Removal of Cr(VI) by magnetic iron oxide nanoparticles synthesized from extracellular polymeric substances of chromium resistant acid-tolerant bacterium Lysinibacillus sphaericus RTA-01.

BACKGROUND: Extracellular polymeric substances (EPS) from Cr(VI) resistant acid-tolerant biofilm forming bacterium (CrRAtBb) Lysinibacillus sphaericus RTA-01 was used for synthesis of magnetic iron oxide nanoparticles (MIONPs) in removal of Cr(VI). METHODS: MIONPs synthesized in EPS matrix were characterized by UV-Vis, DLS, ATR-FTIR, XRD, FESEM, HRTEM and VSM. Primarily, the synthesis of MIONPs was established by the formation of black-colored precipitate through surface plasmon resonance (SPR) peak in between 330 and 450 nm. RESULTS: The size of the spherical MIONPs with diameter range 13.75-106 nm was confirmed by DLS, XRD and FESEM analysis. HRTEM study confirmed the size of the MIONPs in the range of 10-65 nm. Moreover, the EDX and SAED confirmed the purity and polycrystalline nature of MIONPs. The ATR-FTIR peaks below 1000 cm-1 designated the synthesis of MIONPs. Also, the magnetic property of MIONPs was confirmed for separation from the aqueous solution. MIONPs were further checked for the adsorption of Cr(VI) with initial concentration range of 50-200 mg L-1. An adsorption isotherm and thermodynamic study were also carried out and the experimental data was best fitted in Langmuir isotherm model with maximum adsorption percent of 1052.63 mg g-1 of Cr(VI). Post interaction with Cr(VI), the surface characteristic of MIONPs in EPS matrix was evaluated by zeta potential, EDX, ATR-FTIR and XRD. CONCLUSION: This study ascertained the adsorption of Cr(VI) over EPS stabilized MIONPs whereas the zeta potential and XRD analysis confirmed the presence of reduced Cr(IV) on the adsorbent surface.

Study of Complete Haemogram and Iron Profile From Cord Blood of Newborn with Respect to Primigravida, Multigravida and Apgar Score.

Study of different parameters of cord blood usually reflects neonatal health status. One of the widely used system for assessing neonatal health is APGAR score. It is assed at 1 and 5 min from baby's birth. Immediate medical care may improve 5 min score of neonate who showed poor score at 1 min. The main objective of this study is to establish whether any correlation exists between complete hemogram and iron profile with APGAR score and gravid of mother. Cord blood was collected from 96 new born, delivered vaginally, mothers having no chronic medical disease. Different parameters of complete hemogram were assessed along with iron profile and statistical analysis was done by Graph pad Instat3 soft ware. Statistically significant correlation exists between APGAR score (5 min) and MCV (p = 0.005), MCHC (p = 0.016), nRBC (p = 0.002), platelet count (p = 0.001), RDW (p = 0.001). Statistically weak correlation exists between TLC (p = 0.08). Comparing complete blood count with gravid of mother by unpaired t test significant correlation was obtained for HCT (p = 0.035) and RDW (p = 0.03). Apgar score and complete hemogram from cord blood are both non-invasive procedure which help us to asses fetal wellbeing as well as requirement of immediate management. Further more studies are essential to establish the relationship.

Diagnostic and prognostic significance of different mucin expression, preoperative CEA, and CA-125 in colorectal carcinoma: A clinicopathological study.

