Pub Date : 2022-01-01DOI: 10.7860/njlm/2022/59725.2682
Unnikrishnan Govindakurup, Shiji K. Jacob, Febby K Philip
Introduction: Anaemia is a condition marked by low Haemoglobin (Hb) concentration and is an important risk factor for the poor health and development of children and adolescents. Anaemia is not a diagnosis, but merely an objective sign of disease. The correct treatment requires an understanding of the pathogenesis of the condition. Aim: To identify disorders presenting as anaemia in paediatric population. Also to analyse the data by grading of anaemia and to calculate the proportion of anaemia in various paediatric age groups. Materials and Methods: This cross-sectional study was conducted at Government Medical College, Ernakulum, Kerala, India, from September 2017 to February 2018, on 211 paediatric patients of age groups from newborn upto 18 years. After a detailed clinical history and examination, Complete Blood Count (CBC), peripheral smear preparation, reticulocyte count, renal function tests, liver function tests, and if necessary, radiological and bone marrow examination were done. The mean haemoglobin in the categories were compared with Comprehensive National Nutritional Survey Data. The data obtained were entered in Microsoft excel 365 and further analysed. Categorical variables were analyzed by Fisher’s- exact test and continuous variables by Analysis of Variance (ANOVA) and Kruskal-Wallis test and the significance level was set at p-value ≤ 0.05. Results: Of the 211 patients, 120 (56.87%) were males and 91 (43.13%) were females. The average haemoglobin level varies across age groups and sex. In the case of newborns, average Hb was 9.31 g/dL in males and 10.4 g/dL in females. A total of 211 patients presented with 339 disease conditions, with respiratory disorders in 98, followed by 83 nutritional diseases, 49 infections and 35 systemic diseases. Total of 132 patients in age group of 6 months to 4 years, presented with maximum disorders (206). A total of 186 (54.8%) cases presented with Microcytic Hypochromic Anaemia (MHA), 149 (43.95%) with Normocytic Normochromic Anaemia (NNA) and only 4 (1.18%) with Haemolytic Anaemia (HA). No cases of macrocytic anaemia were noted. Conclusion: Total of 76.8% cases of MHA (42.1% of total anaemia cases) are associated with Nutritional, Respiratory and Infectious conditions which can be managed by public health measures. The haemoglobin levels in neonates and less than 6 months age group were significantly less than population mean which needs to be addressed. In similar manner, girls in school going age group had significantly lower Hb than boys.
{"title":"Disorders Presenting as Anaemia among Paediatric Population at a Tertiary Care Centre, Kerala, India: A Cross-sectional Study","authors":"Unnikrishnan Govindakurup, Shiji K. Jacob, Febby K Philip","doi":"10.7860/njlm/2022/59725.2682","DOIUrl":"https://doi.org/10.7860/njlm/2022/59725.2682","url":null,"abstract":"Introduction: Anaemia is a condition marked by low Haemoglobin (Hb) concentration and is an important risk factor for the poor health and development of children and adolescents. Anaemia is not a diagnosis, but merely an objective sign of disease. The correct treatment requires an understanding of the pathogenesis of the condition. Aim: To identify disorders presenting as anaemia in paediatric population. Also to analyse the data by grading of anaemia and to calculate the proportion of anaemia in various paediatric age groups. Materials and Methods: This cross-sectional study was conducted at Government Medical College, Ernakulum, Kerala, India, from September 2017 to February 2018, on 211 paediatric patients of age groups from newborn upto 18 years. After a detailed clinical history and examination, Complete Blood Count (CBC), peripheral smear preparation, reticulocyte count, renal function tests, liver function tests, and if necessary, radiological and bone marrow examination were done. The mean haemoglobin in the categories were compared with Comprehensive National Nutritional Survey Data. The data obtained were entered in Microsoft excel 365 and further analysed. Categorical variables were analyzed by Fisher’s- exact test and continuous variables by Analysis of Variance (ANOVA) and Kruskal-Wallis test and the significance level was set at p-value ≤ 0.05. Results: Of the 211 patients, 120 (56.87%) were males and 91 (43.13%) were females. The average haemoglobin level varies across age groups and sex. In the case of newborns, average Hb was 9.31 g/dL in males and 10.4 g/dL in females. A total of 211 patients presented with 339 disease conditions, with respiratory disorders in 98, followed by 83 nutritional diseases, 49 infections and 35 systemic diseases. Total of 132 patients in age group of 6 months to 4 years, presented with maximum disorders (206). A total of 186 (54.8%) cases presented with Microcytic Hypochromic Anaemia (MHA), 149 (43.95%) with Normocytic Normochromic Anaemia (NNA) and only 4 (1.18%) with Haemolytic Anaemia (HA). No cases of macrocytic anaemia were noted. Conclusion: Total of 76.8% cases of MHA (42.1% of total anaemia cases) are associated with Nutritional, Respiratory and Infectious conditions which can be managed by public health measures. The haemoglobin levels in neonates and less than 6 months age group were significantly less than population mean which needs to be addressed. In similar manner, girls in school going age group had significantly lower Hb than boys.","PeriodicalId":31115,"journal":{"name":"National Journal of Laboratory Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71271374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.7860/njlm/2022/48961.2557
Syed Ghouse Ali Hatim, D. Phaneendra, V. S. Kumar, Sasikala Thallapapaneni, Y. B. Suchetha
