Diagnostic utility of C-kit protein [CD117] expression in differentiating adenoid cystic carcinoma and polymorphous low grade Adenocarcinoma

Background and Objective: To evaluate usefulness of immunohistochemical marker C-kit [CD117] in differentiating Adenoid cystic carcinoma [AdCC] from Polymorphous low-grade adenocarcinoma [PLGA] in patients of salivary gland carcinomas. AdCC is a malignant salivary gland neoplasm with poor prognosis. PLGA is a salivary gland malignancy with indolent growth pattern. Differentiating between the two entities is a diagnostic challenge. We evaluated the role of C-kit in differentiating the two

Methods: This is a Cross sectional study.Samples of 19 tumors including 12 AdCC and 4 PLGA was evaluated at Department of Histopathology, Armed Forces Institute of Pathology, Rawalpindi from December 2015 to August 2016.Immunohistochemical techniques were used to analyze the level of c-kit expression in AdCC [n = 12], polymorphous low-grade adenocarcinoma [PLGA] [n = 6]. Samples were stained using monoclonal antibody against C-kit. Statistical analysis of the data was done using SPSS version 21

Results: Strong diffuse cytoplasmic reactivity was observed in more than 50% of the tumor cells of AdCC whereas less than 20% of cells showed negative to weak positivity in PLGA. Hence, the difference in the expression of c-kit between AdCC and PLGA was statistically significant [p value <0.002]

Conclusions: CD117 expression itself can be used as a marker in differential diagnosis of salivary gland neoplasms. However, the percentage of the CD117 immunoreactive cells and the staining intensities appeared to be important factors in distinguishing AdCC from PLGA

Immunohistochemical expression of human epidermal growth factor receptor-2 in gastric adenocarcinoma in Pakistan

Objective: To determine the frequency of immunohistochemical expression of Human Epidermal Growth Factor Receptor 2 [HER2] in gastric and gastro esophageal junctional adenocarcinoma

Study Design: Cross-sectional study

Place and Duration of Study: Department of Histopathology, Pakistan Naval Ship [PNS] Shifa Hospital Karachi, from Oct 2014 to Oct 2015

Material and Methods: All specimens of gastric and gastroesophageal adenocarcinoma, irrespective of age of patient, histological type and grade of the tumor were included. Poorly fixed specimens and specimens with scanty tumor tissue were not included

Results: Majority of the patients belonged to 51 to 65 years of age group with mean age of 58.58 [SD +/- 5.56] years. Gender distribution showed that 46 [69.6%] were males and 20 [29.33%] were females. Overall frequency of HER2 expression was 38% [n=25] in cases of gastric adenocarcinoma

Conclusion: Expression of HER-2 receptor in gastric adenocarcinoma in this study was 38% and it was associated with histological grade and type of adenocarcinoma. HER-2 more frequently expressed in well differentiated than undifferentiated carcinomas with non-significant p-value i.e. [0.139] and in intestinal type phenotype with significant p-value less than [0.05]

Immunohistochemical expression of epidermal growth factor receptor and c-kit in triple negative breast cancer

Objective: To determine the frequency of immunohistochemical expression of epidermal growth factor receptor [EGFR] and c-KIT in triple negative breast cancer [TNBC]

Study Design: Descriptive, cross-sectional study

Place and Duration of Study: Armed Forces Institute of Pathology [AFIP], Rawalpindi, from January to December 2014

Methodology: Fifty cases of triple negative breast cancer diagnosed on immunohistochemistry were included in the study

Patients' gender and age were noted. Immunohistochemistry for EGFR and c-KIT were applied and the results were recorded. The data were analyzed by using computer software programme SPSS version 19. Descriptive statistics, frequencies and percentages were calculated

Results: Out of 50 patients of TNBC, all patients were females. The ages of the patients ranged between 30 and 80 years with an average age of 48.9 years and standard deviation of +/- 10.0. Out of 50 cases, 29 cases [58%] were positive for EGFR while 15 cases [30%] were positive for c-KIT. Thirteen cases [26%] were positive for both EGFR and c-KIT

