In Silico Investigation of the Mechanism of Disulfide Bond Dissociation by New Frustrated Lewis Pairs.

Understanding the mechanism of disulfide bond cleavage is important in various scientific disciplines including organic synthesis, catalysis, and biochemistry. In this study, an in silico investigation has been carried out for the dissociation of disulfide bonds using newly designed frustrated Lewis pairs (FLPs). The study revealed that the cleavage of the disulfide bond by the FLP P(tBu)3/B(C2NBSHF2)3 can also be used like the conventional FLP (tBu)3P/B(C6F5)3. It has been observed that the reaction is almost thermoneutral in the gas phase but exothermic in nonpolar solvents, such as toluene, heptane, and hexane. Furthermore, the natural bond orbital (NBO) describes insights into the role of FLPs in facilitating this reaction. Additionally, reaction force and force constant studies shed light on the energy requirements for completing the reaction and the synchronous nature of the dissociation process, respectively. Reaction electronic flux (REF) and its separations give the pattern of electronic activity during the chemical reaction. Extended transition state-natural orbitals for chemical valence (ETS-NOCV) and principal interacting orbital (PIO) analysis provide valuable information about the orbital interactions during the chemical reaction.

Insights into the catalytic activity of boron-doped thiazoles in the Diels-Alder reaction.

The role of boron-doped thiazoles as a Lewis acid catalyst in [4+2] cycloaddition reaction between 1,3-butadiene and acrolein has been addressed. Three different organic heterocycles were designed to study their catalytic activity. It has been observed that these heterocycles efficiently work as catalysts than the well-known Lewis acid BF3. All the reactions follow the normal electron demand process and are exothermic. Different conceptual DFT-based reactivity descriptors and electronic structure principles such as maximum hardness and minimum electrophilicity lend additional support to the feasibility of the reaction mechanism. The reaction force (RF), reaction electronic flux (REF), and its different components exhibit a detailed electronic activity throughout the reaction.

Functionalized nona-silicide [Si9R3] Zintl clusters: a new class of superhalogens.

Superatoms, due to their various applications in redox and materials chemistry, have been a major topic of study in cluster science. Superhalogens constitute a special class of superatoms that mimic the chemistry of halogens and serve as building blocks of novel materials such as super and hyper salts, perovskite-based solar cells, solid-state electrolytes, and ferroelectric materials. These applications have led to a constant search for new class of superhalogens. In this study, using density functional theory, we show that recently synthesized [Si9{Si (tBu)2H}3] and [Si9{Si (TMS)3}3] Zintl clusters not only behave like halogens but also when functionalized with suitable ligands exhibit superhalogen characteristics. Frontier molecular orbital (FMO) analyses give insights into the electron-accepting nature of the Zintl clusters. Additional bonding techniques such as energy density at the bond critical point (BCP) and adaptive natural density partitioning (AdNDP) gives complementary information about the nature of bonding in Si9-based Zintl clusters. The potential of these Zintl clusters in the synthesis of new electrolytes in Li-ion batteries is also investigated.

Role of Size and Composition on the Design of Superalkalis.

Superalkalis and superhalogens are atomic clusters that mimic the chemistry of alkali and halogen atoms, respectively; the ionization energies of the superalkalis are less than those of alkali atoms, while the electron affinities of superhalogens are larger than those of the halogen atoms. These superions can serve as the building blocks of a new class of supersalts with applications in solar cells, metal-ion batteries, multiferroic materials, and so on. While considerable progress has been made in the design and synthesis of superhalogens, a similar understanding of superalkalis is lacking. Using density functional theory with hybrid exchange-correlation functional and Gaussian basis sets, we have systematically studied the role of size and composition on the properties of two different classes of clusters whose stabilities are governed by the Wade-Mingos polyhedral skeletal electron pair theory. One class belongs to the closo-borane family LimBnXn (m = 1, 2, 3; n = 6, 12; X = H, F, CN), while the other to the Zintl ions Lim[Be@Ge9]. We show that Li3BnXn and Li3[Be@Ge9] clusters are superalkalis with ionization energies as low as 2.84 eV in Li3B6H6. However, contrary to expectation, the ionization energies do not decrease with increasing cluster volume. Instead, ionization energies are linked to the X ligands' electron affinities; the larger the electron affinity, the higher is the ionization energy. The understanding gained here will help in the discovery of superalkalis and, hence, enrich the library of supersalts.

