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Biomedical subjects

S Jain

Publications and source records attributed to S Jain.

At least 739 records · Page 41Linked to original sources
PubMedDate not supplied

Cytomorphology of filariasis revisited. Expansion of the morphologic spectrum and coexistence with other lesions.

OBJECTIVE: To review the cytomorphologic spectrum of the filarial worm and associated tissue response in 33 cases. STUDY DESIGN: Retrospective analysis was carried out in clinically unsuspected cases of filariasis diagnosed on cytology over a period of 10 years. Twenty-nine aspirate smears from 28 patients were air dried and stained with May-Grünwald-Giemsa stain. Four routine cervical smears and one centrifuged smear of urine were stained with Papanicolaou stain. RESULTS: Microfilariae alone and along with adult gravid females were present in 25 and 4 cases, respectively. In one case both adult male and female worms with microfilariae and eggs were seen. The diagnosis was based on the presence of eggs alone in one case and fragments of female worms in two. Four of these cases were neoplastic lesions, and microfilariae were found incidentally. In one case of splenomegaly microfilariae were seen along with Leishman-Donovan bodies. CONCLUSION: Filariasis can be diagnosed on cytology by demonstrating microfilariae, a male or female worm, or eggs alone. It can be seen in association with neoplastic lesions and rarely with other parasitic infections.

Adolescent↗
PubMedDate not supplied

Liesegang rings in cytologic samples accompanied by calcium oxalate-like crystals. A report of three cases.

BACKGROUND: The presence of Liesegang rings (LRs) in cytologic specimens is a morphologic curiosity. The exact mechanism of formation and composition of these peculiar rings is a mystery. Their morphologic resemblance to parasites is well recognized and illustrated. Their association with calcium oxalate-like crystals and their presence in a tubercular lymph node are described for the first time below. CASES: Giemsa-stained aspiration smears from an enlarged lymph node and two breast lumps showed purple rings of variable morphology resembling ova, larvae or adult parasites. Misdiagnosis of parasites was avoided by careful evaluation. In all three cases the LRs were associated with calcium oxalate-like crystals and were nonbirefringent. CONCLUSION: LRs can be mistaken for ova, larvae or adult parasites. Awareness of their varied morphology is helpful in avoiding misinterpretation and overdiagnosis of parasitic lesions. The coexistence of LRs and crystals was an unusual finding in this study.

Adult↗
PubMedDate not supplied

Gastric tuberculosis. Endoscopic cytology as a diagnostic tool.

OBJECTIVE: To highlight the utility of endoscopic brush smears in the diagnosis of gastric tuberculosis in clinically unsuspected cases. STUDY DESIGN: A retrospective analysis of endoscopic brush smears from 210 patients with gastric symptoms. In seven of these patients (3.3%) the possibility of gastric tuberculosis was suggested in Giemsa-stained smears. Biopsy was available in all cases. Ziehl-Neelsen stain to demonstrate tubercle bacilli was used in brush smears and biopsies in seven and three cases, respectively. RESULTS: Endoscopically the sites involved were antrum (two), pylorus (two), pylorus and duodenum (three). One patient had an ulcerative lesion, and six had growths. Granulomas and/or epithelioid cells were seen in brush smears in all cases. Tubercle bacilli could be demonstrated in cytologic smears in four cases. Endoscopic biopsy showed granulomas in five cases and non-specific gastritis in two. Tubercle bacilli could not be demonstrated in any of the biopsy sections. On further clinicoradiologic investigation, two patients were found to be follow-up cases of pulmonary and nodal tuberculosis. Enzyme-linked immunosorbent assay for HIV, done in three cases, was negative. A final diagnosis of primary gastric tuberculosis in five patients and secondary in two was considered. Six patients responded to antituberculosis treatment and showed healing of the lesions on repeat endoscopy after six months of therapy, while one was a recent case with four weeks' follow-up. CONCLUSION: Endoscopic brush cytology is a reliable modality for the diagnosis of gastric tuberculosis.

Adult↗
PubMedDate not supplied

Rehydration of air-dried smears. An alternative method for cytologic analysis of exfoliative cells.

