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Arya CL, Gupta R, Arora VK. Accidental condom inhalation. THE INDIAN JOURNAL OF CHEST DISEASES & ALLIED SCIENCES 2004; 46:55-8. [PMID: 14870871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
A 27-year-old lady presented with persistent cough, sputum and fever for the preceding six months. Inspite of trials with antibiotics and anti-tuberculosis treatment for the preceeding four months, her symptoms did not improve. A subsequent chest radiograph showed non-homogeneous collapse-consolidation of right upper lobe. Videobronchoscopy revealed an inverted bag like structure in right upper lobe bronchus and rigid bronchoscopic removal with biopsy forceps confirmed the presence of a condom. Detailed retrospective history also confirmed accidental inhalation of the condom during fellatio.
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Arora VK, Gupta R. Private-public mix: a prioritisation under RNTCP--an Indian perspective. THE INDIAN JOURNAL OF CHEST DISEASES & ALLIED SCIENCES 2004; 46:27-37. [PMID: 14870866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
Success of the public directly observed treatment, short course (DOTS) programmes have been widely reported from various parts of the world and have been described from the Indian subcontinent as well. But, it is being increasingly realised that further DOTS successes can take place only by ensuring a private sector participation under the programme. While discussing behaviour-profile of patients, this review enumerates possible reasons for their averseness of a public health facility and preference for a private health. facility. Similarly, behaviour-profile of private health providers brings out the discrepancies in their clinical practices. Both types of profiles are supported with the studies from India and abroad. A comparison is drawn between available services of the public and private health facilities, with a focus on the need for prioritisation of a private-public mix (PPM) in the Revised National Tuberculosis Control Programme (RNTCP). Furthermore, the salient features of schemes recommended by the Directorate General of Health Services, New Delhi, for involvement of the private- practitioners, and the Non-Governmental Organisations are briefly outlined. The underlying obstacles for private sector participation in RNTCP and the projected solutions so as to effect a private-public mix in the Revised Programme are also dealt with. A description of few operating models, trying in the best possible manner to bring about a private sector participation in programme, is presented to make the readers aware of the efforts going on in that direction within the country. The private health sector, easily being a patient's first choice, needs to be integrally involved in RNTCP on a priority basis, feasibility of which, has been successfully documented in the operational trials conducted within the country so far.
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Arora VK, Sarin R, Lönnroth K. Feasibility and effectiveness of a public-private mix project for improved TB control in Delhi, India. Int J Tuberc Lung Dis 2003; 7:1131-8. [PMID: 14677887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023] Open
Abstract
SETTING New Delhi, India. OBJECTIVE To assess the feasibility of a public-private mix (PPM) project for improved tuberculosis (TB) control and determine its impact on case detection, case-management quality, treatment outcome and patient convenience. DESIGN 1) Monitoring of case detection through the review of record data; 2) cohort analysis of patients treated by private providers (PPs); 3) questionnaire-based surveys of patients and private providers. RESULTS A total of 612 cases were detected, of whom 168 (27%) were new sputum-positive cases. Incremental case notification due to PPs was 47% for new cases and 29% for new sputum-positive cases. Sputum examination for diagnosis and evaluation was performed in 100% and 84%, respectively, of notified patients. The treatment success rate for new sputum-positive cases treated by PPs was 81%, which was not significantly different from the 86% in the public sector. Directly observed treatment (DOT) was confirmed by 95% of patients. CONCLUSIONS This PPM project, carried out with government funding in accordance with the RNTCP recommendations and with the support from several government and private organisations, achieved improved case detection as well as acceptable treatment outcome for patients receiving DOT from PPs.
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Abstract
Directly Observed Treatment-Short Course (DOTS) has been a successful strategy in the global control of tuberculosis (TB) in adults. However, reports of implementation are scantily available in pediatric context. Present article reviews diagnostic uncertainties of TB in children commonly faced by physicians on account of the vague clinical presentations, unreliable tuberculin tests or TB score charts, non-specific hematological, biochemical or radiological evidence, difficulty in sputum expectoration and non-availability or ill-affordability of specialised tests. It also describes therapeutic problems arising due to the physician's inexpertise, child's incomprehensibility and parental anxiety. DOTS was found to be highly effective in 930 Indian children having TB over the 6-year study period, during which, a rise in number of cases with adult pattern of disease was also noted. The trend change in pediatric TB scenario is thought to have taken place due to malnutrition so widely prevalent in this country. Irrespective of the changing trend, DOTS strategy was found to be effective for all types of pediatric TB. A need, therefore, exists for quick resolution of the programme issues related to pediatric drug dispensing, physicians' reservations about acceptance of strategy in this age-group, service-utilisation of DOTS providers for the selected cases unable to visit DOTS centres and giving executional priority to children during ongoing expansion of Revised National TB Control Programme (RNTCP) in country.
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Arora VK, Singla N, Sarin R. Profile of geriatric patients under DOTS in Revised National Tuberculosis Control Programme. THE INDIAN JOURNAL OF CHEST DISEASES & ALLIED SCIENCES 2003; 45:231-5. [PMID: 12962456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Abstract
BACKGROUND With an increase in life expectancy and the resultant elderly population, there has been an increase in the number of tuberculosis (TB) cases including those in geriatric age as well. However using Directly Observed Treatment-Short Course (DOTS), all categories of TB patients have been sucessfully treated within the country. A need was felt to study the profile of geriatric TB patients under the Revised National Tuberculosis Control Programme (RNTCP). METHODS A retrospective study of 7439 patients enrolled under DOTS from January 1996 to March 2001 was carried out in a tertiary care referral institute in Delhi and the profile was analysed in terms of the gender, type of TB and ratio of sputum smear-positive to negative patients for both the younger and geriatric age groups. Further, treatment outcomes of the two age groups were analysed and compared for the 2655 new sputum smear patients. RESULTS The male : female ratio of 315 geriatric TB patients enrolled under DOTS was observed to be 3 : 1 as against the 1.4 : 1 in younger TB patients. The occurrence of pulmonary TB was significantly higher than extra-pulmonary TB in geriatric age group (16:1) as compared to the younger age group (4:1). The ratio of new smear-positive to smear-negative patients was almost similar in the two age groups. Further, the treatment outcomes of new smear-positive geriatric TB patients in comparison to younger TB patients showed significantly lower sputum conversion (75.3% vs 85.7% respectively) and cure rates (69.2% vs 80.7% respectively), significantly higher exclusion rates from DOTS (2.3% vs 0.15% respectively) and relatively higher default and treatment failure rates. CONCLUSIONS The present study has identified certain issues in the Indian TB patients of geriatric age. These include a lower reported prevalence amongst females, poor sputum conversion as well as cure rates and higher exclusion as well as default rates. Further studies are needed to address the issues under operational conditions of Indian RNTCP.
