Indian Journal of Pathology: Research and Practice

Introduction: The leiomyomas are commest benign tumors in utreus. It is composed of proliferation of smooth muscle cells and fibrous connective tissue. The various interactions of sex steroid hormones and local growth hormones are important for development of these tumors. Also genetic cause related to mutations in the normal myometrium is considered as the other etiological factor. Aims and Obectives: To study and analyse various histopathological patterns of uterine leiomyomas in surgically excised hysterectomy specimens. Material and Methods: The present study was done at the Department of Pathology, DY Patil, Medical College, Kolhapur, Maharashtra, India, for the period of three years from Jan 2016 to December 2018. Results: A total of 116 surgically excised hysterectomy specimens which were clinically and radiologically suspected of uterine leiomyomas were studied. The maximum numbers of patients in this study were between 41–50 years (46.5%). The clinical sign and symptoms of menorrhagia being the most common indication for hysterectomy. The intramural location was common site of leiomyomas in this study. Conclusion: We observed in female reproductive tract uterine leiomyomas are the most common tumors. Most of the cases were asymptomatic. The intramural location was common site of leiomyomas in this study.

Keywords: Hysterectomy; Leiomyoma; Menorrhagia

Introduction: Vitamin D is popularly known as a sunshine hormone. Deficiency of Vitamin D is very common and one of the major vitamin deficiency in the Indian subcontinent and is a profound health issue in India. In India, lack of Vitamin D is stated to affect nearly 90% of the apparently healthy individuals probably because of poor exposure to sunlight and poor dietary intake. The study was aimed to study the incidence of Vitamin D deficiency in urban population of central Madhya Pradesh. Materials and Methods: The study included patients coming to our diagnostic centre for Vitamin D testing. 500 patients of ages ranging from 0 to more than 80 years and both males and females were part of the study. Vitamin D estimation was performed by CLIA method on Advia Centaur XP (Siemens) fully automated immunoassay analyser. The guidelines provided by Endocrine Society Clinical Practice Guidelines on evaluation, treatment and prevention of Vitamin D deficiency (2011) was used as a basis to classify vitamin D results into deficiency, insufficiency and sufficiency levels. Results: A total of 500 patients of both the sexes and all ages were included in this study. There were 228 (45.6%) males and 272 (54.4%) females. The male to female ratio was 0.83:1. Vitamin D deficiencywas observed in 336 (67.2%) patients and insufficiency was seen in 83 (16.6%) patients. Conclusion: Deficiency of Vitamin D is a public health problem specially in urban population. A public private partnership model with awareness programmes and affordable testing facility will help in detection of Vitamin D deficiency.

Keywords: Vitamin D; Deficiency; Insufficiency; Toxicity

Background: The introduction of modern diagnostic imaging techniques, mainly USG and CT scan now has enabled the detection and location of lesions in sites which are not easily accessible to surgical biopsies, besides offering vast opportunities for fine needle aspiration of the deeper structures. Aims & Objective: study the cytomorphilogical features of intra abdominal mass and thoracic lesions, categorise them organ wise and also as inflammatory, benign and malignant lesions and correlate histopathologically whenever possible. Material and Methods: present study conducted on total 114 guided aspirations under ultrasound/CT scan in radiology department and cytologically evaluated in Department of Pathology, Maharani Laxmi Bai Medical College, Jhansi between august 2016 to august 2018. Results: Adequacy rate was 95.61%. maximum no. of cases-36 (31.57%) were of liver masses, followed by 24 (21.05%) cases of gall bladder masses and 17 (14.91%) of lymphadenopathies. Among the thoracic region, lung tumors comprises maximum no. of cases 19 (16.66%). Rest of the cases were from the ovary 6 (5.26%), 04 (3.50%) cases GIT, 4 (3.50%) from each from CBD and kidney, 1 (0.88%) from intra-abdominal testis and 3 (2.63%) cases were grouped as miscellaneous. 96 cases were subjected to histopathological examination.There is overall sensitivity was 91.80%, specificity 97.37% and diagnostic accuracy was found to be 94.9%. Conclusion - guided FNA is a rapid, accurate, economical and safe diagnostic procedure for deep-seated mass and post procedure complications are few.

