Sixty patients with chronic myeloid leukemia (CML) underwent bone marrow trephine biopsy at presentation. All the biopsies were decalcified, paraffin-embedded and stained with H&E, Gomori's reticulin and Masson Trichrome. A detailed study of the histology including the morphology and topographic distribution of megakaryocytes was done. 55 patients presented in chronic phase. Of these there were 37 cases (67%) of CML-granulocytic (CML-G) type and 18 cases (33%) of CML-granulocytic megakaryocytic (CML -GM) type. Five cases presented in blast crisis. 73% of CML-G had low-grade fibrosis while 83% of CML-GM had high-grade fibrosis. This was statistically significant. On follow-up 25% of CML-G went into blast crisis while all the CML-GM patients remained stable to date. Bone marrow biopsy is a useful investigation in patients of CML at diagnosis as it provides prognostic information. Evaluation of megakaryopoiesis, grading of fibrosis and localization of blasts are possible on a trephine biopsy.
BCR Gene ; biopsy characteristics ; upper case gee ; Myeloid Leukemia, Chronic ; Fibrosis

Objective: To evaluate the pharmacognostical study of leaf of Toona ciliate M. Roem. Methods:The qualitative and quantitative microscopy, phytochemical screening, physicochemical evaluation and fluorescence analysis of the plant were done according to the standard procedure recommended in the WHO guidelines. Results: Macroscopic study shows that leaves are compound type, 30-50 cm length, shape: lanceolate, apex: acute and having the entire margin. Stomata present in the leaf are anomocytic type of stomata. Microscopic evaluation of the leaves powder shows the presence of trichomes (multicelluar), lignified vascular bundles and stomata. The transverse section of the leaf shows the presence of epidermis layer followed by cuticle layer, lignified vascular bundles, trichomes, collenchyma, and palisade cells. Conclusion:Various pharmacognostical parameters evaluated in his study help in the identification and standardization of the Toona ciliata M. Roem.

OBJECTIVETo evaluate the pharmacognostic characters of an important medicinal plant, Holoptelea integrifolia (H. integrifolia) Roxb.

METHODSThe pharmacognostic studies were carried out in terms of organoleptic, microscopic, macroscopic and fluorescence analysis.

RESULTSThe characteristic microscopic features of leaves were observed as trichomes, multicellular trichomes, xylem cells, phloem cells, collenchyma, vascular bundles, spongy parenchyma and palisade cells. The characteristic microscopic features of root bark included cork cambium, primary cortex, phloem fibers, medullary rays, endodermis, pericycle and lignified fibers in the transverse section and longitudinal section. The characteristic microscopy of root bark powder showed the presence of cortex cells, sieve tubes, calcium oxalate crystals and lignified fibers. Macroscopic study showed that leaf shape-oval, apex-acute, base-cordate and leaf margin was entire with glabrous surface, bitter taste and characteristic odour. The morphological features of root bark showed deep fissured, rough and firm surface with rhitydome and the periderm parallel to cambium.

CONCLUSIONSVarious pharmacognostic characters observed in this study help in the identification and standardization of H. integrifolia.

Microscopy ; Plant Extracts ; chemistry ; Plant Leaves ; anatomy & histology ; cytology ; Plant Roots ; anatomy & histology ; cytology ; Spectrometry, Fluorescence ; Ulmaceae ; anatomy & histology ; cytology

A female patient aged 48 years presented with sub-acute onset of weakness in right upper and lower limb over the past one month and numbness over left side of body below neck level. Multiple sclerosis (MS) presenting as Brown-Séquard syndrome is very rare. We present a case of hemicord myelitis which presented as Brown-Séquard syndrome as a first manifestation, which was later diagnosed as MS during subsequent relapses.

STUDY DESIGN: Prospective cohort study. PURPOSE: To evaluate the contribution of upper and lower lumbar segments to flexion and extension of the lumbar spine in normal and diseased spines. OVERVIEW OF LITERATURE: The specific contributions of upper and lower lumbar segments during flexion/extension have rarely been reported. Furthermore, no comparisons between the flexion/extension behaviors of normal and diseased spines have been reported until now. METHODS: Flexion and extension lateral radiographs of 52 adult, asymptomatic volunteers, and 67 adult patients with lumbar spine disc disease were measured using software for total lumbar lordosis, upper lumbar lordosis and lower lumbar lordosis and the intervertebral angles of all segments. RESULTS: In asymptomatic volunteers, the range of movement between flexion and extension was a mean of only 4.2degrees in the lower lumbar spine and a mean of 19.4degrees in the upper lumbar spine. In patients with disc degeneration, the range of movement between flexion and extension was an average 6.5degrees for lower lumbar spine and 15.6degrees for the upper lumbar spine. CONCLUSIONS: The results showed that upper lumbar spine contributes more to the range of motion in flexion and extension than the lower lumbar spine in asymptomatic individuals without lumbar disc disease, as well as in patients with disc degeneration.
Adult ; Animals ; Asian Continental Ancestry Group* ; Cohort Studies ; Humans ; Intervertebral Disc Degeneration ; Lordosis ; Lumbar Vertebrae ; Lumbosacral Region ; Prospective Studies ; Range of Motion, Articular ; Spine* ; Volunteers

OBJECTIVETo present a detailed pharmacognostic study of the leaf of Cayratia trifolia (C. trifolia) Linn. (Vitaceae), an important plant in the Indian system of medicine.

METHODSThe macroscopy, microscopy, physiochemical analysis, preliminary testing, fluorescence analysis of powder of the plant and other WHO recommended methods for standardization were investigated.

