EVALUATION OF SERUM C REACTIVE PROTEIN IN ACUTE APPENDICITIS AND ITS CORRELATION WITH HISTOPATHOLOGY

Background: Acute appendicitis is the most common abdominal surgical emergency, but its diagnosis remains an enigmatic challenge, plagued by a high rate of negative explorations. There is no single reliable test with satisfactory sensitivity and specificity. Ultrasonography is not often available at a rural surgical setup. This study is intended to evaluate the importance Aim: of serum C-reactive protein (CRP) level estimation in diagnosis of acute appendicitis, by comparing with histopathology report. In a Methods: prospective study,100 patients clinically diagnosed as acute appendicitis were selected by purposive sampling method and evaluated as per criteria for serum CRP levels, leucocyte count preoperatively and were followed up postoperatively with histopathology reports. The data was analysed for finding the significance of serum CRP in the diagnosis of acute appendicitis. CRP was positive in 75 of the 77 patients who Results: had histologically proven acute appendicitis and in 3 with normal appendix. The sensitivity, specificity and diagnostic accuracy were 97.4%, 86.96% and 95% respectively. Leucocytosis and neutrophilia when used alone were not specific for acute appendicitis, but when combined with CRP value, diagnostic accuracy was high. Ultrasonography was useful in establishing alternative diagnoses, but had low sensitivity for acute appendicitis. CRP contains important diagnostic information and hence should always Interpretation & Conclusion: be included in the diagnostic workup of acute appendicitis. Since acute appendicitis is very unlikely in those patients with normal WBC count and CRP value, conservative treatment is advised.This study does not undercut the skill of an experienced surgeon in diagnosing acute appendicitis, but CRP estimation compliments clinical diagnosis.

Cancer awareness & its association with demographic variables & mobile phone usage among the rural population of a district in north India

Background & objectives: Lack of awareness is one of the major reasons for the high morbidity and mortality associated with cancers. The present study was aimed to evaluate the awareness of prevalent cancers among the rural population in a district of north India and its association specifically with mobile phone usage. Methods: Using a stratified random sampling technique, households in three villages of Gautam Buddh Nagar district of India were selected. A house-to-house survey on cancer awareness was conducted among adults in selected households and data were analyzed to check for the association of such an awareness with sociodemographic factors and internet usage. Results: The study included 59 males and 145 females, with majority (115) being in the age group of 18-30 yr. Although most (96.5%) of the participants were aware of cancer, the common risk factors and warning signs of cancer were known to only a few. Specific risk factors for cervical and breast cancers were, however, not known to a majority (79.9% and 72.2%). A significant association between the awareness of general risk factors and warning signs as well as specific aspects including risk factors for breast, cervical and oral cancer, HPV vaccine and the education level of the participants (P<0.05 for all). Knowledge of risk factors, warning signs and cancer prevention modalities was higher among mobile phone users who accessed internet for health information. There was no significant association between age group and cancer risk factor awareness, though females were more aware of the risk factors for breast cancer (P=0.002). Interpretation & conclusions: The findings of this study highlight the existing low level of awareness of cervical and breast cancers among the rural population. The association of cancer awareness with education level and mobile phone-based internet usage suggests the potential utility of internet-based platforms such as m-health programmes for cancer prevention activities

Identification of PI3K-AKT signaling as the dominant altered pathway in intestinal type ampullary cancers through whole-exome sequencing

Background@#The genetic landscape of intestinal (INT) and pancreatobiliary (PB) type ampullary cancer (AC) has been evolving with distinct as well as overlapping molecular profiles. @*Methods@#We performed whole-exome sequencing in 37 cases of AC to identify the targetable molecular profiles of INT and PB tumors. Paired tumor-normal sequencing was performed on the HiSeq 2500 Illumina platform. @*Results@#There were 22 INT, 13 PB, and two cases of mixed differentiation of AC that exhibited a total of 1,263 somatic variants in 112 genes (2–257 variants/case) with 183 somatic deleterious variants. INT showed variations in 78 genes (1–31/case), while PB showed variations in 51 genes (1–29/case). Targetable mutations involving one or more major pathways were found in 86.5% of all ACs. Mutations in APC, CTNNB1, SMAD4, KMT2, EPHA, ERBB, and Notch genes were more frequent in INT tumors, while chromatin remodeling complex mutations were frequent in PB tumors. In the major signaling pathways, the phosphoinositide 3-kinase (PI3)/AKT and RAS/mitogen-activated protein kinase (MAPK) pathways were significantly mutated in 70% of cases (82% INT, 46% PB, p = .023), with PI3/AKT mutation being more frequent in INT and RAS/MAPK in PB tumors. Tumor mutation burden was low in both differentiation types, with 1.6/Mb in INT and 0.8/Mb in PB types (p =.217). @*Conclusions@#The exome data suggest that INT types are genetically more unstable than PB and involve mutations in tumor suppressors, oncogenes, transcription factors, and chromatin remodeling genes. The spectra of the genetic profiles of INT and PB types suggested primary targeting of PI3/AKT in INT and RAS/RAF and PI3/AKT pathways in PB carcinomas.

