Introduction: Gallbladder tuberculosis (GBTB) is an exceedingly rare finding presenting as calculous or acalculous cholecystitis. A correct, preoperative diagnosis of GBTB is difficult, and the literature review highlights the fact that most cases are diagnosed postcholecystectomy or at postmortem. Discussion: Mycobacterium tuberculosis can affect any part of the gastrointestinal tract from the mouth to the anal canal along with the other organs of the peritoneal cavity, but the gall bladder is unlikely to be primarily involved. The incidence of localization of the tubercular bacilli in the gall bladder is uncommon as the intact gall bladder mucosa is resistant to the bacterium because of the concentrated bile acids present in the organ. The first case of gallbladder tuberculosis (GBTB) was reported in 1870 by Gaucher, and till now, less than 120 cases have been reported in the English medical literature [4, 5].

Ovarian neoplasms have become increasingly important not only because of the large variety of neoplastic entities but more so because they have gradually increased mortality due to female genital cancers. Ovarian carcinoma represents the sixth most common female cancers and the fourth leading cause of death due to cancers in women. Surface epithelial tumors were commonest variety of ovarian tumors followed by germ cell tumors. Angiogenesis is a critical factor in tumor growth and metastasis, because tumor proliferation is severely limited by nutrient supply to proliferating tumor cells. Hence tumorigenesis of malignant neoplasms associated with extensive neovascularization. The analysis of tumor vascularization by microvessel density (MVD) and it’s prognostic significance has been evaluated in many tumors including ovary. Many studies have established MVD as an important prognostic factor in solid tumors, but there is paucity of literature regarding characteristics of the tumor blood vessels in ovarian surface epithelial tumors. The present study aims to evaluate not just the density of microvessels in ovarian surface epithelial tumors but also the maturity characteristics of proliferating tumor blood vessels with the aid of IMMUNOHISTOCHEMISTRY there by differentiating between benign and malignant epithelial tumors of ovary and predicting the prognosis. Objectives: 1) To determine the incidence of ovarian surface epithelial tumors at our hospital. 2) To clarify the differences in angiogenesis between benign and malignant epithelial tumors.

Objective: The objective of this study was to analyze the prognostic value of lymph node ratio in patients with gastric cancer. Methods: A total of 22 cases of total and subtotal gastrectomy received in the period of January 2015 to July 2018 in the department of pathology of a tertiary care hospital were assessed. The surgical data and the histopathological findings were assessed using definitive criteria. Pearson’s correlation coefficient and chi-square test was used to study the relation between the lymph nodes showing metastasis and the total number of lymph nodes harvested. The relation of LNR with the other clinicopathological parameters was studied. Results: A cut off value of 0.25 was taken and the cases were grouped into low grade and high grade LNR group. In this study we found that the LNR was associated with the number of metastatic lymph nodes, irrespective of the total number of lymph nodes dissected. Hence it could be used as a prognostic indicator even when less number of lymph nodes is retrieved. Conclusions: LNR could be considered as a valuable prognostic factor and could be used as an additional tool with the TNM staging system to assess prognosis in patients post-surgery. It is especially useful in cases where prescribed number of lymph nodes cannot be retrieved.

Puffer fish poisoning remains a severe seafood poisoning condition blamable for numerous human intoxications. Research on puffer fish poisoning enables studying the involvement of puffer fish poisoning in human security. The current study thus intention of investigating whether Arothron hispidus from the south-east coast of India (Palazhyar) cause for the neurodegeneration. Cresyl violet stained sections of the rat brain regions examined for pathological changes in rats treated with A.hispidus toxic extract. We noticed disarrangement and neuron loss in the primary motor area, hippocampus, amygdala, thalamus, temporal lobe, parietal lobe, and cerebellum regions of rats treated with A.hispidus skin extract. Damaged regions directly or secondarily associated with sensory and motor functions, this may cause loss of sensory and motor function. From our observation, we conclude that neuronal loss of a rat's brain treated with skin extract as clear through histopathological analysis, due to the neurotoxic effect of Arothron hispidus.

