Pub Date : 2022-01-01DOI: 10.7860/njlm/2022/48938.2558
Ayushi R. Saxena, Ashumi Gupta
Sebaceous Carcinoma is a rare locally aggressive tumour of adnexal epithelium with a potential to metastasize to regional lymph node and distant organs. It constitutes between 1.5 to 5% of all eyelid malignant tumours. After basal cell and squamous cell carcinomas, it ranks third in incidence. Sebaceous carcinoma is seen more commonly in elderly females with average age at diagnosis in mid-sixties. Few cases have been reported in paediatric age group. Sebaceous Gland Carcinoma (SGC) is a slowly progressive tumor that arises usually from the meibomian gland in the eyelid, and has a locally aggressive nature with a tendency for pagetoid spread. The neoplasm is known to masquerade other benign and less malignant lesions. The non-specific clinical symptoms may lead to a delay in diagnosis of sebaceous carcinoma of the eyelid. Less than 120 cases of extra-occular sebaceous cell carcinoma have been reported so far. Here, the authors present a case of 60 years old female patient, who presented with cheek nodule and cytological diagnosis of metastatic sebaceous carcinoma was made based on cytomorphological features.
{"title":"Metastatic Sebaceous Carcinoma Presenting as Cheek Nodule: A Rare Case","authors":"Ayushi R. Saxena, Ashumi Gupta","doi":"10.7860/njlm/2022/48938.2558","DOIUrl":"https://doi.org/10.7860/njlm/2022/48938.2558","url":null,"abstract":"Sebaceous Carcinoma is a rare locally aggressive tumour of adnexal epithelium with a potential to metastasize to regional lymph node and distant organs. It constitutes between 1.5 to 5% of all eyelid malignant tumours. After basal cell and squamous cell carcinomas, it ranks third in incidence. Sebaceous carcinoma is seen more commonly in elderly females with average age at diagnosis in mid-sixties. Few cases have been reported in paediatric age group. Sebaceous Gland Carcinoma (SGC) is a slowly progressive tumor that arises usually from the meibomian gland in the eyelid, and has a locally aggressive nature with a tendency for pagetoid spread. The neoplasm is known to masquerade other benign and less malignant lesions. The non-specific clinical symptoms may lead to a delay in diagnosis of sebaceous carcinoma of the eyelid. Less than 120 cases of extra-occular sebaceous cell carcinoma have been reported so far. Here, the authors present a case of 60 years old female patient, who presented with cheek nodule and cytological diagnosis of metastatic sebaceous carcinoma was made based on cytomorphological features.","PeriodicalId":31115,"journal":{"name":"National Journal of Laboratory Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71269630","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/2022/53686.2621
H. Sharma, Meghana Bansal, Ritu Sharma, Nikhilesh Kumar, Deepak Munjal
Introduction: Although transfusion of blood and its components is life saving but it may also pose a threat to life as with every unit of blood there is 1% chance of transfusion associated problems which include the transfusion of transmitted diseases as well. The Ministry of Health and Family Welfare (Government of India) under The Drug and Cosmetic Act, 1945 (amended from time to time) mandates the screening of blood donations against five major infections- Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV), Hepatitis C Virus (HCV), Syphilis and Malaria. Aim: To estimate the prevalence of Transfusion Transmitted Infections (TTIs) among blood donors in a tertiary care hospital. Materials and Methods: This is a retrospective five year study from February 2016 to January 2021. The study was undertaken at TS Misra Medical College and Hospital, Lucknow, Uttar Pradesh, India. The sample size included 5420 blood donors. The data concerning type of donors, gender and results of screening tests were obtained from blood bank register/records. Donor selection was based on history of present and past illness and also included a pre-donation questionnaire. Serum samples were screened for Hepatitis B Surface Antigen (HBsAg), antibodies to HIV Type 1 and 2 and antibodies to HCV using Microwell Enzyme Linked Immuno Sorbent Assay (ELISA) Test. For syphilis and malaria detection, membrane based immunoassay and sandwich immunoassay techniques were used respectively. Results: Out of a total of 5420 blood donations over a period of five years, there were 5298 male donors and 122 female donors. There were 5368 replacement donors and 52 voluntary donors. The prevalence of HIV, HBsAg, HCV, syphilis and malaria was 0.16%, 0.77%, 0.11%, 0.53% and 0%, respectively. Conclusion: Voluntary blood donations, stringent screening measures, advanced screening techniques, strict donor selection are essential features for decreasing the prevalence further and also would ensure blood safety.
