Granulomatous reaction - a histopathological study: a retrospective and prospective study of 5 years.

Background: The present study was done to investigate the prevalence of granulomatous infection among the patients. The study was conducted from the time period of July 2008 to June 2013. The study was conducted at the histopathology laboratory, pathology department, P. D. U. government medical college, Rajkot (Gujarat, India). Methods: In the present study, total 300 cases were studied. Specimens for study were received from various departments like surgery, ENT, medicine, pediatrics etc. from July 2008 to June 2013. The sections of these specimens were taken & slides were prepared by staining with Hematoxylin & Eosin (H&E) for microscopic examination. Results: In present study, most the common granulomatous reaction was tuberculosis and majority of cases were found in among young Hindu males specially in the lower socioeconomical class of rural areas. Conclusion: Our study confirms that the most common granulomatous reaction is tuberculosis, mainly found in skin and more common among the population of lower socioeconomic class & rural population, signifying increasing incidence of granulomation infection. The present study is a comprehensive comparative study of granulomatous reactions done in correlation with the age, sex, involved sites and clinical profile of the patients. This information is valuable in policy formation for the control & specific treatment and outcome of granulomatous infection.

A study of prevalence of HIV, HbsAg and HCV in thalassemia major children.

Background: Thalassemias are a group of congenital anemias that have in common deficient synthesis of one or more of the globin subunits of normal human hemoglobin. They are one of the commonest inherited hemolytic disorders Beta Thalassemias major is the clinically most significant homozygous form resulting in reduced or absent beta chain production.In India there is variable carriage rate in different parts of the country. It is more common in Sindhis, Lohanas, Bhansalis and some tribal communities. State wise Punjab, Gujarat, West Bengal have higher incidence. Mainstay of management of thalassemia is 2-4 weekly packed red cell transfusion. Major complications of this treatment are iron overload and chance of contracting transfusion transmitted infections. Most concern amongst them are HIV infection, hepatitis B and C. Objectives of the study: To determine the prevalence of HIV, Hepatitis B and Hepatitis C in multi transfused thalassemia major children & to find some measures to reduce the risk of transfusion transmitted disease in them. Methods: Blood samples of patients attending thalassemia clinic of paediatric department of the Medical college of Saurashtra region were tested for HIV, HbsAg and HCV after obtaining written consent when they came for receiving blood transfusions.. The samples were tested with standard ELISA kit for detection of HIV 1 and 2, HCV and HbsAg on Biorad automatic ELISA reader and washer. Results: Incidence rate for HIV was 3.1%, HCV was 7.8%& HbsAg was 0.52%.The increased sero positivity coincided with increased number of transfusions. There was simultaneous existence of more than one infection in 2 of the cases. Conclusion: Incidence of HIV positivity has decreased due to mandatory screening of all blood bags, proper selection criteria of donors and use of newer techniques for detection. HCV infection can causes chronic liver disease and increased risk of hepatocellular carcinoma. The low incidence of HbsAg positivity can be correlated with high proportion of the children getting vaccinated. The focus is now on minimizing window period donation. Hence selection of donors is of utmost importance. HIV minipool nucleic acid testing (MP-NAT), HIV-1 p24 antigen testing of donor’s blood.Window period is reduced up to 6 days.