Indian Journal of Pathology: Research and Practice

Primary Fallopian tube carcinomas are very rare in incidence. They occur in a wide range of age group ranging from 17 to 88 years. The etiology of these tumours is unknown. Sometimes the tumour presents clinically like an ovarian malignancy and that only rarely the diagnosis of tubal malignancy is made preoperatively. Both the ovarian and Fallopian tube malignancy have similar age of occurrence being more common in nulliparous women and are of serous papillary morphology. Tumours of uncertain origin arising from ovary and tubes have generally been put under ovarian origin since ovarian tumours occurs at a greater frequency than that of the tubes. Here with presenting a case of Primary Fallopian tube carcinoma which was incidentally diagnosed in a case with a preoperative diagnosis of leiomyoma.

Keywords: Primary Fallopian Tube Carcinoma; Papillary Serous Carcinoma. 

In the present study of outpatient settings, pyelonephritis was diagnosed in pregnant women by the history and physical examination & supported by urinalysis result. After a clinopathological confirmation of pyelonephritis, 50 pregnant women were selected. The urine sample was subjected for routine examination & urine sediment was examined for the evidence of pyelonephritis & particularly attention was given to the presence of white blood cell cast. A total of 13% of these patients had WBC cast in urine. Acute pyelonephritis is a bacterial infection of the kidneys that affects 1 to 2 per cent of pregnant women. In most cases, the infection first develops in the lower urinary tract. If it’s not diagnosed and treated properly, the infection may spread from your urethra and genital area to bladder and then to one or both of kidneys.

Keywords: Urine; Pyelonephritis; White Blood Cell Cast. 

Context: Meningiomas are one of the most common primary central nervous system neoplasms. They occur most commonly in female patients being most common in the fourth and fifth decades of age. They may be of intraspinal or intracranial and extraaxial location. Aims: The aim of this study is to highlight the importance of histopathological features in analyzing the behaviour of meningiomas. Settings and Design: This is an analytical study undertaken at the department of pathology in a tertiary care hospital for a period of three years from may 2013 to june 2016. Materials and Methods: All the clinical data of the meningioma cases were obtained from the patient files in the pathology registers. The hematoxylin and eosin stained and mounted slides were retrieved and reviewed from the archives of pathology laboratory. Statistical Analysis: Statistical analysis was carried out using SPSS software version 17. Various tests used in the study were the chi square test and the T test. Results: Out of the 250 cases of meningiomas analysed in this study, 92% of the cases belonged to grade I. Features such as small cell change, hypercellularity, sheet like pattern, nuclear pleomorphism, macronucleoli, vesiculous nuclei, necrosis, hypervascularity and brain invasion were seen predominantly in higher grades ( GRADE II and III) of Meningiomas thereby proving their association with aggressive behaviour of tumour and their association was statistically significant with a P value of <0.0000001. Conclusion: Proper histopatholgical analysis is very important for the diagnosing, grading and prognostication of meningiomas.

Keywords: Meningioma; Atypical Meningioma; Anaplastic Meningioma; Meningioma Histopatholgy. 

Background: Varicocele is the most common treatable cause of male infertility affecting the young couple’s Varicocele is associated with increased incidence of abnormal sperm abnormalities including sperm count, sperm concentration, motility & abnormal morphology of sperm. Abnormally shaped sperm are not capable of fertilising the egg, because they do not function properly leading to male infertility. In testing for teratozoospermia, (abnormal sperm) sperm are collected, stained and analyzed under a microscope to detect abnormalities. These abnormalities may include heads that are large, small, tapered, or pyriform or tails that are abnormally shaped. Patients & Method: The study was conducted at R.D. Gardi Medical College, Ujjain between 8th January 2015 to 30th July 2015. Total of 50 patients in age group of 1845 with clinically proved cases of varicocele from surgical outpatient department were included in the study. The semen sample was evaluated by routine examination including total count, motility & emphasis done on sperm morphology by staining the smear by Paponicolaou method. Results: Over all of the total 50 cases the most prounced abnormality was in head 33 (16.5%) followed by abnormality of tail 27 (13.5%) & mid piece constitute (12%).

Keywords: Male Infertility; Semen Parameters; Varicocele; Teratozoospermia.

Background: In India cervical cancer is the leading cause of morbidity and mortality. Cancer of cervix ispreventable, and can be diagnosed at the premalignant/ preinvasive stage with adequate and repetitive cytological screening by Papanicolaou (Pap) smears. Methods: This retrospective study includes total 820 patients who were presented with various gynaecological problems. Clinical data was obtained by hospital records and smears were revived. Reporting was carried out as per Bethesda system 2014. Results: Total 820 patients were screened. Majority of cases (812 of 820) were negative for intraepithelial lesion (NIL) and there were 7 abnormal Pap smears which includes 3 cases of high grade intraepithelial lesions (HSIL), 2 cases of low grade intraepithelial lesions LSIL(0.2%) and each case of atypical glandular cells(AGUS) and Squamous cell carcinoma (SCC)and 1 case was unsatisfactory for evaluation. Among NIL, 763 (93%) were of non specific inflammatory smear, 16 cases Candidal inflammatory smear and 33 cases were of Trichomonal inflammatory smear. Conclusions: Pap smear cytology is a useful screening tool to detect preinvasive cervical epithelial lesions hence, the incidence of invasive cervical malignancy can be prevented if Pap screening program is effectively implemented in target population.

Keywords: Pap smear; Epithelial Cell Abnormality; Negative for Intraepithelial Lesions. 

Background: Oral cavity lesions are usually squamous cell in nature. These lesions can present as both malignant and premalignant conditions. Premalignant lesions are usually dysplastic lesions which can be mild, moderate and severe, leukoplakias or erythroplakia. 1020% of premalignant lesions have a tendency to progress into malignancy. Hence it becomes important to identify these lesions to prevent progression. Apoptotic index can be used as a simple tool to assess the progression of the disease and identify individuals who have a tendency to development malignancy. Aims: The aim of this study is to assess the apoptotic index in premalignant oral squamous cell lesions and evaluate its usefulness in assessing disease progression. Material and methods: 33 cases were studied. 5 were normal and used as control and the rest of 28 from varying degrees of dysplasia’s. Apoptotic index was assessed on H&E stained sections using oil immersion lens. Apoptotic bodies were counted in 10 oil immersion fields and expressed as a percentage. Results: The results showed that apoptotic index increased with the grade of dysplasia’s, showing a peak in moderate dysplasia. Conclusion: From this study we can conclude that apoptotic index can be used as a simple tool to evaluate patients with oral premalignant lesion. It can also help in identifying patients who will progress to malignancy and can be used as a prognostic marker.

Keywords: Dysplasia; Apoptotic Bodies; Apoptotic Index. 

Background: DowlingDegos Disease (DDD) is a rare genetic disease of the skin having an autosomal dominant inheritance. It is grouped under reticulated pigmented anomalies and manifests as symmetric, progressive, pigmented macules over flexures, scattered comedolike lesions and pitted acneiform scars. Histopathology is required for definitive diagnosis and to distinguish it from other reticulate pigmentary genodermatoses. Aims: 1. To show the existence of this rare disease in the local population. (2) To stress on the clinicopathological correlation for the definitive diagnosis of the disease. Materials & Methods: Punch biopsies of skin received by the Department of Pathology over a span of two years with Dowling Degos Disease as one of the differential diagnosis, were included in the study. The biopsies were processed as per standard protocol. Diagnosis was confirmed by the histopathological examination. Result: A total of six cases were included in the study, out of which four were histologically confirmed as DDD and one case had features overlapping with Reticulate Acropigmentation of Kitamura (RAPK). The study showed female preponderance. Four cases had family history. The clinical and histopathological findings of each case are discussed. Conclusion: Dowling Degos Disease may not be a rare entity. It should be considered as one of the differential diagnoses for pigmentary disorders. With combined clinical and histopathological evaluation, more cases may come into light in the future and DDD may not remain as a rare disorder.

Keywords: DowlingDegos Disease; Genodermatoses; Reticulate Pigmented Disorders. 

Background: Neonatal sepsis remains an important clinical syndrome despite advances in neonatology. Early diagnosis and adequate antibiotic treatment are required because of high rates of mortality and morbidity, especially in developing countries. Early diagnosis of neonatal sepsis is difficult because of nonspecific signs and symptoms, and noninfectious diseases may mimic neonatal sepsis. Hence this study evaluates the role of certain new parameter in neonatal sepsis. Material and method: Before antibiotic therapy, blood samples for VCS parameters i.e. Volume, conductivity and scatter parameters of neutrophils and for culture were taken from patients with a diagnosis of sepsis. Data was analyzed by descriptive statistics. Student t test was used to compare 2 groups. Data included total WBC counts, percentage of neutrophils, and the VCS parameters of neutrophils, which were generated by each individual cell passing through the aperture and were optically and electronically measured by the Coulter LH 780 (Beckman Coulter, Fullerton, CA). VCS parameters were evaluated on the same day of sepsis diagnosis. Results: There were 55 cases and 10 controls. For each case total WBC counts, percentage of neutrophils, and the VCS parameters of neutrophils, CRP were noted. After the statistical analysis there was no statistically significant difference among cases and controls in relation to any of the parameters except for conductivity (C) of neutrophils. Conclusion: A high index of suspicion with or without lab evidences of infection is the key for early diagnosis. Prompt institution of antibiotic therapy and supportive care will save most of the cases of neonatal sepsis.

Keywords: Neonatal Sepsis; VCS Parameters; CRP. 

Introduction: Anemia is major public health problem. Diagnosis of anemia and its correction needs crucial intervention. Peripheral blood smear examination plays an important role in classifying anemais based on morphology of RBCs. Nutritional deficiency is a major risk factor for anemias. Aim of the study: The aimof the study is to look at the morphological patterns and prevalence of anemias in a teaching hospital in rural Telangana. Materials and Methods: It is a hospital based observational study done in the department of Pathology at RVM Institute of Medical Sciences and Research Center, Siddipet district, Telangana State for a period of two months from August 2017 to September 2017. A total of 560 cases attending a rural medical camp were screened for anemia. All the cases were sent to department of Pathology (central laboratory) for routine investigations for anemia. Investigations advised were Hemoglobin estimation, complete Hemogram, Peripheral smear examination and Reticulocyte count. Observations and Results: In the present study all the 560 cases were screened for anemia. 230 (41%) cases were normal and 330 (59%) cases showedanemia.157/330 cases were among 2130 years followed by 3140 years 62/330 cases. Female preponderancewas seen 339/560 (60.5%) compared to males 2 21/560 (39.4%). Clinically about 53.5 % cases presented with pallor. Among 560 cases screened, about 330 (59 %) cases showed features suggestive ofanemia.Microcytic hypochromic anemia was observed commonly among 55.3% cases (310/560) and normocytic normochromic in 230 cases (41%). Conclusion: Microcytic hypochromic anemia was the most common type of anemia identified. Females were commonly affected than males.

Keywords: Anemia Prevalence; Iron Deficiency; Microcytic Hypochromic Anemia; Medical Camp Study. 

Breast disease are one of the commonly encountered condition in females. For the diagnostic work –up of these lesions, clinical examination was followed by FNAC preoperatively and for confirmation histopathological examination has been done. Aims: to study cytology of breast lesions followed by cytohisto correlation, to validate the accuracy of FNAC and histopathology. Materials and Methods: Data was collected from 68 cases during feb 2016 to jan 2017. Results: Out of 68 cases, 4 were unsatisfactory, 10 were nonneoplastic lesion, 40 were benign, 3 were atypical, 3 suspicious for malignancy and 8 were malignant categories as per cytology. Histologically 10 were nonneoplastic and 44 were benign and 10 were malignant. Conclusion: Cytohistological correlation is the diagnostic tool in classifying the breast lesion and helps in overcoming the pitfalls of cytology.

Keywords: Breast; Ductal Carcinoma. 

Introduction: Leprosy is a major public health problem in developing countries including India. It is caused by Mycobacterium leprae and predominantly affects skin and peripheral nerves. It is a chronic disease having varied clinical and also varied biopsy findings. Aim of the study: (a) To analyse the histopathological spectrum of Hansens’s disease based on the histopathological and clinical features. (b) To study clinicohistopathological correlation. Materials and Methods: This was a retrospective and prospective study carried out at Subharti Medical College, Meerut, Uttar Pradesh, over a period of four and half years. All the skin biopsies obtained from patients clinically diagnosed or suspected as having leprosy were studied by way of histopathological examination and Fite stain. The age and gender distribution, sites of lesions, types on histopatholgy, Fite stain positivity and the types of reactions were studied. Results: A total of 216 (17.2%) cases of leprosy were diagnosed among 1255 total skin biopsies. The male to female ratio was 2.27:1. The most common age group was 2130 years, the most common sites were the extremities and most common presentation was as hypopigmented macules. The lepromatous type was the most common on histopathology and the midborderline was the least common. All lepromatous cases were positive for Fite stain. Erythema nodosum leprosum was seen in 30 (13.8%) cases. Conclusion: All cases of clinically suspected leprosy should undergo skin biopsy for histopathological examination and special stain to demonstrate the acid fast bacillus. The indeterminate type shows nonspecific findings on skin biopsy. Reversal reactions and Erythema nodosum leprosum are quite common in leprosy requiring hospital admission to prevent complications.

Keywords: Hansen’s Disease; Histopathology; Bacillary Index; Skin Biopsies; Leprosy Reactions. 

 Background and Objectives: Fine need aspiration cytology (FNAC) has become a rapid, cost effective investigative method for obtaining reliable tissue diagnosis especially for the site like head and neck where considerable overlapping of various structures makes it difficult to reach exact diagnosis. The present study is taken up to evaluate role of FNA in management and diagnosis of various head and neck lesions and to study the spectrum of various lesions encountered. Materials and Methods: Present study is a retrospective descriptive study. A total of 570 cases of palpable head and neck masses were subjected to FNAC at cytology OPD using 2324 gauge needle and 10 ml syringe. Detailed cytological assessment was done. Results: Out of 570 cases, thyroid lesions accounted for 38.07%, lymph node lesions were 33.19%, salivary gland lesions were 9.29% and skin/soft tissue and miscellaneous were 19.47%. Among thyroid lesions goitre (66.8%) accounted for maximum number of cases, metastatic carcinoma(33.86%) was the commonest lymph node lesion followed by tubercular lymphadenitis (19.57%) and pleomorphic adenoma (38.07%) was the commonest among salivary gland lesions. Conclusion: This study concludes that FNAC is quite effective, simple investigative procedure with very good patient compliance. Use of FNAC should be encouraged as an investigation for initial diagnostic evaluation of head and neck lesion and as a tool to avoid unnecessary surgical procedure and its complications.

Keywords: Head and Neck Lesions; Diagnostic Tool; Thyroid Lesions; Tubercular Lymphadenitis.

Introduction: Bladder cancer is the 7t hmost common cancer worldwide and constitutes for 90% of all primary tumors of the same. The current study was undertaken to study the histopathological lesions of the bladder and to determine the association of age and sex, histopathological variants and tumor grading and staging. Objectives: To study the histomorphological patterns of various lesions in bladder biopsies and to analyze the frequency of different urothelial lesions. Methods: The study was conducted from June 2015 to July 2017, in department of Pathology, at DY Patil Medical College, DPU, Pimpri, Pune. Related clinical history of all the cases was recorded. Results: Total of 73 bladder biopsies were analyzed. Clinical symptoms of hematuria, abdominal pain and an increased frequency of micturition were the usual presenting symptoms. Male dominance was noted as compared to females with M: F ratio of 2:1. Maximum incidences of cases were noted in the age group of 61 to 80 years. Neoplastic lesions comprised a total of 74.28% in contrast, the benign lesions were 27.3%. Amongst the malignant lesions majority were of urothelial carcinoma (54.7%) followed by papillary urothelial neoplasm of low malignant potential, low grade papillary urothelial carcinoma and sarcomatoid urothelial carcinoma (2.7%) and urothelial dysplasia (8.21%). Conclusion: Neoplastic lesions were more common than nonneoplastic, most common being urothelial carcinoma and their histopathological variants. Significant male predominance was noted with hematuria being the most common presenting symptom and advanced age had an overall poor survival rate. Pathological grading plays a key role in the prognosis of these tumors.

Keywords: Urothelial Lesions; Hematuria; Urothelial Carcinoma; Histological Variants. 

Fine needle aspiration cytology (FNAC) is a valuable adjunct to preoperative screening in the diagnosis of thyroid nodules and has emerged as one of the wellestablished firstline diagnostic techniques. In most cases, it can distinguish between benign and malignant lesions. FNAC is a rapid, efficient, costeffective, relatively painless procedure with a high diagnostic accuracy. It has high rate of sensitivity and specificity in diagnosing thyroid neoplastic lesions. Purpose of this study was to evaluate the effectiveness of FNAC in the diagnosis of neoplastic thyroid lesions and confirmation of the diagnosis by histopathological study and report the malignancy risk for FNA of thyroid lesions. The present study was carried out in our institute during the January 2012 to September 2016. This study was a retrospective study and a comparison was drawn between FNAC results and final histological diagnosis. In our study, 745 cases of thyroid FNAC smears were analyzed and cytohistopathological correlation was done in 39 cases of neoplastic lesions. 33 cases werediagnosed as neoplastic lesions by FNAC. The overall surgical yield of malignancy by FNAC was 26.84%. In our study, FNAC diagnosis had 79.84% sensitivity, 97.6% specificity, 6.06% false positive rate, 8.9% false negative rate, and 91.86% accuracy. Hence, FNAC has been proven to be an efficient and guide the clinical treatment of patients with thyroid nodules.

Keywords: CytoHistopathological Correlation; Fine Needle Aspiration Cytology; Thyroid Neoplastic Lesions; Accuracy. 

