Search

Objective: To critically analyze the frequency and factors leading to hypocalcemia in Total/ Near Total thyroidectomy Methods: This descriptive case series study was conducted over period of one year by taking sample of 138 patients of simple multinodular goiter or carcinoma of thyroid who underwent total/near total thyroidectomy and patients who had serum calcium

Introduction: Nodes that are aberrant in their size, consistency, or number are referred to as lymphadenopathy. Study Duration: Current research was carried out at Surgery Department of Chandka Medical College (CMC) & Teaching Hospital, Larkana starting from March 2019 to September 2020. Subjects & Methods: After taking written informed consent, 162 patients was included in the study after fulfilling of the inclusion criteria. Chi square test was applied and P-value

Three new ferrocene-substituted aliphatic guanidines were successfully synthesized and well characterized by means of several analytical methods such as: FT-IR, 1H & 13C-NMR, Raman, atomic absorption spectroscopy (AAS), and elemental analysis. The amphiphilic nature of ferrocene-based guanidines has been evaluated by determining their critical micelle concentration (CMC) through tensiometry, and UV-visible spectroscopy. The results obtained through both the techniques are in good agreement with each other. It was observed that the alkyl chain length played a major part in determining the CMC in pure ethanol as well as in ethanol/water mixture. The quantum mechanical parameters such as: the energy of frontier molecular orbitals (EHOMO and ELUMO) and the Mulliken charge distribution on the optimized structures was determined using DFT/B3LYP method combined with 6-31G(d,p) basis set in the gas phase. The shift in the peak potential, current and absorption maxima of the studied ferrocenyl guanidines in the presence of DNA revealed that cyclic voltammetry coupled with UV-visible spectroscopy provided a prospect to elaborate the DNA interaction mechanism, a pre-requisite for the design of new anticancer agents and understanding the molecular basis of their action. The synthesized ferrocenyl derivatives exhibited good scavenging activity against 1,1-diphenyl-2-picrylhydrazyl radical (DPPH). These complexes were also scanned for their in vitro cytotoxicity against human carcinoma cell line (MCF-7) and a normal cell line (MCF-10A) by means of an MTT assay, thereby rendering G-18 as the most potent chemotherapeutic drug.

Introduction: Several studies have shown an association between prostate carcinoma (PCa) and certain viral infections, such as HPV, EBV, CMV, etc. Despite the evidence about the presence of the EBV in PCa tissues, it is unknown if the presence of EBV is associated with any distinct histopathological characteristics and/or survival advantages/disadvantages in patients with PCa. In this study, therefore, we analyzed the LMP-1 expression, and histopathological characteristics of EBV-positive and -negative PCa tissues, followed by the survival analysis in patients from the two groups.Material & Methods: LMP-1 expression was determined using immunohistochemistry in the EBV PCR-positive FFPE PCa samples. Subsequently, two key parameters for the characterization of PCa, i.e., Gleason scores and perineural invasion (PNI), along with intratumoral lymphocytes and stromal lymphocytic infiltration was studied in the EBV-positive and -negative PCa tissues. Lastly, the survival benefit analysis of EBV-positive and EBV-negative PCa patients was performed.Results: EBV LMP1 protein expression was found in 70.96% of EBV PCR-positive PCa tissues. Histopathological analysis showed significantly higher (pConclusion: In conclusion, the presence of EBV in the PCa tissues may lead to aggressive forms of cancer. Further studies with a larger sample size are required to strengthen the link between EBV, PCa prognosis, and survival.

The immune system plays a pivotal role in identification and clearance of tumor cells, but can also be counterproductive and enhance tumor progression. Presence of neutrophils in solid tumors, including the sixth most common cancer globally - head and neck squamous cell carcinomas (HNSCC), is associated with poor prognosis. Pro-inflammatory cytokines regulated by NF-κB promote extravasation of neutrophils into tissue; neutrophils are polarized to anti-tumor (N1) or pro-tumor (N2) phenotype through the action of various pathways, including TGF-β. The mechanism and role of neutrophil recruitment in HNSCC were explored this study. Neutrophils isolated from adult donors were co-cultured for 5 hours with conditioned media (CM) from HNSCC cells SCC-9 and Cal-27, and stained with TNF-α, ICAM-1, CCL2, CCL5 for analysis of neutrophil phenotype by flow cytometry. TGF-β blocking antibody was used to explore the role of TGF-β in polarization of neutrophils. Canonical and non-canonical TGF-β signaling pathway activation was also investigated in these neutrophils through western blots. Using HNSCC patient samples, qPCR was performed for expression of genes involved in apoptosis, epithelial-to-mesenchymal transition, metastasis, and neutrophil function. Following co-culture with 24-hour HNSCC CM, neutrophils begin to exhibit cell surface markers indicative of N2 phenotype, which is impacted by TGF-β blocking antibody. Neutrophils co-cultured with HNSCC CM exhibited altered expression of TGF-β mediators Smad2/3, p38 and Akt, which was abrogated with the addition of TGF-β blocking antibody indicating specificity of a TGF-β induced signaling. Gene expression analysis exhibited significantly higher expression of anti-apoptotic BCL2 and neutrophil function marker alpha defensin 1 in HNSCC patient samples with greater neutrophil infiltration, while caspase 3 was expressed at significantly higher levels in HNSCC patient samples with low neutrophil infiltration. HNSCC cells recruit neutrophils; evidence suggests that TGF-β pathway, which typically promotes N2 phenotype in neutrophils, is involved via canonical and non-canonical mediators including p38 and Akt. Further, HNSCC patient samples have varying levels of neutrophil infiltration and differentially express genes involved in apoptosis, EMT, metastasis and invasion, inflammation. Citation Format: Kulsoom Ghias, Hina Shakeel, Alisalman Sheikh, Syed Hani Abidi, Kiran I. Masood, Saira Fatima, Fareena Bilwani. Mechanism and role of neutrophil recruitment in head and neck squamous cell carcinoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 5942.