Introduction: An alteration of oxidant and antioxidant levels is thought to be involved in the pathogenesis of malaria. Limited data is found on association between oxidant and antioxidant status and significance of oxidative stress index in patients with malarial infection and anaemia in south Indian population. Aim: To measure the levels of oxidants and antioxidants and oxidative stress index in patients with malaria and their association with anaemia. Materials and Methods: The present case-control study was conducted in Department of Biochemistry, Osmania General Hospital, Hyderabad, India. A total of 50 subjects of malaria aged 20-45 years were included as cases based on inclusion criteria and exclusion criteria. Control group comprised of 50 healthy age and gender matched subjects. Haemoglobin (Hb), serum Malondialdehyde (MDA), Superoxide Dismutase (SOD), Total Antioxidant Capacity (TAC) was estimated in both the groups by standard methods using Ultraviolet Spectrophotometer. Independent sample t-test was used to test for the difference in all biochemical parameters among study and control groups. The study of orrelation among the parameters was done by Pearson’s correlation. Results: Both the groups were age and gender matched (p=0.39). MDA was significantly elevated in cases as compared to controls (p<0.0001). SOD, Ferric Reducing Ability of Plasma (FRAP), Hb were significantly lower in cases as compared to controls with p-value <0.0001. In the present study, it was found that there was a significant negative correlation between Hb and oxidative stress index (MDA/FRAP=-0.480) with p-value=0.0001 in patients with malaria. Conclusion: The present study concluded that oxidative stress might be a cause of malarial anaemia. Alterations in oxidant and antioxidant levels might have a role in pathogenesis of malaria. As compared to individual markers, oxidative stress index was found to be significantly associated with malarial anaemia denoting its role as a better marker in these patients. Antimalarial therapy targeting the above factors might decrease the pathogenesis, morbidity and mortality in patients with malaria.
{"title":"Role of Oxidative Stress on Malarial Anaemia: Significance of Oxidative Stress Index in Patients with Malarial Infection","authors":"Syed Ghouse Ali Hatim, D. Phaneendra, V. S. Kumar, Sasikala Thallapapaneni, Y. B. Suchetha","doi":"10.7860/njlm/2022/48961.2557","DOIUrl":"https://doi.org/10.7860/njlm/2022/48961.2557","url":null,"abstract":"Introduction: An alteration of oxidant and antioxidant levels is thought to be involved in the pathogenesis of malaria. Limited data is found on association between oxidant and antioxidant status and significance of oxidative stress index in patients with malarial infection and anaemia in south Indian population. Aim: To measure the levels of oxidants and antioxidants and oxidative stress index in patients with malaria and their association with anaemia. Materials and Methods: The present case-control study was conducted in Department of Biochemistry, Osmania General Hospital, Hyderabad, India. A total of 50 subjects of malaria aged 20-45 years were included as cases based on inclusion criteria and exclusion criteria. Control group comprised of 50 healthy age and gender matched subjects. Haemoglobin (Hb), serum Malondialdehyde (MDA), Superoxide Dismutase (SOD), Total Antioxidant Capacity (TAC) was estimated in both the groups by standard methods using Ultraviolet Spectrophotometer. Independent sample t-test was used to test for the difference in all biochemical parameters among study and control groups. The study of orrelation among the parameters was done by Pearson’s correlation. Results: Both the groups were age and gender matched (p=0.39). MDA was significantly elevated in cases as compared to controls (p<0.0001). SOD, Ferric Reducing Ability of Plasma (FRAP), Hb were significantly lower in cases as compared to controls with p-value <0.0001. In the present study, it was found that there was a significant negative correlation between Hb and oxidative stress index (MDA/FRAP=-0.480) with p-value=0.0001 in patients with malaria. Conclusion: The present study concluded that oxidative stress might be a cause of malarial anaemia. Alterations in oxidant and antioxidant levels might have a role in pathogenesis of malaria. As compared to individual markers, oxidative stress index was found to be significantly associated with malarial anaemia denoting its role as a better marker in these patients. Antimalarial therapy targeting the above factors might decrease the pathogenesis, morbidity and mortality in patients with malaria.","PeriodicalId":31115,"journal":{"name":"National Journal of Laboratory Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71269648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.7860/njlm/2022/50423.2569
H. Bhardwaj, D. Swarup, R. Bansal
Introduction: Blood donation programme is vital to any transfusion service. Deferral is a painful and sad experience both for the donor and the centre. Thus, every blood centre has to pivot between admissible quality and desired quantity. Aim: To find out incidence and pattern of donor deferral in a tertiary care hospital, Meerut, Uttar Pradesh, India. Materials and Methods: A retrospective cross-sectional study was conducted over a period of four years from January 2016 to December 2019 in a blood bank, Department of Pathology in a tertiary care hospital of Meerut, Uttar Pradesh, India. Details of donors who were deferred either temporarily or permanently during the study period were collected from the deferral files. Data analysis was done by calculating the percentage for every cause of donor deferral. Results: Out of the 29,663 donors who registered for blood donation during the study period, 2,626 donors were deferred due to several reasons. Temporary reasons (2592) were like anaemia, medications, alcohol, allergy, low-weight, fever, tattooing and permanent causes (34) were like hypertension, cardiac disorders, diabetes, asthma and thyroid disorders. Anaemia was the most common cause for deferral and total deferral rate came out to be 8.85%. Conclusion: Studying and analysing the profile of blood donors helps to identify categories of population which could be targeted to increase pool of voluntary blood donors. Education, motivation and treatment of these deferred donors due to anaemia or other temporary causes is an important aspect in blood banking, so that these donors may be recruited again.