Background: Buccal mucosa cancer is the most common oral subsitewhichis aggressive in nature, had high rate of locoregional recurrence and mortality in India. Objective: The aim of study was to evaluate prognostic factors for buccal mucosa cancer by univariate and multivariate analysis. Materials and Methods: A retrospective study was performed by reviewing medical records between 2013 and 2016. Results: A total 198 buccal mucosa cancer were selected within the study criteria which includes125 (63.1%) male and 73 (36.9%) femaleparticipant with mean age of 54 years. Of 198 patients, 24 (12%) recurrence and 7 (3.5%) diseasespecific death was reported during followup period of 34 months (Median, 24 months).The KaplanMeier analysis shows 1st, 2nd and 3rdyear overall survivals were 90%, 72% and 48%, respectively. In univariate analysis,patients age, socioeconomic status, risk habits, clinicalTNM stage, tumor depth and cell differentiation were significant at 95% confidence interval (CI), p<0.05 and further validated by multivariate analysis.The multivariate coxregressionhazard risk (HR) revealed, age [HR, 0.593 (0.974 0.361), p=0.039], socioeconomic status [HR, 1.82 (1.432.55), p=0.048], risk habits [HR, 2.08 (2.1684.39), p=0.027], TNM stage [1.27 (1.183.15), p=0.037], tumor depth [HR, 4.08 (1.2213.58); p=0.021] and cell differentiation [HR, 2.45 (1.274.73); p=0.007]astrue independent prognostic factor at 95CI, p<0.05. Conclusion: Although several factors related to disease, the present study revealed that age, socioeconomic status, risk habits and clinical characteristics of TNM stage, tumor depth and cell differentiation may influence the survival outcome of patients.

Keywords: Clinical Stage; Multimodality Treatment; Oral Cancer; Prognostic Factor; Risk Habits. 

Background: Pathologists can quickly transmit the microscopic images photographed in a certain location to remote centers for analyzing the images. Gleason scoring system forms an important prognostic parameter for therapeutic decision and in the overall management of prostate cancer patients. Aims: 1. To study various histopathological patterns of prostatic carcinoma. 2. To evaluate the reproducibility of modified Gleason scoring system and Grade group in prostate carcinoma on microphotographs. Material and Methods: A retrospective study of invasive prostate cancer cases was conducted from January 2014 to October 2016. It was an analytical type of study at a rural tertiary care institute. Histopathology slides of prostate adenocarcinoma slides were retrieved, reviewed, scored and graded according to World Health Organization [WHO] 2016. The representative images captured by 13 megapixel mobile camera were sent to two pathologists by Email and were evaluated separately. The primary Gleason pattern, secondary Gleason pattern, total Gleason score and Grade groups were documented. Concordance and kappa statistics was applied. Results: Twelve cases were analyzed. Concordance was better in secondary Gleason pattern when compared with primary Gleason pattern, total Gleason score and Grade group. The present study showed substantial agreement in primary Gleason pattern; and substantial to almost perfect agreement in secondary Gleason pattern, Gleason total score and grade group. The overall performance of both the pathologists was satisfactory. Conclusions: Modified Gleason scoring system and grade group has good reproducibility in prostate carcinoma on microphotographs. The analysis of representative images is a feasible and time saving exercise.

Keywords: Adenocarcinoma; Gleason Score; Histopathology. 

Background: Blood transfusion is a critical and lifesaving procedure as even a unit of blood can save a patient in need [1]. Safe and adequate supply of blood and blood products is a major public health issue faced globally. One of the important step to warrant blood safety is by properly following the guidelines of criteria for blood donor selection.A large number of donors are deferred from donating blood for several reasons either temporarily or permanently. Hence it is important to understand the various causes of donor deferral so that preventive measures can be undertaken to reduce the deferral rate in future. The aim of this study is to provide safe blood to patients and to understand pattern of donor deferral in our demographic area. Materials and Methods: A retrospective study was conducted to evaluate the profile of deferred blood donors for a period of 3 years from January 2014 to December 2016. Data of different deferral patterns were obtained from donor deferral register.Every donor was thoroughly evaluated by physical examination, hemoglobin estimation, weight, age, blood pressure, pulse rate, temperature. Donors who did not meet the required criteria were deferred and recorded in the donor deferral register. The deferred donors were analysed based on the causes of deferral. Results: A total of 11831 people came to donate blood during the period of study, out of whom 11675 (98.6%) were males and the rest 156 (1.3%) were females. Common causes of donor deferral included low hemoglobin (43%), hypertension (16.5%), alcohol consumption (13.7%), vaccinations (5.2%), Tatooing (4.4%), underweight (2.8%) and medications (2.2 %). Conclusion: Deferral is a form of rejection and it could represent loss of time for both blood donors and blood bank and the importance of explaining the status of deferral cannot be ignored. Efforts must be taken to increase awareness among deferred donors and encouraging them for future donation by donor education helps to reduce much of the loss of precious units of blood.

Keywords: Deferral; Donor; Low Hemoglobin. 

Background: Papulosquamous disorders assume considerable importance because of their frequency of occurrence. As all the lesions are characterized by scaling papules and plaques, clinical confusion may occur in their diagnosis and hence these lesions are commonly misdiagnosed. Separation of each of these lesions becomes important because, for each disease, the treatment and prognosis is disease specific. Aim: To analyse various papulosquamous disorders of skin, to study the histopathological features and also to know the correlation between clinical and histopathological diagnosis. Materials and Methods: This study was done in the Department of Pathology, Narayana medical college and hospital, Nellore, Andhrapradesh, India for a period of 1 year from June 2016 to June 2017. Total 108 cases of papulosquamous skin disorders were studied. Results: Psoriasis was the commonest lesion (53.70%), followed by Lichen planus (29.63%), Pityriasis rubra pilaris (7.41%), Lichen nitidus (5.55%) and Parapsoriasis (3.70%). Papulosquamous skin lesions were common in 2140years age group (38.9%). Papulosquamous skin lesions were more common in males, than females with a male:female ratio of 1.7:1. Both age and sex distribution of cases showed significant p value < 0.001. In our study, histopathology confirmed the clinical diagnosis in 42.6% of cases. Histopathology gave the diagnosis when differential diagnosis were there in 51.85% of cases and in 5.55% of cases, histopathological diagnosis was different from clinical diagnosis. Conclusion: Our study concludes that histopathology is the gold standard investigation for diagnosis, categorization and clinicopathological correlation of papulosquamous skin disorders.

Keywords: Histopathology; Lichenplanus; Papulosquamous Disorders; Psoriasis; Skin. 

Background and AIM: Blood transfusion services aim at providing adequate, safe and quality blood to meet the demands for clinical blood transfusion. The aim of the blood utilization management system is to optimize the utilization of blood products and minimize wastage of blood resources. The present study aims to highlight the services that are provided in our blood bank and special focus on utilization of blood components. Materials and Methods: Present study is a retrospective descriptive study. All the data related to blood donation, blood grouping and Rh (Rhesus) typing, TTI (Transfusion transmitted infections) testing, blood component separation, blood issue and discard details of 2016 were collected from the blood bank. Detail analyses of type of blood donation, TTI results, components issue and discard rates were done. Results: A total of 7,433 blood units were drawn, out of which 98.3% were voluntary blood donation. On TTI testing prevalence of HIV, HbsAg, HCV and Syphilis among blood donors was 0.17%, 0.87%, 0.04% and 0.12%. A total of 9,954 transfusions were done and most common component utilized was RCC (Red cell concentrate) in 46.35% followed by FFP (Fresh frozen plasma) in 29.37% cases. Discard rate was 2.89% cases. The most common reason for discard was found to be TTI positivity followed by expiry. Conclusion: Despite the current advances in technology in healthcare delivery, access to safe blood and blood products and their judicious use remains a big challenge. The study demonstrates transfusion services and trend of utilization of blood and its components. The results allow the identification of blood requisition practices that can be improved, help appraise the effects of blood safety measures and assist in planning future blood supply.

Keywords: Blood Component; Blood Transfusion; Blood Utilization. 

Population explosion has posed a serious threat to the progress and survival of mankind. The Oral contraceptive pills (OCPs) quickly have become the most effective, acceptable and reversible contraceptive. OCPs contain an estrogen and progesterone. Serious side effects of OCPS are cardiovascular diseases such as myocardial infarction, thrombosis, cerebral hemorrhage, and arteriosclerosis. Many epidemiological studies have clearly indicated that arteriosclerosis and myocardial infarction are closely linked to an impaired lipid and lipoprotein metabolism and from such studies it’s also documented that treatment of the lipoproteinemia will reduce the risk of coronary heart disease.

Keywords: Oral Contraceptive Pills (OCPs), High Density Lipoprotein Cholesterol (HDL); Low Density Lipoprotein Cholesterol (LDL); Total Cholesterol (TC) and Triglycerides (TG). 

Context: The classification of breast cancers into subgroups on the basis of gene expression patterns is often regarded as the gold standard, but its use remains limited due to the expense involved. Consequently there is interest in using Immunohistochemical (IHC) markers to classify tumors into subtypes that are surrogates for those based on geneexpression profiling. Aims: To classify molecular subtypes of breast carcinomas based on the surrogate IHC markers and to evaluate the correlation between these subtypes and other clinical parameters Settings and Design: The study was done from January 2014 to June 2016 on 70 cases of modified radical mastectomy specimens diagnosed as invasive breast cancer on histopathological examination. Methods and Material: The Immunohistochemical evaluation of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2/neu) were done on formalin fixed paraffin embedded tissue sections and are compared with the age of the patients, histological grade and tumor stage. Statistical analysis used: Analysis of variance for continuous variables and chisquare test for categorical variables. Results: The surrogate classification consisted of 36 cases of luminal A, 16 cases of luminal B, 13 cases of triple negative/basallike tumors and 05 cases of HER2/neu subtype. The subjects of luminal A subtype were older, had a well/ moderately differentiated histological grade, presented with small tumor size, less number of lymph nodal metastasis and had Early stage breast cancer. Subjects with triple negative tumors were younger, had moderately/ poorly differentiated histological grade, presented with large tumor size, high lymph nodal metastasis and advanced stage breast cancer. Conclusions: IHC markers of breast cancer can be used as surrogate markers for molecular classification and are comparable with other prognostic markers.

Keywords: Breast Carcinoma; Immunohistochemical Markers; Molecular Classification; Progesterone Receptor; Estrogen Receptor. 

Aim/Objective: The objective of this study was to evaluate the diagnostic accuracy of FNAC in various salivary gland lesions and it’s correlation with histopathology, which helps in the appropriate management of the patient. Materials and Methods: A total of 65 FNA were performed on salivary gland lesion from September 2016 to August 2017 at department of pathology of a Tertiary care centre. Surgically resected, formalin fixed specimen were received, they were processed and slides were prepared. The cytological and histopathological stained slides were studied, analysed and correlated clinically. Results: The cytological features of 65 cases were studied and following lesions were observed in FNAC study of 65 cases: 28 were pleomorphic adenomas (43%), 15 were of chronic sialadenitis (23%), 4 were Warthin’s tumours (6%), 4 were mucoepidermoid carcinomas (6%), 4 were benign parotid tumour( 6%), 2(3%)were carcinoma ex pleomorphic adenomas, 2 were metastatic deposits(3%), 4 were cystic lesions (6%) and 2 were malignant tumours (3%)(unclassified). The sensitivity, specificity, positive predictive value and negative predictive value of present study is 78.5%, 75%, 72.4%, 91.6%, 40.9% respectively. Conclusion: FNAC of the salivary gland is a safe and reliable technique in the primary diagnosis of salivary gland lesions. Though the rate of characterization of specific type of tumor is lower, due to variable cytomorphology in case of FNAC, histopathological examination may prove to be accurate and gold standard for diagnosis. This study implies that FNAC of the salivary gland tumours is safe, simple, rapid and costeffective diagnostic method for the patient.

Keywords: FNAC; Sensitivity; Specificity; Cytology; Histopathology. 

Background: Ophthalmic pathology is a distinct branch of pathology that deals with various ocular lesions excised by ophthalmologists. They fall into various categories such as inflammatory, benign, premalignant and malignant and show varied clinical presentations. The definitive diagnosis depends on histopathological study of these lesions. Material and Methods: The present study was conducted as a cross sectional study in the department of pathology, of our tertiary care institute. Total 124 cases included in the study during a period of 2 and half years, i.e. January 2015 to August 2017. Results: Out of total 6301 cases in 2 and half years, ocular lesions were 124 cases (1.96%), maximum cases were in the age group of 3140 years. Among ocular lesions, maximum cases received were eyelid lesions followed by the lesions of conjunctiva. Among total ocular lesions, Nonneoplastic lesions comprised of 32.26%, benign lesions were 54.84%, premalignant lesions were 4.03 % and malignant lesions were 8.87%. Conclusions: Most common ocular malignancy was squammous cell carcinoma and most common nonneoplastic condition found was chronic dacryocystitis. Every lesion presents in a variety of clinical forms in different patients. Hence each lesion must be excised and proper histopathological diagnosis must be made to exclude malignancy.

Keywords: Dacryocystitis; Eyelid; Ocular Lesions. 

Background: Carcinoma breast is the one of the most common causes of cancer death among women. Early diagnosis and effective treatment of the disease are immensely important. The increasing number of options for treatment of carcinoma breast has made the prognostic evaluation of the disease even more important. Proliferation plays an important role in clinical behaviour of invasive carcinoma breast. Ki67 binding, is an objective measurement of cell proliferation which significantly aids in the management of the patients with carcinoma breast. Objectives: 1. Study of expression of Ki67 in primary breast carcinomas. 2. Correlation of Ki67 expression with the histopathological grade of breast carcinomas. Methodology: Forty modified radical mastectomy specimens received at the department of pathology, MIMS, Mandya from January 2015 to June 2016 were examined for gross and microscopic features. Immunohistochemistry was used to study the Ki67 expression. Ki67 status was correlated with tumour grade according to Nottingham modification of Scarff Bloom Richardson grading (NSBR grading. Results: Of 40 cases of carcinoma breast, 97.5% of the cases were positive for Ki67. The range of Ki67 score was 095%. Mean Ki67 in the study was 32.85%. Majority of the cases (62.5%) had high Ki67 expression. There was a significant statistical association between Ki67 expression with grade of the tumor(p value = 0.032). Conclusion: Our study data indicates that, high Ki67 expression is associated with high tumour grade. Conclusively, proliferative activity determined by Ki67 expression may reflect the aggressive behaviour of breast carcinoma. Ki67 detection provides valuable information about proliferative activity of cells therefore, it is necessary to combine this with other prognostic parameters for better evaluation of patient’s outcome as well as treatment decision.

Keywords: Immunohistochemistry; Ki67; Breast Carcinoma; Nottingham Modification of Scarff Bloom Richardson Grading (NSBR Grading).

 Not provided.

Mixed gonadal dysgenesis represents a genetically, phenotypically and clinically heterogenous entity. It is defined by the presence of dysgenetic testis or streak gonads on one side and differentiated testis on the other side. The exact incidence of MGD is unknown. They can present in childhood with abnormal or ambiguous external genitalia or in an adult with history of primary amenorrhea in female and infertility in male. This discussion briefs about a case of mixed gonadal dysgenesis which is presented here for its rarity. A 22 year old female presented with history of primary amenorrhea. A complete clinical, hormonal, radiological and karyotypic analysis followed by exploratory laparatomy with histological examination of the gonadectomy specimens revealed a diagnosis of mixed gonadal dysgenesis. An important differential diagnosis for MGD includes true hermaphroditism. Histopathological examination of the gonads helps in confirming the diagnosis of MGD.

Keywords: Mixed Gonadal Dysgenesis; True Hermaphroditism; Persistent Mullerian Duct Syndrome.

Biotinidase is responsible for cleaving Biotin from Biocytin. Deficiency of biotinidase affects carboxylase enzymes causing dermatological, neurological, immunological or Ophthalmological complications. Biotinidase deficiency is known inborn error of metabolism having a prevalence of 1: 60,000 live births. We are presenting a case of biotinidase deficiency detected and diagnosed at our center.

Keywords: Biotinidase; Biotin; Biocytin; TLC; Organicaciduria. 

Introduction: Lymph node enlargement results due to proliferation of one or more components of the lymph node as a natural immune response to different antigens. Lymphadenopathy, whether localized or generalized, superficial or visceral, is a common finding in patients. Excision biopsy is the procedure of choice because histological diagnosis depends upon the change in the lymph node architectural pattern as well as the morphological details of the individual cells. Objective: The purpose of the present study was to evaluate the etiology of lymphadenopathy in relation to age and sex and the pattern of histological diagnosis in lymph node biopsy specimens in the department of histopathology in our centre. Materials and Methods: The present retrospective study of lymph node biopsies was conducted in the department of histopathology over a period of one year from January to December 2016. A total of 49 lymph node biopsies were taken into consideration. All biopsies were fixed in 10% formalin for 24 hours and later 3-4 micron thick sections were made from the blocks and staines with Hand E stain.Wherever necessary, AFB staining and immunohistochemistry was performed to aid in the diagnosis. Results: A total of 49 lymph node specimens were received from January 2016 to December 2016 . There were 17 (34.7%) males and 32 (65.3%) females. Cervical lymph nodes were the most commonly biopsied group (65.3%), non-neoplastic lesions were more common comprising 47out of 49 ( 95.9%). TB was the most common cause of lymphadenopathy and accounts for 59.18% of all lesions. Conclusion: Biopsy of the enlarged lymph nodes plays a major role in arriving at a correct etiological diagnosis of lymphadenopathy. Non neeoplastic causes like Tuberculosis with a female preponderance and cervical region was the commonest site affected in our study.

Keywords: Lymphadenopathy; Tuberculosis; Reactive Hyperplasia. 

