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Introduction: The spectrum of haematological and non haematological disorders is vast in various age groups. Complete blood counts and other routine laboratory tests are not always sufficient to diagnose these diseases. Bone marrow examination plays an important role in diagnosing their underlying causes. Aim: To analyse the spectrum of various haematological and non haematological disorders reported in Bone Marrow Aspiration (BMA) and compare them with Bone Marrow Trephine Biopsy (BMB) and Flow Cytometry (FCM) findings where applicable. Materials and Methods: A one-year cross-sectional study was conducted in the Department of Clinical Pathology, PGIMS, Rohtak, Haryana, India from April 2022 to March 2023. A total of 518 consecutive BMA samples were morphologically analysed. Comparative evaluations were performed among BMA, BMB, and FCM where applicable. Diagnostic accuracy was calculated, and the findings of discordant cases were tabulated. Definitive diagnosis of lymphoma/leukaemia and Paroxysmal Nocturnal Haemoglobinuria (PNH) cases were made using FCM. Results: The patients' ages ranged from three months to 86 years, with a mean age of 38.4 years. The male to female ratio was 1.3:1, with a slight male predominance. The highest number of cases were of anaemia {183 (35.3%) and 164 (31.7%), respectively} and leukaemia {128 (24.7%) and 134 (25.9%), respectively}, followed by normal marrow studies {39 (7.5%) and 32 (6.2%), respectively} and megakaryocytic thrombocytopenia {24 (4.6% in each} in both BMA and biopsy. Among anaemia cases {183 and 164 cases in BMA and BMB}, the majority were of the megaloblastic type {62 (33.8%) and 54 (32.9%), respectively}, followed by hypoplastic/aplastic type {40 (21.8%) and 50 (30.5%), respectively}. In cases of leukaemia (128 and 134 cases in BMA and BMB), acute leukaemia cases (76 (59.4%) and 82 (61.2%), respectively} outnumbered chronic leukaemia cases {52 (40.6%) and 52 (38.8%), respectively} in both BMA and BMB. The concordance and discordance rate between BMA and BMB were 87.6% (419 cases) and 12.4% (59 cases), respectively. Diagnosis was exclusively made by BMB in cases of myelofibrosis, granulomatous disease, and Hodgkin's lymphoma. Conclusion: BMA cytology is a relatively safe and mildly invasive technique for evaluating various haematological and non haematological disorders with better preservation of cellular morphology. However, in cases with dry/blood taps and focal marrow involvement, BMB should be performed, as it shows well-preserved marrow architecture with all its cellular and stromal components. FCM is a definitive diagnostic modality for further categorisation of acute leukaemia and Chronic Lymphoproliferative Disorders (CLPD). [ABSTRACT FROM AUTHOR]

Langerhans cell histiocytosis (LCH) is a rare cancer involving clonal proliferation of Langerhans cells (LCs) resembling epidermal dendritic cells. It can involve any organ or system. Temporal bone LCH is often confused with ear inflammatory lesions and malignant tumors. Diagnosis is based on clinical, radiological, and pathological findings. The definitive diagnosis is made on biopsy and by immunohistochemical demonstration of CD 1a and or Langerin positivity in the clonally neoplastic cells. The course of LCH is variable from spontaneous regression to repeated recurrences and death. The main form of treatment is chemotherapy. We describe a case of multifocal multisystem LCH in a 4-year-old child who presented with recurrent chronic suppurative otitis media and an external auditory canal polyp. [ABSTRACT FROM AUTHOR]

