Analysis of histopathological patterns of lung and pleural biopsy in correlation with immunohistochemistry

Introduction: Lungs are the most exposed organs to different risk factors  like pollution, smoke, infections, tuberculosis and allergens. Lungs are covered by parietal and visceral layers of pleura within which pleural fluid is present. Aim of the study was to evaluate various histopathological patterns of lung and pleural biopsy in correlation with age, sex and immunohistochemistry examination findings.Material and methods: This is a retrospective study of three year three months done at Pathology Department, S.S.G. Hospital and Medical College, Baroda from October  2016 to  December  2019. In present study, total 169 cases were received for histopathological examination, out of which 151 cases were of lung biopsy and 18 cases were of pleural biopsy. Immunohistochemical examination was done as and when required.Results:Lung biopsy of  151 cases  were examined. Out of which,  88 cases (58.3%) were neoplastic, 54(35.8%) cases were non-neoplastic and  9 cases(5.9%) were inconclusive. The commonest malignancy was  squamous cell carcinoma. Commonest non-neoplastic lesion was interstitial inflammation (6.6%).  Malignancy was seen more  common than inflammatory conditions  in patients presented withlung masses in our institute. While out of 18 cases of pleural biopsy,  6 cases(33.3%) were neoplastic and 12 cases (66.7%) were non-neoplastic. Adenocarcinoma was the most common neoplastic lesion while tuberculosis was the most common non-neoplastic pleural lesion.Conclusion:Histopathological examination plays an important role in making a correct and accurate diagnosis of various lesions of lung and pleura. Although histopathological examination is gold standard, immunohistochemistry can enhance the accuracy of such diagnosis. &nbsp

MSCT coronary angiography in non-invasive assessment of coronary artery bypass grafts patency

Background: Coronary artery disease (CAD) is one of the leading cause of the morbidity and mortality in India and worldwide and last decade has seen a steep rise in incidence of CAD in India and its treatment as bypass surgery. Direct visualization of the grafts and native coronary arteries by invasive catheterization is now being replaced by non-invasive CT coronary angiography with higher slice machines and newer technology as it has good temporal resolution, high scanning speed as well as low radiation dose. We share our experience of graft imaging on 128 slice CT machine.Methods: This is a retrospective, single-center, observational study. We included 500 symptomatic patients who have undergone CT study between the year 2014 to 2018 post bypass surgery.Results: Arterial grafts have a better patency rate than venous grafts. (88% vs. 64.1%). Amongst the individual arterial grafts RIMA had the best patency rate (100%) followed by LIMA (90.8%), RA (68.7%). LAD was the most commonly involved artery (91%).Conclusions: Significant absolute concordance between CT and catheter angiographic findings have been documented for all arterial and venous grafts patency in the literature. The MSCT with retrospective gating permits an accurate and non-invasive evaluation of patent and diseased arterial and vein grafts and could replace conventional angiography for the follow-up of symptomatic, stable patients. Moreover, an optimal diagnostic accuracy was also documented in the appraisal of native vessels distal to the graft anastomoses

Double outlet of right ventricle: imaging spectrum on multi-slice computed tomography

Background: Multi-slice computed tomography (MSCT) is the main stay of pre-operative assessment of many complex congenital heart diseases (CHD) in current clinical practice, one of them is double outlet of right ventricle (DORV). DORV is one of the conotruncal anomalies that encompasses a wide spectrum of anatomic malformations in which both the aorta and pulmonary arterial trunk arise entirely or predominantly from the morphologically right ventricle (RV). Purpose of this article is to understand spectrum of DORV and associated types of ventricular septal defect (VSD) on MSCT imaging with special emphasis of usefulness of 3-D volume rendered (VR) images in pre surgical evaluation.Methods: A total of 500 paediatric patients (<18 years old), who had undergone MSCT were studied during the period 2014 to 2019 at the tertiary cardiac care centre.Results: 500 patients having primary/suspicious diagnosis of DORV on echocardiography during the said period were enrolled in the study. All the patients who underwent MSCT scan, were studied in detail for: DORV spectrum, associated types of VSD and its relationship to the semilunar valves. Out of 500 total subjects, subaortic VSD was the most common type of VSD observed (53%), followed by subpulmonic VSD (22%), non-committed VSD (18%) and doubly committed VSD (7%). Associations of pulmonary stenosis, subaortic stenosis and aortic co-arctation with various types of VSDs were addressed. Associated other anomalies were also analysed.Conclusions: Advances in MSCT technology has revolutionized pre-surgical diagnosis, management approach and post-operative follow-up of DORV patients. Excellent image qualities along with 3D volume rendered images help surgeon understand complex morphology of DORV variants and associated types of VSD. Significant reduction in intra and post-operative mortality in DORV patients in current era is result of MSCT technology

