To estimate the concentration of methemoglobin (MetHb) in malaria patients and correlate with severity of malaria infection. This prospective study included 30 untreated cases of malaria confirmed by Quantitative Buffy Coat (QBC) test and 30 age sex matched non-malarial cases taken as controls. All the patients underwent thorough clinical examination and routine biochemical investigation. Methemoglobin levels were estimated by spectrophotometric (co-oxymeter) method on day 1 and day 10 of diagnosis of all study group patients and correlated with clinical profile and severity. Out of 30 malaria patients 22 were males and eight were females. The clinical presentations in complicated malaria group (n = 21) were fever 21 (100 %), anemia 17 (80.95 %), renal failure 12 (52.38 %) and coma/convulsion 5 (23.8 %). The mean age of the study group was 41.66 years. Mean MetHb in complicated malaria on day 1 was 2.55 ± 1.75 % and day 10 was 10.69 ± 8.19 % (statistically significant). The overall mortality was 13 (43.33 %) among study group while 5 (16.66 %) was found among control group. Mean MetHb who died (n = 13) on day 1 was 3.144 ± 1.829 % and (n = 8) on day 10 it was 19.982 ± 8.406 %. Increase in level of methaemoglobin is detrimental to the body and is associated with increase in mortality. Routine MetHb estimation may be used as a prognostic indicator in the management of malaria patients. It is suggested that addition of drugs which reduce MetHb may be tried along with antimalarial drugs to decrease morbidity and mortality in malaria.
Introduction:
Neuroendocrine tumors (NETs) are neoplasms that arise from cells of the endocrine (hormonal) and nervous systems. Many are benign, while some are malignant. They most commonly occur in the intestine. While the liver is a common site of metastases.
Case Presentation:
We describe a 73-year-old female who reported to our center with complains of swelling and pain in the right upper quadrant of stomach. CECT revealed large well-localized multicystic mass in the right lobe of the liver. A suspicion of hydatid cyst was given. However, immunogenic tests results were negative for hydatid cyst. The AFP level was also unremarkable.
Conclusion:
Histopathological examination with immunohistochemical panel along with other serological and radiological investigations made the diagnosis possible due to its vague clinical presentation.
Adamantinoma‐like Ewing sarcoma (ALES) is a histological subtype of Ewing sarcoma that demonstrates the morphological and immunohistochemical features of the latter, harbors the EWSR1::FLI1 gene fusion, and additionally demonstrates complex epithelial differentiation on morphology and immunohistochemistry. Accurate preoperative diagnosis has potential to inform management and improve patient outcome. Cytomorphology of ALES is not well documented, with available reports showing a spectrum of features. An aspirate from a 30‐year‐old male with a swelling in right parotid region, interpreted elsewhere as acinic cell carcinoma (ACC), was submitted to us for review. Smears showed dispersed cells and loosely cohesive clusters with scant cytoplasm and large nuclei with focal nuclear molding, prompting a diagnosis of malignant neoplasm, possibly neuroendocrine carcinoma. Cytoplasmic vacuoles and tigroid background were present focally, the former of which had possibly led to interpretation as ACC. No material was available for ancillary tests. Parotidectomy revealed features of ALES. The cytological features of ALES in the parotid overlap with several basaloid and round blue cell neoplasms that are more common at this site. ALES should be considered in all salivary gland aspirates with isomorphic small round or basaloid cells, with or without the presence of squamous differentiation. Rosettes, cytoplasmic vacuoles, and a tigroid background are subtle morphological clues to the diagnosis, which if suspected on cytomorphology, can be confirmed using ancillary techniques.
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