Upper gastrointestinal tract disorders are one of the most commonly encountered problems in clinical practice. A variety of disorders can affect the upper GIT (gastro intestinal tract). The definitive diagnosis of upper gastrointestinal disorders rests on the histopathological confirmation and is one of the bases for planning proper treatment. Objectives: To determine the spectrum of histopathological lesions of upper gastrointestinal tract. To establish endoscopic biopsies as an effective tool in the proper diagnosis and management of various upper gastrointestinal tract lesions. Patients and Methods: A prospective study was conducted on the upper GIT endoscopic biopsies and the histopathological assessment was done at the department of pathology, M.S. Ramaiah medical college and teaching hospital from November 2006 to July 2008. Results: Of the total 25 cases of esophageal biopsies, 56% constituted non neoplastic lesions and 44% had neoplastic pathology. The most common malignancy was SCC (squamous cell carcinoma) occurred most commonly (73%) in the middle one third of the esophagus. In stomach biopsies, 41 (60%) had non neoplastic pathology and 27 patients (40%) had neoplastic pathology. The most common malignancy was adenocarcinoma. Conclusion: In our study, the commonest site for upper GI endoscopic biopsy was from the stomach (68%) with 60% non neoplastic and 40% neoplastic lesions. Most common neoplasm of the stomach was adenocarcinoma.. Out of the 100 cases, there was a consensus between endoscopic and histopathological diagnosis in 78% of the cases. Whenever there was a disagreement, the histopathological appearances served to correct a mistaken endoscopic finding. We therefore conclude that endoscopy is incomplete without biopsy and so the combination of methods provides a powerful diagnostic tool for better patient management

Objective: Low molecular weight heparin (LMWH) is an indirect thrombin inhibitor used clinically as an anticoagulant for thromboprophylaxis of patients at risk of deep vein thrombosis. The study was done to assess the magnitude of rise in serum potassium after administration of low molecular weight heparin comparing enoxaparin with dalteparin and to evaluate the frequency of clinically significant hyperkalemia in the population studied. Methods:The study was done as a prospective non-randomized observational study in a population of 32 patients started on heparin for thromboprophylaxis for deep venous thrombosis, pulmonary thromboembolism or stroke. Results:A statistically significant elevation in serum potassium was seen in patients treated with LMWH (p = 0.007). The magnitude of rise in potassium was significantly higher in enoxaparin (p = 0.008) than the dalteparin group (p = 0.447). A clinically relevant hyperkalemia of>5 mEq/l was seen in 25% of the population studied. Other important associations detected from the study were that the advancing age and increasing dose could be potential risk factors contributory to an accentuated rise in serum potassium which may culminate in clinically significant hyperkalemia. Conclusion:The study has highlighted that the likelihood of rise in potassium levels during LMWH therapy necessitates monitoring of serum potassium.

Introduction: Birt-Hogg-Dubé Syndrome is very uncommon in the North America. Several families have been reported since Birt, Hogg, and Dubé described the original kindred in 1977. Birt-Hogg-Dubé Syndrome (BHDS) is inherited in an autosomal dominant pattern and may be due to inactivation of a tumor-suppressor gene, which results in the various skin lesions such as cutaneous hamartomas and risk of internal malignancies. We report a rare case of Birt-Hogg-Dubé Syndrome who presented with lung sarcoma no skin manifestation which is the usual presentation as seen in literature.Case Report: A 25-year-old female presented with some vague chest and abdominal symptoms. CT of the chest showed a mass in the left upper lobe and a cyst in the lung. She underwent left side upper lobectomy. Pathology reported low grade sarcoma, but was otherwise nonspecific. She had small lung cysts in lower lobe consistent with a history of Birt-Hogg-Dube syndrome. At 3 years follow up, patient doing very well. Genetic testing confirmed syndrome in family.Discussion: Mortality and morbidity associated with Birt-Hogg-Dubé syndrome is related to internal manifestations such as pneumothorax or renal cell carcinoma. The morbidity of cutaneous lesions is limited to cosmetic appearance. Surgical removal has provided definitive treatment of solitary perifollicular fibromas. Birt-Hogg-Dubé syndrome patients with a history of smoking appear to have more severe lung disease than those who do not smoke. Conclusion:Birt-Hogg-Dubé Syndrome (BHDS) cannot be prevented, but associated findings of renal carcinoma, pulmonary cysts and pneumothorax can be monitored. Birt-Hogg-Dubé syndrome patients should be counseled regarding the increased risk of pneumothorax with activities altering ambient pressure, such as scuba diving and air travel, particularly if they have chest pain or shortness of breath. Smoking cessation in BHDS patients should be strongly encouraged.

Introduction and objectives: Serum lipid profile is used to measure the systemic health status of an individual. The objective of the study was to evaluate and correlate serum lipid profile in patients with potentially malignant disorders, oral cancer and controls. Materials and Methods: This study was conducted on a sample of 150 subjects in which the subjects were divided into three groups with 50 subjects in each group. The subjects in Group I were Controls (CT) Group II were Potentially Malignant Disorder (PMD) and Group III were Oral Cancer (OC). Out of 150 subjects 50 subjects were diagnosed as potentially malignant disorder and 50 were diagnosed as oral cancer based on histopathological diagnosis. Results: When results of group III were compared and correlated to subjects of group I, a decrease in TC, HDL, LDL and VLDL was elicited. When results of group II were compared and correlated to subjects of group I, a decrease in TC, HDL, LDL and VLDL was elicited. Triglycerides, was not significantly altered in the study. Interpretation and Conclusion:The results of our study showed an evidence of an inverse relationship between serum lipid profile and oral cancer and potentially malignant disorders. The lower serum lipid status may be considered as an indicator to reflect the initial changes occurring in neoplastic cells, thus substantiating their use as a diagnostic adjuvant in monitoring the oral cancer and potentially malignant disorder.

No abstract