Background: Acute myocardial infarction (AMI) is a recognized complication in patients with hyper... more Background: Acute myocardial infarction (AMI) is a recognized complication in patients with hypertrophic cardiomyopathy (HCM). However, there are limited data on outcomes of HCM patients presenting with AMI. methods: We queried the 2003-2011 Nationwide Inpatient Sample databases to identify all patients ≥18 years with the primary diagnosis of AMI. Patients with HCM were then identified using ICD-9-CM code 425.1. Logistic regression was used to compare treatment choice and outcomes in AMI patients with and without HCM. results: From 2003-2011, of 5,900,949 patients with AMI, 5,688 (0.1%) had a diagnosis of HCM. Patients with HCM were more likely to be older (71.4±13.9 years vs 67.8±14.5 years) and women (67.7% vs 40.2%). HCM patients were less likely to have traditional cardiovascular risk factors, including family history of coronary artery disease, dyslipidemia, obesity, smoking and diabetes mellitus. They were more likely to have congestive heart failure, atrial fibrillation, valvular diseases and prior history of cardiac arrest. HCM patients were less likely to have ST-elevation myocardial infarction (STEMI) (22.8% vs 37.5%, p<0.001). HCM patients with STEMI were less likely to receive thrombolysis (1.2% vs 3.8%, p<0.001) or percutaneous coronary intervention (PCI) (31.2% vs 56.8%, p<0.001). HCM patients with non-ST elevation myocardial infarction (NSTEMI) were less likely to receive PCI (14.9% vs 30.8%, p<0.001) or coronary artery bypass surgery (4.7% vs 9.6%, p<0.001). Among patients with STEMI, patients with HCM had 24% lower in-hospital mortality than patients without HCM (adjusted OR 0.76, 95 % CI 0.63-0.91, p=0.004). After further adjustment for treatment received, HCM patients with STEMI had 33% lower in-hospital mortality than patients without HCM (adjusted OR 0.67, 95% CI 0.55-0.80, p<0.001). Among patients with NSTEMI, there was no difference in in-hospital mortality in patients with and without HCM (p=0.91) (interaction p value for HCM and STEMI = 0.039). conclusion: HCM patients represent a small portion of patients with AMI and are less likely to be treated with revascularization. Compared to patients without HCM, HCM patients with STEMI have lower in-hospital mortality.
Interstitial lung diseases (ILDs) are an intriguing group of pulmonary disorders, which still req... more Interstitial lung diseases (ILDs) are an intriguing group of pulmonary disorders, which still require the study of epidemiological, genetic, pathophysiological, clinical, and radiological parameters. Pulmonary hypertension (PH) is an underreported complication in interstitial lung diseases which is associated with worse outcome. In our study, we have reported the spectrum of ILDs and estimated the prevalence of pulmonary hypertension among these subjects at a tertiary care center. A cross-sectional study was performed in which demographical, clinical, radiological, and histological data of subjects with ILD, attending the Department of Respiratory Medicine in the University was collected from 1 st September 2018 to 31 st August 2019. Serological tests were done wherever indicated. Standard criteria along with multidisciplinary opinion were needed to arrive at the final diagnosis. All subjects were screened for pulmonary hypertension via 2-D echocardiography. Mean pulmonary artery pressure ≥20 mmHg was used to define PH. In the defined period, 239 subjects were enrolled (58% females, n=141; mean age 52.38±13.40 years). A tissue diagnosis was obtained in 34% cases. The most common ILD was hypersensitivity pneumonitis (32.2%), followed by autoimmune-ILD (31.4%), idiopathic pulmonary fibrosis (IPF) (15.9%) and sarcoidosis (12.6%), non-IPF idiopathic interstitial pneumonitis (2.1%) and rest 21 (5.9%) subjects were diagnosed as other types of ILD. Pulmonary hypertension was seen in 46.0% of subjects.
