Rectal cap polyposis masquerading as ulcerative colitis with pseudopolyposis and presenting as chronic anemia: a case study with review of literature

Cap polyposis [CP] is an under recognized form of non-neoplastic colonic polyps, characterised by the presence of inflammatory polyps with a distinct "cap" of granulation tissue. CP is often seen masquerading as chronic inflammatory bowel disease. The most common symptoms are mucoid diarrhoea, bloody stools, abdominal pain, and tenesmus. In this case report, we present a patient who was diagnosed with CP during the investigation of unexplained chronic long standing anemia secondary to intermittent rectal bleeding. CP, although rare, should be considered in the differential diagnosis of patients presenting with intermittent rectal bleeding and mucoid diarrhoea

Primary renal leiomyosarcoma: a diagnostic challenge

Primary leiomyosarcoma is an extremely rare entity constituting only 0.5-1% of all invasive renal tumors. It is frequently diagnosed on histological examination because it does not have any specific diagnostic features clinically and radiologically. At times, it is difficult to differentiate leiomyosarcoma from the sarcomatoid renal cell carcinoma even in histopathology as both the tumors have spindle-shaped atypical cells. Moreover, some epithelial markers can be present in pure smooth muscle sarcomas, while some smooth muscle markers are positive in carcinomas. Hence, a diagnosis of primary renal leiomyosarcoma should be made with caution. Since the prognosis for a renal sarcoma is particularly poor, differentiation from sarcomatoid renal cell carcinoma is necessary. The diagnostic challenge of one such tumor is discussed

Cavernous hemangioma of the kidney: a report of two cases and review of the literature

Hemangioma of kidney is a rare benign tumor. Although it may be clinically silent, their main symptom is hematuria, sometimes profuse and relapsing. We report two such cases which presented with episodes of hematuria and were clinically and radiologically diagnosed as transitional cell carcinoma. Nephrectomy was performed in both cases and the histopathological appearance were those of a cavernous hemangioma. A literature review of renal hemangioma is also presented

Clear cell adenocarcinoma of urinary bladder: a case report and review

Clear cell carcinoma is an uncommon but distinct variant of urinary bladder carcinoma histologically resembling the neoplasm in the female genital tract. The histogenesis of this neoplasm is uncertain. The clinicopathologic and histologic features are suggestive of a mullerian origin in some tumors, while some believe it to be glandular differentiation of urothelium or a unique vesicular adenocarcinoma of non-mullerian origin. [1] We present a case of clear cell adenocarcinoma in a 74-year-old woman with review of literature along with its differential diagnosis

Cystic Echinococcosis of the Pelvic Bone with Recurrences: A Case Report

Hydatid cysts commonly affect the liver and the lung. However, they rarely involve bones with vertebral column. We hereby report a case of a female patient with cystic echinococcosis of the hip bone and ilium. She presented with a long history of frequent recurrences highlighting the dismal prognosis at this rare site. Resection of the hydatid cyst from the sacroiliac region was done with allograft and autograft (rib graft) with lumbosacroiliac fixation. Follow-up of the patient at 6 months showed no detectable abnormality on radiology and the patient was doing well.

Community mental health in Peshawar, the need to reform

Community mental health is a neglected field in many developing countries including Pakistan. Common mental disorders are high in prevalence, particularly in women. Community mental health services are lacking in Peshawar, which faces a number of challenges owing to sociopolitical instability. The aim of this literature review is to evaluate and interpret current research relevant to community mental health reform, including a review of the evidence regarding community mental health service. A selected review of published literature was undertaken using the PubMed, PsychINFO and Cochrane Database of Systematic Reviews databases. The intervention studies included in this review demonstrate that community based mental health services closely aligned with primary care services have the potential to facilitate improvements in access to care and also improvements in mental health outcomes. It concludes that lack of proper mental health policy and non-integration of mental health in primary health care adversely affects the outcome of mental health progress in community