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Pilomatrixoma as a diagnostic pitfall in fine needle aspiration cytology: a case report

Sivakumar S

Acta Cytol., 2007 Jul-Aug;51(4):583-5.
PMID: 17718128 DOI: 10.1159/000325801

BACKGROUND: Pilomatrixoma (pilomatrixoma, calcifying epithelioma of Malherbe) is a relatively uncommon, benign neoplasm arising from the skin adnexa. The tumor can cause diagnostic difficulty not only for the clinician but also for the cytologist.

CASE: A 62-year-old woman presented with a right submandibular swelling of 4 months' duration. The clinical findings were highly suspicious for malignancy. A fine needle aspiration biopsy was performed. Three preliminary differential diagnoses were offered: mucoepidermoid carcinoma of the submandibular salivary gland, squamous cell carcinomatous deposit in a submandibular lymph node and calcifying odontogenic tumor. Computed tomography demonstrated no bony lesion. No primary site of squamous cell carcinoma could be identified. An excisional biopsy of the swelling was performed, and the histologic diagnosis of pilomatrixoma was made.

CONCLUSION: The cytologic presentation of pilomatrixoma of the right submandibular region can masquerade as that of a malignant tumor, in this case mucoepidermoid carcinoma, squamous cell carcinoma or odontogenic tumor. This case delineates the cytomorphologic features of pilomatrixoma that may mimic carcinoma.
Role of fine needle aspiration cytology in detection of microfilariae: report of 2 cases

Sivakumar S

Acta Cytol., 2007 Sep-Oct;51(5):803-6.
PMID: 17910352 DOI: 10.1159/000325846

BACKGROUND: Filariasis is a major public health problem in developing countries, and the diagnosis is conventionally made by demonstrating microfilariae in the peripheral blood smear. However, microfilariae have been incidentally detected in fine needle aspirates of various lesions in clinically unsuspected cases of filariasis with absence of microfilariae in the peripheral blood.

CASES: In case 1, a 21-year-old woman presented with multiple left axillary lymphadenopathy of 3 months' duration. In case 2, a 32-year-old woman presented with a thyroid nodule of 7 months' duration. Fine needle aspiration smears from both cases showed sheathed microfilariae of Wuchereria bancrofti. In both cases, microfilariae could not be demonstrated in the peripheral blood smears and the blood eosinophil counts were within normal limits. The histopathologic examination showed neither microfilariae nor adult worm.

CONCLUSION: Although microfilariae in cytologic material are considered incidental findings, these cases illustrate the value of routine fine needle aspiration cytology in the detection of asymptomatic and clinically unsuspected cases of bancroftian filariasis. Absence of microfilariae in the peripheral blood does not exdude filarial infection.
Fulltext The transobturator outside in suburethral sling insertion procedure

Balakrishnan SS, Dass AK, Tan YL

Indian J Urol, 2015 Apr-Jun;31(2):160-1.
PMID: 25878424 DOI: 10.4103/0970-1591.154223

This video describes the transobturator outside in suburethral sling surgical procedure for the indication of urodynamic stress urinary incontinence. A total of 170 cases were performed from January 2007 till December 2013. The average follow up was from 6 months till 7 years. The cure rate was 90%. There were no recurrences in our series. There was one patient with tape exposure after 3 years which required excision.
Cytologic features and differential diagnosis in chondroma of the breast: a case report

Sivakumar S, Kaur G

Acta Cytol., 2009 May-Jun;53(3):303-5.
PMID: 19534271 DOI: 10.1159/000325312

BACKGROUND: Extraskeletal (soft tissue) chondromas are rare neoplasms. They are seen most frequently in the soft tissues of hands and feet. A chondroma occurring in the breast is exceedingly uncommon. We present a case of pure chondroma of the breast in a young woman in whom fine needle aspiration (FNA) cytologic features suggested a cartilaginous neoplasm.

CASE: A 28-year-old woman presented with a mobile lump in the left breast. Mammography showed a high-density nodule without microcalcifications. A clinical diagnosis of fibroadenoma was made. A differential diagnosis was obtained on FNA. Excisional biopsy of the lump showed the histopathologic features of chondroma. There was no recurrence or appearance of new lesion during 13 months of follow-up.

CONCLUSION: Chondroma of the breast shows FNA cytologic features of cartilaginous tumor, but specific tumor typing may not be possible. This case highlights the difficulties that may arise in FNA diagnosis of cartilaginous tumor especially when it occurs at an unusual site. Awareness of the cytologic features combined with clinical and radiologic findings should guide the cytopathologist to make correct diagnosis of this neoplasm.
Fulltext Knee crepitus from an unusual source

Harwant S, Borhan TA, Sivakumar S, Jeevanan J

Med J Malaysia, 2001 Mar;56(1):98-9.
PMID: 11503306

A case report of a missed appendicitis presenting with abdominal wall necrotising fasciitis which extended up to the right knee. This subcutaneous collection in the prepatella region of the right knee presented as a crepitus and mimicked an intraarticular pathology.
Fulltext Joint angle estimation with wavelet neural networks

Sivakumar S, Gopalai AA, Lim KH, Gouwanda D, Chauhan S

Sci Rep, 2021 05 13;11(1):10306.
PMID: 33986396 DOI: 10.1038/s41598-021-89580-y

This paper presents a wavelet neural network (WNN) based method to reduce reliance on wearable kinematic sensors in gait analysis. Wearable kinematic sensors hinder real-time outdoor gait monitoring applications due to drawbacks caused by multiple sensor placements and sensor offset errors. The proposed WNN method uses vertical Ground Reaction Forces (vGRFs) measured from foot kinetic sensors as inputs to estimate ankle, knee, and hip joint angles. Salient vGRF inputs are extracted from primary gait event intervals. These selected gait inputs facilitate future integration with smart insoles for real-time outdoor gait studies. The proposed concept potentially reduces the number of body-mounted kinematics sensors used in gait analysis applications, hence leading to a simplified sensor placement and control circuitry without deteriorating the overall performance.
Assessing modalities used to alleviate postoperative pain in children receiving dental treatment under general anaesthesia: a systematic review

