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Background: Renal involvement in SLE is common. Lupus Nephritis is the major cause of mortality in SLE patients. Renal involvement is a severe form of the disease and subsequent management is planned according to the histopathological class of lupus nephritis. Thus, this study was planned to assess the clinical profile and the extent of renal disease in SLE patients.Methods: A prospective observational study was conducted among SLE patients who got admitted in the Department of General Medicine and Nephrology in Thanjavur Medical College Hospital, Thanjavur from July 2012 to October 2013. Fifty SLE patients who had renal symptoms were included in this study.Results: SLE is Common among females. Common renal presentations were haematuria and proteinuria. 42% of the patients had Class IV lupus nephritis, followed by 24%, 16%, 16%, and 2% of Class III, II, Class V and Class I lupus nephritis respectively. No case of class VI lupus nephritis was reported in this study. ANA was positive among 66%, Anti ds DNA was positive in 64% and C3 level was found to be reduced in 50% of patients. Antiphospholipid antibodies were seen in 2% of the patients.Conclusions: Proteinuria, haematuria, a lower serum C3 level and need for aggressive hypertension management were prominently seen with a worse class of lupus nephritis. Patients with active and proliferative forms of lupus nephritis had a severe course of illness and required aggressive management with immunosuppressants.
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Introduction: CNS infections are an emerging health problemwith poor prognosis if the treatment is not prompt andadequate. Thus, establishing a correct diagnosis is necessaryto quickly start the appropriate treatment. This study wasundertaken to study the etiology and the imaging spectrum ofCNSI in and around western Uttar Pradesh in a tertiary healthcare set up and to correlate the neuro-imaging findings withclinic-pathological data.Material and Methods: In this Prospective Observationalstudy 80 patients clinically suspected of CNS infection werestudied by CT/MRI and the neuro imaging findings werecorrelated with clinical and CSF findings.Results: Based on clinical features, CSF findings, thetreatment given and the response to treatment tuberculousinfection (TBM) was most common infection (41.2%)followed by pyogenic meningitis (36.2%) and viral infection(22.5%). In 29 patients of pyogenic CNS infection mostcommon imaging finding was leptomeningitis(62%)followed by pachymeningitis (31%), hydrocephalus (24.1%),abscess (6.8%), post vasculitic infarct(6.8%) and extra axialcollection(6.8%). In 33 patients of tubercular CNS infectionmost common imaging finding was basal leptomeningitis(78.7%) followed by tuberculoma (72.7%), pachymeningitis(33.3%), hydrocephalus (27.2%), abscess (12.1%), postvasculitis infarct (12.1%) and spinal cord involvement in1 (3%) patient. In the 18 viral CNS infection cases mostcommon imaging finding was parenchymal hyperintensity onMRI or hypodensity on CT with/without peripheral vasogenicedema (94.4%) followed by leptomeningeal/pachymeningealinvolvement (61.1%) and post vasculitis infarct (11.1%).Conclusion: The sensitivity of neuroimaging in pyogenicCNS infection was 81.2% and specificity was 93.7% whilesensitivity of neuroimaging in tubercular CNS infection was88.8% and specificity was 97.8% and in viral CNS infectionsensitivity was 84.2% and specificity was 96.7%. There wassignificant association (p value <0.05) of basal leptomeningitisand granulomas on imaging with tubercular infection andparenchymal signal changes with viral infections
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Leprosy is a major public-health problem in developing countries like India. Studies pertaining to proportion and characteristics of pediatric cases are few in number. As these reflect indirectly the effectiveness of programme, this study has been carried out to know the clinical, bacteriological and histopathological characteristics of childhood leprosy cases who came to Dermatology Venerology Leprology (DVL) Outpatient Department of a Tertiary Care Centre in South India over a period of 2 years (from January 2015 to December 2016). This prospective observational study had 26 (23%) pediatric cases of leprosy out of 113 who attended DVL OPD. The age of childhood leprosy cases ranged from 10 to 18 years with mean of 14 years. 76% cases were males and 24% cases were females. 84% cases presented with hypopigmented, anaesthetic patches, 11% cases with grade 3 disabilities and 3% with tingling and numbness of both feet. 80% cases were MB and 20% were PB. 76% of children had multiple skin lesions and 24% had single skin lesion (SSL). Of the 20 multiple skin lesions cases examined histopathologically, 11 showed features of BT, BL and LL with overall concordance of 55% (11/20). Among cases clinically classified as MB, 33 % cases were smear positive. Overall 7/26 ( 26%) of child cases in our study were bacteriologically positive. Only 19% of patients had history of contact within the household. 8% cases developed LR. Six cases had deformities. The mean duration of symptoms was around six months. All the patients were treated with MDT. The present study though small and may/may not be representative of distribution/profile of leprosy in children at population level indicates the severity of childhood leprosy in society as evidenced by MB nature, high bacteriological positivity and unacceptable disability rate. After in depth studies at community level, strategy need to be improved to ensure early diagnosis and treatment.
