A telepathology based screening tool for COVID-19 by leveraging morphological changes related to leukocytes in peripheral blood smears

As we approach the aftermath of a global pandemic caused by Severe Acute Respiratory Syndrome-Corona Virus (SARS-CoV-2), the importance of quickly developing rapid screening tests has become very clear from the point of view of containment and also saving lives. Here, we present an explorative study to develop a telepathology-based screening tool using peripheral blood smears (PBS) to identify Coronavirus Disease (COVID-19)-positive cases from a group of 138 patients with flu-like symptoms, consisting of 82 positive and 56 negative samples. Stained blood smear slides were imaged using an automated slide scanner (AI 100) and the images uploaded to the cloud were analyzed by a pathologist to generate semi-quantitative leukocyte morphology-related data. These telepathology data were compared with the data generated from manual microscopy of the same set of smear slides and also the same pathologist. Besides good correlation between the data from telepathology and manual microscopy, we were able to achieve a sensitivity and specificity of 0.83 and 0.71, respectively, for identifying positive and negative COVID-19 cases using a six-parameter combination associated with leukocyte morphology. The morphological features included plasmacytoid cells, neutrophil dysplastic promyelocyte, neutrophil blast-like cells, apoptotic cells, smudged neutrophil, and neutrophil-to-immature granulocyte ratio. Although Polymerase Chain Reaction (PCR) and antibody tests have a superior performance, the PBS-based telepathology tool presented here has the potential to be an interim screening tool in resource-limited settings in underdeveloped and developing countries.

Massive Dentigerous Cyst Involving The Entire Right Maxilla - A Case Report

The Dentigerous cysts are odontogenic cysts which originates from reduced enamel epithelium in an unerupted tooth or it encloses the crown of an unerupted or impacted tooth at cementoenamel junction, it is estimated to about 20% of all epithelium lined cysts and 2nd most common odontogenic cyst after radicular cyst. Here is a case report of dentigerous cyst of right maxilla which has been discussed below.

Supernumerary Bones in the Walls of the Bony Orbit.

Occurrence of supernumerary bones in the walls of the orbit especially in the medial wall and the roof has been described in the literature. Studies of the prevalence of supernumerary bones in the bony wall of the orbit are scarce in the literature. Present study was undertaken to find the prevalence of supernumerary bones in the walls of the orbit in a collection of adult Indian skulls. In the present study three hundred and twenty six orbital walls from one hundred and sixty three skulls were examined for the presence of the sutural bones. Their location with reference to the sutures in the walls of the orbit and their size was noted. The supernumerary bones were found in 25 skulls (15.34 %) mainly in the lateral wall (11.04 %) and the roof of the orbit (4.29 %). Prevalence of such supernumerary bones in the walls of the bony orbit is of anthropological interest. Many of the bony ossicles were of sufficiently large size, enough to be visualized on lateral skull X-ray and could easily be mistaken for fracture of the bony wall of the orbit.

Evaluation of oral submucous fibrosis using ultrasonographic technique: A new diagnostic tool.

Aim: The aim of this study is to evaluate oral submucous fibrosis (OSMF) by clinical and histopathological examination, and compare the results with those from ultrasonographic technique. Materials and Methods: 30 clinically diagnosed OSMF patients were subjected to both ultrasonographic and histopathological evaluation before treatment. Later, only ultrasonographical examination was done during 4 th and 8 th week of treatment. Prognosis of the lesion for the treatment was evaluated. Peak systolic velocity (PSV) of blood in the lesional area was statistically analyzed. 10 normal individuals without any mucosal lesions were considered as the control group. Results: In normal individuals, ultrasonography delineates normal mucosa with uniform fine mottled appearance with interspersed hypoechoic areas. Color Doppler and spectral Doppler depicts uniform distribution of blood vessels and normal peak systolic velocity of blood respectively. All OSMF patients were diagnosed upon clinical and histopathological examination. Clinical examination revealed 14 individuals with unilateral palpable fibrotic bands and 16 individuals with bilateral fibrotic bands whereas, ultrasonographic evaluation revealed 6 individuals with unilateral fibrotic bands and 24 individuals were with bilateral fibrotic bands, which was statistically significant. Ultrasonography demonstrated number, length and thickness of the fibrotic bands. Color Doppler and spectral Doppler showed decreased vascularity and PSV in lesional area. Prognosis evaluation revealed 25 cases of good prognosis and 5 cases were showed poor prognosis. Wilcoxon Signed Ranks Test revealed no significant difference of PSV was seen in poor prognosis patients. Conclusion: Ultrasonography is a non-invasive diagnostic tool for OSMF. It could be a better diagnostic tool compared to clinical and histopathological examination.

