Male Genitourinary Tumors : 14 Years Experience in Garhwal Region of India.

Genitourinary tumors may show varied clinical presentation and frequency in different regions of the world. The present study was therefore conducted to analyze the frequency, clinical presentation and the histopathological types of the various male genitourinary tumors diagnosed over a period of 14 years in a major teaching institute of north Himalayan region of India. Material and Methods: Retrospective study was undertaken in the Pathology department of the Institute which included all the cases of male genitourinary tumors which were diagnosed on histopathology from the time period between 1 Jan 1997 till 31st Dec. 2010. Results: The study showed that prostate was the most common site for male genitourinary tumors with prostatic adenocarcinoma as the most common histopathological type of tumor. Testicular Non- Hodgkin’s lymphoma constituted about 8% of total tumors in testes which mostly presented in elderly age group. Renal cell carcinoma (66.2%) was the most common tumor in kidney with much lower frequency of Wilm’s tumor (16.9%). Occasional rare tumors such as hemangioma of urinary bladder and schwannoma of penis were also seen over 14 years. Conclusion: The study concludes clinically patients were associated with more severe symptoms as they presented late to the hospital from the remote areas of this Himalayan region leading to late detection of tumors. Prostatic adenocarcinoma was the most common tumor while renal cell carcinoma was most common tumor in kidney. The present study provides valuable information to clinicians and pathologists regarding frequency, clinical presentation and histopathological types of male genitourinary tumors in this region which can be further used to formulate strategies for better management of these tumors.

Patterns of Glomerulonephritis in Uttarakhand State 13 Years Single Centre Experience at Teaching Institute.

Aims : Glomerular disease is considered to be a common cause of chronic kidney disease and its prevalence and histological pattern differ according to geographical area, race, age in different regions of the world. The present study was therefore conducted to study the pattern of different histological types of glomerulonephritis in this area of Uttarakhand region of India over an extended period of 13 years. Material and Methods : Retrospective study was conducted in the tertiary care centre of Uttarakhand state which included cases of different types of glomerulonephritis diagnosed on histopathology over a period of 13 years. Age, sex, clinical presentation, relevant investigations and the histopathological type of glomerulonephritis were noted for every case. Results : Histopathological examination due to various non-neoplastic renal diseases was done in total 218 cases and out of these glomerular diseases was diagnosed in 178 cases. Proteinurea and edema was the most common presentation. Primary glomerulonephritis was observed in 88.5% cases and secondary in 9.9%. Mesangioprolifrative glomerulonephritis was the most common primary glomerulonephritis and nephropathy due to amyloidosis was the most common type of secondary glomerulonephritis. Conclusion : The study concludes that primary glomerulonephritis is the most common renal disease with mesangioproliferative glomerulonephritis as the most common primary glomerulonephritis and amyloidosis nephropathy as the most common secondary glomerulonephritis which differs from other regions of world. The study may be useful to pathologists, nephrologists and health care providers to formulate a basic platform for effective diagnostic, therapeutic and research base for glomerular diseases so as to prevent its complications.

Megaloblastic anaemia in hospitalised children.

Objective: To study the profile of megaloblastic anaemia in hospitalised children. Study design: Prospective study. Setting: Tertiary care hospital in Uttarakhand. Subjects: 53 children between 6 months and 14 years of age were studied for megaloblastic anaemia. Result: Majority of patients (48.8%) were in the older age group, and only 11% were seen in infancy. Folate and vit B12 deficiency was seen in 55% and 88% cases respectively. 44% had combined deficiency of folate and vitamin B12.11% had pure folate and 44% had pure vitamin B12 deficiency. 66% cases with microcytic blood picture, 70%with dimorphic picture, and 90% of pancytopenia patients on marrow examination had a megaloblastic picture. 60% had malnutrition, and majority belonged to the lower socio-economic strata of society.

Myocardial Infarction Associated with Plasmodium Falciparum Malarial Infection.

Cardiac functions are almost well preserved in malarial infection. We report a rare case with fatal complication of myocardial infarction in patient with delayed diagnosis of Plasmodium falciparum infection. The authors therefore, suggest that every case of fever especially if associated with risk factor for cardiovascular disease should be immediately investigated for malaria so as to prevent this grave complication. This is even more important for people living in malarial endemic areas.

"Effect of short-term cigarette smoking on insulin resistance and lipid profile in asymptomatic adults".

Present study examined the effect of short-term cigarette smoking on insulin resistance and lipid profile in asymptomatic healthy adults. This case control study comprised of 44 healthy male subjects in the age group of 18-40 yrs having BMI 25+3 and WHR < 1.0. Of these 22 smokers were included in the study group and 22 non-smokers in the control group. Subject selection was done such that one smoker and one non-smoker sibling or first degree male relative were selected from the same family. We compared fasting plasma glucose, insulin, lipid profile, and homeostatic model assessment index (HOMA Index) as a measure of insulin resistance between both the groups. Our observation showed that significantly higher values of serum glucose (133.36 +/- 23.45 mg/dl; P < 0.001), serum insulin (32.04 +/- 6.0 2 microU/ml; P < 0.001) and HOMA index (3.62 +/- 0.21; P < 0.001) were found in smokers as compared to non-smokers (serum glucose 86.95 +/- 19.32 mg/dl, insulin 20.09 +/- 4.8 microU/ml, HOMA index 3.29 +/- 0.30). No significant difference was observed for number of subjects having insulin resistance (HI > 3.8) and lipid profile in both the groups. Thus it appears that smokers are prone to develop hyperinsulenemia, hyperglycemia and the metabolic syndrome.