Fungal Profile in Non-Invasive Fungal Sinusitis Using PCR in Post-Covid Scenario at a Tertiary-Care Centre in India.

OBJECTIVE: To detect the presence of Mucorales in the sinuses of healthy individuals and non-invasive fungal sinusitis patients. MATERIALS AND METHODS: Post FESS specimens with appearance suggestive of fungal ball or allergic mucin from 30 immunocompetent patients was sent for KOH smear, HPE, fungal culture and PCR. RESULTS: Fungal culture was positive for Aspergillus flavus in one specimen. PCR demonstrated Aspergillus (21), Candida (14), and Rhizopus in one case. HPE detected mainly Aspergillus in 13 specimens. No fungal presence in four cases. DISCUSSION: There was no significant undetected Mucor colonisation. PCR proved to be the most sensitive test in reliably detecting the organisms. No significant variation in the pattern of fungi were detected between COVID-19 infected and non-infected, but for the slightly higher detection of candida in the COVID-19 infected group. CONCLUSION: There was no significant presence of Mucorales in non-invasive fungal sinusitis patients in our study.

Malignant transformation in a sciatic plexiform neurofibroma in Neurofibromatosis Type 1 - imaging features that aid diagnosis.

A 41-year-old Asian male with NF1 and bilateral sciatic plexiform neurofibromas, presented with unintentional weight loss, increasing size of a left thigh mass associated with increasing pain and radiculopathy. MRI of the left thigh demonstrated imaging features suspicious of malignant transformation. The patient had a new left lung mass, demonstrating avid FDG uptake, raising suspicion for metastasis. Surgical resection of the left thigh mass confirms malignant transformation in a preexisting sciatic plexiform neurofibroma. Diagnosis of malignant transformation in a nerve sheath tumour can be challenging. MRI remains the main preferred imaging modality in the evaluation of these tumours. Imaging features that raise suspicion for malignant transformation are discussed. Although none of these are specific for malignant transformation, studies suggest that the presence of two to four of these features should prompt further investigations.

Nitrogen-doped graphene-like carbon nanosheets from commercial glue: morphology, phase evolution and Li-ion battery performance.

We report a two-step process to synthesize nitrogen-doped graphene-like carbon nanosheets (N-CNS), using commercially available ethyl cyanoacrylate based super glue as a carbon precursor. In this process, super glue is polymerized in aqueous NaCl solution, followed by carbonization at 1000 °C. Scanning electron microscopy (SEM) and high resolution transmission electron microscopy (HRTEM) studies show that the resultant material consists of micron-sized carbon nanosheets with a wrinkled morphology. HRTEM, X-ray diffraction (XRD), XPS and Raman spectroscopic studies confirm the formation of nanocrystalline and graphitic, nitrogen-doped carbon nanosheets. A detailed FTIR analysis of the degradation products of the polymeric precursor (polyethyl cyanoacrylate) at various heat treatment temperatures under an inert atmosphere reveals that the polymer undergoes a cyclization process similar to polyacrylonitrile (PAN) during carbonization to yield the N-CNS. The N-CNS used as an anode for a lithium-ion battery shows stable reversible capacities of 480 mA h g-1 for 100 cycles, which indicates that N-CNS are promising materials for lithium-ion battery applications. In a broader perspective, a unique chemical transformation of polyethyl cyanoacrylate to graphitic carbon may be useful to design new nanostructured carbons for a plethora of applications.

Counter Electrode Impact on Quantum Dot Solar Cell Efficiencies.

The counter electrode (CE), despite being as relevant as the photoanode in a quantum dot solar cell (QDSC), has hardly received the scientific attention it deserves. In this study, nine CEs (single-walled carbon nanotubes (SWCNTs), tungsten oxide (WO3), poly(3,4-ethylenedioxythiophene) (PEDOT), copper sulfide (Cu2S), candle soot, functionalized multiwalled carbon nanotubes (F-MWCNTs), reduced tungsten oxide (WO3-x), carbon fabric (C-Fabric), and C-Fabric/WO3-x) were prepared by using low-cost components and facile procedures. QDSCs were fabricated with a TiO2/CdS film which served as a common photoanode for all CEs. The power conversion efficiencies (PCEs) were 2.02, 2.1, 2.79, 2.88, 2.95, 3.78, 3.66, 3.96, and 4.6%, respectively, and the incident photon to current conversion efficiency response was also found to complement the PCE response. Among all CEs employed here, C-Fabric/WO3-x outperforms all the other CEs, for the synergy between C-Fabric and WO3-x comes to the fore during cell operation. The low sheet resistance of C-Fabric and its high surface area due to the meshlike morphology enables high WO3-x loading during electrodeposition, and the good electrocatalytic activity of WO3-x, the very low overpotential, and its high electrical conductivity that facilitate electron transfer to the electrolyte are responsible for the superior PCE. WO3-based electrodes have not been used until date in QDSCs; the ease of fabrication of WO3 films and their good chemical stability and scalability also favor their application to QDSCs. Futuristic possibilities for other novel composite CEs are also discussed. We anticipate this study to be useful for a well-rounded development of high-performance QDSCs.

