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Abiramalatha T, Ramaswamy VV, Bandyopadhyay T, Somanath SH, Shaik NB, Kallem VR, Pullattayil AK, Kaushal M. Adjuvant therapy in neonatal sepsis to prevent mortality - A systematic review and network meta-analysis. J Neonatal Perinatal Med 2022; 15:699-719. [PMID: 36189501 DOI: 10.3233/npm-221025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Despite appropriate antibiotic therapy, the risk of mortality in neonatal sepsis still remains high. We conducted a systematic review to comprehensively evaluate different adjuvant therapies in neonatal sepsis in a network meta-analysis. METHODS We included randomized controlled trials (RCTs) and quasi-RCTs that evaluated adjuvant therapies in neonatal sepsis. Neonates of all gestational and postnatal ages, who were diagnosed with sepsis based on blood culture or sepsis screen were included. We searched MEDLINE, CENTRAL, EMBASE and CINAHL until 12th April 2021 and reference lists. Data extraction and risk of bias assessment were performed in duplicate. A network meta-analysis with bayesian random-effects model was used for data synthesis. Certainty of evidence (CoE) was assessed using GRADE. RESULTS We included 45 studies involving 6,566 neonates. Moderate CoE showed IVIG [Relative Risk (RR); 95% Credible Interval (CrI): 1.00; (0.67-1.53)] as an adjunctive therapy probably does not reduce all-cause mortality before discharge, compared to standard care. Melatonin [0.12 (0-0.08)] and granulocyte transfusion [0.39 (0.19-0.76)] may reduce mortality before discharge, but CoE is very low. The evidence is also very uncertain regarding other adjunctive therapies to reduce mortality before discharge. Pentoxifylline may decrease the duration of hospital stay [Mean difference; 95% CrI: -7.48 days (-14.50-0.37)], but CoE is very low. CONCLUSION Given the biological plausibility for possible efficacy of these adjuvant therapies and that the CoE from the available trials is very low to low except for IVIG, we need large adequately powered RCTs to evaluate these therapies in sepsis in neonates.
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Affiliation(s)
- T Abiramalatha
- Associate Professor of Neonatology, KMCH Institute of Health Sciences and Research, Coimbatore, Tamil Nadu, India
| | - V V Ramaswamy
- Consultant Neonatologist, Ankura Hospital for Women and Children, Hyderabad, India
| | - T Bandyopadhyay
- Departmentof Neonatology, Dr. Ram Manohar Lohia Hospital & Post Graduate Institute of Medical Education and Research, New Delhi, India
| | - S H Somanath
- Department of Neonatology, All India Institute of Medical Sciences, Mangalagiri, India
| | - N B Shaik
- Consultant Neonatologist, Ankura Hospital for Women and Children, Hyderabad, India
| | - V R Kallem
- Consultant Neonatologist, Paramitha Children's Hospital, Hyderabad, India
| | - A K Pullattayil
- Health Sciences Librarian, Queen's University, Kingston, Canada
| | - M Kaushal
- Consultant Neonatologist and Head of Department, Emirates Specialty Hospital, DHCC, U.A.E
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2
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Singh A, Phulware RH, Ahuja A, Gupta A, Kaushal M. Pleomorphic Adenoma with Extensive Squamous and Adipocytic Metaplasia Mimicking as Low Grade Mucoepidermoid Carcinoma on FNAC. Indian J Otolaryngol Head Neck Surg 2022; 74:2132-2135. [PMID: 36452717 PMCID: PMC9702417 DOI: 10.1007/s12070-020-02039-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 08/04/2020] [Indexed: 11/30/2022] Open
Abstract
Pleomorphic adenoma (PA) is the most common salivary gland tumor, accounting for 54-76% of all salivary gland neoplasms. Extensive squamous metaplasia in PA can be mistaken for malignancy, including low grade mucoepidermoid carcinoma and squamous cell carcinoma. Here, we present an unusual case of PA with extensive squamous metaplasia and keratin cyst formations in a minor salivary gland, and discuss its microscopic features, including the immunohistochemical characteristics, and differential diagnosis of this uncommon presentation.
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Affiliation(s)
- Anu Singh
- Department of Pathology, ABVIMS, PGIMER, RML Hospital, New Delhi, India
| | | | - Arvind Ahuja
- Department of Pathology, ABVIMS, PGIMER, RML Hospital, New Delhi, India
| | - Ankur Gupta
- Department of Otorhinolaryngology, ABVIMS, PGIMER, RML Hospital, New Delhi, India
| | - Manju Kaushal
- Department of Cytopathology, ABVIMS, PGIMER, RML Hospital, New Delhi, India
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3
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Sahu P, Jain S, Kaushal M. Kimura’s disease: A short study of cytomorphologic features with its differential diagnosis and review of literature. Cytojournal 2022; 19:50. [PMID: 36128469 PMCID: PMC9479607 DOI: 10.25259/cytojournal_77_2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 12/20/2021] [Indexed: 11/04/2022] Open
Abstract
Kimura’s disease (KD) is a chronic inflammatory disorder of unknown etiology, endemic in Asia. The typical clinical manifestations include a triad of painless unilateral cervical lymphadenopathy or subcutaneous masses predominantly in the head-and-neck region, blood and tissue eosinophilia, and elevated serum immunoglobulin (Ig) E levels. Many conditions including benign and malignant may mimic KD clinically. This study reports cytologic features of seven cases of KD which were studied and correlated with histology, Ig profile, and peripheral blood examination. KD shows a good response to medical treatment; hence, fine-needle aspiration cytology in conjunction with other laboratory findings lowers the need for additional biopsy procedures for early diagnosis as well as diagnosis of recurrent lesions.
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Affiliation(s)
- Priya Sahu
- Department of Pathology, ABVIMS, and Dr. Ram Manohar Lohia Hospital, New Delhi, India,
| | - Swasti Jain
- Department of Pathology, ABVIMS, and Dr. Ram Manohar Lohia Hospital, New Delhi, India,
| | - Manju Kaushal
- Department of Pathology, ABVIMS, and Dr. Ram Manohar Lohia Hospital, New Delhi, India,
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4
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Aden D, Phulware RH, Kaushal M, Ahuja A. Cytomorphology of myxoid liposarcoma of thigh. Diagn Cytopathol 2022; 50:491-494. [PMID: 35950693 DOI: 10.1002/dc.25031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 06/17/2022] [Accepted: 07/26/2022] [Indexed: 11/08/2022]
Affiliation(s)
- Durre Aden
- Department of Pathology, Atal Bihari Vajpayee Institute of Medical Sciences (ABVIMS), Formerly PGIMER, RML Hospital, New Delhi, India
| | - Ravi Hari Phulware
- Department of Pathology & Laboratory Medicine, All India Institute of Medical Sciences (AIIMS), Rishikesh, India
| | - Manju Kaushal
- Department of Cytopathology, Atal Bihari Vajpayee Institute of Medical Sciences (ABVIMS), Formerly PGIMER, RML Hospital, New Delhi, India
| | - Arvind Ahuja
- Department of Pathology, Atal Bihari Vajpayee Institute of Medical Sciences (ABVIMS), Formerly PGIMER, RML Hospital, New Delhi, India
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5
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Gupta D, Kaushal M, Jain S. Multiple tuberous xanthomas diagnosed on fine-needle aspiration cytology – Report of a rare case. Cytojournal 2022; 19:37. [PMID: 35928525 PMCID: PMC9345104 DOI: 10.25259/cytojournal_86_2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 07/29/2021] [Indexed: 11/17/2022] Open
Abstract
Xanthomas are papulonodular skin lesions present in lipoprotein metabolism disorders, which result in cholesterol deposits in subcutaneous tissue, tendons, ligaments, periosteum, etc. A 28-year-old male presented with multiple soft-tissue swellings, prominently over joints. Fine-needle aspiration (FNA) from multiple sites had similar appearance with foamy histocytes and giant cells. We describe an unusual case of tendinous and tuberous xanthoma diagnosed by cytology. Acquaintance with FNA cytology findings in xanthomas can help to avoid the need of surgical biopsy, as xanthomas can regress on medical therapy alone.
