Browsing by Author "Joshi, K"
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Item Acute myositis complicated by myoglobinuric acute renal failure.(1993-07-01) Ghosh, A K; Sakhuja, V; Joshi, K; Gupta, K L; Chugh, K SItem Acute pneumonitis with pulmonary hemorrhage an uncommon and potentially fatal complication of systemic lupus erythematosus: a case report.(1999-07-22) Chopra, R; Radotra, B D; Varma, S; Gupta, K L; Joshi, KAcute pneumonitis with diffuse alveolar haemorrhage is potentially fatal. When it occurs in a patient of systemic lupus erythematosus, the primary disease itself may be responsible for it; rather than any complicating infection or metabolic/physiological derangement. Diagnosis of primary pulmonary involvement by systemic lupus erythematosus can only be made on open lung biopsy coupled with immunofluorescent and/or ultrastructural studies. Early diagnosis of acute pulmonary complications in systemic lupus erythematosus patients is essential as specific management is reported to improve the chances of recovery.Item Carcinosarcoma of parotid gland having osteosarcoma as sarcomatous component: a case report.(1993-10-01) Rumnong, V; Banerjee, A K; Joshi, K; Kataria, R NWe report a rare case of carcinosarcoma of parotid gland in a pleomorphic adenoma. The tumor showed two distinct heterologous components, a ductal carcinoma and an osteosarcoma. The latter has not been described so far in such tumors arising in pleomorphic adenoma of parotid gland.Item Case report. Extraskeletal mesenchymal chondrosarcoma.(1978-07-01) Joshi, K; Abrol, B M; Roy, SItem Choroid plexus tumours--an immunohistochemical analysis with review of literature.(1994-01-01) Radotra, B D; Joshi, K; Kak, V K; Banerjee, A KImmunohistochemical analysis of 9 choroid plexus papillomas (CPPs) and 3 choroid plexus carcinomas (CPCs) using a panel of antibodies against glial fibrillary acidic protein (GFAP), cytokeratin (CK), epithelial membrane antigen (EMA), S-100 protein, vimentin (vim), and neuron specific enolase (NSE) is presented. Focal positivity was observed for GFAP in 11, vimentin in 7, cytokeratin in 2 and EMA in 3 cases. Diffuse and intense immunoreactivity for S-100 protein was seen in all papillomas, however, unreactive areas were noted in carcinomas. All cases exhibited focal to diffuse NSE positivity. Location and type of the tumour and age of the patient did not influence the staining pattern except for predominant S-100 positivity in papillomas. The significance of these findings is discussed in relation to the differential diagnosis or immunoreactivity patterns of these tumours.Item Congenital nephrotic syndrome of Finnish type with glomerular crescents.(1994-05-01) Ghosh, A K; Sakhuja, V; Joshi, K; Chugh, K SItem Correlation of the growth fraction, nucleolar organizer region counts and epidermal growth factor receptor with histomorphological prognostic criteria in breast cancer.(1997-01-01) Gupta, G R; Datta, B N; Bose, S M; Joshi, KA total of 60 cases of breast cancer were studied to find the correlation between newer parameters of prognosis viz growth fraction (GF), nucleolar organizer region (AgNOR) counts and epidermal growth factor receptor (EGFR) positivity with the various histomorphological factors such as tumour size, nuclear grade, histological grade and mitoses. Growth fraction measured by Ki67 monoclonal antibody varied from 3.6 to 73.7 percent. AgNOR counts ranged from 1.2 to 16.9 dots per tumour cell nucleus with a mean of 6.26 dots. EGFR positivity was seen in 66.7% of cases. Ki67 score correlated with all prognostic variables studied except the presence of axillary metastases. AgNOR counts correlated with size of tumour, axillary lymph-node metastases and Ki67 score but no correlation was seen with histologic or nuclear grade. EGFR positivity correlated strongly with size of the tumour and weakly with Ki67 score, AgNOR counts and mitoses.Item Crescentic glomerulonephritis associated with puerperal sepsis.(1991-10-01) Gupta, K L; Sakhuja, V; Joshi, K; Das, T; Chugh, K SAcute renal failure developed in a young female having puerperal sepsis due to beta-haemolytic streptococci. The patient succumbed to her illness and an autopsy revealed extensive crescentic glomerulonephritis. The association between chronic visceral sepsis and glomerulonephritis is discussed.Item Effect of eradication of Helicobacter pylori on gastric antrum histology.