Histopathological Findings Research Articles

Phlegmonous appendicitis as a variant of uncomplicated appendicitis

Acute appendicitis is the most common cause of surgical acute abdomen, and its classification into uncomplicated, phlegmonous, and complicated forms is crucial for guiding treatment strategies. This study aims to compare the preoperative laboratory findings and postoperative outcomes of phlegmonous appendicitis with uncomplicated and complicated appendicitis. This retrospective cohort study included 1,441 patients who underwent appendectomy between January 2019 and March 2021 at Ankara Bilkent City Hospital. Patients were classified based on histopathological findings into four groups: normal appendix, uncomplicated appendicitis, phlegmonous appendicitis, and complicated appendicitis. Preoperative laboratory values, postoperative complications, and length of hospital stay were analyzed. The distribution of patients was as follows: Group A (normal appendix, 7.6%), Group B (uncomplicated appendicitis, 59.8%), Group C (phlegmonous appendicitis, 17.6%), and Group D (complicated appendicitis, 15%). Phlegmonous appendicitis exhibited significantly higher leukocyte counts and appendix diameters compared to uncomplicated appendicitis but had lower CRP values than complicated appendicitis. The median hospital stay was similar for Groups A, B, and C (1 day) but significantly longer for Group D (2.1 days, p < 0,001). Complication rates were highest in Group D (24.1%) compared to the other groups. While phlegmonous appendicitis shares some clinical and laboratory characteristics with complicated appendicitis, its postoperative outcomes align more closely with those of uncomplicated appendicitis. This suggests that phlegmonous appendicitis may be more accurately classified as a variant of uncomplicated appendicitis, emphasizing the need for consistent classification to improve treatment strategies and patient outcomes.

Case report: Neuroendocrine carcinoma of the nasal cavity in a roe deer (Capreolus capreolus)

Neuroendocrine tumors of the nasal cavity are rare in both animals and humans. This report describes the macroscopic, histopathological and immunohistochemical characteristics of a neuroendocrine tumor in a three-year-old female roe deer (Capreolus capreolus) that was shot due to a facial deformity caused by an oval, firm, exophytic lesion effacing the left frontal and parietal regions. Longitudinal sectioning of the skull revealed a nasal cavity tumor that had invaded the cribriform plate, the rostral bones of the skull, the rostral aspect of the cranial cavity and the frontal sinuses and extended through the lacrimal, sphenoid and zygomatic bones into the subcutaneous tissue. Histopathologically, the tumor consisted of neoplastic cells forming sheets, nests, trabecular and cribriform structures separated by a delicate fibrovascular stroma. Mitoses were rare. Based on the histopathological and immunohistochemical findings, a neuroendocrine carcinoma was diagnosed. Based on thorough database searches, this is the first known case of a nasal neuroendocrine carcinoma in a roe deer.

Dermatological Manifestations of COVID-19: A Comprehensive Review

Background:COVID-19, caused by SARS-CoV-2, manifests in multiple organ systems, including the skin, presenting a range of dermatologic symptoms. Recognizing these cutaneous signs is essential, as they often appear early or alongside respiratory symptoms, aiding in diagnosis and management. Key skin manifestations include pernio-like lesions (COVID toes), maculopapular rashes, urticarial eruptions, vesicular lesions, and vascular-related signs, each potentially valuable for prognostic assessment. Methods:A systematic review of major databases, including PubMed, Google Scholar, Scopus, and Web of Science, was conducted. Studies published between 2015 and 2024 were included, focusing on the prevalence, pathophysiology, and clinical significance of COVID-19-related skin lesions. Selection criteria prioritized case reports, case series, cohort studies, and systematic reviews reporting quantitative data on cutaneous presentations. Main Findings:COVID-19-associated dermatologic symptoms vary in prevalence and severity, with maculopapular rashes and COVID toes being among the most common. Notably, vascular lesions are linked to severe cases and may serve as indicators of coagulopathy or cytokine storms. Cutaneous signs can often precede or appear in the absence of respiratory symptoms, offering clinicians a window for early detection. Histopathological findings reveal immune-mediated mechanisms, suggesting skin lesions could signal systemic inflammation in COVID-19. Conclusion:The diverse skin manifestations of COVID-19 underscore the need for dermatologic assessment in patient care. These findings support the integration of dermatology into COVID-19 care teams, especially for severe cases, where skin signs may correlate with systemic complications. Further research on pathophysiology and long-term effects is essential for advancing diagnostic and prognostic approaches, reinforcing the role of dermatologic indicators in comprehensive COVID-19 management.

