Morphological changes in the Heart in unrelated deaths

Background: Cardiovascular diseases are the major cause of morbidity and mortality worldwide. In the Indian subcontinent, they account for more than 25% of deaths. Numerous studies have been conducted on the cardiovascular system in cases of sudden death; but there has been a major neglect to study the heart in cases of people who died of unrelated causes.In the present study, we have attempted to study the CVS in detail in those individuals who died of unrelated causes and have tried to assess the prevelance of atherosclerosis, conduction system lesions, inflammatory and valvular pathologies in them.Materials and Methods: The present study was a prospective one conducted from June 2007 to June 2009 in the department of Pathology, Kasturba Medical College, Mangalore. The hearts of persons who died of unrelated causes were studied.Results: Various lesions encountered in the heart were coronary artery disease (70.58%), medial hyperplasia of SAnode (38.23%) and AV node (55.88%), chronic inflammation of the conduction system (55.88%) and calcification (11.76%). Malarial myocarditis was seen in 5.88% and pulmonary stenosis was seen in 2.94% of the cases. No cardiac pathology was detected in 5.88% cases.Conclusion: Our study highlights the prevelace of atherosclerotic changes and conduction system abnormalities in the general population. Hence, we conclude that examination of the CVS is extremely important in cases of sudden death; but it should also be made mandatory in unrelated deaths too, as it can diagnose a lot of hidden pathology.  

Corundum type indium oxide nanostructures: ambient pressure synthesis from InOOH, and optical and photocatalytic properties

A simple, cost effective, surfactant free and scalable synthesis of rh-In₂O₃ nanostructures showing intense blue light emission has been developed under ambient pressure.

Cardiac conduction system- A detailed study in 46 cases of sudden death

Background: Atherosclerotic coronary artery disease is the modern pandemic and is said to be responsible for a major chunk of sudden cardiac deaths. However, in few cases; especially among the young, conduction system abnormalities were found to be the cause of death with absence of significant coronary lesions. These days, examination of the cardiac conduction system during autopsy has been abandoned as it is said to be a time consuming process. The present study was undertaken to highlight the importance of examining the cardiac conduction system in all sudden death cases.Materials and Methods: This study was a prospective one, conducted from June 2007 to June 2009 in the department of Pathology, Kasturba Medical College, Mangalore. Forty six hearts of persons who died suddenly were studied.Results: Our study showed that even though atherosclerotic coronary lesions were the most common cause of sudden death, cardiac conduction defects also contributed to a significant number of cases; especially in the young. In our study of 46 cases; 6 cases showed only conduction system abnormalities. These were young adults who had died suddenly. The predominant lesion identified in them was fibromuscular dysplasia of the nodal arteries.Conclusion: A detailed examination of the coronaries and the cardiac conduction system should be made mandatory in all sudden death cases, especially in the young as they will help to throw some light into the cause of death.Journal of Pathology of Nepal (2015) Vol. 5, 709-716

Photocatalytic H2 generation over In2TiO5, Ni substituted In2TiO5 and NiTiO3 – a combined theoretical and experimental study

Role of Ni substitution in modifying the crystal structure, optical absorption properties and electronic properties of indium titanate, In_2(1−x)Ni_2xTiO_5−δ (0.0 ≤ 2x ≤ 0.4) and its consequent effect on the photocatalytic properties for H₂ generation.

The effect of two different dental gels and a mouthwash on plaque and gingival scores: a six-week clinical study

AIM

To evaluate the clinical efficacy of two gel formulations containing chlorhexidine gluconate and neem extract with a commercially available chlorhexidine gluconate mouthwash.

METHOD

An open labelled randomised six-week clinical study with parallel group design in 48 subjects divided into four groups. Plaque accumulation and gingival condition were recorded using plaque index and gingival index. On the basis of mean baseline plaque and gingival scores, subjects were allocated to four different groups, using their assigned products twice a day, before bed and after breakfast. Plaque and gingival scores were recorded after three and six weeks.