{"title":"Study of Blood Donor Deferral in a Tertiary Care Hospital, Northern India","authors":"H. Bhardwaj, D. Swarup, R. Bansal","doi":"10.7860/njlm/2022/50423.2569","DOIUrl":"https://doi.org/10.7860/njlm/2022/50423.2569","url":null,"abstract":"Introduction: Blood donation programme is vital to any transfusion service. Deferral is a painful and sad experience both for the donor and the centre. Thus, every blood centre has to pivot between admissible quality and desired quantity. Aim: To find out incidence and pattern of donor deferral in a tertiary care hospital, Meerut, Uttar Pradesh, India. Materials and Methods: A retrospective cross-sectional study was conducted over a period of four years from January 2016 to December 2019 in a blood bank, Department of Pathology in a tertiary care hospital of Meerut, Uttar Pradesh, India. Details of donors who were deferred either temporarily or permanently during the study period were collected from the deferral files. Data analysis was done by calculating the percentage for every cause of donor deferral. Results: Out of the 29,663 donors who registered for blood donation during the study period, 2,626 donors were deferred due to several reasons. Temporary reasons (2592) were like anaemia, medications, alcohol, allergy, low-weight, fever, tattooing and permanent causes (34) were like hypertension, cardiac disorders, diabetes, asthma and thyroid disorders. Anaemia was the most common cause for deferral and total deferral rate came out to be 8.85%. Conclusion: Studying and analysing the profile of blood donors helps to identify categories of population which could be targeted to increase pool of voluntary blood donors. Education, motivation and treatment of these deferred donors due to anaemia or other temporary causes is an important aspect in blood banking, so that these donors may be recruited again.","PeriodicalId":31115,"journal":{"name":"National Journal of Laboratory Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71270183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.7860/njlm/2022/53583.2655
S. Tewari, S. Garg, S. Garg
Cystoisospora belli (C. belli) is an opportunistic protozoal parasite. It is prevalent in tropical and subtropical areas of the world. It is frequently encountered in immunocompromised patients with Acquired Immunodeficiency Syndrome (AIDS) and other immunodeficiency illnesses. Infection usually occurs due to faecal contamination of food and water. Chronic severe watery diarrhoea occurs in C. belli infected patients. C. belli is diagnosed by demonstration of characteristic oocyst in the stool sample. The common methods used for stool examination are wet saline mount, iodine mount, and modified acid fast staining. Although C. belli is distributed worldwide and more prevalent in developing countries but not much reported from India. Most of the cases reported from India are in Human Immunodeficiency Virus (HIV)-positive patients and not many cases reported in renal transplant cases. Here, a case of 27-year old male post renal transplant patient having severe diarrhoea has been presented. Patient complaining of watery diarrhoea off and on for last one month for which he had taken some medicine from his local level but not got relieved. The patient was negative for HIV and was on immunosuppressive drugs. Stool sample of the patient examined by direct wet mount, iodine mount and acid fast staining. On microscopy characteristic oocysts of C. belli were detected. The patient was given combination treatment to which he responded well.
{"title":"Severe Cystoisospora belli Diarrhoea in Post Renal Transplant Patient","authors":"S. Tewari, S. Garg, S. Garg","doi":"10.7860/njlm/2022/53583.2655","DOIUrl":"https://doi.org/10.7860/njlm/2022/53583.2655","url":null,"abstract":"Cystoisospora belli (C. belli) is an opportunistic protozoal parasite. It is prevalent in tropical and subtropical areas of the world. It is frequently encountered in immunocompromised patients with Acquired Immunodeficiency Syndrome (AIDS) and other immunodeficiency illnesses. Infection usually occurs due to faecal contamination of food and water. Chronic severe watery diarrhoea occurs in C. belli infected patients. C. belli is diagnosed by demonstration of characteristic oocyst in the stool sample. The common methods used for stool examination are wet saline mount, iodine mount, and modified acid fast staining. Although C. belli is distributed worldwide and more prevalent in developing countries but not much reported from India. Most of the cases reported from India are in Human Immunodeficiency Virus (HIV)-positive patients and not many cases reported in renal transplant cases. Here, a case of 27-year old male post renal transplant patient having severe diarrhoea has been presented. Patient complaining of watery diarrhoea off and on for last one month for which he had taken some medicine from his local level but not got relieved. The patient was negative for HIV and was on immunosuppressive drugs. Stool sample of the patient examined by direct wet mount, iodine mount and acid fast staining. On microscopy characteristic oocysts of C. belli were detected. The patient was given combination treatment to which he responded well.","PeriodicalId":31115,"journal":{"name":"National Journal of Laboratory Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71270585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.7860/njlm/2022/53615.2617
R. Sujatha, Rufaida Shafiuddin, M. V. Kulkarni, Y. Manjunatha
