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BACKGROUND: Human hydatid disease (HD) is a chronic parasitic infection caused by Echinococcus species. Classic human hydatid cystic disease is a neglected zoonotic disease caused by the larva of cestode Echinococcus granulosus, leading to serious life-threatening complications. This study examines the range of presentations, mainly uncommon sites and changes in hematological parameters in recurrence and before and after surgery. METHODS: Amongst a total of 109 cases of HD, 25 unusual sites of HD were retrospectively studied in central India tertiary care rural hospitals from January 2016 to December 2020. Demographic details, clinical details, treatment reports, hematological reports, histopathology reports, and ultrasonography (USG)/computed tomography (CT)/magnetic resonance imaging (MRI) reports were also retrieved. RESULTS: Histologically, scolices were found in 40.36% of the cases. Preoperative mean platelet volume (MPV) and platelet count (PLT) were significantly higher and lower, respectively, compared to the postoperative period. The recurrence rate of HD after surgery was 3.6%, while in the case of unusual presentation, recurrence was noted as 8%. All 4 cases of recurrence showed increased PLT (P < 0.0001). CONCLUSION: The study's findings highlight essential features of HD, which help early clinical suspicion, prompt diagnosis, and management to reduce morbidity and mortality related to HD. A possibility of HD should be considered in the differential diagnosis of cystic swellings present anywhere in the body, especially at rare and unusual sites. Platelet parameters and eosinophil count could be utilized to determine early suspicion and rule out the possibility of recurrence of HD.

BACKGROUND: Soft tissue tumors (STT) are rare, heterogeneous neoplasm, derived from the mesoderm. The wide range of STT and absence of recognizable architectural patterns on cytology makes the diagnosis of STT through fine needle aspiration cytology (FNAC) difficult. METHODS: This laboratory-based, non–interventional, observational, retrospective study was conducted on 526 diagnosed cases of STT between 2015 and 2019, for cytohistological correlation. In all the cases, complete clinical details, radiological and clinical data, and cytopathological and histopathological diagnosis were recorded from the Hospital Information System and pathology records. The cytological smears were examined and were categorized as benign, suspicious for malignancy, and malignant. Corresponding histopathology slides were examined for diagnostic concordance considering histopathology as the “gold standard.” Cytohistopathological correlation was assessed in all cases and the diagnostic accuracy of FNAC was expressed as a percentage. Statistical analysis was carried out using SPSS software. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV)‎ were calculated using the respective formulae. P values < 0.05 were considered to be significant. RESULTS: Overall accurate categorizations of benign STT and malignant STT were 61.96% and 17.05%, respectively. The overall diagnostic accuracy of FNAC was 93.5%. Its sensitivity, specificity, PPV, and NPV were 83.68%, 97.39%, 91.47%, and 94.20%, respectively. Correlations with a p value < 0.001 were considered significant. CONCLUSION: FNAC is an important preliminary diagnostic tool in STT and is helpful in the diagnosis of local recurrence and metastatic tumors in the soft tissue. FNAC has a high degree of correlation with core biopsy, thereby avoiding significant clinical complication associated with it.

Background: D-dimer is a fibrin degradation product (FDP), a small protein fragment present in the blood after a blood clot is degraded by fibrinolysis. Aim: To evaluate the association of D-dimer level with prognosis, disease progression and survival of patients in cases of solid malignancies. Setting and Design: Analytical cross sectional study conducted from February 2021 to February 2023. Materials and Methods: Data regarding 100 solid malignancy cases including their preintervention D-dimer levels and its value at follow up, grading, TNM [Tumor size (T), node (N), and metastases (M)] staging of tumor, disease progression and patient status were recorded. Statistical Analysis: Kaplan–Meier curve and Log Rank. Results: Amplified D-dimer level was noted in 85% cancer cases. 76.3% of oral cancer, 82% of breast cancer, 100% cases of digestive tract and ovarian cancer were presented with high D-dimer level. D-dimer in T1 + T2 stage was statistically lower than the D-dimer level of T3 + T4 stage. (χ2 = 5.40, P = 0.002). Comparison of Lymph node in N0 versus N1 + N2 stage (χ2 = 5.82, P = 0.0001) as well as no metastases stage (Mo) versus M1 stages (χ2 = 3.02, P = 0.003) of solid malignancies had significant difference in D-dimer level. D-dimer increased significantly and linearly with recurrence and advancement of solid malignancy. Dead patient had higher D-dimer than alive patients (t = 3.75, P = 0.0001). Increased D-dimer was associated with elevated mortality (P = 0.023, odd ratio = 3.73, survival coefficient = 1.31 with standard error = 0.578). Conclusion: D-dimer is a promising prognostic biomarker which can predict poor clinical outcomes in cancer patients, cancer recurrence, progression, metastases, poor survival.

Introduction: Heat shock protein (HSP) 27, if overexpressed in breast cancers, affects the disease outcome and sensitivity of tumors to chemotherapy and radiotherapy. There are limited studies on actual patients in India, so the present study was designed to contribute our experiences to the literature regarding HSP 27 expression and its significance in breast carcinoma. Materials and Methods: Thirty diagnosed cases of invasive duct carcinoma are evaluated for histopathology grade, stage, and expression of immune markers, namely, ER, PR, HER2, VEGF, and HSP 27, followed up to 2 years after primary management, especially if treated with Herceptin. The staining was evaluated, and data were analyzed using the χ2 and Fisher’s exact tests. Results: HSP 27 is expressed strongly in most ER- and PR-positive cases, but there is no correlation with Her2 and VEGF. The findings suggest more advanced disease, adverse outcomes, and lymph node metastasis. Moreover, these findings are directly related to strong HSP 27 expressions and shorter overall survival in the group of ER/PR-positive breast carcinoma cases, but this relation can be relied upon up to stage II disease. After that, in advance cases, HSP 27 loses its significance slowly and could not establish any link between HSP 27 and Herceptin resistance because of a short follow-up. Conclusion: HSP 27 proved a promising prognostic marker in ER/PR-positive breast carcinoma cases.

