Unusual histological presentation in neurofibromas: Two case reports

Various histological variants of neurofibroma have been described. The objective of this paper is to discuss the unusual histological findings seen in two cases of neurofibromas associated with neurofibromatosis type 1 Both cases presented with multiple subcutaneous nodules. Surgical excision of the largest nodule was done in both the cases. Histological examination of case no.1 revealed a benign tumor of the peripheral nerve sheath, of neurofibroma type with presence of mucus producing glands. The epithelial component was benign in this case. The second case showed presence of rosettes in between areas of typical neurofibroma

Effective Feedback Practices in Formative Assessment : Recognizing the Relevance

Feedback is proposed to be a critical element of formative assessment (FA) but  evidence reflects its sparse  and incongruous implementation . Current study on feedback sessions post formative assessment was undertaken to establish the extent to which it can make significant contribution in improving learning outcomes and the learners’ perception about the same when compared to written feedback comments in answer sheets, which is a routine practice. An Experimental, Randomized, Controlled study with sample population being students in first phase of medical curriculum , were randomized into cases (n= 37) and matched controls ( n= 38) . The cases underwent feedback sessions after formative assessment. Difference in scores between cases and controls in Summative assessment was statistically significant (P = 0.002). Scores in formative and Summative assessment was statistically non-significant (p = 0.30) within controls (n=38) and statistically significant (P = 0.006) within cases ( n= 37). Qualitative analysis was done for comparing the utility and efficacy of feedback sessions compared to written comments on answer sheets. Study concludes that feedback sessions post - formative assessment, irrespective of success, may determine greater involvement of students in learning process and improve learning outcome. The tutors should be made aware of proper feedback techniques and tailor feedback sessions according to specific needs. Students should be made conscious of various assessment process so that they become cognizant of seeking feedback. Keywords : Formative assessment  , Written comments ,  Feedback session

PTEN Immunoexpression in Atypical Endometrial Hyperplasia and Endometrioid Endometrial Carcinoma: A Research Protocol

Introduction: One of the major cancers affecting women is of Endometrial Carcinoma (EC). Therefore, its molecular characterisation remains important. Phosphatase and Tensin Homolog (PTEN) gene defects are one such molecular pathology commonly seen in lesion of atypical endometrial hyperplasia and EC. However, studies on PTEN immunoexpression in India are scarce. Aim: To study immunoexpression of PTEN and its correlation with various clinicopathologic parameters in lesion of atypical endometrial hyperplasia and EC. Materials and Methods: It will be carried out as a crosssectional study with prospective and retrospective design with sample size of 20 cases each in two groups- cases diagnosed on biopsy or surgical specimen of atypical endometrial hyperplasia and endometrioid endometrial carcinoma type -1, dividing them into sample size of 20 for each group. PTEN immunoexpression will be observed by immunohistochemical method on paraffin section of the tissue. The study would make the observation on the PTEN positivity by IHC in atypical endometrial hyperplasia and type-1 EC. The positive research of IHC will be compared for various other clinicopathologic parameters included in the study for both the endometrial lesion. The statistics of comparison will be drawn by using standard statistical test