Introduction: Tumour Associated Tissue Eosinophilia (TATE) is an important phenomenon occurring in the tumour microenvironment and has a pivotal role. TATE is defined as “eosinophilic stromal infiltration of a tumour not associated with tumour necrosis or ulceration”. The exact role of TATE in malignancies is yet unclear but studies have shown that TATE usually has a favourable outcome in head and neck Squamous Cell Carcinoma (SCC). Therefore, more studies are needed to substantiate this data. Aim: To compare TATE between normal epithelium and Oral Squamous Cell Carcinoma (OSCC) and compare TATE between the histological grades of OSCC. Materials and Methods: A retrospective study was conducted at Dr. BR Ambedkar Medical College, Bangalore, Karnataka, India, from June 2019-January 2021 which included 50 cases, 10 from normal mucosa and 40 histopathologically diagnosed cases of OSCC. 1% congo red solution was used to stain 4 μm thick sections. The sections were examined at a high magnification (40X) and 10 microscopic fields were examined in succession for eosinophils. The average number of eosinophils observed were compared using univariate analysis, which included the Analysis of Variance (ANOVA) test and the Chi- square test and a p-value of 0.001 was considered statistically significant. Results: The mean value of tissue eosinophils increased in OSCC compared to normal mucosa, according to present study findings. When comparing different grades of carcinoma, statistical analysis revealed that well differentiated squamous cell carcinoma had a greater TATE than other grades, which was statistically significant (p-value <0.001). Conclusion: The higher eosinophil count in well differentiated OSCC compared to the other grades could be associated with a better clinical outcome for the patient. In OSCC, TATE can be utilised as a predictor of a good prognosis.
{"title":"Tumour Associated Tissue Eosinophilia in Oral Squamous Cell Carcinoma by Special Histochemical Analysis of Tissue Eosinophilia using Congo Red Staining","authors":"R. Sujatha, Rufaida Shafiuddin, M. V. Kulkarni, Y. Manjunatha","doi":"10.7860/njlm/2022/53615.2617","DOIUrl":"https://doi.org/10.7860/njlm/2022/53615.2617","url":null,"abstract":"Introduction: Tumour Associated Tissue Eosinophilia (TATE) is an important phenomenon occurring in the tumour microenvironment and has a pivotal role. TATE is defined as “eosinophilic stromal infiltration of a tumour not associated with tumour necrosis or ulceration”. The exact role of TATE in malignancies is yet unclear but studies have shown that TATE usually has a favourable outcome in head and neck Squamous Cell Carcinoma (SCC). Therefore, more studies are needed to substantiate this data. Aim: To compare TATE between normal epithelium and Oral Squamous Cell Carcinoma (OSCC) and compare TATE between the histological grades of OSCC. Materials and Methods: A retrospective study was conducted at Dr. BR Ambedkar Medical College, Bangalore, Karnataka, India, from June 2019-January 2021 which included 50 cases, 10 from normal mucosa and 40 histopathologically diagnosed cases of OSCC. 1% congo red solution was used to stain 4 μm thick sections. The sections were examined at a high magnification (40X) and 10 microscopic fields were examined in succession for eosinophils. The average number of eosinophils observed were compared using univariate analysis, which included the Analysis of Variance (ANOVA) test and the Chi- square test and a p-value of 0.001 was considered statistically significant. Results: The mean value of tissue eosinophils increased in OSCC compared to normal mucosa, according to present study findings. When comparing different grades of carcinoma, statistical analysis revealed that well differentiated squamous cell carcinoma had a greater TATE than other grades, which was statistically significant (p-value <0.001). Conclusion: The higher eosinophil count in well differentiated OSCC compared to the other grades could be associated with a better clinical outcome for the patient. In OSCC, TATE can be utilised as a predictor of a good prognosis.","PeriodicalId":31115,"journal":{"name":"National Journal of Laboratory Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71270712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.7860/njlm/2022/52989.2599
Anuradha G. Patil, N. Bhargava, Megha M Wadone, A. Anita
Introduction: The central nervous system tumours show a varied histopathological spectrum. The cell proliferation index may provide an objective method for assessing tumour biology. The Ki-67 is considered to be the most reliable proliferative marker predicting the tumour behaviour of various systemic and intracranial neoplasms. As it reflects tumour proliferating potential, it helps in determining the grade and hence the likelihood of recurrence. This study was carried out considering that very few studies of Ki-67 Labelling Index (LI) is seen in Central Nervous System (CNS) neoplasms collectively. Aim: To study the Ki-67 LI in CNS neoplasms and the association of Ki-67 LI with different parameters like age, sex, World Health Organisation (WHO) grading and histological types. Materials and Methods: The present descriptive analytical study was conducted at Department of Pathology, Mahadevappa Rampure Medical College, Karnataka, India, attached to a tertiary care hospital, Kalaburagi, for a period of five years between 1st Aug 2013 to 31st July 2018 after approval from the Institutional Ethics Committee. The formalin-fixed and paraffin-embedded tissue sections were stained with haematoxylin and eosin. Immunohistochemistry (IHC) was carried out with Ki-67 antibody using standard protocol. The data was analysed using IBM SPSS software version 19.0. The descriptive statistics frequency and percentages were calculated. The morphological grading of CNS tumours was done and the distribution of Ki-67 LI values were analysed. Results: A total of 102 histopathologically diagnosed primary CNS tumours were included in the study. High incidence of CNS neoplasms was seen in 3rd to 4th decade with slight male preponderance. This study included 40 meningioma cases. Mean percentages of Ki-67 LI for grade I and grade II meningiomas were 3.3% and 4%, respectively. The Ki-67 mean value for Astrocytomas grade I was 5.6% and grade II was 8.7%. Grade IV Glioblastoma and Gliosarcoma showed mean value of 18% and 18.8%, respectively. It was observed that LI increased with increase in grade of the tumour. Schwannoma and Dysembryoplastic Neuroepethelial Tumour (DNET) showed Ki-67 LI of 2.9% and 2.6%, respectively. Mean value of Ki-67 LI of other primary CNS neoplasms were as follows: Medulloblastoma 53%, Atypical Teratoid/Rhabdoid Tumour (ATRT) 32%, Haemangiopericytoma 8%, Neurocytoma 4%, Malignant Peripheral Nerve Sheath Tumour (MPNST) 3%, Ganglioglioma 4% and Haemangioblastoma 4%. Conclusion: The Ki-67 LI is the simplest and the most reliable method for evaluating the cell proliferation. It has a great value in designating the exact grade of the tumour when used in combination with histopathological features. It can also be used for planning of adjuvant therapy in primary CNS neoplasms.