Prevalence of pulmonary anthracosis in household dogs in southwest states in Nigeria: a sentinel for environmental pollution.

Nigeria, stemming from vehicular traffic, generator sets, industrial sources, residential combustion, and road dust. Pulmonary anthracosis, the accumulation of carbon particles in the lungs, is a known risk factor for cancer. While this condition has been observed in stray dogs, data on its prevalence in household dogs is limited. This study aimed to determine the prevalence of pulmonary anthracosis in household dogs within three southwestern states of Nigeria over a decade (2011-2020) and to analyze the histopathological features of pulmonary anthracosis observed in canine lung tissue samples submitted for post-mortem examination. Lung tissue samples from 472 dog carcasses submitted to the Federal University of Agriculture, Abeokuta, and the University of Ibadan for post-mortem examination were analyzed in this study. Lesions suggestive of pulmonary anthracosis were identified through gross examination and further analyzed histologically to confirm their characteristics. The findings were presented using tables, charts, and chi-square to determine association between breed, age, and sex considering p < 0.05 as significant. Out of total lungs sampled, 150 (31.8%) were positive for pulmonary anthracosis. No significant association was found between breed (p = 0.95) or sex (p = 0.98) and anthracosis, but age was statistically significant (p = 0.01). Histopathological findings included bronchiolar smooth muscle hypertrophy (90%), severe fibrosis (80%), and bronchiolar epithelial hyperplasia (50%). The study concluded that pulmonary anthracosis is prevalent among household dogs in the region. The pathological changes highlighted the adverse effects associated with the condition in affected organs and that black carbon as a major air pollutant that poses health risks to humans and animals.

Comparison of lung disorders following intratracheal instillation of polystyrene microplastics with different surface functional groups.

Microplastics have been detected in the atmosphere, raising concerns about their impact on the lungs. There have been reports on the effects of surface functional groups in evaluating the physicochemical properties of microplastics, but no reports have evaluated their chronic effects. We performed intratracheal installation in rats to evaluate the acute and chronic effects of microplastics with different surface functional groups on the lungs. Unmodified, NH2-modified, and COOH-modified polystyrene particles with a particle size of 1 μm were intratracheally instilled into the lungs of rats. Rats were dissected at 3 days, 1 week, 1 month, 3 months, and 6 months after exposure to analyze inflammatory cells and lung injury factors in bronchoalveolar lavage fluid (BALF) and to observe histopathological findings in the lungs. A significant increase in the number of inflammatory cells in BALF was observed up to 1 week after exposure to the NH2-based modified polystyrene compared to the negative control group. A significant increase was observed 3 days after exposure, and histopathological findings in the lungs also showed an influx of inflammatory cells into the alveolar space in the acute phase, but not in the chronic phase. In in vitro studies using RAW cell lines, NH2-based modified polystyrene also induced the highest oxidative stress compared to unmodified and COOH-based modified polystyrene. These results suggest that these polystyrenes do not have high pulmonary toxicity, although there are differences in toxicity due to differences in surface functional groups only in the acute phase.

Histopathologic spectrum and clinical management of pharyngeal and laryngeal sarcomas.

