Revisiting the Era of Intestinal Tuberculosis: A Case Presenting As Small Bowel Obstruction With Classical Imaging and Histopathological Appearances

The incidence of tuberculosis (TB) worldwide is still significantly high, with India contributing a high global TB burden. This case study features a 49-year-old male who had complaints of pain and abdominal distention for one and a half months. An erect abdominal radiograph showed features suggesting small bowel obstruction. Contrast-enhanced computed tomography (CT) of the abdomen was done. It showed multiple strictures involving the distal jejunum and ileum, causing small bowel obstruction. There was mesenteric and retroperitoneal lymphadenopathy with central necrosis and ascites. The patient was operated on for a small bowel obstruction. The resected intestine showed four strictures, tiny nodules on the serosal surface, and many enlarged lymph nodes. Representative tissue from these areas showed the typical picture of multiple caseating granulomas and fibrosis. Ziehl-Neelsen (ZN) staining highlighted the acid-fast bacilli (AFB). The suspicion index for intestinal tuberculosis (ITB) should be kept high while evaluating patients with intestinal obstruction presenting in endemic areas and high-risk populations, such as HIV-infected, undernourished, immunocompromised, and those with diabetes, smoking, and alcohol addiction.

Histopathological Analysis of Hysterectomy Specimens in a Tertiary Care Centre: A Retrospective Study

Introduction The uterus is a crucial reproductive organ that is susceptible to the development of several non-neoplastic and neoplastic diseases in women, greatly increasing morbidity and mortality. Although there are various therapeutic options, hysterectomy is still a popular treatment option throughout the world. Abnormal uterine bleeding, pelvic pain, pelvic inflammatory disease (PID), prolapse of the uterus, adenomyosis, endometriosis, fibroids, gynecological malignancies, and obstetric problems that require hysterectomy, all samples must be examined histopathologically. Histopathological examination of the specimens obtained after hysterectomy is important for both diagnosis and treatment. The current work aimed to identify the various clinical indications, analyze the clinicopathological correlation in hysterectomy specimens, and analyze the patterns of lesions in hysterectomy specimens. Materials and methods This study was conducted in the Department of Pathology at the Datta Meghe Medical College, Wanadongari, Nagpur, from February 2022 to January 2023. All types of hysterectomy specimens received during this year were examined, and the tissues were processed and stained with H&E. Histopathological examination was performed, and various lesions in the hysterectomy specimens were examined. The study included all forms of hysterectomy, including abdominal, vaginal, laparoscopic, and total abdominal hysterectomy. Results An analysis of 110 cases of hysterectomy revealed that abdominal hysterectomy was the type of hysterectomy in 79 (71.82%) cases, with a maximum age range of 35 to 45 years (42.72%). The proliferative phase endometrium was the most common endometrial pathology, accounting for 43 (39.09%) cases, followed by the atrophic endometrium in 35 (31.82%) cases. Leiomyoma was the most prevalent myometrial lesion, accounting for 52 (47.28%) cases, followed by adenomyosis, accounting for 23 (20.91%) cases. Chronic cervicitis was the most common incidental finding in the hysterectomy samples, accounting for 85 (77.28%) cases. Follicular cysts, representing 22 (20%) cases, were the most common ovarian lesions, followed by serous cystadenoma in seven (6.37%) cases. Two cases of malignant tumors were noted: one case of endometrial carcinoma and one case of mucinous cystadenocarcinoma of the ovary. In most cases, ranging from 70% to 100%, the final histopathological diagnosis supports the preoperative clinical diagnosis. Conclusion Hysterectomy is the most common major gynecological surgery performed under elective conditions. Although histological studies and clinical diagnoses are closely correlated, several lesions, including chronic cervicitis and adenomyosis, were discovered incidentally. Therefore, every hysterectomy specimen must undergo a thorough histological investigation, even if it appears superficially normal, to confirm the diagnosis and improve postoperative care.

