Evaluation of new non-invasive & conventional invasive methods of haemoglobin estimation in blood donors

Background & objectives: The non-invasive method of haemoglobin (Hb) estimation has unique advantages of exemption of finger prick and associated pain, over invasive methods. This study was done to compare invasive and non-invasive methods of Hb estimation in blood donors keeping haematology analyzer (HA) as a reference method. Methods: The blood donors selected or deferred on the basis of CuSO4method (Hb ?12.5 g/dl), were included in the study. Hb values of the donors were estimated by HemoCue and then by OrSense methods. An immediate post-donation venous sample was drawn for analysis on HA. Results: The mean Hb value was 13.98�27 g/dl on HA, 14.87�03 g/dl on OrSense and 15.03�31 g/dl on HemoCue. CuSO4, HemoCue and OrSense demonstrated sensitivities of 18.7, 18.7 and 13.1 per cent, positive predictive values (PPV) of 64.5, 83.3 and 60.9 per cent and specificities of 98.9, 99.6 and 99.1 per cent, respectively. The intra-class correlation coefficient for OrSense was 0.726 while that for HemoCue was 0.851. Bland-Altman plots demonstrated 2SD difference of >2.0 g/dl in Hb estimations between HA and HemoCue/OrSense. Interpretation & conclusions: The non-invasive modality may provide the near-ideal pre-donation Hb screening platform if an improvement can be done in the sensitivity and PPV of the non-invasive method keeping in view its unique advantages.

Dysembryoplastic neuroepithelial tumour of the central nervous system--a case report.

Dysembryoplastic neuroepithelial tumour (DNT) of the central nervous system is a recently recognized entity. We describe the clinical and characteristic histomorphological features in a patient with DNT. As this lesion carries a favourable prognosis, it becomes essential to make an accurate histopathological diagnosis.

Granular cell tumour (choristoma) of the neurohypophysis--a report of two cases.

Granular cell tumours of the neurohypophysis are uncommon and only 30 cases are documented in the literature till 1994. In this communication, the salient clinical and histomorphological features in two patients with granular-cell tumour of the neurohypophysis are described.

Gliomatosis cerebri--a case report.

Gliomatosis cerebri is a vary rare neoplastic lesion of the central nervous system. An intra-vitam diagnosis of gliomatosis cerebri can be suggested with a steleolactic biopsy of the lesion in conjunction with Magnetic Resonance Imaging (MRI) findings in the brain.

Central nervous system ganglioglioma. A clinicopathologic study.

Gangliogliomas are one of the uncommon tumours of central nervous system. Since these tumours have been associated with an indolent clinical course and benign biological behaviour, it is essential to make an accurate histopathological diagnosis of ganglioglioma. In this study the salient clinical and histopathological features in six patients with intracranial ganglioglioma are described.

Toxoplasma gondii IgM antibody prevalence study in patients suffering from neurological disorders.

One hundred and twenty seven patients belonging to Neurosurgery (49), Neuromedicine (48), Cardiac medicine (30) wards and Blood donors (30) as healthy controls were investigated for the prevalence of Toxoplasmosis by means of detecting specific IgM antibody against Toxoplasma gondii (T. gondii) employing Enzyme Immuno Assay (EIA). The detection rate of specific IgM antibody against T.gondii was found to be 32.7% (16/49) among Neurosurgery patients, 20.8% (10/48) among Neuromedical patients and 20% (6/30) among Cardiac medical patients. None of the voluntary blood donors tested was found to have T. gondii IgM antibody. Maximum prevalence rate was found among female patients undergoing Neurosurgery (42.3%) followed by Neuromedical patients (40%). There is an increasing rate of prevalence of Toxoplasmosis from the lower age group upto thirty years and a declining prevalence rate among the higher age groups. The present study revealed high prevalence rate of Toxoplasmosis in Neurosurgery patients (32.7%) and in particular among female (35.2%) than male (17.8%) patients.

Nucleolar organizer regions in pituitary adenomas.

In this study, thirty-two non-functional and eighteen functional pituitary adenomas were analysed for the presence of argyrophilic nucleolar organizer regions (Ag-NORs) in paraffin sections, using an one-step silver-colloidal staining method. Differences in the mean Ag-NOR numbers of functional pituitary adenomas were statistically significant than those of non-functional pituitary adenomas. It is being emphasised that evaluation of Ag-NOR count is a more reliable index than the presence of mitotic figures in predicting the proliferative activity as well as possibility of recurrence in a patient with pituitary adenoma.

