Solid papillary carcinoma of the breast

Solid Papillary Carcinoma (SPC) of the breast is a rare tumor with an incidence of less than 1%, mainly affecting elderly females. It is morphologically characterized by well-defined nodules with low-grade nuclear features associated with fibrovascular cores and shows neuroendocrine differentiation. SPC can be in-situ or invasive but has a favorable prognosis. It is a morphological mimicker of some pre-malignant conditions leading to its frequent misdiagnosis. An appropriate immunohistochemical (IHC) panel workup helps in distinguishing this tumor from its various morphological mimics. In this report, we present one such case of SPC with a small focus of invasion, reviewing the literature.

Change in Carbapenem Susceptibility Patterns among Urinary Escherichia coli isolates at a Tertiary Care Centre

Introduction: Escherichia coli (E.coli) is the major pathogencausing urinary tract infections (UTIs), and carbapenems areprescribed frequently to treat UTIs at tertiary care settings. Itis, therefore, of clinical importance to determine the changein carbapenem susceptibility of E.coli isolated from urinarysamples after adopting a new cleaning policy. Study aimed todetermine the change in antimicrobial susceptibility of E.colistrains isolated from urinary samples towards carbapenems.Material and methods: A retrospective comparison ofcarbapenems susceptibility profile of E.coli isolated fromurine cultures at a tertiary care centre was carried out for twoyears between 2017 and 2018. E.coli isolates were identifiedfrom positive cultures as per the conventional microbiologicalmethods. Carbapenem susceptibility was exhibited usingMeropenem (10 µg) disk on Mueller-Hinton Agar (MHA)using Kirby Bauer disk diffusion method.Results: In a total of 1219 urinary E.coli isolates, sensitivitytowards carbapenems has increased from 81.3% to 84.2%(overall 83.2%). The value of chi-square for the differencein the distribution of Meropenem susceptibility for 2017 and2018 was found to be <0.001, which is highly significant.Hence, the susceptibility profile of Meropenem changedsignificantly in two consecutive years in this tertiary carehospital after adopting a new cleaning policy.Conclusion: E.coli is the leading pathogen causing UTIs,and carbapenems are prescribed frequently, so regularmonitoring of antimicrobial susceptibility is recommended.Better cleaning policies can improve the sensitivity patternsof isolates towards antimicrobials.