IP archives of cytology and histopathology research, Nov 15, 2022
Warthin's tumor is the most common monomorphic adenoma of the parotid gland. It can be coexistent... more Warthin's tumor is the most common monomorphic adenoma of the parotid gland. It can be coexistent with other salivary gland tumors or can be metachronous, multifocal, unilateral, bilateral which perplexes the diagnosis hence delaying or over/under treating the ailment. Rare cases of Warthin's tumor are described in young population especially young non-smoker females. We present a case of Warthin's tumor arising in the left parotid gland of 20-year-old female. This is an Open Access (OA) journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
Metastasis of adenoid cystic carcinoma to the kidney is rare. We present a case of a 50 year old ... more Metastasis of adenoid cystic carcinoma to the kidney is rare. We present a case of a 50 year old male with complaints and radiological findings suggestive of renal cell carcinoma and lung deposits. However, fine needle aspiration was suggestive of adenoid cystic carcinoma metastatic deposits. It was later elicited that the patient had undergone surgery for parotid tumour seven years back which on histology was an adenoid cystic carcinoma. The case is being presented for its rarity.
The gut microbiome has been explored extensively for its importance in the modulation of systemic... more The gut microbiome has been explored extensively for its importance in the modulation of systemic inflammation and immune response; in contrast, the intratumoral microbiome is less studied for its influence on immunity in cancer. Given the established correlation between intratumoral lymphocyte infiltration and patient survival in cases of solid tumors, it was pertinent to explore the extrinsic factor influencing immune cell infiltration in the tumor.
As a part of multi-disciplinary team of the institute in managing Covid positive patients as well... more As a part of multi-disciplinary team of the institute in managing Covid positive patients as well as those admitted with its complications, Pathology department was reporting specimens of suspected fungal infection, received from clinical departments like neurosurgery, otorhinolaryngology, ophthalmology, oral and maxillofacial surgery, respiratory medicine, internal medicine etc. Simultaneous serology and various Covid associated blood parameters were being investigated during admission to hospital, as per the clinical scenario. The aim of this paper is to discuss pathogenesis of fungal infections and bring out any significant pathological differences in Covid 19 positive cases afflicted subsequently by either mucor alone or mixed fungal infections. Out of 274 tissue specimens received between April to November 2021, clinically suspected to be of Covid 19 associated mucormycosis, we found 14 cases of simultaneous co-infection with other species of fungi. 45 specimens were reported n...
Journal of Evolution of medical and Dental Sciences, 2013
UNUSUAL VARIANTS OF FIBROADENOMA BREAST DIAGNOSED ON CYTOLOGY Fibroadenomas are common benign bre... more UNUSUAL VARIANTS OF FIBROADENOMA BREAST DIAGNOSED ON CYTOLOGY Fibroadenomas are common benign breast tumours that display a characteristic morphology, although several epithelial and stromal variations exist which may pose a diagnostic difficulty. We are discussing a case series of four cases of benign fibroadenoma with morphological variations as observed on cytology smears in the department of Pathology, KGMU, Lucknow, UP. Juvenile fibroadenoma constitutes only 4% of the total fibroadenomas with incidence of 0.5% per year. Another very rare histological finding is the presence of multinucleated giant cells throughout the stroma of a benign fibroadenoma, more commonly found incidentally within the interlobular stroma of breast tissue. Similarly apocrine metaplasia has been found to be 28% in a case series (Arno Kuijper et.al) of 396 cases of fibroadenoma. It is important to identify these variants as they may be misinterpreted as malignancy.
Heterogeneity of non-small cell lung carcinoma (NSCLC) among patients is currently not well studi... more Heterogeneity of non-small cell lung carcinoma (NSCLC) among patients is currently not well studied. Pathologic markers and staging systems have not been a precise predictor of the prognosis of an individual patient. Hence, we hypothesize to develop a transcript-based signature to categorize stage IIIA-NSCLC in lung adenocarcinoma (LUAD) and lung squamous cell carcinoma (LUSC), plus identify markers that could indicate the prognosis of the disease. Human Transcriptome Array 2.0 (HTA) and NanoString nCounter® platform were used for high-throughput gene-expression profiling. Initially, we profiled stage IIIA-NSCLC through HTA and validated through NanoString. Additionally, two metastatic markers SPP1 and CDH2 were validated in 47 NSCLC stage IIIA samples through real-time PCR. We observed distinct gene clusters in LUAD and LUSC with down-regulation of six genes and up-regulation of 57 genes through HTA. Ninety-six transcripts were randomly selected after analyzing HTA data and validat...
