Atherosclerosis of Coronary Arteries as Predisposing Factor in Myocardial Infarction: An Autopsy Study.

The incidence of coronary heart disease has markedly increased in India over the past few years. Ischemic heart disease, the largest cause of morbidity and mortality in the developed and developing countries today is overwhelmingly contributed by atherosclerosis. The study highlights the impact of atherosclerotic lesions in the population of Rajkot district. We studied atherosclerotic lesions in coronary arteries in cases subjected to autopsy in last 4 years, to grade and to evaluate the atheromatous plaques; and to assess the cases of myocardial infarction amongst them. The study comprises dissected specimens of heart in total 360 cases subjected for autopsy. The vessels were examined for the presence of atherosclerotic lesions which were graded according to American Heart Association and examined for evidence of myocardial infarction. The study comprises the cases in age group between 20 to 80 years. Commonest type of atherosclerosis seen was grade-4. Left Anterior Descending Coronary was most commonly involved artery. Myocardial infarction was the cause of death in 35 cases (9.72%) The data obtained may form a baseline for the forthcoming studies

Seroprevalence of HIV, HBV, HCV and Syphilis in Blood Donors in Saurashtra Region of Gujarat: Declining Trends Over a Period of 3½ Years

Background: Transfusion of blood and blood products is a life saving intervention and benefits innumerous patients worldwide. At the same time it could be an ominous mode of infection transmission to recipients. In 15 percent of total patients infected with HIV, blood transfusion has been the responsible mechanism of transmission. Methods: In this study, we aimed to access the prevalence and trend of HIV, HBV, HCV and Syphilis over the last 3½ years (January 2008 to June 2011) among the blood donors who came to donate blood at Blood Bank, P.D.U. Medical College & Hospital, Rajkot as well as in various blood donation camps organized by the same blood bank. Results: From the total of 30,178 blood donors, 711 (2.35%) had serological evidence of infection with at least one pathogen, either of HIV, HBV, HCV or Syphilis. These included 131 (0.43%) with HIV, 293 (0.97%) with HBV, 124 (0.41%) with HCV and 94 (0.31%) with Syphilis. Moreover, significantly declining trends of HIV, HBV and Syphilis was observed over the study period. Conclusion: A substantial percentage of blood donors harbor HIV, HBV, HCV and Syphilis infections. Strict selection of blood donors and comprehensive screening of donors’ blood using standard methods are highly recommended to ensure the safety of blood for recipient

Role of Fine Needle Aspiration Cytology in Salivary Gland Pathology and its Histopathological Correlation: A Two Year Prospective Study in Western India.

Background and objectives: Salivary gland lesions account for 2-6.5% of all the neoplasms of the head and neck. Fine needle aspiration cytology (FNAC) is being increasingly used in the diagnosis of salivary gland lesions. The objective of this study was to evaluate the diagnostic accuracy and the sensitivity and specificity of FNAC in various salivary gland lesions in correlation with their histopathology, which helps in the appropriate therapeutic management. Methods: A total of 120 FNACs were done on salivary gland tumours from July 2010 to June 2012 in the Department of Pathology, P.D.U. Government Medical College, Rajkot (Gujarat, India). Formalin fixed (10%), surgically resected specimens were received, they were processed and slides were prepared for histopathological diagnosis. The stained cytological and histopathological slides were studied, analyzed and correlated. Results: The cytomorphological features were studied and analyzed and the following lesions were observed: Pleomorphic adenoma (88), Warthin’s tumour (2), Cystic lesion (4), Mucoepidermoid carcinoma (6), Acinic cell carcinoma (2), Primary lymphoma (2), Carcinoma EX pleomorphic adenoma(4), metastatic malignancy deposits (2), benign parotid tumour (8) and malignant tumour (unspecified)(2). A histopathological correlation was available in 78 cases. Out of these, 71 cases were true positive, 1 was false positive, 2 were false negative and 4 were true negative. Interpretation and conclusion: The overall sensitivity, specificity and the diagnostic accuracy were 97%, 80% and 92% respectively. Hence, the appropriate therapeutic management could be planned earlier. This study documents that FNAC of the salivary gland tumours is accurate, simple, rapid, inexpensive, well tolerated and harmless for the patient

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AIM: The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery. METHODS: This was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin. RESULTS: Overall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P < 0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90-1.55, P = 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69-1.27, P = 0.672). Longer delays were not associated with poorer outcomes. CONCLUSION: One in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease