Symplectic Manifolds, Coherent States and Semiclassical Approximation

We describe the symplectic structure and Hamiltonian dynamics for a class of Grassmannian manifolds. Using the two dimensional sphere ($S^2$) and disc ($D^2$) as illustrative cases, we write their path integral representations using coherent state techniques. These path integrals can be evaluated exactly by semiclassical methods, thus providing examples of localisation formula. Along the way, we also give a local coordinate description for a class of Grassmannians.Comment: 17 pages, preprint TCD-4-93, UR-1324,ER40685-77

ER, PR, HER2/NEU STATUS AND RELATION TO CLINICOPATHOLOGICAL FACTORS IN BREAST CARCINOMA

Objective: The role of hormone receptors as a prognostic and therapeutic tool in breast cancer is widely accepted. The aim of this study was to the analysis of steroid receptor status in breast cancer with clinic pathological characteristics.Methods: In the present study, immunohistochemical assay of two hundred tumor block of patients of breast carcinoma was performed to know the hormone receptor status as well as histological examination. Results: 150 samples were grouped to study hormonal status and their relation with clinic-pathological factors. The results in the present study documented the 42.3 %, 37.6 % and 56.2 % expression rate of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor-2 (Her2/neu) (. The negative expression of ER, PR receptors found higher (57.7 %, 62.4 % respectively). However, Her2/neu positive expression found higher than negative expression (43.8 %). An inverse correlation of Her2/neu expression with ER and PR expression was observed (p=0.007). A significant association of tumor size was observed with ER and PR expression (p=0.02 & p=0.04 respectively). However, no statistically significant association was observed between Her2/neu expression and tumor size (p=0.84).<4 positive lymph nodes showed more no reactivity of the receptors (ER, PR & Her2/neu) than>4 positive lymph nodes. No significant association of lymph node status and histological types was found with receptor expression.Conclusion: In conclusion further functional analyzes of ER, PR and Her2 receptors are needed to investigate the effects of compounds in inhibiting cancer in humans.Keywords: Breast carcinoma, Estrogen, Her-2/neu receptor, Immunohistochemistry, ProgesteroneÂ

Common thrombophilia markers in young patients with primary arterial and venous thrombosis

Background: The pathogenesis of vascular thrombotic event involves an interaction of multiple genetic and environmental factors. Genetic factors include activated protein C resistance, deficiency of natural anticoagulants protein C, protein S, factor V and antithrombin III while acquired cause include presence of antiphospholipid antibody. This study was carried out to establish the role of basic panel of thrombophilia in diagnosing the patients with primary thrombophilia.Methods: A total of 121 consecutive patients with history suggestive of arterial or venous thrombosis were included. History of risk factors including smoking, hypertension, hyperlipidemia, diabetes mellitus and family history of thrombosis were elicited. The initial tests included CBC, PT, APTT, LFT, blood sugar and lipid profile. Functional assay on thrombophilia markers were performed by means of clotting based method.Results: A total of 121 patients were studied, out of which 63 were males and 58 females. The mean age range was 15-40 years. No abnormality was detected in 75 samples, while 46 samples (38%) were positive for one or more thrombophilia markers, of which 6 had more than one thrombophilia marker. Abnormality of a single thrombophilia factor was found in 40 patients, in which two patients were also positive for lupus anticoagulant.Conclusions: An association was found between low levels of protein C, protein S and factor V and a thrombotic event. Screening of these patients using a panel of thromophilia markers can provide valuable information in primary diagnosis of inherited deficiency even in the absence of high end molecular/mutational studies

Prevalence of haemoglobinopathies in anemic females

Background: The β-thalassemias and various other hemoglobinopathies are a major health problem in India.  An accurate diagnosis of patients suffering from β-thalassemia syndrome and other hemoglobinopathies is important for prevention and management of major hemoglobin disorders. High-performance liquid chromatography (HPLC) is a highly sensitive and specific method for the accurate diagnosis of thalassemia and other hemoglobinopathies. Methods: Present study was conducted on 1400 females of reproductive age group for screening of hemoglobinopathies in a rural block of north India. Patients were evaluated for presence of anemia with detailed hematological workup. Anemia cases were further screened by HPLC system for presence of any hemoglobinopathy.Results: 855 subjects out of a total of 1400 were found to be anemic. 359 patients had normocytic normochromic anemia, 399 had microcytic hypochromic picture, 37 had macrocytic picture, while 60 patients had dimorphic anemia. 47 cases were detected positive for various types of hemoglobinopathies. 36 patients were positive for β-thalassemia trait/ heterozygous forming the major portion (76.5%), while one (2%) patient was β-thalassemia intermedia / homozygous and was non-transfusion dependent. 3 patients were positive for HbE heterozygous and hereditary persistence of fetal hemoglobin each, two for HbD Punjab, one each for HbS heterozygous and Hb Lepore.Conclusions: The detection of various hemoglobinopathies is the key to diagnosis and proper treatment of various types of anemia. Antenatal screening should be an integral part of workup in pregnant females to prevent morbidity related to hemoglobinopathies like thalassemias