Identification of PI3K-AKT signaling as the dominant altered pathway in intestinal type ampullary cancers through whole-exome sequencing

Background@#The genetic landscape of intestinal (INT) and pancreatobiliary (PB) type ampullary cancer (AC) has been evolving with distinct as well as overlapping molecular profiles. @*Methods@#We performed whole-exome sequencing in 37 cases of AC to identify the targetable molecular profiles of INT and PB tumors. Paired tumor-normal sequencing was performed on the HiSeq 2500 Illumina platform. @*Results@#There were 22 INT, 13 PB, and two cases of mixed differentiation of AC that exhibited a total of 1,263 somatic variants in 112 genes (2–257 variants/case) with 183 somatic deleterious variants. INT showed variations in 78 genes (1–31/case), while PB showed variations in 51 genes (1–29/case). Targetable mutations involving one or more major pathways were found in 86.5% of all ACs. Mutations in APC, CTNNB1, SMAD4, KMT2, EPHA, ERBB, and Notch genes were more frequent in INT tumors, while chromatin remodeling complex mutations were frequent in PB tumors. In the major signaling pathways, the phosphoinositide 3-kinase (PI3)/AKT and RAS/mitogen-activated protein kinase (MAPK) pathways were significantly mutated in 70% of cases (82% INT, 46% PB, p = .023), with PI3/AKT mutation being more frequent in INT and RAS/MAPK in PB tumors. Tumor mutation burden was low in both differentiation types, with 1.6/Mb in INT and 0.8/Mb in PB types (p =.217). @*Conclusions@#The exome data suggest that INT types are genetically more unstable than PB and involve mutations in tumor suppressors, oncogenes, transcription factors, and chromatin remodeling genes. The spectra of the genetic profiles of INT and PB types suggested primary targeting of PI3/AKT in INT and RAS/RAF and PI3/AKT pathways in PB carcinomas.

Postoperative fever in patients undergoing elective surgeries-etiology, investigations, management: a longitudinal study

Background: Fever is rise in core body temperature above normal diurnal variations. Surgical procedures often disturb normal physiological process and one such manifestation is rise in body temperature. Present study was conducted to study the etiology of post-operative fever, correlation of etiology of fever with post-operative day of onset of fever and to study the investigations of postoperative fever.Methods: This study was conducted over a period of 24 months from 1st November 2017 to 31st October 2019 at Department of Surgery at a tertiary care hospital. A total of 339 patients were enrolled. Data analysis done using descriptive statistics and continuous variables were analyzed using Chi square test.Results: Out of 339 patients of post-operative fever, 207 patients (61%) were in age group of >20-50 years. Mean age was 44.56 years. Male to female ratio was 1.4:1. Maximum incidence of fever were seen after spinal anesthesia. It was observed that the incidence increases as the operative time increases. Incidence were more during months of summer. Around 88.49% developed pyrexia within 48 hours of surgery where no detectable infection was noted. Rest 11.5% had fever after 48 hours of surgery where the causes were UTI (7.4 %), superficial thrombophlebitis (6.8%) or SSI (4.7%). None developed chest infections or DVT.Conclusions: Fever in postoperative period is common in elective clean surgical procedures, likely due to surgical trauma in the first 2 days and patients should be closely monitored. Fever after 48 hours should be investigated for the cause and treated accordingly.