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Singla R, Singla N, Khalid UK, Arora VK. Should pulmonary tuberculosis patients with heavy pre-treatment bacillary load be given more aggressive treatment even under the DOTS strategy? Int J Tuberc Lung Dis 2003; 7:908-9. [PMID: 12971679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
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Dewan RK, Mishra AK, Lewate VK, Kaukab M, Arora VK. Delayed presentation and surgical management of a bronchial tear. THE INDIAN JOURNAL OF CHEST DISEASES & ALLIED SCIENCES 2003; 45:205-8. [PMID: 12866640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
Tracheobronchial injuries following blunt trauma to the chest can be life-threatening. However, failure to diagnose can lead to various acute or chronic complications. A delayed presentation is quite rare and its surgical correction is highly challenging. We present here two cases, which came to us after four and six months of trauma respectively. In these patients, successful surgical repair of totally obstructed right main bronchus in the first case and left main bronchus in the other was carried out. The post-operative course was uneventful with improvement in the respiratory status of both the patients. High degree of suspicion and awareness of the possibility of bronchial tear are required for proper management of such cases.
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Arora VK, Visalakshi P. Multi-drug resistant tuberculosis in context of RNTCP. THE INDIAN JOURNAL OF CHEST DISEASES & ALLIED SCIENCES 2003; 45:215-9. [PMID: 12866642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
DOTS has been successful in improving cure rates in tuberculosis worldwide, but has remained an inefficient strategy in respect of multidrug-resistant tuberculosis (MDR TB). The present article discusses its management in context of RNTCP and focuses specially on DOTS-plus, a strategy arising out of the constitution of Green Light Committee to effectively tackle the cases of MDR TB globally.
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Jaiswal A, Singh V, Ogden JA, Porter JDH, Sharma PP, Sarin R, Arora VK, Jain RC. Adherence to tuberculosis treatment: lessons from the urban setting of Delhi, India. Trop Med Int Health 2003; 8:625-33. [PMID: 12828545 DOI: 10.1046/j.1365-3156.2003.01061.x] [Citation(s) in RCA: 96] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The Revised National Tuberculosis Control Programme (RNTCP), which incorporated the WHO DOTS strategy was introduced in India in the mid-1990s. An operational research project was conducted between 1996 and 1998 to assess the needs and perspectives of patients and providers in two chest clinics in Delhi, Moti Nagar and Nehru Nagar, during the introduction of the new strategy. This paper reports on the findings of the project, concentrating on information collected from 40 in-depth interviews with patient defaulters and from non-participant observations in clinics and directly observed treatment centres. In Moti Nagar chest clinic, 117 of 1786 (6.5%) patients and 195 of 1890 (10%) patients in Nehru Nagar left care before their treatment was complete. It was argued that the reasons for default stem from a poor correlation between patient and programme needs and priorities, and from particular characteristics of the disease and its treatment. Patient needs that were not met by the health system included convenient clinic timings, arrangements for the provision for treatment in the event of a family emergency and provision for complicated cases like alcoholics. The problems facing the provider were poor interpersonal communication with the health staff, lack of attention and support at the clinic, difficulty for patients to re-enter the system if they missed treatment and, in certain areas, long distances to the clinic. Problems related to diseases were inability of the staff to deal with drug side-effects, and patients' conception of equating well-being with cure. Simple, practical measures could improve the provision of tuberculosis (TB) treatment: more flexible hours, allowances for poor patients to reach the clinics and training health care staff for respectful communication and monitoring drug side-effects. The findings indicate a need to rethink the label of 'defaulter' often given to the patients. The important areas for future operational research is also highlighted.
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Puri MM, Gupta K, Arora VK. A case of Hodgkin's disease presenting as lymphocytic interstitial pneumonitis. THE INDIAN JOURNAL OF CHEST DISEASES & ALLIED SCIENCES 2003; 45:139-42. [PMID: 12715939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
Lymphoproliferative disorders of lung have a broad clinical and pathologic spectrum. The clinical and radiographic features are non-specific. Accurate diagnosis is required to initiate appropriate therapeutic intervention. We report a case of Hodgkin's disease mimicking lymphocytic interstitial pneumonitis in a 21-year-young male.
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Puri MM, Arora VK. Role of gallium arsenide laser irradiation at 890 nm as an adjunctive to anti-tuberculosis drugs in the treatment of pulmonary tuberculosis. THE INDIAN JOURNAL OF CHEST DISEASES & ALLIED SCIENCES 2003; 45:19-23. [PMID: 12683708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
BACKGROUND Tuberculosis is a global emergency with about nine million people developing disease every year. The long duration of treatment has emerged as a major obstacle in the control of tuberculosis. There is a need for development of new drugs and or shortened therapy. METHODS The present study was carried out to explore whether any benefit could be achieved by the addition of low level energy laser therapy (LLLT) to the conventional anti-tubercular chemotherapy. One-hundred-thirty new sputum smear positive patients of pulmonary tuberculosis were enrolled to evaluate the bio-stimulatory effects of Gallium Arsenide laser irradiation at 890 nm, as an adjuvant therapy. These patients were randomly divided into two groups to receive either LLLT or sham irradiation (control) concomitantly with anti-tuberculosis chemotherpy. RESULTS The patients treated with semiconductor laser as an adjuvant therapy along with anti-tuberculosis drugs had a faster clearance of tubercle bacilli from the sputum as compared to the control group (P value at :45 days=0.1392, 60 days=0.0117, 75 days=0.00805, 90 days=0.00739). CONCLUSIONS These findings provide preliminary evidence that low level laser therapy with Gallium Arsenide laser may be a promising adjunctive therapy for patients with tuberculosis. Faster conversion of sputum should prevent the development of resistant mutants.
