A huge malignant tumour of breast for radiologists turned out to be a rare benign tumour. An ordinary tumour in an extra ordinary location in 80 year old female! Pleomorphic adenoma in breast was mistaken for a malignant tumour and radical surgery was performed. Hence, clinicians, radiologists and pathologists should be aware of this rare tumour and its clinical, mammographic and variable histological appearances, in order to avoid misdiagnosis and an unwarranted radical surgery.

Lupus Miliaris Disseminatus Faciei is an idiopathic granulomatous skin disease affecting the face. It is also called as Acne agminata or Facial idiopathic granulomas with regressive evolution. It has a predilection for lower eyelids, forehead, nasolabial folds and perioral areas. Caseating as well as non- caseating epithelioid cell granulomas are identified on histopathological examination therefore differentials such as tuberculosis, sarcoidosis, granulomatous rosacea and other granulomatous disorders should be ruled out. A thirteen year old female presented with multiple papules perinasally and periorally around chin. A skin biopsy was performed from the lesion and sent for histopathological examination. On microscopic examination, a granulomatous reaction pattern was seen in the dermis. X-ray chest was unremarkable. Mantoux test was negative. Apple- jelly nodule like appearance was observed on diascopy. A diagnosis of LMDF was rendered on histopathology after clinical correlation. The diagnosis of LMDF should be kept in mind in case of papular eruptions on face not responding to antitubercular treatment. Mainstay of treatment is tetracycline and oral isotretinoin.

Streptococci cause a diverse array of infections. Changing trends in Streptococci causing invasive disease was noticed. This analysis aims to elucidate epidemiological trends amongst various invasive streptococcal diseases (IPD). Surveillance data was abstracted from the Electronic microbiology System for confirmed cases of alpha and Beta-hemolytic streptococci. A total of 91 isolates of streptococci were included. Streptococcus mitis 23 (23.9 %), was the most common isolate followed by Streptococcus agalactiae (Group B) 20 (20.8%) Streptococcus pneumoniae 14 (14.5%) Streptococcus pyogenes (Group A) 7 (7.29%), Streptococcus salivarius 7 (7.29%) and 20other different streptococcal species including (Streptococcus gordonii 5 (5.2%), Streptococcus parasanguinis5 (5.2%), Streptococcus sanguinis 4 (4.1%) Streptococcus species 1 (1%) Streptococcus anginosus 1 (1%), Streptococcus gallolyticus 1(1%), Streptococcus infantarius 1 (1%), Streptococcus intermedius 1 (1%), Streptococcus thermophilus 1 (1%)). Of 91 isolates identified cases of invasive disease, Children ≥1-5 years had the highest incidence for Invasive streptococcal disease (20.4%), Among the IPD, Bacteremia was the most frequently reported clinical manifestation for 64 (70.3%), followed by Invasive soft tissue infection 18 (19.7%) then meningitis 9 (9.8%). There is high prevalence of invasive disease in the study population.

The first successful nephrectomy was performed by the German surgeon Gustav Simon on August 2, 1869 in Heidelberg. There are various indications for this procedure, such as renal cell carcinoma, a non-functioning kidney (which may cause high blood pressure) and a congenitally small kidney. Study period was between June 2014 and March 2018. Total nephrectomies done during this period were 146. Nephrectomies constituted 0.94 % of all the specimens received. Among them 94 were males and 52 were females constituting 64.4 % males and 35.6 % females respectively. In this study, among the 146 nephrectomies, majority was non-neoplastic lesions (114 cases) and 32 cases were neoplastic lesions. Among the 19 cases of renal cell carcinoma, majority cases were of clear cell pattern (8 cases), clear cell with papillary pattern, clear cells with anaplastic areas, chromophil type and chromophobe type, renal cell carcinoma –sarcomatoid variant. Occurrence of various pathological conditions such as infective, inflammatory and neoplastic lesions is common and incidental. Early diagnosis and treatment of the infective and inflammatory conditions will save the kidneys. In case of neoplastic lesions early identification of clinical features and proper usage of various diagnostic modalities will limit the Nephrectomies.

India has the World’s largest burden of tuberculosis and approximately 15- 20% of these cases have extrapulmonary disease (EPTB). The diagnosis of tuberculosis from tissue specimens is usually made by histopathological examination (HPE). However, histopathology does not always give specific findings and needs more than one week for final reporting. In 2013, WHO endorsed Xpert MTB/RIF assay for the rapid diagnosis of EPTB. In the present study the efficacy of this assay to diagnose tuberculosis from tissue specimens was assessed, taking composite reference standard (CRS) as reference standard. A total of 63 consecutive specimens of EPTB (June 2016 to May 2017), one showed the growth of non-tubercular mycobacterium on culture and was excluded from the study. Among the remaining 62 specimens, the most common were female genitourinary specimens (endometrial biopsies)- 30.64%, followed by vertebral tissue 29.03% and bone tissue 9.68%. The positivity shown by smear microscopy and HPE was 12.9% each, culture 14.52% and Xpert MTB/RIF assay 32.26%. The sensitivity and specificity of Xpert MTB/RIF assay in comparison to culture were 100% and 79.25% respectively. Whereas, CRS which includes smear microscopy, culture, histopathological, clinical and radiological findings, as reference standard, Xpert MTB/RIF assay showed sensitivity 64.52%, specificity 100%. This study suggests that Xpert MTB/RIF assay has good diagnostic potential for the rapid diagnosis of tuberculosis in tissue specimens, which could help in the timely initiation of antitubercular treatment and prevention of progression to irreversible changes.

Synovial sarcoma is a translocation associated sarcoma characterized by SS18 – SSX1/2 fusion. It is one of the common adult soft tissue sarcomas predominantly affecting lower extremities. In resource poor settings, exact characterization by molecular methods may not be feasible always. In our study we attempted to study the clinical profile, histomorphology and immunoprofile of cases diagnosed as synovial sarcomas. Forty two cases diagnosed as synovial sarcomas based of presentation, histomorphology and immunopanel were analysed .The median age of presentation was 26 years with male to female ratio of 1.5:1. Majority of the sarcomas were of monophasic type (83%) with predominant hemangiopericytomatous pattern (67%) followed by fascicular pattern (48%). Tumor size was greater in adults older than 20 years when compared to younger age group. Tumors with large areas of calcification were seen with significantly low mitotic index.

The exploration of antibiotic and antiseptic resistance in the hospitals are happened by various reasons including continuous usage of same antiseptics and disinfectants for surface cleaning, inappropriate and misuse of antimicrobials, No follow up of the patients and discontinuation of the course of drugs. This may create a demand for new and long term effective drugs against antibiotic resistance. Comparing to the chemicaly fabricated drugs, metals are considered as the better choice of replacement. From the ancient times, the basic understanding of antimicrobial properties of metal particles like silver, mercury, copper and arsenic are quite available in practice; but their scientific evidences are lacking. Thus this study may provide some information related to the determination of in vitro antibacterial activity of various concentrations of silver solution against several bacterial pathogens isolated from wounds. The evident record of this study highlighted that 10-2 mM silver solution showed maximum bactericidal effect on Staphylococcus aureus, Providencia rettigeri and Pseudomonas aeruginosa with 17mm, 16mm and 16mm inhibitory zone respectively. Other test bacterial species also inhibited but not upto the mark. We may recommend the high concentration of silver solution in the form of antiseptic spray as surface bactericidal mask for wound management.