Background: Gallstones are the major culprits for gallbladder pathologies. More than 95% of biliary tract disease is attributable to cholelithiasis (gallstones). Most patients are unaware of the disease and remain asymptomatic for life. Aim: To determine morphological characterization of gallstones in cholecystectomy specimens to understand its association with etiology. Material and Methods: All cholecystectomy specimens having gallstones received at the Department of Pathology over a period of four years were studied for morphological characterization. Results: Out of 178 gallbladders showing calculi, patients of 5thand 7th decade (24.15% and 21.92%) were commonly affected and majority were females (69%) when compared to males (31%). Most common calculi were mixed type of stones (64.04%). 48.88% gallbladders were having round to oval shaped calculi, 24.15% were polyhedral, multifaceted and 26.97% were irregular in shape. Conclusion: The population of the present study showed mixed type of calculi as common observation which depicts its etiology of change in lifestyle with following western diets and concurrent infectious cause.

Ovarian cancers account for about 3% of all cancers in women and is one of the leading causes of mortality among all cancers of the female genital tract. The study aimed to record the histopathological spectrum of ovarian neoplasms over two years in a tertiary care hospital. This retrospective study was done for a period of 2 years (JUNE 2017 to JUNE 2019) in the Department of Pathology, Narayana Medical College, Nellore. Here we studied 114 cases of ovarian mass specimens, which were fixed in 10%formalin. 4-5micrometer thick sections were cut on a microtome and stained by H and E stain for Histopathological Examination. In this study, 114 cases of ovarian neoplasms were analyzed. Out of these, 101 were benign, three were borderline and 10 were malignant. Histopathologically, surface epithelial tumors were the commonest (96). The second most common was germ cell tumor (10) followed by sex cord-stromal tumors (8). Benign tumors were frequent in 31-40 years of age, borderline tumors in 21-30 years of age, and malignant tumors in 41-50 years of age group. Ovary is a common site of neoplasia in the female genital tract and usually presents with a variety of clinicomorphological and histological features. The study revealed an increased incidence of malignancy because patients usually present in advanced stages of the disease, and this is an alarming finding.

Papanicolaou (PAP) smear is a cyto-diagnostic technique, which is a simple, safe, non- invasive and effective method for detection of pre-cancerous and non- cancerous changes in cervix as well as vagina. Clinical follow up of reported abnormal cases was done by revisiting the records or by following it up with histopathological specimens of the same patient received in our department and cytology-histopathological correlation was done. A total of 2624 PAP smears were analysed during the study period. 51 smears had abnormal PAP findings, out of which 44 cases had histopathology correlation. The present study encountered that cervical cytology is more sensitive in diagnosing glandular malignancy than squamous cell abnormalities.

Background: Diagnostic challenges are associated with skin adnexal tumors because of a broad spectrum of tumor and tumor-like lesions along with their histological variants, the degree of differentiation, the rare incidence of few of these tumors, and the complex nomenclature. The aim of this study is to study the spectrum and microscopic features of Skin adnexal tumors. Methods: A prospective study was conducted over a period of 2 years from August 2017 to July 2019 in the Department of Pathology, Narayana Medical College and Hospital, Nellore. Formalin fixed, paraffin embedded tissue sections were stained with Hematoxylin and Eosin. Result: Out of the total 30 cases diagnosed as Skin adnexal tumors, 15 (50%) tumors were showing Eccrine differentiation followed by tumors with Pilar differentiation, 8 (26.67%), Apocrine differentiation, 5 (16.67%) and Sebaceous differentiation, 2 (6.66%). The age ranged from 13 to 73 years and male to female ratio was 1.14:1. Most of the tumors were benign, 29 cases (96.67%) while only 1 case (3.33%) was malignant. Clear Cell Hidradenoma was the most common tumor. Conclusion: Morphological features and identifying the path of differentiation are of great importance in diagnosing Skin adnexal tumors.

