Tag: pubmed

Indian J Pathol Microbiol. 2021 Jul-Sep;64(3):479-483. doi: 10.4103/IJPM.IJPM_612_20.

ABSTRACT

AIM: The present study evaluates the prognostic significance of perineural invasion (PNI) on 2-year, 5-year, and overall survival in patients undergoing gastrectomy and D2 lymphadenectomy due to locally advanced gastric cancer.

MATERIALS AND METHODS: Included in the study were 231 patients who underwent surgery between November 2006 and October 2018 due to stage 1B and over locally advanced gastric cancer, whose records were reviewed retrospectively.

STATISTICAL ANALYSIS: The variables in the presence or absence of PNI were compared between the two groups with a Chi-square test, a Fisher’s exact test, a likelihood ratio, and a Mann-Whitney U test. Overall survival data were evaluated with a Kaplan-Meier test. Prognostic factors were evaluated with a stepwise Cox regression analysis.

RESULTS: PNI was identified in 167 (72.3%) of the patients. The 2-year, 5-year, and overall survival rates at the end of the follow-up period were 85.9%, 70.3%, and 64.1% in those without PNI, and 52.7%, 38.3%, and 36.5% in those with PNI, respectively. In a multivariate analysis, PNI appeared to be a significant prognostic factor for 2-year survival (P = 0.04) but had no effect on 5-year and overall survival.

CONCLUSIONS: Survival was shorter in patients with PNI than in patients without PNI, and PNI had no effect on overall survival, although it was found to be of prognostic significance for 2-year survival.

PMID:34341257 | DOI:10.4103/IJPM.IJPM_612_20

Indian J Pathol Microbiol. 2021 Jul-Sep;64(3):484-489. doi: 10.4103/IJPM.IJPM_337_20.

ABSTRACT

BACKGROUND AND AIMS: An early correct diagnosis of celiac disease (CD) is fundamental to reversal of symptoms and prevention of complications in pediatric patients. Our aim was to evaluate the role of duodenal bulb biopsy by studying the degree of mucosal damage in the duodenal bulb (D1) and second part of the duodenum (D2) and correlating the findings with serum IgA anti-tTG levels.

SETTINGS AND DESIGN: Pediatric patients (age <18 years) with clinical suspicion of CD and positive IgA anti-tTG titers were consecutively enrolled over a period of one year. Demographic variables, anthropometry, clinical history, laboratory values and endoscopic findings were studied. Endoscopic biopsies obtained from D1 and D2 were evaluated and assigned histopathologic grades that were correlated with serology.

STATISTICAL ANALYSIS USED: Descriptive statistics were employed.

RESULTS: A total of 37 clinically suspected cases of pediatric CD were studied. The mean age was 6.7 years and the M:F ratio was 1:1.3. Thirty-two (32) children had varying degrees of growth impairment. Eight (8) children had only extra-intestinal symptoms. Thirty (30) children were anemic, hypoalbuminemia was seen in five (5) children while transaminitis was seen in two (2) children. IgA anti-tTG >300 U/ml was associated with Marsh-Oberhuber Grade 3 morphology at atleast one site.

CONCLUSIONS: Low positive serology values should be confirmed by histopathology. Biopsies should be taken even in the absence of endoscopic abnormality. Additional D1 biopsies placed in a separate container can increase the diagnostic yield.

PMID:34341258 | DOI:10.4103/IJPM.IJPM_337_20

Indian J Pathol Microbiol. 2021 Jul-Sep;64(3):460-463. doi: 10.4103/IJPM.IJPM_601_20.

ABSTRACT

BACKGROUND: In core needle biopsy (CNB) often the histological grade of invasive breast carcinoma is under-estimated due to heterogeneity of epithelial component. Stroma is relatively homogenous throughout the tumor and strong CD10 stromal positivity is proposed to be associated with high tumor grade.

AIMS AND OBJECTIVES: The aim of this work was to study the expression of CD10 in stromal cells of invasive carcinoma of breast, no specific type (NST) in CNB specimens, and analyze its association with final histological grade and lymphovascular invasion (LVI).

MATERIALS AND METHODS: A total of 50 cases of invasive carcinoma of breast, NST were studied for 18 months. CNB specimens were graded according to modified Scarff-Bloom-Richardson (SBR) system and CD10 positivity was assessed in stromal cells. Mastectomy specimens were also similarly graded. Relation of stromal CD10 positivity with histological grading and LVI was studied.

