Bedabrata Mukhopadhyay

Free radicals and antioxidant status in chronic osteomyelitis patients: a case control study.

INTRODUCTION Osteomyelitis (OM) is a local or generalized infection of the bone and bone marrow which may be multifactorial in its causation. Chronic infection is characterised by sequestrum and involucrum formation. AIM The present study has been carried out for assessing the oxidative stress in chronic OM by measurement of serum oxidants {such as malondialdehyde (MDA), protein carbonyl (PC), nitrite} and the serum antioxidants {such as ascorbic acid, superoxide dismutase (SOD), ceruloplasmin (Cp), blood glutathione} by spectrophotometric method. MATERIALS AND METHODS This was a case control study. About 5 ml of venous blood was collected for the estimation of biochemical parameters. This study comprised of 50 OM patients diagnosed at SSLH Hospital, Varanasi and 50 healthy ages (15-35 y) and sex matched individuals. RESULTS Significantly increased (p<0.0001) levels of serum oxidants and significantly decreased (p<0.0001) levels of all serum antioxidants except ceruloplasmin indicated significantly increased (p<0.0001) levels in response to infections in chronic OM patients as compared to the healthy controls. CONCLUSION These results suggest that there occurs an imbalance between oxidants and antioxidants, especially an increase in oxidative stress, as measured by the levels of the parameters: serum MDA, serum protein carbonyl and serum nitrite.

Free radicals and antioxidants status in neonates with congenital malformation

Background: Several studies using animal models have shown that oxidative stress during pregnancy may play an important role in causing birth defects. Congenital anomalies affect an estimated 270,000 newborns who die during the first 28 days of life every year from different birth defects. Hence, at present many research works are going on to reduce the infant mortality from congenital anomaly. [1] Objective: The objective was to measure the oxidant and antioxidant level in the serum of newborn babies with the congenital anomaly and compare these levels with age and sex matched normal neonates. This is to identify any role of oxidative stress in the causation of congenital anomaly. Materials and Methods: This case-control study included 159 participants: 106 newborns with the congenital anomaly and 53 healthy newborns. The markers of oxidative stress like serum malondialdehyde (MDA) level, protein carbonyl (PC) level, and the activity of antioxidants such as Vitamin C, glutathione were measured in both cases (neonates with congenital anomaly) and controls (normal healthy neonates). These parameters were statistically compared. Results: MDA levels and PC levels were significantly higher (P < 0.0001), and Vitamin C and reduced glutathione levels were significantly lower (P < 0.0001), in newborns with congenital malformation than in healthy newborns. Conclusions: Increased lipid peroxidation and protein carbonylation might play an important role in the pathogenesis of congenital anomaly. Impairment of the free radical/antioxidant balance is leading to increased free radical damage in neonates with congenital malformation.

Correlation of Oxidative Damage with Pro-Inflammatory Markers (IL-6, TNF-α) in Meningocele.

INTRODUCTION Oxidative damage induces alteration in the status of pro-inflammatory markers like IL-6 and TNF-α in meningocele. The study was performed with estimation of the levels of MDA (Malonyldialdehyde), SOD (Superoxide dismutase) taken as oxidative damage markers and IL-6 (interleukin 6) and TNF-α (Tumour necrosis factor alpha) taken as inflammatory markers, in the serum of meningocele patients and age, sex matched normal neonates. Correlation among the different serum levels of MDA, SOD, IL-6 and TNF-α was determined. MATERIALS AND METHODS It is a case-control study, comprising of 153 participants: 101 newborns with meningocele and 52 healthy newborns. The study was conducted in the Department of Biochemistry, Institute of Medical Sciences, Banaras Hindu University, Varanasi, in collaboration with the Department of Paediatric Surgery and Department of Obstetrics and Gynecology, Sir Sunderlal Hospital, Banaras Hindu University, Varanasi. The study was conducted during the period of 2012 to 2014. Serum was extracted from blood collected from both groups i.e. meningocele patient group and healthy neonatal control group. The levels of MDA and SOD were determined by spectrophotometric method. IL-6 was determined by the Human IL-6 High Sensitivity ELISA Kit and TNF-α was determined by the Human TNF-α ELISA KIT. RESULTS The levels of MDA, TNF-α and IL-6 were found to be much higher and level of SOD was found lower in the patients with meningocele as compared to the normal healthy neonates. CONCLUSION Increased MDA (oxidative damage product), IL-6, and TNF-α (inflammatory marker) and low level of SOD shows an increased inflammatory response in Meningocele. Our study shows Negative Correlation between MDA and SOD in case & control groups, while a Positive Correlation between TNF alpha and IL-6 in control & case groups.

