A CLINICOPATHOLOGICAL STUDY ON DISSEMINATED HISTOPLASMOSIS WITH SPECIAL REFERENCE TO ATYPICAL CASES IN A TERTIARY CARE CENTRE -IN EASTERN INDIA.

2021 ◽  
pp. 48-51
Author(s):  
Anuradha De (Pati) ◽  
Roopsa Chakraborty ◽  
Bibhuti Saha
Keyword(s):  
Histoplasma Capsulatum ◽  
Histopathological Examination ◽  
Tertiary Care ◽  
Cd4 Count ◽  
Yeast Cells ◽  
Steady Increase ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Disseminated Histoplasmosis ◽  
India Ink

INTRODUCTION: Untreated Histoplasmosis is fatal for all, immunocompetent or immunocompromised. Histoplasmosis has seen a steady increase in incidence from a single recorded case in Kolkata, India in 1954 to 388 cases from 2004-17 and 161 from 2017-till date all over India. Yet, it has been consistently relegated to a niche of opportunistic infections without a proper diagnostic protocol. To study the clinical OBJECTIVES: features and natural history of disseminated histoplasmosis(DH) and analysis of cases with atypical clinical presentation of Histoplasmosis simulating malignancy in search of a consolidated and efcient diagnostic algorithm in a tertiary care centre. MATERIALS AND METHODS: The retrospective institution-based study was conducted in the Department of Pathology, CSTM from February 2011 to July 2019 in collaboration of Dept. of Tropical Medicine on specimens collected from 33 cases of Skin biopsy, Lymph node biopsy and FNAC aspirate from enlarged lymphnodes, slit skin smear followed by BM Aspirate analysis done in cases of disseminated histoplasmosis, Bone Marrow Biopsy was done in selected cases. Histoplasma capsulatum like yeast cells were detected with Leishman Giemsa stained slit skin smears in 9 cases and in FNA smears in 13cases and they were PAS positive. Diagnosis were conrmed in Histopathological examination along with special stain for fungus in all cases. Radiological investigations (CXR, USG, CT), Routine investigations (Haemogram, LFT, RFT, Electrolytes) along with CD4 count in ART clinic and microbiological tests like Gram stain of SSS, India Ink, KOH preparation, Cryptococcal Ag testing, urine C/S) were corroborated with. RESULTS: All 33 cases FNAC (13),slit skin smear(9) and HPE on rest of the specimen show small, oval yeast cells on LG stain. Biopsy showed histiocytic phagocytosis of yeast cells with foamy macrophages and PMN inltration with NO granulomas in seroposive cases. Gomori Methenamine Silver stain of BM biopsy showed black intracellular yeast consistent with . PAS stained FNAC smears Histoplasma capsulatum showed yeast cells with chromatin dot and surrounding halos with no kinetoplasts. Mycological cultures were in agreement. Here, in most cases, CD4 count and Disseminated Histoplasmosis ndings were not in accordance. DH CONCLUSION: is not uncommon in India and is being increasing day by day and it should be considered in the diagnosis of patients with prolonged fever, weight loss, oropharyngeal ulcers, hepatosplenomegaly, lymphadenopathy and adrenal enlargement. Correct diagnosis by well designed analytical studies utilising appropriate diagnostic modalities in an immunocompromised patient even with minimum suspicion of opportunistic infection, a consolidation of selective investigations like FNAC, HPE and relevant microbiological tests into a diagnostic design for maximum utilization of nances, resources and time, all of which can help to understand the epidemiology of this neglected disease for accurate treatment leading to a favourable outcome.

scholarly journals Clinico-Pathological Study of Ocular Surface Squamous Neoplasia in a Tertiary Care Centre of Western Region of Nepal

2019 ◽  
Vol 7 (1) ◽  
pp. 9-13
Author(s):  
Sushila Patel ◽  
Binita Bhattarai Pokharel ◽  
Anita Shah ◽  
Manita Sunam Goda ◽  
Saraswati Khadka Thapa
Keyword(s):  
Ocular Surface ◽  
Histopathological Examination ◽  
Tertiary Care ◽  
Western Region ◽  
Invasive Squamous Cell Carcinoma ◽  
Care Centre ◽  
Ocular Surface Squamous Neoplasia ◽  
Tertiary Care Centre ◽  
Male Predominance ◽  
Wide Range