OBJECTIVE: To compare the cytologic characteristics of gastric mucosal cell smears prepared by air drying and rehydration prior to alcohol fixing with cells wet fixed in alcohol. STUDY DESIGN: Gastric mucosal cells were obtained from 55 consecutive patients undergoing gastroscopy. Paired smears were made, one immediately fixed in 95% ethanol for 20 minutes (wet fixed [WF]) and the other air dried for at least 20 minutes prior to rehydration with normal saline for 30 seconds and fixation in 95% ethanol for 20 minutes (air dried/rehydrated/fixed [ARF]). Both slides were stained by the Papanicolaou method. Coded slides were examined blind and graded 1 (superior), 2 (satisfactory) or 3 (poor) with respect to staining of chromatin, nuclear membrane, nucleoli, cytoplasm/cell border and group morphology. Histology confirmed a benign disease process or normal mucosa. RESULTS: Comparing grade 1 versus grades 2 and 3, ARF slides were significantly better than WF slides for all cytologic features (P < .05). Comparing grade 1 and 2 versus grade 3, there was no significant difference between ARF and WF slides (P > .05) (chi 2 analysis). CONCLUSION: The cytologic features of ARF smears of gastric cells were equal or superior to those of WF smears. This method of preparing smears is simpler and avoids some of the problems of ethanol fixation of wet smears.

Attitude of Health Personnel↗
PubMedDate not supplied

Fine needle aspiration cytology and core biopsy histology in infiltrating syringomatous adenoma of the breast. A case report.

BACKGROUND: Infiltrating syringomatous adenoma is a rare tumor of the breast that can radiologically mimic invasive duct carcinoma. Detailed fine needle aspiration cytology and needle core biopsy findings on this lesion have not been previously described. CASE: The clinical, radiologic and pathologic findings of an infiltrating syringomatous adenoma of the breast in a 71-year-old female who presented with a subareolar lump are described. The cytology of the tumor was characterized by a combination of a background of plump, fibroblastoid cells and cohesive sheets of bland epithelial cells. Histologically the tumor showed infiltrating, duct-like structures with squamous metaplasia and a desmoplastic stroma. CONCLUSION: Fine needle aspiration cytology and needle core biopsy can distinguish infiltrating syringomatous adenoma from malignant disease of the breast.

Aged↗
PubMedDate not supplied

Esophageal tuberculosis. Endoscopic cytology as a diagnostic tool.

OBJECTIVE: To study the utility of endoscopic cytology in the diagnosis of esophageal tuberculosis in clinically unsuspected cases. STUDY DESIGN: During a period of four years, endoscopic cytology of esophageal lesions was performed on 228 patients. In eight (3.5%) the cytologic diagnosis of esophageal tuberculosis was suggested on smears. Upon endoscopic examination, the sites of involvement were mid esophagus (five cases), upper esophagus (two cases) and lower esophagus (one case). Linear ulcer was seen in six cases; growth and narrowing of the lumen were seen in one case each. Endoscopic brush smears in seven cases and fine needle aspiration cytology smear in one case were collected. Air-dried smears stained by Giemsa stain were reviewed for detailed cytologic assessment. RESULTS: Smears showed well-defined granulomas with necrosis in five cases and granulomas without necrosis in three. Cytologic evidence of concurrent poorly differentiated squamous cell carcinoma was observed in one case. Tubercle bacilli were demonstrated in five cases. Endoscopic biopsy showed granulomas in three cases and tubercle bacilli in one case. In six cases there was no clinical or radiologic evidence of tuberculosis at other sites, thereby suggesting the possibility of primary esophageal tuberculosis. The remaining two cases had a past history of tuberculosis; one presented with cervical lymphadenopathy and one mediastinal lymphadenopathy. All patients received antitubercular treatment, and the patient with concurrent malignancy also received radiotherapy. All but one of the patients who succumbed to aspiration pneumonia responded to treatment. CONCLUSION: Endoscopic cytology is a useful modality in the diagnosis of esophageal tuberculosis in clinically unsuspected cases.

Adolescent↗
PubMedDate not supplied

Oral leiomyosarcoma in childhood. Report of a case with fine needle aspiration cytology.