Background: Metastatic lymph node ratio (MLR) is defined as the ratio of number of positive lymph nodes (LNs) or LNM to total nodes harvested (LNH). Recent studies have suggested that MLR is more accurate in predicting overall survival and recurrence‑free survival rate compared to the number of positive nodes alone. Materials and methods: Total 58 cases of primary organ malignancy were evaluated from June 2018 to June 2019 including Head and neck (HN), Breast, Gastrointestinal tract (GIT) and Genitourinary tract (GUT) malignancy. Age, gender, LNH, LNM, MLR, tumor stage and tumor grade were accessed for each of the cases. Results: Out of total 58, there were 12, 33, 11 and 2 cases each of HN, Breast, GIT and GUT malignancy respectively. M:F ratio was 1:2.2. Maximum cases (39.6%) were seen in the age group of 35-45 years. 186 out of 530 LNs showed metastasis. Mean MLR for lymph node-positive cases were 0.3. Majority of HN malignancy cases (41.6%) were found in T1/T2 stage, breast malignancy cases (42.4%) in T2 stage, GIT malignancy cases (63.6%) in T3 stage, 50% of GUT malignancy cases in T3 and 50% were in T4 stage. Maximum well‑differentiated (10, 83.3%) cases belonged to HN, moderately (15, 45.4%) and poorly differentiated (18, 54.5%) to breast respectively. We found significant association of MLR with tumor stage and tumor grade. (p-value < 0.001) Conclusion: The routine inclusion of MLR in tumor reporting by pathologists may become a prognostic aid for clinicians along with TNM staging system.

Introduction: The Current 3 major LAC guidelines (BSH, ISTH & CLSI) recommends mixing tests for detection of LAC, even though these test order/ sequence vary & there are certain limitations, but still these guidelines advocates mixing test so as to maximize the diagnostic performance. The main objective of this study is to assess sensitivity of these tests in 255 LAC cases. Results: The Coagulometer used is Sysmex CS-5100. RI Cut offs ≤ 10 = Correction & ≥ 15 = Inhibitor & SNR > 1.15 indicates inhibitor. Of 255 LAC cases RI showed a sensitivity of 72% in correctly detecting LAC were as 11.7% were indeterminate & 15% were wrongly interpretated as factor deficiency. SNR showed a sensitivity of 83% in correctly detecting LAC were as 10.9% were indeterminate & 5.8% were wrongly interpretated as factor deficiency. Discussion: BSH & ISTH guidelines recommends Standardised Normalised ratio (mixing test-specific cut off) and Rosners index (ICA) for interpretation of mixing test results in detecting LAC.This study shows that SNR is more sensitive than RI for detecting LAC while interpretating Mixing test results. This study was in correlation with Moore & Kumano’s study. Conclusion: It is difficult to interpretate mixing study results in LAC patients. It is valuable to maximise mixing test interpretation as the dilution can lead to false-negative results .RI & SNR were comparatively analysed for their sensitivity to detect LAC in mixing studies & these data applied with the reagents and equipment employed, SNR was found to be more sensitive as compared to RI.

Introduction: The efforts towards elimination of malaria in Nigeria is being anchored based on a policy document - the National Antimalarial Treatment Policy (NATP). This study is to assess awareness of the NATP and the level of practice of malaria self-care among medical students and the University staffs working in the Medical college/Teaching hospital. Material and Method: A descriptive study that took place at the University of Calabar Teaching Hospital, Calabar involving medical students and members of the staff of the University working in the laboratories. Information was obtained from the participants through administration of structured questionnaire. Results: One hundred and thirty two (65%) were aware of the existence of national antimalarial treatment policy. One hundred and fifty two (73%) of the participants practiced malaria self-care. The association between gender and awareness of antimalarial treatment policy was statistically significant (p-value = 0.020; X2 = 5.46). The odds of being aware of antimalarial treatment policy was increased by a factor of 1.873 being a male rather than being a female (p-value = 0.61). Participants of younger age (age group 17–25) were more likely to visit Chemist shop to purchase antimalarial drug for self-medication than older participants. Conclusion: The level of awareness of the national antimalarial treatment policy was considerably high among the participants with an attendant high level of malaria self-care practices. There is room to improve on the level of awareness and to dissuade young people from practicing self-medication

