Intracranial mature teratoma is a very rare neoplasm. Its location in posterior fossa of cranium is extremely rare, only few cases have been reported in English literature. Though rare, it nevertheless warrants greater emphasis than it receives in the literature. The authors report a case of mature cystic teratoma in posterior cranial fossa in a 5 month old female child. On MRI examination heterogeneously enhancing solid cystic lesion measuring 4.2x4.0x3.9 cm was noted in posterior fossa involving left cerebellar hemisphere. On histopathological examination confirm diagnosis of mature cystic teratoma was established.

A 25 year old man presented in 2019 with increasing pain, coldness of left lower limb and lump at left popliteal fossa. Magnetic resonance imaging was performed before surgery and histopathological and immunohistochemical studies were performed after surgery. This demonstrated a 8x6x2 cm well defined soft tissue mass at the posterior compartment of knee engulfing tendons. A histopathologi¬cal differential diagnosis of benign spindle cell lesion leiomyoma and benign fibrous tumour was made. We describe this rare case of fibroma at posterior compartment of the knee with immunohistochemistry and treatment.

Background: The congenital bleeding disorders haemophilia A and B are estimated to affect between one in 10 000 and one in 50000 males. The clinical profile of hemophilia patients is rarely reported in India. ISTH- Bleeding Assesment Tool score is one such score which not only helps us to diagnose a bleeding diathesis but may also help us in predicting the severity of bleeding potential of any patient with bleeding diathesis. Objective: To describe the clinical and epidemiological profile of hemophiliac patients in Uttarakhand. Calculate Bleeding Assessment Tool score in all patients of haemophilia and differentiate severe haemophilia from moderate haemophilia. Material and Methods: A total of 75 patients of all age groups with haemophilia A and B were included in the study. A detailed clinical history using ISTH -BAT along with clinical assessment by the hematologist was done. Special emphasis was laid on demographic details. Coagulation studies were done on STAGOSTA compact. Chi-square test was used for Assessing BAT scores. Results: The hospital based prevalence was 1.2% for haemophilia A and 0.3% for haemophilia B in our study. There were 74 % severe haemophilia and 5% of mild haemophilia in our study. The presence of inhibitors was 6%. There was significant statistical difference between the BAT score values of moderate and severe haemophilia (p value<0.05). Conclusion: The study suggested high prevalence of haemophilia in the state along with high numbers of inhibitors. More studies are required to establish the role of bleeding assessment tool in differentiating moderate haemophilia from severe haemophilia.

Pigmented lesions encountered in routine clinical practice are mostly asymptomatic and benign in nature. However, rarely, a pigmented lesion can be a sign of malignancy. Primary oral mucosal melanomas are rare and aggressive malignancies. At the time of diagnosis most melanomas are in an advanced stage due to early asymptomatic nature. The prognosis remains poor despite treatment. We report a rare case of cerebral metastasis, from primary malignant melanoma of the mandibular gingiva in a 70-year-old male patient who eventually died before initiating the treatment.

Background: The aim of this study is reviewing the histopathological spectrum of malignant neoplastic lesions of the large intestine. Methods: This is a retrospective & prospective study carried out in the department of pathology from June 2017 to June 2019. The specimens from the medical and surgical gastroenterology department were studied. Variables like age, sex, tumor size, location, type of lesion, the histological pattern of patients were studied. Results: In the series of 140 patients of colorectal neoplasm, the maximum number of patients presented in the fourth decade of life (34.28%) with a mean age of presentation at 53.7years.The youngest patient with adenocarcinoma was 24years (male) of age, and the oldest one was 80 years (male) of age. The male to female ratio was 1.12:1. The proportion of well-differentiated carcinoma was highest in left side colon and rectum, whereas the incidence of moderately and poorly differentiated adenocarcinoma was higher on the right-side colon. Conclusion: Adenocarcinoma is the most common histological variant of colon carcinomas showing slight male preponderance and the most common site being rectum.

Intracranial tuberculous subdural empyema originating from otitis media and mastoiditis is rare. Timely diagnosis and prompt surgical management, followed by microbiological confirmation of the causative agent is known to be life-saving. We report a case of a 10-year old child with subdural empyema with fronto-parietal involvement, who was managed by craniotomy and antitubercular therapy was instituted after microbiological investigations. We urge the necessity of clinical suspicion and immediate surgery for management of such cases.

