Clinical and laboratory profile of TB-HIV co-infected patients with relation to CD4 counts in a tertiary care hospital

Background: Tuberculosis is the commonest opportunistic infection in HIV infected individuals. Global TB report by WHO estimates 0.4 million deaths by TB in 2014 in HIV infected individuals. The clinical profile of TB in HIV infected individuals are variable from region to region based upon the prevalence of HIV in the region. The aim of the present study was to determine the clinical profile of tuberculosis and the distribution of pulmonary and extra pulmonary tuberculosis in HIV infected individuals with relation to their CD4 counts.Methods: A prospective cross sectional study was done for a period of two years from January 2013 to December 2014 at a tertiary care hospital in south India. Sputum samples were screened for Mycobacterium tuberculosis from 150 HIV seropositive individuals in the study. AFB positive smears were graded as per RNTCP guidelines. Clinical profiles of the cases in the study were noted and the Chest X ray, ultrasonogram and other relevant investigations were performed in smear negative individuals to diagnose pulmonary and extra pulmonary tuberculosis.Results: In our study 26-35 years was the major age group (37.33%) with male preponderance. Heterosexual mode of acquisition was common (88.67%) and in 6% the mode was unknown. Fever was the most common symptom (100%) followed by cough with expectoration in 84% of HIV-TB co-infected cases.44% of cases were smear positive for AFB bacilli and 57.58% were graded 3+, 65.33% of cases had pulmonary infiltrates on chest X-ray followed by 16% with effusion. Lymphadenopathy was the most common extra pulmonary involvement seen in 28.67% of cases followed by 14.67% with meningeal involvement. Overall in the study isolated pulmonary tuberculosis was seen in 43 (28.67%) patients, isolated EPTB was seen in 13(8.67%) patients and both were seen in 84 (56%) patients. In all cases of EPTB CD4 cell counts were <200cells/µl.Conclusions: To conclude HIV more commonly affects the economically productive age group with more males than females. Sputum positivity depends upon the stage of HIV infection. Lymphadenopathy is more common form of EPTB and diagnosis can be made by FNAC and Histopathological examination

Histopathological Spectrum of Neoplastic and Non Neoplastic Brain Lesions at a Tertiary Care Centre in South India- A Retrospective Observational Study

Introduction: Brain lesions can be caused by varied etiological factors like neoplastic, infectious, inflammatory and vascular diseases. Accurate diagnosis in very important for correct neurosurgical treatment. A retrospective histopathological study of brain lesions is of utmost importance because as it can demonstrate the changes in the spectrum of brain lesions, burden of disease in the community, can reveal the possible risk factors and can suggest probable treatment methods for various neoplastic and non neoplastic brain lesions. Aim: To evaluate the incidence, age distribution, gender distribution, and histopathological spectrum of neoplastic and non neoplastic lesions of brain. Materials and Methods: This retrospective observational study was conducted in the Department of Pathology at Narayana Medical College, Nellore, Andhra Pradesh, India, from January 2019 to December 2021. Total 216 cases were studied. The tumours were classified under World Health Organisation (WHO) classification. To test the mean difference between the groups, Independent sample t-test was done. Results: Out of 216 cases, 180 (83%) were neoplastic and 36 (17%) were non neoplastic lesions. The male:female ratio was 1.03:1. Non neoplastic lesions were common in males (22, 61.11%), while neoplastic lesions were common in females (92, 51.11%). The most common age group affected was 41-50 years (55, 25.46%). Astrocytoma (41, 22.77%) followed by meningioma (40, 22.22%) were the common neoplastic tumours and haematoma (7, 19.44%) was the most common non neoplastic lesion in adults. Common tumour in children (<18 years) was diffuse fibrillary astrocytoma (3/11, 27.27%) and chronic inflammatory pathology was the common non neoplastic lesion (2/11, 18.18%). Conclusion: Majority of cases were seen in 41-50 years age group. Astrocytoma was the common neoplastic tumour and haematoma was the common non neoplastic lesion in adults. Diffuse fibrillary astrocytoma was the common tumour and chronic inflammatory pathology was the common non neoplastic lesion in children

Pancreatic serous cystadenoma – A case report

Microcystic serous cystadenoma is a benign tumor of pancreas, also termed as Clear cell or Glycogen rich adenoma. It occurs at any site in pancreas and composed of small cystic spaces lined by small cuboidal cells with clear cytoplasm, glycogen. There is an association with von Hippel Lindau syndrome in few cases. Clinical symptoms are variable. Excision is almost curative. We report a case of 70 year old male who presented to the OPD with vague complaints of local discomfort. Ultrasound showed a mass in the pancreas. Pancreatectomy was done and diagnosed as microcystic serous cystadenoma of pancreas on histopathology