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Affiliation(s)
- Deepika Gupta
- Department of Pathology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. RML Hospital, New Delhi, India,
| | - Manju Kaushal
- Department of Pathology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. RML Hospital, New Delhi, India,
| | - Swasti Jain
- Department of Pathology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. RML Hospital, New Delhi, India,
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6
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Kaushal M, Shukla A, Mahajan S. P-209 Management of insulinoma, changing trends in developing world. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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7
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Gupta D, Kaushal M, Jain S. Epithelioid cell granulomas in urine cytology smears: A diagnostic approach. Cytojournal 2022; 19:34. [PMID: 35673699 PMCID: PMC9168401 DOI: 10.25259/cytojournal_82_2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 08/01/2021] [Indexed: 11/04/2022] Open
Affiliation(s)
- Deepika Gupta
- Department of Pathology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India,
| | - Manju Kaushal
- Department of Pathology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India,
| | - Swasti Jain
- Department of Pathology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India,
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8
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Behera P, Jain S, Kaushal M. Aspiration cytology of Facial Nerve Schwannoma of Parotid Gland: a rare diagnosis. Cytopathology 2022; 33:618-621. [PMID: 35385173 DOI: 10.1111/cyt.13125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/30/2022] [Accepted: 03/31/2022] [Indexed: 11/30/2022]
Affiliation(s)
| | - Swasti Jain
- Dept. of Pathology, ABVIMS, Dr RML Hospital, New Delhi, India
| | - Manju Kaushal
- Dept. of Pathology, ABVIMS, Dr RML Hospital, New Delhi, India
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9
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Jain S, Kaushal M, Bhardwaj M. A case of neck swelling with an unusual presentation. Cytojournal 2022; 19:2. [PMID: 35541028 PMCID: PMC9079315 DOI: 10.25259/cytojournal_73_2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 01/20/2021] [Indexed: 11/04/2022] Open
Affiliation(s)
- Swasti Jain
- Department of Pathology, ABVIMS and Dr. RML Hospital, Baba Kharak Singh Marg, New Delhi, India,
| | - Manju Kaushal
- Department of Pathology, ABVIMS and Dr. RML Hospital, Baba Kharak Singh Marg, New Delhi, India,
| | - Minakshi Bhardwaj
- Department of Pathology, ABVIMS and Dr. RML Hospital, Baba Kharak Singh Marg, New Delhi, India,
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10
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Kaushal M, Sasidharan K, Kaushal A, Augustine P, Alex M. Increasing the exclusive breastfeeding rate in a private hospital in UAE through quality improvement initiatives. J Neonatal Perinatal Med 2022; 15:179-186. [PMID: 34120921 DOI: 10.3233/npm-210703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Mother's milk is the best, and ideal method for infant feeding. We found that this practice was not being followed in our hospital. A survey was conducted in the unit with regards to breastfeeding practices which revealed that most babies who were discharged from our nursery were on formula supplements. Our goal was to improve established breastfeeding rates in the unit by increasing the number of full-term healthy babies who were discharged on exclusive Breastfeeding. METHOD A project team was formed, and data were collected through direct observations and direct interviews with postnatal mothers. Exclusive Breastfeeding at discharge was defined as a baby being fully on breastfeed with no additional formula supplements for at least 12 hours prior to discharge. The primary outcome was to increase the percentage of babies being discharged on exclusive Breastfeeding. We used the FOCUS PDCA model to measure improvements and 8 PDCA cycles of 4 weeks duration were implemented to test the changes. RESULTS The interventions we put in place led to a considerable nine times overall improvement in the established breastfeeding rates. Among all the interventions, the most promising results were observed during the PDCA cycles involving staff education, the introduction of antenatal classes for mothers, skin to skin contact and rooming in. CONCLUSION Breastfeeding rates in the private sector with nursery services can be improved by reinforcing breastfeeding education for mothers in addition to training the maternal care staff, empowering them to promote and assist in breastfeeding.
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Singh P, Kaushal M, Marwah S. Subcutaneous nodule in the chest - Uncommon presentation of a common disease. Cytojournal 2021; 18:22. [PMID: 34754321 PMCID: PMC8571266 DOI: 10.25259/cytojournal_29_2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 11/22/2020] [Indexed: 11/17/2022] Open
Affiliation(s)
- Preeti Singh
- Department of Pathology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Manju Kaushal
- Department of Pathology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Sadhna Marwah
- Department of Pathology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India
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12
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Jain S, Kaushal M, Choudhary A, Bhardwaj M. Comparative evaluation of squash smear and frozen section in the intraoperative diagnosis of central nervous system tumours. Cytopathology 2021; 33:107-113. [PMID: 34390057 DOI: 10.1111/cyt.13049] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 07/27/2021] [Accepted: 08/09/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND The squash smear technique was introduced into intra-operative neurosurgical diagnosis as early as 1930. It is becoming increasingly popular in the diagnosis of central nervous system (CNS) lesions, and is fairly accurate even with a small sample. The current study assesses the accuracy and utility of the squash smear and frozen section (FS) techniques in intraoperative consultations. Correlations with histopathological diagnoses are presented. AIMS To compare two intra-operative diagnostic techniques-squash smear cytology and FS examination-in the context of central nervous system tumours. MATERIALS AND METHODS A total of 53 cases of CNS tumours were included in the study, and all were subjected to squash smear examination. FS examinations were conducted for 39 of these samples. The results of the two techniques were compared and correlated with histopathological diagnoses. The observed results were then analysed using SPSS software. RESULTS The most common primary CNS tumours were gliomas and meningiomas (28.3% each). The sensitivity, specificity, positive predictive value and negative predictive value for squash cytology were 86.67%, 87.5%, 81.25% and 91.3%, and for FS were 91.67%, 93.10%, 91.67%, 93.10%, respectively, with a corresponding comparative P-value of 0.56 (insignificant). Cytological diagnosis showed complete correlation with histopathological diagnosis in 39 cases (73.58%), partial correlation in eight cases (15.1%) and no correlation in six cases (11.32%). FS diagnosis showed complete correlation in 29 cases (74.35%), partial correlation in eight cases (20.5%) and no correlation in two cases (5.1%). CONCLUSION Squash smear is a rapid, self-sufficient and cost-effective method for the intraoperative diagnosis of CNS tumours. The squash smear and FS techniques are complementary procedures that assist the pathologist in reaching a diagnosis.