Background: Synovial sarcoma is a translocation-associated mesenchymal neoplasm that represents around 10% of all soft tissue sarcomas. Diagnosing biphasic synovial sarcoma is generally straightforward, owing to distinctive histologic features. Transducer-like enhancer of split 1 (TLE1) is overexpressed in synovial sarcomas. Study aimed to evaluate sensitivity and specificity of TLE1 immunohistochemical expression in synovial sarcoma and its histological mimics. Methods: Conventional sections from 30 cases of synovial sarcoma, 24 cases of monophasic synovial sarcoma mimics and 6 cases of poorly differentiated sarcoma mimics were subjected to TLE1 IHC staining. TLE1 immunostaining was graded from 0, 1+, 2+, 3+, with 2+ or 3+ grades interpreted as positive staining. Results: Of the 60 tumours, majority are monophasic spindle cell type (56.6%), followed by biphasic (16.6%), monophasic epithelial (6.6%), poorly differentiated (13.3%) and calcifying type (6.6%). Upon expression ofTLE1 in tumors, 20c ases showed Grade 3, 8 cases shown Grade 2, 2 cases shown Grade 1 TLE1 Expression in Synovial sarcoma. 2 cases shown Grade 3 and 2 cases shown Grade 2 TLE1 expression in Schwannoma. Whereas 1case shown grade 2 in Rhabdomyosarcoma. 1case shown grade 2 in Hemangiopericytoma. TLE1 sensitivity for diagnosis of synovial sarcomas was 93.3%, and specificity of 73.3% with positive predictive value of 77.77% and negative predictive value of 91.6%. Conclusion: Specificity can be increased with optimal IHC panel which includes BCL2, Pan Cytokeratin, EMA, CD99 and CD34. Molecular confirmation is the diagnostic gold standard for synovial sarcoma, TLE1, in view of its high sensitivity may be a useful marker within the optimal IHC panel for substantiating a diagnosis of synovial sarcoma. Awareness of TLE1 expression in other tumours and its correct interpretation are necessary.

Dengue, an arboviral infection is a notifiable disease in India and is endemic in many regions of the country. CRP levels help in knowing the severity of the disease. Patients with signs and symptoms of Dengue were included in the study. Their demographic data was noted. Serum was tested for NS1 ELISA, IgM ELISA. Positive samples were tested for CRP levels. Platelet count, Blood transfusion information was noted. Dengue positivity was 21%, with male predominance (55.6%), common in young children and teens. CRP level of 12 mg/L was seen in 28.40% of patients. Patients with CRP of 48mg/L required multiple platelet transfusion. Conclusion: our study has correlated dengue positive patient’s platelets, CRP levels and need for blood transfusion. CRP levels help in knowing the severity of dengue disease.

Due to long term morbidity and mortality associated with transfusion transmissible infections (TTI), the present study was undertaken to find out the prevalence of transfusion transmissible seropositive infections among both voluntary and replacement blood donors over a period of ten years at a tertiary care hospital. Aim: The aim of this study is to determine the seroprevalence of transfusion transmissible infections among blood donors. Material and methods: This is a retrospective study conducted on all voluntary and replacement blood donors in a tertiary care hospital for a period of 10 years from 2010 to 2019. Blood samples were screened for HIV, HBV, HCV by ELISA, for syphilis by rapid plasma reagin test and malarial parasites. All seroreactive blood bags considered as positive for TTIs were discarded. Result: Out of total 18490 donor’s blood units screened using standard blood tests for transfusion transmissible infections, replacement donors constituted 26.2% and 73.8% were voluntary blood donors. A total of 161 samples (0.87%) were found to be positive for TTIs. Seroprevalence of HIV, HBV, HCV and Syphilis was found to be 0.13%, 0.62%, 0.08% and 0.02% respectively. No donors were found positive for malaria parasites. Conclusion: Overall seroprevalence of TTI was 0.87% with high prevalence of HBV infection when compared to other TTIs. Safe blood transfusion is still a challenge with this prevalence rate. Hence there is a need of more sensitive screening tests especially in screening HBV infection to minimize TTIs along with strict donor selection criteria.