Primary plasma cell leukemia in 32 years old male A case report.

Plasma cell leukemia (PCL) is a rare disease and is the least common variant of multiple myeloma accounting for 2-3% of all plasma cell dyscrasias. Histogenetically, plasma cell leukemia is derived from terminally differentiated B cells. It is diagnosed by presence of absolute plasma cell count >2000 per cm or >20% circulating plasma cells. Here we report a case of plasma cell leukemia, who presented with easy fatigability, weakness and high grade fever since 1 month. Hematological investigation revealed leukocytosis with plasmacytosis (7420/ mm3). On bone marrow examination, >45% plasma blasts were seen. Biochemical analysis showed high LDH level (4236 U/L) and serum calcium level was also raised (12.3 mg/dl). Final diagnosis of plasma cell leukemia was made. As PCL is rare disease and it is even rarer to find them in a 32 years old. Here we are able to find and document the typical features of PCL.

Progressive multifocal leukoencephalopathy in non HIV, splenectomised, 66 years old male A rare case report.

Progressive multifocal leukoencephalopathy (PML) is a rapidly progressive AIDS-defining disease of the central nervous system. PML affects up to 8% of patients with AIDS and in most cases is fatal within 3–5 months. We presented here a case of 66 years old male who is non HIV with past history of splenectomy, and diagnosed as progressive multifocal leukoencephalopathy which is very rare. Here, we presented this rare entity which may be difficult to diagnose although, histopathological examination helps greatly in the diagnosis of this condition but the specificity and sensitivity of JC virus DNA PCR in CSF are quite acceptable.

Audit of repeat fine needle aspiration in cytopathology laboratory.

Background: FNAC is cost-effective, high diagnostic accuracy, reliable, rapid and inexpensive procedure in diagnosis of various clinically palpable as well as deep seated swellings. This study was intended to discover factors associated with repeat aspiration with the help of audit of cytology laboratory. Material and methods: Retrospective study of 248 cases which came to Cytology Laboratory of Dhiraj Hospital during the period of 1st January 2013 to 30th December 2013 had included. All patients who attended the Cytology laboratory for the FNAC procedure and USG guided FNAC were included in the study. Data for the audit was collected from the cytology records. The following information was documented for this audit: Age and sex, site of FNAC, documented reasons for repeat and patient IPD/OPD numbers. We had also noted the documented reasons for repeats and the duration between the repeats. Results: Out of 248 aspirations, 61 from breast swellings, 75 from the lymph nodes, 58 from the thyroid lesions, and 54 were from the miscellaneous lesions. 31 patients (12.5%) were advised repeat aspiration and 22 (8.87%) were actually repeated. In our study the most common cause for the repeat aspiration was inadequate cellularity (51.61%). Outcome of the repeat aspirations included 16 (72.73%) diagnostic and 6 (27.27%) non diagnostic aspirations. Conclusion: In our study, there were so many reasons for the repeat aspirates. In order of occurrence these are: Inadequate aspirates, non-diagnostic descriptive reports and hemorrhagic aspiration.

Non-neoplastic lesions of the ovary - A review.

Ovary is an important organ as it is concerned with the production of progeny. Ovary is the commonest site of neoplastic and non-neoplastic lesion, can present in childhood to postmenopausal age group and accounts for the most prevalent cause of hospital admissions. non-neoplastic ovarian lesions are classified as inflammatory (infectious and non infection ), non-inflammatory (cystic and non-cystic) and pregnancy related disorders.

Study of innovative teaching methods to enhance teaching and learning in Forensic Medicine.

Background: Didactic lecture is the current method of choice but it is not effective way of teaching. Interactive lecture with various innovative teaching methods is the best proven way for teaching and learning. Material and methods: Cross sectional study was conducted in Department of Forensic Medicine for period of 1 year by voluntary participation of 100 students 2nd MBBS. Three topics of Forensic Medicine were taught by jigsaw, think-pair-share and team project to three equal number groups of students and they were subjected to pre and post intervention questionnaire. Results: There was significance increase in mean post test score for all the innovative teaching methods for all topics. There was no significance difference in mean post test scores of all three innovative teaching methods which indicated that all three innovative teaching methods were effective and good to practice. Conclusion: Instead of didactic lecture, interactive lecture with innovative methods like think-pair-share, team project , and jigsaw is a very helpful and essential for effective teaching and learning.

Histopathological vs cytological findings in cervical lesions (bethesda system) A comparative study.

Background: Cervical cancer is the major health burden in India. For detection in early stage, the screening test is Pap smear. To check the sensitivity and specificity of Bethesda system, the cytological findings have to be correlated with histology considering histopathology as gold standard. Material and methods: The The study was retrospective review of Pap smears in Dhiraj General Hospital in the period from November 2013 to December 2014. They were correlated with corresponding follow-up biopsies using revised 2001 Bethesda System. Results: Most of patients were of group 41-50 years which were 106 (42.4%), followed by group 51-60 years which was 53 (21.2%). Majority of cases were of parity 3 which were 71 (28.4%) followed by of parity 4 which were 53 (21. 2%), Majority of cases were of parity 3 which were 71 (28.4%) followed by of parity 4 which were 53 (21.2%). with mean parity of patient was 3.30. Conclusion: The Pap smear has good sensitivity and specificity in detecting pre-neoplastic and neoplastic lesions of uterine cervix

Histopathological vs cytological findings in cervical lesions (bethesda system) A comparative study.

Background: Cervical cancer is the major health burden in India. For detection in early stage, the screening test is Pap smear. To check the sensitivity and specificity of Bethesda system, the cytological findings have to be correlated with histology considering histopathology as gold standard. Material and methods: The study was retrospective review of Pap smears in Dhiraj General Hospital in the period from November 2013 to December 2014. They were correlated with corresponding follow-up biopsies using revised 2001 Bethesda System. Results: Most of patients were of group 41-50 years which were 106 (42.4%), followed by group 51-60 years which was 53 (21.2%). Majority of cases were of parity 3 which were 71 (28.4%) followed by of parity 4 which were 53 (21.2%), with mean parity of patient was 3.30. Conclusion: The Pap smear has good sensitivity and specificity in detecting pre-neoplastic and neoplastic lesions of uterine cervix.

Role of FNAC in diagnosis of gouty tophi-A case report.

Periarticular nodules may not be recognized as tophi because the clinical diagnosis of gout in many instances is not straightforward. In such a setting, fine needle aspiration cytology (FNAC) of gouty tophi would facilitate the clinical diagnosis and treatment. FNAC is valuable in confirming the nature of periarticular nodules especially in case of gouty tophi as compared to the histopathology. Thus FNAC is the gold standard for the diagnosis of gouty tophi presenting as periarticular nodules.