INTRODUCTION: Ocular surface squamous neoplasia (OSSN) consists of a wide range of conjunctival and corneal lesions ranging from dysplastic lesions to invasive squamous cell carcinoma. In recent times, the incidence of OSSN seems to be on the rise, especially in developing countries. The present study was aimed to analyse demographic pattern, clinical characteristics, and histopathology findings of OSSN in a tertiary care centre of western region of Nepal.  MATERIAL AND METHODS: It was a retrospective study. We analyzed 94 cases of OSSN who presented to cornea department of Lumbini Eye Institute, Bhairahawa, Nepal over a period 1.5 years from 1st July 2017 to 31st December 2018. All the patients with OSSN, detailed clinical history and examination were recorded. Lesions were excised with a 3 mm margin clearance and sent for histopathological examination.  RESULTS: Mean age of our patients with OSSN was 48.89±17.955 years ranging from 17 to 85 years. There were 52 (55.32%) male and 42 (44.68%) female. Mean duration of presentation was 6.34±6.17 months. A solitary nodule at the limbus was the commonest presentation. Right eyes were involved more than left eyes. Lesions were found most commonly on temporal site 52 (55.32%) followed by nasal 36 (38.30%). On histopathological examination benign lesions were found in 31 (32.98%) eyes, preinvasive lesion in 50 (53.19%) eyes and invasive lesions in 13 (13.83%) eyes.  CONCLUSION: OSSN were seen more commonly in young adults with male predominance. Benign and pre invasive lesions are found more commonly than invasive lesions.

CUTANEOUS MANIFESTATIONS OF HIV IN PEOPLE LIVING WITH HIV/AIDS AT TERTIARY CENTRE

2021 ◽  
pp. 70-72
Author(s):  
Anubhav Agrawal ◽  
Simmi Dube ◽  
Aditya Tejwani
Keyword(s):  
Cell Count ◽  
Tertiary Care ◽  
Skin Lesions ◽  
Cd4 Count ◽  
People Living With Hiv ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Cutaneous Manifestations ◽  
Cd4 Cell Count ◽  
Cd4 Cell

BACKGROUND-The study was conducted to describe systematic clinical manifestations among HIV in PLHA at tertiary care centre. METHODOLOGY- This study was designed as cross sectional study at Department of Medicine, tertiary care centre. A total of 100 HIV infected patients were included detailed enquiry about presence of skin lesions along with CD4 cell count was obtained and entered in pretested questionnaire RESULTS-The mean age of patients with HIV was 43.9±10.2 years and Slight female preponderance was observed with male: 3 female ratio of 0.89:1. Mean CD4 count was 243.2±103.2 cells/mm . Majority of patients had CD4 count in the range of less than 3 200 cells/mm (64%) Staphylococcal skin infections were the most common skin lesions observed in 34% patients. All the patients with cutaneous manifestations presented in present study had low CD4 cell count. However, no statistically signicant association between CD4 count and cutaneous manifestations could be documented (p>0.05). CONCLUSION-Cutaneous manifestations are more prevalent in patients with lower CD4 counts and can also be observed with normal CD4 count levels amongst patients with HIV. Occurrence of cutaneous manifestations was higher in patients with lower CD4 count but the observed difference was not statistically signicant.

scholarly journals A retrospective study of brochoscopic profile of patients in a tertiary care centre

2018 ◽  
Vol 6 (3) ◽  
pp. 808
Author(s):  
Amit Kumar ◽  
Prashant Choudhary ◽  
Javed Khan ◽  
Rishi Saini
Keyword(s):  
Histopathological Examination ◽  
Tertiary Care ◽  
Common Finding ◽  
Histopathological Diagnosis ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Demographic Profiles ◽  
Mucosal Growth ◽  
Endobronchial Growth ◽  
Nonspecific Inflammation