Aim: Rapid fixation -Is it an an effective method in the diagnosis of cytological smears. Objective: 1) Is it an accurate method in fine needle aspiration cytology. 2) Is it an accurate method in the diagnosis of various body fluid cytology. 3) To analyse the quality of background staining and cyto-morphology. 4) To compare the quality between rapid and routine fixation method. Methods: Smears are fixing in 95% isopropyl alcohol and stained by hematoxyline and eosin and papaniecolou staining. Result: The cyto-morphology and background staining quality in rapid fixation and routine fixation were analysed and are almost equal to routine fixation method. Conclusion: By rapid fixation the adequacy of the smears can be screened and analysed quickly. So we can reduce the turnaround time (TAT) and more benefit for the patient

Squamous cell carcinoma of kidney is extremely rare tumor and the incidence is less than 1% of all renal malignancies. In the world literature till now, very few cases of primary squamous cell carcinoma of kidney have been reported. Squamous cell carcinoma is frequently associated with renal calculi and hydronephrosis. Squamous cell carcinoma of kidney is very aggressive, presents at an advanced stage and is associated with poor prognosis. Here, we report a case of squamous cell carcinoma diagnosed in hydronephrotic kidney with multiple renal calculi in a 60 year old male patient. Patients presenting with long standing history of renal calculus and associated hydronephrosis should undergo extensive diagnostic workup for the early diagnosis of squamous cell carcinoma, so that we can reduce the morbidity and mortality.

Background: Lung cancer is one of the leading cause of death in developing countries. Epidermal growth factor receptor (EGFR) is a transmembrane protein with cytoplasmic kinase activity that transduces important growth factor signaling from the extracellular milieu to the cell. Materials and methods: This study includes all cases of primary lung squamous cell carcinomas presented in the Department of Pathology from Jan 2011 to Dec 2013 in Sri Ramachandra Medical College. Formalin fixed paraffin embedded tissue stained with H&E were used for routine morphology. Immunohistochemical staining was done using monoclonal anti EGFR antibody by Streptavidin biotin peroxidase complex technique. Positive cases were graded as 1+, 2+, 3+ based on staining intensity. Results: A total of 149 cases of carcinoma lung were retrieved. Of these 26 (20%) were SCC. Eighty eight percent of these were EGFR positive, of which 70% showed 3+ positivity, 11% showed 2+ positivity, 7% showed 1+ positivity. Conclusion: EGFR expression appears to be significant in primary squamous cell carcinoma of the lung which aid in treating these patients with tyrosine kinase inhibitors and may improve the outcome of these patients. We conclude that EGFR marker expression is mandatory not only in lung adenocarcinomas but also in Primary squamous cell carcinoma of the lung.

Introduction: Follicular hyperplasia of the gall bladder is an extremely rare and benign entity characterized by hyperplastic lymphoid follicle with germinal center consisting of the lymphoid population. The lymphoid hyperplasia of the gallbladder is a rare condition, which can be diagnosed only by performing a histological examination. Here, we present the case of a 36-year-old woman with complaints of repeatable pain in the area of the right hypochondrium for a few months. Ultrasonography revealed chronic cholecystitis with a concrement in the lumen. Methods and Materials: We were reported a rare case of follicular hyperplasia of gall bladder in a 36 yrs old female presented into the department of surgery with a right side upper abdomen pain then she was diagnosed as cholecystitis and managed by cholecystectomy and specimen was received and processed for histopathological examination. Results: Due to chronic cholecystitis patient present with right upper abdominal pain and upon histopathological examination diagnosed incidently as follicular cholecystitis. Conclusion: Histopathological examination reveals a rare case of follicular cholecystitis A cholecystectomy was then performed. Histology shows nests of cells with lymphoid origin in the lamina propria, a multitude of lymphoid follicles and areas with pyloric metaplasia in the gallbladder wall. The case presented herein is of reactive lymphoid hyperplasia resembling a lymphoma combined with chronic cholecystitis, pyloric metaplasia, and cholelithiasis.

