Study of malignant tumours of the uterine corpus: histopathology and immunohistochemistry

Background: The uterine corpus represents the second most common site for malignancy in the female genital tract. This study was performed to ascertain the profile of malignant tumours of the uterine corpus reported at our centre.Methods: A retrospective analysis of cases retrieved from the archives of the department of pathology from January 2014 to December 2016. Clinical information of the patients was collected from the hospital records.  Classification and grading of the tumours were done according to the current WHO classification.Results: Nineteen cases were studied. There were ten cases of endometrial adenocarcinoma, five cases of leiomyosarcoma, three cases of endometrial stromal sarcoma and one case of carcinosarcoma(malignant mixed mullerian tumour). The age range of endometrial adenocarcinoma was 55 to 85 years and presented with post menopausal bleeding, whereas endometrial stromal sarcomas occurred in women above 45 years of age. Leiomyosarcomas had age range from 26 to 65 years. All leiomyosarcomas were clinically diagnosed as fibroid. Majority of endometrial adenocarcinomas were well differentiated endometroid type. Out of the three endometrial stromal sarcomas two were high grade, one with metastasis. All leiomyosarcomas showed mitotic rate above 10/10hpf.Conclusions: Endometrial carcinomas form the majority of malignant tumours of uterine corpus and occur in older age group followed by leiomyosarcomas. Endometrial stromal sarcomas are less common and occur in middle aged and older patients. Leiomyosarcomas and stromal sarcomas are usually misdiagnosed as fibroids clinically unless metastases are present

Evaluation of red cell indices and manual reticulocyte parameters in iron deficiency, vitamin B12 deficiency and beta thalassemia minor patients in a tertiary care hospital

Background: Reticulocytes are the youngest erythrocytes released from the bone marrow. Their increase or decrease can be an indicator of erythropoietic activity or failure. Manual reticulocyte count is an assay traditionally used to evaluate the status of erythropoiesis. Reticulocyte parameters could be cost effective methods to guide the clinician in treating anaemias. Aim of current study was to evaluate the role of routine red blood cell parameters and reticulocyte parameters in differentiating various anaemias.Methods: This retrospective cross-sectional study was conducted by retrieving the laboratory parameters of patients admitted at Yenepoya medical college hospital from January 2021 to July 2021, duration of 6 months. Fifty cases of anaemia were included. These included records of patients with anaemia based on Serum Ferritin levels, Vitamin B12 levels, and beta thalassemia cases confirmed using electrophoresis. Other various parameters like mean corpuscular volume, mean corpuscular haemoglobin and mean corpuscular haemoglobin concentration were also taken into consideration for descriptive statistics.Results: Statistically significant correlation was observed for reticulocyte count, reticulocyte production index and other red blood cell parameters like MCV, MCH and MCHC between iron and vitamin B12 deficiency anaemias. No statistically significant correlation was observed in the beta thalassemia group but specifically showed significance in MCV.Conclusions: Reticulocyte count and reticulocyte production index and good markers apart from the routinely used traditional red blood cell parameters in differentiating between iron deficiency and vitamin B12 deficiency anaemias. However, in beta thalassemia minor cases, the mean corpuscular volume is a better marker. Present study showed male gender predominance in anemia which could be due to ethnic and topographical variation

Approach for reporting serous effusion fluid in pleural, peritoneal and pericardial cavity and immunohistochemistry

Background: The aim of this study is to make a detailed cytological study of effusion fluids and compare with cell block study of the representative cases and IHC studies were done.Methods: Prospective study of 216 cases effusion fluids from in and around hospitals, Mangalore. This study conducted over a period of 18 months from October-2014 to April-2016. This study scrutinized and approved by Institutional Ethics Committee. The samples were processed by conventional cytology using Papanicolaou-stain and Cell Block (CB) method using 10% Alcohol-formalin fixative and stained with H and E. The cellularity, architectural patterns, morphological details were studied both smears. Ancillary immunohistochemical staining with calretinin and EMA are done.Results: A total of 216 cases of effusion fluids with cell block study were included, age range of 13 years to 93 years. Pleural fluid comprised of 55.09%, peritoneal fluid of 43.51% and pericardial fluid of 1.38%. 71% were clinically diagnosed as non-neoplastic and 29% were neoplastic condition. In CS study, 84.5% cases were benign/reactive effusion and 8.5% were positive for malignancy. In CB study, 84.5% were benign/reactive effusion and 10.2% were positive for malignancy. In comparison authors found an increase in diagnostic efficacy by 18%. IHC EMA for adenocarcinoma cells has sensitivity of 100% and calretinin for reactive mesothelial cells has specificity of 100%.Conclusions: Authors concluded that cell block technique when used as an adjuvant to routine smear examination in effusion fluids has increased the diagnostic yield and better preservation of architectural pattern. IHC is helpful in differentiating between reactive mesothelial and adenocarcinoma cells