Salivary glands are unique secretory glands due to its histological diversity and heterogeneity. More than 90% pleomorphic adenoma (PA) are found in majorsalivary gland i.e. parotid. This tumor is known to occur at various other anatomical locations apart from the major salivary glands. 8% of PAs involve the minor salivary glands of which 60-65% in the palate and 5.5% at minor salivary glands of cheek. Less frequent sites such as lacrimal gland, external auditory canal, breast and parapharyngeal space, reported sparsely in English literature. PA at breast and external auditory canal (EAC), can be challenging and may lead to a misdiagnosis, as invasive carcinoma. Involvement of parapharyngeal space are also rare and constitute less than 0.5% of head and neck neoplasm. We are presenting here a series of 10 cases of PA at unusual sites with an aim to highlight the role of FNAC, which has sufficiently high accuracy rate and can be a useful guide in making decisions for further management.

Keywords: Pleomorphic Adenoma; Unusual Sites; Aspiration Cytology; Diagnostic Accuracy.

Background: Malignancies of Salivary gland are not uncommon. Among all the neck and head tumors, they account for 2-6.5% of all tumors. For evaluation of tumors of salivary gland, fine needle aspiration cytology (FNAC) is a commonly used method. Objective: To study the efficacy of FNAC in the diagnosis of salivary gland lesions. Methods: Present study was hospital based diagnostic evaluation study conducted among 96 FNACs from December 2013 to May 2015. The study was conducted in the department of Pathology at a tertiary care hospital. Gold standard used was histopathology of lesions. Results: The FNAC findings in this study were: Non-neoplastic 40, Benign 46, Malignant 7, and Suspicious for malignancy 2 and unsatisfactory. Biopsy examination for comparison was available in 37 cases. Sensitivity of FNAC was 100% and the specificity was found to be 96.97%. The positive predictive value was 80% and the negative predictive value was 100%. The overall diagnostic accuracy in the present study was 97.3% for FNAC. Conclusion: FNAC is less costly, rapid, safe technique. The best part is that this technique is minimally invasive technique. It is as good as a diagnostic test.

Keywords: Histopathology; Salivary Gland; Lesions; Technique; Diagnostic Test; FNAC. 

Context: The initial classification of anemia can be improved substantially by including RDW and histograms of the red cell volume as these variable become part of the routine blood counts. Aims: To evaluate the effectiveness of the RDW parameter in the diagnosis of the erythrocyte disorders. Settings and Design: A hospital based cross sectional diagnostic evaluation study, Department of Pathology, Lt. BRKM Government Medical College. Methods and Material: 250 randomly selected cases of anemia were studied. All patients having hemoglobin value of less than 12.5 gm were included in the present study. Initially all patients were screened by automated cell counter. Those with hemoglobin of less than 12.5 gm were included in the present study. A possible pathophysiologic entity was assigned. Now the peripheral smear was screened and a specific etiology (category or cases) was assigned. Statistical Analysis: Chi square test was used wherever appropriate. P value of less than 0.05 was taken as statistically significant. Results: Decreased MCV and mild increase in RDW was seen in thalassemia trait. Serum iron was found to be normal in IDA patients. Low MCV and high RDW was found to be a good predictor of IDA. Single parameter of high MCV was found to be of poor diagnostic value in B12 deficiency anemia. Very high RDW was a consistent feature of sickle cell disease. Fairly deciding heterogeneity was observed with decrease to normal MCV in cases of various types of hemolytic anemia. Conclusion: RDW is a fairly sensitive and specific diagnostic approach and can eliminate unnecessary expensive and invasive investigations.

Keywords: Sickle Cell Disease; Iron Deficiency Anemia; Beta Thalassemia; MCV; RDW; MCH. 

Background: Seventh most common tumor is urinary bladder tumor among which urothelial carcinoma constitutes 90% of primary bladder tumor. Both neoplastic and non neoplastic diseases produce clinical signs and symptoms. Though the non-neoplastic diseases are disabling, the neoplastic lesions are the source of mortality. This study was conducted to analyze frequency and clinical features of various histopathological lesions of bladder tumors. Materials and Methods: this retrospective study was carried out in the department of pathology, Narayana medical college, Nellore. Clinicopathological data of bladder biopsies received from urology department were analyzed. Results: 68 bladder biopsies were studied. Among them 53 cases were neoplastic and 15 cases were non neoplastic lesions. Both neoplastic and non-neoplastic lesions showed male predominance. Neoplastic lesions were noted in the age group of 61-70 years (28.3%) . Non-neoplastic lesions showed predominance in the 31- 40 years age group. Among the neoplastic lesion low grade papillary urothelial carcinoma invading lamina propria constituted maximum number (32.1%) followed by high grade urothelial carcinoma invading muscle layer (24.4%). Few rare tumors like urachal adenoacrcinoma, mucinous adenocarcinoma, sarcomatoid urothelial carcinoma were also encountered in our study. Among the nonneoplastic lesions, granulomatous cystitis were maximum (46.6%) followed by non-specific chronic cystitis, cystitis cystica, cystitis glandularis and eosinophilic cystitis. Conclusion: In the bladder neoplastic lesions are more common than non-neoplastic lesions. Among the neoplastic lesions, papillary urothelial neoplasms are commonest. Grading of urothelial carcinoma along with presence or absence of muscle invasion is an important prognostic factor. Clinical signs and symptoms like haematuria should not be neglected as it may lead to advanced stage of neoplastic lesions at the time of diagnosis.

Keywords: Bladder Lesions; Urothelial Tumors; Non Neoplastic Lesions. 

Background: The salivary gland tumors account for 6% of all the head and neck tumors. Salivary gland lesions consist of non-neoplastic lesions and neoplastic lesions. FNAC is most commonly used method to diagnose the salivary gland tumors. The main objective of our study was to analyze the spectrum of salivary gland lesions and to evaluate the efficacy of cytology in diagnosing salivary gland lesions by correlating with histopathological findings. Methods: The present retrospective study of 50 cases of FNAC and histopathology of salivary gland lesions was carried out in the department of pathology, Narayana Medical College & Hospital, Nellore, Andhra Pradesh, India, during the period of January 2016 to December 2016. Cytological smears were fixed in ethyl alcohol and then stained with Haemotoxylin & Eosin stains. Salivary gland specimens were fixed in 10% formalin and then stained the paraffin sections by Haemotoxylin & Eosin staining technique. Cytohistopathology correlation was done. Result: In our study, age range of salivary gland lesions was from 26 years to 68 years with a mean age of 43.32 years and female to male ratio is 1.5:1. Majority of the salivary gland lesions were noted in 31-40 years age group. Among the 50 cases of salivary gland lesions, 38(76%) cases were benign neoplasms, 7(14%) cases were malignant neoplasms and 5(10%) cases were inflammatory lesion. Among the benign neoplasms, Pleomorphic adenomas were 35 (92.11%) cases and among the malignant neoplasms, mucoepidermoid carcinomas were 4 (57.14%) cases. The overall diagnostic accuracy in salivary gland lesions was 94.67%. Conclusion: The high accuracy, sensitivity and specificity of FNAC confirm that preoperative cytology is a useful, quick, reliable diagnostic technique for rapid and early diagnosis in salivary gland lesions. Few rare tumors can be missed on cytology, but clinical correlation can give clue to the diagnosis of malignant neoplasms.

Keywords: Salivary Gland Lesions; Cytohistopathological Correlation. 

Introduction: Prostatism is a common disease in the geriatric age group. Benign prostatic hyperplasia and Carcinoma of the prostate are increasingly frequent with advancing age. Aim of the present cross-sectional study is to evaluate the complete spectrum of histopathological types of various prostatic lesions. Materials and Methods: A total of 75 prostate biopsies were received from January 2016 to December 2016 in the Department of Pathology, in a tertiary care hospital, Uttar Pradesh. Routine Hematoxylin and Eosin staining was performed. Reporting of malignant cases included Gleason’s grade and score. Relevant clinical data including the age, presenting complaints, and radiological findings were documented for all the cases. Results: A total of 75 prostate biopsies were received, the mean age was 63.04 years. Most common presenting complaint was difficulty in micturition. Study included, 56 (74.66%) cases of Benign prostatic hyperplasia alone and 5 (6.66%) were of Adenocarcinoma. Chronic Prostatitis 6 (8%) was the most common non-neoplastic lesion associated in cases of benign prostatic hyperplasia. Two (2.66%) cases were of benign prostatic hyperplasia along with Basal cell hyperplasia. One (1.33%) case each of granulomatous prostatitis, cystitis glandularis (urothelium), and squamous metaplasia were associated with benign prostatic hyperplasia. One (1.33%) case each of Prostatic intraepithelial neoplasia, Undifferentiated carcinoma, and post operative spindle cell nodule were also noted. Conclusion: Benign prostatic hyperplasia is the most commonly encountered prostatic lesion. In spite of availability of various investigations, a definitive diagnosis of prostatic lesions can be made by histopathological study only.

Keywords: Benign Prostatic Hyperplasia; Chronic Prostatitis; Basal Cell Hyperplasia; Prostatic Intraepithelial Neoplasia; Carcinoma Prostate; Post Operative Spindle Cell Nodule. 

Background: Squash smear technique is reliable diagnostic tool which provides neurosurgeons with rapid intraoperative diagnosis and helps them to modify their surgical approach. This study was done to assess the accuracy and diagnostic utility of squash smear technique by comparing with histopathological diagnsosis. Materials and Methods: Our study included 33 patients who underwent operation in neurosurgical department, Narayana Medical College and hospital, Nellore. Squash smear technique was used to provide intraoperative diagnosis and was correlated with histopathological diagnosis. Results: 33 cases were studied, out of which 2 were inflammatory lesions and 31 were neoplastic. Neoplastic lesions included astrocytomas (42.4%), meningiomas (27.3%), oligodendrogliomas (3.03%), ependymoma (3.03%), chordoma (3.03%), schwannoma (9.09%), choroid plexus papilloma (3.03%), and pituitary adenoma (3.03%). Non neoplastic cases were 2 cases of tuberculoma (6.06%). Accuracy rate of squash smear technique was 87.9% in our study. 100% accuracy was found in astrocytomas which were maximum in our study followed by meningiomas. Conclusion: squash cytology provides reliable and rapid diagnosis for neurosurgeons. Accuracy is good in astrocytomas when compared to inflammatory conditions and rare tumors like ependymoma and chordoma. Clinical features and radiological findings should be considered to increase the accuracy of squash cytology.

Keywords: Squash Cytology; Intraoperative Diagnosis. 

Introduction: Eosinophilic gastroenteritis is a rare inflammatory condition characterized by increase in number of eosinophils. There are various causes enumerated to eosinophilic gastroenteritis includes H pylori infection, drugs, parasites, allergen. Objective: To find the correlation between eosinophilic gastroenteritis and peripheral blood eosinophilia. Materials and Methods: 85 cases are selected.The diagnostic criteria for eosinophilic gastroenteritis is presence of more than 30 eosinophils per high power field. The absolute eosinophil count of all the cases is noted. Results: Among 85 cases, 59 are males and 26 are females. The mean age of male and female patients included in this study is 51.31 years and 52.46 years respectively. The most common site involved is colon. Kappa (weighted) statistics shows 36% agreement. Discussion: Our study shows only 36% patients have raised absolute eosinophil count. Conclusion: Eosinophilic gastroenteritis is common in 5th decade, more common in male patients. Since only 36% of patients have raised absolute eosinophil count. Biopsy remains the gold standard modality of diagnosis.

Keywords: Allergy; Colon; Eosinophilia; Gastroenteritis.

Background: Acute appendicitis is the one of the most common surgical emergencies in world wide. Gold standards method for diagnosis of acute appendicitis is histopathological examination of appendectomy specimen. Appendiceal lumen obstruction caused by faecolith mainly and unusual factors rarely. Spectrums of appendiceal lesions consist of inflammatory lesions to malignant lesions. Methods: The present retrospective study included 159 appendicectomy specimens received in the department of pathology, Narayana Medical College & Hospital. Nellore, Andhra Pradesh, India, during the period of January 2016 to December 2016. Appendicectomy specimens were fixed in 10% formalin and then stained with Haemotoxylin and Eosin staining technique. Results: Among the 159 appendicectomy specimens, Acute appendicitis account for 72 (45.28%) with peak occurrence in the age group 11-20 years (27.67%) and 21-30 years (25.79%) with male predominance (1.74:1). Unusual findings were noted in 21(13.21%) cases on histopathology. Most common unusual findings included chronic obliterative appendicitis (61.90%), followed by acute eosinophilic appendicitis (14.29%) and Carcinoid appendix (9.52%). Other unusual findings include Granulomatous appendicitis, Enterobius vermicularis parasitic infestation and primary adenocarcinoma of appendix. Conclusion: The gross examination of appendix during surgery cannot detect the unusual findings particularly malignancies. Histopathological examination of appendix is essential to avoid the malignancies missed and gives clinician a clear idea regarding treatment strategy.

Keywords: Appendicitis; Carcinoid; Primary Adenocarcinoma; Enterobius Vermicularis. 

Vitamin B12 is a neurotropic, water soluble vitamin and is one of the major cause of development of Diabetic peripheral neuropathy. Metformin is known to cause depletion of vitamin B12 stores resulting in its deficiency. Thus Looking at the increased incidence of type 2 Diabetes mellitus, and the increased prevalence of vitamin B12 deficiency in the Indian population (vegetarian diet being one of the factor) and since the screening of serum vitamin B12 is a bit costly test, according to the result of this study we may arrive to a conclusion regarding supplementation of vitamin B12 for prevention of peripheral neuropathy in diabetes. Long term use of Vitamin B12 supplements in patients will not cause any harm owing to the fact that it being a water soluble vitamin will be excreted in urine if in excess. Biothesiometer is a simple, portable, reliable, non-invasive method to screen the peripheral neuropathy.

Keywords: Vitamin B12; Diabetes mellitus; Metformin Therapy; Biothesiometer.

Background: Bethesda system of thyroid lesion is the six-tired diagnostic classification based on a probabilistic approach in increasing the specificity and sensitivity of FNAC thyroid lesions. Its capacity to facilitate better cytologic -histologic correlation and role of each diagnostic category to conveys specific risks of malignancy. Methods: The present retrospective study of Bethesda system of cytopathology of thyroid lesion was carried in 100 cases in the department of Pathology, Narayana Medical College & Hospital, Nellore, Andhra Pradesh, India, during the period of January 2016 to December 2016. Cytological smears was fixed in ethylalcohol and then stained with Haematoxylin and Eosin staining technique. Results: In our study the lesion wise distribution after The Bethesda System of Reporting Thyroid Cytopathology (TBSRTC) was benign 77.5%, Atypia of undetermined significance 3.5%, with Follicular Neoplasm at 6%, suspicious for malignancy at 2% and malignant at 11%. The sensitivity and specificity after TBSRTC were 88.13% and 100% respectively with a diagnostic accuracy of 98.55%. On estimation of risk for malignancy in each category it showed 1.95% for benign lesions, 33.33% for Follicular Neoplasm category, suspicious for malignancy had 50% risk and 100% risk for malignancy category. Conclusion: The malignancy potential of each category of Bethesda system gives clinician a clear idea regarding its treatment strategy and TBSRTC has a histopathological correlation as good as any system of reporting.

Keywords: Thyroid Cytopathology; Bethesda System.

Background: Endometriosis is an important benign gynecologic pathology defined by presence of a tissue similar to uterine endometrium, which is located endometrial glands and stroma out side of the uterus associated with pelvic pain. The most common site is ovaries followed by posterior broad ligament, fallopian tubes, and colon and round ligaments. Objective: To evaluate the endometriosis cases through pathologic analysis of histological features, age, site, and clinical presentation of endometriosis. Materials & Methods: Retrospective study was undertaken for a period of 2years from May 2015 to May 2017 in department of pathology, Narayana Medical College & Hospital, Nellore, and Andhra Pradesh, India. Results: 20 Cases of endometriosis recorded in the department of pathology in 2 years (May 2015-May 2017). Of all endometriosis cases, majority were found in 30-40 years age group. Most common site was ovary 11 cases (55%), and least common site was abdominal wall (scar) 1 case (5%), sigmoid colon 1 case (5%). Most common presentation was pelvic pain 7 cases (35%) and dysmenorrhea 5 cases (25%), menorrhagia 4 cases (20%) , constipation 1 case (5%) and abdominal lump 1 case (5%). Common associated pelvic pathology was leiomyoma of uterus. Conclusion: Endometriosis has no pathognonomic signs or symptoms and it is difficult to diagnose clinically. Histopathology is gold standard test for confirmation of the diagnosis.

Keywords: Endometriosis; Histogenesis; Histopathology; Ovaries. 

Introduction: Cancer of the uterine cervix is one of the leading causes of cancer death among women worldwide. In India, it ranks as second leading cause next to breast cancer in women. Aims: To study the clinical presentation of cervical carcinoma correlating with histopathological findings in the Charutar area of Gujarat state at Shree Krishna Hospital, Karamsad. Methods and Material: 68 specimens received from 15 April 2015 to 14 April 2016 with clinical suspicion of cervical carcinoma and histopathologically confirmed were considered for study. Clinical details of the patients were noted with the help of semi-structured proforma. Statistical analysis used: The data was Statistically analyzed using STATA 14 software. Results: Out of 68 confirmed cases for malignancy, 43 (63.24%) had large cell non keratinizing squamous cell carcinoma (LCSCC), 34 (50%) were presented with abnormal bleeding per vaginum, 47 (69.12%) were seen between 41-60 years, 66 (97.06%) were multiparous, 48 (70.59%) had poor genital hygiene, 42 (61.76%) were illiterate, 44 (64.70%) were from low economic class, only 03 (4.41%) had history of cervical cancer screening. Conclusion: The most common cervical cancer in this region of India is squamous cell carcinoma. Majority patients had complained of bleeding per vaginum, between 41- 60 year, multiparous, had poor genital hygiene & illiterate. The study concludes that screening of cervical cancer should be emphasised in women especially in rural areas for early detection of cancer and reduce mortality and morbidity in productive age.

