Background: Leprosy is an ancient, chronic granulomatous infectious disease caused by Mycobacterium leprae , principally affecting the skin and peripheral nerves. The clinical manifestations of leprosy are variable and can mimic a variety of other skin diseases. Thus, histopathological examination plays an important role in early diagnosis and management. Aim: The aim was to study the clinicohistopathological correlation of all suspected cases of Hansen's disease. Materials and Methods: A retrospective study was conducted on 207 skin biopsies obtained from patients clinically diagnosed as new lesion of leprosy in the department of pathology from 2016 to 2019. Demographic, clinical details of the patients were retrieved from hospital information system. Hematoxylin–eosin- and Fite–Faraco-stained sections were evaluated for features confirming leprosy and further categorized as per Ridley–Jopling system. Sensitivity, specificity, and concordance rates were studied. Results: The male-to-female ratio was 1.5:1. The agreement between histopathological and clinical diagnoses was more than 90% in all the subclasses except for borderline tuberculoid leprosy (BT) and tuberculoid leprosy (TT) which showed an agreement of 86.5% and 88.4%, respectively. The sensitivity of clinical diagnosis ranged from 69.70% for indeterminate to 100% for histoid and neuritic types. The specificity ranged from 90% for BT and TT to 100% for neuritic leprosy. Conclusion: Clinical diagnosis of early leprosy lesions offers difficulties even to experienced dermatologists as a patient presents in different clinicopathological forms, depending on host immune status. Thus, the correlation between clinical, histopathological, and bacteriological features is required for diagnosis and classification of leprosy. Nerve damage is irreversible; therefore, early detection and treatment is important to prevent Grade 2 disabilities.
Background: Plasma fibrinogen is an indicator of inflammation and endothelial dysfunction has been described as an independent risk factor for cardiovascular morbidity in type 2 Diabetes mellitus patients. Poor glycemic control has been reported to be associated with hyperfibrinogenemia and its complications. This study was aimed to find a correlation of mean fibrinogen level with glycemic control in complicated and uncomplicated cases of Type 2 Diabetes mellitus. Materials and methods: One hundred eight known cases of Type 2 Diabetes mellitus aged ≥ 30 were included in our study of which 39 cases were uncomplicated and 69 cases were complicated Diabetes mellitus. Hundred of non-diabetic age and sex-matched controls were analyzed. Blood samples were collected in Ethylenediaminetetraacetic acid and citrate bulb for estimation of HbA1c and plasma fibrinogen level respectively. Results: Mean fibrinogen level in complicated Type 2 Diabetes mellitus was high 450.43 ±108.51 mg/dl as compared to uncomplicated cases 372.30±123.78 mg/dl (p=0.0001). Mean HbA1c in total Diabetes mellitus cases was 8.02±1.88 mg/dl with a range of 5.50-14.50 mg/dl. A positive correlation was found between HbA1c and mean fibrinogen level (r=0.782, p= 0.001) in type 2 Diabetes mellitus. Duration of diabetes in years showed a significant correlation with mean fibrinogen levels (r=0.295, p=0.002). Conclusions: Plasma fibrinogen level was significantly associated with glycemic control (HbA1c) and duration of Diabetes mellitus in years. Thus, lowering plasma fibrinogen levels could be an important approach to the prevention of cardiovascular complications in diabetics.
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