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Introduction: Squamous cell carcinoma is the most common cancer of the upper aerodigestive tract, accounting for more than 90% of cancers. Its method of spread is through lymphatic channels, with a high propensity toward deposition in the regional lymph nodes. Objective: To determine the pattern of metastesis of squamous cell carcinoma in cervical lymph node in patients with occult primary. Methods: This was an observational cross sectional study which was carried out in the Dept. of ENT, Abdul Malek Ukil Medical College Hospital, Noakhali, Bangladesh from January 2017 to June-2019. A Total 31 patients were selected according to selection criteria and level of involved lymph node and nodal staging was determined by careful clinical examination, biopsy of all suspicious site, CT scan, MRI, USG and X-ray. Results: Thirty One patients with metastatic neck node in whom the primary tumour was not found despite of extensive diagnostic procedure were studied in this series. Patients distribution Male were 78% and female 22%. In this study majority of patients were within 40-80 years and most of patients were male. Unilateral neck node metastasis was found in 90.32% cases and bilateral in 09.68% cases. There is high incidence of unilateral metastatic neck node. Involved lymph node was found single in 54.83% and multiple in 45.17% cases in our study. Consistency of lymph nodes were found hard in 51.61%, firm to hard in 32.25% and firm in 16.12% cases in our study. In this study nodes were found less than 3 cm in 38.70% cases, 3-6 cm in 48.38% cases and more than 6 cm in 12.90% cases. While levelling of the lymph node was concerned, in this study the most commonly involved lymph node region was level-II (41.93%) followed by level-III (16.12%). In this study 38.70% cases were in stage N1, 48.38% in stage N2 and 12.90% in stage N3. Maximum lymph nodes were 3-6 cm in size. Conclusion: Metastetic squamous cell carcinoma in cervical lymph node of occult primary common in .........

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Background: A diagnostic error was a much wider issue in the Laborotory Medicine and further steps are required towards improving in Understanding the issue to reduce the errors in Lab. The current study about the nature of laboratory testing associated errors mainly concerns from ordering test to interpretation of results and importance in reducing errors. Objective: To study errors in 24 hrs lab of GGH Kurnool for 3 months over the whole testing cycle including pre-analytical, analytical, and post-analytical phases. Materials and methods: The number of different type of errors in Pre- analytical, analytical and post-analytical phases was recorded on designed proforma for 2 months from Oct 2021 to NOV 30 2021. All collected data was entered and analysed by using SPSS version 21. Results: Over 2 months, all venous and arterial blood samples were received in 24 hrs lab of GGH. Of the 1, 80, 011 samples received during the study period, 2340 samples were found to be unsuitable for testing, accounting for 1.30% of the rejection. All these samples were rejected due to different types of pre-analytical errors that are due to All these samples were rejected due to different types of pre-analytical errors that are due to misidentification (0.06%), incorrect tube (0.1%) missing samples (0.06%), draw from IV site (0.09%), inadequate samples (0.5%), wrong timing of sample collection (0.09%), hemolysed samples (0.3%) and lipemic samples (0.1%). Conclusions: The use of a consensually-defined list of evidence-based Quality indicators to be applied in the accreditation programs of clinical laboratories according to the current International Standard (ISO 15189:2012) is an effective tool for improving quality, decreasing the risk of errors and increasing patient safety.

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Introduction: In sub-Saharan Africa malaria is the 1st cause of consultation and hospitalization and the 2nd cause of death in health centres. Maradi region is one of the most malaria-endemic areas with periods of high prevalence, particularly during the rainy season, due to the heavy rainfall that occurs between May and October. Methods: This is a descriptive cross-sectional study conducted in the emergency department of the Regional Hospital Centre of Maradi from August 1st to August 31st, 2017. Results: 104 patients were admitted to the adult emergency department for severe malaria out of 305 admissions to the centre, i.e., a prevalence of 34.1%. Our sample was composed of 53.84% men (n=56). The average age of our patients was 38.6 years with extremes ranging from 15 to 90 years. Most of the patients had no comorbidity (80.76% of cases). Thick blood drop was used for diagnosis in 93.25% of cases (n=97). The main clinical manifestations were: neurological forms (34, 61% n=36), severe anemia (31, 73% n=33). Conclusion: This study shows that malaria is a major public health problem in sub-Saharan Africa and particularly in Niger because of its prevalence, severity and morbidity.

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Every health service must have a goal so that the highest level of health can be achieved. One of the health service facilities that have a goal is the puskesmas. Puskesmas is a health service facility that organizes primary health efforts, namely health efforts that become the community's first contact with health services. This study was conducted to determine the relationship between education level, occupation, accessibility, facilities and facilities, staff attitudes, and family support with the utilization of health services at the Naioni Community Health Center, Alak District. The type of research used is descriptive research with a quantitative approach. The method used is a cross sectional study. To obtain data in the field is done by interviewing using a questionnaire to 99 respondents and taken by cluster sampling. Respondents in this study were residents who were in the working area of the Naioni Community Health Center which consisted of 3 villages, namely Naioni Village (18 respondents), Manulai II Village (46 respondents), and Batuplat Village (35 respondents). The results of the study were analyzed using thetest chi-square showing that there is a relationship between accessibility (p = 0.000), facilities and facilities (p = 0.007), attitude of officers (p = 0.000), and family support (p = 0.000) with the utilization of health services in Naioni Community Health Center. While the variables of occupation (p = 0.325) and education (p = 0.258) did not have a relationship with the utilization of health services at the Naioni Health Center, Alak District, Kupang City.

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Primary adenoid cystic carcinoma of lung is an unusual thoracic neoplasm, which is considered as a slow-growing low-grade malignancy. Usually, it is diagnosed at a higher clinical stage and is difficult to resect due to its central location. A 48-year-old female presented with history of breathlessness. On chest Xray and CT-Thorax showed well defined soft tissue lesion in left main bronchus. She underwent left pneumonectomy and subcarinal node dissection. Histopathological examination was consistent with Adenoid Cystic Carcinoma Bronchus.

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Introduction: Dengue fever, the most common arthropod-borne viral illness in humans, is caused by the dengue virus, which is one of the world's most dangerous tropical infectious diseases. Dengue fever epidemics have been reported in India on various occasions. Liver involvement is known to occur in children with dengue fever. Liver dysfunction ranges from mild injury with elevated transaminase activity to severe injury with liver cell failure. Liver dysfunction varies in severity depending on the type of clinical presentation of dengue fever, but it is more common in children with severe dengue fever. Hence the following study was conducted to find out the range of liver dysfunction in children with dengue fever. Material and Methods: The study was conducted in a tertiary care hospital over a period of one year in a total of 100 patients who are serologically positive for dengue fever. Results: Patients were classified as dengue fever (DF)-48%, and dengue hemorrhagic fever (DHF)-52%. Liver function tests AST, ALT and ALP, bilirubin and albumin were deranged in children with dengue hemorrhagic fever. The mean total bilirubin, serum albumin, AST, ALT, ALP, PT, aPTT, INR, BT, CTwere 1.7 mg/dl, 2.9 mg/dl, 382 U/L, 240 U/L, 254.4 U/L, 39.8s, 56.8s, 1.5, 4.6 minutes and 2.5 minutes respectively. Derangement of liver function tests was significant among DHF as compared to DF. Conclusion: Liver dysfunction was very common in all forms of dengue fever, significantly deranged among DHF. AST levels raising significantly when compared to ALT.