An Atypical Case of Acrokeratosis Verruciformis of Hopf Responding to Combined Acitretin and Cryotherapy.

Acrokeratosis verruciformis of Hopf (AKVH) is a rare genetic skin condition associated with an ATP2A2 gene mutation, thus affecting keratinization. Classically, AKVH appears in childhood over acral sites as symmetrical, flat, verruca plana-like lesions with an autosomal dominant inheritance, while sporadic cases affect atypical sites in adulthood. As this entity can closely mimic other verrucous skin conditions, identifying characteristic histopathological changes is essential to make a diagnosis in the absence of genetic studies, especially in resource-poor countries. This is the first reported case of AKVH from North-East India clinically mimicking extensive verruca vulgaris in an adult with a possible sporadic occurrence. AKVH is usually difficult to treat and superficial ablation is the treatment of choice. However, this case highlights the role of cryotherapy with acitretin in the management of AKVH with a rapid response.

Comparative Vision of Nonlinear Thermo-Optical Features and Third-Order Susceptibility of Mechanically Flexible Metallosupramolecular Self-Repairing Networks with Isomeric Organic Acids.

Two self-healing-type supramolecular Ni(II)-metallogels are achieved. The choice of proper low-molecular-weight organic gelators such as trans-butenedioic acid (i.e., trans-BDA) and cis-butenedioic acid (i.e., cis-BDA) and triethylamine in N,N'-dimethylformamide solvent facilitates the metallogelation process. Through rheological investigations the mechanical robustness and viscoelastic properties of synthesized metallogels are explored. An in-depth exploration of thixotropic behavior also supports their self-healing features. Notably, distinct variations in morphologies of metallogels are also ascertained through field emission scanning electron microscopy studies. Furthermore, the existence of versatile noncovalent supramolecular interactions operating throughout the metallogel network is clearly revealed via Fourier transform infrared spectroscopy. Electrospray ionization-mass studies also explore the construction protocol of individual Ni(II)-metallogels. The Z-scan measurements with a 532 nm continuous wave laser were employed to unveil the nonlinear thermo-optical response of two synthesized self-healing metallogels, i.e., trans-BDA-TEA@Ni(II) and cis-BDA-TEA@Ni(II). Crucial parameters like the nonlinear refractive index, nonlinear absorption coefficient, thermo-optical coefficient, and third-order susceptibility of these metallogels are obtained. Metallogels show negative signs for the nonlinear refractive index and the nonlinear absorption coefficient. The real parts of the third-order susceptibility for these metallogels are much greater than the imaginary parts (i.e., χR(3) > χI(3)), making such metallogels very promising for all optical-switching applications.

Comparative outcomes of the voltage-dependent current density, charge transportation and rectification ratio of electronic devices fabricated using mechanically flexible supramolecular networks.

