Introduction: FNAC is an excellent modality for diagnosis of thyroid lesions because of its simplicity and cost effectiveness. Since the introduction of The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) in 2007, it has become a standardized, convenient and more informative system of thyroid reporting. Aims: 1. To study cytological features of FNAC and categorization according to TBSRTC; 2. To assess statistical analysis of FNAC in detecting malignant lesions. Settings and Design: This is a cross-sectional study carried out in the Pathology Department from January 2015 to December 2017. Materials and Methods: We interpreted 329 thyroid FNAC and categorized them according to TBSRTC. 75 cases are correlated histologically. Statistical Analysis: Accuracy, specificity, sensitivity and predictive values. Result: Distribution of different categories are as follows Non-diagnostic/unsatisfactory (ND/UNS)-8.5%, Benign-85.2%, Atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS)-0.6%, Follicular neoplasm/suspicious for follicular neoplasm (FN/SFN)-2.4%, Suspicious for malignancy (SFM)-1.5% and malignant-1.8%. The malignancy risk calculated from histopathological follow up of 75 cases is as follows: ND/UNS 0%, Benign 6.9%, FN/SFN 16.7%, SFM 66.7% and malignant 100%. The positive predictive value, negative predictive value and accuracy of TBSRTC are 100%, 93.1%, 93.7% respectively. Conclusion:The malignancy risk, accuracy, specificity and predictive values are consistent with other studies. Thus TBSRTC allows more standard reporting, specific diagnosis and understanding of terminology between pathologists and clinicians.
Talon noir is an asymptomatic, self-limiting, dermatological condition that is most commonly seen in young athletes and mountain climbers. Histologically, the characteristic findings are intraepidermal hemorrhage and fluid collection due to shearing forces. Here, we report an interesting case in an elderly female, which mimicked acral melanoma clinically and alerted us to do a biopsy for confirmation.
BACKGROUND Chronic gastritis is a common condition in general population. Of the many aetiological factors, Helicobacter pylori is one of the primary cause of chronic gastritis. AIMS To study the histopathological features of chronic gastritis associated with H. pylori infection. To find out the relationship between severity of inflammatory reaction in gastritis and intensity of H. pylori. MATERIALS This cross sectional study was carried out in Regional Institute of Medical Sciences (RIMS) Hospital from October 2013 to September 2015. Patients with symptoms suggestive of chronic gastritis attending RIMS OPD were subjected to upper gastrointestinal endoscopy. One of the biopsy specimens was used for rapid urease test using RUT dry test kit and others were processed for histopathological examination as per standard protocol. All the slides were stained with Haematoxylin and Eosin (H&E) stain and Giemsa stain. Histological variable grading was done using the "Updated Sydney System 1994". All the data thus collected were analysed. RESULTS A total of 60 patients (39 males and 21 females) were included in the study with age ranging from 19 to 82 years. Among the 60 patients, maximum endoscopic findings were ulcer (33.3%) followed by erythematous findings (26.7%). The results of Rapid Urease Test (RUT) were positive in 30% (18/60). The histopathology reports for H. pylori detection were positive in 35% (21/60). The majority (81.7%) of the cases were inflammatory on histopathology followed by neoplasia (8.3%), dysplasia (5%) and normal finding (5%). Neutrophilic activity was present in all cases of chronic gastritis, in which 15, 5 and 11 numbers of cases showed mild, moderate and severe grading respectively. Mononuclear cell infiltration also was present in all cases of chronic gastritis and 8, 16, 7 numbers of cases were found to have mild, moderate and severe grading respectively. Only five mild atrophy, four mild Intestinal metaplasia (IM) and one moderate Intestinal metaplasia (IM) were found in gastritis cases. Correlation coefficient of neutrophilic activity with H. pylori density was 0.725 (p=0.000), which was statistically significant. CONCLUSION In our study, histopathological features of H. pylori associated chronic gastritis have shown H. pylori density, neutrophilic activity, mononuclear cell infiltration, glandular atrophy and intestinal metaplasia. We also have observed the association between neutrophilic activity and H. pylori density.
Background: Research shows that both hypertension and prehypertension accelerate the decline in standardized global cognitive performance. Two important risk factors for development of elevated BP are stress and anxiety. Hence, the study also focuses on assessing stress and anxiety in undergraduate medical students using validated questionnaires. Aims and Objectives: Hypertension and prehypertension are on a rise in undergraduate medical students and are proposed to accelerate cognitive failure. This study aims to provide prevalence of hypertension, prehypertension, anxiety, stress, and its association with cognitive failure among 1st year medical students in a medical college in North India. Materials and Methods: The study is a cross-sectional study conducted in the Department of Physiology of a Medical College on 1st year medical students. Google form was given to the whole batch of 150 medical students. Out of them, 111 students voluntarily participated. Hence, we have included them in our study. Standard questionnaire prescribed by Cohen et al., Spitzer et al., and Broadbent et al., for stress, anxiety, and cognitive failure respectively was given to students. Google documents were used as a platform to create online questionnaires that were automatically posted through a unique URL. Password protected access to URL link and a unique study ID gave students round the clock access. Unique study ID ensured confidentiality of all self-reported data. Student’s response was secured using a “cloud” database, where data were automatically sorted, scaled, and scored by custom Excel formulas. Blood pressure of all the students was measured and a Google form consisting of items from these three questionnaires was filled by the students. Data were organized and statistically analyzed by Chi-square test. Results: In the present study, the prevalence of prehypertension was 46.8% and hypertension was 7.2%. Perceived stress score was moderate in 71.2% of subjects and high in 10.8% of subjects. Moderate-to-severe anxiety was recorded in 21.6% of students. Cognitive failure score was high (>43) in 24.3% of students. A Chi-square test of independence was performed to examine the relation between blood pressure and cognitive failure. Relationship between these variables was significant X2 (1, n=111)=7.08, P=0.029. Patients with hypertension are likely to develop cognitive failure than those with normal blood pressure. Conclusion: The prevalence of prehypertension and hypertension is rising in medical students. Anxiety and stress being the major causes need to be addressed so as to maintain cognitive well-being of the undergraduate medical students.
A BSTRACT Background: Andaman and Nicobar Islands, a Union Territory of India is Tropical Island, has better air quality and since its specific geographic location that may have an impact on the clinical and pathological features. So, this study is intended to describe the clinical and pathological features of COVID-19 infection and its association with the severity of the disease among adult COVID-19 patients. Material and Method: A cross-sectional study done retrospectively among 100 adult COVID-19 RT PCR positive in Tertiary Hospital, tropical Islands by reviewing medical records. The clinical, laboratory parameters were assessed. Results: In the study 65% of the population were male, and 55% of COVID-19 cases were between the age group of 25 to 50 years of age. At presentation, 96% had respiratory symptoms, 91% had fever, 33% had gastrointestinal symptoms, 10% had musculoskeletal symptoms, and 6% have a history of contact with COVID-19 positive patients. The severe COVID-19 patients had longer duration of fever ( P -value 0.041), duration of cough ( P 0.016), duration of breathlessness ( P 0.002), high pulse rate ( P = 0.031) at presentation, had high neutrophil/lymphocyte ratio ( P = 0.001), high neutrophil count ( P < 0.001), low lymphocyte count ( P < 0.001), high CRP ( P < 0.001), and high D-dimer ( P < 0.001) at presentation. Conclusion: Severe COVID-19 patients at presentation had longer duration of fever, cough, and breathlessness, hence should seek early medical care. Lab parameters is a great tool in the assessment of patient who can go to have severe disease and thus help in formulating Guidelines.
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