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Affiliation(s)
- Swasti Jain
- Department of Pathology, Atal Bihari Vajpayee Institute of Medical Sciences, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Manju Kaushal
- Department of Pathology, Atal Bihari Vajpayee Institute of Medical Sciences, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Ajay Choudhary
- Department of Neurosurgery, Atal Bihari Vajpayee Institute of Medical Sciences, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Minakshi Bhardwaj
- Department of Pathology, Atal Bihari Vajpayee Institute of Medical Sciences, Dr. Ram Manohar Lohia Hospital, New Delhi, India
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13
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Jain S, Kaushal M, Ahuja A, Kumar V. Parietal swelling in an old female: A diagnostic conundrum. Cytojournal 2021; 18:11. [PMID: 34221100 PMCID: PMC8248008 DOI: 10.25259/cytojournal_35_2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 07/02/2020] [Indexed: 11/23/2022] Open
Affiliation(s)
- Swasti Jain
- Department of Pathology, ABVIMS and Dr. RML Hospital, New Delhi, India
| | - Manju Kaushal
- Department of Pathology, ABVIMS and Dr. RML Hospital, New Delhi, India
| | - Arvind Ahuja
- Department of Pathology, ABVIMS and Dr. RML Hospital, New Delhi, India
| | - Vijay Kumar
- Department of Pathology, ABVIMS and Dr. RML Hospital, New Delhi, India
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14
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Bharati P, Deepak D, Kaushal M, Gupta P. Diagnostic utility of rapid on-site evaluation of endobronchial ultrasound-guided transbronchial needle aspiration samples: A study in a region of high tuberculosis burden. Cytopathology 2021; 32:428-435. [PMID: 33848034 DOI: 10.1111/cyt.12975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 02/28/2021] [Accepted: 03/12/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has emerged as a very useful tool for precise diagnosis of thoracic lesions. However, the procedure sometimes has a poor yield. Rapid on-site evaluation (ROSE) in EBUS-TBNA has been shown to be helpful to improve its diagnostic yield and minimise the need for repeat procedures. Most of the studies that have evaluated the utility of ROSE have focused on malignant lesions; however, it is important to understand its utility in benign lesions, particularly in a country with a high tuberculosis burden. OBJECTIVE This study was undertaken to evaluate the utility of ROSE in EBUS-TBNA for the diagnosis of patients presenting with mediastinal lymphadenopathy and/or thoracic mass for benign and malignant pathologies. METHODS This was a prospective study including 47 patients who underwent EBUS-TBNA for thoracic lesions (lung masses and hilar/mediastinal lymphadenopathy) over a 10-month period at a single tertiary care centre. In addition to ROSE and definitive cytology, the aspirated material was also sent for cell block and microbiological studies. Endobronchial/transthoracic biopsy was conducted for histopathological evaluation (HPE) where required, at the discretion of the clinician. ROSE diagnosis was then compared with the final diagnosis. RESULTS Of the 47 patients examined using ROSE, granulomas were observed in 33 cases, non-specific inflammation in six cases, and malignancy in five cases; one case was inconclusive and the sample was found to be inadequate in two cases. The ROSE assessment matched the final diagnosis in 84.45% patients. CONCLUSION ROSE is a simple procedure that is able to provide an immediate and accurate assessment of adequacy and has a significant yield, enabling a preliminary diagnosis to be made in both benign and malignant samples.
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Affiliation(s)
- Purnima Bharati
- Department of Pathology, Dr. Ram Manohar Lohia Hospital & ABVIMS, New Delhi, India
| | - Desh Deepak
- Department of Respiratory Medicine, Dr. Ram Manohar Lohia Hospital & ABVIMS, New Delhi, India
| | - Manju Kaushal
- Department of Pathology, Dr. Ram Manohar Lohia Hospital & ABVIMS, New Delhi, India
| | - Prajwala Gupta
- Department of Pathology, Dr. Ram Manohar Lohia Hospital & ABVIMS, New Delhi, India
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Bhatia A, Phulware RH, Ahuja A, Kaushal M. Hamartomas of the Breast: A Mimic of Fibroadenoma and Cytological Pitfall. J Cytol 2020; 37:210-211. [PMID: 33776263 PMCID: PMC7984518 DOI: 10.4103/joc.joc_138_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 09/19/2020] [Indexed: 11/18/2022] Open
Affiliation(s)
- Akanksha Bhatia
- Department of Pathology, PGIMER, ABVIMS, RML Hospital, New Delhi, India
| | | | - Arvind Ahuja
- Department of Pathology, PGIMER, ABVIMS, RML Hospital, New Delhi, India
| | - Manju Kaushal
- Department of Cytopathology, PGIMER, ABVIMS, RML Hospital, New Delhi, India
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16
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Kaushal M, Agarwal P, Srivastava N, Sharma D, Bhardwaj M, Ahuja A. Synchronous malignancies: A tale of two different tumors. INDIAN J PATHOL MICR 2020; 63:147-149. [PMID: 32031151 DOI: 10.4103/ijpm.ijpm_468_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Manju Kaushal
- Department of Pathology, PGIMER, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Poojan Agarwal
- Department of Pathology, PGIMER, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Nishit Srivastava
- Department of Surgery, PGIMER, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Deborshi Sharma
- Department of Surgery, PGIMER, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Minakshi Bhardwaj
- Department of Pathology, PGIMER, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Arvind Ahuja
- Department of Pathology, PGIMER, Dr. Ram Manohar Lohia Hospital, New Delhi, India
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17
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Suteri P, Kaushal M. Space occupying lesion of brain: An unusual site for a common infection. Diagn Cytopathol 2020; 48:782-784. [PMID: 32365273 DOI: 10.1002/dc.24455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 03/18/2020] [Accepted: 04/21/2020] [Indexed: 11/08/2022]
Abstract
Filariasis is a public health menace and is a cause for concern due to its endemicity in tropical and subtropical countries of Africa, Asia, and Western Pacific. Even in endemic areas, it is rare to find filariasis in fluid specimens especially cerebrospinal fluid. Herein, we report a case of unsuspected filarial parasitic infection in an adult male admitted as a case of space occupying lesion in brain with suspicion of lymphoma/granulomatous disease on the basis of clinicoradiological details. To the best of our knowledge, such an extensive brain involvement by filariasis has not been reported before.
