Langerhans cell histiocytosis infiltration into pancreas and kidney

An 18-month-old male presented with a swelling of the neck for 2 months. A presumptive diagnosis of Langerhans cell histiocytosis (LCH) was made on fine needle aspiration cytology from the lymph node. The child received chemotherapy. He remained well for around 10 months, when he represented with loose stools, cough, and respiratory distress. His condition deteriorated over a few hours culminating in death. A partial autopsy revealed LCH infiltration in liver, pancreas, and kidneys along with bronchopneumonia. The pancreatic and renal infiltration by LCH is extremely rare.

Possible GABAergic Modulation in the Protective Effect of Zolpidem in Acute Hypoxic Stress-induced Behavior Alterations and Oxidative Damage

Hypoxia is an environmental stressor that is known to elicit alterations in both the autonomic nervous system and endocrine functions. The free radical or oxidative stress theory holds that oxidative reactions are mainly underlying neurodegenerative disorders. In fact among complex metabolic reactions occurring during hypoxia, many could be related to the formation of oxygen derived free radicals, causing a wide spectrum of cell damage. In present study, we investigated possible involvement of GABAergic mechanism in the protective effect of zolpidem against acute hypoxia-induced behavioral modification and biochemical alterations in mice. Mice were subjected to acute hypoxic stress for a period of 2 h. Acute hypoxic stress for 2 h caused significant impairment in locomotor activity, anxiety-like behavior, and antinocioceptive effect in mice. Biochemical analysis revealed a significant increased malondialdehyde, nitrite concentrations and depleted reduced glutathione and catalase levels. Pretreatment with zolpidem (5 and 10 mg/kg, i.p.) significantly improved locomotor activity, anti-anxiety effect, reduced tail flick latency and attenuated oxidative damage (reduced malondialdehyde, nitrite concentration, and restoration of reduced glutathione and catalase levels) as compared to stressed control (hypoxia) (P < 0.05). Besides, protective effect of zolpidem (5 mg/kg) was blocked significantly by picrotoxin (1.0 mg/kg) or flumazenil (2 mg/kg) and potentiated by muscimol (0.05 mg/kg) in hypoxic animals (P < 0.05). These effects were significant as compared to zolpidem (5 mg/kg) per se (P < 0.05). Present study suggest that the possible involvement of GABAergic modulation in the protective effect of zolpidem against hypoxic stress.

Edible vaccines: current status and future

Edible vaccines hold great promise as a cost-effective, easy-to-administer, easy-to-store, fail-safe and socioculturally readily acceptable vaccine delivery system, especially for the poor developing countries. It involves introduction of selected desired genes into plants and then inducing these altered plants to manufacture the encoded proteins. Introduced as a concept about a decade ago, it has become a reality today. A variety of delivery systems have been developed. Initially thought to be useful only for preventing infectious diseases, it has also found application in prevention of autoimmune diseases, birth control, cancer therapy, etc. Edible vaccines are currently being developed for a number of human and animal diseases. There is growing acceptance of transgenic crops in both industrial and developing countries. Resistance to genetically modified foods may affect the future of edible vaccines. They have passed the major hurdles in the path of an emerging vaccine technology. Various technical obstacles, regulatory and non-scientific challenges, though all seem surmountable, need to be overcome. This review attempts to discuss the current status and future of this new preventive modality.

Multifocal nodular oncocytic hyperplasia in parotid gland: a case report

BACKGROUND

Multifocal nodular oncocytic hyperplasia (MNOH) is a rare lesion of the parotid gland. Fine needle aspiration cytology (FNAC) in MNOH has not been described previously to the best of our knowledge.

CASE

A 55-year-old woman presented with a lump at the left angle of her mouth for 2 months. Local examination revealed a hard, nontender parotid mass. FNAC revealed clusters as well as discretely lying oncocytic cells. cells at places showed moderate nuclear pleomorphism. The features were consistent with a diagnosis of oncocytic neoplasm neoplasm; however, because of pleomorphism, a suspicion of carcinoma was offered. The patient underwent superficial parotidectomy, and histopathology examination revealed it to be multifocal nodular oncocytic hyperplasia.

CONCLUSION

MNOH is a rare nonneoplastic salivary gland lesion and should be considered in the differential diagnosis of oncocytic neoplasm on FNAC.