Nineteen cases [38%] were negative for both EGFR and c-KIT

Conclusion: EGFR expression was observed in 58% and c-KIT expression was seen in 30% of the cases. The results of EGFR expression are almost similar while those of c-KIT are different from international studies which suggest immunohistochemical differences between the studied populations

Clinicopathological characteristics of nasal polyps with chronic sinusitis

Objective: To evaluate the clinicopathological characteristics of nasal polyps associated with chronic sinusitis in polypectomy specimens

Materials and Methods: A total of 78 cases clinically presenting with signs and symptoms of chronic sinusitis with nasal polyps were studied over a period of 2 years

Results: Out of 78 cases 57 were non-neoplastic and 21 were neoplastic polyps, out of these only two cases were malignant. Non neoplastic polyps were bilateral in 37 cases and unilateral in 30. Majority among non neoplastic category were of inflammatory polyps [53.73%]. Other types included allergic 26.86%, fungal infection with polyp 14.92% and lymphocytic category 4.47%. Majority of the cases that is 93.58%, including all types of polyps presented with nasal obstruction and signs and symptoms of chronic sinusitis

Conclusion: Nasal polyps with chronic sinusitis diagnosed clinically are not always non-neoplastic in nature. Hence, histopathological evaluation in all such cases is essential to diagnose both benign and malignant masses

Calretinin expression in the differential diagnosis of ameloblastoma and keratocystic odontogenic tumour

To determine calretinin expression by immunohistochernistry in ameloblastoma and keratocystic odontogenic tumors [KCOT] and to document the use of calretinin as a differentiating marker between the two lesions. A cross sectional study conducted on previously diagnosed cases of ameloblastoma and Keratocystic odontogenic tumour. Armed forces Institute of Pathology, Rawalpindi Pakistan and duration was one year. [Sep 2009 - Aug 2010]. Twenty cases each of Ameloblastoma and KCOT were retrieved from the record files along with their paraffin embedded blocks. Histological features of all the cases were reviewed on freshly prepared slides and a fresh diagnosis made regardless of the previous diagnosis. The immunohistochemical marker, Calretinin, was applied on both types of cases using the avidin-biotinylated peroxidase complex method.The results were interpreted. In the cases of Ameloblastoma the epithelial tumour nests showed positivity for Calretinin expression. In 85% cases; intense and diffuse staining was observed in more than 80% of the stellate reticulum like cells while 15% cases showed focal and moderate staining patterns. On the other hand KCOT showed contrary results as none of epithelial lining expressed positive staining for Calretinin, [p<0.001]. Calretinin can be used as a useful marker for Ameloblastoma and can be used to differentiate KCOT from Ameloblastoma

Clinicopathological and immunohistochemical analysis of anaplastic large cell lymphoma

To study the clinicopathological and immunohistochemical features of Anaplastic Large Cell Lyrnphorna [ALCL]. The study design was cross sectional descriptive study. The study was conducted in Armed forces institute of pathology. The duration of study was two years from 1[st] Jan 2010 to 31st Dec 2011. A total of twenty five consecutive biopsy proven cases of anaplastic large cell lymphoma [ALCL] were selected through non probability, consecutive sampling. The inclusion criteria was, all newly diagnosed patients of ALCL having sufficient tumour material in paraffin embedded tissue blocks with appropriate clinical information regarding age, gender and anatomic location. The exclusion criteria included all poorly fixed specimen. The clinical information regarding age, gender and location was noted. All the cases were evaluated on Haematoxylin and Eosin [H and E]. Cases were subjected to Immunohistochemistry [IHC] using CD45 [LCA], CD3, CD 45 RO, CD 15, CD20, CD 30, ALK, EMA, Cytokeratin and classified according to WHO classification of lymphoid neoplasm. Twenty five cases of anaplastic large cell lymphoma were reported during this time period. Out of 25 cases, 22[88%] were ALCL ALK positive, 2[8%] were ALCL ALK negative and 1[4%] case was cutaneous ALCL. The male to female ratio was 2.5:1. The age range was between 6 years and 70 years with majority of cases in third decade. Seventy six percent were nodal and rest were extranodal. The cervical lymph nodes were the commonest nodal group involved making 15[60%] cases followed by 3 [12%] cases of axillary lymph nodes. The histopathological appearance showed complete effacement of architecture in 17 [68%] of cases followed by sinusoidal distribution in 6[24%] cases while partial effacement of architecture in 2 [8%] of cases. All the cases were positive for CD30 while 23 [92%] cases for CD3, 22 [88%] cases for ALK and 19 [76%] cases positive for EMA. ALK negative lymphomas were 3 [12%] cases. Anaplastic large cell lymphoma is more common in males and young adults. Nodal involvement is more common. Majority of cases show complete effacement of architecture. All cases are CD 30 positive. Most of cases are anaplastic lymphoma kinase antigen positive

