BACKGROUND: This is a retrospective study of 60 cases, to detect the expression of ER, PR, HER2neu, CK5/6 and Ki67 proliferation index in breast carcinomas by immunohistochemical method and to determine the newer molecular classication. Few patients have recurrence inspite of being diagnosed under the category of low risk and few do well in the high risk group which can be attributed to the molecular level differentiation. AIM: The aim of this study is to categorize the patients under molecular classication, and to compare the clinicopathological parameters with it and to denote the signicance of targeted therapy. MATERIALS AND METHODS: A retrospective study of detecting the expression of the above said markers in modied radical mastectomy specimens received at a tertiary care centre during the period from January 2015 to June 2018. A total of 60 cases which included 30 of IDC NST and 30 cases of special variants were selected for immunohistochemical analysis. RESULTS: Out of the 60 cases studied, the most common was found to be the luminal A type comprising 37% and the least common was the luminal B and hybrid types each comprising 8%. The most common grade for HER2 was Grade III (50%). The association of histological grade with the molecular classication was statistically signicant with the p value of 0.01. Basal type (56%) had the highest incidence of N3 stage. ER, PR, HER2 neu, CK5/6 expression and proliferation index with Ki67 had a statistically signicant association with the molecular classication. High proliferation index (>14%) with Ki67 was noted in Luminal B, Basal and Hybrid types. 78% of the total 60 cases were alive and healthy. One death was reported in HER2, Hybrid and Basal types. The negative kappa value obtained while studying the agreement between the histopathological and molecular classication, indicates that the agreement is worse than chance and hence the importance of molecular classication is substantiated for the targeted therapy.
Background: Hypertensive disorder of pregnancy is one of the major cause of maternal and perinatal morbidity and mortality. Early detection of the disease is very important, so as to reduce the adverse effects caused by it. Hypertriglyceridemia is seen before the onset of the hypertension, and therefore it can be used as a predictor of PIH. The purpose of this study is to evaluate ▪The association of early pregnancy triglyceride level with pre eclampsia ▪ Its association with the severity of the disease Materials and Methods: A prospective follow up study was carried out in the obstetric department in Bapuji Hospital, WCH hospital and CG hospital attached to JJM medical college, Davanagere between November 2018 to May 2020 Results: Out of 201 cases, 124 cases had triglyceride level between 150-200 mg/dl. Out of 124 cases, 11 cases developed GHTN and 4 cases developed non-severe PE. 53 cases had triglyceride level between 201-300 mg/dl. Out of 53 cases, 9 cases developed GHTN, 24 cases developed non-sever PE, 16 cases developed sever PE. 20 cases had serum triglyceride level between 301-400 mg/dl. Out of 20 cases, 18 developed severe PE and 2 cases developed non-severe PE. 4 cases had serum triglyceride level more than 400, out of which 3 developed severe PE and 1case developed non-severe PE. Conclusion: PE is associated with increased risk of Maternal and Perinatal morbidity and mortality. In the present study, increased triglyceride level was found in early pregnancy of women who develop hypertensive disorders of pregnancy. Serum triglyceride level in early pregnancy can be used as a prediction of PE.
In this covid 19 pandemic,there were increased incidence of Mucormycosis and thereby increase in usage of antifungals especially oral posaconazole which is more recently available in tablet form.There are already enough case reports of the incidence of new onset hypertension and hypokalemia with supressed renin and aldosterone which is termed as “Posaconazole induced pseudohyperaldosteronism”.We describe here about a similar case that presented with hypertensive urgency as Acute pulmonary edema with an associated primary adrenal insufciency.The potential mechanism include inhibition of 11 β HSD which degrades cortisol to cortisone,thereby increasing the levels of cortisol that stimulates Mineralocorticoid receptor.Also there is inhibition of steroidogenesis at the level of adrenal which in our patient presented with features of Acute adrenal insufciency.
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