ABSTRACT
Objective: to determine the frequency of IgA nephropathy presenting at a tertiary care hospital
Study Design: a cross sectional, observational study
Place and Duration of Study: Pakistan Institute of Medical Sciences, Islamabad and Shifa International Hospital, Islamabad, Pakistan, from November 2008 to November 2014
Methodology: this was a retrospective analysis of renal biopsies for the diagnosis of nephropathy during the study period. Biopsies were stained with fluorescence isothyocyanate [FITC] labelled antibodies against IgG, IgA, IgM, C3, C4 and C1q for fluorescent microscopy. For histopathological examination, the specimens were stained with hematoxylin and eosin, Periodic acid Schiff and methanamine silver stains for light microscopy
Results: out of total 1,658 renal biopsy cases, 142 [8.6%] were diagnosed as IgA nephropathy on light and immunofluorescence microscopy. Majority of IgA nephropathy patients were young [mean age = 33.2] and presented with proteinuria. The frequency rose from 2% in 2008 to 9.4% in 2014
Conclusion: IgA nephropathy was present in younger population and has a rising trend in our population
ABSTRACT
Objective: This audit was carried out principally to assess adherence of histopathological reporting of colorectal cancer cases at Shifa International Hospital [SIH], Islamabad to the College of American Pathologists [CAP] Protocol
Materials and Methods: The audit sample includes 100 cases of colorectal cancer identified via large biopsies. The cases were retrospectively collected from 30-11- 2014 to 04-06-2012 using Oracle software. Reaudit was done from 01-06-2015 to 30-09-2015 and included 09 cases of colorectal cancer
Results: Out of a total of 9 macroscopic features specimen type was mentioned in 100% of reports. 3 parameters [procedure, specimen length and tumor site] were mentioned in more than 90% reports.Macroscopic tumor perforation was mentioned in 84% reports and tumor size in 62% reports. Macroscopic intactness of mesorectum was mentioned in 87% of cases. Out of a total of 24 microscopic features histological tumor type was mentioned in 100% reports. Tumor grade, pathological stage and lymph node involvement was mentioned in more than 90% of reports. Status of proximal and distal margin was given in 99% of reports; however status of radial margin was mentioned in only 92% of reports. Features suggestive of microsatellite instability were mentioned in less than 20% of cases. Reaudit was carried out after an interval of 06 months which showed marked improvement
Conclusion: Audits play an important part in improving the quality of histopathological reporting. Continuous medical education and frequent audits should be imparted so that we as pathologists can learn from our mistakes and play proactive part in better patient management
ABSTRACT
To study the spectrum of histopathological findings in live donor liver graft biopsies. Case series. Histopathology Department, Shifa International Hospital, Islamabad, from January 2011 to March 2014. The biopsies were received in formalin and routinely processed. The changes encountered were divided into three categories: [i] new-onset post liver transplantation [LT] complications [early and late], [ii] acute rejection and [iii] recurrence of original disease. Banff schema 1997 of rejection activity index [RAI], modified histological activity index [mHAI] and recent literature were utilized for evaluation. The results were finalized in the light of clinical details along with relevant laboratory investigations and radiological findings. Seventy eight percutaneous hepatic graft biopsies of 59 patients were evaluated. Among them, findings noticed in descending order of frequencies were Acute Cellular Rejection [ACR] in 37% [n=30], recurrent hepatitis C [HCV] in 22% [n=18], cholestasis/ductular proliferation in 27% [n=22], ischemic/reperfusion injury in 9.8% [n=8] and drug-induced liver injury in 3.7% [n=3]. In the first six months post LT, ACR was the commonest cause of graft dysfunction, while recurrent HCV was noticed to be predominant reason after 6 months. In this study, ACR was the most frequent finding in graft biopsies, followed by recurrent HCV. However, in first six months, ACR is the commonest histopathological finding while recurrent HCV was more frequently documented after 6 months