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Subclinical hypothyroidism (ScHt) is an early stage of hypothyroidism which can progress to overt hypothyroidism and lead to adverse metabolic abnormalities. Surge in frequency of hypothyroidism is seen in chronic kidney disease (CKD) cases, including those receiving dialysis. Many studies reported the relation amid thyroid function with metabolic syndrome, though the link among the Free T3: Free T4 and ScHt is not clearly determined. We wanted to investigate the Free T3:Free T4 ratio in predicting ScHt in CKD. MethodsIn this study, 53 known CKD subjects who have not undergone haemodialysis and 60 normal healthy subjects were included. In both study groups, creatinine and estimated glomerulus filtration rate (eGFR) are determined to evaluate the kidney function. Thyroid function parameters namely serum FT3, FT4 and TSH were measured to determine the FT3 / FT4 ratio. ResultsTSH levels were significantly increased in patients with CKD not undergoing dialysis as compared to patients in the control group (P<0.034). Low Free T3 level (P<0.001) and FT3 / FT4 ratio is highly significant (P< 0.001) in study subjects as compared to controls. Area Under the Curve (AUC) of ROC for the continuous variables of serum FT4 / FT3 ratio was 0.914 with CI: 0.832 to 0.997. ConclusionsIndividually FT3, FT4 have very little sensitivity in the diagnosis of sub clinical hypothyroidism in chronic kidney disease. FT4/FT3 ratio determination is a very useful step in diagnosing ScHt with chronic kidney disease.
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Background: Reactive lymphocytes can be presented with a different number of morphologies. The significance of evaluation of lymphocytes on peripheral smear tests and its clinical correlation are still neglected. Materials and methods: Clinical details along with other clinical investigations like cell counter results of patients presented with lymphocytosis and other hematological parameters including hemoglobin, total WBC count and platelet count, were collected from Department of Pathology, Dhanalakshmi Srinvasan Medical College and Hospital, India. Results: A total number of 120 cases were studied, out of which 82 patients showed absolute lymphocyte count more than 4000/ul. Out of the 120 patients, a total of 31 patients had history of smoking/tobacco chewing. 18(58%) of them showed reactive/ atypical lymphocyte morphology and 13(41%) of them showed mature lymphocytes. Of the 10 patients with alcoholism history, only 4 of them showed a normal morphology of lymphocytes, other 6 patients showed reactive lymphocyte morphology. Only one patient in the study population showed atypical lymphocytes and in peripheral smear and subjected to lymph node biopsy and rest of the patient failed to follow up after advised biopsy. Conclusions: Current study also reports that, lymphocytosis with reactive lymphocytes have a correlation with acute stress, smoking, and other ailments.
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Introduction: CD34 Immunohistochemical antigen serves as a tool in differentiating between benign and malignant conditions. Hence, the study was conducted to determine the stromal expression of CD34 antigen by immunohistochemical method in proliferative lesions of the breast and to evaluate the loss of CD34 antigen expression in stromal cells is specific for malignant lesions. Materials and methods: 108 cases of proliferative lesions of the breast were studied from January 2016 to December 2017 for some time of 2 years. Paraffin-embedded blocks were retrieved for all the cases and underwent routine processing followed by Hematoxylin and Eosin staining. 84 cases of the benign lesion, one case of the borderline lesion and 23 cases of the malignant lesion were studied for CD34 immunohistochemical staining, and semi-quantitative assessment was done. Results: On Hematoxylin and Eosin staining, we have found benign lesions includes 63 cases of fibroadenoma, 7, 4, and 3 cases of the fibrocystic disease, fibro adenosis and fibroadenoma respectively with apocrine metaplasia. Malignant lesions include 22 cases of infiltrating ductal carcinoma, one case of infiltrating lobular carcinoma. One case of borderline phyllodes tumor was also included in this study. In normal breast tissue, stroma was positive for CD34 IHC stain. All the malignant cases are showing loss of CD34 staining. Only one case of borderline phyllodes tumor shows grade 2 staining with CD 34 Antigen. Conclusion: We can concluded that the use of CD34 Immunohistochemical marker positivity as an adjuvant tool in differentiating between benign and malignant conditions where the morphology is equivocal.
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Context: Phosphatase and tensin analog (PTEN) gene mutation has been proven for pro-inflammatory property and proliferative potential through tyrosine kinase pathway. We studied mutated PTEN for its pathogenetic association in arterial atherosclerosis. Aims: The objective was to study mutation of PTEN by immunohistochemical method in arterial atherosclerotic lesions and correlate with grades of atherosclerosis, smooth muscle migration in intima, degree of inflammation and Framingham heart study risk factors. Settings and Design: Human, Prospective Clinical study. Materials and Methods: We studied patients with arterial occlusive disease diagnosed by Doppler ultrasonography over a 2-year period. Immunohistochemistry was performed with mouse monoclonal antibodies for PTEN and smooth muscle actin (SMA). Statistical Analysis Used: Chi-square test. Results and Conclusion: Aorta was the single most common vessel affected (21%). Mean age of patients studied was 48.6 years and 80% were male. Mutant PTEN was associated with higher grades of atherosclerotic lesions (P < 0.0001) graded by American Heart Association classification and with smooth muscle proliferation and migration in intima (P < 0.0001). No statistically significant association with the vessel wall inflammation and other risk factors of atherosclerosis.