Primary non-Hodgkin's lymphoma of breast – A rare cause of breast lump

AbstractWe, here, report a case of primary breast lymphoma in a 59years old female. The diagnosis was suspected on fine needle aspiration cytology and confirmed on excision biopsy of the tumor. Histology and immunophenotyping were in accordance with non-Hodgkin's diffuse large B-cell lymphoma. The patient has been planned for adjuvant chemoradiation. The management and outcome of primary breast lymphoma and carcinoma are totally different. Early and prompt diagnosis of primary breast lymphoma is of utmost importance to avoid unnecessary mastectomies. Fine needle aspiration cytology supplemented by immuno-cytochemistry can be applied as a reliable and cost-effective tool in the early diagnosis of primary breast lymphomas, while histopathology and immunohistochemistry are conclusive

Idiopathic Lipoid Pneumonia: An incidental finding in autopsy specimen

Lipoid pneumonia is a rare form of pneumonia which was initially described to be caused by inhalation or aspiration of fatty substances. Certain autopsy studies have reported the incidence to be 1.0-2.5%. Based on the mode of lipid acquisition, it has been classified into endogenous, exogenous or idiopathic types. Almost 50% of the patients with lipoid pneumonia are asymptomatic, and may be discovered by chance during routine chest imaging. In symptomatic patients, the symptoms are non- specific. However, it can produce inflammatory pneumonitis that can progress to irreversible pulmonary fibrosis as seen in our case. We present a case of a 53-year-old deceased male. A piece of one of his lungs was received after autopsy, which appeared normal grossly. There was no history of any illness before death. Microscopy revealed interstitial fibrosis with collection of foamy macrophages in alveolar spaces and cholesterol crystals surrounded by inflammatory reaction including occasional giant cells. The clinical picture and radiologic changes in cases of lipoid pneumonia can mimic bacterial pneumonia and tuberculosis. The occupational history is of extreme importance and should always be investigated

Comparative analysis of fibreoptic bronchoscope aided cytohistological techniques in diagnosis of benign and malignant lesions of lung

Background: Morbidity and mortality from chronic lung diseases are increasing worldwide. A combination of various cytological and histopathological techniques are required for the high diagnostic accuracy. This study aims to evaluate and compare diagnostic accuracy of fiberoptic bronchoscope aided cytohistological techniques such as BAL (bronchoalveolar lavage), TBNA (Transbronchoscopic needle aspiration) and FB (forceps biopsy) in diseases of lung. Method: A prospective study conducted on 100 patients with symptoms and signs of various respiratory diseases who underwent fibreoptic bronchoscopy. Diagnostic accuracy of various samples alone and in combination were analysed. Results: Sensitivity of BAL-24%, TBNA 64% and FB 66%. Addition of BAL to FB increased the sensitivity to 69%. Addition of BAL to TBNA increased the sensitivity to 70%. Sensitivity of cytological methods (FB and TBNA) 90%. Addition of both BAL and TBNA to FB increased overall senstivity to 93%. FB the most specific amongst the three techniques with specificity of 94% followed by TBNA (59.4%) and BAL (50%). Conclusions: There are variable results regarding diagnostic yields and utilities of various fibre-optic bronchoscope aided cytohistological techniques but there combination adds the yields. Thus a combination of various cytohistological samples should be taken in a patient undergoing fiberoptic bronchoscopic examination to increase the diagnostic yield, to cut short the diagnostic time and early start of treatment

Prevalence of early T-cell precursor acute lymphoblastic leukemia among immunophenotypically categorised acute T-cell lymphoblastic leukaemia cases