Keywords: Ultrasound; Computer tomography; Fine needle aspiration cytology.

Background: p53 protein is a product of TP53 tumor Suppressor gene. TP53 mutations leading to loss of function are the commonest type of genetic damage found in human cancers and oral squamous cell carcinomas, often preceding recognizable histological alterations. Ki-67 has been shown to be excellent for the estimation of the growth fraction in both normal and malignant human tissue and this antibody is now used as the usual standard for the assessment of cell proliferation. Aim: To study the expression of p53 and Ki-67 in premalignant and malignant lesions of oral cavity. Material and Methods: The immunohistochemical expression of Ki-67 and p53 was studied on 110 cases of premalignant and malignant lesions of oral cavity during a period from July 2017 to June 2018. Results: The immunohistochemical expression of Ki-67 and p53 showed similar trends, and increased with the degree of dysplasia. On analyzing statistically, a high significant association was found between p53 expression and higher grades of tumour differentiation. However expression of Ki67 did not show significant association with various grades of differentiation of oral squamous cell carcinoma. Conclusion: p53 and Ki-67 are useful biomarkers of malignant transformation in oral precancerous lesion and may serve as intermediate points for cancer prevention programmes.

Keywords: Ki-67; p53; premalignant; malignant; oral lesions

Over the past several years maternal thyroid disorders influenced the outcome of pregnancy. Maternal and fetal morbidities are well documented complication of pregnancy in thyroid dysfunction. The vast majority of affected women are asymptomatic. Therefore to avoid the potential complications universal screening of antenatal patients was done. Thyroid dysfunction may be overlooked in pregnancy because of their overlying symptoms. Context: “The purpose of this study is to explore the prevalence of thyroid dysfunction in pregnancy and emphasize on the screening of thyroid dysfunction in pregnancy” Settings and design: It is a retrospective study. Material and methods: All Antenatal patients with hypertension and diabetes mellitus irrespective of their trimester were recorded for their thyroid function test. Statistical analysis used: All the results were analyzed and p value, chi square test applied wherever necessary. Results: We have studied 700 antenatal cases and found that thyroid dysfunction was present in 80 cases (11.4%). Of which asymptomatic were 32 cases (40%) and symptomatic were 52 (65%). Conclusion: we have concluded that universal screening of antenatal patients should be done irrespective of their antenatal visit.

Keywords: Thyroid dysfunction; Antenatal; Universal; Screen.

Background:Langerhans cell histiocytosis (LCH) a rare disease with various clinical presentations characterized by the accumulation of CD1a-positive immature dendritic cells. This study was done with the aim of documenting the various clinical presentations of LCH occurring in Indian population. Methods: All histopathologically proven cases of LCH were retrieved retrospectively over a period of 5 years (January 2013- December 2017) at Institute of Child Health and included in our study. Results: Out of 14 cases observed as LCH, 11 cases (78.57%) were between 0-3 years of age, with male predominance. Bone involvement was the commonest presentation seen in 10 cases (71.43%), of which skull was commonly involved in 8 cases (80%). Isolated skin involvement was seen in 3 cases (21.43%), next to bone involvement. 1 case (7.14%) presented with pure lymph node involvement. Conclusion: Lesions presenting as isolated skin involvement is not very rare which can be seen in children upto 3 years of age and in our study, it was observed in 3 cases (21.43%) which is higher than the previous observations [15,16]. Other unusual presentations like sternum, mandible (alveolus) involvement, pure lymph node involvement can also occur. Skin involvement being the second commonest of the presentations next to bone lesions and hence warrants a skin biopsy in susceptible age group (0-3 years) with chronic skin lesion and an associated skeletal survey, so that it offers the clinician a road to the diagnosis and proper treatment is initiated to the patient at the earliest. Follow up of cases is needed to rule out relapse.

Keywords: Langerhans cell histiocytosis; Various presentations; Skin involvement.

