Subhabrata Sengupta

Behavior disparities towards blood donation in Sikkim, India.

Background: The aim of the current research was to determine disparities in blood donation motives among the general mass of Sikkim. Aims: To identify the reasons for people donating and not donating blood voluntarily. Settings and Design: Population based cross-sectional study in Gangtok, East Sikkim. Materials and Methods: PARTICIPANTS: 300 adults by two-stage cluster sampling technique. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Correlates of attitudes towards blood donation. DATA COLLECTION PROCEDURE: The data collection tool used for the study was a pre-tested structured interview schedule by which the principal investigator collected the data using interview technique. Statistical Analysis Used: Percentages and ODDS ratio were used in this study. Results and Conclusions: Out of 300 respondents, overwhelming majority (78.7%) of the respondents in the present study felt that people donate blood to save a friend or a relative. On the contrary, minority respondents (46%) were ready to donate blood voluntarily. Only 12.7% of the respondents had ever donated blood while 87.3% had never donated. Among ever donors, gender wise men donors were found to be more; 89% were married, half were from the 30 to 39 years age group. As the per-capita income or level of education increased, so did the percent of blood donors.

Spectrum of head and neck cancer in children

Aim: To assess the incidence of different head and neck cancers in pediatric age group in a referral hospital. Methods: In this prospective study, children below the age of 12 years underwent a thorough clinical, ENT examination and the diagnosis was conformed histologically in all the cases. Results: Fifty-three were diagnosed to be suffering from different head and neck neoplasms among 21,216 children (0.25%). Male-to-female sex distribution was 1.78:1. The lymphomas were the most common (43.39%) followed by the rhabdomyosarcoma (20.75%) and the nasopharyngeal carcinoma (15.09%). Of the lymphomas, the non-Hodgkins lymphoma was predominant (26.41%). Other lesions were thyroid carcinomas and mucoepidermoid carcinoma of parotid. Conclusions: Malignancy should always be considered in the differential diagnosis of masses in the head and neck region in children.

Clinicopathological correlates of pediatric head and neck cancer.

BACKGROUND The spectrum of head and neck tumors in children continues to be the cause of diverse, diagnostically challenging issues. AIMS To demonstrate and compare the unique clinicopathological features in our study population and their correlations with the final histopathological diagnosis. METHODS Fifty-three children with head and neck cancer were examined thoroughly at the Otorhinolaryngology department in a tertiary care teaching hospital followed by histopathological studies. RESULTS Lymphomas were the most common malignant lesions seen followed by rhabdomyosarcomas, nasopharyngeal carcinomas, and others like thyroid carcinomas and eosinophilic granulomas. In the neck, the commonest cause of primary malignant disease was lymphoma; however, the most frequent lesion was reactive lymphadenitis. In the sinonasal region, the commonest malignancy was rhabdomyosarcoma, which often had extension to the orbit and the face. Recurrent epistaxis was found universally in the malignant cases of this region. In the facial region, disfiguring swelling with proptosis was mainly caused by rhabdomyosarcoma. The only case of tonsillar malignancy was due to non-Hodgkin lymphoma. The duration of disease was less than 1 year. CONCLUSION The most common manifestation of the malignant lesions in the pediatric age group was with a history of an enlarging, painless neck swelling. Still, an insignificant lump in the neck or recurrent bleeding from nose may be the manifestation of an underlying cancer.

Fine needle aspiration cytology as the primary diagnostic tool in thyroid enlargement

Background: In the preoperative decision-making of the thyroid swellings, fine needle aspiration cytology (FNAC) is becoming an ever more vital tool. Objectives: To compare the advantage of preoperative FNAC of thyroid swellings with postoperative histopathology to reach a consensus protocol as a simple procedure for diagnosis and optimal management of thyroid swellings. Materials and Methods: A prospective study of preoperative FNAC was carried out on 178 incidental thyroid swellings attending a tertiary care centre in Kishanganj, Bihar. Evidence-based surgical interventions were done, irrespective of FNAC findings and diagnosis was confirmed by histopathological examination (HPE) postoperatively in all the cases. Results: In the FNAC, preponderance of the cases (75.84%) was colloid goitre followed by granulomatous thyroiditis; follicular carcinoma was noted in 7.30 percent and anaplastic carcinoma in 3.37 percent of cases. Histopathological examination showed colloid goitre predominantly (76.97%), followed by follicular carcinoma (8.99%). The overall prevalence of malignancy was 11.24 percent diagnosed by HPE and 9.55 percent by FNAC. In our FNAC series sensitivity of was 90 percent while specificity was 100 percent; accuracy was 98.88 percent. Predictive value of a positive test and negative tests was 100 percent and 98.75 percent respectively. Conclusion: The study highlights that FNAC should be treated as a first-line diagnostic test for thyroid swellings to guide the management though this is not a substitute for HPE as a need to improve primary healthcare in India.

