Interpretation of Biochemical Tests for Iron Metabolism in Hyperthyroidism

Objective: Several studies suggest that thyroid hormones may affect erythropoiesis. However the mechanism by which thyroid hormones alter the ferritin concentration is not well known. Therefore, the present case-control study was designed to determine the changes due to hyperthyroidism in serum ferritin, iron and transferrin levels and to investigate the inter-relationship between these parameters.Material: This study was conducted on 50 newly diagnosed hyperthyroid patients and the results were compared with 50 age and sex matched healthy controls. Serum ferritin was assessed by two site sandwich immunoassay using direct chemiluminometric technology. TIBC and serum iron were estimated by colorimetric method.Results: Serum ferritin (314.43 ± 68.7 ng/mL) and iron concentration (159.88 ± 36.28 µg/dL) were found to be increased in hyperthyroid patients as compared to healthy controls (255.23 ± 45.5 ng/mL and 110.52 ± 20.52 µg/dL respectively). There was a significant difference between hyperthyroid patients and healthy controls in serum levels of ferritin and iron (p0.05 for both). Serum ferritin and iron were correlated significantly positive with thyroid parameters while a significant negative correlation was found with transferrin.Conclusion: Our data suggest that alterations in thyroid status in a given individual produce significant changes in serum ferritin, iron and transferrin levels. Increased ferritin levels seem to be protective against increased oxidative stress seen in hyperthyroidism but these also increase atherosclerotic risk. However, a large scale study is recommended to establish the fact

Autopsy: a value to primordial and primary prevention for lung diseases

Background: Lung disorders spectrums include congestion, oedema, various inflammatory lesions, chronic obstructive pulmonary diseases and neoplastic lesions. The clinical and radiological findings in respiratory diseases are nonspecific and therefore a histopathological study is essential. Autopsies are necessary to establish cause of death of the person with help of antemortem history and investigations to rule out lung lesions. Aims and objectives were to identify the histopathological spectrum of lung disease and frequency of various lung pathologies in respect to age and sex.Methods: The retrospective study of 285 lung autopsy specimens received were fixed and processed. Routine paraffin sectioning was done followed by hematoxylene and eosin (H and E) staining. Relevant clinical and postmortem findings, gross and microscopic examination findings were recorded.Results: Most common lung pathology found was Edema and congestion in 149 cases (52.2%), pneumonia in 87 cases (30.5%) followed by tuberculosis in 33 cases (11.5%). Out of total 285 cases, 222 (77.9%) were males and 63 cases (22.2%) were females. The male to female ratio was 3.5:1. Maximum numbers of cases, in age group of 31-45 years were 108 cases (37.89%) followed by in age group 46-60 years were 90 cases (31.57%) followed by age group of 16-30 years 15.8%.Conclusions: Advances in diagnostic technology have not reduced the value of autopsy for the study and evaluation of the disease process. It has become crucial for adopting correct prophylactic actions for primordial and primary prevention of pulmonary dysfunctions

Blastoid Variant of Mantle Cell Lymphoma-a Rare Case Report

Abstract Mantle cell lymphoma is now recognised as a rare but distinct entity in the revised WHO classification. It is now well recognised that MCL represent a broad spectrum of different histopathological subtypes. The term blastic or blastoid variant is generally used to describe cases with a homogeneous population of cells displaying lymphoblastic morphology. The blastic form of MCL may be difficult to diagnose however immunophenotyping and molecular analysis show typical mantle cell lymphoma pattern. We present a case of 30 year old male presenting with inguinal mass which was diagnosed as blastic transformation of mantle cell lymphoma based on routine histopathology and immunohistochemistry

Anti-Urolithiatic Activity of Cassia Auriculata Ethanolic Seed Extract in Wistar Rats

Background: Urolithiasis is a medical condition that, despite substantial research in the field of urology, has yet to find a cure within the allopathic medical approach. The process of stone development, known as nephrolithiasis, can occur within the kidney or any segment of the urinary tract, encompassing the ureters and bladder. Material and Methods: The seeds of Cassia auriculata (Linn.) were obtained in June 2021 from Mettukadai hamlet, located in the Erode District of Tamilnadu, India. The herbarium of the plant was meticulously assembled, verified, and afterwards deposited as a voucher specimen. The voucher specimen was retained within the college premises for future reference. Results: The current investigation involved conducting a preliminary phytochemical analysis on the ethanolic seed extract of Cassia auriculata Linn. The research revealed the existence of many phytochemical constituents, including Alkaloids, Flavanoids, Carbohydrate, Sterols, Phytosterols, Phenols, Terpenoids, Amino acids, and Anthraquinones. The acute toxicity experiments revealed that rats exhibited tolerance to a maximum dose of 2000 mg/kg body weight, and no discernible alterations in behavior were detected across all experimental groups. Hence, fractions equivalent to one-fourth and one-eighth of the maximum tolerated dose of 200 mg/kg body weight were selected for subsequent investigations. Conclusion: In summary, the findings suggest that the application of an ethanolic seed extract derived from Cassia auriculata Linn effectively decreased the progression of urinary stone formation. Additionally, it appears that the efficacy of the treatment impact surpasses that of its preventative counterpart

