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Sandhu J, Singh A, Kumar Gupta S, Singh A, Garg B. Peri-ocular, papulo-nodular plaques over bilateral eyelids. Indian J Dermatol Venereol Leprol 2024; 0:1-3. [PMID: 38314972 DOI: 10.25259/ijdvl_377_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 08/24/2023] [Indexed: 02/07/2024]
Affiliation(s)
- Jaspriya Sandhu
- Department of Dermatology, Venereology & Leprology, Dayanand Medical College & Hospital, Ludhiana, Punjab, India
| | - Amandeep Singh
- Department of Dermatology, Venereology & Leprology, Dayanand Medical College & Hospital, Ludhiana, Punjab, India
| | - Sunil Kumar Gupta
- Department of Dermatology, Venereology & Leprology, Dayanand Medical College & Hospital, Ludhiana, Punjab, India
| | - Aminder Singh
- Department of Pathology, Dayanand Medical College & Hospital, Ludhiana, Punjab, India
| | - Bhavna Garg
- Department of Pathology, Dayanand Medical College & Hospital, Ludhiana, Punjab, India
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Arora P, Selhi AK, Narang V, Singh S, Garg B, Kaur H. B-cell acute lymphoblastic leukemia as a secondary malignancy following diffuse large B-cell lymphoma: A rare occurrence. INDIAN J PATHOL MICR 2023:00004270-900000000-99976. [PMID: 38394417 DOI: 10.4103/ijpm.ijpm_316_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024] Open
Affiliation(s)
- Purvi Arora
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India Department of Hemato-Oncology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India Department of MBBS Student, MAMC, New delhi, India
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Soni A, Batta N, Mehmi S, Narang V, Garg B, Kaur H. Secondary amyloidosis with concomitant gastric GIST and gastric adenocarcinoma - A case report. INDIAN J PATHOL MICR 2023; 66:594-596. [PMID: 37530347 DOI: 10.4103/ijpm.ijpm_461_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023] Open
Abstract
Secondary amyloidosis is a well-established entity and has been described in association with chronic inflammatory conditions such as rheumatoid arthritis, ankylosing spondylitis, bronchiectasis, tuberculosis, etc., It has also been reported in association with neoplasms such as Hodgkin's lymphoma, Waldenstrom's macroglobulinemia, renal cell carcinoma, lung carcinoma, etc. However, only a few case reports documenting the association of amyloidosis with gastrointestinal tumor (GIST) and gastric adenocarcinoma are available in the literature. Hereby, we report a case of a 74-year-old male who presented with colicky abdominal pain and vomiting. Ultrasonography revealed a common bile duct (CBD) stone and a small extra-luminal gastric mass. Endoscopic retrograde cholangiopancreatography (ERCP) was performed to remove the CBD stone which revealed an incidental finding of gastric ulcer. A biopsy was taken from the gastric ulcer which on histopathological examination was confirmed as adenocarcinoma leading onto total gastrectomy. During total gastrectomy, an inadvertent injury to the spleen led to simultaneous splenectomy. Multiple samples from the gastric ulcer, the extra-luminal gastric mass, and the spleen were subjected to histopathological examination. Gastric ulcer was confirmed as adenocarcinoma, gastric extra-luminal mass was confirmed as GIST, and splenic examination revealed widespread deposition of amyloid which on Congo-red stain imparted an apple-green birefringence on polarizing microscopy. To the best of our knowledge, this is the first-ever case of such an association where gastric adenocarcinoma occurred with concomitant gastric GIST and secondary amyloidosis of the spleen.
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Affiliation(s)
- Ankita Soni
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Nishant Batta
- Department of Surgical Oncology, Mohandai Oswal Hospital, Ludhiana, Punjab, India
| | - Shefali Mehmi
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Vikram Narang
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Bhavna Garg
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Harpreet Kaur
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
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Narang V, Jindal S, Garg B, Kaur H, Soni A. Intranasal glioma (Nasal heterotopia): A rare cause of nasal polyp in neonates. INDIAN J PATHOL MICR 2022; 65:911-913. [PMID: 36308205 DOI: 10.4103/ijpm.ijpm_57_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023] Open
Abstract
A 3-month-old boy presented with an intranasal polypoidal mass protruding out of the nostril which was present since birth and growing slowly. The mass was non-pulsatile and soft to firm in consistency. It did not increase in size on coughing, crying, or compression of the jugular vein. Magnetic resonance imaging and contrast-enhanced computed tomography (CT) revealed a lobulated well-circumscribed soft tissue mass in the left nasal cavity with no intracranial communication. Complete surgical excision of the mass was carried out via an intranasal endoscopic approach. Histopathological examination confirmed the diagnosis of intranasal glioma.
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Affiliation(s)
- Vikram Narang
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Saveena Jindal
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Bhavna Garg
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Harpreet Kaur
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Ankita Soni
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
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Soni A, Jindal S, Narang V, Garg B, Kaur H. Basal Cell Carcinoma and Intra-Dermal Nevus: An Addition to BCC Associated "MUSK IN A NEST". Indian J Dermatol 2022; 67:481. [PMID: 36578746 PMCID: PMC9792061 DOI: 10.4103/ijd.ijd_677_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Affiliation(s)
- Ankita Soni
- From the Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India E-mail:
| | - Saveena Jindal
- From the Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India E-mail:
| | - Vikram Narang
- From the Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India E-mail:
| | - Bhavna Garg
- From the Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India E-mail:
| | - Harpreet Kaur
- From the Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India E-mail:
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Sandhu J, Gupta SK, Garg B. Erythematous, Non-Tender Plaques on the Shins: A Case of Idiopathic Eosinophilic Panniculitis. Indian J Dermatol 2022; 67:480. [PMID: 36578744 PMCID: PMC9792035 DOI: 10.4103/ijd.ijd_1040_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Affiliation(s)
- Jaspriya Sandhu
- From the Departments of Dermatology and Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India E-mail:
| | - Sunil K. Gupta
- From the Departments of Dermatology and Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India E-mail:
| | - Bhavna Garg
- From the Departments of Dermatology and Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India E-mail:
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Gupta N, Soni A, Mahajan R, Selhi P, Tyagi R, Garg B, Kaur H. Peritoneal malignant mesothelioma: Slippery like an eel to diagnose on cytology-case series of 3 cases. J Am Soc Cytopathol 2021; 11:40-45. [PMID: 34602383 DOI: 10.1016/j.jasc.2021.08.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 08/16/2021] [Accepted: 08/31/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Peritoneal malignant mesothelioma is an extremely rare tumor and is a difficult diagnosis to be made on cytology alone. We report 3 cases where the cytologic features were misdiagnosed as carcinoma/lymphoma but histopathology and immunohistochemistry (IHC) established the diagnosis of malignant mesothelioma. CLINICAL DETAILS Case 1 was a 60-year-old man with multiloculated ascites and omental caking. Peritoneal fluid was reported as malignant on cytology but was misclassified as adenocarcinoma. Case 2, a 45-year-old man with ascites and peritoneal nodularity, radiologically mimicking peritoneal carcinomatosis, was also reported positive for malignancy on ascitic fluid cytology. Fine-needle aspiration (FNAC) from omental fat revealed signet ring cells, thus misleading to cytologic diagnosis of adenocarcinoma. Case 3 was a 63-year-old man with perisplenic mass with extensive omental caking and peritoneal nodularity that was also suspected to be peritoneal carcinomatosis on radiology. FNAC smears from perisplenic mass showed sheets of plasmacytoid cells. On cytology, the differential diagnoses offered were neuroendocrine tumor or non-Hodgkin lymphoma. The diagnosis of malignant mesothelioma was established only after IHC on histopathologic sections in all these cases. None of our patients had history of prior asbestos exposure. CONCLUSION In such clinical scenarios, with radiology suggesting peritoneal carcinomatosis, the cytologic features need corroboration by IHC/fluorescence in situ hybridization on cell block or biopsy to correctly identify malignant mesothelioma and differentiate it from metastatic carcinomatous deposits and benign mesothelial proliferation.
