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Background: To study and compare cytomorphological features of histologically proven cases of benign phyllodes and cellular fibroadenoma.Methods: Smears of histologically-proven cases of benign phyllodes and cellular fibroadenoma in one year, were reviewed. The cellular fibroadenoma had epithelial and/or stromal hypercellularity. The stromal and epithelial components as well as the background cells were qualitatively and quantitatively analyzed.Results: Number, cellularity and type of stromal fragments varied significantly in two groups. Higher number, intermediate to large-sized and hypercellular stromal fragments were commonly seen in phyllodes. Hypercellular (3+ cellularity) fragments were seen in 100% cases of phyllodes against 11.1% cases of fibroadenoma. Large-sized stromal fragments were found in 100% of phyllodes while in only 11.1% cases of fibroadenoma. The ratio of number of epithelial to stromal fragments was significantly high (58.5:1) in fibroadenoma against phyllodes (1.3:1). The epithelial architecture, atypia, apocrine metaplasia and presence of cystic macrophages did not very much in the two groups. The cellularity of the dispersed cells in background did not reveal significant difference though the type of cells varied; the proportion of long and short spindle cells was higher in PT group while proportion of oval cells was higher in FA group.Conclusion: The number, cellularity and nature of stromal fragments, ratio of epithelial to stromal fragments, cellularity and type of background cells are helpful in distinguishing benign phyllodes from cellular fibroadenoma. The identification of these features can improve the pickup rate of phyllodes tumor, thereby assisting proper management.
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Background:We present our experience in utilization, manpower and information management with paucity of resources in a large academic medical centre, situated in a most backward, least literate, remote pocket of the Haryana state in India. Methods:1> Electronic and manual database with their analysis. 2> Previous literature.Results:Budget provided is very low, so cost containment is very significant in our BTS (Blood Transfusion Service). Conclusion:The combinations of therapeutic and diagnostic roles necessitate a multi-pronged approach to utilization management in the BTS. This study will be very helpful for organized approach in a newly stabilizing BTSes of remote areas of other developing countries.
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Background: In India, geographical distribution of blood groups and Rhesus (D) factor varies across the country. The aim of this study is to examine the distribution of these groups among voluntary blood donors at a large academic medical centre; SHKM which is situated in a rural, most backward, least literate, remote pocket of south (Mewat-region) Haryana state in India. Methods: A retrospective study was conducted using 5 year data (August 2013–December 2017) from a regional blood bank in rural south (Mewat-region) Haryana of India. Records of 16,121 voluntary blood donors were reviewed. Results: The distribution of ABO blood group was; blood group O (29.69%); blood group A (22.37%); blood group B (37.72%) and blood group AB (10.22%). A significantly higher proportion of Rhesus (D) positive than Rhesus (D) negative in blood group A and AB (respective p-values are .018 and .089). Conclusion: The sequence of ABO distribution among the rural population in south (Mewat- region) Haryana of India is; B > O > A > AB, with males as the predominant donors.
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Background: Blood donors belong to a heterogeneous group of people in society, differing in their demographic characteristics and the psychological factors that motivate their behavior. It is important to analyze the various blood donor characteristics in order to manage blood donor programmes. Blood safety and blood supply are profoundly impacted by method of recruitment, specific health history taking and blood screening.Objective: The present study was conducted to determine the role of various demographic factors lie age, sex and occupation on the seroprevalence of transfusion transmitted infections (TTIs) among the blood donors at a tertiary care hospital in Delhi over a period of 4 years. Methods: A 4 year retrospective study was conducted at the blood bank of a tertiary care hospital. All data were collected from blood bank records and included records of 1347 voluntary and 7451 replacement donors from January 2014 to December 2017. Screening of blood units was done by enzyme-linked immune sorbent assay (ELISA) method for Human Immune Deficiency Virus (HIV), and hepatitis B virus (HBV) and hepatitis C virus (HCV). Syphilis was tested by rapid plasma resin (RPR) card test. Malaria was tested by antigen rapid diagnostic test. Any sample found reactive was retested for confirmation. Results: Total 8798 blood donor’s samples were analyzed. 4.27% were female and 95.73% were male. Among the 8798 blood donors, 128 blood donors were positive, prevalence of TTIs was at 1.45 %. The overall positivity rates of anti-HIV, HBsAg, anti-HCV, anti-TP and MP were 0.19%, 0.80%, 0.40%, 0.06 % and 0.01% respectively. The prevalence of TTIs was 1.47% for male and 1.06 % for female in the donation population, the prevalence of TTI positive donations was highest in age group of 51-60 years. Regarding occupation, farmers showed the highest incidence (3.36%) of TTIs while businessmen (1.16%) ranked as the bottom. Conclusion: Overall prevalence of TTI is more in voluntary blood donors as compared to replacement donors. Women are safer donors as compared to males. The prevalence of TTI positive donations was highest in age group of 51-60 years. Farmers showed the highest incidence (3.36%) of TTIs while businessmen (1.16%) ranked as the bottom
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Osteoma is the most common benign tumor of the paranasal sinuses. Turbinate osteomas are very rare and only five middle turbinate, two inferior turbinate and one superior turbinate osteoma cases have been reported. We present a rare case of osteoma of the left inferior turbinate in a patient presented with unilateral nasal obstruction that was removed endoscopically and conduct a literature review on turbinate osteomas arising from differen t turbinates.
