Diagnostic Accuracy of Imprint Cytology and Frozen Section for CNS Tumor.

The present study was a cross-sectional type of descriptive one carried out with the objective of determining the diagnostic accuracy of imprint cytology and frozen section of central nervous system tumors. A purposively selected sample of 33 clinically diagnosed patients with CNS tumors has been included for the study. The relevant data on CNS tumors were collected by using imprint cytology, frozen section and paraffin section. The sensitivity of imprint cytology was 75.0% and specificity was 55.17% respectively. On the other hand positive predictive value of imprint cytology was 18.75% and negative predictive value was 94.11%. The sensitivity of frozen section was 100% and specificity was 86.21% respectively. Comparing the findings of the frozen section to histopathology, the positive predictive value was 50.0% and negative predictive value was 100%. The sensitivity and specificity of imprint cytology was lower in comparison to frozen section and paraffin section. Still then imprint cytology is preferred, because it can be carried out rapidly and easily. It will also be a very helpful aid especially when facilities for frozen section are limited but neurosurgical-procedure is available. A well designed research with adequate sample size should be carried out to get better diagnostic accuracy of imprint cytology in central nervous system tumors.

Case Report of Tetralogy of Fallot Associated with Tight Lesion of the Left Anterior Descending Coronary Artery.

A small subset of patients with TOF present later in life with unsuspected or untreated disease. Tetralogy of Fallot in adults represents a special group with peculiar problems related to the effects of prolonged cyanosis over the heart and other organs .Older age has been considered as incremented risk factor for surgical mortality and long-term survival in patients with TOF. Based on this assumption, indication for surgery after long-standing cyanosis has caused controversy. There are few reports that studied this issue have proved some benefit in repairing adults with TOF .The greatest benefit of complete repair at this age is the functional improvement. We report a male patient with TOF with tight lesion of the left anterior descending coronary artery diagnosed at age 40 years and successfully underwent total correction along with CABG. This patient was the oldest documented in Bangladesh undergoing successful corrective surgery for TOF with CABG.

Evaluation of diagnostic accuracy of different biomarkers for prostate cancer

Serum total prostate specific antigen [PSA], free fraction of total prostate specific antigen percent [fPSA%] and prostate specific antigen density [PSAD] have all been considered as valuable non-invasive tumor markers for prostate cancer. This study was carried out to evaluate and compare the performances of serum total PSA, fPSA% and PSAD in terms of their sensitivity, specificity and overall diagnostic accuracy for prostate cancer. Fifty [50] DRE [digital rectal examination]-positive patients admitted in Rajshahi Medical College Hospital [RMCH], Bangladesh during January, 2006 to January, 2008 were included. Estimation of serum total PSA and fPSA% were done by ELISA [Enzyme linked immunosorbent assay] using commercially available kits. Data pertaining to volume of prostate as determined by transabdominal ultrasonography were used to calculate PSAD and histology of the surgically resected prostatic tissue was done for laboratory confirmation of prostate cancer for all patients. Diagnostic sensitivity, specificity and accuracy of serum total PSA, fPSA% and PSAD were calculated using standard formulae against histopathological diagnosis. Prostate cancer was revealed in 41 of 50 patients by histopathological examination with mean age of 71.2 +/- 10.1 years. There were 9 cases detected as Nodular Hyperplasia of Prostate [NHP] with prostate-specific biomarkers mostly within their normal range. The sensitivity, specificity and overall diagnostic accuracy for prostate cancer of serum total PSA [at cut off value of >10 ng/ml] were 80.48%, 88.90% and 82.00%, for serum fPSA [at cut off value of <25%], were 92.68%, 77.80% and 90.00% and for PSAD [at a cut off value of > 0.15 ng/ ml/cm[3]], were found to be 90.00%, 88.90% and 90.00% respectively. Histologically, 27 [65.85%], 13 [31.71%] and 01 [2.44%] cases were labeled as poorly differenntiated, moderately differentiated and well differentiated carcinoma respectively and overwhelming majority had excellent correlation with all prostate-specific biomarkers. These results reinforce that different prostate-specific biomarkers have good diagnostic prediction with free PSA percent and PSAD have slightly better diagnostic accuracy over serum total PSA for prostate cancer

Abdominal actinomycosis

This case report describes abdominal Actinomycosis of the greater omentum which was detected accidentally in a patient who had been suffering from right lower quadrant abdominal pain mimicking acute appendicitis. She had history of previous appendisectomy. During surgery multifocal masses were detected in greater omentum, suspicious of inflammation. She had partial omentectomy done and the specimen was sent for histopathological examination. The histopathological examination confirmed it to be Actinomycosis. The patient had an intensive antibiotic therapy prescribed in order to prevent a disease relapse because it was not sure whether the remaining part of omentum was affected by microscopic Actinomycosis

Goblet cell carcinoid of the vermiform appendix

A 38 years old female was admitted in a private hospital with history of abnormal uterine bleeding. Total abdominal hysterectomy [TAH] with unilateral salpingo-oophorectomy was performed. On request of the patient and their attendants, appendisectomy was done. Histopathology of the Vermiform appendix confrimed it was a goblet cell carcinoid

Ebstein’s Anomaly Corrected by Tissue Valve: Case Report.

Ebstein’s anomaly is a rare form of congenital heart disease with incidence of 1% of all congenital heart diseases. There are two modes of surgical correction of Ebstein’s anomaly: either biventricular repair with or without tricuspid valve replacement, or palliative univentricular repair consisting of bidirectional Glenn shunt or Fontan procedure. We treated a case of severe form of Ebstein’s anomaly with ASD secundum with WPW syndrome. Radiofrequency ablation was done to treat WPW syndrome preoperatively. Celermajer’s index is a prognostic indicator for tricuspid valve repair or replacement. On 04.03.08 tricuspid valve was replaced with 31 mm Carpentier-Edwards bovine pericardial valve under cardiopulmonary bypass. Postoperative period was uneventful. Follow up echo done on 01.06.08 which revealed normally functioning tissue valve found in tricuspid position TR Grade I. So, in conclusion, preoperative evaluation and workout of Celermajer’s index is essential before surgical intervention for decision of tricuspid valve repair or replacement. Last but not the least, any event of arrhythmia should be properly evaluated.

Effect Of Inbreeding On Gestational Period And Anthropometric Measurements At Birth In North India.

The effect of consaguinity on gestational period, birth weight, recumbent length, head circumference and chest girth at birth in a group of 2264 babies (1174 males, 1090 females) delivered in Aligarh during March 1989 to 1991 has been studied. Means and regression coefficients revealed a reduction in all the measurements with inbreeding.