{"title":"Seroprevalence of Transfusion Transmitted Diseases in a Tertiary Care Hospital of Northern India: A Five Year Retrospective Study","authors":"H. Sharma, Meghana Bansal, Ritu Sharma, Nikhilesh Kumar, Deepak Munjal","doi":"10.7860/njlm/2022/53686.2621","DOIUrl":"https://doi.org/10.7860/njlm/2022/53686.2621","url":null,"abstract":"Introduction: Although transfusion of blood and its components is life saving but it may also pose a threat to life as with every unit of blood there is 1% chance of transfusion associated problems which include the transfusion of transmitted diseases as well. The Ministry of Health and Family Welfare (Government of India) under The Drug and Cosmetic Act, 1945 (amended from time to time) mandates the screening of blood donations against five major infections- Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV), Hepatitis C Virus (HCV), Syphilis and Malaria. Aim: To estimate the prevalence of Transfusion Transmitted Infections (TTIs) among blood donors in a tertiary care hospital. Materials and Methods: This is a retrospective five year study from February 2016 to January 2021. The study was undertaken at TS Misra Medical College and Hospital, Lucknow, Uttar Pradesh, India. The sample size included 5420 blood donors. The data concerning type of donors, gender and results of screening tests were obtained from blood bank register/records. Donor selection was based on history of present and past illness and also included a pre-donation questionnaire. Serum samples were screened for Hepatitis B Surface Antigen (HBsAg), antibodies to HIV Type 1 and 2 and antibodies to HCV using Microwell Enzyme Linked Immuno Sorbent Assay (ELISA) Test. For syphilis and malaria detection, membrane based immunoassay and sandwich immunoassay techniques were used respectively. Results: Out of a total of 5420 blood donations over a period of five years, there were 5298 male donors and 122 female donors. There were 5368 replacement donors and 52 voluntary donors. The prevalence of HIV, HBsAg, HCV, syphilis and malaria was 0.16%, 0.77%, 0.11%, 0.53% and 0%, respectively. Conclusion: Voluntary blood donations, stringent screening measures, advanced screening techniques, strict donor selection are essential features for decreasing the prevalence further and also would ensure blood safety.","PeriodicalId":31115,"journal":{"name":"National Journal of Laboratory Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71271033","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/2022/54808.2619
Priya P Kartha, Aysha Ali, K. Jayasree, B. Sreeram
Introduction: Hashimoto’s thyroiditis otherwise called as chronic lymphocytic thyroiditis is the most common cause of hypothyroidism and one of the most common thyroid lesions in Fine Needle Aspiration Cytology (FNAC). Diagnosis depends on clinical findings, ultrasonographic findings, thyroid profile and antithyroid antibody levels along with the FNAC findings. Not much studies are there which have assessed the association of the clinical and biochemical parameters with the cytological findings. Aim: To grade the cytological features of lymphocytic thyroiditis and to study the association of the grades with Thyroid Function Test (TFT) and antithyroid antibody levels. Materials and Methods: A prospective time bound analytical observational study of one year was carried out in the Department of Pathology at Government Medical College, Palakkad, Kerala, India after obtaining approval from the Institutional Ethics Committee (IEC). Out of the total of 462 cases of thyroid lesions who underwent Fine Needle Aspiration (FNA), 147 cases were lymphocytic thyroiditis as per cytology. Of these, 40 cases had Thyroid Stimulating Hormone (TSH), Antithyroglobulin Antibody (ATG) and Antithyroid Peroxidase Antibody (ATPO) levels known which were included in the study. Cytological grading of those were done and the association of the same with the above mentioned parameters was studied. Data was analysed using Statistical Package for the Social Sciences (SPSS) software. Descriptive statistics were calculated and presented as percentages, mean and Standard Deviation (SD). Chi-square test was used to find the association between the categorical variables. The p-value <0.05 was taken as statistically significant. Results: Cytomorphology was diagnostic of thyroiditis in all the cases. Out of the 40 cases, 32 were females.The most common age group affected was 31-40 years, though it ranged from 18-68 years. Most common clinical presentation was diffusely enlarged thyroid, though a few presented as nodular disease. Most of the patients had grade 1 thyroiditis (23 cases) followed by grade 2 (13 cases). Elevated antithyroid antibody levels - ATPO elevated in 32 cases and ATG in 20 cases. TSH was seen elevated in 28 cases of thyroiditis. No association was observed with the antithyroid antibody levels and the cytological grade. Conclusion: Lymphocytic infiltration into the follicles is the diagnostic cytological feature of chronic lymphocytic thyroiditis. TSH elevation and positive ATPO levels strongly suggest Hashimoto’s thyroiditis. No association was found between the cytological grade and TSH and antibody levels.