Background: The purpose of this study was to find out the demographic profiles, indications, bronchoscopic findings and diagnosis of the patients who underwent bronchoscopic examination.Methods: A retrospective analysis of 200 consecutive fiber-optic bronchoscopies was performed at RMCH from June 2015 to June 2017 to find out the demographic and clinical profile of the patients who underwent this procedure. The instrument Olympus video bronchoscope was used for the procedure.Results: Among total of 200 patients, 131 (65.5%) were males and 69 (34.5%) patients were females. 150 (75%) patients were smokers and 50 (25%) patients were non- smokers. Cough was the most common presenting symptom in 180 (90%) of the patients followed by breathlessness 138 (69%), chest pain 114 (57%), hemoptysis 80 (40%), fever 66 (33%). The most common finding is endobronchial growth in 119 (59.5%) followed by nonspecific inflammation 40 (20%), inconclusive 21 (10.5%), normal 12 (6%), suspected growth 8 (4%).Out of 200 patient biopsy was done in 65 patients (32.5%) and most common histopathological diagnosis was malignancy 42 (64.61%), pulmonary tuberculosis 10 (15.38%), Infective pathology 9 (13.8%), inconclusive 4 (6.1%).Conclusions:Bronchoscopy is a safe and useful tool for making the diagnosis of a variety of pulmonary diseases. Endobronchial growth and malignancy were the commonest findings on bronchoscopy and histopathological examination respectively. Moreover, we would like to emphasize the importance of attempting biopsy from the abnormal segment of the lung even when bronchoscopy does not show frank mucosal growth. 

scholarly journals Histomorphological spectrum of intracranial space occupying lesions: Experience at tertiary care centre

2021 ◽  
Vol 8 (4) ◽  
pp. 485-491
Author(s):  
Saroj A Meshram ◽  
Devika S Kinkhede ◽  
Sanjay N Parate ◽  
Dinkar T Kumbhalkar ◽  
Shilpa P Tathe ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Histopathological Examination ◽  
Venous Malformation ◽  
Tertiary Care ◽  
Malignant Neoplasm ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Medical College ◽  
Centre Hospital ◽  
Hematoxylin And Eosin Stain

An “Intra-cranial space occupying lesion” (ICSOL) is defined as a mass in the cranial cavity with a diverse etiology like benign or malignant neoplasm, inflammatory or parasitic lesion, haematoma or arterio-venous malformation. The aim was to study the histomorphological spectrum of intracranial space occupying lesions at a tertiary care centre hospital in order to give accurate pretherapeutic diagnosis to facilitate better therapeutic results. This prospective and descriptive type of study of two years duration was carried out from November 2017 to October 2019 in Govt. Medical College and Superspeciality Hospital, Nagpur in the Department of Pathology. A total of 300 samples were received from Department of Neurosurgery. Detailed collection of clinical data was done in all patients regarding age, sex, clinical symptoms and radiological findings.The samples were received in 10% formalin and subjected to routine histopathological processing. Slides prepared were stained with hematoxylin and eosin stain. Special stains were done wherever required. Total 300 cases were studied of which 261 cases (87%) were neoplastic in nature and 39 cases (13%) were non neoplastic. Amongst primary tumours, most common were gliomas (48%) followed by meningiomas (20%) and schwannomas (9%). ICSOLs can present with nonspecific clinical features. Radio diagnostic investigations are helpful adjunct tools but cannot give exact diagnosis. Histopathological examination remains a gold standard for diagnosing and grading of tumours on which basis clinician can decide further line of management.

scholarly journals SURGICAL MANAGEMENT OF ADENOCARCINOMA OF ESOPHAGOGASTRIC JUNCTION - A TERTIARY CARE CENTRE EXPERIENCE IN SOUTH INDIA

2020 ◽  
pp. 1-4
Author(s):  
Karthikeyan mohan ◽  
Sivakumar kalyanashanmugam ◽  
Prasanna gopal ◽  
Prabhakaran Raju ◽  
Rajendran shanmugasundaram ◽  
...  
Keyword(s):  
Surgical Management ◽  
Metastatic Disease ◽  
Esophagogastric Junction ◽  
South India ◽  
Histopathological Examination ◽  
Tertiary Care ◽  
Type I ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Adenocarcinoma Of Esophagogastric Junction