In this study, we report the synthetic method of two distinct supramolecular metallogels, namely Mn-BDA and Cd-BDA, using Mn(II) acetate tetrahydrate, Cd(II) acetate dihydrate and butane-1,4-dicarboxylic acid (BDA). DMF, a polar aprotic solvent, was immobilized in both metallogel-networks for their synthesis. The metallogelation of Mn-BDA was successfully attained through the instant mixing of a Mn(II)-source and BDA in DMF solvent media. By applying ultrasonication, a Cd-BDA metallogel was prepared. The stoichiometry of gel-forming components concerning metal salts and the LMWG are accountable to obtain respective stable metallogels. Rheological parameters such as storage modulus (G') and loss modulus (G'') explored the mechanical flexibility of the synthesized metallogels through amplitude and angular frequency sweep experiments. Both the metallogels possess significant mechanical stability, which was determined by monitoring diverse gel-to-sol transition shear strain values (γ%). Distinctive morphological visualizations of both of these metallogels (i.e., Mn-BDA and Cd-BDA) were made via field emission scanning electron microscopic (FESEM) studies, demonstrating a fibrous inter-connected network with a hierarchical self-assembled arrangement for Mn(II)-based metallogels and a typical stacked-flake-like association with hierarchical motifs for Cd(II)-based metallogels. EDAX elemental mapping substantiated the presence of metallogel-forming agents such as individual metal acetate salts, BDA acting as a low-molecular weight gelator, and gel-immobilized solvents such as DMF. Furthermore, Fourier transform infrared spectroscopy and ESI-mass spectroscopy were performed for both these supramolecular metallogels. FT-IR spectroscopic and ESI-mass spectroscopic results clearly substantiate the possible non-covalent supramolecular interactions among basic molecular repeating moieties, i.e., butane-1,4-dicarboxylic acid (the low-molecular weight gelator), individual metal salts and gel-immobilized polar aprotic solvent DMF for the construction of distinct stable supramolecular metallogel-systems. The semiconducting property of the fabricated metallogels was investigated. Two Schottky diodes (SDs) composed of ITO/Cd-BDA/Al and ITO/Mn-BDA/Al in a sandwich pattern with Al serving as the metal electrode were fabricated. Both these metallogel-based devices effectively offer significant semiconducting diode features with non-linear J-V characteristics. The non-ohmic conduction protocol of the fabricated metallogel-based devices was explored. Mn-BDA and Cd-BDA metallogel-based fabricated devices have rectification ratios of 6.67 and 23.50, respectively. The gel-based diode performances were examined by observing the voltage-dependent current density, charge transportation and rectification ratio.

Capecitabine and oxaliplatin induced Steven-Johnson syndrome following nivolumab in a patient of metastatic esophageal carcinoma.

Stevens-Johnson syndrome presents as mucocutaneous blistering and sloughing, which may follow a devastating clinical course. Although Stevens-Johnson syndrome has been reported following the administration of anticancer drugs, only a few cases induced by cytotoxic anticancer drugs, administered after immune checkpoint inhibitors, have been reported. The present report describes a case of Stevens-Johnson syndrome caused by capecitabine and oxaliplatin (CAPEOX) combination chemotherapy, in a patient with esophageal squamous cell carcinoma, who had been previously treated with nivolumab.

Impact of COVID-19 on Cancer Patients: An Experience From a Tertiary Care Center in Northeast India.

INTRODUCTION: The COVID-19 pandemic affected the healthcare system worldwide. Cancer patients and oncologists faced challenges equally in the context of the pandemic. The present study was undertaken to assess the impact of COVID-19 on cancer patients, encompassing infection source, care type, treatment delays, and infection outcomes. MATERIALS AND METHOD: This single-center retrospective study was conducted between March 2020 and January 2022 at North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, India. It examined COVID-19 cases in cancer patients with positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcription-polymerase chain reaction (RT-PCR) results. Data collection included demographics, clinical details, COVID-19 specifics, treatment delays, and infection outcomes. RESULT: In our study of 9,854 oncology patients' visits, 26 (0.26%) tested COVID-19 positive by RT-PCR, aged three to 70 years with a male-female ratio of 1:1.67. Twenty-three percent had comorbidities, mainly hypertension. Gastrointestinal cancers (30.8%) and hepatobiliary origin (15.5%) were common. Most patients (69.2%) had stage IV cancer, and 34.6% aimed for curative treatment. The majority of the patients (76.9%) were community-acquired, and the rest (23.1%) contracted during hospital stay. Fever (34.5%) and asymptomatic infection (30.8%) were common presentations. Six (23.1%) comorbid patients required ICU care. Median treatment delay was three weeks, with one COVID-19-related death (3.8%) and six cancer-related deaths. On follow-up, 19.2% had stable disease, 7.7% partial response, 7.7% recurrence, and 23.1% had progression. CONCLUSION: Amid the pandemic, cancer patients safely received treatment. Mild cases were managed at home. Poor outcome was found in comorbid, severe COVID-19 cancer patients. However, the impact of treatment delays on long-term oncological outcomes needs further study.

Renal Thrombotic Microangiopathy: A Complication of Paediatric Systemic Lupus Erythematosus That Requires Attention.