INTRODUCTION Fine needle aspiration cytology (FNAC), along with thyroid ultrasound, is an important tool in evaluation of thyroid nodules that helps in further management of these patients in making a decision of surgical intervention vs follow-up. The Bethesda System for Reporting Thyroid Cytopathology category III of atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) has risk of malignancy (ROM) ranging from 5% to 15%. The aim of the present study was to describe the frequency of AUS/FLUS in thyroid gland FNACs and the surgical outcomes of these cases. METHODS The integrated laboratory management system retrieved the thyroid FNACs from 2010 to 2018 and subsequent surgical pathology specimens. For the AUS/FLUS cases, data regarding patient demographics, cytology and histological diagnoses were recorded. The results were tabulated as the overall frequency of AUS/FLUS in thyroid FNACs, cytohistological correlation (benign and malignant) and ROM. RESULTS Over a period of 9 years, 256 (10.9%) cases out of 2342 thyroid FNACs were reported as AUS/FLUS at our institution. Mean age was 43.5 years. The majority (70.3%) of patients were female. Seventy-two of 104 resection specimens (69.2%) were reported as benign and 32 cases (30.7%) had malignant diagnosis. Upper-bound ROM was 30.7% (32 cases with malignant diagnosis out of 104 resection specimens). Lower-bound ROM was calculated as 12.5% (32 cases with malignant diagnosis out of 256 total AUS diagnosis). CONCLUSION The AUS/FLUS category of thyroid cytology and associated ROM remain an evolving area. Individual institutions should monitor the frequency and include ROM in the dashboard indicators to remain within the recommended range.

Objective: to critically analyze the leakage after open surgical repair of peptic ulcer perforation. Methods: All patients who fulfilled the inclusion criteria and visited to surgical department SMBBMU, Larkana from September, 2018 to March, 2021 were included in the study. Informed consent was taken after explaining the procedure, risks and benefits of the study. X-ray abdomen erect posture, leukocyte count, and serum amylase were performed. After surgery, site of perforation and type of surgery were recorded. Patients were followed for 30 days in order to assess the leakage. Results: Mean ± SD of age was 42.6±8.5 years. Out of 203 patients included in the study, 145 (71.4%) were male while 58 (28.6%) were female, Leakage was noted in 13 (6.4%) patients. Conclusion: It is to be concluded that leakage was less likely prevalent after peptic ulcer perforation repair, but we cannot rule out residual confounders. Practical implication Keywords: Leakage, Peptic Ulcer Perforation, Repair, Peritonitis, Laparoscopy, Surgery.

Spermatocytic tumor is a rare germ cell tumor not related to germ cell neoplasia in situ, and derived from postpubertal-type germ cells. It was previously called "Spermatocytic Seminoma" due to false belief of its origin from germ cell neoplasia in situ. The tumor usually occurs in an older age group and orchidectomy is curative. We present a case of spermatocytic tumor in a 25-year male who presented with right-sided testicular swelling and right-sided varicocele. Radiology revealed a 9.8 × 9 cm testicular mass and the patient underwent right-sided orchidectomy. Microscopic examination showed classic morphology with three characteristic cell types and diagnosis of spermatocytic tumor was made. Key Words: Spermatocytic tumor, testis, young.

The history of glomangiopericytoma began in 1924 when it was initially diagnosed by Stout and Murray. It is a rare tumour of the respiratory mucosa, with a prevalence of less than 0.5% among all sinonasal tumours. Literature shows female predominance among patients who develop glomangiopericytoma. So far, no accurate aetiology has been discovered, but there are certain risk factors, including trauma, use of corticosteroids and high blood pressure, which are believed to cause glomangiopericytoma. Patients usually present with a history of epistaxis or nasal blockage, though symptoms can get worse if the tumour is not resected timely and can lead to visual disturbance, chronic sinusitis and headache. It has reddish polypoidal appearance on examination. The best modality for the treatment of glomangiopericytoma is endoscopic surgical resection via trans-nasal approach. We present the case of a 70-year-old man, with nasal blockage and epistaxis who underwent endoscopic sinus surgery for this condition.

