Indian Journal of Pathology and Microbiology
Home About us Instructions Submission Subscribe Advertise Contact e-Alerts Ahead Of Print Reader Login
Users Online: 377
Print this page  Email this page Bookmark this page Small font sizeDefault font sizeIncrease font size
Export selected to
Endnote
Reference Manager
Procite
Medlars Format
RefWorks Format
BibTex Format
  Most popular articles (Since April 05, 2008)

 
 
  Archives   Most popular articles   Most cited articles
 
Hide all abstracts  Show selected abstracts  Export selected to
  Viewed PDF Cited
REVIEW ARTICLE
Quality control in the histopathology laboratory: An overview with stress on the need for a structured national external quality assessment scheme
Jayaram N Iyengar
January-March 2009, 52(1):1-5
DOI:10.4103/0377-4929.44951  PMID:19136768
The concept of quality control in histopathology is relatively young and less well understood. Like in other disciplines of laboratory medicine, the concept of quality and its control is applicable to pre analytical, analytical and post analytical activities. Assessment of both precision and accuracy performances is possible by appropriate internal and external quality control and assessment schemes. This article is a review of all processes that achieve quality reporting in histopathology. There is a special focus on external quality assessment - a scheme that lacks organization on a national level in our country. Statistical data derived from a small scale external quality assurance program is also analyzed along with recommendations to organize an effective national scheme with the participation of authorized zonal centers.
  36,300 2,874 -
Lymphomas of the gastro-intestinal tract - Pathophysiology, pathology, and differential diagnosis
Diana M Cardona, Amanda Layne, Anand S Lagoo
January-March 2012, 55(1):1-16
DOI:10.4103/0377-4929.94847  
The gastrointestinal tract (GIT) is the most commonly involved site of extranodal lymphomas. The close association between chronic inflammation and specific GIT lymphomas not only provide interesting insights into the pathobiology of lymphomas but also poses unique diagnostic challenges. A clear understanding of marginal zone and mucosa associated lymphoid tissue (MALT) in health and disease is helpful to place GIT lymphomas in proper context. A wide variety of lymphomas besides MALT lymphomas occur in various parts of the GIT. The characteristic pathological, immunophenotypic, and genetic features of different GIT lymphomas categorized according to World Health Organization (WHO) classification are presented. The epidemiological, clinical, and pathological features of lymphomas occurring in each part of the GIT are summarized and the key points regarding lymphomas at each site are emphasized. A tabular summary of the important differential diagnostic considerations at each site is given and suggestions for a minimal diagnostic work up are provided.
  30,067 1,145 4
ORIGINAL ARTICLES
Pediatric patients with bicytopenia/pancytopenia: Review of etiologies and clinico-hematological profile at a tertiary center
Shano Naseem, Neelam Varma, Reena Das, Jasmina Ahluwalia, Man Updesh Singh Sachdeva, Ram Kumar Marwaha
January-March 2011, 54(1):75-80
DOI:10.4103/0377-4929.77329  PMID:21393882
Background: The etiology of bicytopenia/pancytopenia varies widely in children, ranging from transient marrow viral suppression to marrow infiltration by fatal malignancy. Depending on the etiology, the clinical presentation can be with fever, pallor or infection. Knowing the exact etiology is important for specific treatment and prognostication. Aims: To evaluate the etiological and clinico-hematological profile in children with bicytopenia and pancytopenia. Materials and Methods: A review of bicytopenic and pancytopenic children referred for bone marrow examination from January 2007 to December 2008 was done. Detailed history, clinical examination and hematological parameters at presentation were recorded. Results and Conclusion: During the study period, a total of 990 children were referred for bone marrow examination for different indications. Of these, 571 (57.7%) had either pancytopenia (17.7%) or bicytopenia (40%). Commonest form of bicytopenia was anemia and thrombocytopenia seen in 77.5% cases, followed by anemia and leukopenia in 17.3% and leukopenia and thrombocytopenia in 5.5% cases. Most common etiology was acute leukemia (66.9%) in bicytopenic children and aplastic anemia (33.8%) in pancytopenic children. Children with bicytopenia had a higher incidence of underlying malignancy (69.5% vs. 26.6%), splenomegaly (60.5% vs. 37.4%), lymphadenopathy (41.8% vs. 15.1%) and circulating blasts (64.6% vs. 20.1%) and a lower incidence of bleeding manifestations (12.1% vs. 26.6%) as compared to children with pancytopenia.