Systemic lupus erythematosus (SLE) is a multi-system disorder with a variety of clinical presentations. A wide range of renal vascular lesions (VL) is described predominantly in adult patients. The exact prevalence of renal VL in the pediatric SLE (pSLE) population is yet to be determined. A 10-year-old female patient with lupus nephritis (LN) presented with deteriorating kidney function. An exhaustive array of clinical-biochemical and pathological evaluations resulted in a diagnosis of class IV LN with thrombotic microangiopathy (TMA) associated with malignant hypertension and hypocomplementemia. Renal VL is overlooked or underreported in SLE patients, as it is neither accorded much importance in the International Society of Nephrology/Renal Pathology Society (ISN/RPS) classification nor in the activity and chronicity scoring. The TMA lesions in LN patients can be managed following the recently devised PLASMIC score; hence, reporting such VL has therapeutic implications.

Natural Killer Cell Count in Systemic Lupus Erythematosus Patients: A Flow Cytometry-Based Study.

Background Natural killer cells (NK cells) are important mediators of innate immune regulation and literature has shown that they have a role in shaping the adaptive immune system. Objective The present study was undertaken to analyze the NK cell count in systemic lupus erythematosus (SLE) patients as compared to that of controls. Materials and methods Safety of Estrogens in Lupus Erythematosus National Assessment SLE Disease Activity Index (SELENA-SLEDAI) score was assessed in 32 SLE cases. CD3(-) cells were identified as NK cells on flow cytometry, and then their subsets CD56(+) and CD16(+) cells were identified compared to 30 healthy controls. Receiver Operating Characteristic (ROC) curve analysis was performed on NK cells to attempt to determine a cut-off point. Results The CD3(-) NK cells, including the percentages of CD56(+) and CD16(+), were significantly (p<0.001) reduced in SLE patients (12.35%, and 18.7%) as compared to controls (24.67%, and 46.6%). On ROC curve analysis, cut-off values <481/cumm with sensitivity of 86.7% and specificity of 84.4% for CD3(-) NK cells (p<0.001), <23% with 60% sensitivity and 75% specificity for CD56(+) NK cells (p<0.001), and <29% with sensitivity of 70% and specificity of 87.5% for CD16(+) NK cells (p<0.001) were noted. Subsets of NK cells showed no association with the clinicopathological parameters like age, sex, disease activity, anti-nuclear antibodies (ANA), dsDNA, absolute lymphocyte count, and renal involvement. Conclusion NK cells, and their subpopulations of CD56(+) and CD16(+) cells, are decreased in patients with SLE as compared to controls.

Solvent-Driven Variations of Third-Order Nonlinear Thermo-Optical Features of Glutaric Acid-Directed Self-Healing Supramolecular Ni(II) Metallogels.

The generation of solvent-directed self-healing supramolecular Ni(II) metallogels of glutaric acid (i.e., Ni-Glu-DMF and Ni-Glu-DMSO) is described in this article. Polar aprotic solvents like N,N'-dimethylformamide (DMF) and dimethyl sulfoxide (DMSO) are separately entrapped into the Ni(II)-acetate salt and glutaric acid-mediated networks to attain the semisolid flexible scaffolds. The gel nature of the fabricated materials is experimentally proven through different rheological tests such as amplitude sweep, frequency sweep, and thixotropic (time sweep) measurements. The self-repairing strategy and load-bearing features of the synthesized metallogel are studied in this work. The different supramolecular noncovalent interactions working within the soft scaffold are clearly explored. The formation strategy and the microstructural features of these synthesized metallogels are scrutinized through a Fourier transform infrared (FT-IR) spectroscopy study and field-emission scanning electron microscopy (FESEM) morphological analyses. The FT-IR spectroscopy observation displays a considerable amount of shifting of the infrared (IR) peaks of the xerogel samples of both the metallogels Ni-Glu-DMF and Ni-Glu-DMSO. The electrospray ionization (ESI)-mass spectroscopy result demonstrates the plausible construction of the metallogel network. In order to examine the nonlinear optical characteristics of the two synthesized self-healing metallogels Ni-Glu-DMSO and Ni-Glu-DMF, Z-scan measurements are carried out with a continuous wave (CW) diode-pumped solid-state (DPSS) laser at 532 nm. The nonlinear refractive index, nonlinear absorption coefficient, thermo-optical coefficient, and third-order susceptibility of these metallogels were evaluated by analyzing the experimental data from the Sheik-Bahae formalism. The nonlinear thermo-optical study reveals that these solvent-dependent metallogels show negative signs of nonlinear refractive index and nonlinear absorption coefficient. The figure of merit calculated for these compounds shows good agreement for their use in nonlinear photonic devices.

