Indian Journal of Pathology: Research and Practice

 Not Provided.

 Nocardiosis is an uncommon but possibly serious pulmonary infection. It typically affects patients with immune suppression or structural lung disease, but can be isolated in immunocompetent patients without a definable predisposing condition. Pulmonary nocardiosis is a rare disease and now a days its incidence is increasing due to increased use of immunosupreseeive therapy and HIV infection. We report a case of nocardiosis in 65 year old female patient clinically diagnosed as chronic obstructive pulmonary disease (COPD) treated with steroids and beta antagonist and anticholinergic drugs. Presented with nonresolving pneumonia and radiologically mimicking tuberculosis. Sputum analysis revealed Gram positive and acid fast thin beaded and branching filamentous bacteria.

 Sialadenoma papilliferum (SP) is an unusual, benign neoplasm of predominately minor salivary gland which presents as an exophytic papillary lesion on oral of the mucosa. This lesion is included in the group of the ductal papillomas and accouns for less than 1% of minor salivary glands tumors .The present case of SP was observed in 66 year old male patient on left buccal mucosa.

Keywords: Salivary Gland; Buccal Mucosa; Ductal Tumor.

 Introduction: The incidence of chronic myeloid leukemia (CML) increases with age, which can present with anemia initially. In this study, we aim to evaluate CML as a cause of anemia in the elderly. Case Series: From May to July 2015, patients above 60 years clinically suspected with anemia were included. The clinical details including the demographics were retrieved from the case charts. The laboratory parameters were correlated with the clinical features. The anemia was classified based on the morphology of the peripheral smear and graded based on the haemoglobin levels. The diagnosis of CML was confirmed on peripheral smear. Among 102 patients, three patients were diagnosed with CML. Case no 1 and 2 had marked leukocytosis with thrombocytopenia and thrombocytosis respectively, while case 3 presented with pancytopenia. The spleen size varied from minimal to massive. Hemoglobin ranged from 9.6 – 10.4 g/dl. The patient who presented with pancytopenia died while on follow up. Conclusion: The incidence of CML in elderly (2.9%) is similar to the published literature. Other comorbid factors can influence the clinical outcome.

Keywords: Anemia; Pancytopenia; Chronic Myeloid Leukemia; Elderly.

 Background: HbH disease is a nonfatal form of alpha thalassemia syndrome. The alpha thalassemia syndromes are a group of hereditary anemias of varying clinical severity and characterized by reduced or absent production of one or more of the globin chains of hemoglobin molecule. HbH disease is common in Indian Subcontinent but not all the cases detected are reported in literature. Here we report a case of HbH disease in a three year of female patient who presented with history of mild fever and mild distension of abdomen for 15 days.Complete blood count showed HB4.4 gm%, TLC – 10.6 X 103/uL, platelet count was 358 X 103/uL. 8 nucleated RBCs were seen per 100 WBCs. She was given iron therapy for one month but showed mild response only. So a hemoglobin electrophoresis was done.A peripheral blood film was prepared which showed presence of microcytes, few macrocytes, teat drop cells, fragmented cells and polychromatophils and NRBCs. Reticulocyte preparation showed 7% reticulocytes with occasional HbH like inclusions. Hb electrophoresis was done on capillary electrophoresis ( Mini cap, Sebia ) which revealed a HbH band at zone 15. Conclusion: HbH disease is a gentic disease with 25% chance of acquiring the disease with each pregnancy when the partner carries a mutated alpha globin gene. Hence prenatal genetic counselling of family members is necessary. A high index of suspicion is required for a prompt diagnosis and management.

Keywords: HbH Disease; Alpha Thalessemia; Hb Electrophoresis.

 Plexiform neurofibroma are rare benign tumors of the peripheral nerves and usually considered pathognomic of neurofibromatosis Type 1. Plexiform neurofibromas are a more aggressive subtype of neurofibroma and many times shows infiltration of surrounding tissue making it difficult to remove. We present the case of 16 years old male child having history of gradually enlarging mass over back D9L3, since last 10 years associated with mild low back pain, skin pigmentation and history of blurred vision. On examination he was found to be case of Neurofibromatosis Type 1. Mass was resected and histopathologically diagnosed as plexiform neurofibromanodular type. We are presenting this case for its clinical, radiological and histopathological features.

Keywords: Neurofibroma; Nerve Tumor; Neurofibromatosis; Soft Tissue Tumors Back.

