Background Head and neck masses are a common presentation in daily practice and can be challenging to both clinicians and cytopathologists. Fine needle aspiration cytology (FNAC) is a widely used method for the diagnosis of head and neck masses. The aim of the study was to assess our institutional experience of the accuracy of FNAC in the diagnosis of head and neck masses. Methods A total of 1262 FNACs were conducted from January 2013 to December 2016 and subdivided into benign and malignant categories. The thyroid and salivary glands FNACs were classified according to the Bethesda System for Reporting Thyroid cytopathology and to the Milan System for Reporting Salivary Gland Cytopathology respectively. The measures of diagnostic accuracy of FNAC were determined taking histology as a gold standard. Results A total of 7 false negative (FN) and 6 false positive (FP) FNACs were identified. Overall sensitivity and specificity of FNAC for a malignant diagnosis were 92% and 94.4%, respectively. Accuracy of FNACs of head and neck masses was 93.5% for all sites. The salivary gland group had the highest rate of FN (2.8%). All FP were reported in the thyroid group. These cases were cytologically classified suspicious for malignancy (n = 3) and papillary carcinoma (n = 3) and proved to be lymphocytic thyroiditis on final histology. Among the most common locations, cytology of lymph nodes provided the best sensitivity (98.2%). Salivary glands as well as lymph nodes had the best specificity (100%). Conclusion FNAC of head and neck masses has a high accuracy allowing a correct therapeutic management. However, this accuracy depends on the anatomic location of the mass.

Accuracy of fine-needle aspiration cytology of head and neck masses.

Background: To accost things in a particular disciple, egress related to Fine Needle Aspiration Cytology (FNAC) and to standardize reporting pattern, a framework “Milan System for Reporting Salivary Gland Cytopathology” (MSRSGC) has been sponsored. Aim: Aim of this study was to evaluate the potency of salivary gland FNAC reported under Milan guidelines, to calculate malignancy risk, and to compare the preoperative cytological diagnoses with the postoperative histopathological diagnoses. Settings and Design: This was a retrospective study over a period of 2 years (May 2016 to April 2018), which was classified according to Milan system and correlation with histopathology. Furthermore, the risk of malignancy was calculated for all the diagnostic categories. Materials and Methods: FNAC were analyzed on 105 patients with palpable salivary gland. Results were distributed into six categories. About 76 cases were surgically treated and resected tissues were submitted for histopathological examination. Statistical Analysis: The various diagnostic values of the procedure were calculated using the standard formula. Results: We reviewed 105 salivary gland FNA samples and recorded interpretations according to the proposed standardized six categories. Among them, category IV (neoplastic) had more cases (57.14%). The rates of malignancy in histology were as follows: (1) nondiagnostic, 0.0%; (2) nonneoplastic, 0.0%; (3) atypia of undermined significance, 50.00%; (4a) benign, 02.44%; (4b) uncertain malignant potential, 33.33%; (5) suspicious for malignancy, 100%; and (6) malignancy, 93.33%. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of Milan system came out to be 85.00%, 98.14%, 94.44%, 94.64%, and 94.59%, respectively. Conclusion: The six-tier diagnostic categories of the Milan system helps in triaging patients with salivary gland swelling and thus facilitate individualized management.

Effectuation to Cognize malignancy risk and accuracy of fine needle aspiration cytology in salivary gland using “Milan System for Reporting Salivary Gland Cytopathology”: A 2 years retrospective study in academic institution

Objective To provide a detailed anatomic description of middle ear endoscopy via different approaches. Method Using 0, 30 and 90 degree rigid endoscopes, 6 dry temporal bones and 11 temporal bone blocks were examined to define the average range of view obtained by three approaches: 1. via the external ear canal approach; 2. via a retroauricular incision: including two subdivided routes, the mastoid-tympanic antrum route and mastoid-retrotympanum route; 3. via the middle ear cranial fossa. Each region of the middle ear was chosen for inspection. Result 1. via the external ear canal approach, all sites of the tympanic cavity structures were seen with 0, 30 and 90 degree rigid otoendoscopes, including the hidden areas such as the tympanic sinus, facial recess, anterior epitympanic recess, orifice of eustachian tube et al. 2. via the mastoid-tympanic antrum route, the structures of the mastoid cavity, tympanic antrum, epi-mesotympanum were clearly defined; via the mastoid-retrotympanum route, the structures of the mastoid cavity and meso-hypotympanum were also observed; 3. via the middle cranial fossa approach, the structures of the epitympanum, tympanic antrum, mastoid cavity and lateral wall were inspected, most mesotympanic structures were evaluated. Conclusion Middle ear endoscopy through the different approaches provides the otosurgeons a clear view field of the middle ear structures, can therefore decrease the incidence of cholesteatoma recurrence and evaluate the state of the postoperative middle ear cavity. The 30 degree otoendoscope can provide a better visualization of the middle ear structures, via the three approaches, the 90 degree otoendoscope is suited for the inspection of the posterior epitympanum via the transmeatal approach and retrotympanum via mastoid cavity-tympanic antrum route.

Endoscopic anatomy of the middle ear

The present investigation was conducted with 30 chilli genotypes at the experimental field of Regional Spices Research Centre, BARI, Gazipur to assess the genetic association and selection indices among yield and important yield attributing traits. Fruit length, fruit weight, 100 seed weight and fruits/plant showed significant and positive correlation with yield/plant both at genotypic and phenotypic level. Path coefficient analysis revealed that fruits/plant had maximum positive direct effect on yield. Besides fruits/plant; fruit weight, fruit length and number of primary branches/plant also contributed positive direct effect to yield. Selection indices were constructed through the discriminate functions using five characters. Highest relative efficiency was found for fruit weight +fruits/plant +yield/plant comparable to other combinations of characters. This research indicated that the selection of high yielding chilli genotypes based on these three characters might be more efficient. Biplot analysis was also performed to find out superior genotypes.

