Cytological grading of breast cancer according to robinson's grading system

Objective: To see the correlation between cytological parameters and grading of breast cancer according to Robinson's grading system on Fine needle aspiration smears. Study design: It was a correlational descriptive study

Study Design: It was a corelational descriptive study

Place and Duration of Study: It was conducted in the Histopathology Department, Army Medical College, National University of Sciences and Technology[MUST], Rawalpindi, Pakistan from Nov 2012 to Nov 2013

Material and Methods: All cases diagnosed as breast cancer [C 5] or suspicious of breast cancer [C 4], on Fine needle aspiration cytology, were included in the study and women already taking treatment were excluded. A total of 102 samples were included in the study through non probability convenience sampling

Result: The cytological parameters of Robinson's grading system including cell dissociation, nuclear margins and nuclear chromatin showed weak correlation with tumor grade. While cell size, cell uniformity and nucleoli showed moderate correlation. All the parameters were statistically significant with p-value<0.05

Conclusion: This study concludes that all the cytological parameters of Robinson's grading system have correlation with tumor grade

Placental morphology at different maternal hemoglobin levels: a histopathological study

To evaluate the histopathological parameters of the placenta like weight, infarct and syncytial knots, at different maternal hemoglobin levels, in both qualitative and quantitative manner. Descriptive study. Army Medical College, National University of Sciences and Technology in collaboration with Department of Obstehics and Gynecology, Military Hospital, Rawalpindi, Pakistan, from December 2011 to November 2012. A total of 75 placentas were included, that were collected from full term mothers at the time of childbirth. Placental weight was taken without umbilical cord and gross placental infarcts were noted. Samples of placental tissue were taken and stained by haematoxylin and eosin [H and E]. Microscopic study was done to evaluate placental infarcts and syncytial knots. Mean placental weight at normal and low maternal hemoglobin was 581.67 +/- 83.97 g and 482.58 +/- 104.74 g respectively. Gross placental infarcts were found in all cases having low maternal hemoglobin concentration [60% cases]. Syncytial knots were found in all placentas but they were considerably more at decreasing levels of maternal hemoglobin [19.79 +/- 5.22]. The present study showed decrease in placental weight, increase in placental infarcts and syncytial knot hyperplasia at low maternal hemoglobin concentration, displaying adaptive alterations

histopathologic analysis of chronic inflammatory infiltrate in patients of H. pylori associated chronic gastritis

To determine the relationship between H. pylori density with severity of chronic inflammatory infiltrate. A cross-sectional study. The study was carried out in the Department of Pathology [Histopathology], Army Medical College, National University of Sciences and Technology [NUST] Islamabad, from Nov 2011 to Nov 2012. Gastric antral biopsies of H. pylori associated chronic gastritis were included in the study. Demographic characteristics and relevant clinical information were collected. First hundred biopsies of H. pylori associated chronic gastritis were assessed for density of H. pylori and chronic inflammatory infiltrate. Histopathological features like lymphoid aggregates, ulcer slough, superficial epithelial damage, dysplasia and nuclear reactive changes were simply assessed in case of their presence or absence. A sigruficant moderate positive correlation was found between grades of H. pylori and chronic inflammatory infiltrate [rs= 0.636]. Insigruficant correlation was found with lymphoid aggregates, superficial epithelial damage, dysplasia and nuclear reactive changes. In conclusion this study corroborated the determination of histopathological parameters and depicted that, the greater the density of H. pylori mfection, the greater the degrees of chronic inflammatory infiltrate

Aggravation of gentamicin induced nephrotoxicity by ciprofloxacin

To evaluate histopathological changes of gentamicin induced nephrotoxicity in rabbits receiving the combination of ciprofloxacin and gentamicin compared with rabbits receiving gentamicin alone. Laboratory based Randomized controlled trial. Study was conducted in the department of Histopathology with the collaboration of the department of Pharmacology, Army Medical College Rawalpindi and National University of Sciences and Technology [NUST] Islamabad. Eighteen rabbits were used in this study. They were divided randomly into three groups. Each group contained six rabbits. Group 1 [control] was injected subcutaneously with 0.9% NaCl. The second group of animals was injected with gentamicin. The third group of animals was injected with the same dose of gentamicin and additionally ciprofloxacin. The findings were entered and analyzed with the help of histopathological [HP] score calculated by summing up the histological parameters through Microsoft excel and Graph pad Instat 3. Necrosis, congestion and inflammatory infiltrate were graded as absent, mild, moderate and severe. The score assigned was from 0 to 4 accordingly. Highest tubular necrosis grade [grade 3] and maximum inflammatory changes [moderate grade] were observed in 50% of rabbits of group 3, receiving combination of gentamicin and ciprofloxacin. p-values were significant <0.01. Combined administration of ciprofloxacin along with gentamicin in rabbits enhances adverse histopathological effects of gentamicin induced nephrotoxicity

