Death due to sickle cell anaemia, an autopsy diagnosis: a study at a tertiary care hospital

Background: Sickle cell disease (SCD) is the generic term for the group of inherited haemoglobinopathies caused by the occurrence of Haemoglobin S (HbS) in the homozygous or heterozygous form in combination of Hbs with another abnormal haemoglobin such as HbSC or beta-thalassaemias (HbS-thal). Sickle cell syndromes are remarkable for their clinical heterogeneity, including their presentations as sudden and unexpected deaths due to a sickle cell crisis. Less numbers of deaths are reported due to this cause because of ignorance of autopsy surgeon in considering this disease as a cause of death despite of its high prevalence. While doing autopsy in cases of deaths with no apparent cause and physical over activity medical officer must keep in mind the possibility of death due to vaso-occlusive crisis in sickle cell disease.  Methods: The study covers a period of one year (January 2013 - December 2013) and it is a study of cases of autopsy carried out in a tertiary care hospital of South Gujarat.Results: A total of 607 cases examined, out of which sickled red blood cells were detected in 17 cases. The respective records were reviewed. Out of 17 cases, 13 cases were male and 4 cases were females. The youngest person was 15 years female and oldest was 70 years male.  Conclusion: Sickle cell crisis is one of the causes of sudden unexplained deaths. The present study highlights the role of autopsy in such cases. Community awareness and marriage counseling programs are also helpful in preventing sickle cell disease.

Study of cervical pap smears in a tertiary care hospital of south Gujarat, India

Background: In India cervical cancer is the leading cause of morbidity and mortality. Cancer of cervix is preventable, and can be diagnosed at the pre-malignant/pre-invasive stage with adequate and repetitive cytological screening by Papanicolaou (Pap) smears.  Methods: The prospective study includes total 1425 patients who were presented with various gynecological problems. Samples were taken and prepared smear were stained with PAP stain. Reporting was carried out by two independent cytopathologist as per Bethesda system.Results: Total 1425 patients were screened; there were 1034 (72.56%) abnormal Pap smears, with 354 (24.84%) normal cases and 37 (2.59%) unsatisfactory or inadequate samples. Total 27 (1.89%) cases showed epithelial cell abnormalities. ASCUS was the most commonly found (40.74%) epithelial cell abnormality out of 27 cases.Conclusions: Incidence of invasive cervical malignancy can be prevented if Pap screening program is effectively implemented in target population

Changes in WBC and platelet count in patients with malaria: a hospital based comparative study

Introduction: Malaria is one of the most common infectious diseases of tropics. It presents with varied clinicopathological manifestations. Most of the complication in malaria occurs due to various hematological abnormalities. Present study was aimed to find out abnormalities in WBC and platelet counts in patients with malaria. Methods: A total 135 patients either hospitalized or treated on an outpatient basis were included in the study after positive identification for malarial parasites on Giemsa stained PSMP smears. WBC and platelet count was carried out on 3 part hematology analyzer (Sysmax KX 21). WBC count less than 4000/cumm was considered as leucopenia and platelet count less than 150000/cumm was considered as thrombocytopenia. Results: The present study includes 135 patients with malaria from which 72.59% of subjects were male and 27.41% of subjects were female. P. falciparum was present in 68.89% of cases, P. vivax in 28.15% of cases. Majority of patients had normal leucocyte count (97.03%). Neutrophilia with lymphopenia was observed in both species of malaria in our study. Thrombocytopenia was observed in89.62% of cases in malaria. Thrombocytopenia in P. falciparum was found in 92.48% of cases and in P. vivax it was 81.57% of cases. Conclusion: Present study did not show any significant change in WBC count. Present study showed neutrophilia with relative lymphopenia in both group of malaria. Incidence of thrombocytopenia was observed in both species of malaria without any statistical significance.

Mechanical Ventilator for Delivery of 17O2 in Brief Pulses

The 17O nucleus has been used recently by several groups for magnetic resonance (MR) imaging of cerebral metabolism. Inhalational delivery of 17O2 in very brief pulses could, in theory, have significant advantages for determination of the cerebral metabolic rate for oxygen (CMRO2) with MR imaging. Mechanical ventilators, however, are not typically capable of creating step changes in gas concentration at the airway. We designed a ventilator for large animal and human studies that provides mechanical ventilation to a subject inside an MR scanner through 25 feet of small-bore connecting tubing, and tested its capabilities using helium as a surrogate for 17O2. After switching the source gas from oxygen to helium, the 0-90% response time for helium concentration changes at the airway was 2.4 seconds. The capability for creating rapid step changes in gas concentration at the airway in large animal and human studies should facilitate the experimental testing of the delivery 17O2 in brief pulses, and its potential use in imaging CMRO2

The suitability of lightfield camera depth maps for coordinate measurement applications