Early Diagnosis of Intrahepatic Pseudoaneurysm during Radiofrequency Ablation using Contrast-Enhanced Ultrasound.

Radiofrequency ablation is one of the more established forms of local treatment in patients with unresectable tumours, including colorectal hepatic metastases. Complications associated with this method of intervention include thermal and mechanical injuries, including vascular insults resulting in haemorrhage or pseudoaneurysm formation. This is the first case demonstrating the detection of post-ablation acute pseudoaneurysm formation identified on the table using contrast-enhanced ultrasound (CEUS) and the subsequent successful management.

Failure of globe conservation in a case of adult onset retinoblastoma.

Adult onset retinoblastoma is a rare intraocular malignancy. The majority of the cases are treated with enucleation, due to late presentation and advanced-stage tumors. Here we report a case of a 30-year-old female who presented with an intraocular mass with exudative retinal detachment in her right eye. B-scan ultrasound and magnetic resonance imaging (MRI) confirmed the diagnosis of retinoblastoma. In an attempt to salvage the globe, she was treated with chemotherapy, which resulted in excellent regression of the tumor mass by the end of 8 months follow-up. The patient was followed-up regularly with focal treatment whenever necessary. Two years later, she developed a massive recurrence necessitating enucleation. Histopathologic examination revealed a moderately differentiated retinoblastoma with choroidal invasion. Attempt to salvage the globe in adult onset retinoblastoma with chemoreduction and focal therapy may be possible; however, regular long-term follow-up is necessary for recurrence which warrants timely intervention.

Late recurrence of tumor necessitating enucleation in an adult onset retinoblastoma.

Retinoblastoma is the most common primary intraocular malignancy in children. Although rare cases of adult onset retinoblastoma have been reported, the numbers are very few worldwide. We report a case where tumor recurrence following a quiescent period of 3½ years led to enucleation of the eye in an adult onset retinoblastoma. A 33-year-old female was noted to have an intraocular mass lesion in the inferonasal quadrant of the retina. Computed Tomography, B-scan and vitreous biopsy confirmed the diagnosis of retinoblastoma. The patient underwent plaque brachytherapy, cryotherapy, and laser indirect ophthalmoscopy which resulted in complete regression of the tumor mass with no areas of activity. At the last follow up 3½ years after the treatment the right eye showed anterior chamber infiltration with a tumor-like mass. Fundus examination showed vitreous hemorrhage, vitreous seedings and a small focus of tumor reactivation. B-scan, ultrasound biomicroscopy and MRI confirmed the mass lesion. In view of the tumor infiltrating the anterior chamber and involving the ciliary body prompt enucleation of the right eye was performed. The diagnosis of retinoblastoma was confirmed by histopathology. It is important that even after complete regression of the tumor frequent surveillance with fundus examination is necessary to detect early recurrences and to institute prompt management.

Clinicopathological correlation of choroidal melanoma in Indian population: A study of 113 cases.

AIM: To correlate the clinical presentation, tumor characteristics, and histopathological findings of choroidal melanoma in the Indian population MATERIALS AND METHODS: A retrospective analysis of 113 patients of choroidal melanoma over a period of 10 years was done. Patient demography, clinical presentation, tumor characteristics, and histopathological findings were correlated. RESULTS: Among 113 patients histopathologically diagnosed with choroidal melanoma over 10 years, most were males. The mean age was 45.9 ± 14.84 years among which 6 (5.3%) patients were less than 20 years. Thirty-six (31.8%) patients were misdiagnosed. The mean basal diameter was 12.41 ± 1.4 mm. Mixed cell type was seen in 71 (63%) patients, while 28 (25%) patients had spindle cell type. Epithelioid cell type was present in 11 (10%) patients and necrotic cell type was seen in 3 (2%) patients. Enucleation was the primary treatment modality in 107 (94.6%) patients, while exenteration was done in 6 (5.3%) patients. Three patients with epithelioid cell type with orbital extension underwent exenteration. The mean follow-up period was 14 months. No mortality was reported at the end of 5 years in patients with longer follow-up. CONCLUSIONS: Malignant melanoma of the choroid is a rare occurrence. They can occur in younger age group and can be misdiagnosed. Mixed cell type is commonest. Diffuse tumors with epithelioid cell type are likely to have orbital extension.