Exploration of Variable Solvent Directed Self-Healable Supramolecular M(II)-Metallogels (M = Co, Ni, Zn) of Azelaic Acid: Investigating Temperature-Dependent Ion Conductivity and Antibacterial Efficiency.

Molecular self-assembly assisted self-healing supramolecular metallogels of azelaic acid with cobalt(II)-, nickel(II)-, and zinc(II)-based metal acetate salts were successfully fabricated. Individually, N,N'-dimethylformamide and dimethyl sulfoxide were immobilized within these distinctly synthesized soft-scaffolds of metallogels to attain their semisolid viscoelastic nature. Rheological experiments such as amplitude sweep, frequency sweep, and thixotropic measurements were executed for these metallogels to ratify their gel features. The different extents of supramolecular interactions operating within these solvent-directed metallogels were clearly reflected in terms of their distinct morphological patterns as investigated through field emission scanning electron microscopy. Comparative infrared (IR) spectral properties of metallogels along with individual metal salts and azelaic acid were analyzed. These experimental data clearly depict the significant shifting of Fourier transform (FT)-IR peaks of xerogel samples of different metallogels from the gel-forming precursors. The networks present within the soft-scaffold are evidently illustrated by the electrospray ionization-mass experimental data. The temperature-dependent ionic conductivity studies with these solvent-directed versatile metallogel systems were investigated through impedance spectroscopy. The temperature-dependent impedance spectroscopic studies clearly demonstrate that the ion-transportation within the gel matrix depends not only on the types of cations but also on the dielectric properties of the immobilized solvents. The antipathogenic effect of these metallogel systems has also been explored by testing their effectiveness against human pathogenic Gram-negative bacteria Klebsiella pneumoniae (MTCC 109) and Vibrio parahemolyticus, and Gram-positive bacteria like Bacillus cereus (MTCC 1272). These gel soft-scaffolds show no significant cytotoxicity against both the human neuroblastoma cell line-SH-SY5Y and the human embryonic kidney cell line-HEK 293.

Prevalence of human papillomavirus infection in abnormal pap smears.

Objectives: This study was undertaken to study the prevalence of human papillomavirus (HPV) infection using the polymerase chain reaction (PCR) technique in abnormal cervical pap smears and to correlate the different cytological results with HPV infection. Material and Methods: A total of 1788 cervical pap smears of women more than 30 years of age conducted over a period of 1 year 3 months (June 2015-August 2016) were screened by liquid-based cytology. High-risk (HR)-HPV testing was performed by PCR in abnormal lesions. Inflammatory smears and some atypical squamous cells of undetermined significance (ASCUS)-reactive cases were excluded from HPV testing. Histopathological correlation was done wherever possible. Results: The overall prevalence of the intraepithelial lesions/malignancy was ASCUS. (ASCUS) - 79 (4.42%), atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion (ASC-H) - 10 (0.56%), low-grade squamous intraepithelial lesion (LSIL) - 26 (1.45%), high-grade squamous intraepithelial lesion (HSIL) - 15 (0.84%), squamous cell carcinoma - 5 (0.28%), and adenocarcinoma - 1 case (0.06%). Overall, 136 (7.60%) samples were classified as abnormal. Seventy-seven samples were included for HR-HPV testing - 20 ASCUS, 10 ASC-H, 26 LSIL, 15 HSIL, and 6 malignant cases. A control group of ten samples with normal cervical cytology within the normal limit (Control) (WNLc) was tested for HR-HPV. HR-HPV was detected in 20% of samples of the WNLc group, 45% of the ASCUS group, 70% of the ASC-H group, 73.07% of the LSIL group, 86.67% of the HSIL, and 83.34% of the samples in the malignant group. Overall, HR-HPV was detected in 68.83% of abnormal cervical pap smears. Conclusion: Our study shows that the percentage of HR-HPV-positive case increases with the severity of cytologic morphology. HPV had 4 times higher positivity in squamous intraepithelial lesion as compared to ASCUS.