BACKGROUND: Colorectal carcinoma (CRC) is the fourth most commonly diagnosed malignant disease worldwide, with over 1 million new cases and approximately 5,00,000 deaths each year. AIMS AND OBJECTIVES: This prospective observational study was done to study the clinicopathological characteristics of CRC including mucin stains and correlate the preoperative serum carcinoembryonic antigen (CEA) and cancer antigen (CA)-125 levels with the prognosis. MATERIALS AND METHODS: A total of 90 CRCs were included from December 2010 to June 2013. Detailed history and relevant clinical/radiological findings were noted in all clinically and/or radiologically suspected cases of CRC. Preoperative blood samples were collected for serum CEA and CA-125 level estimation. The mucin expression was evaluated with special stains. RESULTS: The combined Alcian blue-periodic acid Schiff (PAS) staining was positive for both stains in 68.88% cases indicating that both neutral and acidic mucins are increased in CRC. High preoperative serum CEA levels were seen in 82.22% cases, whereas preoperative serum CA-125 levels showed an increase in 20% cases. Higher levels of these tumor markers corresponded with higher TNM stage. CONCLUSIONS: Mucin evaluation in CRCs remains one of the valuable methods as mucinous variants correlate with worse prognosis. Preoperative serum CEA level assessment is an indispensible adjunct to the diagnosis and prognosis of CRC. However, preoperative serum CA-125 level measurement is not an efficient tool for prognostication in CRC and should not be recommended for routine use.

Histopathological study of adrenocortical carcinoma with special reference to the Weiss system and TNM staging and the role of immunohistochemistry to differentiate it from renal cell carcinoma.

BACKGROUND: Adrenocortical carcinomas (ACC) are rare tumors with an incidence of 1-2/million/year. They account for 0.05-0.2% of all malignancies. AIMS AND OBJECTIVES: This study was aimed to evaluate the Weiss system to diagnose ACCs and to compare it with TNM staging. The role of immunohistochemistry (IHC) was also evaluated to differentiate ACC from other differential diagnoses especially, renal cell carcinoma (RCC). MATERIALS AND METHODS: A total of 10 ACCs were included from April, 2000 to March, 2012. All the relevant information like weight, tumor size, gross features was recorded. Multiple sections were taken for histologic examination. Immunomarkers like vimentin, synaptophysin, Melan-A, calretinin, inhibin, EMA, cytokeratin, and Ki-67 were used. RESULTS: Out of 10 cases of ACCs (diagnosed by the Weiss system), the tumors were in TNM stage I (1 case), stage II (2 cases), stage III (5 cases), and stage IV (2 cases). The Weiss score in stages I-IV was 4; 5-7; 6-8; and 5-9 respectively. ACCs were positive for vimentin, inhibin, Melan-A, calretinin and negative for EMA and cytokeratin. Proliferative index (Ki-67/MIB-1) was ≥ 20 % (20-65%). CONCLUSION: Both the Weiss system and TNM staging are useful in predicting the malignant behavior and prognosis of ACC. Weight and tumor size, though originally not included in the Weiss system, are also important parameters. In lower stages (stages I and II), the Weiss score is low (4-7) while the score is high (6-9) when the tumor is in higher stages (stages III and IV). IHC plays a vital role to confirm the diagnosis and to exclude the possibility of RCC.

A comparative study of Hasford score and Sokal index in prognostication of the novo chronic myeloid leukemia patients and a search for new prognostic markers.

INTRODUCTION: Chronic myeloid leukemia (CML) is a common myeloproliferative disorder. Based on clinical and hematological parameters, two prognostic scoring systems, i.e., Hasford and Sokal index scoring systems are available to predict survival duration of CML patients on imatinib therapy. AIMS AND OBJECTIVES: Our study's objective is to compare Hasford score with Sokal index for the prognostication of de novo CML patients on therapy and find out new prognostic markers. MATERIALS AND METHODS: This is a retrospective study. The study population comprised 66 patients who were followed up for 60 months. For each patient, at presentation, scoring was performed as per Hasford and Sokal index and Philadelphia chromosome analysis was carried out by conventional cytogenetics. Thereafter, hematological parameters were assessed 3 monthly and conventional cytogenetics was done yearly. RESULTS: Out of these 66 patients, the number of patients belonging to low, intermediate and high risk categories are 21, 33 and 12 respectively by Hasford score and 12, 32 and 22 respectively by Sokal index. Eight patients, who had been categorized into high risk group by Sokal index but intermediate risk group by Hasford score, have shown better survival possibility as monitored by hematological and cytogenetic parameters. Ten cases, categorized into intermediate risk group by Sokal index but low risk group by Hasford score, is doing well till date. CONCLUSIONS: This study shows that Hasford score predicts survival of the patients better than Sokal index. However, multicentric study over a large population is needed to give the final verdict.

