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Background The International Academy of Cytology (IAC) has developed a standardized approach for reporting the findings of breast fine-needle aspiration cytology (FNAC). Accordingly, there are five chief categories of breast lesions, C1 (insufficient material), C2 (benign), C3 (atypical), C4 (suspicious), and C5 (malignant). The prognostication and management of breast carcinoma can be performed readily on the basis of this classification system. The aim of this study was to classify various breast lesions into one of the above-named categories and to further grade the C5 lesions specifically using the Robinson system. The latter grades were then correlated with modified Scarff-Bloom-Richardson (SBR) grades. Methods This retrospective study was undertaken in the pathology department of a hospital located in the urban part of the city of Bangalore. All FNAC procedures performed on breast lumps spanning the year 2020 were included in the study. Results A total of 205 breast lesions was classified according to the IAC guidelines into C1 (6 cases, 2.9%), C2 (151 cases, 73.7%), C3 (13 cases, 6.3%), C4 (5 cases, 2.5%), and C5 (30 cases, 14.6%) groups. The C5 cases were further graded using Robinson’s system. The latter showed a significant correlation with the SBR system (concordance=83.3%, Spearman correlation=0.746, Kendall’s tau-b=0.736, kappa=0.661, standard error=0.095, p≤.001). Conclusions A standardized approach for FNAC reporting of breast lesions, as advocated for by the IAC, improves the quality and clarity of the reports and assures diagnostic reproducibility on a global scale. Further, the cytological grading of C5 lesions provides reliable cyto-prognostic scores that can help assess a tumor’s aggressiveness and predict its histological grade.

Non-Hodgkin’s lymphoma (NHL) is the most common type of Gastrointestinal (GI) lymphoma with known complications such as bleeding, obstruction and perforation. In this article we present a 59-year-old male patient diagnosed with Peripheral T cell Lymphoma – Not Otherwise Specified (PTCL-NOS) with GI involvement was started on chemotherapy. On day 2 post completion of first cycle of chemotherapy, patient had presented to the emergency department with sudden onset abdominal pain and distension. On evaluation, he was diagnosed with multiple perforations in the small bowel. Patient underwent exploration with primary repair of few perforations and ileal resection with double barrel ileostomy. Chemotherapy plays an important role in the management of NHL. One well-known NHL consequence, intestinal perforation, can happen at the time of initial presentation or after starting chemotherapy. Surgeons should be aware of possibility of such complications and high-risk factors for perforation. At present, there is no role for elective surgery in GI lymphoma and is mainly reserved for complications like uncontrolled bleeding, obstruction or perforation.

OBJECTIVES The purpose of this study is to investigate the effect of applying a very minimal weight bearing in the early phase of a general rehabilitation program for returning to sports after periacetabular osteotomy for developmental dysplasia of the hip in physically active populations. METHODS A 22 year-old NCAA Division I female water polo player, with no prior history of hip injury and no signs of developmental dysplasia of the hip (DDH), reported to athletic training facility early season complaining of right hip pain after stationary bike workout. The athlete reported hearing and feeling a sudden “pop” within the right hip with immediate hip pain when she was pedaling at moderate intensity of a stationary bike. Numbness and tingling was felt initially with the mechanism. Tender to palpate at the right hip flexor and anterior hip joint, as well as the greater trochanter. The athlete’s chief complaints were pain with walking and prolonged sitting. Antalgic gait noticed during evaluation. A 6-, 12-, and 24-week rehabilitation protocol were performed. RESULTS X-ray and MRI images showed no avascular necrosis or fracture. An abnormal alpha angle found and no bursitis or tendonitis was shown. A periacetabular osteotomy (PAO) was performed to rotate the acetabular fragment into optimal position and fixed to the pelvis with 3 screws. During the initial 6-week of post-surgical rehabilitation, the level of pain and edema were minimized, the athlete was able to perform toe-touch and partial weight-bearing with crutches, and restored hip ROMs. From 6 to 10 weeks, the athlete recovered full hip ROMs and able to perform lunges, leg press, deadlifts, mini squats back to pre-injury status. The athlete was able to return to activities of daily living (ADLs) after 12 weeks. At 24 weeks, the athlete was able to fully participate in sports without limitations. CONCLUSIONS This case describes the rehabilitation program employed following PAO for an atypical case of DDH in a water polo athlete who had no signs and symptoms of DDH prior to sports participation. At the end of the season, the athlete opted to undergo PAO given the risks and underwent a 6-month rehabilitation before a full return to function. This case report aides with treatment knowledge and postsurgical rehabilitation techniques for athletic trainers.

Pnuemocystis jirovecii pneumonia (PJP) is one of leading causes of acute respiratory failure in patients infected with human immunodeficiency virus (HIV), and the mortality rate remains high in mechanically ventilated HIV patients with PJP. There are several reported cases who received extracorporeal membrane oxygenation (ECMO) treatment for respiratory failure associated with severe PJP in HIV-infected patients. We report a patient who was newly diagnosed with HIV and PJP whose condition worsened after highly active antiretroviral therapy (HAART) initiation and progressed to acute respiratory distress syndrome requiring veno-venous ECMO. The patient recovered from PJP and is undergoing treatment with HAART. ECMO support can be an effective life-saving salvage therapy for acute respiratory failure refractory to mechanical ventilation following HAART in HIV-infected patients with severe PJP.