Plenoptic cameras can capture 3D information in one exposure without the need for structured illumination, allowing grey scale depth maps of the captured image to be created. The Lytro, a consumer grade plenoptic camera, provides a cost effective method of measuring depth of multiple objects under controlled lightning conditions. In this research, camera control variables, environmental sensitivity, image distortion characteristics, and the effective working range of two Lytro first generation cameras were evaluated. In addition, a calibration process has been created, for the Lytro cameras, to deliver three dimensional output depth maps represented in SI units (metre). The novel results show depth accuracy and repeatability of +10.0 mm to -20.0 mm, and 0.5 mm respectively. For the lateral X and Y coordinates, the accuracy was +1.56 m to −2.59 m and the repeatability was 0.25 µm

Diagnostic accuracy of fine needle aspiration cytology in soft tissue tumors: our institutional experience

Background: Diagnosis of Soft tissue tumors by FNAC (Fine needle aspiration cytology) is one of the diagnostic modality of choice in pathological evaluation of soft tissue neoplasms especially to differentiate from the non-neoplastic soft tissue lesions. It is challenging and controversial. Very few centers rely on simple FNAC for diagnosis which is largely due to a lack of experience, familiarity, confidence and tricky cytological features.Methods:We have studied 140 cases of soft-tissue tumors by simple FNAC procedure done by cytopathologist from 01/01/2012 to 31/12/2012. After considering thorough history, clinical, radiology and other findings all cases were reported by the experienced faculty in cytopathology section of our institute.Results:Out of total 140 cases of soft tissue tumors 131 (93.58%) were benign and 9 (6.42%) were malignant. In benign category maximum numbers were lipoma 105 cases (80.15%) followed by benign neural tumors 5 cases (3.82%), ganglion 4 cases (3.05%), benign fibrohistiocytic lesions 2 cases (1.53%) and others. Conclusions: Current study demonstrates that FNAC is valuable as a primary tool in diagnosing soft tissue tumors specifically benign lesions like lipomatous tumors, high grade malignant sarcoma and recurrent lesions. Findings are well supported by histopathological correlation

What the general dental practitioner needs to know about HPV-related oropharyngeal malignancy.

The rates of oropharyngeal squamous cell carcinoma have continued to rise secondary to the increasing prevalence of the human papillomavirus (HPV). HPV-related disease is typically found in younger patients who do not have the traditional risk factors for malignancy. General dental practitioners (GDPs) often examine patients regularly and may therefore have an opportunity to identify oropharyngeal malignancies at an early stage. However, many GDPs are unfamiliar with oropharyngeal anatomy, pathology and clinical examination. This review summarises the key points in identifying patients with oropharyngeal malignancy who necessitate urgent referral

Dynamic Contrast-Enhanced MR Imaging in Head and Neck Cancer: Techniques and Clinical Applications

ABSTRACT SUMMARY: In the past decade, dynamic contrast-enhanced MR imaging has had an increasing role in assessing the microvascular characteristics of various tumors, including head and neck cancer. Dynamic contrast-enhanced MR imaging allows noninvasive assessment of permeability and blood flow, both important features of tumor hypoxia, which is a marker for treatment resistance for head and neck cancer. Dynamic contrast-enhanced MR imaging has the potential to identify early locoregional recurrence, differentiate metastatic lymph nodes from normal nodes, and predict tumor response to treatment and treatment monitoring in patients with head and neck cancer. Quantitative analysis is in its early stage and standardization and refinement of technique are essential. In this article, we review the techniques of dynamic contrast-enhanced MR imaging data acquisition, analytic methods, current limitations, and clinical applications in head and neck cancer. ABBREVIATIONS: AIF ϭ arterial input function; DCE-MR imaging ϭ dynamic contrast-enhanced MR imaging; EES ϭ extracellular extravascular space; GCA

TNF-α-induced E3 ligase, TRIM15 inhibits TNF-α-regulated NF-κB pathway by promoting turnover of K63 linked ubiquitination of TAK1

Ubiquitin E3-ligases are recruited at different steps of TNF-α-induced NF-κB activation; however, their role in temporal regulation of the pathway remains elusive. The study systematically identified TRIMs as potential feedback regulators of the TNF-α-induced NF-κB pathway. We further observed that TRIM15 is “late” response TNF-α-induced gene and inhibits the TNF-α-induced NF-κB pathway in several human cell lines. TRIM15 promotes turnover of K63-linked ubiquitin chains in a PRY/SPRY domain-dependent manner. TRIM15 interacts with TAK1 and inhibits its K63-linked ubiquitination, thus NF-κB activity. Further, TRIM15 interacts with TRIM8 and inhibits cytosolic translocation to antagonize TRIM8 modualted NF-κB. TRIM8 and TRIM15 also show functionally inverse correlation in psoriasis condition. In conclusion, TRIM15 is TNF-α-induced late response gene and inhibits TNF-α induced NF-κB pathway hence a feedback modulator to keep the proinflammatory NF-κB pathway under control