The Bethesda system for reporting thyroid fine needle aspirates: A cytologic study with histologic follow-up.

BACKGROUND: The Bethesda system for reporting thyroid cytopathology represents a major step towards standardization, reproducibility, improved clinical significance, and greater predictive value of thyroid fine needle aspirates (FNAs). AIMS: To elucidate the utility of the Bethesda system in reporting thyroid FNAs. MATERIALS AND METHODS: We retrospectively reviewed thyroid FNAs between April 2009 and March 2012, classified them using the Bethesda system, found out the distribution of cases in each Bethesda category, and calculated the malignancy risk for each category by follow-up histopathology. RESULTS: Of the 1020 FNAs, 1.2% were non-diagnostic, 87.5% were benign, 1% were atypical follicular lesion of undetermined significance (AFLUS), 4.2% were suspicious for follicular neoplasm (SFN), 1.4% were suspicious for malignancy (SM), and 4.7% malignant. Of 69 cases originally interpreted as non-diagnostic, 12 remained non-diagnostic after re-aspiration. In 323 cases, data of follow-up histopathologic examination (HPE) were available. Rates of malignancy reported on follow-up HPE were non-diagnostic 0%, benign 4.5%, AFLUS 20%, SFN 30.6%, SM 75%, and malignant 97.8%. CONCLUSIONS: Reviewing the thyroid FNAs with the Bethesda system allowed a more specific cytological diagnosis. In this study, the distribution of cases in the Bethesda categories differed from some studies, with the number of benign cases being higher and the number of non-diagnostic and AFLUS cases being lower. The malignancy risk for each category correlated well with other studies. The Bethesda system thus allows standardization in reporting, improves perceptions of diagnostic terminology between cytopathologists and clinicians, and leads to more consistent management approaches.

Immunocytochemistry: It's role in diagnosis of undifferentiated neoplasms by fine needle aspiration cytology.

BACKGROUND: Fine needle aspiration cytology (FNAC) is a rapid, cheap and reliable method for diagnosing any accessible lesion. However, there remains a group of malignant undifferentiated neoplasms, which can only be categorized with the help of immunocytochemistry (ICC). The categorization is important due to their vast difference in treatment and prognosis. AIM: To evaluate the effectiveness of ICC in categorizing the undifferentiated neoplasms diagnosed on routine FNAC smears. MATERIALS AND METHODS: Thirty six cases of undifferentiated neoplasms were selected from a group of total 78 cytology cases of undifferentiated tumors from different sites like head and neck, lymph node, soft tissue etc. These were then subjected to a panel of ICC markers based on the clinical and cytomorphological features. RESULTS: Of these, 21 were simple, ten were computerized tomography guided and five were ultrasound guided FNACs respectively. All the 78 cases were confirmed by histopathological examination and immunohistochemistry. Of the 36 cytological cases, final diagnosis correlated in 30 cases histologically. The six cases were incorrect either due to inadequate material on the smears (three cases) or false positive staining (three cases). CONCLUSIONS: Our study found that ICC is a sensitive and specific method for early and definitive diagnosis of undifferentiated neoplasms. However, selection of antibodies must be judicious to make it cost effective.

Atypical fibroxanthoma: an unusual skin neoplasm in xeroderma pigmentosum.

Xeroderma pigmentosum (XP) is a rare autosomal recessive disorder related to defective deoxyribonucleic acid (DNA) repair. Various cutaneous manifestations related to ultraviolet (UV) damage characterize the clinical course. Primary malignant cutaneous neoplasms like squamous cell carcinoma, basal cell carcinoma and malignant melanoma have been reported. Atypical fibroxanthoma is a rare dermal neoplasm occurring in UV-damaged skin. We report an unusual case of atypical fibroxanthoma in a 20-year-old male with XP.

