Death due to sickle cell anaemia, an autopsy diagnosis: a study at a tertiary care hospital

Background: Sickle cell disease (SCD) is the generic term for the group of inherited haemoglobinopathies caused by the occurrence of Haemoglobin S (HbS) in the homozygous or heterozygous form in combination of Hbs with another abnormal haemoglobin such as HbSC or beta-thalassaemias (HbS-thal). Sickle cell syndromes are remarkable for their clinical heterogeneity, including their presentations as sudden and unexpected deaths due to a sickle cell crisis. Less numbers of deaths are reported due to this cause because of ignorance of autopsy surgeon in considering this disease as a cause of death despite of its high prevalence. While doing autopsy in cases of deaths with no apparent cause and physical over activity medical officer must keep in mind the possibility of death due to vaso-occlusive crisis in sickle cell disease.  Methods: The study covers a period of one year (January 2013 - December 2013) and it is a study of cases of autopsy carried out in a tertiary care hospital of South Gujarat.Results: A total of 607 cases examined, out of which sickled red blood cells were detected in 17 cases. The respective records were reviewed. Out of 17 cases, 13 cases were male and 4 cases were females. The youngest person was 15 years female and oldest was 70 years male.  Conclusion: Sickle cell crisis is one of the causes of sudden unexplained deaths. The present study highlights the role of autopsy in such cases. Community awareness and marriage counseling programs are also helpful in preventing sickle cell disease.

Study of cervical pap smears in a tertiary care hospital of south Gujarat, India

Background: In India cervical cancer is the leading cause of morbidity and mortality. Cancer of cervix is preventable, and can be diagnosed at the pre-malignant/pre-invasive stage with adequate and repetitive cytological screening by Papanicolaou (Pap) smears.  Methods: The prospective study includes total 1425 patients who were presented with various gynecological problems. Samples were taken and prepared smear were stained with PAP stain. Reporting was carried out by two independent cytopathologist as per Bethesda system.Results: Total 1425 patients were screened; there were 1034 (72.56%) abnormal Pap smears, with 354 (24.84%) normal cases and 37 (2.59%) unsatisfactory or inadequate samples. Total 27 (1.89%) cases showed epithelial cell abnormalities. ASCUS was the most commonly found (40.74%) epithelial cell abnormality out of 27 cases.Conclusions: Incidence of invasive cervical malignancy can be prevented if Pap screening program is effectively implemented in target population

Changes in WBC and platelet count in patients with malaria: a hospital based comparative study

Introduction: Malaria is one of the most common infectious diseases of tropics. It presents with varied clinicopathological manifestations. Most of the complication in malaria occurs due to various hematological abnormalities. Present study was aimed to find out abnormalities in WBC and platelet counts in patients with malaria. Methods: A total 135 patients either hospitalized or treated on an outpatient basis were included in the study after positive identification for malarial parasites on Giemsa stained PSMP smears. WBC and platelet count was carried out on 3 part hematology analyzer (Sysmax KX 21). WBC count less than 4000/cumm was considered as leucopenia and platelet count less than 150000/cumm was considered as thrombocytopenia. Results: The present study includes 135 patients with malaria from which 72.59% of subjects were male and 27.41% of subjects were female. P. falciparum was present in 68.89% of cases, P. vivax in 28.15% of cases. Majority of patients had normal leucocyte count (97.03%). Neutrophilia with lymphopenia was observed in both species of malaria in our study. Thrombocytopenia was observed in89.62% of cases in malaria. Thrombocytopenia in P. falciparum was found in 92.48% of cases and in P. vivax it was 81.57% of cases. Conclusion: Present study did not show any significant change in WBC count. Present study showed neutrophilia with relative lymphopenia in both group of malaria. Incidence of thrombocytopenia was observed in both species of malaria without any statistical significance.