Sarcomas are rare mesenchymal malignancies (<1% of all cancer types), with 5-15% occurring in the head and neck. Common types include osteosarcoma, chondrosarcoma, and rhabdomyosarcoma. They often recur and have poor survival rates. Treatment involves surgery, radiation, and/or chemotherapy, utilizing a multidisciplinary approach. This study aims to overview sarcomas at our hospital and illustrate the interdisciplinary management of pharyngeal and laryngeal cases. This single-center study provides a comprehensive analysis of head and neck sarcomas (HNS) and examines interdisciplinary treatment approaches for pharyngeal and laryngeal sarcomas in patients treated at the Department of Head and Neck Surgery, Technical University of Munich, from 2007 to 2022. The study encompasses data on age, gender, histopathological diagnoses, treatment modalities, follow-up, and outcomes, with an emphasis on histopathological findings and collaborative therapeutic strategies. 27 cases of HNS were identified (2007-2022). Among these, 11 were pharyngeal or laryngeal sarcomas. All pharyngeal sarcomas underwent primary resection with reconstruction based on tumor location and extent. In laryngeal sarcomas, three required laryngectomy, one had a hemilaryngectomy, and one patient opted for primary radiochemotherapy over laryngopharyngectomy. Adjuvant radiotherapy was given in 5 cases, and radiochemotherapy in 3. Diagnoses included a range of soft tissue and bone sarcomas, such as liposarcoma, synovial sarcoma, and osteosarcoma. During the study period, 4 patients survived, 5 patients were noted as deceased, and survival data for 2 patients remain unavailable. Patients exhibited an average survival of 7,6 (± 10,4) years. The survival times within this limited patient population exhibit significant variation. Histologically, a wide spectrum of low and high-grade soft tissue and bone sarcomas were diagnosed including liposarcoma, synovial sarcoma, Ewing, osteo- or chondrosarcoma. HNS are rare and challenging to treat. Surgery is the primary treatment, with postoperative radiotherapy recommended for incomplete resections or high-risk subtypes. Advanced surgical techniques and reconstruction allow for radical resections while preserving function. Incorporating genetic insights and better sarcoma classification can further optimize treatments.

Pharmacological Treatment of Medication-Related Osteonecrosis of the Jaw (MRONJ) with Pentoxifylline and Tocopherol

Background: This study aimed to evaluate the efficacy of pentoxifylline and tocopherol therapy in patients with medication-related osteonecrosis of the jaw (MRONJ). Methods: During this study, 43 patients participated, including 21 women and 22 men with a mean age of 66.8 years, who showed 63 areas of osteitis altogether. The diagnosis was made based on X-ray imaging and histopathological findings. All the subjects received pharmacological treatment with pentoxifylline 400 mg and tocopherol 400 IU. The study scheme consisted of initial observation and two follow-up examinations every 5–6 months. MRONJ severity, peripheral blood parameters, and CRP levels were evaluated. The obtained results were statistically analyzed. Results: Complete remission occurred in 46% of the subjects, with a higher rate among those taking bisphosphonates intravenously compared to oral administration. The efficacy of pentoxifylline and tocopherol treatment was not influenced by gender or lesion location. Moreover, the worst response to treatment was observed in the group with the highest disease stage, as determined in the initial study. Conclusions: Pentoxifylline and tocopherol therapy in MRONJ was effective in patients taking oral and intravenous bisphosphonates, in patients with osteoporosis, and undergoing oncological treatment. This treatment approach allows surgery to be avoided or significantly reduced. The good response to pharmacotherapy observed in patients with early stages of MRONJ shows an urgent need to monitor the patients treated with bisphosphonates carefully to diagnose MRONJ at the initial phase.

Preliminary Results of Microsurgical Sperm Retrieval in Azoospermic Patients: A Randomized Controlled Trial Comparing Operating Microscope vs. Surgical Loupes

Objectives: To compare surgical outcomes and sperm retrieval rates (SRRs) between conventional microsurgical-assisted testicular sperm extraction (m-TeSE—Group A) and testicular sperm extraction performed with surgical loupes (l-TeSE—Group B) in adult males with non-obstructive azoospermia (NOA). Methods: A multicentric prospective randomized trial (ethics committee no. 202/2022) in accordance with the CONSORT guidelines was conducted from March 2022 to April 2024. Adult males with NOA without genetic alterations who signed the informed consent were enrolled. SRRs, intra- and postoperative complications (according to the Clavien–Dindo classification), and hormonal profile changes were considered as outcomes during the follow-up period. Results: A total of 42 NOA patients were enrolled. The median age was 35 years (IQR: 33–49). The preoperative median FSH was 16.5 mIU/mL (IQR: 11.6–22.5) and the total testosterone was 4.6 (3.5–5.6). Overall, the SRR was 22.6%, with sperm retrieved from 19 testes. Histopathological findings reported Sertoli cell-only syndrome (SCOS) in 46.4% (39 cases), hypospermatogenesis in 26.2%, and germ cell arrest in 26.2% of the patients. No intraoperative complications were recorded. The postoperative complications were minimal (Clavien–Dindo grade I), but no significant differences were recorded in-between the two surgical approaches. Considering the operative time of the testicular exploration alone, Group B seemed to be faster than the m-TeSE, with a median time saving of 8 min (p &lt; 0.01). Conclusion: The use of surgical loupes was safe and comparable with m-TeSE in terms of the SRRs and complication rates. L-TeSE offered a reduction in the operative time compared with m-TeSE.

