Study on Seminal Attributes of X- sperm Enriched Sahiwal Bull Semen

The present study was conducted to observe the effect of percoll density gradient centrifugation on quality of semen. Ejaculates were collected by AV method from Sahiwal bulls. X-sperm enrichment was done by percoll density gradient method i.e. 7 layers (70-10%). Centrifugation was done at 750 g (22-24°C) for 15 min. The pellets obtained were diluted in EYC medium. Semen quality was evaluated in fresh semen (Control), in pellet of normal centrifugation (Group I), supernatant of centrifugation in percoll density gradient (Group II) and pellet of centrifugation in percoll density gradient (Group III). To assess the quality of enriched semen pH, mass motility, progressive motility, live spermatozoa %, abnormal spermatozoa %, HOST % and intact acrosome % were evaluated. Number of progressively motile sperms in pellet of X- enriched semen were non-significantly increased and significantly (P<0.05) decreased in supernatant. The abnormal spermatozoa (%) were decreased in G III as compared to G II Live spermatozoa (%) were increased in enriched semen (pellet). Number of Intact sperms decreased significantly (P<0.05) in supernatant of percoll density gradient centrifuged Sahiwal semen. HOST responsive sperms number was not affected after percoll density gradient centrifugation. Thus, the semen quality of X-sperm enriched semen by percoll density gradient method (7 layer 70%) was not affected hence it can be used to increase female calves’ birth after A.I.

Impact of socioeconomic factors on deciduous teeth eruption among infants born after low-risk pregnancy compared to infants diagnosed with intrauterine growth restriction

Aim: The aim is to assess the impact of socioeconomic factors on deciduous teeth eruption among infants born after low-risk pregnancy and infants diagnosed with intrauterine growth restriction (IUGR). Materials and Methodology: The cross-sectional study included 110 neonates recruited at birth using stratified random sampling based on inclusion and exclusion criteria. Neonates diagnosed without IUGR were allocated to Group I (n = 55) and those diagnosed with IUGR were allocated to Group II (n = 55). The perinatal case history was recorded, followed by intraoral examination at birth, 6 months, and monthly up to 1 year or till first evidence of teeth eruption. Results: The difference between both groups based on socioeconomic status (SES) was found statistically significant (P = 0.043). The first evidence of eruption of deciduous teeth was found delayed in Group II (P = 0.0001). Secondary school education was found statistically significant between both the groups (P = 0.024). The difference between the two groups based on religion (P = 0.353) and gravidity (P = 0.571) was found statistically insignificant. Conclusion: Lower SES and secondary maternal education can be considered statistically significant risk factors of IUGR and delayed deciduous teeth eruption. No correlation of IUGR with religion and gravidity was found.

Successful C-section of a Non-descriptive Goat to Relieve from Dystocia

Present case study was associated with successful management of a pregnant doe from dystocia by caesarean section. A 1.5 years old pregnant non-descriptive doe was admitted in the TVCC, C.V.A.Sc., Pantnagar, Uttarakhand with a history of complete gestation period and prolonged labor (more than 12 hours). There was protrusion of both fetal forelimbs from the vaginal opening. Gynaecological examination revealed that the fetus was in Nape presentation. The case was diagnosed as dystocia due to abnormal fetal disposition. The animal was subjected to caesarean operation. The operation was performed under light sedation with 0.1 ml of xylazine and regional inverted L- block was also done with 2% Lignocaine. An oblique incision was given at left flank and recovery of one dead male fetus occurred. Post-operative treatment was done with Inj. Amoxicillin-sulbactum @10 mg/kg intramuscularly, Inj. Tribivet® 5 ml intramuscularly, Inj. Chlorpheniramine maleate @0.5 mg/kg intramuscularly, Meloxicum@0.5 mg/kg intramuscularly and NS 250 ml for five days. Local antiseptic dressing and fly repellant spray was advised for every alternative day. The skin suture was removed on 10th day post-surgery.

