Cardiological society of India document on safety measure during echo evaluation of cardiovascular disease in the time of COVID-19.

An echocardiographic investigation is one of the key modalities of diagnosis in cardiology. There has been a rising presence of cardiological comorbidities in patients positive for COVID-19. Hence, it is becoming extremely essential to look into the correct safety precautions, healthcare professionals must take while conducting an echo investigation. The decision matrix formulated for conducting an echocardiographic evaluation is based on presence or absence of cardiological comorbidity vis-à-vis positive, suspected or negative for COVID-19. The safety measures have been constructed keeping in mind the current safety precautions by WHO, CDC and MoHFW, India.

Cardiological Society of India: Document on acute MI care during COVID-19.

The unprecedented and rapidly spreading Coronavirus Disease-19 (COVID-19) pandemic has challenged public health care systems globally. Based on worldwide experience, India has initiated a nationwide lockdown to prevent the exponential surge of cases. During COVID-19, management of cardiovascular emergencies like acute Myocardial Infarction (MI) may be compromised. Cardiological Society of India (CSI) has ventured in this moment of crisis to evolve a consensus document for care of acute MI. However, this care should be individualized, based on local expertise and governmental advisories.

Comparative evaluation of cancer chemopreventive efficacy of alpha-tocopherol and quercetin in a murine model.

Chemopreventive efficacy and the mode of action of alpha-tocopherol and quercetin, both known to possess anti-oxidant properties, were evaluated during carcinogenesis in uterine cervix of mice by chronic exposure to methylcholanthrene. Oral administration of alpha-tocopherol and quercetin could reduce the genotoxic effect of the carcinogen as revealed by the micronucleus frequency in vaginal epithelial cells. Both could restrict the progression of dysplastic changes in cervix uteri leading to carcinoma in-situ but the influence of the quercetin was more pronounced. A decrease in lipid peroxides following ingestion of these agents suggests that their chemopreventive action is due to their protective role on DNA damage by free radicals. Increased glutathione and glutathione-s-transferase also indicate their involvement in detoxification. While alpha-tocopherol activated the PBL response towards mitogenic stimulation, quercetin had no such effect.

Chemopreventive activity of quercetin during carcinogenesis in cervix uteri in mice.

The chemopreventive action of quercetin was examined during 20-methyl cholanthrene induced cervical neoplasia in virgin Swiss albino mice. The effects were evaluated on the basis of histopathological observation of the cervical epithelium, micronucleus frequency in vaginal exfoliated cells and some biochemical parameters in the host liver. Quercetin was found to arrest or reverse the progression of cervical neoplasia. The micronucleus frequency was reduced following its administration. The potential anti-carcinogenic effect of quercetin noted in this study is attributed to its antioxidant property which was reflected in the lipid peroxides and their role in the host detoxification system, as expressed in liver glutathione level, glutathione-S-transferase, glutathione peroxidase, catalase and superoxide dismutase activity. As an integral part of the diet quercetin may offer protection to the epithelium from the damaging effects of carcinogenic chemicals.

Interferometer for use in wave-front testing with a cross slit.

A simple and novel interferometric setup for wave-front testing that uses a cross slit is described. In this method, the test beam illuminates a cross slit placed at the front focal plane of a Fourier lens. It selects two orthogonal slices from the test beam, and the interference of these two beams is observed at a slightly defocused plane near the back focal plane. Fringes of different conical forms (circular, elliptical, or hyperbolic) so obtained can be used for testing a coherent wave front in general. The theory, supported by some experimental results, is presented. An application of the method to the study of the nature of asymmetry in the beam profile of a semiconductor diode laser beam is demonstrated.

Evaluation of argyrophilic nucleolar organizer regions (AgNORs) in oral carcinomas in relation to human papillomavirus infection and cytokinetics.

The numbers of argyrophilic nucleolar organizer regions (AgNORs) were quantified in oral carcinomas (n = 39) with or without human papillomavirus (HPV) infection. The AgNOR counts of the HPV-positive samples (7.15 +/- 2.13) were not significantly (P = 0.09) higher than those of the HPV-negative ones (6.16 +/- 1.89). Furthermore, the lesions infected with multiple HPV types had greater counts than those with HPV type 16/18 infection alone. Significant differences were observed between the mean counts of the poorly (10.50 +/- 0.54), moderately (7.31 +/- 1.07) and well- (5.12 +/- 0.85) differentiated carcinomas. The mean AgNOR numbers in the oral carcinomas at TNM stages III/IV were found to be significantly (P < 0.01) higher than the numbers in corresponding stage II lesions. Cytokinetics of the lesions assessed by the bromodeoxyuridine (Brdu) labelling index (LI%) showed a linear correlation (r = 0.91; P < 0.0001) with their respective mean AgNOR counts.

Optical method of determination of stress at a point.

A method of determining stress at a point is suggested here. The effect of bending of a wave front that is due to variations of the refractive index is used to measure different aspects of stresses. A Fourier lens with a cross slit at its front focal plane is used to form interference fringes at planes near its back focal plane. The sample, illuminated by a plane-parallel coherent beam of light, is placed close to a cross slit, and the change in fringe pattern due to axial shift of the spectrum planes of the slits is measured to relate it to the state of stress.

Cytokinetic studies of oral cancer cells using bromodeoxyuridine labelling in relation to factors influencing prognosis.

