CORRELATION OF CELLULAR AUTOLYTIC CHANGES IN BONE MARROW WITH POST-MORTEM INTERVAL

Estimation of post mortem interval is of great importance in both civil and criminal disputes. Determining time since death is extremely difficult and accuracy can never be met. Most of the methods currently employed are temperature based algorithms, rigor mortis, livor mortis, thanato-chemistry etc. But the uncertainties attaching to traditional means of establishing the time since death have directed attention to the chemical changes in the body fluids like cerebrospinal fluid and vitreous humour along with various cellular changes in the body tissues. The study of the viability and morphological changes seen in the cells of various body tissues could provide useful information regarding post-mortem interval. In our study the cellular and cytoplasmic changes observed were time related up to 16 hours. KEYWORDS: Post mortem interval; Cellular changes; Cytoplasmic changes

CORRELATION OF CELLULAR AUTOLYTIC CHANGES IN BONE MARROW WITH POST-MORTEM INTERVAL

Estimation of post mortem interval is of great importance in both civil and criminal disputes. Determining time since death is extremely difficult and accuracy can never be met. Most of the methods currently employed are temperature based algorithms, rigor mortis, livor mortis, thanato-chemistry etc. But the uncertainties attaching to traditional means of establishing the time since death have directed attention to the chemical changes in the body fluids like cerebrospinal fluid and vitreous humour along with various cellular changes in the body tissues. The study of the viability and morphological changes seen in the cells of various body tissues could provide useful information regarding post-mortem interval. In our study the cellular and cytoplasmic changes observed were time related up to 16 hours. KEYWORDS: Post mortem interval; Cellular changes; Cytoplasmic changes

Eosinophilic Cystitis: A Rare Cause of Hematuria in Children

A 7-year-old boy presented with a history of acute onset of hematuria, dysuria, and suprapubic pain. Urine routine and microscopy showed 40–45 red cells/high power field. Urine culture was sterile. Radiological investigations showed a focal mucosal lesion with bladder wall thickening. Biopsy of the lesion revealed an edematous mucosa with florid infiltration by eosinophils into the muscularis propria with focal areas of myonecrosis. He was diagnosed as a case of eosinophilic cystitis. The patient received 6 weeks of tapered prednisone therapy. He was asymptomatic on followup

Subcutaneous phaeomycotic cyst: a case report

Phaeohyphomycosis refers to infection of tissues by dematiaceous fungi which occur most commonly due to traumatic inoculation of fungi. A host reaction to these fungi can ultimately lead to the formation of a cystic cavity or abscess. Here we present a 71 year old woman who presented with a nodular swelling over the left elbow. A surgical excision was performed. On histopathological examination she was found to have a subcutaneous phaeomycotic cyst.

Assessment of the acceptable length of right internal jugular central venous catheters for Indian population

Background: Central venous catheters have been used in various lengths based on the height of the patient or predetermined lengths. This study compared the different lengths of right IJV central venous catheters to determine the better length for average heights of Indian population. Patients and Methods:  This was a prospective observational study done on 148 patients with average heights of Indian population (160±10cm) who are scheduled for right IJV central venous catheters are a part of this study. The patients are divided into 3 group (10,13,15 cm). Three different lengths of catheters are inserted. An anteroposterior chest X-ray was taken for the patients and carina was taken as the acceptable landmark. The outcome measured between the three groups is need for repositioning. Statistical analysis was done using Chi square test, Fisher’s exact test. Results: 10 cm catheters were considered acceptable in terms of less incidence of repositioning and statistically significant with p value of 0.0001(H S) with respect to other lengths (13,15cm) for heights of average Indian population. (160±10 cm). Conclusion: From our study, we concluded that 10 cm CVC catheters are acceptable in cannulating right IJV for an average Indian height adult patients (160±10 cms)

Effects of intracuff alkalinized lignocaine, dexamethasone, or normal saline on endotracheal tube-induced emergence phenomena: A randomized double-blinded study

Context: During endotracheal intubation, as we aim for smooth induction, smooth extubation is also mandatory. During extubation, coughing, sore throat, hoarseness, and laryngospasm are not desired and have to be prevented. Aims: The aim of the study is to study the effects of inflating the endotracheal tube (ETT) cuff with alkalinized lignocaine (Group L) or dexamethasone (Group D) or saline (Group S) on the emergence phenomena of endotracheal extubation. Settings and Design: Tertiary hospital, randomized double-blinded prospective study. Subjects and Methods: A total of 90 patients undergoing surgery under general anesthesia were randomly allotted into three groups, 30 in each group. After endotracheal intubation, the tube cuff was inflated with alkalinized lignocaine (Group L) or dexamethasone (Group D) or saline (Group S) as per the randomization sequence. At emergence and 1 h after surgery for hemodynamic indices and incidence of postextubation, sore throat, cough, hoarseness, and laryngospasm were assessed. Results: With respect to cough and sore throat, Group L and Group D were significantly better than Group S but the hoarseness was the worst in Group D. Conclusions: Inflating the ETT cuff with alkalinized lignocaine or dexamethasone helped in preventing sore throat and cough to a better extent than saline, the hoarseness, however, being the worst in dexamethasone group

Neuroendocrine Cancer of Rectum Metastasizing to Ovary

Neuroendocrine carcinomas (NECs) are rare malignancies that originate from the hormone-producing cells of the body’s neuroendocrine system. Rectal high grade NEC (HG-NEC) constituting less than 1% of colorectal cancers can cause large ovarian metastasis that may be the initial presenting complaint. Ovarian Krukenberg tumor from a primary rectal HG-NEC is a very unusual and exceedingly uncommon differential diagnosis for secondary ovarian malignancy. This case report describes one such extremely rare case of a woman who had presented to the gynecology department with features suggestive of ovarian malignancy and was ultimately diagnosed to have Krukenberg tumor originating from neuroendocrine cancer of rectum. We felt this is a good opportunity to spread more light on neuroendocrine neoplasms that are very rare in gynecological practice

Assessing Hydrolyzed Gluten Content in Dietary Enzyme Supplements Following Fermentation

Partially digested gluten fragments from grains including wheat, rye, spelt and barley are responsible for triggering an inflammatory response in the intestinal tract of Celiac Disease (CD) and Non-Celiac Gluten Sensitive (NCGS) individuals. Fermentation is an effective method to metabolize gluten, with enzymes from bacterial or fungal species being released to help in this process. However, the levels of gluten in commercially available enzymes, including those involved in gluten fermentation, are unknown. In this study we investigated gluten levels in commercially available dietary enzymes combined with assessing their effect on inflammatory response in human cell culture assays. Using antibodies that recognize different gluten epitopes (G12, R5, 2D4, MloBS and Skerritt), we employed ELISA and immunoblotting methodologies to determine gluten content in crude gluten, crude gliadin, pepsin-trypsin digested gluten and a selection of commercially available enzymes. We further investigated the effect of these compounds on inflammatory response in immortalized immune and intestinal human cell lines, as well as in peripheral blood mononuclear cells (PBMCs) from coeliac individuals. All tested supplemental enzyme products reported a gluten concentration that was equivalent to or below 20 parts per million (ppm) as compared with an intact wheat reference standard and a pepsin-trypsin digested standard. Similarly, the inflammatory response to IL-8 and TNF-α inflammatory cytokines in mammalian cell lines and PBMCs from coeliac individuals to the commercial enzymes was not significantly different to 20 ppm of crude gluten, crude gliadin or pepsin-trypsin digested gluten. This combined approach provides insight into the extent of gluten breakdown in the fermentation process and the safety of these products to gluten-sensitive individuals