BACKGROUND An autopsy is a medical procedure that consists of a thorough examination of corpse to determine the cause of death and to evaluate any diseases that maybe present. Most of the chronic liver diseases even in advanced stages may cause no signs and symptoms and may go undiagnosed or are found coincidently during general health checkup, investigation being done for some other disease, surgery or autopsy. The underlying cause of chronic liver diseases vary in different geographic areas and are based on various factors such as socioeconomic status, lifestyle, diet, local and other endemic diseases. Hence, we have conducted this study to unearth the silent liver diseases in medicolegal cases.
Introduction: Sudden Cardiac Death (SCD) is a serious health concern, and the incidence of SCD is rising globally. A number of causes can result in SCD in apparently healthy individuals and in people with undiagnosed cardiac disease. The study was done to evaluate the probable cause of death by observing various histomorphological changes in cardiac autopsies. Aim: To establish the cause of SCD and study the histopathology, age and sex distribution, frequency, and location of different types of cardiac lesions. Materials and Methods: The study was a descriptive, crosssectional, observational study carried out in the Department of Pathology and Forensic Medicine and Toxicology (FMT) at PRM Medical College and Hospital, Baripada, Odisha, over a period of three years. Gross and microscopic findings on Haematoxylin & Eosin (H&E)-stained cardiac sections were studied. The final diagnosis was made on the basis of clinical, autopsy, and histopathological findings. The study was compared with other relevant studies. The data was analysed using Microsoft Excel 2019 software. Results: A total of 164 cases of SCD were included in this study. The maximum number of deaths occurred in the age group of 51-60 years (42 cases). The male to female ratio was 2.6:1, indicating an overall male preponderance. Out of 164 autopsied hearts, 85 cases of Ischemic Heart Disease (IHD), including new, old, and mixed lesions were found, followed by Hypertrophic Cardiomyopathy (HCM) in 25 cases, multiple lesions in 12 cases, dilated cardiomyopathy in four cases, tubercular pericarditis with myocarditis in one case, infective endocarditis in three cases, atherosclerosis in one case, coronary insufficiency in one case, cardiac myxoma in one case. Conclusion: Many factors can lead to SCD in apparently healthy individuals or in people with cardiac disease. In the present study, the most common cause contributing to SCD was IHD. The cause of SCD can be identified by a thorough post-mortem examination and histological analysis.
Introduction: Image-guided percutaneous transthoracic needle biopsy of mediastinal masses is usually safe and effective technique for obtaining tissue for diagnosis and early decision can be taken for effective management. Aim: The purpose of this study was to know the efficacy of different investigative methods for diagnosis of mediastinal masses and to analyse various cytomorphological forms. Materials and Methods: This was a retrospective observational study conducted at Pandit Raghunath Murmu Medical College, Baripada from January 2019 to June 2020. Retrospective review of all Ultrasonography (USG) and Computed Tomography (CT)- guided percutaneous aspirations of the anterior mediastinum mass. Relevant data regarding patient demographics, imaging characteristics of aspirated masses, presence of complications, and subsequent surgical intervention were collected. Cytology and core biopsy pathology results were recorded. The qualitative data were compared using Chi-square test with Yate’s correction. Results: This study included 35 patients (25 male, 10 female). Highest incidence was noticed in anterior mediastinum (n=26, 74.3%) followed by superior (n=4, 11.4%) and posterior mediastinum (n=3, 8.6%). Most of the cases were malignant (n=28; 80%) and Non Hodgkin Lymphoma (NHL) was most common diagnosis (n=10; 28.6%). Radiology yielded the correct diagnosis in 25 out of 35 patients (71.4%). Core biopsy was obtained in six cases and all the cases were diagnosed cytologically with 100% accuracy. There was statistically significant difference between the radiological and cytological diagnosis. The complication rate was minimal (2/35), both were the case of pneumothorax. Conclusion: Image-guided percutaneous aspiration is a safe diagnostic procedure with high diagnostic accuracy in aspiration cytology than radiology. Highest diagnostic accuracy was seen in non hodgkins lymphoma and it can potentially obviate more invasive procedures.
Actinomycetes are branching gram-positive anaerobic bacteria belonging to Actinomycetaceae family and are commensals in human oropharynx, gastrointestinal tract and female genitalia. Thoracic or pulmonary actinomycosis is an uncommon bacterial infection. The diagnosis of pulmonary or thoracic actinomycosis is often confounding because of its shared clinical features with malignant lung diseases and chronic suppurative lung diseases. However, chest physicians should be aware of actinomycosis being a differential diagnosis in persistent shadows in lung as early diagnosis leads to good prognosis. 1
Introduction: Subcutaneous swellings are commonly seen in clinical practice having varied pathology from epidermal inclusion cyst to malignancy. Subcutaneous mycosis is a fungal infection of subcutaneous tissue and dermis which is more prevalent in workers of rural, tropical, and subtropical regions. The subcutaneous infection mostly occurs due to minor trauma which goes unnoticed. Fine Needle Aspiration Cytology (FNAC) followed by microbiological analysis is a cost-effective and simple procedure and can be considered as one of the main modalities for early diagnosis. Moreover, it gives an early presumptive identification of fungus, which helps the clinician in a timely therapeutic approach. Aim: To study the efficacy of FNAC in the diagnosis of subcutaneous mycosis in comparison with culture method. Materials and Methods: A cross-sectional study, including clinically diagnosed cases of subcutaneous mycosis was evaluated between the periods of March 2019 to February 2021 in a tertiary care hospital in Northern Odisha. FNAC samples from all the cases of subcutaneous mycosis were studied cytologically and microbiologically. Cases were analysed and further evaluated on the basis of their age, sex, detailed clinical history, and presentation. FNAC showed the presence of fungal elements in 20 cases. Microbiological evaluation of these samples was carried out. Results: Out of the total 50 cases of subcutaneous mycoses, male (16): female (4) ratio was 4:1 and the commonest age group affected was 20-60 years of age (75%). The most common site of involvement was the lower limb (60%) followed by upper limb (30%). Almost all the cases were from rural areas with a history of trauma present in 11 cases (55%). Out of 50 clinically diagnosed cases, cytological examination revealed fungal element in 20 (40%) cases. The most common cytological diagnosis was abscess with neutrophilic infiltration seen in 13 cases (65%) followed by granuloma in 7 cases (35%). All the 20 samples were further evaluated in conventional methods like KOH mount and culture. Fungal agents were isolated in 13 (65%) cases. Cladosporium spp. was the commonest isolate in 5 cases (25%). Conclusion: Subcutaneous mycosis is a rare disease. FNAC can be used as a rapid and cost-effective screening tool in the diagnosis of such cases as it is more sensitive. Though culture is the gold standard test, it is less specific.
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