(2002-01-13) Nada, R; Bhasin, D K; Joshi, K; Sharma, B C; Ray, P; Pathak, C M; Singh, KBACKGROUND: Helicobacter pylori is a leading cause of gastritis. Some of the histological changes revert after eradication of H. pylori. There is paucity of reports from India. AIM: To study the effect of H. pylori eradication on the histopathological changes. METHODS: Endoscopically obtained antral biopsies from 164 consecutive H. pylori positive cases of dyspepsia were analysed before and 4 weeks after completion of treatment. RESULTS: Treatment for H. pylori resulted in eradication of the organism as confirmed histologically in 123 out of 164 (76.22%) cases. Analysis of histopathological changes in pre and post treatment biopsies from the same patient revealed a significant reduction in neutrophils, eosinophils, chronic inflammatory cells, acute epithelial changes and regenerative foveolar hyperplasia (p < 0.001) There was no difference in these findings in cases where H. pylori eradication failed when compared with their pre-treatment biopsies (p > 0.05). Similarly the pre and post treatment biopsies revealed, no difference in frequency of intestinal metaplasia and gastric atrophy in cases where H. pylori was eradicated or persisted after treatment. CONCLUSION: There was significant reduction in neutrophils, eosinophils, chronic inflammatory cells, acute epithelial changes and regenerative foveolar hyperplasia, following eradication of H. pylori.Item Effect of hematoporphyrin derivative and light on sulfhydryl groups in brain tumour cells.(1995-10-01) Joshi, P G; Joshi, K; Joshi, N BEffect of hematoporphyrin derivative (HpD) and light on sulfhydryl (SH) groups in brain tumor cells was studied. Sulfhydryl groups were measured by 5,5'-dithiobis-(2-nitrobenzoic acid) (DTNB) and a fluorescent probe 3,4-maleimidylphenyl-4-methyl-7-diethylaminocoumarin (CPM). Incubation of cells with HpD in dark resulted in the loss of DTNB as well as CPM reactive SH groups. After 2 hr of incubation DTNB reactive SH groups showed a negligible change while a continuous decrease was observed in CPM reactive SH groups. Cells treated with HpD showed a further degradation of SH groups upon light irradiation. A comparison of cytotoxicity and SH groups under identical conditions showed that blockage of SH groups by HpD binding is not leathal to the cells where as photoinduced cell death was observed on photodegradation of SH groups.Item Effect of renal dysfunction in fulminant hepatic failure.(2000-07-21) Jain, S; Pendyala, P; Varma, S; Sharma, N; Joshi, K; Chawla, YBACKGROUND: Effect of renal dysfunction in fulminant hepatic failure is not studied extensively. METHODS: Fifty consecutive patients of fulminant hepatic failure were studied prospectively to determine the prevalence of renal failure and its effect on survival. RESULTS: The mean age of these patients was 36 +/- 7.2 years and there were 21 males and 29 females. Twenty two patients (44%) were hepatitis B surface antigen (HBsAg) positive. Renal dysfunction was observed in 19 patients (38%). Acute tubular necrosis was seen in 7 patients (38%) while prerenal azotemia and functional renal failure occurred in six patients each (37%). Renal failure occurred more commonly in patients with jaundice. In these patients it occurred in less than four days and prior to onset of encephalopathy, ascites, and gastrointestinal hemorrhage. Histopathological examination of kidney (done in 8 patients) revealed acute tubular necrosis in 4 patients while patients with functional renal failure and prerenal azotemia had normal histology. A good correlation was observed between biochemical parameters and histology of kidney in all the patients. The survival amongst the patients with FHF was 28% (14 of 50 patients). Poor prognostic indicators were a leukocyte count of more than 16.5 x 10(9)/liter, prothrombin index of less than 34%, a peak serum bilirubin of more than 376 mumol/liter and presence of renal failure. Only 3 of 19 patients with renal failure survived. CONCLUSIONS: Renal dysfunction is a major indicator of poor prognosis in patients with FHF.Item External clues to inner malformations.