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Singh V, Jaiswal A, Porter JDH, Ogden JA, Sarin R, Sharma PP, Arora VK, Jain RC. TB control, poverty, and vulnerability in Delhi, India. Trop Med Int Health 2002; 7:693-700. [PMID: 12167096 DOI: 10.1046/j.1365-3156.2002.00909.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The Revised National Tuberculosis Control Programme (RNTCP), based on the World Health Organization's DOTS strategy,* was introduced in India in the mid-1990s. This paper reports the findings from operational research studies in two pilot sites in New Delhi from 1996 to 1998. A variety of operational research methods were used, including semi-structured interviews, focus group discussions, non-participant observations and collection of data from the tuberculosis registers. The cure rates for the clinics were 71 and 75% with a default rate of 6 and 11%, respectively. An important finding was that health workers screened patients to determine their ability to conform to the direct observation of treatment element of the RNTCP. If the health worker was confident that the patient would comply and/or be easy to trace in the community in the event of 'default', they were provided with short-course treatment under the RNTCP. Other patients, largely those who were in absolute poverty, socially marginalized, itinerant labourers, poorly integrated in the city, were put on standard tuberculosis (TB) treatment as for the previous National TB Programme. The programme was evidently excluding the most vulnerable from the best available care. These findings demonstrate the potential dangers of target-driven programmes where there is an absence of support to both frontline health workers and patients. The paper also highlights the importance of operations research in helping to identify problems within TB programmes.
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Singh N, Arora VK, Jain A, Bhattacharya SN, Bhatia A. Cytology of testicular changes in leprosy. Acta Cytol 2002; 46:659-63. [PMID: 12146026 DOI: 10.1159/000326971] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To study the changes in testicular aspirates and semen of patients with leprosy. STUDY DESIGN A prospective study of 56 patients in the reproductive-age group, with no record of treatment for leprosy. Both Ridley-Jopling and WHO classification systems were used. Skin and/or nerve biopsies were performed for documentation of the diagnosis. Semen analysis and fine needle aspirates of the testes were performed. Smears from the testicular aspirates were stained with May-Grünwald-Giemsa and Ziehl-Neelsen stain. RESULTS Five patients were unable to produce an ejaculate. Abnormal semen analysis and/or testicular aspirates were seen in 24 (42.8%) patients. Eleven had oligospermia and eight azoospermia. Abnormalities in testicular aspirates ranged from hypospermatogenesis (4) through maturation arrest (1) and atrophy (11). Two patients had hydrocoele, and two had associated microfilariae. Three patients with multibacillary leprosy had type 2 reaction. Mycobacterium lepre was demonstrable in testicular aspirates from all patients with multibacillary and in three with paucibacillary leprosy. CONCLUSION Abnormal semen analysis and/or testicular aspirates occur in a very high percentage of patients with leprosy. While this is expected for multibacillary disease, the high incidence in the paucibacillary form was surprising. With the rapid elimination of leprosy, fertility-related disability might emerge as a major problem in these people.
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Arora VK, Gupta R, Johri A. Open lung biopsy in diffuse infiltrative lung disease with progressive dyspnoea: is it useful? THE INDIAN JOURNAL OF CHEST DISEASES & ALLIED SCIENCES 2002; 44:203-6. [PMID: 12206483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
Eleven subjects, aged between 15 and 60 years, presenting with diffuse infiltrative lung disease (DILD) and progressive dyspnoea, underwent an open lung biopsy (OLB). The authors feel that OLB does give a confidence to the treating physician to begin with a specific therapy in the form of steroids. But, as a matter of fact, at most health care delivery centres in the country, facilities for OLB are not available. Hence, the specific therapy should be instituted presumptively following an overall suggestion of disease based upon the clinical, physiological (chiefly comprising the pulmonary function test or PFT) and the radiological criteria, so that progression of disease could be arrested at an early stage.
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Puri MM, Dougall P, Arora VK. A case of tuberculosis of the thyroid gland. THE MEDICAL JOURNAL OF MALAYSIA 2002; 57:237-239. [PMID: 24326661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
We report a case of tuberculosis of the thyroid gland associated with mediastinal lymphadenitis in a 30 years-old male, who presented with dysphagia and a mid line anterior neck swelling. Fine needle aspiration was positive for acid fast bacilli. He made an uneventful recovery with antituberculous drugs. Although seldom observed, tuberculosis should be kept in mind in te differential diagnisis of nodular lesions of the thyroid.
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Jain M, Arora VK, Singh N, Bhatia A. Fine needle aspiration cytology of sclerosing lobular hyperplasia of the breast: a case report. Acta Cytol 2001; 45:765-7. [PMID: 11575657 DOI: 10.1159/000328301] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Sclerosing lobular hyperplasia presenting as a palpable, circumscribed nodular mass in a young female's breast is characterized histologically by prominent hyperplasia of the lobules and sclerosis of the intralobular connective tissue. The cytomorphologic features and differential diagnosis of the lesion are presented. CASE A 14-year-old female presented with a painless, progressively increasing, nodular, firm, mobile lump measuring 5 x 5 cm in the right breast. The clinical and radiologic diagnosis was fibroadenoma. Fine needle aspiration smears showed a clean background with uniform, round to oval epithelial cells in flat sheets, round clusters and rosettelike (acinar) arrangements. A few naked nuclei were present, while stromal fragments were not seen. CONCLUSION When analyzed in the context of the clinical findings, the cytologic features of sclerosing lobular hyperplasia help to differentiate it from other benign palpable nodular lesions of the juvenile breast.
