Omental Infarction In A Child

Omental infarction is a rare cause of acute abdomen in children. Typical findings on imaging establish the diagnosis. We present case of a 7 years old boy who presented with acute right iliac fossa pain with diagnosis of omental infarction on imaging and findings confirmed on laparotomy. Sound knowledge regarding this infrequent cause of acute abdomen in children is necessary for timely diagnosis

Ovarian primary neuroendocrine carcinoma of non-small cell type: Report of an extremely rare neoplasm

Paraffin block sections of a uterus and ovarian mass from a 31 year old female were sent for second opinion to the Pathology Laboratory of Aga Khan University. Histologic examination and immunohistochemical features gave a diagnosis of primary neuroendocrine carcinoma of non-small cell type admixed with benign mucinous cystadenoma. This is a rare tumour with only eight being reported in literature

Giving in Transition and Transitions in Giving: Philanthropy in Egypt, Libya and Tunisia 2011-2013

This publication explores how shifts in the sociopolitical environment in Egypt, Libya and Tunisia manifested themselves in the philanthropic realm during an uncertain mid-point in the transitions. To what extent have both institutional and informal philanthropy evolved to keep up with the pace of escalating needs and expectations of the people? As those shifts continue in all three countries, with variations to be explored in each country chapter, the report encourages actors in the sector to take bolder steps from diagnostics to action

Frequency and Characteristics of Breast lymphomas presenting to a tertiary care hospital, Pakistan

Objective: To assess the relative frequency of (primary and secondary) mammary lymphomas presenting to a tertiary care hospital, Pakistan and its categorization according to WHO classification of lymphoid neoplasms. Methods: All NHLs (nodal and extra nodal) diagnosed in the section of histopathology during 1992-2004 were retrieved and reviewed. All patients (n=30) diagnosed with lymphomatous involvement of the breast were selected. Distinction between primary and secondary breast lymphomas was not made owing to lack of availability of clinical information. Results: A total of 5637 breast malignancies were diagnosed in our department during the study period of 10 years and the total number of NHLs (Nodal and extra Nodal) was 2632. Thirty (n=30) patients accounting for 1.13% were diagnosed to have lymphomatous involvement of the breast. The Female to Male ratio was13.5:1; age range was 12-92 years with a median age of 43 years (Mean age 46.5 years and Standard deviation of age was 16.88 years). The sites of the lesions were the right breast in 11 cases (37.93%), left breast in 9 cases (31.03%) and both breasts in 2 cases (6.89%), while the location of 8 masses (27.58%) was unknown. Immunohistochemical studies were negative for cytokeratins (MNF and Cam 5.2) in all cases. All cases of DLBCL expressed B cell lineage antigens and were positive for LCA and Pan B (CD20 and 79a). Conclusion: We concluded that breast lymphomas represent 1.13% of all NHL and 0.5% of all breast malignancies in this study. The most frequent morphologic type was diffuse large B-cell lymphoma. As patients with primary breast lymphoma have a better prognosis than those with carcinoma of the breast or patients with extranodal lymphomas, a multidisciplinary approach including surgery, radiotherapy, and chemotherapy when needed would result in a more favourable outcome

Vascular ehlers-danlos syndrome: a rare disorder presenting with focal convulsions

Vascular Ehlers-Danlos Syndrome (VEDS), previously called Ehlers-Danlos syndrome type-IV, is a heterogeneous group of heritable connective tissue disorders characterized by thin, translucent skin, easy bruising, arterial, intestinal, and/or uterine fragility. There is large vessel involvement that leads to arterial rupture often preceded by aneurysm, arteriovenous fistulae, or dissection. Noninvasive imaging studies such as CT angiography and MR angiography are preferred as diagnostic studies for this condition. We are reporting a 4 years old girl who was presented with right sided unilateral convulsions and hypertension. CT angiogram showed stenosis with post-stenotic dilatation of coeliac and superior mesenteric arteries. There were extensive calcified plaques with atherosclerotic changes in the segment of right common iliac artery with aneurysmal dilatation of celiac, superior mesenteric and common iliac artery. Radiological findings were consistent with vascular Ehlers-Danlos syndrome. She was successfully managed with anti-hypertensive and anticonvulsants

Off-Grid Solar Electrification Sustainability Assessment: A Case Study of Swat

Access to energy is crucial not only for the well-being of people but also for the socioeconomic development of a region. Today, 46.3 million people in Pakistan lack access to the grid whereas those connected have unreliable and interrupted access to energy supply. However, in the wake of prolonged power outages in rural areas accompanied by coincidental spread of awareness on solar photovoltaic (PV) technology, an interesting shift in terms of energy transition is underway. This study focuses on these undocumented changes taking place in the district of Swat. As success and optimality of any system can be best gauged through user's perception, the study attempts at assessing both the sustainability of the installed off-grid solar systems as well as barriers in their diffusion at a larger scale. Where on one hand the findings reveal strong social acceptance for the solar PV technology among users, on the other hand the study observes limited dependence on the technology where reliance on the conventional energy is still very prevalent for heavy load appliances during running electricity hours. Amongst the non-PV users, a strong desire for instalment of PV technology exists. Nevertheless, lack of government support and economic barriers remain major impediments in its adoption. The findings hence underscore significance of supportive policies for augmenting the momentum toward a sustainable energy transition. </p

