Background: Identifying colorectal cancers (CRCs) with high levels of microsatellite instability (MSI-H) is clinically important. Few studies reported the role of histology in identifying MSI-H colorectal carcinomas. Hence the present study was undertaken to assess the value of histopathology in predicting MSI-H and its correlation with histopathologic prognostic features in CRC. Methods: Total 100 histo-pathologically confirmed cases of CRC were enrolled in the study. Tumour's histopathological typing, staging, and sizing was conducted based on WHO criteria. Tumour grade, extent of mucin production, tumour growth pattern and presence of a Crohn's like inflammatory infiltrate were determined. For immunohistochemistry (IHC) we used monoclonal antibodies (ES05 or 25D12). Results: Among 100 tumour samples, loss of MLH1 or MSH2 expression was detected in 13(13%) cases (MSI tumours) while 87(87%) tumours showed normal expression for MLH1 and MSH2 immuno-reactivity (MSS tumours). In terms of MSI/MSS status of tumour samples, statistical analysis showed that abnormal MMR protein expression was associated with tumour site, side of colon with cancer, size of tumour, tumour infiltrating lymphocytes and crohn's like inflammatory infiltrate. Some histopathological and clinical features that appeared highly specific but much less sensitive in predicting MSI include stage, and some features were more sensitive and less specific which include tumour differentiation, CLR, TIL, dirty necrosis and pushing margin. Conclusion: MSI is an important prognostic factor in CRC and an important predictive factor of CRC chemotherapeutic treatment and outcome efficacy. Also result of the study is not consistent in describing various histopathological and clinical features in predicting MSI, CRC.
<b><i>Introduction:</i></b> Onychomycosis is a common nail disorders. Antifungal resistance, interactions, and side effects limit treatment options. Fractional CO<sub>2</sub> (FCO<sub>2</sub>) laser along with topical antifungal is effective in multiple monthly sessions. A modification reducing repeated visits and hence better compliance is preferable. Single-session FCO<sub>2</sub> laser following urea occlusion is reported to be effective. Thus, we conducted a study to determine the efficacy of single-session FCO<sub>2</sub> laser with 1% terbinafine cream with and without “urea cream occlusion” in managing onychomycosis. <b><i>Methods:</i></b> A prospective, randomized, parallel-group study was conducted at a tertiary centre. Onychomycosis was confirmed by positive fungal mount and culture. Patients were randomized into 2 groups and administered single-session FCO<sub>2</sub> laser. Group A was treated after overnight urea cream occlusion and group B without occlusion. Both groups applied 1% terbinafine cream twice daily for 3 months. Response was assessed by improvement in Onychomycosis Severity Index (OSI) at 6 months. <b><i>Results:</i></b> Group A had 10 patients, 14 nails. Clinical improvement was seen in 12/14 (85.7%) nails. Average reduction in OSI was 10.78. Group B had 10 patients, 11 nails. Clinical improvement was seen in 5/11 (45.5%) nails. Average reduction in OSI was 1.73. “Reduction in OSI” was statistically significant (<i>p</i> < 0.05) only in group A. <b><i>Conclusion:</i></b> Single-session FCO<sub>2</sub> laser following overnight urea cream occlusion, followed by 1% terbinafine cream, is effective for management of onychomycosis.
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