Information about the carrying angle and its variations are important in the management of paediatric elbow injuries. We measured the carrying angle using bony landmarks for 300 rural South Indian children aged 5-18 years. The study confirms that the clinical carrying angle correlates best with age up to 15 years, following which there was a slight decrease in the angles. The rate of increase of the carrying angle for boys and girls is 0.42 and 0.60 degrees per year respectively. Sex differences seem to gradually increase with a maximum being around puberty. The carrying angle is greater in girls than in boys by a mean of 1.31 degrees. The carrying angle did not correlate well with height, weight, humeral length or ulnar length. The reproducibility of measuring the carrying angle by the simple technique used in our study leads us to propose that this may be used in actual clinical practice.
A constellation of clinical, serological, endoscopic and histopathologic features is essential in diagnosing CD and autoimmune duodenitis. Biopsy is also a useful tool in diagnosing infectious duodenitis that are missed in other investigations.
Several deficits were identified that need to be rectified to improve the diagnostic accuracy of skin biopsy. A portion of discordant slides showing features compatible with the disease when reviewed by a pathologist and dermatologist together emphasizes the importance of a joint review by both in doubtful cases.
Imatinib, a tyrosine kinase inhibitor, is well known to cause hypopigmentation because of its inhibitory effect on melanocytes. Herewith we report a case of chronic myeloid leukemia who developed extensive hyperpigmentation following imatinib therapy.
Background: Intraepithelial lymphocytes (IELs) are seen in between the epithelial cells in small and large intestine with the functions of immune surveillance and activation.Increased IELs can be the sole histological finding in latent celiac disease (CD).
Aims:To study the utility and clinical relevance of IELs in diagnosing non-neoplastic lesions of duodenum and to determine a cut off for IEL to differentiate CD from other conditions.
Materials & Methods:This was a prospective descriptive study.Duodenal biopsies from 101 patients with symptoms of malabsorption were studied. Informed written consent was taken. Clinical details were collected. Histomorphological parameters were studied on hematoxylin and eosin stained sections. Intraepithelial lymphocyte counts were done on CD3, CD4 and CD8 IHC stained sections. Statistical analysis was done using IBM-SPSS software version 21.P value <0.05 was considered statistically significant. The threshold score of IELs with maximum sensitivity and specificity was validated using the Receiver operator characteristic curve to distinguish CD from non-celiac disease conditions.
Results:We studied 101 duodenal biopsies. Our spectrum included 16 patients of CD (15.8%), 15 of autoimmune duodenitis (14%), 13 of nutritional deficiency associated duodenitis (12.8%), 5 of infectious duodenitis (5%) and 41 patients of non-specific duodenitis (40.6%). The threshold levels were 5/20 villous tip IELs, 24 IELs/100 enterocytes on H& E and >31 IELs by CD3 IHC staining.
Conclusion:Our study proposes IEL counts of >31/100 enterocytes in CD3 IHC staining to be significant in South Indian population to differentiate CD from other conditions.
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