Invasive Papillary Breast Carcinoma

We present the case of a 55-year-old postmenopausal female who presented with complaints of a gradually increasing painless subareolar mass in the left breast of 4 months' duration. Left-sided modified radical mastectomy was performed and the specimen was histopathologically diagnosed as invasive papillary carcinoma. Immunohistochemistry confirmed this diagnosis. All 8 excised axillary lymph nodes were negative for malignant cells. Postoperative chemotherapy was given and for the past 6 months, the patient has maintained a regular follow-up on an outpatient basis. She does not have any evidence of either local or distant recurrence of tumour metastases

Acute spontaneous gastric perforation in neonates: A report of three cases

Gastric perforation in neonates is a rare, serious and life-threatening problem. The precise aetiology is obscure in most cases. By virtue of its high mortality rate, it requires prompt recognition and surgical intervention. We report three cases of neonatal gastric perforation managed by early resuscitation and primary repair

Metaplastic Carcinoma with Predominant Chondrosarcoma of the Right Breast

A 45-year-old female presented with complaint of a lump in the right breast for the last 6 months. Excisional biopsy had been performed outside our institution, which was suggestive of a pure mammary chondrosarcoma. Modified radical mastectomy of the right breast was performed and histopathology was suggestive of a pure mammary chondrosarcoma of the right breast. One axillary lymph node was positive for metastasis, the rest of the lymph nodes were free of metastasis. Immunohistochemistry was suggestive of a metaplastic carcinoma with a predominant chondrosarcoma in the right breast. Postoperative radiotherapy was given to the patient with a further plan of chemotherapy

Duodenal stenosis in a child

We present a case of incomplete duodenal obstruction having a delayed presentation, making diagnosis and early intervention more challenging. Failure of recanalization of the duodenal lumen during the eighth to tenth week of gestation, results in duodenal atresia. Incomplete recanalization can lead to duodenal stenosis or the presence of a duodenal web. In theabsence of other serious anomalies or prematurity, the overall survival for duodenal stenosis or atresia is nearly 100%

Cutaneous lymphangiosarcoma following chronic lymphedema of filarial origin

We are reporting a case of 36 yr old female with chronic filarial lymphedema of both legs. Subsequently she developed lymphangiosarcoma of her left leg which was confirmed histologically and on immunohistochemistry. Only three more cases of lymphagiosarcoma occurring in patients with filarial lymphedema are reviewed from available literature

Hepatic angiosarcoma arising in an adult mesenchymal hamartoma

Embryonal (undifferentiated) sarcomas arising in mesenchymal hamartoma are on record but cases of hepatic angiosarcoma (AS) arising in mesenchymal hamartoma (MH) of the liver are extremely rare. We report one such case in a 20-year-old male patient. He presented with a lump in the right hypochondriac region and pain of two years duration with rapid increase in size since two months. Ultrasonography (USG) revealed a well circumscribed mass on the undersurface of the right lobe of liver suggestive of hemangioma. The patient underwent resection of the mass. Histopathology revealed AS with areas of MH

Histopathological spectrum of lesions of tonsil- A 2 year experience from tertiary care hospital of Maharashtra, India

Background: Palatine tonsils are paired masses of lymphoid tissue which act as immunologic barrier against the entry of pathogenic agents into the respiratory and digestive tracts. Despite their protective function, tonsils are prone to infection. Tonsillitis is a common disease especially among the children. Chronic tonsillitis is a disease with repeated attacks of acute tonsillitis or a subclinic form of a resistant or poorly treated infection. Aim: To study histopathology of various lesions of tonsil. Material and Methods: We studied histopathology of 211 cases representing surgical samples from 115 patients [Tonsillectomy- 104 patients (Unilateral-08, Bilateral-96) and tonsillar biopsy in 11 patients]. Representative bits were taken from formalin fixed tonsillectomy specimens whereas biopsies were submitted entirely. Routine hematoxylin and eosin staining was done. Results: Amongst 211 cases, histopathological examination in 190 cases showed tonsillitis. The other lesions were cartilagenous choristoma in six patients, epidermal inclusion cyst in three cases and reactive lymphoid hyperplasia in one case. One case of inflammatory myofibroblastic tumour was observed. The malignancies were observed in ten cases- squamous cell carcinoma in nine cases and Non-Hodgkin lymphoma in one case

A comparative clinical study of dexmedetomidine versus placebo to attenuate hemodynamic response to endotracheal intubation in patients undergoing off pump coronary arterial bypass grafting

Context: Direct laryngoscopy and endotracheal intubation are the most stressful periods during induction of anesthesia. These events can lead to hypertension, tachycardia, arrhythmias and myocardial ischaemia. Aims: (1) To evaluate the haemodynamic response to laryngoscopy and endotracheal intubation with a single preinduction infusion of dexmedetomidine (DEX) 1 μg/kg over a 10 min period, (2) To assess the incidence of side effects, that is, rebound hypertension, bradycardia and hypotension etc., associated with the use of DEX. Settings and Design: This was a prospective, double-blind, parallel group randomized clinical trial of DEX (1 μg/kg) before anesthetic induction to study the attenuation of hemodynamic response to endotracheal intubation in 60 adult patients undergoing elective off pump coronary arterial bypass grafting. Materials and Methods: Patients were randomly allocated to receive either DEX (DEX group, n = 30) or 0.9% normal saline (PLA group, n = 30). Hemodynamic variables were recorded at baseline (Abbreviated as TB), after completion of drug infusion (Abbreviated as TC), 3 min after induction and immediately before intubation (T0), at the 1 st (T1), 3 rd (T3) and 5 th (T5) min after intubation. Statistical Analysis Used: The data are presented as mean ± standard deviation. Demographic data were analysed by Student′s t-test between the two groups. Analysis of variance for repeated measures f-test was used to analyze changes over time. A P < 0.05 was considered as significant and P < 0.01 or 0.001 was considered as highly significant. Results: All the hemodynamic variables were comparable in both groups at baseline. Heart rate values were statistically significantly lower in the DEX group at TC and highly statistically significantly lower at T1, T3 and T5 values. Systolic blood pressure values were statistically significantly lower in the DEX group at T0 and highly statistically significantly lower at T1, T3 and T5. Diastolic blood pressure and mean blood pressure values and systolic pulmonary artery pressure values were highly statistically significantly lower in the DEX group at T1, T3 and T5. Diastolic pulmonary artery pressure were statistically significantly lower in the DEX group at TC, T0 and T1 and highly statistically significantly lower at T3. Mean pulmonary artery pressure were statistically significantly lower in the DEX group at T0 and highly statistically significantly lower at TC, T1 and T3. Arterial oxygen saturation was statistically significantly lower in the DEX group at TC. There was no case of hypotension or bradycardia in our case series. Conclusions: Dexmedetomeditine (1 μg/kg) attenuates hemodynamic response to laryngoscopy and intubation in elective surgery for off pump coronary artery bypass grafting