Keywords: Cancer; Awareness; Mortality; Hygiene; Screening. 

Background: It is a physiological process in women and is associated with risk to health of both mother and child. To prevent maternal and fetal morbidity and mortality by early assessment of severity of pre eclampsia and eclampsia. Objective: to compare the coagulation parameters between the test group and control group. Materials and Methods: A total number of 30 normal antenatal women without Pregnancy induced hypertension are included in control group and a total number of cases of Pregnancy induced hypertension are taken as test group. Comparision of coagulation parameters like Activated partial thromboplastin time, Prothrombin time and platelet count were studied in these patients. This study was undertaken for a period of one year of January 2016 to January 2017 in department of pathology, central laboratory, narayana medical college & hospital, Nellore. Results: Coagulation parameters such as Activated partial thromboplastin time, Prothrombin time and platelet count were studied in both 30 control and cases. Study showed significant alteration of coagulation profile depending on severity of disease. All results were statistically analysed. Conclusion: Estimation of different parameters like Activated partial thromboplastin time, Prothrombin time and platelet count play s a role in the diagnosis of Pregnancy induced hypertension and evaluation of risk factors, early detection of which will decrease maternal morbidity and mortality.

Keyords: Pregnancy Induced Hypertension; Preeclampsia; Activated Partial Thromboplastin Time; Prothrombin Time; Platelet Count. 

Background: The ABO and Rhesus (Rh) blood group systems are the most important human blood group systems and are responsible for most of the blood transfusion reactions, transplant rejections, parental testing and legal purposes. Settings and Design: A retrospective study was conducted at Blood Bank, GMC, Latur, and Maharashtra. A total of 6224 blood donors were studied, during the period from 1st January 2016 to 31st May 2017. Materials and Methods: ABO and Rhesus grouping of the donors were determined using the standard monoclonal antisera by slide agglutination method and reverse grouping. Statistical Analysis: The frequency of ABO and Rh blood group typing was expressed in simple percentages. Results: Out of 6224 donors, 6117(98.28%) were male and 107(1.72%) were female donors. The commonest ABO blood group was B (32.97%) followed by O (30.14%), A (26.38%) and least common AB (10.51%). Among 6224 donors, 298 (4.79%) were Rh negative while 5926 (95.21%) were Rh positive. Conclusion: Our study throws light on the distribution of blood groups in Latur region, which is important for blood banks and transfusion service policies that could contribute to National Health System.

Keywords: ABO; Rhesus; Blood Group; Donors.

Introduction: The most commonly encountered clinical problem are the lesions of the thyroid. Most of these can be treated medically or surgically. Fine needle aspiration cytology and histopathological examination together are very helpful in establishing the diagnosis. The role of a pathologist is thus very crucial in establishing the nature of thyroid lesions. Materials and methods: We have taken up a prospective study for a period of two years at Narayana Medical College and General Hospital. We have analysed a total of 250 cases during this period. Cytological and histopathological slides were reviewed and the results were analysed. Results: In our study there was a female predominance with non-neoplastic lesions predominating the neoplastic lesions. Nodular goiter was most common among benign lesions and papillary carcinoma was common in the malignant category. Histopathology plays an important role in the diagnosis of lesions which are missed on cytology or inconclusive on cytology. Conclusion: Fine needle aspiration cytology and histopathology go hand in hand in the diagnosis of thyroid lesions giving almost 100% results.

Keywords: Cytology; Histopathology; Thyroid; Lesions. 

Background: The nasal cavity and the paranasal sinuses form a single functional unit. Malignant sinonasal tumours are characterized by low incidence, non specific symptoms, and late presentation. The malignant sinonasal tumours encompass an entire range of both epithelial and non-epithelial tumours. Aims & Objectives: Our study aims to determine incidence, age, sex, site, mode of presentation and histological types of various malignant sinonasal tumours over a 5 year period. Methods: 107 malignant sinonasal tumors biopsied or surgically excised over a period of five years were studied. Results: We encountered 107 cases of malignant tumors with an incidence of 0.24%. Malignant tumors occurred with a mean age of 52.05 years and the male to female ratio was 2.3:1.Among malignant tumors, epithelial tumors (97 cases) constituting 90.65% predominated over non epithelial tumors (10 cases) constituting 9.35% with a ratio of 9.7:1. Out of the 107 cases 58 tumors involved the nasal cavity (54.21%) and 49 involved paranasal sinuses (45.79%). The most common malignant tumor encountered was squamous cell carcinoma-60 cases (56.07%). Conclusion: The clinical and radiological features of masses of nasal cavity and paranasal sinuses are overlapping and often only a provisional diagnosis is possible. Definite diagnosis requires histopathological examination.

Keywords: Sinonasal Tract; Malignancy; Squamous Cell Carcinoma; Epithelial; Nonepithelial. 

Background: Tuberculosis in India continues to be a major health problem with approximately one eight of total cases being extra pulmonary. The gastrointestinal tract is involved in 66-75% of cases of abdominal tuberculosis. The pathologist plays a central role in diagnosis of intestinal tuberculosis (ITB). Many intestinal lesions especially non-neoplastic share the same clinical background, where characteristic pathological features not only suggest specific diagnosis but also the extent and severity of the disease. Aim: To study the profile of tuberculous lesions of small and large intestine including appendix in relation to age and sex distribution, the clinical presentation and regional distribution of the lesions. Method: A prospective study of 30 diagnosed cases of ITB encounterd in surgically excised specimens of small and large bowel including appendix carried over a period of five years.The diagnosis was based on the presence of caseating or non-caseating epithelioid cell granulomas, acid-fast bacilli (AFB) on histology. Results: Intestinal obstruction was the most frequent clinical presentation in ITB cases in this series.The mean age was 34.2 years with M: F ratio of 2:1. Ileum and ileocaecal region weremost frequently involved. The three gross morphological forms of tuberculous enteritis seen were ulcerative in 70%, ulcero-hypertrophic in 20% and hypertrophic in 10 %cases. Characteristic caseating granulomas were seen in 60% cases. Conclusion: Along with clinical, radiological and endoscopic evaluation, the present study showed that histopathological analysis also plays an important role in the diagnostic and therapeutic approach to intestinal tuberculosis.

Keywords: Intestinal Tuberculosis (ITB); Acid- Fast Bacilli (AFB). 

Introduction: Cancer is one of the major health issues worldwide including India. Breast cancer is by far the most frequent cancer in females with rising incidence and usually presents at advanced stage at diagnosis making the outcome poor, however aggressive the treatment may be and leading to disproportionately higher mortality rates. Aims and Objectives: To study the age, incidence, clinical presentation and histomorphological pattern of carcinoma breast in all mastectomy specimens. Methodology: Four year retrospective study of 170 mastectomy specimens received in the department of pathology from Jan 2012 to Dec 2016. All the sections were retrieved and diagnosis were confirmed and the necessary clinical data was obtained from records department. Histological grading were done according to Modified Scraff-Bloom-Richardson Method. Results: The commonest presenting symptom was painless lump (65% of patients) with slight left breast predominant involvement (55%). The most common site of location were in upper outer quadrant (35%) and the least in subareolar region (3%). Among the histological varieties invasive duct carcinoma not otherwise specified was the commonest (83%) and the least was tubular carcinoma (0.5%). Majority of the patients were between 41-50 years (45%). 56% of cases showed evidence of metastasis in lymph nodes. In our study, 52.1% of carcinomas were in Grade I, 41.3% were in Grade II, and 6.6% were Grade III. Conclusion: Carcinoma breast is affecting young to middle age group and the number of cases increasing every year and we cannot prevent this cancer, all we can do is Breast Awareness and screening programmes is the need of the hour.

Keywords: Breast; Mastectomy; Infiltrating Duct Carcinoma; Tumor Size; Grade. 

Context: Cytopathological assessment of bronchoscopy specimens plays a crucial role in the diagnosis of bronchopulmonary lesions. Aim: Our study was aimed to assess the diagnostic efficacy of cytological techniques in bronchopulmonary lesions in correlation with histopathological examination findings. Settings and Design: Correlative study. Methods and Material: 250 patients with symptoms and signs of pulmonary lesions were selected for the study and bronchoscopy was performed. Specimens from bronchial brush followed by bronchioalveolar lavage were collected and routinely stained with Papanicolaou, Hematoxylin & eosin and Giemsa stains and studied. Special stains like Per-iodic acid Schiff and Ziehl-Neelson were performed as per requirement. Endobronchial biopsy specimens were processed as per routine histopathological techniques and stained. Statistical analysis used: Sensitivity, Specificity, Positive Predictive value, Negative Predictive value and Diagnostic Accuracy. Results: The age of the patients ranged from 20 to 87 years. The male to female ratio was 3.2:1. Out of 250 cases, neoplastic lesions were seen in 48 cases and non-neoplastic lesions were observed in 202 cases. Bronchoalveolar lavage cytology showed 36 true positive cases and 202 true negative cases, Bronchial brushing cytology showed 46 true positive cases and 202 true negative cases as confirmed by Bronchial biopsy. Conclusion: Diagnostic efficacy levels of cytological techniques in pulmonary lesions have acquired sensitivity levels high enough to be recommended for use as routine and definitive diagnostic tools in the evaluation of bronchopulmonary lesions.

Keywords: Bronchoscopy; Endobronchial Biopsy; Cytopathological Assessment; Sensitivity; Specificity. 

Identifying and employing appropriate learning styles could play an important role in selecting teaching styles, which can improve education ultimately.The present study aimed to assess the diversity of learning styles amongst medical students of a Basaveshwara Medical College, Chitradurga, Karnataka in 2014. A cross-sectional study which employed VARK learning style’s questionnaire was done on 89 Second year medical sciences students. Data was collected with use of VARK questionnaire. The validity of the questionnaire was assessed on basis of experts’ views and its reliability was calculated by using Cronbach’s alpha coefficients. Data were analysed by using SPSS software and Chi-square test. The preferred learning styles of medical students in the present study were aural and reading/writing. It is suggested that all medical students must be tested to determine their desired learning styles by using VARK questionnaire, also to choose appropriate teaching methods and to improve educational goals.

Keywords: Visual; Aural; Kinesthetic; Reading; Writing; Quad Modal. 

Background: Platelets are the important constituents of blood which are the main players during the process of thrombus formation. Endothelium produces a large number of substances that affect blood flow and can lead to a hypertensive state. Large observational studies indicate that in hypertension, cardiovascular morbidity and mortality are related to the severity of hypertensive state and to the development of cardiac and vascular changes. Platelet count (PLC) and elevated mean platelet volume (MPV) levels are thought to be closely associated with cardiovascular diseases such as acute ischemic stroke, left ventricular hypertrophy, carotid atherosclerosis as well as hypertension. This study was done to evaluate PLC and MPV in hypertensive patients compared to control normotensive subjects. Methods: This was a cross sectional case control study in tertiary care hospital in Mangalore. During this study period 50 control and 50 cases were analyzed. Results: Among the controls majority are males (68%) with mean age of 44 years. Among the cases, majority are males (62%), with mean age of 60 years. In control, mean PLC were 2, 53,380 cells and average MPV was 8.46 fL. Among the case group, the mean PLC was 2, 36, 417 cells and average MPV was 8.40 fL. Since the p values are more than 0.05, there is no difference in PLC and MPV in cases and controls at the 5% level of significance. There was no increase in the platelet indices in hypertensive patients compared to normotensive patients. Conclusion: Though we started our study anticipating an increase in PLC and MPV in hypertensive patients, the results we obtained could not prove such a correlation. A further study and research involving a great number of patients is needed in this field to support the hypothesis.

Keywords: Platelet Count; Mean Platelet Volume; Hypertension; Correlation. 

  Basal cell adenoma (BCA) is a rare benign epithelial tumor of salivary gland. Amongst the head and neck tumors, salivary gland tumors constitute about 2- 6.5% and of these, basal cell adenoma accounts for about 1-3%. We present a rare case of BCA of salivary gland with fine needle aspiration cytology (FNAC) findings and its correlation with histopathological observations along with review of literature 

Keywords: Basal Cell Adenoma (BCA); Fine Needle Aspiration Cytology (FNAC) Histopathology; Submandibular Salivary Gland (SSG).

  Acute myeloid leukaemia accounts for nearly 15% of all leukaemias in children out of which only about 3% mases present with extramedullary deposits in the other sites like the orbit. Bilateral proptosis is fairly common in association with acute and chronic lymphatic leukaemia, on the other hand myelogenous leukaemia rarely give rise to proptosis. Here we present one case of 6 year old presenting as bilateral proptosis with no other manifestations of systemic malignancy at presentation. Radiological investigation, FNAC, bone marrow study and flowcytometry was done for confirmation. The purpose of reporting such a rare entity is to highlight AML as a rare but important differential diagnosis of bilateral proptosis.

Keywords : Acute Myeloid Leukaemia; Orbital Myeloid Sarcoma; Proptosis.

The growing awareness of female breast cancer has led to increased sensitivity toward pAathological breast conditions in pediatric patients. Palpable breast masses arising in adolescent and pubertal girls are uncommon. The most common benign breast lesions are fibroadenoma and benign phylloides tumors. The mammary tumors with myoepithelial component are very rare in pubertal girls. We report a case of adenomyoepithelioma in a 15 year old girl and discuss the problems of diagnosis of breast masses in adolescent girls.

Keywords: Adenomyoepithelioma; Myoepithelial Tumors; Adolescent Girls; Breast Mass.

 

Background: Sebaceous carcinoma of the eyelid is rare. The diagnosis might be difficult because of its ability to masquerade as other periocular lesions. Prognosis is still regarded as being poor compared with most other malignant eyelid tumors with a mortality second only to malignant melanoma. The present reported cases analyses clinical and histopathological findings. Case Reports: Two case reports were presented here. One presented as primary complaint of progressive painless mass in left lower eyelid in a 75 year female and another case in young 30 year old with history of recurrence, operated previously for the same complaint with unavailable previous report. Both cases on histopathology reported as sebaceous gland carcinoma. Conclusion : Early diagnosis and consequent surgical therapy of sebaceous carcinoma of the eyelid leads to a better outcome and higher survival rates than generally assumed. Even local recurrences can be treated successfully. However, sebaceous carcinoma remains a threatening disease, which leads to death in 9% and to mutilating exenteration in 23% published in an English literature.

Keywords: Sebaceous carcinoma; Meibomian gland; Eyelid.

Background: Annually around 100 million cases of dengue fever and half a million cases of Dengue haemorrhagic fever occurs worldwide. Early recognition and prompt initiation of treatment and platelet transfusion in indicated cases are imperative if disease related morbidity and mortality are to be restricted. Aim: To evaluate the role of platelet count in predicting outcome in dengue patients, to observe the number of serologically dengue positive patients requiring platelet transfusion and observe its outcome. Materials and Methods: The present study was conducted in the Department of Pathology, Sree Mookambika Institute of medical Sciences, Kulasekharam, Kanyakumari District, Tamilnadu during a period of three years from 2013 to 2015. In this study fifty dengue positive cases were taken from the Department of General Medicine, Sree Mookambika Institute of Medical Sciences, Kulasekharam. Results: In this study among fifty patients the patients where platelet transfusion was indicated were 43(86%). Thrombocytopenia was observed in 43(86%) 2(4%) patients had platelet transfusion on the day of admission, 26(52%) on the first day after admission, 8(26%) on the second day after admission and 7(14%) on the third day after admission. In this study 27(54%) of the patients were infused 1-2 units of platelets, 5(10%) of patients were given 3-4 units of platelets, 8(16%) of patients were given 5-6 units, 2(4%) were given 7-8 units of platelets and 1(2%) was given 9-10 units. In this study of 50 patients, 43 were transfused platelets. 3(6.98%) took 2 days for platelet count to return to normal levels, 23(53.49%) took 3 days, 9(20.93%) took 4 days, 3(6.98%) took 5 days and 5(11.63%) took 6 days. Conclusion: Platelet transfusion was initiated in patients with moderate to severe thrombocytopenia. The patients had a smooth and rapid recovery with no adverse outcomes related to the transfusion. All patients in our study group made a complete recovery during the hospital stay within the follow up period. Early suspicion, screening, diagnosis and prompt management of Dengue fever will effectively lower any fatality related to this dreaded illness. 

Keywords: Dengue; Thrombocytopenia; Platelet Transfusion; Fever; Haemorrhage.

Background: Lymphadenopathy is an abnormal increase in size and/ or altered consistency of lymph nodes. It is a very common clinical manifestation of regional or systemic disease caused by the invasion or propagation of either inflammatory cells or neoplastic cells into the node and serves as an excellent clue to the underlying disease. Objectives: The study was undertaken to evaluate the diagnostic efficacy of the fine needle aspiration cytology of lymphadenopathy as compared to open biopsy for histopathological examination, to study the frequency of various neoplastic versus non-neoplastic lesions, their distribution in different age groups and to study the different cytomorphological patterns associated with various lymphadenopathies. Methods: A prospective study was conducted in 400 patients with lymphadenopathy referred to the Departmet of pathology, S.V.S Medical college & Hospital , Mahabubnagar. FNA diagnosis was subsequently correlated and compared with the biopsy diagnosis in the available cases. Results: Out of 400 patients of FNAC for lymphadenopathy excisional biopsy was available in only 85 cases. Non neoplastic & neoplastic lesions were been in 308 cases & 64 cases respectively. 28 smears were non diagnostic. Tuberculous lymphadenitis was the most common lesion in 45.75% of the cases. The overall diagnostic accuracy of FNAC in the present study was 89.41.% with accuracy of 87.19 % for tuberculous lymphadenitis and 1000.00% for metastatic carcinoma. Cervical group of lymphnodes were the most commonly affected group of lymph nodes 59.75%. Epithelioid granulomas with necrosis was the predominant microscopic pattern seen in 55.19% cases Overall AFB positivity was seen in 31.14% cases & predominantly seen in necrosis alone pattern(79%), In our study sensitivity, specificity, Positive and negative predictive values of FNAC in lymphadenopathy were 100 %, 96.97%, 90.48% and 100 % respectively. Conclusion: FNAC is a simple,rapid,cost effective diagnostic tool for patients having significant lymphadenopathy. The metastatic carcinomas, and tuberculous lymphadenopathy can be diagnosed by FNAC with a high degree of accuracy. If FNAC is positive surgeon can proceed to treat the patient without excisional biopsy of the enlarged lymph nodes & most of the diseases are medically curable with limited role for surgery in non-neoplastic lesions. Lack of tissue architecture on FNAC can be overcome by subjecting samples to flow cytometry, T-cell, B-cell markers and immunocytochemistry analysis. 

