Hematological aspects in malaria

Background: Malaria is a major health problem at the global level. In Indian subcontinent, it is a major cause of mortality in immunosuppressed patients and in extreme ages of life. This study is based on early detection of malaria by hematological parameters to reduce the mortality in such cases. Materials and Methods: All patients with fever of less than 7 days in duration were included in the study. Hematological parameters were determined by using automated cell counter. Peripheral blood smear examination for malaria parasite was taken as gold standard for the diagnosis of malaria. Result: A total of 110 patients were included in the study. Ninety nine patients had a positive peripheral smear for malarial parasite. Thrombocytopenia (52.52%) alone (platelet count less than 1, 50,000/mm 3 ) was a predictor for malaria and in combination with anemia (Hb < 10 gm/dl) it was next best parameter. Leucocyte count was not predictive. Conclusion: The conclusion of this study is that the presence of thrombocytopenia in a patient with acute febrile illness increases the probability of malarial infection

Pure yolk sac tumor of testis in a 50 years old : A rare case report

Yolk sac tumor (YST) is most common in infants and children in age range of 3-8 years in pure form; however in adults, YST rarely occurs in pure form, but commonly occurs in association with other germ cell tumors as mixed forms. Less than 10 adult testicular pure YSTs have been reported in literature. We report a 50-year-old male with testicular neoplasm involving the left testis, with pain following trauma. Alpha-fetoprotein was markedly raised 5726 IU/ml, and on histopathology, characteristic features of YST with abundant Schiller–Duval bodies associated with reticular and microcystic pattern, and focal solid areas of nests and trabeculae of cuboidal cells, with prominent nucleoli and mitotic figures, were noted, and extensive histopathological search did not reveal presence of any other type of tumor

Lipoma of small intestine

Lipomas of the gastrointestinal tract (GIT) are rare. They are usually submucosal, but rarely involve the muscle layer or serosa. Most ot submucosal lipomas of GIT are present in the colon (65-75%), small intestine (25%) and rarely in stomach or jejunum. These lesions are usually asymptomatic and rarely are incidentally found in autopsies. During lifetime, they are detected when they cause intussusceptions and obstructive symptoms. These lesions can also rarely become ulcerated causing symptoms that come to notice. The present case report is of submucous lipoma in the terminal ileum. A 45-year-old female came complaining of pain in the abdomen, gradually increasing over a period of 4 days. Computerized tomography scan revealed a mass in the submucosa. She was operated, and histopathology examination confirmed the mass as lipoma in the submucosa as well as within the muscle layer of the small intestine

Tubercular breast abscess

Tubercular breast abscess is a rare clinical entity and affects women from mainly the Indian subcontinent. It often mimics breast carcinoma and pyogenic breast abscess clinically. Routine laboratory investigations are not helpful in the diagnosis. Fine needle aspiration cytology (FNAC) or biopsy is essential for diagnosis, and tuberculous culture when positive may be very useful to start antitubercular treatment

Neurilemmoma of nose

Neurilemmomas are uncommon neoplasms. They are solitary encapsulated benign tumors usually occurring along the course of peripheral, cranial or sympathetic nerve. They are rarely malignant. Nasal and paranasalneurilemmomas are extremely rare and few cases have been reported. We report a case of neurilemmoma of nose because it is rare and it grossly appears similar to the benign mucous polyp of the nose. We report a 32-year-old male complaining of foreign body sensation in nose and difficulty in breathing. On examination it was clinically thought to be a mucous polyp, but on histopathological examination it was found to be neuroilemmoma

Mixed germ cell tumors: Report of two cases

Germ cell tumors arise in the ovaries and testis and rarely in other tissues. Mixed germ cell tumors are rare. We report two cases of mixed germ cell tumors, one consisting of seminoma and immature teratoma in the testis of a 30-year-old male and second consisting of a yolk sac tumor and immature teratoma in the ovary of a 17-year-old female. Many combinations of mixed germ cell tumors have been reported but very few cases of the above-mentioned combinations have been reported in literature

