Indian Journal of Pathology: Research and Practice

A 11-year-old male was seen with complaints of general weakness and growth delay with no previous history of blood transfusion and jaundice. On examination the child was pale with thalassemic facies with mild liver and spleen enlargement. His blood picture shaved microcytic hypochromic anaemia.Hemoglobin electrophoresis showed no HbA, with raised HbE and HbF.HPLC showed rise in HbE more than HbF. All these findings were consistent with the diagnosis of HBE-â thalassemia.This case is reported here because of its late presentation and phenotypic diversity that poses a diagnostic and management dilemma.

Keywords: Thalassemia; Hemoglobin E; Phenotypic diversity.

Since the introduction of cervical cancer screening, there has been a reduction in both incidence and mortality of cervical cancer. With several studies claiming a higher accuracy of liquid based cytology (LBC), this new technology virtually replaced conventional pap (CP) smear in developing countries. In this review study, most articles comparing CP with LBC were found to have flaws in study design. In two large studies that fulfill the quality criteria laid down by QUADAS, no significant difference between the two methods was found.Also, CP may have a lower specimen adequacy only if clinicians ignore basic rules of sampling, like removing mucus and cellular debris from the cervical surface and using an adequate collection device. For routine cervical cancer screening purposes, putting emphasis on regular cervical cancer screening by CP seems to be a more reasonable option than substituting CP by the LBC technique. This study concludes that there is no conclusive evidence regarding the better accuracy of LBC. More randomised controlled studies are needed.

Keywords: Liquid; Cytology; Cervical; Review

 Rheumatoid Arthritis (RA) is an autoimmune disease which has its effect on life style of the patients. Naturopathy is a simple and effective system of medicine which has taken its scientific form today. The thought of bending, stretching, twisting into, and then holding, pretzel-like poses while your joints are inflammed may sound impossible. RA may causes inflammation of the joints and other tissues in the body; it can be controlled by the Naturopathy like massage, hot & cold fomentation and Yoga like pawanamuktasana series part -I which has no side effects. During the three month study DAS28 & ESR was monitored. With the application of naturopathy & yoga DAS28 score found p>0.0001 which is more statistically significant and ESR score found p= 0.0210 which is considered to be statistically significant. Traditionally used technique like naturopathy improved metabolism of various organs of the body & yoga is helpful in strengthen the muscles & joints of the patients which further improved the life style of RA patients.

Keywords: Naturopathy; Yoga; DAS28; ESR.

 Background: Hypoplastic left heart syndrome (HLHS) encompasses a spectrum of structural cardiac malformations that are characterized by severe under development of structures in the left heart-aorta complex, including left ventricular cavity. Autopsy reports of this condition occurring in the Indian population are not available. This study was undertaken with the aim of documenting the spectrum of morphological changes of HLHS seen at neonatal autopsy. Methods: All autopsies over a period of fifteen years at All India Institute of Medical Sciences were reviewed and all cases of HLHS were included for analysis. The gross anatomical descriptions, histology and gross specimens were reviewed. Results: Of 618 neonatal autopsies, 6 were found to have HLHS (0.98%). All the six cases showed hypoplasia of the ascending aorta and left ventricle. On morphology and microscopy, two patterns were seen. Pattern 1, seen in four cases, showed partly stenotic patency of mitral and aortic valves, fibroelastosis of the left ventricular endocardium and mural hypertrophy of left ventricular myocardium. In Pattern 2, seen in two cases, there was complete atresia of mitral valve with slit like left ventricle and normal left ventricular endocardium. On microscopy, Pattern 1 cases showed fibroelastotic thickening and calcification of the endocardium. Myocardium showed hypertrophy and presence of sinusoidal vessels. These findings were absent in Pattern 2. All cases showed atrial septal defect and wide patent ductus arteriosus , which are essential to maintain circulation. Conclusion: Hypoplastic left heart syndrome is a complex disorder with a spectrum of malformations. A simplified division into two patterns is useful for autopsy practice and helps in accurate dissection and assessment.

Key words: Hypoplastic left heart syndrome, Endocardial fibroelastosis, Pathology, Autopsy, Congenital heart disease

 Objective: The aim was to assess the status of estrogen and progesterone receptors, p53 and MIB-1 labeling in invasive duct carcinomas in our institute. Study design: A series of 63 invasive duct carcinomas occurring in women for consecutive five years were studied at our institute. Subjects and methods: In this study 63 cases of invasive duct carcinoma, including all the histological subtypes were reviewed with original archival data including histological type of tumour and tumour grade. Tumour blocks of each case were retrieved for immunohistochemical staining of estrogen and progesterone receptors, MIB-1 and p53. The expression was studied using established protocols. The majority of the cases were above 30 years of age and postmenopausal. In total 77.8% had node positive disease with 71% having nodes greater than 2 cm. Estrogen and progesterone (ER and PR) receptor positivity was seen in 32.5% and 28.5% respectively. According to the percentage of nuclear staining, 60.3% of the cases were p53 positive and 77.7% showed proliferation activity as seen by MIB-1 labeling. The cases were analysed after following up with survival data. Conclusion: P53 and MIB-1 are independent indicators of aggressiveness and grade of the tumors. They have the potential to replace SBR grading of breast cancer.

Keywords: Immunohistochemistry; Breast carcinoma; MIB-1 labeling index.