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Introduction: Oral cancers are the most serious health issues in underdeveloped countries such as India and considered as the main cause of death. Among them, oral squamous cell carcinoma is the most common type (90%) of all malignancies. Various oral potential malignant lesions (OPMLs) can transform into malignancies. This study was conducted to determine the significance of Ki‑67 expression in oral potential malignant and malignant lesions (MLs) as well as correlation of mitotic index (MI) with MIB‑1 labeling index (LI) in these lesions. MaterialsandMethods: The study was performed on 60 cases in a tertiary care center over a period of 2 years. Ki‑67 expression, MI and MIB‑1 LI were calculated and correlated. Results: In the studied population, there were 49 (81.7%) males and 11 (18.3%) females. The mean age was 46.60 ± 9.94 (23–68 years), with majority of patients in 41–60 years of age group (46/60 cases). Anterior 2/3rd tongue is the most affected site, presented ulcer as the most common lesion. Smoking, tobacco, and betel nutchewing addiction were presented in 72% of the patients. Among 60 cases, 45 (75%) were OPMLs, while 15 (25%) cases were MLs. MI increases in OPMLs and MLs and comparison was significant (P < 0.01). MIB‑1 LI was significant (P < 0.01) on comparison to dysplasia III and MLs. A positive correlation (0.01) was established between MI and MIB‑1 LI of OPMLs and MLs. Conclusion: Ki‑67 expression was found correlated with the progression of disease from OPMLs to MLs. Therefore, it is considered a proliferative marker that corresponds with disease progression. Both proliferative indices (MI and MIB‑1 LI) are positively correlated
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Background: COVID‑19 virus, causing severe acute respiratory illness (SARS‑CoV‑2), was declared as a pandemic by the WHO in March 2020, after its first outbreak in China at the end of 2019. The major purpose is to establish the role of a hematological and inflammatory markers in early diagnosis of COVID‑19 illness and its relationship with the disease severity. Materials and Methods: The study was performed in a tertiary care center from April to September 2020. The study included 150 hospitalized COVID‑19 Reverse transcription‑polymerase chain reaction positive patients. According to ICMR standards, research patients were grouped into mild, moderate, and severe categories depending on clinical evaluation. Different laboratory parameters complete blood counts, prothrombin time (PT), activated partial thromboplastin time (APTT), d‑dimer, serum ferritin, C‑reactive protein (CRP), and mean results are compared among the patient in three disease severity groups. Results: In the studied population, there were 106 (70.7%) males and 44 (29.3%) females. The average age of the research participants was 48.40 ± 11.50 (21–75 years), with majority of patients being old (>60 years). Hematological markers such as total leukocyte count, Neutrophil‑to‑lymphocyte ratio (NLR), and platelet lymphocyte ratio (PLR) and the levels of PT, APTT, and D‑dimer, as well as ferritin and CRP, all were considerably high with different groups of disease severity (P = 0.001). Conclusion: The study concluded that patients of severe disease category have significantly higher levels of leukocytosis, neutrophilia, elevated NLR, PLR, PT, APTT, D‑dimer, serum ferritin, and CRP. Hematological and coagulation symptoms are associated with COVID‑19 illness, and these indicators might be employed as a prognosticator for prediction of early disease severity.
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Objective: The spectrum of lesions diagnosed by fine needleaspiration cytology with routine & special stains and it’scorrelation with radiological findings.Materials & Methods: The study is performed on a total ofhundred (100) patients over duration from February 2017 toSeptember 2018. The data was collected in cytopathologysection of TMMC & RC from the patients referred from OPDsor was admitted through the period of study.Results: Among 100 FNAC cases, 36(36%) had NecrotizingGranulomatous Lymphadenitis, 23(23%) had GranulomatousLymphadenitis, 20(20%) had Reactive Lymphadenopathy, 6%had suppurative lymphadenitis & 2% had Necrotic Lymphnode, 10(10%) had Metastatic Squamous cell carcinoma,2(2%) had Hodgkin Lymphoma, 1(1%) had Non – HodgkinLymphoma.Conclusion: Our study concluded that FNAC is a minimallyinvasive, cost effective and rapid diagnostic tool. When used inconjunction with radiology for the diagnosis oflymphadenopathy FNAC can be a cost effective method
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Background: Psoriasis is a multifactorial chronic relapsing inflammatory dermatological disorder associated with significant comorbidities. It is characterized by sharply demarcated, erythematous papules, and plaques with abundant silvery-white scales. Due to its variable clinical presentation, histopathology remains the mainstay of diagnosis. However, these histologic features changes with treatment and may also guide in therapeutic decision-making. Aim: The aim is to evaluate and compare the histopathological features of psoriatic lesions before treatment with those receiving treatment for psoriasis. Patients and Methods: A total of 101 biopsies from selected consecutive patients of histopathologically confirmed psoriasis vulgaris were included in the study. These cases were then divided into two groups, Group A includes cases who never received treatment and Group B, those receiving treatment for psoriasis. These biopsies were histopathologically analyzed and compared for various morphological features. Results: Of 101 cases of psoriasis, 72 cases were included in Group A and 29 were included in Group B. Biopsies of Group A showed parakeratosis and acanthosis as a common feature in all of them with dilated or abnormal capillary pattern in dermal papillae in 93.1%. In Group B, in spite of uniform parakeratosis as noticed in Group A biopsies, focal parakeratosis was seen in 83.3%, acanthosis in 87.5%, and dilated/abnormal capillary pattern in dermis was observed to be a universal feature in biopsies of Group B. All other microscopic features of psoriasis also decreased in frequency in Group B. However, statistically significant difference is seen only in changes in morphological features of superficial epidermis that is, parakeratosis, acanthosis, and absent or decreased granular layer in both the groups. Conclusion: Treatment may lead to improvement in the histologic features in epidermis with significant difference in few of them. However, abnormal vasculature in the dermal papillae persists and does not show any improvement with therapy.
