Clinico-Pathological Profile of Oral Mucocele in a Tertiary Care Centre – A Comparative Study

Background: Oral mucocele are common non neoplastic lesions of the oral cavity that develop either as a result of damage to the duct or obstruction to the duct of minor salivary gland. Histopathologically oral mucoceles are divided into two categories: Extravasation mucoceles often seen in young individuals, the lower lip being the classic location. The second category includes retention mucoceles, which occurs most often in older patients usually located in the floor of the mouth and the inside the cheek. Objectives: This study aims to describe the demographic and histological characteristics of Oral mucocele along with com- parative study between Extravasation mucocele and Retention Mucocele. Method: A total of 32 cases of mucocele diagnosed in the Department of the Pathology, between 2012 and 2019 were re- viewed. The clinical data were recorded and histopathologic diagnosis was made. The study variables included were age, gen- der, type, site, color, etiology, symptoms and dimension of the lesion. Results: A total of 32 cases of oral mucocele cases were studied corresponding to a M:Fratio of 1.13:1. Peak incidence occurred in third decade followed by equally in the first and second decades of life. Extravasation Mucocele was the clinical diagnosis in 59.4% and Retention Mucocele in 40.6%. Most lesions were located in the lower lip (59.3%). Conclusion: This study provides an important insight into demographic and histological profile of oral mucocele lesion. It was concluded that oral mucocele predominantly presented in two histological forms, Extravasation Mucocele which was more common than other lesser common form Retention Mucocele. Although these lesion are easily diagnosed on the basis of clini- cal presentation but sometimes these swelling can mimic other benign mucosal lesion of these region, hence histopathologi- cal examination must be done in order to rule out these lesion and also to note any variation from its normal morphological findings.

Modified Alvarado's Score incorporating C-reactive protein for Acute Appendicitis

Background: Acute appendicitis is one of the commonest surgical conditions requiring emergency appendectomy. The diagnosis is usually suspected clinically and confirmed on either ultrasound or Computed tomography. The aim of our study is to improve the diagnostic accuracy of acute appendicitis and reduce the rate of negative appendectomy. We have modified the Alvarado’s score by incorporating C- reactive protein and deleting two of its components (leukocyte shift to left and migration of pain from umbilical region to right iliac fossa). Methods: We successfully used this scoring system on a sample size of 100 patients. Out of 100 patients, diagnosis was confirmed on histopathological examination in 76 patients. Neutrophilic infiltration of the muscularis layer was considered as the diagnostic criteria for acute appendicitis. Ten patients were diagnosed only on CECT abdomen as Appendicular lump. These patients were not operated. Alternate diagnoses were made in twelve patients with MAS score of 5 or less and in two patients with MAS score of more than 6. Results: On statistical analysis, the result showed that the MAS is a very specific (85.7%) and highly sensitive (95.3%) in detecting Acute Appendicitis, taking Histopathology or CT as gold standard test. While, the positive predictive value is 97.6%, negative predictive value is only 75%. Conclusions: This means that it is difficult to rule out acute appendicitis in patients with lower scores. However, for such patients further investigations can be done to reach to a final diagnosis.

Mini Hydrocelectomy – Outcome of A Short Term Study and Comparison with Conventional Jaboulays Technique

Background: Hydrocele is among the commonest benign conditions of scrotum. Its incidence is around 1% in adult male population with a predilection for males above 40 years of age. Conventional surgical procedures like Jaboulays Eversion of Sac (EOS) and Lords plication of redundant tunica vaginalis remain the most commonly used procedures used in the treatment of idiopathic adult hydrocele. Both procedures are invasive and are associated with durable success and low incidence of recurrence. These procedures are however associated with many post-operative complications like pain, hematoma, infection, persistent swelling and induration of scrotal skin, wound related complications, chronic pain and reduced fertility. All these translate into high morbidity, loss of work hours and increased surgical expenses. To avoid / minimize these complications associated with plication or excision of the redundant hydrocele sac fenestration has been proposed as a minimal access procedure. Fenestration exposes the secretory surface of the tunica vaginalis sac to the lymphatic-rich subcutaneous tissues, from where the hydrocele fluid is cleared off the scrotal cavity.  Methods: The present study was carried out in the Department of General Surgery, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard during the time period of June 2014 - December 2015. 120 patients of primary vaginal type hydrocele with ASA grade 1 were randomly allocated into two groups of 60 patients each – one group for the Mini-Hydroceletomy MiH-(Group A) and the other group for routine Jaboulays EOS (Group B). All the patients were followed up for a period ranging from 6-18 months. Results: Mean age of patients was 42 years for jabouleys and 45 for mini hydrocelectomy group. Mean hydrocele volume for Group A was 240 ml and for group B was 252 ml. Average time for the procedure in group A was 10-12 min (mean 11min) and for group B was 25 -30min (mean 27min). In Group A, Average incision length was 2.1 cm whereas in Group B it was 5.4 cm. Conclusions: We hereby present our experience that mini-hydrocelectomy (MiH) technique to be the procedure of choice for medium sized uncomplicated hydroceles.