Ab initio investigation on the mechanism of SO2 activation by P/B intermolecular frustrated Lewis pairs.

CONTEXT: In silico study investigates the activation of sulfur dioxide by newly designed frustrated Lewis pairs, i.e., [P(tBu)3…B(C2NBSHF2)3], where the Lewis acid part is a super Lewis acid. The activation process involves the making of P-S and B-O bonds, leading to the formation of an FLP-SO2 adduct. The calculated results demonstrate that the activation of SO2 by the FLP is almost barrierless and exothermic. Exploration of the impact of the solvent environment on the feasibility and energetics of the reaction has been investigated. The exothermicity is increasing in nonpolar solvents. METHODS: This study focuses on understanding the electronic activity of SO2 activation by FLP with the help of the Minnesota 06 functional, M06-2X (global hybrid functional with 54% HF exchange) along with Pople's basis set, 6-311G (d, p). Principal interacting orbital and extended transition state-natural orbitals for chemical valence studies, giving impactful insight into the favorable orbital interaction and electron transfer in this reaction. Furthermore, useful CDFT descriptors such as reaction force constant and reaction electronic flux profiles along the intrinsic reaction coordinate give insights into the synchronicity and total electronic activity of the reaction.

Removal of Cr(VI) by magnetic iron oxide nanoparticles synthesized from extracellular polymeric substances of chromium resistant acid-tolerant bacterium Lysinibacillus sphaericus RTA-01.

BACKGROUND: Extracellular polymeric substances (EPS) from Cr(VI) resistant acid-tolerant biofilm forming bacterium (CrRAtBb) Lysinibacillus sphaericus RTA-01 was used for synthesis of magnetic iron oxide nanoparticles (MIONPs) in removal of Cr(VI). METHODS: MIONPs synthesized in EPS matrix were characterized by UV-Vis, DLS, ATR-FTIR, XRD, FESEM, HRTEM and VSM. Primarily, the synthesis of MIONPs was established by the formation of black-colored precipitate through surface plasmon resonance (SPR) peak in between 330 and 450 nm. RESULTS: The size of the spherical MIONPs with diameter range 13.75-106 nm was confirmed by DLS, XRD and FESEM analysis. HRTEM study confirmed the size of the MIONPs in the range of 10-65 nm. Moreover, the EDX and SAED confirmed the purity and polycrystalline nature of MIONPs. The ATR-FTIR peaks below 1000 cm-1 designated the synthesis of MIONPs. Also, the magnetic property of MIONPs was confirmed for separation from the aqueous solution. MIONPs were further checked for the adsorption of Cr(VI) with initial concentration range of 50-200 mg L-1. An adsorption isotherm and thermodynamic study were also carried out and the experimental data was best fitted in Langmuir isotherm model with maximum adsorption percent of 1052.63 mg g-1 of Cr(VI). Post interaction with Cr(VI), the surface characteristic of MIONPs in EPS matrix was evaluated by zeta potential, EDX, ATR-FTIR and XRD. CONCLUSION: This study ascertained the adsorption of Cr(VI) over EPS stabilized MIONPs whereas the zeta potential and XRD analysis confirmed the presence of reduced Cr(IV) on the adsorbent surface.

Study of Complete Haemogram and Iron Profile From Cord Blood of Newborn with Respect to Primigravida, Multigravida and Apgar Score.

