Endoscopic Ultrasound-Guided Fine-Needle Aspiration of the Adrenal Glands: Analysis of 21 Patients

BACKGROUND/AIMS: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) cytology of adrenal masses helps in etiological diagnosis. The aim of this study was to evaluate the diagnostic yield of EUS-FNA of adrenal masses in cases where other imaging methods failed and/or were not feasible. METHODS: Twenty-one consecutive patients with adrenal masses, in whom adrenal FNA was performed because conventional imaging modalities failed and/or were not feasible, were prospectively evaluated over a period of 3 years. RESULTS: Of the 21 patients (mean age, 56+/-12.2 years; male:female ratio, 2:1), 12 had pyrexia of unknown origin and the other nine underwent evaluation for metastasis. The median lesion size was 2.4x1.6 cm. Ten patients were diagnosed with tuberculosis (shown by the presence of caseating granulomas [n=10] and acid-fast bacilli [n=4]). Two patients had EUS-FNA results suggestive of histoplasmosis. The other patients had metastatic lung carcinoma (n=6), hepatocellular carcinoma (n=1), and adrenal lipoma (n=1) and adrenal myelolipoma (n=1). EUS results were not suggestive of any particular etiology. No procedure-related adverse events occurred. CONCLUSIONS: EUS-FNA is a safe and effective method for evaluating adrenal masses, and it yields diagnosis in cases where tissue diagnosis is impossible or has failed using conventional imaging modalities.

Genotyping of PRNP coding region for scrapie in Indian sheep

Prions are unprecedented infectious pathogens that cause a group of invariably fatal neurodegenerative disease by an entirely novel mechanism. The conformational change in prion proteins results in a change from a predominantly á-helical protein to a beta-sheet form, which causes scrapie in sheep and goat. The present study was carried out to identify polymorphisms of the prion protein gene [PrP] at the codons [136, 154 and 171] responsible for the susceptibility and resistance of the scrapie disease in the sheep. The ARQ is the most frequent allele which is less susceptible, but may get scrapie. The highly sensitive VRQ and resistant ARR alleles were not present in the M and ya sheep. Genotype ARQ/ARQ, ARQ/AHQ, and AHQ/AHQ were found in the analyzed population with 40.00, 40.00 and 20.00% respectively, showing little resistance to scrapie and require careful selection when used for breeding. Six groups [variants] were found in SSCP [single-str and conformation polymorphism] i.e., out of each group one sample was sequenced. Sequencing [accession No. KF207876-79] of samples allowed the identification of 5 other new polymorphisms on PrP gene at codon positions 98[S/R], 147[D/E], 175[Q/R], 184[N/H] and 189[Q/L]. Absence of ARR allele in the M and ya sheep should be taken into considerationfor the implementation of a preventive selection programme to avoid erosion of the genetic stock. Key words: Scrapie, Allele, PrP gene, Single nucleotide polymorphism, Sheep

Haematological and electrocardiographic variations during menstrual cycle

Menstruation coupled periodic bleeding from the blood vessels, at the time of shedding of the uterine mucosa has directed interest, more especially in the haematological changes during different phases of menstrual cycle. The present study was carried out on 30 healthy female medical students in the age group of 18 to 23 years with the normal menstrual cycle of 30 +/- 3 days. The various haematological parameter and electrocardiography were studied on the 2[nd], 11[th], 14[th] and 22[nd] day of menstrual cycle. The study reveals that the total leukocyte count and total platelet count significantly increased [p<0.001] around mid-cycle, however total eosinophil count significantly decreased [p<0.05] during the same period. Differential leukocyte count, bleeding time, clotting time, heart rate, P-R interval and Q-T interval did not show any significant change during different phases of menstrual cycle, although some mild changes were observed. This study was a moderate attempt to determine regular variation in the different haematological parameters and ECG during the different phases of menstrual cycle in normal healthy females and evaluate conflicting reports on the subjects

Comparison of CEA and CA 19-9 with CA 72-4 in patients with upper gastrointestinal carcinomas in local population

Gastrointestinal carcinomas are amongst the most common malignancy showing an annual increase globally. In our population, there is an increase in GIT carcinomas over the years and these are occurring at a much younger age. Tumour markers are molecular substances produced by all tumour cells which are excreted in body fluids or present on the surface of the cells. CEA, CA 19-9 and CA 72-4 are tumour markers for GIT carcinomas. The study included patients of upper GIT carcinoma and controls of both sexes and all ages. Each category included about 30 blood samples. Serum of each sample was evaluated for tumour markers CEA, CA 19-9 and CA 72-4. The estimations were made by using ELISA/EIA. The t-test and ANOVA were performed for comparison of means, specificity and sensitivity of each marker were also calculated. Showed that in our population GIT carcinoma is common in younger age group. Sensitivity of CEA, CA 19-9 and CA 72-4 is 63.33%, 50% and 63.33% respectively whereas specificity of these markers are 60%, 93.33% and 100% respectively in upper GIT carcinoma. CA 19-9 is tumour marker of choice for pancreatic carcinoma and CA 72-4 for gastric carcinoma

Role of proximal Tube Enterostomy in fire management of typhoid enteric perforation

Typhoid perforation continues to have significant morbidity and mortality. A variety of surgical procedures like primary repair, wedge resection, intestinal resection, ileostomy and hemicolectomy reflect lack of consensus among surgeons. Complications like wound dehiscence, burst abdomen, intra-abdominal abscesses and fecal fistula continue to be unacceptably high. Currently for solitary perforation primary repair is the most acceptable technique whereas for multiple perforations ileostomy is used. Tube enterostomy as an adjunct to primary repair in both solitary and multiple perforations is presented in an attempt to reduce above mentioned postop complications