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Singla R, Gupta S, Gupta R, Arora VK. Efficacy and safety of sparfloxacin in combination with kanamycin and ethionamide in multidrug-resistant pulmonary tuberculosis patients: preliminary results. Int J Tuberc Lung Dis 2001; 5:559-63. [PMID: 11409584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023] Open
Abstract
SETTING Department of tuberculosis and chest diseases of a tertiary referral tuberculosis institute in New Delhi, India. OBJECTIVE To study the efficacy and safety of sparfloxacin, in combination with kanamycin (for the initial 3-4 months) and ethionamide, in multidrug-resistant (MDR) pulmonary tuberculosis patients. DESIGN Prospective, uncontrolled study of nine patients with pulmonary tuberculosis who had received adequate anti-tuberculosis treatment with first-line drugs, including supervised category II treatment regimen as per World Health Organization guidelines for 5 months, and were still sputum smear acid-fast bacilli positive. It was planned to give them kanamycin (initial 3-4 months), ethionamide and sparfloxacin for 2 years. RESULTS All nine patients achieved sputum conversion within 6 months. Seven patients converted within 3.5 months, two of these within 1 month. All patients reported improvement in clinical symptoms, and chest X-ray improved in seven patients. Four patients developed mild to moderate phototoxicity. Eight patients have completed treatment for an average of 19 months (range 15-24 months), and are still under follow-up. One patient defaulted after 7 months of treatment. CONCLUSIONS In MDR-TB patients, sparfloxacin, along with other anti-tuberculosis drugs, appears to be effective and safe. Mild to moderate phototoxicity is common. However, the long-term results, including relapses, are still awaited.
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Chaturvedi S, Arora VK. Soft tissue swelling: cytology comes to rescue. J Postgrad Med 2001; 47:144. [PMID: 11832611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
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Foster JL, Molina RP, Luo T, Arora VK, Huang Y, Ho DD, Garcia JV. Genetic and functional diversity of human immunodeficiency virus type 1 subtype B Nef primary isolates. J Virol 2001; 75:1672-80. [PMID: 11160665 PMCID: PMC114076 DOI: 10.1128/jvi.75.4.1672-1680.2001] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We have characterized the functional integrity of seven primary Nef isolates: five from a long-term nonprogressing human immunodeficiency virus (HIV)-infected individual and one each from two patients with AIDS. One of the seven Nefs was defective for CD4 downregulation, two others were defective for PAK-2 activation, and one Nef was defective for PAK-2 activation and major histocompatibility complex (MHC) class I downregulation. Five of the Nefs were tested and found to be functional for the enhancement of virus particle infectivity. The structural basis for each of the functional defects has been analyzed by constructing a consensus nef, followed by mutational analysis of the variant amino acid residues. Mutations A29V and F193I were deleterious to CD4 downregulation and PAK-2 activation, respectively, while S189R rendered Nef defective for both MHC class I downregulation and PAK-2 activation. A search of the literature identified HIVs from five patients with Nefs predominantly mutated at F193 and from one patient with Nefs predominantly mutated at A29. A29 is highly conserved in all HIV subtypes except for subtype E. F193 is conserved in subtype B (and possibly in the closely related subtype D), but none of the other HIV group M subtypes. Our results suggest that functional distinctions may exist between HIV subtypes.
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Arora VK, Molina RP, Foster JL, Blakemore JL, Chernoff J, Fredericksen BL, Garcia JV. Lentivirus Nef specifically activates Pak2. J Virol 2000; 74:11081-7. [PMID: 11070003 PMCID: PMC113188 DOI: 10.1128/jvi.74.23.11081-11087.2000] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Nef proteins from human immunodeficiency virus type 1 (HIV-1) and simian immunodeficiency virus (SIV) have been found to associate with an active cellular serine/threonine kinase designated Nef-associated kinase (Nak). The exact identity of Nak remains controversial, with two recent studies indicating that Nak may be either Pak1 or Pak2. In this study, we investigated the hypothesis that such discrepancies arise from the use of different Nef alleles or different cell types by individual investigators. We first confirm that Pak2 but not Pak1 is cleaved by caspase 3 in vitro and then demonstrate that Nak is caspase 3 sensitive, regardless of Nef allele or cell type used. We tested nef alleles from three lentiviruses (HIV-1 SF2, HIV-1 NL4-3, and SIVmac239) and used multiple cell lines of myeloid, lymphoid, and nonhematopoietic origin to evaluate the identity of Nak. We demonstrate that ectopically expressed Pak2 can substitute for Nak, while ectopically expressed Pak1 cannot. We then show that Nef specifically mediates the robust activation of ectopically expressed Pak2, directly demonstrating that Nef regulates Pak2 activity and does not merely associate with activated Pak2. We report that most of the active Pak2 is found bound to Nef, although a fraction is not. In contrast, only a small amount of Nef is found associated with Pak2. We conclude that Nak is Pak2 and that Nef specifically mediates Pak2 activation in a low-abundance complex. These results will facilitate both the elucidation of the role of Nef in pathogenesis and the development of specific inhibitors of this highly conserved function of Nef.
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Jain M, Arora VK, Singh N, Bhatia A. Malakoplakia of the appendix. An unusual association with eggs of Taenia species. Arch Pathol Lab Med 2000; 124:1828-9. [PMID: 11100067 DOI: 10.5858/2000-124-1828-mota] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Malakoplakia of the appendix is an unusual condition that has been reported to occur in association with tumors, infections, and immunocompromised states. We describe a case of appendicular malakoplakia associated with eggs of Taenia species. The diagnosis was made on histopathologic examination of surgically resected tissue from an appendicular mass. To the best of our knowledge, this is the first time that helminths have been documented to be associated with malakoplakia. We also discuss the implications of helminthic infestation in the pathogenesis of the lesion.
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Puri MM, Arora VK. Contralateral pleural effusion during chemotherapy for tuberculous pleural effusion. THE MEDICAL JOURNAL OF MALAYSIA 2000; 55:382-4. [PMID: 11200723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
A 25 year old woman developed a right pleural effusion 6 weeks after commencement of short course chemotherapy for left sided tuberculous pleural effusion. Since the patient improved following continuation of the same treatment, it is presumed to be a case of paradoxical response to anti-tuberculosis treatment.
