Biomedical subjects
Publications and source records attributed to Sujata Chaturvedi.
CASE REPORT: We report a case of ganglioglioma of the optic chiasma in an 8-year-old child who presented with gradual deterioration of vision since the age of 3 years and complete loss by 8 years. REVIEW OF LITERATURE: Intensive literature search by the authors showed only 12 cases of ganglioglioma involving the visual pathway reported so far. Report on our case is presented here along with review of literature.
OBJECTIVE: To study the effects of modifications in the Ziehl-Neelsen staining procedure on predictive accuracy for acid fast bacilli in comparison to the conventional technique. Simplicity of procedure and reagent economy were the factors taken into consideration. DESIGN: Comparative evaluation between thick and thin air-dried smears stained conventionally and thick ethanol-fixed smears stained by the modified technique was done. RESULTS: Positive predictive accuracy of all the three smears, that is, thick air-dried, thin air-dried and thick ethanol-fixed, was 100%. Negative predictive accuracy for thick air-dried, thin air-dried and thick ethanol-fixed smears was 36.36%, 32.33% and 34.78%, respectively. Overall predictive accuracy was 66.67% for thick air-dried, 61.90% for thin air-dried and 64.29% for thick ethanol-fixed. These differences were found to be statistically insignificant. CONCLUSION: The modified method offers an accuracy comparable to the conventional technique, is simpler and with improved reagent economy. It is of special importance to diagnostic facilities in rural set-ups.
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Rapid diagnosis of histopathological material is becoming increasingly desirable. In neuropathology, crush smear preparation and frozen section diagnosis of tissues removed during operative procedures, have remained as essential tools for rapid diagnosis. Microwave technology has been introduced into the field of tissue processing and staining in past decade. Now-a-days even automated microwave assisted rapid tissue processors are available. In our study we have analysed the use of a domestic microwave (cost approximately Rs.5000) for urgent histoprocessing (30 minutes). This could be useful in small laboratories or the ones which are in the phase of establishing the department as the procedure is much more economical than obtaining a frozen section (which requires a cryostat worth 3-6 lakhs) and the interpretation of the section obtained does not require any extra experience as these resemble the routinely processed tissue sections. The advantages and limitations of the procedure have been discussed.
Blood collection is an important preanalytical component of haematological testing. This questionnaire based study was conducted on laboratory personnel to elicit their knowledge and practice regarding blood collection procedures for haematological testing. Questionnaire comprised of 37 multiple choice questions, of which 10 questions each were related to essential and desirable knowledge, 10 to practice and 7 to educational and job profile. Ninety four laboratory personnel participated in the study. Analysis was done on SPSS software. Percentages of unsatisfactory scores were 42.6%, 4.3%, 17% and 6% in the essential knowledge, desirable knowledge, practice and total scoring respectively. 91.5%, however, had a satisfactory total score. Importance needs to be given to blood collection procedures both, individually and collectively. The study highlights the deficient areas which need to addressed by all laboratorians. Such studies should also be conducted among nursing and resident staff- the other groups concerned with blood collection.
Mitochondrial encephalomyopathies encompass a group of disorders that have impaired oxidative metabolism in skeletal muscles and central nervous system. As the field of mitochondrial medicine takes shape and physicians in all specialties become increasingly aware of respiratory chain or oxidative phosphorylation (OXPHOS) related disorders, their prevalence remains largely unknown. The unique features of the mitochondrial genome and the dual control over this important cellular apparatus makes the clinical presentation variable and diagnosis difficult. There is a confounding variation in phenotype and genotype, and the natural history of the disorders in individual patients is not accurately predictable. Only recently have things begun to fall into place and some phenotypes defined. Diagnosis requires a complex battery of clinical studies coupled with diagnostic findings on muscle biopsy (abnormal structure, histochemistry, or enzyme studies) or DNA testing. However, a reasonably confident diagnosis can be made by viewing the clinical presentation in the light of family history and some basic, routinely available laboratory investigations. This review tries to give a brief account of mitochondrial structure, function and genetics, and clinical presentation, evaluation, and treatment in suspected cases of mitochondrial encephalomyopathies.