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Background: The Rh blood group system is one of the most polymorphic systems in human. Following the discovery of the ABO blood group systems, the greatest breakthrough in transfusion medicine was the discovery of the Rh antigen. . The most common and immunogenic are D, C, E, c and e. The RhD blood group antigen has been shown to be subject to many phenotypic variations. The “weak D” actually refers to red cells with the aberrant Rh-D protein expressing reduced membrane surface D antigen. There is one misconception that individuals with weak phenotypes cannot make anti-D in contrast to partial D because they have low levels of complete D antigen. Methods: Commercially available monoclonal anti D sera was used to detect Rh-D factor status. Individuals found negative with saline anti-D were further investigated and confirmed for weak D antigen by using anti human globulin serum (Indirect Coomb’s technique). Results: During this study 19,347 healthy blood donors were tested for Rh-D factor status. Among these 17,295(89.4%) were Rh-D factor positive while 2052(10.6%) donors were Rh-D factor negative. Among the Rh-D factor negative individuals, 4(0.19%) were weak D positive. Conclusion: It is important to detect and determine all RH negative individuals by saline method for the detection of weak D status to reduce the chances of alloimmunization.
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Background: Breast cancer is the leading cause of cancer - related deaths in Asia. The number of intra-nuclear silver stained structures, termed AgNORs, is significantly higher in malignant cells than in normal, reactive or benign cells. The purpose of this study was to evaluate the AgNOR scores in FNA smears of breast lesions and their correlation with histopathology. Aims & Objective: To establish AgNOR staining as a diagnostic and prognostic tool in management of various breast lesions. Methods: This was a prospective study conducted over a period of 18 months may 2015 to November 2016. A total of 100 cases were included in the study. AgNOR stain was done in both cytology and scoring was done and analysed. Results: In FNAC aspirates, Mean AgNOR count ranged from 5 to 9.9 per high power field with a mean value of 2.888±2.553. The AgNOR dots morphology was homogenous, symmetric with regular contours in FNAC slides of benign breast lesion. In malignant breast lesions, the dots were asymmetric with irregular contours and were aggregated, smaller and more scattered. Conclusions: The present study showed that fine needle aspiration cytology is a useful modality for diagnosis of breast lesions. It has a high concordance with the histopathology . AgNOR count assessment provides a useful objective measure for segregation of different grades of tumor with 100% accuracy for detection of higher grade of lesions, as observed in present study. For differentiation of benign from malignant lesions too it has a high sensitivity as well as specificity. The usefulness of FNAC to evaluate nodal involvement also showed a 90% sensitivity and 95.6% specificity. On the basis of present study, it could be concluded that AgNOR count estimation using fine needle aspiration is a useful method to differentiate and diagnose breast lesions.
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Objectives: To assess the comparative as well as collective role of various grey scale (GS) ultrasonography (USG) and color doppler (CD) parameters in distinguishing benign from malignant thyroid nodules. To suggest a scoring system for predicting malignancy in thyroid nodules using this array of parameters. Methods: 140 patients with non palpable thyroid nodules were examined by five GS USG and three CD parameters. The results were compared with histopathological examination and evaluated statistically. Each GS and CD parameter was evaluated individually as well as collectively, comparatively. Total score was calculated by assigning each of these eight parameters a score of 0 to 2. Results: Scoring used in this study showed sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy of 87.5%, 90.6%, 70%, 96.7% and 80% respectively. These parameters were 85.4%, 86.2%, 60%, 96%, 80% for CD and 69.2%, 71.9%, 50%, 85.2% and 64% for GS. Two GS USG features showing p value < 0.05 were poorly defined margins and thick incomplete halo while on CD Resistivity index (RI) was found to be very highly significant (p < 0.0001) and Pulsatility index (PI) was highly significant (p < 0.001). Conclusion: Scoring system proposed in this study proved better than GS or CD individually for predicting malignancy in thyroid nodules. Amongst various GS and CD parameters RI showed highest statistical significance. Overall CD showed better accuracy, sensitivity, specificity than GS USG.
