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The aim of this paper is to examine the relationship between financial decision-making ability and financial choices, and also to check the mediating role of time perspective in this relationship. Financial decision-making ability is composed of two factors: financial behavior (FB) and financial literacy (FL). Whereas, three financial choices are used, which are: investment, savings, and consumption. Using structural equation modeling (SEM), the sample of 380 participants was used to analyze the results. The findings indicate that both financial literacy and financial behavior significantly increase the investment and choices of individuals, while financial behavior also increase consumption. In addition, study found that different factors of time perspective also mediate the relationship between financial decision-making ability and financial choices. The paper concludes with significant policy implications.

Purpose: To study the varied clinical presentation and outcome of management of orbital diseases and to ascertain the concordance of FNAC with histopathology. Materials and Methods: This is a prospective interventional study wherein each patient's clinical presentation was noted. Outcome of management was evaluated based on symptomatic relief, regression of signs, noting any intraoperative or postsurgical complication, recurrence, and cosmetic result in terms of surgical scar. Results: Neoplasia was commonest 33/76; (43.42%), followed by infective and inflammatory conditions 21/76; (27.63% cases), thyroid-associated orbitopathy accounting for 12/76 cases (15.78%), whereas cystic lesions and vascular malformations were 4/76 (5.26%) each. Other disorders constituted a mere 2.65%. Proptosis was the commonest mode of presentation. It was seen in seventy out of seventy-six patients (92.1%). In 86.3% of the cases, there was successful surgical outcome. Of 22 surgically managed cases, recurrence was noted in three cases (13.6%). 90% concordance was seen with histopathology in cases where FNAC was done prior to surgery for diagnosing nature of disease. Conclusions: Majority of orbital and adnexal conditions can be provisionally diagnosed based on imaging; however, an adjunct invasive investigation such as FNAC or biopsy may be required. In the present study, in seven cases (9.2%) FNAC was needed, whereas in two cases (2.63%) biopsy was needed. A definitive diagnosis was confirmed by histopathology in 22 surgically managed cases and by excision biopsy in two. 22/76 (28.94%) of the cases needed surgical treatment, and other cases required conservative or palliative approach.

Background: Children with Cerebral Palsy (CP) face malfunctioning in the motor system and go through difficulties in hearing, eating, sight, and musculoskeletal systems and are also mentally impaired. This may render them unable to maintain proper oral hygiene. The objective of this study was to evaluate oral hygiene in children with cerebral palsy in Karachi’s special schools. Methods: A cross-sectional study with a total of 80 CP children was conducted in special schools in Karachi using a purposive sampling technique. CP children aged 12-15, who consented via guardians/school and were able to comply with the procedure were included. CP children on medications or systemic diseases were excluded. Proforma containing demographic details, and dental history questions were asked. Oral examination was done using the Plaque index, Gingival index, and Oral hygiene index simplified was observed. Results: In this study, there were 48 (60%) males and 32 (40%) females. The mean ± SD of age was 14.4 ±1.4. Independent t-test showed that there was a significant association of gingival index means with the institutes selected (p=0.004). The other parameters PI and OHIS did not show any association. Mean PI (mean 1.99, SD 0.62) and GI (mean 1.9, SD 0.60) showed moderate plaque and gingival inflammation and poor oral hygiene index (mean 3.31, SD 1.3). ANOVA showed associations of PI, GI & and OHIS with dental habits. Conclusion: CP children have poor oral hygiene status and therefore need early diagnosis and prompt treatment to prevent complications.