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Jain M, Singh N, Bhatia A, Arora VK. Histological assessment of dermal nerve damage occurring during multidrug therapy for leprosy. INTERNATIONAL JOURNAL OF LEPROSY AND OTHER MYCOBACTERIAL DISEASES : OFFICIAL ORGAN OF THE INTERNATIONAL LEPROSY ASSOCIATION 2000; 68:167-71. [PMID: 11036497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
This is a prospective histomorphological assessment of dermal innervation in biopsies taken before and after multidrug therapy (MDT) from 41 leprosy patients: 35 borderline tuberculoid (BT), 3 borderline lepromatous (BL), 3 lepromatous (LL). Biopsies of the same lesions taken before commencement (diagnostic therapy) and at the end of therapy (check biopsy) were compared. Hematoxylin and eosin, immunoperoxidase stain for S-100 protein, and the Holmes' silver impregnation method for nerve cells and fibers were used. Skin biopsies were classified as having detectable or undetectable nerves. Of 35 patients with BT leprosy, 17 had no detectable nerves in their diagnostic biopsies; in the check biopsies of 13 of these 17, dermal nerves remained undetectable, in 2 they were S-100 positive but were Holmes negative. Identifiable dermal nerves were present in diagnostic biopsies from 18 patients; in the check biopsies 5 of these 18 had no detectable nerves while in the remaining 13 nerve branches could be detected. The study provides histological documentation of complete damage to dermal innervation in 62.85% (22/35) of patients with BT leprosy, of which 14.28% (5/35) occurred during MDT. Of the patients with detectable dermal innervation at the onset of MDT, 27.7% (5/18) suffered continuing damage during MDT.
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Jindal T, Arora VK. Gianotti-crosti syndrome. Indian Pediatr 2000; 37:683-4. [PMID: 10869162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
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Wadhwa N, Arora VK, Singh N, Bhatia A. Fine needle aspiration cytology of primary extraskeletal myxoid chondrosarcoma. A case report. Acta Cytol 2000; 44:445-8. [PMID: 10834009 DOI: 10.1159/000328496] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Extraskeletal myxoid chondrosarcoma is a rare soft tissue tumor of the extremities. Since it usually lacks obvious chondroid differentiation on light microscopy, it needs to be distinguished from other myxoid soft tissue sarcomas. CASE REPORT The diagnosis of extraskeletal myxoid chondrosarcoma was made on fine needle aspiration in a patient with a swelling in the right calf. Cellular myxoid fragments having round to oval cells with grooved nuclei arranged in a cordlike pattern suggested chondroid differentiation. The diagnosis was confirmed by histopathology. CONCLUSION Fine needle aspiration cytology can be diagnostic of extraskeletal myxoid chondrosarcoma even in the absence of obvious chondroid differentiation.
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Arora VK, Singh N, Bhatia A, Radhakrishnan G, Jain BK, Agarwal N. Testicular fine needle aspiration cytology for the diagnosis of azoospermia and oligospermia. Acta Cytol 2000; 44:349-56. [PMID: 10833990 DOI: 10.1159/000328477] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To evaluate qualitative and quantitative cytologic features on testicular fine needle aspiration biopsy in the diagnosis of azoospermia and oligospermia and to correlate cytologic and histologic diagnoses. STUDY DESIGN In this prospective study, 50 infertile males selected from the infertility clinic of Guru Tegh Bahadur Hospital were studied. Fine needle aspiration cytology (FNAC) smears from both testes of 27 azoospermic and 23 oligospermic patients (sperm count < 10 million per milliliter) were stained with May-Grünwald-Giemsa and Papanicolaou stain. Differential counting of 500 spermatogenic cells was done, and the number of Sertoli cells per 500 germ cells was determined for calculating the spermatic index and Sertoli cell index, respectively. FNAC and testicular biopsy were performed under local anesthesia as a minor surgical procedure. RESULTS Six groups were identified on FNAC smears from azoospermic patients: I. normal spermatogenesis (8), II. hypospermatogenesis (2), III. maturation arrest (2), IV. Sertoli cells only (6), V. atrophic pattern (7), and VI. Leydig cell predominance (2). In oligospermic patients two groups were identified: I. those with normal spermatogenesis (4), and II. those with subnormal spermatogenesis (19). Correlation with histopathologic examination was seen in 81.5% azoospermic and 65.2% oligospermic patients. CONCLUSION Qualitative and quantitative evaluation of testicular FNAC provides useful information on both azoospermic and oligospermic patients. FNAC performed under local anesthesia is an acceptable outpatient procedure that consistently yields sufficient diagnostic material in all patients.
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Chakravarti A, Goyal A, Vishwakarma SK, Arora VK. Affection of cervical lymph nodes in rhinoscleroma. Trop Doct 2000; 30:110-1. [PMID: 10842565 DOI: 10.1177/004947550003000222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Zhang JY, Fast DM, Schoenhard GL, Arora VK, Belas FJ, Blair IA. Quantitative determination of SC-68328 in dog plasma using flow injection and tandem mass spectrometry. JOURNAL OF MASS SPECTROMETRY : JMS 2000; 35:354-360. [PMID: 10767764 DOI: 10.1002/(sici)1096-9888(200003)35:3<354::aid-jms942>3.0.co;2-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
A flow injection/tandem mass spectrometric assay was developed to quantitate SC-68328 in dog plasma using its stable isotopic analog [13C4]SC-68328 as an internal standard (IS). Since SC-68328, a manganese-based superoxide dismutase mimetic, is very unstable, very polar and adheres to silica-based high-performance liquid chromatographic columns, the analyte and IS were derivatized to their bis-isothiocyanate forms followed by a liquid-liquid extraction with methylene chloride and analyzed using positive ion electrospray mass spectrometric detection. SC-68328 was quantitated using the peak-height ratio of SC-68328 to its IS using MS/MS in the multiple reaction monitoring mode. The lower limit of quantitation of the assay was 0.25 microg ml(-1) SC-68328 in dog plasma with an inter-day precision of 11.8% and an accuracy of 113% (n = 12). Acceptable precision and accuracy were also obtained for concentrations in the calibration curve range (0.25-10 microg ml(-1) SC-68328 in dog plasma).
