Prevalence of ocular manifestations and related morbidity in severely malnourished children in a tertiary eye care center

Background: Ocular involvement is relatively common in malnourished children, and the consequences of malnutrition on the eye are frequently more severe during the formative years of life. This is a significant cause of avoidable blindness that has to be addressed with affordable methods. This study aims to determine the nature, extent, and seriousness of ocular manifestations in malnourished children and to evaluate the current prevalence given improving nutritional parameters through increased public awareness, education, and knowledge of vaccination and nutrition. Materials and Methods: This study was carried out in the department of ophthalmology of a tertiary eye care center for 1 year. Eye camps were held close by in urban shantytowns. We considered 518 kids between the ages of 6 months and 5 years who lived in those slums. The patient was subjected to a general, systemic, and ocular examination, including a vision and fundus examination. Results: A total of 100 children aged 6 months and 5 years (60 months) who were severely critically malnourished were enrolled and given an eye examination. In this study, 72% of very acutely malnourished children had ocular involvement. Conjunctival pallor was the most general observation in the anterior segment in 179 of the eyes (71.5% of the eyes). Retinal hemorrhage was the most pervasive posterior segment findings in 19 eyes (36.8%). Conclusion: This study is aimed to determine how frequently ocular symptoms occurred in malnourished children who visited tertiary eye care facilities. A vital target population that requires comprehensive screening to avoid vitamin A deficiency (VAD) and detect eye problems early is preschoolers. Every child should also receive an immunization and vitamin A prophylaxis. Low socioeconomic position, illiterate parents, and inadequate sanitation were determined to be the key risk factors for VAD.

Comparative Study of Bone Marrow Aspiration and Bone Marrow Trephine Biopsy in Haematological and Non-Haematological Disorders

Background: This study was conducted in the Department of Pathology, GMC Patiala on 100 patients over period of three years with the objective to study the comparison of the bone marrow aspiration and bone marrow trephine biopsy in haematological and non-haematological disorders in elderly age patients.(Age >50years). Methods: 100 cases with different hematological and non-hematological problems were taken up for the present study with age >50 years. Salah”s bone marrow aspiration needle and Jamshidi’s bone marrow biopsy needle were used to collect the samples. For staining Leishmann’s and H&E stains were used. Results: Majority of the cases were in the age of 50-60. Majority of haematological disorders comprised of anaemia (62%), leukemia(17.7%), multiple myeloma (7.5%), primary myelofibrosis(2.5%), myeloproliferative disorders(2.5%), hypocellular marrow (2.5%), increased eoisinophils and precurcors(1.2%), NHL (1.2%) lymphocytosis(1.2%) and plasmacytosis (1.2%). Both of the 2 cases of non-haematological disorders were of metastatic carcinomatous deposists. Conclusion: The bone marrow aspiration and trephine biopsy were comparative in most of the haematological disorders except in primary and secondary myelofibrosis where biopsy provided clue to the diagnosis. Non-haematological disorders showed the same findings.

Bone Marrow Aspiration Findings in HIV Positive Patients and Correlation with CD4 Count

Background: Bone marrow abnormalities are common in HIV infected individuals and patients with AIDS. Most of the bone marrow abnormalities associated with HIV infection appear to be related directly to the infection or its complications and not to therapeutic intervention. Bone marrow study is an important investigation in HIV infected patients with peripheral hematological abnormalities. The primary objective was to study bone marrow aspiration findings in HIV positive patients and their correlation with CD4 count. Methods: The interventional, crossectional and prospective study was conducted in Department of Pathology, Government Medical College and Rajindra Hospital Patiala on 100 HIV positive patients, during a period of 2 years. Hematological investigations including complete hemogram, peripheral blood film and bone marrow aspiration was done. Absolute CD4 counts were done. Correlation of various bone marrow abnormalities was done with CD4 count. Results: Bone marrow revealed normocellular marrow in majority of cases, followed by hypocellular. Overall prevalence of myelodysplasia was 78%. Dyserythropoiesis was most common dysplastic change (62%) followed by dysmegakaryopoies (36%), dysgranulopoiesis (25%). Reactive plasmacytosis was seen in 44% cases in the range from 6-20%. Increased lymphocytes seen in 9% cases. There was seen significant correlation between myelodysplasia and CD4 count. Conclusion: Bone marrow abnormalities are common in HIV infected individuals and patients with AIDS.So HIV infection should be considered in the differential diagnosis of patients with secondary myelodysplasia or unexplained bone marrow changes.

