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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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Acute appendicitis is a common surgical emergency. Appendix continues to be the major chunk of surgical specimens received in Pathology laboratory. However, pathogenesis of appendicitis remains poorly understood. Obstruction and inflammation is implied in pathogenesis of acute appendicitis. Presently there is increasing evidence of involvement of enteric nervous system in immune regulation and in inflammatory responses. The present study combines routine histopathology and immunohistochemistry to study the role of mast cells and enteric nervous system in pathophysiology of acute appendicitis. We have done a prospective study for a period of one and half years from January 2014 to July 2015. Appendicectomy specimens from patients who are clinically diagnosed as acute appendicitis were included in study group as cases. Appendix specimens removed at Forensic autopsies were used as controls. Study was conducted on total 138 appendix specimens of which 118 were surgically removed from patients with acute appendicitis, taken as study group. 20 specimens from Forensic autopsy, were used as comparison group (normal control group). We found a consistent increase in mast cell and neuronal counts along with prominence of ganglion cells in specimens with acute appendicitis compared to the control group.
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Background: Construction of a question is a very important step in setting up of a question paper in written assessment of students during II M.B.B.S course. The most important aspect of this assessment is framing the question paper. At present long essay type of questions is one of the methods to assess cognitive skills in examinations. The two major categories of assessment are structured and unstructured questions, each of which serves different purposes to draw inferences about a subject’s capability. Objectives: To evaluate II year M.B.B.S students in answering structured essay question versus unstructured essay question and to compare and assess reliability of the structured essay question in Pathology examinations. Materials and methods: Present study was conducted in Gandhi Medical College, for a batch of 205 students i.e. II year students before University examinations. Students were initially tested with unstructured essay question, and then same group of students subsequently tested after one week with structured essay. Marks were tabulated and analyzed. Mean difference in the score of each answer was calculated by Chi square test. Results: A total of 205 students were evaluated for formative assessment by giving two different types of essay questions in Pathology in pre final examinations. 47.8% of students with unstructured essay question evaluation scored less than 10 marks (74.63%) and only 15.61% of students scored 16 and above marks in this group. In structured essay question evaluation (second phase) had higher percentage of student who scored more than 10 marks (73.17%). More than 38% of students scored 16 and above marks in this group. B. Bheeshma, Shyamala Srujana, Padma Sunethri. Comparison of the outcome of structured essay versus unstructured essay questions used as assessment tool in pathology. IAIM, 2016; 3(6): 148-151. Page 149 Conclusion: In this repeated measures study, students administered with structured essay method scored significantly better marks than the unstructured essay method, suggesting a need for introducing structured essay method for better evaluation of students in the examination.
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Introduction: For medical students, second year is crucial, as they enter the clinical postings for the first time and are taught about the pathogenesis of disease, which will enable the students understand medicine with better concept. It is an agreed fact that regular reviewing of teaching learning methods of the teachers is necessary for improvement. Hence to find out the perception regarding the didactic lecture method being followed, the present study was conducted using feedback in form of questionnaire from students. Materials and methods: 197 II year MBBS students appearing for their Part II final university exams were asked to fill up the structured pre-validated feedback questionnaire regarding the didactic lecture method of teaching being followed at pathology department. Questionnaire included set of questions on T/L methods and on the changes recommended. Descriptive statistics were used in the form of frequency distribution and percentages were used to analyze the data. Results: Study showed female preponderance. Majority of the students found the subject to be interesting and agreed that knowledge about pathology helps in clinical posting. 35.53% of the students found general pathology to be difficult subject. Students were satisfied with clinical correlation, content and explanation given to clarify the subject during the lectures. Most of the students agreed that they were encouraged to asked questions and give answers during lectures, and were satisfied with the delivery and pace of lecture. Readability, usefulness and innovative methods S. S. S. Quadri, Shyamala Srujana, S Mahesh, B. Bheeshma. Undergraduate medical students’ feedback and perceptions on teaching learning methodology in Pathology at Government Medical College. IAIM, 2016; 3(7): 28-35. Page 29 during lecture presentation were found to be satisfactory. 56.33% of students agreed that didactic lecture is a very effective teaching learning method. Majority of the students felt the strong need for introduction of integrated teaching, case based and group discussion. Conclusion: Taking feedbacks from the students is one of the accepted and reliable methods of assessment. Majority of the students were satisfied with the present teaching learning method. Introduction of integrated teaching and case based and group based discussion was favored by majority of the students.
