Online ISSN: 2515-8260

Keywords : Biopsy


A Randomized Control Study of Autologous Platelet Rich Plasma and Normal Saline Dressing In Management of Pressure Ulcer In Spinal Cord Injury Patients

Jharwal Rajesh K., Prakash Om, Goswami Mithlesh, Shruti Bhargav

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 1, Pages 888-900

Objectives: Pressure ulcers (PrUs) are the common complications following SCI and there are various options available for PrUs management. In this study the author compared the effect of platelet rich plasma gel dressing of pressure ulcer with normal saline dressing in SCI patients.
Design: This randomized comparative study was conducted in PMR department of SMS medical college.
Method: Fifty eight SCI patients with PrUs, were randomized into PRP gel treatment group (n=29) and normal saline treatment group (n=29) equally. In PRP group, pressure ulcer dressing was done with autologous PRP gel twice weekly for 5 weeks and in NS group, ulcer dressing was done with 9% normal saline on the daily basis for 5 weeks.  Evaluation of PrU healing was done by ulcer staging, measuring wound surface area, Pressure Ulcer Scale for Healing (PUSH), histopathological features of ulcer. 
Results: The mean age of the patients was 37.79±9.90 and 35.14±9.05 years in PRP and NS group respectively. Statistically significant reduction in the stages of ulcer was observed only in PRP gel dressing group only (p<0.001 S) after 5 weeks. The wound area, wound volume and PUSH score of PrU decreased significantly in both groups but on compression among the groups significant decrease in ulcer surface area, and PUSH score was observed in PRP group as compare to NS group. Significant improvement in histopathological of the ulcer was observed after 5 weeks both in PRP (P value= 0.001) and NS (P value= 0.001) group but on comparison among the groups, ulcer treated with PRP gel showed more significant improvement as compare to NS group (P value= 0.001)
Conclusion:  PRP gel dressing is a better alternative as compare to normal saline dressings in PrU healing in SCI patients. 

Elastography plus MRI image-based TRUS biopsy versus extended core biopsy for prostate cancer detection and diagnosis

Dr. Kothapalli Jitender Reddy, Dr. Peddi Raju

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 2161-2165

Aim: The comparison of diagnostic accuracy for prostate cancer detection between elastography plus MRI image based TRUS biopsy versus extended core biopsy.
Methods: This Comparative study was carried out in the Department of Radio Diagnosis, RVM Institute of Medical Sciences & Research Centre for the period of 9 months. 50 Patients with age group of 35 to 75 years, with Serum PSA greater than 4.0 ng/dl were included in this study. All patient underwent TRUS biopsy based on the MRI and elastography images, followed by TRUS guided extended core biopsy (13 cores) done by radiologist randomly. The rate of prostate cancer detection was compared between the two types of biopsies. Group A consisted of cores from MRI plus Elastography guided TRUS biopsy and Group B were cores from extended core biopsy.
Results: The mean age of patients was 64.71. The mean serum PSA for patients was 14.70 ng/dl (6.5 to 40.7). 20 cases presented with AUR and patients were catheterized. The mean size of prostate was 51.07 mg (29 to 84 mg). The mean size of prostate and serum PSA of patients with carcinoma prostate were 14.1 mg and 18.4ng/dl respectively. Prostatic carcinoma detection with extended core biopsy was 42% (n=21). The incidence of prostate cancer detection by MRI plus Elastrography guided TRUS is 41 cases (82%). MRI plus Elastrography guided TRUS biopsy method is considered to be statistically significant as the p value is 0.0369 (since p<0.05) as obtained by fishers exact test. In our study majority of the patients had adenomatous hyperplasia (n=30,60%) as the HPE diagnosis, followed by adenocarcinoma (n==20,40%). The sensitivity of mpMRI plus Elastography image based TRUS biopsy method in detecting Prostate cancer was 84.5% and specificity was 82%. The positive predictive value of this method was found to be 80%.
Conclusion: Even while mpMRI and Elastography are each useful alone for detecting prostate cancer, using both diagnostic methods together for TRUS guided enhances the likelihood of cancer diagnosis over extended core biopsy.

