Granulomatous inflammation is a distinctive pattern of chronic inflammation that is encountered in a limited number of infectious and non-infectious conditions. Recognisation of granulomatous pattern and finding the etiology in a biopsy specimen is very important for specific treatment and outcome of the disease. We aimed at finding the etiology of all granulomatous lesions on tissue biopsy sent for histopathogical examination. A study was done at K S Hegde Medical Academy of Nitte University, Mangalore from January 2009 to December 2010. All the cases which were diagnosed as granulomas on Hematoxylin and Eosin stained sections were selected. Special stains like Ziehl-Neelsen stain, Gomori's Methenamine silver, PAS, Fite Faraco were done whenever required. We encountered 275 granulomatous lesions in our study. The most common sites were skin and subcutaneous tissue, lymph nodes, bones and joints. The commonest cause of granulomas was tuberculosis, followed by leprosy, foreign body granulomas, fungal infections, rhinoscleroma, parasites, tumor granulomas and actinomycosis. The morphological features and special staining helped us to find the specific etiology of granulomas in 253 cases whereas it could not be determined in 22 cases even after special stains. Thus we conclude that histopathological examination of granulomatous lesions helped us to find the exact etiology of granulomas in 92 % of cases. The correlation of histopathology with polymerase chain reaction (PCR) serological tests and culture correlation would have helped to find the specific etiology in the remainder of cases.

Retained surgical sponges are serious adverse events that can result in negative patient outcomes. The primary method of prevention is the sponge count. Searching for sponges to reconcile counts can result in inefficient use of OR time. The purpose of this descriptive study was to estimate the cost of nonproductive OR time (ie, time spent not moving forward with the surgical procedure) spent reconciling surgical sponge counts and the cost of using radiography to rule out the presence of retained sponges. We included 13,322 patient surgeries during a nine-month period. Perioperative personnel required from one to 90 minutes of additional time to reconcile each of 212 incorrect/unresolved counts. The total annualized cost of OR time spent searching for sponges and ruling out the presence of potentially retained sponges using radiography was $219,056. These costs should be included in comprehensive cost analyses when considering alternatives to supplement the surgical count.

Background and Objective: Type 2 diabetic individuals are highly prone to liver function test abnormalities than non-diabetic individuals. Increased activities of liver enzymes such as aspartate aminotransferase (AST), alanine aminotransferase (ALT), and ?- glutamyl transpeptidase (GGT) are indicators of hepatocellular injury. Increased activity of these markers is associated with insulin resistance [1], metabolic syndrome, and type 2 diabetes. Diabetes mellitus burden is one of the key concerns in developing countries like India. In this study, we evaluated the relationships between markers of liver function and the onset of type 2 diabetes. Materials and Methods: This study was conducted after the approval from institutional ethical committee. Twenty five patients reporting to the OPD of K. S. Hegde Hospital diagnosed for type 2 diabetes between the age group of 40-50 years of both sex and 25 healthy age and sex matched individuals were included in the study. Under aseptic precautions blood samples were collected and centrifuged to get serum and was used for estimation. Data were expressed as the mean ± SD. Spearman's correlation coefficients were calculated to evaluate the relationship between serum glucose and liver function enzymes. Result: The results of the present showed that the ALT, AST and GGT levels in Type 2 Diabetic patients was increased significantly (p<0.01) as compared to normal controls. Conclusion: In this study, we found an association between the level of liver enzymes, ALT, AST and GGT in type 2 diabetes. Thus these liver enzyme levels can be used as a biomarker for the assessment of type 2 diabetes.

Spindle cell/sclerosing rhabdomyosarcoma (RMS) is an uncommon type of RMS and has been classified as a separate entity by the WHO in 2013. It affects both children and adults with a greater incidence in males. These tumors can pose a diagnostic challenge and can be difficult to differentiate from other spindle cell malignant tumors in the head and neck. Here, we report a case of spindle cell/sclerosing RMS in a young woman presenting with a swelling on the left side of the face of 3 months duration. A careful correlation with the radiographic images, histopathological findings and immunohistochemistry helped to arrive at a diagnosis.