BACKGROUND: Leiomyosarcomas are rare tumors in the pediatric age group, and occurrence of this neoplasm in the oral cavity is exceedingly rare. This article highlights the fine needle aspiration (FNA) cytology diagnosis of a case of recurrent oral leiomyosarcoma in childhood. CASE: An 11-year-old male noticed a swelling in the oral cavity near the left lower jaw. It was excised and diagnosed as leiomyosarcoma on histopathology. Four months later the patient presented with a progressive swelling in the oral cavity that extended to the lower jaw. The recurrent swelling was subjected to FNA, and its cytologic features were consistent with leiomyosarcoma. There was a very good initial response to chemotherapy and radiation therapy. However, because of noncompliance with advice for further therapy, the patient had a second local recurrence and dissemination of the disease to the skeletal system, abdomen and thorax. FNA cytology diagnosis of the second locally recurrent lesion and abdominal mass were consistent with leiomyosarcoma. Immunocytochemical staining revealed a positive reaction in the cytoplasm of tumor cells for vimentin and desmin in the FNA smear and paraffin section, respectively. CONCLUSION: Fine needle aspiration cytology is a useful technique for detection of recurrence and metastasis during follow-up of childhood oral leiomyosarcoma.

Biopsy, Needle↗
PubMedDate not supplied

Marginal vacuoles in thyroid aspirates.

OBJECTIVES: To report on two cases of metastatic follicular carcinoma with marginal vacuoles (MVs) and review smear results in 441 solitary nodular goiters (SNGs) for this cytologic feature. STUDY DESIGN: The first case was a 55-year-old male who presented with a huge mass in the left hip region; the second case was a 50-year-old male with a thyroid nodule and a large mass on the scalp. The age of the 441 ultrasonographically diagnosed SNG cases ranged from 11 to 75 years. The May-Grünwald-Giemsa-stained fine needle aspiration (FNA) smears of these cases were reviewed by one of the authors (D.K.D.) for various cytomorphologic features, including MVs. RESULTS: FNA smears from the mass in the hip in the first case showed follicular cells with acinar formation and MVs, indicating metastatic follicular thyroid carcinoma (FTC). These features were of help in detecting the thyroid primary, which had previously gone undetected. Aspiration smears from the thyroid nodule and the mass on the scalp in the second case showed tumor cells of FTC with MVs and microfilariae. Review of 441 SNG cases revealed MVs in 42.6% of hyperplastic nodules; that rate was significantly higher (P < .001) than that of colloid goiter (5.2%) and neoplastic goiter (13.3%) but lower (P < .05) than that of thyrotoxic goiter (100%). MVs were limited to neoplasms with a follicular component; that included 15% of follicular neoplasms and 50% of follicular variant of papillary carcinoma (FVPC). The difference between FVPC and the rest of the neoplastic goiters (6%) was statistically significant (P = .002).

Adenocarcinoma, Follicular↗
PubMedDate not supplied

Idiopathic basilary artery occlusion in childhood (case report).

A case of basilar artery occlusion in a 16-year-old-girl has been reported. Reports of 20 such cases occurring in children have been reviewed. In children, basilar artery occlusion is more common in males; no previous case above the age of 3 years has been reported in females. There were preceding TIA's and RIND in the vertebro-basilar territory.

Adolescent↗
PubMedDate not supplied

Tenoxicam-induced gastropathy in the rat: a comparison with piroxicam and diclofenac sodium, and the inhibitory effects of ranitidine and sucralfate.

The ulcer-inducing potential, indicated by the oral dose that induced gastric ulcers in 50% of rats, was higher for tenoxicam (10.2 mg/kg) than for diclofenac sodium (34 mg/kg, equivalent to 6.8 mg/kg tenoxicam) or piroxicam (6.2 mg/kg). The mean lesion scores, a measure of the intensity of ulceration, using 16 and 32 mg/kg tenoxicam given orally were 3.6 +/- 3.4 and 8.7 +/- 7.3, respectively, compared with 9.6 +/- 6.4 and 24.7 +/- 10.5, respectively, for similar oral doses of piroxicam; the differences were statistically significant (P less than 0.05 and P less than 0.001, respectively). The mean lesion score for 32 mg/kg tenoxicam was also significantly (P less than 0.05) less than that for 160 mg/kg diclofenac sodium: 8.7 +/- 7.3 compared with 14.8 +/- 8.1. Ranitidine (20 40 mg/kg) and 260-520 mg/kg sucralfate but not 4 mg/kg ranitidine strongly inhibited ulceration induced by 32 mg/kg tenoxicam.