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Arora VK, Sarin R. Revised National Tuberculosis Control Programme: Indian perspective. THE INDIAN JOURNAL OF CHEST DISEASES & ALLIED SCIENCES 2000; 42:21-6. [PMID: 10851818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
The global tuberculosis programme has promoted the revision of National Tuberculosis Programme by strengthening the focus on Directly Observed Treatment Short-course (DOTS). National Tuberculosis Control Programme (NTCP) which was established in 1962 had less than 30 per cent treatment completion. Based on an in-depth review of the programme by a high level committee in 1992, a Revised National Tuberculosis Control Programme (RNTCP) was envisaged with a view to achieve a cure rate of at least 85 per cent amongst newly detected sputum positive cases under DOTS. By December 1999, 130 million of population had been covered in the country under DOTS. However, there are many challenges that are required to be met before RNTCP can become a success story in our country.
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Chakravarti A, Vishwakarma SK, Arora VK. Solitary neurofibroma causing nasal obstruction. JOURNAL OF THE INDIAN MEDICAL ASSOCIATION 1999; 97:526. [PMID: 10638137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
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Abstract
A quantitative method was developed and validated for rapid and sensitive analysis of cimetidine in human plasma. The method involved the use of liquid chromatography (LC) coupled with atmospheric pressure chemical ionization (APCI) and selected reaction monitoring (SRM) mass spectrometry (MS). A cimetidine analog, SKF92374, was used as the internal standard. Separation of cimetidine and the internal standard was accomplished using a reverse-phase HPLC column (C18). The eluted components were ionized by the APCI source and subsequently detected by a highly selective triple quadrupole mass spectrometer in the SRM mode. Linear standard curves were obtained from 5 ng/mL (lower limit of quantitation) to 10,000 ng/mL. The results demonstrated excellent precision (%RSD 1. 1-8.9%) and accuracy (94.7-108.0%) over this range. In addition, the amount of plasma sample needed for analysis was small (50 muL), and the plasma pretreatment (analyte recovery >94%) was simple and time saving. This assay was used to evaluate cimetidine levels in premature infants following intravenous infusion of cimetidine.
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Malik A, Bhatia A, Singh N, Bhattacharya SN, Arora VK. Fine needle aspiration cytology of reactions in leprosy. Acta Cytol 1999; 43:771-6. [PMID: 10518129 DOI: 10.1159/000331290] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To define diagnostic cytomorphologic features of reactions in leprosy. STUDY DESIGN Part-retrospective, part-prospective, single-blind, controlled study of the applicability of fine needle aspiration cytology in the diagnosis of reactions in leprosy. Cytomorphologic features were compared in 42 clinically diagnosed patients with reactions in leprosy with those in a control group of patients with nonreactional leprosy. The study groups included type 1 and type 2 reactions in 35 and 9 patients, respectively. May-Grünwald-Giemsa and Ziehl-Neelsen staining methods were employed. RESULTS Statistically significant (P < .01) cytomorphologic features of type 1 reaction were the presence of fragments of collagen and elastin; giant cells; giant cells exhibiting elastin phagocytosis; loose, epithelioid cell granulomas; and fibroblasts. Type 2 reaction was characterized in aspirates by the presence of an abundance of neutrophils in a background of lepromatous leprosy (P < .01). CONCLUSION Criteria that are used in histopathology for the diagnosis of leprosy reactions can be applied satisfactorily to cytologic smears. A good correlation between clinical diagnosis and cytomorphology can be achieved. Multiple-site aspirates from the skin, nerve and lymph nodes are helpful in substantiating the diagnosis.
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Bhatia A, Singh N, Arora VK, Bhattacharya SN. Diagnosing granulomatous inflammation of the skin. A cytomorphologic approach based on evaluation of cellular reaction patterns. Acta Cytol 1999; 43:761-6. [PMID: 10518127 DOI: 10.1159/000331288] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To determine the applicability of recognizing cellular reaction patterns in the cytologic diagnosis of granulomatous inflammation of the skin. STUDY DESIGN Prospective. Two hundred seventeen cases of clinically suspected granulomatous dermatitis formed the data for this study. May-Grünwald-Giemsa, Ziehl-Neelsen, periodic acid-Schiff, silver impregnation and Gram staining methods were employed. RESULTS Five cytomorphologic patterns of granulomatous inflammation were identified: epithelioid cell granulomas (77), histiocytic granulomas (20), epithelioid cell granulomas with polymorphous exudate (77), foreign body granulomas (3) and fat necrosis with granulomas (9). CONCLUSION Correlating clinical presentation with cytomorphologic patterns often yields diagnostic information in the workup of granulomatous inflammation of the skin and frequently obviates the need for biopsy.
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Arora VK, Kumar SV. Pattern of opportunistic pulmonary infections in HIV sero-positive subjects: observations from Pondicherry, India. THE INDIAN JOURNAL OF CHEST DISEASES & ALLIED SCIENCES 1999; 41:135-44. [PMID: 10534938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
Prospective analysis for a period of six-and-a-half years was done in 190 patients with HIV infection, which showed post-primary tuberculosis with sputum positive for acid-fast bacilli in 65% of cases. Extrapulmonary forms of tuberculosis especially lymph nodes infection was more frequent. Cervical group of lymph node involvement was the commonest presentation. Procedures such as FNAC/biopsy of lymph nodes and pleura provided the immediate diagnostic yields. These procedures must be considered early in the course of illness of HIV infected patients with suspected extrapulmonary and disseminated tuberculosis. Tuberculosis constitutes a common pathology with an appreciable mortality in disseminated subjects. Majority of patients with tuberculosis responded to 2EHRZ/7HR therapy indicating infection by Mycobacterium tuberculosis rather than by atypical mycobacteria, without any serious adverse reactions. Retrospective analysis of two groups (February 1991-May 1994) and (June 1994-October 1997) shows a significant increase in disseminated tuberculosis and Pneumocystis carini pneumonia indicating late stage of HIV disease.
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Mohanty S, Arora VK, Gandhi V, Singal A, Baruah MC. Lymphangioma circumscriptum of scrotum of late onset. Indian J Dermatol Venereol Leprol 1998; 64:289-290. [PMID: 20921799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Lymphangioma circumscriptum is the commonest type of lymphangioma which is characterised by small, grouped vesicles resembling frog spawn. An interesting case of thin walled lymphangioma circumscriptum is reported which started at a late age of 45 years and limited to scrotum in a 70-year old man.
