Utility of Papanicolaou’s smears in the diagnosis of premalignant and malignant lesions of the cervix in a tertiary care centre of South Gujarat, India

Background: "Preventable but not prevented", this is the reality of cervical cancer today, at least in developing countries. 80% of all the cases of cervical cancer occur in these developing countries. In India, cervical cancer is the leading cause of cancer related deaths in women. The Papanicolaou test is simple, quick, and painless. It is capable of detecting cervical cancer at an early stage and is used widely in developed countries, where it has decreased both the incidence and mortality of cervical cancer. Objective of the study was conducted to determine the importance of conventional Pap smears for the diagnosis of inflammatory, premalignant and malignant lesions of the cervix.Methods: This cross-sectional study was conducted from January 2017 to June 2018 on 2000 women coming for a Pap smear examination in Government Medical College attached to New Civil Hospital, Surat. After doing Pap stain, all cases were reported as per the 2014 Bethesda system.Results: A total of 2000 cases of Pap smears were received out of which 1914(95.7%) cases were satisfactory for evaluation, 86(4.3%) cases were unsatisfactory. The frequency of epithelial abnormalities was 3.66%. The age group of 51-60 years showed the highest epithelial abnormalities. The frequency of epithelial abnormalities in asymptomatic women was 2.3%. Out of the 1844 cases, 103(5.6%) showed changes of atrophy, 1011(54.8%) cases showed inflammatory/reactive changes, whereas organisms were seen in 558(30.3%) cases.Conclusions: Pap smear happens to be an economical, safe and pragmatic diagnostic tool for early detection of cervical cancer

Bone marrow examination in cases of pancytopenia

Background: Pancytopenia is a relatively common hematological entity. This study was undertaken to find out the various causes of pancytopenia by bone marrow examination of patients admitted to New civil hospital, Surat, Gujarat, India.Methods: This was a prospective study carried out to identify the causes of pancytopenia based on bone marrow examination. Bone marrow examinations were performed in 144 cases for different indications over a period of one year 2015, out of which 40 cases have fulfilled the criteria of pancytopenia.Results: Total 40 cases of pancytopenia were examined during period of one year. The commonest cause of pancytopenia was megaloblastic anemia (35%) followed by aplastic anemia (32.5%). other cause includes acute leukemia, myelodysplastic syndrome (MDS) and round cell tumor.Conclusions: Bone marrow aspiration coupled with trephine biopsy can diagnosed majority cases of pancytopenia. Megaloblastic anemia and aplastic anemia are the commonest causes of pancytopenia. A comprehensive clinical and hematological study of patients with pancytopenia will help in the identification of underlying cause

Pattern distribution of abnormal hemoglobin variants by cation exchange High Performance Liquid Chromatography: a study of 9,116 subjects

Background: The present study was conducted to identify pattern distribution of abnormal haemoglobin variants by using HPLC method in a tertiary care hospital, Surat, Gujrat, India.Methods: A cross sectional study of one-year duration was conducted including 9,116 patients screened for the presence of abnormal haemoglobin variants. Blood samples were initially tested for solubility test and run on automated haemoglobin analyzer for complete haemogram. All the suspected and family study cases were processed for HPLC (Bio-Rad Variant II) for conclusive diagnosis. Patients with a history of recent blood transfusion of less than 3 months duration were excluded from the study.Results: A total of 9,116 cases (1390 males, 7726 females) were included in the present study. The age group of patients ranged from 1 month to 95 years. Solubility test and complete haemogram were performed in all the cases. Out of the 9,116 cases, 8409(92.24%)cases had normal HPLC pattern. 492(5.40%)cases were diagnosed as sickle cell trait, 176(1.93%) cases as sickle cell disease, 29(0.32%) cases as β thalassaemia trait, 1(0.01%) case as β thalassaemia major, 2(0.02%)cases as Hb E heterozygous and 03 (0.07%) cases as Hb D Punjab heterozygous. One case of double heterozygous for Hb E-β thalassaemia was also found.Conclusions: HPLC is a rapid, accurate and useful method for diagnosing haemoglobinopathies. It serves as an reliable tool in diagnosing the presence of abnormal haemoglobin variants in suspected cases on routine haematology in developing countries like India, where the resources for detection of haemoglobinopathies are limited. Early diagnosis may help in proper management of patients

Shifting trends of lung tumours and its diagnosis by lung biopsy: a study of 78 cases

Background: The objective of the study was to study the spectrum of pathological lesions in patients with lung mass and to study correlation between clinical findings, histopathological pattern and immunohistochemical stains in various biopsy specimen for differentiation and typing of tumors.Methods: This retrospective study was done for the period of three years at Department of Pathology, New Civil Hospital, Surat, India, which is a tertiary health care Centre. Here we studied 78 cases of lung biopsy received in formalin, which were subjected to histopathological examination. Immunohistochemistry was performed as and when required.Results: Total 78 lung biopsy specimens were examined. Out of which, 59 cases (75.6%) were neoplastic, 12 cases(15.4%) were non-neoplastic and 7 cases (9%) were inconclusive. The commonest histological type of malignancy was adenocarcinoma which is associated with peripheral mass lesion, female gender and in non-smokers. Commonest non-neoplastic lesion was tuberculosis.  Malignancy was seen quite common in patients presented with lung masses in our institute.Conclusions: Lung tumours are quite common in patients presented with mass lesion. Similar to global trend, adenocarcinoma is the commonest histological type now and associated with change in incidence among women, in non-smokers, molecular alteration and prognosis which need further investigation. Immunohistochemistry is helpful in cases which are not accurately subtyped by histomorphology alone.

