Ki‑67 Expression in Oral Potential Malignant and Malignant Lesions and Correlation of Mitotic Index with MIB‑1 Labeling Index

Introduction: Oral cancers are the most serious health issues in underdeveloped countries such as India and considered as the main cause of death. Among them, oral squamous cell carcinoma is the most common type (90%) of all malignancies. Various oral potential malignant lesions (OPMLs) can transform into malignancies. This study was conducted to determine the significance of Ki‑67 expression in oral potential malignant and malignant lesions (MLs) as well as correlation of mitotic index (MI) with MIB‑1 labeling index (LI) in these lesions. MaterialsandMethods: The study was performed on 60 cases in a tertiary care center over a period of 2 years. Ki‑67 expression, MI and MIB‑1 LI were calculated and correlated. Results: In the studied population, there were 49 (81.7%) males and 11 (18.3%) females. The mean age was 46.60 ± 9.94 (23–68 years), with majority of patients in 41–60 years of age group (46/60 cases). Anterior 2/3rd tongue is the most affected site, presented ulcer as the most common lesion. Smoking, tobacco, and betel nutchewing addiction were presented in 72% of the patients. Among 60 cases, 45 (75%) were OPMLs, while 15 (25%) cases were MLs. MI increases in OPMLs and MLs and comparison was significant (P < 0.01). MIB‑1 LI was significant (P < 0.01) on comparison to dysplasia III and MLs. A positive correlation (0.01) was established between MI and MIB‑1 LI of OPMLs and MLs. Conclusion: Ki‑67 expression was found correlated with the progression of disease from OPMLs to MLs. Therefore, it is considered a proliferative marker that corresponds with disease progression. Both proliferative indices (MI and MIB‑1 LI) are positively correlated

Role of Hematological and Inflammatory Markers in Early Diagnosis and Severity of COVID‑19 Disease

Background: COVID‑19 virus, causing severe acute respiratory illness (SARS‑CoV‑2), was declared as a pandemic by the WHO in March 2020, after its first outbreak in China at the end of 2019. The major purpose is to establish the role of a hematological and inflammatory markers in early diagnosis of COVID‑19 illness and its relationship with the disease severity. Materials and Methods: The study was performed in a tertiary care center from April to September 2020. The study included 150 hospitalized COVID‑19 Reverse transcription‑polymerase chain reaction positive patients. According to ICMR standards, research patients were grouped into mild, moderate, and severe categories depending on clinical evaluation. Different laboratory parameters complete blood counts, prothrombin time (PT), activated partial thromboplastin time (APTT), d‑dimer, serum ferritin, C‑reactive protein (CRP), and mean results are compared among the patient in three disease severity groups. Results: In the studied population, there were 106 (70.7%) males and 44 (29.3%) females. The average age of the research participants was 48.40 ± 11.50 (21–75 years), with majority of patients being old (>60 years). Hematological markers such as total leukocyte count, Neutrophil‑to‑lymphocyte ratio (NLR), and platelet lymphocyte ratio (PLR) and the levels of PT, APTT, and D‑dimer, as well as ferritin and CRP, all were considerably high with different groups of disease severity (P = 0.001). Conclusion: The study concluded that patients of severe disease category have significantly higher levels of leukocytosis, neutrophilia, elevated NLR, PLR, PT, APTT, D‑dimer, serum ferritin, and CRP. Hematological and coagulation symptoms are associated with COVID‑19 illness, and these indicators might be employed as a prognosticator for prediction of early disease severity.

A comparative study of histopathological findings in psoriatic lesions with and without treatment

Background: Psoriasis is a multifactorial chronic relapsing inflammatory dermatological disorder associated with significant comorbidities. It is characterized by sharply demarcated, erythematous papules, and plaques with abundant silvery-white scales. Due to its variable clinical presentation, histopathology remains the mainstay of diagnosis. However, these histologic features changes with treatment and may also guide in therapeutic decision-making. Aim: The aim is to evaluate and compare the histopathological features of psoriatic lesions before treatment with those receiving treatment for psoriasis. Patients and Methods: A total of 101 biopsies from selected consecutive patients of histopathologically confirmed psoriasis vulgaris were included in the study. These cases were then divided into two groups, Group A includes cases who never received treatment and Group B, those receiving treatment for psoriasis. These biopsies were histopathologically analyzed and compared for various morphological features. Results: Of 101 cases of psoriasis, 72 cases were included in Group A and 29 were included in Group B. Biopsies of Group A showed parakeratosis and acanthosis as a common feature in all of them with dilated or abnormal capillary pattern in dermal papillae in 93.1%. In Group B, in spite of uniform parakeratosis as noticed in Group A biopsies, focal parakeratosis was seen in 83.3%, acanthosis in 87.5%, and dilated/abnormal capillary pattern in dermis was observed to be a universal feature in biopsies of Group B. All other microscopic features of psoriasis also decreased in frequency in Group B. However, statistically significant difference is seen only in changes in morphological features of superficial epidermis that is, parakeratosis, acanthosis, and absent or decreased granular layer in both the groups. Conclusion: Treatment may lead to improvement in the histologic features in epidermis with significant difference in few of them. However, abnormal vasculature in the dermal papillae persists and does not show any improvement with therapy.

