Oncocytic carcinoma of minor salivary gland: a case report

Oncocytic carcinoma is an extremely rare malignancy of minor salivary gland. The biological behaviour, management and prognosis are not well established due to its rarity and paucity of published literature. We report a case of 32 year old man presented an ulcerated growth measuring 1cm in size in right buccal mucosa along with enlarged left submandibular lymphadenopathy. The diagnosis was suggestive of oncocytic carcinoma of minor salivary gland by cytology and subsequently confirmed by excisional biopsy

Pregnancy outcome of external cephalic version in singleton pregnancy with breech presentation at term

Background: Breech delivery is associated with poor perinatal outcomes irrespective of the route of delivery. External cephalic version can be a useful tool in management of breech presentation at term by converting it to a cephalic presentation. A study was conducted to evaluate maternal and neonatal outcome of external cephalic version in singleton pregnancies with breech presentation in third trimester.Methods: A prospective observational study was carried out at a tertiary care hospital over a period of 2 years. This study included a total of 65 uncomplicated cases of breech presentation who fulfilled the inclusion criteria. External cephalic version was carried out after 36 weeks of period of gestation in primigravida and after 37 weeks in multigravida women. These patients were followed up till delivery and data was collected and analysed regarding the mode of delivery, maternal and fetal outcome.Results: External cephalic version was successful in 41 patients with a success rate of 63%. Out of them, vaginal delivery could be achieved in 31 cases (75.6%) and LSCS was done for rest of the 10 cases. The success rate was higher in multigravida ladies compared to primigravida ladies. No major procedure related adverse event was noticed in our study.Conclusions: External cephalic version is a very safe and easy procedure which can reduce the rate of cesarean delivery in singleton pregnancies with breech presentation. The results of this study are in favor of wider practice of this procedure in selected cases

Investigation of DNA interaction and antiproliferative activity of mixed ligand dioxidomolybdenum(VI) complexes incorporating ONO donor aroylhydrazone ligands

Four new mixed ligand dioxidomolybdenum(VI) [MoVIO2L1-3(Q)] (1–3), [MoVIO2L4(Q)]2 (H2O) (4) [where Q = MeOH for 1 and imidazole for 2–4] complexes have been synthesized using four different ONO donor aroylhydrazone ligands (H2L1–4). All the derived ligands and complexes have been characterised by different physicochemical techniques, that is, elemental analysis, spectroscopic methods (UV–Vis, NMR and IR), and cyclic voltammetry. The molecular geometries of 1–4 were established by X-ray crystallography which reveals - - the Schiff base ligands coordinate - the distorted octahedral metal centres in a di-negative tridentate fashion. The complexes have shown moderate binding affinity (103 to 104 M−1) towards CT-DNA. Further, in vitro cytotoxicity activity of all the complexes were determined against HT-29 (colon cancer) and HeLa (cervical cancer) cell lines. Complex 4, due to the presence of a heterocyclic 2-hydroxy-1-naphthyl moiety in the ligand backbone, was found to be more biologically active in comparison to the others in the series

Analysis of FNAC in diagnosis of lymphadenopathy-a retrospective study from a regional cancer centre, Cuttack, Odisha

Background: Lymphadenopathy is one of the most common clinical presentations and major causes of morbidity. Thus, clinical recognition and urgent diagnosis is of paramount importance. So, we aimed to analysis the diagnostic role of fine needle aspiration cytology (FNAC) in superficial lymphadenopathy in a regional cancer centre, Odisha, India.Methods: A total 1129 cases were retrieved from the hospital record retrospectively from the patients who had presented with superficial lymphadenopathy from January 2015 to December 2015.Results: Out of 1129 lymphadenopathy cases, 671 (59.43%) were male and 458 (40.56%) were female with male to female ratio 1.46:1. The age of the patients ranged from 4 years to 83 years with mean age 48.57 years. The most common site was observed in cervical lymph node 493 (43.66%) followed by submandibuar lymph nodes 198 (17.53%) and supraclavicular lymph nodes 172 (15.23%). 584 (51.27%) were malignant and 545 (48.27%) were benign. Reactive hyperplasia was most common 318 (58.34%) among benign cases where as metastatic squamous cell carcinoma was the most common 261 (50.77%) among malignant lesions. By FNAC all benign lesions were correctly diagnosed, and primary sites of malignancy identified in 442 (85.59%) cases. Cyto-histo correlation was done in 399 cases. The overall diagnostic accuracy of FNAC was found to be   93.98%, sensitivity 93.88%, specificity 94.64%, positive predictive value 99.8% and negative predictive value 71.62%.Conclusions: FNAC is a highly sensitive and specific tool for early detecting primary malignancy and metastatic lesions. Many inflammatory lesions can be treated based on FNAC alone

