ABSTRACT
Introduction: Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is the sudden worsening of symptoms of COPD like shortness of breath, increased quantity and color of sputum, and systemic inflammation, and has a significant impact on survival. Biomarkers such as high-sensitivity C-reactive protein (hsCRP) and procalcitonin have been studied in AECOPD patients as prognostic markers. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are two new inflammatory markers and play a significant role in prognosis in patients with AECOPD. NLR and PLR are easily available and cost-effective markers and have the potential for helping in the risk stratification of hospitalized AECOPD patients. Aim: Study of inflammatory markers in COPD and their correlation with clinical outcome. Methods: A prospective observational comparative study was conducted on 100 patients of COPD at the Department of General Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, and all necessary investigations were done. Results: A total of 100 patients of COPD were taken, 50 patients were in a stable state (controls) and the same number of patients were in an acute exacerbation state (cases). Mean levels of NLR, hsCRP, and procalcitonin in cases were significantly higher as compared to controls whereas levels of PLR in cases and controls were comparable with no significant difference between them. Levels of both of these inflammatory markers (NLR and PLR) were positively correlated with levels of hsCRP and levels of procalcitonin. Of the total 50 patients, 23 (56.00%) patients needed mechanical ventilation and 11 (22%) needed inotropic support. Only 6 out of 50 patients (12.00%) died. Levels of NLR and PLR were positively correlated with the duration of hospitalization. Levels of NLR and PLR were not significantly associated with the need of inotropic support and mortality, levels of NLR were also not significantly associated with the need of mechanical ventilation whereas levels of PLR were significantly higher in patients who required mechanical ventilation. Conclusion: Levels of NLR were raised in patients with AECOPD (cases) than stable state COPD patients (controls). So levels of NLR can be used as a marker to predict acute exacerbation and there was a positive correlation of NLR and PLR with levels of hsCRP and procalcitonin.
ABSTRACT
Background: Thyroid nodules are commonly present in adult population but are rare in pediatric age group. Inspite of being rare, thyroid nodule have a higher chance of malignancy in children. Thus, pediatric patients presenting with thyroid nodule found clinically or incidentally should be worked up to rule out any possibility of malignancy. The besthesda system for reporting thyroid cytopathology (TBSRTC) is widely used for reporting in adults. The present study aims to use TBSRTC for pediatric thyroid lesions reporting.Methods: All pediatric patients with age ? 18 years presenting with thyroid nodule during January 2018 to April 2019 were included in the study, fine needle aspiration (FNA) was done and findings were compared with histology. Statistical analysis was done using SPSS version 18.Results: 42 pediatric patient were included in the study, out of which 2.38% were malignant and suspicious for nmalignant each and 83% were benign.Conclusion: TBSRTC is quite sensitive and specific reporting guideline in pediatric population as in adult population with 100% accuracy in diagnosing benign and malignant cases. This is useful for avoiding unnecessary surgeries.
ABSTRACT
Schwannoma is a slow growing benign peripheral nerve sheath tumor arising from schwann cells. It is also known as neurilemmoma. Although it is common in the head and neck region, it rarely exceeds 10 cm in size. Usually Schwannomas are notlarger than 5 to 6 cm in diameter.Large tumors are uncommon and are found in posterior mediastinum or retroperitoneum. We are presenting an unusual giant cell schwannoma over face (cheek) measuring 12×10cmsin size which caused facial deformity to the patient. The tumor was diagnosed on FNAC where cell block was prepared and IHC was done which showed S-100 positivity. This size schwannomaover cheek site has not been reported in the literature as far our knowledge. Therefore this case is unique for its size over face.
ABSTRACT
Gout is an acute inflammatory disorder caused by deposition of monosodium urate crystals. Gouty tophus can be the initial presenting feature of chronic disease. Diagnosis of periarticular nodules can be a challenge for clinicians. Fine needle aspiration can provide quick, cost-effective and definitive diagnosis for the early management of these patients. Here, we present the case of gouty tophi of the right-hand index finger in a 45-years-old male leading to restricted finger movements