Comparative Evaluation of the Complementary and Alternative Medicine Therapy and Conventional Therapy Use for Musculoskeletal Disorders Management and Its Association with Job Satisfaction among Dentists of West India

ABSTRACTMusculoskeletal problems have become a significant issue in the profession of dentistry. There are currently no recommended effective disease-preventing and modifying remedies. High prevalence rates for musculoskeletal disorders (MSDs) among dentists have been reported in the literature. Complementary and alternative medicine can be helpful in managing and preventing the MSDs. The purpose of this study was to determine if dentists in the western part of India are using complementary and alternative medicine therapies for MSDs, and also to find if those who use complementary and alternative medicine therapies have greater job/career satisfaction compared to conventional therapy (CT) users. Dentists of western India registered under the Dental Council of India (N=2166) were recruited for the study. Data were analyzed using univariate and bivariate analyses and logistic regression. A response rate of 73% (n=1581) was obtained, of which 79% (n=1249) was suffering from MSDs. The use of complementary and alternative medicine or CT was reported by 90% (n=1124) of dentists with MSDs. Dentists using complementary and alternative medicine reported greater health (P<0.001) and carrier satisfaction (P<0.001) and were able to work as many hours they wanted (P<0.001) compared to CT users. Complementary and alternative medicine therapies may improve the quality of life and enhance job satisfaction for a dentist who suffers from MSDs

Evaluation of exfoliative cytology in the diagnosis of oral premalignant and malignant lesions: A cytomorphometric analysis

Background: Many oral squamous cell carcinomas (OSCCs) arise within regions that previously had premalignant lesion. Early diagnosis and prompt treatment of premalignant lesions offers the best hope of improving the prognosis in patients with OSCC. Exfoliative cytology is a simple and non-invasive diagnostic technique that could be used for early detection of oral premalignant and malignant lesions. This study was undertaken to evaluate the quantitative changes in nuclear area (NA), cytoplasmic area (CA) and nuclear-to-cytoplasmic ratio (NA/CA) in cytological buccal smears of oral leukoplakia with dysplasia (OLD) and OSCC patients while comparing with normal healthy mucosa. Materials and Methods: A quantitative study was conducted over 90 subjects including 30 cases each of OLD, OSCC and clinically normal oral mucosa. The smears obtained were stained with Papanicolaou (PAP) stain and cytomorphological assessment of the keratinocytes was carried out. The statistical tools included arithmetic mean, standard deviation, Chi-square test, analysis of variance, Tukey multiple comparison. P < 0.001 was considered as significant. Results: The mean NA of keratinocytes in the normal mucosa was 65.47 ± 4.77 μm 2 while for OLD it was 107.97 ± 5.44 μm 2 and 139.02 ± 8.10 μm 2 for that of OSCC. The differences show a statistically significant increment in NA (P < 0.001). There was significant reduction (P < 0.001) in the CA of keratinocytes from OSCC when compared with those from smears of OLD and normal mucosa with the values of 1535.80 ± 79.38 μm 2 , 1078.51 ± 56.65 μm 2 and 769.70 ± 38.77 μm 2 respectively. The NA/CA ratio in the smears from normal oral mucosa, OLD and OSCC showed a mean value of 0.043 ± 0.004, 0.100 ± 0.008, 0.181 ± 0.015 respectively with a significant difference among the groups (P < 0.001). Conclusion: Evaluation of nuclear and CA of keratinocytes by cytomorphometry can serve as a useful adjunct in the diagnosis and prognosis of a dysplastic lesion which may lead to OSCC

Delayed Diagnosis of Acute Rheumatic Fever in a Patient with Multiple Emergency Department Visits

While the incidence of acute rheumatic fever (ARF) in the United States has declined over the past years, the disease remains one of the causes of severe cardiovascular morbidity in children. The index of suspicion for ARF in health care providers may be low due to decreasing incidence of the disease and clinical presentation that can mimic other conditions. We present the case of a 5-year-old boy with a history of intermittent fevers, fatigue, migratory joint pain, and weight loss following group A Streptococcus pharyngitis. The patient presented to the emergency department twice with the complaints described above. On his 3rd presentation, the workup for his symptoms revealed the diagnosis of acute rheumatic fever with severe mitral and aortic valve regurgitation. The patient was treated with penicillin G benzathine and was started on glucocorticoids for severe carditis. The patient was discharged with recommendations to continue secondary prophylaxis with penicillin G benzathine every 4 weeks for the next 10 years. This case illustrates importance of primary prevention of acute rheumatic fever with adequate antibiotic treatment of group A Streptococcus pharyngitis. Parents should also receive information and education that a child with a previous attack of ARF has higher risk for a recurrent attack of rheumatic fever. This can lead to development of severe rheumatic heart disease. Prevention of recurrent ARF requires continuous antimicrobial prophylaxis. Follow-up with a cardiologist every 1-2 years is essential to assess the heart for valve damage