Browsing by Author "Mohan Kumar"

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A case of endometriosis in episiotomy scar with anal sphincter involvement and extension into ischiorectal fossa
(Jaypee Brothers Medical Publishers (P) Ltd, 2014) Shuchi Jain; Soma Ghoshal; Mohan Kumar; Madhu Jain
Episiotomy scar endometriosis is characterized by presence of endometrial tissue (glands and stroma) and is a rare condition. It may also extend and involve the anal sphincter. The ideal treatment is wide excision to prevent recurrence but it may cause fecal incontinence, if the anal sphincter is involved. We describe here a case with much deeper extension into ischiorectal fossa. She was treated with wide local excision and primary sphincteroplasty. She has remained free of recurrence up to 12 months follow-up. © 2014, Jaypee Brothers Medical Publishers (P) Ltd. All rights reserved.
A cytologic perspective on meibomian gland carcinoma
(S. Karger AG, 2007) Rajendra S. Garbyal; Prajwala Gupta; Mohan Kumar; Anshu Bohra; Amita Chaube
Objective: To reevaluate and reestablish the reproducible diagnostic cytomorphologic features of meibomian gland carcinoma (MGCA), demonstrating the importance of fine needle aspiration cytology (FNAC) in eyelid lesions and leading to better management of the tumor. Study Design: Cytologic smears of previously diagnosed cases of MGCA over a 3-year period were collected, along with their histopathology reports. The cytomorphology of the histopathologically proven cases were reevaluated in greater detail. The cytologic smears were stained with Leishman-Giemsa cocktail and Papanicolaou stain, and the histopathologic sections were stained with hematoxylin-eosin. Special stains and immunohistochemical stains were applied as required. Results: Of the 19 cases, 3 diagnosed as MGCA on cytologic examination were reported as basal cell carcinoma on histopathology. On reevaluation of the cytologic smears, in addition to the regular characteristic features of MGCA, interesting findings such as an isolated dispersed cell population in a bubbly background, signet ring cells, pseudo-mucin cell balls, giant cell reaction and hyaline-like round bodies were observed. Conclusion: This study emphasizes the cytomorphologic features of MGCA in addition to those described in the literature, which could be of a great help in its diagnosis. Further, it emphasizes the importance of FNAC in the diagnosis of MGCA. © The International Academy of Cytology.
A large metatarsal giant-cell tumor
(Informa Healthcare, 1990) Ajay K. Khanna; Subramaniyama V Sharma; Mohan Kumar
A case of 14-cm giant-cell tumor of the first metatarsal bone of a 35-year-old male is reported. A ray excision was carried out. the patient has now been free from disease for 3 years. © 1990 Informa UK Ltd All rights reserved: reproduction in whole or part not permitted.
A yellow patient with hepatomegaly
(BMJ Publishing Group, 1999) O.P. Mishra; Mohan Kumar; V.K. Dixit; V.K. Shukla
[No abstract available]
Abdominal scar endometriosis after caesarean section: A rare entity
(Australasian Medical Journal Pty Ltd, 2011) Ruchi Sinha; Mohan Kumar; Manjari Matah
Scar endometriosis is an uncommon entity. It is often misdiagnosed leading to unnecessary referrals. Gynaecologists and general surgeons must be aware of this entity to avoid discomfort to the patient due to delay in diagnosis. We are presenting a case of scar endometriosis which was misdiagnosed initially. Detailed history of cyclic pain and swelling was the key point for the final diagnosis of scar endometriosis. Medical therapy was ineffective. Surgical excision of mass was the treatment for endometriotic lesion. This article is an attempt to create awareness of this condition among gynaecologists and general surgeons.
Adenoid cystic carcinoma of ceruminous gland: A case report
(2006) Rajendra S. Garbyal; Mohan Kumar; Anshu Bohra
Adenoid cystic carcinoma of the external auditory canal (EAC) is a very rare malignant tumor and its diagnosis is frequently missed because of the superficial nature of biopsies. A 30 year old male presented with 6 months history of recurrent painful right ear discharge. On examination there was a nodule of 2 cms. in diameter. The microscopic examination of the punch biopsy specimen of tumor revealed typical features of an adenoid cystic carcinoma. While reporting the biopsies of external auditory canal one should keep the adenoid cystic carcinoma as one of the possible differentials, especially if the biopsy is superficial, problem is recurrent and histopathological features suggest the granulation tissue.
