ABSTRACT
Introduction: Though Fine needle Aspiration Cytology(FNAC) is good method for diagnosis of lesions, sometimes itdoes not provide precise diagnosis due to inadequate material.Present study was based on use of residual FNAC materialto make cell block in order to find out utility of cell blockpreparation of FNAC.Material and Methods: The two years prospective studycarried out in a tertiary Heath care hospital of central India,included 360 patients referred for FNAC of the lesions fromall body sites. After making the conventional FNAC smears,the remaining material in the needle hub and syringe wasobtained by flushing it with 10% alcohol –formalin. Aftercentrifugation the supernatant was decanted and depositfixed in freshly prepared 10% alcohol-formalin. After halfan hour alcohol-formalin was drained, cell button was takenon whatman-filter paper and processed as surgical tissue inautomated tissue processing machine. FNAC smears andcell block sections were examined separately for cellularity,reporting done and results correlated with histopathology.Results: Of 360 cases FNAC smears and cell blockswere adequate in 324(90%) and 313(86.94%) casesrespectively. Statastical analysis was done in 98 cases inwhich histopathology available. Sensitivity of FNAC was88.06%,specificity of 92.86% and accuracy of 89.47%.Sensitivity of cell block was 90.91%, specificity of 92.86%and accuracy of 91.47%. Sensitivity of combined FNAC andcell block technique was increased to 98.53% with specificityof 93.33% and accuracy of 96.94%.Conclusion: Cell blocks as an adjuvant to FNAC smears isvery effective technique in cytology to reach the definitivediagnosis.
ABSTRACT
Introduction: High prevalence of hemoglobinopathies is seen in central India, screening and genetic counseling are essential for early detection and management. Aim: The retrospective study was performed at Regional hemoglobinopathy detection and management centre (RHDMC) Nagpur, central India to find out relative frequencies of hemoglobinopathies and thalassemia present using solubility test, hemoglobin electrophoresis and high performance liquid chromatography (HPLC) as screening method and to compare results of HPLC with solubility and electrophoresis. Materials and methods: A total of 105,211 cases were screened for sickle cell disease (SCD) and sickle cell trait (SCT) by solubility test during the period of January 2003 to January 2014. Of these 105,211 samples, 60,000 samples which were solubility positive, with doubtful solubility and solubility negative but suspicious for hemoglobinopathy and thalassemia also the cases of anemia were studied by hemoglobin electrophoresis at alkaline pH 8.6. Of which 5,111 cases were further Shrikhande Anuradha V., Pawar Prajkta S. Comparative study of solubility and hemoglobin electrophoresis with high performance liquid chromatography (HPLC) for screening of hemoglobinopathies and thalassemia: Study from central India. IAIM, 2019; 6(3): 111-126. Page 112 studied by HPLC and results of HPLC were compared with combined solubility and Hb electrophoresis. Results: Of 105,211 cases screened for hemoglobinopathy by solubility and electrophoresis, 12,979 (12.33%) were having sickle cell trait (SCT) and 3,062 (2.91%) were of sickle cell disease (SCD). Of 5,111 (100%) HPLC study cases, total SCD and SCT were 3,132 (61.27%) followed by 315 (6.16%) of beta-thalassemia trait and 264 (5.16%) cases of compound heterozygous for HbS and betathalassemia. Hemoglobinopathies E and D alone and its combination with HbS or beta-thalassemia were also found. Rare cases of HbD Iran, HbJ variant and HbQ India, Hb Abruzzo and delta-beta thalassemia were detected. Combined solubility and hemoglobin electrophoresis was effective for diagnosis of SCD and SCT when compared to HPLC with good agreement between two test by kappa statistics, however for detection of beta-thalassemia trait and for compound heterozygous for HbS and beta-thalassemia false negatives cases were more, chi square test showed highly significant P value <0.01. Conclusion: Combined solubility and electrophoresis are simple and cost effective alternative to HPLC for screening large population with high prevalence of SCD when resources are limited but for beta-thalassemia screening HPLC is mandatory.