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.

BACKGROUND: Many countries are implementing measures for social distancing to contain the spread of the coronavirus disease 2019 (COVID-19) pandemic. The Indian government also issued an order for complete lockdown of the country, with all the nonessential services, including most of the services for nonemergency health issues, being temporarily suspended. OBJECTIVES: This study aimed to understand the effect of pandemic lockdown on medical advice-seeking behavior and the medication practices of the non-COVID Indian patients confined to homes, who would have normally visited the outpatient departments (OPDs) for medical advice. MATERIALS And METHODS: It was a questionnaire-based, cross-sectional study conducted online during the lockdown period. The questions dealt with medical advice-related practices, self-medication, the sources of medical advice, and the need to visit emergency department. Evaluation of data was done as for descriptive studies. RESULTS: A total of 106 people (34%) out of the 312 participants had either old or new health problems. Ninety-six of such people (90.5%) tried to manage their sufferings by either continuing the drugs prescribed earlier or by making phone calls to doctors along with taking the help of home remedies, if needed. Ten (9.5%) of the symptomatic participants did not consult any doctor waiting for natural course of relief. None of the participants practiced self-medication of modern medicine therapy. Only one participant (of the total 312) took hydroxychloroquine as self-medication for assumed prophylactic therapy against the COVID-19 infection. CONCLUSION: Most of the people with medical conditions, confined at home due to national lockdown, are coping with their problems without any irrational self-medication with modern medicines or any misuse of prophylactic therapy against the COVID infection. This seemingly positive trend may also have been due to the strict enforcement of the lockdown rules by the law enforcement agencies.

No abstract

Treatment of basal cell carcinoma (BCC) usually involves surgical interventions and laser ablation, but in locally advanced BCC, which arise either from earlier untreated lesions or from recurrence of aggressive BCC, surgery and radiotherapy are not helpful. Vismodegib, the first oral-targeted therapy for locally advanced and metastatic BCC, unsuitable for surgery or radiotherapy, was recently approved by US Food and Drug Administration (FDA). The drug was under the priority review program of FDA and was approved on the basis of promising results of phase II trial. Vismodegib acts by targeting the hedgehog pathway, which is activated abnormally in most BCCs. Approval of vismodegib is a big step ahead in the treatment of advanced BCC, where there was no other effective drug therapy till now.

Background:Despite its large population, access to safe blood is disproportionately low in India. To recruit more members from the general population into the pool of voluntary donors, it is essential to understand the differences in their knowledge, attitudes and practices; and utilise the existing resources to eliminate them. Methods:A quasi-experimental study was conducted on 180 donors and an equal number of potential donors randomly selected from the community, using a structured questionnaire containing questions on attitudes and practices. Knowledge was assessed by interview by a single observer.Results: Donors were found to have a highly significant difference (p<0.00001) from the general population in age, gender distribution, marital status and socioeconomic status and significant difference in educational level (p<0.05). Knowledge about blood donation practices was significantly higher in donors (p=0.0002). Replacement donors constituted 82.2% of the donor category, while voluntary donors dominated (52.3%) in the community. Commonest reasons for non-donation in both groups included apathy. Misconceptions regarding pain, weakness, and increased chances of infection were prevalent. Donors were less likely to perceive blood donation as risky (p<0.00001). There was a highly significant difference in the attitude towards incentives (p<0.00001), the donor group supporting and the community denouncing them. Replacement credits were the most popular incentive. In the donor group, a markedly higher (p=0.0003) proportion had a history of previous donations (55% vs.36.1%). Most of them had a higher number (p<0.00001) and greater frequency of donation. Donors generally reported a better donation experience (p=0.00003) and less complications than the general population (p=0.0002). Conclusions:There is a need to recruit women and young donors from the community, and promote donor retention. Blood donation drives play important role in creating awareness, educating the masses and dispelling myths and misconceptions.