Cytohistological correlation in pituitary tumor and immunological assessment with the help of Ki-67

Background: Tumors of the pituitary gland and sellar region represent approximately 10–15% of all brain tumors. Pituitary adenoma (PA), the most common pathology of the pituitary gland, can be effectively subclassified only with the help of immunohistochemistry (IHC). This is important and needed for individual patient management. Aims and Objectives: The objective of the study was to analyze the importance of intraoperative imprint smear cytology and correlating with final histopathological diagnosis. Furthermore, to classify the different types of PA with the help of IHC, prolactin (PRL), adrenocorticotropic hormone (ACTH), and growth hormone (GH) and to predict the benign, atypical, or malignant nature of the tumor with the help of prognostic marker Ki-67. Materials and Methods: A prospective study was done in 34 cases. The patients whose pituitary gland samples are referred from the endocrine and the neurosurgery department to the pathology department for histopathological examinations were selected. We have studied the clinical features, radiology and touch imprint cytology, histopathology, and IHC with the help of PRL, ACTH, GH, and Ki-67 of PA over 2 years. Results: In our study, we had 32 cases of PA of 34 cases over a span of 2 years. We have seen that there is a correlation between cytological and histological diagnosis of the subtypes of PA in 62% cases, and the Kappa statistics show a moderate extent of agreement (Kappa - 0.320, 95% confidence interval = 0.031–0.609). Ki-67 when compared to the radiological grading showed a high degree of comparability (Chi-square test: P < 0.001). All cases with invasion had a higher Ki-67. On using the Fishers exact test, we found that the Ki-67 expression with GH-producing adenomas and ACTH-producing adenomas was comparable (P = 1.000) while in PRL-producing adenomas too this was not significant (P = 0.269). Conclusion: PA can be effectively classified with the help of IHC. Intraoperative cytology is important in diagnosing PA, but histopathology remains the gold standard in diagnosing and differentiating PA from other pathologies of the pituitary gland. The radiological grading together with immunological classification and the prognostic markers of Ki-67 is important in deciding the benign or atypical nature of the adenomas thus helping in better patient management.

Spectrum of meningioma with special reference to prognostic utility of ER,PR and Ki67 expression

Background: Meningiomas are the most common primary central nervous system neoplasms originating from the arachnoid cap cells and constitute between 13% and 26% of all intracranial tumors. Aims and Objectives: The aim of the study was to analyze the age-, sex-, and site-wise distribution of different histological patterns of meningiomas seen in our center and to assess the status of estrogen receptor (ER), progesterone receptor (PR), and proliferation marker Ki-67 in various grades of meningioma. Materials and Methods: A prospective study was done in 90 cases. Patients presented with symptoms of headache and seizure and underwent subsequent excision surgery at Neurosurgery Department were taken. We have studied histological typing and grading of the tumors, and immunohistochemical staining was done for ER, PR, and Ki-67. Statistical Analysis: Two-group comparison was done using Mann–Whitney U-test and Fishers exact test. Comparison of Ki-67 expression between Grade 1 and Grade 2 meningiomas was determined using Mann–Whitney U-test. Comparison of ER and PR status between different histological grades was done by Fishers exact test. Two-tailed P < 0.001 was considered statistically significant. Results: According to histological type, meningothelial meningioma is most common (38.8%) followed by transitional (22.2%). PR positivity is seen in 96.34% of Grade 1 tumors, and all Grade 2 tumors were PR negative (Fishers exact test P < 0.001). About 3.66% of Grade 1 and all Grade 2 tumors were positive for ER (Fishers exact test two-tailed P < 0.001). Mean Ki-67 labeling index (LI) was 2.57 ± 1.674 among Grade I tumors, 7.11 ± 1.084 in Grade II meningiomas. Conclusions: Most of Grade 1 meningiomas show PRs positivity and lack of ERs positivity. Meningiomas with higher proliferation index and negative PR are very likely to be Grade II or Grade III. Evaluation of ER, PR status, and Ki-67 labeling index (LI) with histological evaluation helps us in providing information about the biologic behavior of meningiomas.

