Comparison of Basement Membrane in Normotensive and Pregnancy Induced Hypertensive Placentae

Introduction: Placenta is related to mother and foetus viaindirect interaction with maternal blood that spurts out ofuteroplacental vessels. By study of placental bed newinformation has come to light, especially for pre – eclampsiaand intra uterine fetal growth retardation.Aim: To study changes in basement membrane in pregnancyinduced hypertensive and normotensive placentae.Materials and Methods: The present study was conducted inthe Department of Anatomy, MMMCH, Kumarhatti, Solan tostudy the histological changes in placenta in pregnancyinduced hypertensive parturients as compared to normotensivesubjects. It was based on 100 cases, 25 from normotensivesubjects (control group) and 75 from clinically proven cases ofpregnancy induced hypertension (study group).An attempt was made to see any changes in histologicalfeatures of placentae of pregnancy induced hypertensive casesand compare it with normotensive placentae.Results and Conclusion: The microscopic study showedsignificant thickening of basement membrane in PIH placentae.As compared to normotensive placentae (control) and are dueto occlusion or narrowing of utero placental vasculaturesuggesting thereby compromised foeto – placental circulation.

Efficacy of fine needle aspiration cytology in Head and Neck lesions.

Background: A perplexing diagnostic and therapeutic dilemma is often presented by masses involving glandular and nodal structures of head and neck - lymph nodes, thyroid gland and salivary glands. Fine needle aspiration of such masses is a rapid, direct and safe adjunctive surgical procedure for obtaining material for cytologic analysis. Objectives: To study the diagnostic efficacy of FNAC in the head and neck lesions and correlate it with histopathology. Material & Methods: It is a study of 289 cases of head and neck area referred to the Department of Pathology, Govt. Medical College Patiala. The cytological diagnosis was compared with histopathology. The false positive/negative data was analysed to calculate the sensitivity, specificity, positive predictive value, negative predictive value and overall diagnostic accuracy of the study. Results: The study included 289 cases between 1-70 years in which 59.86% were females and 40.13% were males. Maximum cases were in the age group of 21-30 years. Maximum numbers of cases were from lymph nodes, 139 (48.09%). The overall accuracy was 96.53% with sensitivity of 91.54% and specificity of 98.16%. Positive and negative predictive values were 94.20% and 97.27% respectively. Conclusion: FNAC is an excellent first line method for investigating the nature of palpable lesions in the head and neck region. It can obviate the need for surgery if the lesion is non-neoplastic.

Hyperthyroidism with Struma ovarii.

Struma ovarii or monodermal teratoma, is a specialized ovarian neoplasm composed entirely of mature thyroid tissue. It is a relatively rare tumor which comprises 1% of all ovarian tumors and 2.7% of all dermoid tumors. Its colour and consistency is like that of a thyroid tissue. The tissue may show any of the pathologic changes seen in a normally placed gland, including diffuse or nodular hyperplasia, thyroiditis, papillary carcinoma, follicular carcinoma and malignant lymphoma. We reported a case of hyperthyroidism with struma ovarii. A 70 year old female was operated for ovarian mass. The sign and symptoms subside after operation.

Seminogram in male partners of Infertile Couples.

Background: Infertility is defined as failure to conceive within one or more years of regular unprotected coitus. The infertility state is dependent on the female factor as well as masculine factor; an altered masculine factor is designated when any cause or causes of infertility reside in the male. The masculine factor as a cause of infertility is present in 40-50% of cases hence the importance of an integral evaluation of the male alterations and its fertility. Objectives: The present study aims to assess the seminal patterns of male partners of 100 infertile couples for various parameters and their possible contribution to infertility. Material and Methods: The present study was conducted on male partners of 100 infertile couples who were referred by Gynecology and Obstetric department to Pathology Department, Government Medical College, Patiala for semen examination. The semen was collected by masturbation in all cases in a clean dry detergent free container. After liquefaction and mixing, basic analysis was done which includes volume, viscosity, pH, spermatozoal concentration, motility and morphology. Data was evaluated by means of chi-square test. Results: Of 100 seminogram, 43% showed alterations in the seminal indexes; with asthenospermia in 39.5%, Oligoasthenospermia in 30.2%, Oligospermia in 16.2%, and Azoospermia in 13.9%. Conclusion: Male factors were mostly responsible as a cause of infertility. Asthenospermia was the most common type of semen defect present in these infertile males. Most of the males with semen defect were of age group >30yrs. Incidence of semen defect among males increased with duration of infertility.

Malignant mixed germ cell ovarian tumor in pregnant female.

Ovarian germ cell tumours comprise approximately 15% to 20% of all ovarian neoplasms. In pregnant females, its incidence is very low. They arise from primordial germ cells derived from the embryonal gonad. Malignant germ cell tumours comprise less than 5% of all ovarian neoplasms. Most malignant ovarian neoplasms in pregnant women are at early stages and are associated with good prognosis both for the mother and for the neonate. Histologic subtypes and prognosis do not differ from tumors not associated with pregnancy. Careful initial surgery with adequate staging biopsies followed by combination chemotherapy can greatly improve the prognosis of these patients. We present a case of malignant mixed germ cell tumor in a pregnant female who presented with abdominal mass after delivering a normal child. Histological and biochemical tumour markers confirmed it to be malignant mixed germ cell tumor.

Cytological study of palpable breast lumps with their histological correlation.

Background: FNAC is an inexpensive and highly accurate means of diagnosing both benign and malignant breast lesions. The procedure provides a rapid and non-morbid diagnosis before the operation which enables the patient and the surgeon to discuss and plan therapeutic alternatives in a rational atmosphere. Objectives: To evaluate role of fine needle aspiration cytology in the diagnosis of breast lesions and to compare the cytological findings with the histopathology wherever possible. In addition the sensitivity, specificity and accuracy of FNAC in breast lesions are carried out. Material and Methods: The present study was carried out on 200 patients who presented with palpable lump in the breast in the Department of Pathology, Government Medical College, Patiala over a period of 2 years. Cytological Diagnosis was correlated with histological findings wherever possible. Results: Cytologically, the lesions were categorized into 4 major categories, benign 143 (71.5%), malignant 37 (18.5%), suspicious or atypical 10 (5%) and unsatisfactory 10 (5%). Out of these 200 cases, 85 cases (42.5%) were available for histopathological examination. The most common benign lesion in this study was fibroadenoma 23/52 (44.2%) and the most common malignant lesion was infiltrating ductal carcinoma (28/33) Diagnostic accuracy of FNAC for benign lesion was 94.2% while for malignant lesion, it was 96.7%. The sensitivity, specificity and overall diagnostic accuracy of FNAC came out to be 93.7%, 98.1% and 96.4% respectively. Conclusion: FNAC is a simple and reliable method for diagnosis of both benign and malignant lesions quite accurately thus reducing unnecessary surgeries. The present study proved that the procedure has high sensitivity, specificity and diagnostic accuracy. Though it cannot categorize the lesion in some cases but it can rule out malignancy in most of the cases. Considering its low cost and quick results, it can be a potential tool for screening of breast cancers.