Cyto-histopathological correlation of thyroid lesions

Background: Thyroid is a frequent site of disease in human body. Fine needle aspiration cytology is a rapid, efficient, inexpensive and safe diagnostic method in these cases. FNAC has some limitations, particularly limited to representatives of samples and exact typing of benign and malignant neoplastic lesions. Thus, FNAC alone may not give a confirmative diagnosis regarding few thyroid lesions. Hence, histopathological study has been the standard technique for the diagnosis of thyroid lesions. Objectives were to study cytomorphological features of thyroid enlargement and palpable lesions of thyroid by FNAC, to correlate cytomorphological features of thyroid lesions with Histopathological features wherever possible and to evaluate sensitivity and specificity of FNAC of thyroid lesions.Methods: In the present study, 385 cases of thyroid FNA’s, have been analyzed and cyto-histopathological correlation has been interpreted wherever available.Results: In present study sensitivity, specificity, positive predictive, negative predictive value and accuracy of FNAC was found out be 92.31%, 97.01%, 85.71%, 98.48% and 96.25%.Conclusions:Fine needle aspiration cytology is a simple reliable and cost effective technique without complications. This can be used as safe outpatient procedure with minimal discomfort to the patient.

A study to evaluate feto-maternal outcome of trial of labour in previous cesarean patients: a prospective observational study at a tertiary care centre in India

Background: Vaginal birth after cesarean section (VBAC) is associated with shorter maternal hospitalizations, less blood loss and fewer transfusions, and fewer thrombo-embolic events than cesarean section (C-section). A 60 to 70% success rate of vaginal birth after previous C-section has been reported by many authors if the primary cesarean was done for nonrecurring indications the subsequent pregnancyMethods: A prospective observational study was conducted at Sassoon general hospital, Pune, India. The 100 patients who fulfilled the inclusion criteria were studied. Maternal and fetal outcomes were analysed.Results: Out of the total 100 cases with previous C-section, successful vaginal delivery was possible in 65% cases. Most common reason for failed attempt to vaginal delivery was failure of labour to progress (40%) followed by failure of induction (28.6%) and non-reassuring FHR (22.9%). Out of the total 35 cases with gestation age over 40 weeks, 51.4% underwent C-section delivery as compared to 26.2% with gestation age of less than 40 weeks (p25, gestation ≥40 weeks and history of previous emergency CS while high success rate was seen with history of any vaginal deliveries. We thus recommend that pregnant woman with history of C-section should be given the option of trial of labour after caesarean (TOLAC), unless contraindicated

Study of reactivity pattern of hormone receptors in patients with breast cancer at a tertiary care hospital, Aurangabad, India

Background: Breast cancer is one of the most common malignancies affecting the female population worldwide. Prognosis and management of breast cancer are influenced by variables such as stage, grade, and hormone receptor status. Tumours that express ER and/or PR have a better prognosis and most of them respond well to hormonal therapy. In addition to hormone receptors, HER2 has emerged in recent years as an important independent predictive marker.Methods: All surgically operated female cases of breast carcinoma which were submitted for immunohistochemistry test for estrogen, progesterone and human epidermal growth factor receptor-2 in the Department of Pathology, MGM Medical College, Aurangabad for the duration of December 2015 to October 2017 were included in this prospective study. A total of 50 patients were taken up for the study.Results: The maximum age of the patients were in the 4th -5th decade and were mostly premenopausal. The tumour was maximum involving the right breast, upper outer quadrant and were BI-RADS 4. Majority were grade 2 and were invasive ductal carcinoma. Hormone receptor status showed ER positivity 48%, PR positivity 46% and HER2 positivity 28%.Conclusions: So, to conclude, immunohistochemical analysis of ER, PR and HER2 receptors is widely available at a reasonable cost and provides valuable prognostic, predictive and therapeutic information. Although we could see different patterns of hormonal receptor status, irrespective of the histological grade, type and lymph node status in our study, HER2 testing along with ER/PR status should be performed routinely in all the patients diagnosed of breast cancer as this will help the clinicians to manage the patients further

Persistence of endodontic infection and Enterococcus faecalis: Role of horizontal gene transfer

The endodontic literature states that a diversity of microorganisms is implicated in cause of root canal infection. There may be a possibility that the actual existence of a specific species is not as imperative as the presence of specific virulent strains of that organism. There are genetic modifications in the cell that furnish an organism with greater pathogenicity. Primary and persistent endodontic infections have difference in their micro-flora. Primary infections usually comprises of mostly anaerobic microbiota whereas multidrug resistant Enterococcus faecalis has been linked to persistent endodontic disease. Horizontal gene transfer is a mechanism that leads to a varied number of traits including acquired antibiotic resistance. Horizontal gene transfer takes place by three processes transduction, conjugation and transformation. The present review expatiates on the mechanism of horizontal gene transfer of acquired antibiotic resistance in E. faecalis