Ground-glass Appearance Research Articles

Status of Hemato-biochemical Parameters in Feline Infectious Peritonitis (FIP) Affected Cats

Feline infectious peritonitis (FIP) is a serious viral disease of cats that usually results in death. There is derangement of vitals in cats due to FIP including clinical and hemato-biochemical parameters. This study reports same findings in a group of six cats (3 Persian, 2 mixed breed, 1 nondescript) affected with FIP. Cats were diagnosed on clinical signs, FIP rapid test, Rivalta test, USG and X-ray. Ground glass appearance of abdomen on X-ray, hyperechogenicity of liver and loss of renal/cortical texture on ultrasonography (USG) was noted. Among the liver function tests, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were increased to 76.2400±4.35373 and 58.6333±13.75860 IU/L, respectively. Kidney function tests including bilirubin, blood urea nitrogen (BUN) and creatinine were raised 3.533±0.4601, 62.5000±2.45967 and 2.8833±0.48402 mg/dl, respectively. Hematological values including haemoglobin (Hb) (10.4500±0.76714), red blood cell count (RBC) (7.4400±0.78636), packed cell volume (PCV) (26.7667±3.59042), white blood cell count (WBC) (18.2850±2.72594 103/μl), granulocytes (15.3167±2.84762%), lymphocytes (1.7000±0.34351%) and platelets (310.8333±75.50074) showed derangement. This study establishes baseline data for FIP cases in this region and can serve as a basis of prognosis of FIP based on clinical and hematobiochemical parameters.

CLINICAL SPECTRUM OF DISEASE IN NEONATES BORN TO MOTHERS WITH COVID-19 IN A TERTIARY CARE HOSPITAL

COVID-19 infection during pregnancy presents potential risks to neonates, yet the full clinical spectrum in newborns born to COVID-19-positive mothers remains under investigation. Understanding the clinical outcomes in these neonates is essential for guiding management and care. Objective: To study the spectrum of clinical presentations in neonates born to mothers who tested positive for COVID-19. Methods: This prospective cross-sectional study was conducted at the Department of Pediatrics, Shifa International Hospital, from April 1, 2020, to April 30, 2021. All neonates born to COVID-19-positive mothers were included in the study and followed daily during their hospital stay. After obtaining parental consent, nasopharyngeal swabs were taken from the neonates for SARS-CoV-2 PCR testing at 24-48 hours of age. After discharge, follow-up calls were made between days 7-14. Data were entered into a predesigned proforma and analyzed using SPSS version 23. Results: A total of 82 neonates were enrolled. Approximately half were born at term, with a mean weight of >2500 grams. Forty-five neonates (53%) underwent SARS-CoV-2 PCR testing within 48 hours of age; all were negative. Sixty-one neonates (74%) were shifted to the mother’s care, while 25% required admission to the neonatal intensive care unit (NICU). The most common reasons for NICU admission included respiratory distress (15%), prematurity (6%), and lethargy (5%). Radiological findings included ground-glass appearance in five neonates (6%) and lung consolidation or infiltrates in two (3%). Hematological and biochemical abnormalities included leukocytosis (7%), leucopenia (3.6%), anemia (1.2%), metabolic acidosis (6%), and respiratory acidosis (3.6%). Most neonates (78.6%) received routine care and were fed breast milk. Fourteen neonates (16.7%) required respiratory support, with 13% needing mechanical ventilation. Complications included pneumonia (7%) and respiratory failure (9%). NICU stay varied, with 11 neonates (13%) staying less than 48 hours and 10 (12%) requiring a more extended stay. Four neonates (5%) died due to multiorgan complications. Conclusion: The majority of neonates born to COVID-19-positive mothers remained asymptomatic. However, symptomatic neonates were at risk of serious complications, requiring close monitoring and management, particularly in those with additional risk factors.