Introduction: The most common malignancy encountered, in current setup is breast cancer in females. It stands second, as the most common cause, of death caused by cancers in developed countries. The diagnosis of the variants of breast cancer can be done with aid of immunohistochemistry (IHC) that is expression of ER, PR, Her2/Neu, and this has led to application of multiple systemic therapeutic strategies. The purpose of this study is to find the proportion of triple negative breast cancers in the study group and to compare the clinical features, natural history and outcome of Triple Negative Breast Cancer (TNBC) to other non-triple variants of breast cancers. Materials and methods: Analysis of retrospective clinical database was performed for 100 cases for the duration of 3 years (2017-2019). Clinical, histopathological and IHC patterns were compared under various headings. Results: Significant difference was found between the two groups in the variables such as age of diagnosis, tumor size, grade, lymphatic spread and prognosis. The patterns of reference amongst them show qualitative difference with triple negative group in view of risk of recurrence which peaked at 4 years and declined rapidly. On the contrary the others presented with constant risk of recurrence over a period of time. Conclusion: Triple Negative Breast Cancer has a more aggressive clinical setup as compared to others, although the findings are transient. The morphological characteristics alone cannot be used to classify breast cancers in two subtypes with different prognosis.

Gall bladder disease is rather encountered on a daily basis in the OPD’s now a day[1]. Many of these get admitted. Most of the cases admitted in the hospitals require radiological intervention. Routine examination of the gall bladder using USG is difficult and challenging. After cholecystectomy has been done it shows different histopathological changes ranging from inflammation to premalignant and carcinoma. This study puts in an effort to find the answer for the same.

Oesophageal carcinoma ranks one of the commonest of all cancers. It sure finds a spot in the top ten. It also ranks itself in the top 5 when mortality of the patient is concerned. 1 Oesophageal Cancers are more often encountered than when compared to statistics of any other era and we encounter it more often in the clinics. The frequency has been on a positive inclination if not straight. It is one of the serious malignancies and has one of the worst prognoses. The morbidity and the mortality is also on a higher scale. The trends are expected to increase in the next decade or two as more and more urbanisation and industrialisation are happening thus indirectly leading to life style modifications. Obesity is also one of the more important causes or rather says obesity has been linked directly to the oesophageal cancers. With increase in the incidence and prevalence of the obesity and also the unhealthy life style modifications, more number of cases is expected to encounter. If global scenario is considered then higher incidence is reported in the developing nations and also majority of the studies indicate that squamous cell carcinoma is the commonest variety. In the last half century more number of cases has been reported than in any other point of time.

Oesophageal carcinoma ranks one of the commonest of all cancers. It sure finds a spot in the top ten. It also ranks itself in the top 5 when mortality of the patient is concerned. 1 Oesophageal Cancers are more often encountered than when compared to statistics of any other era and we encounter it more often in the clinics. The frequency has been on a positive inclination if not straight. It is one of the serious malignancies and has one of the worst prognoses. The morbidity and the mortality is also on a higher scale. The trends are expected to increase in the next decade or two as more and more urbanisation and industrialisation are happening thus indirectly leading to life style modifications. Obesity is also one of the more important causes or rather says obesity has been linked directly to the oesophageal cancers. With increase in the incidence and prevalence of the obesity and also the unhealthy life style modifications, more number of cases is expected to encounter. If global scenario is considered then higher incidence is reported in the developing nations and also majority of the studies indicate that squamous cell carcinoma is the commonest variety. In the last half century more number of cases has been reported than in any other point of time.

