Image Analysis in the evaluation of chronic hepatitis

Chronic hepatitis, a major chronic liver disease with morbidity, continues to affect a large segment of population in the underdeveloped and developing countries. The prognosis not only depends on the etiology but also on the severity of lesions. Prognosis as well as the interference in the pathobiology of the disease with drugs like interferon require definite morphological criteria with regard to severity and progress. The Knodell scoring system is based on the assessment of inflammation, necrobiosis, fibrosis and nodular transformation and given scores [points].The sum of all parameters is finally added to indicate the severity. However, objectivity in identifying the location and severity using image analysis is not carried out hitherto. Image analysis essentially consists of computer assisted morphometric analysis, with tailormade tools for assessment of area, intensity and perimeter and built-in statistical system. An attempt has been made to corroborate Knodell's score with the image analysis. Morphometric evaluation in a selected group of sixteen cases of chronic hepatitis satisfying the clinical criteria. As the portal and parenchymal changes, according to Knodell may reach maximum 20 points' score as fibrosis and nodular transformation to 6, it is considered to group the severity into three -namely 0-4, 5-8 and more than 8. This would obviate ill defined borderline cases falling into one or other groups. The area, perimetry and intensity values are corroborated with Knodell's score of 0-4, 5-8, >8. The three groups are statistically evaluated. Image analysis enabled us to assess the severity of lesions belonging to different categories of Knodell Score. The area and perimeter findings showed significant correlation [P < 0.0007 and P < 0.00] with Knodell score group I, II and III. However, the intensity score did not have any acceptable significance. Based on this statistics the objective evaluation by image analysis is considered rapid, reproducible and accurate

Proteinuria in haemoglobin H disease

While extensive studies are available on the renal manifestations in sickle cell disease, there is no documented evidence in favour of renal changes in the commonly encountered haemoglobinopathy namely,