Peripheral neuropathy and the role of nerve biopsy: A revisit

Background: Nerve biopsy has been widely used to investigate patients with peripheral neuropathy and in many centers, it is still a part of the diagnostic armamentarium. In this study, the histopathological spectrum of the nerve biopsies received is being revisited to analyze the various clinical and pathologic features and also to assess their relevance. Materials and Methods: Retrospective analysis of the data retrieved was done for 74 cases of nerve biopsies. Results: On the basis of the data and histopathological features, broad diagnoses were obtained in 52 cases and further categorized into biopsies being supportive for patient management (including acute and chronic axonopathies and demyelinating neuropathies) and biopsies considered essential for patient management (including vasculitic neuropathies, leprous neuropathies, hereditary neuropathies, and chronic inflammatory demyelinating neuropathies). Nine nerve biopsies did not show any abnormal histopathological features, while 13 nerve biopsies were found to be inadequate for diagnosis, both these groups were categorized as noncontributory. Conclusion: With advanced nerve conduction studies available, nerve biopsy is losing its relevance. However, in our experience, nerve biopsy did complement the clinical findings and nerve conduction studies, with which a close correlation is required to make the histopathology of nerve biopsy more relevant in terms of guiding further specific workup and management.

Vertebro-cerebral cryptococcosis mimicking tuberculosis: A diagnostic dilemma in countries with high burden of tuberculosis.

We report a case of a 30-year-old immunocompetent man with disseminated cryptococcosis who was initially treated with antitubercular therapy due to clinical and radiological diagnosis of vertebro-cerebral tuberculosis. The diagnosis of Cryptococcus infection was made due to incidental isolation of this fungus from blood culture with negative cerebrospinal fluid culture results. Though disseminated cryptococcosis with central nervous system, skeletal, and skin involvement is an uncommon manifestation of Cryptococcus neoformans infection, a high clinical suspicion and early initiation of therapy is needed to recognise and treat such patients efficiently.

Efficacy and safety of unguided percutaneous fine needle aspiration cytology in peripheral lung lesions.

The efficacy and safety of unguided percutaneous fine needle aspiration cytology in peripheral lung lesions were studied in 42 patients. The diagnostic yield of unguided aspiration was 83.3%. The yield in malignant lesion was 85.7% while in benign lesion it was 78.6%. There was no false positive report. Complications seen were asymptomatic pneumothorax and blood tinged sputum in a few cases following aspiration. The procedure was well accepted by the patients. Unguided FNAC is a simple, quick, economical, safe and reliable procedure for the diagnosis of peripheral lung lesions.

Leprosy deformities. II. As parameters to monitor the effectivity of leprosy control programme.

Leprosy deformities have been considered as the main reason for dehabilitation and social ostracism. Prevention of deformities is considered as one of the most important objectives of leprosy control programme. In present work based on deformity status, efforts have been made to evolve new parameters and their possible application in assessment of leprosy control programme.

Leprosy deformities. I. An epidemiological study in a rural area of Rajasthan.

Leprosy deformities have been the cause of dehabilitation, destitution and social ostracism. Present study was planned and conducted in a rural area situated in eastern districts of Rajasthan. Out of 426 cases of leprosy, ninety cases were found suffering with deformities. The influences of various host factors and disease factors, in causation of deformities have been discussed.

Leprosy in eastern region of Rajasthan.

Total population survey covering 28055 persons living in 34 villages of eastern Rajasthan was carried out. Out of 28055 persons 20276 (72.27%) were actually examined and 218 cases of leprosy were detected. Prevalence of leprosy was found to be 10.75/1000, which is very high and contrary to earlier observations regarding leprosy prevalence in Rajasthan. Leprosy problem in Rajasthan has been discussed.