  28,765 1,182 5
IMAGES
Rushton bodies or hyaline bodies in radicular cysts: A morphologic curiosity
Sunitha Jacob
October-December 2010, 53(4):846-847
DOI:10.4103/0377-4929.72081  PMID:21045441
  25,514 738 -
REVIEW ARTICLE
Immunohistochemistry in surgical pathology practice: A current perspective of a simple, powerful, yet complex, tool
Nirmala Ajit Jambhekar, Anshuman C Chaturvedi, Bhulaxmi Prakash Madur
January-March 2008, 51(1):2-11
DOI:10.4103/0377-4929.40382  PMID:18417841
Immunohistochemistry (IHC) is a powerful tool in the surgical pathologists' armamentarium. The requests for IHC and the list of monoclonal antibodies have increased tremendously in the past decade. Issues concerning technical reproducibility, uniformity of interpretation, inter-laboratory comparability, and quality assurance are assuming greater importance due to the increased availability of IHC and its impact on diagnosis and therapy. An attempt has been made to give a current perspective of this simple and yet, in some aspects, a complex tool.
  22,533 2,227 5
ORIGINAL ARTICLES
Alcohol intake and cigarette smoking: Impact of two major lifestyle factors on male fertility
Dushyant Singh Gaur, Manju S Talekar, Ved Prakash Pathak
January-March 2010, 53(1):35-40
DOI:10.4103/0377-4929.59180  PMID:20090219
Context: Lifestyle factors, like alcohol intake and cigarette smoking, have been reported to affect male fertility. Aims: To find out the specific impact of alcohol and smoking on semen quality of male partners of couples seeking treatment for primary infertility. Materials and Methods: From the semen samples analyzed in our andrology laboratory, results of 100 alcoholics and 100 cigarette smoker males were studied following WHO guidelines and compared with 100 strict nonalcoholic and nonsmoker males for presence of asthenozoospermia, oligozoospermia and teratozoospermia. Statistical Analysis: Data was analyzed by F- test using Microsoft Office Excel 2003. Results: Only 12% alcoholics and six per cent smokers showed normozoospermia compared to 37 % nonalcoholic nonsmoker males. Teratozoospermia, followed by oligozoospermia dominated alcoholics. Overall impact of asthenozoospermia and teratozoospermia, but not of oligozoospermia, was observed in smokers. Light smokers predominantly showed asthenozoospermia. Heavy alcoholics and smokers showed asthenozoospermia, teratozoospermia as well as oligozoospermia. Conclusions: Asthenozoospermia, the most common semen variable in our study, can be an early indicator of reduction in quality of semen. Alcohol abuse apparently targets sperm morphology and sperm production. Smoke-induced toxins primarily hamper sperm motility and seminal fluid quality. Progressive deterioration in semen quality is related to increasing quantity of alcohol intake and cigarettes smoked.
  20,358 863 18
Spectrum of microbial flora in diabetic foot ulcers
Ekta Bansal, Ashish Garg, Sanjeev Bhatia, AK Attri, Jagdish Chander
April-June 2008, 51(2):204-208
DOI:10.4103/0377-4929.41685  PMID:18603682
A prospective study was carried out on patients with diabetic foot lesions to determine their clinical characteristics, the spectrum of aerobic microbial flora and to assess their comparative in vitro susceptibility to the commonly used antibiotics. A total of 157 organisms (143 bacteria and 14 fungi) were isolated and an average of 1.52 isolates per case was reported. Polymicrobial infection was found in 35% of the patients. In this study, Pseudomonas aeruginosa among the gram-negative (22%) and Staphylococcus aureus among the gram-positive (19%) were the predominantly isolated organisms, while Candida was the most predominantly isolated fungus. Antimicrobial sensitivity pattern of the isolates is discussed in detail. There was a linear increase in the prevalence of organisms with increase in Wagner's grade. Neuropathy (76%) and peripheral vascular disease (57.28%) was a common feature among the patients. Poor glycemic control was found in 67% of the patients. Awareness about lower limb complications of diabetes was very low (23%) among the patients