(1998-10-29) Gupta, D; Vaiphei, K; Banerjee, C K; Joshi, K; Vashishta, R K; Radotra, B D; Das, A; Banerjee, A KA malformation is a morphological defect of an organ, or a larger region of the body resulting from an intrinsically abnormal developmental process. In this analysis of 1421 neonatal autopsies performed between 1984 and 1993, 243 (17.1%) cases showed malformations. The data was analysed to find external cues to internal malformations. Twenty three (85%) of the 27 neonates with various facial abnormalities had associated internal malformations in the form of cardiac (n = 11; 40%), renal (n = 7; 25%), or gastrointestinal (n = 3; 11%) abnormalities and diaphragmatic hernia (n = 2). Sixty seven neonates had neural abnormalities. These were associated with cardiac (n = 7; 10%), renal (n = 12; 18%) or gastrointestinal (n = 7; 10%) abnormalities; 43 cases, however, did not have any associated malformations. Renal malformations (n = 66) had highest association with skeletal abnormalities (n = 9; 22%). As many as 45(76%) of the 59 cases with cardiac abnormalities had no external anomalies. Five cases of hypoplastic lungs were seen, all associated with external malformations.Item Fatal complications of systemic lupus erythematosus--an autopsy study from north India.(2000-07-24) Jindal, B; Joshi, K; Radotra, B D; Banerjee, A KSystemic lupus erythematosus (SLE) is a multisystem, autoimmune disease with varied clinical manifestations and outcome. It may prove fatal due to disease activity or intercurrent infections. In recent years, earlier diagnosis and better treatment modalities have resulted in a change in the pattern of organ involvement and mode of death in the west. This aspect of the disease is unknown in India. Hence, in this autopsy series of SLE, the organ involvement and cause of death have been studied. Twenty five cases of clinically diagnosed SLE have been analysed retrospectively. Renal involvement was invariably present (96%) with class IV being the commonest lesion in 60% cases. Disease activity was noted in 60% cases. Pleuro pulmonary lesions were seen in 92% cases with infection being the commonest. Pulmonary infections included bacterial pneumonias (13), disseminated tuberculosis (3), pulmonary mucormycosis (1) and aspergillosis (1). Massive pulmonary haemorrhage in 5 cases and acute lupus pneumonitis in one, contributed to the demise of the patient. Vasculitis was evident in single organ in 9 cases, in two or more organs in 3 cases with systemic vasculitis significantly attributing to morbidity in 1 case. Active disease was the cause of death in 60% cases and infection in 40%.Item Fetomaternal outcome in pregnancy with thrombocytopenia: A prospective study from one of the teaching health-care institutes of Ahmedabad, Gujarat(Mrs Dipika Charan of MedScience (India) Publications, 2022-08) Patel, R; Joshi, K; Mehta, H.Background: During pregnancy, hemodilution of plasma volume leads to reduction in platelets count by approximately 6–7% during 3rd trimester. Pregnant women with thrombocytopenia have higher risk of bleeding excessively during pregnancy, labor, and puerperium. The present study focuses on fetomaternal outcome among pregnant women having thrombocytopenia. Aims and Objectives: This study aims to study the incidence of thrombocytopenia in pregnancy, to identify various factors responsible for thrombocytopenia in pregnancy, and to evaluate fetomaternal outcome in patients with thrombocytopenia in pregnancy. Materials and Methods: A prospective study was conducted in the department of obstetrics and gynecology at tertiary care center of Ahmedabad. A total of 96 cases of thrombocytopenia in pregnancy were included in the study. Fetomaternal outcome was assessed among the study participants. Results: The incidence of thrombocytopenia in the present study was 0.77%. Obstetric causes (53.12%) accounted for most common cause of thrombocytopenia, followed by gestational thrombocytopenia (27.08%), dengue (10.41%), malaria (4.16%), and immune thrombocytopenia (4.16%). Postpartum hemorrhage (15.62%), eclampsia (14.58%), disseminated intravascular coagulation (11.45%), and abruption (8.33%) were the most common maternal complications. The most common neonatal complication was prematurity (67.7%) followed by intrauterine growth retardation (23.95%) and birth asphyxia (9.3%). Conclusion: Hypertensive disorders of pregnancy including severe preeclampsia, eclampsia, and HELLP syndrome are found to be the most common cause of thrombocytopenia followed by gestational thrombocytopenia and infectious causes. The present study widened the spectrum of the causes for thrombocytopenia in pregnant women. Gestational thrombocytopenia is associated with mild-to-moderate thrombocytopenia and hardly having any complications.Item Fibrosing cholestatic hepatitis-like syndrome in a hepatitis B virus and hepatitis C virus-negative renal transplant recipient: a case report with autopsy findings.