Animals↗
PubMedDate not supplied

Effect of rofecoxib on antihypertensive effects of candesartan in experimental models of hypertension.

Given the high prevalence of hypertension, concomitant use of nonsteroidal anti-inflammatory drugs and antihypertensive medications is commonly encountered in clinical practice. The present study was designed to study the effect of indomethacin, nimesulide, and rofecoxib on blood pressure (BP) in normotensive and hypertensive rats and also to investigate the effect of rofecoxib on BP control in candesartan-treated hypertensive rats. Male Wistar rats weighing 150-200 g were divided into three groups: control, DOCA-hypertensive, and L-NAME-hypertensive rats. All the rats were given indomethacin (15 mg/kg body weight), nimesulide (20 mg/kg body weight), rofecoxib (10 mg/kg body weight), or vehicle orally and daily for 6 weeks. Hypertensive rats in separate groups were treated with either candesartan (1 mg/kg body weight) alone or a combination of candesartan (1 mg/kg body weight) and rofecoxib (10 mg/kg body weight) orally and daily for 6 weeks. BP measurements were performed using tail cuff method at baseline and 1-week intervals throughout the treatment period. All the three COX inhibitors resulted in increase in BP, but mean change in BP was the highest with rofecoxib. Rofecoxib-treated L-NAME-hypertensive rats exhibited a significant increase in mean arterial pressure at 6 weeks (168.3+/-5.7 mmHg) as compared with DOCA-hypertensive rats (128.818+/-7.2 mmHg). Administration of Rofecoxib L-NAME-hypertensive rats treated with candesartan resulted in a significant increase in BP. Systolic BP at 0 week (107.0+/-4.2 mmHg) rose to 141.6+/-2.0 mmHg at 6 weeks. Systolic BP at 2, 4, and 6 weeks was significantly higher as compared with (L-NAME+candesartan)- and (rofecoxib+candesartan)-treated group. In conclusion, concomitant use of rofecoxib resulted in poor BP control by candesartan in L-NAME-hypertensive rats.

Animals↗
PubMedDate not supplied

Cross polarized spectacles in photosensitive epilepsy.

PURPOSE: To investigate the role of cross polarized spectacles in the treatment of photosensitivity demonstrable by EEG. METHOD: Patients receiving an EEG who tested positive for photosensitivity were invited to participate in the study. The most sensitive light flicker frequency causing a photic response was determined for each patient. Stimulation was repeated with 2 different pairs of spectacles--1 conventionally polarized and the other cross polarized. An EEG was obtained in each case and reported by a neurophysiologist who was unaware of the identity of the 2 types of spectacles. RESULTS: We tested 19 patients, 8 to 18 years of age. Two patients did not benefit from either pair of glasses. In 17 patients, the photic response was greatly diminished or eliminated by polarizing spectacles. In 1 patient, conventional polarized glasses helped, but the cross polarized spectacles did not. In 6 patients, both types of spectacles were equally effective; in 10 patients, cross polarized spectacles were more effective than conventionally polarized spectacles. CONCLUSION: The role of cross polarized spectacles in the management of photosensitivity in a clinical situation merits further investigation.

Adolescent↗
PubMedDate not supplied

Eye infections after refractive keratotomy.