Background: Anemia is a common health problem worldwide, affecting all age groups especially children under five years. Besides causing significant morbidity and mortality, it devastatingly affects physical growth and cognitive skills. Factors leading to anemia in developing countries are manifold. This study determined the frequency, morphological types and factors associated with anemia among hospitalized children aged 1-5 years in a tertiary care hospital. Methods: This study was conducted among hospitalized children aged 1-5 years, at the Pediatric Department Ziauddin University Hospital, Karachi from September 2019 to March 2020. Total 333 admitted children aged 1-5 years were included. Data was accessed from hospital database. Nutritional factors and diet intake in the preceding week were recorded. The frequency, morphological types and severity of anemia were analyzed. Factors associated with anemia were compared by Chi-squared test for qualitative variables and t-test for numerical variables taking p-value ≤ 0.05 as statistically significant. Results: Anemia was detected in 212 (63.7%) children, among which 170 (80.2%) had microcytic and 4.0 (1.9%) had macrocytic anemia. The frequency of moderate anemia was high 103 (48.6%) and severe anemia 18 (8.5%) was low. Factors significantly associated with anemia (p=0.001) were low birth weight, low maternal education, less household income, pica and non-consumption of meat/animal products. Conclusion: More than half of the hospitalized children aged 1-5 years had Hb

Objective: To investigate the anticancer potential of a novel synthetic derivative of a naturally occurring diterpenoid against glioblastoma. Method: The in vitro study was conducted at the Ojha Campus of Dow University of Health Sciences, Karachi, from February to December 2021, and comprised U87 cells. The 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay was used to determine the growth inhibitory effect of 16(R and S) – phenylamino-cleroda3, 13(14) Zdiene- 15, 16 olide and standard drug temozolomide against glioblastoma cells, and half-maximal inhibitory concentration was calculated. Microscopy and immunocytochemistry were used to investigate apoptotic morphology and active caspase-3 and B-cell lymphoma 2 (Bcl-2) expression. Quantitative real time polymerase chain reaction was used to investigate the expression of proliferation markers. Data was analysed using SPSS 21. Results: Both the synthetic derivative and the standard drug significantly inhibited growth of U87 cells (p0.05). Conclusion: The synthetic diterpene derivative PGEA-AN showed growth inhibitory actiity against glioblastoma. Key Words: Temozolomide, Caspase, Glioblastoma, Diterpenes.

Glioblastoma (GBM) is a fatal astrocytic glioma with poor prognosis and treatment resistance. Repurposing potential FDA-approved drugs like anti-psychotics can address the concerns in a timely and cost-effective manner. Epidemiological studies have shown that patients with schizophrenic using anti-psychotics have a low incidence of GBM. Therefore, we aimed to investigate the therapeutic potential of atypical anti-psychotic Iloperidone (ILO) alone and in combination with Temozolomide (TMZ) against GBM. The study assessed the growth inhibitory effect of ILO, TMZ, and their combination (ILO + TMZ) on U-87MG and T-98G cell lines using an MTT assay. The drug interaction coefficient (CDI) was determined, and doses with synergistic effects were used for subsequent experiments, including migratory, invasion, and TUNEL assays. The expressions of DRD2, β-catenin, Dvl2, Twist, and Slug were assessed by RTq-PCR, whereas the β-catenin protein expression was also determined by immunocytochemistry. ILO (p < 0.05) and TMZ (p < 0.01) significantly inhibited the growth of U-87MG cells at all tested doses. The combination of 60 µM of both drugs showed synergistic activity with CDI < 1. The inhibition of migration and apoptosis was more pronounced in the case of combination treatment (p < 0.001). Inhibition of the invading cells was also found to be significant in ILO- and combination-treated groups (p < 0.001). ILO and combination treatment also significantly downregulated the expression of DRD2, while TMZ upregulated the expression (p < 0.001). The expressions of β-catenin (p < 0.001), Dvl2 (p < 0.001), Twist (p < 0.001), and Slug (p < 0.001) were also significantly downregulated in all treatment groups as compared to the vehicle control. The data suggest that ILO possesses strong growth inhibitory activity, possibly due to its effect on DRD2 and β-catenin expression and has the potential to be repurposed against GBM.

