Papillary Carcinoma Thyroid Co-existing with Upper Aerodigestive Tract Squamous Cell Carcinoma: Case Series

The incidental discovery of papillary carcinoma of thyroid in a patient being investigated for squamous cell carcinoma of oral cavity is a rare clinical situation and appropriate management may vary from what was actually planned. We report a case series of 10 patients admitted with variable complaints of pain on swallowing, change in voice and breathing difficulty. Total Laryngectomy was done along with lymph node neck dissection. On histopathological examination, it showed poorly differentiated Squamous cell carcinoma. Tissue sent as paratracheal lymph node showed thyroid tissue with foci of Papillary carcinoma of thyroid which was a coincidental finding. A total of 10 cases with dual malignancy of Upper aerodigestive tract Squamous cell carcinoma coexisting with Papillary carcinoma thyroid as an incidental finding. Of which nine were male and one was female, had undergone Total Laryngectomy, Hemiglossectomy and Hemimandibulectomy was done along with lymph node neck dissection

Evaluation of Appropriateness of Platelet transfusions in a Tertiary Care Centre

Introduction:  Blood transfusion is an essential part of modern health care. Transfusion is considered appropriate when it is used to treat conditions leading to significant morbidity and mortality and which cannot be prevented or managed effectively by other means. The aim of this study was to evaluate appropriateness of platelet transfusions in a tertiary care centre as per National blood transfusion guidelines. Materials & Methods: This study was conducted in a tertiary care centre. A total of 4236 blood request forms were analyzed over a period of 12 months out of which 8.3% (n=352) were for Platelets (PLT). Number of units requested were noted and appropriateness of requested transfusions was assessed according to the National guidelines on transfusion. Results: A total of 4236 blood request forms were analyzed in this study out of which 8.3% (n=352) were for Platelets (PLT). There were 352 platelet requests out of which 59.6 % (n=210) requests were considered appropriate, 30.2% (n=106) were considered inappropriate and 10.2% (n=36) requests could not be assessed due to unavailability of platelet count. Out of 30.2% (n=106) inappropriate transfusions, in 14.8% (n=52) transfusions were appropriate but number of units transfused was inappropriate and in 15% transfusion itself was considered inappropriate. Conclusion: It was observed that 30.2% (n=106) were considered inappropriate and in 10.2% (n=36) requests could not be assessed due to unavailability of platelet count. Regular audits and CMEs should be conducted and development of standard hospital transfusion guidelines are the measures which can be incorporated in this hospital to rationalize the use of blood components

A study of adequacy of completion of clinical biochemistry laboratory request forms

Background: Laboratory request forms are essential communication tool between the clinicians and laboratory personnel. In view of the meagerness of studies exploring request forms as a part of preanalytical errors, we planned to evaluate the request forms received at the clinical biochemistry laboratory. Objective: The aim of this study was to evaluate the adequacy of the details of laboratory request forms that had been submitted to biochemistry department. Materials and Methods: This lab audit was carried out at the clinical biochemistry laboratory of a tertiary care teaching hospital. The forms Laboratory request forms were segregated to evaluate the extent of completion of each form, completion of the columns, legibility of the clinician`s handwriting. The results were expressed in percentages. Results: A total of three thousand and fifty (3050) request forms were analyzed. The location of the patient and referring department were missing in 35.3% and 29.4% of the forms respectively. Provisional diagnosis was provided only in 53.3% of the request forms. Conclusion: This study concludes that the location of the patient, probable diagnosis, medical officer`s signature had not been entered in the request forms. As laboratory plays a crucial role in the patient diagnosis, incomplete data in the request form might significantly affects the lab service which in turn affects the patient’s health care system. The standard of filling of laboratory request forms needs to improve to provide a high quality lab service

Spectrum of Sinonasal Tumors: A 10-year Experience at a Tertiary Care Hospital in North India

Objective: Sinonasal tumors are a highly heterogeneous group of tumors that account for less than 1% of all cancers. Precise diagnosis is essential because the natural history, treatment, and prognosis vary for different neoplasms. We reviewed 610 cases of sinonasal lesions to understand this entity better. Methods: A total of 610 sinonasal biopsies/specimens were received over a period of 10 years (2004–14). All the samples were processed and stained with hematoxylin and eosin. Special staining for microorganisms and immunohistochemistry were performed where indicated. Results: Benign lesions were 72% with nasal polyp being the most common. Malignant lesions made up 21.2% of lesions with nasopharyngeal carcinoma being the most common while 7.7% cases were inflammatory/non-neoplastic. The most common cause for this was fungal sinusitis. The maxillary sinus was the most frequently involved site in all the lesions (62%). The average age of presentation was 40 years old, and the male to female ratio was 3:1 in those with benign tumors. The average age of presentation in the malignant and inflammatory group were 45 and 43 years, respectively, with an almost equal sex ratio in both categories. Computed tomography and magnetic resonance imaging scans were done in virtually all cases to assess the extent of the tumor as well as bony destruction. Local recurrence was the most frequent cause of treatment failure. Conclusion: Tumors of the nasal cavity are often grouped with those in the paranasal sinuses. Benign tumors constituted approximately 75% of tumors in our hospital. Squamous cell carcinoma was the most common malignancy of this region. These tumors need to be studied closely and accurately because their proximity to vital structures pose significant challenges for their treatment and may be the source of significant patient morbidity

Multilingual Interface for Grid Market Directory Services: An Experience with Supporting Tamil

Providing Internet and Web application interfaces in local languages is gaining popularly recently as it helps in making their services accessible to people who cannot understand English language. Grid computing has emerged as one of the recent applications of Internet and aims at delivering computing as the 5 th utility much like the four fundamental utilities—electricity, water, telephone, and gas. This paper presents our work on localization and provisioning of Grid computing services in Tamil (a language spoken in the south Indian state of Tamil Nadu). We have proposed and developed a Tamil interface for the Grid Market Directory (GMD) services as it aims to provide one of the fundamental Grid services that are essential for bringing together producers and consumers of Grid services. The paper presents architecture for location of the GMD and its user interfaces, implementation mechanism, and steps for localization. It then provides snapshots of GMD interfaces in Tamil and demonstrates the overhead of providing GMD services in Tamil is very minimal compared to presenting the same in English. 1

Semantic-based grid resource discovery and its integration with the grid service broker

Abstract: This paper addresses the need of semantic component in the grid environment to discover and describe the grid resources semantically. We propose semantic grid architecture by introducing a knowledge layer at the top of Gridbus broker architecture and thereby enabling broker to discover resources semantically. The semantic component in the knowledge layer enables semantic description of grid resources with the help of ontology template. The Ontology template has been created using Protégé-OWL editor for different types of computing resources in the grid environment. The Globus Toolkit’s MDS is used to gather grid resource information and Protégé-OWL libraries are used to dynamically create knowledge base of grid resources. Algernon inference engine is used for interacting with the knowledge base to discover suitable resources. 1