Guided FNAC has become a clinching investigation for intra-abdominal lesions be it palpable or non-palpable. FNAC as superseded the need for biopsy as it involves a complex setup for laparotomy procedure and very small and deep-seated lesions cannot be approached by biopsy. This study included all palpable and non-palpable lesions in different abdominal organs presented in various departments of Sawai Man Singh Hospital, Jaipur. Relevant investigations were taken by the patients before posting them for procedure including prothrombin time and contraindications considered like haemangiomas, bleeding tendencies. The aspirates were stained with H &E stain and MGG stain and special stains applied when required. A total of 1220 cases were received in the duration of one year. A female preponderance was noted with M: F (1:1.32). The age range was from 11-month-old to 98-year-old patients. Maximum cases were in the age group of 51-60 years (219 cases). Liver was the most common site (45%) followed by gall bladder (31.3%) and then pancreas (6.55%). Majority of lesions were malignant (55.8%) followed by benign (15%). Malignant lesions were noted more in females whereas male population had more of benign and inflammatory lesions. The rate of malignant lesions increased as the age increased. In liver most common malignancies were metastatic lesions whereas in gall bladder, primary lesions were more common. FNAC has a very high sensitivity which makes it a first line investigation in evaluation of abdominal lesions. It has both diagnostic and prognostic value and enables a surgeon for treatment modalities.

Background: The management of prostate cancer may be difficult due to apoptosis resistance. HIF-1α (Hypoxia inducible factor 1α) and CypA (cyclophilin A) over expression promotes this resistance. Caspase 3 is a central executioner of the apoptosis pathway. Changed expression may correspond to tumor cell challenge. Aim: Evaluation of HIF-1α, CypA and Caspase 3 expressions in BPH (benign prostatic hyperplasia), PIN (prostatic intra-epithelial neoplasia) and PCa (prostatic carcinoma). Methods: One hundred four patients with histologically diagnosed prostatic carcinoma, 20 cases with BPH and 24 cases with PIN were investigated. Immunohistochemical assessment was executed to evaluate HIF-1α, CypA and Caspase 3 expressions. Results: In BPH cases, HIF-1α, CypA and Caspase 3 were expressed in 20%, 30% and 60% respectively. In PIN cases, HIF-1α, CypA and Caspase 3 were expressed in 33.3%, 41.7% and 41.7%, respectively while in PCa cases, HIF-1α, CypA and Caspase 3 were expressed in 57.7%, 69.2% and 25% respectively. Increasing stage of prostatic cancer showed a significant increased HIF-1α and CypA immuno-expression with lost caspase 3 immuno-expressions. Conclusions: Distorted HIF-1α, CypA and Caspase 3 expressions may act as a further mechanism of apoptotic resistance in prostatic carcinoma treatment.

Background: Asthma still the mainly prevalence chronic respiratory disease affecting individuals in different ages. The objective of this study was to find out the prevalence of asthma, and its triggering factors among medical students in the College of Medicine University of Hai'l city, Saudi Arabia. Methodology: The study investigated 198 students using online questionnaire. Results: The 198 male medical studentsaged between 20 -27 years with mean age of 21.5. The overall prevalence of asthma in in the medical students at the College of Medicine University of Hai'l was 10%.Regarding to things that aggravates asthma symptomsdust 5/20(25%), smoke 2/20(10%), dust+smoke 4/20(20%), dust+stress 1/20(5%), dust+smoke+stress+animals 2/20(10%), dust+smoke+cold weather 3/2(15%), dust+animal+stress 1/20(5%) and dust+coldweather+animals 2/20(10%). Conclusion: The prevalence of asthma in medical students is relatively high compared to global prevalence rates. The most common allergies triggering asthma symptoms in the college of Medicine, university of Hail, are dust, smoking, Animals and stress.

Intracranial epidermoid tumors are inclusion tumors of the central nervous system. They are congenital neoplasms that grow through desquamation of keratin, cholesterol and cellular debris. They cause mass effect and gradual development of neurological symptoms. Here we present a case of a 65 year old lady who presented with new onset seizures, CT scan suggesting a low grade cortically based neoplasm and a diagnosis of epidermoid cyst was made from histopathological sections.