A study of DNA/BSA interaction and catalytic potential of oxidovanadium(V) complexes with ONO donor ligands

The study of DNA/BSA interaction and the catalytic potential of four mononuclear oxidoalkoxido vanadium(V) [VVO(L¹⁻⁴)OEt] (1–4) and one dinuclear oxidoalkoxido mixed-ligand vanadium(V) [{VO(L²)OEt} ₂ (Q)]{Q = 4,4′-bipyridine}(5) complexes, with tridentate binegative aroylazine ligands are reported [where H₂L¹ = anthranylhydrazone of 2- hydroxy-1- napthaldehyde, H₂L² = salicylhydrazone of 2-hydroxy-1- napthaldehyde, H₂L³ = benzoylhydrazone of 2-hydroxy-1- acetonaphthone, H₂L⁴ = anthranylhydrazone of 2-hydroxy-1- acetonaphthone]. All the complexes are characterized by elemental analysis as well as various spectroscopic techniques. Single crystal X-ray diffraction crystallography of 2 reveals that the metal centre is in distorted square pyramidal geometry with O₄N coordination spheres, whereas 5 exhibits a distorted octahedral geometry around the metal center. In addition, all the complexes (1–5) show moderate DNA binding propensity which is investigated using UV-vis absorption titration, circular dichroism, thermal denaturation and fluorescence spectral studies. The experimental results show that the complexes effectively interact with CT-DNA through both minor and major groove binding modes, with binding constants ranging from 10⁴ −10⁵ M⁻¹. Among 1–5, complexes 3 and 4 show higher binding affinity towards CT-DNA than others and at the same time also exhibit negative ΔTm values of about ∼1.5 and 1.0 °C which resembles the properties shown by cisplatin. All complexes show moderate photo-induced cleavage of pUC19 supercoiled plasmid DNA with complex 3 showing the highest photo induced DNA cleavage activity of ∼48%. In coherence with the DNA interaction studies, 3 and 4 also exhibit good binding affinity towards BSA in the range of 10¹⁰ −10¹¹ M⁻¹, which is also supported by their ability to quench the tryptophan fluorescence emission spectra of BSA. All the complexes show remarkable photo-induced BSA cleavage activity (>90%) at a complex concentration of 50 μM. The catalytic potential of 1–5 is also tested for the oxidative bromination of styrene, salicylaldehyde and oxidation of methyl phenyl sulphide. All the reactions show a high percentage of conversion (>90%) with a high turnover frequency (TOF). Particularly, in the oxidative bromination of styrene the percentage of conversion and TOF vary from 96–98% and 8000–19 600 (h⁻¹) respectively, which signifies the potential of these oxidovanadium(V) complexes to stimulate research for the synthesis of a better catalyst

Monomeric and dimeric oxidomolybdenum(V and VI) complexes, cytotoxicity, and DNA interaction studies: molybdenum assisted C═N bond cleavage of salophen ligands

Four novel dimeric bis-μ-imido bridged metal–metal bonded oxidomolybdenum(V) complexes [MoV2O2L′21–4] (1–4) (where L′1–4 are rearranged ligands formed in situ from H2L1–4) and a new mononuclear dioxidomolybdenum(VI) complex [MoVIO2L5] (5) synthesized from salen type N2O2 ligands are reported. This rare series of imido- bridged complexes (1–4) have been furnished from rearranged H3L′1–4 ligands, containing an aromatic diimine (o-phenylenediamine) “linker”, where Mo assisted hydrolysis followed by −C═N bond cleavage of one of the arms of the ligand H2L1–4 took place. A monomeric molybdenum(V) intermediate species [MoVO(HL′1–4)(OEt)] (Id1–4) was generated in situ. The concomitant deprotonation and dimerization of two molybdenum(V) intermediate species (Id1–4) ultimately resulted in the formation of a bis-μ-imido bridge between the two molybdenum centers of [MoV2O2L′21–4] (1–4). The mechanism of formation of 1–4 has been discussed, and one of the rare intermediate monomeric molybdenum(V) species Id4 has been isolated in the solid state and characterized. The monomeric dioxidomolybdenum(VI) complex [MoVIO2L5] (5) was prepared from the ligand H2L5 where the aromatic “linker” was replaced by an aliphatic diimine (1,2-diaminopropane). All the ligands and complexes have been characterized by elemental analysis, IR, UV–vis spectroscopy, NMR, ESI- MS, and cyclic voltammetry, and the structural features of 1, 2, 4, and 5 have been solved by X-ray crystallography. The DNA binding and cleavage activity of 1–5 have been explored. The complexes interact with CT-DNA by the groove binding mode, and the binding constants range between 103 and 104 M–1. Fairly good photoinduced cleavage of pUC19 supercoiled plasmid DNA was exhibited by all the complexes, with 4 showing the most promising photoinduced DNA cleavage activity of ∼93%. Moreover, in vitro cytotoxic activity of all the complexes was evaluated by MTT assay, which reveals that the complexes induce cell death in MCF-7 (human breast adenocarcinoma) and HCT-15 (colon cancer) cell lines