A New Look at Neurodevelopmental and Neuropsychological Outcome in Children with Congenital Heart Disease

New surgical techniques and advances in intensive care and medical treatment have significantly decreased mortality rates for children and adolescents with complex congenital heart disease (CHD). Survivors are at risk for neurodevelopmental and neuropsychological morbidity caused by both genetic and environmental risk factors, which causes a distinctive pattern of developmental and neuropsychology impairment characterized by mild cognitive impairment, executive functions impaired social interaction, and impairments in core communication skills, including pragmatic language, as well as attention, impulsive behavior, and impaired executive functions among children affected with congenital heart disease. In view of this, the present study reviews the neurodevelopmental and neuropsychological impairment with an objective of insisting the importance in developing and implementing a neuropsychological intervention program for children with congenital heart defect to retrain neuropsychological and neuro-developmental functions. With increased survival rates, the focus of clinical research in the pediatric cardiac population has paralleled the population shift and transitioned from short term surgical survival to the assessment of long- term morbidity

Attitude and practices of parents toward their children's oral health care during COVID-19 pandemic

Rationale: The impact of COVID-19 has affected billions of people affecting nearly all domains of life, including patient's healthcare needs. Due to constrained dental services during lockdown, pediatric dental needs were severely compromised therefore, parental attitude and practices of maintaining child's oral hygiene impose significant impact on child's oral hygiene. Aim: This study aims to assess the attitude and practices of parents toward their children's oral health care during COVID-19 pandemic. Methodology: The present cross-sectional study was conducted with a sample of 120 parents selected randomly from the outpatient department after obtaining informed consent. A structured questionnaire was used to assess attitude and practice of parents toward their child's oral hygiene during lockdown in COVID-19 pandemic. Results: The overall attitude and practice score of parents in maintaining their child's oral hygiene was low, with mean value of 2.36 ± 1.36 and 2.51 ± 1.50, respectively. 60.8% of parents reported the need of dental treatment for their child during the lockdown period whereas 50.8% parents contacted the dentist during this period; majority (37.5%) of which reported due to toothache. 68.3% of parents would like to visit nearby dental hospital for emergencies during lockdown period. Only 33.3% of parents took extra efforts to maintain their child's oral hygiene while 45% made dietary changes in their child's diet to prevent tooth decay. Conclusion: The overall attitude and practices of the parents were poor toward the oral health of their children during the lockdown period in COVID-19 pandemic. There is urgent need of increasing awareness among parents regarding the importance of maintaining their child's oral health. The inability to see the doctor should at least encourage better home practice measures for future. The concept of tele-dentistry is very new and will be the need of the coming modern times.

Length-weight relationship, feeding traits and nutritional value of mahi mahi (Coryphaena hippurus) in the south-eastern Arabian Sea

Aim: The present study was conducted to investigate the length-weight relationship, food and feeding behaviour and proximate composition of an oceanic epipelagic fish, Coryphaena hippurus landed along Karnataka, south-eastern Arabian SeaMethodology: Length-weight relationship, feeding and proximate composition of C. hippurus was studied for a period of one year. The size composition, feeding intensity, frequency, occurrence and index of relative importance (IRI) was determined for each diet component in the stomach. Monthly proximate composition in the dolphin fish was estimated. Results: The fork length of the specimens of C. hippurus collected along Karnataka coast ranged from 30- 123 cm and fishes having length range from 33-73 cm represented 79% of the total fish sampled. The estimated b values of C. hippurus for both males and females were less than 3 which indicated negative allometric growth; the fish grows faster in length than weight. The most dominant item recorded in the gut of C. hippurus was pelagic and mesopelagic teleosts. Cephalopods (squids, cuttlefish and octopus) were the second important food constituent while crustaceans consisting of crabs and shrimps formed very less quantity. Interpretation: Information on length-weight relationship, feeding behaviour and proximate composition of mahi mahi would be useful for developing suitable management plans for the conservation and judicious exploitation of this commercially important resource.

Locally advanced breast cancer: an observational study for the delay in presentation of patients

Background: Breast cancer is the most common cause of cancer in women and cancer related mortality all over the world. There is strong evidence that delayed diagnosis of breast cancer is associated with poor survival. At our center most of the patients with breast cancer presented as locally advanced breast cancer (LABC) which drew our attention to find out the reasons of delay and its association with different socio-demographic variables.Methods: We enrolled 50 histologically proven cases of LABC in this study. With help of semi structured interview, questions were asked from each patient which could reflect their understanding about the disease to find likely reasons for their delayed presentation, including socioeconomic status.Results: In present study most of our patients were more than 45 years, married. 88% presented late due to unawareness and ignorance about nature and severity of breast cancer disease, 86% had financial issues, 64% had shyness as reason, 20% wasted time by taking alternative treatment, 52% presented late due to painless lump; 30% had fear of losing breast, 18% didn’t get support from family, 4% presented late due to other reasons.Conclusions: Awareness and knowledge of breast cancer was found to be poor amongst sufferers prior to their diagnosis, making it important reason for delayed presentation. Other significant factors being socioeconomic status and education. The need for increased awareness and use of screening practices was identified to be essential for early diagnosis of the disease and for improved outcomes.