study of ninety snake bite cases at Pakistan air force [PAF] hospital, shorkot, Pakistan

Analysis of clinicoepidemiological and laboratory findings of snake bite cases managed in PAF Hospital Shorkot. Descriptive observational study. PAF Hospital Shorkot, from July 2008 to June 2011. A total of ninety [90] cases of snake bite who reported in emergency department of the hospital were included in the study. Data of patients was recorded for type of snake [as much as possible], site of snake bite, presence of fang marks, age and sex of the person bitten, date, time and place of bite, time taken by the victim to reach hospital, presence of symptoms and signs of envenomation in victim and type of treatment received before referral. All patients were managed accordingly. Similarly type of in-hospital treatment like giving of anti-venom serum and total duration of hospital stay in each patient was also recorded. Data was then expressed in percentage. There were 70% male and 30% female patients. The age range was 7-54 years with a mean age of 27.8 +/- 10.8 years. Most of the cases of snake bite [82%] occurred between the months of April and September. A total of 60 [66.6%] patients were bitten at night. In 21 [23.3%] cases the victims brought the snakes, Among these, 4 [19.0%] snakes were scaled vipers, 3 [14.3%] snakes were kraits and 2 [9.5%] snakes were cobras, while 57.2% snakes remained unidentified. Majority [63%] had bites on lower extremities, 36% had bites on upper limbs. One [1.1%] victim was bitten on scrotum. Intravenous anti-snake venom was given to 52 [57.8%] patients. Majority of cases of snake bite occur during rainy summer season in rural areas particularly at night. Severity and pattern of envenoming varies from patient to patient. Knowledge of types of snake and risk factors and complications of snake bite is important. Early evacuation of snake bite cases to nearest hospital capable of dealing with snake bite can effectively reduce mortality and morbidity

CD 10 expression intensity in various grades and stages of urothelial carcinoma of urinary bladder

To evaluate CD 10 expression in urothelial carcinoma of the urinary bladder and the association of immunohistochemical [IHC] CD10 expression intensity with grade and stage. Study Design: Descriptive cross-sectional analytical study. Armed Forces Institute of Pathology, Rawalpindi, from January to December 2011. Methodology: Fifty consecutive cases of urothelial bladder carcinomas, obtained through transurethral resections, were included in this study. Hematoxylin-eosin [HE] stained sections from each case were re-evaluated histopathologically according to WHO 2004 grading system. The TNM system was used for pathologic staging. On selected slides IHC CD10 marker was applied and a semiquantitative scoring for its expression based on the percentage of positive cells and intensity was performed. Data was entered and analysed on SPSS version 17. Fisher's exact test was used to compare grades, stages of urothelial carcinoma with CD 10 expression and age groups. P < 0.05 was taken as level of significance. Results: Urothelial carcinoma was more common in males. The male to female ratio was 9:1. The older patients > 50 years had higher grade and stage as compared to the younger patients. All cases of high grade urothelial carcinoma showed higher positivity for CD 10. Twenty cases [86.95%] of high grade urothelial carcinoma were positive with +2 immunostaining while 3 cases [13.04%] were positive with +1 staining. None of the tumors of stage pTa was positive for CD 10 expression. Of all patients with stage pT 1 tumor, 1 case [5.3%] was CD 10 negative and 17 cases [89.9%] were CD 10 positive having +1 staining with 5 - 50% staining and 1 case [5.3%] had +2 staining with more then 50% expression. Out of all patients with stage pT 2, no tumor was CD 10 negative, 3 [13.6%] patients were CD 10 positive with +1 staining and 19 [86.4%] with stage pT 2 tumor had stained positive with +2 staining. CD 10 expression was greater in high grade and invasive urothelial carcinomas; it may be associated with tumor progression in bladder cancer pathogenesis