Background: Cyclophosphamide (CP) is a selective antibiotic used clinically as an anticancer drug. Treatment with CP exhibits a number of side effects. Here in this study, we explored the toxic effects of CP and the ameliorating effects of Sargassum cinereum in albino rats. Material and methods: Eighteen rats divided into 3 groups (6 rats each) control group, CP injected group in a dose of 200 mg/kg b. w and CP injected plus oral administration of S. cinereum group in a dose of 180 mg/kg b. w for 20 consecutive days. Results showed cyclophosphamides induced hematological, biochemical, oxidative and histological changes. Results: Hematological analyses revealed a significant decrease in the RBCs, WBCs' count and Hb concentration. Biochemical analyses revealed increase in the liver enzymes activityincluding ALT, AST and ALP, while albumin and total proteins were significantly decreased. Creatinine, urea, and uric acid levels as well as lipid profiles including cholesterol and triglycerides were increased signifcantly. Moreover, Oxidative stress was active that evidenced by a significant decrease in SOD, GSH and CAT levels, while a significant increase was recorded in the MDA level. For histopathology necrosis and inflammations were oserved in the hepatic and kidney tissues. Treatment with brown seaweed S.cinierium significantly ameliorated all of the above mentioned hematological, biochemical, oxidative damages and histopathological changes induced by CP injection. Conclusion: Cyclophosphamide induced its toxicity throught the activation of the oxidative system in the tissues, while the ameliorative effect of brown seweeds (S. cinereum ) achived throught activation the antioxidant system.

Introduction: Epidermomycoses are superficial yeast infections that affect the epidermis outside the intertrigo. The aim of our work is to draw up a clinico-epidemiological profile of epidermomycoses diagnosed in the mycology parasitology laboratory of the Avicenne military hospital in Marrakech. Materials and methods: This is a retrospective study carried out over a period of 6 years (January 2013 to December 2018) including all the cases of epidermomycosis diagnosed. After collecting clinical information, a direct examination of the samples is carried out before culture on Sabouraud media with incubation at 27 ° C. The identification of the identity was based on the speed of growth, macroscopic aspects and microscopic colonies. The identification of yeasts was based on the filamentation and assimilation of sugars test: Api 20C. Results: Epidermomycosis was confirmed in 108 cases or 57% compared to all of the samples examined. The sex ratio M / F is 0.74, the average age is 35.5 years. Outpatients are the majority (86%). the prevalence of superficial dermatophyte mycoses was 81.4% followed by yeasts (14.6%) and molds (4%). Isolated dermatophytes are dominated by a single species Trichophyton rubrum (92%), yeasts by Candida albicans (45%) Conclusion: Epidermycosis is still a frequent reason for consultation in dermatology. In the face of any clinical suspicion, the mycological diagnosis remains the diagnosis of certainty and for therapeutic orientation.

The main objective of the present research work was to identify the unknown wild mushrooms based on morphological characteristics and DNA based sequencing by using universal primers ITS 1 and ITS 4 which were collected from Andhra Pradesh and Telangana. To test the potential of various extracts of mushrooms by using three different solvents (Methanol, Hot Water and Hexane). To elucidate antimicrobial properties, qualitative and quantitative estimation of phytochemical properties and antioxidant activity was determined by DPPH free radical scavenging activity. Then, IC50 values were determined. The four isolates were identified on the basis of morphological and molecular characterization was identified as Trametes versicolor, Daedaleopsis confragosa, Schizophyllum communae and Tyromyces chioneus. Three different solvents had been shown good antimicrobial activity against all pathogenic microorganisms. The hot water extract of T. versicolor exhibited more amount of phenol content (11.13±0.081) and ascorbic acid content (9.62±0.086). Methanol extract of S. communae showed high amount of flavonoids content (12.58±0.138). Methanol extract of T. chioneus exhibited more amount of β-carotene (3.54±0.010) and hot water extract of D. confragosa exhibited more amount of lycopene content (2.29±0.012). The DPPH free radical scavenging activity and IC50 values was much more exhibited by methanol extracts then followed by hot water extracts and hexane extracts of wild mushrooms they all have exhibited stronger antioxidant activity between (40-50 µg/ml). This comprehensive analysis demonstrates that these mushrooms having a viable source of natural antioxidants that can utilized for functional foods, nutraceutical’s applications with beneficial biological activities and implementation of new drug discovery.

Introduction: Neonatal septicaemia is one of the major factors contributing to the high perinatal and neonatal mortality and morbidity. The definite diagnosis of septicemia is made by a positive blood culture which requires a minimum period of 48-72 hours and yields a positive result in 30-70% of cases. Hence there is a critical need for laboratory tests that aid in the rapid diagnosis of neonatal sepsis. Objective: To evaluate the neonatal hematological parameters of clinically diagnosed cases of sepsis, as ones which can be used to formulate a scoring system in early diagnosis of neonatal sepsis. Design: A diagnostic study conducted at the Neonatal Intensive Care Unit of a tertiary care teaching hospital. Methods: This study consists of 100 neonates admitted at Neonatal Intensive Care Unit at the Dr. D.Y. Patil Medical Hospital, Pimpri, Pune, who were clinically suspected of sepsis. The neonatal hematological parameters included were total leukocyte count, total neutrophil count, lymphocytes, immature cells, immature to total leukocyte ratio, immature to mature cells ratio, nucleated red blood cells, platelet count, and degenerative cells (toxic granules & dhole bodies). These parameters were evaluated based on the standard reference values given by Rodwell et al and were graded as a) score >5- sepsis, score of 3 to 4 – probable sepsis and c) score of <3 as no sepsis. A blood culture was the standard indicator for proven sepsis. Results: There were 21 out of 100 neonates (21%) who had culture proven sepsis and they were predominantly males and less than one day old. Among the different parameters, the sensitivity of TLC was 100%, increased PMN count showed a sensitivity of 95%. The overall sensitivity of culture positive neonates with a score of more than 5 was 69%, specificity was 76% and disease prevalence was 29%. Conclusion: The sensitivities of the various screening parameters were found to be satisfactory in identifying early onset neonatal sepsis. Hematological scoring system is a simple and feasible diagnostic tool to guide towards the decision-making for a rationale treatment.

Introduction: Early diagnosis and therapeutic intervention can improve the outcome of acute myocardial infarction (AMI). However, there are no satisfactory cardiac biomarkers for the diagnosis of AMI within 6 hours of onset of symptoms. Among the novel biomarkers of AMI, we tested the diagnostic accuracy of Heart type Fatty Acid Binding Protein (HFABP) in prospectively recruited patients with independently adjudicated outcomes. Methods: Prospective observational study was conducted at the Department of Pathology and Department of Cardiology, Dr Ram Manohar Lohia Institute of Medical Sciences Lucknow. After taking informed consent, 80 cases of chest pain suggestive of coronary origin (within 6 hours) were included. Results: Group a included 55 patients while Group B included 25 patients. In our study on Receiver operator curve (ROC) analysis, the AUC (Area under curve) was 0.846 (95% C.I. 0.743 to 0.948; p value <0.001) for HFABP. The optimum cut-off value for HFABP to diagnose AMI was 6.38 ng/ml with a Sensitivity, Specificity, PPV (Positive Predictive Value) and NPV of 86.4%, 84.5%, 67.9% and 94.2% respectively. Conclusion: The optimum cut-off value for HFABP to diagnose AMI was found to be 6.38 ng/ml were in concordance with similar studies. A high sensitivity and NPV is essential for the early ‘rule out’ of AMI patients. Since more than 70% of patients who present with acute chest pain to an emergency department do not have AMI, HFABP can be used as rule out tool to prevent unnecessary admissions of patients suspected for AMI considering its high sensitivity and NPV. Though, it was not a reliable marker for AMI diagnosis because of low specificity and positive predictive value. Further larger studies are needed to understand whether HFABP can add incremental value in rule-in AMI.