Background: There is a sharp decline in new SARS-CoV-2 cases in Karachi from July onwards; most of them were asymptomatic. Seroconversion rates vary markedly in different countries. Previously, 36% of seropositivity was reported in the adult population of Karachi in July this year. The current study was conducted to report if seroprevalence has increased and has a possible role in community immunity. Methods: This was a prospective cross-sectional study conducted in the first and second weeks of September 2020 at the National Institute of Blood disease and Bone Marrow Transplantation Hospital (NIBD), Karachi, Pakistan. Blood samples were collected from different segments of the population of Karachi workforce/community. An anti-SARS-CoV-2 test was performed using ECLIA from Roche Diagnostics International. Results: A total of 2404 subjects’ blood samples were received from healthcare workers, the industrial workforce, and healthy blood donors. Seroprevalence in industrial workers was highest (70%) as compared to healthcare workers (40%). Overall seropositivity in males (39%) was higher than females (16%). Blood donors (all males) showed seropositivity of 37.8%. The comorbid state was not significantly associated with seropositivity (p-value >0.05). Total cases of antibody-positive were 1322 of 2100 (55%). Conclusion: Our results confirmed the current seroprevalence of 55% in the adult population in Karachi. There was a sharp rise from 36% reported previously in July. This rise coincided with a sharp decline in new reported COVID 19 cases. We can conclude that the adult population from Karachi has shown an upsurge in seropositivity which will certainly have a beneficial role in SARS-CoV-2 control in the future.

Plasma cell leukemia is one of the most aggressive and rarest forms of plasma cell dyscrasias. It can arise from a leukemic transformation of multiple myeloma or can be primary and the prognosis is very poor. We present the case of a 68 year old male who presented to our hospital with features of acute renal failure. He was diagnosed as a case of Plasma cell leukemia and was treated with chemotherapy. However his condition deteriorated and he died 2 weeks after diagnosis. The recommended treatment of plasma cell leukemia is aggressive chemotherapy followed by stem cell transplantation. However, once diagnosed, the prognosis is very poor.

Background: In a society to improve medical facilities, one of the crucial parts is the availability of safe and good quality blood. The occurrence of adverse events during blood donation affects donor return. Aims and Objectives: To analyse the frequency and significance of adverse events during blood donation. Materials and Methods: This study was conducted for a period of one and a half years from 1st January 2018 to 30th June 2019 on 11,170 allogenic blood donors including both voluntary and replacement donors. The type and frequency of adverse events were recorded during blood donation. Results: 116 adverse events were recorded resulting in 1% adverse event rate, among which majority had vasovagal reaction 89 (76.7%), followed by hematoma formation 15 (12.9%), nerve injury 11 (9.5%) and rebleeding at the site of prick 1 (0.9%). Significant relation with female sex, younger age, low weight, donating in camps and first-time donors was noted. Conclusion: In existing scenario of shortage of blood in India, new and existing donors should be motivated to donate blood regularly by bringing down the events of adverse reactions during blood donation.

Myoepithelioma is a rare benign tumor of the salivary glands. We report an observation of an accessory salivary gland myoepithelioma discovered incidentally in a 36-year-old man. The clinical aspect of the lesion suggests the diagnosis of a benign tumor. Microscopic and immunohistochemical examinations confirmed the myoepithelial nature of the tumor. The diagnosis of this neoplasm remains controversial, however, due to the variable clinical and histological aspects. The prognosis is good Treatment is surgical.

Dengue fever and Dengue Haemorrhagic fever (DF/DHF) is an acute viral disease transmitted by the bite of an infected female mosquito- Aedes aegypti. The dengue virus causes significant morbidity and mortality in many parts of the world, including India where it was first isolated in Calcutta, West Bengal during 1945. This study was conducted to know the seroprevalence of Dengue virus in a tertiary care hospital, Gujarat.Methods: Blood for serological studies are carefully collected taking due universal precautions from suspected DF/DHF cases (a) as soon as possible after hospital admission or attendance. All the patients were screened for Dengue NS1 and anti-dengue IgM antibodies by Enzyme Linked Immunosorbant Assay (ELISA). The study period was 6 months from June 2020 to December 2020.Results: From a total of 6238 serum samples 2764 tested for Dengue NS1 and IgM, 2764 (44.3%) were positive. 1606 (58.1%) were only NS1 positive and 1158 (41.9%) were IgM positive. Conclusion: Surveillance is prerequisite for monitoring the dengue situation in the area and should be carried out regularly for early detection of an impending outbreak and to initiate timely preventive and control measures. [Int J Res Med Sci 2013; 1(4.000): 448-500]