Comparative modeling of sodium- and chloride-dependent GABA transporter 1 and docking studies with natural compounds

Epilepsy is a chronic neurological disorder that causes uncontrolled seizures which can affect the bodyphysically and psychologically. When a person experiences seizure, it is very difficult for them to breathe andthey bite their tongue as a reflex. Glutamatergic and gamma-aminobutyric acid ergic (GABAergic) transmissionin the brain causes seizures. The immature brain is more prone to seizures than the adult brain. Gene SLC6A1produces GABA1 protein which helps in reuptake of GABA from the synapse. Presently in this study, proteinmodeling and molecular docking were performed on protein sequence sodium- and chloride-dependent GABAtransporter 1 that was retrieved from uniport. MODELLER 9.21 versions were used to develop a homologymodel. X-ray structure of Drosophila dopamine transporter in complex with cocaine (4XP4) from speciesDrosophila melanogaster was used as a template. Autodock4.2, a docking software, was used for moleculardocking studies. Against the modeled protein, 22 natural compounds were docked. According to the results,natural compounds like Morusin showed high binding energy against modeled protein than standard drugs.

Development and validation of stability indicating LC-MS/MS Technique for the quantification of tapentadol in biological matrices: Application to bioavailability study in healthy rabbits

An Liquid chromatography tandem mass spectrometry (LC-MS/MS) technique is one of the best analytical methods for thequantification of drugs in biological samples. A stability-indicating analytical technique was developed for the quantitationof tapentadolin biological matrices as tapentadol with short runtime. Developed technique also suitable for bioavailabilitystudies in healthy rabbits. Separation of tapentadol and tapentadol-d3 were achieved from plasma sample with solid-phaseextraction and elution was processed with Luna-C18 (5 μ, 100 mm × 4.6 mm) stationary column with movable phase ratiocomprising 2-mM ammonium acetate buffer (pH-3.6) and acetonitrile in the proportion of 10:90 % V/V. Quantitationwas processed by processing the transitions of tapentadol and tapentadol-d3 at m/z 222.2 → 177.1 and 228.2 → 183.1,respectively, in positive ionization mode. Linearity was performed over the concentration range of 0.121 to 35.637 mg/ml(R2 > 0.99) without matrix effect (2.74%). The inter- and intra-day precision findings were within 8.62% and 11.38%,respectively. Stability data showed that the tapentadol was stable when it exposed to different stability conditions. Thistechnique was effectively applied to bioavailability studies of tapentadol in healthy rabbits

Development And Validation Of Sensitive Lc-Esi-Ms/Ms Method For The Simultaneous Estimation Of Dapagliflozin And Saxagliptin In Human Plasma

Objective: To develop and validate a sensitive liquid chromatography-electrospray ionization-tandem mass spectrometric (LC-ESI-MS/MS) technique for the quantification of dapagliflozin and saxagliptin in plasma by linagliptin as internal standard. Methods: Chromatography was achieved on hypersil C18 (50 mmx4 mm) 5 µ analytical column with 0.1% formic acid and acetonitrile (25:75 V/V) as mobile phase at 0.7 ml/min flow rate. Dapagliflozin, saxagliptin, and linagliptin were detected at m/z 409.14/135.0, m/z 316.2/180.13 and m/z 472.54/456.21 respectively. Drugs and internal standard were extracted by LLE (liquid-liquid extraction). Results: Developed technique was validated over 0.5-1500.0 ng/ml linear concentration range for dapagliflozin and 2.00-2000.0 ng/ml for saxagliptin. This method established with intra-batch and inter-batch precision within 2.44-8.12% and 1.25-7.14 % for dapagliflozin and 1.84-7.5 % and 1.02–6.00 % for saxagliptin. This method established with intra-batch and inter-batch accuracy for dapagliflozin within 98.86-103% and 96.98-102 % respectively and for saxagliptin within 98.05-109.06 % and 97.00-104.00 % respectively. Conclusion: Both dapagliflozin and saxagliptin were stable during three freeze-thaw cycles, long term and bench-top stability studies. The developed method was useful for the routine analysis of dapagliflozin and saxagliptin simultaneously in plasma samples.