Aim of the study: The current study was aimed to investigate the neuropathic pain attenuating mechanism of pregabalin using chronic constriction injury (CCI) model in rats. Material and Methods: The sciatic nerve was ligated by placing four loose ligatures around it to induce neuropathic pain. The pain development in terms of cold allodynia, mechanical hyperalgesia, and heat hyperalgesia was assessed on the 7th and 14th day after surgery, using acetone drop, pinprick, and hot plate tests. On the 14th day after the injury, pain parameters were assessed 30 minutes after administration of pregabalin (30 mg/kg) and sodium nitroprusside (5 mg/kg) in CCI-subjected rats. Results: CCI led to induction of neuropathic pain, which was more prominent on 14th day in comparison to 7th day. A single administration of pregabalin and sodium nitroprusside on 14th day, markedly reduced pain parameters and increased serum nitrite levels. Pretreatment with L-NAME abolished neuropathic pain attenuating effects of pregabalin suggesting that pregabalin may increase the levels of nitric oxide to mitigate neuropathic pain. Pretreatment with naloxone significantly abrogated pain attenuating effects of pregabalin and sodium nitroprusside in CCI-subjected rats suggesting that pregabalin and nitric oxide-mediated analgesic action are mediated through release of endogenous opioids. Moreover, naloxone failed to modulate pregabalin-induced increase in nitric oxide levels suggesting that the opioid system does not control the nitric oxide levels, and opioids may be downstream modulators of nitric oxide. Conclusion: Pregabalin may increase the release of nitric oxide, which may increase the release of endogenous opioids to attenuate neuropathic pain in CCI subjected rats. [ABSTRACT FROM AUTHOR]

Between 2016 and 2020, the number of patients and the overall percentage compared to all hospitalizations have increased from 0.6% in 2016 to 1.0% in 2020 ( I p i SB trend sb < 0.01). In their article entitled "Coding for Physical Restraint Status Among Hospitalized Patients: a 2019 National Inpatient Sample Analysis", Luccarelli et al. found various differences in patient characteristics and outcomes.[1] As they further mentioned "reduction of the use of physical restraints has been a target for quality improvement interventions, and has led to interdisciplinary quality improvement efforts"[1], we used data from the 2016-2020 National Inpatient Sample[2] to evaluate for trends in physical restraint status in the USA among patients of ages 18 and above. Coding for Physical Restraint Status Among Hospitalized Patients: a 2019 National Inpatient Sample Analysis. [Extracted from the article]

Spinal cord contusion injury is one of the most serious nervous system disorders, characterized by high morbidity and disability. To mimic spinal cord contusion in humans, various animal models of spinal contusion injury have been developed. These models have been developed in rats, mice, and monkeys. However, most of these models are developed using rats. Two types of animal models, i.e. bilateral contusion injury and unilateral contusion injury models, are developed using either a weight drop method or impactor method. In the weight drop method, a specific weight or a rod, having a specific weight and diameter, is dropped from a specific height on to the exposed spinal cord. Low intensity injury is produced by dropping a 5 g weight from a height of 8 cm, moderate injury by dropping 10 g weight from a height of 12.5-25 mm, and high intensity injury by dropping a 25 g weight from a height of 50 mm. In the impactor method, injury is produced through an impactor by delivering a specific force to the exposed spinal cord area. Mild injury is produced by delivering 100 ± 5 kdyn of force, moderate injury by delivering 200 ± 10 kdyn of force, and severe injury by delivering 300 ± 10 kdyn of force. The contusion injury produces a significant development of locomotor dysfunction, which is generally evident from the 0-14th day of surgery and is at its peak after the 28-56th day. The present review discusses different animal models of spinal contusion injury. [ABSTRACT FROM AUTHOR]

