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.