Assessment of health related quality of life of asthma patients in a tertiary care teaching hospital

Background: The present study is planned to assess the health related quality of life (HRQoL) in asthma patients by using HRQoL questionnaire (SF-36 v2).Methods: A prospective observational study was conducted for a period of 6 months (September 2017 to February 2018) in Navodaya Medical College Hospital and Research Centre, Raichur on a total of 108 patients of either sex suffering from persistent asthma. The HRQoL of asthma patients was measured by face-to-face interview using HRQoL questionnaire (SF-36v2).Results: Female patients were found to be more affected with asthma compared to male patients and the prevalence of asthma is found to be more in the middle aged and elderly patients compared to adults. The important triggering factors for the asthma were found to be exposure to dust, smoking, alcohol and cooking fuel. The mean physical component summary (PCS) scores is 47.46 (±15.56) and the mean mental component summary (MCS) scores is 66.73 (±13.59). The findings of our study reveals that the physical HRQoL is more affected compared to mental HRQoL as revealed by PCS and MCS scores.Conclusions: The findings of our study conclusively suggest that the physical HRQoL is more affected than mental HRQoL in asthma patients and also the need to improve the quality of life in these patients by appropriate patient education regarding the triggering factors of asthma, preventive measures and the medication adherence.

Evaluation of Anti-inflammatory and Regenerative Efficiency of Naringin and Naringenin in Degenerated Human Nucleus Pulposus Cells: Biological and Molecular Modeling Studies

STUDY DESIGN: Development of an in vitro model for assessing the anti-inflammatory efficacies of naringin (Nar) and naringenin (NG).PURPOSE: To evaluate the efficacy of natural flavonoids as therapeutic drugs against anti-inflammatory processes in the nucleus pulposus (NP) cells using in-vitro and in-silico methods.OVERVIEW OF LITERATURE: Intervertebral disc (IVD) disease is a common cause of low back pain. Chronic inflammation and degeneration play a significant role in its etiopathology. Thus, a better understanding of anti-inflammatory agents and their role in IVD degeneration and pro-inflammatory cytokines expression is necessary for pain management and regeneration in IVD.METHODS: We performed primary cell culture of NP cells; immunocytochemistry; gene expression studies of cytokines, metalloproteases, extracellular proteins, and apoptotic markers using quantitative polymerase chain reaction and reverse transcription-polymerase chain reaction (RT-PCR); cytotoxicity assay (MTT); and molecular docking studies using AutoDock 4.2 software (Molecular Graphics Laboratory, La Jolla, CA, USA) to confirm the binding mode of proteins and synthesized complexes. We calculated the mean±standard deviation values and performed analysis of variance and t-test using SPSS ver. 17.0 (SPSS, Inc., Chicago, IL, USA).RESULTS: Molecular docking showed that both Nar and NG bind to the selected genes of interest. Semi-quantitative RT-PCR analysis reveals differential gene expression of collagen (COL)9A1, COL9A2, COL9A3, COL11A2, COMT (catechol-O-methyltransferase), and THBS2 (thrombospondin 2); up regulation of ACAN (aggrecan), COL1A1, COL11A1, interleukin (IL)6, IL10, IL18R1, IL18RAP, metalloprotease (MMP)2, MMP3, MMP9, ADAMTS5 (a disintegrin and metalloproteinase with thrombospondin motifs 5), IGF1R (insulin-like growth factor type 1 receptor), SPARC (secreted protein acidic and cysteine rich), PARK2 (parkin), VDR (vitamin D receptor), and BCL2 (B-cell lymphoma 2); down regulation of IL1A, CASP3 (caspase 3), and nine genes with predetermined concentrations of Nar and NG.CONCLUSIONS: The present study evaluated the anti-inflammatory and regenerative efficiencies of Nar and NG in degenerated human NP cells. Altered gene expressions of cytokines, metalloproteases, extracellular proteins, apoptotic genes were dose responsive. The molecular docking (in silico) studies showed effective binding of these native ligands (Nar and NG) with genes identified as potent inhibitors of inflammation. Thus, these natural flavonoids could serve as anti-inflammatory agents in the treatment of low back pain and sciatica.