 Dermatofibrosarcoma protuberans (DFSP) is an uncommon cutaneous mesenchymal tumor of intermediate malignancy. It has progressive but destructive growth pattern with propensity for focal recurrence and rare metastasis. Studies on fine needle aspiration (FNA) of DFSP are extremely rare. We present a case of primary DFSPFibrosarcoma variant over left lateral leg in a 60 year old male, which was diagnosed on FNA. An accurate cytological diagnosis is crucial in establishing the adequate therapeutic approach, avoiding mutilating surgery. Correct sub typing of DFSP in FNA smears can be difficult due to its morphological overlapping with other spindle cell lesions occurring in the skin and soft tissue. The combination of characteristic morphological features of DFSP with clinical information is crucial to establish a correct diagnosis of such rare tumor. The goal of this report is to emphasize the role of FNA in early and accurate diagnosis in spite of many overlapping features.

Keywords: Dermatofibrosarcoma Protuberans (DFSP); FNA; Leg; Soft Tissue Sarcoma.

 Breast cancer diagnosed during pregnancy or 12 months postpartum is referred to as pregnancy associated breast cancer and is reported in 1/3000 pregnancies. Delayed diagnosis is a major issue of pregnancy associated breast cancer. Lactating adenomas are the most prevalent breast masses seen in pregnant women. Although they are not thought to carry an increased risk of cancer, Hertel et al reported the case of a patient who developed invasive ductal adenocarcinoma in the previous excision site of a lactating adenoma. Geschicker and Lewis reported a lactating adenoma containing an associated infiltrating carcinoma and A Saglam et al reported the case of a lactating woman with coexistent lactating adenoma and invasive ductal adenocarcinoma. We report the same case of a lactating woman with lactating adenoma and invasive ductal adenocarcinoma as components of the same mass.

Keyword: Coexistence; Invasive Ductal Adenocarcinoma; Lactating Adenoma.

 Malignant glomus tumor, involving the bones is rare. A 24yearold lady was referred with a gradually increasing recurrent tumor over her right wrist since 7 years, for which she previously underwent incomplete resections. Presently, a 9cm x 4cmsized swelling was noted on her right wrist. Plain radiograph revealed an osteolytic lesion in her distal radius, extending into the adjacent carpal bones and soft tissues. Microscopy revealed a tumor comprising round to oval cells arranged around blood vessels; focally displaying moderate nuclear atypia, with mitoses ranging from 23/ 10 highpowerfields, including atypical forms; focal necrosis along with bone infiltration. Immunohistochemically, the tumor cells expressed smooth muscle actin. Ki67/ MIB1 highlighted 30% tumor nuclei. Computed tomogram revealed multiple bilateral pulmonary metastases. This forms the third case of a large malignant glomus tumor, involving bones and soft tissues. It underscores the value of a timely diagnosis, followed by wideexcision in such cases, as these tumors can metastasize. Differential diagnoses are discussed herewith.

Keywords: Glomus Tumor; Malignant Glomus Tumor; Unusual Soft Tissue Tumors; Uncommon Bone Tumors; SMA.

 Hypertension is one of the common medical complications of pregnancy and contributes significantly to maternal and perinatal morbidity and mortality. Hypertension is a sign of an underlying pathology which may be preexisting or appear for the first time during pregnancy. Various Biochemical changes like increase in serum Bilirubin, serum uric acid, LDH, AST, ALT enzymes are seen. Aims and Objectives: Evaluation of Biochemical parameters like serum Bilirubin, serum uric acid, LDH, AST, ALT enzymes in PIH. To identify the early Biochemical parameters predictive of preeclampsia and HELLP (Hemolysis, Elevated Liver enzymes and Low Platelet syndrome) syndrome. Materials and Methods: A two year study from Aug 2011 to July 2013 was carried out in the Dept. of pathology ESIMC, Bangalore on 100 PIH cases. Biochemical parameters were estimated in all the cases. p values for all parameters were statistically derived and evaluated. Results: Total of 100 cases were included in the study. 37 were mild GH (Gestational Hypertension), 9 cases were severe GH, 29 cases were mild preeclampsia and 25 cases were in severe preeclampsia group. Mean value of serum uric acid, LDH and serum Bilirubin in severe preeclampsia was 6.58±5.63, 438.84±483.3 and 0.63±1.04 respectively. Raised LDH, AST, ALT enzymes were observed in severe preeclampsia with a mean value of 31.00±62.05 and 55.60±133.94 in ALT and AST respectively. Conclusion: Raised values of Biochemical parameters could prompt progression of PIH and possibility of adverse outcome. Therefore estimation of Biochemical parameters can be considered as an early, simple and rapid procedure in the assessment of severity of preeclampsia and to prevent progression to HELLP syndrome and DIC (Disseminated Intravascular Coagulation).

Keywords: Hypertension; Preeclampsia; Eclampsia; Biochemical Parameters. 

 The cross sectional study was performed to find out the incidence of âThalassemia in pregnant women of Latur ; Maharashtra from October 2011 to September 2013. The study was conducted at MIMSR, Medical College, Latur. In this study we screened 1186 pregnant women from Obstetrics & Gynaecology OPD of MIMSR, Latur. Whole blood Samples were collected in EDTA bulb for onsite Naked Eye Single Tube Red cell Osmotic Fragility Test (NESTROFT). The screening of β thalassemia trait was done on NESTROFT with 0.36% freshly prepared saline, and β thalassemia trait status of all NESTROFT positive subjects was confirmed by quantization of Hb A2 level, by HPLC machine in special investigation laboratory of GMC & JJ Hospital Mumbai. Out of 1186 women the NESTROFT was positive for 229 subjects, and Hb A2 level was more than 3.5% in 36 subjects, which is a diagnostic of â thalassemia trait. With a 3.03% rate of â thalassemia trait, urges necessity in studying beta thalassemia carrier status in the child bearing group, as a primary step to prevent the birth of beta thalassemia major.

Keywords: βThalassemia Trait; NESRTROFT; HB A2.

 Hypertensive disorders complicate 5%10% of all pregnancies and together they form one member of the deadly triadHypertension, Haemorrhage and Infection Preeclamsia is a syndrome charecterised by hypertention and proteinuria developing after 20 weeks of gestation in a woman with previously normal blood pressure contribute greatly to the fetal morbidity and mortality rates. Aims and Objectives: To evaluate the relationship between platelet count and platelet indices in mild and severe preeclampsia patients. Material and Methods: The study was carried out in the Department of Pathology, ESICMC PGIMSR, Bangalore for one year duration prospectively. The cases which were clinically diagnosed as mild and severe grade of preeclampsia amounting to sixty seven were used for the study. Out of 67, 59 cases were of mild grade and 8 cases were of severe PIH. The statistical analysis was done with mean, standard deviation, oneway ANOVA. Results: There was a significant correlation between increase in platelet count with that of PDW and PLCR with p value of <0.001. Conclusion: Platelet count and Platelet indices will be very much helpful to the physician to make a detailed review and to prevent maternal and fetal morbidity and mortality in PIH.

 Introduction: The human Leucocyte antigen (HLA) system is the locus of genes that encodes for protein on the surface of the cells that are responsible for regulating the human immune system.They play an important role in disease defense, are a major causeof rejection in organ transplant patients. The first association of HLA to inflammatory diseases was discovered in 1972 correlating it to ankylosing spondylitis. After that numerous studies have been conducted associating more than 100 diseases like ocular and systemic diseases to HLA– B27. Present retrospective study was conducted with the aim of establishing the prevalence of HLA– B27 positivity in patients coming to our diagnostic centre from January 2014 to May 2015. Materials and Methods: This was a retrospective study conducted on 700 patients coming to our diagnostic centre for HLA B27 testing for different clinical conditions from January 2014 to May 2015. Test was performed by flow cytometry and all positive tests were confirmed by PCR Microarray Biochip technology for allele specific disease association. Results: There were 305/700(43.5%) males and 395/700(56.5%) females. Male to female ratio was 0.76:1 . Out of 700 patients included in the study, 82 patients were positive for HLAB27. The positivity rate was 11.7%. 54 were males (65.8%) and 28 (34%) were females. Out of 82 positive cases 56 patients had symptoms of arthritis (68.2%), 15 (18.2%) had 1BD, 5 (6.0%) had ocular symptoms, 4(4.87%) had symptoms of backache, 1 each (1.21%) had nonspecific symptoms. Conclusion: The low rate of positivity of HLA B27 in our study population support the view that HLA B27 should not be used as a routine test. However a larger study involving larger population with different racial and ethnic groups of India is needed to establish the role of HLA B27 as a diagnostic and prognostic marker for arthritis, IBD, uveitis and other inflammatory diseases

Keywords: HLA B27; MHC; IBD; AAU; Ankylosing Spondylitis.

 Background: Unopposed estrogenic stimulation either due to exogenous or endogenous source is responsible for endometrial hyperplasia and is rare in women under the age of 30 years with an increasing incidence with age. Endometrial hyperplasia is a distinct clinical and pathologic entity and very closely related with abnormal uterine bleeding. Abnormal uterine bleeding is a relatively common gynecological condition that affects women in adolescent and perimenopausal age group due to anovulatory cycles or irregular maturation of follicles. Objectives: 1. To study the clinicopathological spectrum of endometrial hyperplasia in abnormal uterine bleeding above 40 years of age group. 2) To analyze the different patterns of endometrial hyperplasia and classify them according to WHO classification. Methods: The prospective study included 105 cases who histopathologically diagnosed various patterns of endometrial hyperplasia in patients of abnormal uterine bleeding above 40 years of age over the period of 2 years. The detailed clinical history was obtained. Specimens were routinely processed and H & E stained slides were studied. Result: A total of 105 cases of endometrial hyperplasia were studied. The most common age group presenting with endometrial hyperplasia was 4050 years (74.28%) and most common presenting complaint was menorrhagia (72.38%).The commonest pattern was simple hyperplasia without atypia (77.14% ) followed by complex hyperplasia without atypia. Conclusion: Endometrial hyperplasia is a common condition and usually associated with abnormal uterine bleeding above the age of 40 years. So it deserves special attention because of its relationship of progression to endometrial carcinoma. Early recognition and histopathological work up can prevent disease progression.

Keywords: Abnormal Uterine Bleeding; Endometrial Hyperplasia; Menorrhagia.

 Background: Hystrectomy specimen is the most commonly recived specimen in pathology department.This study was carried out to identify most common pathologies in hysterectomy specimens & to correlate these findings with clinical presentation. Methods:Total 150 cases were studied in department of pathology, Dr. Ulhas Patil Medical College over a period of 2 year,January 2013 to December 2015. Surgical specimens were fixed in formalin & tissues were adequately processed. Sections were stained routinely with haematoxylin & eosin stain. Result: Most common clinical presentation was pain in abdomen ( 70 cases)followed by menorrhagia (43 cases) & something coming out of vagina (27cases) and white discharge (27cases) whereas least common was polymenorrhagia (16 cases) followed by post menopausal bleeding (8 cases), dysmenorrhoea (6cases) & irregular bleeding (2cases). Commonest age group at presentation was fourth decade(4150years) 67 cases(44.67%). Next group was third decade (3140years) 54 cases(36%). Only 2cases(1.33%)were seenin seventh decade. Pathologic examination was confirmed the clinical diagnosis in majority of patients. Conclusion: Hysterectomy still remains widely used treatment modality in developing countries. Every specimen of hysterectomy should be subjected for routine histopatholgy for final diagnosis & management of disease of uterus.

Keyword: Adenomyosis; Dysfunctional Uterine Bleeding (DUB); Endometrial Hyperplasia; Hysterectomy; Leiomyoma.

 Context: Peripheral T cell lymphomas (PTCLs) are uncommon subtypes of non Hodgkin lymphoma (NHL). The diagnosis is often challenging and not infrequently misdiagnosed. Aims: To analyse the morphological and immunohistochemical profile of Peripheral T cell lymphoma. Settings and Design: This study was carried out at the Department of Pathology, where cases were recruited using consecutive sampling method. Methods and Material: Immunohistochemical staining was performed in all cases of lymphoma and results were analysed. Statistical Analysis Used: Frequency distribution of the diagnoses was studied. Results: There were six casesof Peripheral T cell lymphoma – unspecified ( CD3+, CD20), two cases of Angioimmunoblastic T cell lymphoma (AITL)(CD3+, CD10+, CD23+), one case of Lennert’s lymphoma(CD3+,CD20) and a hepatosplenic T cell lymphoma(CD3+,CD2+). Conclusions: PTCLs constituted for 20% of NHLs. Immunohistochemistry was helpful in diagnosis when differentiation from Hodgkin lymphoma was difficult morphologically.

Keywords: Angioimmunoblastic T Cell Lymphoma; Lennert’s Lymphoma; Lymphoma; Non Hodgkin Lymphoma; Peripheral T Cell Lymphoma.

 A pilomatricoma is a benign appendage tumor related to hair cells matrix. Pilomatricoma usually occurs as a solitary firm lesion with predilection for head and neck, and upper extremities. The cytologic findings had features which allowed a correct diagnosis. Findings included are presence of basaloid cells, delicate pink fibres, shadow cells, giant cells, naked nuclei and calcium deposits. Material and Method: The present study includedcytologicallysuspected 8 cases ofpilomatricoma at unusual sites, confirmed on histology. Conclusion: Pilomatricoma generally present as firm subcutaneous nodules in children and young adults and are often misdiagnosed clinically. The physicians and surgeons should be familiar with this entity and consider it in the differential diagnosis of a superficial mass. FNA cytology is characteristic and will allow a conclusive diagnosis even in cases with an aberrant clinical presentation.

Keywords: Pilomatricoma; Unusual Sites; Calcifying Epithelioma; Aspiration Cytology.

 Introduction: Fine needle aspiration cytology (FNAC) is the first line investigation for the diagnosis of palpable thyroid lesions. Cytological diagnosis of palpable thyroid lesions and their classification on the bases of Bethesda Classification (TBSRTC 2007) makes uniformity in the diagnosis, facilitate communication among cytopathologists and surgeons and guide the further management. Aims and Objectives: The aim of the study was to diagnose and classify palpable thyroid lesions on the bases of Bethesda Classification and to correlate the diagnosis with relevant clinical history and investigations and histopathological diagnosis if possible. Materials and Methods: This study was carried out in a tertiary care hospital from January 2011 to December 2012. The clearance was obtained from ethical committee of our hospital. The study included 156 cases which were classified as non diagnostic 8 cases (5.1%), benign category 123 cases (78.84%), atypia of undetermined significance/ suspicious of follicular neoplasm 11 cases (7.05%) and malignant 3 cases (1.92%). Conclusion: Cytological classification of palpable thyroid lesions on the lobes of Bethesda classification helps to guide proper management of patients and facilitates better communication among cytopathologists and surgeons.

Keywords: Fine Needle Aspiration Cytology; Palpable Thyroid Lesion; Bethesda Classification.

 Objective: To study the spectrum of lesions in non pregnant women of reproductive age group presenting with abnormal uterine bleeding in Kumaon region. Study Method: A two year prospective cross sectional study was carried out from September 2013September 2015 in the Department of Pathology and Department of Obstetrics & Gynaecology, Government Medical College, Haldwani and associated Dr. Sushila Tiwari Memorial Hospital, Haldwani. Data was obtained from patient’s proforma which included age, parity, presenting symptoms , bleeding pattern and clinical indication for hysterectomy. The specimens were studied grossly and thereafter processed and stained with hematoxylin & eosin stain for microscopic examination. Results: Majority of lesions were benign in nature (99.6%) while malignant lesions comprised of a very small percentage (0.4%) .The most common age group that presented with AUB was perimenopausal age group ( 40 44 years) that comprised of 65.6% of the total cases. Most common lesion encountered was adenomyosis seen in 67 cases (26.8%) followed by leiomyoma seen in 45 cases (18%) which was the second most common singly occurring lesion. Heavy menstrual bleeding (HMB) was the most common bleeding pattern encountered in our study accounting for 75.6% cases. Clinopathological correlation was seen in 95.6% cases of leiomyoma while it was only 71.6% for adenomyosis.

Keywords: Abnormal Uterine Bleeding; Adenomyosis; Leiomyoma; Heavy Menstrual Bleeding.

 Background And Objectives: Anaemia in children is one of the major health problems in India as well as in many parts of the world. Iron deficiency is well known to cause thrombocytosis. However, Iron deficiency may also lead to thrombocytopenia. The present study was undertaken with an aim to analyse, the improvement in the platelet counts of children between 1 to 12 years of age suffering from microcytic hypochromic anaemia and thrombocytopenia after receiving appropriate iron therapy. Methodolocy: The study was conducted on 561 anemic children in the age group of 1 to 12 years, out of which only 67 children had microcytic hypochromic anemia with thrombocytopenia. The children with Hb% lesser than the cutoff value for their age were included in the study. Detailed clinical history was elicited and thorough clinical examination was performed. Peripheral smears of these patients were examined. Bone marrow examination was done. The complete haemogram including reticulocyte count was done. Results: Childrens with microcytic hypochromic anemia with thrombocytopenia(60 cases) improved with iron therapy whereas in 7 cases causes of thrombocytopenia was different. Interpretation and Conclusion: Pediatric anaemias are very common since children are the most vulnerable for occurrence of these anaemias and thrombocytopenia can be encountered in many cases of microcytic hypochromic anaemia. Therefore it is also necessory to rule out this association before considering other causes of thrombocytopenia in cases of microcytic hypochromic anemia.

Keywords: Microcytic Hypochromic Anaemia; Thrombocytopenia; Bone Marrow Study; Iron Deficiency Anaemia; Paediatric Anaemia. 

 Background and Objectives: Primary malignant tumors of the small intestine are rare and correspond to less than 2% of all tumors of the alimentary tract. Primary nonHodgkin’s lymphoma of small intestine(PLSI) represent 1520% of small bowel malignant tumors. The objective of this study was to ascertain the anatomic distribution, macroscopic type and histological subtypes of PLSI. Materials and Methods: Present study is a prospective descriptive study. During the period 2011-2014 a total of 40 resected specimens of small intestine were received and subjected for detailed morphological examination, out of which 5 cases turned out to be PLSI. These 5 cases were analyzed and classified as per WHO classification. Results: Mean age of presentation was 32 years with male preponderance. Most common presenting complaint was abdominal pain. Most common site was ileum followed by jejunum. Macroscopically they presented diffusely followed by nodular growth. All the cases belonged to Bcell lineage and most common histological subtype was diffuse large B cell lymphoma(DLBCL) followed by MALT lymphoma. Conclusion: Due to its rarity and the lack of characteristic symptoms, PLSI is often not diagnosed until serious complications occur such as intestinal obstruction/ perforation. Hence detailed morphological evaluation is needed to understand the clinicopathological profile of PLSI .

Keywords: Small Intestine; NonHodgkin’s Lymphoma; Intestinal Obstruction.

 Introudction: Blood transfusion is a life saving procedure, which saves million of lives every year. It requires adequate supply of safe blood, which can be achieved by proper predonation donor screening. Donors are deferred from donation for several health reasons. The rate and reasons of deferral vary from region to region. Aim: To study the deferral rate and reasons for deferral in potentially healthy voluntary blood donors at various voluntary blood donation camps organized in Gadag, Karnataka, India. Materials and Methods: Analysis of data obtained from voluntary blood donors in various voluntary blood donation camps held around Gadag district, Karnataka was done at Blood bank, attached to Gadag Institute Medical Sciences, Gadag. Analysis of deferral rate and various causes for deferral were done in both male and female blood donors. Results: Total of 469 voluntary blood donors were registered at blood donation camps and 61 were deferred from donation, which constitutes deferral rate of 13%. Overall deferral was mainly due to low hemoglobin (36.1%). Common reasons for deferral in males were hypotension (41.9%) and low hemoglobin (25.8%), whereas in females low hemoglobin, hypotension and underweight constituted 46.6%, 16.7% and 16.7% respectively. Return rate after temporary deferral was zero in our study.

Keywords: Voluntary; Deferral; Donation; Low Hemoglobin.

 Background: Pesticides are a very important group of environmental pollutants used in intensive agriculture for protection against diseases and pests. Pesticides are the some of the deadliest poison produced by human beings, hence present a health hazards in long term exposure even at low levels. Neurotoxicity is major consequence of pesticide effect. Objectives: To study the hematological parameters – haematocrit (Hct) and absolute erythrocyte count (AEC) and biochemical parameters serum glutamate oxaloacetate transaminase (SGOT) in fish Channa punctatus exposed under different concentrations of Metasystox pesticide. Materials and Methods: The fishes collected from river Gomti, at Lucknow were brought to the biochemical laboratory in the plastic bags for processing of experimental study. This study was demonstrated in fish Channa punctatus, which were exposed 24 to 96 hours to four different concentrations of Metasystox pesticide. Analysis of haematocrit (Hct) and absolute erythrocyte count had been done as pathological parameters and serum glutamate oxaloacetate transaminase (SGOT) as biochemical parameter to know the adverse effect of the pesticide. Results and Conclusion: Significant decrease in absolute erythrocyte count was noticed in fish channa punctatus at all concentrations and the time intervals. The results obtained on hematocrit of the fish channa punctatus were also remarkable; it was fall in level at all concentrations and time intervals. Regarding to biochemical parameter, significant increase in aspartate transaminase enzyme levels were observed in Metasystox pesticide exposed fishes. These results concluded that changes in pathological and biochemical parameters are the adverse effect of the Metasystox pesticide. Therefore it is suggested that pesticide sprayers have to take all the safeguard regarding protection from Metasystox pesticide.

Keywords: Metasystox; Hematocrit; Absolute Erythrocyte Count; Aspartate Transaminase; Toxicity.

 Background: Anemia is a major health challenge to global development. Geriatric anemia is a public health crisis, wide spread in India, which increases morbidity and mortality among older people. An evaluation is always needed to identify the underlying cause. Objective: To study the prevalence of anemia in geriatric patients attending medical OPD of GIMS hospital, Gadag. Methodology: In this prospective study, geriatric patients attending the medical OPD at GIMS hospital were screened for anemia. Patients of age 60 years and above from January 2015 to April 2015 were included in the study. Blood was collected in EDTA tube and hemoglobin was estimated using automated blood cell counter. Results: A total of 450 geriatric patients were evaluated for anemia. Our study showed severe prevalence of anemia (61.8%) in geriatric patients attending GIMS hospital. Among total 450 patients, 12% (54 cases) were mildly anemic, 24.2% (109 cases) were moderately anemic and 25.6% (115 cases) were severely anemic. There is severe prevalence of anemia among geriatric patients attending GIMS hospital. It is important to evaluate anemia, since it is an entity that lies within our ability to diagnose and treat.