桥本甲状腺炎又称慢性淋巴细胞性甲状腺炎，是甲状腺功能减退最常见的病因，也是细针穿刺细胞学检查中最常见的甲状腺病变之一。诊断取决于临床表现、超声检查结果、甲状腺特征和抗甲状腺抗体水平以及FNAC检查结果。很少有研究评估临床和生化参数与细胞学结果的关系。目的:对淋巴细胞性甲状腺炎的细胞学特征进行分级，并探讨分级与甲状腺功能试验(TFT)及抗甲状腺抗体水平的关系。材料和方法:获得机构伦理委员会(IEC)的批准后，在印度喀拉拉邦Palakkad政府医学院病理学系进行了一项为期一年的前瞻性时间限制分析性观察研究。在462例甲状腺病变中，经细针穿刺(FNA)治疗的147例为淋巴细胞性甲状腺炎。其中，40例患者的促甲状腺激素(TSH)、抗甲状腺球蛋白抗体(ATG)和抗甲状腺过氧化物酶抗体(ATPO)水平已被纳入研究。对这些细胞进行了细胞学分级，并研究了其与上述参数的关系。数据采用SPSS (Statistical Package for Social Sciences)软件进行分析。计算描述性统计数据，并以百分比、平均值和标准差(SD)表示。使用卡方检验来发现分类变量之间的相关性。p值<0.05为差异有统计学意义。结果:所有病例均可通过细胞形态学诊断甲状腺炎。在40例病例中，32例为女性。最常见的受影响年龄组是31-40岁，但范围从18-68岁不等。最常见的临床表现是弥漫性甲状腺肿大，尽管少数表现为结节性疾病。甲状腺炎以1级为主(23例)，其次为2级(13例)。抗甲状腺抗体水平升高- ATPO 32例，ATG 20例。28例甲状腺炎患者TSH升高。抗甲状腺抗体水平与细胞学分级无相关性。结论:淋巴细胞向卵泡浸润是慢性淋巴细胞性甲状腺炎的诊断细胞学特征。TSH升高和ATPO阳性提示桥本甲状腺炎。未发现细胞学分级、TSH和抗体水平之间存在关联。
{"title":"Lymphocytic Thyroiditis- Association between Cytology and Biochemical Findings","authors":"Priya P Kartha, Aysha Ali, K. Jayasree, B. Sreeram","doi":"10.7860/njlm/2022/54808.2619","DOIUrl":"https://doi.org/10.7860/njlm/2022/54808.2619","url":null,"abstract":"Introduction: Hashimoto’s thyroiditis otherwise called as chronic lymphocytic thyroiditis is the most common cause of hypothyroidism and one of the most common thyroid lesions in Fine Needle Aspiration Cytology (FNAC). Diagnosis depends on clinical findings, ultrasonographic findings, thyroid profile and antithyroid antibody levels along with the FNAC findings. Not much studies are there which have assessed the association of the clinical and biochemical parameters with the cytological findings. Aim: To grade the cytological features of lymphocytic thyroiditis and to study the association of the grades with Thyroid Function Test (TFT) and antithyroid antibody levels. Materials and Methods: A prospective time bound analytical observational study of one year was carried out in the Department of Pathology at Government Medical College, Palakkad, Kerala, India after obtaining approval from the Institutional Ethics Committee (IEC). Out of the total of 462 cases of thyroid lesions who underwent Fine Needle Aspiration (FNA), 147 cases were lymphocytic thyroiditis as per cytology. Of these, 40 cases had Thyroid Stimulating Hormone (TSH), Antithyroglobulin Antibody (ATG) and Antithyroid Peroxidase Antibody (ATPO) levels known which were included in the study. Cytological grading of those were done and the association of the same with the above mentioned parameters was studied. Data was analysed using Statistical Package for the Social Sciences (SPSS) software. Descriptive statistics were calculated and presented as percentages, mean and Standard Deviation (SD). Chi-square test was used to find the association between the categorical variables. The p-value <0.05 was taken as statistically significant. Results: Cytomorphology was diagnostic of thyroiditis in all the cases. Out of the 40 cases, 32 were females.The most common age group affected was 31-40 years, though it ranged from 18-68 years. Most common clinical presentation was diffusely enlarged thyroid, though a few presented as nodular disease. Most of the patients had grade 1 thyroiditis (23 cases) followed by grade 2 (13 cases). Elevated antithyroid antibody levels - ATPO elevated in 32 cases and ATG in 20 cases. TSH was seen elevated in 28 cases of thyroiditis. No association was observed with the antithyroid antibody levels and the cytological grade. Conclusion: Lymphocytic infiltration into the follicles is the diagnostic cytological feature of chronic lymphocytic thyroiditis. TSH elevation and positive ATPO levels strongly suggest Hashimoto’s thyroiditis. No association was found between the cytological grade and TSH and antibody levels.","PeriodicalId":31115,"journal":{"name":"National Journal of Laboratory Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71271086","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/2022/53594.2611
C. Anushree, S. S. Maharana, Bhavya Nair, Y. Manjunatha
Introduction: Majority of nasal and paranasal sinus lesions clinically present as polypoidal lesions, complicating the diagnosis for the physician which inturn hampers the patient prognosis and in few cases survival of patient, so histopathology is imperative to arrive at the diagnosis. Carcinoma of the paranasal sinus cavity is rare representing 3-4% of head and neck tumours and less than 1% of all malignancies. Aim: To examine the histopathological patterns of neoplastic nasal and paranasal sinus lesions, to categorise neoplastic lesions into benign and malignant types, to find the relation of these lesions with age and sex and also to find the utility of Immunohistochemistry (IHC) in differentiating morphologically suspicious lesions. Materials and Methods: The present cross-sectional study was carried out between January 2020-January 2021. A total of 22 cases were taken for the study, which were received as nasal and paranasal sinus lesions in histopathology. All the lesions received were processed according to standard protocol and diagnosed histopathologically and confirmed by relevant special stains and immunohistochemical analysis (CD99, CD56 etc.). Results: Out of 22 cases, 16 were benign and six were malignant. The lesions were commonly detected between fourth to sixth decades. Male to female ratio was 1.4:1. The ratio of benign to malignant lesion was 2.67:1. The most common benign lesion encountered was capillary haemangioma (seven cases) and malignant lesion seen was squamous cell carcinoma (three cases), comparable to other similar studies. The IHC was done in malignant lesions for accurate diagnosis. Conclusion: In the present study, the cases are divided into benign and malignant lesions with the help of histopathological examination. Cases showing features of malignancy were further subjected to immunohistochemical examination as to diagnose the cases precisely and thus help in patient treatment and prognosis.