Introduction: In HIV infected individuals, CD4 T cell counts along with viral load remains the mainstay for assessing the immune status and for clinical management. As these tests are expensive and not easily available, absolute lymphocyte count (ALC) has been suggested to reflect the CD4 counts. This can then be used to predict the immune status for initiation of chemoprophylaxis for opportunistic infections in resource limited settings. Objectives: This study was undertaken to evaluate ALC as an alternative marker for CD4 counts in HIV infected patients and to assess its clinical utility. Materials and Methods: Haematological parameters and CD4 counts for all HIV positive cases from January 2016 to August 2018 was assessed. The Beckman Counter FC 500 flow cytometer was used for CD4 counts and Sysmex XE 2100 for haematological profile. Spearman correlation and receiver operating curve (ROC) were used for calculating sensitivity, specificity and positive predictive values. Results: Sensitivity, specificity and positive predictive value of ALC < 1200 cells/µl to predict CD4 < 200 cells/µl, was found to be 92%, 53% and 64% respectively. There is a positive correlation between CD4 count and ALC of 0.655 which is statistically significant (p < 0.05). Conclusion: Our data shows a good correlation between ALC and CD4 cell counts, with ALC < 1210 cells/µl cut off to have the maximum sensitivity for predicting CD4 count < 200 cells/µl. Hence, ALC can be considered as an economical and easily available substitute in prediction of low CD4 counts.

Keywords: Absolute lymphocyte count; CD4 counts; HIV.

Objective: The most widely accepted hypothesis is bile stasis caused by gall bladder dyskinesia. The aim of this study is to investigate about relationship between gall stones and different gall bladder pathologies. Methods: Specimens for study was sent by surgery department for histopathology after cholecystectomy. After grossing, sections were submitted for tissue processing. Results: Grossly, size of gall bladder was normal in 91 (60.66%) but fibrotic in 15 (10%) and enlarged in 44 (29.34%) patients. Wall thickness was normal (<3 mm) in 79 (52.67%) and thickened (>3 mm) in 71 patients (47.33%). In microscopy 110 (73.34%) were of chronic cholecystitis, cholesterolosis 15 (10%) cases, xathogranulomatous and acute on chronic cholecystitis 3 cases (2%) each, 1 case (0.67%) each of mucocele and follicular cholecystitis. Hyperplasia was observed in 8 (5.33%) cases. Hyperplasia subclassified into adenomatous and adenomyomatous. Five (3.33%) cases of cholecystitis with metaplasia were seen. There were 4 cases (2.66%) of carcinoma, predominant histologic type being adenocarcinoma. Conclusion: Presence of stones may lead to different mucosal changes from chronic inflammation to carcinoma. Therefore histopathological examination of all cholecystectomy specimens with or without cholelithiasis is essential to diagnose benign as well as malignant pathology.

Keywords: Cholecystitis; Dysplasia; Hyperplasia and Metaplasia.

Background: Congenital Anomalies are one of the leading causes of paediatric mortality in developed & developing countries. Based on World Health Organization 3 million fetuses and infants are born each year with congenital anomalies. In India it is 6-7% which translates to around 1.7 million birth defects annually. This study was undertaken to present the spectrum of multiple congenital anomalies in fetus and neonates. Materials and Methods: This is a prospective based observational study done from March 2018 to March 2019. The data for the study was collected from a maternity hospital in Hyderabad. Autopsy was performed on dead fetuses and neonates with birth defects by a standard technique adopted by Edith L. Potter and was documented. Results: Of the total of 2043 pregnancies, 47 cases had multiple congenital anomalies with a prevalence of 2.3%. Of which 41 were fetal cases (87.23%) and 6 were neonatal cases (12.76%). Increase incidence of birth defects were noted in consanguinity, young primiparous and low socioeconomic group. Malformations of central nervous system (23.91%) was the commonest. Conclusions: Anomalous child has negative impact on mental status of the whole family. The outcome of our study is to initiate a national programme which focuses on prevention, care and surveillance for children born with birth defects.

Keywords: Congenital Anomalies; Birth defects; Fetus; Neonates.