The present study was carried out with the aim to find out the association between serum adiponec... more The present study was carried out with the aim to find out the association between serum adiponectin levels with diabetic retinopathy in order to search for a putative biomarker for development and prevention of Diabetic retinopathy and to co-relate adiponectin levels with the severity of diabetic retinopathy. Patients of Diabetes mellitus attending the outdoor and indoor divisions of the department of Ophthalmology, King George’s Medical University, Lucknow, were recruited for the study with their informed consent. Non proliferative and proliferative diabetic retinopathy was assessed by the Ophthalmologist. 63 subjects in each of the two primary groups; diabetic and non-diabetic were taken. Blood samples each from cases and controls were collected under aseptic condition and the sera samples were used for biochemical tests as well as Adiponectin ELISA. Comparisons between the serum adiponectin levels of different groups were studied and it was found that control group has the highe...
Introduction 67 is one of the most aggression of various gliomas to differentiated low grade and ... more Introduction 67 is one of the most aggression of various gliomas to differentiated low grade and high grade This case control study included Astrocytoma,12 Diffuse Astrocytoma, 13 Ependymoma, 5 Oligodendroglioma, 2 Diffuse Fibrillary Astrocytoma, 2 Gemistocytic Astrocytoma, 2 Myxopapillary Ependymoma, 2 subependymal giant cell Astrocytoma and 1 oligoastrocytoma) and 73 cases of high Anaplastic Astrocytoma, 6 Gliosarcoma, 5 Anaplastic Ependymoma, 4 Anaplastic Oligodendroglioma, 3 Anaplastic oligoastrocytoma and 1 pilocytic Astrocytoma with anaplastic features) along with 5 normal brain specimen as con expression of Ki status with the histomorphological grading and overall survival rate. having Ki6 high grade was higher as compared to low grade having Ki67 score 2 (60.00% vs. 40.00%) and Ki67 score 3 (97.62% vs. 2.38%). Association of Ki67 score and grade of gl statistically significant (p<0.001) a marker of for differentiate high grade and low grade glioma.
IP Archives of Cytology and Histopathology Research
1) To detect Cyclophilin, APC and SFRP5 genes associated with Epithelial ovarian cancer by PCR. 2... more 1) To detect Cyclophilin, APC and SFRP5 genes associated with Epithelial ovarian cancer by PCR. 2) To study and compare the prognostic and diagnostic efficacy of serological markers like Ca 125 and HE4 and their correlation with epithelial/ non epithelial ovarian neoplasms.Comparative observational study, Prospective study 64 cases fulfilling the inclusion criteria and giving their consent for inclusion in the study were enrolled as subjects of the present study over a period of one year. After DNA extraction (Invitrogen mini kit, USA) conventional PCR to amplify the extracted DNA and further subjected them to agarose gel electrophoresis for the identification(expression) of 3 genes i.e Cyclophillin, APC and SFRP5, was done; However, none expressed.ELISA was used to assess CA125 and HE4 pre and post surgical intervention. The serum markers were raised more in malignant epithelial ovarian cancer cases and levels plummeted after surgical intervention, as compared to benign masses. We ...
A thirty two year female presented with painless progressive lump in right breast with intermitte... more A thirty two year female presented with painless progressive lump in right breast with intermittent high grade fever for 10 days. No other symptoms were present. She was non diabetic, non-hypertensive with insignificant family and menstrual history. On examination there was a tender freely mobile lump of approximately 5×4 cm occupying lower inner quadrant having firm consistency and a centre fluctuant area of 1 cm, the overlying skin was erythematous. A single non tender mobile lymph node was present in the right axilla. Contralateral breast was clinically normal. High resolution sonography revealed cystic lesion from 3-6 O’ clock position and axillary lymphadenopathy. The fine needle aspiration cytology showed microfilariae. Hence, a diagnosis of breast filariasis was made. Fluid aspirated from the cavity came out to be sterile. Patient improved symptomatically on di-ethyl-carbazine citrate (DEC) therapy (6 mg/kg for 2 weeks) and the lump too regressed in size.
