Introduction: Gastrointestinal Stromal Tumours (GISTs) are the most common mesenchymal tumours of the alimentary canal. Interstitial cells of Cajal are believed to be the cell of origin of GIST which regulates gastrointestinal peristalsis. GISTs encompass a clinicopathologically distinctive, but heterogenous group of neoplasms with reference to their origin, cellular differentiation and prognosis. Aim: The aim of this study was to analyse the histopathological and immunohistochemical characteristics of GIST. Materials and Methods: A hospital-based cross-sectional study of 108 cases of GIST were studied over a period of three years from January, 2017 to December, 2019 in Department of Pathology, Vydehi Institute of Medical Sciences and Research Institute (VIMS&RC), Bangalore. Patient’s demographic data like age and gender were collected. Tumour characteristics like site, size and number of lesions were analysed. Histopathological and immunohistochemistry for Desmin, CD117 and DOG-1 were analysed for significant association with risk groups. Risk stratification according to the Fletcher's risk classification, the cases were divided was divided into very low, low, intermediate and high risk groups. The master chart of collected data was prepared in Excel sheet. Chi-square test with Yates correction was used to calculate p-value to ascertain statistical significance. The master chart of collected data was prepared in Excel sheet. Descriptive statistical analysis was presented in the form of tables, figures and diagrams wherever necessary using Epi info 07 statistical software package. Results: The mean age of the patients was 55.6±14.4 years. Males (55.6%/60 cases) were commonly affected than females (44.4%/48 cases). Small intestine was the commonest location (44.4%/48 cases). Tumour size ranged from 1.5 cm to 25 cm with a mean of 9.1 cm. Microscopic findings revealed that spindle cell type was the most common (86.1%/93 cases). Majority of the cases belonged to high risk category. Multifocality, necrosis, tumour size and >5 mitosis/50 High Power Field (HPF) showed significant association with high risk category tumours (p-value 0.033, 0.016, 0.004 and <0.001, respectively). Immunohistochemical staining showed positivity for CD 117 (83.3%/90 cases), DOG-1 (88.9%/96 cases) and 108 cases/100% negativity for desmin. Conclusion: This study found significant association of high risk groups with tumour size, multifocality, necrosis and mitosis >5/50 HPF. Risk categorisation of GIST remains important. A combination of CD117 and DOG-1 will be more useful in diagnosing GIST rather than using them alone.
BACKGROUNDMycobacterium tuberculosis remains one of the most significant causes of death from an infectious agent. The rapid diagnosis of tuberculosis and detection of Rifampicin resistance are essential for early disease management. The Gene-Xpert MTB/RIF assay is novel integrated diagnostic device for the diagnosis of tuberculosis and rapid detection of RIF resistance in clinical specimens. This study is to assess the role of molecular diagnostic test, the Gene-Xpert in diagnosing Tuberculosis. Aims and Objectives-1. Application of newer molecular diagnostic test, Gene-Xpert for the diagnosis of tuberculosis in suspected TB patients. 2. To find out sensitivity and specificity of Gene-Xpert. 3. To find out the incidence of drug resistance in newly detected TB with the help of Gene-Xpert. MATERIALS AND METHODSThis is a prospective observational study which was conducted in Government Medical College, Kozhikode. A total of 100 patients were included who met the inclusion criteria. Patients were diagnosed to have TB by AFB culture, smear positivity and also clinically. These diagnosed TB patients were grouped into culture positive and negative, smear positive and negative and Gene-Xpert positive and negative; sensitivity and specificity of Gene-Xpert in diagnosing pulmonary and extrapulmonary TB was found out. The incidence of drug resistance in newly detected TB was also found out. RESULTSThe performance of the Gene-Xpert assay for rapid diagnosis of tuberculosis and detection of Rifampicin resistance in pulmonary and extrapulmonary specimens obtained from possible tuberculosis patients was determined. 100 patients who satisfied the inclusion criteria were selected and 62 pulmonary and 38 extrapulmonary specimens of these patients were studied. 49 (41 culture positive and 8 culture negative for M. tuberculosis) of the 100 patients were diagnosed to have tuberculosis. The sensitivity and specificity of Gene-Xpert was found to be 75.5% and 100% respectively. In pulmonary specimens, sensitivity and specificity were 79.3% and 100% respectively. In extrapulmonary specimens, sensitivity was 70% and specificity was 100%. In smear positive and negative tuberculosis, sensitivity was 100% and 62.5% respevtively. The Gene-Xpert also detected 2 RIF resistant specimens and 35 RIF susceptible specimens. Incidence of RIF resistance in newly detected TB patients was 4.08% (2/49). CONCLUSIONGene-Xpert sensitivity is higher than AFB smear, both in pulmonary and extrapulmonary specimens. Simultaneous detection of Rifampicin resistance is especially beneficial in patient with MDR and HIV associated Tuberculosis. Early detection of TB and RIF resistance helps to initiate the appropriate therapy, thus improving the quality of TB care. However, Gene-Xpert will not replace conventional microscopy, AFB smear, culture and drug sensitivity. So, this test may be done in the context of a comprehensive algorithm including microscopy, AFB smear, culture and drug sensitivity.