Skin and soft tissue infections (SSTI) are the most common infections encountered in community and healthcare settings. There are different risk factors associated with SSTI including trauma, surgery, skin disease, immune defects and injection drug usage. Intravenous drug users (IDU) are frequently susceptible to SSTI due to unsafe injection practices, sharing of needles and low immunity. Intravenous drug usage is most common in young and homeless people globally. Although Staphylococcus aureus and Streptococcus pyogenes are the commonest pathogens however there are serious infections caused by rare pathogens such as botulism by Clostridium botulinum and tetanus by Clostridium Tetni. Prompt diagnosis and accurate management at the healthcare level will help in alleviating the symptoms and improve the outcomes. The continuous education and enhancing the implementation of prevention strategies are the responsibilities of local and national government to reduce the harmful drug use. In this review we are addressing the current challenges associated with causative pathogens for SSTI in IDU and their management and preventive strategies.

Aims: To correlate AGE, TYPE, RBC INDICES in deciding the severity of anaemia in adult females in tertiory care hospital. Settings and Designs: A hospital based cross sectional study was done at our tertiary care centre in central clinical laboratory of Dr. D. Y. Patil Medical College & Hospital and Research Centre, Pimpri, Pune among 1000 adult females to evaluate prevalence of spectrum of anaemia. Considering a confidence level of 95% and confidence interval of 3.1 the number of patients in our study to achieve statistical significance is 999. This was calculated by Survey System (http://www.surveysystem.com/sscalc.htm#one). The Survey System ignores the population size when it is "large" or unknown. Population size is only likely to be a factor when you work with a relatively small and known group of people (e.g., the members of an association). Hence a sample size of 1000 was considered adequate for our study. Results: Majority of the females (42.44%) were in the age group of 26-35 years followed by 31.9% in the age group of 18-25 years, 19.2% in the age group of 36-45 years, 4.9% in the age group of 46-55 years and 1.6% in the age group of 56-65 years. 410 (41%) females had mild anaemia while 440 (44%) and 150 (15%) females had moderate and severe anaemia. The mean corpuscular volume (MCV) of females with mild anaemia was 70.94±1.35fl while the mean MCV of females with moderate and severe anaemia was 66.29±2.43fl and 60.82±1.77fl respectively. There was significant decrease in mean corpuscular volume (MCV) with increase in severity of anaemia as per ANOVA test (p<0.05). The mean corpuscular haemoglobin (MCH) of females with mild anaemia was 25.74±2.38pg while the mean MCH of females with moderate and severe anaemia was 21.16±2.07pg and 17.84±1.96pg respectively. There was significant decrease in mean corpuscular haemoglobin (MCH) with increase in severity of anaemia as per ANOVA test (p<0.05). The mean corpuscular haemoglobin concentration (MCHC) of females with mild anaemia was 32.76±3.14 while the mean MCHC of females with moderate and severe anaemia was 29.55±2.83 and 26.91±2.34 respectively. There was significant decrease in mean corpuscular haemoglobin concentration (MCHC) with increase in severity of anaemia as per ANOVA test (p<0.05). The mean red cell distribution width (RDW) of females with mild anaemia was 17.72±0.87% while the mean RDW of females with moderate and severe anaemia was 18.26±1.18% and 20.05±1.37% respectively. There was increase in red cell distribution width (RDW) with increase in severity of anaemia but the increase was statistically not significant as per ANOVA test (p>0.05). Conclusion: Iron deficiency anemia is increasing in females, specially in reproductive age group of developing countries. The haematological parameters can aid in early recognition of type and cause of anaemia and thereby improve the outcome. The study confirms that iron deficiency anaemia is the most common cause of anaemia in pregnancy and is a major health problem in developing and developed countries. Early detection, treatment and prevention of anemia can improve maternal as well as child outcome.

Background: Breast lumps are a common presentation among females. Breast carcinoma is 2nd commonest malignancy in females in India and needs early detection for proper management. Fine needle aspiration cytology (FNAC) is an established and highly accurate method in the investigation of palpable breast lumps. So the study was performed to analyse the cytomorphological spectrum of palpable breast lesions in a Tertiary Care Centre in North India. Material and Methods: This retrospective study was carried out in the Department of Pathology in GMC, Jammu. Female patients with suspected breast lumps who underwent FNAC in our department over a period of one year were included in the study. Detailed history including patient’s age, site and duration of breast lumps was noted. Findings of FNAC were recorded in detail and results tabulated. Results: Inadequate/Non-Diagnostic aspirations were seen in 13 cases. Majority of cases were seen in 4th decade of life. Among all aspirations, fibroadenoma was the commonest lesion seen in 36.4 % cases while malignancy was seen in 20.1 % cases. Conclusions: FNAC is a rapid, economical, and reliable tool for the diagnosis of palpable breast lesions. FNAC provides useful information in the management of the lesions and prevents unnecessary surgery in cases of non-neoplastic lesions.