Study of different parameters of cord blood usually reflects neonatal health status. One of the widely used system for assessing neonatal health is APGAR score. It is assed at 1 and 5 min from baby's birth. Immediate medical care may improve 5 min score of neonate who showed poor score at 1 min. The main objective of this study is to establish whether any correlation exists between complete hemogram and iron profile with APGAR score and gravid of mother. Cord blood was collected from 96 new born, delivered vaginally, mothers having no chronic medical disease. Different parameters of complete hemogram were assessed along with iron profile and statistical analysis was done by Graph pad Instat3 soft ware. Statistically significant correlation exists between APGAR score (5 min) and MCV (p = 0.005), MCHC (p = 0.016), nRBC (p = 0.002), platelet count (p = 0.001), RDW (p = 0.001). Statistically weak correlation exists between TLC (p = 0.08). Comparing complete blood count with gravid of mother by unpaired t test significant correlation was obtained for HCT (p = 0.035) and RDW (p = 0.03). Apgar score and complete hemogram from cord blood are both non-invasive procedure which help us to asses fetal wellbeing as well as requirement of immediate management. Further more studies are essential to establish the relationship.

Sulfur free radical reactivity with curcumin as reference for evaluating antioxidant properties of medicinal zingiberales.

Rhizome extracts of some members of the medicinal Zingiberales are widely used in dietary intake as well as in the traditional system of medicine. Curcumin, the chrome orange-yellow coloring compound present in turmeric rhizomes, has long been known to possess antioxidant property. Crude methanol extracts of the rhizomes of 11 species--Alpinia allughas, A. galanga, Curcuma amada, C. caesia, C. leucorrhiza, Hedychium coronarium, H. coccineum, H. flavescens, Kaempferia galanga, Zingiber cassumunar, and Z. officinale--were evaluated for their antioxidant properties using sulfur free radical reactivity with curcumin as a reference indicator. Sulfur free radicals (GS.) are generated by irradiating 15 mM glutathione (GSH) solution using a 5100 Ci cobalt-60 gamma irradiator. As reference indicator for the reactivity with sulfur free radicals, we used the depletion of pure curcumin sample in vitro as determined by a simple spectrophotometric method. The addition of the supernatant from crude rhizome extracts to the reaction mixture significantly decreased the depletion of curcumin, indicating that these crude extracts possessed antioxidant properties. The relative curcumin protection by different crude extracts against GS. showed that Z. cassumunar gave the highest degree of radioprotection. Our results reveal the potential medicinal use of rhizomes of medicinal Zingiberales as dietary agents.

Diagnostic and prognostic significance of different mucin expression, preoperative CEA, and CA-125 in colorectal carcinoma: A clinicopathological study.

BACKGROUND: Colorectal carcinoma (CRC) is the fourth most commonly diagnosed malignant disease worldwide, with over 1 million new cases and approximately 5,00,000 deaths each year. AIMS AND OBJECTIVES: This prospective observational study was done to study the clinicopathological characteristics of CRC including mucin stains and correlate the preoperative serum carcinoembryonic antigen (CEA) and cancer antigen (CA)-125 levels with the prognosis. MATERIALS AND METHODS: A total of 90 CRCs were included from December 2010 to June 2013. Detailed history and relevant clinical/radiological findings were noted in all clinically and/or radiologically suspected cases of CRC. Preoperative blood samples were collected for serum CEA and CA-125 level estimation. The mucin expression was evaluated with special stains. RESULTS: The combined Alcian blue-periodic acid Schiff (PAS) staining was positive for both stains in 68.88% cases indicating that both neutral and acidic mucins are increased in CRC. High preoperative serum CEA levels were seen in 82.22% cases, whereas preoperative serum CA-125 levels showed an increase in 20% cases. Higher levels of these tumor markers corresponded with higher TNM stage. CONCLUSIONS: Mucin evaluation in CRCs remains one of the valuable methods as mucinous variants correlate with worse prognosis. Preoperative serum CEA level assessment is an indispensible adjunct to the diagnosis and prognosis of CRC. However, preoperative serum CA-125 level measurement is not an efficient tool for prognostication in CRC and should not be recommended for routine use.

A comparative study of Hasford score and Sokal index in prognostication of the novo chronic myeloid leukemia patients and a search for new prognostic markers.

