International Journal of Health and Clinical Research
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Study of Cytopathological Spectrum of Lymphadenopathy at Tertiary Care Hospital, Gujarat, India
Full text linkLymph nodes are most widely distributed and easily accessible component of lymphoid tissue. Lymphadenopathy is a commonly encountered clinical problem which has multitude of causes varying from non-neoplastic to neoplastic conditions like inflammation, infection, primary or metastatic tumors. Fine needle aspiration cytology (FNAC) is a very simple, quick, and cost-effective method of sampling of superficial masses. This technique is an outpatient department (OPD) procedure and causes minimal trauma to the patient and carries virtually no risk of complication. The main goal of FNA is to determine the presence or absence of neoplasm, assure the clinical benign impression of the mass, and if malignant, to determine the type of malignancy. Aim: To evaluate and diagnose the causes of lymph node swelling for early and prompt treatment as FNAC is the minimally invasive procedure and report can be issued within 2 to 3 hours. Materials and method: Total 110 cases of FNAC of lymph node was studied at the Department of Pathology, GAIMS, Bhuj during period from July 2022 to March 2023. Patients were explained about the procedure and consent was taken. FNAC was done, smears were prepared and subsequently stained using H&E, PAP, Giemsa satin and ZN stain for AFB. Observation and Result: Out of total 110 cases, 61 (55.45%) were male and 49 (44.54%) were female patient. Age ranges from first year of life to 78 years of life, with maximum cases 32 (29.09%) were in age group of >40 years. Based on anatomical site, cervical lymphadenopathy was found to be more common, seen in 85(77.27%) cases out of 110 cases. The non-neoplastic lesions were predominated, diagnosed in 85 (77.27%) patients as compared to neoplastic lesions diagnosed in 25 (22.73%) cases. In non-neoplastic lesions, non-specific reactive lymphadenitis was the most frequent diagnosis with 43 (39.09%) cases followed by tuberculous lymphadenitis diagnosed in 22 (20.00%) case. In neoplastic lesions, metastatic squamous cell carcinoma was common in 18(16.36%) cases, whereas, the primary neoplastic lesions of lymph node (lymphoproliferative disease) constituted only about 07(6.36%) cases. Conclusion: FNAC is less invasive and less time consuming procedure yielding result in 1 to 3 hours of procedure. That’s why FNAC must be first line of investigation in lymphadenopathy to differentiate neoplastic from non-neoplastic lesion and guide the surgeon for line of treatment
Correlation of Neutrophil to Lymphocyte and Monocyte to Lymphocyte Ratio with Acute Phase Reactant in Septicemia: A Prospective Study. NLR and MLR as Alternative in Sepsis
Full text linkIntroduction: Acute phase reactants (Procalcitonin, C-Reactive Protein) are important parameters in diagnosing and prognosticating sepsis. Despite availability of these, all the laboratories and hospitals are not equipped with the high end diagnostic capabilities in developing nations. Using alternative available markers in such conditions is preferable. We correlated the ratios from complete blood count with parameters procalcitonin and CRP.Material and Methods: This was a prospective study conducted in tertiary care hospital. All the patients admitted with diagnosis of sepsis who fulfilled the inclusion and exclusion criteria were included in this study. Venous sample were collected from all the patients. Complete blood count, procalcitonin and C reactive protein was done. Ratio of neutrophil to lymphocyte and monocyte to lymphocyte was calculated and correlated.Results: A total of 102 patients were included in this study. 49 were males and 53 females with an average age of 48.72 ± 11.21. The mean NLR was 14.09 ± 3.31 while mean MLR was 0.71 ± 0.15. Average procalcitonin was 25.38 ± 9.34 and the mean CRP was 142.97 ± 32.20. the correlation was checked using pearson’s coefficient. There was a strong correlation between NLR with procalcitonin and CRP which was statistically significant (<0.001). MLR had a strong to moderate correlation with both the parameters and was statistically significant.Conclusion: Calculating the ratio of blood parameters from the complete blood count is the easy and cheap way to diagnose the sepsis in hospitals where high end clinical investigations are not available
Diagnostic Accuracies of APRI and FIB4 For Predicting Different Stages of Liver Fibrosis In Patients of NAFLD and its Correlation With Fibroscan
Full text linkAim: To analyse the diagnostic Accuracies of APRI and FIB4 for predicting different stages of liver fibrosis in patients of NAFLD and its correlation with Fibroscan. Material and methods: The present study prospective, observational study was conducted among 100 NAFLD patients, diagnosed by USG of both genders were recruited for the study. The laboratory test results that were evaluated included those in the hospital information. All results were obtained within one month of a Fibroscan examination. The cutoff values used for the diagnosis of severe fibrosis were: APRI>1, NAFLD score>0.676 and FIB-4 score >3.25. Results: Mean AST/ALT, APRI and FIB-4 was found to be more in F3+F4 grade as compared to F1+F2 grade. A statistically significant positive correlation was observed between APRI, FIB- 4 when compared to Fibrosis stages as statistically confirmed using Pearson correlation test. FIB- 4 has the best sensitivity while APRI has the best specificity in predicting different stages of liver fibrosis among patients of NAFLD. Hence APRI and FIB-4 was comparable in this study to predict liver fibrosis. Conclusion: We found APRI to be the best index to predict advanced liver fibrosis compared to AST/ALT ratio while comparable with FIB-4, with this index having the strongest correlation with FibroScan results