Mycotic aneurysms of the intracranial vessels.

The salient clinical and pathological features are reported of Aspergillus cerebral aneurysms in four young women who had undergone intra-abdominal surgery under spinal anaesthesia and developed clinical features of meningitis 7-16 days postoperatively. The circle of Willis showed ruptured aneurysm in the basilar artery and its branches. The role of iatrogenic factors in the pathogenesis of Aspergillus cerebral aneurysms is highlighted.

Paraganglioma of the cauda equina region--a report of two cases with review of literature.

Among all extra-adrenal locations, paragangliomas are least commonly found within the spinal canal. so far over 60 cases of paragrangliomas in the Cauda equinal region have been reported. In this report we describe the salient clinical and histopathological features of paraganglioma of the cauda equinal region in two patients.

Intraventricular neurocytoma: a report of two cases.

Central neurocytomas are uncommon intracranial neoplasms. More than one hundred cases are documentated in the literature. In this report we describe the clinical and histopathological features in two patients with intraventricular neurocytoma. As the light microscopic features of neurocytoma resemble with that of an oligodendroglioma, it is essential to differentiate these two tumours, using either ultrastructural or immunohistochemical techniques.

Disseminated intra-cerebral microabscesses: a clinico-pathologic study.

In this retrospective study, clinical and neuropathological features were analysed in eight patients with disseminated intracerebral microabscesses. All the patients presented with clinical features, suggestive of an encephalopathic process of an acute onset. Neuroradiological and laboratory investigations were not helpful in establishing the diagnosis in any patient during their hospital stay. All the eight patients died in the hospital and at autopsy disseminated intracerebral microabscesses were the most striking feature. In two patients hyphae of Candida albicans were demonstrated within the microabscesses. Gram negative bacilli in two patients and gram positive and gram positive cocci in one patient were demonstrated in the microabscesses. Disseminated intra-cerebral microabscesses are usually an unrecognised manifestation of central nervous system infections and should be considered in the differential diagnosis of patients with encephalopathy of unknown aetiology.

Nodular inflammatory mass of the dura mimicking a meningioma--a report of two cases.

Histopathological examination of surgical specimens in two patients with an operative diagnosis of meningioma, revealed the presence of dense nodular aggregation of lymphocytes, plasma cells and conspicious absence of meningothelial components. Possibilities of lymphoreticular malignancy, myeloproliferative disorders and other causes for various inflammatory diseases were excluded by appropriate investigation in these two patients. Pathogenesis of this localised lymphocyte-plasma cell aggreation in the dura manifesting as a space-occupying lesion could not be defined in these two patients. It is emphasised that this benign lesion should be recognised as well as distinguished from secondary lymphomatous deposits and solitary plasmacytoma of the dura.

Utility of silver-colloidal staining method in the diagnosis of medulloblastoma.

Histopathological features of medulloblastomas are usually distinctive. However in rare instances, a distinction between the neoplastic cells of medulloblastoma and the neurones in the cerebellar internal granular layer becomes difficult at light microscopic level. In order to distinguish presence of argyrophilic Nucleolar Organizer Regions (Ag-NORs) was analysed in the paraffin sections of medulloblastoma as well as in the cerebellar internal granular layer. The neoplastic cells in medulloblastoma contained a mean 4.78 Ag-NOR per nucleus while the neurones in cerebellar internal granular layer contained a mean Ag-NOR 0.90 +/- 0.12 per nucleus. Compound Ag-NORs were present in the cells of medulloblastoma while they were absent in the neurones of cerebellar internal granular layer. The results of this study indicate that Ag-NOR technique may be useful in an uncommon situation, where a histopathological distinction between cells of medulloblastoma and neurones in the cerebellar internal granular layer becomes difficult.

Papillary meningioma--a clinicopathological study of six cases.

Papillary meningioma is a rare but a well recognised histological variant of meningioma. Only 52 cases are reported in literature till 1991. This report highlights the clinical and histopathological features of papillary meningioma in six patients. Significance of making an accurate histopathological diagnosis and its relevance in the management of patients with papillary meningioma is emphasised.

Primary Ewing's sarcoma of the base of skull: a case report.

Primary cranial Ewing's sarcoma is an exceptionally rare lesion and only eleven cases have so far been reported. In this report we describe a case of primary Ewing's sarcoma arising from the floor of middle cranial fossa. Salient clinical, neuroradiological and light microscopic features in this case are described. A brief review of earlier published cases of primary cranial Ewing's sarcoma are also presented.