Rhinosporidiosis of parotid duct.

Rhinosporidiosis is a benign chronic granulomatous infection caused by Rhinosporidium seeberi. Rhinosporidiosis is endemic in south Asia, notably in southern India and Sri Lanka. Majority of the cases have been reported to occur in upper respiratory sites, notably anterior nares, nasal cavity, nasopharynx, larynx and soft palate. Only two rare cases of involvement of parotid duct, have been reported in literature. Hence, this case will probably be the third to be reported.

Subclavius posticus muscle: a case report

A rare case of subclavius posticus muscle observed in a male cadaver is reported here. Presence of such accessory muscles have been recognized as possible causes of neurovascular compression syndromes in this region. It has been suggested by several authors that presence of accessory muscles like subclavius posticus can be a potential cause of thoracic outlet syndrome.

Es reportado un caso raro de músculo subclavio posticus observado en un cadáver de sexo masculino. La presencia de tales músculos accesorios ha sido reconocida como posible causa de los síndromes de compresión neurovascular en esta región. Varios autores han sugerido que la presencia de músculos accesorios como subclavio posticus, puede ser una causa potencial del síndrome de salida torácica.

Cementum analysis in cleidocranial dysostosis.

OBJECTIVE: Cleidocranial dysostosis (CCD) is a skeletal disorder associated with dental anomalies such as failure or delayed eruption of permanent teeth and multiple impacted supernumerary or permanent teeth. Absence of cellular cementum at the root apex is presumed to be one of the factors for failure or delayed eruption. The aim of this study was to analyze the root cementum of supernumerary(S) and permanent teeth (P) of a CCD patient and to compare the findings with those of normal individuals with special emphasis on delayed eruption. MATERIALS AND METHODS: Ground sections of 12 extracted teeth (9S + 3P) of a CCD patient and 12 teeth of normal individuals (5S + 7P) were taken for the study. The sections were longitudinal and 50 microm thick. Root characteristics were recorded with the aid of a light microscope. RESULTS: The absence of apical cellular cementum, increased root resorption and increased percentage of the gap type of cemento-enamel (C-E) junctions were significant findings noted both in the supernumerary and permanent teeth of the CCD patient. CONCLUSION: The presumption of cellular cementum is essential for tooth eruption is not supported by the findings of the present study. Delayed exception could be attributed to various other factors like mechanical obstruction, reduced serum alkaline phosphatase levels etc. Also, the significance of the increased percentage of the gap type of C-E junctions and its role in tooth eruption has to be further evaluated.

Accessory muscles of the lower calf.

Two rare cases of accessory muscle of the lower calf observed in dissecting room cadavers are described here. This muscle is supposed to occur in 1% bodies and is implicated in tarsal tunnel syndrome. Occurrence of such anomalous muscles should be considered while examining cases reporting with pain associated with swelling in the region of Achilles tendon since they may mimic a soft tissue tumour.

Candidate genes for drought tolerance and improved productivity in rice (Oryza sativa L.).

Candidate genes are sequenced genes of known biological action involved in the development or physiology of a trait. Twenty-one putative candidate genes were designed after an exhaustive search in the public databases along with an elaborate literature survey for candidate gene products and/or regulatory sequences associated with enhanced drought resistance. The downloaded sequences were then used to design primers considering the flanking sequences as well. Polymerase chain reaction (PCR) performed on 10 diverse cultivars that involved Japonica, Indica and local accessions, revealed 12 polymorphic candidate genes. Seven polymorphic candidate genes were then utilized to genotype 148 individuals of CT9993 x IR62266 doubled haploid (DH) mapping population. The segregation data were tested for deviation from the expected Mendelian ratio (1:1) using a Chi-square test (less than 1%). Based on this, four candidate genes were assessed to be significant and the remaining three, as non-significant. All the significant candidate genes were biased towards CT9993, the female parent in the DH mapping population. Single-marker analysis strongly associated (less than 1%) them to different traits under both well-watered and low-moisture stress conditions. Two candidate genes, EXP15 and EXP13, were found to be associated with root number and silicon content in the stem respectively, under both well-watered and low-moisture stress conditions.