INTRODUCTION: Chronic myeloid leukemia (CML) is a common myeloproliferative disorder. Based on clinical and hematological parameters, two prognostic scoring systems, i.e., Hasford and Sokal index scoring systems are available to predict survival duration of CML patients on imatinib therapy. AIMS AND OBJECTIVES: Our study's objective is to compare Hasford score with Sokal index for the prognostication of de novo CML patients on therapy and find out new prognostic markers. MATERIALS AND METHODS: This is a retrospective study. The study population comprised 66 patients who were followed up for 60 months. For each patient, at presentation, scoring was performed as per Hasford and Sokal index and Philadelphia chromosome analysis was carried out by conventional cytogenetics. Thereafter, hematological parameters were assessed 3 monthly and conventional cytogenetics was done yearly. RESULTS: Out of these 66 patients, the number of patients belonging to low, intermediate and high risk categories are 21, 33 and 12 respectively by Hasford score and 12, 32 and 22 respectively by Sokal index. Eight patients, who had been categorized into high risk group by Sokal index but intermediate risk group by Hasford score, have shown better survival possibility as monitored by hematological and cytogenetic parameters. Ten cases, categorized into intermediate risk group by Sokal index but low risk group by Hasford score, is doing well till date. CONCLUSIONS: This study shows that Hasford score predicts survival of the patients better than Sokal index. However, multicentric study over a large population is needed to give the final verdict.

The Bethesda system for reporting thyroid fine needle aspirates: A cytologic study with histologic follow-up.

BACKGROUND: The Bethesda system for reporting thyroid cytopathology represents a major step towards standardization, reproducibility, improved clinical significance, and greater predictive value of thyroid fine needle aspirates (FNAs). AIMS: To elucidate the utility of the Bethesda system in reporting thyroid FNAs. MATERIALS AND METHODS: We retrospectively reviewed thyroid FNAs between April 2009 and March 2012, classified them using the Bethesda system, found out the distribution of cases in each Bethesda category, and calculated the malignancy risk for each category by follow-up histopathology. RESULTS: Of the 1020 FNAs, 1.2% were non-diagnostic, 87.5% were benign, 1% were atypical follicular lesion of undetermined significance (AFLUS), 4.2% were suspicious for follicular neoplasm (SFN), 1.4% were suspicious for malignancy (SM), and 4.7% malignant. Of 69 cases originally interpreted as non-diagnostic, 12 remained non-diagnostic after re-aspiration. In 323 cases, data of follow-up histopathologic examination (HPE) were available. Rates of malignancy reported on follow-up HPE were non-diagnostic 0%, benign 4.5%, AFLUS 20%, SFN 30.6%, SM 75%, and malignant 97.8%. CONCLUSIONS: Reviewing the thyroid FNAs with the Bethesda system allowed a more specific cytological diagnosis. In this study, the distribution of cases in the Bethesda categories differed from some studies, with the number of benign cases being higher and the number of non-diagnostic and AFLUS cases being lower. The malignancy risk for each category correlated well with other studies. The Bethesda system thus allows standardization in reporting, improves perceptions of diagnostic terminology between cytopathologists and clinicians, and leads to more consistent management approaches.

Immunocytochemistry: It's role in diagnosis of undifferentiated neoplasms by fine needle aspiration cytology.

BACKGROUND: Fine needle aspiration cytology (FNAC) is a rapid, cheap and reliable method for diagnosing any accessible lesion. However, there remains a group of malignant undifferentiated neoplasms, which can only be categorized with the help of immunocytochemistry (ICC). The categorization is important due to their vast difference in treatment and prognosis. AIM: To evaluate the effectiveness of ICC in categorizing the undifferentiated neoplasms diagnosed on routine FNAC smears. MATERIALS AND METHODS: Thirty six cases of undifferentiated neoplasms were selected from a group of total 78 cytology cases of undifferentiated tumors from different sites like head and neck, lymph node, soft tissue etc. These were then subjected to a panel of ICC markers based on the clinical and cytomorphological features. RESULTS: Of these, 21 were simple, ten were computerized tomography guided and five were ultrasound guided FNACs respectively. All the 78 cases were confirmed by histopathological examination and immunohistochemistry. Of the 36 cytological cases, final diagnosis correlated in 30 cases histologically. The six cases were incorrect either due to inadequate material on the smears (three cases) or false positive staining (three cases). CONCLUSIONS: Our study found that ICC is a sensitive and specific method for early and definitive diagnosis of undifferentiated neoplasms. However, selection of antibodies must be judicious to make it cost effective.