RESULTS

Mean plaque and gingival scores were reduced over the six-week trial period for experimental and control groups. Chlorhexidine gluconate gel reduced the plaque and gingival scores significantly more (p<0.05) than the chlorhexidine gluconate mouthwash. Neem extract gel also showed significant (p<0,05) reduction in plaque and gingival scores when compared with the control group. But there was no significant difference between the groups treated with chlorhexidine gel and neem extract gel.

CONCLUSION

The results of this clinical study indicate that better therapeutic efficacy can be achieved using gels for treating oral infections than conventional treatments using mouthwash.

Fine Needle Aspiration cytology versus Fine Needle Sampling without aspiration. A prospective study of 200 cases

In the present prospective study of 200 patients with superficial swelling of various sites, FNS followed by FNA were performed. Fifteen cases were excluded due to inadequate material. In the 80 lymph node cases, FNS was diagnostic in 85% cases as compared to FNA in 87.5%. The diagnostic accuracy was higher for FNA (87.5%) than for FNS (81.25%). However FNS smears were much superior qualitatively than FNA smears and for the diagnosis of malignant conditions FNS was found to be much better. Regarding the 68 thyroid swellings, FNS obtained a diagnosis in 82.4% cases while FNA got it in 77.9%. The diagnostic accuracy with FNS (89%) was much better compared to FNA (75%). Of the 27 breast cases FNS yielded diagnostic material in 70.38% cases while FNA was diagnostic in 85.19%, thus establishing definite superiority. However FNS seemed to be better for diagnosing malignant lesions while FNA appeared better for diagnosing benign ones. In the 5 salivary gland lesions and 5 miscellaneous lesions both FNS and FNA fared equally well. On the whole FNS technique was much more patient friendly and gave high class "text book" quality smears while FNA smears gave quantitatively more adequate material. Both the techniques therefore would be complementary to each other.

Topical phenytoin in diabetic ulcers: a double blind controlled trial

Data of 57 patients who completed the trial and 13 who did not, were analysed. With phenytoin, there was a marginal: increase in the reduction of mean ulcer area and acceleration of effect 3rd on 4th week. With control: the number completing the trial was larger: response to treatment was better in grade II ulcers, Table IV. This study has the hall marks of a real clinical trial, has raised the possibility of wound healing properties of phenytoin and confirms the results of others.

FNAC diagnosis of mucinous carcinoma of male breast--a case report

Mucinous carcinoma of the male breast is a very rare tumour. So far only about 8 cases have been reported in the literature most of which were diagnosed after surgical resection. Fine-needles aspiration biopsy even though a well established procedure for the evaluation of breast masses in female there are only occasional reports of aspirates form male breast masses. We herein-present one case of mucinous carcinoma of breast in a 65 year old male diagnosed by fine needle and confirmed by histopathology.

Coronary atherosclerosis in Mangalore--a random post mortem study

A study was undertaken in Mangalore, South Kanara District of Karnataka, India to evaluate the rising prevalence of coronary artery diseases in our country. Seventy hearts were analysed, at post-mortem, between December 1996 and December 1997. The coronary arteries and the myocardium were examined, both grossly and histologically, to relate them with regard to the age and gender of the deceased. Fifty five hearts were from males and 15 were from females. Forty eight (68.59%) hearts were proven to be afflicted with coronary atherosclerosis. Twenty seven of these had three or four vessel disease. A total of 192 sections from the four major epicardial arteries of the 48 hearts were examined. Of these, 124 showed atherosclerosis (with 37 in advanced stages), of which 103 were occlusive lesions while the remaining 21 were fatty streaks. Severe stenosis (grade III or IV) was commonest in the left anterior descending artery. Twenty one (30%) of the 70 hearts showed histological evidence of myocardial ischaemia. Of these 6 were from females and 15 were males. Myocardial ischaemia was found to have no correlation to the severity of stenosis.