(2003-01-17) Duseja, Ajay; Nada, Ritambhara; Kalra, Naveen; Acharya, S K; Minz, M; Joshi, K; Chawla, YogeshWe report a patient with fibrosing cholestatic hepatitis (FCH)-like syndrome in renal transplant recipient, who was negative for hepatitis-B and C-virus infection. The patient presented initially with extrahepatic biliary obstruction due to stricture at the lower end of the common bile duct. Cholestasis persisted inspite of effective biliary drainage. He was operated for empyema of the gallbladder and histological examination showed the presence of cytomegalovirus inclusions in the wall of the gallbladder. The patient died inspite of aggressive management; autopsy examination of the liver revealed evidence of FCH-like changes.Item A Five Year Retrospective Study of Profile of Leprosy Patients in a Teaching Tertiary Care Centre in Uttarakhand(Hind Kusht Nivaran Sangh (Indian Leprosy Association), 2022-06) Joshi, K; Rizvi, G; Kaushik, A; Joshi, UDespite India reaching elimination levelsas a public health problem, leprosy still remains a major health care problem. The aim of our study is to determine the morphological pattern and the trend of acid-fast bacilli (AFB) positivity of the disease in the post eradication phase. A retrospective study was conducted of skin biopsies clinically diagnosed as leprosy from January 2015 to December 2019. Relevant clinical history was obtained from records. Majority were in the age group of 31-40 years (20%), with male predominance (61.25%). 10.62% cases were of children below the age of 15 years. Histologically, 38.75% of cases were diagnosed as indeterminate leprosy followed by 20% cases of lepromatous leprosy. Hypopigmentation (35.62) was the most common clinical feature. Clinical-histological concordance was highest for histioid leprosy cases (100%) followed by lepromatous leprosy (90.62%). Majority of our cases were multibacillary (71.25%). BI 1+ was seen in 51.75%, whereas BI 6+ was 11.4%. Predominance of multibacillary forms specially with high bacterial load indicates late reporting and need to diagnose and treat early for stopping its transmission. Histopathological examination of skin biopsy is important for early and proper treatment of the patients with early inderminate/atypical clinical manifestations. The health care policies need to be reconsidered and revised both at the national and global levelsItem Glomerular basement membrane thickness in normal adults and its application to the diagnosis of thin basement membrane disease: an Indian study.(2005-10-22) Rayat, C S; Joshi, K; Sakhuja, V; Datta, UMicroscopic hematuria of non-urologic origin warrants ultrastructural study of renal biopsy. Thinning and variations in the texture of glomerular basement membrane (GBM) are difficult to be recognized under light microscope; transmission electron microscope (TEM) therefore plays a vital role in identifying such changes. Ultrastructural morphometry is a valuable diagnostic aid when GBM is suspected of being abnormally thin. In an effort to determine the normal GBM thickness (GBMT) in Indian adults and to determine the cutoff value of GBMT for a diagnosis of thin basement membrane disease (TBMD), we determined GBM thickness in 25 normal adults. Postmortem biopsies of 25 normal adults (16 males and 9 females) aging between 18-58 years were included in the study. GBM thickness was determined through ultrastructural morphometry on accurately enlarged electron micrographs as harmonic mean of 50 orthogonal intercepts across the GBM in each case. Study revealed a mean GBM thickness of 321 nm with a standard deviation (SD) of 28 nm. Mean-2SD (321-56), that is 265 nm, was fixed as cutoff value of GBMT for the diagnosis of TBMD. A systematic split study of control subjects revealed thicker GBM (329+/-38 nm) in higher age group (35-60 years) as compared to GBMT (316+/-21 nm) in lower age group (18-30 years). Males in higher age group also revealed thicker GBM (males: 343+/-39 nm versus females: 300+/-12 nm). Ten patients with non-urologic hematuria and having GBMT<265 nm were diagnosed as cases of TBMD. Patients with TBMD revealed significantly attenuated GBM as compared to age and sex matched controls (214 +/- 40 nm versus 311 +/- 17 nm; p<0.0005). No overlap was observed in the distribution of GBMT in patients of TBMD and age and sex matched controls. Ultrastructural morphometry is the ultimate and appropriate method for diagnosing TBMD.Item Helicobacter pylori in gastric cancer in India.