Clinical, Cytological and Histopathological Study of Salivary Gland Lesions

Background: A prospective study was conducted in the Department of Pathology, GMC Patiala for two years on 60 patients with swellings of jaw seeking consultation in Rajindra Hospital, Patiala. Methods: Fine Needle Aspiration Cytology (FNAC) was done on all these patients followed by microscopic examination of the prepared slides and relevant clinical information was collected. The data was compiled and analysed statistically. In lesions where surgery followed FNAC, the comparison was done with histopathology and statistical values were calculated. Results: The results of the study were: non-neoplastic cases were 51.7% and neoplastic cases were 48.3%. Maximum cases were of chronic sialadenitis (30%) followed by pleomorphic adenoma (23.3%). Parotid gland was involved in maximum cases (60%). Biopsies or specimens for histopathological examination were received for 30 cases; maximum cases of which were diagnosed as pleomorphic adenoma on histopathology. Among malignant tumors, mucoepidermoid carcinoma was the most common. Conclusion: On correlating the cytological and histopathological nature of salivary gland lesions, sensitivity of FNAC came out to be 75%, specificity 100% and accuracy was calculated as 93.3%.

Histopathological and Endoscopic Correlation of Gastric Lesions in Endoscopic Gastric Biopsies

ackground: There are a number of lesions that could affect the stomach varying from dyspepsia to highly lethal cancers; that can be chronic and incapacitating or merely an occasional discomfort or asymptomatic. Objective: The study was done to establish a correlation between endoscopic findings and histopathological characteristics of the various pathological gastric lesions. Methods: The study was a prospective study and done on 150 affected patients in 2 years. The endoscopic biopsy was taken from number of points of suspicious lesion for histopathologic diagnosis of the type of gastric lesions. The biopsies were fixed in formalin and adequately processed. The sections were stained with routine Haematoxylin and Eosin stain. Giemsa staining for H.pylori was also done. Results: In this study the most common clinical indications for endoscopic biopsy were pain epigastrium (82.0%) and dyspepsia (67.3%) with mean age of 54.25 and male predominance (1.9:1). The various gastric lesions were chronic gastritis (66.0%), adenocarcinoma (8.0%), no specific diagnosis (8.0%), dysplasia (4.7%), hyperplastic polyp (4.7%), acute on chronic gastritis (3.3%), eosinophilic gastritis (2.0%), acute gastritis (1.3%), intestinal metaplasia (1.3%) and chronic atrophic gastritis (0.7%). Conclusion: H. pylori is most commonly associated with acute on chronic gastritis.

Histopathological Findings in Spleen on Autopsy—A Study of 100 Cases

Background: Autopsies are carried out to establish the identity, cause of death, time of death, and antemortem orpostmortem nature of death. These help in establishing the cause of death and ascertain the disease process which led to death. It provides the opportunity to discover new diseases, to evaluate toxic effects of drugs and therapies. The spleen is the site of direct and indirect toxicity, a target for some carcinogens, and also a site for metastatic neoplasia. Many systemic or generalized diseases have splenic involvement. Methods: The present study was conducted on 100 specimens of spleen on routine autopsies received in the department of pathology, Government Medical College, Patiala, Punjab to find out the frequency of various lesions in spleen on autopsy. All the histological sections were stained in H & E stain, mounted ,examined microscopically & findings were recorded and tabulated. Results: 80 of the 100 autopsies were males, while 20 were females. In 81 (81%) cases, the microscopic findings were congestion, hemorrhage in 8 cases(8%) ,7 cases (7%) had autolytic changes,1 case(1%) had necrosis, granulomatous pathology were seen in 2 cases (2%) and 1 case (1%) had leukemic infiltration. Conclusion: Despite recent advances in diagnostic technology, there is large number of cases of preventable diseases for which the autopsy has remained an important complementary tool for identifying.