{"title":"Immunohistochemical Study of Ki-67 Labelling Index in Neoplasms of Central Nervous System","authors":"Anuradha G. Patil, N. Bhargava, Megha M Wadone, A. Anita","doi":"10.7860/njlm/2022/52989.2599","DOIUrl":"https://doi.org/10.7860/njlm/2022/52989.2599","url":null,"abstract":"Introduction: The central nervous system tumours show a varied histopathological spectrum. The cell proliferation index may provide an objective method for assessing tumour biology. The Ki-67 is considered to be the most reliable proliferative marker predicting the tumour behaviour of various systemic and intracranial neoplasms. As it reflects tumour proliferating potential, it helps in determining the grade and hence the likelihood of recurrence. This study was carried out considering that very few studies of Ki-67 Labelling Index (LI) is seen in Central Nervous System (CNS) neoplasms collectively. Aim: To study the Ki-67 LI in CNS neoplasms and the association of Ki-67 LI with different parameters like age, sex, World Health Organisation (WHO) grading and histological types. Materials and Methods: The present descriptive analytical study was conducted at Department of Pathology, Mahadevappa Rampure Medical College, Karnataka, India, attached to a tertiary care hospital, Kalaburagi, for a period of five years between 1st Aug 2013 to 31st July 2018 after approval from the Institutional Ethics Committee. The formalin-fixed and paraffin-embedded tissue sections were stained with haematoxylin and eosin. Immunohistochemistry (IHC) was carried out with Ki-67 antibody using standard protocol. The data was analysed using IBM SPSS software version 19.0. The descriptive statistics frequency and percentages were calculated. The morphological grading of CNS tumours was done and the distribution of Ki-67 LI values were analysed. Results: A total of 102 histopathologically diagnosed primary CNS tumours were included in the study. High incidence of CNS neoplasms was seen in 3rd to 4th decade with slight male preponderance. This study included 40 meningioma cases. Mean percentages of Ki-67 LI for grade I and grade II meningiomas were 3.3% and 4%, respectively. The Ki-67 mean value for Astrocytomas grade I was 5.6% and grade II was 8.7%. Grade IV Glioblastoma and Gliosarcoma showed mean value of 18% and 18.8%, respectively. It was observed that LI increased with increase in grade of the tumour. Schwannoma and Dysembryoplastic Neuroepethelial Tumour (DNET) showed Ki-67 LI of 2.9% and 2.6%, respectively. Mean value of Ki-67 LI of other primary CNS neoplasms were as follows: Medulloblastoma 53%, Atypical Teratoid/Rhabdoid Tumour (ATRT) 32%, Haemangiopericytoma 8%, Neurocytoma 4%, Malignant Peripheral Nerve Sheath Tumour (MPNST) 3%, Ganglioglioma 4% and Haemangioblastoma 4%. Conclusion: The Ki-67 LI is the simplest and the most reliable method for evaluating the cell proliferation. It has a great value in designating the exact grade of the tumour when used in combination with histopathological features. It can also be used for planning of adjuvant therapy in primary CNS neoplasms.","PeriodicalId":31115,"journal":{"name":"National Journal of Laboratory Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71270754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.7860/njlm/2022/53145.2601
Unnikrishnan Govind, Febby K Philip
Introduction: Anaemia is a common problem discovered on routine laboratory tests. Based on red cell morphology, anaemia can be classified as microcytic hypochromic, macrocytic and Normocytic Normochromic Anaemia (NNA). Anaemia is not a diagnosis in itself, but merely an objective sign of underlying disease. The correct treatment requires an understanding of the pathogenesis of the condition. Varied number of clinical disorders manifests as NNA and pose a great challenge to the clinician. Aim: To identify the spectrum of disorders presenting as NNA and to grade anaemia across age and sex of individual using World Health Organisation (WHO) criteria. Materials and Methods: This prospective descriptive study was conducted in a tertiary care teaching hospital, Ernakulam, Kerala, India during one year period of February 2017-January 2018. Total of 514 patients meeting the inclusion criteria were recruited for the study. After taking detailed history and clinical examination, investigations were done including Complete Blood Count (CBC), peripheral smear preparation, reticulocyte count, Renal Function Tests (RFT), Liver Function Tests (LFT) and if necessary, bone marrow study and radiological studies were done. The data obtained was statistically analysed using Microsoft Excel 365. Descriptive statistics viz., number of cases, percentage, concomitant involvement with other disorders, differential involvement with various age groups, male:female ratio, and grade of anaemia were utilised to describe the spectrum of disorders presenting as NNA. Results: Of the 514 patients, 433 were adults and 81 were in paediatric age group. The average age in adult males were 58 years and in females 57 years with Haemoglobin (Hb) being 9.04 g/dL and 8.99 g/dL, respectively. Paediatric population had an average Hb of 10.18 g/dL. A total of 106 conditions were seen among the 514 patients. The disease conditions were further categorised into 10 subtypes. Type 2 Diabetes Mellitus (T2DM) constituted single most common associated disorder (112 cases) seen along NNA followed by Coronary Artery Disease (CAD) (74 cases). Idiopathic cases constituted 79 cases. Conclusion: The NNA constituted 25% of the cases presented to the laboratory during the study period. T2DM was associated with NNA along with CAD. An understanding of the categories of anaemia along with a diagnostic protocol will go a long way in better management of the patient.