CLINICAL STUDY OF SYMPTOMATOLOGY, MANAGEMENT AND OUTCOME IN PATIENTS WITH SINO-NASAL MASSES

Dr. Ratna Kumara Ambati, Dr.Bomma Vijay Kumar, Dr. Haritha Surasura, Dr.PolepeddiSarvaniPratyusha, Dr.PotlacheruvuNagaraju, Dr. DharmagaddaRanganath Swamy

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 921-927

Background: Presumptive diagnosis of sinonasal masses can be achieved with the aid of clinical presentation and imaging techniques but histopathological examination remains the mainstay of final definitive diagnosis. The present study was undertaken at a tertiary level hospital to analyse clinical presentations, management and histopathological patterns of Sinonasal masses.
Material and Methods: Present study was single-center, Prospective Non-Randomised study, conducted in patients of all age groups, attending the ENT OPD with masses in sinonasal cavity, diagnosed after complete clinical examination (including endoscopic evaluation), willing to participate.
Results: 40 cases presenting with Sino Nasal cavity masses at OPD were selected as per the inclusion criteria. In our study, most of the patients were in the age group of 31-40 years, with 25% of the study population, followed by patients in the second and third decade with 20% each. There were 24 (60%) males and 16 (40%) females in the study. Overall, non-neoplastic lesions were found to be commonest in occurrence with ethmoid polyp (32.5%) having the highest incidence, followed by antrochoanal polyps (20%), Rhinosporidiosis (2.5%) and Rhinoscleroma (2.5%). Among the benign masses, inverted papilloma was most common (12.5%) followed by hemangioma (10%), ossifying fibroma and osteoma (2.5% each). Carcinoma of the maxilla presented in 3 patients (7.5%) and was the most common malignancy followed by carcinoma of the nasal cavity (5%) and malignant melanoma (2.5%). For non-neoplastic lesions (n=23), majority of the masses were excised either by open surgery or endoscopically with base cauterization (n=21). One case of rhinoscleroma involved medical management along with surgical excision. Medical management was done with antibiotic ciprofloxacin for 6 weeks. Endoscopic surgery resulted in faster recovery and cosmesis.
Conclusion: Clinical diagnosis is often difficult and have to be relied on histopathological examination of biopsy specimen and may require repeated biopsies.

STUDY OF BIOPSY OF PROSTATIC LESIONS

Dr. Bairi Laxminarayana, Dr. V. Srinivas Kumar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 2743-2755

Prostatic pathology is deceptively simple. Benign prostatic Hyperplasia, prostatitis and prostatic carcinoma are the three principal conditions involving the prostate accounting for more than 95% of lesions. Though the morphologic diagnosis of prostatic lesions, separating benign from malignant is relatively straight forward, there are several benign proliferations and normal histo-anatomic structures of prostate which mimic malignancy and their awareness is essential to avoid diagnostic pit falls.

Clinicopathological study of abnormal uterine bleeding in perimenopausal women attending a tertiary care district hospital

Dr. Gayathri BN, Dr. Mallikarjun A Pattanashetti, Dr. Somashekar HK

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 1759-1764

Background: Abnormal Uterine Bleeding (AUB) is defined as any bleeding that does not correspond with the frequency, duration or amount of blood flow of a normal menstrual cycle. Endometrial biopsy is important in perimenopausal age group women (40-55 years) to rule out endometrial pathology and malignancy. This study was done to assess Clinicopathological aspects and different histopathological patterns related to Abnormal Uterine Bleeding as no studies have been done in this region of Karnataka, India.
Methods: This is a cross sectional study done from 2019 to 2020. All female patients in the perimenopausal age group presenting with symptoms of AUB were included. Patients less than 40 years of age and endometrial tissues inadequate for opinion on microscopy were excluded. Relevant history and clinical data regarding pattern and duration of abnormal uterine bleeding was retrieved. Endometrial biopsy tissues was processed and stained by H&E. The diagnosis was done and results analysed.
Results: Present study included 94 biopsies of which 6 biopsies were inadequate for opinion. The most common age group presenting with AUB was 40-45 years (53.40%). The most common symptom was menorrhagia. The commonest histopathological pattern among all the perimenopausal age was disordered proliferative endometrium followed by simple hyperplasia without atypia. Other patterns were proliferative endometrium, secretory endometrium, simple hyperplasia, carcinomas etc. The commonest etiology of AUB was Dysfunctional Uterine Bleeding (46.59%) followed by Endometrial hyperplasias. (23.86%)
Conclusions: Correlation with clinical history, radiological investigations along with endometrial biopsy establishes etiology and diagnosis for patients with AUB.