STATISTICS: Associations between the variables were studied by Chi-square test. A value of P < 0.05 was considered to be statistically significant.

RESULTS: On CNB 46% patients had a grade 2 tumor, followed by 30% grade 3 and 24% grade 1 tumor. Strong CD10 positivity was seen in 40% cases, 32% showed weak positivity and 28% were negative for CD10 in stromal cells in CNB specimen. On evaluation of mastectomy specimen 48% of the patients had a grade 2 tumor, followed by 40% grade 3 tumor and 12% grade 1 tumor. Strong CD10 positivity was found to be significantly associated with final grade 3 tumor (P < 0.001) and LVI (P = 0.005).

CONCLUSIONS: There was underestimation of histological grade on CNB, while strong stromal CD10 positivity in CNB was significantly associated with final grade 3 tumor and LVI.

PMID:34341253 | DOI:10.4103/IJPM.IJPM_601_20

Indian J Pathol Microbiol. 2021 Jul-Sep;64(3):464-468. doi: 10.4103/IJPM.IJPM_371_20.

ABSTRACT

BACKGROUND: Atrial fibrillation(AF) is as an abnormal irregular rhythm with chaotic generation of electrical signals in the atria of the heart. Various studies in the West have proved that atrial substrates, like isolated atrial amyloidosis can trigger the development of atrial fibrillation. In India, these structural changes have been analyzed on autopsied hearts.

AIM: To determine the role of Atrial Amyloid as a substrate for Atrial fibrillation in ante mortem hearts.

METHODS AND RESULTS: Atrial appendages were obtained from seventy five patients undergoing open heart surgery at a tertiary care hospital in south India. They were stained with Hematoxylin &Eosin, Masson’s Trichrome and Congo red stains and were examined for myocarditis, fibrosis and amyloidosis, respectively. 30 (40%) patients were in AF. Amyloid deposits were seen in 3 cases. All the three were in AF and had undergone mitral valve replacement (MVR) (P<0.05). 2 out of the 3 amyloid-positive cases showed active myocarditis and severe scarring but there was no statistically significant correlation between these factors.

CONCLUSION: Amyloid and myocarditis, independently act as an arrythmogenic substrates in the development of atrial fibrillation and are also increasingly associated with female gender and MVR. We hypothesize that the amyloid deposits are due to isolated atrial amyloidosis as they were seen only in young individuals. Some patients in sinus rhythm (SR) had large left atria and myocarditis and probably are at a higher risk for developing AF. Hence, follow-up of these patients is required for prevention of severe organ damage and timely therapeutic intervention.

PMID:34341254 | DOI:10.4103/IJPM.IJPM_371_20

Indian J Pathol Microbiol. 2021 Jul-Sep;64(3):472-478. doi: 10.4103/IJPM.IJPM_682_20.

ABSTRACT

CONTEXT: Role of cancer stem cells in the esophageal carcinogenesis is not clear.

AIM: To assess the expression of CD44 and CD133 cancer stem cell markers in esophageal squamous cell carcinoma (ESCC) and its predisposing lesions by immunohistochemistry.

SETTING AND DESIGN: Prospective study as a part of an intramural research project.

MATERIALS AND METHODS: Tissues samples were obtained with endoscopic biopsy and from surgically resected esophageal specimens. Fifty cases each of histopathologically diagnosed cases of esophageal squamous cell carcinoma and its predisposing lesions (mild, moderate, and severe dysplasia and esophagitis) were evaluated for stem cell marker CD44 and C133 by immunohistochemistry using a scoring system.

STATISTICAL ANALYSIS: Chi-square test, analysis of variance (ANOVA), post-hoc tests (Tukey-HSD) were used as appropriate for data analysis. Two sided P < 0.05 was considered as significant.

RESULTS: CD44 expression was significantly higher in ESCC as compared to dysplasia and esophagitis (mean IS 7.92 ± 1.45 vs. 6.34 ± 0.80 vs 5.15 ± 0.86 respectively, P < 0.001). CD133 expression was also significantly higher in ESCC as compared to dysplasia (mean IS 6.82 ± 1.57 vs. 1.00 ± 0.00 respectively, P < 0.001) while esophagitis showed no expression. CD44 and CD133 expressions were significantly higher in poorly differentiated ESCC than moderately differentiated and well differentiated lesions (CD44 mean IS 6.94 ± 1.44 vs 8.17 ± 1.38 vs. 8.63 ± 1.02 respectively, P < 0.001 and CD 133 mean IRS 5.63 ± 0.81 vs 6.00 ± 00 vs. 9.0 ± 00 respectively, P < 0.001).

