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Biomedical subjects

R R Pai

Publications and source records attributed to R R Pai.

35 records · Page 2Linked to original sources

Giant adrenal cysts.

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Adrenal Gland Diseases↗

Reduction in caseload after multidrug therapy in an urban leprosy control programme--a retrospective study in Bombay.

A fall in the active registered case prevalence rate together with a fall in the active caseload per worker after the introduction of multidrug therapy (MDT) is becoming a managerial issue in leprosy control. A retrospective analysis was undertaken to assess the caseload per paramedical worker with reference to active cases for treatment (3341), cases for surveillance (2227) and cases for care after cure (165) at the end of December 1989. All these cases were under the care of 24 paramedical workers. The analysis showed that the caseload per worker was 239 (active cases 139, plus surveillance cases 93, plus care after cure cases 7), though active registered case prevalence rate declined from 1.82/1000 (before starting MDT) to 0.79/1000 by the end of December 1989. The case detection rate was 0.49/1000 by the end of 1989. So, although the active registered case prevalence rate declines, the worker will have enough to do because of the need for surveillance and the detection of relapses, early neuritis, early disabilities and care after cure. Simultaneously, new case detection and treatment must be continued. All these aspects need to be considered when programme managers are reviewing leprosy control strategy.

Drug Therapy, Combination↗

Fine needle aspiration cytology of the Ewing's sarcoma family of tumors.

OBJECTIVE: To study the cytomorphologic features of the Ewing's sarcoma (ES) family of tumors. STUDY DESIGN: During a period of eight years (1990-1997), 123 soft tissue tumors and 65 bone tumors were evaluated by fine needle aspiration cytology (FNAC); 14 cases were diagnosed as in the ES family of tumors. The ages of the patients ranged from 8 to 30 years. All the cases were histologically confirmed. RESULTS: Of 14 cases of the ES family of tumors, 7 were ES, 3 extraosseous ES (EOE), 2 peripheral primitive neuroectodermal tumor (PPNET) and 2 Askin tumor. Cytologically, smears from all the cases showed round tumor cells with a high nuclear/cytoplasmic ratio. On detailed examination, subtle differentiating features were observed. The cells in ES had finer nuclear chromatin in comparison to those of PPNET and Askin tumor, and punched-out clear cytoplasmic vacuoles were present. PPNET showed nuclear molding, unipolar cytoplasmic tags and Homer-Wright rosettes. Histologically, all cases of ES and EOE and one case of Askin tumor showed periodic acid-Schiff-positive inclusions. CONCLUSION: FNAC features coupled with clinical findings enable a rapid diagnosis of the ES family of tumors, from which treatment modalities can be determined.

Adolescent↗

Extramedullary plasmacytoma diagnosed by fine needle aspiration cytology. A report of four cases.

BACKGROUND: Fine needle aspiration cytology (FNAC) diagnosis of plasmacytoma is rare. CASES: Four cases of plasmacytoma were diagnosed by FNAC. The patients had clinically palpable lesions in more than one anatomic site. The sites of aspiration included lymph nodes, soft tissue swellings and a bony mass. The ages of the patients ranged from 42 to 80 years (mean, 62 years), and all the patients were male. All four cases showed a monomorphous population of well-differentiated myeloma cells in aspiration smears. Serum electrophoresis demonstrated an M spike in all cases, and Bence Jones protein was detected in the urine sample in one case. Radiologic and bone marrow findings also substantiated the diagnosis of multiple myeloma. CONCLUSION: FNAC diagnosis of plasmacytoma at extramedullary sites offers the opportunity for noninvasive verification of widespread involvement.

Adult↗

Primary papillary carcinoma in a thyroglossal duct cyst.

A rare case of primary thyroid papillary carcinoma arising in a thyroglossal duct cyst occuring in a 46 year old man is reported. The diagnosis was not suspected preoperatively. On gross examination of the excised specimen the presence of a papillary tumour in the cystic mass suggested the diagnosis which was proved histopathologically. The thyroid gland was normal on physical examination and scintigram thus ruling out the possibility of metastasis from a primary tumour in the thyroid gland.

Carcinoma, Papillary↗

Primary pulmonary Hodgkin's disease: a distinct entity.

A 30-year-old lady presented with fever, dry cough and weight loss for the preceding five months. Radiological investigations revealed a solitary nodular lesion in the lingula of the left lung. Guided fine needle aspiration cytology failed to yield any diagnostic material. Bronchoscopic cytology was also not contributory. As a last resort open lung biopsy was done and a diagnosis of Hodgkin's disease was made. Hilar and pre aortic lymph node biopsies showed only reactive change. The final diagnosis was primary pulmonary Hodgkin's disease.

Hodgkin Disease↗

Three years assessment of multidrug therapy in multibacillary leprosy cases.

Analysis of Bacteriological Index (BI) of 584 multibacillary leprosy patients who had completed multidrug therapy (MDT) as per the recommendations of World Health Organization (WHO) and Indian Association of Leprologists (IAL) showed smear conversion rates of 56% at 24 doses and 66% at 36 doses. Taking BI as a parameter of judgement, the results indicate distinct improvement over the performance achieved through dapsone monotherapy during earlier period. IAL regimen consisting of daily initial administration of rifampicin for 21 days did not show any distinct advantage over WHO regimen. Bacteriological decline was uniformally noticeable in all patients though in cases with high initial BI, smear conversion rate was much less. All the six patients with BI more than 5, and 59 patients (70%) with BI 1 to 4.9 and 87 patients (64%) with BI 3 to 3.9 have not been rendered negative even after three years of treatment. On the contrary seventeen patients whose skin smears were still positive after receiving 24 supervised doses became bacteriologically negative subsequently, and remained so though chemotherapy was stopped. Such studies on large number of patients for a longer period is essential to establish whether chemotherapy should necessarily be continued up to the point of negativity.

Dapsone↗