WP2.14 - Lung Mycetoma - Chronicles from the Pandemic

Abstract Introduction COVID-19 is a global pandemic which obeys no geographical borders. Post Covid pneumonia sequalae is still an unpredictable course especially with patients with a pre-existing lung compromise. In such scenario, a cohort of patients must also be looked for a fungal infection. Case Study A 31-year-old male presented with history of fever, hemoptysis, and weight loss for 1 month. He suffered from Covid-19 pneumonia 3 months back. He was also diagnosed with Pulmonary tuberculosis 4 years back. Examination revealed right sided tracheal deviation with dull percussion note on the upper and middle zones of the right side of chest. Pulmonary function tests showed a restrictive pattern with a FEV1/FVC ratio of 0.9 (FEV1=2.02, FVC=2.22). Transthoracic echocardiography revealed dextrocardia, moderate TR, and a pulmonary arterial systolic pressure of 25 mm Hg. Contrast enhanced CT scan of thoracic cavity showed reduced right hemithorax, well-defined thick-walled cavities in the upper and lower lobe of the right lung and a ground glass appearance in the bilateral lower lobes. A diagnosis of Lung mycetoma was made along with post covid-19 pneumonia changes. Right posterolateral thoracotomy and right pneumonectomy was performed. Per-operatively, a collapsed lower lobe and stony hard upper and middle lobes of right lung with associated fungal balls were found. Patient was clinically well after a 30-day follow-up period. Conclusion Covid-19 patients with pre-existing pulmonary co-morbidities should be followed with caution and pulmonary symptoms in the post pneumonia patient should raise the suspicion of fungal infections as well.

A rare case of bone lesion: Mandible’s fibrous dysplasia

Fibrous dysplasia is a rare genetic syndrome that affects bone tissue. This pathology replaces the mineralized matrix of the bone affected with connective and fibrous tissue. This article describes a mandibular fibrous osseous dysplasia case and its surgical treatment. A 45-year-old woman complained about a slow development of swelling of the left mandibular bone. The orthopantomography (OPT) and the cone beam computed tomography (CBCT) revealed a well-circumscribed sclerotic lesion with a ground-glass appearance apical to the 3.5 element. The surgery was performed to excise the lesion. Anatomopathological examination of tissue confirmed the suspects among the diagnosis of fibrous dysplasia. The patient underwent to follow-up of 4 years, and no recurrences were found. In the absence of a univocal consensus on therapy, surgery remains the treatment of choice for unifocal forms.

Molecular confirmation that fibrocartilaginous dysplasia is a variant of fibrous dysplasia

AimsFibrocartilaginous dysplasia (FCD) is a subvariant of fibrous dysplasia (FD). This study aims to retrospectively elucidate the clinicopathological and separate genetic features of the cartilaginous and fibro-osseous components of FCD.MethodsIn...

Analysis of serum ascites albumin gradient (SAAG) in cats with hepatic disorder

Three Persian breed cats were diagnosed to be having hepatitis. Clinical examination revealed dullness, dehydration, poor body condition and fluid thrill on the abdominal palpation. Radiography and ultrasonography revealed ground glass appearance of the abdomen and anechoic fluid in the abdomen respectively. Elevated serum ascites albumin gradient with elevated serum alanine transaminase levels were noticed in these cats

Transthyretin amyloid cardiomyopathy in patients with unexplained increased left ventricular wall thickness

Amyloid cardiomyopathy (CA) was previously considered a rare disease; however, rapid advancements in imaging modalities have led to an increased frequency of its diagnosis. The aim of this prospective study was to assess the prevalence and clinical phenotype of transthyretin amyloidosis (ATTR) cardiomyopathy in patients exhibiting unexplained increased left ventricular (LV) wall thickness. From 2020 to 2022, we enrolled 100 consecutive adults with unexplained increased LV wall thickness in the study. The analysis included clinical data, electrocardiography, transthoracic echocardiography, single-photon emission computed tomography/computed tomography with 3,3-disphono-1,2-propanodicarboxylic acid, genetic testing. Overall, 18% of patients were diagnosed with CA, comprising 5% with light-chain amyloidosis, and 12% with ATTR. To evaluate associations with the ATTR diagnosis, a LOGIT model and multivariate analysis were applied. Notably, age, polyneuropathy, gastropathy, carpal tunnel syndrome, lumbar spine stenosis, low voltage, ventricular arrhythmia, LV mass, LV ejection fraction, global longitudinal strain (GLS), E/A, E/E′, right ventricle (RV) thickness, right atrium area, RV VTI, TAPSE, apical sparing, ground glass appearance of myocardium, thickening of interatrial septum, thickening of valves, and the “5–5–5” sign were found to be significantly associated with ATTR (p < 0.05). The best predictive model for ATTR diagnoses exhibited an area under the curve of 0.99, including LV mass, GLS and RV thickness. This study, conducted at a cardiology referral center, revealed that a very considerable proportion of patients with unexplained increased LV wall thickness may suffer from underlying CA. Moreover, the presence of ATTR should be considered in patients with increased LV mass accompanied by reduced GLS and RV thickening.