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Affiliation(s)
- Pooja Suteri
- Department of Pathology, ABVIMS, Dr Ram Manohar Lohia Hospital, New Delhi, India
| | - Manju Kaushal
- Department of Cytopathology, ABVIMS, Dr Ram Manohar Lohia Hospital, New Delhi, India
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Affiliation(s)
- Manjari Kishore
- Department of Pathology, Post Graduate Institute of Medical Education and Research, Dr. Ram Manohar Lohia Hospital, New Delhi, India. E-mail:
| | - Manju Kaushal
- Department of Pathology, Post Graduate Institute of Medical Education and Research, Dr. Ram Manohar Lohia Hospital, New Delhi, India. E-mail:
| | - Shruti Dogra
- Department of Pathology, Post Graduate Institute of Medical Education and Research, Dr. Ram Manohar Lohia Hospital, New Delhi, India. E-mail:
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19
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Gupta D, Raghav S, Kaushal M. Frontal swelling in adult male: Cytological consideration of an uncommon diagnosis. Cytojournal 2020; 17:5. [PMID: 32395149 PMCID: PMC7210467 DOI: 10.25259/cytojournal_79_2019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Accepted: 12/27/2019] [Indexed: 11/11/2022] Open
Affiliation(s)
- Deepika Gupta
- Department of Pathology, Post Graduate Institute of Medical Education and Research, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Sonia Raghav
- Department of Pathology, Post Graduate Institute of Medical Education and Research, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Manju Kaushal
- Department of Pathology, Post Graduate Institute of Medical Education and Research, Dr. Ram Manohar Lohia Hospital, New Delhi, India
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20
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Kishore M, Malhotra P, Kaushal M, Singh P, Kapur N. Fine needle aspiration (FNA) of subcutaneous lesion: A diagnostic dilemma on cytology. Cytojournal 2019; 16:17. [PMID: 31516539 PMCID: PMC6712900 DOI: 10.4103/cytojournal.cytojournal_41_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 02/25/2019] [Indexed: 11/05/2022] Open
Affiliation(s)
- Manjari Kishore
- Address: Department of Pathology, Post Graduate Institute of Medical Education and Research, Dr. RML Hospital, New Delhi, India
| | - Purnima Malhotra
- Address: Department of Pathology, Post Graduate Institute of Medical Education and Research, Dr. RML Hospital, New Delhi, India
| | - Manju Kaushal
- Address: Department of Pathology, Post Graduate Institute of Medical Education and Research, Dr. RML Hospital, New Delhi, India
| | - Preeti Singh
- Address: Department of Pathology, Post Graduate Institute of Medical Education and Research, Dr. RML Hospital, New Delhi, India
| | - Neeti Kapur
- Department of Surgery, Post Graduate Institute of Medical Education and Research, Dr. RML Hospital, New Delhi, India
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Kishore M, Kaushal M, Marwah S, Sharma M, Sharma N, Mittal V. Cytodiagnosis of extramedullary hematopoiesis in thyroid gland unravelling an asymptomatic hematological malignancy. Diagn Cytopathol 2019; 47:320-324. [PMID: 30644655 DOI: 10.1002/dc.24082] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 08/02/2018] [Accepted: 08/28/2018] [Indexed: 11/10/2022]
Abstract
Extramedullary hematopoeisis (EMH), also known as myeloid metaplasia can be seen in association with various hematological disorders. The common sites of EMH are liver, spleen and lymph nodes; but it can occur in almost any organ and in numerous locations. Involvement of the thyroid gland with EMH has rarely been reported. We present a case of EMH in the thyroid gland in an adult female diagnosed on fine-needle aspiration cytology (FNAC) which further helped in revealing an underlying myeloproliferative neoplasm; chronic myeloid leukemia (CML).
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Affiliation(s)
- Manjari Kishore
- Department of Pathology, PGIMER, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Manju Kaushal
- Department of Pathology, PGIMER, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Sadhna Marwah
- Department of Pathology, PGIMER, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Megha Sharma
- Department of Pathology, PGIMER, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Nishi Sharma
- Department of ENT, PGIMER, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Vishakha Mittal
- Department of Medicine, PGIMER, Dr. Ram Manohar Lohia Hospital, New Delhi, India
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Kishore M, Kumar V, Kaushal M, Gomber A. Cytology of achylous hematuria: A clue to an underlying uncommon clinical scenario. Cytojournal 2018; 15:30. [PMID: 30662516 PMCID: PMC6319044 DOI: 10.4103/cytojournal.cytojournal_11_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Accepted: 06/07/2018] [Indexed: 11/04/2022] Open
Affiliation(s)
- Manjari Kishore
- Address: Department of Pathology, Postgraduate Institute of Medical Education and Research, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Vijay Kumar
- Address: Department of Pathology, Postgraduate Institute of Medical Education and Research, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Manju Kaushal
- Address: Department of Pathology, Postgraduate Institute of Medical Education and Research, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Apoorva Gomber
- Address: Department of Pathology, Postgraduate Institute of Medical Education and Research, Dr. Ram Manohar Lohia Hospital, New Delhi, India
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23
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Affiliation(s)
- Manjari Kishore
- Address: Department of Pathology, Post Graduate Institute of Medical Education and Research and Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Manju Kaushal
- Address: Department of Pathology, Post Graduate Institute of Medical Education and Research and Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Arvind Ahuja
- Address: Department of Pathology, Post Graduate Institute of Medical Education and Research and Dr. Ram Manohar Lohia Hospital, New Delhi, India
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24
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Kishore M, Kumar V, Kaushal M. Malignant melanoma of conjunctiva: Diagnosis on fine-needle aspiration cytology. J Lab Physicians 2018; 10:453-456. [PMID: 30498321 PMCID: PMC6210837 DOI: 10.4103/jlp.jlp_43_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Accepted: 08/20/2018] [Indexed: 11/13/2022] Open
Abstract
Malignant melanoma of conjunctiva is an uncommon malignancy. The diagnosis is suspected clinically and confirmed on pathological examination. We present a case of a 63-year-old female with previous history of pigmented lesion in the right eye and subsequently diagnosed as malignant melanoma of right conjunctiva and cornea on fine-needle aspiration cytology and histopathology.
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Affiliation(s)
- Manjari Kishore
- Department of Pathology, Post Graduate Institute of Medical Education and Research, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Vijay Kumar
- Department of Pathology, Post Graduate Institute of Medical Education and Research, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Manju Kaushal
- Department of Pathology, Post Graduate Institute of Medical Education and Research, Dr. Ram Manohar Lohia Hospital, New Delhi, India
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25
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Agarwal P, Kaushal M, Dogra S, Gupta A, Sharma N. Retropharyngeal SOL: An unusual presentation of a multifaceted entity. Cytojournal 2018; 15:12. [PMID: 29937916 PMCID: PMC5994843 DOI: 10.4103/cytojournal.cytojournal_15_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 08/28/2017] [Indexed: 11/04/2022] Open
Affiliation(s)
- Poojan Agarwal
- Address: Department of Pathology, PGIMER, Dr. RML Hospital, New Delhi, India
| | - Manju Kaushal
- Address: Department of Pathology, PGIMER, Dr. RML Hospital, New Delhi, India
| | - Shruti Dogra
- Address: Department of Pathology, PGIMER, Dr. RML Hospital, New Delhi, India
| | - Ankur Gupta
- Department of ENT, PGIMER, Dr. RML Hospital, New Delhi, India
| | - Nishi Sharma
- Department of ENT, PGIMER, Dr. RML Hospital, New Delhi, India
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26
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Kishore M, Kaushal M, Deepak D, Kumari M. Cytopathological examination of bronchoalveolar lavage fluid in diagnosis of pulmonary alveolar proteinosis. J Lab Physicians 2018; 10:109-112. [PMID: 29403217 PMCID: PMC5784280 DOI: 10.4103/jlp.jlp_109_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Pulmonary alveolar proteinosis (PAP) is a rare disease characterized by the deposition of extracellular lipoproteinaceous material within the air spaces. Although the diagnosis is mainly based on histopathological findings, sometimes, the diagnostic yield of transbronchial and even open lung biopsy can be unsatisfactory. The advantage with bronchoalveolar lavage (BAL) cytology is that apart from being safer for the patient, it can sample a much wider area and help in giving an early diagnosis and treatment to the patient. Herein, we present a case of PAP diagnosed on BAL fluid cytology in an elderly female.
