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Biomedical subjects

P A Singh

Publications and source records attributed to P A Singh.

At least 19 recordsLinked to original sources
PubMed2000

Clinico-histopathological concordance in leprosy.

Histopathological examination of biopsies from 111 patients with clinically diagnosed leprosy was carried out in order to observe the clinico-histopathological correlation. Clinical diagnosis was based on Ridley and Jopling (R-J) classification and World Health Organization (WHO) classification. The concordance rate between the two clinical classifications was 73.8%. Sections were stained with haematoxylin and eosin (H&E) and Ziehl-Neelsen's (Z-N) stains. The histological classification was as per the R-J criteria. Skin biopsy showed evidence of leprosy in 104 cases (93.69%). Overall concordance was observed in 58.6% (R-J) and 85.6% (WHO classification). The kappa test, when applied, showed significant agreement between clinical and histopathological diagnosis (z=11.775; P<0.001). Individual subtypes showed variable concordance rates which were again higher using WHO classification. When some of the subtypes were combined, the concordance rate was 83.02% for TT+BT; 72.58% for BT+BB+BL; 73.91% for BL+LL; 80.77% for BL+HL and 100% for LL+HL. (See Introduction for definitions of abbreviations.) The present study highlights the importance of histopathological examination for exact subtyping of leprosy, so as to facilitate the institution of accurate mode of therapy and regular follow-up of patients to prevent undesirable complications.

Biopsy↗
PubMed2000

Histological changes to palatal and paratubal muscles in oral submucous fibrosis.

Oral submucous fibrosis (OSMF) is prevalent in the Indian subcontinent. In a large number of patients conductive deafness due to eustachian tube dysfunction has been found. The present study was, therefore, planned to assess the histopathological changes in palatal and paratubal muscles in oral submucous fibrosis. Incisional biopsy from the soft palate was taken in clinically proven cases of OSMF. In most of the cases, signs of chronic inflammation and fibrosis were seen in the submucosa. Dysplasia was noticed in seven (13.2 per cent) patients. Degenerative changes in palatal/paratubal muscles were found in the form of loss of cross striations in seven (13.2 per cent), oedematous muscle fibres in five (9.4 per cent) and atrophy in five (9.4 per cent) cases. It was concluded that there was definite involvement of palatal and paratubal muscles in OSMF. This could explain the eustachian tube dysfunction in these patients.

Ear Diseases↗
PubMed2000

Gall stones and carcinoma gall bladder.

One hundred and fifty surgically resected gall bladder specimens were included in the study to evaluate the relationship between the prevalence of gall stones and histochemical alteration in sequential changes of metaplasia, dysplasia and neoplasia in gall bladder epithelium. Multiple sections were processed and stained with haematoxylin and eosin, Periodic acid Schiff's stain, Alcian blue (pH 2.5)/Periodic acid, Orcein/Alcian blue (pH 2.5) and Alcian Blue/Periodic acid/Potassium borohydride saponifications stains. Details of gall stones present were also noted. Prevalence of gall stones in gall bladders with metaplastic, dysplastic and neoplastic mucosal changes was significantly higher (P < 0.001) than those gall bladders which had no epithelial changes. Increase in sialomucin with a corresponding decrease in sulphomucin was observed from metaplasia to malignancy. Neutral mucin increased in metaplastic cells but was significantly reduced in neoplastic cells. Loss of O-acylation in sialmucin was also present in neoplastic cells. The histochemical changes suggest that chronic injury due to cholelithiasis induces appearance of neutral mucin positive metaplastic cells, which may further dedifferentiate to sialomucin containing dysplastic or neoplastic cells if the stimulation persists.

Cholelithiasis↗
PubMed1999

Evaluation of the one-minute ultra-rapid urease test for diagnosing Helicobacter pylori.

To determine the diagnostic accuracy of the one-minute ultra-rapid urease test for diagnosing Helicobacter pylori infection, two biopsies were taken from both the gastric corpus and antrum from 1000 patients undergoing upper gastrointestinal endoscopy. All the biopsies were subjected to the one-minute ultra-rapid urease test before imprint smears were prepared from them. Thereafter, the biopsies were fixed in 10% formalin and histological sections were examined for the presence of H pylori by a pathologist who was not aware of the clinical details or the results of the urease test. The prevalence of H pylori in the gastric antrum and corpus was 86.7% and 53.3%, respectively. The sensitivity, specificity, positive and negative predictive value and the overall diagnostic accuracy of the ultra-rapid urease test to diagnose H pylori infection in the gastric antrum were 92%, 100%, 100%, 66%, and 93%, respectively. The corresponding figures for the gastric corpus were 83%, 100%, 100%, 85%, and 91%, respectively. It is concluded that the one-minute ultra-rapid urease test has a high sensitivity and specificity and may be used as a rapid and cheap method to diagnose H pylori infection.

