Primary peritoneal serous carcinoma (PPSC) is a rare malignancy that arises primarily from peritoneal surface epithelium. However there are limited studies on these tumors even in world literature. To study the clinical, pathologic profile, outcome and prognostic features of PPSC. A 5 year retrospective study of PPSC diagnosed and treated at our centre was conducted. The pathological specimen of PPSC diagnosed from January 2008 to December 2012 were reviewed by gynaeconcopathologists. The diagnosis was based on GOG criteria, complemented with IHC. Majority of the patients underwent upfront de-bulking surgery. Postoperatively, six cycles of combination chemotherapy with paclitaxel (175 mg/m 2 ) and carboplatin (AUC 6) was administered every 3 weekly. These patients were analysed for progression free survival (PFS), this was correlated with stage and surgical adequacy. The median age of presentation was 56 years. The total number of ovarian cancers treated during study period was 374. The 30 cases were clinically suspected to have primary peritoneal carcinoma (PPC) on pre-and intraoperatve gross findings, but further evaluation with histopathological examination, IHC and GOG criteria revealed only 10 cases were genuine PPSC. The remaing 20 cases; 13 were found to poorly differentiated ovarian carcinomas, six were primary fallopian tube carcinoma and one was appendicular carcinoma. The 10 (2.7 %) cases of the 374 were eligible for the PPSC analysis. The two (20 %) of the 10 cases had family history of breast and ovarian cancers, two (20 %) cases were diagnosed as abdominal tuberculosis (TB) prior referral to our centre. Radiological presentation includes gross ascites, with omental caking and normal adenexa. The eight (80 %) of 10 cases presented with stage IIIC and other two cases (20 %) with stage IV disease. The eight (80 %) of 10 cases underwent upfront surgery; six (75 %) of these eight cases had optimal cytoreduction, i.e. residual disease (RD) <1 cm or no visible disease (R0) and other two (25 %) suboptimal cytoreduction. The two (20 %) of 10 cases with stage IV disease received neoadjuvant chemotherapy (NACT) followed by interval cytoreduction. After debulking surgery the most useful IHC marker include CK7+, CK20-, CA125+, WT-1+, and GCDFP-. At median follow up of 24 months (range 3-60 months), the median progression free survival (PFS) was 22 months, while the estimated 5 year PFS was 18 %. Stage IV disease and suboptimal surgery had poor outcome. The PPSC presents with advanced stage disease and are observed to be misdiagnosed abdominal TB in tropical countries. The GOG criteria and IHC complement the diagnosis. These have poor outcome despite optimal care, highlighting need for larger studies on this disease.
BACKGROUND: HIV/AIDS remains one of the world's most significant public health challenges, particularly in low-and middle-income countries.HIV affects the immune system. Its effects are seen in all the systems of the body. These manifestations may be due to HIV infection itself or due to opportunistic infections or malignancies. The clinical and pathologic findings in various organ systems including the pulmonary, skin, gastrointestinal, hematological and nervous systems have been well described in the young adult population. The present study was undertaken to study the presentation of HIV/AIDS infection. OBJECTIVES: 1. To study the clinical profile of HIV positive patients.2. To study about the hematological manifestations in HIV positive patients.3. To study the pattern of opportunistic infections in HIV positive patients. DESIGN: This was a hospital based cross sectional study conductedover a period of 2 years from September 2011 to September 2013.SETTING: ESIC Medical College & Post Graduate Institute Of Medical Science &Research Rajajinagar, Bengaluru. METHODS: This study was conducted in Department of General medicine, ESIC-MC & PGIMSR, Rajajinagar, Bangalore. 100 HIV positive patients were included in the study. RESULTS: In this study, out of 100 HIV positive patients, 62% ofpatients were males and 38% females. 56%patients were in the age group of 31-40 years. 61% of patients presented with fever as main symptom followed by weight loss as the next most common mode of presentation.38% belonged to tuberculosis group (both pulmonary and extra pulmonary) and 68% to the nontuberculosis group. Among the tuberculosis group, 16% of patients had pulmonary tuberculosis (PTB). 8% of the patients had tubercular lymphadenopathy. 10% of patients had abdominal tuberculosis and 4% had tubercular meningitis.60% patients had absolute lymphocyte count (ALC) of <1000/mm 3 and 40% patients had >1000/mm 3. 46% patients had CD4 count of less than 200/mm 3 and 54% patients had >200/mm 3 .CD4 count is significantly correlated with ALC with a P value = 0.023*.CONCLUSION: Majority of HIV positive patients presented with increased incidence of fever, weight loss, chronic diarrhea, cough and oral candidiasis. Most of the adults with HIV presented with AIDS defining illnesses and most of them presented with multiple concurrent opportunistic infections. Categorically most of them presented with WHO stage 3 or stage 4 illnesses.
Background: Despite significant advancement in neonatal intensive care, the incidence of late-onset neonatal sepsis (LONS) remains a major cause of neonatal morbidity and mortality. The causative organisms and their susceptibility to antibiotics vary in different regions; which forms a basis in the selection of empiric antibiotic in suspected cases of sepsis. Aims and Objectives: To determine the drug sensitivity pattern of the commonly isolated pathogens in LONS. Materials and Methods:This study was done after obtaining approval from the Institutional Human Ethical Committee of JJM Medical College Davangere. The blood culture sensitivity data of all neonates admitted and treated as cases of LONS over a period of 2 years (December 2013 to December 2015) at the neonatal intensive care unit of Bapuji Hospital were studied retrospectively. Results: A total of 212 neonates admitted were suspected cases of LONS. 51.88% of them were blood culture positive, with 78.18% of the isolated organisms being Gram-positive and 24 (21.81%) Gram-negative. The most frequently isolated organism was coagulase-negative Staphylococcus aureus (78.18%) followed by Klebsiella pneumoniae (10.9%). 71.25% of these organisms showed resistance to ampicillin, and 56.25% showed resistance to gentamicin which is the World Health Organization recommended an empirical choice of antibiotics. Conclusion: Our study has shown an increasing trend of resistance to the commonly prescribed first-line empiric antibiotics such as ampicillin and gentamicin. Hence, periodic surveillance of antibiotic susceptibility is of prime importance to choose the right empiric antibiotic.
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