  17,711 1,601 23
Detection of Hb variants and hemoglobinopathies in Indian population using HPLC: Report of 2600 cases
Ritesh Sachdev, Arpita R Dam, Gaurav Tyagi
January-March 2010, 53(1):57-62
DOI:10.4103/0377-4929.59185  PMID:20090224
Background: Inherited abnormalities of hemoglobin synthesis include a myriad of disorders ranging from thalassemia syndromes to structurally abnormal hemoglobin variants. Identification of these disorders is immensely important epidemiologically and aid in prevention of more serious hemoglobin disorders. Aims: High performance liquid chromatography (HPLC) forms an important tool for accurate and speedy diagnosis of various hemoglobin disorders. About 2600 cases have been studied for identification of various hemoglobin disorders in Indian population. Material and Methods: The study was performed on BIORAD VARIANT using beta thalassemia short program. Results and conclusion: Abnormal hemoglobin fractions on HPLC were seen in 327 of the 2,600 cases displayed. Of this, the beta thalassemia trait was the predominant abnormality with a total of 232 cases (8.9%). There were 15(0.6%) cases of beta thalassemia major and 16 of thalassemia intermedia. The rest comprised of Hb D Punjab (13 cases; 0.5%), Elevated Hb F (25 cases; 0.9%), Hb E (seven cases including two Hb E homozygous and five Hb E heterozygous), Double heterozygous Hb E-beta thal trait (six cases), Hb Q India (five cases), Double heterozygous Hb Q India -beta thal trait (two cases), Hb S (total cases three including one Hb S homozygous; two Hb S -beta thal trait) and one case each of Hb J Meerut, Hb D-Iran and Hb Lepore trait. Detection of this abnormal hemoglobin, particularly keeping in mind a high prevalence of Hb A2, will help in prevention of more serious hemoglobinopathies including beta thalassemia major. HPLC forms a rapid and accurate tool in early detection and management of various hemoglobin disorders.
  17,563 1,652 12
Pathology of pulmonary aspergillomas
Rajeev Shah, Pradeep Vaideeswar, Shobhana P Pandit
July-September 2008, 51(3):342-345
DOI:10.4103/0377-4929.42507  PMID:18723954
Aspergilloma refers to a fungal ball formed by saprophytic overgrowth of Aspergillus species and is seen secondary to cavitatory/cystic respiratory diseases. Paucity of clinical and pathological data of aspergilloma in India prompted us to analyze cases of aspergilloma over 15 years. The clinical features were recorded in all and correlated with detailed pathological examination. Aspergillomas were identified in 41 surgical excisions or at autopsy. There was male predominance; half the patients were in their fourth decade. Episodic hemoptysis was the commonest mode of presentation (85.4%). Forty aspergillomas were complex, occurring in cavitatory lesions (82.9%) or in bronchiectasis (14.6%). Simple aspergilloma was seen as an incidental finding in only one. Tuberculosis was the etiological factor in 31 patients, producing cavitatory or bronchiectatic lesions; other causes were chronic lung abscess and bronchiectasis (unrelated to tuberculosis). Surgical resections are endorsed in view of high risk of unpredictable, life-threatening hemoptysis.
  18,348 775 13
CASE REPORTS
High-grade myxofibrosarcoma-presented as a large mass of right upper arm
Sunil Vitthalrao Jagtap, Akash Jain, Swati S Jagtap, Ashok Y Kshirsagar
January-March 2015, 58(1):105-107
DOI:10.4103/0377-4929.151203  PMID:25673608
Myxofibrosarcoma is one of the rare soft tissue sarcomas. We present a case of a 65-year-old male having large soft tissue mass over right upper arm associated with surface ulceration. On histopathological study tumor was diagnosed as myxofibrosarcoma - high grade according to modified FNCLCC grading system. Like many other tumors of connective tissue, soft tissue sarcoma exhibits high recurrence. In our case, tumor showed features of high grade with local recurrence, large size; however, no evidence of metastasis was noted. For this unpredictable clinical behavior, we are presenting this case.