Diagnostic accuracy of endometrial curettage in endometrial pathology

Abnormal uterine bleeding is one of the most frequent problems in life of an adult female. Uterine curettage or biopsy remains a preferred sampling procedure for diagnosis of the endometrial pathology. The objective of this study was to compare the sensitivity, specificity, positive and negative predictive value of endometrial curettage. This validation study was carried out at the Department of Histopathology, Army Medical College Rawalpindi in collaboration with Military Hospital, Rawalpindi from January to December 2010. The study included 50 curettage and subsequent hysterectomy specimen of the same patients. Non-probability sampling technique was used to divide patients into two groups with 50 patients in each group. One group was of endometrial curettage having endometrial pathology [group A]. Second group was of subsequent hysterectomy specimen of the same patients [group B]. Endometrial curettage was found most accurate in diagnosing endometrial carcinoma. Sensitivity of endometrial curettage was found to be 33% whereas specificity and positive predictive value was found to be 100% each. Negative predictive value was found to be 93.1%. Endometrial biopsy is a sensitive and a specific test in and is accurate in diagnosing endometrial pathology. It is found most accurate in diagnosing endometrial carcinoma

comparative analysis of coronary adventitial T-lymphocytes-an autopsy study

Recent clinical and histopathologic data suggests that inflammation plays a key role in coronary artery plaque instability and subsequent occlusive thrombosis. The intima has received much attention as a site of inflammation, while the adventitia has remained relatively unexplored. The aim of the present study was to investigate the frequency of inflammatory activity in the cap and shoulder region of unruptured, atherosclerotic lesions in coronary arteries and to correlate these findings with distribution of inflammatory cells in adventitia. The study was carried out in Histopathology Department, Army Medical College, Rawalpindi and National University of Sciences and Technology [NUST], from August 2008 to July 2009. Sixty-seven autopsy cases performed at Military Hospital Rawalpindi, Pakistan were selected. The cases were divided into study group and control group. Case group [n=35] included those where cause of death was ischemic heart disease. Those coronary arteries were taken as control [n=32] where atherosclerotic changes were found by chance [death without history of ischemic heart disease]. Plaques in each group were assessed by light microscopy and by immunohistochemistry. The ages of the deceased ranged from 38 to 49 years. Within study group, adventitial lymphocytes exhibited strong correlation with erosion, thrombus formation in culprit plaque [p=0.001]. No correlation was found between adventitial T-lymphocytes and erosion of plaque [p=0.700] in control group. In 72% of culprit plaques moderate staining for T-lymphocytes was observed in adventitia as well as intima. In control group, most of the cases contained scattered cells. Few cases of stable plaques revealed lymphocytes as clusters, both in adventitia and in intima. Adventitial inflammation may play a pivotal role for atherosclerotic lesion histology and atheroma instability. With the help of these autopsy findings, we hope to be able to reduce the incidence of culprit plaques related to inflammatory reaction in patients of ischemic heart disease

Assessment of atherosclerotic plaque vulnerability of coronary arteries in cases of sudden cardiac death

To study the plaque vulnerability in coronary arteries taken from autopsy specimens, of individuals dying of ischemic heart disease in our setup and to compare it with atheroma of those who died of non-cardiac causes. Case control study. Study was carried out in the department of Pathology [Histopathology], Army Medical College, Rawalpindi and National University of Sciences and Technology [NUST], from June 2008 to June 2009. Sixty coronary arteries having atherosclerosis, from autopsies of patients who died of sudden cardiac death were divided into case and control groups. Case group included thirty coronary arteries having atherosclerosis from autopsies of patients of whose death was attributable to Ischemic Heart Disease [IHD]. Control group included thirty coronary arteries where atherosclerotic changes were found by chance [death not attributable to ischemic heart disease]. Plaques were assessed for fibrous cap thickness, foam cells; mean percentage of inflammatory cells on Haemotoxylin and Eosin [H and E] stained slides whereas immunohistochemical [IHC] markers for T-Cells were done by IHC stain method. In present study, foam cells are significantly more in study group than in control group [P=0.007]. Fibrous cap thickness fulfilling the criteria of vulnerable plaque was more in study group as compared to control group [P<0.001]. The present study demonstrated that there was insignificant difference [P=0.152], in the mean percentage of inflammatory cells in case group and control group. An overall significant association was found between vulnerable plaque and death due to ischemic heart disease [P<0.001]. Patients dying of ischemic heart disease have more vulnerable plaque in their coronary arteries as compared to those dying from non ischemic cause. Although this is an autopsy study but the significance of in this study can be very important to guide cardiologists to identify patients at high risk of acute coronary syndrome and use new diagnostic modalities like intravascular ultrasonography and therapeutic strategies like genomic and proteomic techniques. This will help the early detection and treatment of such cases and may ultimately reduce the incidence of sudden cardiac death