Epithelioid malignant peripheral nerve sheath tumor (EMPNST) known as "epithelioid malignant schwannoma", described for the first time in 1954. It is an entity that has the same clinical features as MPNST but whose cytological and histological characters are different. It is characterized by an epithelioid cytomorphology, usually diffuse S100 immunoreactivity and some cases come from preexisting schwannomas. Clinically, it presents as a painful or asymptomatic mass, whether or not it is located on a nerve path. Imaging plays an essential role in preoperative diagnosis and assessment, but histology remains the key examination for confirmation of the diagnosis. Treatment is based on surgery, radiation therapy and chemotherapy. His prognosis is grim. The objective of this work is to underline the histopathological aspects of this very rare entity, in particular in children, by reporting an observation of a 21 month old infant.

Introduction: Blood is an essential therapeutic need, as there is no genuine substitution. Blood transfusion saves many lives in cases of emergency, and is of more concern to transfuse safe blood to avoid further complications mainly transfusion-transmissible infections transfusion-transmissible infections (TTI‟s). In existence of World Health Organization (WHO) approved national hemovigilance protocols in different regions, blood transfusion carries a high risk for both patients and healthcare workers. Materials and Methods: This is a retrospective study was carried at Tertiary Care Teaching hospital on consecutive blood donors‟ records covering the period between September 2019 and August 2020. This blood bank is the center where an effective blood banking system is catering for all the blood needs of patients in the hospitals of this region. Blood samples were collected aseptically by venipuncture from the donors. The samples were analyzed for blood group, HIV-1 & 2, HBV, HCV, VDRL and Malaria following standard procedures. Result: In this study, of the 983 samples, 964 were males and 19 females, which correspond to 98.1% of male and the rest female. The maximum number of patients were in the age group of 18-30 years which were 69.8% (n =687) of total followed by age group 31–50 years having 30.0% (n = 30) in this group and 0.10% were 51-70 years. In this study, the most of donors had „O‟ Blood Group 48.7% (n =479) and least were AB Blood Group 6.5% (n = 64) in this study. The seroprevalence of HIV positive cases were 0.81%, HBV positive cases were 0.91%, HCV positive cases were 0.30%, VDRL positive cases were 0.71% and Malarial Parasite 2.3%. Conclusion: The low prevalence of HIV, HBV, HCV, VDRL and Malaria observed in present study may be due to awareness of donors, strict donor selection criteria and affective screening of the donors.

Introduction: Anaemia in pregnancy is emerging as one of the most important causes of maternal complications, morbidity and offspring mortality in almost all the developing countries of the world including India. Haemolytic anaemia is the anaemia which results from increased rate of red cell destruction. The haemolytic anaemia resulting from intra corpuscular defects are predominantly hereditary in nature. Material and Methods: This is a prospective and descriptive study was carried out on pregnant women with hemolytic anaemias conducted in the Department of Pathology at Tertiary care Teaching Hospital. Inclusion Criteria: Antenatal women (age 18 to 40 years) and Irrespective of gestational age and parity. Anaemias due to other causes (nutritional, blood loss, microangiopathic hemolytic anaemia, acquired hemolysis) were excluded. Hematological parameters were studied using an automated blood cell counter. Result: In our study, 31 women (44.2%) out of 70 persons were within 21-30 year and least were 12 women (17.1%). Of whom 38 were detected to have hemolytic anaemias, 19 had Beta-Thalassemia; 11 had Sickle cell anaemia, 2 had Haemoglobin E Trait. The frequency of Mild to severe anaemia was recorded to be 27.2% to 36.3% sickle cell anaemia, 10.5% to be 39.4% haemolytic anaemia, 47.3% to be 15.7% (β -thalassemia trait), and 100% severe (Haemoglobin E Trait) in pregnant women. Conclusion: Successful outcome in pregnancies complicated with hemolytic anaemias can be achieved with prompt diagnosis, patient education, screening, genetic counselling and prenatal diagnostic testing of foetus and management in a tertiary care hospital by a multidisciplinary approach.

