Extramammary Paget's disease (EMPD) of the vulva is a rare disease that occurs mainly in postmenopausal women. It can be primary or secondary. Prognosis of primary EMPD is good, but when secondary, we need to find the underlying malignancy as the prognosis depends on it. Very few cases of secondary EMPD of the vulva have been reported till now. We hereby report a case of a 65-year-old postmenopausal woman with EMPD secondary to invasive adenocarcinoma with neuroendocrine features in the dermis and she was treated surgically followed by radiotherapy.
Diagnosis of primary vaginal carcinoma is rare because most lesions are secondary. Vaginal carcinoma is common in the post-menopausal group; however, an increasing incidence among younger women is reported, especially in HIV prevalent areas. A suspicious case should be confirmed histologically with a biopsy. Treatment should be individualised depending on the stage of the disease. Here, we are presenting a case of advanced vaginal carcinoma in a young woman.
Background and aims:The ongoing Covid pandemic has burdened the medical system, more so due to the limited availability of ventilators. Our study aims at identifying the role of hematological markers in the risk stratification and the need for ventilator support among ICU admitted COVID-19 patients. Methods: A single centre prospective study was conducted on 100 Covid positive patients admitted in the ICU to determine association between the haematological markers such as Hb, Platelet count, Total and Differential leukocyte count, CRP, AST, ALT, LDH, Ferritin and D-Dimer with the need for oxygen therapy with or without invasive ventilatory support. Comparative analysis was performed between the 2 groups. Results: Neutrophilia, a mean of 76.7% among those ventilated and 71.6% among those non ventilated (p value 0.002; highly significant) and Lymphocytopenia (p value 0.004) with a mean of 14% and 18.6% respectively was noted. Hemoglobin levels were lower in ventilated (mean 11.6g/dl) as against those non ventilated (mean 12.58%) p value 0.046 which was significant. Ddimer was increased in COVID-19 patients; mean 5380 ng/ml in ventilated patients and mean 949ng/ml in those non ventilated (P < 0.001 highly significant). Elevated D-dimer and presence of diabetes correlated with increased chances of mechanical ventilation, while higher hemoglobin levels and associated COPD have a negative association with the need of mechanical ventilation. Conclusion: Hypercoagulability along with neutrophilia and lymphocytopenia can be used as positive associations for the need for invasive mechanical ventilation.
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