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Background: Bone tumours are comparatively uncommon among wide array of lesions and pose a diagnostic problem as they constitute a small portion of diagnostic experience among pathologist. Aims & Objective: To study the histopathological features of bone lesions and their correlation with age of presentation, site and type of lesion. Material and Methods: The present study was carried out at a tertiary care center from October 2003 to January 2006. A total of 79 bone lesions were analyzed. A detail clinical and radiological history was taken. Bone biopsy was performed by either percutaneous method with needle/drill or Open surgical biopsy. If attached soft tissue was also received, bony tissues were put for decalcification (10% nitric acid) and soft tissue was immediately fixed into 10 % formalin and processed by paraffin embedding. Sections were stained by haematoxylin and eosin stain. Results: Incidence of non-neoplatic and benign neoplastic lesions was 68.40% while that of malignant lesion was only 20.22%.Younger patients (58.24%) and males (59.49%) were more commonly affected. Amongst non-neoplastic lesions, tuberculous lesions (17.72%) were commonest while exostosis (15.19%) and osteosarcoma and chondrosarcoma were common benign and malignant neoplastic lesions respectively. Overall most common bone involved was femur. In tuberculous lesions, vertebrae were commonly involved. Osteolytic lesions were more common. Metaphysis was the commonest site. Conclusion: Though bone tumours are less common lesions and pose a diagnostic problem, if viewed in perspective of clinico-radiology and histopathology, a correct diagnosis can be reached.
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Se evaluaron las características clínicas, histológicas y la evolución de una cohorte de pacientes con linfomas de la órbita y anexos oculares. Entre 1995 y 2008 se estudiaron 25 casos de linfomas de la órbita y anexos oculares en un centro oncológico de referencia. En cada caso se analizó el inmunofenotipo usando un panel de anticuerpos monoclonales (CD45, CD20, CD3, CD5, CD23, BCL2, BCL6, BCL10, Ki67, CD30, CD15, BCL1, Kappa, Lambda, CD138). Las lesiones fueron evaluadas utilizando el sistema de clasificación de linfomas (OMS, 2008). Se analizaron 23 linfomas primarios y dos secundarios. Los subtipos histológicos fueron: 16 linfomas B de la zona marginal asociados a las mucosas (MALT), cuatro linfomas difusos de células grandes B, dos linfomas foliculares y un paciente con linfoma Hodgkin. De los 25 casos estudiados, 22 presentaron estadios localizados. El linfoma MALT fue el subtipo más frecuente. En este estudio se observó enfermedad localizada en la mayoría de los casos y con baja progresión a distancia.
Clinical, histological features and outcome of a cohort of patients with orbital and adnexal lymphoproliferative tumors were evaluated. Twenty-five cases in an oncologic referral center from 1995 to 2008, were included in the study. Each case had detailed immunophenotypic analysis using a panel of monoclonal antibodies (CD45, CD20, CD3, CD5, CD23, BCL2, BCL6, BCL10, Ki67, CD30, CD15, BCL1, Kappa, Lambda, CD138). Lesions were classified by using WHO (2008) lymphomas classification. Twenty-three patients were found to have primary and two secondary lymphomas. Histological subtypes were: 16 patients with marginal zone B cell lymphoma of mucosa-associated lymphoid tissue (MALT) lymphoma, four diffuse large B cell lymphomas, two mantle cell lymphomas, two follicular lymphomas, and one Hodgkin lymphoma. Among the 25 patients studied, 22 had localized stage. Extranodal marginal zone lymphoma was the most frequent type of primary orbital and adnexal lymphoma. In this study localized disease was observed in most cases, and distant spread of the lymphomas was infrequent.