The presence of airborne microbes and their relationship to disease has become an important area of study, as many bioaerosols in indoor and outdoor environments have been found to cause adverse health effects. This study was carried out to assess the application of sterile food samples as a novel technique in the bacteriological probing of air quality. In this study, different food items (pawpaw, meat and yam) were sterilized by autoclaving, and exposed to an outdoor air condition, in order to isolate bacteria capable of causing contamination of sterile materials, including processed food samples exposed to the air environment. Five (5) grams each, of the various food samples were exposed at varying elevation to a maximum height of 40 feet above ground level and studied at daily intervals for five consecutive days. The bacterial population dynamics as well as diversity was determined and was observed to vary with respect to the food type used as sampling substrate and exposure duration. In the overall analysis, meat had more bacterial load than pawpaw, while yam was the least. The results obtained from the investigation showed that E. coli (25.9%), Klebsiella pneumonia (16.9%), Pseudomonas auroginosa (15.6%), Staphylococcus aureus (12.9), Shigella spp. (11.7%), Bacillus spp (9.1%), and Salmonella spp (7.9%) were the most frequent bacterial isolates in the air environment studied. The study reveals a novel method of air quality determination using sterile food samples. The study further recommends proper waste management at the tropospheric level to prevent upward movement of particles.

Background: Germ cell Tumours (GCT) of testis accounts for majority of the testicular tumours while Non germ cell tumours of testis are generally rare. Angiomyolipoma (AML) is a common benign mesenchymal tumour that is commonly seen in the kidney and other than this site is generally very rare. The Aim is to study the different testicular lesions and to search for the rare tumours of testis. Materials and methods: It is a Hospital based Prospective observational study over a period of 3 years in orchidectomy specimens. Sample size includes 100 cases. Results : Non neoplastic testicular lesions accounts for the majority of the cases with most commonly seen in second decade of life while the Neoplastic lesions seen mostly in the 3rd and 4th decades of life with encountering one rare case of Testicular Angiomyolipoma. Conclusion: Diagnosing rare tumours of any organ is always a challenging task for every pathologist and it is also a visual treat. Hence it is imperative to maintain hawks vigil during microscopic diagnosis to identify such rare tumours for better management strategies.

Background: Pathology is considered by 2nd-year MBBS medical students to be an interesting and useful but most difficult subject. The problems of memorizing and volatility of the subject faced by the students can be tackled by making them learn by putting them in a particular situation and giving them a task as a source of learning, comparable to an actual task that he may face in his future professional life, addressed to as “Problem-based learning” (PBL). Methods: The Cross-sectional study was carried in Narayana medical college, Nellore. The participants were 150 2nd MBBS students (regular batch) who have completed 3rd semesters of pathology. Data were collected at the end of 3 semesters of pathology using a predesigned questionnaire. Data entry and analysis was done using Microsoft Excel. Percentages were used to analyze the data. Results: A total of 150 students (regular batch) who were going to appear for the 2nd MBBS university exams participated in our study. All of them returned the completed questionnaire. Of the 150, 88% were female students, and 12% were male students. A vast majority of the students, 98 %, found pathology to be an interesting subject. The majority of the students, 80%were satisfied with the content of the lectures taken and only 12.5%, felt otherwise. Blackboard teaching (87%). Conclusion: The study showed that most students had a positive attitude towards pathology. Students are in favor of the use of blackboard teaching, PowerPoint presentations, case-based discussions and integrated teaching.