Commercial malaria rapid diagnostic tests (RDTs) detect P. falciparum histidine rich protein 2 (PfHRP2) and cross react with PfHRP3, a structural homologue. Here, we analysed natural variations in PfHRP2 and PfHRP3 sequences from Indian isolates and correlated these variations with RDT reactivity. A total 1392 P. falciparum positive samples collected from eight endemic states were PCR amplified for Pfhrp2 and Pfhrp3 genes and were sequenced. The deduced protein sequences were analysed for repeat variations and correlated with RDT reactivity. Out of 1392 PCR amplified samples, a single sample was Pfhrp2 negative and two samples were Pfhrp3 negative. Complete Pfhrp2 and Pfhrp3 sequences were obtained for 769 samples and 750 samples, respectively. A total of 16 distinct repeat motifs were observed for Pfhrp2 and 11 for Pfhrp3, including some new repeat types. No correlation was found between variations in the size of Pfhrp2 repeat types 2 and 7, nor between any combinations of repeat motifs, and performance of a commercial RDT at low parasite densities. The findings suggest that sequence diversity in Pfhrp2 and Pfhrp3 genes in Indian isolates is not likely to negatively influence performance of currently used PfHRP2 RDTs.
A 40-year-old-female presented with a right parotid swelling. It was diagnosed as adenoid cystic carcinoma on FNAC. On histopathology final diagnosis of basal cell adenoma was made. Basal cell adenoma is a rare and benign basaloid neoplasm of the salivary gland. The other basaloid neoplasms are pleomorphic adenoma, basal cell adenocarcinoma, adenoid cystic carcinoma, metastatic basal cell carcinoma, metastatic squamous cell carcinoma and small cell carcinoma. Differentiating basaloid neoplasms on FNAC pose diagnostic difficulties. The goal is to discuss problems and pitfalls in FNAC diagnosis of basal cell adenoma and to emphasize on cautious approach while diagnosing basaloid neoplasm on cytology.
Background: Diabetes is a pandemic causing very high morbidity and mortality due to its complications which are a result of micro and macro angiopathy. Platelets play a key role in the vascular complications. These complications are attributed to platelet activation which can be recognised by an increase in platelet volume indices (PVI) including mean platelet volume (MPV) and platelet distribution width (PDW). Platelet indices can be potentially useful surrogate markers for the early diagnosis of thromboembolic and cardiovascular complications in diabetes. Methods: This is a cross-sectional study conducted for 2 years with total 930 subjects. The patients were segregated in 03 groups on basis of HbA1C as (a) Diabetic, (b) Non-Diabetic and (c) FG. Samples for HbA1C and platelet indices were collected using EDTA (ethylene diamine tetracetic acid) as anticoagulant and were processed on autoanalysers.
Results:The study revealed a stepwise increase in the PVI from non-diabetics to IFG to diabetics. MPV and PDW were increased in the IFG cases as compared to the non-diabetic and were markedly increased in the diabetic patients. MPV and PDW of diabetics, IFG and non-diabetics were 17.60±2. 04, 11.76±0.73, 9.93±0.64 and 19.17±1.48, 15.49±0.67, 10.59±0.67 respectively with a significant p value 0.00. Significant positive correlation between PVI with glycaemic levels and duration of diabetes across the groups (MPV-HbA1c r = 0.951; PDW-HbA1c r = 0.875). However, the total platelet count was found to decrease with the increasing glycaemic levels with a p value <0.001. A significant negative correlation was found between glycaemic levels and total platelet count (PC-HbA1c r = -0.164). Conclusions: This study showed that platelet morphology is altered with increasing glycaemic levels. These changes can be known by measurements of PVI which is an important simple and effortless tool can be used more extensively to predict the acute vascular events and thereby help curb morbidity and mortality.
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