Renal pyelic fusion with crossed solitary ureter: Case report and review of literature

Renal fusion anomalies are detected incidentally on imaging, with horseshoe kidney being the most common followed by crossed renal ectopia. We report a rare congenital anomaly of renal pyelic fusion with a solitary ureter. Both the renal units were in the normal position and location. This rare anomaly was associated with lumbar vertebral defects, neurogenic bladder, vesico‐ureteric reflux, upper tract dilatation and recurrent urinary tract infections.     

Comparison of cytological features of myxopapillary ependymomas on crush preparations

Myxopapillary ependymoma (ME) is a rare neoplasm found predominantly in the sacro‐coccygeal region in adults and is characterized by its distinct epithelial and stromal components. From 1990 to April 2008, a total of 10 ME cases were recorded at our institution. Six out of 10 cases underwent frozen section examination with concomitant crush preparations, which forms the basis of this study. The clinical and cytologic findings in all six cases were reviewed. There were four males and two females. The age ranges from 15 to 36 years with a mean age of 27 years. The epithelial component of ME is strikingly similar for all six cases showing tumor cells appearing singly or in loose clusters, most with papillary branching. There was also presence of indistinct cell boundaries, tapered cytoplasmic prolongations, wispy/fragile cytoplasm, and uniform oval‐to‐fusiform shaped nuclei with an evenly distributed chromatin pattern. The stromal component was composed mainly of thick, metachromatic material and adenoid cystic‐like areas. One case showed rosette‐like structures. These aforementioned characteristics can be utilized to distinguish ME from other primary and metastatic tumors such as meningioma, adenoid cystic carcinoma, chordoma, mucinous adenocarcinoma, chondrosarcoma, and germ cell tumors. Diagn. Cytopathol. 2009. © 2009 Wiley‐Liss, Inc.     

Oral health status and treatment needs of children attending special schools in South India: a comparative study

The aim of this study was to assess and compare oral health status and treatment needs of children with special healthcare needs (SHCN) between the ages of 5 and 15, with a matched group of healthy children, in Udupi District of South India. A cross‐sectional study of 265 children with SHCN was compared to 310 healthy children to assess differences in periodontal status, dentition status, treatment needs, and dentofacial anomalies using the WHO criteria. Chi‐square, t‐test, and Z‐tests were performed to compare different variables. p≤ 0.05 was considered statistically significant. A significantly higher prevalence of caries (89.1%), malocclusion, and poorer periodontal status was observed among children with SHCN compared to the healthy control group. Improving the oral health of these children will require maintaining good oral hygiene practices, which can be achieved with appropriate target‐based oral health approaches.     

Prevalence of nonfermenters in clinical specimens

One hundred and thirty three non fermenting gram negative bacilli isolated out of 625 different clinical specimens were identified and characterised. Samples were exudate from chronic suppractive otits media (341), diabetic foot (117) wound (116) and blood (51). Of these isolates Pseudomonas aeruginosa 105(78.94%) predominated followed by Acinetobacter sp 8 [6.1%], Pseudomonas putrifaciens 6(4.5%), Flavobacterium sp 6(4.5%), Xanthomonas maltophilia 5(3.75%), Alkaligenes sp 3 (2.25). 31 (23.30%) were resistant to commonly used antibiotics. Amikacin 85 (63.90%) was found to be more effective than fluoroquinolones (27.8-48.12%).     

Human liver glucuronidation of benzidine

Although glucuronidation is considered an important pathwayin aromatic amine-induced bladder cancer, benzidine glucuronidationhas not been assessed in humans. Glucuronidation of benzidinewas assessed with human liver microsomes and slices. Emulgen911-treated microsomes exhibited a K_m for benzidine of 0.8±0.06mM and a V_max of 4.2±0.7 nmol/mg protein/min. A varietyof agents were tested for their ability to inhibit benzidineN-glucuronide formation. At 0.25 mM, estriol, 17-epiestriol,bilirubin, hyodeoxycholic acid and cyproheptadine were goodinhibitors (<50% of control). Dose-dependent inhibition studieswith estriol, testosterone and 4-aminobiphenyl demonstratedthat each agent reached a plateau as its concentration was increased.When these agents were combined at maximal inhibitory concentrations,additive inhibition was observed. These results suggest thatmore than one UDP-glucuronosyltransferase metabolizes benzidine.The cDNA clones pUDPGT_h-1 and -2 encode transferases which metabolizehyodeoxycholic acid and estrogen derivatives, but neither transferasecatalyzed benzidine glucuronidation. Slices were used to assessmetabolism by intact tissue and converted [³H]benzidine (0.09mM) to N-acetyl-benzidine. N-Glucuronides of both benzidineand N-acetylbenzidine were observed and represented 14–37%of the total recovered radioactivity. The amount of N-acetylbenzidineN'-glucuronide observed was proportional to the amount of N-acetylbenzidineproduced. Thus, N-glucuronidation appears to represent a majorpathway for metabolism of benzidine in humans. The extent ofN-acetylation affects the proportion of benzidine and N-acetylbenzidineglucuronidated by human liver slices.     

