Letter to Editor

Biomarkers in uterine leiomyomas and their clinical significanc

Determination of fluorescent stain and Ziehl - Nelson stain for the demonstration of acid fast bacilli in cytological specimens

Background: Tuberculosis is infectious disease caused by mycobacterium tuberculosis. There are various methods for the diagnosis of tuberculosis such as examination of tubercular bacilli by Ziehl – Nelson (ZN), Auramine – Rhodamine (AR), Kinyoun staining. The present study was conducted to know the prevalence, clinical characters, nature of specimens and tuberculosis confirmation by ZN & fluorescence staining technique using AR in 2101 clinically suspected cases of tuberculosis.Methods: This study was conducted as prospective study in Tertiary care hospital. Present study was done clinically suspected tubercular patients from January to July 2015. On all received samples ZN stain and fluorescent stain was applied.               Results: Among the clinically suspected patients 689 (32.79%) was diagnosed with tuberculosis.  Fever (81.27%) was chief clinical complaint. Among the received specimens maximum cases was of sputum (pulmonary) tuberculosis (88.27%). Tuberculosis was diagnosed in (16.75%) cases with ZN staining and with fluorescent staining in (32.79%) cases.                                                                                                                                                                            Conclusions: In present study fever was chief clinical complaint. Maximum cases of tuberculosis are of pulmonary tuberculosis than extra pulmonary and AR fluorescent staining is more sensitive.

Genomic plasticity associated with antimicrobial resistance in Vibrio cholerae.

The Bay of Bengal is known as the epicenter for seeding several devastating cholera outbreaks across the globe. Vibrio cholerae, the etiological agent of cholera, has extraordinary competency to acquire exogenous DNA by horizontal gene transfer (HGT) and adapt them into its genome for structuring metabolic processes, developing drug resistance, and colonizing the human intestine. Antimicrobial resistance (AMR) in V. cholerae has become a global concern. However, little is known about the identity of the resistance traits, source of AMR genes, acquisition process, and stability of the genetic elements linked with resistance genes in V. cholerae Here we present details of AMR profiles of 443 V. cholerae strains isolated from the stool samples of diarrheal patients from two regions of India. We sequenced the whole genome of multidrug-resistant (MDR) and extensively drug-resistant (XDR) V. cholerae to identify AMR genes and genomic elements that harbor the resistance traits. Our genomic findings were further confirmed by proteome analysis. We also engineered the genome of V. cholerae to monitor the importance of the autonomously replicating plasmid and core genome in the resistance profile. Our findings provided insights into the genomes of recent cholera isolates and identified several acquired traits including plasmids, transposons, integrative conjugative elements (ICEs), pathogenicity islands (PIs), prophages, and gene cassettes that confer fitness to the pathogen. The knowledge generated from this study would help in better understanding of V. cholerae evolution and management of cholera disease by providing clinical guidance on preferred treatment regimens.DBT Indi

Clinico-histological analysis of non-neoplastic lesions of cervix

Background: Cervix from hysterectomy constitutes the majority of gynecological specimens and includes genital infections to invasive carcinoma. These cervical lesions are the source of morbidity and mortality in women. But, there are many benign lesions which appears malignant on gross and microscopy so, misdiagnosed. Hence, clinical and histopathological examination of cervix is required for proper diagnosis and to exclude misdiagnosis.Materials and Methods: This is a retrospective study conducted in Histopathology section of Pathology Department of Rural Institute of Medical Science and Research, Saifai, Etawah (U.P) India from 1 January 2008 to 31 December 2015 on 1544 hysterectomy specimens. Histopathology examination was the diagnostic tool. Cervical pathologies in hysterectomy specimens were evaluated grossly and microscopically and correlated with clinical findings. Results: Vaginal discharge was the most common clinical complaint (43.00%), followed by bleeding complaints (23.38 %). Grossly normal cervix was seen in (32.51 %) and nabothian follicles were found in (20.07%). On histopathology examination, chronic cervicitis was the most common pathology (79.66  %).Conclusion: Cervix is site of shades of grey lesions that include cervical dysplasia to malignancy. But majority of cervical pathologies are benign lesions. However, many times benign lesions are misdiagnosed as malignant. Histopathological examination along with clinical findings is mandatory for the early and accurate diagnosis. Health camps along with cervix screening and educational awareness program should be carried out.</p

Diagnostic dilemma of ectopic breast in axillary region among the patients attending tertiary care hospital in rural India