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Affiliation(s)
- Navita Gupta
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, India
| | - Ankita Soni
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, India
| | - Ramit Mahajan
- Department of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana, India
| | - Pavneet Selhi
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, India
| | - Ruchita Tyagi
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, India.
| | - Bhavna Garg
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, India
| | - Harpreet Kaur
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, India
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Narang V, Singh A, Sood N, Garg B, Kaur H, Jain K, Grover S. Primary Extranodal Non-Hodgkin Lymphomas: A First Tertiary Care Experience from Punjab, North India. South Asian J Cancer 2021; 9:230-232. [PMID: 34136424 PMCID: PMC8203326 DOI: 10.1055/s-0041-1723073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background
Primary extranodal lymphomas are less frequently encountered and difficult to diagnose in routine practice. The histopathological and immunohistochemical studies are essential in addition to clinical details to diagnose. The incidence is varied in different parts of India along with variation in histopathological spectrum.
Methodology
The clinical features and histopathological findings of patients diagnosed with primary extranodal lymphoma over 3-year period were retrieved from archives of pathology department and analyzed.
Results
During the 3-year study period, a total of 135 cases of non-Hodgkin lymphomas were evaluated, and of these, 41.4% (56/135) of cases presented with primary extranodal involvement. The mean age of primary extranodal lymphoma presentation was 61.3 ± 17.5 with M:F ratio of 1:1.1 Most common extranodal site involved was gastrointestinal tract 32.1%, 18/56 (small intestine [17.8%, 10 cases] and large intestine [8.9%, 5 cases]). Non-Hodgkin lymphomas of B cell type were the predominant subtype (48/56, 85.7%), while 8/56 (14.2%) cases were of T cell lineage. Of the B cell non-Hodgkin lymphoma diffuse, large B cell lymphoma was the predominant subtype constituting ~83.3% (40/48).
Conclusion
Primary extranodal lymphomas exhibit varied histomorphological and clinical presentation. The present study is first such analysis from Punjab that intends to compare with studies from other parts of India.
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Affiliation(s)
- Vikram Narang
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | | | - Aminder Singh
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Neena Sood
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Bhavna Garg
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Harpreet Kaur
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Kunal Jain
- Department of Medical Oncology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Sumit Grover
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
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Singh S, Kaur K, Paul D, Jain K, Singh J, Narang V, Garg B, Sood N, Dhillon B. Clinical and Molecular Attributes of Patients With BCR/ABL1-negative Myeloproliferative Neoplasms in India: Real-world Data and Challenges. Clin Lymphoma Myeloma Leuk 2021; 21:e569-e578. [PMID: 33757770 DOI: 10.1016/j.clml.2021.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 01/21/2021] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Classic BCR/ABL1-negative myeloproliferative neoplasms (MPNs) are characterized by clinical and genetic heterogeneity and include 4 distinct constituents. Very little data on clinical presentation and epidemiology of the same is available from the Indian setting. PATIENTS AND METHODS Patients referred to Hematology-Oncology from January 2018 to August 2020 with suspected MPNs were included in the analysis and prospectively followed-up. All patients were initially screened, and only those meeting the updated World Health Organization 2016 criteria were included in the analysis. Epidemiologic, clinical, and molecular characteristics were documented, and patients were followed-up prospectively. RESULTS A total of 233 patients were referred for evaluation of MPN, of which 63 were included in the analysis, including 39 males and 24 females. The median age at diagnosis was 57 years (range, 28-82 years), and 38% patients were younger than 50 years of age. The most common presentations were incidental detection in 35 (55.5%), abdominal symptoms in 13 (20%), fatiguability in 7 (11%), and recent vascular events in 6 (9.5%) patients. Final diagnosis was polycythemia vera in 27, essential thrombocytosis (ET) in 21, prefibrotic myelofibrosis in 9, and myelofibrosis in 6 patients. The frequency of driver mutations in polycythemia vera included JAK2 in 75%; in ET, JAK2 in 33%, CALR in 33%, and MPL in 4%; and in prefibrotic myelofibrosis, JAK2 in 66% and CALR in 33%. Aspirin was used for all patients along with risk-adapted cytoreduction with hydroxyurea. Ruxolitinib was reserved for symptoms refractory to hydroxyurea. After a median follow-up of 15 months (interquartile range, 10-28 months) from diagnosis, disease progression was noted in 4 patients. Two patients died at the end of the follow-up period, including 1 with secondary acute myeloid leukemia post myelofibrosis and one with ET and coexistent oral malignancy. The remaining 61 patients are alive and on regular treatment. RESULTS This is one of the first systematic descriptions and prospective follow-up of patients with BCR/ABL-negative MPNs from India. Our study indicates a younger median age of presentation and higher proportion of JAK2-unmutated disease across all subtypes. The primary role of bone marrow morphology and supportive role of somatic mutations in differentiating MPN subtypes is indicated. CONCLUSIONS This study sets the stage for a collaborative registry for defining epidemiologic data and long-term outcomes with MPN in India.
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Affiliation(s)
- Suvir Singh
- Department of Clinical Haematology and Stem Cell Transplantation, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.
| | - Komalpreet Kaur
- Department of Clinical Haematology and Stem Cell Transplantation, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Davinder Paul
- Department of Medical Oncology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Kunal Jain
- Department of Medical Oncology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Jagdeep Singh
- Department of Medical Oncology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Vikram Narang
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Bhavna Garg
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Neena Sood
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Barjinderjit Dhillon
- Molecular Genetics, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
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Abstract
Aims: The present study was carried out for comparative evaluation of case-based learning (CBL) aided with WhatsApp and didactic lectures (DL) while teaching a pathology topic to second-year medical students. In addition, the acceptability of WhatsApp as an aid to CBL was assessed. Material and Methods: After obtaining informed consent, 70 second-year Bachelor of Medicine and Bachelor of Surgery (MBBS) students were exposed to six sessions of CBL aided by case scenarios for one set of topics of anemia posted on WhatsApp groups. This was followed by six sessions of DL for separate set of topics in anemia. The multiple-choice questions (MCQ) test scores obtained pre and postintervention, of CBL and DL sessions, were compared to paired t-test (within the groups) and Student's t-test (between the groups). Categorical data were analyzed using Chi-square (χ2) test. Student's self-administered questionnaires and focus group discussions (FGDs) were used to collect student perceptions and analyzed quantitatively, as well as qualitatively. Results: The mean MCQ scores obtained postintervention in CBL topics were significantly higher compared to DL (22.78 ± 2.99 vs 17.78 ± 3.35; P < 0.001). Students perceived that CBL enhanced their curiosity; hence, the acquired knowledge through various resources was retained better. It enhanced their analytical skills and interest in learning pathology. In FGDs, the students appreciated the use of WhatsApp as an aid to CBL for its ease of sharing scenario-related additional information and prior discussions among themselves in chat groups at their convenience. Conclusion: CBL aided by WhatsApp helped students acquire knowledge, discuss and learn actively, score more, and retain better than DL. Using WhatsApp as a platform helped them to interact at their ease and seek guidance from their mentors without resistance and hesitation.
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Affiliation(s)
- S Grover
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - B Garg
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - N Sood
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
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Dey D, Jingar P, Agrawal S, Shrivastava V, Bhattacharya A, Manhas J, Garg B, Ansari MT, Mridha AR, Sreenivas V, Khurana A, Sen S. Symphytum officinale augments osteogenesis in human bone marrow-derived mesenchymal stem cells in vitro as they differentiate into osteoblasts. J Ethnopharmacol 2020; 248:112329. [PMID: 31672526 DOI: 10.1016/j.jep.2019.112329] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 10/11/2019] [Accepted: 10/19/2019] [Indexed: 06/10/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Mesenchymal stem cells (MSCs) are multipotent stem cells possessing regenerative potential. Symphytum officinale (SO) is a medicinal plant and in homoeopathic literature, believed to accelerate bone healing. AIM OF THE STUDY This study aimed to determine if homoeopathic doses of SO could augment osteogenesis in MSCs as they differentiate into osteoblasts in vitro. MATERIALS AND METHODS Bone marrow samples were obtained from patients who underwent bone grafting procedures (n = 15). MSCs were isolated, expanded and characterized by flow cytometry (CD90, CD105). Cytotoxicity of SO was evaluated by MTT assay. Osteogenic differentiation was induced in MSCs with β-glycerophosphate, ascorbic acid and dexamethasone over 2 weeks. Different homoeopathic doses of SO (MT, 3C, 6C, 12C and 30C) were added to the basic differentiation medium (BDM) and efficiency of MSCs differentiating into osteoblasts were measured by evaluating expression of Osteocalcin using flow cytometry, and alkaline phosphatase activity using ELISA. Gene expression analyses for osteoblast markers (Runx-2, Osteopontin and Osteocalcin) were evaluated in differentiated osteoblasts using qPCR. RESULTS Flow cytometry (CD90, CD105) detected MSCs isolated from bone marrow (93-98%). MTT assay showed that the selected doses of SO did not induce any cytotoxicity in MSCs (24 hours). The efficiency of osteogenic differentiation (2 weeks) for different doses of Symphytum officinale was determined by flow cytometry (n = 10) for osteoblast marker, Osteocalcin, and most doses of Symphytum officinale enhanced osteogenesis. Interestingly, gene expression analysis for Runx-2 (n = 10), Osteopontin (n = 10), Osteocalcin (n = 10) and alkaline phosphatase activity (n = 8) also showed increased osteogenesis with the addition of Symphytum officinale to BDM, specially mother tincture. CONCLUSIONS Our findings suggest that homoeopathic dose (specially mother tincture) of Symphytum officinale has the potential to enhance osteogenesis.