{"title":"Histopathological and Immunohistochemical Features of Nasal and Paranasal Sinus Neoplastic Lesions- A Cross-sectional Study","authors":"C. Anushree, S. S. Maharana, Bhavya Nair, Y. Manjunatha","doi":"10.7860/njlm/2022/53594.2611","DOIUrl":"https://doi.org/10.7860/njlm/2022/53594.2611","url":null,"abstract":"Introduction: Majority of nasal and paranasal sinus lesions clinically present as polypoidal lesions, complicating the diagnosis for the physician which inturn hampers the patient prognosis and in few cases survival of patient, so histopathology is imperative to arrive at the diagnosis. Carcinoma of the paranasal sinus cavity is rare representing 3-4% of head and neck tumours and less than 1% of all malignancies. Aim: To examine the histopathological patterns of neoplastic nasal and paranasal sinus lesions, to categorise neoplastic lesions into benign and malignant types, to find the relation of these lesions with age and sex and also to find the utility of Immunohistochemistry (IHC) in differentiating morphologically suspicious lesions. Materials and Methods: The present cross-sectional study was carried out between January 2020-January 2021. A total of 22 cases were taken for the study, which were received as nasal and paranasal sinus lesions in histopathology. All the lesions received were processed according to standard protocol and diagnosed histopathologically and confirmed by relevant special stains and immunohistochemical analysis (CD99, CD56 etc.). Results: Out of 22 cases, 16 were benign and six were malignant. The lesions were commonly detected between fourth to sixth decades. Male to female ratio was 1.4:1. The ratio of benign to malignant lesion was 2.67:1. The most common benign lesion encountered was capillary haemangioma (seven cases) and malignant lesion seen was squamous cell carcinoma (three cases), comparable to other similar studies. The IHC was done in malignant lesions for accurate diagnosis. Conclusion: In the present study, the cases are divided into benign and malignant lesions with the help of histopathological examination. Cases showing features of malignancy were further subjected to immunohistochemical examination as to diagnose the cases precisely and thus help in patient treatment and prognosis.","PeriodicalId":31115,"journal":{"name":"National Journal of Laboratory Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71270634","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/2022/53060.2658
K. M. Mathi, M. Chowdary
Introduction: In Low and Middle Income Countries (LMIC) like India, either Fasting Plasma Glucose or Postprandial Plasma Glucose (FPG/PPG) estimations were adopted as surrogate alternative to Glycated Haemoglobin (HbA1c) in Type 2 Diabetes Mellitus (T2DM). However, the reliability of this correlation remains ambiguous due to lack of consensus among the previous studies. Aim: To determine the correlation of FPG and PPG as well as their calculated mean with HbA1c in T2DM subjects for monitoring glycaemic status. Materials and Methods: A single centre, retrospective, cross- sectional data survey was carried out for a sampling frame of 13 months (August 2017 to August 2018) encompassing 1268 T2DM subjects. The data was collected during September 2018 to March 2019 and subsequently analysed during April 2019 to August 2019. The analysis was carried out in two approaches. In the first approach: the data was segregated into two major groups and six subgroups to understand relative concordance and discordance percentage; sensitivity, specificity and accuracy; and absolute and percentage difference recruiting relevant statistical tools. In the second approach, Area Under Curve (AUC) of Receiver Operating Characteristic (ROC) curves were employed to understand changes in FPG/PPG/calculated mean with increasing severity of T2DM. Results: With increasing severity of T2DM (HbA1c), not only gradual exacerbation of underestimation in FPG and overestimation in PPG but also declination of sensitivity in either of them was apparent. Though calculated mean of FPG and PPG measurements appended with intermittent features yet mimics PPG. AUC of ROC analysis revealed relatively high PPG levels at lower HbA1c levels and its replacement with FPG with increasing HbA1c levels. Conclusion: An integrated utility of both FPG and PPG as tuning tools of treatment modalities to achieve desired HbA1c levels in T2DM could be a promising approach.