Spinal cord contusion injury is one of the most serious nervous system disorders, characterized by high morbidity and disability. To mimic spinal cord contusion in humans, various animal models of spinal contusion injury have been developed. These models have been developed in rats, mice, and monkeys. However, most of these models are developed using rats. Two types of animal models, i.e. bilateral contusion injury and unilateral contusion injury models, are developed using either a weight drop method or impactor method. In the weight drop method, a specific weight or a rod, having a specific weight and diameter, is dropped from a specific height on to the exposed spinal cord. Low intensity injury is produced by dropping a 5 g weight from a height of 8 cm, moderate injury by dropping 10 g weight from a height of 12.5-25 mm, and high intensity injury by dropping a 25 g weight from a height of 50 mm. In the impactor method, injury is produced through an impactor by delivering a specific force to the exposed spinal cord area. Mild injury is produced by delivering 100 ± 5 kdyn of force, moderate injury by delivering 200 ± 10 kdyn of force, and severe injury by delivering 300 ± 10 kdyn of force. The contusion injury produces a significant development of locomotor dysfunction, which is generally evident from the 0-14th day of surgery and is at its peak after the 28-56th day. The present review discusses different animal models of spinal contusion injury. [ABSTRACT FROM AUTHOR]

While the incidence of acute rheumatic fever (ARF) in the United States has declined over the past years, the disease remains one of the causes of severe cardiovascular morbidity in children. The index of suspicion for ARF in health care providers may be low due to decreasing incidence of the disease and clinical presentation that can mimic other conditions. We present the case of a 5-year-old boy with a history of intermittent fevers, fatigue, migratory joint pain, and weight loss following group A Streptococcus pharyngitis. The patient presented to the emergency department twice with the complaints described above. On his 3rd presentation, the workup for his symptoms revealed the diagnosis of acute rheumatic fever with severe mitral and aortic valve regurgitation. The patient was treated with penicillin G benzathine and was started on glucocorticoids for severe carditis. The patient was discharged with recommendations to continue secondary prophylaxis with penicillin G benzathine every 4 weeks for the next 10 years. This case illustrates importance of primary prevention of acute rheumatic fever with adequate antibiotic treatment of group A Streptococcus pharyngitis. Parents should also receive information and education that a child with a previous attack of ARF has higher risk for a recurrent attack of rheumatic fever. This can lead to development of severe rheumatic heart disease. Prevention of recurrent ARF requires continuous antimicrobial prophylaxis. Follow-up with a cardiologist every 1-2 years is essential to assess the heart for valve damage. [ABSTRACT FROM AUTHOR]

Background: Prostate cancer is a major health problem throughout the developed world. Tumor grade is one of the most important prognostic factors of prostate cancer. At present, adequate prognostic markers for prostate cancer progression are still lacking, in spite of intensive investigation. Accordingly, we studied the role of immunohistochemical (IHC) expression of p53 and Ki-67 as a prognostic factor in carcinoma prostate and correlated their expression with Gleason's grade. Materials and Methods: In this prospective study, a total of 60 cases including 50 cases of prostate carcinoma and 10 of benign prostatic hyperplasia (BPH) were taken. Tumor grade was determined according to Gleason's grading system. p53 and Ki-67 expressions were determined by IHC staining. The obtained results were analyzed and evaluated using Spearman's statistical test (SPSS version 20). Results: In BPH, p53 was expressed in only 2 of 10 (20%) cases while in carcinoma it was expressed in 38 of 50 (76%) cases. Ki-67 was expressed in only 1 of 10 (10%) BPH cases while in carcinoma it was expressed in 32 of 50 (64%) cases. In present study, 1 of 4 (25%) well differentiated, 23 of 31 (74.19%) moderately differentiated and 14 of 15 (93.33%) poorly differentiated tumors revealed p53 immunopositivity and a statistically significant correlation was observed between p53 expression and increased Gleason's grade (P = 0.038). All 4 (100%) cases of well-differentiated carcinoma were negative for Ki-67 expression. Nineteen of 31 (61.29%) moderately differentiated and 13 of 15 (86.66%) poorly differentiated tumors were positive for Ki-67 and a statistically significant correlation was observed between Ki-67 positivity and increased Gleason's grade (P = 0.002). Conclusions: Both p53 and Ki-67 were significantly up-regulated in malignant lesions as compared to benign lesions and a strong relationship with the Gleason's grading was noticed, therefore, we propose that these markers can be applied along with other prostate cancer prognostic factors. [ABSTRACT FROM AUTHOR]