Background: The “international system for reporting serous fluid cytopathology”(TIS) consists of five diagnostic categories: nondiagnostic (ND), negative for malignancy (NFM), atypia of undetermined significance (AUS), suspicious for malignancy (SFM), and malignant (MAL). The study was conducted to reclassify effusion cytology samples according to the newly proposed TIS to calculate the risk of malignancy (ROM) for each category and to conduct performance analysis. Materials and Methods: The study was a retrospective observational study conducted at a tertiary care institution in North India. Clinical data of the cases from June 2013 to July 2021 were retrieved and the cases were reviewed by two cytopathologists. All cases were reclassified according to the proposed TIS system into five categories. Results: A total of 2318 patients were included in the study over a time span of 8 years, and 1614 (69.6%) cases of pleural effusion cytology, 612 (26.4%) cases of peritoneal effusion cytology, and 92 (3.9%) cases of pericardial effusion cytology were included. All effusion cytology smears were recategorized as per TIS guidelines into ND, NFM, AUS, SFM, and MAL with 4 (0.17%), 1756 (75.75%), 12 (0.51%), 57 (2.46%), and 489 (21.11%) cases, respectively, and ROM was 25%, 17.9%, 66.7%, 75.4%, and 96.5%, respectively, for the categories. Conclusion: Besides being a simple, easy, and user-friendly system, TIS has the benefit of risk stratification and ROM for each category. The TIS system proposed a tiered scheme, which places the effusion cytology into well-defined categories, and therefore has lesser chances of false-positive and false-negative cases.

Keratomycosis is common in Indian subcontinent. Diagnosis of the causal agent and successful management is a challenge for the clinician. Scedosporium is a rare fungus species, and it is relatively rare in causing keratomycosis. We report the case of a 29-year-old male who presented with complaints of redness, watering, and white lesion over his left eye. He sustained an injury in the left eye with vegetative matter. Corneal scraping was sent for potassium hydroxide staining and culture; fungal colony was seen in culture. Colony characters on Sabouraud dextrose agar and lactophenol cotton blue enabled a diagnosis of Scedosporium species. The patient was treated with topical Natamycin 5%, and complete resolution was seen at the end of 4 weeks. This case report highlights good response of keratitis caused by Scedosporium to topical Natamycin therapy.

Purpose: To explore straight incision technique in terms of efficacy for intraocular pressure (IOP) lowering by small-incision cataract surgery (SICS) trab versus modified “frown” incision with triangular scleral flap technique. Methods: This study was done at a tertiary health center. It included 44 eyes diagnosed with cataract and coexisting primary glaucoma that underwent SICS with trabeculectomy using modified “frown” incision with triangular scleral flap technique and straight incision in group A (n = 22) and B (n = 22), respectively. Postoperative evaluation was done at first postoperative day, then at the end of first week, third week, and 6 weeks; at the end of third month and finally at the end of sixth months. Data were entered and analyzed via Microsoft Excel sheet and SPSS software using Mann–Whitney U test for averages and Chi-square test for categorical values. Results: Mean preoperative IOP in groups A and B were 38.6 and 29.1 mm Hg respectively, by applanation tonometry. After 6-month follow-up, mean of difference in IOP (preoperative – postoperative) for group A was 20.8 ± 8.3 mm Hg and that for group B was 17.2 ± 13.5 mm Hg. Conclusion: Capacity of IOP reduction of both techniques was found to be comparable and did not show much difference up to the end of 6 months. Mastering technique of group A (modified “frown” incision with triangular scleral flap technique) requires more expertise; the simpler straight incision technique provided in group B may be effectively used by the novice and current era Ophthalmologists to combat glaucoma coexistant with cataract.

