Primary Malignant Melanotic Nerve Sheath Tumour of the Neck: A Diagnostic Predicament.

Primary malignant melanotic nerve sheath tumours, previously called Melanotic schwannomas are rare pigmented tumours of nerve sheath origin, with unspecified biologic behaviour and uncommon presentation in the head and neck region. A primary melanotic schwannoma of the cervical sympathetic plexus, mimicking a cervical lymphadenopathy requires careful evaluation and planning for an optimal outcome. The management of these neoplasms is still controversial, and hence we present a case report with insight into the diagnostic dilemma in work-up of a neck mass that turned out to be a Primary Malignant Melanotic Schwannoma arising from the cervical sympathetic plexus along with a review of literature.

WITHDRAWN: Heavy metal ions and dyes removal from aqueous solution using Aloevera-based biosorbent: A systematic review.

This article has been withdrawn: please see Elsevier Policy on Article Withdrawal (http://www.elsevier.com/locate/withdrawalpolicy). This article has been withdrawn at the request of the authors, editor and publisher. The publisher regrets that an error occurred which led to the premature publication of this paper. The publisher apologizes to the readers for this unfortunate erro

Immobilization of chromium bioavailability through application of organic waste to Indian mustard (Brassica juncea) under chromium-contaminated Indian soils.

Industrialization results in production of large volume of wastewaters, and disposing of them become a serious problem. The wastewaters may have range of heavy metals, which have an impact on soil and plant health. The objective was to evaluate the influence of farm yard manure (FYM) and pressmud (PM) applications on Indian mustard growth and chromium (Cr) uptake in tannery effluent irrigated Cr-contaminated soil. Soil was collected from the tannery effluent irrigated fields (chromium contaminated) of Shekhpura village of Kanpur, India. A pot culture experiment was carried out by growing Indian mustard (Brassica juncea) var. RH 749 on the Cr-contaminated soil with application of different levels and combinations of FYM and PM (at 0, 2.5, and 5 g kg-1 each). Biomass yield, Cr uptake, bioconcentration factor (BCF), transfer factor (TF), transfer efficiency (TE), and Cr removal indices were examined. Higher doses of FYM and PM resulted in reduction of Cr concentrations in shoot (6.60 to 2.50 µg g-1) and root (27.27 to 9.43 µg g-1); and absorption in plant tissues and had improved total dry matter yield (14.56 to 30.94 g pot-1). The use of FYM and PM had a substantial (p ≤ 0.05) impact on phytoremediation parameters like BCF (0.128 to 0.045), TE (59.61 to 64.51%), and Cr removal (0.65 to 0.51%). Combined application of FYM (5 g kg-1) and PM (5 g kg-1) had enhanced the dry matter yield of shoot (12.51 to 26.40 g pot-1) and root (2.05 to 4.54 g pot-1) and reduced the Cr uptake (138.54 to 108.79 mg pot-1) than the individual amendment addition of FYM (138.52 to 135.89 mg pot-1) and PM (126.02 to 130.52 mg pot-1). Combined application of FYM (5 g kg-1) and PM (5 g kg-1) could be beneficial for remediation of Cr-contaminated areas for cultivation of crops.

Erdheim Chester Disease - Unusual Presentation with Isolated Skeletal Lytic Lesions.

Introduction: Erdheim-Chester disease (ECD) is a rare non-Langerhans cell histiocytosis (LCH) of unknown origin that was first described in 1930. Since then, almost 600 cases have been reported worldwide. Even though this disease primarily affects the bone, it has a varied clinical spectrum of presentation ranging from asymptomatic bone lesions to multisystem involvement. Owing to its protean manifestations ECD is often misdiagnosed or diagnosed late. Case Report: We present a 48-year-old female with a long long-standing history of recurrent bone lesion of the tibia and multiple trivial trauma fractures of long bones. Recently, she also developed a persistent headache and painful swelling of the right shoulder and left hip joint. Radiographs revealed multiple lytic and lytic sclerotic lesions. With the probable diagnosis of LCH, she underwent biopsy which revealed features characteristic of ECD. Conclusion: This case highlights the fact that histopathological confirmation is the key to distinguish various types of histiocytic neoplasms. Overlapping clinical and radiological features with atypical manifestations can occur in both LCH and ECD and does not rule out either of them.

