Clinico-Epidemiological Profile of Acne in Northern India

Acne Vulgaris is a multifactorial disease affecting the pilosebaceous follicle characterized by comedones, papules, pustules, nodules, cysts and scars. Methods: This study was conducted at Department of Dermatology, Venereology & Leprology at Teerthanker Medical College, Moradabad during the period from March 2017 to August 2018. Study was started after approval from Institutional Ethical Committee, Moradabad. 50 patients of acne vulgaris attending to the outpatient department were taken for study. Results: The acne was found on face of all 75 (100.0%) subjects, Back of 22 (29.3%), Cheeks of 65 (86.7%), Chest of 16 (21.3%) and Scalp of 3 (4.0%) subjects. Acne vulgaris is usually seen on sites which have high number of pilosebaceous units. In the present study all the subjects (100%) had lesions on face, 23 (7.7%) had lesions on face and back and 7 patients (2.3%) had lesions on face, back and chest. Conclusion: Higher incidence was seen in 16-20 years age group and females were more commonly affected. Face is the commonest area involved. Acne aggravates on using cosmetics, due to stress and also has seasonal variation too. However, more clinicepidemiological studies are required in Indian community for furtherance of the conclusions.

Alveolar rhabdomyosarcoma in children with histomorphological review.

Rhabdomyosarcomas (RMS) are aggressive malignant neoplasm of mesenchymal origin, related to skeletal muscle lineage. These are the most common soft tissue tumors in children. The diagnosis is made by microscopic analysis and ancillary techniques like immunohistochemistry, electron microscopy, cytogenetics and molecular biology. We encountered a case of a 03 years old child who presented with a tender, reddish, soft swelling over cheek for three weeks. The FNAC was reported as a small round cell tumor, Probably Primitive Neuroectodermal Tumor (PNET). The biopsy of tumor revealed a small round cell tumor with an alveolar pattern. Tumor giant cells were absent and mitotic figures were infrequent. Hence, differentials of alveolar rhabdomyosarcoma and PNET were rendered. Immunohistochemistry (IHC) demonstrated desmin positivity. Thus, a final diagnosis of alveolar rhabdomyosarcoma was offered.

The diagnostic accuracy of fine needle aspiration cytology in leprosy: a clinico-histopathological correlation.

Background: Leprosy is a chronic granulomatous condition mainly affects cooler parts of the body; skin, upper respiratory tract, anterior segment of the eye, superficial portion of peripheral nerves and testes. Redley and Joplin have classified it into five types; Tuberculoid (TT), Borderline Tuberculoid (BT), Mid Borderline (BB), Lepromatous Borderlilne (BL) and Lepromatous (LL). FNAC is simple, rapid and cost effective method over the biopsy to diagnose, classify and monitor leprosy in a patient. The present study was undertaken to evaluate and compare FNAC smears findings with histopathological findings and to classify lesions on RJ scale. Methods: This prospective and descriptive study was done in department of pathology in Sri Venkateshwara institute of medical science, pondicherry, India between June 2007 to June 2010. The patients were examined by the investigator with dermatologist later on slit smear was done. FNAC perform and comparison with biopsy and clinical history was done using SPSS software version 16.0. Results: Total 82 cases were included with age from 8 years to 79 years with mean age 38.16. Male to female ratio was 1.0: 0.7. FNAC shows parity 71.42% for tuberculoid and 58.33% for lepromatous leprosy and histopathology shows parity 100% for tuberculoid and 75% for lepromatous leprosy that indicate FNAC is useful usually for polar or stable group than the unstable or borderline cases. Conclusion: FNAC is a quick and safe for early diagnosis and classify cases into paucibacilary and multibacillary. Exact RJ Scale categorization on FNAC should not be used in isolation but FNAC should be supplemented to the histopathological diagnosis.

Prevalence and spectrum of hemoglobinopathies in tertiary care centre in a rural area of Madhya Pradesh.