Candidemia in intensive care units and their antifungal susceptibility pattern
Full text linkCandida species are the commonest opportunistic fungal infections worldwide. The most common Candida species causing infection is Candida albicans. Candidemia is described as presence of candida species in bloodstream. It is a fatal fungal infection with mortality ranging from 35% to 75%. In ICU patients, the incidence varies from 0.24-34.3 patients per 1000 ICU admissions according to western literature. Antifungal susceptibility testing is a tool of increasing importance in clinical microbiological labs. The goal of AFST is to produce MIC values that may be used to guide patient therapy. Objective: Candidemia in intensive care units and their antifungal susceptibility pattern. Materials and Methods: Blood specimens from clinically suspected cases of BSI were processed by conventional blood culture or automated blood culture system as per availability. Blood from the bottles was subcultured on Sabouraud Dextrose Agar, antifungal susceptibility was performed on Candida isolates against antifungal drugs by broth microdilution. Results: A total of 1816 patients of suspected BSI were admitted in the ICUs during the study period. 75 of these samples were positive for growth of Candida species. Candidemia among males and females was almost equal. Commonest non-albicans species isolated were C. tropicalis. Posaconazole and flucytosine are the two most susceptible antifungal drugs for all the isolated candida species. Conclusion: Antifungal susceptibility plays an important role in targeted therapy of infection caused by common and uncommon Candida species. This will help to prevent emerging antifungal resistance and thereby reduce patient morbidity and mortality
Correlation of mucormycosis with duration of steroid and oxygen therapy
Full text linkIntroduction: Covid-19 patients have many complications after treatment, including fungal infection, disseminated intravascular coagulation, septicemia, cardiac problems, fissures, piles and meningitis. Out of these; Mucormycosis- A lethal fungal infection which is caused by the family of mucorcea; is more prevalent in post covid-19 patients. Mucormycosis is well correlated with post covid-19 infection; who underwent prolonged steroid & oxygen therapy during hospitalization. Mucormycosis is more common in covid-19 patients with immunocompromised status like Diabetes mellitus, Hypertension, cancer, organ transplant etc. Aims & objectives:(1) To correlate mucormycosis, a fungal infection in covid-19 patients with duration of steroid and oxygen therapy.(2) To correlate mucormycosis with various comorbidities & hospitalization. Materials&Method: All radiologically and histopathologically proven cases would be selected for our study. Complete clinical history of patients would be taken. Steroid and oxygen treatment given to the patient would be correlated.Type of study: Prospective & retrospective. Duration of study: 6 months Inclusion criteria: (1) Patients aged 18 years & above.(2) Patient with mucormycosis in covid-19 infection with or without hospitalization.(3)All radiologically suggested fungal infection in covid-19 induced pneumonia with active disease in recovery phase. Exclusion criteria: (1) Age less than 18 years. (2) Patients with incomplete clinical history. Conclusion: Mucormycosis is more common in hospitalized patients with prolonged steroid & oxygen therapy. We may prevent mucormycosis in covid-19 patients by reducing duration of steroid therapy
Cytomorphological classification of Breast lesion on basis of International Academy of Cytology (IAC) Standardized Reporting System in Tertiary health care hospital
Full text linkIntroduction: International Academy of Cytology (IAC) standardized syatem is established for breast fine-needle aspiration cytology (FNAC) reporting. They have five categories devided into C1 to C5. (C1-Insufficient material, C2-Benign lesion, C3- Atypical, C4-Suspicious & C5-Malignant lesion). Aims and Objectives: The aim of our study was categorize breast lesions according to International Academy of Cytology (IAC) standardized reporting system. Materials and Methods: The present study was done during the period between January 2019 and December 2020 in the department of pathology VBCH, Silvassa. 10ml/5ml syringe and 23 gauge needles were used and two types of smears made. 1)Wet smears were stained by H& Eosin stain and 2)dry smears were stained by Giemsa stain. Results: A total 275 cases of Breast were included in the study with 269 (97.82 %) females and 06 (2.18 %) males.We had a wide age group patient ranging from 11 years to 79 years. Most of the cases (60.5%) were in age group of 2nd and 3rd decade, with a predominance of right sided breast lesions.58 (21.09%) malignant (C5), 192 (69.81%) were benign (C2), 09 cases (2.91%) were benign lesions but having nuclear atypia (C3) , 04 cases (1.45%) were suspicious for malignancy (C4) and 12 cases(4.36%). were unsatisfactory for evaluation (C1) . Conclusion: Fine needle aspiration is cost effective, rapid, simple and highly sensitive diagnostic tool. IAC standardized reporting system for breast cytology enhance the diagnostic accuracy of FNAC