Geriatric gynecology: need and spectrum

Background: Geriatric gynaecology deals with gynaecological pathologies essential in post-menopausal women aged 65 years and above. The spectrum of geriatric gynaecological disorders in India differs from those in developed countries as there are no effective screening program for early detection of cancer and the burden of ignorance and taboos. In this study we aim to find the spectrum of gynaecological disorders in geriatric women and establish the need of dedicated geriatric unit.Methods: A cross-sectional comparative study was conducted on menopausal women of age 45 years or above who attended gynecology OPD for general counselling about menopause or treatment of menopausal problems over the period of 6 months duration. All these menopausal women attending OPD during this interval were evaluated on the basis of pretested questionnaire.Results: Out of 234 post-menopausal women who entered the study, 29% women belong to geriatric group. Post-menopausal bleeding due to both malignant and benign causes and pelvic organ prolapse are the major problems in geriatric women whereas somatic complaints like flushing, night sweats are more common in younger menopausal women.Conclusions: Where the medical science has successfully increased the life expectancy, focused approach to geriatric gynecology around us is our responsibility, where female still hesitate to come out. The need for dedicated geriatric gynecology unit in India on urgent basis is emphasized by this study wherein cancers can be screened in early stage and severe lifestyle hampering conditions like pelvic organ prolapse can be treated timely.

Huge Sertoli-Leydig cell tumor: a rare case report

Sertoli-Leydig cell tumors (SLCTs), constitute less than 0.5% of all ovarian tumors. SLCT are rare after menopause (less than10%), 75 years, unmarried, postmenopausal since 30 years, presented with complaints of abdominal swelling. On examination, abdominal mass of 36 weeks, hard, immobile felt. Ultrasonography of abdomen showed lobulated solid cystic lesion of size 22 x 15 x 27 cms with bilateral ovaries not separately visualized. Moderate free fluid in the abdomen, suggestive of malignant neoplastic etiology. CECT Abdomen + pelvis suggestive of primary ovarian malignancy with omental deposits and pelvic adenopathy. CA 125- 415.1 Patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy with huge tumour mass excision (weight 5.25 kg) with umbilical hernia repair. Frozen section suggestive of a huge mass of 30 x 20 x 15 cm, multilobulated, yellowish white tan in colour, solid-cystic in consistency, seen arising from right ovary. Omentum appears normal. Histopathology report s/o- Moderately differentiated Sertoli Leydig cell tumor. Reporting the first, this huge, in this age group with atypical presentation.

Comparative study to determine self-medication practice and pattern in urban and rural areas of Etawah district

Background: According to William Osler, a great feature which distinguishes man from animals is the desire to take medicine. Self-medication is an age old practice. According to World Health Organization guidelines “self-medication is defined as use of medicinal products by the individuals to treat self-recognized disorders or symptoms, or the intermittent or continuous use of a medication prescribed by a physician for chronic or recurring diseases or symptoms.Methods: It was a cross sectional study, which was conducted among residents of urban and rural areas of Etawah district, Uttar Pradesh by using 40×5 cluster sampling. The data was collected by using pre designed, semi-structured questionnaire. Proforma included socio- demographic profile, practice of self- medication and pattern of self-medication.Results: Most of the participants who indulged in self-medication in urban areas 69.5% and rural areas 65% belong to the age group 20-39 years. Majority of the participants (51.0%) in urban areas belonged to the nuclear family while most of the participants (50%) belonged to joint family followed by nuclear family (40%) in rural areas. most common reason for self-medication in urban area was the availability of old prescription which is present in 30.0% (60) of subjects but in rural area most common reason for self-medication was high fee of doctor which was 29.0% (58).Conclusions: Most common age group indulged in self-medication was 20-39 years. Most common reason for self-medication was availability of old prescription at home while in rural area, high fees of doctor was the common reason for self-medicatio

Microbial contamination of mobile phones of health care providers at a teaching hospital in a hilly North Indian State

