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Biomedical subjects

N S Murthy

Publications and source records attributed to N S Murthy.

80 records · Page 5Linked to original sources
PubMedDate not supplied

Utility of repeat fine needle aspiration in acute suppurative lesions. Follow-up of 263 cases.

OBJECTIVE: To determine the clinical value of repeat fine needle aspiration (FNA) as a follow-up strategy in the management of patients in India, clinically suspected of having tuberculosis (TB) but showing a cytologic picture of acute suppuration. STUDY DESIGN: Repeat aspirates from 263 patients presenting with lymph node or soft tissue masses were analyzed. The previous FNA of these cases had shown acute inflammatory exudate but no epithelioid granuloma or acid-fast bacilli (AFB). RESULTS: The repeat FNA helped to detect 55% additional cases of TB within a period of 8 weeks; 67% of them were diagnosed in the second and third weeks. Diagnostic yield rose to 59% after the third FNA. AFB were detected in 34 (13.3%) cases that showed a low bacterial load. In addition, nontubercular lesions, such as epidermal inclusion cyst (4), cysticercosis (3), sialadenitis (2) and metastatic carcinoma (8), were diagnosed. CONCLUSION: All cases showing acute suppuration without granulomas or AFB on the first FNA should be reevaluated by follow-up FNA and staining for AFB. This will enhance the diagnostic yield of tuberculosis in developing countries, where molecular diagnostics are too costly or unavailable. This procedure is cost effective as compared to biopsy and culture. In addition to tuberculosis, many unexpected nontubercular lesions may also be unmasked. Repeat FNA reduces sampling and screening errors, improves sensitivity and helps to study the evolution of epithelioid granulomas.

Acute Disease↗
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Small round cell tumors of the abdomen and thorax. Role of fine needle aspiration cytologic features in the diagnosis and differential diagnosis.

OBJECTIVE: To evaluate the role of cytomorphologic features in the diagnosis and differential diagnosis of small round cell tumor (SRCT) of the abdomen and thorax. STUDY DESIGN: During a period of six years (1985-1990), ultrasound/ computed tomography-guided fine needle aspiration cytology was performed on thoracic and abdominal/ pelvic masses in 899 cases. Slides were not available for review in 28 cases. Review of smears by one of the investigators (D.K.D.) in the remaining cases, which included 239 with intrathoracic and 632 with intraabdominal/pelvic masses, yielded 380 (43.6%) cases of malignancy. Of these, 71 (18.7%) cases were small round cell tumors. In 59 cases of SRCT the smears were found suitable for detailed assessment of cytomorphologic features. RESULTS: The 59 cases of small round cell tumors included 5 cases of neuroblastoma, 7 of hepatoblastoma, 4 of nephroblastoma, 1 of pulmonary blastoma, 2 of Ewing's sarcoma, 23 of non-Hodgkin's lymphoma (NHL), 15 of small cell anaplastic carcinoma (SCAC), 1 NHL/SCAC and 1 small round cell tumor (not otherwise specified). The frequencies of rosettes (60%) and filamentous/fibrillar matrix (100%) in neuroblastoma; acinar formation in hepatoblastoma (100%) and SCAC (93.3%); tubule formation in nephroblastoma (100%); lipid vacuoles (69.6%), exclusive noncohesive cells (95.7%) and lymphoglandular bodies (87%) in NHL; and nuclear molding (100%) and paranuclear blue inclusions (60%) in SCAC were significantly higher as compared to the rest of the SRCTs (P < .01 to < .0001). CONCLUSION: The various cytomorphologic features, alone or in conjunction with other cytologic features, and clinical/imaging findings are very useful in the diagnosis of specific types of SRCT.

Abdominal Neoplasms↗
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Serum lipid profile and its relationship with host immunity in carcinomas of the breast and uterine cervix.

