was not clearly appreciated and in 1 the nonneoplastic macrophages were absent. FNA cytology was found to be quite reliable for arriving at a diagnosis of Burkitt-type lymphoma. More than 50% of the cases were managed without resort to subsequent surgical biopsy. Exploratory laparotomy was avoided in 69% of the cases having abdominal tumors.

Biopsy, Needle↗
PubMedDate not supplied

Possible physiological role of myocardial fatty acid binding protein in phospholipid biosynthesis.

Accumulation of free fatty acids and their esters resulting from the degradation of membrane phospholipids is one of the major causes for the myocardial dysfunction during ischemia and reperfusion. In this communication, we have studied the possible physiological role played by fatty acid binding protein (FABP) in stimulating key enzymes involved in phospholipid biosynthesis. Purified rat heart FABP bound a maximum of either 2 mol of [1- 14C]palmitoyl coenzyme A (CoA), oleoyl CoA, or oleic acid per mol of FABP as observed by Scatchard analysis. FABP caused a threefold increase in the incorporation of [1- 14C]palmitoyl CoA into phosphatidic acid as compared to only a 1.5-fold increase by bovine serum albumin (BSA). Myocardial FABP also enhanced acyl CoA monoacylglycerophosphorylcholine acyl transferase minimally at a substrate concentration (greater than 200 microM), the activity of this enzyme was enhanced 4.5- and 2-fold by FABP and BSA, respectively. The maximum stimulation of the enzyme activity took place at the fatty acyl CoA concentration where inhibition of the enzyme activity is usually observed due to the surfactive property of acyl CoAs. These results thus indicate that under abnormal pathophysiological conditions such as ischemia, when acyl CoA concentration increases, FABP may protect acyl CoA monoacylglycerophosphorylcholine acyl transferase as well as stimulate glycerophosphate acyl transferase to limit the loss of membrane phospholipids, suggesting a possible role of FABP in phospholipid biosynthesis.

Acyl Coenzyme A↗