Objective: To evaluate the usefulness of Tru-Cut biopsy (TCB) in the diagnosis of breast lesions. Methods: An observational non-interventional cross-sectional review was performed of all TCB reports of a mass or lesion observed in patients admitted between January 2008 and December 2010, at King Khalid University Hospital, Riyadh, Saudi Arabia. Results: A total of 275 trucut biopsies were performed during the study period. Histopathology showed 92 (33.5%) malignant lesions, 177 (64.3%) benign lesions and 6 (2.2%) suboptimal or suspicious lesions. Repeat trucut biopsies were done in 29 (16.4%) of the benign cases, 12 (13%) of the malignant cases, and for 6 inconclusive specimens which showed 4 of the 29 benign cases to be malignant lesions, and 5 of the 6 inconclusive cases were also malignant lesions. All 12 malignant cases that had repeat trucut biopsy had a confirmed diagnosis of malignancy. Trucut biospy had a sensitivity of 95.1%, specificity of 100%, positive predictive value of 100%, negative predictive value of 97.2%, and an overall diagnostic accuracy of 98.2%. Conclusion: Trucut biopsy is an accurate alternative to fine needle aspiration cytology in the diagnosis of breast lesions with a high diagnostic accuracy of 98.2%.

Brooke Army Medical Center

Special testing accommodations is an issue that affects both medical specialty boards and physicians with disabilities in the admin-istration of medical specialty examinations. To assess practices of med-ical specialty boards when physicians with disabilities request nonstandardized testing, all

Abstract Objective: This study aimed to evaluate the mortality pattern in children seen at Federal Medical Centre Umuahia (FMCU) Abia state, South Eastern Nigeria. Methods: A retrospective cross sectional descriptive study over a 5-year period from January 1, 2004 to December 31, 2008 using data retrieved from the hospital' s medical records department. Results: A total of 3,814 children were admitted in the hospital and 434 of them died giving a mortality rate of 11%. The mean age was 1.7 (Std D of 3.19). Two hundred and thirty eight of them were males while 196 of them were females giving a sex ratio of 1.2:1. Majority of the mortality (49%) occurred within 24 hours of admission. The major causes of death during neonatal period were birth asphyxia (34%), prematurity (24%) and neonatal sepsis (24%). Malaria was the leading cause of death beyond the neonatal period accounting for 42% of cases. Other common mortality causes were pneumonia, septicaemia, diarrhea, HIV AIDS and meningitis each accounting for 10%, 10%, 7%, 7% and 5% respectively. The months of July, May and March accounted for most deaths (12%, 12% and 11% respectively). Conclusion: Birth asphyxia and malaria associated deaths were responsible for most deaths during neonatal and beyond neonatal periods respectively. Presence of trained personal at all deliveries will help to reduce neonatal asphyxia. Efforts should be made to reinforce the existing effective malaria control tools.

by standardizing both examiners and patients. This article describes our experience in organizing and conducting an OSCE for Oman Medical Specialty Board residents in Psychiatry.

continuous process of certifying individual physicians, described as maintenance of certification. The article stated: The ABMS [American Board of Medical Specialties] continues to work on behalf of its ambitious agenda to improve physician quality through its maintenance of certification program

Abstract Esophageal tuberculosis is rare in both immunocompromised and immunocompetent hosts with advanced pulmonary tuberculosis, even in countries with high prevalence of tuberculosis, e.g., South East Asia. is study presents a case report of esophageal tuberculosis presenting as dysphagia.

Abstract Malignant epithelioid hemangioendothelioma (EH) is a rare tumor of vascular origin. We report a case of a woman who was found to have multiple hepatic masses in the right lobe of the liver on radiologic investigations, initially misdiagnosed as a metastatic carcinoma. The diagnosis of EH was made on histopathological study and confirmed by immunohistochemistry, which showed diffuse response for CD34 marker and no response to tissue CEA, HMB-45 or S-100 protein. Partial hepatectomy was made with good results.

Abstract Bezoars are concretions of swallowed hair, fruit vegetable fibers, and similar substances found in the alimentary canal. The first description of a postmortem human bezoar was by Swain in 1854. Although the prevalence of bezoars in humans is low, an absence of treatment has been associated with mortality rates as high as 30%, primarily because of gastrointestinal bleeding, destruction, or perforation.

Giant Cell Tumors commonly occur at the ends of long bones. However in rare cases, they can occur in the bones of the hands and feet. Tumors in these locations occur in younger patients; in addition, these tumors are more commonly multifocal and are associated with a higher risk for local recurrence than tumors at the ends of long bones. Since lesions in the small bones may be multifocal, a patient with a giant cell tumor of the small bones should undergo a skeletal survey to exclude similar lesions elsewhere. Primary surgical treatment ranges from curettage or excision with or without bone grafting to amputation. The success of surgical treatment depends on the completeness with which the tumor was removed. We are presenting a case report of a 34 year old female, who presented with a swelling in the right hand, following trauma. X-ray of the hand showed an osteolytic expansile lesion at the base of the 1st metacarpal bone. The lesion was initially curetted and then treated by local resection with bone grafting. Histological examination revealed a typical benign giant cell tumor composed of closely packed stromal cells with a variable admixture of giant cells. Follow up at the end of one year did not reveal any recurrence of the tumor.