Background: Acute myocardial infarction (AMI) is a recognized complication in patients with hyper... more Background: Acute myocardial infarction (AMI) is a recognized complication in patients with hypertrophic cardiomyopathy (HCM). However, there are limited data on outcomes of HCM patients presenting with AMI. methods: We queried the 2003-2011 Nationwide Inpatient Sample databases to identify all patients ≥18 years with the primary diagnosis of AMI. Patients with HCM were then identified using ICD-9-CM code 425.1. Logistic regression was used to compare treatment choice and outcomes in AMI patients with and without HCM. results: From 2003-2011, of 5,900,949 patients with AMI, 5,688 (0.1%) had a diagnosis of HCM. Patients with HCM were more likely to be older (71.4±13.9 years vs 67.8±14.5 years) and women (67.7% vs 40.2%). HCM patients were less likely to have traditional cardiovascular risk factors, including family history of coronary artery disease, dyslipidemia, obesity, smoking and diabetes mellitus. They were more likely to have congestive heart failure, atrial fibrillation, valvular diseases and prior history of cardiac arrest. HCM patients were less likely to have ST-elevation myocardial infarction (STEMI) (22.8% vs 37.5%, p<0.001). HCM patients with STEMI were less likely to receive thrombolysis (1.2% vs 3.8%, p<0.001) or percutaneous coronary intervention (PCI) (31.2% vs 56.8%, p<0.001). HCM patients with non-ST elevation myocardial infarction (NSTEMI) were less likely to receive PCI (14.9% vs 30.8%, p<0.001) or coronary artery bypass surgery (4.7% vs 9.6%, p<0.001). Among patients with STEMI, patients with HCM had 24% lower in-hospital mortality than patients without HCM (adjusted OR 0.76, 95 % CI 0.63-0.91, p=0.004). After further adjustment for treatment received, HCM patients with STEMI had 33% lower in-hospital mortality than patients without HCM (adjusted OR 0.67, 95% CI 0.55-0.80, p<0.001). Among patients with NSTEMI, there was no difference in in-hospital mortality in patients with and without HCM (p=0.91) (interaction p value for HCM and STEMI = 0.039). conclusion: HCM patients represent a small portion of patients with AMI and are less likely to be treated with revascularization. Compared to patients without HCM, HCM patients with STEMI have lower in-hospital mortality.
Interstitial lung diseases (ILDs) are an intriguing group of pulmonary disorders, which still req... more Interstitial lung diseases (ILDs) are an intriguing group of pulmonary disorders, which still require the study of epidemiological, genetic, pathophysiological, clinical, and radiological parameters. Pulmonary hypertension (PH) is an underreported complication in interstitial lung diseases which is associated with worse outcome. In our study, we have reported the spectrum of ILDs and estimated the prevalence of pulmonary hypertension among these subjects at a tertiary care center. A cross-sectional study was performed in which demographical, clinical, radiological, and histological data of subjects with ILD, attending the Department of Respiratory Medicine in the University was collected from 1 st September 2018 to 31 st August 2019. Serological tests were done wherever indicated. Standard criteria along with multidisciplinary opinion were needed to arrive at the final diagnosis. All subjects were screened for pulmonary hypertension via 2-D echocardiography. Mean pulmonary artery pressure ≥20 mmHg was used to define PH. In the defined period, 239 subjects were enrolled (58% females, n=141; mean age 52.38±13.40 years). A tissue diagnosis was obtained in 34% cases. The most common ILD was hypersensitivity pneumonitis (32.2%), followed by autoimmune-ILD (31.4%), idiopathic pulmonary fibrosis (IPF) (15.9%) and sarcoidosis (12.6%), non-IPF idiopathic interstitial pneumonitis (2.1%) and rest 21 (5.9%) subjects were diagnosed as other types of ILD. Pulmonary hypertension was seen in 46.0% of subjects.