CONCLUSION: Significantly higher expression of CD44 and CD133 cancer stem cell markers in ESCC as compared to its predisposing lesions (esophagitis and dysplasia) suggests its role in esophageal carcinogenesis.

PMID:34341256 | DOI:10.4103/IJPM.IJPM_682_20

J Indian Soc Pedod Prev Dent. 2021 Apr-Jun;39(2):208-213. doi: 10.4103/JISPPD.JISPPD_70_19.

ABSTRACT

INTRODUCTION: Boston University (BU) approach is a method for early prediction of unerupted permanent mandibular teeth widths based on the mesiodistal widths (MDWs) of primary mandibular canines and first molars. The present study was conducted to test the validity of BU approach by comparing it with Tanaka-Johnston (T/J) approach in the contemporary population.

AIMS AND OBJECTIVE: The aim of the study was to determine the applicability of BU approach for prediction of the MDWs of canines and premolars in the primary schoolchildren of rural Bengaluru.

MATERIALS AND METHODS: The study was conducted in 100 healthy schoolchildren of rural Bengaluru aged between 7 and 11 years. The MDWs of canines and premolars were predicted using both T/J and the considered BU approaches for all the children and were compared.

RESULTS: The correlation coefficient showed a statistically significant correlation between the predicted tooth size from the two predicted methods in the upper and lower arches (P < 0.001), with Pearson’s correlation coefficient showing the very strong positive relationship (r = 0.7). Significant differences were seen between the mean predicted width of canines and premolars by both the approaches (P < 0.001).

CONCLUSION: In spite of the limitations, we recommend the use of BU approach to predict arch length-tooth material discrepancy at an early age and to get at least an approximate estimation of the required space. We also advocate the necessity of further research on this approach prospectively.

PMID:34341243 | DOI:10.4103/JISPPD.JISPPD_70_19

J Indian Soc Pedod Prev Dent. 2021 Apr-Jun;39(2):214-220. doi: 10.4103/JISPPD.JISPPD_194_20.

ABSTRACT

BACKGROUND: Cerebral palsy (CP) is a childhood debilitating condition which impairs the physical and mental ability of an individual to maintain oral health.

AIM: The objective of the present study was assessment of dental neglect and burden of treatment needs of children affected with CP as compared to normal children in a tertiary care hospital in Delhi.

SETTINGS AND DESIGN: A sample size of 104 children of age group of 6-14 years was selected, in which 52 children of CP (case group) and 52 normal school children (control group) were recruited.

MATERIALS AND METHODS: Children from both groups were examined, and calculation of drug master files (DMFS), defs, oral hygiene index (OHI), and gingival index was done. The presence of trauma and malocclusion was assessed. Present caries activity was assessed by the level of Streptococcus mutans present in saliva in both groups. Treatment needs were then assessed based on intraoral findings.

STATISTICAL ANALYSIS: Data were analyzed by SPSS 20.0 software. Student’s t-test and nonparametric statistical tests such as Chi-square test and Mann-Whitney test were used as per the nature of variables studied for statistical analysis with the level of significance denoted at P < 0.05.

RESULTS: The mean DMFS, gingival index, OHI, and treatment needs were observed to be higher in the CP group. Increased S. mutans levels were observed in saliva of CP patients. Defs score, trauma, and malocclusion were not statistically significantly higher in CP group as compared to the control group.

CONCLUSION: Cerebral palsy group had a poor oral and gingival health, a higher DMFT and burden of treatment needs and an increased risk of further caries progression due to high caries activity indicated by increased level of salivary Streptococcus mutans than the control group.

PMID:34341244 | DOI:10.4103/JISPPD.JISPPD_194_20

J Indian Soc Pedod Prev Dent. 2021 Apr-Jun;39(2):196-201. doi: 10.4103/JISPPD.JISPPD_247_20.

ABSTRACT

BACKGROUND: Multiple factors can affect early childhood caries (ECC). Maternal stress and child’s temperament, as predictors of child behavior, are among factors that may be associated with ECC.