  18,072 588 -
ORIGINAL ARTICLES
Immature teratoma of the ovary: A clinicopathological study of 28 cases
Kedar K Deodhar, Pallavi Suryawanshi, Milap Shah, Bharat Rekhi, RF Chinoy
October-December 2011, 54(4):730-735
DOI:10.4103/0377-4929.91508  PMID:22234099
Aim: Immature teratoma (IT) of the ovary represents 1% of all ovarian cancers and 20% of malignant ovarian germ cell tumors. This retrospective study of 28 such cases aims to look at its morphological spectrum and to study the correlation of the grade and stage of the tumor with prognosis. Materials and Methods: A retrospective study of 28 cases of IT of the ovary was done. Neuroepithelium was graded as grade I, II and III according to the standard criteria. The presence of immature mesenchyme was also looked for and similarly graded. Results: The median age for the cases was 19 years and abdominal pain was the commonest symptom. Neuroepithelium was seen in 26 cases (6 were grade I, 13 were grade II, and 7 were grade III); and two showed immature mesenchymal tissue (IM) only. IM was seen in all 28 cases, but no correlation with the grade of the IT of the ovary is found. The follow up is available in 23 cases ranging from 6 months to 78 months (median 33 months). Of these, 13 were stage I, 3 were stage II and 7 were stage III ITs. Out of 23 patients, 17 patients were alive without evidence of disease recurrence during the last follow up. Adverse events in the form of death and local recurrence occurred in 6 patients. One patient died of the disease at 7 months duration from the disease onset (stage III, grade II IT). Conclusion: Morphological spectrum of IT of ovary is varied. Immature mesenchyme was seen in all the cases of IT of ovary and its presence should prompt a careful search for immature neuroepithelium. Stage I IT of ovary has better prognosis. Combination of surgery and chemotherapy can give longer survival even in recurrent disease.
  17,282 553 -
Evaluation of an automated erythrocyte sedimentation rate analyzer as compared to the Westergren manual method in measurement of erythrocyte sedimentation rate
Arulselvi Subramanian, Kanchana Rangarajan, Ravindra Mohan Pandey, Jatin S Gandhi, Vijay Sharma, Sanjeev Kumar Bhoi
January-March 2011, 54(1):70-74
DOI:10.4103/0377-4929.77328  PMID:21393881
Context: Monitor 100® (Electa Lab, Italy) is a newly developed automated method for measurement of erythrocyte sedimentation rate (ESR). Aims: The aim of our study was to compare the ESR values by Monitor 100® against the standard Westergren method. Patients and Methods: This cross-sectional study was conducted at a Level I trauma care center on 200 patients. The samples taken were as per the recommendations charted out by International Council for Standardization in Hematology (ICSH) for comparing automated and manual Westergrens method. Statistical Analysis Used: Bland and Altman statistical analysis was applied for evaluating Monitor 100® against the conventional Westergren method. Results: The analysis revealed a low degree of agreement between the manual and automated methods especially for higher ESR values, mean difference -11.2 (95% limits of agreement, -46.3 to 23.9) and mean difference -13.4 (95% limits of agreement-58.9 to 32.1) for 1 and 2 hours, respectively. This discrepancy which is of clinical significance was less evident for ESR values in the normal range <25 mm/hour (-7.7 mean of difference; -18.9 to 3.5 limits of agreement). Conclusions: The fully automated system Monitor 100® for ESR measurement tends to underestimate the manual ESR readings. Hence it is recommended that a correction factor be applied for the range of ESR values while using this equipment. Further studies and validation experiments would be required.
  16,685 580 -
CD20 positivity in classical Hodgkin's lymphoma: Diagnostic challenge or targeting opportunity
Muhammad Abrar Barakzai, Shahid Pervez
January-March 2009, 52(1):6-9
DOI:10.4103/0377-4929.44952  PMID:19136769
Background: It is now well established that Hodgkin cells are clonal B cells with a CD30 and CD15 phenotype. However, on immunohistochemistry, in our experience and the experience of others, CD20 positivity in an otherwise typical classical Hodgkin's Lymphoma is not uncommon and if associated with CD15 negativity poses a potential diagnostic trap and is likely to be called B-NHL. Objective: To assess the frequency of B-cell related antigens CD20 and CD79a in classical Hodgkin's Lymphoma. Materials and Methods: A total of 91 consecutive cases of classical Hodgkin's Lymphoma were analyzed for co-expression of CD20 and CD79a. Both males and females of all ages were included in this study. All cases of nodular lymphocyte predominant Hodgkin's Lymphoma were excluded. All the cases were stained with a panel of antibodies including LCA, CD20, CD79a, CD30, CD15, CD3, EMA and Alk. Protein. Results: All 91 cases of classical Hodgkin's Lymphoma showed negativity for LCA and positivity for CD30. Eighteen cases (19.8%) showed distinct membrane staining with CD20 in most of the large atypical cells. However, out of these, only 7 cases (7.7%) showed CD79a co-expression, which was largely focal. CD15 negativity with CD20 positivity was seen in 7 (7.7%) cases of otherwise typical classical Hodgkin's Lymphoma. Conclusions/Recommendations: CD20 expression is frequent in classical Hodgkin's Lymphoma and our results are in consensus with reported literature on this subject. In these cases, LCA negativity of large cells was extremely useful in clinching the right diagnosis.
  14,737 1,239 2
Megakaryocytic alterations in thrombocytopenia: A bone marrow aspiration study
Manas Muhury, Alka M Mathai, Sharada Rai, Ramadas Naik, Muktha R Pai, Ruchi Sinha
October-December 2009, 52(4):490-494
DOI:10.4103/0377-4929.56132  PMID:19805953
Context: Dysplastic changes are well documented in myelodysplastic syndromes (MDS). However, they are also observed in non-MDS hematological conditions. Aims: To evaluate the megakaryocytic alterations in the bone marrow aspirations in cases of non-MDS related thrombocytopenia. Setting and Design: A prospective study of 144 bone marrow aspirates was conducted in the department of pathology, Kasturba Medical College, Mangalore. The aspirates were studied to assess the number and morphology of the megakaryocytes in non-MDS related thrombocytopenia and evaluate their significance when compared to changes in MDS. Materials and Methods: The bone marrow aspiration smears were stained with Leishman stain and examined under light microscope. Statistical Analysis Used: Fisher's exact test. A P value less than 0.05 was considered significant. Sensitivity and specificity was calculated for those features which were significant in the relevant hematological disorders. Results: The sensitivity of immature megakaryocytes, dysplastic forms and micromegakaryocytes in cases of immune thrombocytopenic purpura was 100%, 89% and 42% respectively. The specificity of emperipolesis was 74%. In cases of infection-associated thrombocytopenia, immature megakaryocytes had a sensitivity of 100% and cytoplasmic vacuolization were 86% specific. The sensitivity of the dysplastic forms in megaloblastic anemia was 75%. However, no platelet budding was observed. The presence of micromegakaryocyte had a specificity of 83% in MDS, and was statistically significant when compared to cases of non-MDS conditions (P<0.05). Conclusions: Careful understanding of the morphological changes of megakaryocytes in bone marrow aspirates can improve the diagnostic accuracy for a wide range of hematological disorders thereby enabling proper therapeutic interventions.
  14,348 1,035 3
LETTERS TO EDITOR
Coomb's negative autoimmune hemolytic anemia: A diagnostic dilemma for the hematologist
Ruchika Gupta, Deepak Kumar Singh, Sompal Singh, Tejinder Singh
October-December 2008, 51(4):571-572
DOI:10.4103/0377-4929.43771  PMID:19008606
  14,673 670 1
ORIGINAL ARTICLES
Useful markers for differential diagnosis of oncocytoma, chromophobe renal cell carcinoma and conventional renal cell carcinoma
Bita Geramizadeh, Mahmoud Ravanshad, Marjan Rahsaz
April-June 2008, 51(2):167-171
DOI:10.4103/0377-4929.41641  PMID:18603673
Renal oncocytoma, conventional RCC (granular cell type) and chromophobe RCC have different prognosis. Sometimes differentiation between them is difficult in HandE slides. In a 5-year study of 128 renal tumors, we selected 76 cases [30 conventional RCC (CRCC), 16 papillary RCC, 21 chromophobe RCC (ChRCC), 8 oncocytoma, 1 collecting duct carcinoma (cdc)] and staining with Hale's colloidal iron, CK7, CK8, CK18, CK19, CK20, Vimentin, EMA, CD10 and RCC marker were done. No significant difference was seen between renal tumor subtypes with CK8, CK18, CK19, CK20 and EMA. The most useful markers were Vimentin, CK7, CD10, RCC marker and Hale's colloidal iron. Hale's colloidal iron staining with diffuse reticular fine cytoplasmic pattern was present in ChRCCs, but was absent in other subtypes and oncocytomas. Vimentin, CK7, CD10, RCC marker and Hale's colloidal iron can be used for the differential diagnosis of problematic epithelial tumors of kidney (CRCC, ChRCC and oncocytoma) - i.e. ChRCC: Vimentin, CD10 and RCC marker - negative, CK7 - positive and positive diffuse fine reticular cytoplasmic pattern of Hale's colloidal iron; oncocytoma: Vimentin, CK7, RCC marker and CD10 - negative and Hale's colloidal iron - negative; CRCC: CK7 - negative, Vimentin, CD10 and RCC marker - positive and Hale's colloidal iron - negative.