Trace element concentration in groundwater, Tuticorin city, Tamil Nadu, India.

The aim of the present study is to investigate the pollution vulnerability of groundwater aquifers in the coastal regions of Tuticorin city, Tamil Nadu, India. Fourteen samples were analyzed to determine the concentration of trace elements (Pb, Zn, Cd, Hg, Cr and Cu) in the groundwater. Among the total samples six were collected from industrial areas and eight from non-industrial areas of Tuticorin city. The concentration of trace element ranges from 0.01 to 0.19 mg/kg(-1) for Pb, from 0.01 to 0.16 mg/kg(-1) for Zn, from BDL to 0.21 mg/kg(-1) for Cd, from BDL (Below Detection Limit) to 0.023 mg/kg(-1) for Hg, from 0.02 to 0.18 mg/kg(-1) for Cr and from 0.01 to 0.16 mg/kg(-1) for Cu. The trace element concentration in groundwater is higher than the WHO suggested maximum permissible limit except Zn and Cu.

Hydrogeochemical study of shallow carbonate aquifers, Rameswaram Island, India.

Groundwater quality assessment has been carried out based on physicochemical parameters (pH, EC, TDS, CO(3), HCO(3), Cl, SO(4), PO(4), NO(2), Ca(+2), Mg(+2), Na(+) and K(+)) and metal concentration in the Rameswaram Island from 25 bore wells. The Langelier Saturation Index of the groundwater shows positive values (63% samples) with a tendency to deposit the CaCO(3) in the majority of water samples. Scatter plot (Ca + Mg/HCO(3)) suggests carbonate weathering process, which is the main contributor of Ca(2+), Mg(2+) and HCO(3) ions to the water. Gibbs diagram suggests rock-water interaction dominance and evaporation dominance which are responsible for the change in the quality of water in the study area. NaCl and mixed CaNaHCO(3) facies are two main hydrogeochemical facies of groundwater. Mathematical calculations and graphical plots of geochemical data reveal that the groundwater of Rameswaram Island is influenced by natural weathering of rocks, anthropogenic activities and seawater intrusion due to over exploitation. Weathering and dissolution of carbonate and gypsum minerals also control the concentration of major ions (Ca(+2), Mg(+2), Na(+) and K(+)) in the groundwater. The nutrient concentration of groundwater is controlled to a large extent by the fertilizers used in agricultural lands and aquaforms. Comparison of geochemical data shows that majority of the groundwater samples are suitable for drinking water and irrigation purposes.

Validity of heart rate based nomogram fors estimation of maximum oxygen uptake in Indian population.

Maximal oxygen uptake (VO2max) during a graded maximal exercise test is the objective method to assess cardiorespiratory fitness. Maximal oxygen uptake testing is limited to only a few laboratories as it requires trained personnel and strenuous effort by the subject. At the population level, submaximal tests have been developed to derive VO2max indirectly based on heart rate based nomograms or it can be calculated using anthropometric measures. These heart rate based predicted standards have been developed for western population and are used routinely to predict VO2max in Indian population. In the present study VO2max was directly measured by maximal exercise test using a bicycle ergometer and was compared with VO2max derived by recovery heart rate in Queen's College step test (QCST) (PVO2max I) and with VO2max derived from Wasserman equation based on anthropometric parameters and age (PVO2max II) in a well defined age group of healthy male adults from New Delhi. The values of directly measured VO2max showed no significant correlation either with the estimated VO2max with QCST or with VO2max predicted by Wasserman equation. Bland and Altman method of approach for limit of agreement between VO2max and PVO2max I or PVO2max II revealed that the limits of agreement between directly measured VO2max and PVO2max I or PVO2max II was large indicating inapplicability of prediction equations of western population in the population under study. Thus it is evident that there is an urgent need to develop nomogram for Indian population, may be even for different ethnic sub-population in the country.

Clinicopathological Study of a Case of Unsuspected Retinoblastoma.

Retinoblastoma is the most common primary malignant intraocular tumor of childhood. It may present with atypical features, particularly in older children. The authors report a case of unsuspected retinoblastoma following evisceration in a 9-year-old girl who had previous pars plana vitrectomy in the affected eye.

Assessment of groundwater quality and hydrogeochemistry of Manimuktha River basin, Tamil Nadu, India.

