Abdominal Cocoon A Case Report with Short Review of Literature

Abdominal cocoon is a rare entity where there is encapsulation of the small bowel by a fibrous membrane causing clustering of the bowel. The exact aetiology is unclear. We report a case of a 15 year old girl with a history of recurrent colicky abdominal pain in the right lower abdomen. Clinical diagnosis was recurrent appendicitis. She underwent laparotomy for appendicular lump. Histopathological examination of the resected lump grossly and histologically revealed the features of abdominal cocoon. Key Words: Abdominal Cocoon; Sclerosing encapsulating peritonitis; Small bowel. DOI: 10.3329/bsmmuj.v2i2.4763 BSMMU J 2009; 2(2): 81-8

Study of Fine Needle Aspiration Cytology of Breast Lump: Correlation of Cytologically Malignant Cases with their Histological Findings

Background: In Bangladesh a large number of patients have been suffering from breast cancer and with each passing year, the number is increasing. Objectives: To correlate breast lesions diagnosed as cytologically malignant with their histological findings. Methods: This is a prospective study carried out in the Department of Pathology, BSMMU, Dhaka during the period of January 2009 to December 2009. Patients with breast lump, having malignant breast lesions on cytology were included in the study. A total of 524 patients with breast lump underwent FNA examination for the diagnosis during this period. FNA slides were examined under light microscope after Papanicolaou staining and were categorized into five groups: i) inadequate ii) benign iii) atypical cells iv) suspicious for malignancy and v) malignant. Of these, 431 were diagnosed as benign, 4 as atypical, 17 were diagnosed as suspicious for malignancy and 72 cases were diagnosed as malignant. Out of these 72 cases, which were cytologically diagnosed as malignant, 55 corresponding surgical specimens (either mastectomy or lumpectomy specimens) were received for histopathology. The sections were stained with haematoxylin and eosin for microscopic examination. Results: 55 cases which were diagnosed as malignant by FNAC were found to be malignant by histopathology. 54 (98.18%) were invasive ductal carcinoma (NOS) and one (1.82%) was mucinous carcinoma. In this study, considering only cases with a definitive diagnosis of malignancy, the sensitivity of FNAC to diagnose the disease was 100% and accuracy was 100% and Chi-square test revealed Chi-square value 10.83 (P< 0.001). Conclusion: From the present study it is evident that FNAC is a simple and reliable method. No local anaesthesia is required. Operative risk of surgical biopsy, danger of post operative infection can be avoided by adopting the procedure. It helps to confirm the clinical impression without open biopsy. Key words: Breast lump; FNAC; Mastectomy; Malignancy. DOI: http://dx.doi.org/10.3329/bsmmuj.v4i2.8631 BSMMU J 2011; 4(2):60-6

Lymphoid Polyposis in an Adult Male- A Case Report

Benign lymphoid polyposis is a rare histologic entity and should not be confused with malignant disease of the colon and rectum. We present a case of lymphoid polyposis in the intestine in a 26 years old male patient who was admitted for the treatment of faecal fistula. He had history of appendectomy, followed by ileostomy four years back. Physical examination revealed multiple faecal fistulae in the right lower abdomen. Right-sided hemicolectomy was done. Gross examination showed multiple polyps through out the specimen; the junction between caecum and ascending colon was found partially stenosed. Microscopy revealed polypoid structures consisting of multiple lymphoid follicles with prominent germinal centers. A stenosed area represented probable fistulous tract within the fibrosis. The final diagnosis was lymphoid polyposis based on clinical, gross and microscopic features. Keywords: Lymphoid polyposis; Faecal fistula. DOI: http://dx.doi.org/10.3329/bsmmuj.v4i2.8643 BSMMU J 2011; 4(2):119-12

Peutz-Jeghers polyp: A Retrospective Study on Twelve Cases Received at the Department of Pathology, Bangabandhu Sheikh Mujib Medical University

Background: Peutz Jegher syndrome is a rare inherited condition characterized mainly by gastrointestinal hamartomatous polyposis and mucocutaneous pigmentation. The polyps are mostly found in the small bowel and less frequently in the stomach and large gut. Objectives: This study was done to observe the clinical and pathological features of Peutz Jegher polyps. Methods: A retrospective study was carried out in the Department of Pathology, Bangabandhu Sheikh Mujib Medical University (BSMMU) during the five and a half year period from 1st January 2006 to 30th June 2011. From the records the cases which were diagnosed as Peutz Jeghers polyps were sorted out, clinical data was compiled and slides were reviewed. Results: During this period 12 cases were diagnosed as Peutz Jeghers polyp. Most of these (n=58.33%) occurred in the second decade of life and majority (n=9) were located in the large gut including sigmoid colon and rectum. Both sessile as well as pedunculated types were seen. All had characteristic histologic features of Peutz Jeghers polyps and in only one case there was a mild dysplastic change in the glandular lining epithelium. Conclusion: Close monitoring of the patients with peutz Jeghers polyp can reduce the morbidity of this condition.DOI: http://dx.doi.org/10.3329/bsmmuj.v5i1.10994 BSMMU J 2012; 5(1):12-17

Peutz-Jeghers polyp: A Retrospective Study on Twelve Cases Received at the Department of Pathology, Bangabandhu Sheikh Mujib Medical University

