Background: Subcutaneous fungal granulomas are rare deep fungal infections that often mimic neoplastic or inflammatory lesions, making diagnosis challenging, particularly in immunocompetent elderly individuals. Their nonspecific clinical presentation frequently results in delayed diagnosis and inappropriate initial management. Case Details: This is a 74-year-old female presented with a gradually progressive painful swelling over the right thigh for three months. Clinical examination suggested a soft tissue sarcoma, lipoma, abscess, and malignancy considered as differential diagnoses. MRI demonstrated hypertrophied edematous muscles, while FNAC was suggestive of a giant cell-containing lesion. Histopathological examination revealed necrotizing granulomatous inflammation with broad ribbon-like fungal hyphae, establishing the diagnosis of subcutaneous fungal granuloma. Following histopathological diagnosis, the patient was initially prescribed itraconazole 200 mg orally once daily for 3 days and on follow-up, there was clinical improvement in the swelling and associated pain, and the patient was reported to be clinically well without significant ongoing symptoms. Conclusion: Subcutaneous fungal granuloma should be considered in the differential diagnosis of chronic soft tissue swellings, even in immunocompetent elderly patients. Early clinicopathological correlation and histopathological evaluation are essential for timely diagnosis and appropriate management.
Non-neoplastic skin lesions are more prevalent than neoplastic lesions. Clinically, many skin lesions exhibit overlapping morphological features, making correct diagnosis difficult without histopathological evaluation. A pattern-based approach to evaluation of skin punch biopsies facilitates categorization and diagnosis. Aim and Objectives: To analyze the clinical presentation, histopathological spectrum of non-neoplastic skin lesions and classify them based on tissue reaction patterns. Materials and Methods: This retrospective study was conducted over one year (JanuaryDecember 2025) in the Department of Pathology at a tertiary care center. Relevant clinical data were retrieved, histopathological slides were examined, diagnoses were established and categorized according to tissue reaction patterns. Findings were compiled and analyzed in Microsoft Excel. Results: A total of 88 skin punch biopsies were studied: 45 females (51.1) and 43 males (48.9). The most frequently affected age group was 31-40 years (26.1) followed by 41-50 years (21.6) Common presentations included hyperpigmented plaquespatches (33), erythematous lesions (23.9), hypopigmented lesions (12.5) and itchy plaques (13.6). Among major tissue reaction patterns our study found Lichenoid pattern (19.3) to be highest in number within which lichen planus (4) was most frequent. Followed by psoriasiform pattern (18.2) within which prurigo nodularis (6) was most frequent then granulomatous pattern (9.1). 11.4 cases were categorized under nonspecific lesions as few of them had non-specific findings and few others were inadequately sampled. Conclusion: Histopathological tissue reaction pattern analysis along with clinical features helps in categorization which streamlines the diagnosis of non-neoplastic skin lesions in punch biopsies.
Introduction: Adhesive capsulitis is a chronic condition marked by inflammation and stiffness of the shoulder joint. This leads to a significant loss of both active and passive movement. While most rehabilitation approaches focus on the glenohumeral joint, this study also evaluates the role of the scapulothoracic region in shoulder mobility. Objectives: This study evaluates the effectiveness of adding targeted scapulothoracic exercises to conventional occupational therapy. Methods: 16 participants were divided into a control group receiving standard therapy and an experimental group receiving additional scapulothoracic exercises. Outcomes were assessed at baseline, 3 weeks, and 6 weeks, with pain scores, range of motion, muscle strength, and quality of life being the outcome measures. Results: Both groups showed significant improvements (p Conclusion: These findings suggest that incorporating scapulothoracic exercises can enhance overall recovery and improve patient well-being in adhesive capsulitis.
