Common thrombophilia markers in young patients with primary arterial and venous thrombosis

Background: The pathogenesis of vascular thrombotic event involves an interaction of multiple genetic and environmental factors. Genetic factors include activated protein C resistance, deficiency of natural anticoagulants protein C, protein S, factor V and antithrombin III while acquired cause include presence of antiphospholipid antibody. This study was carried out to establish the role of basic panel of thrombophilia in diagnosing the patients with primary thrombophilia.Methods: A total of 121 consecutive patients with history suggestive of arterial or venous thrombosis were included. History of risk factors including smoking, hypertension, hyperlipidemia, diabetes mellitus and family history of thrombosis were elicited. The initial tests included CBC, PT, APTT, LFT, blood sugar and lipid profile. Functional assay on thrombophilia markers were performed by means of clotting based method.Results: A total of 121 patients were studied, out of which 63 were males and 58 females. The mean age range was 15-40 years. No abnormality was detected in 75 samples, while 46 samples (38%) were positive for one or more thrombophilia markers, of which 6 had more than one thrombophilia marker. Abnormality of a single thrombophilia factor was found in 40 patients, in which two patients were also positive for lupus anticoagulant.Conclusions: An association was found between low levels of protein C, protein S and factor V and a thrombotic event. Screening of these patients using a panel of thromophilia markers can provide valuable information in primary diagnosis of inherited deficiency even in the absence of high end molecular/mutational studies

A Comparative Economic Analysis for Cloud Computing

Analyzing the economic viability of using cloud computing services within an organization is an important aspect for business today. Significant cost savings can be obtained through selecting the best net benefit alternative between the defender and multiple challengers of business technology systems being considered. A simple definition of cloud computing is the use of software systems and storage accessed through the Internet. Traditionally, these services are managed and provided from in-house, on-site systems. There are several cloud computing service providers to choose from. This study provides an economic comparison between on-site, Amazon Web Services, and the Google Cloud Platform. This analysis uses present worth, and the minimum attractive rate of return using a five (5) year time-frame. A benefit-cost analysis is provided to determine if the efficiency ratios warrant viability of each alternative. An incremental analysis follows, using each viable alternative to find the best option that provides the highest net benefit to the firm. Outcomes from this methodology will vary depending on the specifics of the alternatives being examined. In this example scenario, a fully remote, cloud computing based company is the recommended strategy to pursue

Cystic fibrosis presenting as small bowel obstruction in pediatric patient: a case report

Intestinal obstruction complete or incomplete has been found commonly in patients with cystic fibrosis in all age groups with variable presentation. Prevalence of intestinal obstruction in children with cystic fibrosis is 7-8%. Neonates present with meconium ileus due to inspissated meconium and complete obstruction. This case demonstrates similar presentation in a pediatric patient. A six day old male patient presented in the pediatric surgery department with abdominal distention, vomiting and fever. Patient was operated and intraoperative meconium plug was seen along with dilated proximal bowel, filled with sticky meconium. Resected gut segment was received in the Department of Pathology. Grossly dilated gut segment on cut section was seen filled with thick putty like greenish fecal matter. Histopathological examination showed features consistent with cystic fibrosis. There are multiple causes for intestinal obstruction in neonates, cystic fibrosis can be one of them which needs to be considered by the clinicians. Such cases need to be reported for better understanding of their clinico-pathological presentation and prevalence

CAM5.2 Expression in Metastatic Tumours of CNS: A Diagnostic Tool

Introduction: Secondary tumours or metastases account for more than half of all brain tumours in adults. Central nervous system is most commonly a target of metastatic dissemination. The judicious use of  selected immunostains is unquestionably helpful in diagnostically challenging cases. CAM 5.2 being highly specific, is emerging as a specific marker to diagnose metastatic carcinoma.Presentation of case: Total six metastatic tumours were studied using CAM5.2. Histopathological sections of brain tissue were stained by routine hematoxylin and eosin (HE) as per standard technique. Representative sections were subjected to immunohistochemical staining with CAM 5.2. Skin biopsy act as a positive control for cytokeratin.All of the 6 cases showed positivity for CAM 5.2. CAM5.2 expression in metastatic tumours was statistically significant (sensitivity 100% 100% specificity).Conclusion: We conclude in our study that CAM5.2 was significantly associated with metastatic tumours, as they were positive using this specific marker

Sclerosing stromal tumor of the ovary: A case report

Abstract Sclerosing stromal tumor (SST) is an extremely rare and benign ovarian neoplasm of the sex cord stromal category which occurs predominantly in the second and third decades of life. Herein, we report a case of sclerosing stromal tumor of ovary in a 22 year old woman who was clinically suspected to have malignancy, but proven to be SST of ovary on histopathological examination. Hence, in such circumstances it is essential to keep in mind the possibility of sclerosing stromal tumor in a young woman

Subcutaneous leiomyosarcoma of scrotum presenting as an exophytic mass: An unusual presentation

Paratesticular leiomyosarcoma originates from testicular tunica (48%), spermatic cord (48%), epididymis (2%) and dartos muscle, as well as subcutaneous tissue of the scrotum (2%). Leiomyosarcomas of the scrotum, not involving the testis, epididymis or spermatic cord, are rare, and belong to the group of subcutaneous superficial leiomyosarcomas. To the knowledge of the authors, less than 10 cases of leiomyosarcoma of the scrotum have so far been reported from India. The tumor usually presents as a painless, slow-growing scrotal mass in middle-aged or elderly men. The current approach is wide local excision, often with adjuvant therapy. The prognosis is usually good following complete excision, though a local recurrence rate of 40% has been reported. Long term follow-up is, therefore, necessary to monitor for recurrence. Herein we present the case of 35-year-old male who presented with an exophytic scrotal mass. Histopathological and immunohistochemical findings of the mass were consistent with leiomyosarcoma

Role of Colour Doppler Imaging in Detecting Prostate Cancer

This prospective study was undertaken to evaluate the role of colour Doppler sonography in the assessment of prostate carcinoma. METHODS: Forty consecutive patients who were suspected of having prostate carcinoma with either raised prostate specific antigen or abnormal digital rectal examination were included in the study. Transrectal greyscale and colour Doppler sonography of the prostate was performed using a 5–9 MHz intracavitary probe. Needle biopsies were taken from areas that showed increased flow on colour Doppler. The results were correlated with the final diagnosis established on histopathological examination. RESULTS: Comparison of greyscale and colour Doppler sonography showed that the latter is more sensitive and specific in predicting the malignancy. The statistical parameters of colour Doppler versus greyscale sonography were: sensitivity 88.23 vs. 73.52, specificity 66.66 vs. 33.33, positive predictive value 93.75 vs. 85.18, and negative predictive value 50 vs. 22.22, respectively. CONCLUSION: Colour Doppler and greyscale sonography should be routinely performed to improve detection of prostate carcinoma and to target the lesion