Colchicines-induced neurotoxicity as an animal model of sporadic dementia of Alzheimer's type

Alzheimer's disease (AD) is the most common type of dementia disorder of elderly affecting millions of people. The pathophysiology of the disease is complex and involves multiple pathways of neuronal damage. Sporadic dementia of Alzheimer's type (SDAT) has been shown to be associated with microtubular dysfunction and is characterized by the appearance of specific cytoskeletal cellular abnormalities, including neurofibrillary tangles and senile plaques. Intracerebroventricular (i.c.v) administration of colchicine, a microtubule-disrupting agent, causes cognitive dysfunction as evidenced by poor retention of memory in both Morris water maze and elevated plus-maze task paradigms that is associated with excessive free radical generation. Biochemical analysis revealed that icv colchicine injection significantly induced lipid peroxidation, increased nitrite and depleted reduced glutathione (GSH) and acetylcholinesterase (AChE) level in rat brains. Chronic treatment with rivastigmine (0.625 and 2.5 mg/kg, po) twice daily for a period of 25 days beginning 4 days prior to colchicine injection significantly improved the colchicine-induced cognitive impairment and reduced AChE level. The results of the present study clearly indicated that colchicines-induced cognitive impairment and oxidative stress in animals and can be used as an animal model for drug screening for Alzheimer's disease.

Protective effect of alprazolam in acute immobilization stress-induced certain behavioral and biochemical alterations in mice

Stress can be viewed as a cause of adverse circumstance that induces a wide range of biochemical and behavioral changes. Oxidative stress is a major contributor to the genesis of neurodegenerative and neuropsychiatric problems. In the present study, we investigated the protective effect of alprazolam in acute immobilization-induced various behavioral and biochemical alteration in mice. Mice were immobilized for a period of 6 h. Alprazolam (0.25 and 0.5 mg/kg, i.p.) was administered 30 min before subjecting the animals to acute stress and several behavioral (mirror chamber, actophotometer, tail flick test) and biochemical tests (malondialdehyde level, glutathione, catalase, nitrite and protein) were performed. Acute immobilization stress for a period of 6 h caused severe anxiety, analgesia and decreased locomotor activity in mice. Biochemical analyses revealed an increase in malondialdehyde, nitrite level and depleted glutathione and catalase activity in stressed brain. Pretreatment with alprazolam (0.25 and 0.5 mg/kg, i.p.) significantly reversed immobilization stress-induced anxiety, analgesia and impaired locomotor activity. Biochemically, alprazolam pretreatment decreased malondialdehyde, nitrite activity and restored reduced glutathione level and catalase activity. These results suggest that alprazolam has a neuroprotective effect and can be used in the treatment and management of stress and related disorders.

Antimicrobial resistance in invasive and colonising Streptococcus pneumoniae in North India

The present study was done to detect the antibiotic resistance in S. pneumoniae. One hundred twenty S. pneumoniae isolates from clinical specimens and 50 from nasopharyngeal sites were subjected to antimicrobial susceptibility testing by Kirby Bauer disk diffusion method and minimum inhibitory concentration (MIC) determination for penicillin and cefotaxime non-susceptible isolates. A total of 22 isolates (18.3%) from clinical sites and eight (16%) from nasopharyngeal sites showed decreased susceptibility to penicillin by oxacillin disk diffusion test. MICs of 26 of these resistant strains ranged from 0.12-1 microg/mL (intermediate resistance) by broth dilution and E test. Only four isolates, two from sputum and two from nasopharyngeal swabs, showed MIC of 2 microg/mL (complete resistance). However, MIC of two cefotaxime resistant isolates (by disk diffusion) was in the susceptible range (0.5 microg/mL). Highest antimicrobial resistance was seen to cotrimoxazole (55.2%) and tetracycline (61.2%). Antimicrobial resistance to cotrimoxazole and tetracycline was much more in clinical isolates than colonizing isolates. Multi-drug resistant phenotype was detected in 76.9% (20 of 26) of isolates that were intermediately sensitive to penicillin and 50% (2 of 4) of penicillin resistant isolates (co-resistant to tetracycline and cotrimoxazole). Routine screening for antibiotic susceptibility is recommended for clinical isolates of pneumococci. Strains with reduced susceptibility to penicillin should be subjected to MIC determination to detect relative resistance or true resistance as such strains are associated with increased virulence. The choice of antibiotics should be guided by the prevalence of local resistance patterns of pneumococci.