Cytokinetics of 27 untreated oral squamous cell carcinomas were evaluated by in vitro bromodeoxyuridine (BrdU) labelling. A mononuclear cell suspension was prepared for the labelling using collagenase and DNase treatment. The labelled cells were visualised by immunofluorescence staining with an anti-BrdU monoclonal antibody. The labelling index (LI%) was calculated by determining the percentage of BrdU labelled cells. The LIs of the carcinomas ranged from 3.8 to 19.2%. The LIs of poorly-differentiated (HG3) tumours were 2-3-fold higher compared with those of well-differentiated (HG1) and moderately-differentiated (HG2) carcinomas. Results also showed statistically significant (P < 0.0005) increases in LIs from nuclear grade 1 (NG1) to nuclear grade 3 (NG3) carcinomas. Higher LIs were observed in stage III/IV (10.82 +/- 4.62; 10.36 +/- 4.90) than those in stage I (6.87 +/- 2.09) and II (7.14 +/- 1.87) carcinomas. A significant (P < 0.0005) difference in LI values was found between the patients with positive and negative lymph nodes. Good correlation (r = 0.77) was exhibited between the LI values and mitotic counts (MC) of the specimens. These results on oral cancer cell proliferation seem to have prognostic implications.

Association of p53 expression with cytokinetics and HPV capsid antigen prevalence in oral carcinomas.

p53 protein expression in oral squamous cell carcinomas (SCCs) was studied in relation to presence of HPV capsid antigens and tumour cell kinetics. The protein and viral antigens were determined from 64 SCCs employing immunoperoxidase and immunofluorescence techniques, respectively. Cell kinetics were assessed by in vitro bromodeoxyuridine labelling. Different levels of p53 were detected in 61% cases. Well-differentiated SCCs (88%) showed increased p53 expression compared with the less differentiated ones. In SCCs with higher cell proliferation rate (LI%, 13.25 +/- 4.64) the expression was almost absent. However, it was higher in stage I than in stage II/III carcinomas and occurred in 54.5% and 75% cases of HPV antigen-positive and -negative (or very little) SCCs, respectively.

Correlation of mitotic abnormalities and the presence of human papillomavirus antigens in squamous cell carcinomas of the oral cavity.

To determine the association of human papillomavirus (HPV) with oral cancer lesions containing abnormal mitoses, we analysed 54 of them by immunohistochemical techniques for the presence of HPV structural antigens and correlated the results with their histology. Sixteen out of 19 lesions with abnormal mitotic figures (MFs) and 15 of the 25 lesions with normal MFs contained the HPV antigen. However, 9 of the 11 koilocytotic lesions with abnormal MFs and 13 of the 17 lesions with normal MFs were HPV antigen-positive. The nature of mitosis was not influenced by the grades of koilocytosis. No correlation of HPV antigen positivity and severity of the oral carcinomas was observed.

Evaluation of pulmonary hypertension in chronic rheumatic mitral regurgitation.

The incidence of pulmonary arterial hypertension (PAH) in 39 patients with angiographically proven chronic rheumatic mitral regurgitation (MR) is reported. The overall incidence of PAH were found to be 76.9%. There were 51.3% patients with mild, 15.4% with moderate and 10.2% with severe PAH. Pulmonary arterial hypertension was present in 93% of patients below 20 years of age. Clinical and radiological assessment of PAH did not show any correlation with the haemodynamic data. Electrocardiographic right ventricular hypertrophy was seen in 4, and biventricular hypertrophy in 5 patients. All of them had moderate to severe PAH. Echocardiographic left atrial (LA) size showed an inverse correlation with mean pulmonary artery pressure (PAP) (p less than 0.001), r = 0.63). Presence of mid-systolic notch in pulmonary valve echoes indicated mean PAP more than 37mmHg (mean 54.1 +/- 19.1). Fifty-six percent patients with mid-systolic notch had moderate to severe PAH. Sixteen (94%) out of 17 patients with raised left ventricular end diastolic pressure had elevated mean PAP, and 30% of them had moderate to severe PAH. This data shows that pulmonary hypertension is relatively common in our patients with chronic rheumatic MR, and that the severity of PAH correlates well.

Brain abscess in cyanotic congenital heart disease.

Twenty-eight patients of cyanotic congenital heart disease (CHD) complicated with brain abscess were reviewed. There were 22 males and 6 females with a mean age of 9.1 +/- 5.5 years. Tetralogy of Fallot was the commonest cyanotic CHD observed. Transposition of great arteries (PS), tricuspid atresia with VSD, PS and double outlet right ventricle with VSD comprised 25% of the cardiac lesions. Febrile illness was the commonest mode of presentation (42.86%). Frontal lobe was the commonest site of abscess localization (37.5%) followed by parietal lobe (32.5%). Multiple abscess were seen in 32.14% and in 35.7% the pus was sterile on culture. Twelve patients died (mortality -42.8%), and autopsy reports were available in 6. Infective endocarditis was suspected in 7 on clinical grounds, while at autopsy, out of 6 only 2 had evidence of right-sided endocarditis. There was no correlation of mortality with age, sex, type of micro-organism, site of abscess localization and the nature of heart disease. Multiple abscesses, features of raised intracranial tension and associated meningitis/ventriculitis predicted a grim outcome.

Development of splenoadrenorenal shunts after obliteration of esophageal varices by endoscopic sclerotherapy.

We present three patients with portal hypertension in whom large splenoadrenorenal shunts developed after obliteration of esophageal varices by endoscopic sclerotherapy.