OBJECTIVES: The aim of this study was to evaluate the association between the salivary cortisol level of mothers as an indicator of maternal stress, child’s temperament, and ECC.

METHODS: Ninety preschool children, who were divided into three groups of ECC, severe ECC (S-ECC), and caries-free (CF), were included in this study, as well as their mothers with no history of anxiety disorders. The salivary cortisol levels of mothers were analyzed using ELISA assay. Children were examined for the evidence of caries, using the decayed-missing-filled teeth index, based on the World Health Organization standard criteria. Child temperament was also assessed, using Cloninger’s Preschool Temperament and Character Inventory, consisting of seven significant factors (cooperativeness, harm avoidance, novelty seeking, reward dependence, persistence, self-directing, and self-transcendence).

RESULTS: The association between the salivary cortisol level of mothers and temperament of children with S-ECC was positive although it was not statistically significant (P > 0.05). Of seven temperament factors, only harm avoidance was significantly different between the CF and S-ECC groups (P = 0.016).

CONCLUSION: Maternal stress and child’s temperament were not associated with ECC. Based on the present findings, children with less harm avoidance may be more prone to S-ECC.

PMID:34341241 | DOI:10.4103/JISPPD.JISPPD_247_20

J Indian Soc Pedod Prev Dent. 2021 Apr-Jun;39(2):202-207. doi: 10.4103/jisppd.jisppd_426_20.

ABSTRACT

BACKGROUND: Atraumatic restorative treatment (ART) and chemomechanical removal of dental caries have been shown to be safe and effective restorative procedures. However, current literature lacks well-design studies comparing the pain perceived by infants using ART and chemo-mechanical removal techniques.

AIMS: To compare pain perception of children of two techniques (ART vs. chemomechanical removal) of restorative treatments for dental caries removal.

SETTINGS AND DESIGN: A randomized clinical trial with two parallels arms (1:1) was conducted in the cities of Manaus (AM) and Uberlândia (MG), Brazil.

METHODS: Children between 4 and 9 years old were selected. In both groups – ART (n = 20) and chemomechanical caries removal (Papaya^® gel) (n = 20) – oximeter measurements (heart rate and blood oxygenation) were performed before the intervention and until the complete removal of the infected caries dentin. At the end of the treatment, a Wong-Baker scale was used to assess pain perception during the procedure. An independent researcher measured, in minutes, the duration of each technique.

STATISTICAL ANALYSIS: Poisson regression analysis was used to evaluate the association between the outcome and the explicative variables.

RESULTS: No statistical difference in pain perception between the two procedures of carious tissue removal was observed. By contrast, a lower heart rate was observed when chemomechanical removal was used (P = 0.013).

CONCLUSION: Children that underwent chemomechanical caries removal presented lower heart rate compared to those who underwent ART. However, both techniques showed minimal or absent perceived pain.

PMID:34341242 | DOI:10.4103/jisppd.jisppd_426_20

Psychiatry Investig. 2021 Jul;18(7):661-669. doi: 10.30773/pi.2020.0447. Epub 2021 Jul 22.

ABSTRACT

OBJECTIVE: Precarious workers have increased over the past two decades in South Korea. Employment instability, especially among young adults, is considered a serious social problem. The unstable employment status of precarious workers has negative impacts on their mental health, such as suicidal behavior. This study aims to identify the effect of the unstable employment conditions on the suicidal behavior of precarious workers.

METHODS: An online survey was conducted with a panel sample of South Korean adults (n=797) who were precarious workers aged between 25-34 years. We applied Model 6 of SPSS PROCESS MACRO 3.5 to examine the multiple mediation effects of depression and anger in the relationship between employment instability and suicide.

RESULTS: Unstable employment had no direct effect on suicidal behavior. The path of unstable employment to suicidal behavior via depression and anger had a significant indirect effect. However, employment and anger were negatively related. The indirect effect of depression and anger on the relation between unstable employment and suicidal behavior was statistically significant.

CONCLUSION: This study suggests an association between unstable employment and suicidal behavior, mediated by depression and anger. Specifically, a high level of unstable employment status increased depression. In contrast, a low level of unstable employment status increased anger, which ultimately led to an increase in suicidal behavior. These contrasting findings are likely to reflect the heterogeneity of precarious workers. Further longitudinal studies are necessary to identify the causality between precarious employment and suicidal behavior over time.

PMID:34340275 | DOI:10.30773/pi.2020.0447