Congenital Presentation of a Solitary Superficial Angiomyxoma in the Parotid Region Masquerading as Parotid Tumor

Superficial angiomyxoma is a rare cutaneous and benign lesion. We present a case of congenital presentation of a superficial angiomyxoma in the parotid region in a 9-year- old female that was misdiagnosed as a parotid tumor. Appropriate diagnosis is important since such lesions have a good prognosis and rarely affect deeper structures. Possibility of superficial angiomyxoma should be kept in mind in the differential diagnosis of lesions of the parotid region

Monitoring of Disease Activity in Chronic Myeloid Leukemia-chronic Phase Patients Treated with Indian Generic Veenat (NATCO) Imatinib Mesylate: A Tertiary Care Experience

Aim: Real-time quantitative polymerase chain reaction (RT-PCR) is a sensitive technique to monitor treatment response in chronic myeloid leukemia (CML). Standardization of RT-PCR protocols and interpretation of results are important to maintain the reliability of this molecular test. Methods: We present the analysis of treatment monitoring after administration of Indian generic imatinib mesylate (IM) (Veenat) in 73 patients with CML-chronic phase using RT-PCR. Results: A consistent decrease in the median breakpoint cluster region-abelson1 (BCR-ABL1) percentage denoting a continued time-bound response to IM is observed. At 6 months, 87.5% patients showing ≥ 1-log reduction in BCR-ABL1 levels subsequently developed ≥ 3-log reduction as compared to 42.8% patients showing < 1-log reduction. All patients with ≥ 3-log reduction in BCR-ABL1 at 12 months maintained treatment response at 18 months. Conclusion: The efficacy of Veenat (NATCO) is comparable to Gleevac (Novartis). Patients who attain ≥ 1-log reduction at 6 months and ≥ 2-log reduction at 12 months are more likely to subsequently attain a major molecular response

Acute Lymphoblastic Leukemia with Normal Platelet Count

B-acute lymphoblastic leukemia (B-ALL) often presents with pancytopenia/bicytopenia, with thrombocytopenia being the most important parameter. The case of a 12-year-old child with bicytopenia on peripheral smear was presented. On bone marrow examination, 85% morphologically lymphoid blasts, negative for myeloperoxidase, and periodic-acid Schiff on cytochemistry were found. The blasts suppressed the erythroid population but not the megakaryocytic population. On flow cytometry, a diagnosis of common-ALL-antigen positive B-precursor ALL was concluded. To conclude, ALL cannot be excluded in patients who present with a normal platelet count. A bone marrow aspirate is crucial in patients with bi/pancytopenia

Sweet′s Syndrome in Acute Lymphoblastic Leukemia with t (9:22)

Sweet′s syndrome (SS) is a rare disease diagnosed in children and is characterized by fever, erythematous skin lesions, and dense infiltration of neutrophils in the upper dermis without evidence of leukocytoclastic vasculitis on histopathology. It may occur secondary to infection, malignancy or drug intake. A case of a 9-year-old boy diagnosed as acute precursor B-cell lymphoblastic leukemia with BCR-ABL1 mutation and treated with induction chemotherapy and imatinib mesylate (IM) therapy is presented. After 8 weeks of consolidation chemotherapy, the patient developed painful and erythematous nodules where a biopsy showed dense neutrophilic infiltrate and edema in the papillary dermis consistent with SS. Whether SS is caused clinically by acute lymphoblastic leukemia, the presence of BCR-ABL1 mutation or due to IM therapy is discussed

Chronic eosinophilic leukemia with Fip 1-like 1-platelet-derived growth factor receptor alpha mutation: A rare case report

Chronic eosinophilic leukemia (CEL) is a rare cause of eosinophilia. CEL is known to be associated with BCR-ABL fusion gene or rearrangement of platelet-derived growth factor receptor alpha (PDGFRA), (Platelet-derived growth factor receptor betaPDGFRB or fibroblast growth factor receptor-1. CEL, no specific type excludes patients with the above mutations and necessitates the presence of clonal cytogenetic abnormality or blast cells more than 2% in peripheral blood and more than 5% in bone marrow. Imatinib mesylate inhibits Fip 1-like 1 (FIP1L1)-PDGFRA-induced colony formation, enabling cells to undergo normal differentiation. Our patient was diagnosed as a case of CEL on clinical grounds along with bone marrow morphology, and imatinib therapy was initiated empirically. Results of FIP1L1-PDGFRA gene rearrangements available subsequently were in concordance with patient profile and response to imatinib therapy

Quality of Life and Its Determinants Among Diabetic Patients in A Rural Area of Gautam Buddha Nagar, Uttar Pradesh, India

Context: Diabetes has become the largest health emergencies of 21st century. The burden of diabetes is increasing globally especially in developing economies like India. In the recent years, Physician’s interest has turned to the concept of quality of life (QOL) as an important treatment goal and an important component of therapy in the management of diabetes. The study was aimed to compare the quality of life of adult diabetic subjects with healthy subjects and to assess the factors affecting the quality of life among diabetic subjects. Methodology: A Community based cross sectional study was conducted among 250 diabetic subjects and 50 healthy subjects more than 18 years of age, based on WHO-Quality of Life-BREF (WHO-QOL-BREF) questionnaire manual in the rural area of District Gautam Buddha Nagar from Jan 2021-June 2022. Data collected were entered and statistically analyzed using statistical software (SPSS-22) Results: Overall quality of life and general health score was significantly poor among diabetic subjects as compared to healthy subjects. Quality of life was significantly lower in diabetic subjects ≥ 60 years of age, illiterate subjects and in diabetic subjects with presence of comorbidity. Conclusions: Overall QOL was poor among diabetic subjects as compared to healthy subjects

Analysis of epithelial-cadherin and human epidermal growth factor receptor 2/ expression in gastric carcinoma using immunohistochemistry

Context: Gastric adenocarcinoma (GAC) is a common malignancy with high mortality-rate. Analysis of molecular markers could form a foundation for the future use of targeted therapies to reduce morbidity and mortality. Aims: To find the prevalence and relation of epithelial cadherin (E-cadherin) and human epidermal growth factor receptor 2 (HER-2/neu) protein expression with histological type and grade of GAC using immunohistochemistry (IHC). Materials and Methods: A total of 100 cases of GAC diagnosed over a 2 year period were studied. Expression of E-cadherin and HER-2/neu was analyzed by IHC in relation to the histological type and grade. Results: Of the 100 cases of GAC studied, 11 revealed a loss of E-cadherin and over-expression of HER-2/neu was seen in 17 cases. Loss of E-cadherin was seen in 50% of signet ring-cell carcinomas but only in 8% of tubular and none of papillary and mucin-secreting GAC (P = 0.003). Of all the cases of tubular GAC with loss of E-cadherin expression, majority (71.4%) were Grade III (P = 0.04). Of all the tubular GAC cases with an over-expression of HER-2/neu, 20% and 67% were Grade I and II GAC respectively while only 13% were Grade III (P < 0.001). Conclusions: Although poorly-differentiated tumors show loss of E-cadherin, better-differentiated tumors over-express HER-2/neu protein. Signet ring-cell carcinoma is more likely to exhibit a loss of E-cadherin protein. Targeted therapy toward HER-2/neu in GAC should be considered. Novel therapy to block E-cadherin down-regulation is justified