Red Blood Cell Morphology in Diabetic Patients: A Case-control Study

Introduction: According to earlier studies, patients suffering from diabetes frequently experience haematological changes. India is the diabetes capital, with 69.1 million residents suffering from the disease. Aim: To study Red Blood Cell (RBC) morphological changes and grading on percentage of cells that differ in size and shape from normal erythrocytes in diabetic patients. Materials and Methods: The case-control study was conducted at Division of Central Clinical Laboratory in Department of Pathology in coordination with Department of General Medicine at Jawaharlal Nehru Medical College, Wardha, Maharashtra, India, from October 2019 to October 2021. Total 90 known cases of diabetes mellitus, aged between 18-80 years and 90 subjects (control group) with normal blood glucose levels were included for the study. Demographic details, anthropometric, parameters i.e, Fasting Plasma Glucose (FPG), Random Blood Sugar (RBS), Glycated haemoglobin (HbA1c) and morphology of blood smear were assessed. Results: The mean age of study group was 54.98±2.31 years and control group was 50.45±17.94 years (p-value= 0.0004). The mean random blood sugar of study group was 163.92±91.31 mg/dL and of control group was 96.92±22.31 mg/dL (p-value=0.0001). Mean HbA1c for the study group was 7.73±1.71%, while in control group was 5.24±0.62% (p-value=0.0001). In the study group, 9 (10%) cases showed a slight anisocytosis (1+) and 3 (3.3%) cases showed moderate anisocytosis (2+), 2 (2.2%) cases showed marked anisocytosis (3+) (variation in size of RBCs with respect to normal) in respect to Mean Corpuscle Volume (MCV), and 11 (12.2%) cases showed MCV 80 fL, while majority of the cases; 77 (85.5%) had normal sized RBCs, had MCV between 80-99 fL. Conclusion: The findings of the study suggest that there is need for some simple and effective techniques like ectocytometry, micropore filtration for routine haematological tests in type 2 diabetes mellitus

Correlation of microvessel density with histopathological parameters of carcinoma breast

Background & objectives: Microvessel density (MVD) is a surrogate measure of tumour angiogenesis, and is well known for over two decades to identify individuals with a high risk of recurrence with greater prevision than traditional markers. This study aims to assess the utility of MVD and its correlation with the Nottingham Prognostic Index (NPI) and other routine histopathological parameters in carcinoma breast. Methods: This two year retrospective, cross-sectional and analytical study evaluated 143 women with breast cancer presenting to rural tertiary hospital in central India. These women were graded histopathologically, the immunophenotype was determined using ER (estrogen receptor), PR (progesterone receptor), Her2 neu (human epidermal growth factor receptor 2 neu) and Ki-67 proliferation index (Kiel-67) immunohistochemical markers and anti-CD34 antibody to stain the endothelial cell clusters displaying the microvessels. The NPI was generated for each participant based on the tumour size, histologic grade and involvement of lymph node. The parameters were compared with the CD34 scores. Differential and inferential statistics, including the independent t test, analysis of variance, Pearson's correlation coefficient, Spearman's rank correlation coefficient and point biserial correlation coefficient, were used for statistical analysis. Results: This study showed that CD34 values ranged from 6-36 microvessels/hpf, with 24.16±6.77 microvessels/hpf as the mean. The mean microvessel counts showed a significant positive correlation with the Bloom–Richardson histological grade, vascular invasion, LN (lymph node) positivity and NPI. However, there was no significant correlation of CD34 values with the participant's age, tumour size neither any significant association of CD34 values with the individual's immunophenotype. Interpretations & conclusions: A positive linear correlation of the microvessel counts and the NPI scores suggest that with an increase in tumour angiogenesis, there was increased proliferative potential. Based on the significant correlation between the microvessel counts and the vascular invasion of the tumour masses in this study, it can be assumed that there will be vascular invasion if the microvessel count is higher and vice-versa. Although it is established that angiogenesis and neovascularization are required for the expansion of the solid tumour tissue, the heterogeneous nature of this entity makes it difficult for obtaining a linear correlation. Hence, it is suggested that though neovascularization permits advanced tumour spread it, however, does not guarantee it

Comparison of Cytokeratin Expression Vis-à-Vis Bloom–Richardson Grading of Breast Carcinoma in Resource-limited Setup: A Cross-sectional Study

Background: Breast cancer is the most common malignant tumor and the leading cause of female mortality. Its incidence and prevalence are rapidly increasing worldwide. Age <35 years, multiple nodal involvements, ad increased size and grade are the bad prognostic factors indicating a higher risk of recurrence. Early diagnosis of breast cancer is one of the best approaches to prevent this disease. Aim: The aim of this study is to develop an understanding of the relationship between cytokeratin (CK) 5/6 and CK 8/18 expression and the Bloom–Richardson (BR) grading of carcinoma breast. Materials and Methods: The present observational, analytical, and cross-sectional study investigated CK 5/6 and CK 8/18 expression in relation to the BR grade in 50 cases of infiltrating ductal carcinoma. Hematoxylin and eosin staining for BR grade and immunohistochemistry for CK 5/6 and CK 8/18 was carried out in the histopathology and immunohistochemistry sections of the Department of Pathology, Jawaharlal Nehru Medical College, Sawangi (M). Results: Out of 50 cases, CK 5/6 expression was observed in the majority of BR Grade III cases (87.50%) indicating a basal phenotype, and CK 8/18 expression was seen in the majority of BR Grade I cases (92.86%) signifying a luminal phenotype. The P value interpretation was found to be statistically significant (<0.05). Conclusions: CKs along with BR grading can be used as an alternative tool for predicting the endocrine status of carcinoma breast instead of employing an expensive panel of markers

