Background: Histoplasmosis is an opportunistic fungal infection commonly seen in immunocompromised patients, especially in AIDS patients, children and elderly patients. Early detection of these organisms can help in curbing the mortality and complications. Fine needle aspiration is an ideal cost effective diagnostic procedure. Diagnosis may be missed if the pathologist is not familiar with cytological features. Case: We describe a case of histoplasma lymphadenitis in retroviral positive female where accurate diagnosis was made possible by using the availability of multidisciplinary expert opinion through referral and telepathology. Conclusion: Diagnosing a fungal infection can prove challenging because of uncommon presentations. Availability of multidisciplinary expert opinion through referral or telecytology can be of great value to a solitary pathologist practicing in a remote community hospital.

Saliva harbors a wide spectrum of proteins/ peptides, nucleic acids, electrolytes, and hormones, that originate from multiple local and systemic sources. Research has identified many of these biomolecules as disease specific, which, along with recent availability of highly sensitive detection technology, has become the driving force for the development of saliva based diagnostic tools. Although saliva offers many advantages over blood, including ease of collection and minimal risk of contracting infections, there are some limitations in its application in clinical setting. These include diurnal variation in salivary composition, influenced by the method of collection, and 1000 folds less concentration of salivary biomolecules as compared to blood etc. Studies have shown mixed results regarding the clinical relevance of analytical tools developed so far. There is a need for further round robin testing, validation studies for reproducibility, sensitivity and specificity and clinical trials on large number of patients. The development of specific and standardized analytical tools, establishing reference ranges, individual cut-off values, and standardization of collection devices and methods will be other major challenges. In future we are likely to see the increased utilization of saliva as a diagnostic fluid in routine clinical practice and it may become the first choice over blood, especially in some specific situations such as in obese and hemophilic patient.

Objective: Describe cytopathological characteristics of nipple discharge. Methods: Four years retrospective cross-sectional study in Yaounde, Cameroon. We included all complete files of adult women with cytopathological analyses of breast discharge without palpable mass. Exclusion Criteria: Pregnant or breastfeeding women, puerperium and first 4 weeks post-abortum. Cytological modifications were classified as benign or malignant. Results: We retained 153 cases. Mean age was 41.2+/-14.4 years. Cytological modifications were malignant in 27 (17.65%) and benign in 126 (82.35%) cases. Of the 27 malignant cases, 18 (11.77%) were carcinomas and 9 (5.88%) were lymphomas. Upon histological analyses, all suspected lymphomas were confirmed while only 1 case of suspected carcinoma turned to be an atypical ductal hyperplasia. Of the 126 cases with benign modifications, 54 (35.29%) had inflammatory lesions, 48 (31.38%) had non inflammatory lesions and 24 (15.69%) had papillomas.

Objective: Describe cytopathological characteristics of nipple discharge. Methods: Four years retrospective cross-sectional study in Yaounde, Cameroon. We included all complete files of adult women with cytopathological analyses of breast discharge without palpable mass. Exclusion Criteria: Pregnant or breastfeeding women, puerperium and first 4 weeks post-abortum. Cytological modifications were classified as benign or malignant. Results: We retained 153 cases. Mean age was 41.2+/-14.4 years. Cytological modifications were malignant in 27 (17.65%) and benign in 126 (82.35%) cases. Of the 27 malignant cases, 18 (11.77%) were carcinomas and 9 (5.88%) were lymphomas. Upon histological analyses, all suspected lymphomas were confirmed while only 1 case of suspected carcinoma turned to be an atypical ductal hyperplasia. Of the 126 cases with benign modifications, 54 (35.29%) had inflammatory lesions, 48 (31.38%) had non inflammatory lesions and 24 (15.69%) had papillomas.