Groundwater quality assessment study was carried out around Manimuktha river basin, Tamil Nadu, India. Twenty six bore well samples were analyzed for geochemical variations and quality of groundwater. Four major hydrochemical facies (Ca-HCO(3), Na-Cl, Mixed CaNaHCO(3), and mixed CaMgCl) were identified using a Piper trilinear diagram. Comparison of geochemical results with World Health Organization, United States Environmental Protection Agency, and Indian Standard Institution drinking water standards shows that all groundwater samples except few are suitable for drinking and irrigation purposes. The major groundwater pollutions are nitrate and phosphate ions due to sewage effluents and fertilizer applications. The study reveals that the groundwater quality changed due to anthropogenic and natural influence such as agricultural, natural weathering process.

Cytopathology of explanted intraocular lenses and the clinical correlation.

PURPOSE: To study the cytopathological features of explanted intraocular lenses (IOLs) and correlate the features with their clinical presentation. SETTING: Ocular Pathology Department, Medical and Vision Research Foundation, Sankara Nethralaya, Chennai, India. METHODS: The study comprised 61 explanted IOLs (48 posterior chamber IOLs and 13 anterior chamber IOLs) removed for the following reasons: pseudophakic bullous keratopathy (36), recalcitrant uveitis (7), retinal detachment (10), endophthalmitis (5), uveitis (7), IOL subluxation (2), and painful blind eye (1). The IOLs were stained with hematoxylin and eosin using a simple cytological technique. The cytopathological features were studied and correlated with the clinical presentations. RESULTS: The mean time of IOL explantation was 10.1 months after surgery. Twenty-one IOLs had granulomatous and nongranulomatous inflammations and 4, nongranulomatous inflammations. One IOL had fungal filaments on the surface. CONCLUSIONS: Intraocular lenses can produce both granulomatous and nongranulomatous inflammation. Granulomatous inflammation was the most common in this series. The surface of IOLs explanted because of intraocular infection may show infective agents.

Detection of mycobacterium tuberculosis by nested polymerase chain reaction in a case of subconjunctival tuberculosis.

PURPOSE: To highlight the importance of nested polymerase chain reaction (PCR) in the detection of Mycobacterium tuberculosis in a case of subconjunctival tuberculosis. METHODS: We report a case of a 60-year-old man with subconjunctival nodule in the right eye for duration of 6 weeks. Biopsy of the nodule showed a granuloma with extensive caseation necrosis. Ziehl Neelsen staining for acid-fast bacilli (AFB) was negative. However, because of a strong suspicion of Mycobacterium infection, PCR for M. tuberculosis genome was done, using the nested PCR technique. RESULTS: Polymerase chain reaction for M. tuberculosis showed amplification of Mycobacterium tuberculosis genome with the nested PCR technique. CONCLUSION: Our case indicates that PCR can be a valuable tool in the diagnosis of conjunctival tuberculosis from paraffin sections.

Immunolocalization and quantification of advanced glycation end products in retinal neovascular membranes and serum: a possible role in ocular neovascularization.

PURPOSE: Earlier studies have revealed the association of advanced glycation end products (AGE) with the pathogenesis of various micro and macro vascular complications. The purpose of the present study is to localize AGEs, namely carboxy methyl lysine (CML-AGE) and methyl glyoxal-derived AGEs (MG-AGE), in retinal neovascular membranes and to quantify them in serum samples. METHODS: Surgically excised retinal neovascular membranes and serum samples obtained from patients with diabetic retinopathy, Eales' disease and nondiabetics were studied. Immunolocalization of AGEs namely CML-AGE and MG-derived AGEs was done using avidin biotin complex method and quantification was done by enzyme linked immunosorbent assay (ELISA). RESULTS: CML-AGE immunoreactivity was detected in all cases of Eales' disease and 61% cases of diabetic retinopathy and none in idiopathic epiretinal membrane (ERM). MG-AGE immunoreactivity was observed in approximately 15% of diabetic retinopathy and none in Eales' disease and and idiopathic ERM. Quantification of AGEs in serum samples revealed statistically significant increased levels of MG-AGE in diabetes, in relation to nondiabetics with idiopathic ERM and CML-AGE in Eales' disease, in relation to diabetics and nondiabetics with idiopathic ERM. CONCLUSION: Results from this study suggest that AGEs formed through glycation and glycoxidation may play an important role in the development of retinal neovascularization. The immunoreactivity of CML-AGEs in neovascular membrane and its increased levels in serum suggest that inspite of the normoglycemic status, glycoxidation and lipid peroxidation due to oxidative stress may trigger retinal neovascularization in Eales' disease, while MG-AGEs in diabetic membrane and serum suggest the role of glycation. Thus the mechanism of neovascularization in different pathological conditions could be different.