IP archives of cytology and histopathology research, Nov 15, 2022
Warthin's tumor is the most common monomorphic adenoma of the parotid gland. It can be coexistent... more Warthin's tumor is the most common monomorphic adenoma of the parotid gland. It can be coexistent with other salivary gland tumors or can be metachronous, multifocal, unilateral, bilateral which perplexes the diagnosis hence delaying or over/under treating the ailment. Rare cases of Warthin's tumor are described in young population especially young non-smoker females. We present a case of Warthin's tumor arising in the left parotid gland of 20-year-old female. This is an Open Access (OA) journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
Metastasis of adenoid cystic carcinoma to the kidney is rare. We present a case of a 50 year old ... more Metastasis of adenoid cystic carcinoma to the kidney is rare. We present a case of a 50 year old male with complaints and radiological findings suggestive of renal cell carcinoma and lung deposits. However, fine needle aspiration was suggestive of adenoid cystic carcinoma metastatic deposits. It was later elicited that the patient had undergone surgery for parotid tumour seven years back which on histology was an adenoid cystic carcinoma. The case is being presented for its rarity.
The gut microbiome has been explored extensively for its importance in the modulation of systemic... more The gut microbiome has been explored extensively for its importance in the modulation of systemic inflammation and immune response; in contrast, the intratumoral microbiome is less studied for its influence on immunity in cancer. Given the established correlation between intratumoral lymphocyte infiltration and patient survival in cases of solid tumors, it was pertinent to explore the extrinsic factor influencing immune cell infiltration in the tumor.
As a part of multi-disciplinary team of the institute in managing Covid positive patients as well... more As a part of multi-disciplinary team of the institute in managing Covid positive patients as well as those admitted with its complications, Pathology department was reporting specimens of suspected fungal infection, received from clinical departments like neurosurgery, otorhinolaryngology, ophthalmology, oral and maxillofacial surgery, respiratory medicine, internal medicine etc. Simultaneous serology and various Covid associated blood parameters were being investigated during admission to hospital, as per the clinical scenario. The aim of this paper is to discuss pathogenesis of fungal infections and bring out any significant pathological differences in Covid 19 positive cases afflicted subsequently by either mucor alone or mixed fungal infections. Out of 274 tissue specimens received between April to November 2021, clinically suspected to be of Covid 19 associated mucormycosis, we found 14 cases of simultaneous co-infection with other species of fungi. 45 specimens were reported n...
Journal of Evolution of medical and Dental Sciences, 2013
UNUSUAL VARIANTS OF FIBROADENOMA BREAST DIAGNOSED ON CYTOLOGY Fibroadenomas are common benign bre... more UNUSUAL VARIANTS OF FIBROADENOMA BREAST DIAGNOSED ON CYTOLOGY Fibroadenomas are common benign breast tumours that display a characteristic morphology, although several epithelial and stromal variations exist which may pose a diagnostic difficulty. We are discussing a case series of four cases of benign fibroadenoma with morphological variations as observed on cytology smears in the department of Pathology, KGMU, Lucknow, UP. Juvenile fibroadenoma constitutes only 4% of the total fibroadenomas with incidence of 0.5% per year. Another very rare histological finding is the presence of multinucleated giant cells throughout the stroma of a benign fibroadenoma, more commonly found incidentally within the interlobular stroma of breast tissue. Similarly apocrine metaplasia has been found to be 28% in a case series (Arno Kuijper et.al) of 396 cases of fibroadenoma. It is important to identify these variants as they may be misinterpreted as malignancy.
Heterogeneity of non-small cell lung carcinoma (NSCLC) among patients is currently not well studi... more Heterogeneity of non-small cell lung carcinoma (NSCLC) among patients is currently not well studied. Pathologic markers and staging systems have not been a precise predictor of the prognosis of an individual patient. Hence, we hypothesize to develop a transcript-based signature to categorize stage IIIA-NSCLC in lung adenocarcinoma (LUAD) and lung squamous cell carcinoma (LUSC), plus identify markers that could indicate the prognosis of the disease. Human Transcriptome Array 2.0 (HTA) and NanoString nCounter® platform were used for high-throughput gene-expression profiling. Initially, we profiled stage IIIA-NSCLC through HTA and validated through NanoString. Additionally, two metastatic markers SPP1 and CDH2 were validated in 47 NSCLC stage IIIA samples through real-time PCR. We observed distinct gene clusters in LUAD and LUSC with down-regulation of six genes and up-regulation of 57 genes through HTA. Ninety-six transcripts were randomly selected after analyzing HTA data and validat...