Primary non-Hodgkin's lymphoma of breast with scalp involvement in follow-up--an uncommon presentation.

Primary non-Hodgkin's lymphoma of the breast is a rare tumour accounting for 0.04 to 0.5% of all malignant breast tumours. The aim of this case presentation is to report such rare entity with an uncommon presentation. A 48-year female presented with rapidly growing firm mass in right breast (upper outer quadrant) and fine needle aspiration cytology (FNAC) was performed for clinical suspicion of breast carcinoma. Cytological examination of smears showed large cells arranged discretely, though occasional small clusters were also seen. The cells had high nuclear-cytoplasm (N-C) ratio and prominent nucleoli. Based on cytomorphology, differential diagnoses of high grade non-Hodgkin's lymphoma and poorly differentiated carcinoma was made. A tru-cut biopsy was suggested for confirmation. Histologic examination revealed diffuse large cells (monomorphic type) with prominent nucleoli.The tumour cells were reactive for CD45, CD20, and negative for cytokeratin, CD30, CD3 and CD5. A histopathologic diagnosis of non-Hodgkin's lymphoma of diffuse large B cell lymphoma type was confirmed. The patient was treated with combined chemotherapy and radiotherapy. After one year, the patient developed a swelling in the scalp and proved to be diffuse large B cell lymphoma by tru-cut biopsy. Now, the patient was treated with chemotherapy alone. Two-year follow-up of the case was uneventful. Since FNAC is initial diagnostic tool for breast lesions, a differential diagnosis of breast lymphoma should always be kept in mind, especially in poorly differentiated malignant tumours. Such cases need to be confirmed by histopathology and immunohistochemistry.

Neonatal sepsis: Role of a battery of immunohematological tests in early diagnosis.

BACKGROUND AND OBJECTIVE: Worldwide, many neonates with sepsis die due to lack of early diagnosis. In this study we attempt to analyze the value of various immunological and hematological parameters, singly and in combination, for the diagnosis of neonatal sepsis, with the aim being to formulate guidelines for the early diagnosis of the condition. MATERIALS AND METHODS: In this prospective study, 62 patients having clinical suspicion of neonatal sepsis were evaluated with a battery of investigations. Neonates admitted for other causes and without clinical suspicion of sepsis were selected as controls (n=40). The tests included blood culture, hemoglobin level, total and differential blood count, absolute neutrophil count, ratio of immature to total neutrophil count (I/T ratio), micro-erythrocyte sedimentation rate (m-ESR), C-reactive protein (CRP), platelet count, serum IgM level, and plasma fibrinogen level. Patients were divided into proven cases (positive blood culture) and probable cases (negative blood culture). RESULTS: Positive blood culture was seen in 38 cases (61.3%). Raised m-ESR (>8 mm in the first hour) was seen in 63.2% of proven and 66.7% of probable cases. I/T ratio of ≥0.2 was seen in 63.2% and 58.3% of proven and probable cases, respectively. Morphological changes in neutrophils were detected in 68.4% of proven cases and 91.7% of probable cases. Positive CRP test (≥6 mg/l) was found in 84.2% of proven cases and 100% of probable cases. Raised serum IgM, leucopenia, and neutropenia were seen in a small number of patients (11%-37%). Raised fibrinogen level (>400 mg/l) was seen in patients as well as in controls. CONCLUSIONS: The four useful tests that we identified were m-ESR, I/T ratio, morphological changes in neutrophils, and CRP; and role of these tests in early diagnosis of neonatal sepis were statistically significant (P<.05). The most sensitive test was CRP (84%) and the most specific test was m-ESR (94%). A combination of three or all of these four tests was highly specific (95%-100%).

Primary pediatric gastrointestinal lymphoma.