Background Thyroid cancer is the most common endocrine malignancy across the globe and is among the fastest-growing cancers worldwide. Thyroid tumors are divided into differentiated and non-differentiated, with each having further subtypes, with papillary carcinoma being the most common one. Immunohistochemical (IHC) markers' studies play a crucial role in the accurate diagnosis of thyroid neoplasms. To the best of our knowledge, this topic has been the least researched in Pakistan. Objectives This study was designed to determine the diagnostic utility of immunohistochemical markers in the diagnosis of thyroid cancers in correlation with histopathology as the gold standard. Methods This retrospective, single-center study was carried out on 124 patients with thyroid cancer treated at our institution. The type of cancer, patient gender, and immunohistochemical markers used in each patient were recorded, and the sensitivity and specificity of the markers used in each tumor case were calculated. Results The mean age of patients was found to be 48.5 ± 15.6 years; 56 (45.2%) of the patients were male and 68 (54.8%) were female. Out of the 124 patients, 75 (60.5%) had papillary, 19 (15.3%) had medullary, 16 (12.9%) had anaplastic, and eight (6.5%) had follicular carcinoma, while six (4.8%) had primary thyroid lymphoma. Thyroglobulin was found to be a reliable tumor marker in both papillary and follicular tumors. The cluster of differentiation56 (CD56) negativity was a useful double panel study along with thyroglobulin in the confirmation of papillary carcinomas. Tumor markers used in medullary carcinoma include calcitonin, chromogranin, and synaptophysin. Cytokeratin AE 1 and vimentin were found to be useful for anaplastic tumors, while Ki 67 was a reliable marker for primary thyroid lymphoma.

A wide variety of diseases and drugs can cause cutaneous pustular eruptions. Acute generalized exanthematous pustulosis (AGEP) is a unique drug-induced dermatosis clinically presented as erythematous papular and pustular eruption, usually caused by certain systemic drugs. We are presenting a very rare association of AGEP with a biological agent, cetuximab. A male aged 66 years, who was recently diagnosed with a case of squamous cell carcinoma of glottis, presented in the dermatology clinic with a recent onset of fever and widespread pustular eruption over the face, trunk, and limbs. The eruption was noted after the injection of cetuximab given for his squamous cell carcinoma. The clinical history, typical physical findings, and histopathological features confirm the diagnosis of AGEP. The injection cetuximab was stopped and the patient was treated with some topical and systemic medications and the symptoms resolved completely in a few weeks. Our case is an interesting clinical presentation of AGEP due to cetuximab therapy and confirms that this is an extremely rare and proven adverse effect of cetuximab. To our knowledge, this is the first-ever reported case of AGEP associated with cetuximab. Physicians need to be aware of this unique but important side effect of cetuximab and perform a proper physical examination and specific investigations that can be useful to reach a final diagnosis.

Background The most common endocrine tumor is thyroid cancer. Follicular thyroid carcinoma (FTC) accounts for 5-10% of all thyroid cancers. Patients with FTC frequently present with more advanced diseases and a higher occurrence of distant metastases because of the propensity of vascular invasion. FTC is mainly treated with surgery while radioactive iodine (RAI) therapy is the main adjuvant therapy according to the American Thyroid Association guidelines. Methodology This was a retrospective observational study of FTC patients aged 18 and above conducted at a tertiary care hospital in Karachi from January 01, 2010 to December 31, 2019. Results A total of 404 patients with thyroid carcinoma were sorted, of which 40 (10.1%) were FTC cases. Overall, 50% of the patients were in the age group of 41-60 years, and the female-to-male ratio was 1.5:1. The majority of patients (60%) presented with neck swelling, followed by bone and lung metastasis in 20% and compressive symptoms in another 20%. On fine needle aspiration cytology (FNAC), 50% had Bethesda category III-IV nodules while 10% had Bethesda category II. Overall, 50% had a total thyroidectomy while 50% had a lobectomy followed by a completion thyroidectomy. On histopathology, 23 (57.5%) patients had minimally invasive FTC while 17 (42.5%) had widely invasive FTC. A total of 17 (42.5%) patients had received RAI 30-100 mCi while 10 (25%) received more than 100 mCi. Conclusions FTC can present with both local or metastatic symptoms. The atypical presentation of metastatic FTC should be considered, diagnosed, and managed early to limit mortality and morbidity. Ultrasound is the best diagnostic investigation of choice followed by FNAC. Surgery is the mainstay of treatment and should be followed by RAI in select cases. Thus, understanding the trend of FTC and proper planning and utilization of the resources will help developing countries in effectively treating the FTC.