{"title":"Evaluation of Plasma Glucose Estimations as Reliable Economical Surrogate for HbA1c in Monitoring Glycaemic Status of T2DM Patients: A Retrospective Study","authors":"K. M. Mathi, M. Chowdary","doi":"10.7860/njlm/2022/53060.2658","DOIUrl":"https://doi.org/10.7860/njlm/2022/53060.2658","url":null,"abstract":"Introduction: In Low and Middle Income Countries (LMIC) like India, either Fasting Plasma Glucose or Postprandial Plasma Glucose (FPG/PPG) estimations were adopted as surrogate alternative to Glycated Haemoglobin (HbA1c) in Type 2 Diabetes Mellitus (T2DM). However, the reliability of this correlation remains ambiguous due to lack of consensus among the previous studies. Aim: To determine the correlation of FPG and PPG as well as their calculated mean with HbA1c in T2DM subjects for monitoring glycaemic status. Materials and Methods: A single centre, retrospective, cross- sectional data survey was carried out for a sampling frame of 13 months (August 2017 to August 2018) encompassing 1268 T2DM subjects. The data was collected during September 2018 to March 2019 and subsequently analysed during April 2019 to August 2019. The analysis was carried out in two approaches. In the first approach: the data was segregated into two major groups and six subgroups to understand relative concordance and discordance percentage; sensitivity, specificity and accuracy; and absolute and percentage difference recruiting relevant statistical tools. In the second approach, Area Under Curve (AUC) of Receiver Operating Characteristic (ROC) curves were employed to understand changes in FPG/PPG/calculated mean with increasing severity of T2DM. Results: With increasing severity of T2DM (HbA1c), not only gradual exacerbation of underestimation in FPG and overestimation in PPG but also declination of sensitivity in either of them was apparent. Though calculated mean of FPG and PPG measurements appended with intermittent features yet mimics PPG. AUC of ROC analysis revealed relatively high PPG levels at lower HbA1c levels and its replacement with FPG with increasing HbA1c levels. Conclusion: An integrated utility of both FPG and PPG as tuning tools of treatment modalities to achieve desired HbA1c levels in T2DM could be a promising approach.","PeriodicalId":31115,"journal":{"name":"National Journal of Laboratory Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71270787","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/2022/52303.2636
M. Shankar, Anjali Sharma, Mumta Singh, .. Sugandha
{"title":"Unusual Analytic Error Which Can Mimic as a Preanalytical Error","authors":"M. Shankar, Anjali Sharma, Mumta Singh, .. Sugandha","doi":"10.7860/njlm/2022/52303.2636","DOIUrl":"https://doi.org/10.7860/njlm/2022/52303.2636","url":null,"abstract":"","PeriodicalId":31115,"journal":{"name":"National Journal of Laboratory Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71270994","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/2022/53673.2626
Subhashini Ramamoorthy, S. Sinhasan, Basavanandaswami C Harthimath
Introduction: Breast cancer is the most commonly diagnosed cancer and the leading cause of cancer death in females. There is increasing awareness and the associated anxiety and stress among women, who perceive every symptom in breast as carcinoma, compels the patients to seek medical advice. Fine Needle Aspiration Cytology (FNAC) is a relatively simple, reliable, atraumatic, economical and complication free technique for the evaluation of mass lesions. Aim: To study the varied spectrum of breast tumours and to evaluate the diagnostic utility of cytological findings by comparing it with histopathological findings in breast tumours. Materials and Methods: The present study was a hospital- based cross-sectional study conducted in the Department of Pathology, Indira Gandhi Medical College and Research Institute, Pondicherry, India, from November 2017-October 2019. All cases of breast tumours, sent by surgeon, as out-patient or in- patient, who underwent FNAC followed by surgical biopsy, were included in this study. A total of 150 cases were studied. FNAC smears were stained using Haematoxylin and Eosin (H&E) and Papanicolaou (Pap) stains and air-dried smears were stained using May Grunwald Giemsa (MGG) stain. The excised specimen after surgery was subjected to detailed histopathological examination. Representative bits were taken from appropriate sites and stained using H&E stains, special stains and Immunohistochemistry (IHC) were carried out wherever necessary. Results: Majority of cases were in the age group of 21-30 years. There were 149 cases of female patients and only one case of male patient with breast carcinoma during the study period. Cytology showed 117 cases of benign tumours and 33 cases were malignant. Histopathology revealed 116 cases of benign tumours and 34 cases of malignant. One case was given as Atypical Ductal Hyperplasia (ADH) in cytology, found to be malignant Infiltrating Ductal Carcinoma (IDC) on histopathological examination. Five cases on cytology which were given as suspicious of carcinoma (C4 category) were found to be IDC on excision biopsy. Benign lesions were common in right breast, whereas malignant lesions were common in left breast. The diagnostic value of FNAC was assessed and showed sensitivity: 97.06%, specificity: 100%, Positive Predictive Value (PPV): 100%, Negative Predictive Value (NPV): 99.15% Accuracy of 99.33%. Conclusion: The present study was an attempt to compare cytological and histomorphological findings in breast tumours to know the diagnostic accuracy of FNAC and also studying the spectrum of breast lesions. The high specificity and negative predictive value showed high accuracy of FNAC in diagnosing the malignancy. It is an established method to determine the nature of breast lesions. In the present study, fibroadenoma was the commonest benign tumour and IDC- Not Otherwise Specified (NOS) type was the commonest malignant tumour.