OBJECTIVE The incidence of adenocarcinoma of esophagogastric junction is on the rise. The optimal treatment strategy for these tumours has not been clearly established. The aim of this study is to analyse the clinical presentations, management and outcomes following surgery in patients with adenocarcinoma of the esophagogastric junction presenting to a tertiary care centre in South India. METHODS Retrospective analysis of prospectively maintained database was performed. Data of all patients operated for adenocarcinoma of esophagogastric junction was analysed with regards to surgical management and clinico-pathological outcomes. RESULTS Fifty two patients underwent surgery for esophagogastric junction malignancy in our institution from January 2015 to December 2018. Among them, type I, type II and type III tumours contributed to 6, 16 and 30 patients, respectively. Thirty-four patients (65.4%) were male. Mean age of the patients was 57 years. Six patients (11.5%) received neoadjuvant therapy. Fourteen patients (26.9%) were found to have unresectable or metastatic disease during surgery. Six patients (11.5%) underwent multiorgan resection. Mean tumour length was 5.4cm. Number of lymph nodes retrieved ranged from 2 to 25. Majority of the patients had stage 3 disease on histopathological examination. Major postoperative morbidity (Clavien Dindo grade ≥ 3) was seen in 9 patients. Reoperation was required in 4 patients. In-hospital mortality rate was 11.53%. On follow up, locoregional recurrence was documented in 5 patients. CONCLUSION Esophagogastric junction adenocarcinoma is an aggressive malignancy with high incidence of unresectable or metastatic disease. Majority of patients presented with larger tumours and at an advanced stage of the disease leading to poor outcomes.

scholarly journals Prevalence of cryptococcal meningitis in a tertiary care centre.

2020 ◽  
Vol 7 (3) ◽  
pp. 15-21
Author(s):  
Ashish Bajaj ◽  
Bibhati Mishra ◽  
Poonam Loomba ◽  
Archana Thakur ◽  
Abha Sharma ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Cryptococcal Meningitis ◽  
Tertiary Care ◽  
Cns Infection ◽  
Fungal Culture ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Cryptococcal Antigen ◽  
India Ink ◽  
Appropriate Treatment

Background: Cryptococcal meningitis has emerged as an important opportunistic central nervous system (CNS) infection in Human Immunodeficiency Virus (HIV) positive patients. It is associated with a high mortality rate. Hence early diagnosis is necessary to start appropriate treatment. Cryptococcosis is generally found in association with acquired immunodeficiency syndrome (AIDS) although it has been reported to cause disease in HIV-seronegative patients also. Objective:Prevalence of Cryptococcal meningitis in a tertiary care centre. Material & Methods: A total of 93 Cerebrospinal fluid samples from suspected cases of fungal meningitis were received in the microbiology department of GB Pant Hospital(GIPMER) from January to June 2018. Samples were subjected to direct microscopy- wet mount, India ink preparation and Gram stain, Cryptococcal antigen detection(Latex agglutination), and Fungal culture. In vitro susceptibility of Cryptococcus isolates to Fluconazole, Voriconazole, 5- Flucytosine and Amphotericin B was performed using standard broth microdilution method. Results: Out of 93 CSF samples, 6 were positive for India ink preparation and showed gram positive budding yeast cells by gram staining. All 6 samples were positive for the cryptococcal antigen test and fungal culture. Five were identified as C. neoformans and one C. gatti. All strains were susceptible to Amphotericin B. Four patients were HIV reactive and succumbed to the diseaseduring treatment. Two patients were found to be coinfected with Hepatitis B virus. Ashish Bajaj1, Bibhabati Mishra2, Poonam S Loomba2, Archana Thakur3, Abha Sharma4, Prachala G Rathod1, Madhusmita Das1, Ashna Bhasin1 1Senior Resident, 2Director Professor, 3Director Professor & Head, 4Assistant Professor, Department of Microbiology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India ABSTRACT Cryptococcal meningitis has emerged as an important opportunistic central nervous system (CNS) infection in immunosuppressed patients.It is associated with a high mortality rate(>30%) in immunosuppressed patients especially those infected with HIV, hence early diagnosis is necessary to start appropriate treatment. Prevalence of cryptococcal infection is increasing in developing nations including India as per some recent studies.(1) Conclusion: Index of suspicion of Cryptococcus infection as a possible cause of meningitis must be considered in chronic meningitis cases. Microscopy (India ink preparation) may be used as a cheap and rapid diagnostic tool.

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