A Histopathological Study of the Spectrum of Skin Lesions in a Tertiary Care Hospital: A Retrospective Study

Background The skin is the largest organ of the body with many different functions. All age groups are affected by skin diseases, which are widespread in underdeveloped nations. From a straightforward vesicular non-neoplastic lesion to a catastrophic neoplastic lesion, skin disorders exhibit a wide variety of geographic patterns. To make an accurate diagnosis, identify etiological agents, and assist a dermatologist or clinician in selecting the best course of treatment, a skin biopsy must undergo histopathological analysis. The present study was conducted to investigate the histological diagnosis of skin lesions, establish the distribution by age and sex, identify the most prevalent skin lesions, and further subclassify the most prevalent condition. Methodology A retrospective, cross-sectional study was conducted in the Department of Pathology at Datta Meghe Medical College, Wanadongari, Nagpur over the course of a year. Hematoxylin and eosin were used to stain a total of 50 skin biopsy samples, with special stain when necessary, and then examined. Results The study involved a total of 50 patients, with 39 (78%) males and 11 (22%) females. With 16 (32%) cases in the 21-30-year age group, the early age group preponderance was recorded. Overall, 16 (32%) cases had microbial diseases, followed by eight (16%) cases with non-infectious vesicobullous diseases and vesicopustular disease, and five (10%) cases with non-infectious erythematous papular and squamous disease. In 12 (24%) cases, leprosy was the most prevalent microbiological disease. In five (10%) cases, pemphigus vulgaris was the most prevalent vesicobullous condition. Psoriasis, which was present in two (4%) cases, was the most common non-infectious erythematous papular and squamous disease. Squamous cell carcinoma, which was seen in seven (14%) cases, was the most prevalent neoplastic lesion. Conclusions In skin lesions, males outnumbered females. Patients in the younger age groups were most commonly involved. Leprosy and squamous cell carcinoma were, respectively, the most prevalent non-neoplastic and neoplastic skin lesions in our study.

A Review of Amelioration of Awareness About Blood Donation Through Various Effective and Practical Strategies

Blood donations play a crucial role in medical care; however, the global shortage of donors remains and has a serious impact on medical interventions. The challenges involved include the lack of public awareness of the importance of blood donation, the lack of understanding of the process and eligibility criteria for blood donation, and the lack of comprehensive strategies aimed at raising awareness and participation among potential donors, with particular emphasis on the involvement of young people. It is essential to recognize that blood donation delivers significant benefits to donors and recipients, improves overall health, and ultimately saves lives. Various initiatives, such as blood donation camps, dynamic social media campaigns, and strategic networking of medical professionals, have proved effective in promoting blood donation. In particular, in the event of an emergency, the availability of sufficient blood supplies is increasingly essential, underlining the urgent need to establish and maintain a sustainable blood donor network. An in-depth understanding of the motivation and conservation of donors is crucial in this context, as it is known that demographic factors significantly impact the frequency of blood donation. In addition, ethical and legal considerations require careful attention, highlighting the essential role of obtaining informed consent and ensuring the confidentiality of donors throughout the process. As we look ahead to the evolving landscape, it presents a series of formidable challenges. These challenges encompass the critical necessity to broaden and diversify our donor base, thereby extending and varying our sources of financial support for specific initiatives, organizations, or projects. Moreover, we must proactively harness the opportunities presented by emerging technologies and commit ourselves to closing the information gaps within the existing public knowledge sphere. In summary, the review emphasizes the paramount importance of ongoing efforts to strengthen and enrich donors' engagement through customized strategies and educational outreach.

An Overview of Preventive Strategies and the Role of Various Organizations in Combating Antimicrobial Resistance

The rise of antimicrobial resistance (AMR) is a major global public health threat due to excessive and inappropriate use of antibiotics and is responsible for prolonged illness, longer hospital stays, and economic burden to society. This article aims to review the factors, role of antimicrobial stewardship, preventive strategies, and role of various organizations in combating AMR. Three major factors of AMR are inappropriate and excessive utilization of antibiotics, nonadherence to infection control measures, and the emergence of pathogens that are resistant to multiple drugs. Antimicrobial stewardship initiatives play a vital role in promoting judicious and targeted utilization of antimicrobials, thereby safeguarding their efficacy and mitigating the emergence of resistance. Implementing such programs optimizes patient outcomes by ensuring that individuals receive the most suitable therapeutic interventions. International organizations have a vital role to play in addressing AMR by promoting the responsible use of antimicrobials, developing new drugs, and improving surveillance systems. As AMR's impact grows, it is critical to take a collaborative and interdisciplinary approach to mitigate its consequences effectively.

Xanthogranulomatous Oophoritis: A Rare Case Report

Xanthogranulomatous oophoritis is a rare, chronic and non-neoplastic condition in which a heavy foamy histiocyte inflammatory infiltrate admixed with neutrophils, plasma cells, multinucleated giant cells, fibroblasts and foci of necrosis causing extensive tissue damage and organ destruction. The gallbladder and kidney are just two examples of the different organs that exhibit histological changes resembling xanthogranulomatous alteration. The present case involved a 40-year-old female who presented with a tuboovarian mass and was ultimately diagnosed with xanthogranulomatous oophritis, despite initial clinicoradiological suspicions for malignancy. Xanthogranulomatous oophritis is a significant entity because, clinically and radiographically, it resembles tumours of the ovary and hinges on a careful histopathological analysis to establish a diagnosis.