A Study of Comprasion of Conventional Cytology with Liquid Based Cytology of Thyroid FNAC – A Study of 100 Cases

Background: Fine Needle Aspiration (FNA) cytology of the thyroid has been increasingly utilized for the investigation of thyroid lesions. FNA of the thyroid gland is considered to be most cost effective and accurate primary diagnostic procedure for thyroid nodules. In the recent years many approaches has been devised to improve the quality of thyroid FNA cytology because the conventional smear (CS) is subject to error in sample collection and slide preparation. The liquid based cytology (LBC) originally developed for the application of gynaecologic cervical smears, has progressively gained for application of both non gynaecologic and fine needle aspiration cytological material. According to the Wilcoxon signed ranked test for thyroid lesions LBC was not useful in goitre and infectious lesions. It gave better results in anaplastic and medullary carcinoma. So conventional smear is more sensitive, specific and accurate than LBC. Methods: in this prospective study, we had 100 cases of thyroid. In each case, two passes were performed. The first pass was for CS and the second pass yielded material for LBC. Both CS and LBC smears were compared for cellularity, background blood and necrotic cell debris, cell architecture, informative background, presence of a monolayer of cells and nuclear and cytoplasmic details and test on an for statistical analysis. Results: Diagnostic accuracy was better in CS compared withLBC smears as CS was most sensitive (93.18%) and accurate (91.75%) method for analysis of thyroid while LBC method is sensitive (89.04%) and accuracy (86.59%).Conclusion: Conventional smear is more sensitive, specific and accurate than LBC because LBC introduce more cytological artifacts to thyroid aspirates.

Study of Ascitic Fluid by Liquid Based Cytology and Its Comparision with Conventional Cytosmears and Cell Block Preprations.

Background: Ascites refers to increased volume of fluid collecting within peritoneal cavity which becomes clinically detectable when atleast 500 ml has accumulated. Cytological examination of ascitic fluid gives information about inflammatory and noninflammatory lesions including malignancies, which is done by conventional cytosmears, SurePath liquid based cytological smears and cell block preparations. Aims: The aim of our study was to study the different causes of ascites and their comparison on liquid based cytology with conventional cytology and cell blocks. Methods: Ascitic fluid was obtained from 75 patients of either sex. Microscopic examined was carried out by SurePath liquid based cytology, conventional fixed sediment smears, and cell blocks. Results: Observations were categorised into inflammatory, malignant and inconclusive. Out of 75 cases examined by conventional smears, cytological diagnosis of inflammatory or benign was rendered in 45(60%), 7(9.3%) were diagnosed as malignant and 5(6.7%) were given suspicious of malignancy and 18(24%) were inconclusive. By liquid based cytology 53(70.7%) were rendered inflammatory or benign, 12 (16%) as malignant, 2(2.7%) as suspicious of malignancy and 8(10.7%) were rendered inconclusive. By cell block methodology 52(69.3%) were rendered inflammatory or benign, 11(14.7%) as malignant and 12(16%) as inconclusive. Statistical analysis: Revealed that liquid based cytology was most sensitive (85.71%) and accurate (97.33%) method for analysis of ascitic fluid and conventional smears were least sensitive (50%) and accurate (90.67%). Conclusion: Liquid based cytology showed more sensitivity and accuracy than conventional cytosmears and cell block methods in diagnosing malignant lesions.

Histopathological Pattern of Soft Tissue Tumours in 200 Cases.

Background: Soft tissue tumors are a diverse and fascinating group of lesions that arise from the supporting soft tissue of the body. Although pathologically diverse, they frequently exhibit similar clinical presentations and radiological features. Correct histopathological diagnosis is therefore crucial. This study aims to analyze the histopathological findings of soft tissue tumors and their distribution according to age, sex and site of occurrence in patients. Methods: This study comprised of minimum of 200 cases. All soft tissue tumors received in the Department of Pathology, Govt. Medical College, Patiala were analysed. Their gross features, microscopic findings were analysed in detail. Soft tissue tumors were divided into benign and malignant categories and their further sub typing were done according to WHO Classification. The distribution of soft tissue tumors according to the age, sex and site of occurrence was studied. Results: Out of 200 cases of soft tissue tumors, 169 cases (84.5%) were benign, 20 cases (10.0%) were malignant and 11 (5.5%) were classified under intermediate category. Adipocytic tumors formed the largest group constituting 92 cases (46%).Vascular tumors were the second commonest (18%) followed by peripheral nerve sheath tumors (10.5%). The benign tumors were seen in younger age as compared to malignant tumors. Conclusion: Benign tumors were more common than malignant. The most common benign tumors were lipoma followed by hemangioma (14.0%) and schwannoma (5.5%).There is wide range of their distribution according to age, sex and site. The benign tumors were seen in younger age as compared to malignant tumors.