Three new ferrocene-based thioureas with different chain lengths were synthesized, characterized, and tested as surface active agent. To get insight of their various aspects of corrosion inhibition of mild steel in 1 M HCl, various standard methods were employed i.e., weight loss, electrochemical impedance spectroscopy, polarization, FT-IR, scanning electron microscopy, and DFT. The results obtained from these methods clearly revealed the linear dependency of inhibition potential with the surface activity, concentration of inhibitor molecules as well as the temperature of the system. The theoretical results were found to be in close agreement with the experimental measurements.

Background IgG4 related disease (IgG4-RD) is a spectrum of immune mediated disorder involving various organs of the body. In this study the clinical spectrum of possible IgG4-RD was explored. Methods Subjects tested for serum IgG4 and all biopsies of subjects with suspected IgG4-RD received at the clinical laboratory of a tertiary care hospital from April 2015 to December 2019 were included. Medical charts of subjects registered were reviewed and telephonic interviews were conducted. Subjects were divided into two groups: group I had biochemical evidence of IgG4-RD while group II had histopathological evidence of IgG4-RD. “Comprehensive diagnostic criteria for IgG4-RD, 2011” was used for labeling patients as possible, probable and definitive IgG4-RD. Results A total of 177 study subjects were recruited in the current study. Group I included 10 children and 105 adults whereas group II had 5 children and 57 adults. Out of the total 177 subjects definitive, probable and possible IgG4-RD were seen in (n = 2, 1.1%), (n = 61, 34.4%) and (n = 114, 64.4) subjects respectively. The commonest organs involved in all the study subjects were pancreas (57.6%), submandibular gland (12.4%) and liver (6.2%). Conclusion The clinical feature of IgG4-RD include single or multiple organ involvement with pancreas being the most frequently affected organ in the current population. Amalgamation of clinical, biochemical and histopathological findings are essential for the IgG4-RD, although none is pathognomonic by itself.

Background Neo-adjuvant chemotherapy (NAC) is frequently administered in breast carcinoma patients. The clinical response to NAC guides further treatment. The pathological response is not only an independent prognostic factor, but it also guides further treatment and prognosis. Objectives The aim of our study was to find the degree of concordance between clinical and pathological response assessments after NAC in Invasive lobular Carcinoma (ILC) cases by using World Health Organization (WHO) criteria and different pathological systems, respectively. We also tried to identify any useful parameter of clinical assessment that could better correlate with pathologic assessment and provide a better estimation of residual tumor. Methods This retrospective study was conducted on 26 ILC tumors diagnosed in 24 patients who were treated with NAC followed by surgical resection between January 2009 and December 2020. Medical records and microscopy glass slides were reviewed for clinical and pathological response assessments, respectively. Results The pre-treatment tumor area ranged from 1.8-255 cm2 and the mean±SD was 52.2±66.8 cm2. After NAC, complete clinical response was observed in four (15.3%) cases. The clinically assessed mean tumor area significantly reduced from 52.2±66.8 cm2 to 17.2±22.6 cm2 (p-value

Malignant eccrine spiradenoma (MES) is an exceedingly rare skin adnexal tumor that arises from pre-existing benign eccrine spiradenoma (BES). MES tumors show a wide spectrum of morphological features, posing a diagnostic challenge to the pathologist. Sarcomatous (heterologous) elements are seen in a few of these tumors, further complicating the morphological picture. We herein describe a case of a 66-year-old male who presented with a recently enlarging, ulcerated, nodular skin lesion over the right leg that had been present for the last 25 years. The patient underwent wide local excision of the tumor. Microscopic examination revealed a neoplastic lesion comprising benign and malignant components. The carcinomatous component showed features of infiltrating adenocarcinoma, not otherwise specified, whereas the sarcomatous component showed predominant osteosarcomatous and focal chondrosarcomatous differentiation. The benign component showed morphological and immunohistochemical features of BES. No adjuvant treatment was administered. The patient was alive and disease-free for 14 months, after which he was lost to follow-up. Careful identification and knowledge related to histological diversity are keys to the correct diagnosis of this rare tumor. MESs are potentially aggressive tumors, and therefore, close long-term follow-up should be maintained.