Prostate cancer Detection and Diagnosis: Elastographyplus MRI image-based TRUS biopsy versus extended core biopsy

Dr. Sidhant Lochav, Dr.Varsha Gangta, Dr. Aditya Kaul,Dr. Bhavika Jakhu, Dr. Venus Garg, Dr. Govind Khatri

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 1119-1123

Aim: The comparison of diagnostic accuracy for prostate cancer detection between
elastography plus MRI image based TRUS biopsy versus extended core biopsy.
Methods: This Comparative study was carried out in the Department of Radio Diagnosis,
Maharishi Markandeshwar Medical College and Hospital, Kumarhatti, Solan, Himachal
Pradesh, India for the period of 6 months. 50 Patients with age group of 35 to 75 years, with
Serum PSA greater than 4.0 ng/dl were included in this study. All patient underwent TRUS
biopsy based on the MRI and elastography images, followed by TRUS guided extended core
biopsy (13 cores) done by radiologist randomly. The rate of prostate cancer detection was
compared between the two types of biopsies. Group A consisted of cores from MRI plus
Elastographyguided TRUS biopsy and Group B were cores from extended core biopsy.
Results: The mean age of patients was 63.71. The mean serum PSA for patients was 14.77
ng/dl (6.5 to 40.7). 20 cases presented with AUR and patients were catheterized. The mean
size of prostate in all 50 patients was 51.77 mg (29 to 84 mg). The mean size of prostate and
serum PSA of patients with carcinoma prostate were 14.9 mg and 18 ng/dl respectively.
Prostatic carcinoma detection with extended core biopsy was 42% (n=21). The incidence of
prostate cancer detection by MRI plus Elastography guided TRUS is 41 cases (82%). MRI
plus Elastography guided TRUS biopsy method is considered to be statistically significant as
the p value is 0.0369(since p < 0.05) as obtained by fishers exact test. In our study majority of
the patients had adenomatous hyperplasia (n=30,60%) as the HPE diagnosis, followed by
adenocarcinoma (n==20,40%). The sensitivity of mpMRI plus Elastography image based
TRUS biopsy method in detecting Prostate cancer was 84.5% and specificity was 82%. The
positive predictive value of this method was found to be 80%.
Conclusion: Although mpMRI and Elastography are individually useful for detection of
prostate malignancy, combining both the diagnostic tools for TRUS guided increases the rate
of cancer detection than that of extended core biopsy.

PROFILE OF ANALYSIS OF COLONIC BIOPSIES IN CHRONIC COLITIS IN TERTIARY CARE HOSPITAL OF CENTRAL INDIA

Dr.Pradip Butale, Dr. Syed Waseem, Dr. BalawantKove

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 1149-1158

Background: Chronic colitis, regardless of type, is defined histologically by chronic
inflammation, mainly plasmacytosis, in the lamina propria. Specific diagnosis of chronic
colitides in biopsies can be challenging for practicing pathologists. The present research was
undertaken to study complete clinico-pathology of chronic colitis, pathological pattern and
spectrum of colitis, also study correlation of colonoscopy and histopathology of these
lesions.Method:This study was a retrospective and prospective analysis of 187 cases
ofhistopathologicallyproven colitis on colonic biopsies over a period of 5 years from June 2015
to May 2020. Results:Majority of specimen were rectal biopsies (57.22%) followed by mapping
biopsies (34.22%). Of 85 cases where both colonoscopy and histopathology diagnosis was
available, 61 (71.76%) colonoscopy diagnosis were consistent with histopathology. Among 187
cases, 107 were inflammatory bowel disease (57.22%), they were further sub classified as
ulcerative colitis (UC) (96.26%), Crohn’s (0.93%) and indeterminate colitis (2.8%). Cases of
UC had features of basal plasmacytosis (97.19%), crypt distortion (93.45%), crypt loss
(70.09%) and goblet cell depletion.48cases diagnosed as non-specific colitis. Infectious colitis
comprised 8.56% of total colitis cases. It included tuberculosis 4 (2.14%), CMV colitis
2(1.07%) and 5.35% cases of acute self-limiting colitis. 5(2.67%) cases were diagnosed as
lymphocytic colitis and 2 cases showed focal active colitis. Also, found single case of
eosinophilic colitis and radiation proctitis each.Conclusion:Good clinico-pathological
correlation helps to reduce number of cases diagnosed as non-specific colitis. To improve the
detection rate of microscopic colitis, it is important to take multiple biopsies from normal
looking colon on colonoscopy.

