Expression of BRCA1 by immunohistochemistry and its association with ER, PR, Her2neu status in infiltrative ductal carcinoma of breast.

BACKGROUND: Breast cancer is a heterogeneous disease, which differs in its clinical behaviors and responses to treatment and outcome. The prognosis of breast cancer depends on histopathological parameters and molecular subtypes. Among more than 300 genes, which are involved in the pathogenesis of breast cancer tumor suppressor gene such as BRCA1 is known to play a significant role in hereditary cancers. However, its role in sporadic cases of infiltrating ductal carcinoma is yet to be established. AIMS AND OBJECTIVES: To evaluate the expression of BRCA1 in infiltrative ductal carcinoma and to analyze the association of BRCA1 with histopathological parameters and estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor2 (Her2) neu expression. MATERIALS AND METHODS: This was a laboratory-based exploratory study in which 56 patients with infiltrative ductal carcinoma who underwent radical mastectomy from October 2019 to July 2021 were included. Patients with chemotherapy and radiotherapy, trucut biopsies, and incomplete patient details were excluded. Immunostaining for BRCA1 was performed. Individual clinicopathological parameters were compared with the BRCA1 mutation. Statistical analysis was done using SPSS 22. A P value of < 0.05 was considered statistically significant. RESULTS: Among 56 cases of IDC, 18 cases (32.1%) showed BRCA1 mutation. BRCA1 mutation was associated with postmenopausal age, larger tumor size, lower tumor grade, and higher tumor staging. When we analyzed the biomarkers with BRCA1 mutation, it showed a negative association with ER, PR, and Her2 neu and a high Ki67 proliferation index. No family history of breast carcinoma was seen in 34/56 patients where history was available. CONCLUSION: Our study showed BRCA1 mutation in 32.1% and associated with postmenopausal age group, larger tumor size, and higher staging and negative hormonal status of breast carcinoma.

A questionnaire-based survey to assess knowledge and practice of health care workers regarding genital hygiene: from a rural tertiary hospital in India.

PURPOSE: Maintaining good genital hygiene is an important component in reducing human papilloma virus (HPV) infections and its sequelae such as cervical pre-cancer and cancer. Awareness on the exact practice of maintaining genital hygiene is important as they are different in men and women, and both are equally important in reducing genital HPV infections. STUDY DESIGN: A questionnaire-based survey was undertaken to assess knowledge and practice of cervical cancer and its relationship with genital hygiene. Interns, post graduate students, consultants, and nurses were invited. Domain-based assessment was done. Correlation between the domains was performed using Pearson's coefficient. RESULTS: 87 respondents completed the questionnaire. Six domains on awareness of physical and genital hygiene, cervical cancer causation and prevention, health education and personal experience of cervical cancer were explored. In the awareness domains, the response was uniformly poor in 45-50% of respondents. Nurses had poor knowledge in every domain of the questionnaire. CONCLUSIONS: There is an urgent need to improve and bridge the gap of knowledge and practice in hygiene and cervical cancer. This is necessary since nurses and interns are the first line for disseminating proper information to the general public. Webinars, seminars, and continued medical education (CME) programs must be included in the training curricula to impart knowledge on genital hygiene and cervical cancer.

GeneXpert assay - A cutting-edge tool for rapid tissue diagnosis of tuberculous lymphadenitis.