Cardiovascular fitness is of prime importance in order to lead a healthy life. The growing incidence of cardiovascular disease in India is of much concern to the medical fraternity and has been extensively reviewed. 1,2 The huge burden of cardiovascular disease in India has been attributed to the large population and high prevalence of risk factors in the subcontinent. 1 A number of modifiable and non modifiable risk factors for cardiovascular disease have been identified on the basis of Framingham study. 3 Among the various risk factors, obesity and diabetes mellitus are of particular concern because the incidence of these diseases has also been increasing alarmingly

Brachial plexus blockade requires efficient and thorough understanding of the detailed anatomy of the plexus and the variations associated with the plexus. Anomalies associated with the branches of the plexus may complicate attempts of nerve blockade for anesthesia. The present case report presents an unusual variation of brachial plexus noticed during routine cadaveric dissection. A rare neural communication between ulnar and radial nerves was observed in the left axilla at high humeral level proximal to the entry of the radial nerve into the radial groove. The communicating ramus also gave a branch to the medial head of triceps brachii 0.3 cm distal to the origin of the communication. Further, there was also a communication between the musculocutaneous and median nerves in the distal half of the arm after the musculocutaneous nerve pierced the coracobrachialis muscle. Though the variations of the brachial plexus have been described in the literature, yet studies regarding the communication between ulnar and radial nerves are rare and the coexistence of this variation along with median and musculocutaneous nerve communication is unique. Knowledge of such rare variations and anomalies is important to minimize the possible complications of regional anesthesia and surgery. Such an unusual variation, as noted in the present study, may prove useful in nerve grafting and neurophysiological evaluation to diagnose peripheral neuropathies. Further, their knowledge is of immense importance in traumatology of the shoulder joint, radial neck dissections and management of fracture of the surgical neck of humerus. Anatomic variations of peripheral nerves are important for Orthopedic surgeons, Neurophysicians, Physiotherapists and Radiologists. The present article is a humble attempt to reinforce awareness of such neural variations among clinicians.

Brachial plexus blockade requires efficient and thorough understanding of the detailed anatomy of the plexus and the variations associated with the plexus. Anomalies associated with the branches of the plexus may complicate attempts of nerve blockade for anesthesia. The present case report presents an unusual variation of brachial plexus noticed during routine cadaveric dissection. A rare neural communication between ulnar and radial nerves was observed in the left axilla at high humeral level proximal to the entry of the radial nerve into the radial groove. The communicating ramus also gave a branch to the medial head of triceps brachii 0.3 cm distal to the origin of the communication. Further, there was also a communication between the musculocutaneous and median nerves in the distal half of the arm after the musculocutaneous nerve pierced the coracobrachialis muscle. Though the variations of the brachial plexus have been described in the literature, yet studies regarding the communication between ulnar and radial nerves are rare and the coexistence of this variation along with median and musculocutaneous nerve communication is unique. Knowledge of such rare variations and anomalies is important to minimize the possible complications of regional anesthesia and surgery. Such an unusual variation, as noted in the present study, may prove useful in nerve grafting and neurophysiological evaluation to diagnose peripheral neuropathies. Further, their knowledge is of immense importance in traumatology of the shoulder joint, radial neck dissections and management of fracture of the surgical neck of humerus. Anatomic variations of peripheral nerves are important for Orthopedic surgeons, Neurophysicians, Physiotherapists and Radiologists. The present article is a humble attempt to reinforce awareness of such neural variations among clinicians.

Brachial plexus blockade requires efficient and thorough understanding of the detailed anatomy of the plexus and the variations associated with the plexus. Anomalies associated with the branches of the plexus may complicate attempts of nerve blockade for anesthesia. The present case report presents an unusual variation of brachial plexus noticed during routine cadaveric dissection. A rare neural communication between ulnar and radial nerves was observed in the left axilla at high humeral level proximal to the entry of the radial nerve into the radial groove. The communicating ramus also gave a branch to the medial head of triceps brachii 0.3 cm distal to the origin of the communication. Further, there was also a communication between the musculocutaneous and median nerves in the distal half of the arm after the musculocutaneous nerve pierced the coracobrachialis muscle. Though the variations of the brachial plexus have been described in the literature, yet studies regarding the communication between ulnar and radial nerves are rare and the coexistence of this variation along with median and musculocutaneous nerve communication is unique. Knowledge of such rare variations and anomalies is important to minimize the possible complications of regional anesthesia and surgery. Such an unusual variation, as noted in the present study, may prove useful in nerve grafting and neurophysiological evaluation to diagnose peripheral neuropathies. Further, their knowledge is of immense importance in traumatology of the shoulder joint, radial neck dissections and management of fracture of the surgical neck of humerus. Anatomic variations of peripheral nerves are important for Orthopedic surgeons, Neurophysicians, Physiotherapists and Radiologists. The present article is a humble attempt to reinforce awareness of such neural variations among clinicians.