Mobile phone is a ubiquitous device used in health care settings as well. Its frequent handling, closeness to the body and heat generated during functioning provides a favourable environment for microbial contamination and growth; as well as opportunities for their transfer from one person to another through health care provider. Objective: To investigate whether health care workers mobile phones carry microbes and to identify areas or health personals where this was more common. Material and methods: A cross sectional study was conducted at a medical college and its associated hospital in a northern hilly state of India to determine the prevalence of microbial contamination of mobile phones used by health care providers. Doctors, Nurses, Laboratory Technicians and Medical Interns were contacted at their place of work to collect swab samples from their mobile phones. Sample collection sites included out-patient clinics as well as in-patient wards, emergency department and intensive care unit. All health care providers available at the time of visit to these departments were included in the study. Swab samples collected were immediately transferred to microbiology department where overnight incubation in peptone water at 37°C followed by culture and appropriate testing to identify organisms was done. Result: A total of 100 swab samples were collected, 28 from doctors, 20 from nurses, 25 from technicians and 27 from medical interns. All of them except one showed growth. Single growth were 56 while 43 cultures had multiple growths. Organism of medical importance isolated included Coagulase Negative Staphylococci (CoNS), Methicillin Resistant CoNS, Methicillin Resistant Staphylococcus aureus (MRSA), Klebsiella, S. aureus, E.coli among others. Conclusion: Almost all mobile phones were contaminated, more than half of whom were harbouring pathogenic micro-organisms. It could be a major threat to the health care providers as well as patients in form of nosocomial infections.

Trend Analysis Of Leprosy Cases At A Primary Health Centre In Thane District Of Maharashtra

Introduction: India reports more than 60% of leprosy cases. The state of Maharashtra reported more than 15000 new cases in the year 2015-16. These figures show that we are miles away from the ultimate goal of leprosy eradication. This study was planned to analyse trends of Leprosy in a PHC located in Thane district of Maharashtra. Objectives: 1) To analyze the trends of leprosy cases in study area. 2) To give recommendations on the basis of study data. Results: The number of new cases reported fluctuates over the five year period. But the %MB cases have remained high and fairly constant which are comparable to national and state average. The % of children among Leprosy patients is on a rise with every 3rd patient being a child in last year of this Trend Analysis. The Prevalence Rate was 3.6/10000 in 2012 which went up in subsequent year and settled down at 4.4 for years 2015 and 2016. The ANCDR on other hand also went up in 2013 and has shown a gradual decline between years 2014 – 2016. Conclusion: This 5 year short term study shows that though it was difficult to absolutely conclude a rising or a decreasing trend, however, the Prevalence rate of leprosy cases in study area remained constant and the ANCDR showed a decline over most of study period.

Comparison of priming versus slow injection for reducing etomidate-induced myoclonus: a randomized controlled study / 대한마취과학회지

BACKGROUND: Etomidate injection is often associated with myoclonus. Etomidate injection technique influences the incidence of myoclonus. This study was designed to clarify which of the two injection techniques—slow injection or priming with etomidate—is more effective in reducing myoclonus. METHODS: This prospective randomized controlled study was conducted on 189 surgical patients allocated to three study groups. Control group (Group C, n = 63) received 0.3 mg/kg etomidate (induction dose) over 20 s. Priming group (Group P, n = 63) received pretreatment with 0.03 mg/kg etomidate, followed after 1 min by an etomidate induction dose over 20 s. Slow injection group (Group S, n = 63) received etomidate (2 mg/ml) induction dose over 2 min. The patients were observed for occurrence and severity of myoclonus for 3 min from the start of injection of the induction dose. RESULTS: The incidence of myoclonus in Group P (38/63 [60.3%], 95% CI: 48.0–71.5) was significantly lower than in Group C (53/63 [84.1%], 95% CI: 72.9–91.3, P = 0.003) and Group S (49/63 [77.8%], 95% CI: 66.0–86.4, P = 0.034). Myoclonus of moderate or severe grade occurred in significantly more patients in Group C (68.3%) than in Group P (36.5%, P < 0.001) and Group S (50.8%, P = 0.046), but the difference between Groups P and S was not significant (P = 0.106). CONCLUSIONS: Priming is more effective than slow injection in reducing the incidence of myoclonus, but their effects on the severity of myoclonus are comparable.

