Nitrogen and sulphur mustard induced histopathological observations in mouse visceral organs.

Nitrogen mustards (HN) and sulphur mustard (SM) are potent alkylating blister inducing chemical warfare agents. Single 1.0 LD50 dose produced a progressive fall in body weight from second day onwards in all groups of mustard agents exposed animals. Histological examination of spleen, liver skin and kidney revealed significant histopathological lesions in nitrogen mustards and sulphur mustard. These lesions include granulovascular degeneration with perinuclear clumping of the cytoplasm of hepatocytes and renal parenchymal cells. Renal lesions were characterized by congestion and hemorrhage. The maximum toxic manifestation were noted in spleen and skin of HN-3 exposed mice while sulphur mustard reported maximum toxicity in liver and kidneys. The study suggests both nitrogen mustards and sulphur mustard to be extremely toxic by percutaneous route based on histopathological observation and can contributed to earlier reported free radical generation by these toxicants.

Intestinal parasitosis among subjects undergoing cataract surgery at the eye camps in rural hilly areas of Nepal.

Present study investigated the intestinal parasitosis among 221 subjects undergoing cataract surgery (M: 129 and F: 92; aged 13-86 years) at the eye camps in three rural hilly districts (Ramechhap, Sindhupalchok and Dhading) in 2006. Stool samples collected in clean, dry, screw capped plastic containers were examined locally by direct smear technique and anti-parasitic drugs were distributed to parasite positive subjects. The remaining stool samples were fixed with 10% formal-saline, transported to Shi-Gan Health Foundation/Nat'l Inst of Trop Med and Public Health Research, Kathmandu and re-examined by formal-ether sedimentation technique. A total of 148 samples (66.9%) were positive for some kind of intestinal parasites (F: 68.5% and M: 65.9%; P > 0.05). Ramechhap (Manthali) and Sindhupalchok (Chautara) had higher positive rate (71.8% and 70.7%, respectively) than in Dhading (Salyantar) (60.0%) (P > 0.05). Tibeto-Burman (indigenous nationalities) ethnic group had highest positive rate (70.1%) compared with Indo-Aryan (64.7%) and Dalits (57.7%). Subjects without toilet (latrine) had marginally higher positive rate (69.7%) than those having toilet at their home (65.5) (P> 0 .05). Age was independent of positive rate. Vegetarians had marginally higher parasitic infection rate compared to their non-vegetarian counterparts. Helminths were more common than protozoa. Overall, hookworm was the commonest parasite detected. However, Ascaris was common in Dhading District. Entamoeba histolytica was most common among protozoa and was followed by Cyclospora and others.

Rapid rescreening of cervical smears by cytopathologists: experience at a WHO collaborating centre for research in cytology.

The conventional 10% random full rescreening of cervical smears has been criticized as a quality assurance measure as it is not scientifically based and tends to detect only a few false negative cases. Rapid rescreening (RR) of negative cervical smears seems to be a viable alternative, especially in developing countries, as it picks up more positive lesions, reduces the false negative rate and is cost effective. We performed rapid review on 12374 cervical smears received under a hospital based cervical cancer screening programme. An additional 498 lesions were picked up on RR including a sizeable number of low and high grade lesions as well as 2 malignant cases. Thus RR led to an increase in efficiency of our laboratory.

Presidential address.

PIP: During this graduation address at the International Institute for Population Sciences in Bombay, India's Secretary of Health and Family Welfare noted that India has achieved a sustained decline in fertility, but that additional efforts must be made to increase maternal age, lengthen birth intervals, and reduce the number of higher-order births. Women must be given greater access to family planning information and methods, to maternal health care, and to safe abortion. In particular, the estimated 30 million women with unmet need for contraception must be served. Infant survival, which is intimately linked with fertility reduction, has improved because of an increase in immunization. The success of the immunization program created the confidence to attempt the highly successful Pulse Polio Immunisation Programme in the past year, and the success of this program, in turn, has led to plans to carry out a week-long, country-wide health check-up of all 5-10 year old children. Additional efforts have been made to improve outreach, decentralize the Family Welfare Programme, eliminate target-setting, improve quality, and place family planning within the broader context of reproductive health.^ieng

Transthoracic (percutaneous) fine needle aspiration cytology diagnosis of pulmonary tuberculosis.