Background and objectives: Breast developmental anomalies are common. Normally there are two breasts with nipple and areola. When it is more than two breasts, it is called Polymastia. It can also be known as ectopic or accessory breast. Diagnosis is must because it shows same disease conditions which are seen in normally occurring breast tissue. The aim of present study was to know the clinical characters, symptoms and microscopic pathological, physiological changes seen with patients diagnosed with axillary accessory breast tissue.Materials and Method: Present study was conducted in tertiary care hospital in cytology and Histopathological section of Pathology in the period from January 2013 to December 2015 on axillary swelling. FNAC &amp; histopathology were diagnostic tool.Result: The minimum age of patients with accessory breast was 10 years and maximum was 35 years, maximum number of patients; 12 (54.54%) belonging to 21 to 30 years age group. Common clinical complaint was swelling axillary region (100%). Among these patients, 21 (95.45 %) were female only one (4.54%) patient was male. Bilateral swelling was found in eight (36.36 %) cases. Clinically lipoma was most common provisional diagnosis in eight (36.36%) patients.Conclusion: Ectopic breast tissue usually presents with axillary swelling. In axillary swelling along with lipoma, lymphadenopathy, neurofibroma, sabeceous cyst accessory breast as a diagnosis should be kept in mind. Every Axillary swelling must be examined because it can be accessory breast tissue.  JCMS Nepal. 2016;12(2):74-7</p

Pattern and frequency of endometrial and ovarian pathologies with adenomyosis uteri in patients who attended the tertiary care hospital among rural population of North India

Background: Adenomyosis is myometrium uterine pathology commonly seen in peri-menopausal women who usually present with menorrhagia and dysmenorrhea. Adenomyosis uterus is diagnosed by the histopathological examination of the hysterectomy specimens. Aims: To know the clinical symptoms seen with adenomyosis and to diagnose endometrial, ovarian, and other associated pathologies in adenomyosis uteri patients. Setting and Design: Tertiary care hospital and retrospective study. Materials and Methods: Present study was performed on hysterectomy specimens between January 2008 and December 2014 in the Pathology Department of Rural Institute of Medical science and Research, Saifai, Etawah (Uttar Pradesh). Specimens were grossly examined, sectioned, and hematoxylin and eosin stain was applied. Statistical Analysis: Percentage. Result: A total of 353 patients were included. The common age group of patients with adenomyosis was 41–50 years (44.75%). Menorrhagia (70.25%) was a prime clinical symptom. Among endometrial pathologies and changes, proliferative phase was maximum (44.47%), followed by secretory phase (25.21%) and endometrial hyperplasia (12.46%). Common pathologies seen in ovary were simple serous cyst (39.58%), corpus luteal cyst (27.08%), and endometrial polyp (40.74%). Conclusion: Adenomyosis is a myometrial lesion present in 41–50 years of age group with clinical symptoms of dysfunctional uterine bleeding. Proliferative phase, secretory phase, and endometrial hyperplasia were commonly seen with adenomyosis. Simple serous cyst was a common pathology seen in ovary. Endometriosis change in the ovary was also seen, confirming a strong association between adenomyosis and endometriosis. Endometrial polyp was also common

Effect of sulphur crosslinking on the stability and transition of triple helical DNA

177-187In continuation to our work on order-order and order-disorder transition in triple stranded DNA when it is bounded to netropsin, we report in this communication the stabilizing / destabilizing effect of disulphide linkage on the phase dynamics of the triplex using the amended Zimm-Bragg theory. <span style="font-size:14.0pt;font-family:Arial; mso-fareast-font-family:" times="" new="" roman";mso-ansi-language:en-us;mso-fareast-language:="" en-us;mso-bidi-language:ar-sa"="">It <span style="font-size:14.0pt; font-family:" times="" new="" roman";mso-fareast-font-family:"times="" roman";="" mso-ansi-language:en-us;mso-fareast-language:en-us;mso-bidi-language:ar-sa"="">is observed that in contrast to the sequential triplex → <span style="font-size:14.0pt; font-family:" times="" new="" roman";mso-fareast-font-family:"times="" roman";="" mso-ansi-language:en-us;mso-fareast-language:en-us;mso-bidi-language:ar-sa"="">duplex →<span style="font-size:14.0pt;font-family:HiddenHorzOCR;mso-hansi-font-family: " times="" new="" roman";mso-bidi-font-family:hiddenhorzocr;mso-ansi-language:en-us;="" mso-fareast-language:en-us;mso-bidi-language:ar-sa"=""> single strand melting of the uncrosslinked triplex, crosslinking causes the triplex state to melt directly to the single stranded state, with no apparent intermediary of a duplex state. Since there is no overall difference in the enthalpy of crosslinked and uncrosslinked triplexes, the transition is entropy driven.</span

Tuberculous orchitis mimicking a testicular tumor: A diagnostic dilemma

A 37-year old man presented with 5 months history of left scrotal mass and had underwent left orchidectomy following a presumptive diagnosis of testicular tumour. Histopathological diagnosis of testicular tuberculosis was subsequently made, which revealed a case of isolated TB orchitis. It signifies that the careful evaluation of patients with testicular mass is extremely significant for diagnostic accuracy, optimal treatment and avoiding unnecessary surgery in case of testicular tuberculosis. Simultaneously it will also help in early detection of testicular malignancies and vital for the clinicians to avoid negligence charges