Characteristics of Patients with Hypertension Admitted for COVID-19 Treatment in Khulna: Single-Centre Cross-Sectional Study

Background: The outbreak of coronavirus disease 2019 (COVID-19) has become a large threat to global health due to its high contagious nature and varied mortality. Arterial hypertension represents one of the most common comorbidities in patients with COVID-19. Close connections between inflammation and blood pressure (BP) have been described, and inflammation plays a key role in the outcome for patients with COVID-19. Objective: This study aims to investigate the clinical characteristics of patients with hypertension admitted for COVID-19 treatment in Gazi Medical College Hospital (GMCH), Khulna, Bangladesh. Methods: This was a cross-sectional type of observational study on patients with hypertension who were diagnosed with COVID-19 based on laboratory and/or radiological findings and admitted to Gazi Medical College Hospital, Khulna, Bangladesh, from July 1 to July 31, 2021. In that timeframe, overall, 215 patients with COVID-19 were admitted. Among them, 37 patients having hypertension fulfilled the inclusion criteria for the study. Demographic, clinical, laboratory and radiological data of those 37 patients were recorded and analyzed. Results: Among 37 study subjects, 54.1% were female. The mean age of the patients was 59.6±13.9 years. Among the study subjects, diabetes (56.8%) was the most common comorbidity. Regarding laboratory parameters, the mean Hb of the patients was 11.4±1.9 g/dl. In addition, the mean random blood sugar (RBS) level was 11.6±2.9 mmol/l. Neutrophilia and lymphocytopenia were observed in 86.5% and 83.8% cases, respectively. The mean D-dimer (2.4 mg/l) and CRP (72.5 mg/l) levels were well above their normal limits. In high resolution CT scan of the chest (HRCT chest), bilateral lung involvement was present in 89.2% cases. Ground-glass appearance was the most frequent (91.9%) radiologic pattern. Among antihypertensive drugs, losartan potassium was the most frequently used category (29.7%). Total 7 (18.9%) patients were severely affected with COVID-19 and admitted to the ICU, requiring mechanical ventilation. During our study, 2 patients (5.4%) died either due to multiple organ dysfunction syndrome or cardio-respiratory failure. Conclusion: The study provides key information to better understand the clinical characteristics of patients with hypertension admitted for COVID-19 treatment, which may help physicians to identify the factors associated with adverse outcomes in this disease. Mediscope 2024;11(1): 34-40

Panoramic Radiographic Evaluation of the Osseous Morphological Changes in Iraqi Patients with Chronic Renal Failure

To make comparative evaluation of gonial cortical bone thickness, antegonial index, gonial angle values and mandibular canal bone resorption, pathologies like ground-glass appearance in jawbones and brown tumor i n Iraqi patients undergoing dialysis due to chronic renal failure and patients from the healthy control group on panoramic .Panoramic radiographs were taken from 40 patients divided into two groups (20 normal and 20 dialysis patients) .Gonial cortical thickness, antegonial index and gonial angle values with the mandibular canal wall resorption were assessed , pathologies such as ground-glass appearance and Brown tumor as “available” or “not available.” Mandibular canal wall resorption (Chi-square:16.52 , P&lt;0.01) was found highly statistically significant difference between the patient and control groups ,resorption detected mainly in right side of male patients .Panoramic radiographs showed decreasing in values of the measuring parametersin patients receiving dialysis treatment due to chronic renal failure compared to the control group.

Pneumocystis Pneumonia Infection Following the Initiation of Pembrolizumab Therapy for Lung Adenocarcinoma: A Case Report.