Keywords: Lymphadenopathy; Diagnostic Efficacy; Fine Needle Aspiration Cytology and Histopathological Examination.

  Background: Quality assurance is an integral part of modern laboratory services. Quality control is relatively easy in hematology and biochemistry laboratories however, similar quality standards are difficult to analyze in surgical laboratories. Comparing the diagnostic accuracy of frozen section with gold standard histopathology can be used for this purpose. Methodology: The data for this two and a half year (January 2014- June 2016) retrospective analysis was retrieved from the records of Department of Pathology, Dayananad Medical College and Hospital Ludhiana, Punjab. The routine protocol of intraoperative consultations in the Department included prior intimation (at least 2 hours before expected sampling) with relevant clinical details and indication of frozen section. The sample was received in normal saline and representative sections were submitted for frozen section after thorough gross examination of the tissue. Results: A total of 200 cases were retrieved from the archives of Department of Pathology during this retrospective analysis. Majority (34.5%) of the intraoperative consultations were sought from the Gynaecology unit {Uterus 53 cases (26.5%) and ovary 16 (8%) cases}. Overall concordance rate was 95% (190/200) with sensitivity of 96.4% and specificity of 100%. Conclusion: The intra-operative consultations using frozen section is a very useful in assessing the quality assurance and the rospective analysis of these methods with routine histopathology can yield adequate quality assessment of a laboratory.

Keywords: Quality Assurance; Surgical Laboratories; Frozen Section.

  Introduction: Skin is a complicated protective covering [1]. It is divided into two seemingly separate but functionally interdependent layers, i.e., epidermis and dermis. Adnexae extend from epidermis into the dermis and consist of specialized cells for hair growth, epithelial renewal (stem cells), and temperature regulation [2]. Epidermis has the capacity to develop an array of keratinocyte lesions, the causes of which are not known. Adnexal tumors may be benign or malignant, solitary or multiple [3]. Aim of the Study: 1. To study the histomorphological features of tumors of epidermis and epidermal appendages. 2. To analyze the clinicopathological features of these tumors. Materials and Methods: This was a 5 years’ study on tumours of epidermis and epidermal appendages, studied i.e., from Jan. 2012 to Dec. 2016. Both biopsies and resected specimens were included in the study. Results: 69 cases of tumours of epidermis and epidermal appendages were encountered, of which, 51 cases (73.91%) were epidermal neoplasms, and 18(26.08%) cases were neoplasms of epidermal appendages. Out of 69 cases, 36(52.17%) were benign neoplasms and 33(47.83%) were malignant neoplasms. The incidence of keratinocytic tumours was high in the present study. Among adnexal tumours, most common were benign sweat gland tumours followed by tumours of hair follicle and sebaceous gland. Malignant adnexal tumours and hematolymphoid tumours were very rare. Conclusion: Skin tumours, at times, may be difficult to diagnose clinically. Hence histopathological examination is a must for definitive diagnosis. Increasing public awareness and surveillance will help in diagnosing the cases early for better management and prognosis.

Keywords: Epidermis; Appendages; Histopathology; Skin and Tumours.

Introduction: The cytological study of pleural fluids is a very simple and relatively non invasive technique, but one of the oldest cytological methods to achieve diagnosis. Cytological evaluation of the pleural fluid is performed mainly to know the presence or absence of malignant cells and to differentiate between transudate and exudates. Determining the etiologic cause of pleural fluid accumulation in pleural cavity is critical for proper treatment of these disorders. Aim: The study was conducted to know the analysis of pleural fluid effusion cases in hospital based population, Nanded district, Maharashtra state. To know the proportion of neoplastic and non neoplastic effusions and to know the pleural effusion caused by bacterial, viral and fungal infections (To rule out Transudates or Exudates), in relation to age, sex, clinical complaints and biochemical investigations. Material and Methods: The material for this study is obtained from in-patients attending the Dr SCGMC and Hospital, Nanded, Maharashtra. The study includes 265 cases of pleural fluid analysis, that is the cases of pleural effusion received from all departments namely tb-chest, medicine and surgery during the year 2016. Results: Out of 265 cases, 249 cases (93.96%) were negative for malignancy and remaining 12 cases (4.53%) were positive for malignancy. Suspicious cases were 4(1.51%). Majority were exudates and adenocarcinomas predominated in number among the malignant cases.

Keywords: Pleural Fluid; Benign; Malignant; Exudates; Mesothelial Cells.

  Background: Fine needle aspiration cytology is an important tool in the diagnosis, prognosis and management of breast carcinoma. It has been recommended that cytological grading should be included in the FNA reports to know the tumor aggressiveness and prognostication. Among the many cytological grading systems existing, there is still no agreement on the most reliable system. Aim: The study was undertaken to evaluate three cytological grading systems and correlate with histological grading by Nottingham modification of Scarff Bloom Richardson (SBR) method. Materials and Methods: Cytological grading by Robinson’s grading, Fisher’s modification of Black nuclear grading and Howell grading systems was done on 50 carcinoma breast cases. Histological grading by Nottingham modification of SBR grading was done. Cytohistologic grading correlation was done by testing concordance, association and correlation. Results: The three cytological grading systems correlated well with histological grading. Fisher’s modification of Black nuclear grading system demonstrated the best correlation ( = 0.61; P < 0.001) and concordance (Percent of agreement=70%) with the SBR’s grading system.Conclusions: Fisher’s modification of Black nuclear grading system is simple, reproducible and showed the best concordance with histological grading.

Keywords: Breast Carcinoma; Cytological Grading; Fine Needle Aspiration Cytology; Prognosis.

  Background: Pregnancy induced hypertension (PIH) is one of the most common causes of both maternal and neonatal morbidity and associated with adverse pregnancy outcomes.Profound changes in coagulation and fibrinolytic system occur during normal pregnancy causing hypercoagulable state. Early identification of high risk women and monitoring derangements in their coagulation system are surely pivotal in the prevention of complications. Hence, this study was undertaken to compare the coagulation profile in pre-eclamptic and eclamptic patients with normotensive pregnant patients. Material and Methods: A total of 240 patients were categorized into two equal groups as Group I - Cases (120 patients of pre-eclampsia and eclampsia) and Group II - Control (120 healthy pregnant women). The coagulation parameters such as BT, CT, PT, aPTT, platelet count of the patients required for the study were carried out by using semi-automated CA-54 coagulation analyzer and kits. Results: Mild PE did not reveal any significant changes in coagulation parameters as compared to healthy pregnant women. However, severe PE and eclampsia were characterized by thrombocytopenia and coagulation abnormalities indicating intravascular coagulation. Platelet count and aPTT had predictive value in screening for consumptive coagulopathy in the severe cases of PE and eclampsia. Discussion: Coagulation studies are the simple, cost effective and readily available tools in early diagnosis of maternal derangement of coagulation in pre-eclampsia and eclampsia. The information of present study might enrich the knowledge of clinician for early identification of pre-eclampsia.

Keywords: Pregnancy Induced Hypertension; Coagulation Profile; Eclampsia; Pre- Eclampsia.

Introduction: Lymph node pathology is complex as it can be affected by a variety of non-neoplastic and neoplastic diseases. Histopathological examination especially at low magnification gives considerable information and helps to arrive at a diagnosis. Aims and Objectives: To study diagnostic histopathological patterns of various lymph node lesions and to study in depth rare lymph node lesions. Materials and Methods: This was a retrospective study carried out in the department of Pathology, Topiwala National Medical College and BYL Nair Hospital, Mumbai, over a period of two years. A total of 255 lymph nodes were examined on routine histopathology and immunohistochemistry was done in a few cases of lymphomas. Observations and Results: There were 153 males and 102 females in the study and the age ranged from 1 year to 85 years. The non neoplastic causes were common for lymphadenopathy and in specific causes, tuberculosis was most common Incidence of metastatic malignancy was 9 % and of lymphomas was 11 %. Conclusion: Lymphadenopathy occurs more commonly due to non-neoplastic causes. Metastatic involvement of lymph nodes is mostly due to carcinomas. Histological evaluation of lymph nodes at low magnification helps to evaluate the architectural patterns of lymph nodes. These along with the identification of the cellular composition help in the diagnosis of lymph node diseases.

Keywords: Lymph Node Lesions; Lymphadenopathy; Immunohistochemistry.

  Background: Routine screening test like Pap smear test can detect early changes in the cervical epithelial cells, thereby facilitating the appropriate management of the disease. The present study investigates the distribution of cervical lesions among rural Indian population from a single center. Methods: The cross-sectional study, conducted between 2015 and 2017, evaluated 281 cervical smears obtained from female subjects aged 20-75 yrs, suspected with abnormalities. The smears collected were subjected to Pap smear test, and interpreted according to Bethesda system of classification 2001. The subjects were grouped based on the age as: 20-40 yrs, 1-50 yrs, 51-70 yrs, and 71-80 yrs, and the age-wise distribution of various types of cervical lesions was evaluated. Results: Out of the 281 smears; abnormal, atrophic, and normal smears were noted in 89.67%, 5.69%, and 4.62% respectively. Smears negative and positive for intraepithelial lesions or malignancies were noted in 6.86%, and 12.81% of the cases respectively. AGUS, LSIL, HSIL, and SCC were more frequent in women belonging to >50 years of age. Conclusion: The present study showed higher incidence of intraepithelial lesions in elderly women (>50 yrs) compared to other age groups.

Keywords: ASCUS; HSIL; NILM; Pap Smear; SCC.

Background: Meningiomas are common brain tumors which are mostly benign and recur frequently. These tumors exhibit steroid hormone receptors which are related to the behavior of the tumor. Aim: To conduct a retrospective study to evaluate the presence of progesterone and estrogen receptors in meningiomas and to correlate their expression with expression of proliferative marker Ki67. Materials and Methods: 24 cases of meningiomas were studied immunohistochemically to detect the expression of ER,PR and Ki67. Other parameters like age and sex were also analyzed. Results: 24 Cases were analyzed and all of them were ER negative. 3 cases were strongly positive, 16 cases were moderately positive and 5 cases were weakly positive for PR immunoreactivity. 3 cases showed moderate positivity, 13 cases were weakly positive and 8 were negative for Ki67. 2 cases of atypical meningioma and 1 case of meningothelial meningioma showed moderate positivity with Ki67and weak positivity with PR immunostaining. Most of these tumors were in the age group of 40-50 years and were seen in females. Conclusion: Tumors with increased PR expression had decreased proliferative rate when compared to tumors with increased Ki67 and decreased PR expression indicating that
PR expression is better prognostic marker for these tumors.

Keywords: Meningioma; Progesterone; Estrogen Receptors; Proliferative Marker Ki67.

  Introduction: Liquid based cytology (LBC) has played a pivotal role in exfoliative cytology. However it can be implemented in Fine needle aspiration (FNA) samples. Automated techniques have been widely used, but limited due to cost and availability. Aim: The objective of the study was to assess the diagnostic efficacy of Manual LBC in FNAC samples. Methods: In this prospective study, a total of 60 FNA samples from various anatomical sites were evaluated. Smears were made from conventional preparation (CP) and manual LBC (MLBC) preparation. Both CP and MLBC preparations were compared for cellularity, background, monolayers, cell architecture, cytoplasmic and nuclear details by a semiquantitative scoring system. P<0.005 was considered statistically significant. Results: Diagnostic accuracy was better in MLBC to CP in view of absence of blood and debris, presence of monolayers and preservation of nuclear and cytoplasmic details. However, with regard to cellularity, informative background and cell architecture there was no statistical significance. Conclusion MLBC performed on FNA samples can be safe, cost effective promising diagnostic technique in combination with CP to achieve high diagnostic yield.

Keywords: MLBC; CP; FNA Samples.

Context: The antiglobulin test is an important test in the detection of immunoglobulin or complement bound on the surface of red blood cells (RBC) and serum antibodies. It is possible that anticoagulants used for collection of blood samples may affect the end result of this test. Aim: To study the variation in degree of agglutination between the antiglobulin test performed on plain blood and anticoagulated blood. Settings and Design: Antiglobulin Test was performed on blood samples collected from umbilical cord of 100 new-born babies during delivery in plain vials and vials with anti-coagulant like ethylenediaminetetraacetic acid (EDTA) and citrate. Methods and Materials: 6 ml of blood samples were collected from umbilical cord immediately after delivery and 2 ml each transferred into: EDTA, Citrate and Plain vials. The sample thus collected was used for performing the direct antiglobulin test. 10% red cell suspension was sensitized with Anti D IgG (as supplied by Tulip diagnostics) at different dilutions of 1/10, 1/20, 1/30 and 1/40. The washed saline suspension of RBC’s is treated with Anti- human globulin serum and agglutination is observed under a microscope at 5X bjective. The picture is taken of microscopic field using MIPS (micro image processing system) and saved Statistical Analysis used: Friedman test and Wilcoxon signed-rank test. Results: The degree of agglutination at various dilutions obtained by using plain blood samples was found to be higher than that obtained by using anticoagulated blood. The citrated blood samples gave intermediate agglutination results between blood samples collected in plain and EDTA vials.

Keywords: Antiglobulin Test; Agglutination; EDTA; Citrate.

 
Background: The prevalence of dyslipidemia in diabetes mellitus [DM] is 95%. Diabetic patients with accompanied dyslipidemia are soft targets of cardiovascular deaths. Glycated Hemoglobin [HbA1C] the gold standard for assessing the glycemic status, has been regarded as an independent risk factor for Coronary Heart Disease [CHD] and stroke. Various studies have contradicting results on the impact ofHbA1C levels on lipid profile in diabetics. Aim: To find out association between glycemic control (HbA1C), age, gender and serum lipid profile in type 2 diabetic patients and non-diabetic subjects. Materials and Methods: A cross-sectional study carried out in SRM Hospital and Research Centre, Chennai. Total 450 subjects (150 controlled & 150 poorly controlled diabetics, 150 non-diabetics) with equal number of males and females in each group and investigated for HbA1C and lipid profile. Statistical Analysis: The data were analyzed by SPSS version 21 using Independent samples student ‘t’ test. ‘p’ value <0.05 was considered as statistically significant. Results: There was a significant increase in mean Total Cholesterol [TC], Triglyceride[TG], Low Density Lipoprotein Cholesterol [LDL-C], Fasting Blood Glucose [FBG] levels and HbA1C between non-diabetics, controlled and poorly controlled diabetics. But High Density Lipoprotein-Cholesterol [HDL-C] was not significant between these study groups. TC, TG, LDL-C levels between males and females in each group were not statistically significant. But mean HDL-C was non-significantly lower in female diabetics. Subjects with worse glycemic control (HbA1C >9%) possessed significantly high values of TC, TG, LDL-C, FBG except HDL-C. No significant correlation for age with respect to serum lipid profile. Conclusion: We conclude, HbA1C predicts dyslipidemia . This highlights the usefulness of HbA1C as dual biomarker (glycemic control and lipidemic state) for screening high risk diabetic patients.

Keywords: Glycated Hemoglobin (HbA1C); Dyslipidemia; Diabetes.

  Background: Psoriasiform term implies that a lesion clinically or histologically mimics psoriasis. Psoriasiform dermatoses often poses diagnostic dilemma to both pathologists and dermatologists. It is essential to follow a systematic approach and use appropriate clinicopathological correlation to arrive at a diagnosis. Aims and objectives: To study histomorphological features of psoriasiform disorders. Material and methods: This is a prospective study of 57 patients diagnosed clinically as psoriasis or with psoriasis as one of the differential diagnosis. Relevant clinical history and physical examination were noted. The skin biopsies taken after the consent were processed in histopathology laboratory and stained with hematoxylin and eosin. A detailed microscopic study of the histomorphological features was done. Obervations and Resutls: The psoriasiform lesion comprised 6% of the total skin biopsies received in the department of pathology. The age distribution pattern revealed that the highest percentage was in the age group of 21-50 yrs with a male preponderance with a ratio of 1.1:1. Psoriasis was the most common lesion noted in the study. Other psoriasiform disorders were parapsoriasis, Pityriasis rosea, Bowens disease, mycosis fungoides, seborrheic dermatitis. Conclusion: There is certain amount of overlap of both clinical pattern and of psoriasis and psoriasiform disorders. Recognition of these commonly encountered psoriasiform disorders clinically and confirming it on histopathology is the key to correct diagnosis and better patient care.

Keywords: Psoriasiform; Parapsoriasis; Pityriasis Rosea.

  Papulosquamous group of skin lesions have certain common clinical presentations and lead to confusion in diagnosis. We undertook this study to analyze the histomorphological findings of various papulosquamous lesions of skin in detail, and to correlate the clinical findings with histomorphological features. Biopsy of clinically diagnosed/suspected cases of apulosquamous lesions were performed in the department of dermatology and sent to the department of pathology in 10% formalin. The specimen obtained were subjected for tissue processing after fixation. Tissue sections are prepared from paraffin block and stained with haematoxylin and eosin, followed by microscopic examination. A total of 50 cases were studied. Psoriasis was
the commonest lesions (44%) followed by Lichen Planus (34%), Pityriasis Rosea (10%), Parapsoriasis (6%), Pityriasis Rubra Pilaris (4%) and Lichen Nitidus (2%). Lesions occurred in all age groups but were common in oung and middle aged. Males were commonly affected. There is an overlap in morphology and distribution of these lesions leading to difficulty in diagnosis. Distinct histopathological features and clinical correlation gives a conclusive diagnosis. Specific histomorphological diagnosis is important to distinguish these lesions 
as the treatment and prognosis varies significantly.