Solitary fibrous tumor (SFT) is a rare spindle-cell neoplasm originating from the mesenchyme. It was originally thought to occur exclusively in the intrathoracic region but has been recently described in extrapleural sites including the orbit. SFT of the orbit is a rare lesion, which can be misdiagnosed as hemangiopericytoma, fibrous histiocytoma, meningioma, or neurofibroma. Immunohistochemistry plays an important role. We report an orbital SFT in a 39-year-old female presented with painless, progressive proptosis, and diminished vision in the right eye for the duration of 6 months. Magnetic resonance imaging demonstrated well-defined enhancing mass lesion. The patient underwent complete tumor removal through a right fronto-orbital approach, and a pathological diagnosis of the solitary fibrous tumor was made. Postoperatively, the patient was symptom-free. Clinical and pathological findings including immunohistochemistry are presented along with a brief discussion of literature. [ABSTRACT FROM AUTHOR]

It is known that some organic materials show a good capacity for selective removal of Cr(VI) from contaminated water; however, the exact mechanism of such removal has yet to be investigated and established. In this study, coconut husk, a waste material with no or low cost, has been used as a representative material to investigate the exact mechanism of Cr(VI) removal by organic matter from synthetic wastewater. The investigation has been carried out in two significant stages. First, the adsorption phenomenon was studied using batch kinetic and column studies to determine the isotherms and kinetic models and effects of process parameters like solution pH and contact time. 100% Cr(VI) removal was achieved at pH 2 within 30 min at a stirring rate of 300 rpm. Although an impressive adsorption capacity of 222.22 mg/g was calculated using the Langmuir model, there was a poor fit of the observed data with the known adsorption models, leading to the inference that the mechanism of removal involved processes other than simple adsorption. The virgin and exhausted material were further characterized using field emission-scanning electron microscope (FE-SEM), thermal analysis, Attenuated total reflection-Fourier transform infrared spectroscopy (ATR-FTIR) and X-ray photoelectron spectroscopy (XPS). From the characterization results, it was found that Cr(VI) was first adsorbed at the functional groups followed by oxidation of major components like hemicelluloses, cellulose, and lignin, present in the adsorbent, resulting in the formation of ethers, carboxylic groups, and other carbonyl functionalities. Cr(VI) itself got reduced to Cr(III) and precipitated as Cr(OH) 3 inside the pores of the adsorbent. The study conclusively established that Cr(VI) removal by organic matters such as coconut husk is essentially a sorption coupled redox process. [Display omitted] • Cr(VI) removal was investigated by coconut husk as a representative biosorbent. • 100% Cr(VI) removal was achieved at pH 2 in batch adsorption study. • Cr(VI) was reduced to Cr(III) while the components of coconut husk were oxidized. • Sorption coupled with redox reaction was found responsible for Cr(VI) removal. • The removal mechanism may inspire the design of high-capacity adsorbents for Cr(VI). [ABSTRACT FROM AUTHOR]

The article presents a case study of a 19-year-old pregnant female suffering from swelling in the submandibular region. It mentions that ultrasonography revealed hypoechoic lesion with cystic changes. It also mentions the presence of foamy and pigment-laden macrophages and multinucleated giant cells along with lymphocytes. It also mentions that ectopic thyroid was diagnosed in the submandibular mass.

This document is a letter published in the Annals of Hematology that discusses factors associated with inpatient mortality during daunorubicin and cytarabine induction in adults with acute myeloid leukemia (AML). The authors conducted a study using the 2016-2020 National Inpatient Sample (NIS), which is a large database of hospital records in the USA. They found that several patient characteristics and comorbidities were associated with higher or lower chances of inpatient mortality. Factors such as weekend admissions, cirrhosis, obesity, chronic kidney disease, and age over 60 were associated with higher mortality, while being Hispanic, having a larger bed size, and having diabetes or hypertension were associated with lower mortality. The study also found that complications such as septicemia, acute kidney injury, and cardiogenic shock were common during induction therapy and increased mortality. [Extracted from the article]