Histopathological Study of Skin Adnexal Tumors – A Ten Years Study

Background: Adnexal tumors of skin are uncommon in routine practice and may cause diagnostic problems clinically. Presence of Multiple tumors can be considered as marker for visceral malignancy e.g. multiple trichilemmoma-breast malignancy. Adenexal tumors of the skin are classified into four groups. Aim: To correlate skin adenexal tumors with age, sex and location and incidence in the Department of Pathology, Gandhi Hospital, Hyderabad. Materials and methods: Total number of cases was 136, during study period from April 2007 to March 2017 (ten years) in present study. All slides stained with routine Hematoxylin and Eosin and special stains accordingly. Results: Total number of Adenexal tumors were 136; benign tumors were 134 (98.4%), malignant tumors were 02 (1.6%), Largest group was sweat gland tumors (42.1%) e.g. chondroid syringoma, eccrine poroma, syringo cystadenoma papilleferum, hair follicle tumors (35.4%) e.g. trichoepithelioma, pilomatricoma and sebaceous adenoma and sebaceous carcinoma. Undifferentiated and others (21%) e.g. benign trichogenic tumors were also noted. Conclusion: The incidence of benign skin adenexal tumors was more as compared with the malignant tumors. Malignant tumors were seen predominantly in elderly

Phytochemical investigation, antioxidant and wound healing activities of Citrullus colocynthis (bitter apple)

Objective: To undertake metabolite profiling of various plant parts of Citrullus colocynthis, and assess antioxidant and wound healing activities of fractions for therapeutical applications. Methods: Extracts from leaves, stem, root, fruit pulp and seeds were analyzed using gas chromatography-mass spectrometry and high performance liquid chromatography. Variation in antioxidant potential was assayed by 1,1-diphenyl-2-picrylhydrazyl (DPPH) free radical scavenging assay. The extract with highest antioxidant potential was subjected on in-vivo wound healing activity using excision wound model. Results: Metabolite profiling of Citrullus colocynthis identified 70 chemically diverse metabolites from different plant parts by using a combination of GC-MS and HPLC. Concentration of colocynthin, a principal active secondary metabolite, ranged from 3.15 mg/g dry weight to 242.00 mg/g dry weight, the lowest being in leaves and highest in fruit pulp. DPPH radical scavenging activity of free radical (IC50) ranged from 196.44 μg/mL in fruit pulp to 413.33 μg/mL in leaves tissues. Significant wound contraction and increase in hydroxyproline content of granulation tissue were observed with ointment formulated from methanolic extract of fruit pulp. Conclusions: The study indicates that the methanol extract of Citrullus colocynthis fruit pulp when applied topically may promote wound contraction in rat model attributable to the accumulation of colocynthin. The high quantity of colocynthin (242.00 mg/g dry weight) and substantial concentration of 2,4-di-tert butyl phenol (3.2％), squalene (4.2％) and δ-tocopherol (2.5％) make this plant to provide new opportunities for development of medicinal, nutraceutical and dietary supplements with optimized functionality.

Phytochemical investigation, antioxidant and wound healing activities of Citrullus colocynthis (bitter apple)

Objective: To undertake metabolite profiling of various plant parts of Citrullus colocynthis, and assess antioxidant and wound healing activities of fractions for therapeutical applications. Methods: Extracts from leaves, stem, root, fruit pulp and seeds were analyzed using gas chromatography-mass spectrometry and high performance liquid chromatography. Variation in antioxidant potential was assayed by 1,1-diphenyl-2-picrylhydrazyl (DPPH) free radical scavenging assay. The extract with highest antioxidant potential was subjected on in-vivo wound healing activity using excision wound model. Results: Metabolite profiling of Citrullus colocynthis identified 70 chemically diverse metabolites from different plant parts by using a combination of GC-MS and HPLC. Concentration of colocynthin, a principal active secondary metabolite, ranged from 3.15 mg/g dry weight to 242.00 mg/g dry weight, the lowest being in leaves and highest in fruit pulp. DPPH radical scavenging activity of free radical (IC

Ecocardiografía transesofágica intraoperatoria para evaluar el defecto tipo Gerbode / Intraoperative transesophageal echocardiography to evaluate a Gerbode defect

The Gerbode Defect is a rare form of intracardiac shunt from the left ventricle to the right atrium resulting from a defect in the membranous portion of the inter-ventricular septum. This defect can be congenital or acquired, with acquired causes including complications of aortic valve replacements and endocarditis. Intraoperative real time transesophageal echocardiography and 3D echocardiography are vital for diagnosis and anatomic characterization of the shunt. A thorough understanding of echocardiography is necessary to visualize the shunt across various anatomic planes which aids in surgical correction.