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Affiliation(s)
- D Dey
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - P Jingar
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - S Agrawal
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - V Shrivastava
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - A Bhattacharya
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - J Manhas
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - B Garg
- Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India
| | - M T Ansari
- Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India
| | - A R Mridha
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - V Sreenivas
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - A Khurana
- Central Council for Research in Homoeopathy, New Delhi, India
| | - S Sen
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India.
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Goyal RC, Tyagi R, Garg B, Mishra A, Sood N. Pulmonary Hydatid Disease with Aspergillosis - An Unusual Association in an Immunocompetent Host. Turk Patoloji Derg 2019; 35:166-169. [PMID: 29630082 DOI: 10.5146/tjpath.2017.01396] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Echinococcosis is a common cause of pulmonary cavities. Aspergillus fumigatus, a saprophytic fungus, can colonise pulmonary cavities caused by tuberculosis, sarcoidosis, echinococcosis, bronchiectasis and neoplasms. Infection by Aspergillus is often seen in immunosuppressed cases. However, co-infection of Aspergillus with pulmonary echinococcosis is unexpected and very unusual, especially in an immunocompetent patient. We present the case of a 45-year-old immunocompetent male who came with non-resolving pneumonia and fever for 8 months and dyspnoea since 15 days accompanied by recurrent episodes of hemoptysis since 5 days. Chest X Ray and Computed Tomography scan showed a cystic lesion in the middle lobe of the right lung. Middle lobectomy with video-assisted thoracoscopic surgery was performed and histopathology revealed ectocyst of Hydatid cyst which was also colonised by septate fungal hyphae exhibiting acute angled branching, morphologically consistent with Aspergillus. Gomori Methanamine Silver and Periodic Acid Schiff stains highlighted the hyphae of Aspergillus as well as the lamellated membranes of ectocyst and an occasional scolex of Echinococcus. Sections from surrounding lung parenchyma also showed these fungal hyphae within an occasional dilated bronchus. Thus a diagnosis of dual infection of Aspergillosis and Pulmonary Echinococcosis was established. The possibility of dual infection by a saprophytic fungus must be kept in mind while dealing with a case of a cavitary lesion in long-standing and non-resolving pneumonia, even in an immunocompetent patient. Establishing the correct diagnosis of Aspergillosis with Echinococcosis is essential for proper and complete management.
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Gupta RK, Tyagi R, Singh V, Kapoor S, Singh G, Ralhan S, Selhi PK, Garg B, Kaur H, Sood N, Aslam N, Wander GS. Morphological spectrum of atherosclerotic lesions in a tertiary care Institute in Punjab. Asian J Med Sci 2018. [DOI: 10.3126/ajms.v10i1.21664] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background: The incidence of coronary artery disease (CAD) has risen considerably in developing world due to industrialization, urbanisation and lifestyle changes, especially among Indians and South Asians. The onset of CAD has been seen to occur at an early age and the severity of the disease and mortality associated with CAD has also increased. The pathology of atherosclerosis needs to be re-evaluated to develop targeted therapy which can contain the disease process at the earliest stage.
Aims and Objectives: Most of the morphological studies on atherosclerosis have been done on autopsy cases. In this study, we have analysed the morphological spectrum of atherosclerotic lesions in live patients.
Materials and Methods: We retrospectively analysed the histopathology slides of 85 cases whose endarterectomy plaques were received in the Department of Pathology over a period of three and half years (January 2014 to June 2017) and classified the lesions according to Modified American Heart Association classification of atherosclerosis.
Results: The average age of patients was 60 years and male to female ratio of 4.3:1. Left anterior descending artery was the commonest vessel involved (52.4%). Majority of the cases had fibrocalcific plaques,followed by fibrous cap atheroma and calcified nodules.
Conclusion: Coronary artery plaques were found even in patients less than 40 years old. Aggressive lipid defense therapy needs to be the cornerstone of management of CAD.
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Gupta N, Kumar R, Khan R, Seth T, Garg B, Sharma A. PO-284 Involvement of versican, a chondroitin sulfate proteolgycan in the pathogenesis of multiple myeloma. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Goel P, Tyagi R, Kaur G, Garg B, Selhi PK, Kaur H, Mehta V, Sood N. Entamoeba histolytica: A surprising coexistence with adenocarcinoma - Never brush aside brushings for biopsy. J Lab Physicians 2018; 10:251-254. [PMID: 29692598 PMCID: PMC5896199 DOI: 10.4103/jlp.jlp_129_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Entamoeba histolytica has been rarely reported as superadded infection over carcinomatous growth on rectal brushings. We present a case of 68-year-old male who presented with abdominal pain and bleeding per rectum who was found to have an ulceroproliferative growth on sigmoidoscopy. Rectal brushings revealed coexistence of E. histolytica with malignant cells of adenocarcinoma. No organism was detected on biopsy of the tumor, which also showed adenocarcinoma, because of possible surface colonization of the tumor by Entamoeba. This case highlights the role of rectal brushings in detecting superadded infection in a case where both brushings and biopsy were performed. It is always important to report infection superadded on malignancies for optimum management of the patients.
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Affiliation(s)
- Palvi Goel
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Ruchita Tyagi
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Gursheen Kaur
- Department of Cardiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Bhavna Garg
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Pavneet Kaur Selhi
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Harpreet Kaur
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Varun Mehta
- Department of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Neena Sood
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
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16
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Narang V, Kaur R, Garg B, Mahajan R, Midha V, Sood N, Sood A. Association of endoscopic and histological remission with clinical course in patients of ulcerative colitis. Intest Res 2018; 16:55-61. [PMID: 29422798 PMCID: PMC5797272 DOI: 10.5217/ir.2018.16.1.55] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 06/10/2017] [Accepted: 06/16/2017] [Indexed: 12/21/2022] Open
Abstract
Background/Aims The therapeutic goal for treating ulcerative colitis (UC) patients has shifted to achieving mucosal healing over the past few years. However, at present, limited data is available on the correlation between endoscopic findings and histological remission in patients with endoscopic mucosal healing. Methods This was a prospective observational study conducted over a period of 18 months (January 2014 to June 2015) at Dayanand Medical College and Hospital, Ludhiana, Punjab, India. Patients diagnosed with UC who had been in clinical remission (n=76) for at least 6 months were evaluated for endoscopic remission. Those in endoscopic remission (Mayo score ≤1; 46/76, 60.5%) were subjected to multiple biopsies from the rectosigmoid region and histological remission, which was then defined as grade 0/1 as per the Geboes criteria. Results Of the 46 patients in endoscopic remission (age, 18–73 years; male:female=1.5:1.0), majority had E1 (proctitis) disease (21/46, 45.6%) followed by E2 (left sided colitis) (18/46, 39.1%) and E3 disease (pancolitis) (7/46, 15.2%) at baseline. Histological remission was noted in 67.3% (31/46) of the patients, while 32.7% (15/46) still retained the histologically active disease in the form of infiltration of the lamina propria by eosinophils and neutrophils (13/15, 86.6%), cryptitis (14/15, 93.3%), and crypt abscesses (8/15, 53.3%). On follow-up, after 1 year, 87.1% (27/31) of the patients who had been in histological remission remained clinically asymptomatic, while 12.9% (4/31) had relapsed. Among the 15 histologically active patients, 46.6% (7/15) remained in clinical remission, while 53.3% (8/15) had relapsed. Conclusions Histological remission, rather than endoscopic remission, predicts a sustained clinical remission and allows monitoring of therapy for the subsequent disease course in patients with UC.