Sivakumar S, Venkiteswaran A, Roslan MA, Musa S

J Clin Pediatr Dent, 2024 May;48(3):15-23.
PMID: 38755977 DOI: 10.22514/jocpd.2024.054

Postoperative pain is generally a novel experience among paediatric patients. Topical anaesthetics, distraction procedures, and buffering of anaesthetic solutions have been used in reducing the postoperative pain. In this review, the authors assessed various modalities used to alleviate postoperative pain in children's dental treatment under general anaesthesia. Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) protocol were strictly adhered to in this systematic review. Specific keywords including postoperative pain, general anaesthesia, children, and dental extraction were used in the search for relevant randomized control trial studies in Web of Science, Scopus and PubMed, and included articles published until June 2021. From a total of 191 abstracts, 21 were reviewed. From the six studies with the usage of non-steroidal anti-inflammatory drugs (NSAIDs) alone or in combination with paracetamol, four observed that the preoperative use of NSAIDs alone or in combination was better than paracetamol alone, one discovered preoperative intravenous paracetamol was better than postoperative intravenous paracetamol, and the remaining study found no difference among various groups. Of two studies comparing the usage of non-steroidal anti-inflammatory drugs with opioid analgesics, one stated intravenous fentanyl in combination was better, while the other study found no difference among groups. The results obtained in this review can be utilized by physicians to control postoperative pain in children undergoing dental treatment under general anaesthesia.
Bis[1-(pyridin-2-yl)ethanone-kappa N 4-phenylthiosemicarbazonato-kappa 2N4,S]manganese(II)

Usman A, Razak IA, Chantrapromma S, Fun HK, Sreekanth A, Sivakumar S, et al.

Acta Crystallogr C, 2002 Sep;58(Pt 9):m461-3.
PMID: 12205370

One half of the molecule of the title complex, [Mn(C(14)H(13)N(4)S)(2)], is related to the other half by a twofold axis passing through the Mn atom. This high-spin Mn atom is six-coordinated, in an octahedral geometry, by the azomethine N, the pyridyl N and the thiolate S atom of two planar 1-(pyridin-2-yl)ethanone N(4)-phenylthiosemicarbazone ligands. In the crystal, the molecules are interconnected by N-H.S and C-H.N interactions, forming a three-dimensional network.
Fulltext Assessing the potential association between Epstein-Barr virus and oral squamous cell carcinoma: a systematic review and meta-analysis

Sivakumar S, Gupta AA, Nik Mohd Rosdy NMM, Venkiteswaran A, Raj AT, Awan KH

Transl Cancer Res, 2020 Apr;9(4):3092-3100.
PMID: 35117672 DOI: 10.21037/tcr.2020.01.09

BACKGROUND: This study aims to qualitatively and quantitatively review the association between Epstein-Barr virus (EBV) and oral squamous cell carcinoma (OSCC).
METHODS: PubMed, Scopus, and Web of Science databases were searched using the keywords "EBV or Epstein Barr virus and Oral cancer or Oral squamous cell carcinoma" for published case-control studies in the English language upto August 2019.
RESULTS: The search yielded 985 articles out of which 966 articles were excluded by screening their titles and abstracts as they were irrelevant or duplicates. Based on the full-text assessment of the remaining 19 articles, only 7 satisfied the inclusion criteria and were included in the qualitative analysis, out of which only 4 were compatible to be included in the meta-analysis. The diagnostic modalities used included immunohistochemistry, in situ hybridization and polymerase chain reaction. The diagnostic targets included latent membrane protein (LMP)-1, EBV determined nuclear antigen-1, EBV-encoded small non-polyadenylated RNA-2. The meta-analysis showed that there is an association between the EBV and OSCC.
CONCLUSIONS: Determining the association of EBV with OSCC is highly tedious due to the contrasting data obtained from individuals' studies which in turn is due to the wide variations in the sensitivity and specificity of the diagnostic modalities used and diagnostic targets selected. Although the meta-analysis revealed an association between EBV and OSCC, the number and the quality of the studies included in the meta-analysis are limited, thus the association requires further validation for any conclusive inference.
Hospital Mortality and Adverse Events Following Repair of Congenital Heart Defects in Developing Countries

Bateson BP, Deng L, Ange B, Austin E, Dabal R, Broser T, et al.

World J Pediatr Congenit Heart Surg, 2023 Nov;14(6):701-707.
PMID: 37386780 DOI: 10.1177/21501351231176189

BACKGROUND: Mortality associated with the correction of congenital heart disease has decreased to approximately 2% in developed countries and major adverse events are uncommon. Outcomes in developing countries are less well defined. The World Database for Pediatric and Congenital Heart Surgery was utilized to compare mortality and adverse events in developed and developing countries.
METHODS: A total of 16,040 primary procedures were identified over a two-year period. Centers that submitted procedures were dichotomized to low/middle income (LMI) and high income (HI) by the Gross National Income per capita categorization. Mortality was defined as any death following the primary procedure to discharge or 90 days inpatient. Multiple logistic regression models were utilized to identify independent predictors of mortality.
RESULTS: Of the total number of procedures analyzed, 83% (n = 13,294) were from LMI centers. Among all centers, the mean age at operation was 2.2 years, with 36% (n = 5,743) less than six months; 85% (n = 11,307) of procedures were STAT I/II for LMI centers compared with 77% (n = 2127) for HI centers (P