Background: Chronic kidney disease (CKD) is associated with progressive biochemical and haematological changes resulting from declining renal function. Routine haematological parameters and complete blood count (CBC)-derived indices associated with inflammation may provide useful information regarding disease severity. This study evaluated the association of haematological parameters and CBC-derived indices associated with inflammation across different stages of CKD. Methods: A hospital-based cross-sectional analytical study was conducted among 125 adult patients with CKD stages 3b5 attending a tertiary care hospital between May 2024 to September 2025. Haematological parameters, including haemoglobin, red blood cell count, haematocrit, red cell distribution width (RDW), mean platelet volume (MPV) and neutrophil-to-lymphocyte ratio (NLR), were analysed and compared across CKD stages. Continuous variables were compared using one-way analysis of variance, while categorical variables were analysed using the Chi-square test. Results: Haemoglobin concentration, red blood cell count and haematocrit declined significantly with advancing CKD stage (all PConclusion: In this cross-sectional study, advanced CKD stages were associated with lower erythroid parameters and higher CBC-derived indices associated with inflammation. These routinely available haematological measures may provide useful adjunctive information for clinical assessment and monitoring across CKD.
Background: Postoperative sore throat (POST), post-extubation cough and hoarseness of voice are common complications following endotracheal intubation. Topical application of lubricants to the endotracheal tube has been proposed to reduce these airway symptoms, but evidence comparing betamethasone gel and lignocaine gel remains limited. Methods: This prospective comparative study included 80 adult patients undergoing elective surgery under general anaesthesia with endotracheal intubation. Patients were allocated to receive either betamethasone gel or lignocaine gel applied to the endotracheal tube (40 patients per group). The severity of POST, post-extubation cough and hoarseness of voice was assessed at 1, 6 and 24 hours after extubation using a four-point ordinal scale. Between-group comparisons were performed using the Mann-Whitney U test, while within-group changes over time were analysed using the Friedman test. Results: Baseline characteristics were comparable between the groups. Betamethasone gel significantly reduced POST severity compared with lignocaine gel at 1, 6 and 24 hours (all p
Hydatid disease caused by Echinococcus granulosus most commonly involves the liver and lungs; however, primary involvement of atypical anatomical sites is uncommon and often poses diagnostic challenges. This retrospective case series describes four patients diagnosed with hydatid cysts at rare locations, including the orbit, gluteal muscle, kidney, and pancreas, at a tertiary care center in Central India. All cases presented as cystic masses clinically mimicking other benign or neoplastic conditions. Definitive diagnosis was established on histopathological examination demonstrating characteristic laminated cyst walls, germinal membranes, and protoscolices or hooklets. Serological investigations were not uniformly available, which is acknowledged as a limitation. This series highlights the importance of considering hydatid disease in the differential diagnosis of cystic lesions at unusual sites, particularly in endemic regions.
Background: Hepatitis A virus (HAV) and hepatitis E virus (HEV) are important causes of acute viral hepatitis in India. Data on their seroprevalence, demographic distribution, and co-infection with hepatitis B virus (HBV) and hepatitis C virus (HCV), remain limited from South India. This study aimed to determine the seroprevalence and epidemiological profile of HAV and HEV infections among patients with suspected acute viral hepatitis. Methods: A retrospective record-based study was conducted at a tertiary care centre in South India over a four-year period. Laboratory records of 612 patients evaluated for suspected acute viral hepatitis were retrieved. Serological results for anti-HAV IgM, anti-HAV IgG, anti-HEV IgM, HBsAg and anti-HCV were analysed along with demographic characteristics, pregnancy status and seasonal distribution. Results: Acute HAV and HEV infection was detected in 198 (32.4) patients. HAV infection was more common than HEV infection 135 (22.1) vs. 54 (8.8), while mixed HAVHEV infection was observed in 9 (1.5) patients. HAV infection occurred mainly among children and adolescents, whereas HEV infection was more frequent among young and middle-aged adults. Isolated anti-HAV IgG positivity was detected in 72 patients. Concurrent HBV andor HCV infection was identified in 48 (7.8) patients. Among 36 pregnant women, HEV infection was more frequent than HAV infection 9 (25.0) vs. 6 (16.7), with most HEV-positive cases detected during the third trimester. Nearly three-fourths of acute HAV and HEV infections occurred during the monsoon and post-monsoon months. Conclusion: Acute HAV infection was more common than HEV infection among patients with suspected acute viral hepatitis. HAV infection occurred mainly among children and adolescents, whereas HEV infection was more frequent among adults and pregnant women. Concurrent HBV andor HCV infection and seasonal clustering were also observed. Comprehensive serological assessment provides valuable epidemiological information for the evaluation of acute viral hepatitis.