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Affiliation(s)
- Vikram Narang
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, India
| | - Ravneet Kaur
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, India
| | - Bhavna Garg
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, India
| | - Ramit Mahajan
- Department of Gastroentrology, Dayanand Medical College and Hospital, Ludhiana, India
| | - Vandana Midha
- Department of Internal Medicine, Dayanand Medical College and Hospital, Ludhiana, India
| | - Neena Sood
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, India
| | - Ajit Sood
- Department of Gastroentrology, Dayanand Medical College and Hospital, Ludhiana, India
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17
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Bhatnagar K, Narang V, Garg B, Sood N. Xanthogranulomatous Oophoritis: A Rare Case Report. Iran J Pathol 2018; 13:372-376. [PMID: 30636962 PMCID: PMC6322522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2017] [Accepted: 08/18/2018] [Indexed: 11/29/2022]
Abstract
Xanthogranulomatous oophoritis is an uncommon, non-neoplastic, chronic process in which the affected organ is destroyed by massive cellular infiltration of foamy histiocytes admixed with multinucleated giant cells, plasma cells, fibroblasts, neutrophils, and foci of necrosis. The etiology of this entity is unknown, but it shares histopathological findings similar to those of xanthogranulomatous change occurring in various organs, including the gallbladder and kidney. The current case was a 20-year-old female presenting with a tubo-ovarian mass with suspicion of malignancy on clinicoradiological findings and final diagnosis of xanthogranulomatous oophritis established on histopathology. Clinically and radiologically, xanthogranulomatous oophritis mimics tumor of the ovary and fallopian tube, thereby making it an important entity. A vigilant histopathological evaluation is important to diagnose the disease.
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Affiliation(s)
- Kaneeka Bhatnagar
- Senior Resident, Dept of Pathology, Dayanand Medical College and Hospital, Ludhiana, India,Kaneeka Bhatnagar, Senior resident, Dept of Pathology, Dayanand Medical College and Hospital, Ludhiana, India
| | - Vikram Narang
- Dept. of Pathology, Dayanand Medical College and Hospital, Ludhiana, India
| | - Bhavna Garg
- Dept. of Pathology, Dayanand Medical College and Hospital, Ludhiana, India
| | - Neena Sood
- Dept. of Pathology, Dayanand Medical College and Hospital, Ludhiana, India
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18
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Tyagi R, Singh A, Garg B, Sood N. Beware of Bone Marrow: Incidental Detection and Primary Diagnosis of Solid Tumours in Bone Marrow Aspiration and Biopsies; A Study of 22 Cases. Iran J Pathol 2018; 13:78-84. [PMID: 29731799 PMCID: PMC5929392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 04/26/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND & OBJECTIVE Introduction: First detection of any solid tumour as metastatic deposits in bone marrow directs clinicians to start searching for the primary tumour. Detection of bone marrow metastasis determines the stage of the malignancy, prognosis, mode of treatment, chemotherapeutic response and follow-up in case of relapse. The aim of the current study was to analyse the clinico-haematological presentation and morphological pattern of infiltration of solid tumours detected first as metastatic deposits on bone marrow examination. METHODS Three-year retrospective analysis of MGG-stained bone marrow aspiration smears and touch imprints of the bone marrow biopsy and Hematoxylin and Eosin (H&E) stained histopathological sections of biopsies was performed at the Department of Pathology at a tertiary care institute (January 2014 to December 2016). The morphological pattern of metastatic deposits and haematological profiles of the patients were analysed. Exclusion criterion was the presence of hematolymphoid malignancies. RESULTS In 22 cases, bone marrow was the first site of detection of metastasis. The age of the patients ranged from 3 years and 10 months to 82 years, with equal gender predilection. Overall, 16 cases had cytopenias, 9 cases each had leucocytosis and leukoerythroblastic presentation. The metastasis was from Ewing's sarcoma, prostate carcinoma, gastric adenocarcinoma invasive duct carcinoma breast, gallbladder carcinoma, lacrimal duct carcinoma and invasive papillary urothelial carcinoma. CONCLUSIONS Bone marrow examination is a cheap and reliable investigation to detect metastasis in an unsuspecting case. Bilateral trephine biopsies are recommended to increase the efficacy of detecting bone marrow metastasis.
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Affiliation(s)
- Ruchita Tyagi
- Dept. of Pathology, Dayanand Medical College and Hospital, Tagore Nagar, Ludhiana, India,Corresponding information: Ruchita Tyagi, Assistant Professor, Department of Pathology, Dayanand Medical College and Hospital, Tagore Nagar, Ludhiana – 141012, Punjab, Phone number: +919876589911,
| | - Aminder Singh
- Dept. of Pathology, Dayanand Medical College and Hospital, Tagore Nagar, Ludhiana, India
| | - Bhavna Garg
- Dept. of Pathology, Dayanand Medical College and Hospital, Tagore Nagar, Ludhiana, India
| | - Neena Sood
- Dept. of Pathology, Dayanand Medical College and Hospital, Tagore Nagar, Ludhiana, India
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19
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Jagdev SK, Tyagi R, Garg B, Sood N. Mucormycosis in Intestines–An Underdog among Invasive Intestinal Infections. J Clin Diagn Res 2018. [DOI: 10.7860/jcdr/2018/31363.11119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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20
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Singh HP, Grover S, Garg B, Sood N. Histopathological Spectrum of Soft-Tissue Tumors with Immunohistochemistry Correlation and FNCLCC grading: A North Indian Experience. Niger Med J 2017; 58:149-155. [PMID: 31198267 PMCID: PMC6552737 DOI: 10.4103/nmj.nmj_226_16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Soft tissue tumors (STT) are mesenchymal neoplasms with a diverse spectrum and overlapping clinical, radiological and histological features. Histopathology and immunohistochemistry (IHC) are essential to make a diagnosis. Fédération Nationale des Centres de Lutte Contre le Cancer (FNCLCC) Sarcoma Group grading system based on tumour differentiation, mitotic rate and necrosis helps in predicting the tumour progression and treatment response. AIMS The goal of this study was to analyze the incidence, histological spectrum and IHC features of STTs and to grade sarcomas according to FNCLCC grading system. MATERIAL AND METHODS This is a four year study conducted in the Department of Pathology of a tertiary care centre from July 2009 to June 2013. All histopathologically diagnosed STTs were evaluated for gross and microscopic appearance. IHC was done wherever needed and clinical correlation was attempted. Sarcomas were graded according to FNCLCC grading system. RESULTS Of the total 270 cases studied, benign, intermediate and malignant STTs were 67.0%, 7.0% and 25.9% respectively. Adipocytic, vascular and peripheral nerve sheath tumors (PNST) formed the bulk of overall STTs (34.1%, 18.5% and 11.1% respectively). Sarcomas not otherwise specified were found to be the most common soft-tissue sarcomas followed by smooth muscle sarcomas and tumors with uncertain differentiation (11.5%, 4.1%, and 3.3%, respectively). Benign STTs were seen two decades earlier and were superficial in location as compared to sarcomas. On FNCLCC grading, grade 3 soft tissue sarcomas were slightly higher in number than grade 2 (27 vs 24). On IHC a definitive diagnosis was reached in 33 malignant, all intermediate and nine benign cases. CONCLUSION The incidence of intermediate and malignant STTs is increasing due to early detection and better diagnosis by ancillary techniques like IHC. FNCLCC grading helps to prognosticate the malignant STTs thus guiding further plan of action while in some tumors like MPNST and Angiosarcoma it has no prognostic significance.