Association of Helicobacter pylori with Parkinson's Disease

BACKGROUND AND PURPOSE: Parkinson's disease (PD) is a major neurological disorder that requires lifelong treatment, and the combined presence of Helicobacter pylori (H. pylori) infection can increase the required anti-PD medications. We aim to investigate the effect of H. pylori infection in Indian PD patients. METHODS: We prospectively recruited 36 PD patients from December 2007 to January 2011. All patients underwent a detailed neurological evaluation and serological examination for H. pylori infection. Seropositive and seronegative patients were considered to be the cases and controls, respectively. All patients who were seropositive received triple therapy for 2 weeks. Outcome measures of the mean ‘off’ Unified Parkinson's Disease Rating Scale (UPDRS)-III score, mean ‘on’ UPDRS-III score, mean onset time, mean ‘on’ duration, and mean daily ‘on’ time were measured at baseline and at a 3-week follow-up. RESULTS: H. pylori-IgG positivity was present in 18 (50%) PD patients. The prevalence of men (72.2% vs. 33.3%), mean duration of disease (13.8 vs. 12.5) and mean levodopa equivalent daily dose (824 mg vs. 707 mg) were significantly higher among H. pylori positive patients than in controls (p<0.0001). Controls had a significantly longer ‘on’ duration and daily ‘on’ time, and better ‘on’ UPDRS-III scores. Seropositive patients took a significantly longer time to turn ‘on’ after a levodopa challenge. At the 3-week follow-up, H. pylori eradication significantly improved the mean ‘on’ UPDRS-III score, onset time, ‘on’ duration, and daily ‘on’ time. CONCLUSIONS: H. pylori infection was present in 50% of Indian PD patients. H. pylori seropositivity was associated with a poor response to levodopa and increased medication usage, while eradication therapy was associated with better patient outcomes.

Expression profile of mce4 operon of Mycobacterium tuberculosis following environmental stress

Background: The mce4 operon is one of the four mce operons with eight genes [yrbE4A, yrbE4B, mce4A, mce4B, mce4C, mce4D, mce4E and mce4F] of Mycobacterium tuberculosis. It expresses in the later phase of infection and imports cholesterol for long term survival of the bacilli. To cause latent infection, M. tuberculosis undergoes metabolic reprogramming of its genes to survive in the hostile environment like low availability of oxygen and nutrition depletion inside the host

Objective: To analyze real time expression profile of mce4 operon under various stress conditions

Methods: M. tuberculosis H37Rv was exposed to surface stress [0.1% SDS for 30 min and 90min in late log and stationary phase of culture], hypoxia [5, 10, 15 and 20 days] and grown in the presence of either glycerol or cholesterol as sole source of carbon. The expression profile of genes of mce4 operon was analyzed by real time PCR

Results: Surface stress induced expression of mce4C and yrbE4B in late log phase on 30 min and 90 min exposure respectively. The SDS exposure for 30 min induced mce4C, mce4D and mce4F in stationary phase. All eight genes were induced significantly on 10th and 15th days of hypoxia and in the presence of cholesterol

Conclusion: Hypoxia and cholesterol are potent factors for the expression of mce4 operon of M. tuberculosis

Review on the comparison of effectiveness between denosumab and bisphosphonates in post-menopausal osteoporosis

OBJECTIVE: Osteoporosis is a rapidly rising cause of concern for elderly patients. Various classes of drugs are available in the market. Bisphosphonates are considered as a first-line therapy for the prevention and treatment. Denosumab is an antiresorptive agent which is a RANK ligand inhibitor. There is a scarcity of comparison between these two classes of drugs. The aim of this study is to compare efficacy of Bisphosphonates and Denosumab in various parameters. MATERIALS AND METHODS: Literature search was done for randomized controlled trials (RCTs) comparing bisphosphonates with denosumab. RCTs with a treatment period of at least one year with a baseline bone mineral density (BMD) and bone turnover markers (BTM) and follow up values at one year were included in the study. All included studies were also analysed for complications. The study has also been registered in PROSPERO International prospective register of systematic reviews. RESULTS: A total of five RCTs were identified providing data on 3751 participants. In all five studies, the BMD changes at both hip and spine were statistically significant in favour of denosumab. Result was similar in three studies that studied BMD changes at the wrist. Denosumab also produced significant reduction in BTM as early as one month, but at one year there was no difference compared to the bisphosphonates. There was no statistically significant differences in the complication rates. CONCLUSION: Though both bisphosphonates and denosumab were effective with similar side effects, the latter was statistically superior in increasing the BMD and reducing the BTM.

Fetuin A: A Newer Marker for Pre Diabetes.

