ABSTRACT
Background: Cutaneous malignancies are rare with respect to other malignancies. The distribution of various histologies of these malignancies is not uniform. We aimed to study the distribution of these malignancies and their epidemiological pattern in Eastern Rajasthan with the data collected from various pathology labs in Jaipur. Methods: In this retrospective chart review we analysed the data of 453 patients presenting with histopathologically proven cutaneous malignancies to four major pathology departments and labs in Jaipur, Rajasthan. We recorded the distribution of these histologies according to incidence, age of presentation, gender and site predilection. The data was subsequently analysed using statistical methods. Results: Squamous cell carcinoma (36%)was the most common histology which was closely followed by basal cell carcinoma(31%). Malignant melanoma (13%) was the third most common histology to present. Other less common histologies to present were dermatofibrosarcoma, Kaposi sarcoma, non hidgkin lymphoma etc. The age range varied from 14 to 90 years. The mean age of presentation was 54.3 years. Male had a slight preponderance (1.36 times more than females)overall. Except Bcc, which had a female preponderance. Head and neck(38.41%) was the most common site to be affected overall followed by lower limbs(31.56%). Interpretation: The idea of distribution of these rare malignancies in our part of the country will not only help us in proper surgical management but also in educating the public about the possible causes and the need for early intervention leading to better prognosis.
ABSTRACT
CONTEXT: Acute appendicitis poses a significant diagnostic challenge to the surgeon. Despite modern advances, the diagnosis of appendicitis remains essentially clinical. Ultrasonography is effective in supplementing the clinical diagnosis. AIMS: This study aims to evaluate the negative appendicectomy rate in patients subjected to appendicectomy and to assess the usefulness of ultrasound in improving the diagnostic accuracy. SETTINGS AND DESIGN: It is a retrospective review of prospectively collected data on 118 patients operated for suspected acute appendicitis in a single surgical unit between May 2001 and December 2002. METHODS AND MATERIAL: The detailed history, clinical examination and preoperative investigations according to protocol were recorded on a proforma. All patients underwent an ultrasonography of whole abdomen including pelvis. Each patient with suspected acute appendicitis was subjected to surgery and appendix was submitted for histopathological examination. The negative rate of appendicectomy, sensitivity and specificity of ultrasonography and positive and negative predictive value of ultrasound were calculated. RESULTS: The negative appendicectomy rate was 23.72%. In males it was 13.43% and in females 37.25%. Ultrasonography had a sensitivity of 63.33 % and a specificity of 82.14 %. The predictive value of a positive test was 91.93% and the predictive value of a negative test was 41.07%. CONCLUSIONS: The clinical diagnosis of acute appendicitis when supplemented with an ultrasonography, can achieve a reasonable degree of diagnostic accuracy with resultant low negative exploration rates thereby reducing the financial burden and morbidity by avoiding unnecessary appendicectomy and keeping the cost of treatment affordable.
