UTILITY OF MILAN SYSTEM FOR SALIVARY GLAND CYTOPATHOLOGY IN A TERTIARY CARE HOSPITAL IN WESTERN INDIA: AN INSTITUTIONAL EXPERIENCE

2021 ◽  
pp. 18-22
Author(s):  
Saket Sharma ◽  
Prachi Parikh ◽  
Heena Parikh
Keyword(s):  
Salivary Gland ◽  
Predictive Value ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Diagnostic Category ◽  
Benign Neoplasm ◽  
Salivary Gland Neoplasm ◽  
Western India ◽  
Care Hospital ◽  
Cation System

Introduction: Fine-needle aspiration cytology (FNAC) can be challenging to provide a precise diagnosis in salivary gland cytopathology due to diversity of lesions and cytomorphological convergence between the tumors and within the same tumor of salivary gland. The recently proposed Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) provides a risk stratication-based classication system with an intrinsic risk of malignancy (ROM) for each diagnostic category, which aims to furnish useful information to the clinicians. This study was undertaken to evaluate the diagnostic utility and validity of MSRSGC. A 4-year retrospective Materials and Methods: study was conducted at a tertiary care hospital in Central Gujarat in Western India. A total of 90 cases of FNAC of salivary gland lesions for the period of January 2018 to March 2021 were reviewed. Patient clinical details, FNAC smears and histological slides where available were retrieved from the departmental records. Results: The cases belong to following categories: non-diagnostic (4.4%), non-neoplastic (10%), atypia of undetermined signicance (1.1%), benign neoplasm (68.9%), salivary gland neoplasm of uncertain malignant potential (8.9%), suspicious for malignancy (2.2%), and malignant (4.4%). Out of 90 cases, 62 cases (68.8%) had follow-up. The ROM were 7.6% for category IV—A and 50% for category IV-B. The sensitivity, specicity, positive predictive value, negative predictive value, and likelihood ratio for differentiating between benign and malignant lesions were recorded as 98.1%, 42.9%, 92.8%, 75.0%, and 1.750, respectively. Conclusion: Application of MSRSGC has immense value for standardization of reporting of salivary gland FNAC. The Milan system of reporting is a risk stratication system which can improve the overall effectiveness of reporting and care of patients.

scholarly journals Salivary Gland FNA Diagnostics in a Real-Life Setting: One-Year-Experiences of the Implementation of the Milan System in a Tertiary Care Center

Cancers ◽  
2019 ◽  
Vol 11 (10) ◽  
pp. 1589 ◽  
Author(s):  
Erkka Tommola ◽  
Satu Tommola ◽  
Sinikka Porre ◽  
Ivana Kholová
Keyword(s):  
Salivary Gland ◽  
Classification System ◽  
Predictive Value ◽  
Care Center ◽  
Tertiary Care ◽  
Diagnostic Category ◽  
Real Life ◽  
Benign Neoplasm ◽  
Tertiary Care Center ◽  
One Year

The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) was introduced in 2018 following other organ specific cytopathological reporting systems and it aimed at bringing a practical, evidence-based, user-friendly classification system with characterization and management algorithms. At the Department of Pathology, Fimlab Laboratories, Tampere, Finland all salivary fine needle aspirations (FNAs) have been given cytopathological diagnoses according to the MSRSGC since January 2018. Analyses of a one-year-period (January 2018–December 2018) consisted of 183 salivary FNA samples from 138 patients with correlation to histopathology in 90 cases with surgical follow-up. The MSRSGC performance in patient based analysis was as follows: accuracy was 90.9%, sensitivity was 61.5%, specificity was 100%, positive predictive value was 100%, and negative predictive value was 89.4%, respectively. Risks of malignancy (ROMs) in MSRSGC categories were: 0.0% (0/15) in non-diagnostic category, 100.0% (1/1) in non-neoplastic category biased by only one falsely-negative lymphoma case, 14.3% (1/7) in atypia of undetermined significance category, 0.0% (0/28) in benign neoplasm category, 27.3% (3/11) in neoplasm of uncertain malignant potential category, and 100% for both suspicious for malignancy (4/4) and malignancy (4/4) categories, respectively. The MSRSGC has been proven as a reliable classification system in salivary gland FNA routine diagnostics in a tertiary care center.