Clinicopathological, Immunological, and Laboratory Parameters of Childhood Lupus Nephritis: A Study from Northeast India.

Background Lupus nephrtis in children is associated with high morbidity and mortality. The incidence of childhood systemic lupus erythematosus (SLE) ranges from 3.3 to 8.8/100000 children with a higher Asian preponderance. The predominance of SLE in female pediatric patients increases gradually with age to the values observed in adults. Objectives To assess the clinical, immunological, and histopathological spectrum of childhood lupus nephritis in northeast India and explore the relationship between clinical, biochemical, serological, and histopathological findings. Materials and Methods A retrospective descriptive study was performed over 8 years. Histopathology slides were reviewed by two pathologists, whereas other details were collected from patients' records. Statistical Analysis Statistical analysis was based on the chi-square test and a p -value < 0.05 was considered statistically significant. Results Fifty-three cases of lupus nephritis were included in the study. The patients' age ranged from 5 to 18 years with a mean age of 14.5 years and a female: male ratio of 6.5:1. Edema and hypertension were the commonest clinical presentations, whereas proteinuria was the commonest presenting laboratory parameter. Amongst all the immunological markers, dsDNA was the commonest. Histopathologically, predominantly study population belonged to class IV lupus nephritis. The patients with class IV showed a statistically significant correlation with proteinuria and hematuria at the time of diagnosis. Immunological markers, namely, ANA and anti-ds-DNA positivity were significantly associated with advanced renal histopathology. Conclusion cSLE in northeast India presents mostly as Class IV LN presenting mostly with deranged laboratory parameters and preponderance of various immunological markers and clinical presentations.

A Comparative Study of Immunofluorescence on Formalin-Fixed, Paraffin-Embedded Versus Fresh Frozen Kidney Biopsy.

Background Immunofluorescence techniques done on formalin-fixed, paraffin-embedded tissue can serve as salvage techniques in cases where immunofluorescence on the frozen section may not be adequate or available. The present study was undertaken to assess the diagnostic utility of paraffin immunofluorescence by proteinase K digestion on renal biopsy compared to fresh frozen immunofluorescence. Methodology The paraffin immunofluorescence by proteinase K digestion of paraffin-embedded renal biopsy (IF-FFPE) was standardized and compared with the immunofluorescence on fresh frozen tissue (IF-Frozen). A total of 50 cases of the native renal biopsy were included in the study, and their intensity for fluorescein isothiocyanate-labeled IgA, IgG, IgM, C3, kappa, and lambda was compared. Results A total of 50 cases of the native renal biopsy were included in the study, and their intensity for fluorescein isothiocyanate-labeled antibodies of IgA, IgG, IgM, C3, kappa, and lambda was compared. The difference of 2+ intensity of antibodies between IF-FFPE and IF-Frozen was noted mainly in lupus nephritis (15%), followed by IgA nephropathy (10%) and membranoproliferative glomerulonephritis (7%). IF-FFPE showed a sensitivity of 90.3%, 91.8%, 82.7%, 81.1%, 92.1%, and 94.6% for IgA, IgG, IgM, C3, kappa, and lambda, respectively, whereas specificity was 100% for IgA, IgG, C3, kappa, and lambda and 95.2% for IgM. Conclusions Immunofluorescence techniques done on formalin-fixed, paraffin-embedded tissue can serve as salvage techniques in kidney biopsies.