Fine needle aspiration cytology in systemic lupus erythematosus lymphadenopathy. A case report

BACKGROUND

Systemic lupus erythematosus (SLE) is an autoimmune disease of unknown etiology characterized by inflammation in various organ systems, including lymph nodes, due to the production of antinuclear antibodies. The onset of disease is between ages 13 and 40 years, with a female preponderance.

CASE

A 30-year-old female presented with right cervical lymphadenopathy and gave a history of intermittent fever and swollen joints of 2.5 years' duration. The patient was on intermittent corticosteroids. With a suggestion of tuberculous lymphadenitis, the patient underwent fine needle aspiration (FNA). The diagnosis of lupus adenopathy was established by FNA of enlarged right cervical lymph nodes. Smears showed predominantly typical and atypical immunoblasts, plasma cells, occasional Reed-Sternberg-like cells and dispersed hematoxylin bodies. Smears were negative for acid-fast bacilli.

CONCLUSION

When SLE patients develop lymphadenopathy, FNA cytology helps differentiate lupus adenopathy from infectious conditions, such as tuberculous adenitis, and from Kikuchi's lymphadenitis.

Neurogenic appendicopathy--role of enterochromaffin cells in its pathogenesis

One hundred cases of neurogenic appendicopathy were histochemically studied for schwann cells and enterochromaffin cells. The early phase, labelled as neuro-appendicopathy (29 cases) showed minimum to moderate number of extraepithelial enterochromaffin cells without neurogenous hyperplasia. In 53 cases, there was intra and submucosal neural hyperplasia with increase in the extraepithelial enterochromaffin cells, representing the active phase. The late phase known as obliterative neurogenic appendicopathy, showed extraepithelial enterochromaffin cells and schwann cell proliferation of variable grades (18 cases). The origin of extraepithelial enterochromaffin cells is related to proliferating nerve plexus, rather than epithelial enterochromaffin cells.

Connective tissue stromal changes in tumours and tumour-like lesions of the breast

Between June 1994 and December 1995, one hundred and fifteen tumours and tumour-like lesions of the breast were studied in the Department of Pathology, Kasturba Medical College, Mangalore. Neoplasms constituted 80.9% and tumour like lesions accounted for 19.13%. Among the tumours, 51.6% were benign and 48.4% were malignant. Tumour-like lesions included the entire spectrum of fibrocystic disease. Tumours were common between 2nd and 8th decades while tumour-like lesions were uncommon above 6th decade. Whereas benign tumours exhibited ground substance, collagen and reticulin fibres in varying amounts, tumour-like lesions and carcinoma showed more of collagen fibres and less of ground substance. Elastosis and lymphoplasmacytic infiltrate were prominent features in carcinomas rather than in benign lesions.

Mast cell numbers in lymphnode lesions

Mast cells were counted in 50 axillary lymphnodes draining breast carcinoma and 50 other lymphnodes from various sites with different histological lesions. All the lymphnodes, except those with tuberculous lymphadenitis were associated with increase in the number of mast cells. Highest number of mast cells (mean 172.80/mm2) were found in filarial lymphadenitis and lowest in tuberculous lymphadenitis (mean 8.87/mm2). In the axillary lymphnodes draining breast carcinoma, higher mast cell count was observed in reactive nodes. As these lymphnodes showed micro-metastasis the mast cells gradually decreased in number, and with extensive metastasis only few mast cells were seen. On comparison, the reactive lymphnodes draining breast carcinoma and other reactive nodes, the latter were associated with more mast cells.

Paneth cell metaplasia in colonic adenocarcinoms

The junctional mucosa of 49 colorectal carcinomas were studied for Paneth cell metaplasia. Twenty two cases (44.89%) showed Paneth cells in the junctional mucosa. The carcinomas were seen mainly in the age range of 51 to 60 years (38.4%) The occurrence of Paneth cell metaplasia was higher in the vicinity of tumours of ascending colon and in well differentiated grades of adenocarcinomas. This probably indicates the reactive host response in the junctional mucosa which is of better prognostic significance.