Pneumocystis pneumonia (PCP) is an opportunistic infection that presents a ground-glass appearance in the lungs on chest radiography. Interstitial lung disease is a commonly reported adverse effect of immune checkpoint inhibitor (ICI) treatment; however, there are few reports of ICI treatment-associated PCP infection. A 77-year-old man with lung adenocarcinoma was administered pembrolizumab and hospitalized for dyspnea 2 weeks after treatment. Chest computed tomography showed bilateral ground-glass opacities in all lung lobes. PCP was therefore diagnosed, and steroids and sulfamethoxazole-trimethoprim were initiated. Following treatment, the patient's condition improved promptly. This report suggests that ICI treatment can cause PCP infection.

Retrospective analysis of respiratory virus infections in adults with hematologic malignancies.

The study aimed to evaluate respiratory virus infections in adult patients with hematological malignancies (HM). The medical records of patients who were followed up by the hematology clinic at Başakşehir Çam and Sakura City Hospital between March 2021 and March 2023 with a diagnosis of HM and who underwent real-time polymerase chain reaction (RT-PCR) testing for nasopharyngeal/oropharyngeal specimens taken with suspected respiratory tract infection constituted the study data. Infections were symptomatic in 64.56% of patients, and the most common symptoms were fever (48.10%) and cough (18.99%). The mortality rate was 25.32% over a two-year period. When the samples were examined, positive test frequency was 43.04%, and the three most common pathogens were Influenza A (10.13%), SARS-CoV-2 (8.86%), and rhinovirus/enterovirus (7.59%). The frequency of positive tests from HMs was highest in patients with AML (p=0.042). Respiratory PCR kit positivity was higher in patients who had any symptoms (p=0.002) and cough (p=0.003). Test positivity was higher in patients with any pathological radiological finding (p=0.039) and ground glass appearance (p=0.010). The risk of death was found to be 5.848 times higher in patients with dyspnea compared to those without (OR: 5.848, 95% CI: 1.143-29.915, p=0.034). Respiratory tract virus panel PCR test positivity is more common in patients with HM presenting with respiratory tract infection symptoms in the presence of AML diagnosis, symptomatic infection, cough, radiological findings, and ground glass appearance. Mortality risk is high in HM patients with respiratory tract virus infection who have shortness of breath.

PRONOSTIC DES PATIENTS HOSPITALISES POUR COVID-19 AU CENTRE DE TRAITEMENT DES EPIDEMIES (CTE) DE L’HOPITAL REGIONAL DE THIES DU 1ER MAI 2020 AU 15 SEPTEMBRE 2020

SummaryIntroduction: Since the beginning of March 2020, Senegal has been confronted with the COVID-19 pandemic, and its first case was recorded on 2 March of the same year. In the Thiès region, studies have focused mainly on the management of confirmed cases of COVID-19, but few have addressed the evolutionary aspect. We therefore took upon us to assess the prognosis of patients after hospitalisation in order to evaluate possible somatic or psychological effects linked to COVID-19.Methodology : This was a prospective study from May 1st to September 15th 2020 (i.e. the first wave of the covid-19 pandemic), descriptive with analytical aims. The population represented confirmed cases of COVID-19 hospitalised at the CTE of the Thiès regional hospital. This was an item-based tele-evaluation approach, and data were collected using a structured survey form and by telephone call, then analysed using SPSS Statistics version 25 software.Results : At the end of data collection, 97 patients were identified according to the established criteria. The majority of patients came from Thiès (40%), followed by Tivaouane (14%, 24.1 km from the CTE) and Pout (12%, 16.1 km from the CTE). The mean age of the patients was 49.63 +/- 17.7 years, ranging from 7 to 79 years, and 55% were male.Twenty-seven percent were asymptomatic. For those who were symptomatic, the most frequent symptoms were fever (37%), headache (34%) and cough (33%), followed by agueusia (22%), asthenia (21%) and difficulty breathing (11%).Anaemia was noted in 16% of patients, leucopenia in 3%, thrombocytosis and thrombocytopenia in 3%.COVID-19 pneumopathy (ground-glass appearance) was noted in 7%.No patient experienced any psychological effects during this study. However, one patient had persistent dyspnoea.In our work, fifty-four percent (54%) of patients were not followed up after their recovery from COVID-19. However, 22% of patients were monitored for hypertension and 16% for diabetes. The majority of patients (91%) were «satisfied», or even «very satisfied» (4%), with their care at the CTE.Conclusion : Patients admitted at the Thiès CTE during the first wave of the COVID pandemic were predominantly male. They were followed up systematically on a case-by-case basis unless they had comorbidities such as hypertension or diabetes. The majority of these patients were very satisfied with their care at the CTE. Overall, the outcome was favourable, but one case of persistent respiratory distress was noted, possibly associated with a «long COVID» Keywords: COVID-19, CTE, effects