Pathology of high altitude pulmonary oedema

To describe autopsy findings in fatal cases of high altitude pulmonary oedema. Descriptive study. The study was carried out between 1999 and 2002 at an army field medical unit in Baltistan, Armed Forces Institute of Pathology, Rawalpindi and Army Medical College, Rawalpindi, Pakistan. Autopsies were performed in 17 fatal cases of High Altitude Pulmonary Edema [HAPE] occurring among soldiers serving in Siachen. All cases were males with a mean age of 26.8 years [19-35]. The mean altitude at which HAPE occurred was 5192 meters [2895-6492], and the mean duration of stay at these altitudes was 15.3 days [1-30]. Eleven individuals had undergone proper acclimatization. The commonest clinical findings were cough [70%] dyspnoea [53%], nausea [47%], headache [41%], vomiting [35%], chest pain [35%] and tightness in chest [24%]. Cyanosis and frothy secretions in the nostrils and mouth were present in all but one case. Mean combined weight of lungs was 1470 grams [1070-1810]. There was marked congestion of outer and cut surfaces. Interstitial oedema was present in all cases. RBCs and leukocyte infiltrates were seen in 13 and alveolar hyaline membranes in 9 cases. Thrombi were seen in 2 cases. Cerebral oedema was present in 9 cases. HAPE can occur after more than two weeks of stay at high altitudes despite proper acclimatization. Concomitant cerebral oedema is frequently present. Our autopsy findings are consistent with what has been reported previously

Second-opinion histopathology - a study of 142 cases at armed forces institute of pathology [AFIP], Rawalpindi, Pakistan

To assess the histopathological diagnosis made on the cases sent for second opinion to the Department of Histopathology. A descriptive study. Department of Histopathology AFIP, Rawalpindi, Pakistan from July 2010 to April 2011. During the study period, 142 cases were received for second opinion by the department. The demographical details of the patients were entered in a profroma. After initially seeing the H and slides, immunohistochemical and special stains were applied where required. The initial diagnosis and review diagnosis were then analysed. During the study period, 142 cases were analysed, 81 were male and 61 female patients. There was wide age range, from 2 months to 90 years. Out of the total 22 [15.5%] were reviewed for benign conditions and 120 [84.5%] were malignant. Majority of cases were from lymphoreticular system. In 72 [50.7%] cases diagnosis was changed on review out of which 9 were benign conditions and rest malignant. Out of the 63 malignant 27 cases and 3 out of 9 benign cases, were those where change in diagnosis was such that it changed the treatment pattern. In 12 cases the review diagnosis was changed from benign to malignant and vice versa. Getting second opinion on surgical biopsy material is very important part of treatment, particularly in our set up, where all the laboratories are not fully equipped.

Clinicopathological analysis of odontogenic cysts in a selected Pakistani population

The cysts of the jaw are broadly classified as odontogenic and non-odontogenic. The odontogenic cysts are pathological fluid filled cavities lined by odontogenic epithelium and further sub-classified as inflammatory and developmental. The objective was to determine the types, frequency, distribution, and demographic characteristics of odontogenic cysts in our setup. This 8 years retrospective study [from January 2003 to December 2010] was conducted at Histopathology department of Armed Forces Institute of Pathology, Rawalpindi [Pakistan]. The histopathology record of odontogenic cysts were reviewed for age, gender, site, associated tooth and histopathological diagnosis. The data was analysed by using SPSS soft ware package version 17. The data revealed that periapical, dentigerous and odontogenic keratocysts were the most commonly reported odontogenic cysts which reported in the age range of 4 to 72 years [mean 29.09 +/- 13.53 years]. Amongst them 67.7% were males and 32.3% females with peak incidence in the 2[nd] and 3[rd] decades. The association of age and teeth with different type of cysts was statistically significant while gender association was insignificant although having predilection for males. None of the case of odontogenic keratocyst was found in deciduous teeth. The statistically significant association of different types of Odontogenic cysts with the age, site, teeth and male prevalence reveals that demographic knowledge can be helpful in early diagnosis and their prompt treatment