Carcinomas of the uterine cervix and breast, which have a different etiopathogenesis, are the most common malignancies among Indian women. Between these two cancers a comparative study was undertaken in which serum lipids were assessed along with host immunity. Thirty randomly selected cases each of breast and cervical carcinoma, and 20 matched healthy control women were studied by means of standard procedures. Significantly higher (P < 0.001) mean levels of triglycerides (x = 192.1 mg/dl, SD +/- 113.5) and total cholesterol (x = 212.9 mg/dl, SD +/- 49.78) were observed in breast cancer as compared to controls or cervical cancer patients. Patients with cervical cancer had low mean values of all lipid fractions. Women with the above malignancies also showed a significantly decreased CD3+ and CD4+ population (P < 0.001), while there was a significant increase in CD8+ cells (P < 0.005) compared to normal controls. Interestingly, a significant relationship (P < 0.05) was observed between CD8+ cells and LDL-cholesterol among the cancer patients (r = 0.3652 and r = 0.4298 for carcinomas of breast and cervix, respectively.

Adult↗
PubMedDate not supplied

A step towards quality medical research.

Only well planned and conducted research can answer questions that arise in day-to-day clinical practice. Unfortunately, most studies in India are deficient in design or execution. The results thus obtained are biased and cannot be extrapolated to the population studied. Some important questions which arise during the statistical design of investigations are selection of subjects on which observations are to be made, number of observations falling into different groups, allocation of subjects among different groups, etc. Besides planning and execution, appropriate methods need to be chosen for data analysis beforehand. If the study has been well designed and correctly analysed, the interpretation of results can be fairly simple. The present communication focuses on some issues relating to the planning of investigations in medical research with emphasis on statistical design.

Research Design↗
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Screening for cancer of uterine cervix and approaches adopted in India.

Cervical cancer is the leading malignancy among Indian women. It has been estimated that in the absence of any control programme, the incident number of cervical cancer cases in the country would rise to 140 thousand by the turn of this century. Cytology screening remains the main stay for the control of cervix cancer. In the present communication the evidence available for screening for cancer of cervix has been presented. Difficulties in organising cervical cancer screening programmes in India and the alternative approach have been discussed.

Cervix Uteri↗
PubMedDate not supplied

Natural history of precancerous and early cancerous lesions of the uterine cervix.

A prospective study of cervical dysplasia cases and control cases matched for age and parity was undertaken in search of factors related to cervical carcinogenesis. Cytologic examination of 66,736 women revealed negative findings in 28.5%, inflammation in 70.3%, dysplasia in 1.4% and carcinoma in 0.1% of the cases. Data on epidemiologic features, cytomorphologic characteristics and serologic findings of antibodies to herpes simplex virus (HSV) were collected for proven cancer patients, dysplasia cases and control subjects. Cancer patients revealed significantly elevated antibodies to HSV as compared to the controls. The analysis revealed a higher proportion of dysplasia cases with an age at consummation of marriage of less than or equal to 15 years as compared to controls, with a relative risk of 1.5 (P less than .05). Similarly, a higher proportion of women with dysplasia had HSV-II-specific antibodies as compared to control women. The relative risk was found to be 1.3, which was not statistically significant (P greater than .05). The Mantel-Haenszel summary relative risk between antibodies to HSV and the two groups (dysplasia cases and controls), adjusted for the age at consummation of marriage, worked out to be 1.38, which was also statistically not significant (P greater than .05). The overall progression rate of dysplasia to malignancy was found to be 11.7% at the end of 54 months (during a total follow-up period of 84 months). Progression to cancer was highest in severe dysplasia cases and less in mild dysplasia cases. The progression rates were also significantly higher in the group of women who revealed antibodies to HSV II. Similar differences in the progression rates were observed with regard to the age at consummation of marriage.

Adult↗
PubMedDate not supplied

Epidemiologic analysis of Trichomonas vaginalis infection in inflammatory smears.

Infections of the lower reproductive tract are common in Indian women of reproductive age. Hospital-based cytologic screening was undertaken on 63,265 women. The smears were examined for the presence of specific infections, such as Candida, herpes simplex virus, human papillomavirus, Trichomonas vaginalis (TV) and Chlamydia. This paper highlights the prevalence of TV infection in inflammatory cervical smears. Among the various infections detected, the rate of TV infection was the highest (5.1%). On further analysis the rate of TV infection showed an increasing trend up to the age of 49 years; an inverse association was observed with the educational status of the women. The prevalence was high in women with clinical signs (vaginitis, 6.9%) and low in those with a prolapsed uterus (1.2%) as compared to a normal cervix. These observations reveal the need for providing proper counseling and education on sexual behavior and genital hygiene besides treatment to control and prevent these infections.

Adult↗