Verrucous hemangioma is an uncommon capillary or cavernous hemangioma with reactive epidermal changes of hyperkeratosis, acanthosis, and papillomatosis. Lesions are mostly seen at birth or appear during childhood. These growths are usually located on the lower extremities, and involvement is generally unilateral. Diagnosis of this unusual presentation can only be confirmed following histopathology. Surgical excision resulted in a satisfactory functional and cosmetic outcome. [ABSTRACT FROM AUTHOR]

Juvenile arthritis (JA) is an autoimmune condition affecting children. We used the 2017 National Inpatient Sample (NIS) to evaluate the impact of JA in the United States. The admission data were converted to weighted form and patients between the ages of 0 and 18 (inclusive) were used in our study. 560 weighted cases were found in 2017. It was more common in females than males (340 females, 220 males), Whites (235 cases), and Medicaid covered 61.6% of all patients with JA (345 cases). The total hospital charges were $25,147,389 while the mean length of stay (LOS) was 4.55 days. The highest number of cases was reported in April 2017. [ABSTRACT FROM AUTHOR]

Introduction: Oral squamous cell carcinoma is a major cause of death throughout the developed world. It is associated with smoking and alcohol consumption. Human papillomavirus (HPV) type 16 has also been suggested to play a role in etiology of head and neck squamous cell carcinoma (HNSCC). p16 expression is now being used as a surrogate marker of HPV infection in squamous cell carcinoma and provides important prognostic information and future therapy planning.Materials and Methods: In this prospective study, total of 75 cases of HNSCC were taken. Tumor grade was determined according to World Health Organization (WHO) criteria. p16 expression was determined by immunohistochemical staining. The obtained results were analyzed and evaluated using Chi-square test (Statistical Package for Social Sciences (SPSS) version 20), value of P <0.05 was taken significant.Results: Out of 75 cases, 78.7% cases were positive for p16 (inclusive of all grades), while 21.3% cases were negative. Expression of p16 was higher in nonsmokers and nonalcohol consumers and significantly associated with paan chewing habit. No significant correlation was seen with history of abnormal sexual habits, but p16 expression was significantly correlated in cases with multiple sexual partners (P = 0.003), with increasing histological grade (P = 0.045) and in cases with lymph node metastasis (P = 0.03).Conclusion: As HPV integration with transcription of viral oncoprotein induces overexpression of p16, immunohistochemical expression of p16 can be used as a surrogate marker of HPV. This approach can be implemented in diagnostic laboratories and can provide support for vaccination program in high risk group. [ABSTRACT FROM AUTHOR]

The practice of placing a small amount of chewing tobacco or snuff in the oral cavity and leaving it in place for extended periods of time appears to be finding its way into young and middle aged adults as a socially acceptable and popular habit. Cancer development at the site of placement and other oral mucosal lesions caused by these products has been described from several population groups. As the composition and the pattern of use of the product vary, evaluation of each type of smokeless tobacco (ST) has to be undertaken with caution. This review thus, highlights the use of ST and its significance as the causative for oral cancer. [ABSTRACT FROM AUTHOR]

Malignant peripheral nerve sheath tumor (MPNST) is a rare nerve sheath tumor derived from Schwann cells or pleuripotent cells of neural crest. Neurogenic tumors make about 10-20% of all mediastinal tumors. Incidence of MPNST is 0.001% in general population and 0.16% in patients with neurofibromatosis I (NF I). We report a case of 60 year female presenting with progressive cough and breathlessness for2 years. The CECT revealed multiple focal enhancing lesions along inferior mediastinal pleural surface and along lateral pleural surface. A thoracotomy and tumor excision was done and MPNST was diagnosed on microscopy and immunohistochemistry. This case highlights that this unusual tumor may involve lung parenchyma. So this possibility should be kept in mind in patients with intrathoracic mass. [ABSTRACT FROM AUTHOR]