Correlation of Cytomorphology with Flowcytometric Immunophenotyping of Acute Myeloid Leukemia in Tertiary Care Hospital

Introduction: WHO classification utilizes morphology,genetic information, immunophenotyping, biologic andclinical features to define specific disease entity. Althoughit gives an accurate detailed diagnosis, immunophenotypingby flow cytometry gives an immediate prompt diagnosis.Morphological diagnosis for leukemias may sometimes be notcorrelating with flow cytometry diagnosis. Study objectiveswere to correlate morphological and flowcytometric results ofpatients diagnosed with acute myeloid leukemias.Material and methods: Study was conducted in departmentof pathology. Cases were classified as Acute leukemia basedon CBC, peripheral smear, bone marrow morphology, specialstains cytochemistry and Flow cytometry Immunophenotyping.Categorization was done based FAB system.Results: Total 92 cases of AML were diagnosed oncytomorphology, cytochemistry and Flow cytometry werestudied. Out of which M0 were 6.5%, M1-13%, M2-27.2%,M3-17.4%, M4-15.2% and M5 were 20.6%. There was 88%correlation between cytomorphology and flowcytometry.Conclusion: Interpretation of immunophenotyping byflowcytometry, done in close conjunction with morphology,is mandatory for appropriate diagnosis of acute myeloidleukemia. However morphology combined with cytochemistryis also very helpful in the diagnosis of AML if facility offlowcytometry is not available

National Vitamin A Prophylaxis Programme: need for change in current age strategy.

Child survival and Safe Motherhood Programme emphasises on giving vitamin A prophylaxis upto three years of age only, contrary to earlier practice of its administration upto six years of age, based on the assumption of reduction of serious manifestations of vitamin A deficiency three years of age onwards. A cross-sectional study enrolling 1094 children was done to investigate vitamin A deficiency in under six children in urban slums of Nagpur city in Central India in post CSSM scenario. Clinical as well as subclinical (detected by abnormal conjunctival impression cytology) assessment of vitamin A status was performed according to standard procedures, as per WHO recommendations. The overall prevalence of xerophthalmia was 8.7%. Only milder manifestations of xerophthalmia were observed. Significantly higher prevalence of xerophthalmia was observed in more than three years of age. Although nonsignificant, higher prevalence of subclinical vitamin A deficiency was observed in above three years of age group. In view of current age strategy for vitamin A supplementation (< or = 3 years) and observed higher prevalence of clinical and subclinical vitamin A deficiency above three years of age in this study (also endorsed by earlier studies) a call for review of current age strategy for vitamin A supplementation is warranted.

Subclinical vitamin A deficiency in undersix children in Nagpur, India.

The present cross sectional study was carried out to estimate prevalence of subclinical vitamin A deficiency among undersix children by using conjunctival impression cytology in urban slums of Nagpur city in central India. The study population included 308 non-xerophthalmic undersix children selected randomly. Conjunctival impression cytology was performed by standard procedure. Out of 308 children 110 (35.7%) had subclinical vitamin A deficiency. Increasing prevalence of subclinical vitamin A deficiency was non-significantly associated with advancing age. Higher prevalence of subclinical vitamin A deficiency was observed in severely malnourished children. The prevalence of subclinical vitamin A deficiency observed in this study (35.7%) is much more than the criteria laid down by WHO, which warrants community wide intervention. This problem assumes more significance because they are apparently healthy and if timely vitamin A supplementation is not given, any intercurrent infection is likely to worsen the vitamin A status and result in known consequences of xerophthalmia.

Malignant transformation of plantar ulcers in leprosy.

Malignant transformation of plantar ulcers in leprosy is not uncommon. The apparent rarity of these neoplasms could be because many observed cases are not reported. To determine the extent of the problem, 133 consecutive cases of plantar ulcers seen over two years were studied clinically as well as histologically. Plantar ulcers were more common in the distal third of foot (64.67%) but malignant transformation was seen more often in plantar ulcers of proximal third of foot (64.29%). Malignant transformation was more common in plantar ulcers of long duration. Histologically, most of the lesions were benign, being instances of pseudo-epitheliomatous hyperplasia (57.89%) or atypical pseudo-epitheliomatous hyperplasia (13.53%). However, squamous cell carcinoma was observed in 10.53% cases. Thus it may be that more cases with this complication will be detected if it is borne in mind that malignant change may be encountered in such ulcers.