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Introduction: Conventional oral squamous cell carcinoma (OSCC) is relatively easy to diagnose on histopathology, as it comprises dysplastic epithelial cells with variable degrees of squamous differentiation. Different grading systems have been employed in grading OSCC based on its dysplastic features and host response. Some unusual features such as clear cell change, epithelial–mesenchymal transition (EMT), stromal hyalinization, stromal desmoplasia, perineural invasion, vascular invasion, tissue eosinophilia, giant cells, and tertiary lymphoid follicle formation are evident in OSCC histologically but have not yet been accounted in any grading systems of OSCC except perineural and vascular invasion. Aim: The aim of the present study was to identify these uncommon features and to correlate them with different grades of OSCC. Materials and Methods:This study was conducted on 100 histopathologically confirmed OSCC cases retrieved from the archives of our department. They were graded on the basis of Broder's grading system and were reviewed for the features mentioned above. Data collected were subjected to statistical analysis. Results: Clear cell change, EMT, foreign body giant cells, and tumor giant cells were observed in 13%, 20%, 1%, and 3% of cases, respectively. We found stromal desmoplasia in 15% and stromal hyalinization in 9% of cases. Tissue eosinophilia, tertiary lymphoid follicle formation, and perineural invasion were observed in 12%, 3%, and 2% of cases, respectively. Vascular invasion was not evident in any of the cases examined. Conclusion: The incidence of the unusual features was 7.8% in our study.
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Background: The objective of the present study was to study the effect of stress on hypertension in various professional groups.Methods: A cross sectional study was done from 1st August 2015 to 30th August 2017 in district Bareilly. A predesigned and pretested questionnaire was used comprising of demographic data and stress. Three types of professionals were included in this study: doctors, managerial staff and school teachers from the teaching institutions.Results: This study showed association of hypertension with stress level and found that 24.62% doctors, 72.31% school teachers and 27.69% managerial staff were hypertensive with mild stress level. Among all study subjects 41.54% were hypertensive with mild stress level. 15.38% doctors, 10.77% school teachers and 46.92% managerial staff were hypertensive with moderate stress level. Among all study subjects 24.36% were hypertensive with moderate stress level. 46.15% doctors, 0.76% school teachers and 8.46% managerial staff were hypertensive with severe stress level. Among all study subjects 18.46% were hypertensive with severe stress level. Chi-square test for association was applied and p-value was found significant for doctors, managerial staff and insignificant in school teachers. Among all study subjects p value 0.016 was found significant.Conclusions: The present study showed highly significant association for hypertension with stress level among doctors and managerial staff with p value (0.005) and (0.001).
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Background: Intrauterine contraceptive device is a long acting, effective and reversible method of contraception. It can be inserted post placental during vaginal or LSCS delivery and within 48 hours of delivery. This study evaluates the acceptance, safety, side effects and complications associated with immediate post-partum intrauterine contraceptive device (PPIUCD) insertion.Methods: The study was conducted at Hindu Rao Hospital and NDMC Medical College, Delhi for a period of 18 months. Patients admitted and delivered at Hindu Rao Hospital were counseled for PPIUCD, CuT 380 A / CuT 375 insertions and it was inserted within 10 minutes of delivery of placenta during vaginal delivery or LSCS or within 48 hours of delivery. Patients were followed at 6 weeks and then between 6 to 12 months of delivery for continuation, side effects or any complications.Results: After counseling 1253 (9.8%) patients agreed for PPIUCD insertion out of which 650 patients came for follow up. 46% women came for routine follow up while 54.06% came with one or the other complications. Missed thread was most common complications, followed by bleeding P/V and pain abdomen. Expulsion in 5.5% and CuT failure was seen in 0.92% women only. Removal of IUCD was done in 94 patients for one or other reasons. There was retention of PPIUCD in 84.5% while removal was done in 14.5% during period of 6 months to one year follow up. Missed thread was main cause of anxiety among acceptors.Conclusions: Immediate PPIUCD is safe and effective method of contraception with a high retention rate. Though acceptance in initial months was less but it gradually increased over time with increasing awareness, counseling of patients and training of health personnel.
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Thanatophoric Dysplasia (TD) is a congenital, sporadic and most lethal skeletal dysplasia caused by new mutation in FGFR3 gene. Authors report such a rare case of a term alive baby with dysmorphic features, born to an unbooked, 40 years old G4P3+0 with non-consanguineous marriage; admitted at 9 months of gestation to present hospital with complain of pain abdomen for 2 days. Patient delivered a term female baby of vaginally which had delayed cry after birth, Admitted in NICU immediately with respiratory distress. The baby looked dysmorphic and suggested TD as most likely diagnosis. The case is being reported for its rarity and for high importance of early booking and anomaly scan. Early diagnosis is important since it provides alternative options of termination of pregnancy when an affected foetus is detected.