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Affiliation(s)
- Manjari Kishore
- Department of Pathology, PGIMER, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Manju Kaushal
- Department of Pathology, PGIMER, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Desh Deepak
- Department of Respiratory Medicine, PGIMER, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Manju Kumari
- Department of Pathology, PGIMER, Dr. Ram Manohar Lohia Hospital, New Delhi, India
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27
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Nagpal R, Kaushal M, Kumar S. Cytological Diagnosis of an Uncommon High Grade Malignant Thyroid Tumour: A Case Report. J Clin Diagn Res 2017; 11:ED03-ED05. [PMID: 28892908 DOI: 10.7860/jcdr/2017/28531.10132] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 05/03/2017] [Indexed: 11/24/2022]
Abstract
Anaplastic Thyroid Carcinoma (ATC) is a relatively uncommon highly malignant tumour originating from the follicular cells of thyroid gland having poor prognosis. It accounts for 2% to 5% of all thyroid carcinomas and patients typically present with a rapidly growing anterior neck mass with aggressive symptoms. A 53-year-old male presented with diffuse neck swelling measuring 8x6 cm and right cervical lymph node measuring 2x2 cm since one month which was associated with dyspepsia and dyspnoea. Ultrasound and Contrast Enhanced Computed Tomography (CECT) neck revealed enlarged right lobe of thyroid and multiple enlarged cervical lymph nodes with soft tissue density nodules in bilateral lungs. Fine Needle Aspiration (FNA) from the swelling revealed giant cell, spindle cell and squamoid pattern. Focal areas showed follicular epithelial cells arranged in repeated microfollicular pattern suggesting an underlying follicular neoplasm. FNAC smears from the lymph node also revealed similar findings. Based on the cytomorphological and radiological findings, final diagnosis of ATC probably arising from underlying follicular carcinoma with cervical lymph node and lung metastasis was given. FNAC leads to prompt and definitive diagnosis, so that therapy can be initiated as soon as possible for better outcome. Multimodality therapy (surgery, external beam radiation, and chemotherapy) is the mainstay of treatment.
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Affiliation(s)
- Ruchi Nagpal
- Senior Resident, Department of Pathology, PGIMER, Dr RML Hospital, New Delhi, India
| | - Manju Kaushal
- Professor, Department of Pathology, PGIMER, Dr RML Hospital, New Delhi, India
| | - Sawan Kumar
- Senior Resident, Department of Pathology, PGIMER, Dr RML Hospital, New Delhi, India
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28
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Kumari M, Udayakumar M, Kaushal M, Madaan GB. Unusual presentation of disseminated histoplasmosis in an immunocompetent patient. Diagn Cytopathol 2017; 45:848-850. [DOI: 10.1002/dc.23742] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 04/10/2017] [Accepted: 04/18/2017] [Indexed: 11/11/2022]
Affiliation(s)
- Manju Kumari
- Department of pathology; PGIMER, Dr. RML Hospital; New Delhi India
| | | | - Manju Kaushal
- Department of pathology; PGIMER, Dr. RML Hospital; New Delhi India
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29
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Chopra A, Singh Y, Kaushal M, Taneja A, Kulshreshtha B. Simultaneous Occurrence of Thyroiditis in Ectopic and Eutopic Thyroid Masquerading as Thyroglossal Cyst. J Clin Diagn Res 2017; 11:OD17-OD19. [PMID: 28658835 DOI: 10.7860/jcdr/2017/25192.9897] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Accepted: 03/16/2017] [Indexed: 11/24/2022]
Abstract
Ectopic thyroid gland is a rare condition usually presenting with neck swelling or hypothyroidism. In most cases, ectopic thyroid tissue is the only functioning thyroid tissue, but it may rarely be associated with normal thyroid gland. Thyroiditis in an ectopic thyroid gland is very rare. Here, we describe a 13-year-old girl who was initially suspected, as a having a thyroglossal cyst. Thyroid functions were suggestive of thyrotoxicosis. She was diagnosed to have simultaneous occurrence of thyroiditis in the ectopic and eutopic thyroid glands. This case was exceedingly rare since this patient presented with thyrotoxicosis unlike previous reported cases who were either euthyroid or hypothyroid.
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Affiliation(s)
- Aditi Chopra
- Senior Resident, Department of Endocrinology, PGIMER, Dr RML Hospital, Delhi, India
| | - Yogendra Singh
- Senior Resident, Department of Endocrinology, PGIMER, Dr RML Hospital, Delhi, India
| | - Manju Kaushal
- Professor, Department of Pathology, Dr RML Hospital, New Delhi, India
| | - Anil Taneja
- Professor, Department of Radiology, Dr RML Hospital, Delhi, India
| | - Bindu Kulshreshtha
- Associate Professor, Department of Endocrinology, PGIMER, Dr RML Hospital, Delhi, India
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30
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Tilak AS, Wani SP, Datta A, Patil MD, Kaushal M, Reddy KR. Evaluation of Ageratum conyzoides in field scale constructed wetlands (CWs) for domestic wastewater treatment. Water Sci Technol 2017; 75:2268-2280. [PMID: 28541934 DOI: 10.2166/wst.2017.119] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Ageratum conyzoides were evaluated in field scale subsurface flow constructed wetlands (CWs) to quantify its nitrogen (N) and phosphorus (P) uptake and compare with wetland plants (Pistia stratiotes, Typha latifolia and Canna indica). The two-field scale subsurface flow CWs, located in the International Crops Research Institute for Semi-Arid Tropics, received wastewater from an urban colony. The CW1 and CW2 had the same dimensions (length:10 m, width:3 m, total depth:1.5 m and sand and gravel:1 m), similar flow rates (3 m3/d), hydraulic loading rates (HLRs-10 cm/d) and hydraulic retention time (HRT-5 days) from July 2014-August 2015. The vegetation in both CWs consisted of Pistia stratiotes, Typha latifolia, Canna indica, and Ageratum conyzoides, respectively. The CW1 (% reduction with respect to concentrations) reduced total suspended solids (TSS) (68%), NH4-N (26%), NO3-N (30%), soluble reactive P (SRP) (20%), chemical oxygen demand (COD) (45%) and fecal coliforms (71%), while the CW2 (%-reduction with respect to concentrations) reduced TSS (63%), NH4-N (32%), NO3-N (26%), SRP (35%), COD (39%) and fecal coliforms (70%). Ageratum conyzoides can be used in combination with Pistia stratiotes, Typha latifolia and Canna indica to enhance removal of excessive N, P and fecal coliforms from domestic wastewater.