简介:乳腺癌是最常见的癌症，也是女性癌症死亡的主要原因。妇女越来越意识到这一点，并感到焦虑和压力，她们认为乳腺癌的每一种症状都是癌症，迫使患者寻求医疗建议。细针穿刺细胞学(FNAC)是一种相对简单、可靠、无创伤、经济、无并发症的肿块评估技术。目的:研究乳腺肿瘤的不同谱，并通过比较乳腺肿瘤的细胞学表现和组织病理学表现来评价其诊断价值。材料和方法:本研究是一项基于医院的横断面研究，于2017年11月至2019年10月在印度本地治里英迪拉甘地医学院和研究所病理学系进行。所有由外科医生送出的门诊或住院的乳腺肿瘤患者，均接受了FNAC和手术活检，纳入本研究。共研究了150例病例。FNAC涂片采用苏木精和伊红(H&E)和巴氏染色(Pap)染色，风干涂片采用May Grunwald Giemsa (MGG)染色。术后切除标本进行详细的组织病理学检查。从适当部位取代表性位，用H&E染色，特殊染色和免疫组化(IHC)进行染色。结果:以21 ~ 30岁年龄组居多。研究期间女性乳腺癌患者149例，男性乳腺癌患者1例。细胞学检查显示良性肿瘤117例，恶性肿瘤33例。组织病理学检查显示良性肿瘤116例，恶性肿瘤34例。1例细胞学检查为不典型导管增生(ADH)，组织病理学检查为恶性浸润性导管癌(IDC)。5例细胞学检查怀疑为癌(C4型)，切除活检发现为IDC。良性病变多见于右乳，恶性病变多见于左乳。评估FNAC的诊断价值，敏感性为97.06%，特异性为100%，阳性预测值(PPV)为100%，阴性预测值(NPV)为99.15%，准确率为99.33%。结论:本研究旨在比较乳腺肿瘤的细胞学和组织形态学表现，以了解FNAC诊断的准确性，并研究乳腺病变的谱。FNAC具有较高的特异性和阴性预测值，对恶性肿瘤的诊断具有较高的准确性。这是一种确定乳腺病变性质的既定方法。在本研究中，纤维腺瘤是最常见的良性肿瘤，而IDC- Not otherspecified (NOS)型是最常见的恶性肿瘤。
{"title":"Comparison of Cytological and Histomorphological Findings in Breast Tumours- A Study from a Tertiary Care Hospital in Southern India","authors":"Subhashini Ramamoorthy, S. Sinhasan, Basavanandaswami C Harthimath","doi":"10.7860/njlm/2022/53673.2626","DOIUrl":"https://doi.org/10.7860/njlm/2022/53673.2626","url":null,"abstract":"Introduction: Breast cancer is the most commonly diagnosed cancer and the leading cause of cancer death in females. There is increasing awareness and the associated anxiety and stress among women, who perceive every symptom in breast as carcinoma, compels the patients to seek medical advice. Fine Needle Aspiration Cytology (FNAC) is a relatively simple, reliable, atraumatic, economical and complication free technique for the evaluation of mass lesions. Aim: To study the varied spectrum of breast tumours and to evaluate the diagnostic utility of cytological findings by comparing it with histopathological findings in breast tumours. Materials and Methods: The present study was a hospital- based cross-sectional study conducted in the Department of Pathology, Indira Gandhi Medical College and Research Institute, Pondicherry, India, from November 2017-October 2019. All cases of breast tumours, sent by surgeon, as out-patient or in- patient, who underwent FNAC followed by surgical biopsy, were included in this study. A total of 150 cases were studied. FNAC smears were stained using Haematoxylin and Eosin (H&E) and Papanicolaou (Pap) stains and air-dried smears were stained using May Grunwald Giemsa (MGG) stain. The excised specimen after surgery was subjected to detailed histopathological examination. Representative bits were taken from appropriate sites and stained using H&E stains, special stains and Immunohistochemistry (IHC) were carried out wherever necessary. Results: Majority of cases were in the age group of 21-30 years. There were 149 cases of female patients and only one case of male patient with breast carcinoma during the study period. Cytology showed 117 cases of benign tumours and 33 cases were malignant. Histopathology revealed 116 cases of benign tumours and 34 cases of malignant. One case was given as Atypical Ductal Hyperplasia (ADH) in cytology, found to be malignant Infiltrating Ductal Carcinoma (IDC) on histopathological examination. Five cases on cytology which were given as suspicious of carcinoma (C4 category) were found to be IDC on excision biopsy. Benign lesions were common in right breast, whereas malignant lesions were common in left breast. The diagnostic value of FNAC was assessed and showed sensitivity: 97.06%, specificity: 100%, Positive Predictive Value (PPV): 100%, Negative Predictive Value (NPV): 99.15% Accuracy of 99.33%. Conclusion: The present study was an attempt to compare cytological and histomorphological findings in breast tumours to know the diagnostic accuracy of FNAC and also studying the spectrum of breast lesions. The high specificity and negative predictive value showed high accuracy of FNAC in diagnosing the malignancy. It is an established method to determine the nature of breast lesions. In the present study, fibroadenoma was the commonest benign tumour and IDC- Not Otherwise Specified (NOS) type was the commonest malignant tumour.","PeriodicalId":31115,"journal":{"name":"National Journal of Laboratory Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71271432","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/2022/51953.2609
S. Maiti, K. Mukherjee, Debopriyo Samaddar, Debojyoti Bhattacharjee