Environmental surface sampling of SARS-CoV-2 in selected hospitals in Malaysia.

COVID-19 has spread rapidly worldwide. The role of fomites in facilitating onward transmission is plausible. This study aimed to determine the presence of viable virus and its persistence on the surfaces of fomites in wards treating COVID-19 patients in Malaysia. This study was conducted in two stages. First, environmental sampling was performed on random days in the intensive care unit (ICU) and general wards. Then, in the second stage, samples were collected serially on alternate days for 7 days in two selected general wards. In Stage 1, a total of 104 samples were collected from the surfaces of highly touched and used areas by patients and healthcare workers. Only three samples were tested positive for SARS-COV-2. In Stage 2, three surface samples were detected positive, but no persistence of the virus was observed. However, none of the SARS-CoV-2 RNA was viable through tissue culture. Overall, the environmental contamination of SARS-CoV-2 was low in this hospital setting. Hospitals' strict infection control and the compliance of patients with wearing masks may have played a role in these findings, suggesting adherence to those measures to reduce occupational exposure of COVID-19 in hospital settings.

Telangiectatic Osteosarcoma in a Young Child - A Case Report and Review of the Literature.

Introduction: Osteosarcoma (OS) is one of the most common primary malignant bone tumors in children and adolescents. OS incidence varies significantly with age and peak incidence is in adolescent age group. Telangiectatic osteosarcoma (TOS) is an unusual variant of OS, forming 3-10% of all OSs. Only few case reports of this rare variant of OS are described in the literature. Case Report: We report a 6-year-girl who presented with fracture of the left proximal humerus after a trivial trauma. X-ray left shoulder showed osteolytic lesions in the left proximal humerus with fracture of proximal humerus. Open biopsy from the left proximal humerus osteolytic lesion suggested clusters of highly atypical cells like osteoid material and focal areas of hemorrhage and necrosis suggestive of TOS. The child was started on chemotherapy followed by limb-salvage surgery with wide resection of the tumor in the left proximal humerus. She completed her adjuvant chemotherapy and is currently doing well for the past 4 years. Conclusion: OS occurs more frequently in adolescents around the knee in the metaphyses. The most common histologic type is osteoblastic/fibroblastic or chondroblastic type. Very few cases have been reported in <5 years age group and it's relatively rare in 5-10-year-old children. Rare histologic variants, especially telangiectatic variant, are more common in younger children and occur more in upper limbs. Imaging reveals mainly osteolytic lesions, unlike in conventional OS. This case highlights the utmost role of histopathology in the diagnosis of the bone tumors which would guide the management appropriately.

Reducing chromium uptake through application of calcium and sodium in spinach.

In peri-urban areas, the use of wastewater for crop production is a common practice due to water scarcity. Moreover, in the recent years, large quantity of wastewater generation and discharge as industrial effluent in water resources is another issue for reduction of water quality. The leather industries are significantly contributing chromium (Cr) in effluent, whereas, other industries may have salt and cationic load in their discharges are mixed up. Therefore, it is mandatory to study the interactive effect of different effluent constituents on crop plants. In this connection, a pot culture experiment was conducted at the ICAR-Indian Institute of Soil Science, Bhopal to compute the effect of application of calcium (Ca) and sodium (Na) ions on Cr uptake by spinach crop in Vertisol of central India. Three levels of Cr (0, 50, 100 mg kg-1), calcium (0, 2, 4 mM), and sodium (0, 40, 80 mM) were applied in combinations. The spinach variety All Green was used as a test crop and harvested at full maturity. Results showed that application of Ca and Na reduced the Cr uptake in spinach crop. The reduction of Cr uptake was more in the root than shoot. Applied calcium acted as an essential plant nutrient and enhanced the crop biomass. Sole applications of Na adversely affected the crop biomass and Cr uptake in both root and shoot of spinach. In conclusion, application of Ca fertilizers reduced the Cr toxicity in spinach and could be used as a strategy for the safe utilization of tannery industrial effluents for crop production.

Chromium toxicity mediated by application of chloride and sulfate ions in Vertisol of Central India.