(1999-04-15) Bhasin, D K; Kakkar, N; Sharma, B C; Joshi, K; Sachdev, A; Vaiphei, K; Singh, KBACKGROUND/AIMS: Helicobacter pylori infection has been implicated in pathogenesis of gastric cancer. Since there is paucity of reports from developing countries on association of H. pylori with gastric cancer, we performed case control study to find out the relationship between H. pylori and gastric cancer and also compared characteristics of gastric cancer and H. pylori positivity in younger and older patients. PATIENTS AND METHODS: Gastrectomy (n = 37) or endoscopic biopsy (n = 43) samples from area adjoining the cancer were collected from 80 patients of gastric cancer. Tissue specimens were stained with hematoxylin-eosin and Giemsa stains and histological type of cancer was determined according to Lauren, as intestinal or diffuse type. The presence of H. pylori was assessed by Giemsa staining. Eighty age and sex matched patients with non-ulcer dyspepsia (NUD) served as controls. RESULTS: Of 80 patients, 48 had intestinal type, 28 diffuse type and 4 had mixed type of gastric cancer. Tumour was located in antrum in 37, in body in 31, and at other sites in 12 cases. H. pyolri infection was present in 29 of patients compared to 36 patients with non-ulcer dyspepsia (p > 0.05, odd ratio 0.69, confidence interval 0.37-1.32). The positivity for H. pylori was higher in intestinal type than in diffuse type (p < 0.05) of gastric cancer but similar in patients with growth in antrum and body (p = NS) of stomach. There was no significant difference in tumor type, tumor site, frequency of intestinal metaplasia and H. pylori positivity (39% vs 35%, P > 0.05, odd ratio 1.19, confidence interval 0.44-3.23) in younger (< 45 yrs) and older (> 45 yrs) patients. CONCLUSIONS: Approximately one-third of patients with gastric cancer show presence of H. pylori infection on histological examination. No difference in H. pylori positivity were observed in young and old patients of gastric cancer.Item High frequency of loss of allelic integrity at Wilms' tumor suppressor gene-1 locus in advanced breast tumors associated with aggressiveness of the tumor.(2009-10) Gupta, S; Joshi, K; Wig, J D; Arora, S KBackground: The product of Wilms' tumor suppressor gene (WT1), a nuclear transcription factor, regulates the expression of the insulin-like growth factor (IGF) and transforming growth factor (TGF) systems, both of which are implicated in breast tumorigenesis and are known to facilitate angiogenesis. In the present study, WT1 allelic integrity was examined by Loss of Heterozygosity (LOH) studies in infiltrating breast carcinoma (n=60), ductal carcinoma in situ (DCIS) (n=10) and benign breast disease (n=5) patients, to determine its possible association with tumor progression. Methods: LOH at the WT1 locus (11p13) as determined by PCR-RFLP for Hinf1 restriction site and was subsequently examined for its association with intratumoral expression of various growth factors i.e. TGF-β1, IGF-II, IGF-1R and angiogenesis (VEGF and Intratumoral micro-vessel density) in breast carcinoma. Results: Six of 22 (27.2%) genetically heterozygous of infiltrating breast carcinoma and 1 of 4 DCIS cases showed loss of one allele at WT1 locus. Histologically, the tumors with LOH at WT1 were Intraductal carcinoma (IDC) and were of grade II and III. There was no correlation in the appearance of LOH at WT1 locus with age, tumor stage, menopausal status, chemotherapy status and lymph node metastasis. The expression of factor IGF-II and its receptor, IGF-1R was significantly higher in carcinoma having LOH at WT1 locus. A positive correlation was observed between the TGF-β1, VEGF expression and IMD scores in infiltrating carcinoma. Conclusions: The current study indicates that the high frequency of loss of allelic integrity at Wilms' tumor suppressor gene-1 locus in high-graded breast tumors is associated with aggressiveness of the tumor.Item Histomorphological criteria for prognosis in breast cancer.(1990-10-01) Vaiphei, K; Joshi, K; Ayyagari, S; Banerjee, COne hundred cases of carcinoma breast were analysed with regard to histological features and clinical follow-up. Bad prognostic factors included tumour size larger than 5cms; absent or minimal intraduct component in the tumour and absent or minimal periductal elastosis. Conversely significant intraduct component in the tumour and periductal elastosis were associated with better survival. Degree of lymph nodal involvement did not influence the outcome. One reason for this unexpected finding could be that patients with more than 3 lymph node involvement were given additional chemotherapy.
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