Background: Peutz Jegher syndrome is a rare inherited condition characterized mainly by gastrointestinal hamartomatous polyposis and mucocutaneous pigmentation. The polyps are mostly found in the small bowel and less frequently in the stomach and large gut. Objectives: This study was done to observe the clinical and pathological features of Peutz Jegher polyps. Methods: A retrospective study was carried out in the Department of Pathology, Bangabandhu Sheikh Mujib Medical University (BSMMU) during the five and a half year period from 1st January 2006 to 30th June 2011. From the records the cases which were diagnosed as Peutz Jeghers polyps were sorted out, clinical data was compiled and slides were reviewed. Results: During this period 12 cases were diagnosed as Peutz Jeghers polyp. Most of these (n=58.33%) occurred in the second decade of life and majority (n=9) were located in the large gut including sigmoid colon and rectum. Both sessile as well as pedunculated types were seen. All had characteristic histologic features of Peutz Jeghers polyps and in only one case there was a mild dysplastic change in the glandular lining epithelium. Conclusion: Close monitoring of the patients with peutz Jeghers polyp can reduce the morbidity of this condition.DOI: http://dx.doi.org/10.3329/bsmmuj.v5i1.10994 BSMMU J 2012; 5(1):12-17

Vitamin D and gastrointestinal cancer

Vitamin D serves as a precursor to the potent steroid hormone calcitriol, which has widespread actions throughout the body. Calcitriol regulates numerous cellular pathways that could have a role in determining cancer risk and prognosis. Low Vitamin D levels have been implicated in numerous disease processes including fracture risk, falls, cardiovascular disease, hypertension, diabetes mellitus, and cancers. Metabolite of 1, 25-dihydroxyvitamin D3 (1,25[OH]2D3) regulates numerous genes that control gut physiology and homeostasis. 1,25(OH)2D3 serves various functions such as maintaining the integrity of epithelial barrier and absorption of calcium and phosphate, and the host's defense against pathogens, and the inflammatory response by several types of secretory and immune cells. Although epidemiological data remain inconsistent, and randomized control trials in humans do not yet exist to conclusively support a beneficial role for Vitamin D, results from some correlating studies strongly suggest that Vitamin D deficiency increases the risk of developing cancer and that avoiding deficiency and adding Vitamin D supplements might be an economical and safe way to reduce cancer incidence and improve cancer prognosis and outcome. The present review highlights the role of Vitamin D in cancer of the gastrointestinal tract including esophagus, gastric (stomach), liver, pancreas, and colon

Discharge against medical advice in Special Care Newborn Unit in Chattogram, Bangladesh: Prevalence, causes and predictors.

IntroductionDischarge against medical advice (DAMA) is an unexpected event for patients and healthcare personnel. The study aimed to assess the prevalence of DAMA in neonates along with characteristics of neonates who got DAMA and, causes and predictors of DAMA.Methods and findingsThis case-control study was carried out in Special Care Newborn Unit (SCANU) at Chittagong Medical College Hospital from July 2017 to December 2017. Clinical and demographic characteristics of neonates with DAMA were compared with that of discharged neonates. The causes of DAMA were identified by a semi-structured questionnaire. Predictors of DAMA were determined using a logistic regression model with a 95% confidence interval. A total of 6167 neonates were admitted and 1588 got DAMA. Most of the DAMA neonates were male (61.3%), term (74.7%), outborn (69.8%), delivered vaginally (65.7%), and had standard weight at admission (54.3%). A significant relationship (p ConclusionsIdentification of predictors and reasons behind DAMA may provide opportunities to improve the hospital environment and service related issues so that such vulnerable neonates can complete their treatment. We should ensure better communication with parents, provide provision for mothers' corner, especially for outborn neonates, maintain a standard ratio of neonates and healthcare providers, and adopt specific DAMA policy by the hospital authority

Map of Chattogram division.

IntroductionDischarge against medical advice (DAMA) is an unexpected event for patients and healthcare personnel. The study aimed to assess the prevalence of DAMA in neonates along with characteristics of neonates who got DAMA and, causes and predictors of DAMA.Methods and findingsThis case-control study was carried out in Special Care Newborn Unit (SCANU) at Chittagong Medical College Hospital from July 2017 to December 2017. Clinical and demographic characteristics of neonates with DAMA were compared with that of discharged neonates. The causes of DAMA were identified by a semi-structured questionnaire. Predictors of DAMA were determined using a logistic regression model with a 95% confidence interval. A total of 6167 neonates were admitted and 1588 got DAMA. Most of the DAMA neonates were male (61.3%), term (74.7%), outborn (69.8%), delivered vaginally (65.7%), and had standard weight at admission (54.3%). A significant relationship (p ConclusionsIdentification of predictors and reasons behind DAMA may provide opportunities to improve the hospital environment and service related issues so that such vulnerable neonates can complete their treatment. We should ensure better communication with parents, provide provision for mothers’ corner, especially for outborn neonates, maintain a standard ratio of neonates and healthcare providers, and adopt specific DAMA policy by the hospital authority.</div

Cause behind DAMA according to care-givers’ response.

Cause behind DAMA according to care-givers’ response.</p