Small bowel histomorphology in surgical complications of ascariasis: a small series.

BACKGROUND: Ascariasis is a worldwide health problem. Patients usually get treated with antihelminthics. Rarely, undiagnosed cases can present with surgical complications. AIM: To study the clinico-pathological characteristics of small bowel specimens of patients presenting with surgical complications of ascariasis. METHODS: This is a retrospective analysis of small bowel specimens of patients presenting with surgical complications of ascariasis from a period of 2010 to 2012, received in our department. RESULTS: The patients were of all age groups and mainly presented with intestinal obstruction and perforation. Transmural gangrenous change was seen in all nine cases. Encysted ova were seen in five cases. Two of the cases showed partial to complete infarction of isolated mesenteric lymph nodes. CONCLUSION: Ascariasis may cause transmural gangrene of bowel as well as mesenteric lymph node infarction.

Assessment of Titanium Level in Submucosal Plaque Around Healthy Implants and Implants with Peri-implantitis: A Clinical Study.

BACKGROUND: The present study focused on assessing the level of titanium in submucosal plaque in the peri-implant area with peri-implantitis in comparison to healthy implants. METHODOLOGY: Sixty patients with titanium dental implants were recruited. The degree of titanium in submucosal plaque around peri-implantitis and healthy implants was estimated using inductively coupled plasma mass spectrometry. RESULTS: The mean ± standard deviation probing depth in Group I was 3.12 ± 1.1 and in Group II was 7.2 ± 2.5; gingival index was 0.64 ± 0.3 and 1.64 ± 0.8 in Group I and Group II, respectively. The plaque index was 0.82 ± 0.2 in Group I and 1.5 ± 0.6 in Group II. The mean plaque mass in Group I was 24.1 ± 3.8 ng/ul and 49.3 ± 6.4 ng/ul in Group II. The mean titanium level in Group I was 0.08 ± 0.02 µg and in Group II was 0.91 ± 0.04 µg. A highly significant difference between both groups was found (P < 0.05). CONCLUSION: There was a significantly higher titanium level in submucosal plaque around dental implants with signs of peri-implantitis as compared to healthy dental implants.

Umbilical cord ulceration: An underdiagnosed entity.

Umbilical cord ulceration is a rare condition presenting with sudden fetal bradycardia due to fetal hemorrhage and in most cases leading to intrauterine death. A strong association with intestinal atresia has been reported. Most cases present after 30 weeks of gestation, with preterm labor or rupture of membranes followed by sudden fetal bradycardia. We report two such cases of umbilical cord ulceration and review the available literature. One of the cases interestingly presented at 26 weeks, much earlier than what is reported in the world literature. In view of high perinatal mortality and morbidity, awareness of this condition is mandatory for timely and appropriate management to improve the fetal outcome.

Epidermal inclusion cyst in breast: Is it so rare?

BACKGROUND: Epidermal inclusion cyst in the breast (EICB) is very rare. It presents as breast lump mainly in peri-areolar region and needs to be differentiated from other breast lesions with predominance of squamous cells. AIM: To analyze the role of fine needle aspiration cytology (FNAC) in patients presenting with breast lump. MATERIALS AND METHODS: The present study is a retrospective study over the period of past 2 years, where the patients presented with firm breast lumps. Six of these cases were diagnosed as EICB on FNAC. Smears from these cases were reviewed for cytomorphological findings and correlated with clinico-radiological details. RESULTS: Patients ranged in age from 25 to 60 years, and female to male sex ratio was 2:1 (female 4, male 2). Mammography was done in women (4), which showed solid, well-defined mass lesions in peri-areolar region and were suggestive of benign breast lesions (3) and infective lesion (1). FNA was performed; Giemsa-stained smears showed predominantly mature benign squamous cell and anucleated squames in all cases, thus one of the cytological diagnoses was EICB. Five of these cases had histological confirmation. CONCLUSION: EIC of breast is not that rare lesion as considered. The patients may not seek medical attention because of small painless swelling; unless the lump increases in size or becomes painful. FNAC is confirmatory in the presence of a typical pultaceous aspirate and cytomorphological features of EIC. Thus, FNAC plays a crucial role in its diagnosis and management. Symptomatic cases should be readily excised and need histological correlation to rule out any potential complications that can arise in these cysts.