Ferrocene derivatives have attracted significant interest as potent biological agents and novel drug candidates. Hence, the present research work was focused on the synthesis and characterization of ferrocene-integrated anilines (FB1-FB4) through different spectroscopic techniques such as: FT-IR, multinuclear (1H and 13C) NMR, Raman, atomic absorption spectroscopy, elemental analysis, and single-crystal X-ray crystallography. The crystallographic analysis revealed a supramolecular structure mediated by secondary non-covalent interactions (π—H and π—π). These ferrocenyl derivatives demonstrated a quasi-reversible electrochemical behavior with one electron transfer from Fe(II) to Fe(III)., which was evident by the change in the peak potential at different scan rates. The theoretically calculated energies of the HOMO-LUMO orbitals and the Mulliken charge distribution for the optimized structures determined by the DFT/B3LYP method associated well with the electrochemically measured redox potentials. The computational measurements also led to a close agreement between the found and observed vibrational frequencies having a correlation coefficient of 0.999. The in silico docking analysis against α-amylase, urease, and tyrosine kinase revealed that the docking scores are in close agreement with the in vitro obtained IC50 values of inhibitors. The synthesized compounds exhibited notable free radical scavenging activity against DPPH with IC50 values between 15.9–31.5 µM. The anticancer activity data revealed modest cytotoxicity against the subjected cancer cell line (MCF-7) compared with standard chemotherapeutic drug (cisplatin). However, these ferrocenyl analogs had fewer toxic effects in normal cells (MCF-10A). The results of the antidiabetic assay established that FB1 (IC50 = 19.27 µg/mL) is potentially more active inhibitor of α-amylase, the theoretical docking studies stating that FB1 is more prone towards hydrophobic interactions with Leu165 and Trp 59, in the active pocket of alpha-amylase. Together, the current study reveals the anti-cancer, anti-diabetic and anti-oxidant potential of newly synthesized ferrocene-substituted anilines.

Erythema annulare centrifugum (EAC) is an unusual skin condition appearing as recurrent erythematous annular eruptions associated with autoimmune disorders, infections, and various neoplastic conditions. We present a very rarely reported association of EAC with Hashimoto thyroiditis (HT) in a young male. A 26-year-old male recently diagnosed as case of HT presented in the dermatology clinic with nine-month history of non-itchy persistent annular lesions on the body. The morphology and biopsy of lesions confirmed the diagnosis of EAC. HT is a part of the spectrum of autoimmune thyroid diseases with its own specific cutaneous manifestations. Our case also depicts the impact of antigen-antibody related immunological reaction, which might be involved in the development of both HT and EAC, and it could be the stages of the same pathological condition of two different clinical presentations.

Background The 2014 WHO Classification of ovarian neoplasms introduced a new entity of seromucinous tumors associated with endometriosis. These tumors encompassed a spectrum from benign to malignant and included seromucinous cystadenoma/ cystadenofibroma, seromucinous borderline tumor/atypical proliferative seromucinous tumor and seromucinous carcinoma. However, the 2020 WHO Classification of Female Genital Tumours removed seromucinous carcinomas as a distinct entity and recategorized them as Endometrioid carcinomas with mucinous differentiation. Here we describe clinico-morphologic features of seromucinous tumors recategorizing cases originally diagnosed as seromucinous carcinoma in light of 2020 WHO classification and present detailed review of literature. Methods Slides of seromucinous tumors were reviewed. Special emphasis was given to evaluation of stromal invasion. Follow-up was obtained. Results Ten cases were diagnosed. Mean age was 40 years. Four cases were bilateral. Mean size was 19 cm. Grossly; luminal papillary projections were seen in 6 cases. Tumors demonstrated a papillary architecture with papillae lined by stratified seromucinous epithelium showing nuclear atypia. Stromal invasion was seen in 4 cases. Six cases were reported as borderline seromucinous tumors and 4 cases originally diagnosed as seromucinous carcinoma were recategorized as endometrioid carcinoma with mucinous differentiation on review. Endometriosis was seen in 4 cases. CK7, PAX8 and ER were positive in 7/7 cases. Two cases showed extra-ovarian involvement. Follow up was available in 7 cases. Six patients were alive and well at follow up ranging from 8 to 46 months. Six patients received chemotherapy postoperatively. One patient with carcinoma died of disease 18 months postoperatively. Conclusion In our series, 4 cases were originally diagnosed as seromucinous carcinomas. However, these were recategorized in light of the 2020 WHO Classification of Female Genital tumors as endometrioid carcinomas with mucinous differentiation. Six cases were diagnosed as seromucinous borderline tumors. Thus, majority of cases were borderline in agreement with published literature.

Endocrine pathology primarily includes non-neoplastic and neoplastic lesions of ‘thyroid’, ‘parathyroid’, ‘pituitary’, ‘adrenal’ and ‘pancreatic’ biopsies, thyroid being the most common. Disease spectrum ranges from ‘inflammatory’ to more common ‘neoplastic’ disorders. Thyroid neoplasms, in particular various types of thyroid carcinomas, are among the most frequently encountered biopsies. One particular area of difficulty and controversy includes ‘follicular neoplasms’ of thyroid where diagnostic criteria and even diagnostic entities and nomenclature keep on changing every few years. This chapter covers diagnostic light microscopic features with latest criteria as per the most recent WHO guidelines. Ancillary testing like special stains and immunohistochemical stains utility is also incorporated for ready reference.