The present study was carried out with the aim to find out the association between serum adiponec... more The present study was carried out with the aim to find out the association between serum adiponectin levels with diabetic retinopathy in order to search for a putative biomarker for development and prevention of Diabetic retinopathy and to co-relate adiponectin levels with the severity of diabetic retinopathy. Patients of Diabetes mellitus attending the outdoor and indoor divisions of the department of Ophthalmology, King George’s Medical University, Lucknow, were recruited for the study with their informed consent. Non proliferative and proliferative diabetic retinopathy was assessed by the Ophthalmologist. 63 subjects in each of the two primary groups; diabetic and non-diabetic were taken. Blood samples each from cases and controls were collected under aseptic condition and the sera samples were used for biochemical tests as well as Adiponectin ELISA. Comparisons between the serum adiponectin levels of different groups were studied and it was found that control group has the highe...
Introduction 67 is one of the most aggression of various gliomas to differentiated low grade and ... more Introduction 67 is one of the most aggression of various gliomas to differentiated low grade and high grade This case control study included Astrocytoma,12 Diffuse Astrocytoma, 13 Ependymoma, 5 Oligodendroglioma, 2 Diffuse Fibrillary Astrocytoma, 2 Gemistocytic Astrocytoma, 2 Myxopapillary Ependymoma, 2 subependymal giant cell Astrocytoma and 1 oligoastrocytoma) and 73 cases of high Anaplastic Astrocytoma, 6 Gliosarcoma, 5 Anaplastic Ependymoma, 4 Anaplastic Oligodendroglioma, 3 Anaplastic oligoastrocytoma and 1 pilocytic Astrocytoma with anaplastic features) along with 5 normal brain specimen as con expression of Ki status with the histomorphological grading and overall survival rate. having Ki6 high grade was higher as compared to low grade having Ki67 score 2 (60.00% vs. 40.00%) and Ki67 score 3 (97.62% vs. 2.38%). Association of Ki67 score and grade of gl statistically significant (p<0.001) a marker of for differentiate high grade and low grade glioma.
IP Archives of Cytology and Histopathology Research
1) To detect Cyclophilin, APC and SFRP5 genes associated with Epithelial ovarian cancer by PCR. 2... more 1) To detect Cyclophilin, APC and SFRP5 genes associated with Epithelial ovarian cancer by PCR. 2) To study and compare the prognostic and diagnostic efficacy of serological markers like Ca 125 and HE4 and their correlation with epithelial/ non epithelial ovarian neoplasms.Comparative observational study, Prospective study 64 cases fulfilling the inclusion criteria and giving their consent for inclusion in the study were enrolled as subjects of the present study over a period of one year. After DNA extraction (Invitrogen mini kit, USA) conventional PCR to amplify the extracted DNA and further subjected them to agarose gel electrophoresis for the identification(expression) of 3 genes i.e Cyclophillin, APC and SFRP5, was done; However, none expressed.ELISA was used to assess CA125 and HE4 pre and post surgical intervention. The serum markers were raised more in malignant epithelial ovarian cancer cases and levels plummeted after surgical intervention, as compared to benign masses. We ...
A thirty two year female presented with painless progressive lump in right breast with intermitte... more A thirty two year female presented with painless progressive lump in right breast with intermittent high grade fever for 10 days. No other symptoms were present. She was non diabetic, non-hypertensive with insignificant family and menstrual history. On examination there was a tender freely mobile lump of approximately 5×4 cm occupying lower inner quadrant having firm consistency and a centre fluctuant area of 1 cm, the overlying skin was erythematous. A single non tender mobile lymph node was present in the right axilla. Contralateral breast was clinically normal. High resolution sonography revealed cystic lesion from 3-6 O’ clock position and axillary lymphadenopathy. The fine needle aspiration cytology showed microfilariae. Hence, a diagnosis of breast filariasis was made. Fluid aspirated from the cavity came out to be sterile. Patient improved symptomatically on di-ethyl-carbazine citrate (DEC) therapy (6 mg/kg for 2 weeks) and the lump too regressed in size.
Uploads
Papers by Riddhi Jaiswal