Expression of p53 in adenoid cystic carcinoma of salivary glands - a clinicopathological and immunohistochemical correlation

To document p53 protein expression in Adenoid cystic carcinoma [AdCC] of salivary glands and correlate this expression with clinicopathological parameters in prognostic assessment of AdCC at microscopic level. This Correlation study was carried out at Armed Forces Institute of Pathology [AFIP], Rawalpindi for 6 months. A total of 40 cases of AdCC diagnosed in salivary glands of five years duration [2006-2010] were retrieved from tumor registry. Clinical information was extracted from histopathology request forms submitted with the specimens. Fresh slides were prepared for histopathological [H and E stalling] and subsequent p53 immunohistochemical evaluation. Out of 20 patients [50%] belonging to 31-50 years age category, 12 were positive and 8 cases were negative for p53 expression. Majority of patients were male [n=27, 67.5%], among which 17 yielded positive while 10 had negative p53 expression. Among tumors evolving from major salivary glands [n=13], 10 showed positive whereas only 3 displayed negative results for p53 expression. Maximum number of tumors [n=17, 42.5%] were greater than 4 cm in size with 12 of them as p53-positive and 5 as p53-negative. Results for histopathological subtype and tumor grade were similar, with 34 [85%] revealing cribriform growth pattern, thus having grade Il neoplasms, with equivocal p53 staining, yielding 18 as p53-positive and 16 as p53-negative neoplasms in each parameter. Though small in count, all tumors with solid histological subtype [n=5, 13%], hence with grade Ill neoplasms exhibit positive p53 expression. Perineural invasion '.vas present in 77% [n=31] of tumors, among which 17 were having positive while 14 were having negative p53 expression. Lymphovascular invasion was present in 37 [92.5%] cases, among which 22 yielded positive while 15 had negative expression of p53. Tumors with larger size [_4cm], solid growth pattern, grade Ill neoplasm and major salivary gland as primary tumor site bear positive correlation with p53 protein. Though none of the correlation turned out as statistically significant to be used as key element in prognostic assessment of AdCC at microscopic level, however the above mentioned parameters can be considered important while planning the management which may need an aggressive approach in these cases. There is a need of more research for additional comprehensive prognostic assessment of salivary gland AdCC

Clinicopathalogical analysis of benign salivary gland tumours: a study of 242 cases at AFlP Rawalpindi [Pakistan]

Objective: to analyze the clinicopathological aspects of benign salivary gland tumors. Materials and Methods: This descriptive case series study was carried out from Jan 2003 to Dec 2009 at Armed Forces Institute of Pathology Rawalpindi, [Pakistan]. All cases of benign salivary gland tumors were reviewed and their diagnoses were reconfirmed. The data regarding all the major and minor salivary gland tumor was analyzed using computer soft ware program SPSS [version 17]. The descriptive statistics and frequency was calculated for type of tumors, age, gender, site and size. Association of these parameters with the type of tumor was calculated by using chi square test. Results: the most common histological tumor type found was pleomorphic adenoma, followed by Myoepithelioma. All these cases presented between 12 and 85 years of age [mean 39.7 +- 16.91] mostly in the 3rd and 4th decades of life with 48.7% males and 51.3% females respectively. The most frequent site involved by these tumors were parotid gland [66.5%]. Submandibular gland, minor salivary glands of palate and lip were the other sites involved, but none of the tumor was found in sublingual gland. The tumor size ranged between 0.4 to 18 cm with maximum variation in Pleomorphic adenoma and myoepithelioma. Conclusion: benign salivary gland neoplasm are more common than their malignant counterparts. They occur mostly in 3rd and 4th decade. Parotid gland is the most common site and pleomorphic adenoma remains the most common bengin salivary gland neoplasm followed by myoepithelioma.

