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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
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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.
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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.
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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.
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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.
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Background: Vaginal cytology is an efficient inexpensive and a rapid method for identifying diseases including establishing the hormonal condition of the patient. The Evaluation of the endocrinologic status of the female patient by means of the study of vaginal cells is actually one of the earliest diagnostic applications of clinical cytology. Though the vaginal cytologic characteristics of gynecologic patients have been studied throughout the world this subjected has received little attention. Vaginal cytology is useful for assessing ovarian function from puberty throughout the reproductive years, menopause and senium. Also it is used to estimate time of ovulation, to determine ovarian dysfunction, to assess placental function or dysfunction in obstetrics, to assist in selecting hormonal therapy and to follow hormonal treatment results. Aim and objectives: To ascertain the effective utilization of cost effective test of vaginal hormonal cytology as a supplement for costly biochemical hormonal estimation. A prospective study was undertaken with the following objectives: To study the normal hormonal patterns in females of different age groups and to study abnormal hormonal patterns in high risk pregnancies and in different clinical situations. Materials and methods: A prospective, hospital based study was done on vaginal smears obtained from One hundred and Sixty (160) patients, attending Gynecology and Obstetrics Out-patient department and few In-patients at Gandhi hospital, Secunderabad during the period of August 2004 to October 2006. The study group included randomly selected female patients of reproductive age groups (18 years to 35 years.);.with normal menstrual cycles; normal perimenopausal (36 years to 45 years.) and postmenopausal (above 45 years.) women, pregnant patients in the 1st, 2nd, 3rd trimesters T. Sundari Devi, Rajyalakshmi, S. Srujana, K.R.K. Prasad, O. Shravan Kumar. A 3 years study of vaginal hormonal cytology at tertiary hospital. IAIM, 2017; 4(8): 20-32. Page 21 and 1st stage of labour as well as post partum patients. The study group also included patients with primary infertility, menorrhagia, secondary oligomenorrhoea (scanty menstruation), threatened abortions, inevitable abortions, pre mature rupture of membranes, post maturity and patients with neoplastic lesion i.e. ovarian tumor. The material collected for the vaginal smear dried very rapidly during collection. Hence fixation was done within 30 sec. of spreading. The fixatives used were – 95% Ethanol or 80% Isopropyl Alcohol. Other fixatives used were ether / 95% alcohols; 100% methanol; Rapid fixative as cytospray; 2 to 10% carbowax in 95% ethanol (for mailing unstained smears). The stains used were Papanicolaou’s stain and Giemsa stain. Results: Vaginal hormonal cytology is a useful diagnostic aid in the female reproductive process. It may also provide a key to more effective conception control, as well as improvement in the treatment of menstrual disorders, anovulation, and other underlying disorders. In the present Indian scenario with lack of adequate clinical history available to the pathologist, in a rural setup as well the urban conditions; vaginal hormonal study is still a low cost diagnostic and prognostic test procedure. Hence the present study emphasizes the utility of vaginal smear study even today compared to the costly biochemical parameters available in the market which is a financial burden to poor patients. Conclusion: Vaginal smear collected between 4-11 days and 12-16 days of the normal menstrual cycle showed scattered intermediate and superficial cells. Vaginal smears collected between 17-28 days of normal menstrual cycle showed, predominately intermediate cells with folding and crowding. The KPI peak is between 12-16 days. This is extreme midzone shift, with clusters of navicular cells in all the three trimesters, of pregnancy. First stage of labour could be suspected with identification of increase in the number of superficial cells, with marked decrease in the intermediate cell values.
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Background: Sildenafil causes vasodilatation by relaxing the smooth muscles of blood vessels. This enhances endometrial development, the health of which is indispensable for implantation and embryonic and fetal development. Aim: To assess the role of Sildenafil when used in ovulation induction cycles with Clomiphene Citrate (CC) with reference to Endometrial Thickness (ET), follicular development, Pregnancy rates and Side Effects. Materials and methods: In this prospective comparative study on 80 infertile women, we randomly divided them into two groups. In group A with 40 patients, ovulation induction with CC was given and in group B with 40 patients oral Sildenafil Citrate 25mg – BD, was added from Day 8 up to hCG trigger, in the CC induced cycle. A transvaginal ultrasound was done on Day 13 to assess follicular growth and ET. A urine β-hCG on Day 30 was done to detect pregnancy. Patients were followed up for 8 weeks to monitor miscarriages, ectopics and multi foetal gestation. Results: Mean ET at the time of hCG trigger was 9.64 in the Sildenafil group compared to 8.47 in group A without Sildenafil (p value 0.01). 65% of the patients in group B conceived with 3 cycles of ovulation induction compared to 42.5% who conceived in group A (p value 0.04). The mean of total number of follicles greater than 18 mm at hCG trigger was 1.62 and 1.91 in group A and B respectively (p – 0.09). Side Effects were significantly higher in group B with sildenafil compared to group A with CC alone (p – 0.006). L. Pranathi Reddy, Y. Madhavi, Mohammed Ismail Khan. Role of Sildenafil in ovulation induction – A comparative study of outcomes with Sildenafil in ovulation induction cycles with Clomiphene Citrate. IAIM, 2016; 3(12): 26-32. Page 27 Conclusions: As our study shows that use of Sildenafil improves ET and rates of conception, we recommend the routine use of Sildenafil in ovulation induction protocols.
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A 3-month old male child weight 3.2 kg presented was with anaemia (Hb 3.1 mg/dl) and massive hepatospleenomegaly. His respiratory and CVS systems were normal. Osmatic fragility and G6PD spot test were normal. Hb electrophoresis showed HbA-86.02%, HbF 2.8% and HbA2 3.9%. Bone marrow aspiration and biopsy showed typical Gaucher cells. This case was diagnosed as an infantile Gaucher's disease.
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Filariasis is a major public health disease in India especially at coastal areas of Andhra Pradesh, India. Microfilaria is some time seen as an incidental finding during fine needle aspiration cytology smear (FNAC). But it is very rare to find microfilaria in cytological smears of parotid lesions. This is unique finding not reported till to date at our institute. Microfilaria is seen mainly in peripheral blood smear. Wuchereria bancrofti is the most common parasite which causes lymphatic filariasis in India. Here we reported a case in which microfilaria is seen in cytological smears of parotid lesion, first time at our institute of Gandhi Medical College, Telangana, India.