Xp11.2 Translocation Renal Cell Carcinoma: A Rare Renal Cell Carcinoma.

Translocation-associated renal cell carcinoma (TRCC) is a group of under-recognized malignant renal neoplasms owing to the unavailability of ancillary diagnostic tools and considering the fact that these tumors may histomorphologically mimic a heterogeneous group of neoplasms ranging from benign to malignant ones. Xp11.2 translocation-associated renal cell carcinoma is a disease of the young with a relatively less known prognosis owing to the rarity of such reported neoplasms. The histological appearance of bulbous tumor cells with abundant, vacuolated cytoplasm and the presence of psammomatoid bodies are clues to the diagnosis but are not entirely specific. The immunohistochemistry (IHC) finding of transcription factor E3 (TFE3) positivity is an important pointer, but the demonstration of Xp11.2 translocation by fluorescence in situ hybridization (FISH) serves as the confirmatory test. In our case report, we highlight the fact that a combined approach involving light microscopy, immunohistochemistry, and fluorescence in situ hybridization is the key to its diagnosis.

Suberic Acid-Based Supramolecular Metallogels of Ni(II), Zn(II), and Cd(II) for Anti-Pathogenic Activity and Semiconducting Diode Fabrication.

The importance of three synthesized metallogels of suberic acid distinctly with nickel, zinc, and cadmium acetate salts has been uncovered. For the creation of these soft materials, N,N'-dimethyl formamide was utilized as a source of the trapped solvent. The synthesized metallogels display intriguing viscoelasticity, and the interpretation of experimental parameters obtained from rheological results advocates the gel behavior. Microstructural analysis combined with energy-dispersive X-ray confirms the occurrence of individual gel-developing constituents as observed in different hierarchical microstructural patterns. Significant variations in microstructural arrangements with diverse extent of supramolecular non-covalent patterns inside gel networks were perceived through field emission scanning electron microscopy, atomic force microscopy, and transmission electron microscopy analyses. Fourier transform infrared and electrospray ionization-mass spectral analyses and powder X-ray diffraction analysis of metallogel samples of different gel-establishing ingredients help to investigate the possible supramolecular interactions dictating the metallogel scaffolds. Thermogravimetric analysis of xerogel samples was collected from the synthesized metallogels to understand the thermal stability. These gel materials were characterized by their potential antibacterial efficiency. The potency of metallogels against selective Gram-positive and Gram-negative bacteria was visualized via a spectrophotometer. Human pathogens like Klebsiella pneumoniae (MTCC 109), Salmonella typhi (MTCC 733), Vibrio parahaemolyticus, Bacillus cereus (MTCC 1272), Lactobacillus fermentum (NCDO 955), and Staphylococcus aureus (MTCC 96) are employed in this study. Apart from the biological significance, our metallogels demonstrate as incredible diode performance of fabricated semiconducting systems, which exhibit a considerable amount of non-linearity demonstrating a non-ohmic conduction mechanism at room temperature in dark conditions. Device fabrication was achieved from these metallogels employing the sandwich model with indium tin oxide-coated glass substrates/metallogel/Al structure.

Pediatric chronic myeloid leukemia in myeloid blast crisis.

Chronic myeloid leukemia (CML) accounts for 2-3% of childhood leukemias. About 5% of cases present in a blastic phase of CML which clinically and morphologically mimics more common acute leukemias of childhood. We report a case of a 3-year-old male who presented with gradual onset swelling of the abdomen and extremities along with generalized weakness. Examination revealed massive splenomegaly, pallor, and pedal edema. Initial workup showed anemia, thrombocytopenia, and leukocytosis (120,000/uL) with a blast percentage of 35%. Blasts were positive for CD13, CD33, CD117, CD34 and HLA-DR, and stained negative for Myeloperoxidase and Periodic Acid Schiff. Fluorescence in situ hybridization was positive for b3a2/e14a2 junction BCR-ABL1 transcript and negative for RUNX1-RUNX1T1/t(8;21), clinching the diagnosis of CML in myeloid blast crisis. The patient expired within 17 days of diagnosis and initiation of therapy.