Keywords: Geriatric; Anemia; Prevalence.

 Background: Central nervous system (CNS) tumors which constitute 12% of all tumors. They often present diagnostic dilemmas because tumors ofvarying histogenesis show considerable overlap in morphological features and divergent differentiation. Immunohistochemistry (IHC) has become an important tool in the diagnosisof brain tumors. The judicious use of a panel of selected immunostains is unquestionably helpful indiagnostically challenging cases as an accurate histologicdiagnosis helps in predicting the clinical outcome of various brain tumors. Materials and Methods: A total of 40 consecutive suspected CNS tumours wereevaluated using routine Hematoxylin and Eosin stain. In addition, an IHC panel comprising of glial fibrillary acidic protein (GFAP), S100 protein (S100), epithelial membrane antigen (EMA), vimentin (VIM), synaptophysin (Synapto), neurofilament (NFP), and cytokeratin(CK) were used for confirmation of diagnosis. Proliferation in all cases was assessed using MIB1 labelling index. Results: Astrocytomas occurred most frequently in the study, followed by meningiomas. Other rare tumors included primary CNS lymphomasand mesenchymal tumors. Single case of rare primary CNS synovial sarcoma was also encountered. Grading of the tumors wasdone as per the revised World Health Organization criteria. Conclusion: This study highlights the utility of immunohistochemistry as an adjunct to routine histologic diagnosis for proper classification and grading of CNS neoplasms.

Keywords: Brain Tumors; Histopathology; Immunohistochemistry.

 Background: Ovarian tumors are common forms of malignancy in women & mortality rate because of ovarian malignancy is increasing now a days. Present study is thesis topic consist of retrospective & prospective study of 130 ovarian tumours was carried out at department of pathology, NKP Salve institute of medical science Nagpur from June 2005 to May 2010. Commonest tumour was surface epithelial stromal tumour constituting 97(74.61%) cases followed by germ cell tumors 24(18.46% ) cases, sex cord stromal tumour 7(5.38 %) & metastatic tumor 2(1.53%)Out of 130 cases, 113(86.92%) were benign tumors & 15 (11.53%) were malignant surface epithelial tumour. Only 2(1.53%) were borderline.Commonest clinical presentation in all ovarian tumors was pain (49.23%) & lump (38.46%) in abdomen.

Keywords: Ovarian Neoplasms; Surface Epithelial Tumor; Bening; Malignant.

 Background: Although major progresses have been made in the diagnostic approaches of peripheral neuropathy in past ten years, 25 to 40% of patients remain undiagnosed. Recently, with use of immunohistochemical (IHC) and ultrastructural techniques, the diagnostic yield has enhanced. The aim of this study was to study the diagnostic utility of incorporating myelin stain, antiNeurofilament (NF) immunostain and ultrastructural evaluation in comparison with routine histological stains, to establish an optimal diagnostic protocol for workup of neuropathies. Methods: Thirty four nerve biopsies received from patients with neuropathies were included with relevant clinical and electrophysiological information. In all the cases, nerve biopsy tissue submitted for evaluation was processed for light microscopic (LM), histochemistry using Luxolfast blue (LFB) myelin stain, and IHC using antiNF antibody. In 15 cases, an additional bit was received in saline/3% glutaraldehyde for electron microscopic (EM) examination. Statistical analysis was performed using Epi Info 3.5.3 software (CDC, Atlanta, 2008) for definitive correlation. Results: Overall the diagnostic yield was 46.7% with morphology alone but when combined with LFB stain combined was 73.3% (p<0.05). Combined diagnostic yield of H&E with NF was 17 cases (56.7%) (p>0.05). On evaluating the combined efficacy of LFB, NFIHC and EM in comparison to routine staining using hematoxylin and eosin, it was observed that 21 biopsies (70%) were abnormal of which 10 were missed on routine examination (p<0.05). Conclusion: This study highlights that large number of cases and the spectrum of nerve pathologies that were otherwise missed owing to evaluation by routine histology alone can be diagnosed using a protocol which combines myelin stain, IHC with NF, and at least assessing semithin sections, for optimal workup of nerve biopsies. Since proper evaluation and accurate diagnosis have direct therapeutic and prognostic connotations, it is imperative that diagnostic centres evolve diagnostic protocol combining the above methodologies.

