Independent diagnostic utility of CD20, CD200, CD43 and CD45 in chronic lymphocytic leukaemia.

Immunophenotyping plays a major role and is essential for establishing the diagnosis of chronic lymphocytic leukemia (CLL). Though CLL has a characteristic phenotype, diagnosis may be challenging due to immunophenotypic overlap with other B cell non-Hodgkin's lymphomas (B-NHL). Markers like CD200, CD43, CD20 and CD45 were found valuable in CLL and we investigated their diagnostic efficiency and accuracy in 174 patients with leukemic B-NHL. On the integration of four markers by a scoring system, 96% (49/51) of CLL cases showed a score of 3 or 4 and 90% (36/40) of non-CLL cases had a score of 0 or 1. This scoring system for CLL diagnosis showed a sensitivity of 98.2% and 96% in the analytical cohort and validation cohort respectively, which was significantly higher than the classical Matutes score. Hence we strongly suggest considering the expression of CD200, CD20, CD43 and CD45 in the diagnosis of B-NHL cases.

How Reliable Is Automated Urinalysis in Acute Kidney Injury?

OBJECTIVE: Examination of urine sediment is crucial in acute kidney injury (AKI). In such renal injury, tubular epithelial cells, epithelial cell casts, and dysmorphic red cells may provide clues to etiology. The aim of this study was to compare automated urinalysis findings with manual microscopic analysis in AKI. METHODS: Samples from patients diagnosed with AKI and control patients were included in the study. Red blood cells, white blood cells, renal tubular epithelial cells/small round cells, casts, and pathologic (path) cast counts obtained microscopically and by a UF1000i cytometer were compared by Spearman test. Logistic regression analysis was used to assess the ability to predict AKI from parameters obtained from the UF1000i. RESULTS: There was poor correlation between manual and automated analysis in AKI. None of the parameters could predict AKI using logistic regression analysis. However, the increment in the automated path cast count increased the odds of AKI 93 times. CONCLUSION: Automated urinalysis parameters are poor predictors of AKI, and there is no agreement with manual microscopy.

Collecting duct carcinoma of kidney: Masquerading as genitourinary tuberculosis - Lessons learnt.

We present a case of Collecting duct of Bellini carcinoma (CDC) which was masquerading as Genitourinary Tuberculosis/chronic granulomatous disease in a 43 year old women, who presented with complaints of low grade fever, loss of appetite, left loin pain and dyspnoea with recent onset of haemoptysis. After extensive evaluation, she was referred to urology where she underwent a laparoscopic assisted open left radical nephrectomy which was reported to be Collecting duct carcinoma.This case is being presented for the diagnostic dilemma it elicited throughout the evaluation.

Role of transcutaneous electric nerve stimulation in the management of trigeminal neuralgia.

BACKGROUND: Trigeminal neuralgia typically involves nerves supplying teeth, jaws and face of older females. Though the etiology is usually obscure, different treatment modalities have been tried for it viz. medicinal treatment, injection alcohol, peripheral neurectomy, rhizotomy, and microvascular decompression etc. Transcutaneous electric nerve stimulation (TENS) is an emerging and promising option for management of such patients. AIMS AND DESIGN: The present study was designed with an aim to study the efficacy of TENS in management of trigeminal neuralgia. MATERIALS AND METHODS: The study was conducted on 30 patients of trigeminal neuralgia confirmed by diagnostic nerve block. They were given bursts of TENS for 20-40 days over the path of the affected nerve and subsequently evaluated at 1 month and 3 month intervals by visual analogue scale (VAS), verbal pain scale (VPS), a functional outcome scales for main daily activities like sleep, chewing, talking, or washing face. RESULTS: The results showed that, on VAS, the score decreased from 8.9 (Pre TENS) to 3.1 at 1 month and 1.3 at 3 months, and on VPS, the score decreased from 3.5 (Pre TENS) to 1.2 at 1 month and 0.3 at 3 months. Similarly, a considerable decrease in scores was seen on functional outcome scale for different activities. No side effects like irritation or redness of skin were seen in any of the patients. CONCLUSIONS: Thus, TENS was found to be a safe, easily acceptable, and non-invasive outdoor patient department procedure for management of trigeminal neuralgia.

Infected cementoblastoma.

Cementoblastoma is a relatively uncommon, benign odontogenic neoplasm of jaws. Mandible is affected more than the maxilla. The lesions are generally diagnosed on a routine radiograph. The localized expansion of cortical plates is observed. Radiographically, it consists of well-defined radiopacity with a radiolucent band. Here is a case report of a female aged 55 years having swelling in the right mandibular angle with an extraoral draining sinus. A panoramic radiograph shows a dense radiopaque mass along the roots of the third molar surrounded by a radiolucent band. Surgical excision was carried out and a histopathological examination was carried out which was suggestive of cementoblastoma.

A comparative review of treatment of 80 mandibular angle fracture fixation with miniplates using three different techniques.

Standard treatment of mandibular angle fracture with miniplates according to recommendations of Champy et al. (1976) consists of fixation with one miniplate at superior border of mandible ventral to external oblique line. In certain constellations, second miniplate at lower border may provide additional stability. In this retrospective study 80 patients with mandibular angle fracture were divided into 3 sub-groups reported at DIRDS Faridkot were treated by intraoral, extraoral and combined intraoral and transbuccal approach. There was no significant difference in complication rates encountered with these techniques. Decision regarding treatment approaches for open reduction of mandible fracture often relates to surgeon's experience and training. In some cases, choice is affected by availability of equipment. More difficult cases involving endentulous atrophic mandible or comminution should be considered for extraoral approach. Intraoral open reduction and fixation was used for non-comminuted and non-complicated fractures. The combined transbuccal/Intraoral procedure is now preferred method because of ease of use and facilitation of placement of plate in neutral mid point area of mandible.