Keywords: Papulosquamous; Histopathology.

Introduction: Granulomatous mastitis (GM) is a rare chronic inflammatory lesion of breast of unknown etiology. This entity clinically and radiologically may simulate carcinoma and presents as palpable breast lump with history of associated pregnancy, lactation or history of oral contraceptive intake. Cytological diagnosis is difficult as microscopic features are non specific and overlaps with other etiologies. Aims/Objectives:To study clinical presentation and cytological features of granulomatous mastitis with histopathological correlation. Methods: Prospective study of 24 cases was done over a period of three years and diagnosed as granulomatous mastitis on FNAC. Clinical data were collected and histopathological correlation was done among 18 cases. Results: Study comprised of 24 cases of granulomatous mastitis with age group ranging from 18 to 48 years (mean age - 33 years). Out of 24 cases, 16 cases had history of taking oral contraceptive pills and 14 were lactating. All the patients presented with breast lump, with abscess in four cases and axillary lymphadenopathy in three cases. Diagnosis of granulomatous mastitis was done on cytology based on the presence of epithelioid cells either in granulomas or scattered along with multinucleated giant cells against background comprising predominantly of neutrophils. Histopathological correlation was done among 18 cases with 100% correlation. Conclusion: Granulomatous mastitis is essentially a diagnosis of exclusion, which can be established by fine needle cytology in majority of cases thereby preventing unnecessary surgeries. matous mastitis diagnosed on cytology with 100% histopathological correlation.

Keywords: Granulomatous; Mastitis; Cytology; Histopathology; Granulomas.

  Cutaneous involvement is a prominent feature in connective tissue disease and the skin lesions are extremely important in diagnosing and subclassifying patients with these conditions. Fifty cases of connective tissue diseases of skin were studied over a period of two years to analyze overlapping of histopathological features, ossible transformation of one disease to the other and co-existing conditions. Routine Haematoxyline and Eosin (H&E) sections were studied along with special stains like Periodic Acid Schiff(PAS) and Verhoeff Vangiesson (VVG) wherever necessary. Fifty cases studied included 18 morphea, 9 systemic sclerosis (SS), 9 discoid lupus erythematosus (DLE), 7 acute cutaneous lupus erythematosus (ACLE), 4 subacute lupus erythematosus (SCLE), 2 lichen sclerosus et atrophicus (LSet A) and 1 case of poikiloderma atrophicans vasculare (PAV). Considerable overlapping of features were observed among skin lesions in acute, subacute and chronic lesions of lupus erythematosus and in cutaneous lesions of systemic sclerosis and morphea. In conclusion, as there is a considerable overlapping of histopathologic features in connective tissue diseases of skin, often it is necessary to use other diagnostic tools like serological and immunological study in conjunction with histopathology with the background of clinical history for a conclusive diagnosis.

Keywords: Connective Tissue Diseases of Skin; Histopathologic Features; Overlapping Features; Coexistence.

  Although clinical and radiographic examination for breast lesions have come to play an important role in the assessment of the malignant potential of a lesion involving the breast, histopathology remains the gold standard in this regard, not only for its diagnostic role but also due to its prognostic implications and as guide to further management. The present prospective observational study was conducted at a rural medical college over 2 years from September 2013 to August 2015 in which 274 cases of breast lesions were assessed and correlation was done between clinic-radiological and histological diagnoses. 67.88% of the lesons were benign neoplasms while 8.46% were malignant. Clinico-radiological features were found to have 93.84% sensitivity and 93.58% specificity for identifying benign lesions; the sensitivity for malignancies was 93.58% while the specificity was 93.84%.

Keywords: Histopathology; Breast Malignancy; Benign Breast Disease; Clinico-Pathological Study.

Background: Conventional Practical Examination (CPE) or Viva only tests the overall performance of the students (cognitive domain) but other domains like psychomotor skills, comprehension and interpretation ability etc. remain overlooked. So Objective Structured Practical Examination (OSPE) is developed as a tool to overcome these limitations of CPE. Aims & Objectives: To compare the effectiveness of Objective Structured Practical Examination (OSPE) with Conventional Practical Examination (CPE) as an assessment tool in pathology subject among 2nd year MBBS students. Materials & Methods: OSPE along with CPE were conducted in the subject of pathology among 123, 2nd year MBBS students during the year 2014. Results of both the methods were compared to each other for their effectiveness as an assessment tool in pathology practical examination. Results: Students got better results in OSPE as compared to CPE. Mean marks obtained in OSPE were 8.6 while 2.9 in CPE out of 10. Most frequently obtained marks in CPE were 2 while in OSPE its 9.SD (Standard Deviation) is 1.3 in OSPE as compared to 1.7 in CPE. Conclusion: OSPE is a reliable, objective, valid and effective method as compared to CPE for assessment of medical student’s performance in pathology practical examination. However, OSPE should be used judiciously to complement CPE rather than totally replacing it.

Keywords: Objective Structured Practical Examination (OSPE); Conventional Practical Examination (CPE); Pathology; MBBS.

Hemoglobinopathiesare monogenic disorders of erythrocyte production. We present an observational study of 200 anaemic patients at a tertiary health care center presented over two years (January 2015 to December 2016). Sickle-thalassemia was the most common form of haemoglobinopathy (56.4%), followed by β-thalassemia carrier (16.6%), Sickle cell trait (15.3%) β-thalassemia (10.2%), & Sickle cell disease (1.28%), respectively. Almost equal incidence in male and female were found. The maximum number of cases came to attention in the age group of 6-15 years followed by those in the age group of 16-30 years.

Keywords: Haemoglobinopathy; Sickle Thalassemia; β-Thalassemia; β-Thalassemia Carrier.

  Introduction: Head and neck lesions are frequent entities encountered in clinical practice. Fine needle aspiration cytology is a simple, rapid, and cost-effective method to sample superficial masses found in head and neck. Common pathologies encountered in head and neck region are specific and nonspecific lymphadenopathies, salivary gland neoplasms, sialadenitis, and lesions of skin appendages.FNAC enables a useful primary evaluation in these cases. Objectives: The objectives were to study various cytological features of neoplastic and non-neoplastic lesions of head and neck region and to evaluate the distribution of various lesions among different age groups. Materials and Methods: A cross-sectional study was conducted from May 2014 to December 2014. FNA was performed on 300 patients with head and neck masses. Thyroid lesions were excluded from study. Aspirations were performed using 22-25 G needles with syringe, and smears stained using Leishman and H & E stain. Fine needle aspiration diagnosis was correlated with relevant clinical details and investigations. Results: Out of 300 fine needle aspiration procedures, 60% were from lymph nodes, 10% from salivary gland, 14% from benign neoplasms and 14% were cysts. Diagnosis was inconclusive in 2% of the cases. The most common diagnosis was reactive/non-specific lymphadenitis (38%) followed by benign neoplasms and cysts (14%). Metastatic carcinomatous deposits in lymph node were most common type of cancer followed by lymphoma. Conclusion: FNA of head and neck masses is a very useful diagnostic tool in separating inflammatory and neoplastic lesions, thus avoiding unnecessary surgeries. FNAC can be recommended as a first line investigation in the diagnosis of head and neck swellings.

Keywords: FNAC; Head and Neck; Reactive Lymphadenitis; Salivary Gland.

  Introduction: A palpable breast lump is a common clinical problem that needs thorough evaluation by clinical examination, FNAC, mammography and biopsy if required. Aim of the Study: To study the accuracy of fine needle aspirations in breast diseases and compare it with histopathology. Materials and Methods: This was a prospective study carried out in the department of Pathology, Shadan Institute of Medical Sciences and Research Centre, Hyderabad. Fine needle aspiration cytology (FNAC) and corresponding histopathology were studied in 81 cases over a three year period. Results: The patient age ranged from 12 to 64 years. Non – neoplastic lesion constituted 12%, benign tumors 47% and malignant tumors 40% on FNAC. Failed aspiration was 1%. There were one false positive and four false negative cases on FNAC. This was mainly due to limitations in FNAC, both in interpretation and nature of lesion. The overall diagnostic accuracy of FNAC was 93.8% with accuracy rate of 90% in non–neoplastic, 73.7% in benign and 93.8% in malignant lesions. Overall sensitivity and specificity were 88.5% and 97.7% respectively. No significant complication was observed in any of the cases investigated by fine needle aspiration cytology. Conclusion: FNAC as an OPD procedure is simple and easy to perform, takes less time gives quicker results. FNAC procedure has no significant complications. It can be used for diagnosis in non-neoplastic and benign proliferative conditionswith reasonably good diagnostic accuracy.

Keywords: Breast Lesions; FNAC; Histopathology Correlation.

  Introduction: Blood safety is always remaining a point of concern. In blood bank all the procedures are starting with donor selection. Individuals disqualified from donating blood are known as “deferred” donors Aim: The aim of the study is to evaluate and analyze the blood donor deferral pattern, apply these findings to recruit them in future for donation and to compare with previous published studies. Materials and Methods: Retrospective study of blood donors was done of four years from January 2013 to December 2016 at tertiary care center. Donor deferral data was analyzed from indoor and outdoor donor forms and registers. Results: Total 4902 potential blood donors were screened at our institute and our outdoor voluntary blood donation camps. 4399 (89.74%) were accepted for blood donation and 503 (10.26%) were deferred. Total number of temporary deferral was 408 and permanent deferral was 95. Discussion: In our study the deferral rate was 10.26%. In order to lessen the loss of blood donors and future recruitment of potential temporary blood donors this study was conducted. Low hemoglobin was the commonest cause (53.20%) of temporary deferral. The commonest age group of deferral is 18-25 years age group. Conclusion: A donor directory should be made and a special mention in it should be there of temporary deferral donors for future recruitment of them. Analysis of deferral pattern helps in formulating a policy for deferral that helps to prevent loss of blood unit by future recruitment of temporary deferred donors and to ensure safe transfusion by forming a permanent deferral registry.

Keywords: Blood Safety; Screening; Donor Deferral.

Introduction: Liver is one of the most common sites for both neoplastic and nonneoplastic lesions. In the suspected liver diseases ultrasound is the first and most important diagnostic tool. As sonography alone has its limitations, cytomorphologic analysis by FNA is required to increase the diagnostic accuracy. Aims and Objectives: To evaluate various neoplastic and nonneoplastic lesions encountered in the liver and to correlate ultrasound findings with the USG FNA diagnosis in liver lesions. Materials and Methods: This was a prospective study comprising of 102 cases of liver lesions diagnosed clinically or radiologically.Abdominal ultrasonography was carried out in all cases. FNAC was performed under ultrasound guidance. Smears were stained with H & E and Wrights stain and were examined for detailed cytomorphological analysis. Observation and Results: The mean age of the patient was 53yrs with M: F ratio of 1.5:1. Out of 102 cases, 3 cases (2.94%) each of inflammatory, cirrhosis, regenerative hyperplasia, one case (0.98%) of simple hepatic cyst, and 83cases (81.37%) were malignant, while one case (0.98%) was suspicious of malignancy. Eight (7.84%) cases were inconclusive. Thus diagnosis was possible in 94 cases with diagnostic yield of 92.2%. Malignant liver aspirates formed vast majority 83 cases (81.37%).Of these 83 cases, primary malignant liver lesions formed 42 cases (50.6%). Out of these 42 cases, 40 cases were hepatocellular carcinoma and two cases were NHL. Metastatic tumour constituted 41 cases (49.4%) of which 35 cases were adenocarcinoma deposits, five cases were Squamous cell carcinoma deposits and one case of lymphoma deposit was found. On ultrasound examination out of 40 cases of HCC, 32 cases had solitary SOL, and 8 cases had multiple SOL. Metastatic carcinoma group showed solitary lesions in 10 cases and multiple lesions in 30 cases. All 3cases of NHL presented as multifocal lesions. Ultrasound diagnosis correlated well with 73 cases out of 90 cases. Discrepancies were found in 17 cases of hepatic lesions between ultrasound diagnosis and cytological diagnosis. Conclusion: Malignant tumors were the commonest of the liver lesions with same incidence of primary and metastatic deposits. HCC presented as solitary lesion and deposits presented with multiple SOLs in most of the cases. On radiological examination, neoplastic and nonneoplastic lesions show overlapping features, hence cytomorphological analysis by FNAC increases the diagnostic accuracy.

Keywords: Fine Needle Aspiration Cytology; Ultrasound; SOL; Hepatocellular Carcinoma; Metastatic.

Introduction: Dysfunctional uterine bleeding (DUB) is defined as increased abnormal endometrial bleeding unrelated to any anatomic lesions/ organic pathology of the genital tract [1]. It is a common problem in woman of reproductive age and about 20% of women affected will seek consultation [2]. Objectives: 1.To study morphological features of endometrium in DUB. 2.To correlate with age, parity and bleeding pattern in women clinically diagnosed as DUB. Methodology: Study was conducted for a period of two years (January 2014 to December 2015) in department of Pathology, Shri Nijalingappa Medical College, Bagalkot. Endometrial samples were obtained from endometrial biopsy or from dilatation and curettage (D & C) and studied with routine haematoxylin & eosin slides. Results: A total of 284 samples were received. Maximum incidence of DUB was found in age group 41-50 years (37.32%), followed by 31-40 years (35.56%) in multiparous (71.83%) women presenting with menorrhagia (71.83%). Endometrial hyperplasia was the predominant lesion seen in 46.47%, of which simple hyperplasia without atypia were 32.74%, complex hyperplasia without atypia in 7.40%, simple hyperplasia with atypia in 2.11% and complex hyperplasia with atypia in 4.22%. Proliferative endometrium was seen in 19.71%, secretory endometrium in 10.21%, disordered proliferative phase in 4.93%, irregular ripening in 8.80%, irregular shedding in 1.75%, atrophic endometrium in 2.46%, while 5.62% samples were considered inadequate. Conclusion: No age was exempted from DUB and highest incidence was noted in 3rd and 4th decades with menorrhagia as the commonest bleeding pattern occurring in multiparous women and microscopically endometrial hyperplasia was most commonly found.

Keywords: Dysfunctional Uterine Bleeding; Menorrhagia; Endometrial Hyperplasia.

Introduction: Alkaptonuric ochronosis is a rare autosomal recessive metabolic disorder resulting from deficiency of homogentisic acid oxidase enzyme leading to deposition of homogentisic acid in various tissues of the body (ochronosis). The most common clinical features are arthritic changes in weight-bearing joints, lumbosacral degenerative disc disease, dark brown discoloration of urine on air exposure, ocular and cutaneous pigmentation, coronary and valvular calcification and renal calculi formation. Histopathological examination from cutaneous/bony lesion is confirmatory. Case History: 52 year old female sustained a stress fracture of the right femoral neck, necessitating surgical repair, which showed black pigmentation of the femoral head and glenoid labrum. On examination pigmentation of the sclera and ear lobe was also noted. Further work up and histopathological examination with histochemistry confirmed it as a case of Ochronotic arthritis. Conclusion: The case is being presented for its rarity.

Keywords: Ochronosis; Homogetisic Acid Oxidase

 Background: High level of CA 125 with associated ovarian mass is highly suspicious of ovarian carcinoma but the possibility of other benign conditions with associated pelvic mass and elevated CA 125 also to be considered. Case Report: We present a case of 51 year old female, who presented with menorrhagia and a pelvic mass with a raised CA 125 of 983.1 U/ml. With a clinical diagnosis of ovarian carcinoma, she underwent staging laparotomy and post operative specimen was subjected for histopathological examination. The biopsy showed benign cystic teratoma with endometriosis in the opposite ovary. Conclusion: The present case emphasizes that not all pelvic masses with raised CA 125 should prompt the diagnosis of ovarian carcinoma, there are various other benign conditions which should be included in the differential diagnosis of a perimenopausal woman. Good clinical history and screening for other benign conditions should be given importance in such patients.

Keywords: Elevated CA 125; Benign Cystic Teratoma; Endometriosis

Introduction: Filariasis is a major health problem in tropical countries including India. Fine needle aspiration cytology plays an important role in prompt recognition of disease. Extranodalfilariasis is a rare entity, and the breast is also one of the sites for filariasis. Patients commonly present with an underlying lump that may occasionally mimic malignancy. The disease mainly involves the lymphatic system of the body. The most frequently involved lymphatics are those of the lower limbs, retroperitoneal tissues, glands, spermatic cord, and epididymis. Lymphatic filariasis is mostly caused by Wuchereriabancrofti and Brugiamalayi. However, filarial breast nodule is a very rare finding even in an endemic region. Here, we present 4 cases of filarial breast lump diagnosed by fine needle aspiration cytology. Case Series: The present cases included incidentally detected four cases of microfilaria in breast aspirates along with the associated underlying breast pathology. Conclusion: Filarial breast nodule is rare, and it often mimics a neoplastic breast lesion. FNAC is a very effective diagnostic tool in the diagnosis of filarial breast lesion and it helps avoid unnecessary surgical procedure. It should be considered as a differential diagnosis for short-lasting nodular breast lump, especially in countries like India, where filariasis is an endemic disease.

Keywords: Microfilaria; Cytology; Breast Lump.

Platelet Satellitism (PS) is a unique, uncommon phenomenon seen in peripheral blood smears prepared from Ethylene Diamine Tetra acetic Acid (EDTA) mixed blood. PS may lead to a misdiagnosis of thrombocytopenia unless peripheral smears are examined carefully. Here, we describe two case of PS incidentally detected during routine check-up.

Keywords: Pseudothrombocytopenia; Satelletism; Platelet; EDTA.