OBJECTIVE: The present study was carried out to assess the utility of transthoracic (percutaneous) fine needle aspiration (FNA) cytology in the diagnosis of pulmonary tuberculosis. DESIGN: During a period of 6 years (1985-90), 202 ultrasound and computerized tomography (CT)-guided transthoracic FNA of pulmonary lesions were performed. Review of smears available in 190 cases revealed 38 (20%) cases of pulmonary tuberculosis. Age of the patients ranged from 11 months-75 years with a median of 40 years. The common clinical diagnoses were malignancy (14 cases), tuberculosis (8 cases) and pneumonitis (7 cases). The sites of FNA were lungs in 36 cases and pleural based lesions in 2 cases. RESULTS: Epithelioid granuloma without necrosis (type 1 reaction) were observed in 4 (10.5%) cases. Epithelioid granuloma with necrosis (type 2 reaction) and necrosis without epithelioid granuloma (type 3 reaction) were seen in 17 (44.7%) cases each. The overall rate of AFB positivity was 45.8%. The rate of acid-fast bacilli (AFB) positivity in type 1, 2 and 3 reactions were 0%, 38.5% and 60.0% respectively. CONCLUSION: This study shows that transthoracic (percutaneous) FNA is a useful means for diagnosis of pulmonary tuberculosis, especially when the clinical and/or radiological features are non-specific or point towards malignancy rather than tuberculosis.

Efficacy of a hospital based cytology screening program.

From 1976 to 1986, a total of 117,471 women attending gynecologic outpatient departments of six hospitals in Delhi, India, were screened cytologically. The cytodiagnosis revealed 30,399 (25.9%) normal finding, 84,889 (72.3%) inflammatory changes, 1910 (1.6%) dysplasia of various grades and 213 (0.2%) malignant lesions. Of the 213 cases detected as malignant, clinical suspicion of cervical cancer was not present in 125 women (58.7%). Histologically malignancy was confirmed in 192 women (90.1%) of the 213 cytologically diagnosed malignant cases. The diagnosis revealed 94 (49.0%) as carcinoma in situ and the rest of the cases were invasive lesions. This was in contrast to only 5.2% (10/194) of cases with carcinoma in situ seen at the cancer clinic during 1983-1986 in one of the major collaborating hospitals of Delhi. The analysis of data according to age revealed that median age at detection of mild/moderate, severe dysplasia, carcinoma in situ (CIS) and invasive cancers was 34.0, 37.9, 38.6, and 47.8 years, respectively, indicating a latency period of one and a half decade from the onset of precursor lesions to invasive disease. Mass population screening in our country is not feasible in the near future and this may be true also for other developing countries. In its absence cytological screening of patients attending hospitals and maternity homes can give a large yield of early cervical cancers, which are curable.

Superficial and deep-seated tuberculous lesions: fine-needle aspiration cytology diagnosis of 574 cases.

Over a period of 2 yr (1987-1988), FNA smears in 574 cases were found to have cytologic features suggestive of or consistent with tuberculous lesions. The age of the patients ranged from 6 mo to 75 ye, with a median of 24 yr. The male to female ratio was 273:301. Sites of FNA were superficial lymph nodes (SLN) in 440 (76.7 percent) cases, superficial extranodal sites (SENS) in 50 (8.7 percent), both SLN and SENS in 7 (1.2%), the thoracic cavity in 16 (2.8%), and the abdominal cavity in 61 (10.6%). Cytologic features were described under 3 major cytologic patterns, i.e., type I: epithelioid granuloma without necrosis, type II: epithelioid granuloma with necrosis, type III: necrosis without epithelioid granuloma. Type I, II, and III reactions were observed in 181 (31.5%), 183 (31.9%), and 210 (36.6%) cases, respectively. The overall AFB positivity was 30.8%. The AFB positivities for type I, II, and III cytologic reactions were 5.4%, 32.0%, and 48.5%, respectively. The AFB positivity was low (less than 30.0%) in swellings of the body surface (23.8%) and abdominal organs (18.9%). High positivity (greater than 60.0%) was observed in lesions of the thorax (63.6%) and thyroid (62.5%).

Inflammatory lesions of the breast: diagnosis by fine needle aspiration.

Amongst 1061 breast lesions diagnosed by fine needle aspiration (FNA) over a period of 6 years (1985-1990), 128 were reported to be showing changes consistent with an inflammatory lesion. On review, the cytodiagnosis was found to be inaccurate in 31 cases. The cytological features of the 97 cases that were correctly reported are described in this report. The cytological diagnoses issued in these 97 cases were acute mastitis or breast abscess (57 cases) and tuberculous mastitis (30 cases). Non-specific chronic mastitis and miscellaneous conditions accounted for four and six cases respectively. Acid fast bacilli (AFB) were demonstrated in 28.0% of tuberculous mastitis cases and 10.0% of those diagnosed as acute mastitis or breast abscess. FNA cytology was found to be useful for the diagnosis of inflammatory lesions of breast and their classification, as only five out of 57 cases of acute mastitis/breast abscess and one out of 30 tuberculous mastitis cases were suspected on clinical grounds.

Tuberculous lymphadenitis: correlation of cellular components and necrosis in lymph-node aspirate with A.F.B. positivity and bacillary count.

