No abstract

Collagen vascular diseases (CVDs) like systemic lupus erythematosus (SLE), rheumatoid arthritis, Sjogren syndrome (SS), and scleroderma are immunologically mediated disorders that typically have multisystem involvement. Although clinically significant liver involvement is rare, liver enzyme abnormalities are common in these patients. The reported prevalence of hepatic involvement in SLE, histopathologic findings, and its significance is very variable in the existing literature. It is important to be familiar with the causes of hepatic involvement in SLE along with histomorphological features which aid in distinguishing hepatitis of SLE from other hepatic causes as they would alter the patient management and disease course. Histopathology of liver in SLE shows a wide morphological spectrum commonly due to a coexisting pathology. Drug induced hepatitis, viral etiology, and autoimmune overlap should be excluded before attributing the changes to SLE itself. Common histopathologic findings in SLE include fatty liver, portal inflammation, and vascular changes like hemangioma, congestion, nodular regenerative hyperplasia, arteritis, and abnormal vessels in portal tracts.

Perineural infiltration is present in OSCC but perineural spread along the inferior alveolar canal is absent. It is a bad prognostic indicator.

BackgroundBreast cancer is the most common cancer to affect women in South Africa. Whilst the lifetime risk is lower than in highincome countries, 1 outcomes are worse with reduced survival. This poor ratio of diagnosis to survival is often linked to difficulty in accessing care and poor availability of treatment options after diagnosis. [2][3][4][5] Screening and early diagnosis are limited and patients commonly present with advanced stage of disease limiting their outcomes despite treatment. Commonly cited or implied reasons for late diagnosis are often related in the literature to delay to care, both patient related delay, and provider (or system) delays. A delay of more than three months to presentation has been associated with more advanced breast cancer at diagnosis and decreased survival, 6 however most studies from low-and middle-income countries (LMICs) indicate that the average delay exceeds this time. In countries of similar upper-middle income economic background to South Africa, delay to care (both patient-and provider-related) of more than three months ranges from 56% in Malaysia to 70% in Brazil. 7,8 In South Africa, few studies have examined the managementThe effect of beliefs about breast cancer on stage and delay to presentation: results from a prospective study in urban South Africa Background: The disparity in breast cancer survival in Africa is often linked to poor education and awareness leading to late diagnosis and subsequent reduced survival. This study was designed to explore the relationship of attitudes and beliefs held regarding breast cancer to the stage and delay to diagnosis in South Africa. This study provies an epidemiological analysis of the spectrum of disease and outcomes of primary amputation for diabetic foot sepsis in a regional rural hospital. Methods:Women attending an open-access breast unit over 14 months with newly-diagnosed breast cancer answered a survey regarding their fears and beliefs of breast cancer care. Questions addressed demographic, socioeconomic and educational factors linked to delay, and documented time taken to care. Odds ratio with 95% confidence intervals were calculated to identify factors associated with advanced stage at presentation and delay greater than six months. Results: Of the 233 participants the median (IQR) age was 56 years (46-65). The most common stage at presentation was Stage 3 (55%), with 30.5% presenting with T4 tumour at presentation. Most women believed cancer could be beaten (90.0%), and their families would support them (92.8%). They disagreed that cancer was a curse (93.8%), punishment (90.5%) or that alternative therapies or traditional healing would cure their cancer (75.3% and 85.5% respectively). On univariate analysis, age under 45 years and transport difficulties predicted advanced stage at presentation. No socio-economic factors or beliefs increased the risk of delay to presentation. Conclusion:Participants' beliefs about their new breast cancer were most commonly appropriate, and showed a low level of fatalism, in contr...

Systemic amyloidosis of amyloid light chain associated protein (AL), also called primary amyloidosis, frequently involves the liver, but rarely causes clinically apparent liver disease. The more common presentation is with acute renal failure. Hepatomegaly and mild elevation of alkaline phosphatase are the most common clinical and biochemical findings, respectively. We report a case of systemic amyloidosis of AL that clinically presented as acute-on-chronic liver failure and resulted in a fatal clinical course in a 56-year-old man.