BACKGROUND: The most prevalent clinical entity of extra pulmonary tuberculosis is tuberculous lymphadenitis. However, it resembles other granulomatous conditions pathologically and obtaining tissue for microbiological diagnosis is also difficult. Thus it is a challenging task for diagnosis and early initiation of management. Fine needle aspiration cytology and biopsy are the diagnostic methods generally used to obtain the lymph node samples for histopathological and microbiological diagnosis. Mycobacterium culture on Lowenstein-Jensen medium remains the gold standard for definitive diagnosis, but its major limitations is a prolonged turn-around time of 2-4 weeks. The GeneXpert Mtuberculosis/RIF assay is a novel molecular diagnostic method for rapid diagnosis of tuberculosis and rifampicin resistance in clinical specimens. METHODS: This was a cross sectional analytical study conducted on 67 cases of suspected tubercular lymphadenitis at R.L Jalappa Hospital and Research Centre, Tamaka, Kolar. The study was carried out between December 2017 to June 2019. The samples were collected using excision biopsy and subjected to GeneXpert Mtuberculosis/RIF assay and histopathology. Further, sensitivity, specificity, positive predictive value and negative predictive value was measured and compared with histopathology. RESULTS: The average age of the patients was 37.04 ± 19.27 and majority was males. The lymph nodes were predominantly present in cervical region. Histopathology analysis reveals 46 positive cases of tuberculosis Lymphadenitis and GeneXpert Mtuberculosis/RIF assay detects 42 cases of tuberculosis Lymphadenitis. In the present study, GeneXpert Mtuberculosis/RIF assay had a sensitivity of 82.60% and specificity of 85% when compared to histopathology. Further the PPV and NPV was found to be 92.68% and 68% respectively. GeneXpert Mtuberculosis/RIF showed 2 cases of rifampicin resistance out of 67 cases. In this study, the GeneXpert Mtuberculosis/RIF showed the results in 0.79 days. CONCLUSION: The present study showed that GeneXpert Mtuberculosis/RIF is a simple and reliable technique for diagnosing tuberculosis Lymphadenitis with high specificity and sensitivity as compared histopathology. Further, the methods elicit rapid diagnosis and also detected rifampicin resistance. It is thus a reliable and useful diagnostic modality in rapid detection of the causative agent and initiation of appropriate category anti-tubercular therapy when necessary.

Epidermal Cyst in the Breast: A Diagnostic Dilemma.

Epidermal cyst [10] and panniculitis are relatively uncommon conditions [2]. A combination of these arising in the breast is extremely rare. We report a case of epidermal cyst with panniculitis in the breast. A patient presented with a large breast lump of 5 cm in the right breast. Sonography showed a well-defined, central hyperechoic mass. A giant fibroadenoma was suspected clinically and based on imaging. Fine needle aspiration revealed a benign breast lump. The lump was excised, and the specimen revealed an epidermal cyst with panniculitis.

Parathyroid cyst: a rare case report.

Parathyroid cysts are rare lesions arising in the neck and anterior mediastinum. Fewer than 250 cases have been pub lished in the literature. Parathyroid cysts constitute only 0.6% of all thyroid and parathyroid lesions, but should be considered in the differential diagnosis of anterior neck masses, particularly in the presence of hypercalcaemia.

Gluteal region musculoskeletal hydatid cyst: Case report and review of literature.

Hydatid disease is a parasitic infestation of humans and herbivorous animals, caused by Echinococcu granulosus. Dogs and some wild carnivores, like foxes, are definitive hosts, harboring worms in their intestines. Musculoskeletal cysts account for 0.7-3% of total cases of hydatidosis. Primarymuscular hydatidosis without involving the thoracic or abdominal organs is extremely rare. Intramuscular infestation may mimic a soft tissue tumor leading to inappropriate cyst rupture with the attendant risks of anaphylaxis and dissemination to other organs. So preoperative evaluation is critical to avoid lifethreatening complications. We report a case of 34-year-old male patient with a cystic gluteal swelling turning out to be hydatid cyst on surgical exploration. Surgical excision with a pharmacology complementary treatment with antihelementhics is necessary to achieve the complete healing.

Spigelion hernia: fascia lata repair is an alternative option in absence of prolene mesh.

Spigelian hernia is rare. Seven cases of Spigelian hernia are presented. These include two recurrent Spigelian hernias. Incisional hernias through Spigelian aponeurosis after Pfannensteil incision are not included. Clinical examination is the mainstay of diagnosis. The true incidence is possibly higher, as a low Spigelian hernia is not recognised and often diagnosed as a direct inguinal hernia. Ultrasound scanning is recommended, as it is non-invasive and easily available and can detect the hernial orifice in the Spigelian fascia at an early stage. Recurrence of Spigelian hernia took place in two cases through the site of prolene stitch of a previous repair. Hernioplasty with tension free fascia lata graft/prolene mesh was carried out in all cases. The cost of fascia lata graft is only a scar in the thigh. In a mean follow-up of 3.1 -year no patient has reported back with recurrence This is the ideal substitute for the patients in developing countries where synthetic meshes are still not freely available.