Introduction: Fine needle aspiration cytology (FNAC) has become popular as a valuable tool in preoperative assessment of breast masses, helping the clinician to plan appropriate management. It is a rapid, simple, cost - effective procedure with minimal complications. Aims and Objectives: 1) To assess distribution pattern of non-malignant breast lesions. 2) To evaluate diagnostic accuracy of FNAC with cytohistological correlation. Materials and Method: Cross-sectional descriptive study with the use of secondary data was done for 2 years, including all the non-neoplastic and benign neoplastic cases where FNAC on breast lumps was performed in the department of Pathology, SDM College of Medical Sciences, Dharwad, Karnataka, India. Cases where the aspirate were acellular or hemorrhagic and malignant breast neoplasms were excluded from the study. FNAC slides were collected from the departmental archive and were reviewed. Results: Of the total 339 cases, 11 (5.60%) were males and 328 (94.39%) were females. Age group ranged from 10 to 70 years. Fibroadenoma was the most common lesion (72.27%). 98 cases were followed up with biopsy, out of which 95 cases were concordant and 3 were discordant. Diagnostic accuracy of FNAC was found to be 96.93%. Conclusion: The most common benign breast lesion was found to be fibroadenoma. Discordance rate of FNAC was 3.06%. Hence, FNAC is a valuable tool in the evaluation of non-malignant breast lesions.

Introduction: This study aimed to differentiate among the species belonging to the Candida parapsilosis complex, which is one of the leading causes of systemic mycoses through molecular characterisation and to determine their antifungal resistance pattern. Material and Methods: Ninety-five C. parapsilosis complex isolates identified using two yeast identification systems, BioMérieux ID 32C and Vitek 2™ with YST card, were included in this study. Molecular characterisation was achieved by polymerase chain reaction–restriction fragment length polymorphism analysis of the secondary alcohol dehydrogenase gene. Isolates that could not be identified using this technique were identified by internal transcribed spacer (ITS) sequencing. Antifungal susceptibility was evaluated using the Vitek 2™ AST-YS06 card. Results: Out of the 95 isolates, 94 were identified as C. parapsilosis sensu stricto, and only one isolate was identified as C. orthopsilosis; the latter result was achieved using ITS sequencing. C. orthopsilosis was susceptible against all tested antifungal agents. Among the C. parapsilosis sensu stricto isolates, three were found to be resistant: one to amphotericin B, two to fluconazole of which one showed intermediate resistance to voriconazole. Discussion: Isolation rates of C. orthopsilosis and C. metapsilosis in this study show that they are rare species. It was not possible to compare resistance among these three species due to very low isolation rates of C. orthopsilosis and C. metapsilosis. The use of molecular identification tests for these species in routine laboratory settings remains controversial. Nevertheless, their isolation rates and antifungal resistance patterns are important from the epidemiological viewpoint.

Introduction: The term gallbladder mucocele refers to an overdistended gallbladder filled with mucoid or clear and watery content. Usually noninflammatory, it results from outlet obstruction of the gallbladder and is commonly caused by an impacted stone in the neck of the gallbladder or in the cystic duct. Case Report: A Patient 27 yrs female came with pain in abdomen to the opd, the patient presented with 3 day history of vomiting and inappetance. The ultrasound was done and chronic cholecystitis with cholelithiasis diagnosis was given and the patients were operated and the laproscopic cholecystectomy specimens were sent to pathology department. Laparoscopic cholecystectomy was performed and the gall bladder was sent for routine histopathological evaluation. The diagnosis of mucocele was made on histopathological examination.

