Metastatic eyelid tumours are rare and account for less than 2% of all eyelid neoplasms. We report a case of metastatic breast carcinoma to the eyelid in a 60-year-old Chinese lady presenting with a 2-year history of enlarging, painless nodular lower eyelid swelling. The 1 cm diameter lesion was provisionally diagnosed as a sebaceous cyst. However the excision biopsy revealed a mucinous carcinoma expressing oestrogen receptor protein. She had a past history of mastectomy one year previously and histology showed an infiltrating ductal carcinoma (oestrogen receptor status negative) without evidence of axillary lymph node metastasis. She had completed adjuvant radio- and chemotherapy. Further treatment of the current lesion involved a wide excision which did not show any residual malignancy. She had no other evidence of metastasis and was treated with letrozol. We highlight this case to create awareness among clinicians and opthalmologists on the possibility of metastatic disease as a cause of eyelid swelling, especially in patients with a history of cancer. It may also be the first sign of metastatic disease of an internal malignancy. A review of the literature is also presented.
Eyelids ; Metastatic to ; Neoplasm Metastasis ; Carcinoma ; brief historical notes, excludes case histories

The concordance between endoscopic and histological gastritis was determined in 52 patients referred for upper gastrointestinal endoscopy. The study was conducted in Northeastern Peninsular Malaysia, an area with a low background prevalence of H. pylori infection. Endoscopic and histological gastritis were assessed in accordance with the Sydney System. The results showed poor concordance between endoscopic and histological gastritis even after reclassifying mild endoscopic gastritis as normal. The low prevalence of H. pylori was validated in this study.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Endoscopy, Gastrointestinal ; standards ; Female ; Gastritis ; diagnosis ; pathology ; Helicobacter Infections ; diagnosis ; epidemiology ; Helicobacter pylori ; Humans ; Malaysia ; epidemiology ; Male ; Middle Aged

This case report describes a 35-year-old lady who presented with generalized weakness and lethargy of two weeks duration and jaundice of more than 20 years duration. Her initial workup was suggestive of haemolysis and blood film showed a leucoerythoblastic picture with moderate microspherocytes. She was finally diagnosed as a case of hereditary spherocytosis after ruling out other possible causes of chronic haemolysis and supported by an abnormal osmotic fragility test, although family members refused for screening. Hereditory spherocytosis is uncommon in Malay population and presentation with jaundice of 20 years duration with leucoerythroblastic picture on blood film were interesting features in this case. Patient is being followed closely for need of splenectomy in near future as per severity of haemolysis and currently being managed with folic acid supplement.
Chronic ; Spherocytosis, Hereditary ; Patients ; Picture ; Films

Objective:Polycystic ovary syndrome(PCOS)is a pathophysiological disorder affecting reproductive and metabolic indices in females.The present study was designed to compare the efficacy of metformin and D-chiro-inositol in PCOS patients.Methods:In a tertiary care hospital in North India,prospective observational research was undertaken on 100 patients with PCOS,which was diagnosed based on European Society of Human Reproduction and Embryology Guidelines and ultrasound of lower abdomen.The study involves various clinical characteristics into considera-tion for the determination of statistical significance(P＜0.05)in PCOS patients.Student's t-test along with the association between PCOS and patients taking metformin and D-chiro-inositol,as well as their impact on various biochemical parameters,were investigated finally using Pearson Correlation Analysis.Results:This study comprises 50 patients taking metformin and 50 patients taking D-chiro-inositol in women suffering from PCOS.Body mass index(BMI)and waist-to-hip ratio(WHR)were statistically significant(P＜0.05)within the groups of both metformin and D-chiro-inositol.Biochemical parameters such as luteinizing hormone(LH),follicle stimulating hormone(FSH),anti-mullerian hormone(AMH)and glycated hemoglobin(HbA1c)were found to be statistically significant(P＜0.05)in both groups.LH,FSH and AMH(14.40±0.52;14.28±0.53;1.99±0.10)were comparatively lower in patients taking D-chiro-inositol as compared to metformin group(14.17±0.42;19.88±1.01;2.61±0.04).HbA1c(3.71±0.08)with P＜0.05 was found to be decreased more in metformin group as compared to patients taking D-chiro-inositol(4.90±0.09).A positive correlation was found between HbA1c and LH in metformin,& HbA1c and FSH in D-chiro-inositol groups,respectively.Conclusion:The results indicate that D-chiro-inositol shows better results in reducing clinical variables involved in causing PCOS as compared to metformin whereas metformin has better glycemic control in PCOS patients.