Objective: To evaluate the role of Fetuin A levels in predicting glycemic outcome in individuals with impaired fasting glucose. Research Design and Methods: A total of 742 young individuals were recruited for the study out of which 177 had impaired fasting glucose, 468 had normoglycemia and 97 individuals with diabetes. These individuals were offsprings of diabetics (either mother or father or both) and were siblings amongst themselves belonging to age group of 18-35 years. Various biochemical investigations such as fasting plasma glucose, glycosylated Hb, serum insulin, C-peptide and Fetuin A were carried out. People with impaired fasting glucose were followed and analyzed according to glycemic outcome and quartile of Fetuin A level. Results: A total of 66 individuals with prediabetes reverted back to normal, 28 progressed to diabetes and 83 remained with prediabetes over a mean±S.D follow up of 24±4.1 months. People in the highest quartile of fetuin A had the highest Insulin, Insulin Resistance, Increased loss of beta cell activity, decreased sensitivity to insulin and a higher rate of progression to diabetes (relative risk 11.96, 95% CI 5.9 to 24.01, p<0.001) and a significantly lower rate of reversion to normoglycemia (relative risk 5.62, 95% CI 3.16 to 9.9, p<0.001) than those in other Fetuin A quartiles. fetuin A correlated positively with Insulin (r= +0.289, p<0.001), C-peptide (r=+ 0.177, p<0.001), %β cell function(r= -0.368, p<0.001), insulin resistance (r= +0.436, p<0.001) and glycosylated Hb (r=+0.958, p<0.05) and negatively with % sensitivity to insulin( r= -0.287, p<0.001). Cox regression analysis showed that baseline fetuin A, insulin levels and fasting glucose levels were predictive of reversion to normoglycemia. Conclusions: Increased fetuin A levels had an adverse impact on glycemic outcomes thus suggesting that fasting plasma glucose and Fetuin A can be used as a tool to determine the susceptibility of an individual to develop pre-diabetes and thus diabetes mellitus.

Scaling up Weekly Iron and Folic Acid Supplementation in Jharkhand, India Minimizing Challenges, Maximizing Opportunities.

Objectives: Jharkhand is a predominantly tribal Indian state. Home to 3.5 million adolescent girls, two-thirds of Jharkhand's adolescent girls were reported to be anaemic. In 2000, the Government of Jharkhand launched the Adolescent Girls Anemia Control Programme (AGACP) in five of its 24 districts with technical support by UNICEF. This presentation summarizes a decade of experience in scaling up Jharkhand's AGACP. Methods: In its initial phase, the programme covered around 250,000 school-going adolescent girls in 2800 schools. The intervention included weekly iron and folic acid (IFA) supplementation, bi-annual deworming, and nutrition counselling. The second phase was launched in 2009 to cover two million adolescent girls. During this phase the programme faced important challenges due to a break-down in the supply chain of IFA supplements and deworming tablets. However, weekly nutrition counselling sessions continued. The third phase of the programme was inaugurated in 2012 with the advent of the National Weekly Iron and Folic Acid Supplementation (WIFS) programme implemented in a convergent manner by the Departments of Health and Family Welfare, Women and Child Development, and Education. Results: The programme has been universalized across all 24 districts, by the state government. Currently, the programme covers 3 million adolescents. Conclusions: Approaches used for stabilizing the programme are valuable lessons (do's and dont's) in piloting, stabilizing and scaling up a large scale programme for the control of anaemia in adolescent girls in resource-constrained settings.

Endoscopic Ultrasound-Guided Fine-Needle Aspiration of the Adrenal Glands: Analysis of 21 Patients

BACKGROUND/AIMS: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) cytology of adrenal masses helps in etiological diagnosis. The aim of this study was to evaluate the diagnostic yield of EUS-FNA of adrenal masses in cases where other imaging methods failed and/or were not feasible. METHODS: Twenty-one consecutive patients with adrenal masses, in whom adrenal FNA was performed because conventional imaging modalities failed and/or were not feasible, were prospectively evaluated over a period of 3 years. RESULTS: Of the 21 patients (mean age, 56+/-12.2 years; male:female ratio, 2:1), 12 had pyrexia of unknown origin and the other nine underwent evaluation for metastasis. The median lesion size was 2.4x1.6 cm. Ten patients were diagnosed with tuberculosis (shown by the presence of caseating granulomas [n=10] and acid-fast bacilli [n=4]). Two patients had EUS-FNA results suggestive of histoplasmosis. The other patients had metastatic lung carcinoma (n=6), hepatocellular carcinoma (n=1), and adrenal lipoma (n=1) and adrenal myelolipoma (n=1). EUS results were not suggestive of any particular etiology. No procedure-related adverse events occurred. CONCLUSIONS: EUS-FNA is a safe and effective method for evaluating adrenal masses, and it yields diagnosis in cases where tissue diagnosis is impossible or has failed using conventional imaging modalities.