BACKGROUND: Primary non-Hodgkin's lymphoma (NHL) of the gastrointestinal (GI) tract is the most common extranodal lymphoma in pediatric age group. Yet, the overall incidence is very low. The rarity of the disease as well as variable clinical presentation prevents early detection when the possibility of cure exists. MATERIALS AND METHODS: We studied six cases of primary GI NHL in pediatric age group with reference to their clinical presentation, anatomic distribution and histopathologic characteristics. RESULTS: All were males except one. Intestinal obstruction was the presenting feature in 50%. Half the cases showed ileocaecal involvement, while large bowel was involved in 16%. Histology showed four cases of diffuse large B-cell lymphoma (DLBCL), one case of Burkitt lymphoma, and one Burkitt-like lymphoma. Immunohistochemistry for Tdt, CD20, CD3, CD30, bcl2, bcl6 confirmed the morphological diagnosis. CONCLUSION: Pediatric GI lymphoma commonly involves the ileocaecal region and presents with intestinal obstruction. A higher prevalence of DLBCL is found compared to other series. A high proliferative index is useful in differentiating Burkitt-like lymphoma from DLBCL.

Histologic pattern, bilaterality and clinical evaluation of 957 ovarian neoplasms: a 10-year study in a tertiary hospital of eastern India.

OBJECTIVE: The aim was to study the distribution of morphological pattern of benign and malignant ovarian neoplasms in different age groups in eastern India and to determine the likelihood of bilateral involvement in different morphologic subtypes. MATERIALS AND METHODS: 957 cases of ovarian tumors were studied over a period of 10 years (from January 2001 to December 2010). RESULTS: Most of the benign tumors occurred between 20 and 40 years of age, while the malignant lesions presented commonly between 41 and 50 years. The most common histological types were serous cystadenoma (29.9%), followed by mature teratoma (15.9%) and mucinous cystadenoma (11.1%). Major proportion of malignant ovarian tumors was contributed by surface epithelial tumors (60.9%). Serous cystadenocarcinoma was the predominant malignant tumor (11.3%). Metastatic tumors were found to involve the bilateral ovaries in 72%, while 49.5% of malignant serous tumors were bilateral. Borderline serous tumors showed bilateral involvement more commonly (27.4%) than borderline mucinous tumors (15.7%). Most of the malignant tumors presented as stage III (60%) or stage II (20%) disease. The overall survival rate was 85% for stage I tumors, 65% for stage II, 30% for stage III and 15.5% for stage IV tumors. CONCLUSION: We noted an earlier age at presentation of malignant tumors. Mature teratoma was found to be the second most common benign tumor (after serous cystadenoma). We also noted a lower percentage of endometrioid tumors. Lower number of stage IV tumors was noted, with a significant number of malignant ovarian tumors presenting at an earlier age.

Distinction of phyllodes tumor from fibroadenoma: Cytologists' perspective.

BACKGROUND: Fibroadenomas and phyllodes tumors may have similar cytological appearances. However, a detailed study of cytomorphology of stromal elements may be helpful in differentiation. AIM: To evaluate the cytological features of phyllodes tumor in our study with special reference to features that can help distinguishing it from fibroadenoma. MATERIALS AND METHODS: The archival materials of our hospital were searched from January 2006 to January 2009 for histopathologically-diagnosed cases of phyllodes tumor. The cases in which previous cytopathology smears were available were included in the study. The cytomorphology of 10 such cases were compared with 25 cytologically-diagnosed and histopathologically-confirmed cases of fibroadenoma. RESULTS: The size, cellularity of stromal fragments, and the proportion of spindle cells in the background are important features in such differentiation.

The pattern of malignant epithelial tumours of deep seated organs in young adults.

Epithelial malignancy is common in older age group but it is also an Important cause of morbidity and mortality in young adults. The reports of deep seated carcinomas diagnosed in a one-year time period by CT guided FNAC in a medical college of West Bengal were analysed. Of total 447 malignant lesions of lung diagnosed by aspiration cytology 15 cases (3.3%) occurred in 15-39 years age group.