Immunohistochemistry-based comparative study in detection of Hirschsprung's disease in infants in a Tertiary Care Center

Background: Hirschsprungs disease (HD) is the major cause of pediatric intestinal obstruction with a complex pattern of inheritance. The absence of ganglion cells along with an analysis of hypertrophy and hyperplasia of nerves in the nerve plexus of submucosa and muscularis mucosae is regarded as a potential hallmark for its diagnosis. Aims and Objectives: This study was undertaken to ascertain the (1) clinical profile, (2) mode of presentation, and (3) to compare the role of calretinin immunostaining with acetylcholinesterase in the diagnosis of HD. Materials and Methods: This prospective and observational study was conducted in the Department of Pathology, IPGME & R from June 2014 to May 2015. One hundred and four patients clinically and radiologically diagnosed with HD underwent surgery were included in the study. The data of every patient including age, sex, and presenting symptoms were recorded. Eventually, histopathological, calretinin, and acetylcholinesterase immunohistochemical examination were done. Results: Total numbers of cases studied were 104, which aged between 0 days and 365 days. Male preponderance (76.92%) was noted. The overall sensitivity, specificity, positive, and negative predictive value of acetylcholinesterase were 100%, 86.44%, 84.91%, and 100%, respectively. The concordance of detection of ganglion cells and nerve fibers, and thereby diagnosis of Hirschsprungs and non-HD using calretinin and the gold standard was statistically in strong agreement ((κ = 0.749, 95% confidence interval: 0.635–0.863). Conclusions: Calretinin stands out as the single and indispensable tool that differentiates HD from other mimickers.

Leydig cell tumor of testis in a child: An uncommon presentation

Leydig cell tumors (LCTs) are rare testicular tumors. Incidence is 1%–3% of all testicular neoplasms, bilateral in 10%. They are frequently hormonally active, leading to feminizing or virilizing syndromes. LCTs can be either pure or mixed with germ cell tumors or other sex cord-stromal tumors. Here, we are reporting a benign pure LCT in a 6-year-old boy presented with pseudopuberty.

Pancreatoblastoma an Unusual Occurrence of a Tumour in Paediatric Age Group: A Case Report.

Pancreatoblastoma, is rare exocrine malignant tumour of childhood. We are reporting a case of three-year-old child presented to our hospital suffering from vague abdominal pain for further examination and treatment. Clinical examination revealed only a palpable abdominal mass. CT Scan revealed a huge complex space occupying lesion 9.1x8.8x9.2cm with large central cystic degeneration and lobulated enhancing peripheral solid components with foci of calcification, seem to arise from body and tail regions of pancreas. Surgery was done and mass was removed. By histopathology and immunohistochemistry it was diagnosed as pancreatoblastoma. The prognosis is very good in paediatric age, lacking evidence of metastatic disease at first presentation. Therefore early diagnosis is needed for specific treatment. The case is being reported because of its rarity.

Spectrum of Pediatric gastrointestinal tumors with special refer- ence to clinico-pathological findings.

Background: Alimentary tract malignancies in children are rare and the incidence is less than 1% of pediatric tumors. Rapid diagnosis is essential for early surgical intervention and adjuvant therapy in case of malignant tumors . Aims and Objectives: This study was undertaken to ascertain the clinical profile, anatomic distribution and histological subtypes of all pediatric gastrointestinal masses. Material and methods: This prospective study was conducted in tertiary care hospital from July 2010 to June 2015. Total 21 patients with clinically and radiologically detected gastrointestinal masses were evaluated. The data of every patients including age, sex and presenting symptoms were recorded. Resected specimens were obtained for histopathological examination and categorization was done according to WHO classification. Results: Among 21 cases, 16 were males (76.2%). The median age was 6 years. Maximum cases of benign lesions were mature teratoma (3 cases; 14.28%), followed by inflammatory myofibroblastic tumor (9.5%; 2 cases) and tuberculosis (9.5%; 2 cases) respectively. Other benign cases were pseudo lymphoma (9.5%; 2 cases), stomach GIST (4.8%; 1 cases) and carcinoid tumor (4.8%; 1 cases). Non- Hodgkin lymphoma (28.5%; 6 cases) was the most common malignancy.