International Archives of Integrated Medicine

8-13

Authors: B. Vijayanirmala, T. Sundari Devi, Shahistha, P.V. Ramana

Background: The salivary glands, mainly parotids are the site of origin of a wide variety of neoplasms. At the same time, they are relatively uncommon and show racial and geographical variations. Majority (80%) are benign tumors, only about 20% are malignant. Histopathology of parotid neoplasms is most complex and diverse of any organ in the body. Also histopathology plays a major role in the diagnosis of these neoplasms with very few contribution using special stains, immunohistochemistry and cytogenetic studies. Aim: The aim of the present study was to analyze the relative incidence, clinical presentation and spectrum of neoplasms in the parotid glands with their micromorphology at Gandhi hospital, Secunderabad, which is a tertiary referral hospital in Telangana state. Material and methods: A retrospective and prospective study of all parotid gland tumors received in the department of pathology for histopathological examination at Gandhi hospital, Secunderabad during a period of 5 years, from January 2013 to January 2018 was done. The clinical data like age, sex, duration were recorded. Grossly representative bits from the tumors were processed, sections made, stained with routine Hematoxylin and Eosin and examined under microscope. Data of 48 cases recorded during the 5 years period was analyzed. Results: 48 cases were studied during the 5-year period. Of them 39 cases were benign neoplasms and 8 cases were malignant. Benign tumors were more common in the parotid gland compared to malignant tumors, the most common benign tumor being Pleomorphic adenoma. Mucoepidermoid carcinoma was the most common malignant tumor. Most of the benign tumors occurred in the 3rd and 4th decade while the malignant tumors were more common in the 6th decade. Conclusion: Pleomorphic adenoma is the most common benign tumor and Mucoepidermoid carcinoma is the most common malignant tumor.

19-27

Authors: Debashis Roy Burman, Sujit Kumar Dutta, Indranil Dhar

Though incidence of Colorectal carcinoma is relatively less in consideration of world wide data, Indian scenario differs in higher incidence of Grade 3 carcinoma with signet ring cell component. We tried to find association between intercellular adhesion and propagation of cancer cell in Adenocarcinoma of Colorectal region. E-cadherin (ECAD) is the strongest intercellular adhesion molecule of epithelial cells and Autocrine Motility Factor (AMFR) is known propagator of cancer cell. We studied simultaneous immunohistochemical expression of these two molecules in 92 already diagnosed cases that were treated surgically by Colectomy or Abdomino Pelvic Resection. Normal Colorectal mucosa reacted strongly with ECAD and weakly with AMFR. With increasing dedifferentiation of the tumor, reversal manifested- more aggressive grades showed varied expression in comparison to its less aggressive type. Gastric 3 adenocarcinoma show weak ECAD (83% vs. 35%) and more AMFR (93% vs. 35%) expression in comparison to Grade 1. Weak ECAD and strong AMFR was also associated with increase in depth of tumor invasion. As ECAD and AMFR is at least partially responsible for varying histologic grade and behavioral pattern of colorectal adenocarcinoma, simultaneous evaluation of both parameters is helpful to understand pathway of progression of such cancer cell.

32-39

Authors: V. Ramya, Dunnuthala Sreenivasulu Reddy, Shafath Ahmed

Background: Hypocalcemia occurs as a manifestation of nutritional deficiency of calcium and vitamin D. Deficiency of calcium in the diet has been identified as a leading cause of nutritional rickets. Infants less than 6 months are reliant on mothers for their daily calcium requirements. Calcium has a wide range of biological functions in both the ionized form as well as the bound complexes. It also plays an important role in skeletal mineralization. Aim of the study: To rule out the prevalence of hypocalcemia in the mothers of the infants and to establish if there was an association between the infant and maternal serum calcium. Materials and methods: Totally 50 children who were admitted in pediatric ward between Ages 1 Months to 6 months were assessed. A standard questionnaire was administered and venous blood samples collected from the mother-infant pairs. The samples were analyzed for calcium and albumin and corrected calcium levels calculated. Results: A total of 93 mother-infant pairs were screened. 94(78.3%) of these gave samples which were analyzed. The mean age of the infants sampled was 3.5 months. The mean age of the mothers was 27.2 years with a standard deviation of 5.8 years. 78 (83%) infants were born at term and 16 infants (17%) were born preterm. 58 of 93 infants (62.4%) were exclusively breastfeeding whereas 35 of 93 infants (37.6%) were breastfeeding but not exclusive. Prevalence of hypocalcemia was 34% in the infants with 95% CI of 29.4-45%. Prevalence of hypocalcemia in the mothers of the infants was 39.4% with a 95% CI of 29.8. There was no statistically significant association between hypocalcemia in the mother and infants. OR 1.4 (95% CI 0.6-3.4) and P= 0.447. Conclusion: There is a high prevalence of hypocalcemia in breastfeeding infants as well as in lactating women. However, there is no significant association between maternal and infant hypocalcemia. The recorded prevalence values .from the general population is quite high and were found to be due to dietary deficiency of both calcium and vitamin D. The values are much higher than those obtained during our study. The study population is ideal as it has taken into account the general population.

