Diagnostic value of fine needle aspiration biopsy of palpable colonic masses.

OBJECTIVE: To assess the role of fine needle aspiration biopsy (FNAB) in patients with palpable colonic masses. STUDY DESIGN: FNAB was performed on 32 patients with palpable colonic masses before subjecting them to colonoscopic examination. Smears prepared from the material obtained by aspiration biopsy were examined. The results of aspiration biopsy were confirmed by histopathologic examination of the tissue obtained on colonoscopy or surgery or by a salutory response to antituberculous therapy in patients with tuberculosis of the colon. RESULTS: Twenty-nine patients had carcinoma of the colon, and three had ileocecal tuberculosis. Aspiration biopsy could correctly diagnose all the cases with malignancy and two of the three cases with colonic tuberculosis. Colonoscopy could not be performed on two patients with cancer of the colon. However, a barium enema examination revealed evidence of cecal malignancy in both patients. In the two patients diagnosed as having colonic tuberculosis by FNAB, colonoscopic biopsies revealed only nonspecific changes. There were no false positive results or complications of the procedure. CONCLUSION: FNAB is a simple, rapid and accurate method of diagnosing palpable colonic masses.

Oesophageal subepithelial fibrosis: an extension of oral submucosal fibrosis.

Fifty-five patients with oral submucosal fibrosis and an equal number of patients with no evidence of the disease were studied. All patients underwent upper gastrointestinal endoscopy and any abnormality was noted. Multiple oesophageal biopsies were obtained from the upper end of the oesophagus and from any endoscopically observed abnormality. The histological changes in the two groups were assessed blindly by an experienced histopathologist. Histological abnormalities were noted in the oesophageal mucosa in 2% of controls and 66% of patients with oral submucosal fibrosis (p < 0.0001). In the control group, acanthosis was seen in one patient, while in the patient group atrophy of the squamous epithelium was evident in 52%, hyperkeratosis in 52%, parakeratosis in 30%, dyskeratosis in 14%, acanthosis in 14%, and papillomatosis and mild dysplasia in 2% patients. Subepithelial collagenization was seen in 32 (64%) patients. The oesophageal abnormalities were seen more frequently in patients who had consumed Pan masala, Gutka, betel nut, tobacco or a combination of some or all of these, with or without betel leaf, for > or = 5 years compared to those consuming them for a shorter period of time (91% vs 46%, p < 0.001). It is concluded that oral submucosal fibrosis is not a disease confined to the oral cavity; the oesophagus may also be involved in about two-thirds of patients.

Ayurvedic concept of food in pregnancy.

Food is given great importance in Ayurveda. Dietetics is a pre-requisite to leading a healthy life. The author outlines the significance of this point in the article.