Lipofibroma of the Uterine Cervix- A Rare Benign Tumor with Brief Review of Literature

Lipomas of the uterus are rare and cervical involvement is another rare entity. Approximately 200 cases have been reported in the literature and the incidence ranges between 0.03% to 0.2%. The lesion has lately been discussed interestingly due to its diagnostic confusion with sarcomas on radiographic examination and also due to their disputed histogenesis. We report a case of 36 years old woman presenting with non-specific lower abdominal pain and vaginal discharge who underwent hysterectomy for abnormal pap smear result and an ultrasound diagnosis of a large cyst in the posterior lip of the cervix. Histopathology revealed intramural lipofibroma of the cervix

Clinical and laboratory profile of TB-HIV co-infected patients with relation to CD4 counts in a tertiary care hospital

Background: Tuberculosis is the commonest opportunistic infection in HIV infected individuals. Global TB report by WHO estimates 0.4 million deaths by TB in 2014 in HIV infected individuals. The clinical profile of TB in HIV infected individuals are variable from region to region based upon the prevalence of HIV in the region. The aim of the present study was to determine the clinical profile of tuberculosis and the distribution of pulmonary and extra pulmonary tuberculosis in HIV infected individuals with relation to their CD4 counts.Methods: A prospective cross sectional study was done for a period of two years from January 2013 to December 2014 at a tertiary care hospital in south India. Sputum samples were screened for Mycobacterium tuberculosis from 150 HIV seropositive individuals in the study. AFB positive smears were graded as per RNTCP guidelines. Clinical profiles of the cases in the study were noted and the Chest X ray, ultrasonogram and other relevant investigations were performed in smear negative individuals to diagnose pulmonary and extra pulmonary tuberculosis.Results: In our study 26-35 years was the major age group (37.33%) with male preponderance. Heterosexual mode of acquisition was common (88.67%) and in 6% the mode was unknown. Fever was the most common symptom (100%) followed by cough with expectoration in 84% of HIV-TB co-infected cases.44% of cases were smear positive for AFB bacilli and 57.58% were graded 3+, 65.33% of cases had pulmonary infiltrates on chest X-ray followed by 16% with effusion. Lymphadenopathy was the most common extra pulmonary involvement seen in 28.67% of cases followed by 14.67% with meningeal involvement. Overall in the study isolated pulmonary tuberculosis was seen in 43 (28.67%) patients, isolated EPTB was seen in 13(8.67%) patients and both were seen in 84 (56%) patients. In all cases of EPTB CD4 cell counts were &lt;200cells/µl.Conclusions: To conclude HIV more commonly affects the economically productive age group with more males than females. Sputum positivity depends upon the stage of HIV infection. Lymphadenopathy is more common form of EPTB and diagnosis can be made by FNAC and Histopathological examination

Expression of Her2/neu in Urothelial Neoplasms and its Association with Histopathological Prognostic Parameters

Background & Aims: Bladder carcinoma is the second common malignancy of the urogenital system. Bladder malignancy encompasses 5.2% of all forms of cancer. According to study, Her2/neu expression can be considered as a prognostic clinical biomarker for bladder cancer. Target therapy using novel and recombinant chemodrugs such as transtuzumab can be applied in Her2/neu positive cases. Current study aimed to evaluate urothelial neoplasms incidence, to assess Her2/neu expression, and to compare its expression with prognostic factors. Materials & Methods: The present study is a prospective study conducted in the Department of Pathology, Narayana Medical College and General Hospital, Nellore, India, for a period of 2 years from June 2019 to June 2021. All the urothelial neoplasm cases reported during the study period were included, and Her2/neu immunohistochemistry has been assessed for the cases. Results: Among 71 bladder specimens, 48 had urothelial carcinomas (54% of high grade and 46% of low grade), and 20 had benign neoplasms. Among high-grade carcinomas, 91% were muscle invasive and among low grade, 55% were non-muscle invasive. Lateral wall is the common site of urothelial carcinoma. The mean age for high-grade carcinomas was 61-70 years, and it was associated with higher grades and stages of the tumor. In high grade and low-grade carcinomas, males outnumbered females. A significant correlation observed between tumor grade and stage. A significant association was found between Her2/neu overexpression with the grade and size of the tumor. No association was found between Her2/neu expression and age, gender, stage, and invasion. Conclusion: It is concluded that identifying the expression of Her2/neu in urothelial carcinoma can help identify eligible candidates for targeted therapy