Seroprevalencija virusnog proljeva goveda u uzgojnim farmama u Indiji

Bovine viral diarrhoea (BVD) is an important infectious viral disease affecting cattle populations all over the world. In addition to direct loss caused by the disease, the virus causes immunosuppression thereby predisposing the host to other diseases. A cross-sectional study was undertaken to detect the prevalence of BVD in 14 well-organized herds located in different parts of India. A total of 880 serum samples (646 cattle and 234 buffaloes) were screened by a commercial ELISA kit, detecting antibodies towards the p80 (NS3) region of BVDV. The overall true prevalence was 56.67% (95% CI: 53.26-60.02%) and within herds, it ranged from 0-99.99%. The prevalence rate was higher in cattle (65.42%) than in buffaloes (32.49%) and the difference was statistically significant. Further, a significant difference in prevalence among cattle breed types was recorded, with the lowest in indigenous cattle (16.49%) followed by crossbreeds (16,97% and exotic breeds (87.80%). Higher positivity was detected among females (68.87%) than males (48.83%) but this difference was not significant, as revealed by multivariate regression analysis. Of the 10 semen stations studied, the prevalence varied from 9.72% to 72.68%. However, none of the animals from these semen stations turned positive in the antigen ELISA test, suggesting the antibodies detected in this study were from past infections. On the two dairy farms/bull mother farms showing very high positivity, two (one each) persistently infected cows were detected during whole herd screening by antigen ELISA test. One bull mother farm was free of BVD antibodies suggesting it is possible to maintain BVDV-free herds. The present study indicates the endemicity of BVDV in Indian organized herds, and therefore a suitable testing strategy and management should be adopted in response to testing to control the introduction and further transmission of the disease on farms.Virusni proljev goveda (BVD) važna je zarazna virusna bolest od koje obolijevaju goveda diljem svijeta. Osim izravnoga gubitka uzrokovanog bolešću, virus uzrokuje imunosupresiju zbog čega domaćin postaje podložan drugim bolestima. Provedeno je presječno istraživanje kako bi se otkrila prevalencija BVD-a u 14 organiziranih uzgoja koji su uključivali farme bikovskih majki i stanice za proizvodnju sjemena za UO. Uzgoji su se nalazili u različitim područjima Indije. Ukupno je 880 uzoraka seruma (646 goveda i 234 bivola) analizirano komercijalnim ELISA testom za otkrivanje protutijela na regiju p80 (NS3) BVDV-a. Ukupna je stvarna prevalencija iznosila 56,67 % (95 % CI: 53,26 – 60,02 %), a unutar stada kretala se u rasponu od 0 do 99,99 %. Stopa prevalencije bila je veća u goveda (65,42 %) nego u bivola (32,49 %) i razlika je bila statistički znakovita. Nadalje, zabilježena je znakovita razlika u prevalenciji među pasminama goveda, s tim da je najmanja bila u autohtonih pasmina goveda (16,49 %), slijede zatim križanci (61,97 %) te egzotične pasmine (87,80 %). Veća je pozitivnost zabilježena u ženki (68,87 %) u odnosu na mužjake (48,83 %), ali multivarijantna regresijska analiza nije potvrdila znakovitost te razlike. Među deset istraživanih stanica za proizvodnju sjemena za UO, prevalencija je varirala od 9,72 % do 72,68 %. No ni jedna životinja iz tih stanica nije bila pozitivna na antigenskom ELISA testu, što pokazuje da protutijela pronađena u ovom istraživanju potječu od prijašnjih infekcija. Na dvjema farmama mliječnih krava - bikovskih majki tijekom testiranja cijelog stada antigenskim ELISA testom, utvrđena je visoka pozitivnost pri čemu su dvije krave bile stalno zaražene. Na jednoj farmi bikovskih majki nisu pronađena BVD protutijela što upućuje na to da je moguće održati stada bez ove bolesti. Rezultati istraživanja upućuje na endemičnost BVDV-a u organiziranim uzgojima goveda u Indiji zbog čega postoji potreba za odgovarajućim strategijama testiranja i upravljanja stadom kako bi se kontrolirao unos bolesti i njezino širenje na farmama

