Role of Ki-67 and Argyrophilic Nucleolar Organiser Region (AgNoR) Counts in Squamous Cell Carcinoma

Background: Squamous cell carcinoma of the cervix is the most common subtype of cervical cancer and it usually accounts for 80-90% of the cases. These carcinomas mostly grow at the squamocolumnar junction (SCJ). The tumour tends to grow outward showing an exophytic growth especially at the squamocolumnar junction outside the external uterine wall whereas cancer tends to grow along the cervical canal showing an endophytic growth pattern where the SCJ is located within the cervical canal. This study has experimentally shown the role of AgNOR and Ki-67 scores in tumour proliferation. Methods: Cervical specimens were obtained and prepared in a specified fashion as described. The samples were de-waxed and staining was done with AgNOR. Then, the AgNOR was counted and scoring was done. Again, the samples were also stained with Ki-67. Results: This study has included 235 cases from the Department of Pathology of Ganesh Shankar Vidyarthi Memorial Medical College, Kanpur, India. The mean value of AgNOR count in the Control group came to be 10.62�45 while the mean AgNOR count was found to be 10.62�45, 15.10�79, 18.39�67, 19.75�74 and 19.59�59 for in-Situ SCC, well-differentiated SCC, moderately differentiated SCC, poorly differentiated SCC, SCC with basaloid differentiation, respectively. Conclusion: The study confirmed that AgNOR count increases with a higher grade of malignancy. It was concluded that AgNOR and Ki-67 scores can be used as an efficient predictor of tumour proliferation.

Comparative evaluation of different cost effective ovulation induction drugs and their effect on follicular growth, endometrial thickness and pregnancy outcome

Background: Ovulatory dysfunction is a common cause of female infertility, occurring in up to 20 - 30% of infertile women. The most commonly prescribed ovulation drugs are clomiphene citrate (CC), tamoxifen, aromatase inhibitors (such as letrozole) and gonadotropins. Objective of the study was to evaluate the efficacy of clomiphene citrate, letrozole and tamoxifen for ovulation induction in anovulatory infertility.Methods: Randomized open label interventional clinical trial. Patients were randomized to 3 drug groups. After baseline investigations, they were subjected to ovulation induction and then USG monitoring of follicular growth and ovulation. The primary outcome measured was occurrence of conception. Secondary outcome was effect on endometrial thickness and ovulation rate.Results: In the study, letrozole group showed 100% mono-follicular response. Mid cycle endometrial thickness in about 17% of cases in CC group is ≤8 mm. But all the cases in tamoxifen and letrozole group have ET >8 mm. This difference is statistically significant. The ovulation and conception rates are highest in letrozole group but the difference was not statistically significant.Conclusions: Letrozole produces higher mid cycle endometrial thickness, 100% mono follicular development than clomiphene and tamoxifen. This difference is found to be statistically significant. Ovulation rate and conception rate is highest in letrozole group. But there is no statistically significant difference among the three drugs.

Thanatophoric dysplasia: a case report

Thanatophoric Dysplasia (TD) is a congenital, sporadic and most lethal skeletal dysplasia caused by new mutation in FGFR3 gene. Authors report such a rare case of a term alive baby with dysmorphic features, born to an unbooked, 40 years old G4P3+0 with non-consanguineous marriage; admitted at 9 months of gestation to present hospital with complain of pain abdomen for 2 days. Patient delivered a term female baby of vaginally which had delayed cry after birth, Admitted in NICU immediately with respiratory distress. The baby looked dysmorphic and suggested TD as most likely diagnosis. The case is being reported for its rarity and for high importance of early booking and anomaly scan. Early diagnosis is important since it provides alternative options of termination of pregnancy when an affected foetus is detected.

An Unusual Case Of Vulval Tuberculosis In Pregnancy

Tuberculosis (TB) continued to be a major health problem throughout the world, especially affecting developing countries. India and China together account for 40% of the world’s TB burden. Here, we present a rare case of genital TB in a 24-year-old pregnant woman (G2P1 + 0.34 weeks of pregnancy) with chronic vulval ulcer of 2 years. Histopathological examination was suggestive of TB, but acid-fast bacilli culture of biopsy specimen was found negative. The patient was started on anti-TB therapy. After 3 months, there was a remarkable improvement in her symptoms and >50% regression of the lesion.

Higher Bifurcation of Brachial Artery with Superficial Course of Radial Artery in Forearm.

An unusual case of bilaterally symmetrical higher bifurcation of brachial artery into radial and ulnar arteries with superficial course of radial artery in right forearm is reported. Accurate information regarding these variations is important during vascular and re-constructive surgery and also in evaluation of angiographic images.