BACKGROUND: Ocular infections are serious and potentially vision-threatening complications of refractive keratotomy. We have performed an integrative review of published literature to address important issues concerning these complications. METHODS: Articles in MEDLINE and published manuscripts and abstracts reporting previously unpublished cases of infections after refractive keratotomy were systematically identified and reviewed. Our review did not target patients treated with relaxing incisions for postkeratoplasty astigmatism. Pertinent data were abstracted and analyzed. RESULTS: Forty-three cases (47 episodes: 42 keratitis and 5 endophthalmitis) of infection appeared in 26 published reports from 1975 to 1994. The frequency ranged from 0.25% to 0.70%. In 22 (47%) eyes, infection occurred before 2 weeks. Thirty-five (74%) infections were located in the inferior half of the cornea, and 22 (62%) were located in the inferotemporal quadrant. Thirty-one (66%) infections were bacterial (32% gram-positive, 23% gram-negative, 9% acid fast, 496 unknown), 5% fungal, 6% viral, 19% sterile, and 4% of unknown origin. Spectacle-corrected visual acuity after conservative treatment was 20/40 or better in 70% of eyes. Penetrating keratoplasty was performed in six cases. Potential associations included reoperations in 12 (26%) eyes, postoperative contact lens wear in 7 (15%), and intraoperative perforation in 7 (15%). CONCLUSIONS: The published literature indicates that infections after refractive keratotomy may compromise visual function. Approximately half of the infections occur in the first 2 weeks. Reoperations, postoperative contact lens wear, and intraoperative perforations may be significant risk factors.

Contact Lenses↗
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Gallbladder carcinoma: experience of 116 cases.

BACKGROUND: Aggressive surgical treatment is now being advocated even for advanced carcinoma gall bladder (GBC). We reviewed our data of GBC over the last 5 years to analyse patient and survival characteristics in our patients. PATIENTS AND METHODS: Case records of all cases of GBC admitted to surgical wards in our hospital between 1994 to 1998 were reviewed for details such as age, sex, religion, symptoms, signs, investigations, treatment and survival. World literature was reviewed by using Medline search of the subject. RESULTS: A total of 116 patients with confirmed GBC were admitted during these five years. Their mean age was 54 +/- 11 years. Females greatly outnumbered males. The commonest symptom was abdominal pain (95%) followed by GB mass (78%). Associated gallstones were present in 67% cases. Adenocarcinoma was the commonest variety (79%). CT scan and USG were helpful in 78% and 89% cases respectively. Maximum patients (67%) presented with Nevins' stage V and most of these were treated with supportive therapy only. CONCLUSIONS: Our patients were at least a decade younger than patients in other series and presented at an advanced stage. Radiological investigations (USG and CT scan) played a vital role in diagnosing or suspecting the disease. Curative resections were performed in few cases. Our own results, though limited favour an aggressive surgical approach. Based on our observations we have recommended certain cancer preventive steps and future treatment strategies.

Adult↗
PubMedDate not supplied

Effect of renal dysfunction in fulminant hepatic failure.

BACKGROUND: Effect of renal dysfunction in fulminant hepatic failure is not studied extensively. METHODS: Fifty consecutive patients of fulminant hepatic failure were studied prospectively to determine the prevalence of renal failure and its effect on survival. RESULTS: The mean age of these patients was 36 +/- 7.2 years and there were 21 males and 29 females. Twenty two patients (44%) were hepatitis B surface antigen (HBsAg) positive. Renal dysfunction was observed in 19 patients (38%). Acute tubular necrosis was seen in 7 patients (38%) while prerenal azotemia and functional renal failure occurred in six patients each (37%). Renal failure occurred more commonly in patients with jaundice. In these patients it occurred in less than four days and prior to onset of encephalopathy, ascites, and gastrointestinal hemorrhage. Histopathological examination of kidney (done in 8 patients) revealed acute tubular necrosis in 4 patients while patients with functional renal failure and prerenal azotemia had normal histology. A good correlation was observed between biochemical parameters and histology of kidney in all the patients. The survival amongst the patients with FHF was 28% (14 of 50 patients). Poor prognostic indicators were a leukocyte count of more than 16.5 x 10(9)/liter, prothrombin index of less than 34%, a peak serum bilirubin of more than 376 mumol/liter and presence of renal failure. Only 3 of 19 patients with renal failure survived. CONCLUSIONS: Renal dysfunction is a major indicator of poor prognosis in patients with FHF.

Acute Kidney Injury↗