El Defecto de Gerbode es una rara manifestación de la comunicación interventricular del ventrículo derecho a la aurícula derecha, resultante de un defecto en la porción membranosa del tabique inter-ventricular. El defecto en cuestión puede ser congénito o adquirido y entre las causas adquiridas se encuentran complicaciones de los reemplazos de la válvula aórtica y la endocarditis. La ecocardiografía intraoperatoria en tiempo real y la ecocardiografía en 3D son vitales para el diagnóstico y la caracterización anatómica de la intercomunicación. Se hace necesario comprender a fondo la ecocardiografía para visualizar la intercomunicación a través de distintos planos anatómicos, lo cual ayuda a la corrección quirúrgica.

Patterns of respiratory tract lesions – A cytohistopathological analysis

Background: Respiratory tract lesions are commonest for which patients attend the chest clinics. The lesions may be inflammatory or neoplastic. Materials and methods: 594 patients attending to chest clinics and admitted in Government General and Chest Hospital Hyderabad during the period of 2 years from September 2006 to August 2008 were included. All of the patients with clear cut evidence of tuberculosis and pneumonia were excluded from the study. Results: Majority of patients were in the age group of 41-60 years. Youngest patient was 20 years. Males were 443 (74.57%) and females were 151 (25.43%). Commonest presentation was cough with expectoration 567 (94.45%) followed by fever 101 (17.0%), chest pain 84 (14.14%), hemoptysis 57 (9.59%), Shortness of breath 51 (8.58%) and weight loss 34 (5.72%). Conclusion: In the present study even though malignancy was proved with positive cytologic examination by identifying the malignant nature of the cells, the typing of cell was difficult in some cases, but was excellent with squamous cell carcinoma and small cell carcinoma.

Evaluation of causes of deferral of blood donors in blood bank – A study of 2 years at tertiary care hospital blood bank

Background: Millions of patients who are in need of blood transfusion do not have timely access to safe blood. Donor selection is important to ensure safe blood supply. Blood transfusion services (BTS) have the responsibility to collect blood only from donors who are at low risk for any infection that could be transmitted through transfusion and who are unlikely to jeopardize their own health by blood donation. A rigorous process to assess the suitability of prospective donors is therefore essential to protect the safety and sufficiency of the blood supply, and safeguard the health of recipients of transfusion and blood donors themselves, while ensuring that suitable donors are not deferred unnecessarily. Aim: To study the incidence and causes for deferral of both voluntary and replacement Donors in Blood Bank. Materials and methods: The study was conducted over a period of 2 years from 2015 January to 2017 January at Gandhi Hospital Blood Bank, under Gandhi Hospital; which is a tertiary care referral Hospital. Results: A total of 2510 donors of both voluntary and replacement category were deferred, among which males were 1790 were males and 720 were females. The commonest cause of deferral among males was alcohol intake within 24 hours, followed by underweight and hypertension. The commonest cause among female donors was anemia followed by menstrual history within one week. Conclusion: Analysis and evaluation of deferral in blood donors helps us to understand the causes of deferral and deferral rate. This helps us in providing safe blood to the recipients by promoting blood donation by healthy donors. There is a need to motivate more voluntary non remunerable donors to ensure safe blood to all by conducting educational and motivational programs.

Sero prevalence and trends of TTI in voluntary and replacement blood donors in a tertiary care hospital blood bank – A 3 year retrospective study

Background: Blood Transfusion plays a vital role in patient management and is lifesaving in many instances. It plays a pivotal role as a specialized modality of treatment and saves millions of lives worldwide each year and reduces morbidity. It is well known to be associated with a large number of complications, some of them trivial while others are life threatening, demanding for meticulous pre transfusion testing and screening. The priority objective of BTS is to ensure safe, adequate accessible efficient blood supply at all times. The magnitude of TTI varies from country to country and depends directly on the TTI load of society and also effective screening of donors at blood bank. Materials and methods: A retrospective study was conducted in our hospital blood bank from 2014- 1016, to study the sero- prevalence and trends in TTI, including HIV, HBV, HCV, VDRL, and malaria. The total number of voluntary and replacement donors increased steadily in 3 years. Results: The sero- prevalence of HBV, HCV and HIV decreased steadily over 3 years, whereas incidence of syphilis increased steadily. HBV was noted to be more in voluntary donors than in replacement donors. Blood unit utilization index was calculated and ranged from 90.9% in 2014 to 88.9% in 2015 and 91.6% in 2016. Most common cause for discard of the blood units was TTI followed by expiry of products. Conclusion: Strict selection of blood donors is mandatory and is recommended to ensure safe blood supply. Voluntary blood donations need to be increased to decrease the incidence of TTI.