AgNOR count and subjective AgNOR pattern assessment (SAPA) score in carcinoma of the pancreatic head including periampullary tumors
(2005) Ajay K. Khanna; Sanjeev K. Yadav; Vinod K. Dixit; Mohan Kumar
Context: Only a few studies are available in the literature regarding the AgNOR (argyrophilic nucleolar organizer region) count in pancreatic adenocarcinoma but studies on the SAPA (subjective AgNOR pattern assessment) score are completely lacking. Objective: We attempted to estimate the AgNOR count and the SAPA score in carcinoma of the pancreatic head including periampullary tumors and to correlate them with other various clinico-histological parameters. Setting: Patients undergoing pancreatic resection at the University Hospital, Banaras Hindu University, Varanasi, India. Patients: Twenty-four cases of carcinoma of the pancreatic head including periampullary tumors. In addition, on the resected specimen of the pancreas, the area which was normal was chosen and, in that normal tissue, the AgNOR was also studied. Main outcome measures: Patients were studied for the AgNOR count and the SAPA score, and the values were correlated with the size of the tumor, the type of tumor and histological type and grade of tumor. Results: The values of the AgNOR count and the SAPA score were significantly higher in cases of pancreatic cancer than in the healthy pancreas. The AgNOR count was 1.6±0.1 in the healthy pancreas while it was 2.8±0.5 in cases of pancreatic carcinoma (P<0.001). The SAPA score was 5.6±0.2 in the healthy pancreas while it was 8.0±1.4 in pancreatic carcinoma (P<0.001). Tumors less than or equal to 2 cm in size had an AgNOR count of 2.6±0.08 while the AgNOR count was 3.4±0.02 in tumors larger than 2 cm (P<0.001). The SAPA score was also higher in tumors greater than 2 cm in size (7.3±0.2 vs. 9.4±0.8; P<0.001). Periampullary tumors had a significantly lower (P<0.001) AgNOR count (2.7±0.06) and SAPA score (7.8±0.2) as compared to carcinoma of the head of the pancreas (AgNOR count 3.3±0.03 and SAPA score 9.2±0.7). Well-differentiated carcinomas had significantly lower AgNOR counts as compared to other tumors except acinar cell carcinomas since acinar cell carcinomas are also well-differentiated tumors. The SAPA score was also higher in moderately-differentiated tumors and the difference between moderately-differentiated tumor and other types of tumors was significant although there was no significant difference between cystadenocarcinomas and unclassified tumors, and between acinar cell carcinomas and well-differentiated tumors on SAPA scoring. Conclusions: The values of the AgNOR count and the SAPA score are well-correlated with the size of the tumor, the type of tumor and the histological grade.
An extract of Pueraria tuberosa tubers attenuates diabetic nephropathy by upregulating matrix metalloproteinase-9 expression in the kidney of diabetic rats
(John Wiley and Sons Inc., 2017) Yamini B. Tripathi; Rashmi Shukla; Nidhi Pandey; Vivek Pandey; Mohan Kumar
Background: Currently, no drug is available to directly target the signaling molecules involved in the pathogenesis of diabetic nephropathy (DN); only antihypertensive and antidiabetic drugs are in clinical use. In the present study, the therapeutic effects of a active fraction of tubers from Pueraria tuberosa (hereafter referred to as PTY-2) were investigated in streptozotocin (STZ)-diabetic rats with DN, with particular emphasis on its effects on extracellular matrix (ECM) accumulation and matrix metalloproteinase (Mmp)-9 expression in kidney tissue. Methods: Rats were injected with 55 mg/kg, i.p., STZ. After 40 days, rats were divided into groups as follows (n = 6 per group): Group 1, age-matched rats not injected with STZ (non-diabetic control); Group 2, STZ-diabetic DN rats; and Group 3, PTY-2 (30 mg/100 g, p.o.)-treated DN rats. After 20 days treatment, the effects of PTY-2 on serum urea and creatinine concentrations, urinary levels of glucose, creatinine, protein, and ketone bodies, and urine pH were determined. Kidney tissue was evaluated for Mmp-9 expression and histological changes. Results: Blood glucose, serum urea, creatinine, and urine protein levels were significantly higher, and creatinine clearance was significantly lower, in Group 2 versus Group 1 rats. There was a higher degree of glomerulosclerosis, expansion of the mesangial matrix, and excess ECM deposition and eosinophilic casts in kidneys from Group 2 versus Group 1 rats. Furthermore, Mmp-9 activity and expression were significantly reduced in kidney homogenate of Group 2 versus Group 1 rats. Interestingly, PTY-2 treatment significantly reversed all these changes in DN rats. Conclusion: Treatment of DN rats with PTY-2 significantly attenuated the severity of DN by increasing the expression and activity of Mmp-9, consequently degrading the ECM accumulated in kidney tissue. © 2016 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd
Argyrophilic nucleolar organizer regions: Their value and correlation with clinical prognostic factors in breast carcinoma
(1997) Anand Kumar; Anand Kumar Kushwaha; Mohan Kumar; Saroj Gupta
Background and Objectives: Argyrophilic nucleolar organizer regions (AgNORs) have been recently identified as a marker of proliferative index in various tumors. These were evaluated in 46 patients with primary breast carcinoma and were correlated with clinical prognostic parameters of breast cancer. Ten patients with benign breast tumors served as controls in the study. Methods: AgNORs were stained in paraffin sections of the tissues using Ploton's silver technique. For each specimen, the number of AgNORs within the nuclei of 100 tumor cells were calculated. The average number of AgNORs per nucleus was calculated and the results expressed as mean ± S.D. Results: AgNOR count was significantly higher in breast carcinoma (6.61 ± 1.75) than in benign breast tumors (1.88 ± 0. 19). Further, the AgNOR count in breast carcinoma showed a statistically significant increase in correlation with the increase in the size of the tumor, stage of the cancer, number of metastatic lymph nodes, and tumor recurrence at various sites. However, the differences in AgNOR count at different lymph node levels and histologic grading were not statistically significant. Conclusions: These results indicate that breast tumors with a higher AgNOR count, even at the initial stage, have a poor prognosis and require aggressive treatment for better control of the disease. Further, it is suggested that the patients with a benign tumor and more than three AgNORs per nucleus need careful surveillance.
Association of carcinoma of the gallbladder with typhoid carriage in a typhoid endemic area using nested PCR.
(2008) Gopal Nath; Yogesh Kumar Singh; Kailash Kumar; Anil Kumar Gulati; Vijay Kumar Shukla; Ajay Kumar Khanna; Sunil Kumar Tripathi; Ashok Kumar Jain; Mohan Kumar; Tej Bali Singh
Although well studied the association between chronic typhoid carrier state and carcinoma of the gallbladder (CaGB) remains unproven. The study was performed at a tertiary care medical center in North India and involved 52 patients with CaGB, 223 patients with benign gallbladder diseases, 508 healthy individuals and, 424 corpses. For the detection of Salmonella enterica serovar Typhi, hepatobiliary specimens were subjected to DNA extraction for specific nested- PCR amplification of the S. Typhi flagellin gene. Anti-Vi S. Typhi antibodies were detected in serum samples from patients by indirect haemagglutination. Thirty five of the 52 (67.3%) CaGB patients were PCR-positive for the S. Typhi flagellin gene; significantly higher than for patients with benign gallbladder diseases (95/223, 42.6%; p<0.01) and corpses (35/424, 8.2%; p<0.001). The numbers of individuals that had significant anti-Vi antibody titres (> or = 160) in their serum were 20/52 (38.5%) for CaGB patients, 31/223 (13.9%) for patients with benign gallbladder diseases, and 47/508 (9.2%) for healthy individuals. Specific nested-PCR amplification of the S. Typhi flagellin gene in hepato-biliary specimens was more sensitive for detection of S. Typhi carriage than anti-Vi antibody titres in serum. The results demonstrate an association between typhoid carriage and gallbladder diseases, both CaGB and benign. S. Typhi specific immunosuppression is also suggested in patients with gallbladder diseases.
BHUx: A patent polyherbal formulation to prevent atherosclerosis
(2005) Yamini B. Tripathi; Birendra K. Singh; Ravi S. Pandey; Mohan Kumar
Ayurvedic medicine is a time-tested system of medicine which has been in clinical use for centuries in India. Being a time-tested system, it has an edge over other existing systems of health management, especially for dealing with chronic disorders such as coronary artery disease, which is of a complex multi-etiological nature. Recently, we have shown that BHUx, a patented polyherbal formulation consisting of the aqueous fraction of five medicinal plants of the ayurvedic system, has significant anti-inflammatory properties through inhibition of cyclooxygenase-2 and lipoxygenase-15. Here we have investigated its effect on diet-induced atherosclerosis in albino rabbits. BHUx was given orally for 3 months to rabbits pre-treated with an atherogenic diet for 3 months. After 6 months, the dorsal aorta was processed for histological studies for calcium and collagen content. The results demonstrated a remarkable reduction in intimal thickening in the treated animals. In addition, there was less calcification at the intima-medial interface and increased intensity of collagen cap on the surface along with an increase in survival, compared with the sham control. We suggest that BHUx is a potent, multi-factorial formulation against atherosclerosis. © The Author (2005). Published by Oxford University Press. All rights reserved.