Introduction: Constrictive Pericarditis (CP) is an uncommon but important disease characterised by impaired diastolic ventricular filling and impaired ventricular ejection as a result of thickened, fibrosed and often calcified pericardium. Aim: To analyse histomorphological features of pericardial biopsy removed in patients with clinical and radiological features of constriction. Materials and Methods: The present study was a retrospective observational study conducted at LPS Institute of Cardiology and Cardiothoracic Vascular Surgery and Department of Pathology, GSVM Medical College, Kanpur, Uttar Pradesh, India. A total of 108 patients with CP were studied between a time period of January 2008 to June 2019. Clinical, demographic, laboratory and operative data of patients were retrieved from record section of mentioned departments and analysed. On histology the following parameter, if present, were recorded: inflammation and its type, granulation tissue, fibrosis, extracellular collagen deposition, granuloma, haemosiderin deposition, mesothelial hyperplasia, capillary proliferation, and calcification. Data was analysed using Microsoft Office Excel spread sheet. Results: Out of 108 cases, 98 cases (90.7%) had increased pericardial thickness and 10 cases (9.2%) had normal pericardial thickness, despite clinical and echocardiographic features of restriction. In majority of cases (96 cases, 88.9%), inflammation was of chronic type and only in 8 cases (7.4%), it was of acute nature. Tubercular pericarditis was the major cause in 46 cases (42.6%) followed by chronic non specific idiopathic in 39 cases (36.1%). Conclusion: The current study evaluated the histological features of CP in a semiquantitative grade manner thus helping clinician and pathologists to guide for other ancillary testing and thus guide toward accurate diagnosis. The current study evaluated the histological features of CP in a semiquantitative grade manner thus helping pathologists to guide for other ancillary testing and thus guide toward accurate diagnosis.

Introduction: The Gleason grading system is one of the most powerful prognostic predictors of carcinoma prostate. In 2014, a newer grading system, the International Society of Urologic Pathology (ISUP) grading system was proposed. The present study is a retrospective study conducted to compare the cytological grading of prostate carcinoma with the newly proposed ISUP grading system for prostate carcinoma. Materials and Methods: The present study is a retrospective study that included 42 cases of carcinoma prostate. The clinical data of the cases, fine-needle aspiration cytology slides, and histological slides were retrieved and reviewed. The cases were regraded using the ISUP grading system for prostate carcinoma. Statistical analysis was done using the Statistical Package for the Social Sciences (SPSS). Data were statistically analyzed and Chi-square testing was used to compare the two grading systems. Results: A total of 42 cases were studied. The preoperative grade was assigned to the smears and 26.19% (11 cases) were categorized as grade 1, 40.47% (17 cases) as grade 2, and 33.3% (14 cases) as grade 3. Histological sections were also graded according to the ISUP/grade groups (GG) system and 26.19% (11 cases) were graded as GG 1, 33.3% (14 cases) as GG2, 19.04% (8 cases) as GG3, 16.67% (7 cases) as GG4, and 4.47% (2 cases) as GG5. Conclusion: In the present study, it was concluded that there is a direct concordance between the histologic grade as proposed in the ISUP grading system and the cytologic grade on FNA.

The present paper studies the effects of financial development on the human capital development of Pakistan. An annual time series data over the period of 1991 to 2016 is used. Financial development is measured through three proxies, which are, bank deposits, broad money supply, and domestic credit to the private sector (DCPS). In addition, human capital development is measured by the human development index (HDI). The empirical findings indicate that a strong financial institution enhances human capital development in Pakistan. Similarly, the inflow of remittances increases human capital development. On the contrary, the unemployment rate, and a large population reduces the development of human capital. Thus, the findings of the present paper recommend some useful insights for the policymakers of Pakistan.

The present study examines the effects of oil price on white precious metal returns by using quantile-on-quantile regression proposed by Sim and Zhou (2015). In this study, we mainly focus on the returns of three white precious metals, which include palladium, silver, and platinum. The study is conducted on the monthly data of crude oil price and white precious metals from the period of January 2000 to December 2016. We use QQR approach to capture the complete picture of the studied relationship. Unlike conventional techniques, QQR provides the comprehensive results of the variables at distinct quantiles. Similarly, the ARDL technique has also been used. Results reveal that the change in global oil price increases the returns of platinum and palladium. Whereas, an insignificant relationship has been found between the oil prices and silver returns. Results indicate that palladium and platinum both precious metals act as a safe haven for investors. In contrast, change in oil prices will not lead to high silver returns. Therefore, investors need to be prudent while investing in silver. These results have important policy implications for policymakers and investors.

