Histopathological and immunohistochemical analysis of small intestinal biopsies in adults suspected of celiac disease

Objective: To analyse histomorphological and immunohistochemical analysis of small intestinal biopsies in adults suspected of celiac disease. Study Design: Descriptive study. Place and Duration of Study: Department of Histopathology, Army Medical College, Rawalpindi, from November 2014 to December 2015

Methodology: Fifty cases of small intestinal mucosal biopsies [duodenal and jejunal] were analysed in adult patients aged above 14 years suspected of celiac disease. Their histomorphological data was recorded using Modified Marsh Criteria. Type of intraepithelial lymphocytes was assessed using immunohistochemistry. Intraepithelial lymphocytes were counted both by H and E stain and immunostain CD3 and CD20

Results: Thirty-four percent patients were aged between 21 - 30 years and 22% patients aged between 41 - 50 years. There were 84% [n=42] males. Thirteen [26%] cases showed focal villous atrophy, 32 [64%] cases showed partial villous atrophy and 5[10%] cases showed complete villous atrophy. Anti-tissue transglutaminase antibody was positive in 21[42%] cases. CD3 immunomarker was positive for intraepithelial lymphocytes in all 50 cases while CD20 immunomarker showed focal positivity in areas with lymphoid follicle formation. The count of intraepithelial lymphocytes was found to be almost equal [with a difference of 3 - 4 lymphocytes] on both H and E stain and immunostain CD3 and CD20

Conclusion: Males aged 21 - 30 years were the most commonly affected group. The most frequent change in histology was partial villous atrophy along with lymphocytic enteritis. All the intraepithelial lymphocytes were present in crescendo- pattern of distribution

Aggravation of gentamicin induced nephrotoxicity by ciprofloxacin

To evaluate histopathological changes of gentamicin induced nephrotoxicity in rabbits receiving the combination of ciprofloxacin and gentamicin compared with rabbits receiving gentamicin alone. Laboratory based Randomized controlled trial. Study was conducted in the department of Histopathology with the collaboration of the department of Pharmacology, Army Medical College Rawalpindi and National University of Sciences and Technology [NUST] Islamabad. Eighteen rabbits were used in this study. They were divided randomly into three groups. Each group contained six rabbits. Group 1 [control] was injected subcutaneously with 0.9% NaCl. The second group of animals was injected with gentamicin. The third group of animals was injected with the same dose of gentamicin and additionally ciprofloxacin. The findings were entered and analyzed with the help of histopathological [HP] score calculated by summing up the histological parameters through Microsoft excel and Graph pad Instat 3. Necrosis, congestion and inflammatory infiltrate were graded as absent, mild, moderate and severe. The score assigned was from 0 to 4 accordingly. Highest tubular necrosis grade [grade 3] and maximum inflammatory changes [moderate grade] were observed in 50% of rabbits of group 3, receiving combination of gentamicin and ciprofloxacin. p-values were significant <0.01. Combined administration of ciprofloxacin along with gentamicin in rabbits enhances adverse histopathological effects of gentamicin induced nephrotoxicity

Diagnostic accuracy of endometrial curettage in endometrial pathology

Abnormal uterine bleeding is one of the most frequent problems in life of an adult female. Uterine curettage or biopsy remains a preferred sampling procedure for diagnosis of the endometrial pathology. The objective of this study was to compare the sensitivity, specificity, positive and negative predictive value of endometrial curettage. This validation study was carried out at the Department of Histopathology, Army Medical College Rawalpindi in collaboration with Military Hospital, Rawalpindi from January to December 2010. The study included 50 curettage and subsequent hysterectomy specimen of the same patients. Non-probability sampling technique was used to divide patients into two groups with 50 patients in each group. One group was of endometrial curettage having endometrial pathology [group A]. Second group was of subsequent hysterectomy specimen of the same patients [group B]. Endometrial curettage was found most accurate in diagnosing endometrial carcinoma. Sensitivity of endometrial curettage was found to be 33% whereas specificity and positive predictive value was found to be 100% each. Negative predictive value was found to be 93.1%. Endometrial biopsy is a sensitive and a specific test in and is accurate in diagnosing endometrial pathology. It is found most accurate in diagnosing endometrial carcinoma