Introduction: A urinary tract infection (UTI) is an infection in any part of urinary system namely kidneys, ureters, bladder and urethra. UTIs are caused by both Gram-negative and Gram-positive bacteria, as well as by certain fungi. The most common causative agent for both complicated and uncomplicated UTIs is uropathogenic Escherichia coli (UPEC). Materials and Methods: This is a prospective study and observational study conducted in the Department of Microbiology, Surabhi Institute of Medical Sciences. A total of 200 consecutive urine samples were screened from patients with symptomatic UTI. Clean-catch midstream urine samples were collected in sterile disposable container and processed within one hour. Semi quantitative loop measuring 2.2 mm diameter with a holding capacity of 0.004ml was employed to culture urine on CLED agar and MacConkey’s agar. The inoculated plates were incubated over night at 370C Isolates in significant number (colony count ≥ 105 CFU/ml) were identified by standard procedures. Results: A sum of 200 patients who satisfied the inclusion principles during the investigation were enlisted. The present study shows the pathogens causing UTIs and their antibiotic susceptibility pattern. Escherichia.coli 48.5% was the predominant pathogen followed by Klebsiella pneumoniae 23%, Proteus spp. 13.5%, Staphylococcus aureus 7.5%, Pseudomonas aeruginosa 2.5%, Citrobacter spp. 3%, Staphylococcus saprophyticus 0.5%, Enterococcus faecalis 1% and Acinetobacter spp. 0.5%. In our study, high susceptibility of meropenem (76.2%) and imipenem (72.1%) was seen and least were Ciprofloxacin 13.5%. Conclusion: Infections caused by ESBL- producing bacteria often limits therapeutic options, leading to high disease burden. Therefore, diagnostic laboratories are in need of reliable, cost efficient and less labour-intensive methods to use in the detection of ESBL- producing bacteria. The public health implications of this are disturbing thus the need to rapidly detect these pathogens in the laboratory.

Background: Antimicrobial stewardship (AMS) programs have shown to reduce the emergence of antimicrobial resistance (AMR) and health-care-associated infections (HAIs), and save health-care costs associated with an inappropriate antimicrobial use. Methods: This is a prospective, descriptive and observational study conducted at Department of Microbiology, Surabhi Institute of Medical Sciences over a period of 1 year included 410 patients. Patients of either sex of any age who have been admitted inward and on antibiotic therapy were included. Outdoor patients were excluded in our study. Conducted from various clinical Departments such as Medicine wards, Surgical wards, Paediatric wards and Orthopaedics wards. All data was be documented and reviewed periodically. Any deviations from the agreed criteria were communicated, discussed, and documented. Results: On the basis of gender, frequency of Male patients were recorded little bit higher (62.6%) than female (37.4%). So, the hospital attendance rate of this study was male predominant. Majority of subjects belonged to 21-40 years (32.1%) followed by 1-20 years (29.5%) of age range. When it is categorized according to ward, in Medicine ward was recorded 34.8%, and for Orthopaedics it was 20.0%, while 30.9% for surgery and 14.1% paediatrics wards. For this study, subjects were categorised in eighteen groups on the basis of their diagnosis. Out of which, majority of the population (20.50%) were found with diagnosis of carcinoma followed by orthopaedic diseases (19.90%), while least number of patients (0.9%) were diagnosed with ophthalmological as well as thyroid diseases. Beta lactam and Cephalosporin were found the most frequent used first antibiotic even after surgery. Even for the each wards, Beta lactam and Cephalosporin were recorded highly significant and most desirable choices among all the antibiotics. Conclusions: Implementation of a multidisciplinary antibiotic stewardship program in this academic, large, Indian hospital demonstrated feasibility and economic benefits.