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Background: Fine Needle Aspiration Cytology (FNAC) is a simple, rapid, cost effective and reliable technique which can be used as a routine outpatient department (OPD) procedure and first line of investigation in diagnosing a variety of superficial and deep lesions. Lymphadenopathy is of great clinical significance and the underlying cause may range from a treatable infectious etiology to malignant neoplasms. In this study, we describe the diagnostic utility of FNAC in the assessment of lymph node lesions with an emphasis on the diagnosis of non-neoplastic, benign and malignant neoplastic processes. Cytomorphological patterns of tuberculous lymphadenitis were also observed. Methods: This was a retrospective study and a total of 736 patients including all age groups and both sexes presenting with palpable or deep lymph nodes in FNAC clinic of our institute over a period of 2 years were included in our study. FNAC was conducted with 22-24 Gauge disposable needles attached to 20c.c syringes. Smears were fixed in 95% ethyl alcohol and stained with Papanicolaou stain. Leishman stain was done on air dried smears. Ziehl- Neelsen (ZN) staining was done wherever required. Results: Out of 736 aspirations from lymph nodes, the most frequent cause of lymphadenopathy was found to be Tuberculosis with 419 cases (56.92%). The next frequent diagnosis was reactive lymphadenitis with 193 cases (26.22%) followed by metastatic lymphadenopathy in 47 cases (6.38%). A diagnosis of lymphoproliferative disorder was rendered in 20 cases (2.71%). In 10 cases (1.35%) FNAC was inconclusive. Conclusion: In our study, the predominant cause of lymphadenopathy was tuberculous lymphadenitis, seen in more than half of total cases, followed by reactive lymphadenopathy and malignant neoplasms. FNAC was helpful in establishing the diagnosis in 98.65% of the cases.
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A case of pulmonary blastomycosis on autopsy in a middle aged male from rural background is presented herewith. Blastomycosis is a pyogranulomatous disease caused by the dimorphic fungus blastomyces dermatitidis. Blastomycosis is endemic in regions of North America that border the Great Lakes. It is one of the great mimickers in medicine. Pulmonary blastomycosis has a broad range of clinical presentations, varying from completely asymptomatic pulmonary infiltrates to diffuse and massive parenchymal involvement that can lead to Acute Respiratory Distress Syndrome (ARDS). Human infection occurs when soil containing microfoci of mycelia is distributed and airborne conidia are inhaled. If natural defences in the alveoli fail to contain the infection, lymphohematogenous dissemination ensues. Diagnosis is based on culture and direct visualization of round, multinucleated yeast forms that produce daughter cells from a single broad- based bud. Most of the cases of blastomycosis reported in India are imported from the endemic areas of the World except a few authochthonous cases in North India.
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Background: Celiac disease is an autoimmune disorder caused by the ingestion of wheat gluten and related proteins in genetically susceptible individuals. It is characterized by anti-tissue transglutaminase (anti-tTG) antibodies. Duodenal biopsy is the gold standard for diagnosis. Correlation of clinical, serologic, and histological features is essential for a definitive diagnosis. The ratio of diagnosed versus undiagnosed cases is quite high. Aims: This study aimed to correlate the degree of mucosal damage with anti-tTG levels, mean baseline hemoglobin and endoscopic findings. Setting and Design: Two hundred twenty six adults suspected to have celiac disease were studied. Marsh grades were compared with anti-tTG levels, hemoglobin, endoscopy, and clinical presentations. Materials and Methods: Esophagogastroduodenoscopy, serum levels of anti-tTG, complete hematologic work-up, and duodenal biopsy were performed in all 226 cases (including three siblings of confirmed patients) with well-defined symptom groups. Histopathological grading was done as per modified Marsh system. Correlation of all the parameters was performed with Marsh grades. Statistical Analysis : Performed on SPSS version 15.0. Tests applied include one way ANOVA, Chi-square test, repeated measure analysis, and Bonferroni's method for comparison. Results were considered significant when P<0.05. Results and Conclusions: Anti-tTG levels, mean baseline hemoglobin, and endoscopic findings were found to correlate with increasing severity of mucosal damage with P<0.001 for all. Anti-tTG levels of grades 1+2 and those of grade 3a were significantly different from levels of grades 3b and 3c+4 with P<0.001 for each. Varied clinical presentations of celiac disease were seen in the adult wheat eaters of North India.