44-49

Authors: Farida Begum, P. Ravi Kumar

Introduction: Fine needle aspiration cytology (FNAC) has revolutionized the approach to diagnosis and management of breast and various other lesions. Its accuracy in many situations avoids any unnecessary surgical procedures. The aim of this study was to analyze and correlate the diagnosis of breast lesions on cytology with histopathology. Materials and methods: This prospective study was done at Government Medical College, Nizamabad, and Telangana State (TS) during June 2016 to May 2018 and total numbers of cases included were 200. A detail clinical and family history was taken before the procedure of FNAC and examination of both the breast was done. Results: The study included 200 breast masses/ cases, which were diagnosed on cytology. The age group included in this study was between 16 years and 75 years. Most of the cases in this study were in the age group 16- 30 years (91 cases) followed by 31- 45 years group (66 cases), followed by 46-60 years (34 cases) and least numbers of cases were noted in 61-75 years age group (09 cases). In this study, most common diagnosis was Fibroadenoma and least common diagnosis given on cytological examination was tubular Adenoma. Conclusion: FNAC is an important diagnostic adjunct in the management of patient with a breast lump. Recently FNAC popularity has grown many folds and has become a most valuable tool in the diagnosis of palpable breast masses owing to its distinct advantages of being sensitive, specific, expedient, economical and safe. Lack of local or general anesthesia makes the procedure more comfortable for the patient and the pathologist.

63-69

Authors: Sivabackiya C, Srinivasan B, Maignana Kumar, Sabari Sridhar OT, Kailash S, Shabeeba Kailash, Gopalakrishnan

Background: Depression is one of the commonest neuropsychiatric disorders in patients with diabetes mellitus (DM). Diabetes with depression is associated with a low quality of life (QoL). Complications in DM and depression still remain poorly identified and inadequately treated. But treatment of depression among DM patients is almost totally ignored and the QoL is poor. Materials and methods: A prospective observational study was conducted on 100 type 2 Diabetes mellitus patients diagnosed with clinical depression (ICD-10) at a tertiary care hospital. They were treated for depression along with DM medications and followed up till 6 months was assessed by WHO Quality Of Life (WHOQOL) – BREF scales. Results: There was a statistically significant improvement in overall WHO QOL scale from 5.96±1.23 at baseline to 6.71±1.15 at 6 months (P value < 0.001). Among various domain, the mean Physical health domain was 17.72±2.281 at baseline, which has improved to 25.56±3.367 at 6 months follow up and the mean Psychological domain score was 16.32±2.174 at baseline and has improved to 22.64±2.343 at 6 months follow up. Conclusion: QoL is a domain of major importance and it affected in patients with DM and depression. Treatment of depression in DM patients is almost ignored. In the current study, treating depression in DM patients enhanced the quality of life (P value < 0.001). Hence diagnosis and treatment of depression in these patients is particularly important in order to reduce complications and improve quality of life.

77-83

Authors: B. Lakshminarayana, Rammohan, G. Saisoumya, J. Tulasi, V. Srinivaskumar

Background: Tzanck smear named after Arnault Tzanck (1886-1954), to evaluate Cytopathology as a quick less invasive method for early diagnosis of bullous lesions. Aim: To determine the diagnostic value of Tzanck smear in vesiculobullous skin lesions, to evaluate the vesiculobullous lesions and correlating the diagnosis with Tzanck smears and histopathological findings and when required with Immmunoflourescence. Materials and methods: 565 patients clinically diagnosed as vesico-bullous skin lesions were included in the present study from July 2011 to July 2018 for a period of 7 years. Tzanck smear preparation and biopsy as well as immunoflouresence tests were done in all 565 patients. Results: Out of the 565 patients with vesiculo bullous lesions, 297 were males, and 268 were females. The concordant results between cytology and histopathology was observed in majority (92.7%) direct immunoflouresence test was done in some which also confirmed the diagnosis. Conclusion: The Tzanck smear test is an inexpensive, useful, and an easy diagnostic tool for vesiculo-bullous lesions of skin diseases and can be recommended as a bedside first line investigation.

89-92

Authors: Hardik Gandhi, Nehal Tiwari

Synchronous primary neoplasms are defined when two or more neoplasms take place concurrently in the same patient. Double synchronous primary gynaecological neoplasms are relatively uncommon and the incidence rate ranges from 0.6% to 5.4%. Synchronous malignancies of the ovary and the uterine cervix are rare situations in which the prognosis is established not only by clinical stage but also by the histological grade of the adenomatous component. Here we have presented the case of a 60 year old patient who presented for diffuse abdominal pain and weight loss that was diagnosed with synchronous cervical and ovarian carcinoma on histopathology. This case report of double synchronous primary neoplasm of the cervix and ovary is presented here because of its rarity.