  14,207 1,046 15
Quick score of hormone receptor status of breast carcinoma: Correlation with the other clinicopathological prognostic parameters
Lakmini K.B Mudduwa
April-June 2009, 52(2):159-163
DOI:10.4103/0377-4929.48906  PMID:19332901
Background: Immunohistochemical assessment of the hormone receptor status of breast carcinoma is a routine investigation. However, there is no worldwide consensus on the scoring system. The Quick Score is claimed to be a reliable scoring system, which assesses both the proportion of stained cells and the intensity of staining. Aims: To assess the value of Quick Score in terms of accepted clinicopathological parameters and to document the prevalence of hormone receptor-positive breast carcinomas in the study sample. Materials and Methods: Clinicopathological parameters of 151 breast cancers were compared with the Quick Scores for estrogen receptor (ER) and progesterone receptor (PR) status. Results and Conclusions: The Quick Score for ER was 0 in 54.3% (82/151) and for PR was 0 in 51.7% (75/145), indicating no hormone receptor expression in the majority. The Nottingham grade and the mitotic count had a significant inverse relationship with the Quick Score for hormone receptor status. The Nottingham Prognostic Index (NPI) also had an inverse relationship with the hormone receptor status.
  14,245 926 9
REVIEW ARTICLE
Biology of aging brain
SK Shankar
October-December 2010, 53(4):595-604
DOI:10.4103/0377-4929.71995  PMID:21045377
Normal aging of the nervous system is associated with some degree of decline in a number of cognitive functions. With the present day attempts to increase the life span, understanding the metabolic interactions and various mechanisms involved in normal neuronal aging continues to be a challenge. Loss of neurons is now recognized to be more modest than the initial estimates suggested and the loss only affected some of the specific neuroanatomical areas like hippocampus and prefrontal cortex. Individual neurons in addition show reduced size of dendritic and axonal arborization. Neurons have significant homeostatic control of the essential physiological functions like synaptic excitability, gene expression and metabolic regulation. Deviation in these normal events can have severe consequences as observed in aging and neurodegeneration. Based on experimental evidence, the evolution of aging is probably the result of altered metabolic triad: the mitochondria, reactive oxygen species and intracellular calcium homeostasis. Perturbations in the metabolic and functional state of this triad lead to a state of decreased homeostatic reserve, where the aged neurons still could maintain adequate function during normal activity. However, these neurons become vulnerable to the stress of excessive metabolic loads associated with spells of ischemia, trauma progressing to neuronal degeneration. Age-related neuronal dysfunction probably involves a host of subtle changes involving the synapses, receptors, neurotransmitters, cytological alterations, electrical transmission, leading to cognitive dysfunction. An exaggeration of it could be the clinical manifestation of dementia, with intraneuronal accumulation of protein aggregates deranging the metabolic state. This review deals with some of the structural, functional and metabolic features of aging nervous system and discusses briefly the functional consequences.
  13,957 578 17
CASE REPORTS
Placental site nodule: A tumor-like trophoblastic lesion
Sunitha Jacob, Debahuti Mohapatra
April-June 2009, 52(2):240-241
DOI:10.4103/0377-4929.48931  PMID:19332926
Placental site nodule is an uncommon, benign, generally asymptomatic lesion of trophoblastic origin, which may often be detected several months to years after the pregnancy from which it resulted. This entity may have bizarre histologic findings and should be distinguished from other aggressive lesions like placental site trophoblastic tumor, epithelioid trophoblastic tumor and squamous cell carcinoma.
  14,080 312 1
ORIGINAL ARTICLES
Study of a manual method of liquid-based cervical cytology
Anita N Kavatkar, CA Nagwanshi, SM Dabak
April-June 2008, 51(2):190-194
DOI:10.4103/0377-4929.41678  PMID:18603678
We report a study of a manual liquid-based cytology (MLBC) method. Slides are prepared by using a polymer solution and allowing it to dry, forming a membrane. The aims of the study were to prepare cervical cytology smears using the manual method, observe morphology, compare with direct scrape smears and correlate with histopathology wherever possible. Out of 105 cases, the membrane was intact, indicating a good MLBC preparation, in 97 cases. Simultaneous conventional smears were taken in 81 patients. There was an 88.8% agreement in the diagnoses of general category in both groups. The diagnosis of negative for intraepithelial lesion or malignancy (NILM) in both groups was made in 70 cases. The MLBC preparation was unsatisfactory in two cases which showed high grade squamous intraepithelial lesion and low grade squamous intraepithelial lesion, respectively, on the conventional smear. One MLBC smear diagnosed as atypical squamous cells of undetermined significance was reported as NILM on conventional smear. Cytohistologic correlation was done in nine cases, all of which showed cervicitis on histopathology. The MLBC method was found to be comparable to the conventional scrape smear. Further study of this method as a cost-effective alternative to the mechanized methods would be worthwhile.