Diagnostic accuracy of fine needle aspiration cytology in soft tissue tumors: our institutional experience

Background: Diagnosis of Soft tissue tumors by FNAC (Fine needle aspiration cytology) is one of the diagnostic modality of choice in pathological evaluation of soft tissue neoplasms especially to differentiate from the non-neoplastic soft tissue lesions. It is challenging and controversial. Very few centers rely on simple FNAC for diagnosis which is largely due to a lack of experience, familiarity, confidence and tricky cytological features.Methods:We have studied 140 cases of soft-tissue tumors by simple FNAC procedure done by cytopathologist from 01/01/2012 to 31/12/2012. After considering thorough history, clinical, radiology and other findings all cases were reported by the experienced faculty in cytopathology section of our institute.Results:Out of total 140 cases of soft tissue tumors 131 (93.58%) were benign and 9 (6.42%) were malignant. In benign category maximum numbers were lipoma 105 cases (80.15%) followed by benign neural tumors 5 cases (3.82%), ganglion 4 cases (3.05%), benign fibrohistiocytic lesions 2 cases (1.53%) and others. Conclusions: Current study demonstrates that FNAC is valuable as a primary tool in diagnosing soft tissue tumors specifically benign lesions like lipomatous tumors, high grade malignant sarcoma and recurrent lesions. Findings are well supported by histopathological correlation

Autopsy Findings in Malaria cases; a Hospital Based Study

Introduction: Malaria is a huge health care burden in terms of mortality and morbidity worldwide. There has been evidence in the literature where many unexpected/unexplained deaths turned out to be related to malaria in endemic regions. Autopsy study of cases with unexplained fever are turn out to be malarial death. Method: This study included 598 cases of autopsy. H&E staining, bleaching techniques and pearl’s stain were used to identify malarial pigments in suspected cases. Results: In present study out of 598 autopsy cases, 12 cases were diagnosed having death due to malaria. All cases showed significant splenomegaly and microscopic examination of submitted organs showed presence of malarial pigments. Conclusion: In malaria endemic areas death due to unexplained fever, jaundice or severe hepato-splenomegaly should be critically investigated

Study of cervical pap smears in a tertiary care hospital of south Gujarat, India

Background: In India cervical cancer is the leading cause of morbidity and mortality. Cancer of cervix is preventable, and can be diagnosed at the pre-malignant/pre-invasive stage with adequate and repetitive cytological screening by Papanicolaou (Pap) smears.  Methods: The prospective study includes total 1425 patients who were presented with various gynecological problems. Samples were taken and prepared smear were stained with PAP stain. Reporting was carried out by two independent cytopathologist as per Bethesda system.Results: Total 1425 patients were screened; there were 1034 (72.56%) abnormal Pap smears, with 354 (24.84%) normal cases and 37 (2.59%) unsatisfactory or inadequate samples. Total 27 (1.89%) cases showed epithelial cell abnormalities. ASCUS was the most commonly found (40.74%) epithelial cell abnormality out of 27 cases.Conclusions: Incidence of invasive cervical malignancy can be prevented if Pap screening program is effectively implemented in target population

Utility of bronchoalveolar lavage in cytology; a study at tertiary care hospital

Background: Numerous case reports have shown the advantage of using bronchoalveolar lavage (BAL) in cytologic diagnosis of primary and secondary malignant neoplasm of the respiratory system. Aim: The aim of this study was to determine the usefulness of BAL in the diagnosis of malignant and non malignant lesions of the lower respiratory tract. Material & Method: A retrospective analysis of 13 cases of BAL fluid received at cytology department was analyzed for its utility in diagnosing and its usefulness for confirming the diagnosis. Result: From 13 cases 3 cases were found to be positive for malignant cells.Male to female ratio was 4:1. Age distribution varied between 18years to 80 years. Conclusion: BAL proved to be a valuable diagnostic tool in detecting malignant and non malignant lesions

Hydatid Cyst in Humerus- A Rare Case Report

Hydatid disease is caused by ingestion of eggs of Echinococcus species and formation of cyst in organs where the parasite larvae are deposited. E.granulosus, a cestode commonly causes hydatid disease in humans. This case report highlights an unusual presentation of the hydatid cyst. The authors hereby, present a case of 37-year-old male patient with discharging sinus over left upper arm since 13 days along with complain of pain and swelling over left upper arm since 5 years which gradually increased. Laboratory analysis was performed and the patient underwent Ultrasonography (USG) and Magnetic Resonance Imaging (MRI) studies. Histopathological examination confirmed the diagnosis as hydatid cyst. Extensive curettage was done and postoperative albendazole was given. Ossesous hydatid disease, a rare diagnosis, should be included in the differential diagnosis for cystic lytic lesions of bone. To the best of our knowledge, not more than handful of cases of hydatid disease of the humerus has been reported in our country, making this a rare case report