Chromium (Cr) is one of the toxic metals adversely affecting organisms including humans in the ecosystems, and it is present in considerable concentration in the tannery industrial effluent. Toxicity expression of Cr is suspected to be influenced considerably by other accompanying ions present in the effluent used for irrigation. In a screen house experiment, interactive effects of chloride and sulfate ions in a Vertisol on uptake of Cr by spinach crop were investigated and treatments imposed were three levels each of Cr (0, 50, 100 mg kg-1), chloride (Cl-) (0, 25, 50 mM kg-1), and sulfur (S) (0, 4, 8 mM kg-1) in possible combinations. Plant growth parameters and leaf Cr concentrations were recorded to find out the effect of anions on Cr dynamics in the plant. Increasing the concentration of Cl- ions in soil reduced the Cr concentration in both root and shoot. Similarly, increasing the concentration of S from 4 to 8 mM kg-1 also reduced the concentration and uptake of Cr. Application of sulfate ions augmented the plant growth and counters the negative effect of Cl- ions and Cr. Thus, the study revealed that the addition of S fertilizers could minimize the Cr toxicity in high Cr contaminated soils.

Impact of Long-Term Application of Sewage on Soil and Crop Quality in Vertisols of Central India.

Shortfall of rain and the decreased groundwater level force farmers to use poor quality water for crop production in developing countries. In this study, the quality of agricultural produce and soil health affected by sewage water (Patranala) irrigation was evaluated. Sewage sediment, soil and crop samples were analyzed for physico-chemical properties. Sewage water found to contain trace concentration of heavy metals. However, long-term application of this water for crop production could build up a significant amount of trace metals in both soil and sediments. The DTPA extractable heavy metals ranged Cu 2.7-7.59, Cd 0.04-0.06, Pb 1.29-2.05, Cr 0.01-0.04, Ni 0.24-1.03 and Zn 0.63-2.59 mg kg-1 soil. The heavy metal risk assessment (hazard quotient, HQ) was calculated and found that HQ for these metals in the crops under study was in safe limits. From the study, it is concluded that growing vegetables using sewage water of Patranala is safe, but periodic monitoring to be carried out to avoid food chain contamination.

Correlation between Ultrasound-based TIRADS and Bethesda System for Reporting Thyroid-cytopathology: 2-year Experience at a Tertiary Care Center in India.

BACKGROUND: In recent times, high-resolution ultrasound thyroid imaging has paved the way for significant transformation in clinical approach to thyroid nodule. There are several risk stratification systems in thyroid imaging, developed with an aim, not only to reduce the inter-observer variability but also to establish effective communication system. Thyroid image reporting and data system (TIRADS) classification system, which is similar to breast imaging reporting and data system for breast lesion, is the most useful of all. To our knowledge, there is just a handful published research articles available based on Indian population in this regard. In this article, we study the thyroid nodules using high-resolution ultrasound in Indian population and we try to correlate the TIRADS and Bethesda system for reporting thyroid cytopathology. MATERIALS AND METHODS: This prospective study includes 184 patients studied over a period of 2 years (April 2015-April 2017). Patients having thyroid nodule in B-mode ultrasound and are scheduled to get a fine-needle aspiration cytology (FNAC) done. Bethesda classification of these nodules is tabulated in follow-up period simultaneously. By comparing these data, efficacy of TIRADS in differentiating benign from malignant nodules are assessed finally using accuracy, positive predictive value (PPV), cross-tabulation, and Chi-square tests. RESULTS: Out of the 117 TIRADS 2 nodules, none turned out to be Bethesda IV or higher, which means none of these nodules turned out to be malignant. The risk of malignancy for TIRADS 2, TIRADS 3, TIRADS 4, and TIRADS 5 was 0, 2.2, 38.5, and 77.8%, respectively. The risk of malignancy percentage in our study is similar to those values obtained in other prominent studies. CONCLUSION: The probability of a particular nodule being malignant can be effectively inferred from the ultrasound-based TIRADS system with a certain level of confidence. Considering our results and other literature reviews, it be can be safely assumed that FNAC can be at least deferred in patients having TIRADS 2 nodules, which contribute to majority of newly detected cases. In our experience, there is a remarkable correlation exists between TIRADS ultrasound classification and Bethesda cytology, especially for benign nodules.