CA 19-9 in various gastrointestinal malignancies in an indian population
(2004) A.K. Khanna; S.K. Yadav; V.K. Dixit; G. Nath; Mohan Kumar
[No abstract available]
Carcinoma of the tongue in a renal transplant recipient: a rare post-transplant malignancy
(2015) Jai Prakash; Mohan Kumar; Kishan Aralapuram
Current immunosuppression improved long-term outcome of transplant patients, but it also increased the incidence of de novo malignancy. Organ transplant recipients have a three to four-fold increased risk of developing carcinoma in comparison with the general population. Common malignancies encountered after transplantation include cancer of the skin, lips, post-transplant lymphoproliferative disease, ano-genital carcinoma and Kaposi sarcoma. Squamous cell carcinoma of the tongue is very rare. We report here a case of squamous cell carcinoma of the tongue in an adult male patient who developed it 11 years post-transplant. He underwent right hemiglossectomy and his graft function remained stable.
Castleman disease presenting with cervical adenopathy in a four-year-old girl: A case report and review of literature
(Journal of Clinical and Diagnostic Research, 2017) Ankur Singh; Vijay Kumar Jha; Rajniti Prasad; Mohan Kumar; Om Prakash Mishra
Castleman Disease (CD) is an uncommon cause of cervical lymphadenopathy in paediatric age group. It is not uncommon to misdiagnose such condition in lack of facility and expertise. Only few cases have been reported from outside Indian Subcontinent so far in paediatric age group (≤18 years), presenting with cervical adenopathy. Four-year-old girl child presented to our OPD with bilateral enlargement of cervical nodes. Tissue diagnosis of cervical node revealed CD. We managed the case conservatively without any surgical intervention. Child responded well to conservative treatment and is in follow up without any problem of recurrence and need of surgery. This case highlights overall benign course of disease in unicentric hyaline vascular type CD. © 2017, Journal of Clinical and Diagnostic Research. All rights reserved.
Cholecysto-hydatid cyst fistula
(2004) Anand Kumar; Divya Narain Upadhyaya; Seema Singh; Mohan Kumar; Mumtaz Ahmad Ansari
A 27-year-old woman developed recurrent hydatid of liver. CT scan showed unilocular cysts in segments IV and VII. Intraoperatively, there was a fistulous communication between the gall bladder and the cyst in segment IV. Partial pericystectomy along with cholecystectomy was done for the segment IV cyst; percutaneous aspiration, instillation and re-aspiration using hypertonic saline was done for the cyst in segment VII. This was followed by albendazole treatment.
Cholecystokinin and gastrin receptors targeting in gastrointestinal cancer
(2012) Rajani Rai; Vishal Chandra; Mallika Tewari; Mohan Kumar; Hari S. Shukla
Cholecystokinin and Gastrin are amongst the first gastrointestinal hormone discovered. In addition to classical actions (contraction of gallbladder, growth and secretion in the stomach and pancreas), these also act as growth stimulants for gastrointestinal malignancies and cell lines. Growth of these tumours is inhibited by antagonists of the cholecystokinin and gastrin receptors. These receptors provides most promising approach in clinical oncology and several specific radiolabelled ligands have been synthesized for specific tumour targeting and therapy of tumours overexpressing these receptors. Therefore, definition of the molecular structure of the receptor involved in the autocrine/paracrine loop may contribute to novel therapies for gastrointestinal cancer. Hence, this review tries to focus on the role and distribution of these hormones and their receptors in gastrointestinal cancer with a brief talk about the clinical trial using available agonist and antagonist in gastrointestinal cancers. © 2012 Elsevier Ltd. All rights reserved.