Correlation of steatosis with fibrosis and necro-inflammation in chronic hepatitis C infection in the absence of confounding factors

To assess the frequency and degree of hepatic steatosis in patients of chronic hepatitis C infection and determine its correlation with stages of fibrosis and necro-inflammatory grades. Cross-sectional study. The study was carried out in the Department of Pathology [Histopathology], Army Medical College, Rawalpindi, from March 2006 to March 2007. Patients who had undergone a liver biopsy for evaluation of hepatitis C virus infection were included in the study. Demographic characteristics and laboratory data were collected at the time of biopsy. First hundred biopsy specimens meeting the inclusion criteria were assessed for steatosis, necro-inflammation and fibrosis. Steatosis was present in 46 patients and graded as mild [41.3%], moderate [54.3%] and severe [4.3%]. An overall significant correlation was found between grades of steatosis with stage of fibrosis [p < 0.0001] but no correlation was found with necro-inflammatory grades. Only focal necrosis revealed weak correlation with grades of steatosis [p < 0.003]. These results suggest a possible role of the hepatitis C virus itself in the pathogenesis of steatosis and indicate its close relationship with fibrosis and focal degeneration in chronic hepatitis C. Necro-inflammation seen in liver biopsy is host immune reaction to hepatitis C virus and is not related to steatosis

Effects of amlodipine besylate on spermatogenesis in sprague dawley rats

To determine the effects of chronic treatment with amlodipine besylate on spermatogenesis in Sprague Dawley rats. Quasi experimental study. The study carried out in the department of Physiology, Army Medical College Rawalpindi in collaboration with the department of Pathology, Army Medical College and National Institute of Health, Islamabad during April 2007 and March 2008. Thirty male Sprague Dawley rats were divided into two groups; each comprising of 15 rats. Group A was given vehicle whereas group B was given amlodipine besylate [norvasc] by oral and gavage for 50 days along with standard rat diet. Testes were removed 24 h after the last experimental day and sectioned. The sections were stained by hematoxylin and eosin and examined microscopically. Results were analyzed on SPSS version 13. There were significant differences in mean tubular diameter and height of germinal epithelium of testes between amlodipine and vehicle treated rats. Long term treatment with amlodipine besylate [norvasc] results in suppression of spermatogenesis in male rats

Liver biopsy in chronic hepatitis C: An assessment of inter and intra-observer's variability

To evaluate the inter and intraobserver variability in the histological grading and staging according to modified Knodell scoring system. A cross-sectional comparative study. Histopathology department Army Medical College, Rawalpindi, Pakistan from June 2006 to December 2006, at the Slides and original reports of already reported chronic hepatitis C cases were retrieved from the case files. A total of 52 liver biopsies of patients were reevaluated by two pathologists. The inter and intraobserver reproducibility for grade of necroinflammation and stage of fibrosis were calculated by using kappa statistics. For grades of necroinflammation a substantial level of interobserver [kappa=0.802] and intra-observer [kappa= 0.749] reproducibility was found. Disagreement in the interobserver results was detected in 11.5% cases, with difference of only one grade in all the cases. Disagreement in the intraobserver diagnosis was noted in 15.4% cases, again with the difference of only one grade of necroinflammation. Similarly for the stage of fibrosis, a substantial level of interobserver [kappa= 0.66] and intra-observer [kappa=0.77] reproducibility was present. Main disagreement for interobserver results was of stage 2 and 3 fibrosis. For intraobserver stage of fibrosis, disagreement was found in 9 cases [17.3%]. There was disagreement in 6 of the 9 cases with fibrosis stage 3, where original histological stage was reported 4. There were 3 [5.8%] cases where presence of steatosis was missed [all in non-tabulated form of reports]. Substantial level of inter and intra-observer agreement can be achieved, both for the necroinflammatory grade and stage of fibrosis, if the scoring system of chronic hepatitis is strictly followed