Primary leiomyomas are rare benign tumors of the lung and only 25 cases have been documented in children, most of which are endobronchial. Leiomyomas are benign smooth muscle neoplasms, usually diagnosed on morphological characteristics. However, immunohistochemistry plays a crucial role in the lineage differentiation when these are encountered at unusual sites or with unexpected morphological features. We report a case of endobronchial tumor of a 13-year-old male child who presented with a dry cough and hemoptysis. A mass lesion in the right main bronchus was detected by bronchoscopy and contrast-enhanced computed tomography. On histopathological examination of the resected specimen, a diagnosis of myxoid leiomyoma was made. To the best of our knowledge, this is the first case of myxoid leiomyoma to be reported in the respiratory tract. This case also demonstrates the need for a high index of suspicion and the role of immunomarkers in the diagnosis of such challenging cases.

Background: Filariasis, a global problem, is a major public health issue in India. Despite its high incidence, it is unusual to detect microfilaria in cytological smears, though unexpected detection of microfilariae in fine needle aspiration cytology (FNAC), exfoliative and fluid cytology have been reported previously. The study analyzed the role of cytology in detection of asymptomatic carriers of microfilariae. Methods:This was a retrospective, observational study and included cases of filariasis from cytological records spanning five years. The epidemiological, clinical, hematologic and radiologic details were noted. The slides were retrieved and examined. Descriptive statistical analysis was utilized.Result: Filariasis was diagnosed in 0.03% of the total cytology cases studied during the period, constituting 0.04% of FNACs (two cases of inguino-scrotal swellings, two of breast lumps, one of thyroid swelling) and 0.02% of cervicovaginal smears (two cases). None of them was clinically suspected to be filariasis. Radiological examination was also misleading. None of the cases demonstrated raised leukocytosis or microfilaremia and eosinophilia was present in 3 cases (42.9%). Apart from microfilariae of Wuchereria bancrofti, eggs were present in one case. This was associated with inflammation in all cases, cell adherence in 42.9% and coexistent hyperplastic and neoplastic conditions in 57.1% cases. Conclusion:The detection of microfilariae in cytological material in the absence of clinical, radiologic or hematologic suspicion, in an area of relatively low prevalence of filaria, points to the need for a high index of suspicion and careful screening of all smears, as cytology may play an important role in the diagnosis of asymptomatic carriers of microfilariae.

mmol/L) in 34%, high total cholesterol (.5.2 mmol/L) in 29% and high LDL-C (.4.1 mmol/L) in 20% of patients. 89% of dyslipidemic patients were on simvastatin on admission and of those 49% only achieved an LDL-C target less than 2.6 mmol/L. Conclusions: The present study shows a high prevalence of diabetes, hypertension, and dyslipidemia in the Omani population undergoing CABG. The most common pattern of dyslipidemia is low HDL-C. A small percentage of the study group had achieved therapeutic LDL-C targets, which put them at continuous risk of rapid atherosclerotic attrition of coronary bypass grafts.Synopsis: Three generations ago, most physicians learned very little about cholesterol, and many doubted the value of treating elevated values. Six decades of double-blind controlled trials have converted cholesterol into a daily conversation piece, and a standard of care requirement for cardiovascular disease. In a similar manner today, we are faced with a global increase in aging with significant impacts on a large number of associated risk factors and illnesses that threaten to eventually overburden an already stretched healthcare system. Nevertheless, aging per se has not been examined with an appropriately intense investigational effort. Life expectancy is lengthening in every developed nation. Three quarters of babies will live to their 75th birthday, and many will reach 80 plus years. Purpose: The object of this poster is to provide background information to better understand the roles of leptin and cholesterol ester transfer protein (CETP), along with suggestions for future studies and therapeutic approaches. Methods: Literature review and an examination of present prevailing beliefs. Results: Leptin is an adipokine, a biological mediator, which signals longer-term caloric intake and which facilitates synaptic plasticity in the hippocampus, promotes beta-amyloid clearance and improves memory in animal models of aging. In a prospective study of approximately 200 Framingham subjects (average age 87), after 7 years of leptin assay, greater leptin levels were associated with a lower risk of dementia and Alzheimer disease, as well as a greater total brain volume in asymptomatic adults. CETP regulates high-density lipoprotein metabolism. A genetic variant VV improved the odds of reaching 100 and reduced the risk of developing dementia. Compared with those elderly subjects lacking this gene variant, those with the gene were twice as likely to have good cognition. Subjects reaching 100 years of age were three times more likely to possess the VV gene variant of CETP compared with control patients.