A Study on the association between plasma glucose, glycosylated hemoglobin and macro metals Calcium and Magnesium in Diabetes Mellitus

  Abstract       To find out the association between Fasting plasma glucose, glycosylated Hemoglobin to macro metals calcium and magnesium in a randomly selected 50 patients ( both diabetic and non diabetic) attending the MHC. Comparison of both men and women (men= 26, women=24) in the age group of 23 to 72 years were enrolled, Fasting plasma glucose, glycoHb, calcium and magnesium were measured using the fasting blood samples.  The parameters were then subjected to statistical analysis to find out the relation between any two analytes.  Results of paired t tests with a p of <0.01 was considered significant and p<0.001 were considered highly significant to conclude an association between the analytes studied. This study has proved beyond doubt that calcium and magnesium are indeed involved in diabetes mellitus both in its regulation and glucose metabolism. As the study was carried out during a short period of 1 Month, we were unable to indicate control subjects but purely worked out to find the association between FPG, Glycosylated hemoglobin, calcium and magnesium. The study recommends that along with glucose and Glycosylated hemoglobin, calcium and magnesium assays too should be carried out as additional parameters in the evolution of diabetes mellitus.Based on this study we strongly recommend that further research should be carried out to establish the role of calcium and magnesium especially red cell calcium and magnesium and diabetes mellitus

Acid-Fastness of in Surgical Pathology Practice

Background Histoplasmosis (HP) is diagnosed by visualizing intracellular microorganisms in biopsy and/or culture. Periodic-acid Schiff (PAS) and Gomori methenamine silver (GMS) staining methods are routinely used for identification. The acid-fast property of Histoplasma was identified decades ago, but acid-fast staining has not been practiced in current surgical pathology. Awareness of the acid-fast property of Histoplasma, which is due to mycolic acid in the cell wall, is important in distinguishing Histoplasma from other infective microorganisms. Here, we examined acid-fastness in previously diagnosed cases of Histoplasma using the Ziehl-Neelsen (ZN) stain and correlated those findings with other known fungal stains. Methods All cases diagnosed as HP were retrieved and reviewed along with ZN staining and other fungal stains. We also stained cases diagnosed with Cryptococcus and Leishmania as controls for comparison. Results A total of 54 patients ranging in age from 11 to 69 years were examined. The most common sites of infection were the skin, adrenal tissue, and respiratory tract. Of the total 43 tissue samples, 20 (46.5%) stained positive with the ZN stain. In viable cases, a significant proportion of microorganisms were positive while necrotic cases showed only rare ZN-positive yeasts. In comparison to PAS and GMS stains, there was a low burden of ZN-positive yeasts. Cryptococcus showed characteristic ZN staining and all cases of Leishmania were negative. Conclusions Although the morphology of fungal organisms is the foundation of identification, surgical pathologists should be aware of the acid-fast property of fungi, particularly when there is the potential for confusion with other infective organisms

Mastoid Osteoma – Is “Trauma” A Possible Etiologic Factor

A 19 year old female presented with painful postaural swelling of three years duration with preceding history of trauma. Clinically and radilogically the diagnosis of mastoid osteoma was made. As patient was symptomatic the osteoma was removed and cortical mastoidectomy was done. We emphasise that symptomatic mastoid osteomas must be treated early even if they are small in size to prevent the development of giant osteomas. The case is reported for its rarity with relevant review of literature.  To the best of our knowledge, this is the first case report in which there is a definitive history of trauma preceding the development of osteoma suggesting its possible role as an inciting factor

Radiation-Induced Sarcoma Originating in Recurrent Juvenile Nasopharyngeal Angiofibroma

Juvenile nasopharyngeal angiofibroma is a benign disease affecting young males with a propensity to invade intracranially and into the orbit along preformed pathways. Complete surgical excision is the mainstay of management. Patients with multiple recurrences along with tumour extension into skull base and orbit can be considered for external beam radiation as either adjuvant or definitive treatment. Possibility of radiation-induced malignancy has been speculated by many authors, proof of which exists in only two studies so far. This report focuses on radiation-induced leiomyosarcoma in a patient with recurrent juvenile nasopharyngeal angiofibroma