Background: With recent surge in SARS-COVID-19, cases of rhinocerebral mucormycosis are on rise. Rapid diagnosis of mucormycosis is essential as delay in the treatment is associated with dreadful outcome. Many studies have found that crush cytology smears can rapidly diagnose mucormycosis as compared to histopathology, thereby reducing the time for arriving at final diagnosis, here, we present a novel approach to the rapid diagnosis of mucormycosis by crush cytology and analyze whether it has a higher sensitivity in diagnosing cases of mucormycosis. Aims and Objectives: This study aims to analyze the efficacy of crush cytology smear in rapid diagnosis of mucormycosis. Materials and Methods: Biopsies received from all the clinically suspected cases of mucormycosis with a history or associated present COVID-19 infection. The biopsy was processed for KOH preparation, crush cytology smear and confirmation were done by histopathological examination. Special stains were done wherever necessary. Results: Out of 50 cases of clinically suspected mucormycosis, 43 confirmed on histopathology. Out of 43 confirmed cases of mucormycosis, 33 (76.74 %) were male and 10 (23.25%) were female with male: female ratio of 3.3:1. The mean age of the studied cases was found to be 52.32±12.59 years. The most common presenting complaint was fever (79.07%), followed by headache/retro-orbital pain (62.79%), rhinorrhea (58.14%), and facial swelling (53.49%). Out of 43 patients, 41 recovered from COVID-19 disease with mean duration of 12 days. Hospital stays of patients with for COVID-19 varied from 7 days to maximum of 35 days. Out of 43 cases of mucormycosis, 24 cases were diagnosed with KOH mount with sensitivity of 55.81% and 39 cases with crush cytology smears with sensitivity of 90.69%. Conclusion: The diagnosis of mucormycosis is done with the gold standard methods such as histopathological examination and culture studies but the present study emphasizes on use of crush cytological smears prepared from sinonasal biopsies in suspected cases of mucormycosis in rapid and accurate diagnosis of mucormycosis.
Background: Diseases of gastrointestinal (GI) tract present wit myriad signs and symptoms. Appropriate management of these diseases involves proper evaluation. Upper GI endoscopies are becoming increasingly popular because it helps in first localizing the lesion and then biopsy specimens can be obtained from affected area. Duodenal biopsy followed by histopathological examination may clinch the diagnosis in majority of the cases. Aims and Objectives: The aim of the study was to find out diagnostic utility of endoscopic duodenal biopsies and histopathological finding in the upper GI diseases. (1) To analyze duodenal endoscopic biopsy samples obtained from patients presenting with the upper GI symptoms. (2) To correlate endoscopic and histopathological findings in studied cases. Materials and Methods: A retrospective and prospective observational study was carried out at the private histopathology center over a period of 2 years. All the patients underwent upper GI endoscopy with duodenal biopsies using flexible endoscope. Histopathology of the samples obtained from endoscopic duodenal biopsies in patients presenting with the upper GI symptoms were analyzed. The endoscopic findings such as mass lesion or ulcerative lesion were correlated with histopathological findings. Results: Out of these 704 biopsies, 303 (43.04%) were esophageal biopsies, 220 [31.25%] were gastric, and 181 [25.71%] were duodenal biopsies. There were 129 (71.27%) males and 52 (28.73%) females with a M: F ratio of 2.5: 1. The mean age of the cases was found to be 54.7±12.32 years. Out of 181 biopsies which were performed in this study, 100 (55.25%) lesions were found to be having neoplastic etiology whereas 81 (44.75%) lesions were found to have non-neoplastic etiology. Among patients who were found to have duodenal growth on endoscopy well differentiated adenocarcinoma (15.47%) followed by moderately differentiated adenocarcinoma (6.63%) were the common pathologies. In cases of non-neoplastic etiology, non-specific duodenitis was most common pathology (17.13%). Conclusion: Endoscopic biopsy followed by histopathological examination is cornerstone of the management of patients presenting with intractable upper GI symptomatology.
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