Evaluation of the category high-grade squamous intraepithelial lesion in The Bethesda System for reporting cervical cytology.

BACKGROUND: High grade squamous intraepithelial lesion (HSIL) is a category of The Bethesda System (TBS) for reporting cervical cytology that is in vogue since the introduction of the said system in 1988 and it was not modified in 2001 modification of TBS. The term includes moderate dysplasia (CIN II), severe dysplasia (CIN III) and squamous cell carcinoma in situ. Terms like ASC-US used in TBS are being considered to be not very useful in the prediction about the possible behavior of the pathological status of the cervix. After more than 10 years of use the term HSIL also needs fresh evaluation as in this category two entities of potentially different outcome are clubbed. AIMS: The aim was to find out whether it is justified to have a term like HSIL which includes different points of the spectrum of intraepithelial pathology of cervix from moderate hyperplasia through carcinoma in situ, all having different significance. MATERIALS AND METHODS: In this study 619 cases of cervical cytology reported by TBS were evaluated by comparing them with biopsy reports of the same lesion for the assessment of the sensitivity, specificity and positive predictive value of HSIL as a category of diagnosis in TBS. RESULTS: As a category, HSIL had the diagnostic sensitivity of 96.4%, specificity of 87.5%. The positive predictive value was 96.4%. CONCLUSION: HSIL as a diagnostic category shows a very good predictive accuracy, which implies that it provides a very high probability of the accurate diagnosis collectively of all the conditions in the disease spectrum from moderate dysplasia through in situ carcinoma. Hence, HSIL was found to be a very useful diagnostic category in TBS that conveys proper message to the clinician.

Histopathological study of adrenocortical carcinoma with special reference to the Weiss system and TNM staging and the role of immunohistochemistry to differentiate it from renal cell carcinoma.

BACKGROUND: Adrenocortical carcinomas (ACC) are rare tumors with an incidence of 1-2/million/year. They account for 0.05-0.2% of all malignancies. AIMS AND OBJECTIVES: This study was aimed to evaluate the Weiss system to diagnose ACCs and to compare it with TNM staging. The role of immunohistochemistry (IHC) was also evaluated to differentiate ACC from other differential diagnoses especially, renal cell carcinoma (RCC). MATERIALS AND METHODS: A total of 10 ACCs were included from April, 2000 to March, 2012. All the relevant information like weight, tumor size, gross features was recorded. Multiple sections were taken for histologic examination. Immunomarkers like vimentin, synaptophysin, Melan-A, calretinin, inhibin, EMA, cytokeratin, and Ki-67 were used. RESULTS: Out of 10 cases of ACCs (diagnosed by the Weiss system), the tumors were in TNM stage I (1 case), stage II (2 cases), stage III (5 cases), and stage IV (2 cases). The Weiss score in stages I-IV was 4; 5-7; 6-8; and 5-9 respectively. ACCs were positive for vimentin, inhibin, Melan-A, calretinin and negative for EMA and cytokeratin. Proliferative index (Ki-67/MIB-1) was ≥ 20 % (20-65%). CONCLUSION: Both the Weiss system and TNM staging are useful in predicting the malignant behavior and prognosis of ACC. Weight and tumor size, though originally not included in the Weiss system, are also important parameters. In lower stages (stages I and II), the Weiss score is low (4-7) while the score is high (6-9) when the tumor is in higher stages (stages III and IV). IHC plays a vital role to confirm the diagnosis and to exclude the possibility of RCC.

