Visceral leishmaniasis with an unusual presentation in an HIV positive patient

Visceral leishmaniasis is a disease caused by a haemoflagellate protozoan of the genus Leishmania. It has a wide geographical spread. Classic cases are found primarily in children and present with typical features that include fever, anaemia, hepatosplenomegaly, hypergammaglobulinaemia, and pancytopenia. The diagnosis is usually achieved by bone marrow smears, culture and serology; however, it can manifest itself atypically, mostly in patients infected with HIV and geriatric immunocompetent patients. We report an unusual case of visceral leishmaniasis diagnosed in a 27 year-old HIV-infected male who presented with abdominal discomfort and diarrhea of four weeks duration associated with nausea and vomiting, but with no typical symptoms or signs of visceral leishmaniasis. The diagnosis was established through the identification of the Leishmania organisms in duodenal and colonic biopsies and confirmed by subsequent bone marrow smears

Tissue microarray: a rapidly evolving diagnostic and research tool

Tissue microarray is a recent innovation in the field of pathology. A microarray contains many small representative tissue samples from hundreds of different cases assembled on a single histologic slide, and therefore allows high throughput analysis of multiple specimens at the same time. Tissue microarrays are paraffin blocks produced by extracting cylindrical tissue cores from different paraffin donor blocks and re-embedding these into a single recipient [microarray] block at defined array coordinates. Using this technique, up to 1000 or more tissue samples can be arrayed into a single paraffin block. It can permit simultaneous analysis of molecular targets at the DNA, mRNA, and protein levels under identical, standardized conditions on a single glass slide, and also provide maximal preservation and use of limited and irreplaceable archival tissue samples. This versatile technique, in which data analysis is automated facilitates retrospective and prospective human tissue studies. It is a practical and effective tool for high throughput molecular analysis of tissues that is helping to identify new diagnostic and prognostic markers and targets in human cancers, and has a range of potential applications in basic research, prognostic oncology and drug discovery. This article summarizes the technical aspects of tissue microarray construction and sectioning, advantages, application, and limitations

Multiple and bilateral lactating adenomas of breast and axilla

A26 year old multiparaous Yemeni lady presented during the 3rd trimester of her pregnancy with multiple painless rapidly enlarging bilateral breast and axillary masses with erythema of the overlying skin. Histopathological examination of both breast and axillary masses revealed lactating adenomas although uncommon are the most prevalent breast masses seen in pregnant women. they could be single or multiple and can occur in the breast or in ectopic locations in this case the lesions were multiple bilateral occurring simultaneously in the breast and ectopic locations and reaching enormous proportion [11cm in diameter] with associated overlying engorgement and erythema thus raising the possibility of malignancy lactating adenomas are benign lesions and most show spontaneous involution however the diagnosis is not always straightforward and surgical resection may be required for definitive diagnosis and exclusion of other pathologic processes

role of internet and telemedicine in modern medical practice

The revolution in the information technology has mede profound and unprecedented changes in the society and in the world of science including medical and health related sciences. With this revolution will come an enormous potential to increase efficiency of clinical, reduce human errors, and improve the quality of medical care. Moreover, electronic medical information will help to democratize medicine. So physicians and health care providers realize that they must adopt these technologies since they are going to be standards of clinical practice very soon and surveys are showing that expanding numbers of physicians and health care providers are accessing the web daily for medical information, consultations, and distant learning. This emerging environment will also have a great influence on patient eduction and will certainly affect physician-patient relationship. Actually the internet is a key influence in changing the balance of knowledge between physicians and the public,empowering patients to become more involved in health care decision-making since more patients are coming to the physicians with information from the internet about illnesses, medical treatment, and the availability of clinical trials. The most important areas are the internet, the world wide web [www] and telemedicine which begins to enter the mainstream of health care. This article focuses light on some of the applications of internet in clinical practice. It also provides some guidelines for the effective use and retrieval of medical information from the internet