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Affiliation(s)
- A S Tilak
- International Crops Research Institute for the Semi-Arid Tropics (ICRISAT), ICRISAT Development Centre (IDC), Patancheru Hyderabad 502324, India E-mail:
| | - Suhas P Wani
- International Crops Research Institute for the Semi-Arid Tropics (ICRISAT), ICRISAT Development Centre (IDC), Patancheru Hyderabad 502324, India E-mail:
| | - A Datta
- International Crops Research Institute for the Semi-Arid Tropics (ICRISAT), ICRISAT Development Centre (IDC), Patancheru Hyderabad 502324, India E-mail:
| | - M D Patil
- International Crops Research Institute for the Semi-Arid Tropics (ICRISAT), ICRISAT Development Centre (IDC), Patancheru Hyderabad 502324, India E-mail:
| | - M Kaushal
- International Crops Research Institute for the Semi-Arid Tropics (ICRISAT), ICRISAT Development Centre (IDC), Patancheru Hyderabad 502324, India E-mail:
| | - K R Reddy
- Soil and Water Science Department, University of Florida, Gainesville, USA
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31
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Agarwal P, Kumar V, Kaushal M, Kumari M, Chaudhary A. Indian visceral leishmaniasis with extensive lymphadenopathy - An unusual presentation: A case report with literature review. Cytojournal 2017; 14:9. [PMID: 28567110 PMCID: PMC5430503 DOI: 10.4103/1742-6413.205312] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2016] [Accepted: 11/02/2016] [Indexed: 11/04/2022] Open
Abstract
Visceral leishmaniasis (VL), also known as kala-azar, is a life-threatening systemic disease caused by the obligate intracellular protozoan, Leishmania, and transmitted to humans by the female phlebotomine sand fly (Phlebotomus argentipes). The disease is fatal, if left untreated. We report a case of a patient clinically suspected of disseminated tuberculosis, but fine needle aspiration cytology of cervical and axillary lymph nodes yielded a diagnosis of leishmaniasis. Diagnosis of VL was challenging as the disease closely mimicked tuberculosis in the setting of extensive lymphadenopathy including conglomerate of mesenteric lymph nodes, on and off fever, and granulomatous lymphadenitis on aspiration. Bone marrow examination was further performed. A detailed workup revealed patient to be severely immunocompromised and newly diagnosed human immunodeficiency virus (HIV) positive. Worldwide, India has the largest number of VL cases, accounting for 40%-50% of world's disease burden and the second largest HIV-infected population, accounting for approximately 10% of the global disease burden. HIV increases the risk of developing VL by 100-2320 times in endemic areas and concurrently VL promotes the clinical progression of HIV disease. Co-infection with HIV alters the body's immune response to leishmaniasis thus leading to unusual presentations. This case highlights the diagnostic problem in the aforesaid setting. Moreover, co-infection with HIV in VL can be a potential source of drug resistance. An early diagnosis and intensified treatment is the key to patient management.
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Affiliation(s)
- Poojan Agarwal
- Address: Department of Pathology, Post Graduate Institute of Medical Education and Research, Dr. RML Hospital, New Delhi, India
| | - Vijay Kumar
- Address: Department of Pathology, Post Graduate Institute of Medical Education and Research, Dr. RML Hospital, New Delhi, India
| | - Manju Kaushal
- Address: Department of Pathology, Post Graduate Institute of Medical Education and Research, Dr. RML Hospital, New Delhi, India
| | - Manju Kumari
- Address: Department of Pathology, Post Graduate Institute of Medical Education and Research, Dr. RML Hospital, New Delhi, India
| | - Arvind Chaudhary
- Department of Medicine, Post Graduate Institute of Medical Education and Research, Dr. RML Hospital, New Delhi, India
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Abstract
Concomitant infection with Aspergillus species and cervical squamous cell carcinoma in the female genital tract is a rare occurrence and attributed to the opportunistic nature of infection in the immunocompromised state due to the underlying malignancy. The contamination of smears with Aspergillus species should be excluded. The diagnosis of Aspergillus species infection along with squamous cell carcinoma was established on cervicovaginal pap smears in a 62-year-old female presented to gynecological clinic with complaints of stress urinary incontinence. Speculum examination revealed first-degree cervical descent. Smears showed features of squamous cell carcinoma along with fungal spores and fruiting body with hyphae of Aspergillus species. The presence of fruiting bodies and hyphae of Aspergillus species with coexisting squamous cell carcinoma is rare in routine pap smears. True infection needs to be distinguished from contamination by Aspergillus species. Early diagnosis can be established on routine cervicovaginal Pap smear examination.
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Affiliation(s)
- Prajwala Gupta
- Department of Pathology, PGIMER, Dr. RML Hospital, NEW DELHI, INDIA
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Abstract
Salivary gland cytopathology is a diagnostically challenging area with overlapping cytomorphological features between benign, malignant, and metastatic tumors. We report the case of 45-year-old male who presented with two swellings in right retroauricular and infraauricular region along with a palpable single right cervical lymph node. On ultrasonography of the neck, a possibility of malignant lesion was given. Contrast enhanced computed tomography of the head showed a large well-defined space occupying lesion in right temporooccipital region eroding the skull bone with both extra and intracranial extension. Fine needle aspiration was performed from both swellings and cervical lymph node. Based on cytological features and clinicoradiological examination, a possibility of metastasis from epithelial malignancy (adenocarcinoma) was suggested. The retroauricular region swelling was excised, and a diagnosis of salivary duct carcinoma was given on histopathology. In this article, we discuss the diverse presentation, cytomorphological features, and differential diagnosis of this rare salivary gland tumor.
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Affiliation(s)
- Charu Agarwal
- Department of Pathology, PGIMER, Dr. RML Hospital, New Delhi, India
| | - Manju Kaushal
- Department of Pathology, PGIMER, Dr. RML Hospital, New Delhi, India
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Abstract
Cutaneous meningiomas are rare tumors. These are ectopic meningothelial cells located in the dermis and subcutis, and are usually seen on the scalp. Here, we report the case of a 40-year-old woman who presented with a slowly growing asymptomatic mass over the scalp in the right parieto-occipital region. The lesion was firm, adherent to underlying structures, and covered by normal appearing skin. The cytomorphological features along with histological and immunohistochemical studies showing positivity for epithelial membrane antigen, Vimentin, and S100 helped in making a definitive diagnosis of cutaneous meningioma. No evidence of intracranial meningioma was noted in contrast-enhanced computed tomography of the brain.
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Affiliation(s)
- Manjari Kishore
- Department of Pathology, PGIMER, Dr. RML Hospital, New Delhi, India
| | - Manju Kaushal
- Department of Pathology, PGIMER, Dr. RML Hospital, New Delhi, India
| | | | - Neha Sharma
- Department of Pathology, PGIMER, Dr. RML Hospital, New Delhi, India
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35
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Agarwal C, Kaushal M. Parathyroid lesions: Difficult diagnosis on cytology. Diagn Cytopathol 2016; 44:704-9. [PMID: 27246113 DOI: 10.1002/dc.23508] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 04/22/2016] [Accepted: 05/05/2016] [Indexed: 11/09/2022]
Abstract
Cytology of parathyroid lesion (PL) is often confused with that of thyroid lesions. Differentiation between thyroid and PL is very difficult on cytomorphology because of their similar features and close anatomical proximity. Three cases of PLs reported on cytology in last one year were retrieved from archives of cytology department. Their cytomorphological details were studied and were correlated with the available biochemical parameters. Histopathology was available in two cases. Radiological assistance and parathyroid hormone (PTH) assessment in our cases formed the basis of diagnosing PLs on cytology. We discuss the differential diagnosis and pitfalls in cytological diagnosis of PLs. However, histopathology remains the gold standard for diagnosis. Interpretation of PLs on cytology remains problematic due to its rarity and limited available literature. The cytomorphology combined with clinical and biochemical data supported by histopathology are necessary to improve the diagnostic sensitivity of PLs. Diagn. Cytopathol. 2016;44:704-709. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Charu Agarwal
- Department of Pathology, PGIMER, Dr. RML Hospital, New Delhi, India
| | - Manju Kaushal
- Department of Pathology, PGIMER, Dr. RML Hospital, New Delhi, India
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Kaushal M, Wani SP, Patil MD, Datta A. Monitoring Efficacy of Constructed Wetland for Treating Domestic Effluent-Microbiological Approach. CURR SCI INDIA 2016. [DOI: 10.18520/cs/v110/i9/1710-1715] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Dhillon M, John R, Prabhakar S, Sharma S, Kaushal M. Drill bit failure and retrieval during arthroscopic ACL reconstruction. J Clin Orthop Trauma 2016; 7:80-82. [PMID: 28018080 PMCID: PMC5167445 DOI: 10.1016/j.jcot.2016.06.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Revised: 02/04/2016] [Accepted: 06/10/2016] [Indexed: 10/21/2022] Open
Abstract
A case of broken drill bit during arthroscopic ACL reconstruction and the technique adopted to overcome this complication is presented. We also review the literature for intra-operative incidents and technical complications during arthroscopic ACL reconstruction and various precautions we should implement to prevent such technical pitfalls from coming into reality.