Keywords: Diagnostic Yield; Immunohistochemistry; Nerve Biopsy; Ultrastructure.

 Context: Lichen planus (Greek leichen’ “tree moss”; Latin planus, “ flat”) is a unique, common inflammatory disorder that affects the skin, mucous membranes, nails and hair. Lichen planus may be clinically confused with guttate psoriasis, drug reaction, lichen nitidus and secondary syphilis. Any papular lesion such as granuloma annulare, Pityriasis rosea, and lichen amyloidosis may mimic lichen planus. The violet color of the papulonodular lesions of Kaposi’s sarcoma may transiently be confusing but skin biopsy is definitive. Because all papulosquamous disorders are characterized by scaling papules, clinical confusion may result during their diagnosis. Separation of each of these becomes important because the treatment and prognosis for each tends to be diseasespecific. Aim: To study the pattern of clinical and histopathological features of lichen planus of the skin with clinicopathological correlation. Material and Methods: The present study of 12 cases of lichen planus of the skin was carried out in the Department of Pathology of a tertiary care centre from December 2009 to October 2011. In this study, the patients which were clinically diagnosed as lichen planus of skin, before starting the treatment and attending the outdoor skin department were selected. Histopathological findings were interpreted in light of clinical details. Results: Out of 12 cases 6 (50%) were males and 6 (50%) were females with male to female ratio of 1:1. Maximum number of cases 6 (50%) were noted in the age group of 2140 years. Mean age was 26.16 years. Histopathological findings: hypergranulosis, hyperkeratosis, vacuolar alteration, band like infiltrate, irregular acanthosis with saw toothed rete ridges and melanin incontinence were noted in most of the cases of lichen planus. Conclusion: Histopathology serves as a diagnostic tool and rules out other lesions which mimic lichen planus.

Keywords: Lichen Planus; ClinicoHistopathological.

 Background: Chronic inflammation is often marked by granuloma formation. This is a diagnostic sign of a plethora of lesions. Individual entities have their respective and unique presentation and hence the need to accurately identify the etiology of individual granulomatous lesion. This has a direct relationship with treatment protocols and hence patient morbidity. With this study we try to understand the various clinical settings and presentations in all the granulomatous lesions encountered in our Department of Pathology, Histopathology, in a year. Materials and Method: Retrospective study of cases diagnosed as granulomatous lesions throughout the body received over a period of 1 year from January 2015 to December 2015. All the lesions reported on histopathology were studied for individual characteristics and etiology with the help of special stains wherever required. Result: Fourty cases of granulomatous lesions were studied at Department of Pathology, Krishna Institute of Medical Sciences, Karad, Maharashtra, India. Most commonly affected age group was 3rd decade and females being most commonly affected with 29 cases (72.50%). Lymph node was the most commonly affected site with 19 cases (47.50%) with tuberculosis predominating the etiologies in 18 cases (45%). Other conditions noted were Leprosy, Fungal infections and Inflammatory conditions. Conclusion: Tuberculosis is the predominant etiological factor behind granulomatous lesions throughout the body, most commonly affecting lymph nodes. Most commonly granulomatous lesion encountered in skin is Leprosy. Fungal infections had considerable share in granulomatous lesions affecting predominantly the head and neck region.

Keyword: Granuloma; Tuberculosis; Organs; Stains.

 Activity of adenosine triphosphatasc (ATPase), aryl hydrocarbon hydroxylase (AHH) enzymes and MDA were investigated employing serumfree murine live explant culture from day 0 through 4 following Plasmodium berghei infection (5% parsitaemia). Results demonstrate the maintenance of ATPase activity in the tissue from normal mice, with attenuation noticed in the tissue from infected animalsthroughout the period of culture The enzyme activity also exhibited responsiveness to Picroliv(0.5mg/ml) added to the culture system, The drug metabolizing enzyme (DME) AHH was also expressed in significantly (p > 0.01) high amounts in both the type of tissue onday 0 decreasing by 10 fold in 24 ours. MDA level also changes during culture and found a very positive response with picroliv. Subsequently, upto day 4, the activity profile did not show much change. However, Picroliv(0.5mg/ml) responsiveness was found to be better in the tissue culture system in the absence of serum with each explants containing the component cell types of liver makes it a novel approach to evaluate the biochemical basis of enzyme regulation.

Keywords: ATPase; AHH; MDA; DME.