Background: Transrectal fine-needle aspiration cytology (TRFNAC) is a beneficial practical method for the early diagnosis of prostate lesions. Aim: The aim of this study was to analyze the efficacy of TRFNAC in diagnosing prostatic lesions and its correlation with histologic diagnosis and evaluate the survival outcome and prognostic factors in prostatic cancer (PCa). Setting and Design: This was a retrospective study conducted from January 2014 to December 2018. Materials and Methods: Data regarding clinical findings, prostate-specific antigen (PSA), TRFNAC diagnosis, histopathological findings, treatment, and patient status were retrieved. Statistical Analysis: The Kaplan–Meier curve and log-rank (Mantel-Cox) were used for analysis. Results: Two hundred and fifty-seven cases of the prostatic lesion were selected. The overall diagnostic accuracy of TRFNAC for prostatic lesions was 95.41%. The sensitivity and specificity of TRFNAC were reported as 84.84% and 97.1%, respectively. The positive predictive value (PPV) and negative predictive value were reported as 82.35% and 97.57% on TRFNAC, respectively. The diagnostic accuracy of TRFNAC for prostate intraepithelial neoplasia was 22.2%. The overall survival outcome in PCa patients was 100% at 1 year, 71.2% at 3 years, and 59.3% at 5 years. Survival outcome significantly altered depending on the Gleason score, PSA level, metastases status, and treatment given, which showed Chi-square values of 78.49 (P = 0.000), 39.26 (P = 0.000), 16.52 (P = 0.000), and 31.92 (P = 0.000), respectively. The median survival time of PCa cases was 1522.01 days with a standard error of 152.92. Conclusions: TRFNAC is a beneficial and reliable tool for screening and diagnosing prostatic lesions. Prognostic factors such as surgery alone or combination, Gleason score ≤ 6, no metastases status, and PSA < 50 are associated with good survival.

Background: The coronavirus disease (COVID-19) has spread worldwide, and the pathogenic mechanism is still under investigation. Preliminary reports suggest a link between ABO blood groups and susceptibility to severe COVID-19. Aim: The aim of this study was to confirm the link between ABO blood type, the risk of coronavirus infection, and the severity of COVID-19 disease. Setting and Design: This was a retrospective cohort study. Materials and Methods: The study was carried out at tertiary care rural hospital in Central India. The patients admitted to the COVID unit over 6 months were enrolled in the study. The data further statistically analyzed the outcome of COVID-19 disease and its relation with the patient's blood group and serum ferritin levels. Results: The data analysis observed no significant impact of blood group on the outcome of COVID-19 in terms of death and cured cases. The mortality rate was 27.2% in the AB blood group, with the highest reported serum ferritin levels (1007.78 ± 1301.25). Compared to other blood groups, A (8.1%), followed by O (13.5%), with the lowest mortality rate (P = 0.31). Alanine transferase and aspartate transferase were maximally seen in patients having blood group AB +, and lower values were observed in blood group A. Conclusions: Blood groups A and O were considered COVID-19 protective in mortality following the cytokine storm. AB blood group had high serum ferritin levels, so it can be a potential tool to predict mortality and may be considered the culprit for the triggering “cytokine storm.”

Background: Iron-deficiency anemia (IDA) in children and infants can have long-term adverse consequences on neurodevelopment and behavior, which can be irrevocable in some cases and detrimental to the immune system. Aim: The aim of this study was to investigate the role of IDA and its effects on immunity in CD8 and CD4 lymphocytes. Settings and Designs: This was a prospective study. Materials and Methods: A total of 40 pediatric cases (2–12 years) were first time diagnosed as IDA based on complete blood count (CBC) parameters, peripheral blood smear, and serum ferritin levels. Flow cytometric immune assays were used to determine the number of CD4+ and CD8+ lymphocytes and the ratio of CD4+/CD8+. Statistical Analysis: Pearson's correlation coefficient and Students' unpaired t-test were used. Results: The difference between the case and control groups in hemoglobin (Hb), red blood cell (RBC) indices, red cell distribution width, RBC count, and serum ferritin is highly significant. A significant linear positive association between CD3+ and CD4+ cell counts and serum ferritin and a significant linear positive correlation between CD4+ cell counts and Hb were observed. However, there was a nonsignificant linear positive association of both parameters, hemoglobin (Hb) and mean corpuscular volume (MCV) with CD3+ cell count, CD4+ cell count, and CD4+/CD8+ cell ratio. Conclusion: Iron deficiency does not affect total white blood cell count or differential leukocyte count on routine CBC, but it can alter cellular immunity (CD3+ cell count, CD4+ cell count, and CD4+/CD8+ cell ratio).

Meckel's diverticulum (MD) is usually silent and asymptomatic. Acute diverticulitis, perforation, intestinal obstruction, hemorrhage, and other complications are seen in