  12,987 1,171 2
Activity-based costing methodology as tool for costing in hematopathology laboratory
Sumeet Gujral, Kanchan Dongre, Sonal Bhindare, PG Subramanian, HKV Narayan, Asim Mahajan, Rekha Batura, Chitra Hingnekar, Meenu Chabbria, CN Nair
January-March 2010, 53(1):68-74
DOI:10.4103/0377-4929.59187  PMID:20090226
Background: Cost analysis in laboratories represents a necessary phase in their scientific progression. Aim: To calculate indirect cost and thus total cost per sample of various tests at Hematopathology laboratory (HPL) Settings and Design: Activity-based costing (ABC) method is used to calculate per cost test of the hematopathology laboratory. Material and Methods: Information is collected from registers, purchase orders, annual maintenance contracts (AMCs), payrolls, account books, hospital bills and registers along with informal interviews with hospital staff. Results: Cost per test decreases as total number of samples increases. Maximum annual expense at the HPL is on reagents and consumables followed by manpower. Cost per test is higher for specialized tests which interpret morphological or flow data and are done by a pathologist. Conclusions: Despite several limitations and assumptions, this was an attempt to understand how the resources are consumed in a large size government-run laboratory. The rate structure needs to be revised for most of the tests, mainly for complete blood counts (CBC), bone marrow examination, coagulation tests and Immunophenotyping. This costing exercise is laboratory specific and each laboratory needs to do its own costing. Such an exercise may help a laboratory redesign its costing structure or at least understand the economics involved in the laboratory management.
  12,787 532 2
Geographical location and age affects the incidence of parasitic infestations in school children
Paran Rayan, Susan Verghese, Pauline Ann McDonnell
July-September 2010, 53(3):498-502
DOI:10.4103/0377-4929.68292  PMID:20699511
Environmental factors affect the dissemination and distribution of intestinal parasites in human communities. To comprehend the prevalence of parasitic infestation and to examine whether geographical location and age also influence the prevalence of infection, fecal samples from 195 school children (rural = 95; male = 39; female = 56) (urban = 100; male = 60; female = 40) of five age groups ranging from 5 to 11 years in two different socio-economic zones (rural and urban) were screened for specific intestinal parasites using standard histological techniques. Percentage incidences of parasitic species found in fecal wet mounts and concentrates in rural children were Entamoeba coli (25.3%), Giardia lamblia (17.9%), Blastocystis hominis (14.7%), Entamoeba histolytica (4.2%), Iodamoeba butschlii (1.1%), Hymenolepis nana (1.1%) and Ascaris lumbricoides (1.1%). Whereas the percentage incidences among urban children were E. coli (26%), A. lumbricoides (21%), B. hominis (18%), G. lamblia (14%), T. trichiura (8%), I. butschlii (4%) and A. duodenale (1%). Such findings may be related to dietary differences, living conditions and the greater use of natural anti-helminthic medicinal plants in rural communities. These results are important for both epidemiological data collection and for correlating dietary differences to intestinal parasitic diseases. Aims: We chose to investigate whether geographical location and age affect the prevalence and distribution of intestinal parasites among school children from two separate regions (rural and urban) in areas surrounding, Chennai, Tamil Nadu, India. Settings and Design: A study of the prevalence of parasitic infestations was undertaken among primary school children, in rural and urban communities around Chennai, Tamil Nadu, India. Materials and Methods: Faecal sample collection, direct microscopic techniques, macroscopic examination and concentration techniques for identifying the parasites. Statistical analysis used: Percentage incidences of parasitic species found in faecal wet mounts and concentrates were done instead of statistical analyses. Results: Both macroscopic and microscopic examinations of faecal samples revealed that the overall percentage prevalence of parasite species encountered in rural children were Entamoeba coli (25.3%), G. lamblia (17.9%), B. hominis (14.7%), Entamoeba histolytica (4.2%), I. butschlii (1.1%), H. nana (1.1%), Ascaris lumbricoides (1.1%). The prevalence among urban children were E. coli (26%), A. lumbricoides (21%), B. hominis (18%), G. lamblia (14%), T. trichiura (8%), I. butschlii (4%) and A. duodenale (1%). Overall, comparative significant differences were noted between rural and urban children for E. histolytica (4.2 vs. 14%), G. lamblia (17.9 vs. 14%), A. lumbricoides (1.1 vs. 21%) and T. trichiura (0 vs. 8%), with the major difference being the much higher occurrence of A. lumbricoides and T. trichiura infections in urban children. Conclusions: One of the greatest challenges for healthcare professionals is the prevention and treatment of protozoal and helminthic parasitic infections. From our study we conclude that the prevalence of different pathogenic species of amoeba such as Entamoeba histolytica (4.2 vs. 0%) and G. lamblia (17.9 vs. 14%), (P value was equal to 1) was significantly higher among rural children compared to children from urban areas. In contrast, the prevalence of nematodes such as A. lumbricoides (21% vs. 1.1%), T. trichiura (8% vs. 0%) and A. duodenale (1%) was also significantly higher among rural children.