Objective: Triple negative breast cancer (TNBC), despite being the uncommon subtype, contributes a major portion to mortality and associated with poor prognosis. The purpose of this study was to evaluate the cytological criteria for the diagnosis of TNBC through fine-needle aspiration cytology (FNAC). Material and Method: Clinical, cytological, histological, and immunohistochemical (IHC) data of 256 patients were evaluated, and patient were classified as TNBC and non-TNBC phenotype by IHC. All cytological specimens were reviewed for 12 criteria: cellularity, tubule/gland formation, syncytial clusters, large bare nuclei, nuclear atypia, chromatin pattern, cell borders, nucleolus, cytoplasm, lymphocytic infiltrate, calcification, and necrosis. The Fischer's exact test was used to show test association. Result: Out of 256 patients, 82 patients were TNBC, and 174 patients were non-TNBC. TNBC phenotype showed statistically significant association to cellularity, tubule/gland formation, syncytial cluster formation, bare nuclei, nuclear atypia, cell borders, lymphocyte infiltration, and necrosis. Conclusion: FNAC can be helpful in making diagnosis of TNBC and along with ER, PR, HER2 characterization, helpful in planning treatment strategy, saving time, manpower, and resources in the patient management.

Introduction: Fine-needle aspiration cytology (FNAC) is a well-established technique for evaluation of salivary gland lesions, but because of the heterogenicity and morphological overlap between spectrum of lesion, there are a few challenges in its wide use. Recently, “The Milan system for reporting salivary gland cytopathology” (MSRSGC) was introduced, providing guide for diagnosis and management according to the risk of malignancy (ROM) in different categories. The current study was conducted retrospectively to reclassify the salivary gland lesions from previous diagnosis and to evaluate the ROM in different categories. Material and Methods: Clinical data, FNAC specimen, histological, and clinical follow-up of cases were retrieved, cytological features were re-evaluated, and cases were reclassified as follows: Category 1: Non-diagnostic (ND); Category 2: Non-neoplastic (NN); Category 3: Atypia of undetermined significance (AUS); Category 4a: Neoplasm: benign (NB), Category 4b: Neoplasm: salivary gland neoplasm of uncertain malignant potential (SUMP); Category 5: suspicious of malignancy (SM); and Category 6: Malignant (M). Result: Total 293 cases were evaluated cytologically, and histological follow-up was available in 172 cases. The distribution of cases into different categories was as follows ND (6.1%), NN (38.2%), AUS (2.7%), NB (33.4%), SUMP (2.0%), SM (2.4%), and M (15%). Overall, ROM reported were 25%, 5%, 20%, 4.4%, 33.3%, 85.7%, and 97.5%, respectively for each category. Overall, sensitivity was 83.33%, specificity was 98.31%, positive predictive value was 95.74%, and negative predictive value was 92.80%. Conclusion: MSRSGC is a recently proposed six category scheme, which places salivary gland FNAC into well-defined categories that limit the possibilities of false negative and false positive cases.

Purpose: The current paper analyzes the effects of capital flow and capital control on economic growth in developed and developing countries. We used four main components of capital flow such as, FDI, exports, remittances and external debt Design/Methodology/Approach: The econometric models are tested by using the annual data of 1995-2017 from 54 countries, classified as developed (high-income) and developing (middle-income) economies. Findings: Empirical estimation of PMG revealed that all four components of capital flow augment the economic growth in both developed and developing countries. However, restrictions on these flows reduces the impact of FDI, external debt and exports but raises the influence of remittances on the economic growth. Implications/Originality/Value: The findings of this paper also provides some useful insights for policymakers to use capital control as a tool for economic progress.