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Affiliation(s)
| | - R. John
- Corresponding author. Tel.: +91 9781335111.
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Abstract
Langerhans cell histiocytosis (LCH) is a relatively rare and unique disease. An incidence of 7.9% in the jaws is reported. We report a case of 9-year-old male child referred to us from dental outpatient department, who presented with a firm swelling in right lower jaw along with bilateral submandibular lymphadenopathy for 1-month. Fine-needle aspiration was done from lytic lesion in the body of mandible and multiple smears were prepared. On the basis of the clinical and cytomorphological findings, a diagnosis of LCH was suggested. The diagnosis was confirmed on histology. Thus, a high possibility of LCH should be considered in children presenting with lytic lesions in head and neck region.
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Affiliation(s)
- Palak Agarwal
- Department of Pathology, Dr. RML Hospital and PGIMER, New Delhi, India
| | - Manju Kaushal
- Department of Pathology, Dr. RML Hospital and PGIMER, New Delhi, India
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39
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Kumar N, Gupta BB, Sharma B, Kaushal M, Rewari BB, Sundriyal D. Role of fine-needle aspiration cytology in human immunodeficiency virus-associated lymphadenopathy: a cross-sectional study from northern India. Hong Kong Med J 2014; 21:38-44. [PMID: 25418928 DOI: 10.12809/hkmj144241] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To evaluate the role of fine-needle aspiration cytology in the diagnosis of human immunodeficiency virus (HIV)-associated lymphadenopathy. DESIGN Case series. SETTING Tertiary care teaching hospital, India. PATIENTS Fifty consecutive HIV-positive patients, who presented with lymphadenopathy at the out-patient department and antiretroviral therapy clinic. RESULTS Tubercular lymphadenitis was the most common diagnosis, reported in 74% (n=37) of patients; 97.2% of them were acid-fast bacilli-positive. Reactive lymphadenitis and fungal lymphadenitis were present in 10 and 1 cases, respectively. The most common cytomorphological pattern of tubercular lymphadenitis was necrotising suppurative lymphadenitis, present in 43.2% (n=16) of patients. Of eight biopsies done in reactive cases, six turned out to be tubercular lymphadenitis. Fine-needle aspiration cytology had a sensitivity of 83.7% for diagnosing tubercular lymphadenitis. CONCLUSION Necrotising suppurative lymphadenitis should be recognised as an established pattern of tubercular lymphadenitis. Reactive patterns should be considered inconclusive rather than a negative result, and re-evaluated with lymph node biopsy. Fine-needle aspiration cytology is an excellent test for diagnosing tubercular lymphadenitis in HIV-associated lymphadenopathy.
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Affiliation(s)
- Naveen Kumar
- Department of Medicine, PGIMER and Dr RML Hospital, New Delhi 110001, India
| | - B B Gupta
- Department of Medicine, PGIMER and Dr RML Hospital, New Delhi 110001, India
| | - Brijesh Sharma
- Department of Medicine, PGIMER and Dr RML Hospital, New Delhi 110001, India
| | - Manju Kaushal
- Department of Pathology, PGIMER and Dr RML Hospital, New Delhi 110001, India
| | - B B Rewari
- Department of Medicine, PGIMER and Dr RML Hospital, New Delhi 110001, India
| | - Deepak Sundriyal
- Department of Medicine, PGIMER and Dr RML Hospital, New Delhi 110001, India
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Kaushal M, Agarwal R, Aggarwal R, Singal A, Upadhyay M, Srinivas V, Paul VK, Deorari AK. Cling wrap, an innovative intervention for temperature maintenance and reduction of insensible water loss in very low-birthweight babies nursed under radiant warmers: a randomized, controlled trial. ACTA ACUST UNITED AC 2013; 25:111-8. [PMID: 15949199 DOI: 10.1179/146532805x45700] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
AIM The value of polythene film ('cling wrap') to improve thermal control and reduce postnatal weight loss in preterm, very low-birthweight babies was investigated. METHODS Consecutively born babies with birthweights between 750 and 1500 g were stratified by birthweight (<1250 g, 1251-1500 g) and randomised either to the cling wrap (CW) or no cling wrap (NCW) group. The baby bassinette of the RW was covered with cling wrap up to the level of the neck in the CW group for the 1st 7 days. The primary outcome variables were the incidence of hypothermia (axillary temperature < or = 36 degrees C) after initial stabilisation during the first 7 days and cumulative weight loss (percentage of birthweight) at 48 hours of age. RESULTS Of 51 babies, 26 were randomised to the CW and 25 to the NCW group. None of the babies in the CW group developed hypothermia in the 1st 7 days but 36% in the NCW group (p = 0.001) did. Babies who were hypothermic on admission took less time to reach normal temperature in the CW group. Cumulative weight loss in the 1st 48 hours was 5.0 + 5.6% in the CW group and 8.6 + 7.0% in the NCW group (p = 0.06). CONCLUSION Use of CW might be a simple method of maintaining temperature in very low-birthweight babies in developing countries.
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Affiliation(s)
- M Kaushal
- Neonatal Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
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Satpute R, Lomash V, Kaushal M, Bhattacharya R. Neuroprotective effects of alpha-ketoglutarate and ethyl pyruvate against motor dysfunction and oxidative changes caused by repeated 1-methyl-4-phenyl-1,2,3,6 tetrahydropyridine exposure in mice. Hum Exp Toxicol 2013; 32:747-58. [DOI: 10.1177/0960327112468172] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) is a neurotoxin associated with drug abuse and causes permanent symptoms of Parkinson's disease (PD) by destroying dopaminergic neurons in the substantia nigra of the brain. In the present study, the neuroprotective effects of two carboxylic acid compounds, viz. alpha-ketoglutarate (A-KG), a Kreb’s cycle intermediate and ethyl pyruvate (EP), a lipid-soluble analogue of pyruvate, were evaluated against MPTP intoxication in mice and compared with madopar (MD; combination of levodopa plus benserazide), a standard drug. Animals received oral treatment of A-KG (500 mg/kg), EP (100 mg/kg) or MD (5 mg/kg) daily for 5 days followed by intraperitoneal administration of MPTP (20 mg/kg) and posttreatment (+10 min) of A-KG, EP or MD daily for the remaining 5 days. MPTP caused the inhibition of complex I of electron transport chain accompanied by oxidative stress in the brain. It also caused cytotoxicity in the midbrain region as characterized by histology and immunohistochemistry. Treatments of A-KG and EP were found to resolve the loss of motor coordination, oxidative stress, diminished complex I activity and tyrosine hydroxylase–positive neurons in midbrain. A-KG and EP also regressed the histological damage in the brain and minimized the accumulation of alpha-synuclein in the midbrain region. The data suggest that A-KG and EP which are nontoxic carboxylic acid compounds could be of potential therapeutic value in the treatment of PD.