EMERGENCY OSTEOPERFORATION IN POST-OPERATIVE SPONDYLOGIS

Pardaev Saidkasim Narkulovich; Narkulov Maksudzhon Saidkasimovich; Meliboev Salim Tashtanovich; Khasanov Aziz Batirovich

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 9, Pages 2304-2310

Infectious spondylitis accounts for 4 - 8% among suppurative diseases of the musculoskeletal system, and its frequency is estimated at 1.0 - 2.5 cases per 100,000 population. A special form of spondylodiscitis - acute post-manipulation spondylodiscitis - is observed in one of 40-50 patients who underwent discectomy from the posterior approach for a herniated disc, which, given that this operation is the most frequent in neurosurgery, allows one to assess the total volume of the problem.

Evaluation of Spectrum of Neck Masses on MDCT and Tissue Diagnosis Correlation

Shaina Kaur; Anisha Galhotra; Arnav Galhotra; Ritu Dhawan; Kamini Gupta; Parambir Sandhu; Kavita Saggar

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 11, Pages 8316-8327

INTRODUCTION: The neck is a part of the body that has many vital structures in a relatively small region with complex anatomy. Various pathologies of the neck may present as neck swellings. The mass may be first noticed by the patient, other individual or by the physician as an incidental finding during physical examination. With the improvement of CT imaging techniques, shorter examination time, higher resolution imaging, Multidetector CT is particularly useful in evaluation of neck masses. AIM OF STUDY: To assess the role of MDCT in neck masses for characterization of nature of lesion (benign or malignant) and organ of origin and to Correlate with tissue diagnosis wherever possible. MATERIALS AND METHODS: Patients presenting with clinical suspicion of neck masses and referred for MDCT neck to the Department of Radio-diagnosis and Imaging, DMCH, Ludhiana were included in this study. RESULTS: 18.9% patients were in 31-40 years age group. Mean age for malignant lesions was 58.3 years. Most common space involved was visceral space (48.9%) and the most common diagnosis was benign thyroid nodule(s) (30%). Many of malignant lesions showed ill-defined margins (68.18%), necrosis (62.5%), heterogeneous enhancement (68.2%), bony infiltration (20.8%), obliteration of fat planes (8.3%), metastasis (45.8%), involvement of adjacent neck spaces (37.5%), vascular involvement in form of internal jugular vein thrombosis (8.3%) of cases. In diagnosing malignant lesions, CT had a sensitivity of 95.83%, specificity of 96.30%, positive predictive value of 92.00%, negative predictive value of 98.11% and accuracy of 96.15%. CONCLUSION: MDCT has high accuracy for characterization of a lesion as benign or malignant. It provides the best possible contrast of soft tissue (with the choice of appropriate delay, contrast agent volume, flow rate and scanning time), visualization of vascular structures, extent of lesion, bone and airway details, thus helps in making diagnosis and deciding further course of management.

Study of nontuberculous mycobacterial diseases diagnosed by rapid immunochromatotography method

Jeppu udayalaxmi; Ganesh Arjun

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 10, Pages 1622-1630

Background: Most laboratories do not have facilities for identification of mycobacteria to species level. BD MGIT TBc immunochromatographic strip differentiates mycobacteria grown in liquid media as MTC or NTM. In the present study we clinically correlate NTM identified by above method. Methods: Culture was done by BD BACTEC TMMGIT 960. All positive cultures were subjected to a BD MGIT TBc immunochromatographic strip method for differentiating MTC and NTM. Results: Of the 29 cases of suspected NTM there was a single case of UTI, a case of right frontal lobe abscess, a case of synovitis, a case of post hernioplasty infected mesh and 25 patients were having respiratory symptoms. All patients responded well to antibiotic therapy which included ATT, fluoroquinolones, cephalosporins, azithromycin, clarithromycin singly or in combination. Conclusions: Diagnosis of NTM done with BD MGIT TBc immunochromatographic card test was found to useful in the absence of a definitive species identification.