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Arora VK, Tumbanatham A. Severe arthropathy with ofloxacin in two cases of MDR tuberculosis. Int J Tuberc Lung Dis 1998; 2:941-3. [PMID: 9848618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
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Bhatia A, Singh N, Arora VK, Gupta K. Prospective peer review in fine needle aspiration cytology. Another step toward quality assurance. Acta Cytol 1998; 42:865-8. [PMID: 9684569 DOI: 10.1159/000331960] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To analyze the effects of a prospective peer review program on diagnostic accuracy in a routine cytopathology laboratory. STUDY DESIGN For the study, 4,836 consecutive cases subjected to fine needle aspiration cytology (FNAC) over a one-year period were used. Nine pathologists performed both reporting and peer review functions. Disagreements were classified into "diagnostic errors" and "diagnostic discrepancies," depending on their impact on patient care. The effect of this review on turnaround time was statistically analyzed. A retrospective review of 4,025 cases from the preceding year was performed for comparison. RESULTS Sixty-six cases with diagnostic disagreements were detected by prospective review. There were 28 diagnostic errors and 38 diagnostic discrepancies. The initial turnaround time for diagnostic FNAC in 90% of total cases was < 24 hours; mean delay for the remainder was 3.3 days. Prospective peer review added a further delay of 1 and 1.5 days, respectively. The number of diagnostic disagreements was significantly higher in the retrospective review (P < .01). CONCLUSION Prospective peer review of diagnostic FNAC resulted in improved accuracy of diagnosis and reduced potential for inappropriate therapy; however, turnaround time was significantly increased.
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Singh N, Bhatia A, Arora VK, Bhattacharya SN. Fine-needle aspiration cytology of lepromatous leprosy. LEPROSY REV 1998; 69:145-50. [PMID: 9715599 DOI: 10.5935/0305-7518.19980015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A prospective study correlating cytopathology with clinical morphology and histopathology in 22 patients with lepromatous leprosy was performed. Aspirates were taken from skin lesions in all patients. Lymph node aspirates were also performed in four patients with lymphadenopathy. Fine-needle aspirates yielded sufficient cellular material with excellent preservation of morphological detail. Diagnosis and correlation with bacillary index, clinical and histopathological findings was possible in all patients. In addition, the two patterns, partial and diffuse, of lymph node involvement could be recognized. Fine-needle aspiration cytology is a simple method for the laboratory assessment of leprosy.
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Abstract
Dermoids or hairy polyps, the most primitive forms of teratoma are rare lesions affecting the nasopharynx. They arise during early embryogenesis, being derived from only two germinal layers, ectoderm and mesoderm and are invariably benign. They usually present at or soon after birth with signs of upper aerodigestive tract obstruction. A case of hairy polyp of nasopharynx in a neonate is reported for its rarity. The etiology of teratomas, their classification in head and neck region, clinical features, and management in neonates are discussed.
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Arora VK, Venubabu K. Cotrimoxazole induced toxic epidermal necrolysis in a suspected case of Pneumocystis carinii pneumonia with human immuno deficiency virus infection. THE INDIAN JOURNAL OF CHEST DISEASES & ALLIED SCIENCES 1998; 40:125-9. [PMID: 9775570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Toxic epidermal necrolysis due to trimethoprim sulphamethoxazole therapy in a subject of HIV with suspected pneumocystis carinii pneumonia, is reported, because of its rarity in Indian conditions. Patient showed excellent recovery on corticosteroid therapy.
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Singh N, Ramesh V, Arora VK, Bhatia A, Kubba A, Ramam M. Nodular post-kala-azar dermal leishmaniasis: a distinct histopathological entity. J Cutan Pathol 1998; 25:95-9. [PMID: 9521498 DOI: 10.1111/j.1600-0560.1998.tb01696.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Post-kala-azar dermal leishmaniasis (PKDL) is an infrequently occurring sequel to treated visceral leishmaniasis. Diagnosis, particularly in non-endemic areas, is difficult because the clinical appearances may be subtle and simulate lepromatous leprosy. The histopathology of the condition has been a neglected subject. Nodular lesions constitute one of the large variety of lesions that can be seen in PKDL. This paper describes the histopathology of such lesions in 26 patients seen over a period of approximately 8 years in a non-endemic setting. All the biopsies had strikingly similar light microscopic features with characteristic findings: a dense lymphohistiocytic infiltrate beneath an atrophic epidermis, pronounced follicular plugging, vascular hyalinization and collagen changes and negative Fite stain. These allow a definite diagnosis of PKDL even in the absence of demonstrable Leishman-Donovan (L-D) bodies.
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Bhatia A, Arora VK, Singh N. Cytological assessment of bronchoalveolar lavage: a valuable diagnostic tool in pulmonary diseases. THE INDIAN JOURNAL OF CHEST DISEASES & ALLIED SCIENCES 1998; 40:1-4. [PMID: 9727277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Arora VK, Singh N, Chaturvedi S, Bhatia A. Fine needle aspiration diagnosis of a subcutaneous abscess from Enterobius vermicularis infestation. A case report. Acta Cytol 1997; 41:1845-7. [PMID: 9390155 DOI: 10.1159/000333199] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Extraintestinal infestation by Enterobius vermicularis is uncommon. It has been reported to occur in the peritoneal cavity, ovary, fallopian tube, endometrium, lung, liver and urinary tract. CASE REPORT Fine needle aspiration diagnosis was made in a case of enterobiasis presenting with a subcutaneous abscess in the natal cleft. Eggs, as well as fragments of cuticle of the adult worm, were found; the morphology of both was best visualized in Papanicolaou-stained smears. Polarizing microscopy highlighted the equally spaced parallel grooves of the cuticle. CONCLUSION Fine needle aspiration cytology of subcutaneous abscesses due to enterobiasis can be diagnostic when eggs, or eggs with cuticle, are identified in a suppurative or granulomatous inflammation.