Pathology teach and tell disseminated candidiasis in an infant with acute myeloid leukemia without prior chemotherapy

Opportunistic fungal infections are significant problems for neutropenic patients who are undergoing cytotoxic therapy for acute leukemia. Systemic and hepatosplenic candidiasis have been reported in acute leukemic patients who are on chemotherapy. Gastrointestinal tract involvement is a rare phenomenon in disseminated candidiasis, especially in acute leukemia. We report one such rare case of acute myeloid leukemia in an infant who died of disseminated candidiasis with gastrointestinal tract involvement prior to the institution of chemotherapy.

Disseminated herpes simplex infection with cystic fibrosis: a case report

A 6 months old female infant presented with history of fever, cough and severe respiratory distress. There was past history of recurrent attacks of pneumonia. She succumbed to the illness after a hospital stay of 7 days. Postmortem revealed morphological evidence of cystic fibrosis along with herpes simplex infection of liver and adrenals. The co-existence of disseminated herpes simplex infection and cystic fibrosis is very rare.

Plasmacytoma of the clivus: a case report

A 60-year-old male presented with headache and diplopia for 2 months. Computed tomography of the head showed a heterogeneously enhancing expansile lytic lesion in clival region. The patient underwent surgery and histopathological examination revealed it to be plasmacytoma of the clivus. The multiple myeloma work-up was negative. Solitary plasmacytoma localized to the skull base is extremely rare. Prior to this, only three case reports of plasmacytoma of the clivus have been described in the English literature.

Primary chondrosarcoma of ethmoid bone in a 6-year-old child

Chondrosarcoma (CS) is a distinctly uncommon tumor in young patients and tends to be located in the extremities. Cartilaginous tumors in young patients are benign tumors. We report a case of a childhood CS in a 6-year-old boy who presented with right-sided proptosis. Radiological examination revealed a large destructive mass in right ethmoidal sinus extending into the surrounding sphenoidal sinus, intracranially, and the into right orbit, causing proptosis. Biopsy of the mass showed characteristic features of a well-differentiated CS. There are no reports of CS presenting as proptosis and arising from ethmoid bone. This case highlights the rarity of this tumor with regard to age of presentation and site of origin.

Simple and economical method for speciation and resistotyping of clinically significant coagulase negative staphylococci

An attempt was made to speciate 102 clinically significant isolates of coagulase negative staphylococci (CoNS) by a practical scheme adapted from various references. This scheme utilizes slide and tube coagulase test, urease test ornithine decarboxylase, novobiocin susceptibility and aerobic acid from mannose for assigning species group. Inclusion of one or two additional tests in a species group could identify the isolates to species level. Ninety eight (97%) isolates were conveniently identified as S. epidermidis (41%), S. saprophyticus (16.6%), S. haemolyticus (14.7%), S. hominis (14.7%), S. lugdunensis (4.9%), S. schleiferi (1.9%) and S. capitis (1.9%). Only four isolates were not identified to the species level, two of which were probably S. capitis subspecies ureolyticus / S. warneri / S. simulans . Antibiotic susceptibility testing showed maximum resistance to ampicillin (89%) followed by cefotaxime (59%) with no resistance to vancomycin. The increasing recognition of pathogenic potential of CoNS and emergence of drug resistance amongst them denotes the need to adopt simple laboratory procedures to identify and understand the diversity of staphylococci isolated from clinical material.

Mixed medullary and follicular cell carcinoma of the thyroid with lymph node metastasis in a 7-year-old child

A 7-year-old boy presented with midline swelling in the neck. On fine-needle aspiration cytology it was diagnosed as papillary carcinoma of the thyroid. The patient underwent total thyroidectomy. Histopathological examination, immunohistochemistry and electron microscopy revealed the presence of two intermingled components: medullary carcinoma and papillary carcinoma. One of the submandibular lymph nodes had metastasis of both the components. The case was diagnosed as 'mixed medullary and follicular cell carcinoma' with papillary carcinoma pattern and lymph node metastasis. Mixed medullary and follicular cell carcinoma with intermingling of medullary and papillary carcinoma components is a rare tumor. In adults, only eight such cases with lymph node metastasis have been published. To the best of the authors' knowledge no pediatric case has previously been reported in the English-language literature.