ABSTRACT
Background: Cytological evaluation and diagnosis of lymphadenopathy plays an important role in distinction between reactive hyperplasia and malignancy. Being a tertiary cancer care centre, lymph node enlargement clinically suspected to be due to malignancy constitute the commonest indication for fine needle aspiration cytology [FNAC] at our centre. The aim of this study was to determine the utility of FNAC in evaluating enlarged lymph nodes and to categorizethe causes of lymphadenopathy diagnosed by FNAC at our centre
Material and Methods: Data was collected from the records of department of Pathology over a period of three months from January to March 2014. The data was analyzed and various parameters studied
Results: There were 2000 aspirates over a period of three months of which 270 [13.5%] were from lymph nodes. Of these, 130cases [48.2%] have metastatic deposits.We also came across 16 cases [5.9%] of lymphoma, 5 cases[1.9%] of granulomatous lymphadenitis, 2 cases[0.7%] of suppurative lesion and 99 cases [36.7%] of reactive hyperplasia during this period. In 3 cases [1.1%], the lesion turned out to be of salivary gland origin. Aspirates were suboptimal for diagnosis in 15 cases [5.5%]. Aspirates were more in males [181] as compared to females [89]. The most common site of aspiration was the cervical lymph node[64.5%],followed by supraclavicular=81[30%], inguinal=33[12.22%], axillary=19[7.04%] sub mental=1[0.37%] and others=7[2.59%]. Apart from metastatic carcinomas other metastatic malignancies we came across were malignant melanoma, neuroblastoma, germ cell tumor and synovial sarcoma
Conclusion: FNAC of lymph nodes helps in rapid diagnosis of lymphadenopathy. Categorizing the cause of lymph node enlargement as metastatic malignancy,lymphoma, reactive change, inflammatory cause,suppuration etc. can be done by FNAC.In patients with known histologically proven malignancy in whom a subsequent enlargement of lymph node occurs,a cytological diagnosis of metastasis helps in avoiding unwanted surgery for confirming metastasis.In patients without a previous diagnosis of malignancy, FNAC not only confirm metastatic deposit but in most conditions give a clue regarding site of primary. The use of immunocytochemistry and cell block preparations have increased the scope of FNAC
Subject(s)
Humans , Male , Female , Child , Adult , Aged , Aged, 80 and over , Middle Aged , Biopsy, Fine-Needle , Tertiary Care Centers , HyperplasiaABSTRACT
India shares the largest burden of under-nutrition in world. The aim of this study was to conduct follow-up assessment of under-nourished children attending anganwadi center [AWC]. This was a retrospective cohort study conducted in 50 AWC of Tapi district. Total 529 children aged 1-6 years diagnosed as under-nourished before 1 year were included. Pre-structured questionnaire was used for present day assessment of these children followed by Epi-info mediated analysis. Children of literate mothers had higher weight gain. Ninety percent of children attended anganwadi regularly, however 25% of children dropped out for more than 1 month. In 1 year, growth had faltered in 20% children and was stagnant in 63% of them. Children who were treated for under-nutrition; that completed course at Child Development and Nutrition Center; and whose parents were counseled about the under-nourished status of child had higher weight gain than their counterparts. Parents of under-nourished children must be counseled about the nutritional status of their child. In cases of under-nourished child, referral to higher center must be ensured by health worker. Supplementary feeding as a long-term solution to country's under-nutrition problem should be studied in detail with the alternative solutions
ABSTRACT
The study is to investigate the foot care practices among filarial lymphoedema patients, which is relevant to strengthen the second pillar of the Programme to Eliminate Lymphatic Filariasis (PELF). The patients are drawn randomly from a clinic as well as from the community. After getting verbal consent, each patient was subjected to an in-depth interview by using a structured questionnaire on how she/he dealt with lymphoedema and probed about various foot care practices. Of the six foot care measures, most of the patients are practising one or two measures only. Substantial numbers of patients are practising the washing the affected limb regularly. Though majority use normal footwear, none of the patients use specially made footwear. Other foot care practices like, massaging, elevation and exercising of affected, limb and use of bandage are practised by a few patients. The patients' education and lymphoedema grade had significant influence on number of foot care practices adopted. The present results are not surprising, but disappointing, as a few patients are practising the measures specifically aimed to ameliorate the lymphoedema condition. Though the present study area is covered by the mass drug administration under PELF, no serious attempts are made to alleviate disability and morbidity control. Appropriate care of affected limb at early stage can help in prevention or reversal of the progression of the disease, in addition to decrease in frequency of acute lymphangitis attacks. PELF is one of the functions of primary healthcare (PHC) system and hence, peripheral level health institutions of PHC system including primary health centres, health sub-centres and their health workers should take lead in encouraging the patients to modify their behaviour with foot care practices.