Helicobacter pylori Infection and Associated Risk Factors in Patients with Upper Gastrointestinal Symptoms

Background: H. pylori infection is the most common chronic bacterial infection in the world which can result in various gastrointestinal diseases, ranging from inflammation to even malignancy. Its prevalence is higher in developing countries, especially in lower socioeconomic groups. This study aimed to establish the prevalence of H. pylori infection in symptomatic patients and its relationship with various risk factors specially smoking, alcohol and socioeconomic status. Methods: A prospective cross-sectional study was done in symptomatic patients undergoing gastroduodenoscopy, to assess the prevalence of H. pylori and its associated risk factors in a tertiary care hospital of South Delhi. The gold standard diagnosis of H. pylori infection was histologic presence of the bacteria in the gastric biopsy. The variables analyzed as possible risk factors included demographic and living characteristics, socioeconomic status, smoking, alcohol, and clinical indications of H. pylori infection. Results: A total of 70 patients with upper gastrointestinal symptoms were included in the study. On histopathology, 51were found positive for H. pylori infection with a prevalence of 72.86%. No statistically significant difference was found between the H. pylori infection and socioeconomic status. H. pylori infection was found to be statistically significant for subjects who consumed alcohol (93.3%, p=0.046). They had 6.67 times risk of developing H. pylori infection compared to non-alcoholics. There was no significant association of H. pylori infection among the smokers and the non-smokers. Conclusions: There was no significant relationship between smoking, tobacco consumption, socioeconomic status and H. pylori infection. However, alcohol consumption (93.3%, p=0.046) and non-vegetarian diet (80%, p=0.01236) showed a higher significant association with active infection.

Epidermoid Cyst of Glans Penis in an Adolescent Male: A Common Entity at an Uncommon Site.

Epidermoid cysts are benign lesions occurring anywhere in the body, but it is a rare entity over glans penis. Even though a few cases are been reported in adult age group, epidermoid cyst occurring at glans penis in young age is very rare. The etiology in penile area is not specific, but it may represent a monolayer teratoma of germ cell origin or an abnormal embryogenic closure of the median raphe. Being benign its harmless, but secondary infections are common which gives an indication for surgical removal of the cyst. Here, we report a case of epidermoid cyst in a 14-year-old boy who came with painless swelling over the glans penis.

Epidermoid Cyst of Ovary: A Rare Entity.

Rare instances of epidermoid cyst of ovary have been reported in literature with incidence of <1% among all the ovarian tumors. It often mimics mature cystic teratoma of the ovary and needs extensive sampling and careful microscopic examination to rule out the presence of adnexal structures and other tissues. Most of the cases in literature were reported as an incidental finding, but large epidermoid cyst of the ovary is seen as a rare entity. We present one such quizzical case of a large epidermoid cyst of ovary occurring in a 44-year-old female presenting with multiple fibroids of uterus.

Hematological profile and pregnancy: a review.

Many physiological hematological changes occur during pregnancy to accommodate the demands of the developing foetus. Infect, these changes may appear to be pathological in the non-pregnant state. Although physiological in nature, but abnormal hematological profile does affect pregnancy and its outcome. One of the most important underlying cause of maternal mortality is due to underlying hematological complications. This review deals with thorough understanding of range of these haematological parameters during pregnancy.

Significance of apoptosis in prostatic intraepithelial neoplasia and carcinoma.

This study was carried out to assess the significance of apoptosis in prostatic intraepithelial neoplasia (PIN) and prostate cancer. A total of 120 prostatic specimens were studied in the department of Pathology [corrected] JNMC, Aligarh. The rate of apoptosis in PIN and prostate cancer was examined by quantifying the number of apoptotic bodies per hundred cells (apoptotic index) on haematoxylin and eosin stained histological sections [corrected] A significant correlation was noted between increasing apoptotic indices and increasing Gleason grades within a cancer.