Background: Serum cancer antigen 125 (CA-125) is widely used in the evaluation and triage of adnexal masses. Several hospital-based Indian studies have reported very high diagnostic accuracy for CA-125 in distinguishing malignant from benign ovarian tumours. However, many such studies are derived from general gynaecological practice and contain predominantly benign lesions. The performance of CA-125 in malignancy-predominant cohorts, such as those encountered in tertiary oncology services, is less well characterised. Methods: We conducted a retrospective observational study of consecutively archived ovarian resection and oophorectomy specimens diagnosed at a single tertiary centre. Sixty unique patients were analysed after exclusion of duplicate records. Tumour behaviour and histogenetic category were assigned from the recorded histopathological diagnosis according to the fifth edition of the WHO Classification of Female Genital Tumours. Serum CA-125 values recorded at diagnosis were analysed using the conventional threshold of 35 UmL. Because 45 of specimens were recorded as having been resected after neoadjuvant chemotherapy (NACT), a pre-specified sensitivity analysis was performed in patients without recorded NACT. Continuous variables were compared using the MannWhitney U test and categorical variables using Fisher exact test. Proportions are presented with exact 95 confidence intervals (CI), and diagnostic discrimination with the area under the receiver operating characteristic curve (AUC) and bootstrap 95 CI. No values were imputed. Results: Of 60 patients, 41 (68.3had malignant tumours, 10 (16.7) benign lesions, two (3.3) borderline tumours, and seven (11.7) nonspecific or unclassified lesions. Epithelial tumours predominated (4660, 76.7). Median age was 46.0 years (IQR 42.056.0) and did not differ between malignant and benign groups (p0.716). CA-125 was available for 38 patients and was significantly higher in malignant than benign tumours (median 100.6 vs 23.2 UmL; p0.0069). At 35 UmL, sensitivity was 76.9 (95 CI 56.491.0), specificity 75.0 (42.894.5), and AUC 0.801 (0.6400.935). Six of 26 malignancies had CA-125 values below 35 UmL. In patients without recorded NACT, sensitivity decreased to 63.6 and AUC to 0.727. Among malignant tumours, CA-125 was higher in specimens following NACT than in those without recorded NACT (median 420.3 vs 46.2 UmL; p0.049). Bilateral ovarian involvement was significantly associated with malignancy (1217 malignant vs 19 benignborderline; p0.011). Conclusions: In this malignancy-predominant cohort, CA-125 at the conventional 35 UmL threshold showed only moderate discrimination and missed approximately one-quarter of malignancies. Bilaterality demonstrated a stronger association with malignancy than the CA-125 threshold. The findings suggest that the near-perfect performance reported in some benign-predominant surgical series may partly reflect case mix. CA-125 should therefore not be interpreted in isolation in referral populations. Prospective studies incorporating marker timing, menopausal status, and imaging morphology are required to evaluate its performance in multimodal diagnostic models.
Background: Phlebotomy is a core skill required for safe blood specimen collection in clinical and laboratory practice. This study evaluated the knowledge, attitude and practical competency of BSc Medical Laboratory Technology students after completion of a value-added phlebotomy course. Methods: A descriptive questionnaire-based educational evaluation was conducted among 63 fourth-semester BSc MLT students after completion of a 30-hour value-added phlebotomy course. Knowledge, attitude and practical competency were assessed using a validated structured questionnaire and faculty-assessed practical checklist. Data were analysed using descriptive statistics. Results: Among the 63 students, 56 (88.9) demonstrated good knowledge and 54 (85.7) demonstrated good practical competency. Domain-wise analysis showed the highest scores for patient preparation (knowledge: 99.2; practice: 95.0), infection prevention (knowledge: 93.3; practice: 97.9), and specimen collection and handling (knowledge: 92.1; practice: 97.3). Positive attitude scores ranged from 87.4 to 91.6 across the assessed domains. Comparatively lower performance was observed in venepuncture technique (knowledge: 80.0; practice: 84.7) and patient identification and communication (87.4). Conclusion: BSc Medical Laboratory Technology students demonstrated good knowledge, favourable attitudes and satisfactory practical competency following the value-added phlebotomy course. Domain-wise assessment identified venepuncture technique and patient communication as areas requiring additional reinforcement during training.
