BACKGROUND: Leprosy is a chronic infectious granulomatous disease caused by Mycobacterium leprae. It is a spectral disease which is classified into five groups according to Ridley and Jopling based on clinical, histological, microbiological and immunological criteria. Adequate clinical information combined with bacilloscopy and histopathology is helpful not only in classification of different types of leprosy but also useful for management of the cases.METHOD: 50 cases of leprosy were examined and clinical data was recorded. Slit skin smears were stained with Ziehl Neelsen stain. Skin biopsy was stained with Hematoxylin-Eosin stain and Fite Farraco stain was performed to demonstrate acid fast bacilli. All patients were classified according to Ridley & Jopling classification. Clinico-histopathological correlation was done. Statistical analysis was done using SPSS (Statistical Package for the Social Sciences) 16.0.RESULTS: Most common histological type of leprosy was tuberculoid leprosy seen in 19(38%) cases followed by indeterminate leprosy. Overall clinico-histopathological correlation was seen in 39.58%. The correlation was highest in indeterminate and histoid leprosy (100%) followed by lepromatous leprosy (66.66 %%) and tuberculoid leprosy (50%). Slit skin smear showed bacilli in 12 out of 48 cases (25%) while biopsy showed bacilli in 16 out of 48 cases (33.3%).CONCLUSION: In the present study, clinical diagnosis did not correlate with histopathological diagnosis significantly (p value=0.04159). The study emphasizes the role of histopathological and bacilloscopic examination to aid the clinical diagnosis for accurate typing of leprosy cases then better management of the patient.

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Summary We report details of 2 patients who had been treated for a long time by dapsone monotherapy and who had remained smear negative for over 10 years, but were fo und to have relapsed with borderline-tuberculoid (BT) leprosy.Relapses in lepromatous leprosy (LL) fo llowing treatment are not uncommon. Long after smear negativity has been achieved with DDS monotherapy, patients are known to relapse.I-6 Almost all of these relapses have been of lepromatous or borderline lepromatous type with skin smear positivity and continued lepromin negativity.However, in the past, a few patients on relapse or reactivation presented with a tuberculoid picture, and this was usually because of late reversal reaction secondary to continued treatment.7 In retrospect, it is now considered that these patients were more probably of BL rather than of lepromatous type.In contrast to the above, reports of JonquieresB and Waters & Ridley9,lo concern the appearance of BT relapses in long-treated LL patients. A similar observation of BT relapse in 2 old lepromatous patients, treated for long periods with dapsone montherapy and who had remained skin smear negative for a number of years, was made by us and is reported.PATIENT 1 This Indian female was diagnosed as a case of leprosy 28 years ago. To begin with she had impaired sensation on the right lower limb. She had no patch or any other problem 5 years later, following her first child's birth, she had painful eruptions, appearing rapidly over the buttocks and fa ce. This was associated with fever, joint pains and severe pain in the limbs. She was diagnosed as a case of leprosy and put on DDS together with antireaction drugs. She improved in the ensuing 3-4 weeks. Subsequently, she was continued on 25 mg DDS doses, which she took irregularly. During her next ENL

Background: Ewing\'s family tumors are malignant and occur in children and young adults.Sinonasal region is slightly rare in occurrence and can present in various types of symptomatology .Ewing sarcoma (ES) and primitive neuro-ectodermal tumor(PNET) are the most common entities in this family. The preliminary diagnosis is always confused because of delayed symptoms and improper histopathological and immunohistochemistry (IHC). Most of the complaints are because of tumor mass pressing and displacing the neighboring structures. Case presentation: 36-years old male adult reported with progressively increasing face swelling on the bridge of the nose and forehead predominately on left side of three years duration. There was pain and blocking of left side nose first and then on the other side. There were also off and on episodes of epistaxis. Ultrasonography (US) and color flow imaging (CFI) confirmed the swelling of solid consistency with hypervascularity. The patient underwent CECT and MRI studies which delineated the entity and was confirmed by histopathology. Conclusion: Sino nasal masses require detailed cross sectional imaging studies, histopathological and immunohistochemistry confirmation for proper and in time management strategies.

Background: Common carotid artery occlusion (CCAO) can be noticed while carrying out routine sonography and color flow imaging (CFI) of the carotid vessels. The complete evaluation is required when detected in these types of cases. The presenting feature may vary from minor to the major category. Internal carotid artery (ICA) and external carotid artery (ECA) may or may not be the part of occlusion. Case report: we report a 39-years old male who reported with sudden loss of vision in right eye. He underwent carotid ultrasonography (US) and was found to be having complete occlusion of right CCA and ICA. Conclusion: Non alarming stroke may not be the finding in complete occlusion of CCA and their distal branches. There can be isolated finding of retinal artery occlusion as happened in our case. Color flow imaging is the modality of choice for clinching the diagnosis.