Spectrum of Breast Lesions on Fine Needle Aspiration Cytology in Punjab

Background and Objectives: Breast lumps can be diagnosed in a short time by fine needle aspiration cytology (FNAC). Moreover, being cost effective, it is rendered the first choice by surgeons and patients.This study was carried out to outline the spectrum of breast lesions on FNAC in patients presenting with breast lumps in two tertiary care teaching hospitals of Punjab.Methods: A cross sectional descriptive study was conducted from January, 2018 to October, 2019.Hundred cases of lumps in breast were taken from Sahara Medical College and Sughra Shafi Medical Complex, Narowal and Lahore General Hospital, Lahore. Cytological diagnosis was made and correlated clinically and histologically. Data analysis was done by Statistical Package for the Social Sciences (SPSS) version 24.0 and expressed as frequency and percentages.Results: Majority (58%) of cases were Class-2 smears on cytology while 11% were malignant andbelonged to Class-5. Among the benign lumps, fibroadenoma was the most common (55.1%) followed by fibrocystic disease (17.2%) and acute mastitis (12%). Thirty-one cases were in grey zone i.e. Class-3 smears showing atypia and Class-4 smears that were suspicious of malignancy.Conclusion: By screening patients with lumps in breast, early and effective management can be made possible. Class 3 and 4 smears should be confirmed with excision and biopsy of the lump for conclusive diagnosis.</p

GeneXpert Technology for the diagnosis of HIV-associated tuberculosis: Is scale-up worth it?

Recent evaluations of the GeneXpert MTB/RIF assay for the simultaneous detection of Mycobacterium tuberculosis and drug resistance in less than 2 h have stimulated tremendous enthusiasm. This is the breakthrough that tuberculosis (TB) control has been waiting for. In this (retrospective review) case study, sputum samples from strongly suspected pulmonary tuberculosis patients were collected and assessed for the GeneXpert MTB/RIF assay for diagnosing TB and drug resistance in comparison with other tests, including Ziehl–Neelsen smear and Löwenstein–Jensen test. Of 3,784 cases, 5.7% (216/3,784) were human immunodeficiency virus (HIV)-positive and TB co-infected patients. In diagnosing HIV-positive and TB co-infected cases, the sensitivity and specificity of GeneXpert were 76.4% and 100%. While in HIV-negative and TB suspected cases, the sensitivity and specificity were 95.6% and 100%. This new test represents a major milestone for global TB diagnosis and care. It also represents new hope for the millions of people who are at the highest risk of TB and drug-resistant disease. GeneXpert is World Health Organization-endorsed technology representing the gold standard for TB testing despite attaining less sensitivity for HIV and TB co-infected patients as compared to HIV-negative patients