  12,907 244 4
HEMATOLOGY SECTION - ORIGINAL ARTICLES
Comparative study of peripheral blood smear, quantitative buffy coat and modified centrifuged blood smear in malaria diagnosis
PL Bhandari, CV Raghuveer, A Rajeev, PD Bhandari
January-March 2008, 51(1):108-112
DOI:10.4103/0377-4929.40419  PMID:18417878
The present study was aimed at modifying the centrifuged blood smear (modified centrifuged blood smear or MCBS), to make it a feasible and standardized procedure. The results obtained were compared with the current diagnostic methods - peripheral blood smear (PBS) and quantitative buffy coat (QBC). Blood samples collected from 100 suspected malaria patients were subjected to all three tests. It was found that PBS had 86.79% sensitivity and was absolutely specific. QBC was 96.22% sensitive and 93.61% specific. The majority of variations occurred in PBS negative cases; cases with parasite count <++ and with Plasmodium falciparum. It was seen that by the addition of centrifugation to the conventional smear technique (MCBS) improved its sensitivity from 86.79% to near 100%. QBC and MCBS were found superior to PBS. Since MCBS combines principles of both QBC and PBS, it is as sensitive as QBC, as specific as PBS, and above all, easily performed and affordable.
  11,752 1,098 8
BRIEF COMMUNICATION
Viral markers in patients with hemophagocytosis: A prospective study in a tertiary care hospital
Baijayantimala Mishra, Neelam Varma, Suma Appannanavar, Pankaj Malhotra, Mrinalini Sharma, Anil Bhatnagar, Radha Kanta Ratho, Subhash Varma
April-June 2012, 55(2):215-217
DOI:10.4103/0377-4929.97876  
Background : Hemophagocytic syndrome (HPS) is a rare clinicopathological condition characterized by the activation of macrophages with prominent hemophagocytosis in bone marrow and other reticulo-endothelial systems. HPS can be familial or secondary to infections including viruses. Aim : To study the viral markers in patients with HPS. Materials and Methods : Serum samples of patients with HPS and control group were screened for anti EBV VCA IgM, and IgG, anti-Parvo B19 IgM, and anti-CMV IgM antibodies using commercially available ELISA kits and CMV and ParvoB19 DNA by polymerase chain reaction (PCR). Results and Discussion : The present prospective study reports the profile of viral markers in HPS cases from north India. Among the 14 HPS cases 43% (6/14) were positive for at least one viral marker tested, of which EBV was found to be the most prevalent (3/6: 50%) followed by parvovirus B19(2/6: 33%) and cytomegalovirus (1/6: 17%). Mortality was noted in 33% of virus associated HPS patients. Our study highlights the higher association of Epstein-Barr virus (EBV) with HPS as compared to other viruses along with higher rate of mortality in both parvovirus B 19 and EBV associated HPS.
  12,295 162 2
LETTERS TO EDITOR
Megakaryocytic emperipolesis: A histological finding in myelodysplastic syndrome
MN Sable, K Sehgal, VS Gadage, PG Subramanian, S Gujral
October-December 2009, 52(4):599-600
DOI:10.4103/0377-4929.56153  PMID:19805998
  12,136 305 3
  Search 
  The Journal 
  Site Statistics 
  Addresses 
  My Preferences 
  Online Submission 
  Editorial Board