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Affiliation(s)
- R. Satpute
- Toxicology Laboratory, Defence Research and Development Establishment, Nagpur, India
| | - V. Lomash
- Division of Pharmacology and Toxicology, Defence Research and Development Establishment, Gwalior, India
| | - M. Kaushal
- BIMR College of Life Sciences, Gwalior, India
| | - R. Bhattacharya
- Division of Pharmacology and Toxicology, Defence Research and Development Establishment, Gwalior, India
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Shaw S, Kaushal M, Halbert K. A soft, inflatable patient support. Ann R Coll Surg Engl 2013. [PMID: 23485007 PMCID: PMC4098592 DOI: 10.1308/003588413x13511609958055g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- S Shaw
- Wrightington, Wigan and Leigh NHS Foundaiton Trust, UK.
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Shaw S, Kaushal M, Halbert K. A soft, inflatable patient support. Ann R Coll Surg Engl 2013; 95:158-9. [DOI: 10.1308/rcsann.2013.95.2.158a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- S Shaw
- Wrightington, Wigan and Leigh NHS Foundaiton Trust, UK
| | - M Kaushal
- Wrightington, Wigan and Leigh NHS Foundaiton Trust, UK
| | - K Halbert
- Wrightington, Wigan and Leigh NHS Foundaiton Trust, UK
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Gupta AK, Kaushal M. P5-23-07: Treatment Strategy of Locally Advanced Breast Cancer in Sub Group (T3N1M0, T4bN1M0) in Developing Countries. Cancer Res 2011. [DOI: 10.1158/0008-5472.sabcs11-p5-23-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
With the recent advances in modern day chemotherapy and hormonal therapy for locally advanced breast cancer [stage III, T3 N1 and T4bN1], most of the oncologist around the globe now prefer to give neoadjuvent chemotherapy and, or hormonal therapy followed by surgery in the treatment of these cases.
Randomized research have also shown that this strategy provides ‘pathological complete resolution’ as compared to surgery and then adjuvant chemotherapy in terms of decreasing in size of tumar, decrease in vascularity of tumor mass and micrometastasis. Some author believes that this improve the overall survival duration of patients.
This protocol is widely accepted but ….
BUT WHAT IF YOU LOSE YOUR PATIENT ON FOLLOWUP …
Especially in the developing countries of south east asian region and African continent, where there is poor socioeconomic status and lack of education among common people. The patient gets frustrated after first few doses of neoadjuvent therapy, due to side effects of chemotherapy and don't consider chemotherapy as a treatment compare to surgery. Thus the patient loses faith in treatment strategy itself and go untraceable after one or two sessions of the therapy. The government of developing countries lack resources in terms of manpower and money for satisfactory completion of treatment making the above condition even worse. In our study we followed 230 patients of locally advanced breast cancer in subgroup of stage III [T3 N1, T4bN1] and divided them into two plans on random basis. In first plan we approached with the surgical management followed by adjuvant chemotherapy & counseled the patients for completion of chemotherapy. This plan was shown to 115 patients, out of which 100 patients provided good acceptance & completed the course of chemotherapy. There were 15 patients who remained untraceable after surgery.
On the other hand in the 2 group the patients were counseled for neoadjuvent chemotherapy and then surgery in next stage. In this group 115 patients were introduced, out of which 60 patients were lost on follow up after 2–3 sessions. The majority of patients complained about the side effects of chemotherapy and financial reasons and did not come back. Rest of the patients completed the whole course. With no doubt about the result of the treatment, the second group has equivocal survival advantages in terms of morbidity and mortality, but we lost more than half of the patients of second group before completion of treatment.
Primarily the acceptance of surgical treatment is more in developing countries, as it is quite more feasible for government and even economical for common people. Thus we prefer the strategy of surgery followed by adjuvant chemo/hormonal therapy in locally advanced breast cancer [stage III T3N1, T4bN1] especially in developing countries like India.
THE MOTTO OF THIS STRATEGY IS TO PROVIDE BENEFIT OF COMPLETE TREATMENT TO THE PATIENT THAN TO LOSE THE PATIENT COMPLETELY BEFORE TREATMENT.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P5-23-07.
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Affiliation(s)
- AK Gupta
- 1Mahatma Gandhi Memorial Medical College and Maharaja Yashwantrao Hospital, Indore, Madhya Pradesh, India
| | - M Kaushal
- 1Mahatma Gandhi Memorial Medical College and Maharaja Yashwantrao Hospital, Indore, Madhya Pradesh, India
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Affiliation(s)
- Meenakshi Batrani
- Department of Pathology, Dr. Ram Manohar Lohia Hospital and Post Graduate Institute of Medical Education and Research, New Delhi 110001, India.
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Kaushal M, Chattopadhyay I, Phukan R, Purkayastha J, Mahanta J, Kapur S, Saxena S. Contribution of germ line BRCA2 sequence alterations to risk of familial esophageal cancer in a high-risk area of India. Dis Esophagus 2010; 23:71-5. [PMID: 19473207 DOI: 10.1111/j.1442-2050.2009.00975.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The incidence of esophageal squamous cell carcinoma (ESCC) is very high in the northeast region of India. An earlier study from China and Iran suggested that mutations in BRCA2 gene may play a role in the etiology of familial ESCC. However, the frequency of BRCA2 gene germ line mutations and its contribution to risk of familial aggregation of ESCC in high-risk region of India are not known. In the current study of 317 cases of esophageal cancer, 92 (29%) cases had a family history of esophageal and/or other cancers. Of these 92 patients, 45 (49%) patients had a family history of esophageal cancer. The risk of developing esophageal cancer was higher in cases where family history showed occurrence of cancers in first-degree relatives (odds ratio [OR]: 3.1; confidence interval [CI]: 1.9-5.3) than in second-degree relatives (OR: 1.3; CI: 0.25-3.2). Moreover, the risk of developing esophageal cancer was higher in subjects whose predegree suffered from esophageal cancer (OR: 2.4; CI: 1.1-4.1) than from any other cancers (OR: 1.1; CI: 0.32-3.3). The subjects with family history of cancer were more likely to develop ESCC if they were tobacco chewers (OR: 4.2; CI: 2.1-5.8) and betel quid users (OR: 3.6; CI: 1.8-4.6). Screening for mutations of the BRCA2 gene in the germ line DNA was carried out for 20 familial and 80 nonfamilial ESCC patients. One hundred unrelated healthy controls from the same population were included in this study. Nonsynonymous variants in exon 18 (K2729N) and exon 27 (I3412V) of BRCA2 gene were found in 3 of 20 patients with familial ESCC. No sequence alterations were found in 80 nonfamilial ESCC cases (P=0.01) and 100 healthy controls (P=0.0037), suggesting that germ line BRCA2 gene mutation may play a role in familial aggregation of ESCC in high-risk region of India.
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Affiliation(s)
- M Kaushal
- Institute of Pathology, Indian Council of Medical Research, Safdarjung Hospital Campus, New Delhi, India
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Date R, Kaushal M, Ramesh A. A review of the management of gallstone disease and its complications in pregnancy. Am J Surg 2008; 196:599-608. [DOI: 10.1016/j.amjsurg.2008.01.015] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2007] [Revised: 01/19/2008] [Accepted: 01/14/2008] [Indexed: 10/21/2022]
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Kaushal M, Shukla S, Mathur R, Kaushal D, Gupta R, Songara M. Complications of surgery in management of locally advanced breast carcinoma. EJC Suppl 2008. [DOI: 10.1016/s1359-6349(08)70617-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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