The skin is the biggest organ of our body; hence limitless diversity of the various types of lesions leaves a general pathologist struggling. This diversity ranges from allergic, inflammatory, bullous to melanocytic and non-melanocytic neoplasms including a wide variety of adnexal tumours. At times distinguishing features are subtle, and not enough clinical presentation and details are provided which are mandatory for critical evaluation of skin biopsies in correct perspective. For the obvious reason, a general pathology atlas cannot do justice with this subject as the subject demands; however an attempt is made to adequately describe diagnostic features of more commonly encountered lesions.

Objective: To determine the cases of Noninvasive Follicular thyroid neoplasm with papillary like nuclear features (NIFTP) in Pakistani population retrospectively. Another objective was to determine their clinical and radiological outcomes with respect to local and systemic disease recurrence, reconfirming the benign course of this new nomenclature in Thyroid tumors by WHO in our population would encourage adopting the new conservative treatment approach in such patients. Methods: This is a retrospective cohort study conducted at a tertiary care center in Karachi, Pakistan from 2007-2016. All follicular Variant papillary thyroid cancer (FVPTC) reported from a single institute had their histopathology slides reexamined for diagnosing NIFTP as per the new WHO criteria. These cases were then followed retrospectively from their diagnosis onset through their medical and electronic health record for any local or systemic disease recurrence. Results: There were 199 cases of Papillary Thyroid cancer (PTC) which included 22 cases of FVPTC. Eleven cases fulfilled NIFTP criteria with tumor size ranging from 1.1cm to ≥ 5.5cm. All patients in the NIFTP group underwent total thyroidectomy. Nine patients (81.81%) received RAI131 therapy. Four (45%) patients had a median follow up of three to four years. There was no disease recurrence seen on both ultrasound and RAI scans of patients in the NIFTP group. Seven patients (87.5%) had normal surveillance thyroglobulin levels except one whereas three patients were lost to follow up. There was no disease recurrence seen both radiologically and biochemically in the NIFTP group. Conclusion: Our study favors the low risk nature of NIFTP with no disease recurrence in the cases studied and encourages de-escalation of treatment. doi: https://doi.org/10.12669/pjms.36.2.1123 How to cite this:Jabeen S, Fatima S, Sheikh A, Islam N. Non Invasive Follicular Thyroid Neoplasm with Papillary like nuclear features (NIFTP): A time for change in Pakistan. Pak J Med Sci. 2020;36(2):151-155. doi: https://doi.org/10.12669/pjms.36.2.1123 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

In our search for new therapeutic agents, ferrocene-based thioureas (M1–M9) were successively synthesized and characterized by various analytical techniques like FT-IR, Raman, CHNS, AAS, and multinuclear (1H and 13C) NMR. The interaction of the compounds with DNA was investigated by electrochemical and spectroscopic measurements. These complexes exhibited impressive binding constants ranging from 9.75 × 103 to 5.71 × 104 M−1. The diffusion coefficients of the drug–DNA adducts are lower than that of the free drug indicating the formation of a high molecular weight complex that diffuses slowly towards the electrode. The cathodic peak potential shift in the cyclic voltammetric behavior of the synthesized complexes by the addition of DNA is attributable to the electrostatic interactions between the compound and DNA, an indicator of the oxidizable behavior of the compounds in the presence of the negative environment of DNA. The energies of the frontier molecular orbitals (EHOMO and ELUMO) and the Mulliken charge distribution on the optimized structures were determined using the DFT/B3LYP method combined with the 6-31G(d,p) basis set in DMSO. The theoretically calculated HOMO and LUMO energies (HOMO–LUMO band gap) based on the DFT study correlate well with the electrochemically determined redox potentials (electrochemical band gap), having a correlation coefficient of 0.953. The synthesized thioureas were preliminarily screened for their in vitro antimicrobial and cytotoxic activities. However, the most significant antitumor activity was found for M3 with an IC50 value of 1.87 μM. These compounds played a significant role in arresting microbial growth. The computational measurements were found to be in close agreement with the outcomes of biological activities.

In our search for new anticancer and DNA interacting drugs, ferrocene-incorporated nitro 1a-1b and aniline compounds 2a-2b were successfully synthesized and characterized by various physicochemical and spectroscopic methods. The proposed nitrophenylferrocenes were prepared by the coupling reaction between ferrocene and the diazonium salts of different nitroanilines using a phase transfer catalyst. In the subsequent reactions, these nitro compounds were reduced to the corresponding anilines using zinc dust/ammonium formate. Charge distribution and the HOMO/LUMO energies of the optimized structures that were calculated using the DFT/B3LYP method correlate well with the experimentally determined redox potential values. The nature and extent of binding of these complexes with the biomolecule, SS-DNA was examined by cyclic voltammetry, UV–Vis spectroscopy, and viscometry; the complexes exhibited good binding strengths to DNA. The diffusion coefficients of the compound-DNA adducts for all the complexes are lower than that of the free compound and the small values of the binding site sizes also indicate the dominance of electrostatic interactions. These compounds have also been demonstrated to be decent candidates in terms of free radical scavenging, protein kinase inhibition, and cytotoxicity.