Clinicopathdlogicai of Clinicopathological study of extranodal Non-Hodgkin Lymphoma [NHLS] at Armed Forces Institute of Pathology [AFIP] Pakistan

To evaluate the Clinicopathological analysis of extranodal Non-Hodgkin Lymphoma [NHLs] reported in Armed Forces institute of Pathology [AFIP] Rawalpindi, Pakistan. Record of a total of 206 cases of extranodal NHLs diagnosed between January 2009 to December 2010 was retrieved from AFIP tumour registry. Basic epidemiological data regarding each case was collected from the request forms. The specimens were received in 10% formal saline. Gross examination of surgical specimens was performed arid recorded on a proforma. The material was processed under standardized conditions for paraffin embedding. The sections were stained with hematoxylin and eosin [H/E]. Immunohistochemistry panel was applied for the categorization of the lymphomas according to the 2008 WHO guidelines. Data was entered and analysed on SPSS version 14. Out of 206 cases, 147 [71.3%] were males and 59 were females [28.6%]. Male to female ratio was 2.4:1. The age ranged between 7-99 years. The most commonly affected age group was the 5[th] decade with 40 cases [19,4%], The most commonly involved site was head and neck, 85 cases [41.2%], followed by the GIT, 61 cases [29.6%]. Diffuse large B-cell lymphoma [DLBCL], was the most common histologic type, 165 cases [80%].Diffuse large B-cell lymphoma is the most common extranodal Non Hodgkin lymphoma, in our population

Histomorphological analysis of oral white lesions

To histomorphologically analyze the oral white lesions. Descriptive, cross-sectional study. Department of Histopathology, Armed Forces Institute of Pathology [AFIP], Rawalpindi. From May 2011 to May 2012. A total of 54 patients presenting with oral white lesions were included. Age, gender, site and size was recorded. The biopsy sample was fixed in 10% formalin and after standardized processing, slides were prepared, stained by Hematoxyline and Eosin, with special stains when required. The histopathological diagnosis of lesion was recorded. Mean and standard deviation were calculated for quantitative variable. Frequency and percentages were calculated for qualitative variables. Out of total 54 patients 28 were male and 26 females. The age range was 17-80 years with mean age 49.70 years. Majority of the patients were between 50-60 years. Buccal mucosa was affected in majority of the cases [63%], followed by lip mucosa and tongue. Histologically Lichen Planus was the most common lesions [33%], followed by non specific inflammation [14.8%], keratosis without dysplasia [11%], keratosis with dysplasia [7.4%], Pemphigus Vulgaris [6%] and Squamous cell carcinoma [1%].Lichen Planus is the most common cause of white lesion in our set up. Biopsy of an intact epithelial lesion should be considered if the lesion does not resolve in due course of time

Oral squamous cell carcinoma: a clinicopathological study of 467 cases at afip Rawalpindi, Pakistan

The purpose of this study was to determine the clinicopathological and demographical characteristics of histologically diagnosed cases of oral SCC. Evaluation is based on age, gender, site of tumor and histological differentiation. Histologically diagnosed cases of oral SCC during a period of 3 years [Jan 2007 - Dec 2009] were retrieved from the tumor records of Department of Histopathology, Armed Forces Institute of Pathology, Rawalpindi, Pakistan. Biopsy specimens at the institute are obtained from Armed Forces as well as public and private sector hospitals including the review cases for second opinion. All the cases were subjected to the analysis of age, gender distribution, site of tumor occurrence and grade of histological differentiation. Out of a total of 12611 tumors recorded at AFIP Tumor registry, 467 cases of oral neoplasms were diagnosed as SCC [3.7%]. Among head and neck tumors recorded in the study period, oral SCC comprises 32.9% of the total. The mean age [ +/- standard deviation] of patients was 55.9 +/- 13.3 years [range, 5-90 years] with a male predominance [52.5%], yielding male to female ratio of 1.1:1. Peak incidence is found in 60 years of age. Most common site was buccal mucosa [29.8%] followed by tongue [23.1%] and mandible [13.5%]. Most common histological grade was well differentiated [67.5%] followed by moderately differentiated [26.8%] and poorly differentiated [5.8%] histological subtypes. Oral SCC is the most common malignancy of head and neck region in our community with peak incidence in comparatively older age group. There is an overall male predominance except in younger age group, where it is more common in females. Most common site of tumor is buccal mucosa. The well differentiated grade is the most common histological type of differentiation

