Computed tomography [CT] scan; ring enhancing lesions on brain

Ring enhancing lesions are a common neurological problem seen in either gender and in all age groups. Objectives: To determine the clinical presentations and etiological factors in patients with ring enhancing lesion on CT scan brain. Design: Case series study. Period: One year. Setting: Department of medicine, Liaquat University Hospital, Hyderabad. Patients and methods: Subjects of either sex =12 years of age, presented with seizures, fever, focal neurological signs and deficit, headache, weight loss and vomiting and had single or multiple ring enhancing lesions on computed tomography [contrast CT brain film] were enrolled and entered in the study. CT scan brain was advised to evaluate any identified lesion and then certain specific biochemical tests were also advised to detect the particular existence etiological factor. The data was analyzed in SPSS 16 and the frequency and percentage was calculated. Results: During one year study period, total 50 subjects were detected as ring enhancing lesion on CT scan. The mean age +/-SD of the over all population was 28.87+/-4.84 whereas the mean age +/-SD of male and female population was 27.76+/-6.53 and 30.76+/-5.83 respectively. Ring enhancing lesions were right sided in 30 patients [60%], on the left side in 15 [30%] and bilateral lesions were identified in 6 subjects [10%] on brain imaging. Majority of the ring enhancing lesions were single 45 [90%] and the parietal lobe was observed as the commonest site. The headache, seizures, fever, pyramidal signs and papilledema was identified the common clinical features whereas the common etiological factors responsible for ring enhancing impression on brain CT scan were tuberculoma 17[34%], brain tumor 12[24%], metastasis 05[10%] and brain abscess 04[08%]. Conclusions: The male population was predominant while the seizure was observed as common clinical feature whereas the tuberculoma, brain tumour and metastasis are the common etiological factors responsible for ring enhancing lesion on brain imaging.

mucin content a prognostic indicator in colorectal carcinoma?

To evaluate the mucin profile ofcolorectal adenocarcinoma by means of a histochemical study and to correlate mucin content and histological grade vis-a-vis prognosis. Descriptive study. Jinnah Postgraduate Medical Centre Karachi, from August 2004 to August 2007. Seventy patients who underwent surgical resection of sporadic colorectal adenocarcinoma over a 3-year period were evaluated for histological classification as to mucinous [MUC] or a non-mucinous [nMUC] subtype. They were further divided by histological differentiation into low-grade and high-grade tumors. The two groups were compared in terms of mucin content by histochemical techniques. Relationship between mucin content and histological grade was also analyzed. On the basis of mucin content all cases were divided into mucinous [MUC; n = 14; 20%] and non- mucinous [nMUC; n = 56; 80%] adenocarcinomas. The predominant mucin on histochemistry ofcolorectal adenocarcinoma [nMUC and MUC] was sialomucin. Tumors were further graded historically into low-grade [85.71%] and high-grade [14.28%]. MUC adenocarcinoms showed a higher proportion of high grade tumors. Both MUC and nMUC are distinct histological subtypes of colorectal adenocarcinoma. No relationship could be established between pattern of mucin secretion and histological differentiation, however there is a definite relationship between mucin content and histological grade. It could be concluded from this study that mucin content vis-a-vis histologic grade have an influence on prognosis. Further elucidation and follow-up is needed

Incidence of colorectal carcinoma: is there a "shift to the right"?

This study was carried out in Department of Pathology, Basic Medical Sciences Institute, Jinnah postgraduate Medical Center, Karachi over a period of five years. 124 cases of colorectal adenocarcinoma were studied with respect to age, gender and location. Relationship of these variables to each other was also analyzed. Patients with an age range of 10 - 80 years were divided into different age groups. Most of the patients were in 41 - 60 years age group [55; 44.5%]. Gender distribution revealed male predominance with a male to female ratio of 2.54:1. Incidence of colorectal cancer in both the male and female patients is more in 41 - 60 years age group. Relationship of location of tumor to age and gender reveal a male predominance in all the locations with highest number of both male and female patients, [59; 47.6%] seen the in rectum in 21 - 40 years age group [44; 40.7%]. Tumors in distal locations are much more common in this study than tumors in proximal subsites indicating that no 'shift to the right' is seen. In conclusion, incidence of colorectal carcinoma is more in young patients less than 60 years of age with a male predominance and a distal location specifically the rectum