Prurigo Pigmentosa Associated with a Ketogenic Diet in a Romanian Patient: A Case Report

Background/Objectives: Prurigo pigmentosa (PP) is a rare inflammatory dermatosis characterized by recurrent pruritic eruptions resolving with reticulated hyperpigmentation. Initially described in young Asian women, PP is increasingly reported worldwide, often linked to ketosis-inducing factors such as low-carbohydrate diets. This report documents the first case of PP in a Romanian patient and highlights the importance of recognizing the condition in diverse populations. Methods: We describe a 16-year-old girl with a six-month history of pruritic eruptions on the neck, trunk, shoulders, and thighs. A detailed clinical assessment was conducted, including dietary history, physical examination, laboratory evaluation of urinary ketones, and skin biopsy for histopathological analysis. Results: Clinical examination revealed erythematous papules and plaques with peripheral pustules and post-inflammatory hyperpigmentation. Substantial weight loss and elevated urinary ketone levels suggested dietary-induced ketosis from a strict low-carbohydrate diet. Histopathological findings confirmed the diagnosis of PP. The patient’s skin lesions resolved following carbohydrate reintroduction and doxycycline therapy. Conclusions: This case highlights the association between ketosis and PP, emphasizing the importance of thorough dietary history-taking and histopathological confirmation for accurate diagnosis. As ketogenic diets become more popular globally, heightened awareness of PP is essential to ensure timely diagnosis and effective management.

Clinical and Histopathological Characteristics of Acquired Inflammatory Blaschko-Linear Disorders.

Acquired inflammatory Blaschko-linear dermatoses have not been studied extensively. Descriptive studies on segmental vitiligo have yielded insights helpful in counseling patients. Similar insights are expected from studies on other acquired inflammatory Blaschko-linear diseases. Consecutive patients with an acquired inflammatory Blaschko-linear disease presenting to the dermatology outpatient department of the study center were recruited in a case series. Detailed history and examination, clinical photographs, and histopathological findings were recorded and analyzed. Features were compared between linear and generalized forms to look for any differences. Out of 99 patients, linear lichen planus (n = 47), linear morphea (n = 31), and lichen striatus (n = 9) were observed most commonly. Skin lesions were present in multiple lines in 52 (52.5%). In 12 (12.1%), more than one anatomical site was involved. In 10 (10.1%), two different Blaschko-linear diseases were seen, and in 3 (3.1%) both diseases occurred in the same/adjacent segments. The disease extended from one or both ends in 64 (88.9%). Nineteen (19.2%) had both linear and generalized disease, with linear lesions being more severe than the generalized lesions (P = 0.038133). Some (18/47, 38.3%) linear lichen planus cases showed prominent atrophy since the onset and formed a distinct subset, predominantly over the head and neck site (P < 0.00001). Histopathology of linear lichen planus differed from controls with generalized lesions in terms of having deeper infiltrate (P = 0.000124), and multi-focal, rather than confluent, lichenoid infiltrates. Atrophy was noted from the onset in 13/31 (41.9%) cases of linear morphea. Limitations include cross-sectional design and lack of controls with generalized nonlinear diseases. Acquired inflammatory Blaschko-linear disorders show distinct characteristics like involvement of multiple lines and sites, directional progression, and atrophic variants. These can be used for differentiating among different Blaschko-linear diseases, monitoring progression, and counseling patients.

Changing trends from inguinal radical orchiectomy to testis-sparing surgery in pediatric testicular tumors

Changing trends from inguinal radical orchiectomy to testis-sparing surgery in pediatric testicular tumors

Drug associated bullous pemphigoid: what's new?