Extrapleural Solitary Fibrous Tumor (SFT) at Dorsum Foot - A Rare Case Report.

Solitary fibrous tumor is a benign tumor. But it has tendency for local recurrence as well as metastasis. WHO classifies it under the category of fibroblastic/myofibroblastic tumor. It most commonly occurs in pleura and very rare in extra-pleural site such as sub-cutaneous or deep soft tissue of extremity, head and neck, mediastinum, retroperitoneum, etc. Histologically SFT show patternless hypercellular and hypocellular areas of fibroblast proliferation, collagen deposition, hemangiopericytoma like areas with myxoid change or fibrosis. This tumor needs to be differentiated from other spindle cell tumors with immunohistochemistry. It is a rare entity with only a few cases reported. We report a case of 60 years old male with well circumscribed painless, swelling dorsum foot. It was clinically diagnosed as inverted papilloma, but microscopy was consistent with typical features of SFT. This was confirmed by CD 34 & CD99 positivity. This case is being presented for its rare location.

Squamous Cell carcinoma (Moderately Differentiated) of Conjunctiva – A Rare Case in a Five Year Retrospective Study.

Worldwide squamous cell carcinoma (SCC) of the conjunctiva is a rare malignancy; however, it is reported to be the most common malignant tumour of the ocular surface. Its incidence varies between 0.02 and 3.5/100.000. We report a case of squamous cell carcinoma of conjunctiva presented with triangular pedunculated mass of left eye of 75 years old female. It is diagnosed on FNAC and confirmed on histopathological examination after excision. On analyzing the data of FNA done (19150) and biopsies received (23158) in 5 years in the department of pathology, we found only five cases of eye region came for FNA while 25 biopsies of eye region received and diagnosed rightly. Out of all these cases, this is the only case of squamous cell carcinoma of conjunctiva in this study. Incidence of SCC of conjunctiva in our retrospective study of data of total pathological biopsies received found to be 4.3/100000.

Correlation between Clinical Features, Endoscopic Findings and Histopathological Characteristics in Various Esophageal Lesions-A study of 200 Cases.

Background: The present study analyzed the correlation between clinical features, endoscopic findings and histopathological findings in esophageal lesions. Methods: A sample size of 200 patients was taken in the study conducted in Department of Pathology. Data for patient’s age, gender, clinical features (dysphagia, pain epigastrium, regurgitation, loss of weight, loss of appetite), site of biopsy (upper, middle and lower one third of esophagus), endoscopic appearance (erythema, ulceration, nodular and stricture) were analysed. Results: Frequency of various esophageal lesions both benign and malignant (esophagitis, benign lesions, dysplasia, Barrett’s esophagus, SCC-WD, SCC-MD, adenocarcinoma) was calculated in the study group. Finally, correlations were established between age, gender, above mentioned clinical features, endoscopic findings and final histopathological diagnosis of various esophageal lesions. It was concluded that GERD was the most common esophageal lesion and SCC was the commonest malignancy in our region, being more common in men, in old age group (41-60 years). SCC involved the middle esophagus while GERD, BE and adenocarcinoma involved the lower esophagus more commonly. A statically significant correlation was found between dysphagia, loss of weight and esophageal carcinoma. Conclusion: It was concluded that gastro-esophageal Reflux disease was the most common esophageal lesion and Squamous Cell Carcinoma was histopathologically the commonest esophageal malignancy in our region, being more common in men in the old age group (41-60 yrs).

