ABSTRACT
Background: Scrub typhus is a documented disease in Himachal Pradesh, but there have been few clinico-epidemiological studies in this area. The present study is done with IgM ELISA as a diagnostic test which has higher sensitivity and specificity as most of the previous studies had used Weil Felix test as a diagnostic test. Methodology: This was a prospective observational study. All the patients more than 18 years of age with positive IgM ELISA for scrub typhus with/without eschar were included. The clinical profile was observed. IgM scrub typhus was done by ELISA. Results: Total of 39 patients were observed between July 2016 to Dec 2016. Maximum patients were observed in August, September, and October. Fever with Headache was the most common presenting complaint. Eschar was present in 10 % patients. Complications were seen in 76.92 %. The mortality rate was 0 %. Conclusion: The varied presentations and high rate of complications require a high index of suspicion for Scrub Typhus. The general physicians should be sensitized for the early diagnosis and treatment to reduce morbidity and mortality.
ABSTRACT
Context: Prostate adenocarcinoma (PC) is one of the common cancers in India and world over. Numerous prostatic, nonprostatic lesions, and normal structures can be very similar to adenocarcinoma. A pathologist's awareness of the benign mimics is important for the diagnosis of PC. Aim: The aim of this study was to determine the prevalence, clinical, and histopathological features of PC, and its common mimics, and to study the criteria for their distinction from PC. Materials and Methods: A prospective study of histopathological features of radical prostatectomy and transurethral resection of the prostate specimens, sent to the department of pathology in a medical college, for a period of 2 years was done. A brief clinical history followed by a clinical examination, including per-rectal findings and serum prostate-specific antigen (PSA) levels, was noted. Results: After excluding all the cases of benign hyperplasia of prostate without any associated findings, 50 cases of operated surgical specimens of prostate were studied. PC was the most frequent diagnosis in 28 patients of 50 cases (56.0%). Basal cell hyperplasia formed the predominant mimic (26.0%), followed by prostatic intraepithelial neoplasia (8%), prostate atrophy (4%), clear-cell cribriform hyperplasia(4%),, and one case of atypical adenomatous hyperplasia (2%). Serum PSA was >4 ng/mL in all the cases of PC. In three of the mimics, PSA was >4 ng/mL and in the rest it was <4 ng/mL. Immunohistochemistry (IHC) was not applied in our study. Conclusion: Biopsy still remains a gold standard for diagnosis of PC and its mimics. All the lesions in the above study were diagnosed on routine hematoxylin and eosin staining. IHC is useful especially for lesions in the grey zone but not in routine histopathological study and should not be used as a screening test but should be applied in specific selected cases only.
ABSTRACT
A case of xeroderma pigmentosum with multiple cutaneous malignancies is being reported. The case presented with freckles, letigens, and keratosis, a non-tender ulcerated nodular lesion on the nose, a nodular ulcerated lesion on the right outer canthus of the conjunctiva, and a nodular growth which developed on the right cheek which on histopathology was found to be squamous cell carcinoma, basal cell carcinoma and malignant melanoma respectively.
ABSTRACT
Patients with malignant bone tumours often come at a very late stage of disease to Medical Colleges. Because of their high mortality rate, accurate & quick diagnosis of these lesions become essential, inspite of clinical, radiological and histopathological assessments. A simple, inexpensive, safe & least traumatic technique-fine needle aspiration cytology (FNAC) in diagnosis of 55 malignant bone tumours was carried out. Specific tumour types metastatic tumour (12), Giant cell tumour (12), Ewing's sarcoma (10), Osteosarcoma (7), Multiple myeloma (7), Chordoma (3), Chondrosarcoma (3) and Fibrosarcoma (1) could be ascertained in 87.2% whereas malignant tumour was suggested in 94.5% (52 cases).