Background: Hand eczema is a common inflammatory dermatosis influenced by endogenous susceptibility and environmental exposures. Its clinical and occupational patterns may vary across geographical and occupational settings. Methods: A hospital-based descriptive cross-sectional study was conducted among 100 patients with clinically diagnosed hand eczema from January to August 2024. Sociodemographic characteristics, occupational exposures, clinical features, aggravating factors, and associated dermatological conditions were recorded. Data were summarised using frequencies and percentages, and exploratory sex-wise comparisons were performed using appropriate statistical tests. Results: More than half of the patients were aged 3145 years (56), and 55 were men. Manual labourers formed the largest occupational group (28), and occupational exposure was reported by 76. Itching (90) was the predominant symptom and erythema (80) the most common morphological feature. Palmar involvement was recorded in 75, bilateral disease in 60, and chronic disease lasting 6 months in 45. A history of atopy was reported by 54 of study population. Conclusion: Hand eczema was commonly associated with occupational exposure and predominantly affected adults in the working-age group. The high proportion of chronic disease and reported exposure-related factors indicates the need for greater attention to occupational and environmental factors during clinical assessment.
Background: Non-communicable diseases (NCDs) such as diabetes, hypertension, cardiovascular disease, hypercholesterolemia, and cancer are major causes of morbidity and mortality in India, particularly in urban populations. The shift from traditional cereals to refined grains has contributed to unhealthy dietary patterns. Millets are nutrient-rich, low-glycaemic cereals with proven benefits in NCD prevention and management; however, their consumption remains limited despite national promotion initiatives. Objectives: To assess awareness regarding the health benefits of millets and their role in NCD prevention and control, assess attitudes toward millet consumption, and identify barriers to regular millet consumption. Methods: A community-based cross-sectional study was conducted among 110 adults aged 18 years residing in the urban field practice areas of Gandhi Medical College, Hyderabad. Results: Among participants, 28 reported having at least one NCD. Overall, 76 demonstrated good awareness regarding the nutritional and health benefits of millets. Knowledge of the role of millets in NCD prevention was good in 51.9, moderate in 36.2, and poor in 11.9. However, 56 reported strong barriers to regular millet consumption. All participants believed millets are beneficial for health, while only 35.5 liked the taste of millet-based foods. Nevertheless, 80 expressed willingness to include millets in their regular diet. Conclusion: Despite high awareness and a positive attitude toward millet consumption, several barriers continue to limit regular intake. Improving nutrition education, accessibility, and supportive policies may promote millet consumption as a sustainable dietary strategy for NCD prevention and control.
Background: Primary mesenchymal chondrosarcoma is a rare malignant neoplasm originating from bone and soft tissue commonly involving maxilla and mandible, but can also involve ribs, pelvis, femur, and spine. Case report: 16 years-old-female presented with weakness and paresthesia of lower limbs since 15 days with difficulty in walking. CT scan showed pre and paravertebral soft tissue density lesion extending from D8 to D12 vertebral body levels. MRI showed heterogenous lesion with hypo and hyperintense areas in T1W1 and hyperintense on T2. Tumor is excised and on histopathological examination revealed the features of mesenchymal chondrosarcoma. Conclusion: Mesenchymal chondrosarcoma is a rare malignant mesenchymal tumor located in bone, intracranial sites or soft tissue with non-specific findings on imaging. Histopathology and additional immunohistochemistry is gold standard for diagnosis.