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Background: Soft tissue sarcomas are uncommon malignant mesenchymal tumours, of unknown etiology, accounting for less than 1% of the all the malignant neoplasms, with a median age of occurrence at 65 years, having male preponderance, 3/4th of them occurring in the deep soft tissues, especially thigh, with median diameter of 9 cm. 2/3rd of them metastasizing to the lung. Sarcomas need thorough evaluation by radiology to assess the extent, depth and neurovascular involvement. Morphology has to be correlated with histochemistry and immunohistochemistry. Aim: To study the prevalence, in relation to age, sex, site and size. To correlate histopathological findings with immunohistochemistry marker studies at our institution, studying and comparing with changing overviews and evolving literature. Materials and methods: All the soft tissue mass specimens submitted to the Department of Pathology, Gandhi Hospital, Hyderabad, from January 2011 to December 2015, were subjected to routine processing and those cases on histopathology, suspected to be sarcomas were included in the study, analyzed with ancillary techniques to arrive at final diagnosis. Results: A total of 40 sarcomas were encountered out of 20460, histopathology biopsy load at Gandhi Hospital, Hyderabad, constituting an incidence rate of 2%. Majority of the tumours were seen in the age groups of 40-49 years and 60-69 (20% each) with male preponderance (67.5%), occurring mostly in the trunk region (50%), with average size of 10 cm and constituting 0.6% of cancer incidence. Liposarcoma was the commonest soft tissue sarcoma in the present study. Conclusion: Liposarcoma was the commonest soft tissue sarcoma in the present study followed by Undifferentiated Pleomorphic sarcoma and Leiomyosarcoma. Most of the tumors presented with N. Sreemani Kumari, Shyamala Srujana, O. Shravan Kumar. 5 years study of soft tissue sarcomas at Gandhi Hospital, Hyderabad - A tertiary care centre. IAIM, 2016; 3(7): 334-344. Page 335 mass lesion, pressure symptoms and incidentally detected on imageology. FNAC was not very helpful in present study. Prediction of the course of the disease was difficult as most of the patients were referred to cancer institutions in the city, for further management.
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Background: Estimation of low density lipoprotein cholesterol (LDL-C) is crucial in management of coronary artery disease patients. There are many homogenous assays currently available for the estimation of serum LDL-C. Most clinical laboratories determine LDL-C (mg/dl) by Friedewald’s formula (FF). Recently Anandaraja and colleagues have derived a new formula for calculating LDLC. This formula needs to be evaluated before it is extensively applied in diagnosis. Aim: The aim of this study was to compare the results obtained by direct homogenous assay for LDLC to those obtained by Friedewald’s and Anandaraja’s formulas with the assumption that the results obtained by direct assay are the most accurate. Materials and methods: We measured Lipid profile (TC, TG, HDL-C, D-LDL-C) by direct homogenous method in 715 fasting samples. Simultaneously Friedewald’s and Anandaraja’s formulas were also used for calculation of LDL-C (FF-LDL-C and AR-LDL-C, respectively). Results: The mean LDL-C levels were 117.78 ± 13.797, 115.51 ± 12.854 and 112.93 ± 11.671 mg/dl for D-LDL-C, FF-LDL-C and AR-LDL-C respectively. There was a statistically significant difference between the results (P ˂ 0.001) obtained by calculation formulas compared to the measured LDL-C. There was underestimation of LDL-C by 2.27 mg/dl and 4.85 mg/dl by Friedewald’s and Sridevi V, Vinit Anand, Mahendrappa S.K. Comparison of Friedewald’s and Anandaraja’s formula with direct estimation of low-density lipoprotein cholesterol in Shivamogga population. IAIM, 2016; 3(7): 120-131. Page 121 Anandaraja’s formulas respectively. In this study, the Pearson’s correlation between FF-LDL-C and D-LDL-C was 0.881 and that between AR-LDL-C and D-LDL-C was 0.880. Bland–Altman graphs showed a definite agreement between mean and differences of the calculation formulas and direct LDL-C with 95% of values lying with in ±2 SD limits. Conclusion: The results of our study showed that FF is better in agreement with D-LDL-C than Anandaraja’s formula for estimation of LDL-C by calculation though both lead to its underestimation.