ABSTRACT
Placental site trophoblastic tumour (PSTT) is a rare variant of gestational trophoblastic disease developing from intermediate trophoblasts. PSTTs are incredibly rare tumours with 1 in 100000 pregnancies and only about 200 cases reported till date with mortality reaching up to 25% in undiagnosed c ases. We present the case of a 37year old female, gravida 4 para 3, presenting with uncontrollable post caesarean haemorrhage for which she underwent subtotal hysterectomy. Histopathological examination revealed Placental site trophoblastic tumour. Placent al site trophoblastic tumour, being a rare entity, pose difficulties in its early diagnosis. Delayed diagnosis can lead to distant metastases, thus worsening the prognosis.
ABSTRACT
Placental site trophoblastic tumour (PSTT) is a rare variant of gestational trophoblastic disease developing from intermediate trophoblasts. PSTTs are incredibly rare tumours with 1 in 100000 pregnancies and only about 200 cases reported till date with mortality reaching up to 25% in undiagnosed c ases. We present the case of a 37year old female, gravida 4 para 3, presenting with uncontrollable post caesarean haemorrhage for which she underwent subtotal hysterectomy. Histopathological examination revealed Placental site trophoblastic tumour. Placent al site trophoblastic tumour, being a rare entity, pose difficulties in its early diagnosis. Delayed diagnosis can lead to distant metastases, thus worsening the prognosis.
ABSTRACT
Background:Accurate diagnosis and widespread use of diagnostic tests with easy accessis important to contain the spread of SARS-CoV-2. A Real-time reverse transcription polymerase chain reaction (RT-PCR) has high cost and can be performed in special laboratories. There have been several easy to perform rapid antigen detection tests developed and recommended to use at point of care for timely detection of positive patients and their isolation to limit the spread of infection. The aim of the study was to compare the cost effectiveness and the role of RT-PCR and rapid antigen testing in diagnosing different suspects of COVID-19.Methods:In this cross-sectional study the data of all the suspected cases who underwent COVID-19 testing over a period of seven weeks at divisional level was used for analysis.Results:The widespread use of rapid antigen testing makes it more cost effective in detecting COVID-19 cases than the highly sensitive and specific RT-PCR testing. Conclusions:Rapid antigen tests can be used as a screening testing tool in high-risk groups to identify the infected persons quickly and for preventing the transmission of infection particularly in low resource settings.
ABSTRACT
Aim of the present study was to assess physical activity, nutrition and psychological status of the population during lockdown due to covid-19. Online survey was conductedamong 534 participants within the age range of 16-78 years using convenient sampling. Participantsfrom varied regions within India and abroad were enrolled for the present study. Volunteered participants were solicited to take part in a survey that has to be carried out by filling an online questionnaire form available to them as a URL link in the invitation through WhatsApp/Messenger. The gathered data has been compiled, coded and cleaned using Microsoft Excel. Analysis has been carried out employing descriptive and inferential statistics in SPSS 17.0.Majority of participants in the studied population showed significant change in their nutrition and physical activity status due to lockdown. Covid-19 lockdown did limit their daily activities. It also had impacted their psychological status.The current investigation accentuates the need to pursue suitable life style for the maintenance of optimum metabolism and physiology. Sticking to more regular timetable of meals, effective management of stress levels and continued physical activity during the quarantine and in all the following phases of living is desirable.
Subject(s)
Male , Female , Adolescent , Adult , Middle Aged , Aged , Exercise/psychology , Quarantine/psychology , Mental Health , Feeding Behavior/psychology , COVID-19/epidemiology , Sleep , Social Behavior , Pandemics/prevention & control , Diet, Healthy/psychology , Interpersonal Relations , Life StyleABSTRACT
Pathologists have been using their tool of trade, “the microscope,” since the early 17th century, but now diagnostic pathology or tissue-based diagnosis is characterized by its high specificity and sensitivity. Technological telecommunication advances have revolutionized the face of medicine, and in pursuit of better health-care delivery, telepathology has emerged. Telepathology is the practice of diagnostic pathology performed at a distance, with images viewed on a video monitor rather than directly through the (light) microscope. This article aims to provide an overview of the field, including specific applications, practice, benefits, limitations, regulatory issues, latest advances, and a perspective on the current status of telepathology in Indian scenario based on literature review.
ABSTRACT
Background:Practice of hand washing is very important to eliminate the microbial contamination especially during the work in laboratories, hospital and even at home before taking food. Proper use of hand sanitizer can significantly reduce the rate of hospital acquired infection also. Methods:The current investigation was designated to identify different bacterial species from the upper skin of hands of the laboratory managements through conventional culture methodsand the efficacy of the samples (Dettol, Purell and Savlon) against the isolated bacteria throughagar well diffusion method and minimum inhibitory concentration (MIC)Results:Different concentrationssuch as 25%, 50% and100% of eachof antimicrobial agentsshowed their antibacterial activity againstStaphylococcus spp., Klebsiellaspp.,E. coliand Pseudomonasspp. those were isolated from the hand.25% of Dettolexhibited 20mm zone diameter against Klebsiellaspp. Whereas 25% of Purell and Savlon unveiled 15mm and 22mm zone of inhibition against E. coliand Pseudomonasspp. respectively. In case of 100% sample of Dettol, Purelland Savlon, the highest zone diameter was observedas 55mm, 50mm and45mm against Klebsiellaspp.,Staphylococcus spp., and E. coliconsecutively. The MIC of Dettol sample was 8μl against Staphylococcus spp., and Pseudomonasspp.In case of Purell, the MIC was 128μl againstStaphylococcusspp., Klebsiellaspp. and Pseudomonas spp. were inhibited at 4μl samples.Conclusions:The in-vitro antibacterial activity of the hand sanitizers was so satisfactory against the isolated bacteria. This finding would be very helpful for the laboratory management in order to minimize the rate of contamination during the research and supervision of the different experiment.
ABSTRACT
Background: Non communicable diseases have taken over previously life threatening infections in the demographic transition. As the burden of NCDs including diabetes is increasing at an alarming rate the complications related to these diseases are also increasing leading to huge morbidity. Likewise, blindness/ visual impairment due to diabetic retinopathy is now slowly and steadily replacing refractive errors and cataracts as a cause of morbidity.Methods: This cross sectional study was carried over a period of one year in an ophthalmic unit of a tertiary health care institute in which known diabetic patients were screened for diabetic retinopathy besides various modifiable and non-modifiable risk factors.Results: Overall prevalence of diabetic retinopathy in our study population was found to be 29.0%. Among various risk factors duration of diabetes, hypertension, HbA1C >6.5% and serum creatinine >1.1 mg/dl were found to be significantly associated with diabetic retinopathy.Conclusion: Regular screening for diabetic retinopathy besides prevention and strict control of risk factors is key to prevention and progression of blindness/ visual impairment due to diabetic retinopathy.
ABSTRACT
Background: Procalcitonin in cerebrospinal fluid has been evaluated with regard to its usefulness in distinguishing between the possible causative organisms for infections. CSF PCT as a diagnostic marker has also been evaluated for differentiating bacterial from viral meningitis with conflicting results obtained so far. The current study was designed to see the role of procalcitonin as diagnostic marker and in differentiating bacterial from aseptic meningitis in pediatric age group.Methods: Children from 5 months to 15 years of age who were suspected cases of meningitis and were admitted to Pediatric Department in SKIMS Srinagar, Jammu and Kashmir were included in this case control prospective study conducted from 2014 to 2016. The total number of 200 children participated in the study among which 100 were cases and 100 controls. Serum and CSF PCT was measured by a fluorescence immunoassay using QDX Instacheck with a detection limit of 0.25-100 ng/ml. Data was analyzed by using standard statistical tests using SPSS 20.Results: The mean CSF PCT in ng/ml in our study for viral meningitis was 0.59'0.43 (range=0.00-1.90), for bacterial meningitis 4.92'1.50 (range=2.89-10.82) and for controls 0.22'0.11 (range=0.00-0.32), respectively. CSF PCT was significantly higher in viral and bacterial meningitis as compared to controls (p<0.01) and significantly higher in bacterial meningitis as compared to viral meningitis (p<0.01). An AUC of 1.000 was established using serum and CSF PCT for bacterial meningitis. The diagnostic accuracy of serum and CSF PCT was almost 100% at cut-off of 2.2 ng/ml and 2.89 ng/ml, respectively.Conclusions: Author have concluded that CSF PCT can be used as a diagnostic marker with better results in differentiation of bacterial from aseptic meningitis.