Incidence and etiology of pancreatitis among alcoholic and non-alcoholic patients

Introduction: Etiology of Pancreatitis continues to stir up controversy. The incidence of acute pancreatitis has been reported to vary around the world in different studies. The etiological profile of pancreatitis may be different in different parts of the world and it is therefore important that experiences from different parts of the country be recorded. Alcohol was once thought to be most common etiology. Recent studies in western countries show that non-alcoholic causes include more than 50% of causes of pancreatitis. Aim: The aim this study was to know the etiological factors of pancreatitis and to compare the serum amylase, lipase levels in alcoholic and non- alcoholic patients. Materials and methods: This was a prospective observational study conducted in Gandhi Medical College and Hospital, Secunderabad from December 2012 to November 2014 with duration of 2 years. 75 patients were included in this study according to inclusion and exclusion criteria. Detailed history along with physical examination and laboratory investigations for confirmation of diagnosis and etiology were done. Results: In the present study, out of 75 cases, 40 had significant history of alcohol consumption, while 35 were found to be non-alcoholics. The age group of patients in our study was from 18yrs to 62 years. 20 out of 45 alcoholics were less than 40 years old while 21 out of 35 non alcoholics were less than 40 years old. Out of the 75 cases, 51 were males while 24 were females. In our study alcohol causes pancreatitis in 60% of the cases while non-alcoholic causes of pancreatitis included 40% of cases. Mean amylase, mean lipase and amylase: lipase ratio values were raised more in alcoholics than non-alcoholics. Recurrent pancreatitis was also observed in alcoholics than non-alcoholics. N L Varunmai, Mudumala Issac Abhilash, M Uma Devi, P Shravan Kumar. Incidence and etiology of pancreatitis among alcoholic and non-alcoholic patients. IAIM, 2017; 4(5): 117-121. Page 118 Conclusion: Within limitations of this study, concluded that alcohol remains to be most common cause of pancreatitis in south India (Telangana), incidence of recurrent pancreatitis was significantly high in alcoholics and Serum lipase: amylase ratio more in alcoholics than non-alcoholics.

A study of clinical and histopathological correlation of lichen planus

Introduction: Lichenoid tissue reaction or interface dermatitis embraces several clinical conditions, the prototype of which is lichen planus and its variants. Others include drug induced lichenoid dermatitis, special forms of lichenoid dermatitis, lichenoid dermatitis in lupus erythematosus, and other disorders all of which have salient clinical and histological features. The aim of this study was to correlate the clinical features with histopathological findings in all clinically suspected cases of lichen planus and assess the clinical diagnostic accuracy. Materials and methods: This study had been carried out over a period of 2 years from July 2015 to June 2017 in the Department of Pathology, Gandhi Hospital. Histopathological sections of skin biopsies from 85 patients were studied after routine H and E staining and morphological changes were noted. The patients’ clinical findings were then correlated with the histological changes. The results were then analysed. Results: Total numbers of biopsies inclusive of LP and LP like lesions were 85. Among them, the number of patients having LP was 50. The age ranged from 18 to 65 years (mean 37.1 years). The mean duration of the lesion was 12.02 months (approx 1 year). Males were affected more than females. Out of the 85 cases, 50 were Lichen planus and 35 were lichenoid eruptions. Of the Lichen planus, 31 (61.6%) cases were of classical lichen planus, 6 (13.3%) cases were of hypertrophic lichen planus, 4 (8.3%) cases were of lichen planus pigmentosus, 4 (6.6%) cases were of actinic lichen planus, 3 (5%) cases were of eruptive lichen planus, 1 (1.6%) case each of atrophic lichen planus, annular lichen planus. N. Srivani, B.V.N. Sravani, Shyamala Srujana, O. Shravan Kumar. A study of clinical and histopathological correlation of lichen planus. IAIM, 2017; 4(9): 136-144. Page 137 Conclusion: In the present study, maximum number of cases occurred in age group of 18-28 years. Though pruritis is a common symptom, it is nonspecific. Therefore, histopathology remains the most important diagnostic tool for proper evaluation of Lichenoid eruptions/ Lichen planus.