Bullous pemphigoid (BP) is considered to be one of the most common autoimmune diseases affecting the skin. Drug associated BP (DABP) is a subset of BP that is caused by the ingestion of specific types of medications. Until this point more than 80 medications have been associated with this condition that only recently has started to be better described. DABP has a better clinical course and prognosis compared to that of idiopathic BP, especially when the suspected inciting medication is discontinued in a timely manner. Therefore, it is very important to obtain detailed medical histories from BP patients especially if they are receiving multiple medications and also to be vigilant for subtle, but important, indications in histopathological, ELISA and immunofluorescence findings as well as in the clinical manifestations of the disorder.

Exploring acemannan-loaded nanogel formulation for the treatment of IMQ-induced psoriasis-like inflammation: In vitro characterization and in vivo efficacy assessment.

This study aimed to explore a nanogel formulation containing acemannan as a carrier for the treatment of psoriasis-like skin inflammation. Several acemannan concentrations, such as F1 (2.5%) and F2 (5%), were used to prepare the nanogel formulation by homogenization. The formulation was then assessed for in-vitro performance. Four groups of animals were randomly assigned to the animals: Cluster I consisted of normal saline control; Cluster II was assigned Imiquimod (IMQ) control (5%); Cluster III was assigned IMQ+2.5% acemannan (F1); and Cluster IV was assigned IMQ+5% acemannan (F2). The effectiveness of the gel in the in vivo study was evaluated in terms of body weight, scaly skin, skin redness, inflammation, patches, moisturizing effect, pro-inflammatory cytokines, nitric oxide, and histopathological examination. The prepared nanogel possessed the desired characteristics in terms of in vitro evaluation parameters. The average particle size was around 199.6nm, with a polydispersibility index (PDI) of 0.338 and a zeta potential of -65.9mV. The nanogel formulation significantly (P<0.05) regulated in vivo performance, including redness, scaly skin, inflammation, patches, moisturizing effect, pro-inflammatory cytokines, and nitric oxide. The histopathological findings suggested that acemannan was effective in rejuvenating the affected skin.

Kidney Biopsy-Proven Diabetic and Non-Diabetic Kidney Diseases and Outcomes in Patients With Type 2 Diabetes Receiving Dialysis: The REIN Registry.

Chronic kidney disease (CKD) in patients with diabetes does not always equate to diabetic kidney disease (DKD). This study aims to delineate and compare the clinical characteristics, survival rates, and access to kidney transplantation among patients with type 2 diabetes commencing dialysis, who were classified by kidney biopsy as having either DKD or non-diabetic kidney disease (non-DKD). We used the comprehensive French Renal Epidemiology and Information Network registry to analyze baseline clinical characteristics at dialysis inception and outcomes defined as death and access to kidney transplantation. We employed a multivariate Cox proportional hazards model and the Fine-Gray competing risk model to assess the probabilities of mortality and transplantation. Adults in the Renal Epidemiology and Information Network registry in France with a diagnosis of type 2 diabetes who initiated kidney replacement therapy from January 2009 to December 2015 and had a previous native kidney biopsy. We analyzed data from 2,869 patients with diabetes, 45% of whom had a biopsy-confirmed diagnosis of DKD. Among these patients, half presented additional histopathological findings indicative of nephroangiosclerosis and focal segmental glomerulosclerosis. The clinical profiles of patients with DKD and non-DKD were largely comparable. There were no significant differences in dialysis survival rates or kidney transplantation access between the groups, even after adjusting for confounding variables and considering competing risks. At the 6-year mark, the mortality rate was 60.3% (95% CI: 55.5-64.5) for the DKD group and 60.3% (95%CI: 55.9-64.3) for the non-DKD group. Multivariable Cox analysis revealed no significant difference in mortality risk between the DKD and non-DKD groups. The study limitations include potential residual confounders, lack of predialysis data, kidney biopsies possibly outdated, nonrandom biopsy indications, and survival bias because of analysis at dialysis inception. In patients with diabetes initiating dialysis, clinical characteristics and outcomes following dialysis initiation were similar in biopsy-proven DKD versus non-DKD. Our results suggest that the diabetic milieu has a more significant impact on outcomes in patients with diabetes treated with dialysis than the underlying pathological kidney diagnosis.