Hepatitis, a condition of liver’s inflammation that can be self-limiting or, in certain chances, it may lead to liver cancer, fibrosis or cirrhosis. Hepatitis viruses mainly cause hepatitis in the world. People with hepatitis C have predominant chances to develop diabetes as HCV virus participates in causing type 2 diabetes. HCV virus causes pathogenesis in two ways: it either directly destroys the β cells of pancreas or contributes to the specific autoimmunity of β cells. The present cross sectional study was done in Wazirabad Tahsil of Gujranwala District to analyze the percentage of patients suffering from hepatitis C who had the risk of diabetes mellitus. For this research work, demographic information and data about any other medical history were collected by using a questionnaire. Blood samples were collected from hospital and real time PCR was performed to measure the viral load and blood sugar was measured by using glucometer. Data were then analyzed by using statistically designed software. A total of 29.33% patients, having hepatitis C, were found to be diabetic in Tehsil Wazirabad. 14.70% male and 38.59% female patients having hepatitis C were diabetic. From results shown that the patients of hepatitis C are at higher risk to develop diabetes, therefore; it is supposed that persons having hepatitis C should regularly visit doctors for routine check-up of diabetes and change their life style to reduce the risk of developing diabetes.

This study is aimed to investigate the impact of international trade and trade duties upon the current account balance of the balance of payment of N-11 countries. Two constituents of each factor have been considered for the purpose of analysis. For International trade, import (IMPT) and export (EXPT) of goods and services have been considered whereas, for trade duties, taxes on international trade (TOIT) and customs and other import duties (CID) have been taken as the research variables whereas, current account balance (CAB) has been taken as the dependent variable. For the purpose of analysis panel data of N-11 countries for 27 years from 1990 to 2016 has been tested using different econometric technique such as Panel unit root test, Panel co-integration test, Hausman test, Panel regression analysis and Panel causality analysis. The results demonstrate that overall research variables are co-integrated and having long term relationship and affecting each other in the conventional manner. Notably, it is observed via results that in case of N-11 countries the CAB itself is the regulating factor and all other factors are adjusted according to the movement of CAB. The study provides recommendations for the rectification of current account deficit position and also provides scope for future research as well.

INTRODUCTION: A comparison of precision of intraocular implant power calculation by computing keratometry values by two different methods, namely, the automated and manual keratometry (MK), was done. For checking this accuracy, the parameter taken into consideration was the absolute refractive error which was ascertained postoperatively. SUBJECTS AND METHODS: This study was conducted in the Department of Ophthalmology, Sri Aurobindo Institute of Medical Sciences and PG Institute, Indore. At a tertiary eye care centre in Central India (Sri Aurobindo Institute of Medical Sciences, Indore). Duration of the study was 18 months. Sample size was 66 individuals who were with cataract (nuclear sclerosis I to III). Although keratometry was done by both methods and implant power derived separately by computing both readings, decision of which power to be implanted in an eye would depend on the group, in which patient would fall. Group A were prospective candidates who would be implanted intraocular lens (IOL) of that power as assessed by computing MK value, whereas Group B were participants who would be implanted IOL of that power as assessed by computing value obtained by automated keratometry (AK). First patient fell in Group A and second in Group B, third again in Group A till 33 patients had been operated in each group. RESULTS: Bland–Altman plot thus obtained showed that the two keratometers are comparable. The postoperative refractive errors for the two Groups (A and B), showed that if an error of ±0.50 D or less is considered, then in Group A 81% of patients achieved this and 87% of patients required this as spectacle aid in Group B. CONCLUSIONS: In this study, we compared the accuracy of AK with that of MK for calculation of implant power. It was concluded from this study that AK is a simple keratometric technique that appeared to be more accurate than MK.

Keratitis of varied etiology is not uncommon in the Indian subcontinent. This case is one such an instance of keratitis caused by dematiaceous fungus in an urban dweller not engaged in farming or any other soil/earth-related work. Although healing of the ulcer occurred in the usual course, thinning persisted for a fortnight. This case highlights medroxyprogesterone acetate used topically to achieve collagen synthesis, thereby affect repair of the thinned cornea.