Jarcho-Levin syndrome.

Jarcho-Levin syndrome is an eponym that represents a spectrum of short trunk skeletal dysplasias with variable involvement of the vertebrae and ribs. Initially considered to be lethal, it is now accepted as compatible with life in its milder presentations. Here are reported two neonates with the lethal variety of this syndrome. One neonate had associated anomalies like hydrocephalus, hydroureteronephrosis and meningomyelocoele while the other had no additional anomalies. Also is reviewed the literature regarding this less understood disorder focusing on the applied clinical aspects that have stemmed out from the recent molecular research.

Variations of the location of the greater palatine foramina in dry human skulls.

Seventy-one adult skulls (58 dentulous skulls: 56 bilateral and 2 unilateral, 13 edentulous: 11 bilateral and 2 unilateral) of unknown sex were examined for the variations of the location of the greater palatine foramen. The location of greater palatine foramen (GPF) was noted with relation to mid sagittal suture (MSS), posterior palatal border (PPB), and maxillary molars by measuring the distances using a sliding caliper to the nearest millimeter. Difference in the distance of the foramen from MSS and PPG in both the skull types was found to be statistically insignificant. Commonest location of the foramen was found to be opposite to third molar tooth (85.95%), followed by the interval between second and third molar teeth (13.15%), and opposite to the second molar tooth (only one case - 0.88%). Well-formed bony canals were found along the groove for the palatine nerves and vessels unilaterally in the right side in two skulls. These observation may be of help to the dental surgeon during the peripheral block of maxillary nerve for the maxillo-facial surgery.

Retromolar foramen.

Of the many variants in the mandible, the retromolar foramen is the most important. The incidence of retromolar foramen was studied in a collection of 157 south Indian mandibles available at the department of Anatomy, St. John's Medical College, Bangalore. On each side of the mandible, the area behind the last molar tooth was inspected for the presence of retro molar foramen. Wherever present, their distance from the last molar tooth and their size if they were sufficiently large were measured with a sliding caliper to the nearest millimeter. Retromolar foramen were found to be bilateral in 8 mandibles (5.1%) and unilateral 20 [right: 9 (5.7%); left: 11 (7%)] mandibles. The diameter of the foramina was 2 mm on both sides.

Morphological variations of the lung fissures and lobes.

BACKGROUND: Knowledge of the position of fissures of the lungs is necessary for the appreciation of lobar anatomy and thus locating the bronchopulmonary segments. METHODS: Morphological variations of fissures and lobes of the lungs were studied in 30 pairs of lungs from cadavers. RESULTS: Five right-sided lungs showed absence of horizontal fissure, 19 showed incomplete horizontal fissure. Eleven right-sided and 14 left-sided lungs showed incomplete oblique fissure and two right-sided lungs showed both absence of horizontal fissure and an incomplete oblique fissure. Accessory fissure was seen in three left-sided and one right-sided lungs. CONCLUSIONS: Awareness regarding anatomical variations is essential for performing lobectomies and segmental resection and interpreting radiological images.

The varying shape of the coronoid process of the mandible.

The coronoid process (meaning crow) is a flattened triangular bony process of the ramus of the mandible. It is usually directed upwards and slightly forwards in the living subject. The coronoid process is of clinical significance to the maxillofacial surgeon for reconstructive purposes. Several authors have described the varying shapes of the process. In the present study, the variable shape and surface area of the coronoid process were observed in a collection of 154 south Indian mandibles. Using the criterion proposed by Isaac and Holla (2001), the coronoid process of each side was inspected for the shape and direction, and surface area of the ramus and the coronoid process was also calculated. The shape of the coronoid process was bilaterally triangular in 16.2%, hook-shaped in 45.5%, rounded in 18.2% rounded and hook-shaped in 4.5%, and unilaterally triangular in 12.3%, hook-shaped in 11.7%, and rounded in 7.1% of the mandibles. The coronoid processes faced directly upward in 55.4%, forward in 40.7% and backward in 3.8% of the mandible.