Etiology of primary amenorrhea: Experience from a tertiary care hospital in Western India

2021 ◽  
Vol 14 (6) ◽  
pp. 674
Author(s):  
RajeshKumar Mishra ◽  
UttaraAiyer Kohli ◽  
Atul Seth ◽  
SumeetRanjan Tripathy
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Primary Amenorrhea ◽  
Western India ◽  
Care Hospital

Sphenoid Wing Meningiomas: Experience from a Tertiary Care Hospital in Western India

2017 ◽  
Vol 9 (2) ◽  
pp. 104-109
Author(s):  
Bandlish Deepak ◽  
◽  
Salgotra Bhagwati ◽  
Somil Jaiswal ◽  
Jadhav Prashant ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Western India ◽  
Care Hospital

Application of the Milan System for Reporting Salivary Gland Cytopathology: A 10-Year Experience in a Single Japanese Institution

2020 ◽  
pp. 1-9
Author(s):  
Yukiya Hirata ◽  
Kayoko Higuchi ◽  
Koichi Tamashiro ◽  
Keisuke Koja ◽  
Yuiko Yasutomi ◽  
...  
Keyword(s):  
Salivary Gland ◽  
Predictive Value ◽  
Diagnostic Category ◽  
Needle Aspiration ◽  
Salivary Gland Neoplasm ◽  
Published Evidence ◽  
Risk Of Malignancy ◽  
Categorization System ◽  
Sensitivity Specificity

<b><i>Objective:</i></b> The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) is a recently published evidence-based categorization system for salivary gland fine-needle aspiration (FNA). We applied MSRSGC to Japanese cases and evaluated its utility. <b><i>Study Design:</i></b> A total of 480 FNA cases were reviewed. We recategorized each case into one of the MSRSGC categories. The risk of neoplasm (RON) and the risk of malignancy (ROM) for each diagnostic category in MSRSGC, and the sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) for malignancy and for neoplasms were calculated for cases with histological follow-up. In addition, the overall ROM (O-ROM) was calculated for all FNA cases. <b><i>Results:</i></b> RON, ROM, and O-ROM rates were as follows – non-diagnostic: 51.3, 5.1, and 1.0%; non-neoplastic: 0, 0, and 0%; atypia of undetermined significance: 83.9, 12.9, and 7.3%; neoplasm, benign: 100, 0, and 0%; salivary gland neoplasm of uncertain malignant potential: 100, 32.1, and 23.7%; suspicious for malignancy: 100, 85.7, and 60%; and malignant: 100, 100, 81.8%. The sensitivity, specificity, and accuracy with (without) indeterminate cases for malignancy were 65 (100), 99 (99), 92% (99%) and PPV and NPV were 96 and 100%, respectively, and those for neoplasms were 84 (100), 100 (100), 85% (100%), and PPV and NPV were 100 and 100%, respectively. <b><i>Conclusions:</i></b> The MSRSGC is useful for stratification of ROM and for promoting the performance of salivary gland FNA. The MSRSGC could be easily introduced in Japan and may improve the Japanese salivary gland FNA status.

scholarly journals Drug Utilization Pattern in Patients with Different Types of Dementia in Western India

2014 ◽  
Vol 2014 ◽  
pp. 1-9
Author(s):  
Mansi Patel ◽  
Anuradha Joshi ◽  
Jalpa Suthar ◽  
Soaham Desai
Keyword(s):  
Medical Records ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Lewy Body Dementia ◽  
Descriptive Statistics ◽  
Western India ◽  
Care Hospital ◽  
Prospective Data ◽  
Different Types ◽  
Analyze Data

Background.Dementia is one of the most frequent disorders among elderly patients, reaching to epidemic proportions with an estimated 4.6 million new cases globally annually. Partially effective treatments are available for dementia.Aims & Objectives.We aim to study drugs used in dementia and find out frequency of types of Dementia.Method.This was an observational study conducted at rurally based tertiary care hospital. Prospective data was collected from outpatient department, while retrospective data was collected from medical records. Descriptive statistics were used to analyze data.Result.Total 125 prescriptions of patients diagnosed with dementia were analyzed. Alzheimer’s dementia was most common (65.6%), followed by vascular dementia (21.6%), and frontotemporal dementia (10.4%), with the rarest being Lewy body dementia in (2.4%) cases. 60.57% of patients were males. Mini Mental Score Examination mean score was 15.93 ± 1.37. Frontal Battery Assessment mean score was 4.75 ± 1.01. Prescribed drugs were Donepezil (68.49%), Rivastigmine (13.63%), Donepezil + Memantine (6.43%) and Galantamine (12.83%), Quetiapine (38.46%), Lorazepam (23.07%), Clozapine (11.53%), Escitalopram (10.25%), Haloperidol (3.84%), Zolpidem, Sertraline, Olanzepine (2.56%), Nitrazepine, Lamotrigine, Fluoxetine, Tianeptine (1.28%), Folic acid, and Vitamin B12, respectively.Conclusion.Alzheimer’s is the most common type of dementia while Donepezil was the most frequent drug.

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