Spectrum of histopathological findings in postmenopausal bleeding

Objective:To determine the frequencies of histopathological findings in endometrial and endocervical biopsy samples with clinical history of Postmenopausal Bleeding (PMB). Study Design:Descriptive cross-sectional study. Place and Duration of Study:Section of Histopathology, Department of Pathology and Laboratory Medicine, The Aga Khan University Hospital, Karachi, from February 2012 to January 2013. Methodology:Atotal of 157 consecutive endometrial and endocervical biopsy specimens with history of postmenopausal bleeding were included. After microscopic examination, frequencies of histological findings in different age groups were generated. Chi-square and independent sample t-tests were applied to see whether the difference was significant which was set at p \u3c 0.05. Results:One hundred and twenty-one (77.1%) specimens showed benign pathologies while 36 (22.9%) were malignant. Endometrial polyp was seen in 67 (42.7%) cases followed by endometrial carcinomas in 25 (15.9%), endometrial hyperplasia in 21 (13.4%), cervical carcinoma in 12 (7.6%) and cervical polyps in 9 (5.7%) cases. Ahighly significant increase in the percentage of malignant and pre-malignant lesions was seen with increasing age group (p \u3c 0.001). Mean age of patients with type-2 endometrial carcinoma was higher than type-1 endometrial carcinoma but statistical significance was not observed (70.2 ±6.5 vs. 61.8 ±9.1 years respectively, p=0.069). Conclusion:Although benign pathologies were more common in postmenopausal bleeding but the collective proportion of endometrial and cervical malignancies and pre-malignant conditions was quite high. Therefore, PMB should be urgently evaluated for cause and early commencement of treatmen

Significance of immunohistochemistry in accurate characterization of malignant tumors

Background: To determine in a large series of surgical biopsies the role and significance of immunohistochemistry in the adequate and accurate characterization of malignant tumors. Methods: A retrospective study of 20,000 consecutive surgical biopsies reported in the Section of Histopathology, AKU in 2003. Data was obtained by retrieving the filed surgical biopsy reports in the section. Results And Conclusions: Out of the 20,000 biopsies, 6534 (32.67%) were neoplastic. 4726 neoplasms (72.33%) were malignant, and 1808 (27.67%) were benign. Immunohistochemistry was performed on 29.49% of malignant tumors, and 4.97% of benign tumors. Immunos were performed on only 2.82% of routine squamous cell carcinomas and adenocarcinomas of various organs, and in only 1.9% of infiltrating breast carcinomas, the commonest malignant tumors in females. In contrast, immunos were performed on 97.12% of non-Hodgkin\u27s lymphomas, 97.94% of Hodgkin\u27s lymphomas, 98.09% of malignant spindle cell neoplasms, 87.96% of small round blue cell tumors of childhood, 87.30% of neuroendocrine neoplasms, and 84.37% cases of malignant melanomas. In addition, immunos were performed on all cases of malignant undifferentiated neoplasms and were able to resolve the issue in over 89% of such cases. Immunos were also performed on 54.74% of metastatic tumors. Lymph nodes were the commonest organs on which immunos were performed i.e. 96.50% of lymph node tumors, followed by CNS and renal neoplasms with 33.01% and 25.92% respectively

Challenges and pitfalls in diagnosis of parosteal Osteosarcoma: a clinicopathologic study of 23 cases

Objective: Parosteal Osteosarcoma (PO) is an uncommon variant of osteosarcoma. Diagnosing PO is important due to its malignant nature but the diversity of histologic features makes it challenging by adding a number of soft tissue, bony and cartilaginous lesions into the list of differential diagnosis. Our aim was to study the clinicopathologic and histological features of PO with emphasis on features helpful in its discrimination from other mimicking lesions. Methods: We reviewed 23 cases of PO diagnosed in our institution between January 2001 and August 2015. Results: Femur was the most commonly involved bone (68.2%) along with other long bones and rib in a single case. Soft tissue component was graded as Grade1 in 9(39%), Grade2 in 8(34.7%) and Grade3 in 4(17.3%) cases. Bony component was seen either in combination of or exclusively as parallel streams and interconnected trabeculae (mosaic-pattern). Out of 9 cases with cartilage component, 3 showed a cartilage cap. 2(8.6%) cases showed dedifferentiation into osteosarcoma. Conclusion: PO should always be considered in the differential diagnosis of every lesion arising from the bone surface. Knowledge of the variations in histologic features helps to reach the correct diagnosis which should never be made without radiological correlation

Angiokeratoma of tongue:a series of 14 cases

Angiokeratomas (AC) are vascular lesions which are defined histologically as one or more dilated blood vessels lying directly subepidermal and showing an epidermal proliferative reaction with ectatic capillaries in the papillary dermis. Only three other cases of isolated mucosal angiokeratoma have been reported in the indexed literature. We reviewed all cases of angiokeratoma located on the tongue, diagnosed in our department during a study period of 10 years (1995-2005). Histologically all 14 cases showed dilated and congested blood vessels in the upper papillary dermis. They lack deep dermal involvement. Hyperkeratosis and acanthosis were also seen in most of the cases. No clinical data was available to assess systemic disease. A higher incidence of of AC in tongue is seen in our study