Diagnostic utility of C-kit protein [CD117] expression in differentiating adenoid cystic carcinoma and polymorphous low grade Adenocarcinoma

Background and Objective: To evaluate usefulness of immunohistochemical marker C-kit [CD117] in differentiating Adenoid cystic carcinoma [AdCC] from Polymorphous low-grade adenocarcinoma [PLGA] in patients of salivary gland carcinomas. AdCC is a malignant salivary gland neoplasm with poor prognosis. PLGA is a salivary gland malignancy with indolent growth pattern. Differentiating between the two entities is a diagnostic challenge. We evaluated the role of C-kit in differentiating the two

Methods: This is a Cross sectional study.Samples of 19 tumors including 12 AdCC and 4 PLGA was evaluated at Department of Histopathology, Armed Forces Institute of Pathology, Rawalpindi from December 2015 to August 2016.Immunohistochemical techniques were used to analyze the level of c-kit expression in AdCC [n = 12], polymorphous low-grade adenocarcinoma [PLGA] [n = 6]. Samples were stained using monoclonal antibody against C-kit. Statistical analysis of the data was done using SPSS version 21

Results: Strong diffuse cytoplasmic reactivity was observed in more than 50% of the tumor cells of AdCC whereas less than 20% of cells showed negative to weak positivity in PLGA. Hence, the difference in the expression of c-kit between AdCC and PLGA was statistically significant [p value <0.002]

Conclusions: CD117 expression itself can be used as a marker in differential diagnosis of salivary gland neoplasms. However, the percentage of the CD117 immunoreactive cells and the staining intensities appeared to be important factors in distinguishing AdCC from PLGA

Immunohistochemical expression of Alpha Methylacyl-Coa Racemase [AMACR] in carcinoma prostate in Pakistani population

Objective: To determine the frequency of expression of positive diagnostic marker alpha methylacyl-COA RACEMES [AMACR] in the examination of prostate needle biopsy specimens from patients of adenocarcinoma prostate from a subset of Pakistani population

Study design: Cross-sectional study

Place and Duration of Study: Department of Histopathology, Armed Forces Institute of Pathology, Rawalpindi from Apr 2015 to Oct 2015

Material and Methods: All specimens of adenocarcinoma prostate diagnosed at Armed forces institute of pathology on the basis of immunohistochemistry and routine histopathology irrespective of age of patient, histological type or grade of the tumor were analyzed. Mean and Standard deviation were calculated for quantitative variables like patient's age and frequencies along with percentages were calculated for qualitative variables like AMACR expression

Results: Out of the total 80 cases, 68 [85%] were positive for AMACR while 12 [15%] were negative. Among the cases that were negative 9 [11.3%] showed 1 +/- staining [Weak, non-circumferential] and 3 cases [3.8%] displayed 0 staining [No cytoplasmic staining]

Conclusion: Positive staining for AMACR can be used to support a diagnosis of cancer on prostate needle core biopsies when the focus in question is <1mm in maximum dimension. The results of AMACR expression in a subset of Pakistani population are comparable to the western studies. AMACR staining must be interpreted in the context of basic haematoxylin and eosin criteria for malignancy along with the results expansion of other supportive markers, such as a basal cell specific marker like p63 or 34betaE12

Efficacy of early oral refeeding in patients of mild acute pancreatitis

Objective: To compare Early Oral Refeeding [EORF] with Routine Oral Refeeding [RORF] on outcome of patients of mild Acute Pancreatitis [AP] in terms of Mean Length of Hospital Stay [LOHS]

Methods: This randomized controlled trial was conducted at Surgical Department CMH Rawalpindi, from 1[st] Feb 2015 to 01st Aug 2016. A total of 60 patients with pain epigastrium were enrolled in the study. Severity of pancreatitis was assessed using Glasgow Scale. Patients were randomly divided in two groups. Group-A was started feeding within 12 hours [EORF group] and Group-B after 12 hours [RORF group]. Demographic details and data were recorded on a structured proforma. After discharge, LOHS was measured for both groups and outcome was compared

Results: The groups were comparable with respect to age, sex, etiology, Glasgow Scale, time from onset of pain and Serum Amylase levels at admission. Treatment was standardized according to international guidelines for both groups. The mean LOHS was 7.8 +/- 2.14 days in the Group-A and 10.03 +/- 1.75 days in Group-B. The difference in the mean LOHS between the two groups was statistically significant [p<0.05]

Conclusion: In patients of mild acute pancreatitis, early oral feeding is feasible and safe and has better outcome then those with routine oral refeeding

Common transfusion-transmitted infectious agents among thalassaemic children in Bangladesh.

Transfusion-dependent children are more prone to acquiring various transfusion-transmitted infections (TTIs), such as hepatitis B (HBV), hepatitis C (HCV), HIV, and others. Since the magnitude of these infections among thalassaemic children in Bangladesh is not well-known, this study was conducted to assess the prevalence of TTIs among them (who received more than three blood transfusions) compared to their age- and sex-matched controls (non-thalassaemics and those who had never had a transfusion). Seromarkers for HBV, HCV, HDV, Treponema pallidum, and HIV were tested, and the results were analyzed using SPSS/Windows 10.5. Of 259 children studied, 152 (58.69%) were thalassaemic (mean age 6.8 +/- 3.6 years), and 107 were controls (mean age 6.7 +/- 3.53 years). The HBV and HCV-markers were found significantly more often among multi-transfused thalassaemic children than among the controls in terms of HBsAg (13.8% vs 6.5%, p < 0.04), anti-HBc total (39.5% vs 9.4%, p < 0.0001), and anti-HCV (12.5% vs 0.9%, p < 0.0001). HBeAg did not differ (p = 0.82) between the thalassaemics (9.52%) and the controls (14.28%), whereas anti-HBe differed (0% vs 57.14%, p < 0.003). Neither the thalassaemics nor the controls were positive for HDV, HIV, or T. pallidum. Since more thalassaemic children acquired hepatitis B and C infections through multiple blood transfusions, it is recommended that the safe blood-transfusion programme be strengthened and mass vaccination against HBV (even who suffer from HCV) in Bangladesh be undertaken.

Zinc in CSF of patients with febrile convulsion.

OBJECTIVE: This prospective study was carried out from July-December 1999 to see the status of zinc in CSF of children with febrile convulsion and to compare this to that of control. METHODS: Forty-two cases of febrile convulsion and 30 controls (fever without convulsion) were enrolled into the study. CSF zinc was estimated by atomic absorption spectrophotometry (AAS) in Atomic Energy Center, Dhaka and compared between the two groups. RESULTS: The mean zinc level in CSF in the study sample was 40.19mgm/L and that in control was 74.98mgm/L. This difference was statistically significant (p<0.001). CONCLUSION: The study concludes that a significantly lower of zinc exists in CSF of children with febrile. However no relationship was found between CSF zinc status with age, sex, degree & duration of fever and time of lumbar puncture after convulsion.