Bacteriological Techniques↗
PubMed1999

Testicular biopsy in infertility.

Eighty-eight infertile couples attended the infertility clinic. Semen analysis was abnormal in 64 cases. The cases were divided into 3 groups according to sperm count:Group I (count zero), group II (count < 20 million/ml) and group III (20-50 million/ml). The morphology of testicular biopsy categorised into 5 groups were normal--10(15.63%), hypospermatogenesis--42(65.63%), the Sertoli cell only syndrome--2(3.13%), maturation arrest--2(3.13%) and tubular hyalinization--8(12.50%). Quantitative analysis of biopsies was done using mean Johnson score(MJS) and Silber score(SS). The morphology in any single section was not uniform but of mixed type. Normal spermatogenesis in azoospermics indicated bilateral ductal obstruction. As compared to MJS, SS showed a more direct correlation between number of mature spermatids per tubular cross section and sperm count in unobstructed cases.

Biopsy↗
PubMed1999

Effect of helium-neon laser on wound healing.

To estimate the biostimulatory effects of low intensity laser radiation on healing of skin wounds, two linear skin wounds were produced on either side of dorsal midline in rats and immediately sutured. Wounds on the left side were irradiated daily with helium neon laser at 4 Joules/sq.cm for 5 min., while those on right side were not exposed and served as controls. The mean time required for complete closure in control group was 7 days while irradiated test wounds took only 5 days to heal (P < 0.01). The mean breaking strength, as measured by the ability of the wound to resist rupture against force, was found to be significantly increased in the test group. Early epithelization, increased fibroblastic reaction, leucocytic infiltration and neovascularization were seen in the laser irradiated wounds. The results establish the biostimulatory effects of low intensity laser radiation on healing of skin wounds.

Animals↗
PubMed1998

Diagnosing Helicobacter pylori by imprint cytology: can the same biopsy specimen be used for histology?

Imprint cytology of the gastric mucosa has been found to be very simple, inexpensive, and rapid for diagnosing Helicobacter pylori infection. However, there is a fear that preparing imprint smears may damage the biopsy specimen for subsequent histologic examination. This study was planned to investigate whether this damage happens. Four antral biopsy specimens were obtained from each of the 100 patients undergoing upper gastrointestinal endoscopy. Imprint smears were made from two biopsy specimens, which were then fixed in 10% formal saline and sent for histologic study. The third and fourth biopsy specimens were directed fixed in 10% formal saline for histologic examination. Two pathologists examined the imprint smears. Agreement between the two observers was observed in 97% of cases. Beyond-chance agreement was good with a kappa index of 0.90. H. pylori organisms were seen in 82% of biopsy specimens from which imprint smears were prepared and in the same percentage of biopsy specimens that were processed directly. The pathologists could not identify the histologic sections form which imprints were made. It is concluded that imprint cytology is an excellent method of diagnosing H. pylori infection and that preparing imprint smears does not alter the quality of the tissue. The same biopsy specimen can be used for histologic studies.

Cytodiagnosis↗
PubMed1998

Helicobacter pylori-induced lymphonodular hyperplasia: a new cause of gastric outlet obstruction.

A 30-year-old female was seen with symptoms and radiological evidence of gastric outlet obstruction. Endoscopic examination revealed findings suggestive of gastric outlet obstruction with nodularity of the antral mucosa leading to deformity of the pylorus. Endoscopic biopsies from the nodular antral mucosa showed presence of Helicobacter pylori-induced lymphonodular hyperplasia without evidence of mucosa-associated lymphoid tissue lymphoma. Anti-H. pylori therapy resulted in eradication of the H. pylori infection and the signs and symptoms of gastric outlet obstruction. The case demonstrates that H. pylori-induced lymphonodular hyperplasia can also cause gastric outlet obstruction. We believe this is the first such case to be reported.

Adult↗
PubMed1997

A correlative study of histology and imprint cytology in the diagnosis of gastrointestinal tract malignancies.

Endoscopic mucosal biopsies from 323 patients (201 from upper gastrointestinal tract and 122 from lower gastrointestinal tract) were studied to correlate the diagnostic efficacy of histology and imprint cytology in the diagnosis of malignant lesions of gastrointestinal tract. Of these 71 were from normal controls, 113 from benign lesions and 131 from malignant lesions. Histology showed no false positive reports but it was false negative in 6 cases (3 in oesophagus, 1 in stomach and 2 from colon). Imprint was false positive in 3 cases (2 oesophagus, 1 colon) and false negative in 2 cases (both oesophagus). The overall diagnostic accuracy of histology and imprint cytology in oesophagus, stomach and lower gastrointestinal tract was 95%, 98%, 98% and 95%, 100%, 98% respectively. When combined, the diagnostic accuracy increased to 98%, 100% and 100% in oesophagus, stomach and lower gastrointestinal tract respectively. The sensitivity, specificity, positive predictive value, negative predictive value and overall diagnostic accuracy for histology and cytology irrespective of the site was 96%, 100%, 100%, 94%, 97% and 98.5%, 97%, 98%, 98%, 98% respectively. Thus imprint cytology can act as an adjunct to bioptic histology to increase the diagnostic efficacy and save the time but definitely it cannot replace it as chances of false positives are high.