Utilization of mechanical power and associations with clinical outcomes in brain injured patients: a secondary analysis of the extubation strategies in neuro-intensive care unit patients and associations with outcome (ENIO) trial

Background: There is insufficient evidence to guide ventilatory targets in acute brain injury (ABI). Recent studies have shown associations between mechanical power (MP) and mortality in critical care populations. We aimed to describe MP in ventilated patients with ABI, and evaluate associations between MP and clinical outcomes. Methods: In this preplanned, secondary analysis of a prospective, multi-center, observational cohort study (ENIO, NCT03400904), we included adult patients with ABI (Glasgow Coma Scale ≤ 12 before intubation) who required mechanical ventilation (MV) ≥ 24 h. Using multivariable log binomial regressions, we separately assessed associations between MP on hospital day (HD)1, HD3, HD7 and clinical outcomes: hospital mortality, need for reintubation, tracheostomy placement, and development of acute respiratory distress syndrome (ARDS). Results: We included 1217 patients (mean age 51.2 years [SD 18.1], 66% male, mean body mass index [BMI] 26.3 [SD 5.18]) hospitalized at 62 intensive care units in 18 countries. Hospital mortality was 11% (n = 139), 44% (n = 536) were extubated by HD7 of which 20% (107/536) required reintubation, 28% (n = 340) underwent tracheostomy placement, and 9% (n = 114) developed ARDS. The median MP on HD1, HD3, and HD7 was 11.9 J/min [IQR 9.2-15.1], 13 J/min [IQR 10-17], and 14 J/min [IQR 11-20], respectively. MP was overall higher in patients with ARDS, especially those with higher ARDS severity. After controlling for same-day pressure of arterial oxygen/fraction of inspired oxygen (P/F ratio), BMI, and neurological severity, MP at HD1, HD3, and HD7 was independently associated with hospital mortality, reintubation and tracheostomy placement. The adjusted relative risk (aRR) was greater at higher MP, and strongest for: mortality on HD1 (compared to the HD1 median MP 11.9 J/min, aRR at 17 J/min was 1.22, 95% CI 1.14-1.30) and HD3 (1.38, 95% CI 1.23-1.53), reintubation on HD1 (1.64; 95% CI 1.57-1.72), and tracheostomy on HD7 (1.53; 95%CI 1.18-1.99). MP was associated with the development of moderate-severe ARDS on HD1 (2.07; 95% CI 1.56-2.78) and HD3 (1.76; 95% CI 1.41-2.22). Conclusions: Exposure to high MP during the first week of MV is associated with poor clinical outcomes in ABI, independent of P/F ratio and neurological severity. Potential benefits of optimizing ventilator settings to limit MP warrant further investigation

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BackgroundDisorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021.MethodsWe estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined.FindingsGlobally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer.InterpretationAs the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed

Role of fine needle aspiration cytology and cell block in diagnosis of scar endometriosis: A case report

Presence of endometrial glands and stroma in places other than the uterus is called endometriosis. It can be pelvic or extra-pelvic. Abdominal scar endometriosis is an extra-pelvic endometriosis that can occur after surgery involving the uterus. Post-caesarean section, scar endometriosis is a rare event. The diagnosis is frequently made only after excision of disease tissue. We present a case of post-caesarean section abdominal scar endometriosis presenting as a tumor on the abdominal wall, which was diagnosed by fine needle aspiration cytology and confirmed by cell block preparation