Prathvi Shetty

A Comparative Study on Fine Needle Aspiration Cytology versus Fine Needle Capillary Cytology in Thyroid Nodules

OBJECTIVES Fine needle aspiration cytology (FNAC/FNA) is the primary investigation for thyroid nodules. Fine needle capillary cytology (FNCC/FNC) is an alternative technique not commonly used, though it is easy to perform. Both the techniques have their own advantages and disadvantages. This study aims to compare these two cytological techniques for better specimen and cytological diagnosis. METHODS This prospective study was conducted on 50 patients attending the FR Muller Medical College Hospital from May 2006 to April 2008. The patients with thyroid nodules (diagnosed by palpation) were subjected to both the cytological techniques; FNA and FNC. The specimen and results were compared and then correlated with the final histopathological findings wherever surgical specimens were available (38 cases). RESULTS The mean age of the patients was 39.16 with a female predominance. The majority of cases were diagnosed to have nodular goiters. The FNC technique yielded 88% diagnostic superiority and adequate specimens compared to 94% by FNA. Sensitivity was 50% for FNC and 100% for FNA while specificity was 100% for both techniques; accuracy score was 97.4% for FNC and 100% for FNA in predicting malignancy. While sensitivity was 75% for FNC and 100% for FNA; specificity was 100% for both techniques, and accuracy score was 97.4% for FNC and 100% for FNA in the prediction of neoplasia. CONCLUSION The results indicated that there was no significant difference between the two techniques; if done in tandem can give better and accurate cytological diagnosis. In highly cellular lesions, in which abundant material was obtained, FNC was more likely to be diagnostically superior, but FNA can diagnose most of the lesions. In less cellular lesions, FNA is more likely to be diagnostically superior to FNC.

Human dirofilariasis: an emerging zoonosis in India.

Human dirofilariasis is an uncommon zoonotic infection having a widespread geographical distribution. World over 800 cases of Dirofilaria are on record with highest numbers from Italy, Sri Lanka and republics of the ex-Soviet Union. Dirofilaria repens belongs to the subgenus Nochtiella and is the most common species identified in India. Topographically, the orbital/periorbital regions are the most common regions involved by Dirofilaria. We present a brief review of cases from India including two received in our own institute. This review focuses on the epidemiology of the disease including its geographical distribution and the probable causation of the recent increase in its incidence in Indian subcontinent.

Double whammy - mediastinal and ovarian teratoma: a rare clinical co-existence.

Teratomas are germ cell tumours arising as the result of abnormal development of totipotential cells. They are commonly encountered in the gonads and occasionally found in mediastinum. We report a case of asymptomatic 28 years old lady with concomitant mature cystic teratoma in her mediastinum and left ovary which was diagnosed incidentally during health check up. This case is reported because of its rare and unusual coexistence.

Isolation and Characterization of an Unknown Chrysosporium sp. Producing Subcutaneous Mycosis in an Immunocompromised Patient

AbstractWe report a case of subcutaneous fungal abscess over the great toe caused by a keratinophilic fungus, an unknown Chrysosporium sp., in a 60-year-old diabetic female who was treated successfully with oral fluconazole. The fungus was isolated from aspirated pus, and septate hyphae were seen in fine needle aspiration cytology. Ovoid- to club-shaped hyaline one-celled conidia (aleuriconidia) with broad truncated bases were seen, and sequencing of ITS1-5.8S-ITS2 rDNA revealed belonging to the order Onygenales and most closely related to Chrysosporium spp. isolated from a fowl. Of the 65 species within the genus Chrysosporium, very few have been reported as pathogenic.

Incidence of gastric carcinoma in patients presenting with dyspepsia in tertiary care hospital

Context: Gastric carcinoma often present with nonspecific gastrointestinal symptoms like dyspepsia making its diagnosis difficult and its later detection in an advance stage. To reduce the mortality and morbidity early diagnosis of gastric carcinoma is of utmost importance. Aims: The aim was to detect gastric carcinoma in patients presenting with dyspepsia symptoms for upper gastrointestinal (UGI) endoscopy and to study the incidence of carcinoma stomach related to factors like age, alcohol and smoking. Design: Surveillance cross section study. Subjects and Methods: Data were collected in all clinically diagnosed cases of dyspepsia undergoing UGI endoscopy at Father Muller Medical College Hospital, with sample size of 119 patients. Multiple (6-8) biopsies from suspected lesions were taken and sent for histopathological examination. Statistical Analysis Used: Frequency, percentage, Chi-square test and Fischers exact test. Results: Of the 119 patients subjected to UGI endoscopy, 13 (10.9%) of them had gastric carcinoma. Mean age of the patient in the study was 49.76. Majority of the patients were males 58.82% (n - 70) and females were 41.17% (n - 49). Gastric carcinoma was predominantly seen in males - 76% and females - 24%. Alarm symptoms were found present in 53.84% with gastric carcinoma. Gastric carcinoma had strong association with smoking 38.46%, but not significant with alcohol consumption and showed peaking in incidence in the fifth and sixth decade. Conclusions: A high index of suspicion by clinicians and availability of endoscopic facilities may help detect early lesions, especially in elderly patients with alarm symptoms.