Epithelioid haemangioendothelioma of the palate

Epithelioid Haemangioendothelioma [EHE] is an uncommon malignant vascular neoplasm that can develop at any anatomical site. In our report we describe a case of oral Epithelioid Haemangioendothelioma. A 13 years old male boy presented in the Oral Surgery Department of Armed Forces Institute of Dentistry with a growth in the left hard palate for the past 3 weeks. The growth was removed surgically and the specimen was sent to the Histopathology department of Armed Forces Institute of Pathology. On the basis of morphological features it was diagnosed as Epithelioid Haemangioendothelioma of the palate

study of fine needle aspiration cytology [FNAC] appearance of salivary gland tumors

To analyse the Fine Needle Aspiration Cytology [FNAC] appearance of salivary glands tumors diagnosed at AFIP Rawalpindi. The study was carried out in the Histopathology department of AFIP. A total of 95 patients were selected from January 2009 to December 2010. All the patients diagnosed as salivary gland tumors were included in the study. The FNA was performed on these patients and the material was spread on slides. These slides were then stained with Hematoxylin/Eosin and Haema color [Modified Giemsa Stain]. Routine light microscopy was performed on these cases and diagnosis was made. The data analysis was performed using SPSS version 14. The study included 95 patients with salivary gland swellings. There were 50 [60%] male and 45 [40%] female patients with an age range of 13-75 years. Pleomorphic adenoma was the most common diagnosis, 48 cases [47.8%], followed by Mucoepidermoid Carcinoma 10 cases, and Adenoid Cystic Carcinoma 7 cases. Others tumors included 4 cases of Adenocarcinoma [4.2%], 3 cases of Warthin's tumor [4%], one case each of Squamous cell Carcinoma [0.6%], Oxyphilic cell tumor [0.6%] and Benign Hemangiomatous Lesion [0.6%]. Thirteen cases of malignant neoplasms [15.4%] and 7 cases of benign neoplasms [7.1%] could not be exactly typed. It is concluded that Pleomorphic Adenoma was the most common salivary gland tumor diagnosed on FNAC, followed by Mucoepidermoid Carcinoma and Adenoid Cystic Carcinoma

Nephroprotective activity of some herbal preparations

The present paper is the first review of published literature on plants and their products which have been studied experimentally/clinically for their effects on renal functions. It covers literature reports that have appeared till June 2003 and covered in PubMed and MAP A [Medicinal and Aromatic Plants Abstracts]

Radial artery as a grafting surgery: Early experience at AFic / NIHD

The long-term patency of vein grafts in the coronary circulation has been poor. By contrast, the left internal thoracic artery [LITA] graft to left anterior descending coronary artery [LAD] has been associated with excellent patency and good clinical results. The revival of radial artery [RA] as a graft has offered another source of arterial conduit in addition to the use of right internal thoracic artery [RITA]. We evaluated our early experience with the use of RA as a conduit for coronary artery bypass grafting [CABG] surgery to establish its safety and efficacy. we studied 606 consecutive patients from January 2003 to December 2003 who underwent CABG surgery at our institute. Radial artery was used as a conduit 'in 214 patients. Data was collected prospectively. In the radial artery group, the age range was 27 - 72 years, mean age 49.5 years. 136 [64%] of the patients had diabetes, only 7 [3.27%] patients were females. 8 [3.73%] patients had left ventricular ejection fraction of less than 30%, 146 [68.22%] patients had EF of 30-45% and rest were with good left ventricular function. 23 [10.74%] patients were classified as unstable/urgent. The conduits included were 206 left internal thoracic arteries, 26 right internal thoracic arteries and 214 radial arteries and 170 were vein grafts. Average number of grafts per patient was 2.87. Top ends of the free arterial grafts as well as all the vein grafts were anastamosed directly to the ascending aorta. Patients were followed up to 6 weeks, 24 weeks and then 6 monthly thereafter. Complications included intra operative or post operative myocardial infarction in 6 [2.8%] patients, sternal wound infection in 4 [1.86%] patients, reoperation for excessive bleeding 17 [7.94%] patients. 14 [6%] patients required intra aortic balloon pump support, 46 [21%] required inotropic support. The incidence of hand complication was 7% [15 patients]. The overall mortality rate in radial artery group was not much different from the non-radial artery group of patients undergoing CABG surgery in our settings. Conclusions: Radial artery may be used as a conduit for coronary artery bypass grafting operation with confidence as regards its safety