Allergic fungal rhinosinusitis (AFRS) is more commonly implicated worldwide by Dematiaceous fungi, whereas in India, Aspergillus flavus is more frequently identified. Scopulariopsis brevicaulis an uncommon cause of sinonasal disease, with very rare reports of its association with AFRS. We report a case of a 24-year-old immunocompetent male presenting with a four-year history of unilateral nasal obstruction, watery nasal discharge, and sneezing. Radiological evaluation revealed diffuse involvement of left maxillary, ethmoid, frontal, and sphenoid sinuses, suggestive of AFRS. Endoscopic sinus surgery revealed extensive fungal debris and polypoidal mucosa. Direct microscopy demonstrated septate hyaline hyphae, and fungal culture grew Scopulariopsis brevicaulis. The patient responded well to surgical management alone. This case highlights Scopulariopsis brevicaulis as a rare etiological agent of AFRS in an immunocompetent host. Recognition of this uncommon presentation underscores the importance of mycological evaluation in chronic rhinosinusitis and reinforces surgery as the cornerstone of management in non-invasive disease.
Mixed epithelial and stromal tumor (MEST) of the kidney is a rare, predominantly benign biphasic neoplasm, classically seen in perimenopausal women and often associated with estrogen exposure. Occurrence in young males without hormonal therapy is exceptionally uncommon and poses significant diagnostic challenges. We report a case of a 34-year-old male who presented with abdominal discomfort and was found on ultrasonography to have a large retroperitoneal cystic mass, initially misinterpreted as a pancreatic pseudocyst. Subsequent contrast-enhanced CT revealed a mixed solidcystic lesion arising from the left kidney, radiologically suspicious for malignancy, leading to radical nephrectomy. Histopathological examination demonstrated a characteristic biphasic tumor composed of benign epithelial elements and ovarian-type stromal proliferation. Immunohistochemistry confirmed renal epithelial differentiation and stromal lineage, establishing the diagnosis of renal MEST. The patient remains asymptomatic with no recurrence on follow-up. This case highlights the radiologic pitfalls associated with cystic renal masses, particularly in atypical clinical settings, and emphasizes the pivotal role of histopathology and immunohistochemistry in achieving accurate diagnosis and avoiding potential overtreatment.
Background: Undernutrition among school-going children remains a major public health challenge in India, particularly in rural communities. Evidence comparing the nutritional status of children attending government and private schools in rural Telangana is limited. Methods: A community-based comparative cross-sectional study was conducted between July 2005 and January 2006 among school-going children aged 610 years in Aliabad village, Medchal district, Telangana. All eligible children from government and private schools were included using a census approach. Nutritional status was assessed using the WHO 2007 Growth Reference through WHO AnthroPlus software and classified as normal, moderate undernutrition or severe undernutrition based on weight-for-age and BMI-for-age Z-scores. Clinical examination was performed to identify common co-morbidities. Data were analysed using descriptive statistics and the Chi-square test. Results: Overall, 409 children were studied, including 312 (76.3) from government schools and 97 (23.7) from private schools. Undernutrition was present in 218 (53.3) children, comprising 116 (28.4) with moderate and 102 (24.9) with severe undernutrition. Government-school children had a significantly higher prevalence of undernutrition than private-school children (61.5 vs. 26.8, p
Introduction: Early clinical exposure (ECE) is an integral component of the competency-based undergraduate medical curriculum in India and can be delivered through different instructional methods. Evidence directly comparing different ECE methods in the same group of students is limited. This study compared knowledge gain following case-scenario and video-assisted lecture methods of ECE and assessed students' perceptions of these approaches. Methods: This educational interventional study employed a two-period, two-topic crossover design involving 96 first-year MBBS students in the Department of Physiology during NovemberDecember 2024. Students received ECE on two topics using both case-scenario and video-assisted lecture methods in a crossover sequence. Knowledge was assessed using identical pre-test and post-test questionnaires. Students' perceptions were evaluated using a structured questionnaire and open-ended feedback. Knowledge gain was analysed using paired statistical tests and a linear mixed-effects crossover model. Results: Significant improvement in post-test scores was observed following both teaching methods (p Conclusions: Both case-scenario and video-assisted lecture methods of ECE significantly improved immediate knowledge among first-year MBBS students. Although knowledge gain was comparable between the two approaches, students showed greater preference for case scenarios. The findings support the complementary use of both methods while planning ECE sessions in undergraduate medical education.