Background: Testicular FNAC is a simple and an inexpensive method for evaluation of testicular pathology including inflammatory, non-neoplastic and neoplastic conditions and now has gained popularity as a diagnostic and therapeutic modality in management of male infertility. Assessment of spermatogenesis in azoospermic males is important in the diagnosis of infertility and being a minimally invasive and cost effective method, it gives an insight into the various factors leading to azoospermia. Aims & Objectives: To assess spermatogenesis on testicular FNAC and to determine causes of male infertility in azoospermic males. Methods and Materials: The study was conducted in 50 azoospermic infertile males in the Department of Pathology. Detailed history of the patient, hormonal levels and ultrasound findings were taken into account wherever possible. FNAC was performed on bilateral testis and cytological smears stained with Giemsa were then evaluated for spermatogenesis. Results: Of the 50 cases, maturation arrest was found to be the most common cytological pattern encountered (46%) followed by Sertoli cell only syndrome (28%). Varicocele was the most common clinical condition associated with infertility (12%). Conclusion: The purpose of this article was to review the role of testicular fine needle aspiration cytology in male infertility and interpret the results for evaluation of spermatogenesis.

Keywords: Spermatogenesis; Azoospermia; Cytological diagnosis; Testicular FNA.

Introduction: to study histopathological evaluation and its correlation with fluorescent staining used in the diagnosis of leprosy in tissue section and comparision of fluorescent staining with zn staining. Materials and Methods: 40 Skin biopsies cases from leprosy patients were received and processed as for routine histopathology. Sections of 5 microns were taken and routine H & E staining, ZN staining and fluorescent (auramine-rhodamine) staining is done. Various Stained sections were examined under light and fluorescent microscope there after result were ploted in tabulated form and various graphs. Results: Age group of 31–40 years were affected most with 13 cases (32.5%) Males were affected the most, with 23 cases (57%.5) and females being 17 cases (42.5%) with sex ratio is 1.35, that 80% of the patients belong to rural areas, Borderline Tuberculoid Leprosy was the most common histopathological diagnosis which constitutes 20 (50%) Positivity rate with fluorescent stain was 65%, whereas with Ziehl–Neelsen was 17.5%. Staining by fluorescent method detected an additional case which was missed by Ziehl–Neelsen that shows improvement in Positivity rate by 47.5% and hence sensitivity as evident by present study. Conclusion: Hitopathological correlation with fluorescent (auramine-rhodamine) staining is significant. Fluorescent microscopy has higher case detection rates when compared to ZN stain. It can be used as a supplementary tool when ZN staining method fail to detect the bacilli. The procedure is valuable in cases where negativity of sections is to be certified. Positivity rate with fluorescent stain was 65%, whereas with Ziehl–Neelsen was 17.5%. Staining by fluorescent method detected an additional case which was missed by Ziehl– Neelsen that shows improvement in Positivity rate by 47.5% and hence sensitivity as evident by present study. Comparision between ZN stain and fluorescent stain was found significant with p < 0.001 (calculated statistically by chi square test).

Keywords: Fluorescent stain (Auramine-Rhodamine); ZN stain; tissue section; Histopathological diagnosis.

Introduction: We studied effectiveness of PDCA cycle in improving compliance of laboratory staff with respect to universal safety precautions. Material and Methods: We noted compliance of staff to safety precautions like wearing apron, gloves, hand wash, avoiding eating and drinking in the lab before and after the institution of PDCA cycle for a period of 1 month. The significance of difference was calculated using Chi squared test. Results: We found significant improvement in avoiding eating and drinking in lab (p: < 0.0001), wearing apron (p: < 0.012), wearing hand gloves (p: < 0.000423), hand wash (p: <0.001). Conclusion: PDCA technique is effective in improving compliance to universal safety precautions and can be applied in bigger scale for other problems.

Keywords: PDCA; Universal safety precautions.

Introduction: Aim of the study is to assess the CD44s expression in oral squamous cell carcinoma and its correlation with various histomorphological grades of the tumor and its prognostic significance. Material and Method: 42 Cases of Oral squamous cell carcinoma were included in the study. Histological grading of tumor was done on Haematoxylin and eosin stained tissue sections. Immunohistochemical study was done with CD44s antigen Marker. The histomorphological grades of tumors were correlated with CD44s expression based on degree of intensity and distribution of CD44s immunostaining. Correlation was evaluated statistically using Yate’s Chi Square test. Result and Conclusion: The study showed decrease in the intensity of CD44s expression with increase in tumor grade. This suggests that CD44 plays an important role in cell-cell and cell-matrix interaction and helps in cell adhesion, which decreases with increasing cancer stage. Thus it can be concluded that CD44s expression can be useful in evaluating the tumor progression and be of value in predicting the prognosis of the disease.

