Even before the onslaught of COVID-19 pandemic could settle, the unprecedented rise in cases with COVID-19 associated mucormycosis has pushed the medical health to the fringe. Hyperglycaemia and corticosteroids appear to be the most consistent associations leading to the commonest manifestation of mucormycosis, Rhino-Orbito-Cerebral Mucormycosis. To address challenges right from categorisation and staging of the disease to the management of relentless progression, a multi-disciplinary expert committee was formed to handle the task in an evidence-based format to enforce best practices. The report of the committee on one hand attempts to succinctly present the currently available evidence while at the other also attempts to bridge the evidence-deficient gaps with the specialty-specific virtuosity of experts.

Context: The worldwide prevalence of rheumatoid arthritis (RA) is about 1%, whereas in India, it is approximately 0.75%. The current therapy for RA includes nonsteroidal anti-inflammatory drugs corticosteroids, disease-modifying anti-rheumatic drugs and some recently developed biologic agents, but all of these are associated with adverse effects. Some herbal drugs, such as Boswellia serrata, have been reported to possess anti-inflammatory activity. Aims: The aim of this study is to evaluate the anti-arthritic activity of Boswellia serrata extract (BSE) in complete Freund's adjuvant (CFA)-induced arthritis in rats. Materials and Methods: Thirty-six Wistar rats were divided into six equal groups. RA was induced by intradermal injection of 0.1 ml CFA in hind paw. Body weight, ankle diameter, paw volume, arthritic index, tumor necrosis factor-α (TNF-α), and histopathological examination were assessed. The experimental data were statistically assessed by one-way analysis of variance (ANOVA). Statistical Analysis Used: The recorded data were analyzed using paired t -test and ANOVA test using SPSS. The data were analyzed and represented as mean difference. Value of P < 0.05 was considered statistically significant. Results: BSE at dose 180 mg/kg showed statistically significant improvement in body weight and decrease in ankle diameter and arthritic index ( P < 0.05); however, there was insignificant change in paw volume ( P = 0.056). This improvement was comparable with Indomethacin. The level of TNF-α did not show any statistically significant change ( P = 0.076). Histopathological results also exhibited a reduction in inflammatory parameters. Conclusions: BSE might have usefulness as an adjunct to conventional therapy of RA.

Metastasis of adenoid cystic carcinoma to the kidney is rare. We present a case of a 50 year old male with complaints and radiological findings suggestive of renal cell carcinoma and lung deposits. However, fine needle aspiration was suggestive of adenoid cystic carcinoma metastatic deposits. It was later elicited that the patient had undergone surgery for parotid tumour seven years back which on histology was an adenoid cystic carcinoma. The case is being presented for its rarity.

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SUMMARYWe present a young patient with occasional chest pain and an incidentally found posterior mediastinal mass on radiology which was confirmed as mature teratoma on histopathology. The gross specimen received in the department of pathology was globular measuring 9.0×7.0×5.5 cm and varying in consistency from soft cystic to firm. Cut surface showed numerous hair entangled in pultaceous material. Representative sections were taken and stained with H&E stain. Histopathology revealed haphazardly distributed mature derivatives of all the three germ layers comprising of epidermis, pilo sebaceous units, nerve bundles (ectodermal), cartilage, bone, salivary gland clusters, blood vessels, muscle bundles, fibrous tissue infiltrated by foreign body giant cells, lymphoid follicles (mesodermal) and pseudostratified columnar epithelium (mesodermal), thus establishing the diagnosis of mature teratoma. BACKGROUND

UNUSUAL VARIANTS OF FIBROADENOMA BREAST DIAGNOSED ON CYTOLOGYFibroadenomas are common benign breast tumours that display a characteristic morphology, although several epithelial and stromal variations exist which may pose a diagnostic difficulty. We are discussing a case series of four cases of benign fibroadenoma with morphological variations as observed on cytology smears in the department of Pathology, KGMU, Lucknow, UP. Juvenile fibroadenoma constitutes only 4% of the total fibroadenomas with incidence of 0.5% per year.Another very rare histological finding is the presence of multinucleated giant cells throughout the stroma of a benign fibroadenoma, more commonly found incidentally within the interlobular stroma of breast tissue. Similarly apocrine metaplasia has been found to be 28% in a case series (Arno Kuijper et.al) of 396 cases of fibroadenoma.It is important to identify these variants as they may be misinterpreted as malignancy.

Although both pulmonary and extrapulmonary tuberculosis (TB) are commonly encountered in developing countries, tenosynovitis is an uncommon presentation of musculoskeletal TB. TB mimics a lot of other conditions and causes diagnostic dilemma in day-to-day practice. We present the case of a 30-year-old male who presented with the complaints of swelling of right index finger which was initially suspected to be giant cell tumour of the flexor tendon sheath but on histological examination turned out to be tuberculous tenosynovitis.