The overall profile of breast cancer and immune characteristics of Sri Lankan women in this study was largely comparable to profiles documented elsewhere in the region despite the lower prevalence of ER.
GCa HER2 positivity was 9%, associated with a lower median overall survival. Adverse histological features had a positive correlation with HER2 positivity. These histological features could direct patients for confirmatory HER2 testing in limited resource settings.
Context:Aerva lanata is not prescribed for long-term use in Ayurveda as it is believed to produce structural changes in the urinary tract of the patients leading to renal failure.Aim:To investigate the toxic effects of Aerva lanata on the structure and function of urinary tract of a rat model (Sprague-Dawley rats).Settings and Design:An experimental study. Thirty male and thirty female healthy rats were randomly assigned to three groups (test groups 1, 2 and control) and administered dried infusion of A. lanata 25g/200ml (low dose), 100g/200ml (high dose) and distilled water respectively, for 30 days.Materials and Methods:Blood and urine were collected and creatinine was measured. Creatinine clearance (Ccr) and urine flow rate (UFR) of rats were determined to assess renal function. Kidneys, ureters, and bladders of rats were harvested for light microscopic (LM) studies. Electron microscopic (EM) studies were done on kidney tissues.Statistical Analysis Used:Difference in mean values of Ccr and UFR between test groups and the control group were compared statistically using independent T test. LM and EM findings of the two treated groups (T1 and T2) were statistically compared with the control group (C) using standard normal distribution.Results:Ccr and UFR of test groups were not significantly different from that of the control group. LM studies did not show any histological changes suggesting toxicity. EM, however showed significant ultra structural changes in proximal convoluted tubular epithelial cells of rats in the two test groups.Conclusion:Administration of dried Aerva lanata for a period of one month did not produce significant effects on renal function of rats. However administration for the same period caused significant ultra structural changes in the proximal convoluted tubular epithelial cells.
Giagantomastia is a rare disorder known to occur in pregnancy, causing enlargement of the breasts greater than that of gravid enlargement. The histological features of gigantomastia are glandular hyperplasia and an increase of stromal tissue. Illustrated by one documented case, cytomorphology of gigantomastia was misdiagnosed as a phyllodes tumor. We document the cytomorphology of an axillary mass in a gravid woman of 24 years with gigantomastia. She presented in her first trimester with bilateral mastalgia and swelling, nonresponsive to antibiotics. Imaging excluded mass breast lesions and a pituitary prolactinoma. The breasts progressively enlarged, became warm, tender, and developed skin ulcerations and a peau d'orange appearance. Subsequently she developed a mass in her left axilla. On aspiration of the mass, some of the cytomorphological features were suspicious for a metastasis, which correlated well with her clinical features. Careful evaluation suggested cytomorphology to be compatible with benign accessory breast tissue with possible hormone related changes of pregnancy. Histology of the excised axillary mass confirmed this diagnosis. Thus, awareness of this rare condition and careful evaluation is mandatory to avoid misdiagnosis in a similar clinical context.
Background Trans rectal ultrasound guided prostate biopsy (TRUS) was introduced to Sri Lanka in 2002. Objectives 1. To study clinicopathological features of males subjected to TRUS biopsy 2. To compare estimation of tumour burden by two methods in carcinoma prostate (CaP). Methods 749 symptomatic males subjected to TRUS biopsy over 64 months at a single centre. Information was retrieved from case records. Tumour burden in CaP was calculated as: 1. Calculated tumour burden (CTB)total percentage tumour in each core/total number of cores 2. Percentage positive biopsy cores (PPBC)number of positive cores / total number of cores X 100. SPSS 15.0, student's t test and Spearman's rank correlation coefficients were used for statistical analysis. Results 35.2% had CaP, microacinar in type. 34.88% were poorly differentiated. CaP was frequent among older patients (P<0.00001). The prostate volume in CaP was significantly lower than in the benign group (P<0.05). Prostate specific antigen (PSA) level was significantly higher in CaP (P<0.00001). A 99.6% sensitivity and 4.7% specificity was observed at PSA of 4ng/ml for detecting CaP. Specificity was 98% at 25.5ng/ml, with a sensitivity of 44.4%. CTB and PPBC had similar correlations with biochemical/histological parameters of CaP and were strongly correlated (0.786). Interpretation Males with CaP were older, had higher PSA levels and smaller prostates. A cut off level of PSA >4ng/ml could be used for directing symptomatic patients for TRUS biopsy to detect CaP, keeping in mind that specificity is 98% only at 25.5ng/ml. Both CTB and PPBC could be used to calculate tumour burden in TRUS with CaP.
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