Atypical fibroxanthoma: an unusual skin neoplasm in xeroderma pigmentosum.

Xeroderma pigmentosum (XP) is a rare autosomal recessive disorder related to defective deoxyribonucleic acid (DNA) repair. Various cutaneous manifestations related to ultraviolet (UV) damage characterize the clinical course. Primary malignant cutaneous neoplasms like squamous cell carcinoma, basal cell carcinoma and malignant melanoma have been reported. Atypical fibroxanthoma is a rare dermal neoplasm occurring in UV-damaged skin. We report an unusual case of atypical fibroxanthoma in a 20-year-old male with XP.

Vanishing bone disease (Gorham's disease) - a rare occurrence of unknown etiology.

A 20-year-old male patient presented with painful swelling around left elbow joint. Radiographic examination revealed osteolytic lesion with pathological fracture of lower end of humerus and upper radius. Upper end of ulna was completely absent along with bony erosion. Histopathology of the bony tissue revealed hemangioma-like lesion composed of vascular channels lined by benign endothelium replacing bone. The diagnosis of Gorham's massive osteolysis was made. Gorham's disease is a benign self-limiting condition affecting any age, may involve any part of the skeleton and is characterized by replacement of bone by hemangiomatous tissue resulting in formation of lesions exhibiting massive osteolysis, which may be to the extent of disappearance of the affected bone in radiograph. This nonhereditary case was not associated with nephropathy, which is often a coexistent condition. The case is being reported for its rarity.

Clinicopathologic study of parapharyngeal tumors.

BACKGROUND: Parapharyngeal space (PPS) tumors are rare. Three main groups are identified, namely those of salivary origin, neurogenic tumors and paragangliomas. Early pathological classification of PPS tumors is important for pin point diagnosis and timely management. AIMS: The PPS is a complex anatomical potential space and poses high risk of per and postoperative complication. This study was done to perform optimum preoperative evaluation by clinicoradiologic correlation and guided fine needle aspiration cytology (FNAC) which is essential to minimize intraoperative risk. MATERIALS AND METHODS: Guided FNAC was carried out to diagnose parapharyngeal tumors in 48 patients from January 2008 to January 2010. The inflammatory lesions were excluded in the present study. Correlation with histopathology was done in all the cases. RESULTS: The mean age for all the patients was 38.2 years. There were 23 male and 25 female subjects. Seventy nine percent of the lesions were benign with pleomorphic salivary adenoma being the commonest, while only 20.8% of the lesions were malignant. All the patients presented with neck swelling. No complication was encountered in the present study. CONCLUSION: FNAC can replace incisional biopsy which may be hazardous in this area. Immediate treatment can be planned based on the FNAC report.

Primary non-Hodgkin's lymphoma of breast with scalp involvement in follow-up--an uncommon presentation.

Primary non-Hodgkin's lymphoma of the breast is a rare tumour accounting for 0.04 to 0.5% of all malignant breast tumours. The aim of this case presentation is to report such rare entity with an uncommon presentation. A 48-year female presented with rapidly growing firm mass in right breast (upper outer quadrant) and fine needle aspiration cytology (FNAC) was performed for clinical suspicion of breast carcinoma. Cytological examination of smears showed large cells arranged discretely, though occasional small clusters were also seen. The cells had high nuclear-cytoplasm (N-C) ratio and prominent nucleoli. Based on cytomorphology, differential diagnoses of high grade non-Hodgkin's lymphoma and poorly differentiated carcinoma was made. A tru-cut biopsy was suggested for confirmation. Histologic examination revealed diffuse large cells (monomorphic type) with prominent nucleoli.The tumour cells were reactive for CD45, CD20, and negative for cytokeratin, CD30, CD3 and CD5. A histopathologic diagnosis of non-Hodgkin's lymphoma of diffuse large B cell lymphoma type was confirmed. The patient was treated with combined chemotherapy and radiotherapy. After one year, the patient developed a swelling in the scalp and proved to be diffuse large B cell lymphoma by tru-cut biopsy. Now, the patient was treated with chemotherapy alone. Two-year follow-up of the case was uneventful. Since FNAC is initial diagnostic tool for breast lesions, a differential diagnosis of breast lymphoma should always be kept in mind, especially in poorly differentiated malignant tumours. Such cases need to be confirmed by histopathology and immunohistochemistry.