Purpose: To assess the significance of attenuation correction on sensitivity, specificity and diagnostic accuracy of myocardial perfusion SPECT. Methods: 102 patients referred for myocardial perfusion imaging (MPI) were divided into two groups: 42 patients (mean age: 54.6 ± 12.6) were enrolled in the group A, who had undergone coronary artery angiography, within six months of the scan. 60 patients (mean age: 49.79 ± 11.3) were placed in the group B who had a

The aim of study was to evaluate the effectiveness of 99mTc-MIBI (hexakis 2-methoxyisobutyl isonitrile) scintigraphy to differentiate malignant from benign lesions, detected on 99mTc-MDP planar bone scans. 59 patients with bony lesions were studied prospectively and compared with histopathology. Each patient underwent a 99mTc-MDP scan, and if evidence of lesion found, patient underwent 99mTc-MIBI scintigraphy after three to four days. 99mTc-MIBI scans were evaluated visually and quantitatively. For quantitative analysis count ratio of lesion to contralateral normal side (L/C) was taken and Student T test was applied. 99mTc-MDP scans showed increase tracer uptake but no significant difference between benign and malignant uptake was seen. Significant difference (p value 0.015), was seen in malignant (L/C 3.51 ± 1.02) and benign lesions (L/C 2.50 ± 0.42) on 99mTc-MIBI scan. Three of thirty benign lesions did not show significant 99mTc-MIBI uptake. Six malignant lesions appeared as false negatives. Specificity of 99mTc-MIBI was 86.66%, Negative Predictive Value (NPV) 81.25% whereas the sensitivity was 79.31%. 99mTc-MIBI scintigraphy provides its usefulness by distinguishing malignant from benign lesions along with correct identification of metastatic lesions. NPV points toward its ability to correctly diagnose the normal (benign) cases. However biopsy still remains the gold standard and a definitive diagnostic modality.

Purpose: To evaluate the role of fine needle aspiration (FNAC) as a diagnostic tool in cases of orbital and ocular adnexal masses. Cytological findings were correlated with histopathological diagnosis wherever possible. Methods: FNAC was performed in 29 patients of different age groups presenting with orbital and ocular adnexal masses. Patients were evaluated clinically and investigated by non-invasive techniques before fine needle aspiration of the masses. Smears were analyzed by a cytologist in all cases. Further, results of cytology were compared with the histopathological diagnosis. Results: The age of patients ranged from 1 to 68 years (mean: 29.79±19.29). There were 14 males and 15 females with a male to female ratio of 0.93:1. Out of 29 cases, 26 aspirates were cellular. Cellularity was insufficient in three (10.34%) aspirates. Out of 26 cellular aspirates, 11 were non-neoplastic while 15 were neoplastic on cytology. Subsequent histopathologic examination was done in 21/26 cases. Concordance rate of FNAC in orbital and ocular adnexal mass lesions with respect to the precise histologic diagnosis was 90%. Conclusion: When properly used in well-indicated patients (in cases where a diagnosis cannot be made by clinical and imaging findings alone), FNAC of orbital and periorbital lesions is an invaluable and suitable adjunct diagnostic technique that necessitates close cooperation between the ophthalmologist and cytologist. However, nondiagnostic aspirates may sometimes be obtained, and an inconclusive FNAC should not always be ignored.

Background: Thyroid nodule is one of the most common endocrinopathies occurring children and adolescents. Though thyroid nodule is rare in the pediatric age group, the rate of malignancy is much higher in this age group compared to adult population. Aim: The objective is to study the application of The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) in pediatric patients and compare the findings with histology. Materials and Methods: A total of 218 cases younger than 18 years were studied in a 4-year period from August 2010 to July 2014. The smears were categorized according to TBSRTC into six categories — Nondiagnostic, benign, atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS), suspicious for follicular neoplasm (SFN), suspicious for malignancy (SM), and malignancy. Results: Out of 218 cases, 33 were males and 185 were females. Histological follow-up was available in 44 cases. The diagnosis according to TBSRTC included 12 (5.5%) nondiagnostic, 151 (69.26%) benign, 23 (10.5%) AUS/FLUS, 18 (8.2%) SFN, 5 (2.3%) SM, and 9 (4.1%) malignancy cases. On histological follow-up, the rate of malignancy in each category was 0%, 0%, 8.3%, 10% 100%, and 100%, respectively. Conclusion: The study demonstrates that TBSRTC in pediatric thyroid nodule is as sensitive and specific as in adults, especially with 100% accuracy in the diagnosis of benign and malignant categories.

