ABSTRACT
BACKGROUND: Malignant melanoma is a tumor of melanocytic origin. Although uncommon in India as compared with the west, its prevalence is increasing. OBJECTIVES: To document the pattern of clinicopathological features of malignant melanoma cases attending in a regional cancer center in eastern India. MATERIAL AND METHODS: The present study was a retrospective study of 182 cases diagnosed histopathologically as malignant melanoma during 2011–2016. RESULTS: Out of the total cases, 170 (93.4%) were cutaneous and 12 (6.6%) were noncutaneous melanoma. The most common age group was sixth decade with a male predominance. Conventional melanotic melanomas were 176 (96.70%), and only 6 cases (3.30%) were amelanotic melanoma. Among noncutaneous melanomas, 6 were in anorectum, 2 in conjunctiva, and 1 case each in nasal cavity, palate, gingivo-buccal sulcus, and vagina. The acrallentigenous type was the most common variety, and the mixed epithelioid and spindle cell type was the most common histopathological pattern. Clark's level III was the most common level of invasion. CONCLUSION: The lower extremity is the most common site for melanoma, whereas extracutaneous melanomas are exceedingly rare and aggressive neoplasms. Melanoma can metastasize to regional lymph nodes, however, visceral metastasis to liver can also occur. In the absence of pigment in amelanotic melanoma, immunohistochemical markers such as HMB 45 can be used for definitive diagnosis.
ABSTRACT
Aims and objective :To compare combinations of Propofol-Ketamine and Propofol-Fentanyl for total intravenous anesthesia in short surgical cases in pediatric patients. The study also compared recovery characteristics and the incidence of side effects / complications in the groups. Methodology: The patients were randomly divided into two groups depending upon the drug combination used for Total Intravenous Anaesthesia. Group I : 30 patients were given i.v. Ketamine followed by Propofol. Group II: 30 patients were given i.v. Fentanyl followed by Propofol Recovery characteristics were compared and the incidence of side effects and complications in two groups were noted. Results: The pulse rate and blood pressure remained near to preinduction value in group I, while in group II these values decreased. After induction RR increased in group I but decreased in group II at 1,3%5 min after induction.None of the patients in both groups were observed to have nausea, vomiting and respiratory depression. . A significant no. of the patients in group II were observed to have either pain on injection site or restlessness. Conclusion: Propofol-Ketamine and Propofol-Fentanyl combinations provide satisfactory surgical conditions for minor surgical procedures in paediatric patients, but the Propofol-Ketamine combination gives better hemodynamic stability and less restlessness during induction and maintenance of anaesthesia.
ABSTRACT
A 32-year-old lady came for a routine gynecological check up. Her cervical cytologic smear was reported as low grade squamous intraepithelial lesion. As a part of basic routine investigation, cervical punch biopsy was done. Astonishingly it revealed multiple rhabditiform larvae of Strongyloides stercoralis. These were curved thick with pointed end and a short buccal cavity. She did not have any history of immunosuppression including steroid therapy and was otherwise normal. Extensive review of the literature on parasites encountered in cervix yielded few case reports on strongyloides in cytologic smears, but failed to reveal any report till date on S. stercoralis found in histopathology section. Our case is probably the fi rst in the world and the fi rst reported from India to the best of our knowledge. We describe this case of strongyloidiasis of cervix with review of the literature on various parasites encountered in the cervix because of its rarity and also to keep this parasitic infestation as a differential diagnosis of cervical lesions.