ABSTRACT
Background: Spindle cell lesions of gastro-intestinal tract (GIT) are relatively uncommon tumours compared to epithelial tumours. The anatomic location of spindle cell tumour is important, whether the tumour is located in mucosa, submucosa or muscularis propria.Methods: Authors endeavoured to study the histopathological spectrum of spindle cell lesions for a period of one year from January 2018 to December 2018 in our hospital.Results: This was a prospective study of 1 year starting from January 2018 to December 2018. A total of 30 cases of spindle cell lesions of gastrointestinal tract were seen. Out of 30 cases 23 were gastrointestinal stromal tumours (GIST), 2 cases were schwannomas, 2 cases were of leiomyomas, 1 case was fibromatosis, 1 case was inflammatory fibroid polyp, and one case was inflammatory myofibroblast tumour.Conclusion: GISTs are the commonest spindle cell tumours of GIT. Besides GIST, there are other spindle cell tumours which range from benign to malignant, and need to be differentiated from GIST for proper management
ABSTRACT
Background:The skin is the largest organ of the body, comprising of epidermis, dermis and hypodermis. Thus, a wide range of diseases can develop from the skin ranging from infectious diseases to malignancy, some of which may present as non-healing ulcers. Skin biopsy forms the fundamental basis for differentiation of similar looking lesions, thus helping the pathologists to make a definitive diagnosis and more so to the clinician for better management of patients. The objective was to study the histopathological spectrum of chronic non healing ulcers of skin for proper management and treatment.Methods:This was a hospital-based study which was conducted in SKIMS,Soura, a tertiary care hospital of Kashmir valley for a period of 1year extending from January 2018 to December 2018. All the patients who presented with the complaint of non-healing ulcer for more than 4 to 6 weeks were subjected to skin biopsy and histopathological examination.Results:A total of 260 biopsies were examined. Out of 260 patients 146 were males and 114 were females. Ninety out of 260cases (34.61%) and 170 (65.39%) were diagnosed as malignant and benign ulcers respectively.Diabetic ulcer was the second most common cause ofnon-healing ulcers followed by bacterial infections and tuberculosis. Squamous cell carcinoma was the most common neoplastic pathology. Conclusions: It was concluded from the study that non-healing skin ulcers can be encountered at any age in daily medical practice
ABSTRACT
Background: Conventional TBNA has been used in the evaluation of intrathoracic lymphadenopathy with varied success rates depending upon size, site and aetiology of the node. Although mediastinoscopy has higher successes but it comes at the cost of general anaesthesia, more complications and limited access to the inferior and posterior mediastinum. Endobronchial ultrasound guided transbronchial needle aspiration has the advantage of real time nodal sampling with good success rates and minimal complications. The aim of our study was to assess the diagnostic yield and safety of EBUS TBNA in the evaluation of intrathoracic lymphadenopathy.Methods: This prospective observational study was conducted at government chest diseases hospital Srinagar over a period of two years from January 2016-December 2018 on 100 consecutive patients who underwent EBUS TBNA procedure for evaluation mediastinal and hilar lymphadenopathy. The data was collected and analysed for diagnostic yield and safety profile.Results: Out of the 100 subjects included in the study 52% were males and 48% were females. Mean age of the study population was 48.5±16.65 years. Most of the nodes sampled were subcarinal in location followed by paratracheal and hilar group. Granulomatous pathology (tuberculosis and sarcoidosis) was present in 41 patients followed by malignancy in 39 patients. Anthracosis was the cause of lymphadenopathy in 4 of the patients. There were no major complications in our study.Conclusions: EBUS TBNA is an effective and safe procedure for evaluation of mediastinal and hilar lymphadenopathy.
ABSTRACT
Background: Medical thoracoscopy or pleuroscopy, in recent past has received lot of interest for diagnostic as well as therapeutic purposes. In the evaluation of undiagnosed pleural effusion, it has become a key diagnostic modality as it is a cost effective and safe procedure. The aim of present study was to assess the diagnostic yield of medical thoracoscopy in patients with undiagnosed exudative pleural effusion.Methods: This prospective study was conducted at government chest diseases hospital Srinagar between December 2016 to June 2018. One hundred and twenty-five (125) patients who fulfilled inclusion criteria were included in this study. Thoracoscopy was done using rigid thoracoscope under local anesthesia. Thoracoscopic and histopathological data of enrolled patients was collected prospectively and analysed.Results: Patients enrolled in the study were in the age range of 17 to 82 years and consisted of 80 males and 45 females. Most common thoracoscopic finding was multiple variable sized nodules (53.6%) followed by sago grain infiltration (15.2%). Malignancy was the most common histopathological diagnosis (60.8%) with metastatic adenocarcinoma being the most common histopathological diagnosis (50%). The overall diagnostic yield of thoracoscopy was 90.4%.Conclusions: Medical thoracoscopy is a safe procedure with excellent diagnostic yield for evaluation of undiagnosed pleural effusion with minimal complication rates.