Introduction: Transfusion transmitted infections (TTI) are major risk factors for blood transfusion. To increase the blood safety IDNAT has been introduced along with compulsory donor screening tests in all NACO assisted blood banks by Government of Karnataka and KSAPS from Dec. 2011. To evaluate the safety benefits of introducing IDNAT and to estimate the seroprevalence of infectious markers TTI and their yearly trends among blood donors, a retrospective studywas conducted at Blood bank of Hassan Institute of Medical sciences, Hassan, Karnataka. Materials and Methods: Blood bank records were reviewed retrospectively from January 2013 to December 2016. Results of mandatory serological tests and NAT Yield cases were compared. Descriptive statistics were used to estimate the prevalence of TTI and to show their yearly trends for four consecutive years. Result: Total numbers of blood units collected during study period were 18,694. Voluntary donors were 69% and Replacement donors were 31%. Out of 176 infective cases detected 23 were serologically non reactive but NAT reactive giving a high NAT yield of 1 in 812 cases.Overall prevalence of TTI was 0.94% and seroprevalence of HIV (0.08% ), HBV ( 0.80%), HCV (0.06% ), Syphilis (0.01% ). An increasing trend of HBV infection and decreasing trend of HIV, HCV were observed among blood donors in these four consecutive years. Conclusion: The present study population showedcomparatively low prevalence of Transfusion transmitted infection and it clearly indicated the benefits of IDNAT screening for the improvement of blood safety.

Keywords: IDNAT; Blood Safety; Blood Transfusion.

 Introduction: Cardiac autopsy is the main diagnostic tool to study various histomorphological changes in normal and diseased heart. An autopsy study gives a good measure of the prevalence, grading and distribution pattern of atherosclerotic lesion especially in developing country where resources are limited. Methodology: This retrospective study was conducted in Department of Pathology, Hassan Institute of medical sciences, Hassan . The study period was between January 2013 to August 2016. Heart specimens were obtained from medico legal autopsy performed in the Department of Forensic Medicine,Hassan Institute of Medical science. Heart specimens received as a part of examination of multiple viscera or only heart was taken out from dead body for pathological examination. Results: Out of 149 autopsied heart130( 87%) of cases showed significant coronary artery atherosclerosis in one or more vessels and Triple artery disease was commonest involvement seen in 114 (76%) cases. Conclusion: This study highlights the cardiovascular risk factor screening from early ages of third decades. Most of our observation correlated with the similar studies.

Keywords: Coronary Atherosclerosis; Histopaothology; Heart Autopsy.

Context: Blood transfusion is a life saving measure in various medical and surgical emergencies. Transfusion medicine, apart from being important for the medical treatment of each patient, also has great public health importance. Aims: The aim of our study was to know the prevalence of transfusion transmissible infections among blood donors in our college hospital blood bank. Settings & Design: Retrospective study conducted for 2 years. Methods & Material: This was a retrospective study conducted at the blood transfusion centre of a tertiary care hospital.Voluntary donors were evaluated for the prevalence of HIV, HBS Ag, HCV, Syphilis and Malaria. All the samples were screened by third generation ELISA Kits for HIV, HBsAg and HCV, by Rapid Plasma Reagin method for Syphilis, and by Immunochromatographic test for detection of Plasmodium falciparum and Plasmodium vivax antigen. Results: Total number of voluntary blood donors in the two year period were 3355. The seroprevalence of HIV, HBsAg, HCV were 0.42%, 1.88% and 0.29% respectively. No blood donors were tested positive for syphilis and malaria. Conclusions: Blood is still one of the main sources of transmission of infections. HIV, HBsAg , HCV are still prevalent among voluntary donors.

Keywords: Seroprevalence; Hepatitis B.; Hepatitis C.; Human Immunodeficiency Virus; Donors.

Background: Platelet indices viz. Mean platelet volume (MPV), Platelet distribution width (PDW) and Platelet large cell ratio (P-LCR) are measured in the automated cell counter. These indices are well utilized for certain conditions like idiopathic thrombocytopenic purpura, aplastic anemia and other hemotological disorders to assess the prognosis. Platelet count is decreased in various conditions including infectious and non-infectious disease processes. Infectious conditions like dengue fever, malaria, rickettsia, leptospirosis cause fever and variable degree of thrombocytopenia. Hence a detailed study of platelet indices is undertaken in patients having fever with thrombocytopenia. Materials & Methods: Present study was a prospective study. A total of 150 patients were included over a period of 1 year from Jan 2011 to Dec 2011. Detailed histories, physical and clinical examination of the patients were done to assess the etiology of febrile thrombocytopenia. Serological investigations for dengue fever, leptospirosis and rickettsia were done for confirmation. Results: Majority of the cases were of viral fever (72.6%), which includes dengue fever (10.6%), followed by malaria (15.3%), septicemia (4.6%), enteric fever (4%), leptospirosis (2%), rickettsia & brucellosis (0.6%). The platelet indices PDW (74.6%), MPV (86.6%), P-LCR (80.6%) showed less significant changes. Conclusion: Platelet indices are not changed significantlyin febrile thrombocytopenic patients. Whenever patient with thrombocytopenia presents with changes in platelet indices, non infectious conditions should also be considered in differential diagnosis to manage the patients effectively for better clinical outcomes.

Keywords: Febrile Thrombocytopenia; Platelet Indices.

Context: Transfusion dependent anemia importantly includes thalassemia patients. Thalassemia major is most common monogenic disorder in the world. Thalassemia is a major problem not only for the patients and their families but also for each country’s public health systems with regard to treatment expenses including regular injections, iron chelating agents, frequent hospitalizations and other medical consistencies and they are vulnerable to, social and psychological problems. Aims: Determination of prevalence and severity of depression in transfusion dependent thalassemia major patients attending a tertiary care hospital. Settings and Design: Cross-sectional study. Methods and Material: The study was done at a tertiary care teaching hospital. Thalassemia major patients who received blood transfusions for 2 to 4 weeks interval in the hospital were included in this study. Hamilton Anxiety rating (HAM-A) scale and Hamilton Depression rating scale (HAMD) were used to diagnose the severity for each case. Statistical Analysis Used: WHO Epi Info 7 software was used. Categorical data was expressed in terms of rates, ratios and percentage. Results: Males (83.33%) outnumbered females (13.34%) with male to female ratio of 4:1. Nearly half of the study population was aged between 10 to 12 years. Out of 30 patients, 25 were males and 5 were females. Age range was 10 -18 years with mean age of 12.45 ± 2.41 years. The prevalence of depression was 44.34% with majority showing mild depression. The prevalence of anxiety was 36.67% with majority showing mild severity followed by mild to moderate severity. Conclusions: This study help to understand emotional disorders and the severity of anxiety and depression in  thalassemia patients who are chronically ill and undergo prolonged treatment. Early assessment and treatment by psychiatrist will surely help to have good psychological condition.

Keywords: Transfusion Dependent; Thalassemia; Depression; Anxiety.

Introduction: Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with onset or first recognition during pregnancy. Women with GDM alone or with type 2 DM are at increased risk of cardiovascular disease (CVD) in future. Literature has shown that platelets play a significant role in the pathogenesis of GDM.There are very few studies relating GDM and platelet parameters emphasized on platelet count (PLT), Mean platelet volume (MPV) and Platelet distribution width (PDW) but not about plateletcrit (PCT) and P-LCR (platelet large cell ratio). The objective of this present study is to compare the platelet parameters including platelet count (PLT), MPV, PDW, PCT and P-LCR in gestational diabetic subjects with healthy pregnant women and to evaluate the effect of GDM on platelet parameters. Materials and Methods: Prospective cross sectional study was conducted for 6 months duration. Ninety GDM patients diagnosed by Oral glucose challenge test (OCT) and Oral glucose tolerance test (OGT) along with ninety normal pregnant females as control were taken up for study. Investigation panel including platelet parameters were done. Results: Statistically significant increase was noted in MPV (p<0.002) and platelet distribution width (p<0.004)and significant decrease was noted in platelet count (p<0.01) in gestational diabetics compared with control group. PCT is decreased in test group but it is only weekly significant (p<0.09), there is no significant difference in P-LCR (p<0.25) among the groups. Conclusion: Determination of these platelet parameters are simple, inexpensive, routinely available and can be used as a predictive markers to identify GDM patients who are at increased risk of CVD in later life.

Keywords: Gestational Diabetes Mellitus; Platelet Parameters; Predictive Value; Screening Methods.

Background and Objectives: The evaluation and management of various hepatic lesions is a common clinical problem and their appropriate management depends on accurate diagnosis. Aim of the study is to study the cytomorphological features of various neoplastic lesions of liver and role of ultrasonography guided fine needle aspiration cytology (FNAC) in the diagnosis of liver malignancies. Materials and Methods: Fifty patients with evidence of liver disease underwent USG guided percutaneous FNAC . Cytomorphologicaldiagnosis were correlated with clinical, biochemical and radiological findings. Results: The age of the patients ranged from 6yrs to 75yrs with 40% males and 60% females. Of the 50 patients the cytological diagnosis of malignancies were rendered in 40 patients and smears of the 10 patients were benign, inflammatory and hemorrhagic. The primary liver lesions were more common than the metastatic lesions. The commonest primary liver malignancy was hepatocellular carcinoma followed by cholangiocarcinoma and hepatoblastoma. The metastatic lesion predominantly was adenocarcinoma. Conclusion: USG guided FNAC of the liver is a safe, simple, cost effective and accurate method for cytological diagnosis of hepatic malignancies.

Keywords: Hepatocellular Carcinoma; Cholangiocarcinoma; Metastatic Adenocarcinoma.

Background: Transfusion transmitted diseases continues to be a major threat for safe transfusion practices. Lack of study from this part of the country propelled us to conduct this study. Materials and Methods: This was a retrospective hospital record based study conducted in a blood bank of a rural tertiary care medical college hospital at Karwar, Karnataka, India. Five year data of blood donors with transfusion transmitted infections (TTIs) were evaluated and analyzed. Results: Among the 2655 donors screened, males (88.5%) were predominant. Among donors screened, hepatitis B (0.67%) was the most common TTI screened. No cases of Hepatitis C was seen during the study period. Conclusion: Prevalence of TTI amongst blood donors in the present study is comparatively low compared to various studies. Larger studies are necessary to predict overall prevalence in this part of the country. Being a smaller blood bank does give better screening strategies and improved donor recruitment, thereby improving blood safety.

Keywords: Blood Donors; TTI; Rural; Hepatitis B.

Background and Objectives: Fine needle aspiration cytology (FNAC) is an accurate, cost effective and safe technique for diagnosing neoplastic lesions of the bone. Objective of the study is to know the utility of fine needle aspiration cytology in the diagnosis of bone tumors and assess the diagnostic accuracy of this technique. Materials and Methods: FNA of bone was performed in 30cases. Smears prepared were fixed in 95% ethyl alcohol and stained by Hematoxylin and Eosin. 9 smears were considered unsatisifactory as they contained acellular hemorrhagic aspirates. The remaining 21 smears were classified as malignant lesion(12) and benign lesions (9). 15 out of the 21 cases were subjected to histopathological examination. Results:The malignant tumors were giant cell tumor (6), osteogenic sarcoma (1), chondrosarcoma (2) and adamantinoma(1), fibrosarcoma (1) and metastasis (1). The benign tumors were osteochondroma (6), osteoblastoma (2) and enchondroma (1). Histological correlation was obtained in 14 cases of the 15 cases operated and the diagnostic accuracy was 93.3% in this study. A case of chondroblasticosteogenic sarcoma that was reported as chondrosarcoma was the only diagnostic error in the study. Conclusion: Fine needle aspiration of bone is a simple reliable and accurate diagnostic technique that can facilitate patient management and preoperative decision making patient decision making and avoid unnecessary invasive procedures for patients with primary or metastatic bone lesions.

Keywords: Fine Needle Aspiration; Bone Tumors; Osteosarcoma; Adamantinoma.

Introduction: Recent advance in the field of tumour suppressor genes and oncogenes have provided the tool for the study the genetic changes occurring at different stages of carcinogenesis including transition from premalignant to malignant. Methodology: Histopathologically diagnosed benign lesions, premalignant lesions & SCC were included in the study which consist of 33 cases of oral squamous cell carcinaoma (of which14 were well differentiated, 14 moderately differentiated and 02 poorly differentiated) and 03 were verrucous carcinoma. 11 premalignant lesions and 08 were benign lesions of the oral cavity. These cases were subjected to routine H&E staining and p53 immunohistochemical staining. Results: In this study, 4 out of 7(57.14%) cases of hyperplasia showed basal p53 positivity whereas the only cases of squamous papilloma was p53 negative. It was observed that 69% of malignant and 63% of premalignant lesions showed suprabasal p53 positivity whereas only one case of benign lesions showed the above pattern of staining. Conclusion: In conclusion, expression of p53 above the basal layer is an early event in oral carcinogenesis and an indicator of a developing carcinoma preceding morphological alterations.

Keywords: p53 Staining; Benign; Premalignant; Malignant Oral Lesions.

Context: Cervical carcinoma is the fourth common malignancy in women worldwide and second most common in developing countries including India. Cytological screening leads to a reduction in the rate of invasive cancer of uterine cervix. The present study highlights the importance of cytospin method of liquid based cytology which improves the efficacy of Papanicolaou smears. Objectives: To compare efficacy of cytospin Papanicolaou smears with conventional Papanicolaou Smears in cervical cancer screening based on Bethesda system of classification, 2014. Materials and Methods: A prospective study of cervical cytology of 134 samples was carried out on women from age group of 18-65 years. Using Ayre’s spatula one slide was prepared and immediately fixed in fixative. The residual material was rinsed in fixative then spun in cytospin to obtain direct smear. Both conventional and cytospin smears were stained by Papanicolaou stain. Results: Of the 134 cervical cytospin smears studied, 87.9% (118 cases) were non-neoplastic, 9.6% (13 cases) were neoplastic lesions and 2.2% (3 cases) were unsatisfactory. The most common neoplastic lesion was LSIL and HSIL accounting for 3% (4 cases) each followed by ASCUS, squamous cell carcinoma and adenocarcinoma. Cytospin showed significant difference in the morphological features compared to conventional. Conclusion: Cytospin method of liquid based cytology is recommended as it improves the sample quality, morphology and also cost effective. It is an alternative screening method in low resource settings, like developing countries including India where women are at high risk for developing cervical cancer.

Keywords: Cervical Carcinoma; Conventional Pap Smear; Cytospin Pap Smear; Liquid Based Cytology.

Introduction: Among the most widely studied tumour suppressor gene are RB & p53 which express PRB retinoblastoma protein & p53 protein respectively. These proteins control cell cycle and are involved in the inhibition of cell proliferation. Mutation of these proteins produce uncontrolled cell proliferation. Methodology: The detailed history including the duration, site, onset, progression, personal habits and duration of those habits like smoking, beetle quid chewing were noted. The clinical diagnosis was recorded. Results: In our study, the most common location was tongue 48% followed by the BUCCAL mucosa of 34% and the least common was the floor of the mouth 6%. It was observed that 59% of the cases in the age group 50-60 year showed suprabasal p53 positivity. Conclusion: No significant association observed between P53 and age,smoking and tobacco use.

Keywords: Oral Lesions; P53; Tobacco.

Objective: Despite progress in prophylaxis and treatment modalities, tuberculous (TB) lymphadenitis still remains a major health problem in developing countries. In India, extrapulmonary TB accounting 20% of all TB cases and its prevalence in the country varies between 8.3% and 13.1%. The aim of this study was to describe various cytological pictures of tuberculous lymphadenitis with their relative frequency and to assess correlation between Fine needle aspiration cytology (FNAC) and Ziehl-Neelsen (Z-N) staining in diagnosing tuberculous lymphadenitis. Materials and Methods: A total of 132 cases with cytological proven tuberculous lymphadenitis were taken up for the study. Details such as age, sex, group of lymph nodes involved, type of aspirate, cytomorphological patterns and Acid fast bacilli (AFB) positivity on ZN staining were analysed. Results: The sites of distribution of lymphadenopathy were as follows: Cervical lymph nodes – 109, Axillary – 21, Inguinal lymph nodes – 02. Cytological patterns in all 132 cases were as follows: Pattern A – 22, Pattern B – 73, Pattern C – 37 cases. On grading of AFB positivity, Grade 1+ observed in 22.7%, Grade 2+ observed in 31.6% 2, and Grade 3+ observed in 45.5% cases. Conclusion: FNAC is a simple, cost effective and minimally invasive technique to diagnose tuberculous lymphadenitis. Since granuloma formation is not often seen in purulent aspirate, ZN staining must be done to rule out tuberculous lymphadenitis.

Keywords: Cytomorphological Patterns; Tuberculous Lymphadenitis; Ziehl Neelsen Stain

 Background: The various histological methods of identification of Helicobacter pylori have different sensitivity and specificity with varying strengths and weaknesses in terms of cost and convenience. Aim: The aim of this study is to compare the efficacy of Giemsa stain with Immunohistochemistry in diagnosing Helicobacter pylori in paraffin embedded tissue sections. Materials and Methods: This is a retrospective study done in a tertiary care centre for a period of 3 years. Multiple bits were taken from the lesion and the adjacent areas in random sample of 50 gastrectomy specimens and processed routinely for paraffin embedding. Sections were stained for Giemsa and immunohistochemistry apart from the routine Haematoxylin and eosin stain. Statistical Analysis: The data were entered and the statistical comparison between the two tests were done using SPSS software version 21. Results: Out of 50 cases of adenocarcinoma stomach, 39(78%) were males and 11(22%) were females. Out of 50 cases H.pylori was detected in 21 cases using Giemsa stain with 42% of positivity (Table.1). Out of 50 cases, Immunohistochemistry detected H.pylori in 25 cases (4 cases more than Giemsa) with a positivity rate of 50%. Conclusion: Sensitivity of Immunohistochemistry is more when compared with Giemsa special staining. Immunohistochemistry can be used to detect coccoid forms of Helicobacter pylori especially in screening for the presence of Helicobacter pylori in high risk patients and also in patients who had been treated with proton pump inhibitors and to confirm eradication following antibiotics against Helicobacter pylori.