A Retrospective Study of Frontal Fibrosing Alopecia from North-East India.

Background: Frontal fibrosing alopecia (FFA) is an important cause of scarring alopecia seen mostly in post-menopausal women but sometimes in pre-menopausal women and men. Although considered a variant of lichen planopilaris due to its histopathological characteristics, it has distinct clinical features and associations, which make it a unique entity. We hereby report a series of patients with FFA from North-East India. Aims and Objective: This study aimed to analyse the clinical and histopathological characteristics of FFA. Materials and Methods: We retrospectively analysed clinical records and histopathological features of FFA cases diagnosed in the Dermatology Outpatient Department from April 2013 to February 2023. Results: A total of 21 patients, who were diagnosed with FFA from April 2013 to February 2023, were analysed. Of these, 19 patients were female, with a male-to-female ratio of 9.5:1. The mean age of study population was 48.33 years. The majority of the patients were from the post-menopausal age group (15/19 females, 78.94%). Lichen planus pigmentosus (6, 28.57%) was the most commonly associated disease, followed by androgenetic alopecia and lichen planopilaris (2 each, 9.52%). The main histological features noted were perifollicular lymphocytic infiltrate in 18 (85.71%), followed by hydropic degeneration of basal follicular keratinocytes in 15 (71.42%) and melanin incontinence in 14 (66.66%) patients. Conclusion: Our study is the first study from North-East India focusing on the clinical presentation and histopathological characteristics of FFA. Furthermore, with respect to the recent development in FFA, our study attempted to determine the clinical significance of the proposed criteria for the diagnosis of FFA patients by Tolkachjov et al. (2018), viz. International FFA Cooperative Group Criteria (2021).

Clinicopathological Profile of Immunoglobulin A Nephropathy: A Study from Northeast India.

Immunoglobulin A (IgA) nephropathy is the most common primary glomerulopathy, with wide variation in its prevalence as well as clinical symptoms. Among the laboratory parameters, increased serum creatinine (SCr) levels, mean arterial pressure (MAP), and a decreased estimated glomerular filtration rate (eGFR) point toward poorer renal function. The Oxford 2016 scoring system for IgA nephropathy identified various histopathological variables, which serve as indicators of renal outcomes. There is a paucity of studies on the prevalence as well as the various clinical laboratory parameters correlating with the 2016 Oxford scoring system in northeastern India. The present study showed that IgA nephropathy was more common in the second and third decades, more prevalent in females, and mostly presented with edema. Nephrotic proteinuria, higher SCr, MAP, and decreased eGFR levels at presentation suggested poorer renal function in most subjects. The endocapillary hypercellularity, segmental sclerosis, tubular atrophy, and crescent variables of the 2016 Oxford scoring system showed a statistically significant relationship with various laboratory parameters at presentation.

Pediatric chronic myeloid leukemia in myeloid blast crisis

ABSTRACT Chronic myeloid leukemia (CML) accounts for 2-3% of childhood leukemias. About 5% of cases present in a blastic phase of CML which clinically and morphologically mimics more common acute leukemias of childhood. We report a case of a 3-year-old male who presented with gradual onset swelling of the abdomen and extremities along with generalized weakness. Examination revealed massive splenomegaly, pallor, and pedal edema. Initial workup showed anemia, thrombocytopenia, and leukocytosis (120,000/uL) with a blast percentage of 35%. Blasts were positive for CD13, CD33, CD117, CD34 and HLA-DR, and stained negative for Myeloperoxidase and Periodic Acid Schiff. Fluorescence in situ hybridization was positive for b3a2/e14a2 junction BCR-ABL1 transcript and negative for RUNX1-RUNX1T1/t(8;21), clinching the diagnosis of CML in myeloid blast crisis. The patient expired within 17 days of diagnosis and initiation of therapy.