A Rare Case of Uterine Myxoid Leiomyosarcoma

A 49-year-old female patient was referred to a tertiary care hospital with a history of postmenopausal bleeding and abdominal pain that had persisted for the last two months. An abdominal examination revealed a huge mass that had been present for 12 weeks. A fibroid uterus was suggested by USG. A biopsy was done and sent to histopathology which revealed myxoid leiomyoma. Subsequently, the patient underwent total abdominal hysterectomy without bilateral salpingo-oophorectomy. Histopathological examination confirmed the diagnosis of myxoid leiomyosarcoma (MLMS) of the uterus.

Well Differentiated Villoglandular Papillary Adenocarcinoma of the Cervix: A Rare Case Report

The Villoglandular papillary adenocarcinoma (VGA) is a variant of adenocarcinoma of the cervix. It occurs in young women having a favorable prognosis. Pathologically, VGA poses a diagnostic challenge. Here we present a rare case of a middle-aged female patient complaining of bleeding per vagina since1year. Histopathological examination reported it as a well-differentiated villoglandular adenocarcinoma of the cervix. This tumor as a separate entity should be recognised, distinguished from other variants of adenocarcinomas. Because of its good behaviour and favourable prognosis usually itsallow conservative treatment.

Establishment of Correlation of Ki-67 Proliferative Index Expression in the Peritumoral Tissue with Tumor Mass in ER (Estrogen Receptor) Positive Breast Carcinoma

Background: Breast carcinoma is the second most frequently occurring malignant tumor. It usually arises in a multistep fashion from intermediary lesions to invasive cancer. Identifying such predominantly occurring lesions adjacent to malignancy and studying of Proliferative Ki-67 index and (ER) status in such lesions and substantiate their possible identity as a premalignant lesion. The study tries to establish the lesions which have the potential for progression to overt malignancy, thereby indicating early identification and appropriate treatment. Aim: To establish a correlation in the expression of Ki-67 proliferative index in the peritumoral tissue with tumor mass of ER-positive breast carcinomas. Objectives: 1.To study the expression of ER in breast tumor mass. 2. To study expression of Ki-67 proliferative index in breast tumor mass and peritumoral tissue. 3. To assess the expression of Ki-67 proliferative index in breast tumor mass and peritumoral tissue. Study design: Observational prospective study. Materials and Methods: 32 mastectomy specimens of diagnosed cases of breast carcinoma sent to the Histopathology Section are studied. Gross features are described and the histopathological section stained by (H & E) stain and immunohistochemistry using monoclonal antibody to (ER) and proliferation-associated antigen (Ki-67) are studied. Statistics: Chi-square test, Spearman’s rank-order correlation coefficient, and software used in the analysis were SPSS 22.0 version and Graph Pad Prism 6.0 version and p<0.05 is considered as the level of significance. Results: In this study out of 32 ER-positive cases, 24 showed positivity for Ki-67 in tumor mass and 22 cases showed high Ki-67 in peritumoral tissue. Maximum lesions were proliferative lesions with atypia like ADH and DCIS. Conclusion: Ki-67 is an accurate nuclear proliferative marker to assess cell proliferation status. In breast carcinoma adjacent peritumoral lesions show a high proliferative index which suggests a link and a trail of generation of premalignant lesions converting to invasive carcinoma. Proliferative lesions with and without atypia, moderate epithelioid, atypical ductal hyperplasia, and DCIS more or else equals IDC for Ki-67 proliferative index. Such cases should be regularly followed up for progression of these lesions to malignancy.

Impact of COVID-19 Pandemic on the Number of Research and Publications-A Review

COVID-19 is having a major effect not only on healthcare delivery systems but also on the science and research sector. The pandemic of COVID-19 immediately closed universities as well as colleges all over the world, amid government orders to adopt social distance, which could help to flatten the transmission curve and decrease the total mortality from the pandemic. Fundamental scientific studies have been especially difficult hit as a result of statewide lockdown restrictions, whilst clinical researchers have encountered similar difficulties as a result of the cessation of medical care and a sudden return to full-time clinical tasks. The number of publications on COVID-19 has rapidly and dramatically increased. This emphasizes the importance of collaborating with other medical research facilities in addition to intra-institute cooperation and collaboration. One method to modify the picture of clinical research is to incorporate additional innovation into the study's design.