Sclerosing mucoepidermoid carcinoma of the thyroid was first reported in 1991. This tumour type may develop as associated to Hashimoto thyroiditis. There are two variants of mucoepidermoid carcinoma of thyroid. The conventional and the sclerosing variants. Sclerosing mucoepidermoid carcinoma with eosinophilia of thyroid (SCME) has recently been recognised as a separate disease entity by the WHO. We report a case of SCME in a 62-year-old male patient who presented with a painless anterior neck swelling. Total thyroidectomy was performed, and no adjuvant treatment administered. The patient remained disease free up until 10 months of follow-up. Approximately 40 cases are reported in literature. We report the second case of SCME in Asian men. Sclerosing mucoepidermoid carcinoma with eosinophilia of thyroid should be differentiated from the conventional mucoepidermoid carcinoma. Patients should also be advised of long-term follow-up for surveillance.

In the present work synthesis and characterization of five new bisferrocenyl bisthiourea analogues (G2M, S2M, G3F, G4F and T2M) is reported. UV–Visible and electrochemical studies were performed in order to have optical (absorption maximum, Molar absorption coefficient and optical band gap) and electrochemical parameters (Oxidation/reduction potentials and nature of the electrochemical process) of the compounds. In vitro various biological studies such as antibacterial, antifungal, anti-oxidant and antidiabetic activities were carried out to have comparative overview of the phermacochemical strength of the newly synthesized compounds. Similarly, theoretical analysis was accomplished utilizing density functional theory calculations. DFT/B3LYP (6-31G d, p) technique was used. With a view to explore the structure activity relationship (SAR) of the compounds theoretical docking analysis (against α-amylase, α-glucosidase) was also performed to have pictorial view and understanding of the actual interactions responsible for the activity. S2M displayed best antibacterial activity. Similarly, Antifungal and antidiabetic activities showed G3F as a best candidate, whereas T2M proved to be the best antioxidant agent.

Three new thiourea based ferrocenyl surfactants i.e. 1-(decanoyl)-3-(4-ferrocenylphenyl) thiourea ( DP ), 1-(decanoyl)-3-(4-ferrocenyl-2-methylbenzyl) thiourea ( DMth ), 1-(decanoyl)-3-(3-ferrocenylphenyl) thiourea ( DM ) have been successfully synthesized and well characterized by various analytical techniques, such as FT-IR, 1 H and 13 C NMR, AAS and elemental analysis. Furthermore, the single crystal XRD analysis was done for DP . To evaluate their amphiphilic nature, their CMC was determined through UV–visible spectroscopy that varies between 0.05 mM and 0.5 mM. The DP compound possesses lower CMC, whereas DM has considerably higher CMC value. Cyclic voltammetric technique was used to determine their redox behavior around CMC as well as their redox potentials, which follow the same trend as that of CMC. The DFT calculated energies of HOMO and LUMO orbitals correlate well with the experimentally determined redox potentials.

Stem cells are the small units of multicellular creature. Regeneration and self-renewal are the ability of the stem cells. Each tissue is having particular stem cells, specific to it. These normal stem cells are converted into cancer stem cells through mutations in it. Although the expression of oncogenes is enhanced a lot, the tumor-supressing gene is lessened. Cancer stem cells are isolated and visualized through different techniques like immunocytochemical staining, spectral karyotyping, immunohistochemistry, induction method and dissection measures, then are performed histological procedures which include fascination, immunohistochemistry, dispensation, in situ hybridization and also quantitative examination of tissue flow cytometric analysis. For the analysis of quantization, statistical tests are also performed as two-sample t-test, Chi-square test, SD and arithmetic mean. Tumor cells generate glioma spheres. These are used in cancer study. Axin 1 is the gene suppressing cancer. Its removal causes the generation of liver cancer. Curcumin is the most effective for suppressing cancer as it increases the normal stem cell function and decreases the cancer stem cell function. Brahma-related gene 1 is crucial for the safeguarding of the stem cell residents in tissue-specific comportment. Different types of cancers originate through genetic mutation, tissue disorganization and cell proliferation. Tumor configuration is produced by the alteration in original cell culture having stem cells and progenitor cell populations. The developmental facets about cancer cells and cancer stem cells as well as their personal natal functions sustain an intricate steadiness to settle on their personal donations to the efficacy or harmfulness of the biological organization.