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Chugh IM, Agarwal AK, Arora VK, Shah A. Bilateral miliary pattern in sarcoidosis. THE INDIAN JOURNAL OF CHEST DISEASES & ALLIED SCIENCES 1997; 39:245-9. [PMID: 9654821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Baude EJ, Arora VK, Yu S, Garbers DL, Wedel BJ. The cloning of a Caenorhabditis elegans guanylyl cyclase and the construction of a ligand-sensitive mammalian/nematode chimeric receptor. J Biol Chem 1997; 272:16035-9. [PMID: 9188508 DOI: 10.1074/jbc.272.25.16035] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Substantial guanylyl cyclase activity was detected in membrane fractions prepared from Caenorhabditis elegans (100 pmol cGMP/min/mg at 20 degrees C or 500 pmol cGMP/min/mg at 37 degrees C), suggesting the potential existence of orphan cyclase receptors in the nematode. Using degenerate primers, a cDNA clone encoding a putative membrane form of the enzyme (GCY-X1) was obtained. The apparent cyclase was most closely related to the mammalian natriuretic peptide receptor family, and retained cysteine residues conserved within the extracellular domain of the mammalian receptors. Expression of the cDNA in COS-7 cells resulted in low, but detectable guanylyl cyclase activity (about 2-fold above vector alone). The extracellular and protein kinase homology domain of the mammalian receptor (GC-B) for C-type natriuretic peptide (CNP) was fused to the catalytic domain of GCY-X1 and expressed in COS-7 cells to determine whether ligand-dependent regulation would now be obtained. The resulting chimeric protein (GC-BX1) was active, and CNP elevated cGMP in a concentration-dependent manner. Subsequently, a search of the genome data base demonstrated the existence of at least 29 different genes from C. elegans that align closely with the catalytic domain of GCY-X1, and thus an equally large number of different regulatory ligands may exist.
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Adiga BK, Singh N, Arora VK, Bhatia A, Jain AK. Rhinosporidiosis. Report of a case with an unusual presentation with bony involvement. Acta Cytol 1997; 41:889-91. [PMID: 9167721 DOI: 10.1159/000332723] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Rhinosporidiosis, a fungal infection due to Rhinosporidium seeberi, frequently produces polypoidal lesions in the nose. Sites like the conjunctiva, larynx, trachea, nasopharynx, skin and genitourinary tract are less frequently involved. Generalized rhinosporidiosis with skin and visceral involvement is extremely rare. This report describes the fine needle aspiration cytology (FNAC) of rhinosporidiosis occurring as a solitary lesion with erosion of cortical bone. CASE REPORT FNAC of a soft tissue swelling overlying a lytic lesion on the anterior aspect of the tibia was performed in a 40-year-old male. Smears revealed numerous sporangia and spores of R seeberi. There were no mucocutaneous lesions. Histologic examination confirmed the bony involvement. CONCLUSION The FNAC diagnosis of rhinosporidiosis is specific. Preoperative diagnosis is possible even in cases with unusual clinical presentations.
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Gupta K, Singh N, Bhatia A, Arora VK, Singh UR, Singh B. Cytomorphologic patterns in Calmette Guerin bacillus lymphadenitis. Acta Cytol 1997; 41:348-50. [PMID: 9100765 DOI: 10.1159/000332523] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To study the cytomorphologic patterns of Calmette Guerin bacillus (BCG) lymphadenitis and compare it to those of tuberculous lymphadenitis. STUDY DESIGN A retrospective cytomorphologic study of 136 cases of clinically diagnosed BCG adenitis. All fine needle aspiration smears of lymphadenitis in the age group 2 months to 2 years during a three-and-half-year period were analyzed. RESULTS Three distinct cytomorphologic patterns were seen in 112 cases. They were acid-fast bacilli in a necrotic background (62), granulomas with necrosis (47) and granulomas in a reactive lymphoid background (3). CONCLUSION The cytomorphologic patterns in BCG lymphadenitis were similar to those seen in tuberculous lymphadenitis; however, an exudative response and high acid-fast bacillus positivity was seen more frequently in BCG lymphadenitis. Moreover, Ziehl-Neelsen staining helped to distinguish these cases from pyogenic abscesses.
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Abstract
OBJECTIVE To study the occurrence and significance of Charcot-Leyden crystals (CLC) in routinely processed, eosinophil-rich smears. STUDY DESIGN Fine needle aspiration (FNA) smears of 258 cases of cysticercosis, 35 of lymphatic filariasis and 19 of nonparasitic lesions with significant eosinophils were screened for the presence of CLC and correlated with the cytomorphology of the underlying disease. RESULTS Charcot-Leyden crystals were seen in lymphatic filariasis (4), eosinophilic granuloma (1), chronic myelogenous leukemia (1) and pyogenic abscess (1). CLC were conspicuous by their absence in smears of cysticercosis, although cholesterol crystals were frequently observed. CLC were present in both May-Grünwald-Giemsa- and Papanicolaou-stained smears. Necrosis was a prominent cytologic feature in all cases with CLC. CONCLUSION CLC encountered in routinely processed aspirates containing eosinophils, albeit infrequently, indicate in vivo formation. Necrosis probably provides a milieu for suspension of eosinophils, facilitating the formation of CLC. Absence of CLC in cysticercosis could be attributed to the high lipid content of these lesions, as indicated by the frequent occurrence of cholesterol crystals.
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MESH Headings
- Adult
- Aged
- Biopsy, Needle
- Child, Preschool
- Crystallization
- Cysticercosis/diagnosis
- Cysticercosis/pathology
- Elephantiasis, Filarial/diagnosis
- Elephantiasis, Filarial/pathology
- Eosinophilic Granuloma/diagnosis
- Eosinophilic Granuloma/pathology
- Eosinophils/chemistry
- Eosinophils/parasitology
- Eosinophils/pathology
- Female
- Glycoproteins/analysis
- Humans
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/diagnosis
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/pathology
- Lymphadenitis/diagnosis
- Lymphadenitis/pathology
- Lysophospholipase
- Male
- Suppuration
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Chakravarti A, Vishwakarma SK, Arora VK. Plasmacytoma of the maxilla. Indian J Otolaryngol Head Neck Surg 1997; 49:44-6. [PMID: 23119249 PMCID: PMC3450734 DOI: 10.1007/bf02991711] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Plasmacytoam of maxilla is an extremely rare tumor. Histopathological examination led to the final diagnosis. Co-existence of multiple myeloma should be ruled out in all such cases. Radiotherapy is the main stay of treatment. A close follow-up is needed for clinical evidences of recurrence.
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