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Background: Yellow phosphorus containing rodenticide poisoning are common in Adult critical care. They cause coagulopathy and liver cell failure in humans. Till date, only liver transplants had been advocated as the final treatment of fulminant liver failure occurring as a complication of rodenticide poisoning. In this study, an innovative Treatment approach was given to liver cell failure cases who had consumed yellow phosphorus paste.Methods: Retrospective analysis of case records of liver cell failure cases due to the consumption of phosphorus containing Rodenticide poisonings, were analysed for a period of 1 year from January 2018 to January 2019 in a public hospital. Medical case records were obtained from records department and Postmortem registers. Symptoms, signs, investigations, treatments, complications, and outcomes were tabulated.Results: Total 11 cases were studied. 8 cases of liver cell failure and coagulopathy in whom therapeutic heparin free plasmapheresis was given, recovered completely from liver cell failure. A significant drop in Haemoglobin, platelet count, PT INR Ratio and rise in serum alkaline phosphatase, were the predictable factors used for the intervention of therapy with 5 cycles of heparin free plasmapheresis to eliminate toxic effects of phosphorus on liver cells and in the blood. A comparative analysis of untreated cases (n=3) vs treated with plasmapheresis (n=8), showed a significant statistical difference (P <0.005) in outcomes with a degree of freedom=2.Conclusions: Plasmapheresis can be a therapeutic treatment for liver cell failure caused due to the consumption of yellow phosphorus. Predictable factors for impending liver cell failure in whom plasmapheresis will be of benefit are dependent upon prothrombin time, INR ratio, Liver enzymes and time interval between consumption and onset of liver cell failure.
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Introduction: Breast lesions are a common cause of morbidity and mortality in women; with breast carcinoma being most common female cancer worldwide, requiring prompt diagnosis. Fine needle aspiration cytology (FNAC) is a valuable diagnostic tool with high degree of accuracy.Aims and objectives:To determine the accuracy of FNAC in diagnosis of palpable breast lumps. To correlate the cytological findings with histopathological examination of surgical specimens.Methods: We conducted a retrospective study from January 2016 to December 2017. FNAC of breast lump was performed in 271 patients out of which 104 patients underwent subsequent histopathlogical examination. These 104 patients were considered as our study group. Cyto-histopathological correlation was done in 104 patients.Results: The age range of 104 patients was 14-70 years. Mean age was 32 years ± 15 years. 54 patients presented with lump in left breast, 46 patients in right breast and 4 with bilateral lumps. Out of 104 patients, 77 cases were benign, 24 were malignant and 3 were atypical/suspicious lesions on cytological examination. On histopathological examination, 77 cases were benign, 26 were malignant and 1 was atypical/suspicious. Cyto-histological concurrence was 93.05% and 79.2% for Fibroadenoma and Infiltrating ductal carcinoma respectively. Overall sensitivity of FNAC procedure was 94.17%, specificity 100% and accuracy 93.26%. Conclusion: We concluded that FNAC is a simple, reliable method for diagnosis of both benign and malignant lesions and can be used in the evaluation of breast lesion.