Keywords: CD44s; Oral squamous cell carcinoma; Cell adhesion.

Background and objectives: Vitamin B12 is an essential nutrient that plays crucial roles in the human body. B12 deficiency primarily affects the hematopoietic system, but its effects extend to other tissues and organs, most notably the nervous system. The neurological symptoms of vitamin B12 deficiency are non specific and can be irreversible. Holotranscobalamin (Holo-TC) also called as active B12 has been suggested as sensitive marker for early diagnosis of B12 deficiency; therefore measurement of Holo-TC may be useful for taking therapeutic measures before neurological damage of vitamin B 12 deficiency develops. Methods: We tested serum samples of 50 cases for hemoglobin levels, MCV and total vitamin B12 assay. We divided them into two groups and also tested for Holo-TC.Group: 1) Hemoglobin above 11.0 gm %, MCV between 85–96 fl and serum B 12 in the range of 200-300 pmol/L. Group: 2) Hemoglobin less than 11.0 gm % and serum B12 less than 200 pmol/L. MCV and hemoglobin was measured by Sysmex KX-21 five part differential cell counter. PBF of all subjects was examined for evidence of hyper segmentation. Cases having history of any disease were not included in the study. Results: Group 1 cases were having total serum B 12 level in normal range but Holo- TC value of these cases was found decreased suggestive of early vitamin B12 deficiency. Group 2 cases were having a low value of serum B12 with markedly low value of Holo-TC suggesting that value of Holo-TC decreases with decrease in serum B 12 levels. Conclusions: Data present in this study show correlation between Serum Vitamin B12 and Holo-TC results. In majority of cases significant correlation was observed between the two indices. We predict that Holo-TC is a good marker for early diagnosis of vitamin B12 deficiency.

Keywords: Hemoglobin; MCV; Vitamin B12; Holo-TC.

Background and Objectives: Thyroid is unique in being largest endocrine organ amenable to physical examination and is affected by plethora of disorders ranging from developmental to neoplastic. After diabetes mellitus, commonest of the endocrine disorders are of thyroid gland. Solitary thyroid nodule leads to cosmetic issues, compression on adjacent organs or can have malignant potential. FNAC has been foremost diagnostic tool compared to others, requiring no admission/anesthesia. This study is done to determine age and sex distribution of thyroid lesions with clinical correlation, to evaluate diagnostic accuracy of FNAC in diagnosing lesions of thyroid. Materials and Methods: This Prospective study (June 2014 – November 2016) comprised of 162 cases, referred to Navodaya Medical College Hospital & Research Centre, Raichur and FNAC of thyroid lesions were done with histopathological correlation in 78 patients and statistical analysis was performed in 71 cases, as 7 cases with cytological diagnosis of follicular neoplasm and hurthle cell neoplasm were excluded because cytologically it cannot be differentiated as benign /malignant. Results: Thyroid lesions were common in age group of 31-40 years, with female predilection (83.95%), neck swelling was predominant clinically (100%) and least common was fever and pain. Among the non neoplastic lesions-nodular goiter (93 cases; 57.40%) was common followed by lymphocytic thyroiditis (13 cases; 8.02%), hashimotos thyroiditis (11 cases; 6.79%), Multi nodular goiter (8 cases; 4.93%), hyperplastic nodule (6 cases; 3.70%) Colloid cyst (5 cases; 3.08%) colloid nodule (3 cases; 1.85%) and in Neoplastic follicular neoplasm (6 cases; 3.70%), Hurthle cell adenoma (1 case; 0.61%) papillary carcinoma (10 cases; 6.17%), medullary carcinoma (2 case; 1.22%), (papillary carcinoma with hashimotos thyroiditis (1 case; 0.61%) and anaplastic carcinoma (1 case; 0.61%) were seen. By comparing the result of FNAC and histopathology, FNAC has sensitivity of 80%, specificity 96.4% & PPV 85.7% and NPV 94.7% and accuracy of 93.0%. Conclusion: Thyroid cytology proves to be a reliable, simple and cost-effective first line diagnostic procedure with high patient acceptance and without complications. The ideal test should have a sensitivity and specificity of 100%. The closest method to ideal test is, thus, FNAC which has high sensitivity and specificity. However, a combination of both FNAC and Ultrasound will give optimal results and avoid mismanagement. Thus FNAC is followed as first line pre-operative procedure due to its simplicity, cost-effectiveness & good diagnostic accuracy.

