We report a rare case of prolapsed omentum presenting as mass per vagina in a 24 year old unmarried female following dilatation and curettage for termination of pregnancy by unqualified physician. Patient presented to Obstetrics and gynaecology (OBG) outpatient with bleeding per vagina since 15 days. Per speculum examination showed a greyish yellow mass protruding through cervical os into the vagina. Ultrasonography showed defect in the fundus of uterus. Past history revealed, she had undergone medical termination of pregnancy (MTP) outside at 5th month of gestation by nonallopathic doctor. Emergency laparotomy was done. Histopathologic examination of mass showed omental fat arranged in lobules with mixed inflammatory cell infiltrate. Uterine perforation is a well known complication of induced abortion. Although most uterine perforations at the time of curettage during abortion go unrecognized, serious complications do occur.
Background: COVID -19 has wide range of presentation, from asymptomatic infection to severe viral pneumonia and death. D-dimer >1μg/ml is one of the risk factors for mortality. CT chest plays an important role in early detection and monitoring of disease. Objectives: 1. To compare D-dimer value and CT chest findings in Covid-19 patients. 2. To study platelet count, PT, aPTT and CRP in Covid-19 patients. Methodology: RT-PCR confirmed Covid- 19 patients admitted in hospital investigated with D-dimer and CT chest were included in the study. Case details retrieved from medical records. Venous blood collected and plasma processed in coagulation analyser for PT, aPTT, INR and D-dimer. Platelet count was performed using auto analyser. CT findings were retrieved from radiology software (PACS). Statistical tests used were mean, percentage and Fisher’s exact test (SPSS Version 20). Results: During study period of January-June 2021, 38 patients were included. Mean age was 51.1±15.6 years and M:F ratio 2.8:1. 65.8% patients had comorbidities (25/38). D-dimer elevated in 60.5% (23/38) patients. CT showed 10.53%, 28.94%, 60.53% of patients had affected lungs of <15%, 15%-49% and ≥50% of the total area and showed significant association with D- dimer (P=0.018). 17.4% (4/23) patients with elevated D-dimer did not survive. 15.8% (6/38) patients had low platelet, 23.7% (9/38) had abnormal PT, 70.3% had abnormal aPTT and 89.5% (34/38) had elevated CRP. There was no significant correlation between platelet, PT, aPTT, CRP and D-dimer. Conclusion: D-Dimer is elevated in COVID -19 patients and shows significant association with lung involvement and can be used as prognostic marker.
Background: Tumour-infiltrating lymphocytes are important predictors of response to neoadjuvant therapy in breast cancer. It remains unclear whether Tumour infiltrating lymphocytes scores in core needle biopsies are closely representative of those in the whole tumour of surgically resected specimens.
The study aims to evaluate the concordance between tumor-infiltrating lymphocytes scores of core needle biopsies and surgically resected specimens as per recommendations and to assess the reliability of tumor-infiltrating lymphocytes score in core needle biopsies.
Materials and Methods: Retrospective study from January 2016 to March 2019 done in tertiary care hospital. Tumor-infiltrating lymphocytes scores were sub-classified as low (≤10%), intermediate (11–49%), and high (40-90%). Relevant statistical tests were used and reliability score was done by Fisher’s test.
Results: The mean value of tumor-infiltrating lymphocytes in 34 cases was 27.03% in core needle biopsies and 34.6% in surgically resected specimens. High tumor-infiltrating lymphocytes score was seen in 8 (23.6%) and 11 (32.4%) cases and low to intermediate score was seen in 26 (76.4%) cases and 23 (67.6%) in core needle biopsies and surgically resected specimens respectively. Intermediate and high tumor-infiltrating lymphocytes categories in core needle biopsies accounted for good agreement with surgically resected specimens (60%-intermediate, 87.5 %-high). More than three cores had a better agreement.
Conclusions: Tumor-infiltrating lymphocytes score in core needle biopsies is of reliable value in breast cancer. Discrepancies may occur in tumours with HER2neu phenotype, PR status, and younger age.
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