Globally cervical cancers affect about 15% of the women and are the second most common cancer among female population. A dramatic reduction has been observed in the incidence and mortality of cervical cancer after the introduction of Pap test. This study was carried out to assess the role of pap test in cervical cytology and to determine the prevalence of various lesions. This cross sectional study was carried out among 400 patients who attended Gynaecology. Out Patient department. Smears were taken from female patients in the age group of 30-60years with complaints like frothy white discharge, post-coital bleeding, intermenstrual bleeding, dyspaerunia and lower abdominal pain. After fixation in 95% alcohol and staining, each smear was carefully examined. The cytological smears were made by staining under Papanicolaou’s technique and interpreted using new 2001 Bethesda system. Although majority of the smears were negative for any intraepithelial lesion or malignancy, (87.3%), inflammation was present in 69.7% of the smears and 62.5% showed non specifc inflammation. In addition, 28(7.0%) showed candida infection and 1(0.25%) had evidence of Trichomonas infection. Pap test continues to be an essential screening tool to detect early cervical lesions. In addition, it pap test is useful in highlighting the significance of screening test in women of both reproductive and postmenopausal age groups.

Introduction: Ovarian lesions are commonly encountered lesions of diverse morphological spectrum that may develop from neonatal period to post-menopause. They are amongst the most frequent cause of hospitalization and surgery in gynaecological practice. Distinguishing non-neoplastic lesion from a neoplastic lesion on the basis of clinical, radiological or gross characteristics alone is a challenge, thus histopathological examination is must as it is also important in guiding therapy. Objectives: This study was undertaken to study the various histopathological patterns of ovarian lesions, their classification and relative distribution of these lesions. Material and Methods: This is a retrospective study of ovarian lesion specimen that was received in the Histopathology section of our department over a period of 5 years from January 2013 to December 2017. Results: A total of 190 cases of ovarian lesions were included in this study with age range from 14 years to 75 years. 106 were non-neoplastic and 84 were neoplastic in nature. Functional cyst including Corpus luteal cyst was the commonest non-neoplastic lesion (26 cases) followed by 21 cases each of endometriotic cyst and simple cyst. Out of 84 neoplastic lesions, 74 were benign, 3 were Borderline and 7 were malignant in nature. Serous cystadenoma was the commonest benign lesion and Serous carcinoma was the most common malignant tumor in our study. Conclusions: Ovarian lesions comprises of wide spectrum of lesions and their presenting clinical, radiological and gross features are very similar. Hence Histopathology forms the mainstay of definitive diagnosis and categorization of these lesions.

Objectives: To find the prevalence & clinical profile of various benign breast lesions in females presenting with breast lump and to establish its cytohistologic correlation. Methods: A prospective study was conducted in the Department of Pathology, Chirayu Medical College and Hospital, Bhopal [M.P]. A total of 203 patients were diagnosed with benign breast lesions both by Fine Needle Aspiration Cytology and Hisopathology over a period of twenty four months. Data including age, complaints and clinical examination was collected from patients presented for FNAC in Cytology Department with Breast complains. Result: Benign breast lesions are more common in younger age group. Of 203 cases 47.3% belongs to 3rd decade of life (Age 21-30yrs) followed by 31% from 4th decade (31-40). The commonest mode of presentation was Lump in breast in 55.7% cases. The spectrum of lesions were Fibroadenoma 54.2% (n=110), Fibrocystic disease 14.3% (n=29), Fibroadenoma with atypia 3.9% (n=8), Granulomatous mastitis 3.4% (n=7), Breast abscess 4.9% (n=10), Galactocele 2.0% (n=4) and Acute mastitis 3.0% (n=6), Papillary lesion 3.4% (n=7), Phyllodes 2.0% (n=4), Duct ectasia 1% (n=2), Fat necrosis 0.5 % (n=1). Histology was available for 117 cases. No discrepancy was noted. Conclusion: It is essential to diagnose the Breast lesions at the earliest for appropriate management. Diagnosis by FNAC is safe, easy, accurate and economical procedure with easy repeatability, yielding quick results and reducing the need for open biopsies in the reproductive age group. Confirmation of diagnosis by Clinical Examination, FNAC and Histopathology is an important part of diagnostic workup.