ARTIFICIAL NEURAL NETWORKS (ANNs) APPLIED TO ATR-FTIR SPECTRA TO CLASSIFY MEDICALLY IMPORTANT Trichosporon SPECIES

To distinguish clinically signicant fungus, Fourier transform infrared spectroscopy (FTIR) was used. In this work, 75 Trichosporon strains from ve different species were cultivated on SDA media and FTIR attenuated total reection (ATR) readings was taken. The classication (FTIR spectra) results of cluster analysis were compared to articial neural network (ANN) analysis (supervised approach). Validation of training set showed that both techniques properly categorized 100% of the spectra, at least for T. asahii (n = 62) and T. inkin (n = 8). With the addition of T. loubieri (n=1) and T. asteroids (n=1), the ANN's accuracy became reliant on the training database, resulting in 90% to 100% classication.

COMPARISON OF CLINICOPATHOLOGICAL PARAMETERS WITH HISTOLOGICAL AND MOLECULAR CLASSIFICATION OF BREAST CANCERS

BACKGROUND: This is a retrospective study of 60 cases, to detect the expression of ER, PR, HER2neu, CK5/6 and Ki67 proliferation index in breast carcinomas by immunohistochemical method and to determine the newer molecular classication. Few patients have recurrence inspite of being diagnosed under the category of low risk and few do well in the high risk group which can be attributed to the molecular level differentiation. AIM: The aim of this study is to categorize the patients under molecular classication, and to compare the clinicopathological parameters with it and to denote the signicance of targeted therapy. MATERIALS AND METHODS: A retrospective study of detecting the expression of the above said markers in modied radical mastectomy specimens received at a tertiary care centre during the period from January 2015 to June 2018. A total of 60 cases which included 30 of IDC NST and 30 cases of special variants were selected for immunohistochemical analysis. RESULTS: Out of the 60 cases studied, the most common was found to be the luminal A type comprising 37% and the least common was the luminal B and hybrid types each comprising 8%. The most common grade for HER2 was Grade III (50%). The association of histological grade with the molecular classication was statistically signicant with the p value of 0.01. Basal type (56%) had the highest incidence of N3 stage. ER, PR, HER2 neu, CK5/6 expression and proliferation index with Ki67 had a statistically signicant association with the molecular classication. High proliferation index (>14%) with Ki67 was noted in Luminal B, Basal and Hybrid types. 78% of the total 60 cases were alive and healthy. One death was reported in HER2, Hybrid and Basal types. The negative kappa value obtained while studying the agreement between the histopathological and molecular classication, indicates that the agreement is worse than chance and hence the importance of molecular classication is substantiated for the targeted therapy.

ORIGINAL ARTICLE ON THE MORPHOLOGICAL STUDY OF FORAMEN MAGNUM

Introduction: Centrally in the deepest part of posterior cranial fossa is the largest foramen, Foramen magnum surrounded by basilar part of occipital bone on either side. Because of relation between the FM and the vital structures passing through it, study on its morphometric features is of great signicance. Aim and objectives: The objectives were to study the various morphological features of the foramen magnum in dry skulls using an analogue Vernier calliper. Materials and methods: 50 dry skulls (8 base skulls, 42 full skulls) of human cadaver of unknown age and sex were obtained to study the morphometric features like shapes, anteroposterior and transverse diameters and FM index in the department of Anatomy, Kanyakumari Government medical college, Asaripallam. Results: The classication of determined shapes were round in 29.7%, hexagonal in 18.2%, egg shaped in 16.9%, oval in 12.7%, tetragonal in 11.4%, pentagonal in 3.7% and irregular in 7.4%. In 12% of the skulls the occipital condyles were found to protrude into the foramen. The mean value of anteroposterior and transverse diameter was found to be 35 ±1.2mm, and 28 ± 1.4 mm respectively and average foramen magnum index was 1.25 ± 0.8. Conclusion: Foramen magnum dimensions are used for sex determination. The structural integrity of foramen magnum is usually preserved in re accidents and explosions due to its resistant nature and secluded anatomical position. The data obtained from protrusion of occipital condyles would help in neurosurgical approach of foramen magnum meningiomas.