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Cancer of the cervix, is second most frequent cancer among the Indian women. To bring down the burden of cancer, in addition to opportunistic cervical cytology along with Mass screening programs, it is imperative to involve nursing staff & paramedical personnel in educating the masses. This cross sectional study describes findings of a pilot screening program, undertaken among nursing staff of a tertiary care hospital. It was found that even among the educated nursing staff there is low level of awareness for usage of pap testing. Cervical cytology revealed wide variety of inflammatory lesions. With the low doctor to population, involvement of the nursing personnel for Periodical cytological screening for prevention of cervical cancer would go a long way in early detection of various cervical abnormalities and increasing awareness among them.
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Background: Febrile nonhemolytic transfusion reactions (FNHTRs) are common complications associated with allogenic transfusion and it is caused by the leucocytes and cytokines released by leucocytes during storage of blood/ blood components. These reactions are generally not life threatening, but they are expensive in their management, evaluation, and associated blood-product wastage. 1st log prestorage universal leukoreduction (ULR) i.e. removal of Buffy coat is a useful and effective procedure in developing countries to control FNHTRs significantly. Aims and Objects: To know the efficacy of pre-storage 1st log universal leuckoreduction in controlling febrile nonhemolytic transfusion reactions (FNHTRs). Place and Duration of Study: Study was carried out at Blood Bank, Department of Pathology, G. R. Medical College, Gwalior from January 2009 to December 2013 (5years). Materials and Methods: Study was divided into control group (Year: 2009) and study group (Years: 2010-13). 14,292 recipients in control group and 45,064 in study group were transfused with non-leukoreduced and prestorage 1st log leukoreduced blood/ blood components respectively. Usefulness of prestorage 1st log ULR over non-leukoreduced blood/ blood components was observed, compared and discussed. Result: In the control group 610 (4.26%) out of 14,292 (p=0.0003) and in study group 381(0.84%) out of 45,064 (p=0.0003) recipients were reported to have FNHTRs. The comparative study showed significant reduction in FNHTRs from 4.26% to 0.84% (↓ 3.42%) (p=0.000001). Conclusion: 1st log Universal Leukoreduction (ULR) is a better option over Selective Leukoreduction (SLR) to prevent FNHTRs and it also helps the transfusion services of under-resourced developing countries in many ways.
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Introduction: Transfusion Transmitted Infections (TTIs) are a major problem associated with blood transfusion. Accurate estimates of risk of TTIs are essential for monitoring the safety of blood supply and evaluating the efficacy of currently employed screening procedures. Aims: To determine the prevalence of transfusion transmitted infections among blood donors in greater Gwalior region and its surrounding areas i.e. central India and its comparison with other relevant studies. Place and Duration of Study: Study was carried out at Blood Bank, Department of Pathology, Gajra Raja Medical College, Gwalior, India from January 2009 to December 2013 (5 year study). Methodology: Total 67,123 blood units collected from blood donors were tested for transfusion transmitted infections (TTIs) i.e. HIV I & II, HBV, HCV,VDRL and Malaria parasite at Blood Bank as per guidelines of World Health Organization (WHO) for Asia Pacific region and Food and Drug Administration, Government of India. Results: Out of 67,123 blood units studied, voluntary units were 61309(91.3%) and replacement units were 5823 (8.7%). In the present study total TTIs positive units were 2747 (4.09%) (p=0.000005). Amongst them HBV were 2360 (3.51%) (p=0.000005), HIV positive units were 91(0.13%), HCV were 161 (0.24%), VDRL were 114 (0.17%) and Malaria 21 (0.03%). Conclusion: Our study concluded that amongst all the TTIs in the blood donors in Gwalior and its surrounding area, seroprevalence of HBV was significantly higher than other infections. It is also higher than similar studies conducted in other parts of India.
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Facioscapulo humeral muscular dystrophy (FSHD) is a rare type of myopathy and differs clinically and genetically from Duchenne muscular dystrophy. It is an autosomal dominant disorder and as the name designates it has the characteristic distribution of the weakness. The face is almost always affected. Progression of the disease is slow and symptoms begin in adolescence but signs may be evident in children. We present a case of facioscapulo humeral muscular dystrophy in a 14 year old girl & the case was sporadic in nature.