Correlates of voluntary blood donation among people in a hill capital in India

In an attempt to understand the problems and to improve voluntary blood donation at Gangtok, East Sikkim, this study was designed to assess the possible reasons for donating and not donating blood. Study Design: Population based cross-sectional study; Study Period: 01.01.2004 to 30.03.2004. (Three months activity); Setting: Gangtok, East Sikkim; Interventions: None; Study Population: 300 adults; Sampling Technique: Two-stage cluster sampling technique; Main Outcome Measures: socioeconomic and demographic variables of voluntary blood donation. Data Collection Procedure: Three hundred adults were selected from the adult population of Gangtok, East Sikkim. Then by interview technique the principal investigator Dr. Namgay Shenga collected the data using the pretested, close-ended structured schedule. In 300 adults, the study showed a significant association between attitude towards voluntary blood donation and education. There was a significant association between knowledge about blood donation and attitude towards voluntary blood donation, along with moral obligation, charity and duty parameters. Variables that were not significantly associated with voluntary blood donation were age, sex, religion, marital status, community status, occupation and per-capita monthly income. Several possible reasons have been put forward for not donating blood voluntarily, varying from problems of time, procedure and physical health. The finding of the study indicated that education gives birth to an ocean of difference between the positive attitudes of the general mass towards voluntary blood donation, in true life practice. The results suggested that reinforced steps should be taken to educate the population about voluntary blood donation. Key words: Attitude, variables, voluntary blood donation

Benign Calcified Thyroid Cyst With Skin Sinus Formation

Objectives: To present a rare case of calcified thyroid cyst with discharging neck sinus and its probable explanation.

Fourth branchial pouch sinus - an unusually late initial presentation.

ObjectiveHere we present an unusual case of a male patient with 4th branchial pouch sinus with an initial presentation of pseudothyroiditis at an unusually late age of 20 years.MethodCase report and a review of the world literature concerning 4th branchial pouch sinus is presented.ResultThe patient was diagnosed by radiology and endoscopy and treated surgically. Histopathology revealed chronic inflammatory changes, which pointed towards recurrent sub clinical low-grade inflammations over the years keeping the condition occult till 20 years of age.ConclusionAccording to available literature it almost always presents in the first decade of life when it might be misdiagnosed. However our report shows it may also exist with sub clinical inflammations or infections and present at a much later stage in life, when the possibility of such a sinus shouldn’t be ruled out on the basis of lack of history of recurrent neck inflammations.

An attempt to define the type of biopsy in a sinonasal lesion showing bony erosion.

ObjectivesTo present a case of sino-nasal destructive mass initially diagnosed as an inflammatory lesion following punch biopsy from the lesion however the post surgical histopathology was diagnostic of Grade 2 angiocentric immunoproliferative lesion (AIL). The reasons for the initial misdiagnosis are analyzed.Materials and methodsA 76-year-old male patient presenting with progressive bilateral nasal obstruction for 1 year. Repeated punch biopsies from the mass were suggestive of an inflammatory lesion.ResultThe patient underwent surgical exenteration of the mass and the final histopathology report suggested AIL Grade 2. The patient was thereafter treated with chemotherapy and radiotherapy.ConclusionInitial superficial punch biopsies lead to incorrect diagnosis leading to an unnecessary surgical exenteration. The explanations for the initial misdiagnosis are given below and appropriate diagnostic protocols, mode and depth of biopsy are suggested based on the case study.

Total Reconstruction of Lower Eyelid in a Post-traumatic Patient Using Modified Fricke’s Cheek Flap

Eyelids are very complex structure, reconstruction of which is a challenge to surgeons. Reconstruction of eyelids may be required in a variety of conditions like congenital anomalies, trauma, or postsurgical excision in malignant lesions involving the eyelids. There are numerous ways to reconstruct the eyelids; the best procedure depends on both the skill of the surgeon and the condition of the patient. Fricke′ lateral temporal based flap was first described in 1829 for reconstruction of the eyelids and lateral canthal region. This flap had inherent problems regarding cosmetic appearance of the eyebrows. The modified Fricke′s flap based on the cheek has the advantage of avoiding such complications. It is very easy and rapid outpatient department (OPD) based procedure with acceptable cosmetic and functional result. It can be done by all ear, nose, and throat (ENT) and head and neck surgeons without any reconstructive training. In this article we are presenting a case of total reconstruction of lower eyelid using the modified Fricke′s cheek flap.

Persistent Deciduous Molar as an Etiology for a Maxillary Sinus Mucocele

Mucoceles are accumulations of trapped mucus, forming cystic expansile lesions. Maxillary sinus mucoceles are rare amongst paranasal sinus mucoceles, usually being a late sequel of Caldwell-Luc surgery. We present a case of a maxillary sinus mucocele due to a persistent carious deciduous molar in a middle aged patient, reported to highlight its unusual etiology.