Background: Haemoglobinopathies like thalassaemia and sickle cell anaemia etc are increasing due to unawareness of rural population. This study indicates type of haemoglobinopathies amongst the patients of a rural based tertiary care hospital in one year and nine months. Methods: Five hundred ten patients were studied during last one year and nine month for all suspected cases of haemolytic anaemia based on Complete Blood Count, Red cell indices and Peripheral blood smear examination. Sickling test, test for Hb F and haemoglobin electrophoresis with quantification of bands are done in all these cases Results: Out of all 510 cases of anaemia 461 cases (90.39%) were confirmed to nonhaemolytic anaemia whereas 49 cases (9.60%) had shown abnormal haemoglobin bands on electrophoresis. Out of these 49 cases 29 (59.18%) were Males and 20 (40.81%) were females. Most common Haemoglobinopathy observed was Sickle cell  Thalassaemia 23 (4.50%) followed by  Thalassaemia Trait 9 (1.76%), Sickle Cell trait 7 (1.37%).  Thalassaemia Major 5 (0.98%) & Sickle Cell Disease 5 (0.98%) have equal prevalence. The onset of disease was most prominent in Neonatal to pediatric age group including early adolescent (0-18 years) followed by reproductive age group (19- 45 years). Few cases of old age (46+ years) were detected. Conclusion: Study provides data on the spectrum & pattern of Haemoglobinopathies in a rural tertiary care centre. Screening of all anemic patients should be done for Haemoglobinopathy and proper Genetic counseling must be given to all cases to prevent incidence of cases in future generation.

Diagnostic accuracy of FNAC in diagnosis for causes of lymphadenopathy: a hospital based analysis.

Introduction: The lymphadenopathy consist wide range of etiology from inflammatory process to a malignant condition and it is most common clinical presentation in outpatient department. Fine needle aspiration cytology is a simple, safe, reliable, rapid and inexpensive method of diagnosis in lymph nodes. Aims and objectives: To find out diagnostic accuracy of FNAC in lymphadenopathy and common pattern of lymphadenopathy in our institute. Methods: This prospective study was carried out in the department of Pathology of Index Medical College Hospital and research Centre, Indore, India from June 2011 to May 2013. The patients with palpable lymph nodes were included in this study. The slides were stained with Papanicolaou and May Grunewald Geimsa stain. Special stain like Ziel Neelson, Alcian blue was done whenever is required. A detailed analytic study was performed for correlation of Cyto-histopathological diagnosis. Results: The result shows male to female ratio of 1.0:0.8. The age of the patients ranges from 2 to 79 year with mean age of 32 years. The study shows reactive hyperplasia 149 (33.38%), tubercular lymphadenitis 177 (39.77%), granulomatous lymphadenitis 32(7.1%), lymphoma 25 (5.5%), metastatic carcinoma 40 (8.9%) and others 22 (4.9%). We found cyto-histpathological concordant in 161 (95.8%) cases and discordant in 7 (4.2%) cases. Conclusion: The sensitivity of FNAC in lymphoma and metastatic tumors is 81.48% and 97.5% with test accuracy of 96.5% and 99.4% respectively. Hence FNAC should be used as preliminary screening investigation in all forms of lymphadenopathy and interpretation should be done in conjunction with clinical picture of the patients.

Pattern of Congenital Anomalies in Newborn : A Hospital Based Prospective Study.

This hospital based prospective descriptive study highlights the point prevlance of congenital anomalies in one year. The number of congenital anomalies were more in males (M: F = 1.6:1.4), in neonates of young (= 20 years) and elderly mothers (= 35 years). The pattern of congenital anomalies included musculoskeletal (30.6%), CNS (20.5%), GIT (18.5%), skin (7.6%), genitourinary (4.7%), CVS (4%) etc. In musculoskeletal group, telipes was most common malformation followed by spinabifida and polydactyly. In CNS, group meningomyeleceole was the most common malformation followed by anencephaly and hydrocephalus. Frequency of congenital anomalies were more common in muslims as compared to hindus (1.77% vs. 1.4%), in cesarean born babies as compared to vaginally delivered (1.96% vs. 1.48%), in LBW babies (4.95%) and still born as compared to live born babies (4.46% vs. 1.39%). Present study stress upon the importance to carrying out a thorough clinical examination of neonate at birth.

Sturge Weber Disease in a Child

Sturge Weber Disease is one of the important neurocutaneous syndrome characterized by abnormities of both the integument and central nervous system. We present here a classical case of Sturge Weber Disease. This 16 month male child had facial angioma and seizures. CT Scan head was consistent with the diagnosis.