Idiopathic systemic granulomatous pathology causing sudden death due to myocarditis: A rare case report.

Idiopathic granulomatous myocarditis is extremely rare, particularly since the introduction of drugs effective against tuberculosis (TB), viruses, fungi and the effective treatment of sarcoidosis. Here is a case of a 65-year-old female prisoner having history of sudden collapse and ultimately death. Autopsy fi ndings of various viscera on histopathological examination show granulomatous pathology, that is, in spleen, liver and in the left ventricular wall of heart. Ziehl-Neelsen staining of the sections show the absence of acid fast bacilli, negative for fungal staining as most of the granulomas are noncaseating type with presence of giant cells having no asteroid body and Schuamann body, real-time polymerase chain reaction for TB is negative. Idiopathic giant cell myocarditis is a disease of relatively young adults, that is, between 3rd and 4th decade of life. So, this case is strongly considered to be a case of sudden death due to myocarditis as a result of idiopathic systemic granulomatous pathology, a rare case in in literature.

Therapeutic potential of sunflower seeds: An Overview.

Sunflower plant (Helianthus annuus) is a miraculous oil seed crop which is cultivated globally for its seeds. Sunflower seeds, a nutrient dense food has been found to have a potential role in chronic inflammatory conditions, bacterial and fungal infections, cardiovascular diseases, skin diseases and even cancers. These benefits of sunflower seeds are attributed to the presence of phytosterols, unsaturated fatty acids, proteins, variety of vitamins and minerals. Various studies have demonstrated the therapeutic usefulness of sunflower seeds in multiple clinical conditions. This article is to give an overview about wide array of uses of sunflower seeds and to enlighten the therapeutic potential of cheap , accessible and easily available oil seed crop – ‘Sunflower’ in human beings.

Primary pterygium surgery –comparsion of limbal conjunctival autografting versus intra- operative mitomycin-C.

Pterygium is a fibro vascular encroachment of the conjunctival tissue on to the cornea, causing variable degree of ocular morbidity. Various surgical modalities have been developing to decrease the recurrence. The idea of study is to compare the relative efficacy of two well known procedures i.e. conjunctival autografting and intra-operative Mitomycin –C (0.02%) with reference to recurrence and complication rate.

Conventional dacryocystorhinostomy versus endonasal dacryocystorhinostomy:a comparative study.

The objective of present study was to compare the results of endonasal endoscopic dacryocystorhsrtostomy and external dacryocystorhinostomy. It was a prospective non-randomized study. forty corsecutive patients having complaints of watering with complete naso lacrimal dact obstruction were selected for the study. Dacryocystography was done in all the cases. Selection of type of operation was left to the patient’s choice. All patients had preoperative counseling and both the procedures were explained in detail with their advantages and disadvantages. Twenty patients underwent endonasal dacryocystorhinostomy and twenty had external dicryocystorhinostomy Silicon intubation was done in all cases of endonasal dacryocystorhinostomy for three months after surgery. The final follow-up was done at 12 months after surgery. The patency of lactimal passage was confirmed by syringing and patients were questioned about their symptoms. There was no significant difference in the results of both surgeries. The complication rate in both groups was almost equal. Thus we came to the conclusion that these two different dacryocyatorhinostomy techniques are acceptable alternatives.

Carotid cavernous sinus fistula presenting with pulsating exophthalmos and secondary glaucoma.

Carotid cavernous sinus fistula is abnormal communications between the carotid arterial system and the venous cavernous sinus. Carotid cavernous sinus fistula can develop either because of trauma or spontaneous causes. Spontaneous carotid cavernous sinus fistula is often associated with a pre-existing aneurysm in the intracavernous portion of internal carotid artery. However, these fistulas may be congenital arteriovenous connections that open spontaneously in the settings of collagen vascular disease, atherosclerosis, hypertension, or may develop in females during peripartum period. A case of spontaneous carotid cavernous sinus fistula in a young adult male who presented with pulsating exophthalmos and secondary glaucoma is presented. Characteristic features of arteriovenous fistula--bruit, thrill, corkscrew episcleral vessels were present. Radiological investigations were done to confirm the diagnosis. Transvenous embolisation was done to close the fistula.