Examination of Radiological Findings and Clinical Parameters in Paediatric Patients with Covid-19

Objective: It was aimed to evaluate the relationship between imaging techniques and clinical and laboratory parameters in paediatric COVID-19 patients.&#x0D; Methods: Our study included 187 patients under the age of 18 whose diagnosis of COVID-19 was confirmed by PCR test. Demographic, clinical, laboratory and radiological imaging findings of the patients were reviewed retrospectively from their file records.&#x0D; Results: 57.2% of the patients were male and the mean age was 110.1±67.4 months. A pulmonary finding associated with COVID-19 was detected in 21 (12%) of 175 patients who underwent Posterior-anterior (PA) chest X-ray. The most common findings were consolidation (n=16; 9.1%), bilateral ground-glass appearance (n=11; 6.3%), and atelectasis (n=5; 2.9%), respectively. Computed lung tomography was performed in 67 of the patients. The presence of a pulmonary finding associated with COVID-19 was detected in 28 (41.8%) of these patients. The three most common findings were consolidation (n=16; 23.9%), bilateral ground glass appearance (n=16; 23.9%), and atelectasis (n=15; 22.4%), respectively. It was determined that for patients with imaging findings on PA X-ray needed more paediatric intensive care, the length of their hospital stay was longer, comorbid diseases were present, their cough and tachypnea complaints were more pronounced (p

A Rare Case of Localized Pulmonary Alveolar Proteinosis With Part-solid Ground-glass Nodule-like Appearance

A Rare Case of Localized Pulmonary Alveolar Proteinosis With Part-solid Ground-glass Nodule-like Appearance

The melatonin agonist ramelteon attenuates bleomycin-induced lung fibrosis by suppressing the NLRP3/TGF-Β1/HMGB1 signaling pathway

PurposeThe possible effects of ramelteon, a melatonin receptor agonist on bleomycin-induced lung fibrosis were analyzed via transforming growth factor β1 (TGF-β1), the high mobility group box 1 (HMGB1) and Nod-like receptor pyrin domain-containing 3 (NLRP3) which are related to the fibrosis process. Materials and methodsBleomycin (0.1 ​mL of 5 ​mg/kg) was administered by intratracheal instillation to induce pulmonary fibrosis (PF). Starting 24 ​h after bleomycin administration, a single dose of ramelteon was administered by oral gavage to the healthy groups, i.e. PF ​+ ​RM2 (pulmonary fibrosis model with bleomycin ​+ ​ramelteon at 2 ​mg/kg) and PF ​+ ​RM4 (pulmonary fibrosis model with bleomycin ​+ ​ramelteon at 4 ​mg/kg) at 2 and 4 ​mg/kg doses, respectively. Real-time polymerase chain reaction (real-time PCR) analyses, histopathological, and immunohistochemical staining were performed on lung tissues. Lung tomography images of the rats were also examined. ResultsThe levels of TGF-β1, HMGB1, NLRP3, and interleukin 1 beta (IL-1β) mRNA expressions increased as a result of PF and subsequently decreased with both ramelteon doses (p ​< ​0.0001). Both doses of ramelteon partially ameliorated the reduction in the peribronchovascular thickening, ground-glass appearances, and reticulations, and the loss of lung volume. ConclusionsThe severity of fibrosis decreased with ramelteon application. These effects of ramelteon may be associated with NLRP3 inflammation cascade.

Chest X-ray’s findings in symptomatic patients positive for coronavirus disease (COVID-19)

