Fungal infection mimicking soft tissue lesion: Role of on-site evaluation, special stain, and cellblock

BACKGROUND

Fine-needle aspiration (FNA) cytology is a basic diagnostic method used for the investigation of superficial and deep lesions. The implementation of rapid on-site evaluation (ROSE) in cytological analysis can help in reducing the inadequacy rate and obtaining proper samples for further tests/analysis.

CASE PRESENTATION

We report a case of 44-year-old male, who presented to our outpatient department with complaints of swelling in his right arm for the last 34 years. FNA with ROSE using 1% aq. toluidine blue helped identify the pathology (fungal lesion) in the patient with further confirmation by cellblock, periodic acid Schiff & Gomori methenamine silver stains.

CONCLUSION

The role of FNA was significant in the above case, special stains prove their efficacy when sufficient sample is available. The differential diagnosis of fungal etiology should be considered in subcutaneous soft tissue lesions. There has been a major leap in diagnostic cytopathology with the advent of molecular testing. However, FNA still holds its charm.

Extra-ocular sebaceous carcinoma - A rare case report

Sebaceous gland carcinoma is a rare and aggressive skin cancer derived from the sebaceous glands. Sebaceous carcinomas are divided into those occurring in ocular (75%) and extra-ocular locations. A 45-year-old female patient presented with rapidly growing swelling over the upper back region. It was provisionally diagnosed as an infected sebaceous cyst, and an excision biopsy was received in the pathology department. Histopathology was reported as sebaceous carcinoma, Grade II, Stage P T3 Nx. Immunohistochemistry was positive for epithelial membrane antigen. Sebaceous carcinoma accounts for 0.2-4.6% of all malignant cutaneous neoplasms, and the estimated rate of occurrence is only 1-2 per 1 million individuals per year. These tumors frequently present with a painless sub-cutaneous nodule, but they can also present as pedunculated lesions, irregular mass, or diffuse thickening of the skin. Hence, they are misinterpreted as other benign tumors or inflammatory conditions, thereby leading to delay in diagnosis, inappropriate treatment, increased morbidity, and mortality.

A survey of E-learning methods in nursing and medical education during COVID-19 pandemic in India

BACKGROUND

COVID-19 pandemic has necessitated mandatory e-learning in medical and nursing education. How far are developing countries like India (with wide socioeconomic and cultural diversity) geared up for this challenge remains unexplored. At this critical juncture, we aim to evaluate if online teaching methods are as feasible, acceptable, and effective as in-class teaching for medical/nursing students.

OBJECTIVES

The questionnaire captured: (1) practicability/feasibility of online classes, (2) health issues from online classes, (3) current methods for e-teaching, and (4) student attitudes and preferences.

DESIGN

Cross-sectional survey.

SETTINGS

Population-based study in India.

PARTICIPANTS

Nursing and medical undergraduate students (I-IV year).

METHODOLOGY

The online questionnaire was distributed to 200 medical and nursing colleges across India. Categorical variables were analyzed using chi-square tests. Binary logistic regression was done to analyze factors predicting health issues in students. p < 0.05 was considered significant.

RESULTS

Overall, 1541 medical and 684 nursing students completed the survey from 156 cities. The availability of laptop (p < 0.0001), Wi-Fi (p < 0.0001), dedicated room (p < 0.0001), and computer proficiency was more in students of affluent families and those from cities (p < 0.0001). Class duration >4 h/day (p < 0.0001), each class >40 min (p < 0.009) and pre-existing health issues (p < 0.0001) predicted the occurrence headache, eyestrain, anxiety, neck/back pain, and sleep disturbance. Power-point presentation was the most widely (80%) used method of teaching. Only 30% got adequate time to interact with teachers. Only 20.4% felt e-learning can replace conventional teaching. Students preferred: 3-6 classes/day, each class <40 min, 10-20 min break between classes and interactive sessions.

CONCLUSION

There is a need to improve information and communication infrastructure to enhance feasibility of e-learning for nursing/medical students in India. There should be guidelines (number of classes/day, length of each class, break between classes, curriculum, etc) to improve the retention capacity in students and reduce health issues. Continuous feedback from teachers and students will be required to make e-learning effective.