Observation of multiple doubly degenerate bands in Tl-195

The High-spin states in 195Tl, populated through the 185,187Re(13C, xn) fusion evaporation reaction at the beam energy of 75 MeV, were studied using the Indian National Gamma Array (INGA). More than 50 new γ transitions have been placed in the proposed level scheme which is extended up to the excitation energy of ≈ 5.6 MeV and spin. Two pairs of degenerate bands based on two different quasi-particle configurations have been identified in this nucleus indicating the first observation of such bands in an odd-A nucleus in region and signify the first evidence of multiple chiral bands in a nucleus in this region. The total Routhian surface calculations predict triaxial shapes for both the configurations and thereby, support the experimental observation. The importance of multiple neutron holes in the orbital and the stability of shapes for these two configurations have been discussed.Financial support of Department of Science & Technology, Govt. of India for clover detectors of INGA (Grant No. IR/S2/PF-03/2003-II) is greatfully acknowledged. One of the authors (S. Bhattacharya) acknowledges with thanks the financial support received as Raja Ramanna Fellowship from the Department of Atomic Energy, Govt. of India. T.R and Md. A.A acknowledge with thanks the financial support received as research fellows from the Department of Atomic Energy (DAE), Govt. of India

New high precision study on the decay width of the Hoyle state in C-12

Precise estimation of the rare direct 3α decay of the Hoyle state of 12C has been made to unveil its unusual α-cluster configurations ranging from linear 3α chain structure to diffuse Bose gas as well as Bose Einstein condensate. The present new high precision, nearly zero background experimental study with Hoyle events has converged on the upper limit for direct decay at ∼0.019% with 95% confidence limit, which is more than a factor of 2 lower than the limit obtained in the previous studies.Two of the authors (S.B. and A.R.) acknowledge the financial support received as Raja Ramanna Fellowship from the Department of Atomic Energy, Government of India

Observation of multiple doubly degenerate bands in ¹⁹⁵Tl

The High-spin states in 195 Tl, populated through the 185,187 Re( 13 C, xn) fusion evaporation reaction at the beam energy of 75 MeV, were studied using the Indian National Gamma Array (INGA). More than 50 new γ transitions have been placed in the proposed level scheme which is extended up to the excitation energy of ≈ 5.6 MeV and spin =22.5ħ . Two pairs of degenerate bands based on two different quasi-particle configurations have been identified in this nucleus indicating the first observation of such bands in an odd- A nucleus in A∼190 region and signify the first evidence of multiple chiral bands in a nucleus in this region. The total Routhian surface calculations predict triaxial shapes for both the configurations and thereby, support the experimental observation. The importance of multiple neutron holes in the i13/2 orbital and the stability of shapes for these two configurations have been discussed.Financial support of Department of Science & Technology, Govt. of India for clover detectors of INGA (Grant No. IR/S2/PF-03/2003-II) is greatfully acknowledged. One of the authors (S. Bhattacharya) acknowledges with thanks the financial support received as Raja Ramanna Fellowship from the Department of Atomic Energy, Govt. of India. T.R and Md. A.A acknowledge with thanks the financial support received as research fellows from the Department of Atomic Energy (DAE), Govt. of India

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London