Cytomorphologic features of tuberculous lymphadenitis cases as observed in lymph-node aspirates were analysed and correlated with AFB positivity and bacillary count. Cytologic features were categorized under three major groups, viz. epithelioid granuloma without necrosis, epithelioid granuloma with necrosis and necrosis without epithelioid granulomas. These three major groups showed a distinct trend in respect of their cellular constituents. While cases with appreciable lymphocytic and multinucleated giant cells component showed a significant decreasing trend, cases with neutrophilic infiltration showed an increasing trend (P less than 0.001). In the above three groups, 9.1 percent, 64.7 percent and 77.4 percent respectively showed AFB positivity, the difference being highly significant (P less than 0.001). All 14 cases with very high bacillary count (greater than 50 bacilli per 500 oil immersion field) were associated with necrosis and 71.4% of them neutrophilic infiltration. A univariate analysis revealed that in presence of lymphocytes, epithelioid cells and Langhan's giant cells, AFB positivity was significantly lower while the picture was just the reverse in presence of necrosis and neutrophilic infiltration (P less than 0.001). The odd's rations for all these variables were highly significant (P less than 0.001). However, a multivariate regression analysis revealed that necrosis was the only independent contributing factor towards AFB positivity.

Cadmium nephropathy in a freshwater fish, Puntius conchonius Hamilton.

Renal pathology was examined in a freshwater fish, Puntius conchonius, during a 12-week exposure to 500, 630, and 840 micrograms CdCl2/liter (1/25, 1/20, and 1/15 fractions of the 96-hr TLm, respectively). Multifocal tubular epithelial degeneration including severe vacuolation and nuclear pyknosis and karyorrhexis composed the most obvious lesions. The degenerative changes were found mainly in the proximal segments, while the distal segments and the collecting tubules and ducts remained unaffected. Collapsed and shrunken glomeruli and swollen Bowman's spaces were also frequently observed. The cadmium-exposed fish appeared heavily stressed and moribund. A comparison of the renal pathology with that of other fishes and mammals and possible mechanisms of cadmium nephropathy are discussed.

Branchial pathogenesis in a freshwater fish, Puntius conchonius Ham., chronically exposed to sublethal concentrations of cadmium.

Effects of sublethal concentrations, 630 and 840 micrograms/liter (0.05 and 0.066 fractions of the 96-hr LC50), of cadmium chloride on the gills of a freshwater fish, Puntius conchonius, were examined light microscopically during a 12-week exposure. The secondary gill lamellae showed disrupted epithelium, necrosis, accumulation of cellular debris, capillary congestion, and wilting of the pillar cell system. Hypertrophy and hyperplasia of chloride cells as well as partial or complete fusion of secondary lamellae also occurred in the Cd-exposed fish. Branchial lesions together with coagulation film anoxia are likely to result in serious respiratory distress and related tissue hypoxia.

Effect of organomercurial poisoning on the peripheral blood and metabolite levels of a freshwater fish.

This work evaluated the hematological and biochemical changes in the fish, Puntius conchonius, under experimental organomercurial poisoning. Long-term (8 weeks) exposure to 3.63 and 6.03 mg/liter methoxyethyl mercuric chloride (MEMC) (0.2 and 0.33 fractions of 96-hr LC50) led to morphological aberrations in mature erythrocytes including nuclear and cytoplasmic deterioration, vacuolation, chromatin condensation, and hypochromia. Immature erythrocytes showing membrane leakage were also encountered. Erythrocyte count and hemoglobin (Hb) were significantly lowered after 1 and 3 weeks followed by a marginal rise persisting upto 8 weeks. Differential leucocyte counts revealed significant thrombocytopenia, lymphocytosis, and neutropenia. Collateral evaluation of blood glucose and tissue glycogen levels revealed significant hyperglycemia as well as glycogen depletion in liver and brain. Heart glycogen content evinced a substantial increase after 5 and 8 weeks exposure.

Erythrocytic and leukocytic responses to cadmium poisoning in a freshwater fish, Puntius conchonius Ham.

Chronically sublethal concentrations of cadmium caused conspicuous hematological anomalies in the cyprinid fish, Puntius conchonius. Exposure to 0.63 and 0.84 mg/liter cadmium chloride (1/20 and 1/15 of 96-hr LC50) induced morphological aberrations in mature erythrocytes including cytoplasmic vacuolation, hypochromia, deterioration of cellular membrane, basophilic stippling of cytoplasm, clumping of chromatin material and extrusion of nuclei, and schistocytosis. Anomalous basophils and monocytes were also encountered though less frequently. Decreased erythrocyte counts, hemoglobin and hematocrit values were also associated with chronic cadmium poisoning. The mean corpuscular hemoglobin and mean corpuscular volume increased (30 days) but mean corpuscular hemoglobin concentration showed no obvious change. A significant thrombocytopenia (90 days), elevated small lymphocyte and basophil populations, and a mild neutropenia were manifested in the cadmium-exposed fish. Large lymphocytes were not significantly affected.