Study of Cervical PAP Smear in a Tertiary Care Hospital

Introduction: Sepsis in elderly patients is a critical clinicalissue due to high rates of morbidity and mortality. The modernage cell counters precisely measure volume, size and internalstructure of the cell thereby assessing increase in volumeand cytoplasmic granularity of leukocytes as seen in casesof sepsis. The present study was done to evaluate the useof Volume Conductivity Scatter (VCS) parameters as earlyindicators of sepsis in elderly patients and to overcome theshortcomings of blood culture by using a more precise VCStechnology to assess morphologic changes in cell populationsin sepsis.Material and Method: The study included 51 patients abovethe age of 50 years which were divided into 2 groups Group1, patients with localised infection (n= 39) and Group 2 withsystemic infection (n=12). Group 3 included 30 controlswithout any signs of infection and with total leucocyte countand differential counts within normal limits. Coulter LH 750cellular analysis system was used.Result: Significant increase in both mean neutrophil volume(MNV) and mean monocyte volume (MMV) was reportedamong the patients with sepsis as compared to localizedinfections or control. With a cut off of 145 and 170 for MNVand MMV respectively, a sensitivity of 96% and 91.4% wasobtained in predicting sepsis.Conclusion: Both MNV and MMV have the potential to beused as early indicators of acute bacterial infections.

Quality Control of Fresh Frozen Plasma using Factor VIII and Fibrinogen Levels as Measure: One Year Study in a Tertiary Care Hospital

Introduction: Quality control of blood and its componentsensures the availability of high quality product with maximumefficacy and minimal risk to recipients. As per standardguidelines, for quality assurance of FFP, 1% of all the unitsprepared or 4 units per month are tested for stable coagulationfactors: Factor VIII and Fibrinogen levels.Material and methods: The retrospective data was collectedfrom archives of blood bank from the period of 1st January2017 to 31st December 2017 in AIMSR, Bathinda. Out oftotal 3476 units collected, 2155 were processed for componentseparation. 1.9% of Fresh Frozen plasma (41/2155) were testedfor total volume, fibrinogen content and factor VIII levels forquality control with the help of semi-automated coagulometer.Results: 97.5% of FFP samples tested had factor VIII levelsabove 0.7 IU/mL and 100% of samples had fibrinogen content>200mg/dl.Conclusion: It is concluded that quality of FFP being preparedat our blood bank meets the international standards. Regularquality evaluation and maintenance of records helps to keepup the working standards and any deficiency can be checkedand curtailed.

Study of Cytomorphology Patterns of Breast Lesions and their Correlation with Thyroid Profile Over a Period of One and Half Years in a Tertiary Care Centre of Malwa Region

Introduction: Fine needle aspiration cytology (FNAC) has become an increasingly popular technique for assessment and initial diagnosis of breast lumps as it is the least invasive technique for obtaining a cytological diagnosis and is of high accuracy if done by experienced personnel. Thyroid hormone receptors affect both the normal breast cell differentiation and breast cancer cell proliferation, with effects of thyroid hormones similar to those caused by estrogens. Relationship between thyroid disease, such as nodular hyperplasia, hyperthyroidism and thyroid cancer, with breast cancer was demonstrated in several studies. In the present study, we have evaluated the correlation of cytomorphological diagnosis of breast lesions with thyroid profile. Material and Methods: Total of 80 cases were included in the study and all necessary statistical analysis was done including the percentages, means, standard deviations, ranges and p values. Results: Triiodothyronine (T3) and Tetraiiodothryronine (T4) levels were statically significantly lower among participants with malignant breast lesions as compared to benign breast lesions.(p < 0.01).However mean values of both were normal in both these groups. Thyroid stimulating hormone (TSH) levels among study participants with malignant breast lesions were statistically higher than those of benign breast lesions. However mean in both these groups was within normal range. Conclusion: No significant correlation between thyroid profile and breast lesions was established. But the effect of thyroid hormone on breast cancer clearly requires further research

Diagnostic Accuracy of Fine Needle Aspiration Cytology in Neck Swellings

Introduction: Neck swellings are commonest incidentalfindings that are present in all age groups. Objective of thecurrent research was to study the diagnostic accuracy offine needle aspiration cytology in neck swellings keepinghistopathology as gold standard.Material and methods: This is a prospective study conductedfrom January 2017 to December 2017 comprising of 70 casesof neck lesions who underwent FNAC at Adesh HospitalBathinda. Histopathological diagnosis was considered asgold standard. Efficacy of FNAC was determined in termsof sensitivity, specificity, Positive predictive value, NegativePredictive value and diagnostic accuracy.Results: Sensitivity, specificity, Positive predictive value,Negative Predictive value and diagnostic accuracy were83.33%, 100%, 100%, 98.46% and 98.57%.Conclusion: FNAC should be treated as a first-line diagnostictest for neck swellings. As maximum number of cases ofhead and neck lesions are nonneoplastic, FNAC can avoidunnecessary surgeries.

Epithelial inclusion cyst of the cecum: A rare entity.

Epithelial inclusion cyst of the cecum (EICC) or epidermoid cyst of the cecum is extremely rare. Only seven cases of EICC have been reported in the English literature until now. A case of EICC is being reported in a 25-year-old female who presented with a pelvic mass associated with lower abdominal pain radiating to back. Abdominal contrast-enhanced computed tomography scan showed a welldefined mass juxtaposed to cecum. During operation, a subserosal cystic mass was found adherent to the anterior wall of the cecum and confirmed to be an epithelial inclusion cyst histopathologically. It is being reported due to its extreme rarity.

Human trichinosis in remotes of Uttarakhand, India.

Trichinosis is a parasitic zoonosis caused by ingestion of infected meat containing larvae of Trichinella, more prevalent in developing countries. Although infection with Trichinella is globally distributed, it has been documented only rarely in India. The reports are available where Trichinella larvae were found from animals in India but, to our knowledge, only one human case has been reported from India (Punjab), so far. This is the first report of small multiple outbreaks of human trichinosis in India (2009-2011). Epidemiological, clinical, and laboratory findings of trichinosis patients belonging to remote areas of Uttarakhand were analyzed retrospectively and prospectively. Patients belonged to remote areas of Garhwal, Uttarakhand, 77.78% were male, and 22.22% were female. The age of patients ranged from 9-55 yrs. History of eating meat of wild boar was given by all (100%). The signs and symptoms of the patients varied even after intake of same diet, and included generalized weakness/malaise, myalgia, fever, gastrointestinal symptoms, facial/periorbital edema, subconjunctival hemorrhages, retinal hemorrhages, muscle atrophy, and dyspnea. Laboratory investigations revealed eosinophilia, leukocytosis, creatine phosphokinase (CPK) and serum glutamic oxaloacetic transaminase (SGOT) elevation in 100%, 88.89%, 50% and 16.67%, respectively. Muscle biopsies revealed larvae in 27.78%. One patient expired while others improved. The prevalence of trichinosis is likely to be underestimated. The aim of this study is to emphasize on the magnitude of the problem, to educate people, especially in the affected areas about this health hazard and help implementation of epidemiological studies and preventive measures.

Gorlin's Syndrome-A case report.

Gorlin's syndrome is a rare disorder transmitted as an autosomal dominant trait. Most common phenotypic expression of this syndrome is a basal cell carcinoma (BCC). It is characterized by multiple skin lesions on head and neck region. We present a case of49 year old male who presented with basal cell carcinoma at multiple sites simultaneously.