Background:Breast carcinoma is the most common malignancy globally. Cytological evaluation in breast lesions is largely subjective. Gradual progression of cells from normal to invasive involves nuclear changes that need to be viewed objectively.Aims:This study aims to apply nuclear morphometry on cytological breast aspirates. It evaluates its utility in differentiating benign vs. malignant lesions and correlates it with cytologic grading in malignant cases.Setting and Design:Nuclear morphometric parameters of malignant and benign cases were compared. Parameters of malignant cases were correlated with cytologic grading.Materials and Methods:Cytology was used to categorize aspirates from breast lumps into malignant (53 cases) and benign (29 cases). One hundred cells per case in both groups were mapped on DEBEL Cytoscan and six geometrical and three textural parameters obtained were compared. In malignant cases, morphometry was correlated with Robinson’s cytologic grading, which was further correlated in tissue sections (45 cases) with modified Scarff-Bloom-Richardson histologic grading.Statistical Analysis:Students “t”-test was applied for comparison between benign and malignant cases. One-way ANOVA followed by Bonferroni’s post hoc comparison was applied to compare the three cytologic grades. Results were considered significant when P<0.05.Results:Nuclear morphometry successfully differentiated between benign and malignant aspirates and correlated significantly with cytologic grades. Morphometry was especially useful in the diagnosis of atypical ductal hyperplasia and ductal carcinoma in situ. Useful parameters were mean nuclear area, long axis, short axis and total run length. Cytohistologic correlation was 83.3%, 88.9% and 88.9% for cytological grades 1, 2 and 3 respectively.Conclusions:Nuclear morphometry was thus a useful objective tool in the evaluation of breast masses.

Medical education is considered as a complex, demanding and stressful program, on successful completion of which an undergraduate student is required to attain unique and diverse competencies. 1 There is an increasing interest and concern regarding the role of learning environment in undergraduate medical teaching in recent years. 2,3 However, studies done from India have been very few and restricted to one city only. 4,5 It is no longer an acceptable premise in academia that a good or effective learning environment can be provided by just a teacher who possesses virtues such as good communication skills, knowledge, credibility and preparedness which contribute towards teaching excellence. An ideal academic environment may be defined as one that best ABSTRACT Background: The educational environment in a college is one of the most important factors in determining the success of the curriculum and the student. The DREEM inventory is a validated global instrument for measuring the educational environment in undergraduate medical education. A study was undertaken to assess the educational environment as perceived by the students of a new medical college established in India in 2008. Objectives: To compare the quality of the educational environment in preclinical years as perceived by the first two batches of students in a new medical college so that appropriate remedial measures could be taken, and also to identify gender differences, if any in the students' perception. Methods: The DREEM questionnaire was administered to 156 students (2008 batch, n=56 and 2009 batch, n=100) on different occasions after a lecture class. Purpose of the study was explained to the students before administering the questionnaire. Confidentiality was maintained. Statistical analysis used: Cronbachs alpha for internal consistency and reliability. Unpaired t test was used for comparison. Results: The response rate was 100% (256 /256 students). The overall DREEM score was 126.3/200 indicating that perception of the educational environment of the medical school was more positive than negative. However, the study revealed some problem areas within the educational environment. Conclusion: A large number of diverse and hidden factors influence the way students perceive their educational environment. It should be a continuous process to monitor the feedbacks from the students to identify problem areas so that necessary remedial measures can be instituted at the earliest.

m e d i c a l j o u r n a l a r m e d f o r c e s i n d i a 7 2 ( 2 0 1 6 ) 6 7 -7 0 a r t i c l e i n f o Results: Mean age of the patients was 42.5 years. These lesions were more common in adult females (5/7). Thigh was the commonest location (4/7). The mean duration of these lesions was 2.0 years. Clinical diagnosis was papilloma (4/7) and acrochordon (3/7). Histopathology revealed the presence of varying amounts of mature ectopic adipocytes in the dermis located around dilated, ectactic blood vessels. Disorganised dermal collagen bundles and atrophic pilosebaceous units were seen.Conclusion: This study is a first from the Indian subcontinent and highlights the need for awareness of this rare clinical condition both by the dermatologists and the surgeons.Histopathology is essential for diagnosis as clinically they may mimic papillomas or skintags. An early diagnosis may permit a more conservative resection of the tumour. #

Background:Transthoracic fine needle aspiration cytology (FNAC) is an established and safe technique for diagnosis of thoracic mass lesions. Computed tomography (CT) scan depicts clear anatomical details and provides access to any area of the body. It is, however, expensive and the needle is not passed in real time. Ultrasound is cheaper, radiation free, and allows real time monitoring. Its limitations are obscurement of lesions by aerated lung, smaller, deep seated, and cavitary lesions.Aims:This study aims to compare sensitivity and specificity of CT scan and ultrasonography (USG) in thoracic FNAC.Materials and Methods:The study was conducted on patients who presented with thoracic mass lesions in lungs, mediastinum, hilar lymph nodes, thoracic vertebrae, paraspinal soft tissue, and pleura. One hundred and twenty patients were studied. Only those cases in which sonographic guidance was not possible were taken up for CT guided FNAC. The lesions were assigned to benign and malignant categories and into specific diagnoses where possible. Biopsy correlation was available in 113 cases. Patients were lost to follow-up in five lung and two mediastinal masses.Statistical Analysis:Statistical tests applied included diagnostic tests for sensitivity and specificity.Results:An accuracy of 70.8% was found for image guided FNACs with a sensitivity and specificity of 92.2% and 100%, respectively. CT had a sensitivity of 93.2% and specificity of 100%. For USG guidance, the same was 91.3% and 100%, respectively.Conclusions:Precision of USG and CT scan is comparable for guidance in FNAC from thoracic mass lesions.