RESULTSLeaves are trifoliolated with petioles (2-3 cm) long. Leaflets are ovate to oblong-ovate, (2-8 cm) long, (1.5-5 cm) wide, pointed at the tip. The leaf surface shows the anisocytic type stomata covered with guard cells followed by epidermis layer. Leaf surface contents including veins, vein islet and vein termination were also determined. Transverse section of leaf shows the epidermis layer followed by cuticle layer and vascular bandles (xylem and phloem). The mesophyll is differentiated into palisade and spongy parenchyma. Abundant covering trichomes emerge from the upper epidermis. Trichomes are uniseriate and multicellular. Strips of collenchyma are present below and upper layer of epidermis.

CONCLUSIONSIt can be concluded that the pharmacognostic profile of the C. trifolia is helpful in developing standards for quality, purity and sample identification.

India ; Pharmacognosy ; methods ; Plant Leaves ; anatomy & histology ; Vitaceae ; anatomy & histology

Urachal cysts are uncommon. Rarely, these cysts can become infected. Tuberculosis of the urachal cyst is exceedingly rare, with only one case reported previously in the English language literature. Here we report the case of a 23-year-old male who presented with an infra-umbilical mass that turned out to be tuberculosis of the urachal cyst.
Antitubercular Agents/therapeutic use ; Drug Therapy, Combination ; Humans ; Male ; Tomography, X-Ray Computed ; Treatment Outcome ; Tuberculosis/diagnosis/*microbiology/therapy ; Urachal Cyst/diagnosis/*microbiology/therapy ; Young Adult

BACKGROUND/AIMS: Although carcinoid tumors usually have good prognosis, early and specific diagnosis is important. Computed tomography and magnetic resonance imaging do not provide findings that are specific for carcinoids, and somatostatin receptor scintigraphy suffers from low spatial resolution. 18-Fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) has limited sensitivity for carcinoids due to low uptake of the marker. A PET/CT system that uses the somatostatin receptor-based PET tracer 1,4,7,10-tetraazacyclododecane-N(I),N(II),N(III),N(IIII)-tetraacetic acid (D)-Phe(1)-thy(3)-octreotide ((68)Ga-DOTATOC) has also been used in the evaluation of carcinoids, although information regarding its use for the detection of primary pulmonary carcinoids is limited. Thus, we investigated the value of (68)Ga-DOTATOC PET/CT for the diagnosis of primary pulmonary carcinoid tumors. METHODS: This was a retrospective analysis of patients with primary pulmonary tumors who underwent (68)Ga-DOTATOC PET/CT. All the patients had a histopathologic diagnosis of carcinoid. The rate of detection of primary pulmonary carcinoid tumors using (68)Ga-DOTATOC PET/CT was assessed. RESULTS: Twenty patients were diagnosed as having carcinoid, and 19 tumors showed significant uptake on (68)Ga-DOTATOC (detection rate, 95%). The maximal standardized uptake value (SUV(max)) ranged from 1.1 to 66, with a median value of 21.6. In one patient, (68)Ga-DOTATOC PET/CT revealed additional lesions. CONCLUSIONS: Our results demonstrate that (68)Ga-DOTATOC PET/CT is useful in the evaluation of primary pulmonary carcinoids and should be included in the diagnostic work-up of these patients.
Adolescent ; Adult ; Carcinoid Tumor/*diagnosis/radiography/radionuclide imaging ; Female ; Gallium Radioisotopes/*diagnostic use ; Humans ; Lung Neoplasms/*diagnosis/radiography/radionuclide imaging ; Male ; Middle Aged ; Octreotide/*analogs & derivatives/diagnostic use ; Positron-Emission Tomography/*methods ; Radiopharmaceuticals/*diagnostic use ; Retrospective Studies ; Tomography, X-Ray Computed/*methods

This paper discussed the injury mechanism and management of a patient who had concomitant ipsilateral hip and knee dislocations and contralateral open leg fracture. A 32-year-old man presented with ipsilateral fracture-dislocations of the left hip (Pipkin's type IV) and knee (Moore II) joints and contralateral open fracture of the leg bones after a car accident. After emergency resuscitative measures, the hip joint was reduced and Pipkin's fracture was fixed using Ganz approach with lag screws; knee joint was reduced closely and tibial plateau fracture was stabilized with lateral buttress plate and a transarticular spanning fixator. The open fracture on the other leg was debrided and fixed with an external fixator. There was no instability in both joints after fixation when he was examined under anesthesia. The fractures united after 3 months and the patient had no residual instability of hip and knee. There was no clinical or radiological evidence of osteonecrosis in the hip joint after 6 months. At one-year follow-up, he had satisfactory functional outcome with almost normal range of motion at both joints. Ipsilateral hip and knee dislocations are rare injuries and more caution is needed for early diagnosis. A timely appropriate intervention can provide good functional outcome to the patient in this situation.
Adult ; Fractures, Open ; surgery ; Hip Dislocation ; surgery ; Humans ; Knee Dislocation ; surgery ; Leg Injuries ; surgery ; Male ; Tomography, X-Ray Computed

Pulmonary blastoma (PB) is a rare thoracic malignancy and preoperative diagnosis is challenging. A young man presented with dyspnea and chest pain for 3–4 months and chest-computed tomography (CT) revealed large mass in the left lung upper lobe and pleural effusion. Repeated CT-guided fine-needle aspiration cytology from the lesion and pleural fluid aspiration was negative for malignancy. F-18-fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET-CT) revealed heterogeneous tracer avidity in left lung mass with areas of necrosis. Real-time PET-CT-guided biopsy from metabolically active component of the lesion revealed biphasic PB on histopathology.