ABSTRACT
Background:Radiological determination of gender relies predominantly on the skeletal radiology and assumes importance in mass natural disasters, bomb explosions, exhumations and warfare where skeletal fragmentation is common. Varied literature is present regarding the role of foramen magnum in establishing gender identification.The objective of the study wasto establish normative values of cross-sectional area of foramen magnum in both genders using NCCT and try to ascertain any significant difference in cross-sectional area in the two genders which may help in gender identification.Methods:NCCT head images of 378 subjects were analysed in individuals beyond the age of skeletal immaturity. Free ROI technique using electronic calliper tool was used. The cross-sectional area of foramen magnum was automatically obtained after tracing its whole inner circumference.Results:Mean cross-sectional area of foramen magnum in females was 806.79±106.58 mm2and was 878.33±98.42 mm2in males. Although the cross-sectional area in males was greater than females no statistically significant difference was found. The correlation coefficient was found to be weaker (R=0.0413). Conclusions: No statistically significant difference was found between the two genders. The correlation coefficient was also weak to draw any inference about the gender of the skull on CT imaging. Further studies are needed to include other parameters like the sagittal and transverse diameters of foramen magnum in a larger sample to show importance of foramen magnum, if any, in helping gender identification of skeletal remains
ABSTRACT
The mint oil obtained from Mentha arvensis L. is an important ingredient of ointments, pain balms, lozenges, syrups and various cosmetic preparations. Using half sib progeny selection method, CSIR-CIMAP, Lucknow, India has developed a new chemotype (MAC/BS-11) of Mentha arvensis. Essential oil extracted from the aerial shoots of this chemotype (MaP) is rich in pulegone. Here, we conducted a blind pharmacological study using MaP to evaluate its therapeutic profile against skin inflammation using in vivo and in silico assays. Results of this study conclude that MaP significantly (P <0.05) reduced the skin thickness, ear weight and pro-inflammatory cytokines production in 12-O-tetradecanoylphorbol-13-acetate (TPA)-induced mouse ear inflammation model. In vivo toxicity profiles indicate that it is safe for topical application on skin. Molecular docking study also revealed its strong binding affinity to the active site of the pro-inflammatory proteins. These findings suggest that MaP, a pulegone rich essential oil of Mentha arvensis, could be a potential therapeutic candidate for the treatment of skin inflammation.
ABSTRACT
Background: Characterisation of pancreatic cystic lesions has a direct role in their management and computed tomography is the mainstay of investigation for diagnosing and characterising them. Objectives: The aim of this study was to prospectively assess the diagnostic accuracy of contrast-enhanced computed tomography (CECT) in preoperative characterisation of pancreatic cystic lesions with histopathology as the reference standard. Method: A total of 38 patients with cystic pancreatic lesions diagnosed after clinical, laboratory and sonographic evaluation, irrespective of age, were preoperatively evaluated with CECT. Images were reviewed for the general characteristics of the lesions on pre-contrast and portal venous phase images and overall diagnostic accuracy calculated. Imaging findings were compared with histopathology, or cytology and/or intra-operative findings. Results: Serous cystadenoma (SCA) was the most common cystic pancreatic lesion found in 31.6% of patients followed by mucinous cystadenoma (MCA) (26.3%), solid pseudo-papillary tumour (SPT) (21.1%) and intra-ductal papillary mucinous neoplasm (IPMN) (10.5%). Three patients (7.9%) had simple cysts and one patient (2.6%) had a lymphangioma. The diagnostic accuracy of CECT for pancreatic cystic lesions was found to be 72.5%. Conclusion: The diagnostic accuracy of computed tomography (CT) was high for SCA, IPMN and pancreatic cysts, and low for MCA and SPT. Combination of a multiloculated cystic lesion with locule size of less than 20 mm, septal enhancement with relative lack of wall enhancement, central scar and lobulated outline are highly specific for SCA. Unilocular or macro-cystic pattern with locule size of more than 20 mm, female gender and wall enhancement with smooth external contour are pointers towards MCA. Solid cystic pancreatic head lesions in young females may be suggestive of SPT. A dilated main pancreatic duct in a cystic lesion with internal septations may point towards IPMN. Fluid attenuation lesions with imperceptible non-enhancing wall indicate pancreatic cysts. Lastly, pseudocysts and neuroendocrine tumours with cystic components are great mimickers of pancreatic cystic lesions, and a history of pancreatitis and hormonal profile of patients should always be sought
Subject(s)
Cystadenoma, Mucinous , Cystadenoma, Serous , PatientsABSTRACT
Aim: There were delays reported by patients in chemotherapy administration in daycare oncology. Therefore, we decided to audit all processes which are involved in chemotherapy administration. The objective was to improve our service by decreasing the time between admission and initiation of chemotherapy and identify the reasons for delays. Materials and Methods: The audit was conducted in three parts. In Review I, audit tool was developed and information documented of 109 patients receiving chemotherapy at daycare center from April 14 to May 13, 2015. Five processes were assessed out of which delay in initial assessment by the nurse was the only factor identified leading to delay in chemotherapy. Review II was done from March 1 to 31, 2016 of 208 patients after increasing the number of nurses and Review III from June 7 to August 25, 2016 of 287 patients by dividing the initial assessment process at two different areas to decrease delay in initial assessment. Results: Seventy-two percent of patients had their initial assessment done within 15 min of arrival in daycare in the first audit. In the second part of audit this percentage decreased to 55%, and finally, in the third part of the audit, percentage was improved and increased to 75% after separating initial assessment process into two areas (P < 0.001, Kruskal–Wallis test). Conclusion: After separating initial assessment process into two different areas, delays in chemotherapy administration were reduced.