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Affiliation(s)
- Hena Paul Singh
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Sumit Grover
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Bhavna Garg
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Neena Sood
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
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21
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Grover S, Dhiman AK, Garg B, Sood N, Narang V. Acquired aplastic anemia associated with trisomy eight converting into acute myeloid leukemia. J Lab Physicians 2017; 9:207-209. [PMID: 28706392 PMCID: PMC5496300 DOI: 10.4103/0974-2727.208259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Aplastic anemia (AA) is nowadays considered to be a clonal disorder arising from a defective hematopoietic stem cell developing after a generalized insult to bone marrow. Immunosuppressive treatment (IST) of AA causes suppression of the target dominant population of haematopoietic cells allowing the defective non targeted clones to expand. This may give rise to acute leukemia. Cytogenetic studies for chromosomal aberrations such as trisomy and monosomy may help in detecting such conversions. We present a case of acquired AA in a 60-year-old male presenting with pancytopenia and hypoplastic marrow treated with antithymocyte globulin, converting into myelodysplastic syndrome and later on acute promyelocytic leukemia after being in remission for 4 years. The patient was found to have trisomy 8 on fluorescence in situ hybridization and karyotyping.
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Affiliation(s)
- Sumit Grover
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Amit Kumar Dhiman
- Department of Medical Oncology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Bhavna Garg
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Neena Sood
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Vikram Narang
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
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Abstract
BACKGROUND Congenital malformations (CMF) are major causes of fetal demise which can be detected antenatally by Ultrasonography (USG). METHODS We studied 100 perinatal autopsies for CMF. Sensitivity of USG was determined and accuracy of USG with that of autopsy was compared. RESULTS At Autopsy 134 individual CMF were seen in 40 cases. The sensitivity of USG in detecting major CMF was 54.47%. A complete agreement between autopsy and USG findings was seen in 13/40 (32.5%) and partial agreement in 17/40 (42.5%) fetuses while autopsy completely changed antenatal diagnosis in 10/40 (25%) fetuses. Major findings were added in all 17 fetuses with partial agreement. In 2 cases, CMF suspected on USG were not detected on autopsy due to fetal maceration. CONCLUSION Autopsy significantly adds to the prenatal USG diagnosis and may help in predicting the probability of recurrence, and thus counseling the affected couple to prevent any such future event.
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Affiliation(s)
- Sumit Grover
- a Department of Pathology , Dayanand Medical College and Hospital , Tagore Nagar, Ludhiana , India
| | - Bhavna Garg
- a Department of Pathology , Dayanand Medical College and Hospital , Tagore Nagar, Ludhiana , India
| | - Neena Sood
- a Department of Pathology , Dayanand Medical College and Hospital , Tagore Nagar, Ludhiana , India
| | - Kamaldeep Arora
- b Department of Neonatology , Dayanand Medical College and Hospital , Tagore Nagar, Ludhiana , India
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23
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Peluso M, Kellett A, Davies D, Samaan J, Brewer T, Van Schalkwyk S, Garg B, Mayanja-Kizza H, Margolis C, Rohrbaugh R. Towards a Universal Medical Education Global Health Curriculum: Update on
the Bellagio Global Health Education Initiative. Ann Glob Health 2017. [DOI: 10.1016/j.aogh.2017.03.107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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24
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Garg B, Rastogi R, Gupta S, Rastogi H, Garg H, Chowdhury V. Evaluation of biliary complications on magnetic resonance cholangiopancreatography and comparison with direct cholangiography after living-donor liver transplantation. Clin Radiol 2017; 72:518.e9-518.e15. [PMID: 28118992 DOI: 10.1016/j.crad.2016.12.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 12/13/2016] [Accepted: 12/23/2016] [Indexed: 02/08/2023]
Abstract
AIM To evaluate the imaging characteristics of biliary complications following liver transplantation on magnetic resonance cholangiopancreatography (MRCP) and its diagnostic accuracy in comparison with direct cholangiography. MATERIAL AND METHODS In this prospective study, 34 patients being evaluated for possible biliary complications after living-donor liver transplantation (LDLT) with abnormal MRCP findings were followed up for information regarding direct cholangiography either endoscopic retrograde cholangiopancreatography (ERCP) or percutaneous transhepatic cholangiography (PTC) within 7 days of MRCP. Twenty-nine patients underwent ERCP and five patients underwent PTC. RESULTS Compared to findings at direct cholangiography, MRCP presented 96.9% sensitivity, 96.9% positive predictive value, and 94.1% accuracy for the detection of biliary complications. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for detection of anastomotic strictures, biliary leak, and biliary stone or sludge on MRCP was found to be 100%, 84.6%, 91.3%, 100% and 94.1%; 72.7%, 95.7%, 88.9%, 88% and 88.2%; 80%, 100%, 100%, 96.7% and 97.1%, respectively. CONCLUSION MRCP is a reliable non-invasive technique to evaluate the biliary complications following LDLT. MRCP should be the imaging method of choice for diagnosis in this setting and direct cholangiography should be reserved for cases that need therapeutic interventions.
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Affiliation(s)
- B Garg
- Department of Radiology, Indraprastha Apollo Hospital, Sarita Vihar, New Delhi 110027, India
| | - R Rastogi
- Department of Radiology, Indraprastha Apollo Hospital, Sarita Vihar, New Delhi 110027, India.
| | - S Gupta
- Department of Liver Transplant Surgery, Centre for Liver and Biliary Sciences, Indraprastha Apollo Hospital, New Delhi, India
| | - H Rastogi
- Department of Radiology, Indraprastha Apollo Hospital, Sarita Vihar, New Delhi 110027, India
| | - H Garg
- Department of Hepatology and Gastroenterology, Centre for Liver & Biliary Sciences, Indraprastha Apollo Hospital, Sarita Vihar, New Delhi 110027, India
| | - V Chowdhury
- Department of Radiology, Indraprastha Apollo Hospital, Sarita Vihar, New Delhi 110027, India
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25
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Tyagi R, Kaur D, Kaur G, Garg B, Sood N, Gupta S. Nodular Cystic Basal Cell Carcinoma of the Trunk: a Diagnostic Dilemma in an Unsuspecting Youth. Iran J Pathol 2017; 12:410-412. [PMID: 29563940 PMCID: PMC5844689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 04/26/2017] [Indexed: 11/15/2022]
Abstract
Basal cell carcinoma (BCC) commonly affects the elderly and is mostly confined to the head and neck region. Only 10% of all cases occur on the trunk. We presented a case of bullous lesion on the abdomen in a young male, initially diagnosed by clinicians as a vascular nevus. Histopathological examination and immunohistochemistry (IHC) revealed it to be Nodular cystic variant of BCC. This rare variant of BCC morphologically resembles benign skin adnexal tumor of Eccrine syringofibroadenoma. Ber Ep4 positivity on IHC established the correct diagnosis. This case highlights that nodular cystic variant of BCC can be a diagnostic dilemma for clinicians and pathologists.
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Affiliation(s)
- Ruchita Tyagi
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, India
| | - Dilpreet Kaur
- Department of Internal Medicine, Dayanand Medical College and Hospital, Ludhiana, India
| | - Gursheen Kaur
- Department of Skin and venereal diseases, Dayanand Medical College and Hospital, Ludhiana, India
| | - Bhavna Garg
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, India
| | - Neena Sood
- Department of Internal Medicine, Dayanand Medical College and Hospital, Ludhiana, India
| | - Sunil Gupta
- Department of Skin and venereal diseases, Dayanand Medical College and Hospital, Ludhiana, India
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26
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Narang V, Dhiman A, Garg B, Sood N. Female Genital Tract Involvement in Acute Lymphoblastic Leukemia: A Rare Case Report. J Clin Diagn Res 2016; 10:ED09-ED10. [PMID: 28208868 DOI: 10.7860/jcdr/2016/23832.9099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 10/19/2016] [Indexed: 11/24/2022]
Abstract
Female Genital Tract (FGT) involvement with hematologic neoplasms is uncommon and the hematologic malignancies which involve the female genital organs are usually non-Hodgkin's lymphoma. Involvement of the uterus and cervix with Acute Lymphoblastic Leukaemia (ALL) is extremely rare, and ovarian involvement is even rarer. We report the case of a young lady who presented with tubo-ovarian mass, excessive post-operative bleeding (post-total abdominal hystrerctomy and bilateral salpingo-oophorectomy) and was diagnosed to have ALL with blood and tissue involvement by histopathology and flow cytometry.