HISTOPATHOLOGICAL SPECTRUM OF OVARIAN TUMORS : 5 YEARS RETROSPECTIVE STUDY IN A TERTIARY REFERRAL HOSPITAL IN ASSAM

Introduction : Ovarian tumor accounts for 30% of female genital tract cancers and comprises of large variety of neoplastic entities. Mortality rate has due to ovarian tumor has gradually increased. The present study was undertaken to study the frequency of various histomorphological spectrum, histological subtypes and age distribution pattern of ovarian tumors. Methods: Retrospective study was carried during period of 1st January 2015 to 31st st December 2019, 455 cases of ovarian neoplastic lesions were taken from the records of the department. Classication was done according to WHO classication. Results: Of the 455 cases, 332 cases (73%) were benign, 16 cases (3.5%) cases were borderline and 107 cases (23.5%) cases were malignant. Among the histological subtypes surface epithelial tumors are common comprised of 76.9% followed by germ cell tumors (19.6%). Serous cystadenoma (42.8%) was the most common benign tumor followed by mature cystic teratoma (16.5%). Among the malignant tumors, the most common was Serous cyst adenocarcinoma (11.9%) Tumors were seen over age range of 11-81 years. Maximum number of cases were in the 4th to 6th decade. Benign tumors were primarily seen in Younger age group , whereas malignant tumors were common in elderly age group. Conclusions: In our study we analysed all the spectrum of ovarian tumors diagnosed on the basis of histomorphology. Surface epithelial tumors were the commonest ovarian tumor. Maximum numbers of ovarian tumors were in the age range 40-59years and malignant tumors were common in age >40 years

THE ROLE OF MULTI DETECTOR COMPUTERIZED TOMOGRAPHY (MDCT) IN EVALUATION OF MAXILLOFACIAL FRACTURES.

Objective: The purpose of our study was to assess the role of Multidetector Computerized tomography in the evaluation of maxillofacial fractures and to describe the frequency and types of fractures that underwent CT scans. Subjects And Methods: The study included 50 patients suspected of facial trauma referred from the emergency unit from PESIMSR ,Kuppam. All patients were subjected to non contrast MDCT in axial cuts and images are transferred to workstation then coronal and sagittal reconstruction obtained. Results: There were 37 male and 13 female patients. The maximum number of patients fall into 21-40 years followed by 41 to 60 years .50 patients had total 170 fractures. It was found that the maxillary sinus is the most common to be fractured (found in 24 cases) followed by nasal bone (18) , zygomatic arch (17), mandible (13) ,greater wing of sphenoid (9), sphenoid sinus (8), frontal sinus (7) ,pterygoid plates (7), bony nasal septum (6) ,ethmoid sinus (3).Among complex facial fractures orbital fractures are the most frequent (found in 47 cases), followed by zygomatico-maxillary junction fractures (4) ,Tripod fractures( 4) , and Naso-orbito-ethmoid region fractures (3). Conclusion: Maxillofacial trauma is one of the most common emergency requiring accurate and early diagnosis. MDCT is useful diagnostic tool for the identication and classication of maxillofacial region fractures and aiding in surgical planning.

ROLE OF SONOURETHROGRAM IN EVALUATION OF SHORT SEGMENT ANTERIOR URETHRAL STRICTURE

INTRODUCTION: Retrograde urethrography (RGU) is the standard imaging study for the evaluation of anterior male urethra. Sonourethrography(SUG) offers comparable information with added advantages. MATERIAL AND METHODS: 196 males with anterior urethral stricture studied. RGU/MCU, sonourethrogram and urethroscopy done in all and information regarding urethral stricture was compared keeping urethroscopy as gold standard. Strictures > 4 cm were excluded. Chiou et al classication used to classify urethral stricture on SUG. Bulbar urethra was the most common si RESULTS & DISCUSSION: te for urethral stricture. Sensitivity of sonourethrography for location of stricture was >98%. Strength of agreement between SUG and urethroscopy for location of stricture was very good. Number of the strictures were diagnosed with higher accuracy on urethroscopy than SUG and RGU respectively. Kappa value for number of strictures was suggestive of very good agreement between SUG & urethroscopy. Length of stricture in urethroscopy was better correlating with SUG. Both RGU and SUG were equally sensitive in location and number of stricture while RGU correlated poorly in the bulbar urethra, older studies also showing RGU underestimating the length of stricture in bulbar urethra. Sonourethrography also providing additional information regarding periurethral pathologies. The complications encountered during RGU were contrast intravasation, pain during the procedure, urethral bleeding and UTI after the procedure. During sonourethrography no signicant complication noted. CONCLUSIONS: Sonourethrography is a multiplanar, easily available and cost-effective technique for evaluating anterior urethra without radiation exposure. When compared with RGU, sonourethrography is equally efcacious with added important technical advantages which help surgeons to plan surgical procedure.