Background: The coronavirus disease (COVID) flared-up as pneumonia for an unknown cause in December 2019 in Wuhan, China, and was spread swiftly outside of Wuhan to other countries, later. Objective: To find out the Chest X-ray’s findings in positive cases for Covid-19. Methodology: A cross-sectional study was conducted at Department of radiology, Farooq Hospital Lahore. 150 patients of different age groups were enrolled in this study with convenient sampling technique. We included only those patients in this study who were symptomatic and have positive PCR of Covid-19 virus while the asymptomatic were excluded. Results: All 150 patients were with the history of positive polymerase chain reaction (PCR) of COVID and were symptomatic. 85 (56.7%) males and 65 (43.3%) females were enrolled in this study. Out of 150 patients 54 (63%) patients presented with the history of fever, 103 (68.7%) had history of diabetes, 54 (36%) had history of hypertension, 57 (38%) had history of smoking, 69 (46%) had history of cough, and all patients presented with the history of loss of smell. On X-ray 87 (58%) shows Air Space Opacification, 98 (65.3%) shows Inflammatory Process, 46 (30.7%) shows Ground Glass Appearance, 52 (34.7%) shows Consolidation, 9 (6%) shows Pleural effusion, 15 (10%) has cardiomegaly, 15 (10%) has bronchitis and 8 (5.3%) has pulmonary edema. Conclusion: The chest X-ray is the basic modality for identifying patients with COVID-19 pneumonia and it is especially useful due to its low cost and low radiation exposure. Early changes in the lung parenchyma and consolidation and hazy pattern can be detected and that will help to reduce the rate of hospitalization due to Covid-19. Key words: Chest X-ray, Covid-19, viral infection, pandemic disease, mortality

Monkeypox: A Histopathological and Transmission Electron Microscopy Study.

The global outbreak of human monkeypox virus (hMPXV1) in 2022 highlighted the usefulness of dermatological manifestations for its diagnosis. Infection by the human monkeypox virus thus necessitated inclusion in the diagnostic repertoire of dermatopathology. To assess the histopathological and microscopical findings of cutaneous lesions related to hMPXV infection, we analyzed skin biopsies from patients with positive MPXV DNA polymerase chain reaction presenting with a typical course of hMPXV1 infection. The most prominent histopathological findings were ascribable to a pustular stage in which epidermal necrosis with areas of non-viable keratinocytes and a "shadow cell" appearance were evident; in some cases, the deep portion of the hair follicle and the acrosyringial epithelium were affected. The main cytopathic modifications included ballooning keratinocytes, followed by Guarnieri bodies and a ground glass appearance of the keratinocytes' nuclei, together with a dense mixed inflammatory cell infiltrate with prominent neutrophil exocytosis. Transmission electron microscopy analysis demonstrated viral particle aggregates in the cytoplasm of keratinocytes, without any involvement of the nucleus. Interestingly, we also found the presence of viral particles in infected mesenchymal cells, although to a lesser extent than in epithelial cells. Through this study, we contributed to expanding the histological and microscopic knowledge of the human mpox virus, a key step to understanding current and potential future trends of the disease, as well as of other Orthopoxvirus infections.

Clinical diagnosis and treatment of multiple pulmonary nodules

CT screening has markedly reduced the lung cancer mortality in high-risk population and increased the detection of early-stage pulmonary neoplasms, including multiple pulmonary nodules, especially those with a ground-glass appearance on CT. Multiple primary lung cancer (MPLC) constitutes a specific subtype of lung cancer with indolent biological behaviors, which is predominantly early-stage adenocarcinoma. Although MPLC progresses slowly with rare lymphatic metastasis, existence of synchronous lesions and distributed location of these nodules still pose difficulty for the management of such patients. One single operation is usually insufficient to eradicate all neoplastic lesions, whereas repeated surgical procedures bring about another dilemma: whether clinical benefits of surgical treatment outweigh loss of pulmonary function following multiple operations. Therefore, despite the anxiety for treatment among MPLC patients, whether and how to treat the patient should be assessed meticulously. Currently there is a heated discussion upon the timing of clinical intervention, operation mode and the application of local therapy in MPLC. Based on clinical experience of our multiple disciplinary team, we have summarized and commented on the evaluation, surgical treatment, non-surgical local treatment, targeted therapy and immunotherapy of MPLC in this article to provide further insight into this field.