Biopsy↗
PubMed1997

Point prevalence of peptic ulcer and gastric histology in healthy Indians with Helicobacter pylori infection.

OBJECTIVES: To study the prevalence of peptic ulcer and the histological appearance of the gastric mucosa in healthy, asymptomatic Indians infected with Helicobacter pylori. METHODS: Asymptomatic, healthy individuals without any GI symptoms were invited to undergo endoscopy of the upper GI tract. A careful search was made for any erosion or ulcer. Four biopsy specimens were obtained from the gastric corpus and antrum. Histological sections were stained with hematoxylin and eosin for histological details and with Loffler's methylene blue for the presence of H. pylori. Alcian blue periodic acid-Schiff stain (pH 2.5) was used to classify and grade areas of intestinal metaplasia. RESULTS: Histological examination showed chronic gastritis in 72 (80%) persons. Pangastritis was seen in 22% of subjects; pangastritis with antral predominance, in 28%; and antrum-only gastritis, in 50%. Activity was noted in biopsy specimens from only 33% of the subjects. H. pylori infection was present in 70 (78%) subjects. All of these subjects had evidence of chronic gastritis. Endoscopic examination revealed a normal appearance in 88 individuals. In two individuals a duodenal ulcer was seen. Both subjects had severe H. pylori infection in the antral mucosa. Of the 70 persons having H. pylori infection, only two (2.8%) had a duodenal ulcer. CONCLUSIONS: This study showed that despite a high prevalence of H. pylori infection in asymptomatic, healthy Indians, the point prevalence of peptic ulcer is low, and chronic active gastritis is uncommon.

Adolescent↗
PubMed1997

Mucin histochemistry--a simple and effective method for diagnosing premalignant and early malignant lesions of lower gastrointestinal tract.

Mucin histochemistry of colo-rectal mucosa was studied in 124 biopsies which included 28 specimens from normal mucosa, 35 inflammatory lesions, 20 polyps, 26 malignant lesions and 15 specimens from transitional mucosa. The stains used were Haematoxylin and Eosin, Periodic acid schiffs, Alcian blue--Periodic acid schiffs (pH 2.5), Orcein--Alcian blue and Periodic acid sodium borohydride saponification. Normal mucosa, mucosa from inflammatory lesions, juvenile and hyperplastic polyps had neutral mucin in traces along with O-acylated sialomucins and sulphomucins. Predominant changes in adenomatous polyps and malignancy were a significant loss of sulphomucins and O-acylation at position C7, C8 or C9 in sialomucins. The changes in transitional mucosa were more on the pattern of malignant lesions. The alterations in the amount and/or pattern of mucin in colorectal mucosa has been found to predate frank morphological changes of malignancy. A routine use of mucin histochemistry in suspicious colorectal biopsies might be helpful in diagnosing premalignant and early malignant lesions in otherwise apparently normal colorectal mucosa or mucosa with chronic inflammatory changes and thereby reduce mortality.

Histocytochemistry↗
PubMed1997

Re-classification of carcinoma cervix uteri by mucin histochemistry.

Biopsies of cervix uteri from 166 patients with benign and malignant lesions (12 normal, 48 inflammatory lesion, 6 adenocarcinoma, 2 adenosquamous carcinoma and 98 from squamous cell carcinomas) were studied histochemically. The stains used were PAS with/without diastase, AB/PAS (pH 2.5) and OR/AB. In inflammatory lesions neutral mucin was predominent which was replaced by sialomucin and sulphomucin in endocervical polyps. In malignant lesions sulphomucin was predominent. Seventeen percent cases of squamous cell carcinomas needed reclassification after mucin staining. Of the fourteen large cell non-keratinizing squamous cell carcinomas, 12 were reclassified as squamous cell carcinoma with mucin secretion and 2 as adenosquamous carcinoma. One case of small cell non-keratinizing squamous cell carcinoma was reclassified as moderately differentiated adenocarcinoma. None of the keratinizing carcinomas had evidence of mucin secretion. Mucin histochemistry should be done routinely on non-keratinizing squamous cell carcinomas to pick up more cases of carcinoma with evidence of mucin secretion which can be missed on routine haematoxylin and eosin stains. Such carcinomas are known to pursue a more aggressive clinical course and have a poorer prognosis than non-mucin secreting type of squamous cell carcinoma.

Adenocarcinoma↗