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Affiliation(s)
- Vikram Narang
- Assistant Professor, Department of Pathology, Dayanand Medical College and Hospital , Ludhiana, Punjab, India
| | - Amit Dhiman
- Assistant Professor, Department of Medical Oncology, Dayanand Medical College and Hospital , Ludhiana, Punjab, India
| | - Bhavna Garg
- Professor, Department of Pathology, Dayanand Medical College and Hospital , Ludhiana, Punjab, India
| | - Neena Sood
- Professor and Head, Department of Pathology, Dayanand Medical College and Hospital , Ludhiana, Punjab, India
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27
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Pathria G, Garg B, Garg K, Wagner C, Wagner SN. Dual c-Jun N-terminal kinase-cyclin D1 and extracellular signal-related kinase-c-Jun disjunction in human melanoma. Br J Dermatol 2016; 175:1221-1231. [PMID: 27145925 DOI: 10.1111/bjd.14713] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2016] [Indexed: 12/25/2022]
Abstract
BACKGROUND Activity of both c-Jun and cyclin D1 is deemed critical for melanoma cell proliferation. This functionality is corroborated by frequently elevated expression and activity of these proteins in human melanomas. Correspondingly, alleviating c-Jun and cyclin D1 function is vital to the success of antimelanoma therapeutics. OBJECTIVES To understand the role of the c-Jun N-terminal kinase (JNK) signalling pathway in melanoma cell proliferation and survival. METHODS The effect of JNK inhibitors SP600125 and JNK-IN-8 on the proliferation and survival of genetically highly representative human melanoma cell lines was studied in assays of proliferation and apoptosis. Changes in c-Jun and cyclin D1 protein and mRNA levels in response to JNK and mitogen-activated protein kinase kinase (MEK) inhibition were investigated through immunoblotting and quantitative reverse-transcription polymerase chain reaction. The effects of JNK and MEK inhibitors on cell-cycle distribution were assessed by flow cytometry. RESULTS We demonstrate the requirement of JNK signalling in melanoma cell proliferation and survival. While JNK inhibition suppressed the expression and activity of c-Jun, it failed to suppress cyclin D1 levels. Consistently with its inability to downregulate cyclin D1, JNK inhibition failed to induce G1 arrest. In contrast, the blockade of MEK-extracellular signal-regulated kinase (ERK) signalling, although unable to suppress c-Jun activity and expression, paradoxically abated cyclin D1 levels and triggered G1 arrest. This previously unreported dual disconnect between JNK-cyclin D1 and ERK-c-Jun levels was confirmed by concomitant JNK and BRAF inhibition, which suppressed both c-Jun and cyclin D1 levels and exhibited a heightened antiproliferative response. CONCLUSIONS Dual disjunction between JNK-cyclin D1 and ERK-c-Jun signalling forms the basis for further investigation of combined JNK and MAPK signalling blockade as a more effective therapeutic approach in human melanoma.
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Affiliation(s)
- G Pathria
- Division of Immunology, Allergy and Infectious Diseases, Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - B Garg
- Division of Immunology, Allergy and Infectious Diseases, Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - K Garg
- Division of Immunology, Allergy and Infectious Diseases, Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - C Wagner
- Division of Immunology, Allergy and Infectious Diseases, Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - S N Wagner
- Division of Immunology, Allergy and Infectious Diseases, Department of Dermatology, Medical University of Vienna, Vienna, Austria
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28
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Abstract
Splenic epidermoid cysts are rare non-parasitic true cysts affecting the spleen. We report a five-year-old child who presented with an abdominal lump associated with pain of 15 days. Ultrasonography of the abdomen showed a huge cystic lesion of obscure origin. At laprotomy a huge unilocular cyst involving upper part of spleen containing pultaceous fluid was seen and its removal necessitated splenectomy. Histopathological findings were consistent with splenic epidermoid cyst. Thus histopathology helped in elucidating the aetiology and diagnosis.
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Affiliation(s)
- Sumit Grover
- Assistant Professor, Department of Pathology, Dayanand Medical College & Hospital , Ludhiana, Punjab, India
| | - Bhavna Garg
- Professor, Department of Pathology, Dayanand Medical College & Hospital , Ludhiana, Punjab, India
| | - Neena Sood
- Professor and Head, Department of Pathology, Dayanand Medical College & Hospital , Ludhiana, Punjab, India
| | - Satpal Singh
- Professor, Department of G.E. Surgery, Dayanand Medical College & Hospital , Ludhiana, Punjab, India
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29
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Singh A, Sood N, Puri HK, Selhi PK, Garg B. Primary Hepatic Epithelioid Hemangioendothelioma: Diagnostic Dilemmas in Cytology and Histology. J Oncol Pract 2016; 12:394-6. [DOI: 10.1200/jop.2015.010090] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Affiliation(s)
- Aminder Singh
- Dayanand Medical College and Hospital, Tagore Nagar, Ludhiana, India
| | - Neena Sood
- Dayanand Medical College and Hospital, Tagore Nagar, Ludhiana, India
| | - Harpreet K. Puri
- Dayanand Medical College and Hospital, Tagore Nagar, Ludhiana, India
| | - Pavneet K. Selhi
- Dayanand Medical College and Hospital, Tagore Nagar, Ludhiana, India
| | - Bhavna Garg
- Dayanand Medical College and Hospital, Tagore Nagar, Ludhiana, India
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Abstract
BACKGROUND Schwannomas, also known as neurilemmomas, are benign slow-growing neoplasms originating from a Schwann cell sheath. These neoplasms are rare among the mesenchymal tumors of the gastrointestinal tract. In the stomach, Schwannomas only represent 0.2 % of all gastric tumors; this makes the presentation of a schwannoma in the stomach of a man in his seventh decade unusual. This case report highlights the rarity of a schwannoma at the greater curvature of the stomach because only a few cases have been reported in the literature. This case describes the importance of including gastric schwannomas in the differential diagnosis when preoperative assessment reveals a submucosal gastric mass with gastrointestinal stromal tumor as a leading differential diagnosis because of its common occurrence at this site. CASE PRESENTATION A 72-year-old man of Indian origin presented with a painless abdominal mass with nonspecific gastrointestinal upset. An endoscopy showed a submucosal lesion in his stomach measuring 4 × 3 × 2 cm. Histology revealed a benign spindle cell tumor. Immunohistochemistry confirmed the diagnosis of gastric schwannoma. He is on regular follow-up and doing well. CONCLUSIONS It should be remembered that a schwannoma can present as a mass lesion in the stomach and mimic gastrointestinal stromal tumor. Patients should undergo an endoscopy and a biopsy of the lesion should be done. Many patients do not undergo endoscopy which can delay diagnosis and management. As these tumors have an excellent prognosis, surgical removal is sufficient treatment. Surgeons, radiologists, pathologists and gastroenterologists must be aware of this entity.
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Affiliation(s)
- Aminder Singh
- Department of Pathology, Dayanand Medical College & Hospital, Tagore Nagar, Ludhiana, Punjab, 141001, India.
| | - Ankur Mittal
- Department of Pathology, Dayanand Medical College & Hospital, Tagore Nagar, Ludhiana, Punjab, 141001, India.
| | - Bhavna Garg
- Department of Pathology, Dayanand Medical College & Hospital, Tagore Nagar, Ludhiana, Punjab, 141001, India.
| | - Neena Sood
- Department of Pathology, Dayanand Medical College & Hospital, Tagore Nagar, Ludhiana, Punjab, 141001, India.