Class I histiocytosis: Response to combination of etoposide and prednisolone
(1999) Vikram Datta; O.P. Mishra; B.K. Das; Mohan Kumar; V. Bhargava; P.N. Singla
[No abstract available]
Clinical value of fine needle aspiration cytology and biopsy in the evaluation of male infertility... A comparative study of 60 infertile patients
(2004) Mufti Mahmood; Jagdishwar Kumar Singh; U.S. Dwivedi; Mohan Kumar; P.B. Singh
To compare the diagnostic value of cytological smears of fine needle aspirate with that of histological sections obtained by testicular biopsy in the evaluation of infertility, 60 patients of infertility with azoospermia and severe oligospermia (sperm counts of <5 million/ml) were undertaken for the study. A detailed history was taken and the duration and type of infertility whether primary or secondary was noted. A thorough general physical examination included the examination of the genitalia. Testicular samples were obtained by fine-needle aspiration using a 10 ml syringe and 21-gauze needle. The samples were fixed in 95% alcohol and stained with papanicoloau stain. A testicular biopsy was taken after exploring the same tract and these sections were stained with haematoxylin and eosin. The cytological smears and histological sections were examined separately and the results compared. The cytological smears were divided into four groups: normal, with all spermatogenic cells present, hypospermatogenesis; spermatogenic arrest and sertoli cell only syndrome. There was 95% correlation between the diagnosis on the cytological smears and histological sections. However, there was some discrepancy in hypospermatogenesis and maturation arrest groups, they being difficult to diagnose even on histology.
Clinico-histopathological study of varicose vein and role of matrix metalloproteinases-1, matrix metalloproteinases-9 and tissue inhibitor of matrix metalloproteinase-1 in varicose vein formation
(Medknow Publications, 2016) Bitan Naik; Mohan Kumar; Ajay Kumar Khanna; Pradeep Kumar Suman
Background and Aims: Varicose vein (VV) is an important cause of morbidity in the young and elderly population. Many studies of the Western country suggest that matrix metalloproteinases (MMPs) and tissue inhibitors of MMPs have a crucial role in the pathogenesis of VV, but limited work has been done in Indian population. The aim of this study is to study detailed histology of VV and to see the expression of MMP-1, MMP-9 and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1). Materials and Methods: A total of 63 cases of VV and 10 control leg veins were included in this prospective study. Paraffin sections of VV were prepared. Hematoxylin and eosin (H and E), Masson trichrome and Verhoeff's staining were performed. Immunohistochemistry of VV was done with MMP-1, MMP-9, and TIMP-1 antibodies. Cytoplasmic expression of MMP-1, MMP-9 and TIMP-1 were graded as intense positive (++), weak/slight positive (+), and absent (-). Results: Focal intimal thickening (47.6%), increased medial thickening (73%) and fragmentation of elastin fibers (84.1%) were the major histological changes noted in H and E and special stained sections. MMP-1 expression increased in all layers of VV in 58 cases (92.1%) as compared to control veins. As compared to the control veins, intimal and adventitial expression of MMP-9 were increased in 31 (49.2%) and 40 (63.5%) cases, respectively. Expression of TIMP-1 was absent in both the varicose and the control veins. Conclusion: Increased expression of MMP-1 and MMP-9 suggests they have an important role in the pathogenesis of V.V. © 2016 Indian Journal of Pathology and Microbiology.
Comparison of immunohistochemistry with conventional histopathology for evaluation of sentinel lymph node in breast cancer
(2011) Rahul Khanna; Shilpi Bhadani; Seema Khanna; Manoj Pandey; Mohan Kumar
The best method of pathological evaluation of sentinel lymph node in breast cancer has not been agreed upon. Immunohistochemical (IHC) techniques have shown a greater sensitivity over conventional histology for the detection of micrometastais. The aim of the study was to determine whether IHC for Epithelial Membrane Antigen (EMA) on the sentinel node could be more sensitive than conventional histology for diagnosing micrometastasis in sentinel lymph nodes. Eighty-four clinically node negative breast cancer patients underwent sentinel node biopsy at time of surgery for breast cancer. The node was subjected to conventional histopathology as well as IHC for EMA. The sensitivity of histology viz a viz IHC for EMA for detection of sentinel node metastasis was 88% and the specitficity was 96%. The overall diagnostic accuray of histology viz a viz IHC was 93%. There were 4 patients with micrometastasis (<2.0 mm), which were positive on IHC but negative on histology. Two patients with poorly differentiated breast cancer had a false negative IHC for EMA result as compared to histology. Immunohistochemistry for Epithelial Membrane Antigen can increase the detection rate of micrometastasis in sentinel lymph node. This can have important bearing on deciding the need of adjuvant systemic therapy. A false negative result for EMA may be seen in patients with poorly differential cancer. Therefore the best policy seems to employ both histopathology and IHC for EMA for the comprehensive evaluation of sentinel lymph node in breast cancer. © 2010 Association of Surgeons of India.