Spectrum of lymph node lesions as determined by histopathology

Background and Objective: Lymph node lesions form a wide range of spectrum, exhibiting manifestations in both hematopoietic tissue and lympho reticular system. It is necessary to document the same spectrum in a particular region to understand the trend and diseases occurring frequently in that region. The range encompasses benign reactive changes to frank malignant lymphoma and metastatic deposits. Histopathology is considered to be the gold standard and its relevance to clinical diagnosis is studied here. Materials and Methods: A total of 200 cases were studied retrospectively in this study. Samples received were either biopsy or node resection specimens, and clinical history was recorded for each of them. Immunohistochemistry and special stains were performed as and when required. Results: Clinical diagnosis had a diagnostic accuracy of 71% approximately using histopathology as the gold standard. Most of the benign diseases were either reactive or tubercular lymphadenitis, whereas non-Hodgkin Follicular lymphoma had the maximum incidence among lymphomas. Conclusion: This study concluded that cervical group of superficial lymph nodes are most frequently encountered as palpable nodal swellings. The clinical suspicion of malignancy remains high in most of the cases due to the matted and enlarged presentation of lymph nodes. Histopathology revealed that only 33.5% of the cases to be malignant of which the most common was Follicular Lymphoma (non-Hodgkin type). The clinical accuracy of diagnosing malignant lesions thus coming to 71% approximately

Isolated peritoneal hydatidosis clinically mimicking ovarian tumor: A rare case report

Hydatid cyst disease is rare and it is a parasitic infection where humans accidentally get infected by ingesting larval forms of parasite whereas, the definitive hosts are dog. The common sites of hydatid cyst are liver, lungs, spleen. Unusual sites of the hydatid cyst is reported in subcutaneous tissue of anterior abdominal wall, peritoneum. We report an unusual form of the primary hydatid cyst disease involving peritoneum in a 65-year-old female, presenting as swelling in the abdomen since 3 months. Sonography revealed a cystic mass and diagnosis of ovarian tumor was considered. The Cancer Antigen 125 (CA--125), an ovarian malignant marker was normal. Exploratory laprotomy was carried out. Cytological examination, gross, and the histopathological findings suggested the diagnosis of hydatid cyst disease involving only peritoneum. Primary isolated hydatidosis involving peritoneum is very rare and only few cases have been reported. Moreover, it mimics other tumors of the abdomen like in our case we considered it as an ovarian tumor

Seroprevalence of human immunodeficiency virus in voluntary blood donors: Declining trend

Background: Seroprevalence of human immunodeficiency virus (HIV) in selected groups can produce an indication of secular trends of the infection. In this article, we studied the trend of HIV infection in voluntary blood donors over a period of 7 years. Materials and Methods: The study was conducted in a blood bank of a tertiary care hospital. More than 16,500 donors were screened by enzyme-linked immunosorbent assay for HIV infection over a period of 7 years. Statistical Analysis: Trend analysis was performed to identify the year-wise HIV positivity pattern among the blood donors during the study period. Cochrane-Armitage Chi square for linear trend was applied to the data to observe whether there was any significant decline in HIV seropositivity among the blood donors. Results: In our study, the seroprevalence of HIV declined from 0.57% in 2006 to 0.18% in 2012. This declining trend tended to be statistically significant (Cochrane-Armitage Chi square for linear trend 3.65, P = 0.056). Conclusion: This study indicated the decreasing trend of HIV seropositivity among voluntary blood donors. Long-term surveillance of blood donors can provide important information on the course of the HIV pandemic

Magnitude of asymptomatic hepatitis B virus surface antigen carrier state in voluntary blood donors: Predonation screening and gender considerations

Context: Safety of blood transfusion. Aims: The study was conducted to assess the overall prevalence of hepatitis B surface antigen (HBsAg) in blood donors (BDs), to know the gender differences in prevalence and to understand the implications. Settings and Design: Blood bank of a tertiary care hospital. Observational study. Materials and Methods: Data of 17,976 voluntary BDs who donated blood between January 2006 and December 2012 was evaluated. Fresh serum samples of all BDs were screened for HBsAg using HEPALISA (3 rd generation ELISA method, manufactured by J. Mitra & Co. Pvt. Ltd., New Delhi, India). Statistical Analysis Used: Statistical analysis was performed using the Chi-square test, df and P value. Results: Totally 17,976 BDs were studied, of which 16,972 (94.4%) were males and 1,004 (5.6%) were females. The male to female ratio was 16.8:1. Among HBsAg-positive BDs, 230 (98.7%) were males and 3(1.3%) were females. The HBsAg prevalence was - overall 1.3%, males - 1.3%, females - 0.29%. The difference in prevalence of HBsAg in males and females was statistically significant (χ2 = 8.29, df = 1, P = −0.004). The rate of HBsAg positivity showed a slight decline over last 5 years. Conclusions: The study region has a low prevalence for HBsAg. Low prevalence in women makes them better donors; hence they could be encouraged to donate blood voluntarily. Increase in proportion of women in BDs can minimize transmission of hepatitis B virus by transfusion