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Malhotra R, Kumar V, Garg B, Singh R, Jain V, Coshic P, Chatterjee K. Role of autologous platelet-rich plasma in treatment of long-bone nonunions: a prospective study. Musculoskelet Surg 2015; 99:243-248. [PMID: 26193983 DOI: 10.1007/s12306-015-0378-8] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Accepted: 07/08/2015] [Indexed: 06/04/2023]
Abstract
PURPOSE Fracture union is a complex biological process, which depends upon several systemic and local factors. Disturbance of any of these factors may lead to nonunion of the fracture. These nonunions have a huge impact on quality of life as well as socioeconomical aspects. The platelets on activation release a number of growth factors and differentiation factors, which play important role in fracture healing. This study aimed to look for efficacy of platelet-rich plasma in the treatment of established fracture nonunions of long bones. METHODS A total of 94 patients with established nonunion of long bone (35 tibia, 30 femur, 11 humerus, 4 radius, 12 ulna, 2 with both radius and ulna) were included in this study. We injected 15-20 ml of autologous platelet-rich plasma (>2,000,000 platelets/μl) under image intensifier at each nonunion site. The fracture union was evaluated clinically and radiologically regularly at monthly interval till 4 months. RESULTS Eighty-two patients had their fracture united at the end of 4 months. Thirty-four patients showed bridging trabeculae on X-rays at the end of 2 months, while 41 patients showed bridging trabeculae at the end of third month. Twelve patients did not show any attempt of union at 4 months and were labeled as failure of treatment. There were no complications. CONCLUSION Platelet-rich plasma is a safe and effective treatment for the treatment of nonunions. More studies are needed to look into molecular mechanism of this fracture healing acceleration by platelet-rich plasma.
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Affiliation(s)
- R Malhotra
- Department of Orthopedics, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - V Kumar
- Department of Orthopedics, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - B Garg
- Department of Orthopedics, All India Institute of Medical Sciences, New Delhi, 110029, India.
| | - R Singh
- Department of Orthopedics, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - V Jain
- Department of Orthopedics, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - P Coshic
- Department of Transfusion Medicine, AIIMS, New Delhi, India
| | - K Chatterjee
- Department of Transfusion Medicine, AIIMS, New Delhi, India
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Singh A, Narang V, Sood N, Garg B, Gupta VK. Malaria Diagnosis Using Automated Analysers: A Boon for Hematopathologists in Endemic Areas. J Clin Diagn Res 2015; 9:EC05-8. [PMID: 26557525 DOI: 10.7860/jcdr/2015/15108.6696] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 09/10/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND Haematological abnormalities are common in acute febrile tropical illnesses. Malaria is a major health problem in tropics. In endemic areas especially in the post monsoon season, it is not practical to manually screen all peripheral blood films (PBF) for malarial parasite. Automated analysers offer rapid, sensitive and cost effective screening of all samples. AIM The study was done to evaluate the usefulness of automated cell counters analysing their histograms, scatter-grams and the flaggings generated in malaria positive and negative cases. The comparison of other haematological parameters were also studied which could help to identify malaria parasite in peripheral blood smear. MATERIALS AND METHODS The blood samples were analysed using Beckman coulter LH-750. The abnormal scatter grams and additional peaks in WBC histograms were observed diligently & compared with normal controls. Haematological abnormalities were also evaluated. STATISTICAL ANALYSIS Statistical analysis was done by using software Epi-Info version 7.1.4 freely available from CDC website. Fisher exact test was applied to calculate the p-value and value < 0.05 was considered as significant. Final identification of malarial parasite species was done independently by peripheral blood smear examination by two pathologists. RESULTS Of all the 200 cases evaluated abnormal scatter grams were observed in all the cases of malaria while abnormal WBC histogram peaks were noted in 96% cases demonstrating a peak at the threshold of the histogram. The difference between number of slides positive for abnormal WBC scatter gram and abnormal WBC histogram peaks were statistically highly significant (p=0.007). So abnormal WBC scatter gram can better give idea of malarial parasite presence. Of the haematological parameters thrombocytopenia (92% cases) emerged as the strongest predictor of malaria. CONCLUSION It is recommended for haematopathologists to review the haematological data and the scatter plots on the analyser along with peripheral blood smear examination.
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Affiliation(s)
- Aminder Singh
- Assistant Professor, Department of Pathology, Dayanand Medical College and Hospital , Ludhiana, Punjab, India
| | - Vikram Narang
- Assistant Professor, Department of Pathology, Dayanand Medical College and Hospital , Ludhiana, Punjab, India
| | - Neena Sood
- Professor and Head, Department of Pathology, Dayanand Medical College and Hospital , Ludhiana, Punjab, India
| | - Bhavna Garg
- Professor, Department of Pathology, Dayanand Medical College and Hospital , Ludhiana, Punjab, India
| | - Vikram Kumar Gupta
- Assistant Professor, Department of SPM, Dayanand Medical College and Hospital , Ludhiana, Punjab, India
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Batra J, Attresh G, Garg B. Response to "Transpalatal screw traction: a simple technique for the management of sagittal fractures of the maxilla and palate". Int J Oral Maxillofac Surg 2015; 44:670-1. [PMID: 25684351 DOI: 10.1016/j.ijom.2015.01.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Accepted: 01/21/2015] [Indexed: 11/18/2022]
Affiliation(s)
- J Batra
- Post Graduate Institute of Dental Sciences, Pt. B.D Sharma UHS, Rohtak, Haryana India.
| | - G Attresh
- Post Graduate Institute of Dental Sciences, Pt. B.D Sharma UHS, Rohtak, Haryana India
| | - B Garg
- Post Graduate Institute of Dental Sciences, Pt. B.D Sharma UHS, Rohtak, Haryana India
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Abstract
Sweet's syndrome is characterized by erythematous tender nodules and plaques over face and extremities. Fever, leukocytosis with neutrophilia, and a neutrophilic infiltrate in the dermis are characteristic features. Neutrophilic dermatosis of dorsal hands is a rare localized variant of Sweet's syndrome occurring predominantly over dorsa of hands. Various degrees of vascular damage may be observed on histopathology of these lesions. Both Sweet's syndrome and its dorsal hand variant have been reported in association with malignancies, inflammatory bowel diseases, and drugs. We report a patient with neutrophilic dermatoses of dorsal hands associated with erythema nodosum. He showed an excellent response to corticosteroids and dapsone.
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Affiliation(s)
- S Kaur
- Department of Dermatology and Venereology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - D Gupta
- Department of Internal Medicine, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - B Garg
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - N Sood
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
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Abstract
We are reporting a case of bilateral eosinophilic mastitis which is rare and hardly heard. It is a mimicker of carcinoma breast both clinically & radiologically. A 30 years old non diabetic female presented with bilateral breast lumps with history of rhinitis off & on and peripheral eosinophilia. Mammography was suspicious while ultrasonography was diagnostic of bilateral mastitis. Aspiration cytology exhibited inflammatory lesion rich in eosinophils. Histopathology revealed the diagnosis of eosinophilic mastitis. Eosinophilic infiltration of the breast is a rare manifestation of tissue involvement in peripheral eosinophilia and bilateralism is even rarer.
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Affiliation(s)
- Aminder Singh
- Department of Pathology, Dayanand Medical College & Hospital, Tagore Nagar, Ludhiana, Punjab, India
| | - Pavneet Kaur
- Department of Pathology, Dayanand Medical College & Hospital, Tagore Nagar, Ludhiana, Punjab, India
| | - Neena Sood
- Department of Pathology, Dayanand Medical College & Hospital, Tagore Nagar, Ludhiana, Punjab, India
| | - Harpreet Puri
- Department of Pathology, Dayanand Medical College & Hospital, Tagore Nagar, Ludhiana, Punjab, India
| | - Bhavna Garg
- Department of Pathology, Dayanand Medical College & Hospital, Tagore Nagar, Ludhiana, Punjab, India
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Abstract
Ovarian-type surface epithelial carcinomas of testis and paratestis are very rare. These tumors develop from mesothelial inclusions or abnormalities in the development of coelomic epithelium. The diagnosis of these lesions can be difficult, both clinically and radiologically, as morphological, immunohistochemical and ultrastructural features overlap with serous tumors arising in the female genital tract. The pathologist should be aware of the histopathological features and immunostains which help in reaching definite diagnosis. To the best of our knowledge only one such case has been reported in Indian literature. We hereby report a case of young male with this unusual lesion diagnosed on histopathology.