VESTIBULAR MIGRAINE-UPDATES AND CHALLENGES: REVIEW OF LITERATURE

Complaints of dizziness or vertigo entirely are common in patients with migraines, at least occasionally. Vestibular migraine was recently integrated as an independent article in the International Classication of Headache Disorders 3-beta appendix. Despite this, it is still an underdiagnosed condition. The exact mechanism of vestibular migraine is still unclear. This review presents an overview of the history, epidemiology, pathophysiology, clinical characteristics, diagnostic criteria, differential diagnosis and the treatment of VM.

CHEST X RAY SCORE AND CLINICAL SEVERITY IN COVID-19 PATIENTS

INTRODUCTION: Various chest X-ray scoring systems have been discovered and are employed to correlate with clinical severity, outcome and progression of diseases. With, the coronavirus outbreak, few chest radiograph classication were formulated, like the BSTI classication and the Brixia chest X-ray score. Brixia CXR scoring is used for assessing the clinical severity and outcome of COVID-19. This study aims to compare the Brixia CXR score with clinical severity of COVID-19 patients. MATERIAL& METHODS:This was a retrospective study in which medical records of patients aged 18 years or above, who tested for RTPCR or st st Rapid Antigen Test (RAT) for COVID positive from 1 February 2021 to 31 July 2021 (6 months) were taken. These subjects were stratied into mild, moderate and severe patients according to the ICMR guidelines. Chest X Rays were obtained and lesions were classied according to Brixia scoring system. RESULTS: Out of these 375 patients, 123 (32.8%) were female and 252 (67.2%) were male subjects. The average brixia score was 11.12. Average Brixia CXR score for mild, moderate and severe diseased subjects were 5.23, 11.20, and 14.43 respectively. DISCUSSION:The extent of chest x-ray involvement is proportional to the clinical severity of the patient. Although, a perplexing nding was that the average Brixia score of the female subjects were slightly higher than their male counterparts in the same clinical groups. CONCLUSION: Brixia CXR score correlates well with the clinical severity of the COVID-19.

STUDY ON NEWER PSYCHIATRIC CASES VISITING OPD AFTER ONSET OF PANDEMIC COVID-19

Introduction : It is predicted by the experts that there will be a steep rise in the number of psychiatric cases post covid-19 pandemic. It is important to gauge the situation of mental health in population to be able to provide mental health services in a better way. Objective: The aim of this study is to determine the impact of the pandemic and other factors contingent to the pandemic on the mental health status of general population. Materials and method: The study was done over a period of 1 month after the lockdown. Study was done on 160 patients visiting Psychiatry OPD th in Mental Hospital, Indore for the rst time. Patients were diagnosed using International classication of diseases- 10 edition. Results: In our study we found that a majority of 45 of the 160 patients were suffering from Major Depressive Disorder followed by 24 patients of 160 suffering from nonorganic unspecied psychosis. Conclusion: It is important to assess the number of psychiatry patients visiting OPD to be able to cater to the needs of general population. It is also important to assess any role of psychosocial factors operating during pandemic being responsible for any rise in number of psychiatric cases.

A PROSPECTIVE HISTOPATHOLOGICAL STUDY OF MENINGIOMAS IN A TERTIARY CARE CENTRE OF VIJAYAWADA

Background: Meningiomas are neoplasms arising from the arachnoidal cap cells in the meningeal coverings of the spinal cord and brain. These are the most common benign intracranial tumours and account for about 13-26% of all primary brain neoplasms. These are generally benign neoplasms of adults most often seen in middle age, but about 10% are atypical or malignant. These neoplasms are graded by WHO as Grade I , II and III . Benign meningiomas can be cured by surgical resection where as higher grade meningiomas require radiotherapy after surgical resection as these higher grade meningiomas have greater recurrence and aggressive behavior. Aims and Objectives: To study the variants and histopathological spectrum of meningioma and prognosis of variants. Material & Methods: The present study is a prospective study conducted in the department of Pathology, Siddhartha medical college from June 2019-May 2020. During this study, 16 cases of meningiomas were diagnosed and reviewed. Result:In our study of 16 cases females were 62.5%. The most common age group is 41-60 yrs (68.75%). Most common variant was noted to be transitional meningioma followed by meningothelial meningioma. Out of the 16 cases, grade I were 81.25%. Conclusion: Meningiomas account for 28-30% of primary central nervous system tumors and unveil a heterogeneous histopathology. The histological appearance of meningioma determines the grading for the management of the various subtypes and also associated with patient's prognosis. Hence a continuous revision of histopathological classication systems is required to improve the diagnostic accuracy. Benign meningiomas are the most common type. From our study, we conclude that transitional meningioma is the most common benign variant.