{"title":"Descriptive Study of the Spectrum of Disorders Presenting as Normocytic Normochromic Anaemia from a Tertiary Care Setting at Ernakulam, Kerala, India","authors":"Unnikrishnan Govind, Febby K Philip","doi":"10.7860/njlm/2022/53145.2601","DOIUrl":"https://doi.org/10.7860/njlm/2022/53145.2601","url":null,"abstract":"Introduction: Anaemia is a common problem discovered on routine laboratory tests. Based on red cell morphology, anaemia can be classified as microcytic hypochromic, macrocytic and Normocytic Normochromic Anaemia (NNA). Anaemia is not a diagnosis in itself, but merely an objective sign of underlying disease. The correct treatment requires an understanding of the pathogenesis of the condition. Varied number of clinical disorders manifests as NNA and pose a great challenge to the clinician. Aim: To identify the spectrum of disorders presenting as NNA and to grade anaemia across age and sex of individual using World Health Organisation (WHO) criteria. Materials and Methods: This prospective descriptive study was conducted in a tertiary care teaching hospital, Ernakulam, Kerala, India during one year period of February 2017-January 2018. Total of 514 patients meeting the inclusion criteria were recruited for the study. After taking detailed history and clinical examination, investigations were done including Complete Blood Count (CBC), peripheral smear preparation, reticulocyte count, Renal Function Tests (RFT), Liver Function Tests (LFT) and if necessary, bone marrow study and radiological studies were done. The data obtained was statistically analysed using Microsoft Excel 365. Descriptive statistics viz., number of cases, percentage, concomitant involvement with other disorders, differential involvement with various age groups, male:female ratio, and grade of anaemia were utilised to describe the spectrum of disorders presenting as NNA. Results: Of the 514 patients, 433 were adults and 81 were in paediatric age group. The average age in adult males were 58 years and in females 57 years with Haemoglobin (Hb) being 9.04 g/dL and 8.99 g/dL, respectively. Paediatric population had an average Hb of 10.18 g/dL. A total of 106 conditions were seen among the 514 patients. The disease conditions were further categorised into 10 subtypes. Type 2 Diabetes Mellitus (T2DM) constituted single most common associated disorder (112 cases) seen along NNA followed by Coronary Artery Disease (CAD) (74 cases). Idiopathic cases constituted 79 cases. Conclusion: The NNA constituted 25% of the cases presented to the laboratory during the study period. T2DM was associated with NNA along with CAD. An understanding of the categories of anaemia along with a diagnostic protocol will go a long way in better management of the patient.","PeriodicalId":31115,"journal":{"name":"National Journal of Laboratory Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71270828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.7860/njlm/2022/53247.2591
Nisith Kr Das, Abinash Panda
Introduction: Multidrug-Resistant Tuberculosis (MDR-TB) is a significant public health problem. The number of MDR-TB cases is very high in India and the management is inadequate due to resource constraints. The assessment of MDR-TB burden has to be reliable for programmatic management of MDR-TB under the Revised National Tuberculosis Control Program (RNTCP) of India. Aim: To find the clinico-demographic profile and pattern of MDR-TB among the tuberculosis patients reporting to a nodal tuberculosis centre in Southern Odisha, India. Materials and Methods: The patient record based cross-sectional study was carried out on a convenience sample of 125 sputum positive MDR-TB cases admitted to the Directly Observed Treatment Short-course (DOTS) plus centre of the Nodal Tuberculosis Centre at Berhampur, Odisha, India, during the period from April 2017 to March 2018. A predesigned case record form was used to collect data on the socio-demographic profile, addictions, co-morbidity, Human Immunodeficiency Virus (HIV) status, Bacille Calmette-Guerin (BCG) immunisation status, pattern of drug resistance, history of anti-TB treatment, presenting symptoms at admission, adverse drug reactions observed during the treatment for MDR-TB. The data was analysed using GraphPad Prism trial version 7.0. Descriptive statistics were used to present the final data. Results: Highest number of study participants (95, 76%) were within 18-45 years age group and 90 (72%) of the patients were males. Rural habitation (90, 72%), engagement in labour works (65, 52%), low socio-economic status (75, 60%) were the common socio-economic characteristics. Resistance to rifampicin was the commonest variety 101 (80.8%) and 80 (64%) were newly diagnosed cases of tuberculosis. The commonest presenting symptom was cough in 97 (77.6%) patients and gastrointestinal upset was the commonest adverse drug reaction encountered during therapy. Conclusion: The MDR-TB affects the population in their most productive age. Rifampicin resistant TB was the predominant variety observed in the study population. The MDR-TB can be successfully treated with maximally effective and complete drug regimes.
