Graphical abstract

In Bangladesh, patients suffering from breast cancer have been increasing. Because of the existing social circumstances, the tendency to overlook the complaints, and because female patients are hesitant to be examined by the clinicians for lump in the breast, they report in advanced stage of breast cancer 1. FNAC of breast lump can be effectively used as a diagnostic tool in the diagnosis and management of breast lump on an outpatient basis as hospitalization of the patient is not necessary. Fine needle aspiration cytology (FNAC) of breast is an important part of the triple assessment of palpable breast lump (clinical examination, imaging [mammography or ultrasonography], and FNAC). It has been shown that FNAC can reduce the number of open biopsies 2. The most common sign and symptom of breast disease is a palpable mass; although breast diseases can also present as inflammatory lesion, nipple secretion or imaging abnormalities 3 .

A multi-staged cr oss sectional study was conducted among childr en aged 2 -17 year s to assess the level of soil tr ansmitted helminthes (ST H ) infections and its r elation to socio-demogr aphic char acter istics among them. T wo thousand childr en wer e r andomly selected fr om two r ur al and four differ ent communities of ur ban ar eas of Dhaka distr ict since November 2009 to J une 2010. F our differ ent communities classified as higher , medium, poor er and slum/ low socio-economic gr oups fr om ur ban ar eas wer e selected on the basis of their place of r esidence with differ ent socio-economic status. Ur ban study subjects wer e again sub gr ouped into upper (higher and medium socio-economic) and lower (poor er and slum/low socio-economic) classes. Stool specimens of the r espondents wer e collected and tested at the Par asitology depar tment of I E DC R , using the K ato-katz faecal technique for identification of helminthes eggs following their mor phology (A . lumbr icoides, T tr ichiur a, and A . duodenale), and lar val stage (S. ster cor alis). A bout 32.15% study population har bor ed at least one of the four helminthes species. B aseline pr evalence of infections and mean par asite loads for A scar is lumbr icoides wer e 40.61% and 600.80 e/g, for T r ichur is tr ichiur a 30.42% and 206.11e/g, and for A . duodenale 6.80% and 78.75 e/g. T hr ee childr en (0.49% ) wer e positive for Str ongyloides ster cor alis. Single infection of 78.32 % and double infection of 21.68 % wer e r ecor ded. Single infection of A . lumbr icoides (40.61% ) and T tr ichiur a (30.42% ) and double infection of A . lumbr icoides -T tr ichiur a (18.61 % ) wer e mor e pr evalent. T he pr evalence of ST H infection was 25.47 % and 38.68 % for r ur al and ur ban ar eas r espectively (P <.001). A mong ur ban study subjects, the distr ibution of ST H infection was 0.0 % in the higher (living in higher socioeconomic ar eas) (only 3 samples could be collected), 26.75 % in medium (living in medium socio-economic ar eas), 45.95 % in poor er and 50.54 % in slum/low socio-economic gr oups. Significantly higher number of ST H infection was obser ved among lower than that in upper socio-economic classes (P <.001). T hese r esults suggest that ST H infections r emain a ser ious health pr oblem among childr en in B angladesh and need appr opr iate pr evention and contr ol measur es.K ey wor ds: Pr evalence, ST H , childr en, par asite load, ur ban and r ur al ar eas, K ato-katz technique.

A 42-year-old female patient presented with loss of vision and proptosis of her right eye. Computerized tomography (CT) scan revealed hyperostotic lesion involving the right sphenoid ridge, anterior clinoid process and roof and lateral wall of orbit with mass effect on the intraorbital contents. CT findings were suggestive of intra-osseous meningioma arising from right sphenoid bone. Later, MRI of the brain and orbit and histopathology of the lesion confirmed the case as an intra-osseous meningioma of the sphenoid bone. Though meningioma of tuberculum sella and primary calvarial meningioma were reported earlier, intraosseous meningioma of the sphenoid bone is rare.Ibrahim Med. Coll. J. 2012; 6(2): 73-75

HER-2 (also known as HER-2/neu) is a member of the epidermal growth factor (EGF) receptor family. The amplification of oncogene HER-2 is presented in 20 to 30% of breast cancers and results in an increase of the protein expression. HER-2 over expression has also been shown to correlate with poor prognosis. It is associated with poorly differentiated high grade tumors with lymph node involvement, greater risk of recurrence and relative resistance to some types of chemotherapy. The receptor is however a target for treatment with anti HER-2 antibody trastuzumab (Herceptin). Immunohistochemistry analysis for HER 2 scoring is subjective, requires trained personnel and expertise. One of the main concerns with IHC is that there is evidence of significant inter-observer variation in the assessment of staining, which can lead to misclassification of HER2 status. Chromogenic in situ hybridisation (CISH) testing is sensitive and specific in detecting HER-2/neu gene amplification. Direct evaluation of gene amplification using CISH assay is a reliable method for routine diagnostic evaluation of HER2/neu status in breast cancer patients, especially in specimens showing 2+ IHC score. This observational experimental study was carried out in the Department of Pathology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, during the period of July 2014 to June 2015, The aim of this study was to assess HER-2 expression accurately in equivocal immunohistochemistry (2+) invasive breast cancer cases by Chromogenic in situ hybridisation and to associate the findings of CISH assay with the histologic prognostic and predictive factors (eg: tumor size, regional lymph node metastases, tumor grade and type. A total of 20 archival paraffin tissue blocks and IHC slides with IHC score 2+ for HER-2 were included in this study. All the slides were reviewed. CISH assay was done on section from archival paraffin block.CISH assay showed amplification of the HER-2 neu gene in 30% of cases. Majority (60%) was nonamplified. In two cases the results were unsatisfactory for interpretation. The differences were not statistically significant (p>0.05) among three groups (amplified, nonamplified and unsatisfactory) regarding the baseline characteristics (age and sex) with CISH. All the results of CISH assay in association with tumor size, tumor grade and lymphnode metastasis were not statistically significant. HER-2 / neu status is the one of the most important prognostic and predictive factor. It is a target for treatment with anti HER-2 antibody trastuzumab (Herceptin). Detection of HER-2/ neu status by IHC may sometimes be difficult and inaccurate, specially in IHC score 2+ cases. Based on the findings of the study, CISH can be considered as a useful, simple and reproducible method for detecting HER-2/ neu gene amplification in cases with borderline (2+) immunohistochemistry score and patients may be benefited from Trastuzumab therapy.