Exploring the Pathogenic Role of Stress in Inflammatory Bowel Disease and its Management

Every organism is constantly adapting to changes happening in the environment.  This adaptation helps in maintaining homeostasis.  All organisms must adapt at molecular, cellular, physiological, and behavioral levels.  Amongst many factors which act as a threat to homeostasis, one of them is stress.  The organism has to bring about both physiological and behavioral changes.  The various researches in recent years have shown that adverse life events, along with chronic stress, and depression leads to increased likelihood of relapse in patients with quiescent IBD. Many studies of experimental stress in animal models of colitis support this. Till date, the therapeutic successes of stress reduction therapies have not been explored largely.  This is also due to methodological difficulties in going ahead with such studies.  This paper tries to explore the recent researches in enhancing our understanding of the pathogenic role played by psychological stress in inflammatory bowel disease and focuses our attention on the need for controlled studies on the curative prospective of stress reduction therapies for IBD.

Glycaemic Regulation with Zinc Combination in Type 2 Diabetes Mellitus

Introduction: Zn supplementation improved glutathione peroxidase enzyme activity and decreased malondialdehyde and nitric oxide levels in diabetic rats, revealing Zn's defensive effect against oxidative stress in type 2 diabetes. The investigators have discovered that consuming Zn increased liver function and protected pancreatic tissue from damage caused by diabetes. Since Zn also prevents chronic hyperglycemia, it helps to minimize oxidative stress caused by type 2 diabetes. Diabetes mellitus (DM) is a global health problem that affects more than 3 million people worldwide (16% of population). Chronic hyperglycemia causes oxidative stress in diabetic patients by the development of free radicals (oxidants) and lowering the antioxidant protection mechanism. Aim: Glycaemic Regulation with Zinc Combination in Type 2 Diabetes Mellitus. Materials and Methods: Faculty of Medicine and Diabetic Opd, Datta Meghe Mediсаl Соllege and Shаlinitаi Meghe Hоsрitаl аnd Reseаrсh Сenter, Nаgрur in соllаbоrаtion with Dаttа Meghe Institute оf Mediсаl Sсienсes Deemed to be University, Sаwаngi, Wаrdhа, Mаhаrаshtrа. Results: The mean Zn level was 12.213±2.342in all participants and 9.121±1.782 in the control group, whereas it was significantly low (9.121±1.782) in the diabetic group, and there was statistically significant difference in Zn levels between the controls and the diabetic group (P < 0.001).FBS, HbA1C, serum Zinc mean effects between control and patients showed statistically significant differences in type 2 diabetes mellitus (P <0.0001). Conclusion: Our findings show that people with diabetes have lower levels of Zn than healthy people. The cause and effect of the association between very low levels of Zn and the progression of diabetes, or diabetes that causes Zn deficiency, is still unknown. Low levels of Zn are associated with poor glycemic control, and poor glycemic control is a good indication of Zn deficiency, as there was a negative association between serum Zn and FBS and HBA1C. If diabetic patients have low glycemic regulation, a long history of diabetes, obesity, or are over the age of 50, we look to assess their levels in Zn so that Zn alternative treatment can begin to release oxidative stress in this high-risk group.

Study of Serum Pancreatic Amylase and Lipase Enzyme in Patients with Type 2 Diabetes

Introduction: Diabetes mellitus (DM) is a metabolic disorder that is greatly exacerbated by a complete lack of insulin or insulin resistance. The pancreas is a multicellular organ, the exocrine half accounting for 84% of its volume and the endocrine half accounting for only 2%. Since these two parts of the world have a close relationship with structure and function, the disruption of one can affect the other. Hemoglobin A1C (HbA1c) represents the glycemic status of the patient over the previous three months. Evidence suggests that pancreatic endocrine hormones, especially insulin, affect pancreatic exocrine function. Insulin has a detrimental effect on exocrine acinar cells. Exocrine acinar cells attached to it contain a variety of enzymes, including amylase and lipase, which help digest certain food particles. Aim: Study of serum pancreatic amylase and lipase enzyme in patients with type 2 diabetes. Materials and Methods: This cross sectional study was done in the Department of Biochemistry, dept. of medicine and Diabetic OPD, Datta Meghe Medical College and Shalinitai Meghe Hospital and Research Centre, Nagpur. For this study 40 diagnosed type 2 diabetic patients of both sexes with age ranging 35-60 years were selected as study group. Results: FBS, HbA1C, serum pancreatic amylase, and lipase mean effects between control and patients showed statistically significant differences in type 2 diabetes mellitus (P <0.0001). Conclusion: We concluded that pancreatic amylase and lipase function are impaired in type 2 patients with diabetes, and this observation is particularly important in type 2 diabetes. It has been suggested that the analysis of pancreatic enzymes in diabetic patients may be a useful parameter in determining the progression of the disease.