{"title":"Clinical Epidemiology of Multidrug Resistant Tuberculosis in a Nodal Drug Resistant- TB Centre in Southern Odisha: A Cross-sectional Study","authors":"Nisith Kr Das, Abinash Panda","doi":"10.7860/njlm/2022/53247.2591","DOIUrl":"https://doi.org/10.7860/njlm/2022/53247.2591","url":null,"abstract":"Introduction: Multidrug-Resistant Tuberculosis (MDR-TB) is a significant public health problem. The number of MDR-TB cases is very high in India and the management is inadequate due to resource constraints. The assessment of MDR-TB burden has to be reliable for programmatic management of MDR-TB under the Revised National Tuberculosis Control Program (RNTCP) of India. Aim: To find the clinico-demographic profile and pattern of MDR-TB among the tuberculosis patients reporting to a nodal tuberculosis centre in Southern Odisha, India. Materials and Methods: The patient record based cross-sectional study was carried out on a convenience sample of 125 sputum positive MDR-TB cases admitted to the Directly Observed Treatment Short-course (DOTS) plus centre of the Nodal Tuberculosis Centre at Berhampur, Odisha, India, during the period from April 2017 to March 2018. A predesigned case record form was used to collect data on the socio-demographic profile, addictions, co-morbidity, Human Immunodeficiency Virus (HIV) status, Bacille Calmette-Guerin (BCG) immunisation status, pattern of drug resistance, history of anti-TB treatment, presenting symptoms at admission, adverse drug reactions observed during the treatment for MDR-TB. The data was analysed using GraphPad Prism trial version 7.0. Descriptive statistics were used to present the final data. Results: Highest number of study participants (95, 76%) were within 18-45 years age group and 90 (72%) of the patients were males. Rural habitation (90, 72%), engagement in labour works (65, 52%), low socio-economic status (75, 60%) were the common socio-economic characteristics. Resistance to rifampicin was the commonest variety 101 (80.8%) and 80 (64%) were newly diagnosed cases of tuberculosis. The commonest presenting symptom was cough in 97 (77.6%) patients and gastrointestinal upset was the commonest adverse drug reaction encountered during therapy. Conclusion: The MDR-TB affects the population in their most productive age. Rifampicin resistant TB was the predominant variety observed in the study population. The MDR-TB can be successfully treated with maximally effective and complete drug regimes.","PeriodicalId":31115,"journal":{"name":"National Journal of Laboratory Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71271019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.7860/njlm/2022/55124.2637
S. Chauhan, Sunita Sharma, Smita Singh, S. Mukherjee
LCH is a disease of abnormal clonal proliferation of langerhans cell of the bone marrow derived monocyte-macrophage lineage. Cells with characteristic coffee bean / grooved / indented nuclei with a background of histiocytes, lymphocytes, eosinophils and other inflammatory cells are seen. Clinical presentation varies from unifocal unisystem to multifocal unisystem to multifocal multisystem. We present a rare case of multisystem LCH involving high risk organs in a two and a half year old child. presented with the chief complaints of fever and red raised maculopapular lesions on trunk, palm, forehead and scalp for one and a half yrs with hepatosplenomegaly. There were no lytic lesions of the bones. Hematological parameters showed anaemia with thrombocytopenia while Bone Marrow Aspirate showed increase in histiocytic cell with some cells showing characteristic coffee bean, cleaved irregularly contoured nuclei. However, eosinophilia was not seen. Sections from the skin lesions showed cells with similar morphology without usually accompanied eosinophilia. The cells were CD1a and S100 positive. So a FINAL DIAGNOSIS of langerhans cell histiocytosis was made. The emphasis here lies on thorough analysis of the clinical presentations, imaging studies and scrupulous histomorphological and immunohistochemical examination, so that early diagnosis and timely intervention is ensured in such cases where the characteristic features like lytic lesions of bone and eosinophilia is not found.