Background: Patients with Human Immunodeficiency Virus (HIV) infection are predisposed to numerous opportunistic infections due to decreased cell mediated immunity, Tuberculosis being most common. Low CD4 count is associated with low immunity and higher risk of tuberculosis.Methods: Author conducted a retrospective study in the department of Pulmonary medicine in a tertiary care teaching hospital during January to December 2017. Author collected data of all the patients with HIV diagnosed with Tuberculosis from the ART centre. Author collected demographic details including age, sex, symptoms at presentation, details of diagnosis of TB including type of tuberculosis, CBNAAT results, CD4 count at the diagnosis of TB, details of ART therapy and ATT therapy and outcomes of treatment.Results: Eighty one patients with HIV-TB co- infection were included in the study. Males (70.37%) were more affected than females. Mean age of the study group was 39.97±10 years. Sixty one patients (75.4%) were diagnosed with Pulmonary Tuberculosis and 20 (24.6%) patients were diagnosed with extra pulmonary TB. Mean CD4 counts of the cohort was 226±110/µl. Eighty percent of patients developed Tuberculosis with CD4 count <250/µl.Conclusions: Author found in this study higher proportions of tuberculosis (80.2%) in patients with HIV infection with CD4 count <200/µl. Author also found higher proportion of pulmonary Koch’s in patients with low CD4 count (CD4 <200/µl).
Background Lichen planus (LP) is a common long term inflammatory disorder that affects skin and mucous membranes. Though mostly asymptomatic in oral mucosa it may cause severe morbidity in erosive cases. The relation between LP and liver diseases especially hepatitis C have been proposed by many authors with varied results. Alteration in liver function tests reflected by increased levels of transaminase levels, i.e., serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT) with or without the presence of antibodies against hepatitis C virus (HCV) has been observed in oral lichen planus (OLP) patients in many studies. So this study was undertaken with the intent to further evaluate any alliance between OLP and liver disease principally hepatitis C. Materials and methods The study consisted of 30 histopathologically confirmed patients of OLP and 30 age and sex matched healthy volunteers visiting the outpatient department of a dental hospital over a period of 1 year. All subjects in both groups were subjected to SGOT, SGPT and HCV antibodies detection. Results The percentage of patients with elevated SGOT and SGPT values was higher among the OLP patients in the study group (40%) in comparison to subjects in the control group (7%). The mean values of SGOT and SGPT were also higher in the study group in comparison to the control group. No HCV antibodies were found in the serum of subjects in both the study group and control group. Conclusion Liver disease or hepatitis C can be considered a risk factor for LP and may lead to diagnosis, early treatment and possibly a better prognosis in asymptomatic OLP patients. Further studies with large samples are recommended to prove the current hypothesis regarding the association between LP and chronic liver disease and/or HCV infection. How to cite this article Sobti G, Manjunath M, Deepak TA, Krishna S, Annaji AG. Oral Lichen Planus in Relation to Transaminase Levels and Hepatitis C Viral Antibodies Detection: A Clinical Study. World J Dent 2016;7(2):64-68.
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