ABSTRACT
Pathologic increase in portal pressure can be caused by increased resistance to blood flow at the level of the portal vein (pre-hepatic), hepatic sinusoids (hepatic) or hepatovenous outflow (post-hepatic). This results in recruitment and dilatation of tiny portosystemic collateral pathways, diverting portal venous blood flow to low pressure systemic veins. Based on the location of the causative factor of portal venous resistance, different collateral pathways and shunts may develop, resulting in unique syndromes of portal hypertension and in-turn requiring unique treatment options. Knowledge of the common and less-common portosystemic collateral pathways have important implication for clinicians and interventionalists. The objective of this pictorial review is to illustrate the various collateral pathways using diagrammatic and conventional non-invasive and invasive radiologic examples. Additionally, we will briefly address minimally invasive interventional techniques used to treat the sequelae of portal hypertension.
Subject(s)
Dilatation , Hypertension, Portal , Portal Pressure , Portal Vein , Radiology, Interventional , Varicose Veins , VeinsABSTRACT
Primary central nervous system lymphoma is a well-known entity. However, the hypothalamus is a rare location, especially in adults. Few cases of secondary lymphomas have been reported. We report a case of primary hypothalamic lymphoma in an adult male with normal pituitary functions. Lymphoma should be considered as one of the differential diagnosis of lesions involving the hypothalamic/third ventricular area
ABSTRACT
Objective: The purpose of this study is to assess the efficacy of Transient Evoked Otoacoustic Emission [TEOAE] as screening test for auditory function in neonates
Study Design: A cross-sectional study
Place and Duration of Study: This study was conducted at United Medical and Dental College, Creek General Hospital, Karachi, from July 2106 to May 2017. A total number of 120 newborn babies were screened for hearing loss before discharge from hospital but 20 were lost for follow up and 100 cases were included in this study
Method: TEOAE was done in all neonates born during this period at 3rd day after birth. Those who were found to have hearing loss, TEOAE was repeated at the end of 1st week and again in 6th week after birth. BERA was done in those cases who showed hearing loss on TEOAE on all three occasions. All the 100 cases were followed up regularly for more than one year for appearance of any sign or symptom related with hearing loss or speech development failure
Result: Out of 100 cases included in this study, 96 were found to have no hearing loss on TEOAE and 1 on BERA test. Remaining three cases were found to have hearing loss on both TEOAE and BERA test. True negative cases where no hearing loss was found on TEOAE and subsequent follow up were 96. True positive cases were 3 where hearing loss was found on TEOAE and BERA and also on subsequent follow-up. False positive case was 1, where hearing loss was detected on TEOAE but BERA showed normal hearing and subsequent follow-up also showed normal hearing and false negative result was not detected in any case. Sensitivity of TEOAE was found to be 100%, specificity is 98.9%, accuracy is 99%, positive predictive value is 75% and negative predictive value is 100% in this study
Conclusion: TEOAE was found to be a cost-effective and practicable method of recognizing congenital hearing loss. It should be done in all newborns as routine screening for hearing loss
ABSTRACT
Malaria is a major health problem in India. In cases of fever with thrombocytopenia, malaria should be on top of the differential diagnosis. This was a study of admitted patients in medical wards of Bhaskara Medical Colleges, Hyderabad who were diagnosed with malaria and they were assessed for thrombocytopenia using automated quantitative D3 analyser. The data were analysed using SPSS version 16.0. Viral haemorrhagic fevers can also be presented as fever with high haematocrit and leucopenia along with thrombocytopenia. In our study, the commonest cause of thrombocytopenia in malaria was vivax malaria.