Background: Volatile substance use (VSU), commonly known as inhalant abuse, is a public health concern, notably among youth in socioeconomically disadvantaged contexts, yet data from India on its medical and psychosocial correlates remain scant. Methods: This cross-sectional, hospital-based study included 50 VSU cases and 50 age- and gender-matched healthy controls in Kolkata, India. Sociodemographic and clinical characteristics, WHOQOL-BREF-based quality of life, and comprehensive haematological and biochemical profiles were compared between groups. Statistical analyses included t-tests, chi-square, Mann-Whitney U, and effect-size estimation. Results: Glue was the predominant inhalant (94), with early onset and frequent concurrent substance use. Cases had significantly higher odds of below-secondary education (OR 28.5) and unemployment (OR 6.65) than controls. Mean platelet count was significantly lower (p 0.001) and hepatic enzymes were significantly higher (SGOT, ALP, GGT: p
Introduction: Automated haematology analysers provide red cell indices and graphical distributions that complement blood film examination, which remains essential for identifying morphological abnormalities and mixed cell populations. Objective: To describe peripheral blood smear findings and automated RBC histogram patterns among anaemic patients and evaluate their distribution across different morphological patterns. Materials and Methods: This descriptive observational study was conducted at a tertiary care teaching hospital from February to April 2026. Anaemic patients fulfilling WHO 2024 criteria were included. Complete blood counts, RBC indices, and automated histograms were obtained using a Sysmex XN-1000 analyser, alongside peripheral blood smear evaluation. Results: Of 144 patients, 66.0 were female, and 47.9 were aged 3140 years. Microcytic hypochromic anaemia was the most common morphological pattern (64.6), followed by normocytic normochromic (20.1), macrocytic (7.6), and dimorphic anaemia (4.9). Left-shifted histograms were seen in 38.2 of patients, broad-based curves in 30.6, and normal curves in 18.1. All 11 macrocytic anaemia patients (100) showed right-shifted curves. Peripheral smears identified polychromatophils, red cell agglutination, and sickle cell morphology in four, two, and one patients, respectively. Four patients had pancytopenia. Conclusion: Microcytic hypochromic anaemia was the commonest morphological pattern. Histogram patterns varied with red cell morphology, while specific abnormalities such as agglutination, sickle cell morphology and polychromatophilia were identified on peripheral smear. RBC histograms provide useful information on red cell volume distribution but should be interpreted along with peripheral smear findings.
Apoptosis is a tightly regulated form of programmed cell death essential for tissue homeostasis and genomic integrity. Its dysregulation contributes to diverse pathological conditions, particularly cancer, where evasion of apoptosis enables malignant transformation, tumour progression, immune escape, and therapeutic resistance. Contemporary understanding recognises apoptosis as an integrated network involving mitochondrial, death receptor, and caspase-dependent signalling pathways rather than isolated linear cascades. This review synthesises current insights into the molecular mechanisms governing apoptotic regulation and examines how disruptions in BCL-2 family proteins, p53 signalling, caspase activation, and inhibitor of apoptosis proteins promote carcinogenesis. Particular emphasis is placed on translational advances in apoptosis-targeted therapy, including the clinical success of BH3 mimetics, emerging p53-modulating strategies, and combinational approaches designed to overcome apoptotic resistance. By integrating mechanistic biology with therapeutic development, this review highlights apoptosis not only as a hallmark of cancer but also as a therapeutically exploitable vulnerability in selected cancer contexts, particularly in haematological malignancies, although its translation in solid tumours remains variable and often limited. Understanding tumour-specific apoptotic dependencies may enable more precise and less toxic anticancer strategies in the evolving era of precision oncology.
