Intraparotid Facial Nerve Schwannoma in a 40-Year-Old Male with Hearing Loss – A Case Report

Schwannoma is a benign tumor of axonal nerve sheath. Head and neck area, particularly parotid gland is an uncommon site for Schwannoma, however it can rarely arise from the intraparotid part of facial nerve and present as either a symptomless mass or facial paresis. Its diagnosis before surgical intervention is important for the conservation of parotid gland and facial nerve. On clinical examination and imaging studies, it can be misdiagnosed easily. FNAC is a helpful tool for its diagnosis. This entity should not be ignored while dealing with parotid masses. We present a case of a patient who came with the complaint of a parotid mass. Magnetic resonance imaging (MRI) scan suggested a parotid tumor which proved to be a spindle cell neoplasm on Fine Needle Aspiration Cytology (FNAC). A definite diagnosis of schwannoma of intraparotid facial nerve was made on histopathological examination of the excision sample

The Stromal Expression of CD-10 in Breast Carcinoma and its Association with Estrogen, Progesterone receptors, Her2Neu and Tumor Grade

Introduction: In previous studies, role of stromal component in epithelial malignancies has been highlighted. CD10 is a member of metalloproteinase family that breaks down the protein components of extracellular matrix and epithelial tissue remodeling thus playing an important role in carcinogenesis and metastasis. To evaluate CD 10 expression in breast carcinoma and assess its association with grade of the tumor, ER, PR and Her 2 Neu status. Methodology: The study was carried in Federal Government Polyclinic Hospital (FGPH) and Pakistan Institute of Medical Sciences (PIMS), Islamabadԁ. Immunohistochemical panel of CD 10, ER, PR and Her 2 was applied to 171 cases of invasive breast carcinoma. The association of CD 10 anԁ ER/PR status was evaluated. Results: Among 171 cases of breast carcinoma, 77.8% cases were CD-10 positive. A total of 65.5% of ER negative cases expressed strongly positive CD-10 in the stroma as compared to 37.2% of ER positive cases (P=0.001).  In 64.4% of PR negative cases expressed strong positivity of CD-10 in the stroma compareԁ with 37.5% (42/112) PR positive cases (P=0.001). The association of CD-10 with HER-2-NEU was not significant (P=0.749).  Association of high-grade tumor with CD 10 was not statistically significant (P=0.258). Conclusion: It was observed that CD10 expression is associated with negative ER, PR status and with higher grades of the tumors, showing its prognostic significance. Key Words: Breast cancer, CD 10, Estrogen receptors, HER2neu, Progesterone receptors &nbsp

Hospital preparedness for disaster and mass casualty management in Pakistan: A cross-sectional evaluation study

Background: World Health Organization has advocated preemptive readiness of health systems to manage disastrous events. Pakistan is known to be highly susceptible to disasters on the one hand and significantly lacking in coping ability on the other. Preparedness of health facilities in such locales is especially important, despite which there is little published evidence regarding hospitals’ response capacity in Pakistan.Methods: From 12 most disaster prone districts of the country, a purposive sample of 20 hospitals was assessed using 51 indicators, scored as fully (2), partially (1), or not prepared (0). Two domains, disaster preparedness and mass casualty management, and five subdomains, networking, planning, staff-readiness, materials, and safety, were evaluated. Proportions of maximum possible scores achieved by an entity were categorized as acceptable (≥66 percent), partial (35-65 percent), or inadequate (<35 percent).Results: Out of the 20 hospitals, 14 (70 percent) were secondary and 3 tertiary level facilities (30 percent). Overall, hospitals were partially prepared with a score of 54.0 percent, 95 percent confidence interval [52.3 percent, 54.7 percent]. Disaster preparedness, 55.2 percent [54.0, 57.0], was significantly better prepared than mass casualty management, 49.2 percent [46.8, 51.6], p < 0.001. Overall, facility safety was the least prepared among the subdomains, 38.3 percent [31.8, 44.8], while materials were the best, 75.9 percent [72.6, 79.3]. The least prepared subdomains were staff-readiness in Punjab, 52.1 percent [47.5, 56.8], and facility safety in KP, 29.2 percent [22.1, 36.4].Conclusions: Hospitals’ preparedness for disaster and mass casualty management is deficient in these most vulnerable districts of Pakistan. Improvement initiatives commensurate with locale vulnerabilities should be instituted