Relation of mast cell, nerve and fibrosis in appendix

The relationship of mast cells, nerves and fibrosis was studied in 50 cases of Appendix using simple histochemical technique. In the mucosa, the mast cell number was greater in the early stages of fibrosis. Both in the mucosa and submucosa mast cells were found closely associated with neural tissue. As the fibrosis increased this association between mast cells and neural tissue was retained only in the submucosa.

Mast cell count in surgically resected appendices

Two hundred appendices were studied for mucosal and submucosal mast cell counts. In histologically normal appendices mucosal mean mast cell count (47.63/sq mm) was more than submucosal mean mast cell count (44.27/sq mm). Those patients who were aged under 15 and above 46 years showed more mean mucosal mast cell count compared to others. In acute appendicitis both mucosal and submucosal mast cells were decreased and in subacute appendicitis their count was found to be intermediate between normal and acute appendicitis.

Pleomorphic xanthoastrocytoma

Pleomorphic xanthoastrocytoma is an unusual brain tumour of children with a favourable prognosis. The tumour takes origin from subpial astrocytes of the cerebral cortex. Histologically proliferation of spindle cells, mono and multinucleated giant cells containing lipid droplets and the absence of necrosis are distinctive features. Herein we report the morphological and immunophenotypical features of a case of pleomorphic xanthoastrocytoma.

Extragonadal germ cell tumours in Mangalore with review of the literature

In the present study 32 extragonadal tumours, reported in 38 years (1956 to 1994) from the department of pathology, Kasturba Medical College, Mangalore were analysed. These were seen predominantly in infants and children mainly affecting females. The commonest sites of these tumours were sacrococcygeal region (46.88%) followed by retroperitoneum and mediastinum. The rarest sites were mesentery, fallopian tube and suprasellar region in the cranial cavity. Histologically 27 out of 32 cases were teratomas, 75% of which were benign.

Hibernoma of scalp: case report and review of literature

Hibernomas are uncommon, benign neoplasms of adipose composed of brown fat. A review of the world literature revealed about 115 cases. These tumors are asymptomatic and slow-growing, commonly seen in the the interscapular region. We herein present the third documented case of a scalp hibernoma.

Microfilariae in cytologic smears: a report of six cases

BACKGROUND

Filariasis is a major public health problem in tropical countries, including India. Despite this high incidence, it is unusual to find microfilariae in fine needle aspiration cytology. (FNAC) smears and body fluids. Six cases of filariasis diagnosed by FNAC are reported.

CASES

In case 1, a thyroid aspirate from a 23-year-old female showed a microfilaria with colloid and thyroid follicular cells. In case 2, pericardial fluid from a 50-year-old male with breathlessness and chest pain showed clusters of malignant cells and many microfilariae. In case 3, a bronchial aspirate from a 55-year-old male with fever and chest pain showed aggregates of acute inflammatory cells and a microfilaria. Cases 4 and 5 were lymph node aspirates from a 29-year-old male and 3-year-old female. Both smears showed microfilariae in a background of reactive lymphoid cells. In case 6, FNAC from a 21-year-old female with a cystic swelling in the breast showed clusters of microfilariae, lymphocytes and granular debris.

CONCLUSION

In three of the six cases microfilariae were the cause of symptoms, whereas in the other three cases, microfilariae were associated with other diseases, including malignancy. Thus, careful screening of FNAC smears might be helpful in detecting microfilariae, even in asymptomatic patients.