Neonatal sepsis: Role of a battery of immunohematological tests in early diagnosis.

BACKGROUND AND OBJECTIVE: Worldwide, many neonates with sepsis die due to lack of early diagnosis. In this study we attempt to analyze the value of various immunological and hematological parameters, singly and in combination, for the diagnosis of neonatal sepsis, with the aim being to formulate guidelines for the early diagnosis of the condition. MATERIALS AND METHODS: In this prospective study, 62 patients having clinical suspicion of neonatal sepsis were evaluated with a battery of investigations. Neonates admitted for other causes and without clinical suspicion of sepsis were selected as controls (n=40). The tests included blood culture, hemoglobin level, total and differential blood count, absolute neutrophil count, ratio of immature to total neutrophil count (I/T ratio), micro-erythrocyte sedimentation rate (m-ESR), C-reactive protein (CRP), platelet count, serum IgM level, and plasma fibrinogen level. Patients were divided into proven cases (positive blood culture) and probable cases (negative blood culture). RESULTS: Positive blood culture was seen in 38 cases (61.3%). Raised m-ESR (>8 mm in the first hour) was seen in 63.2% of proven and 66.7% of probable cases. I/T ratio of ≥0.2 was seen in 63.2% and 58.3% of proven and probable cases, respectively. Morphological changes in neutrophils were detected in 68.4% of proven cases and 91.7% of probable cases. Positive CRP test (≥6 mg/l) was found in 84.2% of proven cases and 100% of probable cases. Raised serum IgM, leucopenia, and neutropenia were seen in a small number of patients (11%-37%). Raised fibrinogen level (>400 mg/l) was seen in patients as well as in controls. CONCLUSIONS: The four useful tests that we identified were m-ESR, I/T ratio, morphological changes in neutrophils, and CRP; and role of these tests in early diagnosis of neonatal sepis were statistically significant (P<.05). The most sensitive test was CRP (84%) and the most specific test was m-ESR (94%). A combination of three or all of these four tests was highly specific (95%-100%).

Study of histopathological features and proliferation markers in cases of Wilms' tumor.

CONTEXT: The spectrum of pediatric renal tumors is different from adult renal tumors, and Wilms' tumor (WT) forms the majority. The histological type and clinicopathological staging are the two important prognostic parameters. The role of newer prognostic factors is not clear. AIMS: This study was performed to analyze the histopathological spectrum of pediatric renal tumors and to study the expression of proliferation markers (Ki-67 and p53) in WT and correlate its expression in epithelial and blastema components in different stages. MATERIALS AND METHODS: Twenty-seven cases of pediatric renal tumors were collected over 2 years. Hematoxylin-eosin staining was used for diagnosis. Immunostaining was performed for Ki-67 and p53. Ki-67 proliferation index (PI) and p53 expression were determined in each case and for the epithelial and blastema components separately. STATISTICAL ANALYSIS AND RESULTS: We had 20 cases of WT (74.1%), three cases of mesoblastic nephroma (11.1%), three cases of clear cell sarcoma (11.1%) and one case of rhabdoid tumor (3.7%). It was observed that the PI of the epithelial component (57.2%) was significantly higher than that of blastema (39.53%) in all stages. The PI in Stage II is significantly higher than that in Stage I. Statistical analysis could not be performed in Stages III and IV due to the small number of cases. p53 expression did not show any significant difference in the epithelial and blastema components. There was also no significant difference between the stages. CONCLUSION: In this study, we found the differences between PI of different tissue components of WT, with the epithelial component having a higher PI, which correlated with the stage of advancement of the disease.