ABSTRACT
Background: Breast lump is the most common presentation of the breast disease. Fine needle aspiration cytology (FNAC) is a simple, rapid and safe, method to diagnose the breast lesions.The objective of thisstudy was to determine the cytomorphological patterns of various breast lesions diagnosed on FNAC. Methods: This study was conducted on 280 patients presenting with breast lump over a period of 3 years.Results: The age range of these patients was from 11-80 years. Female patients were more than male patients. Left breast involvement was more common than the right breast. The cytological diagnosis included benign breast disease (C2-88%), atypical/probably benign (C3-1%), suspicious for malignancy (C4-3%), malignant (C5-8%). Fibroadenoma and invasive ductal carcinoma were most common among benign and malignant lesions respectively.Conclusions:The primary goal of aspiration cytology is to separate malignant lesions from benign ones and it also makes an important tool in guiding further management of a case. So, it is concluded that FNAC should be used as a routine diagnostic procedure due to its cost effectiveness and quick results, thus maximizing the availability of effective health care to patientswith breast lesions.
ABSTRACT
Introduction: Splenectomy addresses the role of the spleen in hematological disorders particularly those ofcellular sequestration and destruction and antibody production. Splenectomy is indicated in specific cases ofanemia.Material and methods: The study was conducted in the department of General and Minimal Invasive Surgery incollaboration with the department of Clinical Hematology, Sher-I-Kashmir Institute of Medical Sciences, Srinagarfrom Jan 2012 to Jan 2016.The study included 33 patients The patients were studied in regards to thevariables1.clinical and demographic information. 2.surgical findings.3.preoperative and post operativehaematological profile.4.immediate and late complications.5.hospital stay6.persistence of disease.Result: In our study, out of 33 patients, laparascopic splenectomy(LS) was performed on 19 patients(57.6%) and14 underwent open splenectomy(OS).. Mean age was 28.89 years in LS group.and 36 years in OS group. Malefemale ratio was 4/15 in LS and 3/11 in OS. Mean operation time was 107.5 minutes in LS and 80.7 minutes in OS(pvalue <.001). Mean intraoperative blood loss was significantly lower for LS vs OS (76.43 mL vs 133.57 mL; P =.003). There was no statistical significant difference in complications between the two groups. Also, There wasno significant difference between LS and OS in terms of remission rates.Conclusion: Laparoscopic splenectomy is a safe and effective procedure in experienced hands. It is superior withregard to hospital stay, operative blood loss, postoperative pain and cosmesis as compared to Open Splenectomy.
ABSTRACT
Background: Pancytopenia refers to combination of anaemia, leukopenia and thrombocytopenia. It may be a manifestation of a wide variety of disorders, which primarily or secondarily affect the bone marrow. However, aetiology of pancytopenia varies from one geographical region to another. Bone marrow aspiration plays an important role in identifying the cause of pancytopenia. This study was carried to identify the causes of pancytopenia and to find out the bone marrow morphology in cases of pancytopenia.Methods: This study was conducted in the department of haematology in a tertiary care center in Kashmir valley for a period of 3 years. Inclusion criteria: cases with hemoglobin less than 10 gm/dl, total leucocyte count of less than 4000/mm3 and platelet count less than 100,000/mm3 were included in the study.Exclusion criteria: Patients receiving chemotherapy/radiotherapy were excluded from the study. Bone marrow aspiration (BMA) was performed from posterior iliac crest of the patients. Bone marrow aspiration smears were stained with Leishman stain for microscopy.Results: A total of 334 cases were studied during a period of 3 years. Age of patients ranged from 1 year to 85 years with mean of 43.59 years.180 cases were male, and 154 cases were female with male:female ratio of 1.2 :1. The commonest cause of pancytopenia was megaloblastic anemia seen in 103 cases (30.8%) followed by dual deficiency anemia seen in 69 cases (20.7%).37 cases (11%) were of acute leukaemia. Aplastic anemia was seen in 35 cases(10.5%). Other causes of pancytopenia were myelodysplastic syndrome, multiple myeloma, iron deficiency anemia and hypersplenism.Conclusions: Bone marrow aspiration in patients of pancytopenia helps in the identification of the underlying cause in most of the cases. BMA is helpful for understanding the disease process; and in planning further investigations and management of cytopenia patients.
ABSTRACT
Background: Plasma cell dyscrasia (PCD) is the term used to describe the disorders characterized by neoplastic proliferation of plasma cells with the abnormal production of immunoglobulins (Ig). Patients with multiple myeloma frequently have abnormal coagulation tests. Aim of the present study were to correlate prothrombin time (PT) and Activated Partial Thromboplastin time (aPTT) with Ig concentrations in patients with newly diagnosed with PCD and to compare PT and aPTT values in untreated and treated patients diagnosed with PCDMethods: This study was conducted in the department of clinical hematology of SKIMS, a tertiary care hospital in northern India from 2015 to 2016. Patients diagnosed with PCD were advised for coagulogram (PT, aPTT) as a base line investigation. A total of 72 patients were included in the study.Results: 37% of multiple myeloma cases (newly diagnosed) and 22% of light chain disease patients presented with prolonged PT whereas none of the patients in treated cases of PCD had prolonged PT. The mean Ig concentration was significantly higher in patients with prolonged PT and aPTT compared to that of patients with normal PT and aPTT values. In IgA myeloma, the mean immunoglobulin concentration was 3643 mg/dL with a mean PT and aPTT values of 18.8s and 36.6 (p value: 0.006). The mean free light chain concentration in kappa (k) light chain myeloma was 1727 mg/L with a mean PT value of 20.5 s, mean aPTT value of 37.4 s (p-value: 0.026).Conclusions: Patients with newly diagnosed myeloma presented with prolonged PT as compared to the treated cases. Also, mean Ig concentration was significantly higher in patients with prolonged PT and aPTT compared to that of patients with normal PT and aPTT values.