Geo-Accumulation Indices of Heavy Metals in Soil and Groundwater of Kanpur, India Under Long Term Irrigation of Tannery Effluent.

Soil and groundwater from long-term (>50 years) tannery effluent irrigated areas of Kanpur were analyzed and significant buildup of heavy metals such as Cr, Ni, Cd, Pb, Zn, and As in the range of 252-972, 23-30, 2.3-14.1, 23.7-58.8, 138-338 and 6.8-11 mg kg-1, respectively in soil was found. Few groundwater samples in the effluent irrigated areas also exhibited high Cr concentration above the permissible limit of United States Environmental Protection Agency. The tannery effluents contained 1.53-57.3 ppm Cr, 0-0.12 ppm Ni, 0-0.02 ppm Cd, 0-0.07 ppm Pb, 0-0.48 ppm Zn and 0-0.03 ppm As. The Geo-accumulation index (Igeo) revealed that soil samples were unpolluted to moderately polluted with Cu, Ni, Zn, Pb and As; moderately polluted in case of Cd; and heavily to extremely polluted by Cr.

Impact of pigeon pea biochar on cadmium mobility in soil and transfer rate to leafy vegetable spinach.

Introduction of heavy metals in the environment by various anthropogenic activities has become a potential treat to life. Among the heavy metals, cadmium (Cd) shows relatively high soil mobility and has high phyto-mammalian toxicity. Integration of soil remediation and ecosystem services, such as carbon sequestration in soils through organic amendments, may provide an attractive land management option for contaminated sites. The application of biochar in agriculture has recently received much attention globally due to its associated multiple benefits, particularly, long-term carbon storage in soil. However, the application of biochar from softwood crop residue for heavy metal immobilization, as an alternative to direct field application, has not received much attention. Hence, a pot experiment was conducted to study the effect of pigeon pea biochar on cadmium mobility in a soil-plant system in cadmium-spiked sandy loam soil. The biochar was prepared from pigeon pea stalk through a slow pyrolysis method at 300 °C. The experiment was designed with three levels of Cd (0, 5, and 10 mg Cd kg(-1) soil) and three levels of biochar (0, 2.5, and 5 g kg(-1) soil) using spinach as a test crop. The results indicate that with increasing levels of applied cadmium at 5 and 10 mg kg(-1) soil, the dry matter yield (DMY) of spinach leaf decreased by 9.84 and 18.29 %, respectively. However, application of biochar (at 2.5 and 5 g kg(-1) soil) significantly increased the dry matter yield of spinach leaf by 5.07 and 15.02 %, respectively, and root by 14.0 and 24.0 %, respectively, over the control. Organic carbon content in the post-harvest soil increased to 34.9 and 60.5 % due to the application of biochar 2.5 and 5 g kg(-1) soil, respectively. Further, there was a reduction in the diethylene triamine pentaacetic acid (DTPA)-extractable cadmium in the soil and in transfer coefficient values (soil to plant), as well as its concentrations in spinach leaf and root, indicating that cadmium mobility was decreased due to biochar application. This study shows that pigeon pea biochar has the potential to increase spinach yield and reduce cadmium mobility in contaminated sandy soil.

Small cell neuroendocrine carcinoma of the cervix: a rare entity.

Small cell carcinoma of the cervix is a rare and a very aggressive tumour. Once being considered to be a rare type of squamous cell carcinoma, evidence has proven that most of the tumours express one or more markers of neuroendocrine differentiation. The behaviour of this rare malignancy is different from that of squamous cell carcinomas, with a high propensity for nodal and distant metastases. Hence, there is a need to highlight this histopathological entity.

Granular cell tumor in inguinal region: A case of mistaken identity on cytology.