Introduction: Management of post Coronavirus Disease-2019 (COVID-19) complications are the new challenges nowadays. It has been observed that in post COVID-19 cases the serum levels of several electrolytes and trace elements are deranged. Aim: This study was conducted to estimate the levels of different serum minerals and trace elements in one month post COVID-19 follow-up patients and compared with normal age- sex matched controls. Materials and Methods: This hospital based cross-sectional study was conducted in the Department of Biochemistry in a tertiary care centre, over a period of six months (from January 2021 to June 2021). After fulfilling proper inclusion criteria, 223 COVID-19 follow-up patients of both genders (134 males and 89 females) were included as ‘case’ group. Age-sex matched 250 healthy volunteers were recruited as ‘control’ group. Levels of serum electrolytes (sodium and potassium) and trace elements (zinc, iron, calcium, phosphate, copper, magnesium and selenium) were estimated, analysed and compared against each other. Tables and statistical analysis was done using Statistical Package for the Social Sciences (SPSS) version 20.0. Results: In this study, the levels of serum zinc and iron were found to be higher and serum calcium, phosphate, copper, magnesium and selenium levels were reduced in post COVID-19 one month follow- up cases in comparison to controls. Female cases were in deficient state of iron, calcium, copper and magnesium but had high serum zinc and phosphate when compared to males. No abnormalities were noted in the level of electrolytes in post COVID-19 cases. Conclusion: Assessment and monitoring of levels of the mineral throughout the course of post COVID-19 follow-up is advisable for timely and appropriate measures to combat with post COVID-19 complications.
{"title":"Status of Common Serum Minerals and Trace Elements in COVID-19 Follow-up Cases: A Hospital-based Study from Eastern India","authors":"S. Maiti, K. Mukherjee, Debopriyo Samaddar, Debojyoti Bhattacharjee","doi":"10.7860/njlm/2022/51953.2609","DOIUrl":"https://doi.org/10.7860/njlm/2022/51953.2609","url":null,"abstract":"Introduction: Management of post Coronavirus Disease-2019 (COVID-19) complications are the new challenges nowadays. It has been observed that in post COVID-19 cases the serum levels of several electrolytes and trace elements are deranged. Aim: This study was conducted to estimate the levels of different serum minerals and trace elements in one month post COVID-19 follow-up patients and compared with normal age- sex matched controls. Materials and Methods: This hospital based cross-sectional study was conducted in the Department of Biochemistry in a tertiary care centre, over a period of six months (from January 2021 to June 2021). After fulfilling proper inclusion criteria, 223 COVID-19 follow-up patients of both genders (134 males and 89 females) were included as ‘case’ group. Age-sex matched 250 healthy volunteers were recruited as ‘control’ group. Levels of serum electrolytes (sodium and potassium) and trace elements (zinc, iron, calcium, phosphate, copper, magnesium and selenium) were estimated, analysed and compared against each other. Tables and statistical analysis was done using Statistical Package for the Social Sciences (SPSS) version 20.0. Results: In this study, the levels of serum zinc and iron were found to be higher and serum calcium, phosphate, copper, magnesium and selenium levels were reduced in post COVID-19 one month follow- up cases in comparison to controls. Female cases were in deficient state of iron, calcium, copper and magnesium but had high serum zinc and phosphate when compared to males. No abnormalities were noted in the level of electrolytes in post COVID-19 cases. Conclusion: Assessment and monitoring of levels of the mineral throughout the course of post COVID-19 follow-up is advisable for timely and appropriate measures to combat with post COVID-19 complications.","PeriodicalId":31115,"journal":{"name":"National Journal of Laboratory Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71270333","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/2022/55027.2613
Sheetal Maheshkumar Sale, V. Mane, Poornima Kadam