Unilateral Carotid Body Tumour: A Case Report

The carotid body, which is located bilaterally on the medial side of the carotid bifurcation, is the largest group of paraganglia in the head and neck. Chemoreceptor cells in the carotid bulb give rise to uncommon tumours known as Carotid Body Tumours (CBTs). The authors describe a case of a CBT in a 40-year-old woman who had a painful, pulsatile, lateral neck enlargement on the right side that had been developing over time. Due to the numerous difficulties and problems brought on by their high vascularity and close proximity to cranial nerves in the neck near the carotid bifurcation, they pose a surgical challenge. Based on the patient's medical history, the results of clinical and radiological examinations, and the successful surgical removal of the tumour, the diagnosis was suspected. The results of histological analysis supported the diagnosis of a CBT

Utility of COX-2 as Immunohistochemical Prognostic Marker in Relation to Various Histopathological Parameters and TNM Staging in Colorectal Carcinoma

Introduction: The most prevalent neoplasm of the gastrointestinal system is colorectal carcinoma. After lung and breast carcinoma, malignant colorectal cancer appears to be characterised by inflammation. Among the numerous recognised indicators of inflammation, Cyclooxygenase-2 (COX-2) has been identified as playing a key role in the early phases of carcinogenesis. The link between higher expression of COX-2 and the early stages of carcinogenesis and cancer development implies that COX-2 might be a target for pre-cancerous colorectal lesion imaging. Aim: To assess the expression of COX-2 in colorectal carcinoma and the association with various histopathological parameters and Tumour Node Metastasis (TNM) staging. Materials and Methods: The current study is an observational, cross-sectional, retrospective, and prospective study that will take place in the Histopathology and Immunohistochemistry unit of the Department of Pathology, Jawaharlal Nehru Medical College, Sawangi (Meghe), Wardha, Maharashtra, India. Sample collection will be done during the the period of august 2021 to july 2024. The study included approximately 60-65 resected specimens from confirmed and planned Colectomy, Hemicolectomy, and Proctocolectomy specimens received in the Department of General Pathology, JNMC. Observations and results will be collected from the immunohistochemistry study by using COX-2 as a prognostic marker in colorectal carcinoma and correlating it with the TNM staging. Statistical analysis will be made by chi-square test and regression analysis

Comparative evaluation of role play and group discussion as teaching-learning method for behavior management in pediatric dentistry

Communication, behavioral and attitudinal skills are an integral part of teaching behavior management to dental undergraduate students. Due to the complexity of these skills, clinical teaching through didactic method imparts minimal capacity for adopting deep approach to learning. The implication of role play and group discussion could be an opportunity to facilitate such learning outcome. The objectives of this study were to evaluate and compare the efficacy of role play and group discussion as teaching-learning methods for behavior management in pediatric dentistry. The study was carried out with ninety-two final BDS undergraduate students at Sharad Pawar Dental College &amp; Hospital, INDIA. Tell-Show-Do, non-pharmacological behavior management technique was taught to intervention and control group by role play and group discussion method respectively. To assess knowledge gain, pre-test and post-test was conducted. To evaluate acquisition of communication, behavioral and attitudinal skills, students were made to perform a clinical procedure i.e. placement of pit and fissure sealant in primary molars. Each student was evaluated by direct observation using a check-list. &nbsp;Role play method was found to be highly effective as significant difference was observed in knowledge gain (p=0.020) and acquisition of behavioral and attitudinal skills (p= 0.027) among intervention and control group