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Despite clinical evidence of brain dysfunction in schizophrenia, little progress was made for most of the last century in determining its organic parameters. Neuropathology, over the past few decades, has made a substantial contribution to the understanding of cellular and molecular mechanisms of schizophrenia. During the last 10-15 years the concept of schizophrenia as a 'functional' psychosis has changed to the current paradigm of schizophrenia as a neurodevelopmental disorder. Much still has to be unravelled and learnt. This review gives a brief account of the relevant neuroanatomy, viral hypotheses of schizophrenia etiology, pathologic findings reported, concept of neurodevelopmental model and avenues for the future.
OBJECTIVES: To study the efficacy and tolerability of prochlorperazine (PCZ) management of acute migraine. DESIGN AND METHODS: A double blind comparative study was conducted to assess the efficacy of buccal PCZ 3 mg compared with oral ergotamine tartarate 1 mg plus caffeine 100 mg (ERG) or placebo (buccal or oral) for treatment of acute migraine. In all, 114 episodes of acute migraine were evaluated. Patients graded symptoms on a four-point scale before and up to 4 hours after treatment. The primary efficacy parameters included headache resolution within 2 hours (grade 3 or 2 to grade 0) and alleviation of other accompanying symptoms of migraine. The supplementary endpoints included improvement in quality of life (QOL). RESULTS: The percentage of patients reporting resolution of headache (to grade 0) was 51.4% for buccal PCZ and 21.7% for buccal placebo, 23.1% for oral ERG and 28.6% for oral placebo, headache tended to recur in both the placebo and ERG groups after initial improvement. Buccal PCZ was well tolerated; no signs of local irritation were evident, and patients found the formulation easy to use. Mild but transient sedation and drowsiness were observed in 41%. CONCLUSIONS: In the present study, PCZ 3 mg via the buccal route produced faster improvement and greater efficacy than placebo (oral as well as buccal) or oral ERG. The global QOL score 2 hours after treatment scores was higher in the PCZ group. Buccal PCZ may represent a particularly effective alternative for acute migraine treatment.
OBJECTIVE: To study the significance of cytologic features in distinguishing small cell carcinoma (SCC) from non-small cell carcinoma (NSCC). STUDY DESIGN: Prospective study of 76 patients with lung carcinoma. Percutaneous fine needle aspiration and bronchial washings stained with Papanicolaou and May-Grünwald-Giemsa stain were used for categorization of tumors according to the World Health Organization classification. Each tumor was also scored for the presence or absence of standard cytologic criteria used in the diagnosis of SCC. Data were analyzed for sensitivity, specificity and significance using the chi 2 and Fisher exact tests. Undifferentiated and unclassified tumors were examined immunocytochemically for the presence of neuron-specific enolase, epithelial membrane antigen and leukocyte common antigen. Cytologic diagnoses were compared with histopathologic diagnoses. RESULTS: Seventy-six lesions classified on cytomorphology consisted of SCC (15), NSCC (50), non-Hodgkin's lymphoma (1), carcinoid (1) and undifferentiated or poorly differentiated carcinomas (9), 2 of which showed nuclear molding and salt-and-pepper chromatin. Immunocytochemistry and biopsy confirmed the diagnosis of SCC in those two patients. CONCLUSION: Nuclear molding, cell size and scant, basophilic cytoplasm were highly sensitive and specific by univariate analysis for distinguishing SCC from NSCC. Other features, such as salt-and-pepper chromatin, crush artifact and apoptotic bodies, also had significantly high specificity; however, their low sensitivity precluded their usefulness in separating SCC from NSCC. Thus, morphologic evaluation plays a major role, while immunocytochemistry can make a limited contribution in differentiating SCC from NSCC.
Prion diseases is another name for a group of 'transmissible spongiform encephalopathies'. Creutzfeldt-Jakob disease, the first prion disease described in humans, occurs in sporadic, familial or iatrogenic form. Other transmissible spongiform encephalopathies in humans such as familial Creutzfeldt-]akob disease, Gerstmann-Sträussler-Scheinker disease and fatal familial Insomnia have been shown to be associated with specific prion protein gene mutations. In 1996, a new variant of Creutzfeldt-Jakob disease was reported in the United Kingdom among young patients with unusual clinical features and unique neuropathological findings. This new form could be due to transmission to humans of the agent causing bovine spongiform encephalopathy. While examination of brain tissue is the key to making a diagnosis, it is not always possible antemortem. Immunological tests such as ELISA or western blot assays along with tests for 1 4-3-3 protein in the cerebrospinal fluid remain the main tools of diagnosis. Conventional disinfection and sterilization practices are Ineffective for these agents. The unusual properties of prions pose a challenge for treatment, surveillance and control of these diseases.