Objectives To present the clinicopathological experience of Olfactory Neuroblastoma (ONB) with emphasis on histopathological and immunohistochemical features. Methods A descriptive cross-sectional study was done on 36 cases of ONB, selected by non-probability purposive sampling. Theses cases of ONB were retrieved and reviewed from surgical pathology database of Aga Khan University Hospital reported between January 1993 and March 2015. Results Tumor size and age of presentation was wide in range without any distinct bimodal distribution. Nasal cavity was most common site along with involvement of paranasal sinuses. More than 50% cases had Kadish stage A. Microscopically, most cases were Grade-1 and majority showed partial or complete lobular architecture. Neurofibrillary matrix was observed in 2/3(rd) of cases. Among immunohistochemical markers, Neuron Specific Enolase was most frequently expressed. Unusual positive expression of Cytokeratin AE1/AE3 and Cytokeratin CAM5.2 was also seen focally in few cases. Conclusion The ONB has great variability of histological and clinical presentation, and immunohistochemical markers are useful to differentiate from more common small round blue cell tumours of nasal cavity.

Keeping in view the significance of cationic surfactants in various fields of life since the ancient times, here we are reporting the synthesis of a new ferrocenyl thiourea derivative along with an entirely new series of ferrocene based cationic surfactants in which variable alkyl chain lengths are introduced while keeping the head structure same, thus acting as a key to comparative study of their potential self-aggregation properties and bioactivities. Critical micelle concentration has been determined which is a supporting evidence to the amphiphilic nature of the synthesized compounds. Furthermore, cell cytotoxicity and three types of antioxidant activities also helped depict the therapeutic properties of the synthesized compounds.

A 62-year-old man, suffering from bronchial asthma was evaluated due to intractable cough. His dyspnea was controlled but cough remained unresponsive to escalation of asthma management steps. Cough occurred in bouts, especially during night time and was occasionally productive of mucoid sputum. Other than bilateral rhonchi on chest auscultation, remaining systemic examination was unremarkable. CT chest showed a mass lesion in the bronchus intermedius that was confirmed on bronchoscopy and was removed after electrocautery snare excision. Histopathology of the lesion was consistent with endobronchial chondroma. The patient experienced a dramatic resolution of cough post tumor removal. Follow up bronchoscopy after 24 months revealed no tumor recurrence.

Background: Mycosis fungoides (MF) is the most common primary cutaneous lymphoma. It affects usually the covered areas of the body in elderly males in 6th and 7th decades of life. Atypical dermal lymphoid infiltrate is seen along with epidermotropism. Nuclei of neoplastic cells are convoluted. The neoplastic cells demonstrate positivity for CD3 (Pan T) immunohistochemical stain. Majority show increased CD4 to CD8 ratio. The present study was done to study the clinicopathological features, which might be of help in reaching a correct diagnosis in these cases. Materials and Methods: A retrospective descriptive study was conducted on 60 reported cases of MF. The retrieved slides were reviewed for clinical and histopathological features and immunohistochemical profile. Results: The ages ranged from 20–84 years, mean age was 47 years. Majority (75%) of patients were male. Trunk and extremities were the sites most commonly affected. There was significant inverse correlation between epidermal thickness and tumor stage (P = 0.02). Thickened epidermis was seen in patch stage and thickness reduced with progressing stage. The intensity of dermal infiltrate and cell size was also statistically significantly linked to stage progression (P < 0.001 each). In addition, proliferation index also correlated significantly with tumor stage (P = 0.002). Conclusion: Clinical information and histological features are equally important in the accurate diagnosis of MF. Papillary dermal fibrosis is a useful diagnostic clue. CD4:CD8 ratio is not increased in all cases; it may be decreased or remain unchanged.

Background Parathyroid cancer is a rare cause of primary hyperparathyroidism. It presents a diagnostic and therapeutic challenge that may not be recognized preoperatively, and is often not conclusively identified during the operation. We present the case of a lady with backache and hypercalcemia, but with inadequate work-up for her condition for several years. Case presentation A middle aged lady of Asian descent presented with backache. Initial work up revealed mild hypercalcemia, negative work up for multiple myeloma, negative sestamibi scan for parathyroid pathology. A phenomenally elevated parathormone (PTH) level—2105 pg/mL (16–87 pg/mL), and rising serum calcium, 15.1 mg/dL, (8.6–10.5 mg/dL), ordered years later prompted a repeat sestamibi scan and ultrasonography of neck. Based on these investigations, a diagnosis of primary hyperparathyroidism, with high suspicion of parathyroid cancer was made. The patient underwent surgical tumour resection, with subsequent histopathological confirmation of diagnosis. Conclusion In the setting of hypercalcemia, PTH level assessment is a must. This helps to differentiate between the parathyroid dependant and independent causes of high serum calcium, thereby encouraging a comprehensive pathway to the work up of the cause of hypercalcemia. The parathyroid cancer is a very rare cause of hypercalcemia, which needs to be considered in the differentials of primary hyperparathyroidism, particularly in the setting of high PTH levels. Electronic supplementary material The online version of this article (10.1186/s13104-018-3711-0) contains supplementary material, which is available to authorized users.