Effect of lifestyle and dietary factors in the development of brain tumors

Introduction:

A brain tumor occurs when neurons are mutated and thus abnormal cells are formed. Glioma and meningioma are the two most common types, comprising approximately 75% of all brain tumors. The incidence rate of all primary brain tumors was 15.80/100,000 person-years in females and 14.33/100,000 person-years in males. An association of higher risk of brain tumors in adults with cured meat and fruit/vegetable consumption, the primary source of dietary N-nitroso compounds, is seen. Cigarette smoking is a major source of chemical carcinogens. The present study aimed at determining the effects of lifestyle and dietary habits in the development of brain tumor.

Methods:

The study aimed at the assessment of various dietary factors, lifestyle, and occupational and personal habits in patients diagnosed with brain tumor in a rural tertiary health-care hospital, using a structured questionnaire and statistical analysis.

Results:

It was observed that – (1) people with stressful, sedentary lifestyle and wrong diet and those addicted to alcohol consumption and the habit of cigarette smoking have higher risk of brain tumors; (2) males are more prone to brain tumors; and (3) among subtypes, majority had glioblastoma and the least had meningioma and opdivoglioblastoma and according to location, majority had cerebellopontine angle tumor and the least had left thalamic glioma and multicentric glioma. Primary care to preoperative brain tumor patients should be given in terms of preventing exposure to radiations, avoiding cigarette smoking, providing healthy diet, and avoiding chronic stress and environmental pollution and postoperative patients should be taken care including avoiding infections by maintaining proper hygiene and providing healthy diet for their speedy recovery.

Conclusion:

People with stressful life condition, wrong diet, and sedentary lifestyle and those addicted to alcohol, with the habit of cigarette smoking, have higher risk of brain tumors. Males are more prone to brain tumors.

Role of Immunophenotypes in Carcinoma Breast

Background

Nottingham's modification of Bloom-Richardson histopathological grading system (NGS) for carcinoma breast is a time-tested prognostic indicator; however, of lately, breast cancer has been evaluated through molecular techniques, particularly assessing the gene expression profiling and establishing molecular or immunophenotypes. The present-day utility of NGS needs to be reassessed with the modern predictive markers, this may help refine breast cancer classification specifically to help improve the treatment protocol.

Objective

The objective was to compare breast cancer immunophenotypes with prognostic factors such as age (based on menstrual status), tumor size, lymph node (LN) status, also to compare the NGS grade with the molecular immunphenotypes of breast cancer.

Materials and Methods

The present work was carried out in the Histopathology and Immunohistochemistry section of Department of Pathology, of a central Indian medical college and rural hospital from January 2013 to July 2016. It was a prospective analytical study. A tota1 of 114 female patients presenting in the outpatient department of surgery with lump in breast were included in the present study. All patients underwent modified radical mastectomy for tumor resection. Tumor masses and LNs were subjected to routine hematoxylin and eosin staining as well as immunohistochemistry then examined by a senior pathologist. Comparisons were made between molecular immunophenotypes with patient age, tumor size, and LN status, further NGS grade of breast cancer was compared with immunophenotypes.

Results

The study found that the molecular immunophenotypes when compared with clinical prognostic parameters, i.e; age (based on menstrual status of female), LN involvement in patients of breast carcinoma showed inconsequential correlation, the tumor size showed significant correlation. However, when histopathological grades were compared with molecular immunophenotypes, a significant correlation was seen.

Conclusion

NGS grade being an excellent predictive prognostic tool should be continued for assessing the grades in breast cancer patients. The molecular markers correlate with the histopathological grading and indirectly aid the oncologist in assessing the aggressiveness, these immunophenotypes are not helpful as suitable prognostic tools. As the molecular phenotypes definitely indicate the hormonal receptor status in breast cancer patients, they become mandatory in guiding oncologists for planning the treatment strategy and protocol.

Isolated pulmonary mucormycosis presenting as cavitary lesion in an immunocompetent adult: A rare case report

Cavitary lung lesions have a specific array of differential diagnosis. Among rare causes is mucormycosis that should not be overlooked. A high index of suspicion is necessary for a correct diagnosis and aggressive management. It usually occurs in immunosupressed patients. It is a life-threatening, rapidly progressive, and angioinvasive fungal infection. We present a case of pulmonary mucormycosis presenting as a cavity in an immunocompetent middle aged male.