{"title":"Langerhans Cell Histiocytosis without Eosinophilia and Lytic Lesions of Bone: A Rare Disease with Unusual Presentation","authors":"S. Chauhan, Sunita Sharma, Smita Singh, S. Mukherjee","doi":"10.7860/njlm/2022/55124.2637","DOIUrl":"https://doi.org/10.7860/njlm/2022/55124.2637","url":null,"abstract":"LCH is a disease of abnormal clonal proliferation of langerhans cell of the bone marrow derived monocyte-macrophage lineage. Cells with characteristic coffee bean / grooved / indented nuclei with a background of histiocytes, lymphocytes, eosinophils and other inflammatory cells are seen. Clinical presentation varies from unifocal unisystem to multifocal unisystem to multifocal multisystem. We present a rare case of multisystem LCH involving high risk organs in a two and a half year old child. presented with the chief complaints of fever and red raised maculopapular lesions on trunk, palm, forehead and scalp for one and a half yrs with hepatosplenomegaly. There were no lytic lesions of the bones. Hematological parameters showed anaemia with thrombocytopenia while Bone Marrow Aspirate showed increase in histiocytic cell with some cells showing characteristic coffee bean, cleaved irregularly contoured nuclei. However, eosinophilia was not seen. Sections from the skin lesions showed cells with similar morphology without usually accompanied eosinophilia. The cells were CD1a and S100 positive. So a FINAL DIAGNOSIS of langerhans cell histiocytosis was made. The emphasis here lies on thorough analysis of the clinical presentations, imaging studies and scrupulous histomorphological and immunohistochemical examination, so that early diagnosis and timely intervention is ensured in such cases where the characteristic features like lytic lesions of bone and eosinophilia is not found.","PeriodicalId":31115,"journal":{"name":"National Journal of Laboratory Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71271167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.7860/njlm/2022/55950.2651
Sanuvada Vijay Rama Raja Sekhar, Regidi Swathi Ratnam, B. Gouthami, B. R. Chandra
Introduction: The salivary glands are subjected to various pathological conditions ranging from simple inflammation to most complex malignant lesions. Majority of these lesions can be diagnosed by simple histopathological examination. But, as these salivary gland lesions are not common, the incidence of these varies in different geographic locations. Aim: To study the spectrum of different salivary gland lesions and demographic data in a tertiary care hospital serving North East coastal area of Andhra Pradesh. Materials and Methods: This was a retrospective study conducted in Great Eastern Medical School and Hospital,Srikakulam, Andhra Pradesh, India. Total of 85 salivary gland lesions were analyzed for a period of 4 years (December 2015 to November 2019). From the records of Histopathology, Department of Pathology, data was retrieved. Typing of the salivary gland tumours were done using sections stained with Hematoxylin and Eosin (H&E). All the cases were analysed and divided according to the demographics and histological type. Descriptive statistics were used and data was tabulated in frequency and percentages. Results: A total of 85 salivary gland lesions were studied, of which 14 (16%) were non-neoplastic and 71 (84%) were neoplastic in nature. Among the neoplastic lesions, 56 (66%) were benign and 15 (18%) were malignant. There was slight male preponderance with a ratio of M:F=1.3:1. Majority of the tumours occurred in parotid gland (73), followed by submandibular gland (7) and minor salivary glands (5). All the tumours were classified and graded according to World Health Organization (WHO), while Brandwein Grading System was followed for mucoepidermoid carcinoma. Pleomorphic adenoma was the most frequent benign tumour and mucoepidermoid carcinoma was the most common malignant tumour. Conclusion: Though benign salivary gland tumours are more frequently encountered in the present study, malignant salivary gland tumours are not uncommon.
{"title":"Clinicopathological Spectrum of Salivary Gland Lesions - A Retrospective Study from Tertiary Care Research Institute, Andhra Pradesh","authors":"Sanuvada Vijay Rama Raja Sekhar, Regidi Swathi Ratnam, B. Gouthami, B. R. Chandra","doi":"10.7860/njlm/2022/55950.2651","DOIUrl":"https://doi.org/10.7860/njlm/2022/55950.2651","url":null,"abstract":"Introduction: The salivary glands are subjected to various pathological conditions ranging from simple inflammation to most complex malignant lesions. Majority of these lesions can be diagnosed by simple histopathological examination. But, as these salivary gland lesions are not common, the incidence of these varies in different geographic locations. Aim: To study the spectrum of different salivary gland lesions and demographic data in a tertiary care hospital serving North East coastal area of Andhra Pradesh. Materials and Methods: This was a retrospective study conducted in Great Eastern Medical School and Hospital,Srikakulam, Andhra Pradesh, India. Total of 85 salivary gland lesions were analyzed for a period of 4 years (December 2015 to November 2019). From the records of Histopathology, Department of Pathology, data was retrieved. Typing of the salivary gland tumours were done using sections stained with Hematoxylin and Eosin (H&E). All the cases were analysed and divided according to the demographics and histological type. Descriptive statistics were used and data was tabulated in frequency and percentages. Results: A total of 85 salivary gland lesions were studied, of which 14 (16%) were non-neoplastic and 71 (84%) were neoplastic in nature. Among the neoplastic lesions, 56 (66%) were benign and 15 (18%) were malignant. There was slight male preponderance with a ratio of M:F=1.3:1. Majority of the tumours occurred in parotid gland (73), followed by submandibular gland (7) and minor salivary glands (5). All the tumours were classified and graded according to World Health Organization (WHO), while Brandwein Grading System was followed for mucoepidermoid carcinoma. Pleomorphic adenoma was the most frequent benign tumour and mucoepidermoid carcinoma was the most common malignant tumour. Conclusion: Though benign salivary gland tumours are more frequently encountered in the present study, malignant salivary gland tumours are not uncommon.","PeriodicalId":31115,"journal":{"name":"National Journal of Laboratory Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71271412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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