Skin Adnexal Tumors - A Histopathological Spectrum at a Tertiary Care Hospital

Aims:Skin adnexal tumors (SAT) are large and diverse group of benign and malignant tumors which exhibit morphological differentiation towards one of the different types of adnexal epithelia present in normal skin: pilosebaceous unit, eccrine and apocrine. The aim of this study was to recognize various histopathology of skin adnexal tumors, their frequency, age and site distribution. Methods:It was a study of 50 cases of skin adnexal tumors, diagnosed on histopathological examination over a period of 2 years (July 2015 to June 2017) in the Pathology Department, B.J. Medical college, Ahmedabad. Histopathological examination was done on Formalin fixed, Paraffin embedded tissue sections stained with H&E. Special stains like PAS stain and Reticulin were also used, wherever required. Results:Skin adnexal tumors were most common in the age group of 31 to 40 years (38%, 19/50). Male to female ratio was 1:1.27. The head and neck region was the most common site affected (60%) with 32% cases located on the face. 98% cases were benign and only a single case (2%) was malignant. The sweat gland tumors formed the largest group involving 70% of cases. Nodular hidradenoma was the most common benign tumor. Sebaceous carcinoma was the only malignant adnexal tumor reported in our study. Conclusion: Skin adnexal tumors are relatively rare. Benign adnexal tumors are far more common than their malignant counterparts. Face is the commonest site for occurrence of SATs. Nodular hidradenoma is the most frequently encountered tumor among all SATs.

Knowledge Of Cervical Cancer And Pap Smear Among Indian Women.

Introduction: Cancer of the uterine cervix is an important cause of morbidity and mortality among women worldwide and a leading public health problem. Currently cervical cancer is potentially curable, but still continues to be the second most frequent cause of death by neoplasia in women and the survival rate in 5 years varies from 44 to 66%. Method: This study was carried out during the period of January 2012 to June 2012in one of the tertiary care teaching hospital. In depth interview of 100 women were taken before and after awareness program in the form of lecture on cervical cancer- the occurrence and prevention. The data before and after were compared and analyzed. Results: most of the patients are in 4th decade of life (59 %). The educational level of respondents ranged from primary to tertiary level. Only a few patients (20 %) were aware that early detection and treatment regarding cervical cancer. Risk factors for cervical cancer were known by less than 35 % of the patients. Only 8 % of the respondents had heard of HPV or knew about its association with cervical cancer. Twenty-seven patients asserted that they had knowledge of the Pap smear test. Conclusion: By improving their knowledge and awareness regarding cervical cancer, we are able to reduce the incidence. [Parikh U NJIRM 2016; 7(5):60-63]

Sample rejection as a quality indicator for continual improvement of laboratory services, tertiary care hospital.

Background: Quality in the health care institutions is multifaceted & multidimensional with its core element as the customer’s satisfaction. Improvement in the health care services is a long drawn relentless process which can be achieved by implementing a carefully planned Quality Management System. Laboratory services B.J. Medical College & Civil Hospital Ahmedabad, has set its Quality indicators and is monitoring it as a part of continual improvement. One of the Quality indicators is Sample rejection. The laboratory aims to reduce the sample rejections by complying with the standards & recommended guidelines. Methods: This is to monitor & analyze the Sample Rejections as a Quality Indicator for Continual improvement of the Microbiology Department. Primary data collection done before training & secondary data collection done after the training of nursing staff & Resident Doctors. Results: The sample rejection rate of the Microbiology Laboratory in the month of July 2010 was 0.31%. After the training of the nursing staff as well as resident doctors regarding proper collection & transport of samples based on scientific principles, a decreasing trend in the sample rejection rate is observed. i. e. from .31% to 0.11 % in the 13 months duration of study.Conclusion: The implementation of a systematic error-tracking system i.e. monitoring the sample rejections, analysing its trend, taking preventive & corrective actions to reduce the sample rejection rate in daily practice definitely improves the quality of the laboratory results and is a quality indicator for continual improvement of the laboratory.

Accuracy of fine needle aspiration cytology in diagnosis of thyroid swelling.

Fine needle aspiration cytology is a well established, safe and out patient procedure used in diagnosis of thyroid swelling. Aims: The aim of this study is to determine the accuracy of FNAC in detection of thyroid lesions at our institute. Material and methods: 100 cases of thyroid swelling were diagnosed and treated at M.P.Shah medical college, Jamnagar from Jan1997 to May 1998. FNAC results were compared with final histopathological diagnosis. FNA results were classified as inadequate material, non-neoplastic, neoplastic and malignant lesions. Results: FNA analysis showed 74.19%(69 cases) non-neoplastic lesion, 19.35%(18cases) neoplastic lesion and 6.45%(6cases) malignant lesion. Histopathological analysis showed 70.18%(40) non-neoplastic lesion and 29.83%(17) neoplastic lesion – 15.79%(9) adenomas and 14.04%(8) carcinomas. Conclusions: The accuracy rate of FNAC in diagnosis for non-neoplastic, neoplastic and malignant lesions were 90.91%,100% and 100% espectively. So, overall accuracy of FNA in present study was 92.98%.

Changing spectrum of complications in plasmodium vivax malaria.

Aims: To study the incidence and outcome of complications in Plasmodium vivax. Material and methods: An analysis of smear positive Plasmodium vivax patients admitted to Civil Hospital, Ahmedabad from July2007 to September 2007 was done. Results: There were 118 cases of malaria: Plasmodium vivax only in 23 cases (19.4%), 1 was mixed infection and 94 were Plasmodium falciparum only. Out of the 23 vivax cases , thrombocytopenia was seen in 22 cases (95.6%), hepatitis and jaundice seen in 7 cases (30.4%), and acute renal failure in 5 (21.7%). Death occurred in 2 (8.6%) and 20 (86.9%) patients recovered. The study included 19 adult patients and 4 pediatric cases. Conclusions: Plasmodium vivax can cause thrombocytopenia , jaundice, acute renal failure all of which occurs more commonly in Plasmodium falciparum. The study intends to highlight that Plasmodium vivax can also cause grave systemic complications but prognosis is favorable if early referral and timely supportive treatment is given.