Effect of Aqueous Extract of Ichthyotoxic Plant Bridelia micrantha (Hochst) (Baill) on Haematology, Histopathology and Carcass Characteristics of African Catfish (Clarias gariepinus) (BURCHELL, 1822) Juvenile

The Bridelia micrantha (Hochst.) (Phyllanthaceae) is an ichthyotoxic plant used in catching fish in Nigeria. The toxicity of aqueous extract of B. micrantha on Clarias gariepinus was investigated under statics bioassay conditions. The concentrations of the leaves extract used were 0.00, 0.10, 0.20, 0.30, 0.40, 0.50 and 0.0.60ml/l. The 24hrs, 36hrs, 48hrs, 72hrs, and 96hrs LC50 were 0.40mg/l, 0.30mg/l, 0.26mg/l, 0.22mg/l and 0.21mg/l respectively, with the range of maximum admissible concentration (MATC) were 0.004 – 0.04, 0.003 – 0.03, 0.0026 – 0.026, 0.0022 – 0.022, and 0.0021 – 0.021 respectively. The opercula ventilation and loss of reflex increased with an increase in the concentrations of the leaves extract at the end of 96-hour exposure period. Respiratory distress, loss of balance, settling at the bottom motionless and erratic swimming was observed before death during the exposure period. There was no significant difference in physicochemical parameters of test media (P&lt;0.05) before, during and after the experimental period. Total Dissolved Solids and Conductivity increased significantly (p&lt;0.05) with increase in extract concentration. Temperature had nonsignificant (p&lt;0.05) reduction at all extract concentrations. Blood analysis revealed significant (P&lt;0.05) reduction in the blood parameters (Haemoglobin, Packed Cell Volume, Red Blood Cells, White Blood Cells, Platelet, Mean Corpuscular Volume and Mean Corpuscular Haemoglobin) of exposed fish. There was severe reduction in Carcass/Proximate (Moisture, Crude Protein, Crude Lipid, Ash, NFE, and Energy) composition of Clarias gariepinus juvenile exposed to B. micrantha. Histopathological examinations of the test fish showed some pathological disruptions, such as skin layer with severe superficial spreading of melanoma, The liver cells revealed hepatic tissue with severe ground glass (GG) appearance of the cytoplasm and intra hepatic hemorrhage (IHH), The gill showed severe effect on the gill architecture with hypertrophy of the gill arch, gill filament and aggregate of inflammation (AI), while the kidney revealed severe degeneration of the renal tissue with severe intra renal necrosis (TN). The result of this study calls for the need to discourage the use of toxic plants for catching fish in Cross River and Nigeria water bodies.

Pulmonary involvement in antineutrophil cytoplasmic antibody-associated vasculitides: A single center experience from Turkey.

Pulmonary involvement is an important cause of mortality and morbidity in antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV). In this study, we aimed to evaluate the type and frequency of pulmonary involvement and investigate the potential relationship between thorax computed tomography (CT) signs and other systemic clinical findings in AAV. A total of 63 patients over the age of 18 and diagnosed with AAV were included in this study. Thoracic CT imaging findings and clinical features of the patients at the time of diagnosis were retrospectively evaluated. The frequency and distribution of detected pathological findings on imaging according to disease types, in addition to the relationship of these findings with other systemic findings and disease severity, were analyzed. Of 63 patients, 50 (79.4%) had pulmonary symptoms at the time of presentation. Most frequently observed pulmonary finding of thorax CT was nodular opacity. Consolidation, cavitary nodules, bronchiectasis, emphysema and fibrotic sequelae change were more common in the patients with diagnosis of granulomatosis with polyangiitis. Honeycomb, atelectasis, interstitial pneumonia, pulmonary venous congestion and pleural effusion were more common in the patients with diagnosis of microscopic polyangiitis. Ground-glass appearance, central airway disease, peribronchovascular nodules, pericardial effusion and lymphatic adenomegaly (>10 mm) were more common in the patients with diagnosis of eosinophilic granulomatosis with polyangiitis. Interstitial lung disease, pulmonary hemorrhage and severe lung involvement were found significantly increased in patients with myeloperoxidase antibody (MPO)-ANCA positivity (P < 0.05). Lung involvement was detected in almost all of the patients with AAV. Both interstitial lung disease and severe lung involvement were more frequently found in patients with MPO-ANCA positivity compared to other patients. Pulmonary examination by an imaging technique in all patients with AAV may be useful to determine the vasculitis subtype and to determine the extent of the disease. Pulmonary involvement is quite common in AAV. Every patient with suspected AAV should be examined with imaging for lung involvement, even in the absence of respiratory symptoms. Severe pulmonary involvement is associated with the presence of severe disease and MPO-ANCA positivity.