An Unusual Schwannoma in the Proximal Part of the Left Arm – A Case Report

Background: Schwannomas are the most common benign tumors of peripheral nerves, originating from Schwann cells and accounting for 90% of all peripheral neural tumors. However, their occurrence along the musculocutaneous nerve in the upper extremity is rare. Due to their slow growth and nonspecific symptoms, diagnosis can often be delayed or challenging. Imaging modalities such as ultrasonography (USG) and magnetic resonance imaging (MRI) play a crucial role in preoperative diagnosis, though definitive confirmation requires histopathological analysis. Case Presentation: We present the case of a 22-year-old female who presented with swelling, numbness, weakness, and paresthesia in the left arm. Clinical examination revealed a mobile, round, firm mass on the volar aspect of the proximal part of the left arm with a positive Tinel’s sign but no neurological deficits. Laboratory findings showed mild anemia, but other parameters were within normal limits. Imaging studies suggested an intramuscular peripheral nerve sheath tumor. USG revealed a fusiform hypoechoic mass with characteristic “split fat sign” and increased vascularity, while MRI demonstrated an encapsulated lesion with hyperintense T2 signal, fascicular sign, and intense post-contrast enhancement, consistent with schwannoma. Histopathological examination confirmed the diagnosis, revealing spindle-shaped cells with wavy nuclei and Verocay bodies, without evidence of malignancy. Conclusion: This case report highlights the importance of integrating clinical, radiological, and histopathological findings to achieve an accurate diagnosis of schwannomas, particularly in atypical locations such as the upper extremities. Early identification and appropriate management are crucial in preventing complications and preserving nerve function.

Accurate diagnosis of hydatidiform mole cases requires integrating histopathological findings with genetic testing

Accurate diagnosis of hydatidiform mole cases requires integrating histopathological findings with genetic testing

Prevalence and clinical features of progressive pulmonary fibrosis in patients with unclassifiable idiopathic interstitial pneumonia: A post hoc analysis of prospective multicenter registry.

Idiopathic interstitial pneumonias (IIPs) may remain unclassifiable owing to inadequate, nonspecific, or conflicting clinical, radiological, or histopathological findings despite multidisciplinary discussion (MDD). Unclassifiable IIP (UCIIP) is a heterogeneous disease that can present with progressive pulmonary fibrosis (PPF). This study aimed to investigate the prevalence and clinical features of PPF in patients with UCIIP. In this post hoc analysis of a prospective multicenter registry of 222 patients with IIPs, 71 with UCIIP diagnosed using MDD were enrolled. PPF was defined based on worsening symptoms and radiological and physiological progression using the guideline criteria within 12 months or the criteria from the INBUILD trial within 24 months. The median age was 72 years, and surgical lung biopsy was performed in 19.7%. Of the 66 patients with adequate follow-up data, 30 (45.5%) met either criterion and were diagnosed with PPF. UCIIP patients with PPF had significantly higher serum surfactant protein-D level and percentage of bronchoalveolar fluid neutrophils, lower %forced vital capacity and %diffusing capacity for carbon monoxide, and a higher proportion of honeycombing on high-resolution computed tomography and desaturation on exertion than those without PPF. Additionally, they had significantly more anti-fibrotic therapy and long-term oxygen therapy, a higher incidence of acute exacerbation, and a poorer prognosis than those without PPF. Cox proportional hazards analysis revealed that PPF was a significant poor prognostic factor, regardless of the criteria. PPF is common and associated with poor prognosis in patients with UCIIP. Appropriate evaluation and management of PPF are essential for UCIIP.