Acute lymphoblastic leukaemia is the most common hematopoietic malignancy in childhood, comprising of B-cell lineage (85%) and T-cell lineage (15%). Recent studies have identified a subtype of T-cell acute lymphoblastic leukaemia (T-ALL) termed “early T-cell precursors (ETP)” recognised as a new provisional entity in 2016 update to the World Health Organization (WHO) classification of acute leukaemia, early T-cell precursor acute lymphoblastic leukemia (ETP-ALL) is characterized by a unique immunophenotype and genetic profile and its origin has been found to be from migration of cells from thymus to bone marrow. Hence, our study aims at reporting the prevalence of ETP-ALL among immunophenotypically categorised acute T-cell lymphoblastic leukaemia cases. Present work is a retrospective observation of acute T-cell lymphoblastic leukemias and reporting ETP-ALL cases seen during the period of over two years (from August 2018 to August 2020) received for flowcytometry in the department of Pathology, PGIMS, Rohtak, Haryana. Peripheral blood showed features of acute leukemia and immunophenotyping was performed. Fourteen cases were received for flowcytometry showing features of acute leukemia and immunophenotyping was performed revealing two ETP-ALL cases with positivity for cytCD3, CD7 (T-cell markers), HLA-DR, CD13 (myeloid marker-aberrant expression), sCD34, CD117 (stem cell markers), CD19 (B-cell marker) and dim expression of CD45. This study is a supportive data for immunophenotypic identification of ETP-ALL cases in centres where genetic study and other ancillary techniques are not available. It needs to be differentiated from non ETP-ALLs as this entity has been reported to show treatment failure with the treatment modalities for non ETP-ALLs

Immunophenotyping of non-Hodgkin’s lymphoma by flowcytometry on fine needle aspiration

Background: Lymphoma represents one of the major health problems all over the world. Flow cytometry (FCM) can be used on fine-needle aspiration cytology (FNAC) from lymph node as an ancillary technique. Aim of the study was to assess the utility of flowcytometry (FCM) in diagnosis and differentiation of reactive hyperplasia and non-Hodgkin’s lymphoma (NHL) on FNAC.Methods: The study was carried out on 50 cases, 25 each of reactive hyperplasia and suspicious or confirmed NHL on FNAC. FCI was performed with a complete panel of antibodies on FACS Canto II FCM.Results: All 25 cases of reactive hyperplasia on FNAC were polyclonal on FCM. FCM could be performed in 22 cases (88%) out of 25 suspicious NHL and in three cases the material was inadequate on aspirate. Out of 22 cases of NHL on FNAC 17 cases (77.30%) were diagnosed as B-NHL on FCM. Light chain restriction was demonstrated in 15/17 cases. With the help of FCI, 6 cases were diagnosed as small cell lymphocytic lymphoma, one case as mantle cell lymphoma, one case as follicular lymphoma, and 9 cases as B-NHL-NOS. Histopathology diagnosis was available in nine cases and were in concordance to FCM. Sensitivity of combined FNAC and FCM in sub-classification was 77.30% (17/22). Four cases showed discordance between FNAC and FCM.Conclusion: We concluded that FCM enhances the diagnostic ability of FNAC, playing a crucial role in a rapid and accurate differential diagnosis between reactive hyperplasia, B-NHL and T-NHL

Spectrum of acute and chronic leukemia at a tertiary care hospital, Haryana, India

Background: Leukemias are primary neoplasms arising from the malignant proliferations of blood cells or their precursors. Leukemias are classified into acute/chronic myeloid and lymphoid subtype. Typing of leukemia is essential for effective therapy because prognosis and survival rate are different for each type and sub-type.Methods: A total of 356 patients diagnosed to have acute/chronic leukemia were included in our study. Only newly diagnosed cases were included in this study and patients on cancer treatment and other primary hematological malignancies like lymphomas, plasma cells disorders and metastatic deposits were excluded. Findings of bone marrow aspiration and peripheral blood were interpreted in respect to history and clinical examination. FAB classification of acute leukemia was applied for sub-typing.Results: In our study, 66.8% of patients had acute leukemia while 33.2% had chronic leukemia. Overall male preponderance was found comprising 56.46% of all cases. Male to female ratio was 1.5:1. Acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) were found in 29.7% and 37.3% of the patients respectively. Of chronic type leukemia, 28.3% patients had chronic myeloid leukemia (CML) and only 4.7% had chronic lymphocytic leukemia (CLL). L2 was the most common (49.2%) subtype in ALL, followed by L1 (43.3%). AML sub-typing revealed M3 was the most common (50%), followed by M2 (28.7%).  Adult patients (70.5%) were more commonly affected than children (29.5%). In paediatric patients ALL was the predominant diagnosis (65.71%), whereas in adult AML cases were maximum (77.27%).Conclusions: Detailed hematological analysis including peripheral blood and bone marrow aspiration smears examination with cytogentic analysis are necessary for early and definite diagnosis and effective management of hematological malignancies.