Genetic Association Analysis and Selection Indices for Yield Attributing Traits in Available Chilli ( Capsicum annuum L.) Genotypes

Variability and correlation studies in chilli (Capsicum annuum L.) at Allahabad agro-climatic conditions.

Thirty genotypes of chilli were evaluated in RBD with three replications at vegetable research farm, CHF, CAU, Pasighat, Arunachal Pradesh, India during kharif , 2011. Variability, correlation and path analysis were carried out to study the character association and contribution, respectively. Analysis of variance revealed significant differences among the genotypes for all traits. High PCV and GCV, heritability, genetic advance were observed for days to first flowering, plant height, number of seed per fruit, number of fruit per plant, ascorbic acid and fruit yield per plant. Correlation indicated that fruit yield per plant was positively and significantly correlated with number of branch per plant, number of fruit per plant and chlorophyll content while negative and significant association was established with ascorbic acid content. Maximum positive direct effect on fruit yield per plant was imposed by fruit weight, number of fruit per plant, number of seed per fruit and capsaicin content. DOI: http://dx.doi.org/10.3329/bjb.v43i3.21600 Bangladesh J. Bot. 43 (3): 283-291, 2014 (December)

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Selection parameters for fruit yield and related traits in chilli (Capsicum annuum L.)

Kartagener’s syndrome: A clinical reappraisal with two case reports

Objectives: To evaluate the predictability of aditus patency in mucosal chronic otitis media (COM) with sclerosed mastoid using clinical and radiological tests. Study design: Prospective study. Materials and methods: Thirty-five cases of mucosal COM with sclerosed mastoid were taken for antrotomy with tympano­ plasty. The preoperative evaluation of aditus patency was done using clinical examination, inflation deflation test for Eustachian tube function and high­resolution computed tomography (HRCT) temporal bone. The intraoperative patency was tested by water test. Results: This study shows that there is statistically insignificant correlation between duration of discharge, tympanosclerosis and Eustachian tube function with aditus patency. There is statistically significant relationship between HRCT temporal bone and aditus patency (p < 0.0001). Conclusion: High­resolution computed tomography temporal bone is a reliable predictor for aditus patency and we recom­ mend routine use in sclerosed mastoid before all tympano­ plasties for best results.

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Clinical and Radiological Predictability of Aditus Patency in Mucosal COM with Sclerosed Mastoid: An Analytical Study

Present study was carried out to screen the cowpea genotypes and to determine the effect of different level of aluminium on morpho-physiological, growth, yield and quality attributes. Twenty cowpea genotypes with four aluminium levels i.e. 0, 20, 40, 60 ppm in three replications was investigated in factorial complete randomized block design. Individual main effect and their interaction effects were studied for plant height at weekly interval, biomass, number of nodule per plant, root length, shoot length, dry matter of root, shoot, leaf, total dry matter, number of pod per plant, pod weight, yield and seed protein content. Cowpea genotypes exhibited significant differences for all 13 observed traits. Aluminium treatment expressed significant differences for all the attributes under study except biomass per plant. However, interaction effect was found to be significant for all studied characters except plant height at all stages. Among the aluminium treatments; observed traits were performing better at 20 ppm of Al, whereas, pod yield and protein content were best under the control.

Screening of cowpea [Vigna unguiculata (L.) Walp.] for aluminiumtolerance in relation to growth, yield and related traits

Aim: Palpable masses in the head and neck region can arise from various structures, such as lymph node, thyroid gland, major and minor salivary glands, soft tissues, blood vessels, and neural structures. Fine needle aspiration cytology (FNAC) is a simple, quick, inexpensive first-line method to evaluate such swellings and thus confirm the diagnosis. This study correlates aspiration cytology as an indispensable tool in diagnosing various head and neck swellings and their prevalence with respect to age, sex, site of origin, and nature of those masses. Materials and methods: This study was done from January 2007 to December 2013 in the Department of Otorhinolaryngology and Department of Pathology. All the patients presenting with various head and neck swellings underwent FNAC, and the results were correlated with anatomical sites and frequency of occurrence and categorized into various clinicopathological groups. Results: This study included 1,272 cases who were evaluated by FNAC for head and neck swellings. In this study, 32 patients presented with frank abscesses, 36 cases with submandibular region swellings, seven cases with submental swellings, 70 cases with various swellings in the neck and postauricular area, 47 cases with various facial and scalp swellings, two cases from oral cavity, 74 cases with parotid masses, 680 cases with lymphadenopathy, and 324 cases with thyroid lesions. Conclusion: Fine needle aspiration cytology is a useful, reliable, cost-effective, and valuable diagnostic tool for the initial evaluation and diagnostic categorization of all superficial and deep-seated lesions in the head and neck region as it is a fairly sensitive and specific procedure in addition to being simple, rapid, accurate, and without any significant complications and above all without affecting the underlying tissue morphology altogether.

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Apoorva Kumar Pandey

Papers

Selection parameters for fruit yield and related traits in chilli (Capsicum annuum L.)

Kartagener’s syndrome: A clinical reappraisal with two case reports

Clinical and Radiological Predictability of Aditus Patency in Mucosal COM with Sclerosed Mastoid: An Analytical Study

Screening of cowpea [Vigna unguiculata (L.) Walp.] for aluminiumtolerance in relation to growth, yield and related traits

Distributive Analysis of Head and Neck Swellings with Their Cytopathological Correlation