Study of Histomorphological Patterns of Uterine Leiomyomas: An Observational Study

Introduction: Uterine leiomyoma, also known as a fibroid, is a benign mesenchymal tumor derived from the smooth muscle of the uterus. It is the most common tumor in women with an estimated incidence of 20%-40% in women during their reproductive years. Leiomyoma can occur in any organ, but the most common forms appear in the uterus. This study is conducted to analyze histomorphological patterns of uterine leiomyomas.Methods: An observational cross-section was conducted between 1st June 2021 and 31st May 2023 in the Department of Pathology of a Medical College and Teaching Hospital. Patients with leiomyoma were included in the study. Clinical, sonographic, gross, and histopathology findings were analyzed. Ethical approval for the study was obtained from Institutional Review Committee (Reference Number: LMC10/B-021).Results: There were 100 patients with leiomyoma during the study period, among whom 55 (55%) were 40-49 years old. There were 65 (65%) patients in the group with a parity of two to three. Abnormal uterine bleeding was observed in 60 (60%) of the cases. Histologically 84 (84%) of the cases were simple conventional leiomyoma. The co-existing conditions found were cystic ovarian disease 37 (37%), adenomyosis 19 (19%), and cervical intraepithelial neoplasia 12 (12%).Conclusions: Conventional leiomyoma is the commonest histological subtype and and the most common clinical presentation is abnormal uterine bleeding.

Incidence, pathophysiology, risk factors, histopathology, and outcomes of COVID-19-induced acute kidney injury: a narrative review.

The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has led to a significant burden on global healthcare systems. COVID-19-induced acute kidney injury (AKI) is among one of the complications, that has emerged as a critical and frequent condition in COVID-19 patients . This AKI among COVID-19 patients is associated with poor outcomes, and high mortality rates, especially in those with severe AKI or requiring renal replacement therapy. COVID-19-induced AKI represents a significant complication with complex pathophysiology and multifactorial risk factors. Indeed, several pathophysiological mechanisms, including direct viral invasion of renal cells, systemic inflammation, endothelial and thrombotic abnormalities as well as nephrotoxic drugs and rhabdomyolysis are believed to underlie this condition. Moreover, histopathological and immunohistopathological findings commonly observed in postmortem studies include acute tubular necrosis, glomerular injury, and the presence of viral particles within renal tissue and urine. Identified risk factors for developing AKI vary among studies, depending on regions, underlying conditions, and the severity of the diseaseMoreover, histopathological and immunohistopathological findings commonly observed in postmortem studies include show acute tubular necrosis, glomerular injury, and viral particles within renal tissue and urine. While, identified risk factors for developing AKI vary among studies, according to regions, underlying conditions, and the gravity of the disease. This narrative review aims to synthesize current knowledge on the incidence, pathophysiology, risk factors, histopathology, and outcomes of AKI induced by COVID-19.

Endometrial Hyperplasia on Rising Trends among Peri-Menopausal Women

Endometrial hyperplasia demonstrates a uterine pathology characterized by a range of endometrial morphological remodeling. The clinical importance of endometrial hyperplasia lies in its progression to endometrial carcinoma. Objectives: To analyze histopathological findings of endometrial biopsy in perimenopausal women having abnormal uterine bleeding and to observe the correlation of various risk factors with endometrial hyperplasia. Methods: The cross-sectional study was conducted at the Department of Gynaecology, Nishtar Medical University, Pakistan. Two hundred and fifty-five perimenopausal women having abnormal uterine bleeding of 3-12 months’ duration were included. The participants were subjected to histopathological analysis of endometrial biopsy obtained by dilatation and curettage. All the information and the histopathology report were entered on a specific proforma. Data analysis was performed using SPSS software version 26.0. Results: Out of a total of 255 patients, the mean age was 48+/-6 years. A vast majority was grand multiparous (n=163, 64%). Out of a total of 255 endometrial samples, the majority (n=88, 34.5%) turned out to be proliferative endometrium, indicating hormonal imbalance like unopposed estrogen stimulation. In total, 66 (25.9%) samples fulfilled the criteria of endometrial hyperplasia. 54 (21.7%) had endometrial hyperplasia without atypia, while 12 (4.2%) had atypical endometrial hyperplasia. Regarding atypical uterine bleeding, the commonest symptom was heavy regular cycle (n=74, 29%) followed by irregular vaginal bleeding (n=70, 27.5%). Conclusions: It was concluded that atypical uterine bleeding in the peri-menopausal life period is alarming. All such women should undergo endometrial histopathological examination to detect endometrial hyperplasia to prevent its progression to endometrial carcinoma.