Background:. Fractures of the metacarpals and phalanges are common. Placement of Kirschner wires (K-wires) is the most common form of surgical fixation. After placement, a key decision is whether to bury the end of a K-wire or leave it protruding from the skin (exposed). A recent systematic review found no evidence to support either approach. The aim of study was to investigate current clinical practice, understand the key factors influencing clinician decision-making, and explore patient preferences to inform the design of a randomized clinical trial. Methods:. The steering group developed surveys for hand surgeons, hand therapists, and patients. Following piloting, they were distributed across the United Kingdom hand surgery units using the Reconstructive Surgery Trials Network. Results:. A total of 423 hand surgeons, 187 hand therapists, and 187 patients completed the surveys. Plastic surgeons and junior surgical trainees preferred to leave K-wires not buried. Ease of removal correlated with a decision to leave wires exposed, whereas perceived risk of infection correlated with burying wires. Cost did not affect the decision. Hand therapists were primarily concerned about infection and patient-related outcomes. Patients were most concerned about wire-related problems and pain. Conclusion:. This national survey provides a new understanding of the use of K-wires to manage hand fractures in the United Kingdom. A number of nonevidence-based factors seem to influence the decision to bury or leave K-wires exposed. The choice has important clinical and health economic implications that justify a randomized controlled trial.

The risk of endophthalmitis is always a concern when an intraocular procedure is performed. Intravitreal injection is a frequently used method for therapeutic management of many diseases, affecting the posterior segment of the eye. Hence, it is important to assess the risk of complications, especially endophthalmitis. Most studies conducted concentrate on risk assessment from single use from single drug vial. The present article reports the occurrence of cluster endophthalmitis following multiple intravitreal bevacizumab injections from a single vial. Intravitreal injection of bevacizumab was administered to eight eyes of eight patients. Administered dose was prepared from single 4-ml vial of bevacizumab and was injected in the eye, after patient preparation and under aseptic conditions. The procedure was repeated for the remaining patients, thereby imparting multiple pricks in the same vial. Four of the eight patients reported to the hospital on the 3rd day after injection with complaints of pain, watering, and diminution of vision. Two patients reported the following day with similar complaints. Two patients who did not report by the 4th day were contacted and recalled for an examination. All the patients were thoroughly examined using slit lamp biomicroscopy and indirect ophthalmoscopy. Six out of eight were clinically diagnosed to have endophthalmitis and were administered intravitreal antibiotics. The present report highlights possibility of microbial contamination of the drug vial or during compounding process. However, from the present incident, we are encouraged to stay vigilant and wary of contamination

A case of lymphoepithelial carcinoma (LEC) occurring in right submandibular gland of a 13-year-old Indian male is presented, wherein the lesion unveiled itself only after multiple fine needle aspiration (FNA) procedures. This unusual neoplasm has high frequency of occurrence in Eskimos and a predilection for the parotid gland. The aspirates obtained were highly cellular comprising tight clusters of atypical epithelial cells with admixture of lymphocytes. Histopathological examination of the resected submandibular gland and lymph node chain was consistent with the diagnosis of LEC. Immunohistochemistry (IHC) revealed cytokeratin (CK)-positive and S-100-negative tumor cells lying admixed with CD45-positive lymphoid cells. A detailed otorhinolaryngological examination with inclusion of multiple biopsies was found negative for any primary tumor. Although histopathological features of this entity are well established, only a handful of case reports describing cytological features of this entity are present in medical literature. We conclude that the cytomorphological features of LEC are sufficiently distinctive to at least, suggest a possibility of this lesion.