A 63-year-old male presented with sudden increase in size of a right inguinal swelling which was present for the past 10 years. Clinical diagnosis of inguinal soft tissue mass/lymph node enlargement was made and patient was investigated further for a conclusive diagnosis. Ultrasound examination suggested it to be a lymph node and guided fine needle aspiration cytology was performed. Cytology was suggestive of a reactive lymph node. Subsequently, an excision biopsy was performed that revealed a granular cell tumor with many lymphoid aggregates. On reviewing the cytosmears, we realised that the granular neoplastic cells were mistaken for histiocytes; and the lymphoid background and bare nuclei mislead us to consider it a reactive lymph node. Since granular cell tumor can occur almost anywhere, a careful examination of cytosmears and knowledge of its distinctive cyto-morphological features would be helpful in providing an accurate diagnosis on cytology.

Repair of Cartilage injuries using in vitro engineered 3D cartilage tissue- Preliminary Results of Our Animal Studies.

INTRODUCTION: The cartilage injuries demand novel therapeutic approaches as the success rates of the current conventional strategies for the repair of injured articular cartilages are not that encouraging. Earlier we have reported that the Thermoreversible Gelation Polymer (TGP) is an ideal scaffold for human chondrocyte expansion in vitro. In this study, we report the preliminary results of the in vitro expansion, characterization and experimental in vivo transplantation of chondrocytes in a rabbit model of cartilage injury. MATERIALS & METHODS: Nine rabbits were included in this study scheduled for two years, after approval by the ethics committee. In the first animal, Chondrocytes were isolated from the weight bearing area of patellar groove in the left hindlimb and cultured in TGP Scaffold and maintained at 37°C in 5% carbon dioxide incubator for 64 days without growth factors. Then the TGP-Chondrocyte construct was transplanted into an experimental defect created in the knee of the right forelimb of the same rabbit. After a period of 10 weeks, a biopsy was taken from the transplanted region and subjected to morphological analysis, characterization by histopathology (H&E stain) and Immunohistochemistry (S-100 staining). RESULTS: The chondrocytes in the 3D TGP culture had round to oval shaped morphology without any de-differentiation which is otherwise observed in Conventional 2D cultures. A macroscopic structure which resembled cartilage was appreciated in the TGP construct in vitro after 64 days which was then transplanted to the rabbit. The H&E and Immunohistochemistry studies confirmed the presence of chondrocytes in the biopsy tissue. CONCLUSION: Based on the results, we conclude that the TGP significantly supports the in vitro expansion of chondrocytes for a longer period and the 3D culture using TGP preserves the phenotype of the articular chondrocytes. The tissue thus grown when implanted with the TGP has engrafted well without any adverse reactions and upon confirmation of safety following completion of the entire study with adequate follow-up, human applications could be considered.

Solid variant of papillary carcinoma of nipple: an under recognized entity.

Papillary lesions of the breast represent a heterogeneous group with differing biological behavior. Solid papillary carcinomas are uncommon tumors composed of circumscribed large cellular nodules separated by bands of fibrosis. Correct diagnosis is crucial but may be difficult, as many other benign and malignant lesions have similar histological appearances. Immunohistochemistry plays a useful role in their differentiation. We describe one such case of a solid variant of papillary carcinoma of the left nipple in a 75-year-old woman, who had no other palpable mass in rest of the breast tissue. The case is documented for the rarity of its occurrence and significance of recognition of this lesion.

Extramedullary relapse of acute lymphoblastic leukemia in breast: a rare presentation.

Unusual sites of relapses following allogenic hematopoietic stem cell transplantation (HSCT) for acute lymphoblastic leukemia (ALL) are rarely reported. Our report describes a thirty-two-year old female, who developed extramedullary (EM) breast relapse after allogenic HSCT for pre B cell Philadelphia chromosome negative ALL. She had no evidence of leukemia in her marrow demonstrating 100% full donor chimerism, while she had ALL relapse in her breast.

Intraosseous calcifying epithelial odontogenic tumor in a case with multiple myeloma.

Calcifying epithelial odontogenic tumor (CEOT), also known as Pindborg tumor, is a rare benign odontogenic tumor of locally aggressive behavior. It is more common in the posterior part of the mandible of adults, typically in the fourth to fifth decades. Its origin as well as its true malignant potential is not clearly known. It usually starts as a painless swelling and is often concurrent with an impacted tooth. A case of CEOT in a 55-year-old man with multiple myeloma is presented. Clinical, radiological, and pathologic findings are discussed.