Introduction: Breast cancer is regarded as the most common cancer among women, and about 6.6% of cases are diagnosed among women 40 years old or younger. Inflammatory cells can regulate the tumor microenvironment and are clearly implicated in tumor development by facilitating proliferation, migration, and survival. Several cytokines, including interferon-a, interleukin (IL)-2, IL-6, IL-8, IL-10, and tumor necrosis factor-a, have essential and coordinated functions in breast carcinogenesis. Materials and Methods: This is a prospective study and observational study conducted in the Department of Pathology, Dr. V.R.K. Women’s Medical College Teaching Hospital & Research Centre over a period of 1 year with a sample of 40 patients. Two to five grams of tumour tissue and another sample from the normal peri-tumoural breast tissue were taken from the resected breast immediately after surgery. Specimen were fixed in 10 % buffered formalin, processed and embedded in paraffin. Paraffin section was stained with hematoxylin and eosin staining for histopathology and grading of the tumour. Immunohistochemistry was done for detection of cytokine IL 10 following a standardized protocol described earlier. Results: The mean patient age was 50 years (range 30-70years). Even though either side of the Breast can be affected in Ca. Breast, for the reasons not known there is slight preponderance to left side breast. Most of the gross tumours were of size 4-5 cms (n=17 i.e, 42.5%) followed by 5- 6 cm (n=10 i.e, 25%). Majority of the patients are categorized as grade-II i.e. 47.5% of cases and next is grade-I tumours i.e. 30.0% cases. All grade 3 tumours expressed strong expression of IL-10 indicating that probably IL-10 expression is more in high grade tumours. Conclusion: IL-10 may serve as a useful biomarker with potential prognostic value as there is statistically significant association of high IL-10 mRNA levels and the breast tumour tissue when compared with peri-tumoral tissue. Evidence from various studies suggests that IL-10 within tumour tissue has an important role in initiation and progression of breast carcinoma. This is also supported by high serum IL-10 levels noticed in such patients, although the mechanisms involved in the process are not exactly known.

Introduction: Meningiomas are the most common primary benign tumors of the central nervous system (CNS) as well as intradural part of the spinal cord. The prevalence of expression of progesterone receptor (PR) among patients with meningioma has been reported to be determined by different clinicopathologic factors particularly tumor grade as it was established by the WHO. Ki-67 is a nuclear non histone protein. It is used as a marker of proliferative activity and as a prognostic indicator in many tumors like breast carcinomas, neuroendocrine tumors, prostate, brain, nephroblastomas and lung. Materials and Methods: This is a Prospective study conducted in the Department of Pathology at Dr. V.R.K. Women’s Medical College Teaching Hospital & Research Centre. The study included histopathologically diagnosed cases of different histological variants of all intracranial and intraspinal meningiomas. A total number of 50 cases were studied over a period of 1 year. All intracranial and intraspinal meningiomas received at the Upgraded department of Pathology with adequate pre-operative, intra-operative and post-operative information, were included in the study. Results: The maximum number of cases were seen in the age group of 40-49 years (26.6%) followed by 50-59 years (23.3%). In the present study, out of 60 cases, 47 (78.3%) were females and the remaining 13 (21.6%) cases were males. Among the total 60 cases of Meningiomas, it was observed that intracranial location was more commonly involved comprising of 56 (93.3%) cases followed by Intraspinal location observed in 04 (6.6%) cases. Overall including the both grades total 51 cases out of 60 i.e. 85% were positive for PR, and 9 cases (including both the grades) i.e. 15% were negative for PR. Most of the grade I meningiomas (50 out of 56 cases i.e. 89.2% of grade I tumors) were positive for PR and few (6 out of 56 i.e. 10.7% of grade I tumors) were negative. Conclusion: Present study concluded that meningiomas will express PR. And this expression of PR has a significant inverse relationship with Ki- 67 i.e. as the Ki-67 expression denotes grade of meningioma, with increasing grade PR expression is reduced. So, Immuno histochemical staining with Ki-67 and PR antibody will help in deciding the grade of meningioma and helps to select the cases for which hormonal therapy can be employed.