Utilization of PD modalities: evolution

In the early 1960s, peritoneal dialysis (PD) was introduced as a form of long-term maintenance therapy in patients with end-stage renal disease (ESRD). We have come a long way since. Increasing understanding of peritoneal kinetic behavior, its innovative manipulation to meet patient needs, critical monitoring of clinical outcomes, and parallel development in technology have all contributed to the worldwide success of the therapy over the past four decades. In this article we review the evolution of the various PD modalities in the context of these factors.     

In-vitro efficacy of antibacterials against bacterial isolates from corneal ulcers

PURPOSE: To analyse the in-vitro efficacy of commonly used antibacterials against bacterial pathogens from corneal ulcers. METHODS: We evaluated 596 patients seen over 18 months, period, September 1999 through March 2001. Corneal scrapings were subjected to microscopy and cultures using standard protocols. Antibacterial susceptibility of isolated bacteria were determined by the Kirby-Bauer disc-diffusion method. RESULTS: 626 bacterial pathogens were isolated from 596 corneal ulcer cases. 411(65.65%) were gram positive cocci Streptococcus pneumoniae (41.85%) was the predominant bacterial species. The antibacterial susceptibility was: 451(72.04%) to cefazolin, 471(75.24%) to chloramphenicol; 321(51.28%) to cephaloridine; 430(68.69%) to vancomycin; 564(90.09%) to ciprofloxacin; 429(68.53%) to norfloxacin; 464(74.12%) to gentamicin and 202(32.27%) to co.trimoxazole. CONCLUSION: This study provides information on the efficacy of ocular antibacterials commonly used against bacterial pathogens of keratitis. It is hoped that this information will help decision-making in empiric initial treatment of bacterial keratitis.     

Mitomycin-C-augmented trabeculectomy for neovascular glaucoma. A preliminary report

PURPOSE: This study aimed to investigate the safety and efficacy of trabeculectomy with intraoperative mitomycin C (MMC) in the management of eyes with neovascular glaucoma (NVG). METHODS: Fifteen eyes of 14 patients with NVG were included in the study. NVG was secondary to central retinal vein occlusion (3 eyes), hemiretinal vein occlusion (2 eyes), proliferative diabetic retinopathy (8 eyes), branch retinal vein occlusion (1 eye) and idiopathic (1 eye). Preoperative retinal ablation was performed in eyes with evidence of posterior segment ischaemia. Following this, all eyes underwent trabeculectomy with intraoperative MMC (0.4 mg/ml for 3 minutes). Clinical outcome assessment included visual acuity, intraocular pressure (IOP), bleb appearance, identification of complications and antiglaucoma medications required to control IOP. RESULTS: The mean IOP decreased from 38.6 +/- 12.9 mmHg (range, 15-64 mmHg) to 17.4 +/- 9.33 mmHg (range, 4-34 mmHg) (P = 0.001). Preoperative visual acuity ranged from light perception to 6/9 in the affected eye. Thirteen (86.6%) of 15 eyes improved vision or retained preoperative vision, one (6.7%) eye lost light perception and one (6.7%) eye developed tractional retinal detachment two years after trabeculectomy. Ten (66.7%) of 15 eyes were classified as surgical success with a mean follow-up of 28.6 +/- 26.3 months (range, 2-82 months). None of the patients developed choroidal haemorrhage, hypotony maculopathy, late onset bleb leak or endophthalmitis. CONCLUSION: Trabeculectomy with intraoperative MMC is a good treatment modality in the management of eyes with NVG.