Introduction: Cytological study of fluids is an inexpensive, simple procedure and has significant utility in diagnosing neoplastic and non neoplastic lesions. The cytological examination of fluids in combination with physical examination helps identify aetiologic agents, follow the natural process of the disease and monitor the response to the treatment. Aim: To determine the diagnostic utility of serosal fluid cytology and analyse the incidence of neoplastic and non neoplastic lesions using serous fluid cytology. Materials and Methods: This was a descriptive cross-sectional study comprising 375 cases conducted in a tertiary care hospital, Sangli, Maharashtra, India, from August to July 2021. Purposive sampling was used to recruit the participants. All the patients with pleural effusions, ascites or in whom Cerebral Spinal Fluid (CSF), pericardial and synovial fluids examination was indicated were included. The provisional diagnosis was obtained from case sheets, including relevant clinical information. Smears were prepared from freshly tapped specimens without adding anticoagulants and were processed by routine, conventional smear technique. The data were analysed using the SPSS version 22.0 for Windows. Numerical variables were reported as frequency and percentage. The chi-square test was used wherever necessary, and the p-value less than 0.05 were considered significant. Results: The peritoneal fluid was the most common fluid collected in the present study, followed by pleural fluid and CSF. The malignancy rate in the present study was 19 (10.4%) of peritoneal fluid, 6 (5.9%) for pleural fluid, and 2 (4.1%) for CSF. Adenocarcinoma was the most common malignancy found in present study. Conclusion: Adenocarcinoma was the most common malignancy found in this study, which was in concordance with the research conducted earlier, where gold standard investigations confirmed the findings. In the peritoneal fluid, most of the patients had cirrhosis and tuberculosis. In pleural fluid and cerebrospinal fluid, most of them had tuberculosis and chronic inflammatory conditions, respectively. Previous researchers confirmed similar findings in their studies. It is seen that malignant and benign conditions like tuberculosis can be diagnosed well with effusion cytology.
{"title":"Importance of Serosal Fluid Cytology as an Aid to Primary Diagnosis: A Descriptive Cross-sectional Study","authors":"Sheetal Maheshkumar Sale, V. Mane, Poornima Kadam","doi":"10.7860/njlm/2022/55027.2613","DOIUrl":"https://doi.org/10.7860/njlm/2022/55027.2613","url":null,"abstract":"Introduction: Cytological study of fluids is an inexpensive, simple procedure and has significant utility in diagnosing neoplastic and non neoplastic lesions. The cytological examination of fluids in combination with physical examination helps identify aetiologic agents, follow the natural process of the disease and monitor the response to the treatment. Aim: To determine the diagnostic utility of serosal fluid cytology and analyse the incidence of neoplastic and non neoplastic lesions using serous fluid cytology. Materials and Methods: This was a descriptive cross-sectional study comprising 375 cases conducted in a tertiary care hospital, Sangli, Maharashtra, India, from August to July 2021. Purposive sampling was used to recruit the participants. All the patients with pleural effusions, ascites or in whom Cerebral Spinal Fluid (CSF), pericardial and synovial fluids examination was indicated were included. The provisional diagnosis was obtained from case sheets, including relevant clinical information. Smears were prepared from freshly tapped specimens without adding anticoagulants and were processed by routine, conventional smear technique. The data were analysed using the SPSS version 22.0 for Windows. Numerical variables were reported as frequency and percentage. The chi-square test was used wherever necessary, and the p-value less than 0.05 were considered significant. Results: The peritoneal fluid was the most common fluid collected in the present study, followed by pleural fluid and CSF. The malignancy rate in the present study was 19 (10.4%) of peritoneal fluid, 6 (5.9%) for pleural fluid, and 2 (4.1%) for CSF. Adenocarcinoma was the most common malignancy found in present study. Conclusion: Adenocarcinoma was the most common malignancy found in this study, which was in concordance with the research conducted earlier, where gold standard investigations confirmed the findings. In the peritoneal fluid, most of the patients had cirrhosis and tuberculosis. In pleural fluid and cerebrospinal fluid, most of them had tuberculosis and chronic inflammatory conditions, respectively. Previous researchers confirmed similar findings in their studies. It is seen that malignant and benign conditions like tuberculosis can be diagnosed well with effusion cytology.","PeriodicalId":31115,"journal":{"name":"National Journal of Laboratory Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71271153","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/2022/59725.2682
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":"1 1","pages":""},"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}
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