Incidence of primary bone tumours and tumour like lesions in and around Dakshina Kannada district of Karnataka

A total of 523 cases of primary bone tumours and tumour like lesions in and around Dakshina Kannada district of Karnataka were diagnosed over a period of 36 years. About 39% of these tumours were malignant and the remaining benign. Among the malignant tumours the highest incidence was of osteosarcoma (45.7%) followed by Ewing's sarcoma (19.4%). Osteochondroma was the most frequent in the benign tumour category (30.3%). Peak incidence of tumour was in the 2nd and 3rd decade of life with a male preponderance. The most commonly affected bones were femur, tibia and humerus in that order. Results indicate a significantly higher incidence of primary bone tumours in this part of India.

Nongestational choriocarcinoma of the ovary -- a case report

Nongestational choriocarcinoma is an extremely rare malignant tumour of the ovary. It may be pure or combined with other germ cell tumours. A case of nongestational choriocarcinoma with mature cystic teratoma is presented herewith.

Angiomatoid malignant fibrous histiocytoma

Three cases of angiomatoid fibrous histiocytoma of the lower extremity are described. All the three patients were young and gave a history of swelling of 1-5 years duration. Histologically, the lesions were characterised by the presence of large blood filled spaces lacking endothelial lining, being surrounded and lined by sheets of proliferating histiocytes, many of which contained haemosiderin pigment.

Primary retroperitoneal tumours a 25 year study

Primary retroperitoneal neoplasia is not a common condition. Out of the 34 tumours analysed in the present study 15 were germ cell tumours, 10 were soft tissue tumours and 9 were tumours of the sympathetic nervous system. Among the 15 germ cell tumours, 9 were mature teratomas while there were 2 each of immature teratoma, embrayonal carcinoma and dysgerminoma. Out of the 10 soft tissue tumours 9 were sarcomas with 5 liposarcomas, 3 leiomyosarcomas and 1 neurogenic sarcoma. The only benign soft tissue tumour was a lipoma. The 9 tumours of the sympathetic nervous system included 7 neuroblastomas and 2 ganglioneuroblastomas. Overall, in the present series majority of the primary retroperitoneal tumours (22 out of 34 i.e. 70.6%) were malignant tumours.

Rhinoentomophthoromycosis: a report of three cases

Three cases of rhinoentomophthoromycosis involving the nasal region are presented diagnosis in the first two cases was made on surgical biopsy and in the third case by fine needle aspiration biopsy. A granulomatous inflammatory reaction was seen in tissue around hollow broad hyphae of the fungus. The hyphal strands were surrounded by eosinophilic deposits Splendore--Hoeppli phenomenon.

Acute leukaemia following malignant ependymoma: a case report

Though an increasing number of chemotherapy- and radiotherapy-related leukaemias are being reported, acute promyelocytic leukaemia developing as a therapy-related second malignancy is still uncommon. Here we report a case of acute promyelocytic leukemia, microgranular variant, developing in a case of intracranial malignant ependymoma, 1.5 years following treatment with craniospinal radiotherapy.

Pathways of glucose catabolism in Mycobacterium smegmatis

Glucose metabolism in Mycobacterium smegmatis was investigated by the radiorespirometric method and by assaying for key enzymes of the major energy-yielding pathways. Glucose is oxidized in this organism mainly through the Embden-Meyerhof-Parnas pathway, irrespective of the carbon source used for growth. The pentose phosphate pathway plays only a minor role and its extent depends on the carbon source used for growth. Enzymes of glycolytic and oxidative pathways were detected in cells grown on glucose, glycerol, or pyruvate but enzymes of the Entner-Duodroff pathway could be detected only in glucose-grown cells. Labeled acetate is utilized by cells cultured on glucose, glycerol, and pyruvate. In all cases more of C1 of acetate was converted to CO2 while incorporation into cellular constituents was maximum from C2 of acetate.

Production of aflatoxin m in a liquid medium

Aspergillus flavus NRRL 3251 grown on modified yeast extract-sucrose medium produced 1 mg of aflatoxin M(1) per 100 ml of medium.