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Background: Palpable breast lumps are quite common which can be benign or malignant. Carcinoma breast is the second most common cancer after cervical cancer. Fine needle aspiration cytology (FNAC) is a minimally invasive, rapid, reliable and cost-effective outdoor procedure to provide effective diagnosis and way to further planning of treatment without need for biopsy. The objective of the study is to study the spectrum of various breast lesions on cytomorphology and its histopathological correlation. Methods: This was a two years retrospective study from June 2014 to May 2016 including 280 cases aspirated from palpable breast lumps. Physical examination of breast lumps by palpation was done. Cytological diagnosis was made and histopathological correlation was done, wherever available. Results: On cytomorphological study of 280 breast lump aspirates 32 (11.43%) were inflammatory lesions, 180 (64.29%) benign, 6 (2.14%) atypical/probably benign, 8 (2.86%) suspicious of malignancy, 46 (16.43%) malignant and 8 (2.86%) were unsatisfactory for evaluation, of these 280 cases, 70 (25%) were available for histopathological examination. The most common benign lesion in the present study was fibroadenoma 115 (41.07%) and the most common malignant lesion was ductal carcinoma 43 (15.36%). Conclusion: Fine needle aspiration cytology is a rapid and reliable tool to provide effective diagnosis in palpable breast lumps. It should be used as routine diagnostic procedure to provide the effective health care to the patients with breast lesions.
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Background: Blood transfusion has profound role to play in specific illness, but still due to unsafe and careless practices the peril of transfusion transmissible infections (TTIs) such as human immunodeficiency virus (HIV), hepatitis C virus (HCV), hepatitis B virus (HBV), syphilis and malaria prevails. Objective: To study the seroprevalence of TTIs in healthy blood donors in specific Kuppuswamy’s socio-economic scale at a Blood Bank of a tertiary care teaching hospital in north India, to enhance the awareness about transfusion related risks and to implement better strategic measures to prevent TTI, in high risk groups. Material and Method: Total 10,569 blood units were collected from Jan-2014 to Septmeber-2015. All donors were categorised according to the Kuppuswamy’s Socioeconomic Status Scale (KSESS) followed by screening of all sera samples for hepatitis B surface antigen (HBsAg), antibodies to HCV, HIV types 1 and 2 using enzyme-linked immunosorbent assays (ELISA) and for malaria antigen and Treponema pallidum by using immunochromatographic tests and Rapid Plasma Reagin test (RPR) respectively. All the samples found reactive for HIV, HBsAg, and HCV were again confirmed by second ELISA. Results: The overall seroprevalence was HCV 2.06 % (218/10569) > HBV 1.71% (181/10569) > HIV 0.03% (3/10569). No donor was found positive for Malaria and VDRL. The prevalence of transfusion transmissible diseases in specific socio economic class was as follows-:Upper lower class (IV) 248/2261 (10.96%) > Lower class (V) 34/483 (7.03%) > Lower Middle class (III) 97/5789 (1.67%) > Upper middle class (II) 22/1552 (1.42%) > Upper class (I) 1/484 (0.20%) and seroprevalence of transfusion transmissible diseases in each socio economic class, out of total donations was as follows-: Upper lower class (IV) 248/10569 (2.35%)> Lower middle class (III) 97/10569 (0.92%) >Lower class (V) 34/10569 (0.32%)> upper middle class (II) 22/10569 (0.21) >Upper class (I) 1/10569 (0.009%). Conclusion: Maximum positive TTIs had association with low socio-economic status people with increased medical and behavioral risk factors. Hence, we conclude that awareness among the high risk population group, strict and skillfulness selection of donors and use of effective laboratory screening tests is the prerequisite for the safe donation!!
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Background: Presently, fine needle aspiration (FNA) biopsy is the preliminary, non-invasive test for diagnosis of suspected lymphadenopathy. Apart from its diagnostic yield, it helps identifying the origin, grading and typing of the metastatic lesions in many cases. Methods: In the present study, data of 369 patients with suspected neoplastic lymphadenopathy presenting to the surgical and medical outpatient department of our institute over a period of 3 years was collected. FNA biopsy was performed on the most prominently visible and palpable lymph node. The use of special stains was performed in selected cases. Results: Of 369 cases studied, cytological diagnosis was offered in 358 cases, while unsatisfactory smears were reported in 11 cases. Of these 358 cases where a cytological diagnosis of either primary or metastatic lymphadenopathy was given, 244 were males and 114 were females. Metastatic tumors in the lymph nodes were reported in 307 cases and lymphoma in 51 cases. The distribution of lymphadenopathy revealed involvement of cervical group in 222 cases, axillary group in 57 cases, supraclavicular in 28 cases & inguinal in 24 cases. The commonest primary tumor, metastasizing to lymph nodes was squamous cell carcinoma (52.44%). Conclusion: In our study, FNA biopsy proved to be a safe and non-expensive technique that provided a high diagnostic accuracy with zero false positive results, confirmed the presence of secondaries where primary tumor was evident and guided the response to medical treatment.