Keywords: Fine Needle Aspiration Cytology (FNAC), Thyroid Swellings.

Background: Dysfunctional uterine bleeding is a form of abnormal uterine bleeding in the absence of organic disease of the genital tract. It is present with considerable morbidity and affects the patient’s personal, family and social life. Objective: The aim of the study was to analyze the histopathological patterns of endometrium in patients presenting with DUB and also to correlate histopathological patterns of DUB with clinical presentation, age, parity and bleeding patterns in women clinically diagnosed as DUB. Material and Methods: In this study a total number of 950 endometrial biopsies were included from patients with dysfunctional uterine bleeding submitted to the department of Pathology, GMCH, Udaipur from July 2014 to October 2016 and clinical history of the patients was taken. The endometrial samples included biopsies and hysterectomy specimens which were fixed in 10% formalin for 12-24 hours and the entire tissue was taken for routine processing. Slides were examined and histopathological diagnosis was made.Results:The age of the patients in the present study ranged from 20-56 years. Maximum number of cases were seen in age group 41-50 years (38.7%). Menorrhagia was the most commonest presenting symptom accounting for 55.4% of cases followed by menometrorrhagia (16.7%) and the least being oligomenorrhoea (4.9%). The incidence of DUB was found to be highest in multipara (72.4%) followed by 13.9% in grandmultipara and least in nullipara (4.2%). Maximum number of patients presented with symptoms for a duration of 1-6 months accounting for 56%. Proliferative endometrium (59.2%) was the dominant histopathological finding in DUB patients followed by secretory endometrium (22.2%). Among 950 patients, endometrial hyperplasia was seen in 41 patients (4.3%) and endometrial carcinoma in 7 patients only (0.7%). Conclusion: The present study revealed that proliferative and secretory endometrium are the most common endometrial histopathological patterns in endometrial samples obtained for dysfunctional uterine bleeding in our region. Histopathological evaluation of endometrium helps to exclude the local causes and establishes the diagnosis of DUB, its types, clinical correlation to histopathological findings and finally helps to determine the mode of management.

Context: Ovary contains four major types of tissue (Surface epithelium, Germ cells, Sex cords and Ovarian stroma), all of which can give rise to a variety of neoplasms, often combined with a varied morphological and histological features. Aims: The aim was to study the age distribution, frequency and histomorphological diversity of different ovarian tumors. Methods and Material: The present retrospective and prospective study was carried out in the Department of Pathology, B.J. Government Medical College, Pune, Maharashtra, India, from January 2016 to December 2018. The diagnosis was confirmed by histopathological examination using Hematoxylin and Eosin (H & E) stain. Special stains were used whenever needed. Statistical analysis used: MS Excel Work sheet. Results: Out of 219 ovarian neoplasms analysed in this study, 216 were primary (98.63%) and 3 were metastatic tumors (1.36%). Among these 219 cases 174 were benign tumors (79.45%), 41 were malignant tumors (18.72%) and 04 were borderline tumors (1.82%). The Surface epithelial tumors were most common ovarian tumors constituting 176 cases (80.36%), followed by Germ cell tumors constituting 28 cases (12.78%), Sex cord stromal tumors were 12 in number (5.47%) and 3 were Metastatic tumors (1.36%). Serous cystadenoma was the most common benign tumor and serous cyst adenocarcinoma was the common malignant ovarian tumor. A wide variation of age was noted. Age ranged from 10-79 years. Majority of the cases were seen in age group of 21-40 years. Conclusion: From this study it is concluded that on morphological basis, tumors originating from surface epithelium are the common variant and majority of the ovarian tumors are benign.

Keywords: Germ cell tumor; Histomorphological diversity; Metastatic tumor; Neoplasms; Ovarian tumor; Surface epithelial tumor.