Keywords: Helicobacter Pylori; Giemsa; Immunohistochemistry; Gastric Adenocarcinoma; Gastric Biopsy

Background: The safety of blood and blood products is improved by stringent donor selection. Donor deferral, either temporarily or permanently is an important documentation towards safe blood transfusion. Thus it should be evaluated on regular basis. Aims: To analyze the donor deferral rate, to document the causes and their frequency distribution with respect to gender. Settings and Design: This was a prospective study conducted on potential donors registering in Blood bank, Navodaya Medical College, Hospital and Research Centre, Raichur, Karnataka. Detailed history taking, physical examination and screening tests on the blood units collected were performed. Methods and Material: This study was conducted over 2 years (Jan 2014 to Dec 2015). Donor request form was given and those who did not fulfill the donor selection criteria were deferred and analyzed. Results: A total of 6834 donors were registered for blood donation, of which 909 cases (13.3%) were deferred. Deferral rate was 89.2% among males and 10.8% among females. Majority were temporarily deferred- 704 cases (77.4%); most frequently due to low hemoglobin value (17.7%) followed by fever (14.3%). Permanent deferral category included 205 cases (22.6%); mainly due to Hepatitis B virus (HBV) seropositivity (44.9%) followed by hypertension (20.9%). Female donors were deferred more frequently (47%) than males (8.2%); commonest reason being low hemoglobin and fever in both. Conclusion: Donor deferral is beneficial for donors and recipients as it minimizes potential health problems within the community. Hence regular evaluation guides transfusion committee in modifying planning strategies to preserve donor pool.

Keywords: Blood Donor; Donor Deferral; Permanent; Temporary.

Context: Ovarian lesions can present in the form of pain in abdomen, mass lesion or infertility. Any age group can be affected. Mass lesions of ovary are important, as they can be neoplastic or non-neoplastic. Appropriate treatment and prognosis is dependent upon the proper classification and diagnosis of ovarian mass lesions, which can be achieved by histopathological examination of excised ovarian tissue. Aims: Present study aims at classifying ovarian lesions histopathologically and finding the frequency of various ovarian tumors. Methods and Material : Present study is a retrospective study carried out at tertiary hospital attached to medical college in rural area of Maharashtra. All oophorectomy specimens received in central clinical laboratory from January 2012 to June 2016 were included in the study. Clinical details were obtained from requisition forms submitted by gynaecology department along with the ovarian specimen sent for histopathological examination. For detail information regarding the case, case sheets were obtained from medical record section of the hospital. Histopathological slides were retrieved from filing and studied blindly by two histopathologists independently. Results thus obtained were compared with original reports and finalized. Results: A total of 152 cases were included in the study. Histopathological examination was performed on 188 ovaries, of which 59 ovaries didn’t show any pathology. Of the remaining 129 ovaries, non-neoplastic lesions were more common (n=85; 65.89%) than neoplastic lesions(n=44; 34.10%). Follicular cysts were commonest amongst non-neoplatic lesions. In neoplastic category benign tumors were more frequent than malignant tumors. Serous cystadenomas were commonest among benign tumors whereas serous cystadenocarcinomas were commonest among malignant tumors. Conclusions: Histopathological examination of excised ovarian tissue forms the mainstay of diagnosis in most of the cases.

Keywords: Ovarian Lesions; Follicular Cyst; Serous Cystadenoma; Serous Cystadenocarcinoma; Teratoma

Introduction: Hysterectomy is the most common major gynaecological surgery done in the world. Common reasons include abnormal uterine bleeding (AUB) and leiomyoma. Aim and Objectives: This study was done to assess the indications and associated pathological findings among hysterectomy cases in our centre. Materials and Methods: This was a prospective study conducted over a period of three years from Jan 2014 to Dec 2016. All cases of hysterectomy conducted for gynaecological reasons were included in the study. Results: A total of 319 cases were included in the study. Most of the patients who underwent surgery were in the 4th and 5th decade. Common clinical indications included AUB and fibroid. In 45.76% of the hysterectomy specimens, no significant pathology was identified. Most significant histopathological findings were leiomyoma followed by adenomyosis. Conclusion: Hysterectomy still continues to be the surgery of choice for benign conditions, even though in developed countries, it continues to reduce with advent of newer methods. Larger studies are necessary to identify the reasons for hysterectomy, and to avoid hysterectomy for benign conditions, particularly in our part of the world.

 Context: Accurate preoperative diagnosis of thyroid lesions is imperative and helps surgeons to decide the management of the patients. The differential diagnosis of these nodules includes from non neoplastic to malignant lesions. Aims: This study was conducted to assess the utility of cell blocks in hemorrhagic and cystic thyroid aspirations. Settings and Design: This was a prospective study conducted over a period of one year in the department of Pathology. Methods and Material: All Thyroid FNAs that yielded either blood tinged colloid or cystic fluid or hemorrhagic material were included in the Study. CBs were prepared from the residual material after preparation of smears. The cytomorphology of FNA smears were compared with histopathology of cell blocks in all cases. Results: Sensitivity, specificity, PPV, NPV of FNAC was 100%, 94.2%, 83.3%, 100% respectively. Percentage of false positive cases was 5.7% with diagnostic accuracy of 95%. In the present study Cell blocks were contributory to FNAC diagnosis in three cases (6%). Conclusions: Cell block preparation as an adjuvant to FNAC can reduce diagnostic pitfall and improve accuracy of FNA diagnosis. It gives an added opportunity to study architecture of the tissue. Cyto-histologic correlation in all cases may help to improve efficiency of Pathologists.

Keywords: FNAC; Cell Block; Thyroid Nodule; Cyto Histologic Correlation.

Introduction: Women worldwide suffer from gynaecological and obstetric disorders that require hysterectomy as a treatment option. Hysterectomy forms the major bulk among the specimens received in our histopathology laboratory, hence this study was undertaken to know the incidence and also understand the variety of lesions in the hysterectomy specimen. Materials and Methods: The present study was done in the Department of Pathology, KBNIMS, Kalaburagi, from July 2014 to June 2016. All types of hysterectomy specimens (with or without adnexa) received during this period, were studied. Results: Total number of hysterectomy specimens received was 269. Out of 269 cases, non-neoplastic lesions were 141(52%), benign tumors were 114 (43%) and malignant tumors were 14 (5%). One case of tuberculosis of the endometrium was diagnosed. Malignant lesions were 3(1.2%), 2 cases of endometrial adenocarcinoma and 1 case of endometrial stromal sarcoma. Incidence of leiomyoma in present study was 31.8% (86/269) with mean age of 42.42 years and incidence of adenomyosis was 32%. Among 6 malignant tumors of cervix, 4(82%) cases were squamous cell carcinoma, 1 (9%) case of adenocarcinoma, 1 (4.5%) case of adenosquamous carcinoma. One of primary adenocarcinoma of fallopian tube was diagnosed,which was not diagnosed clinically. One case of mucinous cystadenocarcinoma with metastasis to the serosa of the uterus and to the colon, was diagnosed. Conclusion: Study of hysterectomy specimens is fascinating, as a variety of lesions are encountered. This specimen needs to be thoroughly studied, in order to know the different types of lesions in the female genital tract.

Keywords: Hysterectomy; Leiomyoma; Squamous Cell Carcinoma; Tuberculous; Endometritis.

 Context: Thalassemia is a group of inherited hemoglobin disorders characterized by reduced synthesis of one or more of the globin chains leading to imbalanced globin synthesis which is the major factor in determining the severity of the disease in the thalassemia syndromes. The objectives of this study was to analyze the anemia and biochemical profile in thalassemia major patients as very few studies have been done in this region of country. Aims: Determination of anemia and biochemical profile of thalassemia patients. Settings and Design: Cross-sectional study. Methods and Material: The study was done at a tertiary care hospital from January 2014 to December 2014. 35 thalassemia major patients who received blood transfusions in the hospital were included in this study. Complete blood count, Peripheral Smear Examination, Serum Ferritin and Fasting plasma glucose was done. Statistical analysis used: The data was analysed using SPSS version 20. Categorical data was expressed in terms of rates, ratios and percentage. Results: Male to female ratio of 4:1. About 51.43 % of patients were aged between 10 to 12 years. Mean hemoglobin was 6.8 gm±1.08 gm% and peripheral smear examination showed microcytic hypochromic anemia in most of the patients (74.29%)The raised serum ferritin levels were noted in 94.29% of the patients. The activity of all the liver enzymes AST, ALT and ALP were raised. Conclusions: The patients with transfusion dependent thalassemia major are at risk of developing severe anemia and biochemical abnormalities. Hence screening is essential as per guidelines.

Keywords: Thalassemia; Anemia; Biochemical Profile; Ferritin

 There is persistent shortage of active blood donors to meet the increased demand of blood in blood banks. The safety of blood with regard to the risk of transfusion transmissible infection is also an issue of utmost concern in India. Recruitment of voluntary non remunerated blood donors poses major challenge to transfusion services. Hence, there is a serious need to improve the recruitment and retention of healthy voluntary donor population to ensure a safe blood transfusion practice. Students are the appropriate, potential population to recruit regular blood donors and the role of college students in voluntary blood donation is crucial to meet the demand of safe blood. Knowing the attitude and perception of youngsters will help to identify factors and to develop strategies that influence the recruitment and retention of voluntary non-remunerated blood donors. Objective of this study is to assess the knowledge, attitude and practice regarding blood donation among college students. This is a cross-sectional descriptive study carried out at blood bank, Srinivas institute of medical sciences and research centre, Surathkal over a period of one year. A total of 250 college students were recruited. Pretested questionnaires were used to assess their knowledge, attitude, and practice towards blood donation. The age of respondents ranged from 18 - 30 years. Majority of the donor had good knowledge about the age criteria for donor selection, minimum body weight and minimum interval between two donations. Less than half of the participants had some knowledge about the volume of blood collected, provision for blood component separation, storage and shelf life of blood components. There were 115 respondents who had never donated blood before and the chief reason for not donating blood was fear of needle. Around 90% of donors showed positive attitude by expressing their willingness to donate blood if they were asked to donate blood in future. Assessment of knowledge, attitude and perception amongst student population regarding blood donation will help in designing effective health education strategy to improve voluntary blood donation.

Keywords: Blood Donors; Blood Bank; Voluntary; Knowledge; Attitude.

Background: Ultrasonography (USG) guided Fine Needle Aspiration Cytology (FNAC) is an established, safe, reliable and accurate procedure for cytological diagnosis of various retroperitoneal lesions. Aims & Objectives: To study the sensitivity, specificity and diagnostic accuracy of USG guided FNAC in retroperitoneal lesions. Materials & Methods: USG guided Fine Needle Aspirations (FNA) were performed in 54 patients with various retroperitoneal lesions during May 2009 to December 2011. Their cytological diagnosis was compared to Histopathological (HP) diagnosis. True and false (positive and negative) data was analyzed to measure sensitivity, specificity and diagnostic accuracy of USG guided FNAC. Results: Adequate material was aspirated in all 54 cases (Sample adequacy rate 100%). Maximum cases were from Kidney (21) followed by Lymphnode (13), Soft tissue (9), Adrenal (5), Pancreas (4) and Germ cell tumors (2). FNAC was diagnostic in all 54 cases. Among which, 36 cases (66.7%) were malignant and 18 cases (33.3%) were benign. HP correlation was available in 35 (64.8%) cases. HP diagnosis was different from FNAC diagnosis in only 2 (5.7%) cases. Diagnostic Accuracy, Sensitivity and Specificity of USG guided FNAC in retroperitoneal lesions were 94.3%, 92.6% and 100% respectively. Conclusion: Having high sensitivity, specificity and diagnostic accuracy, USG guided FNAC is an OPD based safe, reliable and accurate diagnostic procedure for various retroperitoneal lesions. It doesn’t only provide a preoperative diagnosis to aid in surgical management of resectable tumors, but also helps in avoiding a purely diagnostic laparotomy in cases of advanced cancer or benign lesions.

Keywords: USG Guided; FNAC; Retroperitoneal; Sensitivity; Specificity; Accuracy

 Introduction:  One of the most important prognostic factors in breast cancer is metastasis to regional lymph nodes resulting in a reduced overall survival rate. Mast cells in tissue release both pro-tumourigenic and antitumourigenic substances and can determine progress of the tumour including invasion and metastasis. The present study endeavored to assess mast cell density (MCD) in regional axillary lymph nodes in cases of carcinoma breast with clinicopathological correlation to infer their biological role and pathological significance. Methods: Tissue from forty seven cases of invasive carcinoma of breast (mastectomy with regional axillary lymph node clearance) was analyzed and routine histological findings were recorded. Mast cells were clearly demonstrated in tissue using Toluidine Blue stain at pH 2.3. Mast cells were counted using an eyepiece grid and expressed as no. of cells / per sq. mm, i.e., mast cell density (MCD). The distribution of mast cells within all the sampled lymph nodes (with and without metastasis) was recorded. Results:  Mast cell density was statistically significantly (p<0.0001) increased in regional axillary lymph nodes without microscopic metastatic deposits (n= 255; Mean MCD +/- SD:  6.0 +/- 3.4) compared to lymph nodes showing metastatic deposits (n=140; Mean MCD +/- SD: 0.57 +/- 0.59). Conclusions: Our results indicate a clear anti-tumourigenic role of mast cells within the regional lymph node tissue in carcinoma breast, possibly limiting the mechanisms for invasion of lymphoid tissue and limiting the metastasis. Mast cell density could thereby be a significant prognostic indicator in the management of patients with breast carcinoma.

Keywords: Breast Carcinoma; Lymph Node; Mast Cell; Metastasis; Toluidine Blue.

 Fine needle aspiration cytology (FNAC) is an important diagnostic tool used preoperatively for diagnosis of palpable and non palpable mass lesions. Various techniques have been described for doing the procedure. Aims & Objetive: We conducted a study with the objective of evaluating role of cytospin technique in inadequate and hemmorhagic samples in cytology. To perform immunocytochemistry on the cytospin slides if required during the diagnosis. Results: 19 thyroid cases, 6 salivary gland cases, 30 lymph node cases, 12 soft tissue cases, 9 breast cases and 4 miscellaneous cases were done. Cellularity was inadequate in 1.3% cases in conventional FNAC whereas inadequacy was seen in 8.8% cases of cytospin slides. The cellular details were clear and satisfactory in 100% of the cases in both conventional and cytospin slides. The cytospin slides prepared from the residual hub material was diagnosed as colloid goiter whereas only abundant colloid was seen on conventional smears where opinion was not possible. Granulomas were missed with cytospin technique due to significant decrease in the background caseous necrosis and scattered cellularity. Immunocytochemistry on cytospin slides was convenient due to monolayered cells aiding in appropriate diagnosis. Conclusion: Cytospin can be used as an adjunct to routine smears where limited material or hemorrhagic material is present. Special ancillary tests like immunomarkers and special stains can be done on these slides which aids in rapid and definitive diagnosis.

Keywords: Conventional FNAC; Cytospin Technique; Immunochemistry.

 Introduction: Nasal polyps are polypoidal masses arising from the nasal cavity and paranasal sinuses. They can be non-neoplastic, can have an infective etiology, or they can be benign or malignant. Aim of the Study: To study the histopathological spectrum of nasal polyps. Materials and Methods: This was a prospective study done over a period of 16 months. The study group consisted of 93 individuals from 10 years to 69 years in whom excised nasal polyps were studied histopathologically. These cases were classified into non neoplastic, benign and malignant lesions. Observations and Results: The male to female ratio was 1.73:1. The non-neoplastic lesions were more common (67.74%) than the malignant lesions (5.38%). Allergic morphology was more common. Rhinosporidiosis was a frequent infective etiology. Among benign lesions, hemangioma and among malignant lesions, squamous cell carcinoma were more common. Conclusion: Nasal polyps most commonly show allergic and inflammatory morphology. Rhinosporidiosis presents as nasal polyps in endemic coastal areas. Overall the study has found 5.38% malignant cases, so thorough sampling and study is recommended for all nasal polyps.

Keywords: Nasal polyps; Rhinosporidiosis; Hemangioma; Lesions.

Synovium is a specialized mesenchymal tissue in which varied pathological lesions can occur, but most common are non neoplastic lesions. Aim of the Study: To determine histopathological spectrum of non-neoplastic lesions of synovium and to correlate the clinical and histopathological diagnosis in our tertiary care hospital. Materials & Methods: Prospective study of 65 synovial biopsy samples. Patient’s complete clinical data, radiological findings, biochemical and serological parameters were obtained. Synovial fluid analysis was done in available cases. Histopathological examination of synovial biopsy tissue was done with routine and special histochemical stains wherever necessary. Statistical analysis for sensitivity, specificity and diagnostic accuracy was done. Results: We observed arthritis was common in 5th decade with Male-Female ratio of 1.7: 1. Most were monoarticular disease with the knee joint commonly affected. The common clinical manifestation was joint pain and swelling. The most common lesion was chronic nonspecific synovitis followed by osteoarthritis, tuberculous arthritis, rheumatoid arthritis and septic arthritis. One case of pigmented villonodular synovitis [PVNS], gouty arthritis and ochronotic arthritis were observed in our study. In our study, the diagnostic accuracy of synovial biopsy in comparison with clinical impression was 85% with 73% sensitivity, 97% specificity, 96% positive predictive value and 78% negative predictive value, 27%false negative rate and 3% false positive rate. Conclusion: In our study, we observed that synovial biopsy is cost effective and offers immense help to clinicians in providing appropriate treatment for patients, especially in long standing and subtle inflammatory lesions.

Keywords: Synovial Biopsy; Synovitis; Histopathology; Correlation; Diagnostic Accuracy.