Mylohyoid bridging in South Indian mandibles.

The incidence of the bony bridging of the mylohyoid groove of the mandible was studied in a collection of two hundred and twenty five south Indian mandibles. The bony bridging was noticed in 6.39% of the mandibles studied. The incidence of this trait shows a wide range of variation among the different population groups of India. The bony bridging of the mylohyoid may be useful as a non-metric trait in population studies when used in combination of other non-metric traits.

Incidence of morphological variants of mandibular lingula.

The ligual of mandible is a tongue shaped bony projection on the medical surface of the ramus close to the posterior margin of the mandibular foramen. Since the inferior alveolar nerve enters the mandibular foramen to supply the strctures of the lower jaw, the relationship of lingula to the inferior alveolar nerve is of clinical significance to dental surgeons. It becomes a necessety to know the morphology of linguls so as to preserve the important structures during surgical interference of mandible around the lingula region. The present study was undertaken mainly to establish the frequency of various morphological types of lingula in adult human mandibles of South Indian background. The material for this study comprised of a collection of 147 (294 sides) dry adult human mandibles. In each mandible, the lingula was scored using the classification proposed by Tuli et al (2000). More frequently observed bilaterally were the Truncated and Nodular types. These two types occurred more frequently unilaterally as well. The assimilated type, whether unilateral or bilateral was more or lesws similar in frequency along with other non metric variants of the skull, morphological types of lingula can also be useful as anthropological marker to assess population and recial distances.

The direction and location of mental foramen and incidence of accessory mental foramen in south Indian mandibles.

One hundred and forty two south Indian mandibles of unknown sex were examined for the variations of the location and direction of the mental foramen. Accessory mental foramen were also looked for. The findings have been compared with those of other studies in the literature. Topography of the mental foramen is of practical importance to the dental and maxillo-facial surgeon for purpose of anesthesia and surgical procedures.

Posterior bridging of the atlas vertebra in south Indians.

The vertebral artery is vulnerable to compression in its course between foramen transversarium and the foramen magnum during extreme rotation of the head and neck. This situation may be aggravated by the presence of posterior or lateral bridge of the atlas and result in compromised blood flow. The incidence of the bony ring formed by posterior bridging has been demonstrated in atlases of various races across the world: it varies between 1.875% to 29.2%. In an examination of sixty south Indian atlases it was found in 11.7% of the cases. The presence of this bony bridging should be taken in to account during a surgical manipulation of the cervical spine.

Adaptive response to low dose of EMS or MMS in human peripheral blood lymphocytes.

Human peripheral blood lymphocytes stimulated in vitro for 6 hr were exposed to a low (conditioning) dose of ethyl methanesulfonate (EMS; 1.5 x 10(-4) M) or methyl methanesulfonate (MMS; 1.5 x 10(-5) M). After 6 hr, the cells were treated with a high (challenging) concentration of the same agent (1.5 x 10(-3) M EMS or 1.5 x 10(-4) M MMS). The cells that received both conditioning and challenging doses became less sensitive to the induction of sister chromatid exchanges (SCEs) than those which did not receive the pretreatment with EMS or MMS. They responded with lower frequencies of SCEs. This suggests that conditioning dose of EMS or MMS has offered the lymphocytes to have decreased SCEs. This led to the realization that pre-exposure of lymphocytes to low dose can cause the induction of repair activity. This is a clear indication of the existence of adaptive response induced by alkylating agents whether it is ethylating or methylating in human lymphocytes in vitro.

Paracondylar foramen--a new anomalous aperture of the occipital bone.

A new anomalous apperture has been identified by the author in association with the occipital bone. It was situated in the interval between the jugular fossa and the occipital condyles. Out of 118 skull bases examined four instances of this anomalous apperture were found (2 complete and 2 incomplete). The author speculates that they may transmitting the posterior condylar emissary vein in the absence of the condylar canal or in its abrrent course to the jugular foramen. In view of its topographical location the author proposes the name--'Paracondylar foramen' to this anomalous apperture.