Haematological Profile in Different Clinical Spectrums of Dengue

Background: To describe the hematological profile occurring at different clinical spectrums of dengue. Methods:Study was conducted in Department of Pathology, Teerthankar Mahaveer Medical College and Research Centre Moradabad, Uttar Pradesh. A total of 100 cases were enrolled with patients who were serologically positive for Dengue either by ELISA/Card(NS1, IgG, IgM) method. A blood specimen of 2 ml was obtained from all the patients under aseptic conditions and was sent for evaluation using Sysmex XS 800i automated counter. Various hematological and biochemical parameters were noted. All the patients were followed up till day 5. Results: Out of a total of 100 cases enrolled in the study a total of 55 (55%) did not have bleeding manifestations and comprised the Group I of study whereas remaining 45 (45%) patients presented with bleeding manifestations and were placed in Group II of study. Age of patients ranged from 4 to 80 years. Maximum number of patients were in age group 21 to 40 years (42%). Mean age of patients was 34.04±17.58 years. Majority of cases were detected on ELISA (54%). Mean TLC was 6549±4093/cumm. A total of 87% cases had platelet count <150,000/cumm. Group I where 34.5% patients had platelet count <50,000 in Group II this proportion was 62.2%, thus showing a significant difference between two groups (p=0.038). The proportion of patients with platelet count >100,000/cumm was 26%, 22% and 35% respectively on baseline, day 3 and day 5 where as proportion of those with platelet count <20,000/cumm was 16%, 10% and 6% respectively on baseline, day 3 and day 5 respectively. No significant difference between two groups with respect to any of the biochemical parameters (p>0.05) was observed. Conclusion: The findings in present study provide a deep insight into the hematological picture vis-à-vis the clinical and biochemical profile of dengue fever at a tertiary care centre. Considering the relevance of onset and hematological changes, the findings in present study were somewhat skewed as most of the patients included in the present study had delayed admission and as such the onset record was not available. The present study was also limited by the duration of follow-up and outcome evaluation, including relapse.

Significance of Silver Stained Nucleolar Organiser Region (AgNOR) in Fine Needle Aspiration Smears of Breast Lesions

Background: Breast cancer is the leading cause of cancer - related deaths in Asia. The number of intra-nuclear silver stained structures, termed AgNORs, is significantly higher in malignant cells than in normal, reactive or benign cells. The purpose of this study was to evaluate the AgNOR scores in FNA smears of breast lesions and their correlation with histopathology. Aims & Objective: To establish AgNOR staining as a diagnostic and prognostic tool in management of various breast lesions. Methods: This was a prospective study conducted over a period of 18 months may 2015 to November 2016. A total of 100 cases were included in the study. AgNOR stain was done in both cytology and scoring was done and analysed. Results: In FNAC aspirates, Mean AgNOR count ranged from 5 to 9.9 per high power field with a mean value of 2.888±2.553. The AgNOR dots morphology was homogenous, symmetric with regular contours in FNAC slides of benign breast lesion. In malignant breast lesions, the dots were asymmetric with irregular contours and were aggregated, smaller and more scattered. Conclusions: The present study showed that fine needle aspiration cytology is a useful modality for diagnosis of breast lesions. It has a high concordance with the histopathology . AgNOR count assessment provides a useful objective measure for segregation of different grades of tumor with 100% accuracy for detection of higher grade of lesions, as observed in present study. For differentiation of benign from malignant lesions too it has a high sensitivity as well as specificity. The usefulness of FNAC to evaluate nodal involvement also showed a 90% sensitivity and 95.6% specificity. On the basis of present study, it could be concluded that AgNOR count estimation using fine needle aspiration is a useful method to differentiate and diagnose breast lesions.

Cytomorphological Study of Palpable Breast Lumps: Spectrum of Lesions and Diagnostic Utility of FNAC.

Background: Palpable breast lumps are quite common which can be benign or malignant. Carcinoma breast is the second most common cancer after cervical cancer. Fine needle aspiration cytology (FNAC) is a minimally invasive, rapid, reliable and cost-effective outdoor procedure to provide effective diagnosis and way to further planning of treatment without need for biopsy. The objective of the study is to study the spectrum of various breast lesions on cytomorphology and its histopathological correlation. Methods: This was a two years retrospective study from June 2014 to May 2016 including 280 cases aspirated from palpable breast lumps. Physical examination of breast lumps by palpation was done. Cytological diagnosis was made and histopathological correlation was done, wherever available. Results: On cytomorphological study of 280 breast lump aspirates 32 (11.43%) were inflammatory lesions, 180 (64.29%) benign, 6 (2.14%) atypical/probably benign, 8 (2.86%) suspicious of malignancy, 46 (16.43%) malignant and 8 (2.86%) were unsatisfactory for evaluation, of these 280 cases, 70 (25%) were available for histopathological examination. The most common benign lesion in the present study was fibroadenoma 115 (41.07%) and the most common malignant lesion was ductal carcinoma 43 (15.36%). Conclusion: Fine needle aspiration cytology is a rapid and reliable tool to provide effective diagnosis in palpable breast lumps. It should be used as routine diagnostic procedure to provide the effective health care to the patients with breast lesions.