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Affiliation(s)
- Vikram Narang
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
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Narang V, Garg B, Sood N, Kaur H. Multifocal hemangioendotheliomas of bone mimicking metastases. INDIAN J PATHOL MICR 2014; 57:609-10. [PMID: 25308018 DOI: 10.4103/0377-4929.142692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Hemangioendotheliomas are rare vascular tumors that can arise from soft tissue or bone. The former comprises hemangioma, epithelioidhemangioma, hemangiomatosis and massiveosteolysis or Gorham's disease (which mimics malignantneoplasm due to aggressive osteolytic destruction). The rarer malignant counterparts are epithelioidhemangioendothelioma, hemangioendothelioma and angiosarcoma in increasing order of malignancy. The diagnosis of these lesions is difficult both clinically and radiologically. Hereby we report an unusual case which was mistaken for metastasis and was diagnosed with the help of histopathology.
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Affiliation(s)
- Vikram Narang
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
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Abstract
Coccidioidomycosis is a fungal disease found only in the Western Hemisphere. In recent years, the incidence of the disease has increased in California and Arizona, which may be partially due to the rapid immigration of previously unexposed persons from states outside the endemic areas. The disease in the nonendemic areas is usually imported. Determining a history of exposure is critical for performing the diagnosis of coccidioidomycosis in these cases. Histopathological examination is the key to the diagnosis when fungal culture and molecular studies are not available. We hereby report an imported case of cutaneous coccidioidomycosis, which to the best of our knowledge is the first case report from North India.
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Affiliation(s)
- Vikram Narang
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Bhavna Garg
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Neena Sood
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Sukhjot Kaur Goraya
- Department of Dermatology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
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Singh A, Sood N, Kaur H, Garg B, Munjal M. Primary diffuse large B cell lymphoma of the base of tongue: a rare entity. Am J Otolaryngol 2014; 35:435-8. [PMID: 24636915 DOI: 10.1016/j.amjoto.2013.12.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Accepted: 12/21/2013] [Indexed: 11/28/2022]
Abstract
Primary lymphomas of the oral cavity are uncommon and of the tongue even rarer. It is more common in the masticatory mucosa than the lingual and buccal mucosa. We describe a 63 year old male who presented with dysphagia & change in voice. Computed tomography revealed a 4.8 × 3.7 cm mass localized to the base of tongue. He underwent biopsy and IHC studies & was diagnosed as having diffuse large B cell lymphoma. The patient was successfully treated with wide excision of the lesion and is undergoing chemotherapy now. Although oral lymphoma of tongue is very uncommon, it should always be considered in differential diagnosis of various benign and malignant lesions in this region. A proper clinical evaluation and histopathologic as well as immunohistochemical evaluation of biopsy specimen are required to establish the diagnosis and for further management. This is one of the few cases of non-Hodgkin's lymphoma of the base of tongue being reported from India.
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Affiliation(s)
- Aminder Singh
- Department of Pathology, Dayanand Medical College & Hospital, Ludhiana, Punjab, India.
| | - Neena Sood
- Department of Pathology, Dayanand Medical College & Hospital, Ludhiana, Punjab, India.
| | - Harpreet Kaur
- Department of Pathology, Dayanand Medical College & Hospital, Ludhiana, Punjab, India.
| | - Bhavna Garg
- Department of Pathology, Dayanand Medical College & Hospital, Ludhiana, Punjab, India
| | - Manish Munjal
- Department of Pathology, Dayanand Medical College & Hospital, Ludhiana, Punjab, India
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41
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Garg B, Sood N, Kaur H, Mittal D. Solid pseudopapillary tumour of pancreas: a report of 5 cases. J Assoc Physicians India 2014; 62:61-64. [PMID: 25327098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A solid pseudopapillary tumour of the pancreas (SPT) is a rare neoplasm accounting for less than 2% of exocrine pancreatic neoplasms. SPT occurs in adolescent young females and is mostly benign. It is a low-grade malignant tumour that may evolve years before symptoms start and has a favourable prognosis. In this report we present five cases (four females, one male, aged 16, 45, 23, 17 and 55 years, respectively) of SPT localised in the pancreas, and discuss the clinical, imaging and histologic findings with a review of the literature. We retrospectively reviewed these five patients with SPT who underwent surgical resection in our hospital with a definitive histologic diagnosis of SPT.
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Anchlia S, Parmar B, Garg B, Sheth N, Agarwal M. Outcome assessment of six different surgical techniques in the management of temporomandibular joint ankylosis. A retrospective evaluation of 467 joints. Int J Oral Maxillofac Surg 2013. [DOI: 10.1016/j.ijom.2013.07.664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Garg B, Sood N, Sidhu UP, Malhotra V. Role of fiberoptic bronchoscopy and utility of bronchial washings and brushings in the diagnosis of lung diseases. Indian J Chest Dis Allied Sci 2013; 55:145-148. [PMID: 24380221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Transbronchial lung biopsy via fiberoptic bronchoscope is an extremely useful technique by which bronchial as well as lung biopsies along with brushings and washings can be easily and safely taken. Fiberoptic bronchoscopy (FOB) was performed and biopsies were done in 250 patients. In addition, bronchial brushings and washings were also taken in 140 and 115 cases, respectively. Adequate material was obtained in 242 cases. The cases were broadly classified into neoplastic and nonneoplastic categories. Malignancies and specific granulomatous diseases, tuberculosis and sarcoidosis were the main diseases diagnosed. Brushings showed a sensitivity of 88.2% and a specificity of 98.9% for the diagnosis of neoplasms. On the other hand, washings had only a 34.9% sensitivity and a 98.6% specificity in diagnosing neoplastic disorders. We concluded that FOB is a safe and effective tool in the diagnostic work-up of suspected malignancies and neoplastic lung diseases.
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Affiliation(s)
- Bhavna Garg
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, (Punjab), India.
| | - Neena Sood
- Department of Respiratory Diseases, Dayanand Medical College and Hospital, Ludhiana, (Punjab), India
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Kapil R, Dhawan S, Singh B, Garg B, Singh B. Systematic formulation development of once-a-day gastroretentive controlled release tablets of rivastigmine using optimized polymer blends. J Drug Deliv Sci Technol 2012. [DOI: 10.1016/s1773-2247(12)50090-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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45
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Dongre A, Deshmukh P, Garg B. P1-419 Health promoting school initiative in ashram schools of Wardha district: an evaluation. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976g.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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46
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Maliye C, Taywade M, Gupta S, Deshmukh P, Garg B. P2-445 Maternal risk factors associated with low birth weight in Wardha, India. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976l.75] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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47
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Maliye C, Kumar R, Deshmukh P, Garg B. P2-444 Incidence and correlates of "growth faltering" among 0-6 year's children: a panel study from rural Wardha, India. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976l.74] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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48
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Dongre A, Deshmukh P, Murali N, Garg B. P1-133 Tobacco consumption among adolescents in rural India: where and how tobacco control should focus its attention? Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976d.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
PURPOSE To assess the results of treatment for flexion-type supracondylar humeral fracture in children. METHODS The treatment of 14 children with flexion-type supracondylar humeral fracture was reviewed. Severity was classified according to the Gartland system for extension-type fractures. Type-I fractures were treated with immobilisation in an extension cast. For type-II and -III fractures, closed reduction was first attempted followed by percutaneous pinning. If closed reduction failed, open reduction and internal fixation was performed. RESULTS Patients were followed up for at least one year (range, 14-36 months). Treatment results were excellent in 7 patients, good in 4, fair in 3, and poor in none. Patients were pain-free and satisfied and none suffered any activity restriction. CONCLUSION Closed reduction and percutaneous pinning is a good treatment option for type-II and -III flexion-type supracondylar humeral fractures.
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Affiliation(s)
- B Garg
- Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India.
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50
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Abstract
Eosinophilic granuloma is the most common and benign form of a rare proliferative disorder: Langerhans' cell histiocytosis. Spinal involvement is rare and only 15 adult cases have been reported. We present an unusual variant of eosinophilic granuloma in a 25-year-old woman with radiological evidence of vertebra plana. Plain radiography, magnetic resonance imaging, bone scan, and blood tests were carried out, and a specimen was taken from L4 using computed tomography-guided biopsy. Gram staining, acid fast bacillus smear, bacterial and fungal cultures were negative. Histological examination of the biopsy showed features of eosinophilic granuloma with aggregates of Langerhans histiocytes. The patient was treated with low-grade radiotherapy at 150 cGy per day for 7 days. She was asymptomatic at one-year follow-up although the radiological picture was unchanged.
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Affiliation(s)
- B Garg
- Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India.
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