Salivary C-Reactive Protein in Hashimoto's Thyroiditis and Subacute Thyroiditis

C-reactive protein (CRP), an acute-phase reactant, has been identified as a saliva-based biomarker of inflammation. The objective of the study was to estimate and compare salivary CRP levels in Hashimoto's thyroiditis (HT) and Subacute thyroiditis (SAT). The study included 30 HT patients who presented with clinical features of hypothyroidism, 15 SAT patients who presented with clinical features of hyperthyroidism, and 20 healthy age- and sex-matched euthyroid controls. CRP levels in saliva were estimated using an Enzyme-Linked Immunosorbent Assay method with enhanced sensitivity. In HT, the mean salivary CRP levels did not differ significantly from controls. SAT patients had significantly elevated salivary CRP levels compared to HT patients and controls. The rise in salivary CRP levels in SAT patients conceivably reflects the presence of an inflammatory process. Saliva CRP levels appear to serve as inflammatory markers in SAT patients and may aid their clinical evaluation

Histopathological features of Papillary Thyroid Carcinoma with special emphasis on the significance of nuclear features in their diagnosis

Background: Papillary carcinoma (PTC) is the most common thyroid malignancy comprising 80-85%. In addition to papillary architecture, nuclear features like clear, ground glass or Orphan Annie-eyed appearance, oval shape, increased nuclear size, hypodense chromatin, intranuclear cytoplasmic inclusions, nuclear grooving, nuclear overlapping, and mitotic figures play a vital role in the diagnosis although some of the features may be seen in other diseases of thyroid. Objectives: To evaluate and establish the diagnostic significance of each nuclear feature in PTC. Settings and Design: Among the thyroidectomy specimens received in the department of pathology, only the PTC cases were chosen. Multiple sections were studied from the tumor by two different pathologists with a special emphasis on morphological and nuclear features. Statistical analysis: Fischer′s exact test was done to find the correlation between the grading of nuclear features and cell population. Materials and Methods: Forty-one PTC cases were studied. Many H and E-stained slides of the tumor were studied by two different pathologists, and average of both observers was analyzed with special reference to nuclear features in classical and other variants of PTC. Results: The study evaluated that the ground glass nuclei, nuclear grooving, and nuclear overcrowding were the most common features seen in all (100%) cases though percentage of cells exhibiting these features varied from tumor to tumor. Other features mentioned above were less frequently encountered (42%-95%). Conclusion: In PTC, especially in variants, nuclear features are of utmost importance as they have to be differentiated from other thyroid diseases presenting with similar architectural morphology. Hence, more tissue sections have to be screened

Spatiotemporal distribution of foot-and-mouth disease in Nepal between 2019 and 2021

Abstract Foot-and-mouth disease (FMD) is a highly contagious viral disease affecting cloven-hoofed livestock. It is caused by the FMD virus (FMDV), which has seven distinct serotypes (O, A, C, SAT I, SAT II, SAT III, and Asia 1). In Nepal, FMD is a prevalent and economically important livestock disease, with hundreds of outbreaks yearly across different regions. However, there is limited understanding of the recent epidemiological trends of FMD in the past few years in Nepal. This study aims to analyze the spatial and temporal distribution of FMD in Nepal from 2019 to 2021. The FMD and TADs Investigation Laboratory, under the Government of Nepal, conducts annual risk-based surveillance of FMD in the country. The nonstructural protein (NSP) serosurveillance and serotyping (for outbreak confirmation) data from this laboratory were used for the study. The samples were collected either by the laboratory staff or were sent to the laboratory. Data analysis and mapping were performed using Epi info version 7.2.5.0 and QGIS version 3.22.5, respectively. Our findings revealed that 37.65% of samples (n = 417) tested positive for serotyping. The highest number of positive cases occurred in March–April, followed by December. Geographically, the Terai region had the most positive cases, followed by hills and mountains. The positivity rate for serotyping did not significantly vary by animal species (p > 0.05). Serotype O was the dominant serotype in all years, accounting for 98% of cases, while serotype A was found in only 2% of serotype-positive samples. In NSP serosurveillance, out of 3216 samples tested, 15.07% (474/3146; 95% CI, 13.86–16.36) tested positive. NSP seropositivity varied significantly by year (p  0.05). In conclusion, FMD remains endemic in Nepal, with a consistent epidemiological pattern except that the Asia 1 serotype was not detected in the past years. We recommend expanding FMD surveillance activities to high-risk areas and collecting data on potential risk factors driving FMD infection in the country. This will enable the implementation of suitable control measures