Introduction: Fine needle aspiration cytology (FNAC) is a useful diagnostic modality in soft tissue lesions. However an exact cytological diagnosis is often difficult due to constraints of recognizable tissue architectural pattern. Aims/Objectives: 1) To study distribution pattern of various soft tissue lesions at our institute. 2) To assess the utility of FNAC in those cases where biopsy was available. Material and Methods: This is 8 years study of FNAC’s performed in the Department of Pathology, SDM Institute of Medical Sciences and Hospital, Dharwad. Correlating clinical, cytomorphological and imaging modalities, final diagnosis was arrived at. In cases of biopsy, histopathological correlation was carried out. Results: 653 cases FNAC were of soft tissue lesions in which 613 cases (93.88%) were benign and 40 cases (6.12%) were malignant. In benign category, maximum cases were lipoma (85.31%) followed by benign spindle cell lesion (5.38%). In malignant category, maximum cases were small round cell tumor (17.5%) followed by spindle cell sarcoma (15%). Histopathological correlation available in 112 cases with diagnostic accuracy of 99.10%. Our study results were comparable with other studies on FNAC of soft tissue lesions. Conclusion: Fine needle aspiration cytology is an effective and reliable diagnostic tool in categorizing soft tissue lesions pre-operatively for further clinical management. Diagnostic accuracy is increased with correlation of clinical and imaging findings.

Keywords: Soft tissue lesions; FNAC; Histopathology.

Background: Frozen section is an important tool in the intraoperative diagnosis of ovarian tumours which guides the surgeon in tailoring the surgical therapy, especially in younger women. Aim: To determine the accuracy of frozen section in ovarian neoplasms and to study the possible sources of discordance. Methods: Retrospective study of 78 ovarian tumours sent for frozen section from July 2016 to July 2018. The frozen and paraffin section reports were compared and accuracy, sensitivity, specificity, positive predictive value and negative predictive value of frozen section was determined individually for benign, borderline and malignant tumours. Statistical Analysis: Sensitivity, specificity, positive predictive value and negative predictive value were calculated for benign, borderline and malignant tumours separately. Results: The overall accuracy of frozen section in diagnosis of ovarian tumours was 97.4%. The sensitivity and specificity for benign tumours was 100%; for borderline tumours it was 100% and 97% respectively; for malignant tumours 92% and 100% respectively. The major source of discordance was found to be in regard to borderline mucinous tumours, with 28.5% showing invasion on final paraffin section. Conclusion: Accuracy of frozen section is high in benign and malignant ovarian tumours. The accuracy rate declines in cases of borderline tumours especially the mucinous type. Deferring the frozen section report to paraffin section is indicated when the diagnosis of borderline versus invasion is difficult or suspected.

Keywords: Accuracy; Borderline; Frozen Section; Mucinous; Ovarian tumors.

Background: Blood transfusion has become one of the important modalities of treatment in hospitals these days. Transfusion transmissible infections (TTI) remain one of major complications of blood transfusion. This study is aimed at assessing the seroprevalence of Hepatitis C virus (HCV) among healthy blood donors in our region and its implications in safe blood practices. Materials and Methods: This is a retrospective study done over a period of 3 years from August 2015 to July 2018 in two blood banks of Gadag i.e. Gadag Institute of Medical Sciences (GIMS) blood bank and Indian Medical Association (IMA) blood bank. A total of 20,144 blood donors were included in the study. It included both voluntary donors and replacement donors. Donors were screened using donor questionnaire form followed by general physical examination for medical and surgical illness. The blood samples of eligible blood donors were subjected to a test that detected the presence of antibodies to HCV by using Qualisa 3rd generation ELISA kit. Result: In the present study, the total number of donors is 20,144. Out of this, 19,676 (97.67%) were males and 468 (2.33%) were females. Out of 20,144 donors, 16,541 (82.1%) were voluntary donors and 3603 (17.9%) were replacement donors. Total number of seropositive cases of hepatitis C was 9. The overall seroprevalence was 0.045%. All the seropositive cases were males. The prevalence of seropositive cases among voluntary donors was 0.03% and among replacement donors was 0.14%. Conclusion: Seroprevalence of Hepatitis C infection in the region of Gadag is 0.045%.

Keywords: Seroprevalence; Replacement donors; Voluntary donors