Reconstruction of lower eyelid defect with mustarde flap: A 5 years retrospective study
Full text linkReconstruction of eyelids can be challenging after tumour excisions. Various reconstructive options are available but complete knowledge about the anatomy and its function is important. To restore the function and aesthetic outcome is critically important. Despite many surgical options available: in our paper we want to provide the most reliable and useful method of lower eyelid reconstruction by MUSTARDE flap.Aim: To evaluate the clinical outcome of Mustarde cheek rotation flap in reconstruction of large lower eyelid and cheek defects. Materials and method: It is a retrospective study conducted in the Department of Plastic Surgery, Guwahati,Assam,India Medical College, Guwahati,Assam,India, Assam. 7 patients who underwent Mustarde cheek rotation flap during a period from1st July 2017 to 30th June 2022 are evaluated in this study. Results: All the 7 patients showed favourable outcome with good cosmesis. There was no major complication regarding the flap post operatively. One patient with basal cell carcinoma (BCC) of lower eyelid showed mild ectropion on follow up without corneal exposure. Conclusion: Mustarde cheek rotation flap is a versatile flap for reconstruction of large lower eyelid and cheek defects. It has good cosmetic outcome with minimal patient morbidity
A study on presence of parasites in commonly used raw herbal greens
Full text linkIntroduction: Helminthic infectivity of fresh green leafy vegetables still remains the most common public health problem. Consumption of raw and unwashed vegetables is an important means of transmission of several infectious diseases. Aim: The present study aimed to evaluate the presence of helminthic larvae in raw herbal greens retailed at chennai markets. Materials and Methods: A total of 3 different types of raw herbal greens: roots and leaves of coriander, mint and spinach were collected and tested for parasitic larvae by saline wet mount preparation. Results: Strongyloides larvae were detected in 3 types of raw herbal greens: roots and leaves of coriander, mint and spinach among which coriander roots and leaves showed greater load of nematode larvae than mint and spinach. Commonly these leafy greens are consumed raw, therefore appropriate washing and proper cooking of all vegetables is very important. Conclusion: This study highlights the necessity of appropriate washing and cooking of green leafy vegetables before they are consumed
Evaluation of using temporalis fascia and cartilage graft in type I tympanoplasty among the patient from district Nainital
Full text linkThe tympanic membrane which is pearly greyish in colour has a function to amplify and transmit sound waves and perforation could be caused due to recurrent middle ear infection or trauma results in symptoms like discharging ear, hearing impairment and otalgia. A total of 120 patients were enrolled for the present study and Pure tone audiometry test along with other tests were performed to evaluate improvement in hearing and closure of the perforation. The mean age of the study population was 29.33±10.77 years, the mean Preop PTA was 39.22±6.39, the mean preop air bone gap was 29.78±4.73 and the post op PTA and air bone gap was 32.91±7.001 and 23.54±6.29 respectively.In preoperative cartilage group, Ab gap was 29.04±4.915, the postoperative AB gap was 23.85±6.65 and 23.07±5.94 for temporal fascia and cartilage respectively. No significant difference was observed among grouped variables among both the groups. It was observed thatpreop PTA (38.53±5.85), preop air bone gap (29.43±4.64), post op PTA (31.45±5.28) and postop air bone gap (22.43±5.51) was significantly less than in patients in whom healing was not present. The mean surface area (%) was greater in patients in whom healing was not present (53.85±17.22 vs 45.56±14.90). Thus, we found that Type I tympanoplasty is an effective and safe procedure with a high anatomical success rate in the treatment of mucosal COM. Tympanoplasty with cartilage graft had a hearing outcome comparable to temporalis fascia graft. We found that factors like age, gender, side of involvement of ear, size and site of perforation and grafting techniques did not affect the success rate of tympanoplasty
Study of Prevalence of Thalassemia and its variants using HPLC – A Hospital based Retrospective Study
Full text linkBackground: Structural defect in haemoglobin are the most common inherited abnormalities of hemoglobin synthesis. Objective: Early and accurate diagnosis of hemoglobinopathies. Diagnosis of these disorders through HPLC is most convient investigation for diagnosis of hemoglobinapathies. Results and conclusion: Abnormal hemoglobin fractions on HPLC were seen in 338 cases of total 730 samples examined. Out of all the cases, β Thalassemia Minor was the predominant abnormality. 75 cases (10.27%) were β Thalassemia Major and 17 cases (2.325%) were β Thalassemia Intermedia. 2 cases with diagnosis of Sickle β thalassemia were reported. In our study, one case of δβ thalassemia and 4 cases of δβ thalassemia trait were also reported. HPLC is easy and convient method to rule out hemoglobinopathies. The trend of labelling the diagnosis of hemoglobinopathy with HPLC instead of Hb Electrophoresis is rapidly rising. Thus, HPLC is a better tool to rule out hemoglobinopathy and improve the life standards of general population