Evaluation of peripheral lymphadenopathy by fine needle aspiration cytology: a one year study at tertiary centre

Background: Lymphadenopathy is common presenting features in various non-neoplastic and neoplastic lesions. Fine needle aspiration cytology (FNAC) is simple, quick, inexpensive and minimally invasive technique that can be used as an outpatient procedure to diagnose them. The present study was undertaken to assess the various causes of lymphadenopathy through FNAC, and to see the distribution of lesions with respect to age and gender. To assess the diagnostic accuracy of lymph node fine needle aspiration (FNA) cytology in various non-neoplastic and neoplastic conditions.Methods: Total 555 cases of the lymph node FNAC were studied from January 2014 to December 2014 in Cytopathology department of Government Medical College, Surat .The cytomorphologic features seen in the aspirates were analyzed and correlated with their etiology.Results: In this study 555 cases of cervical lymphadenopathy were analysed. The age of the patients ranged from 5 months to 90 years of which 60.2% were males and 39.8% were females. Maximum numbers of cases 147(26.4%) were in the age group of 21- 30 years. The most common lesion encountered was tuberculous lymphadenitis 44.8% followed by metastatic tumors 31.3%, reactive lymph node 16.7%, acute lymphadenitis 5.4% and lymphoma 1.8%. Male showed predominance of metastatic carcinoma and lymphoma while chronic reactive hyperplasia and tuberculous lymphadenitis were equally distributed in both male & female.Conclusions: FNAC is safe, rapid and cost effective method in establishing the diagnosis in large number of cases of lymphadenopathy. It can differentiate a neoplastic from a non-neoplastic process and therefore influence patient management preventing patient from being subjected to unnecessary surgery

Extraskeletal myxoid chondrosarcoma of thigh: a rare case report

Extraskeletal myxoid chondrosarcoma (EMC) are a rare entity of soft tissue tumors that occur predominantly in soft tissue of lower extremities. Here we present a case of 45-year-old female presented with left thigh swelling. MRI finding suggested primary neoplastic lesion. Fine needle aspiration cytology (FNAC) suggested myxoid soft tissue neoplasm/sarcoma. Morphological examination revealed typical extraskeletal myxoid chondrosarcoma with strong immunoreactivity for vimentin and focal immunoreactivity for epithelial membrane antigen (EMA)

Calcifying fibrous tumour: a rare case report of an exceptional lesion localized in retroperitoneum, mesentery and pelvis

Calcifying fibrous tumours are rare benign lesions affecting mostly children and young adults. A 17-year-old female presented with abdominal pain and abdominal distention. Physical examination revealed intra-abdominal mass occupying retro peritoneum and right iliac fossa. Excisional biopsy from peritoneum and mesentery were performed. Histopathologically, it was composed of hypocellular hyalinised collagenized stroma, spindle cells, psammomatous and dystrophic calcification and mononuclear inflammatory cell infiltration. Authors are here in reporting a case of calcifying fibrous tumour and discussing its clinical and morphological features with regard to the literature

Disease Specific Autoantibodies in Idiopathic Inflammatory Myopathies

Idiopathic inflammatory myopathies represent still a diagnostic and therapeutic challenge in different disciplines including neurology, rheumatology, and dermatology. In recent years, the spectrum of idiopathic inflammatory myopathies has been significantly extended and the different manifestations were described in more detail leading to new classification criteria. A major breakthrough has also occurred with respect to new biomarkers especially with the characterization of new autoantibody-antigen systems, which can be separated in myositis specific antibodies and myositis associated antibodies. These markers are detectable in approximately 80% of patients and facilitate not only the diagnostic procedures, but provide also important information on stratification of patients with respect to organ involvement, risk of cancer and overall prognosis of disease. Therefore, it is not only of importance to know the significance of these markers and to be familiar with the optimal diagnostic tests, but also with potential limitations in detection. This article focuses mainly on antibodies which are specific for myositis providing an overview on the targeted antigens, the available detection procedures and clinical association. As major tasks for the near future, the need of an international standardization is discussed for detection methods of autoantibodies in idiopathic inflammatory myopathies. Furthermore, additional investigations are required to improve stratification of patients with idiopathic inflammatory myopathies according to their antibody profile with respect to response to different treatment options

A Review on Image Segmentation Clustering Algorithms

Abstract — Clustering attempts to discover the set of consequential groups where those within each group are more closely related to one another than the others assigned to different groups. Image segmentation is one of the most important precursors for image processing–based applications and has a crucial impact on the overall performance of the developed systems. Robust segmentation has been the subject of research for many years, but till now published work indicates that most of the developed image segmentation algorithms have been designed in conjunction with particular applications. The aim of the segmentation process consists of dividing the input image into several disjoint regions with similar characteristics such as colour and texture