Objective: The objective of the study was to evaluate prothrombin time/international normalized ratio (PT) along with activated partial thromboplastin time (APTT) and its association with platelet and red blood cell (RBC) cell population data for initial assessment of thrombotic tendencies. Materials and Methods: Blood samples of 43 patients diagnosed with a beta-thalassemia major who were transfusion dependant were taken for assessment of mean platelet volume (MPV), plateletcrit (PCT), and platelet distribution width (PDW) along with RBC distribution width and correlated with APTT. Results: Elevated APTT and PT were noted among patients with thalassemia along with elevated PCT and red cell distribution width-coefficient of variation (RDW-CV). Reduced PDW was noted. Elevated APTT was positively associated with RDW and MPV and negatively associated with PDW and PCT. Conclusion: In our study, elevated levels of PCT RDW CV, PT, and APTT were observed. Elevated levels of APTT were also noted to be positively correlated with MPV and RDW CV.

Grading system for prostatic cancer (PC) was first described in1966 by Dr. Donald Gleason. Over the years, histologic, clinical diagnosis and management of PCa have evolved, leading to revisions of the Gleason system first by the International Society of Urological Pathology (ISUP) in 2005 and more recently in 2014. Unlike the original Gleason score (GS) ranging from 2 to 10, the current system no longer assign Scores 2–5, the lowest score being 6. The new grading system of 2014 proposed Five Grade Groups based on revised GS which produces a smaller number of grades with the most significant prognostic differences and may contribute to a decrease in the overtreatment of low-grade PC detected by prostate-specific antigen screening. This review provides an update on the evolution and revision of the Gleason grading system, with a discussion on the deficiencies, benefits, and limitations of the revised and new grading system of ISUP 2005, 2014, and 2019.

Introduction: The global incidence of low birth is 15%, and in India, it is 18%.Together with gestational maternal age and size, placental factors contribute to 32% of low-birth weight.Various factors influence the fetal growth such as the factors originating from fetus itself, maternal factors, placental factors, and the factors due to interaction of all these factors.Materials and methods: The placenta was collected from 30 mothers of low-birth-weight babies and 60 placentas from mothers of normalbirth-weight babies in the Department of Obstetrics and Gynecology from October 2020 to December 2020.Information regarding maternal characteristics, placental morphometry, and newborn parameters were recorded.Results: Mean of placental weight is significantly less in case group (420 + 7 gm) compared with control (560 + 100) group.Mean of placental length, breadth, surface area, diameter, and thickness is significantly less in the case group compared with the control group (p <0.05).The presence of hard areas, focal avascular villi, syncytial knotting, focal hyaline degeneration, and fibromuscular sclerosis was seen more in lowbirth-weight babies when compared with normal-birth-weight babies (p <0.05).Conclusion: Placental factors such as placental weight, placental length, breadth, diameter, surface area, thickness, and volume were less in low-birth-weight babies.All the microscopic and gross findings like the presence of hard areas, focal avascular villi, syncytial knotting, focal hyaline degeneration, and fibromuscular sclerosis were seen more in low-birth-weight babies.

Alzheimer's disease is a neurodegenerative condition that involves cholinergic neuronal dysfunction, oxidative stress, amyloid beta protein accumulation as a characteristic of neuropathology.Sida rhombifolia is traditionally known for the treatment of neuronal disorders.This study was designed to evaluate the effect of S. rhombifolia extract (SRE) on scopolamine (SCO) induced amnesia in rats.Sida rhombifolia hydroethanolic extract (SRE) was subjected to in-vitro tests.Furthermore, in rats amnesia was induced with SCO (1mg/kg.i.p) for 30 days and treated with 100, 200, and 400 mg/kg of SRE for 15 days.Antioxidant activity of SRE was demonstrated by decreasing DPPH and H 2 O 2 levels.Treatment group rats reversed SCO induced amnesia by improvement in spatial memory, decreased transfer latency and increased step through latency significantly (p < 0.001) in behavior models such as Morris water maze, elevated plus maze, and passive avoidance task, respectively.SRE administration decreased acetylcholinesterase enzyme, β amyloid 1-42 levels significantly (p < 0.001), scavenges SCO induced oxidative stress by increased glutathione and decreasing lipid peroxidase levels.Histopathological studies revealed mild neuronal damage in treatment groups as compared to SCO-induced rats and is validated its implication for the treatment of cognitive impairment.

Introduction: Thyroid Fine Needle Aspiration (FNA) has been widely used as a first line investigation to assess thyroid nodules, as it is rapid, cost effective, safe and reliable. Thyroid cytology categories are required for coding, audit and comparison The RCPath system of thyroid cytopathology is a modification of the British Thyroid Association (BTA)/ RCP Thy1–5 systems. This study has been undertaken to evaluate the utility of Thy system while reporting thyroid FNACs in our hospital. Materials and Method: A retrospective study was conducted from 2009 to 2015 in which 189 cases of thyroid aspirates were reclassified according to Thy in to five categories by cytologist. Results: A total of 189 thyroid lesions were analysed. Category wise distribution of aspirates was Thy 1+ Thy 1c (Non- Diagnostic) 8 cases. Thy 2 + Thy 2c (Non Neoplastic) were 156 (86.19%). Thy 3a (Neoplasm possible – atypia/nondiagnostic) were 5 (2.77%), Thy 3f – (Neoplasm possible- Suggesting follicular neoplasm) were 9 (4.97%), Thy 4 (Suspicious for malignancy) were 2 (1.10%), Thy (Malignant) were 59 (4.97%) Age and sex wise distribution was interpreted. Thyroid diseases were more prevalent in women and most common age group affected was 3rd to 4th decade. Out of all cases 181 were satisfactory for evaluation. Among them 156 (86.19 %) were Non-neoplastic which included simple goitre, thyroiditis, toxic goitre and thyroid cysts. Malignant lesions were 9 which included papillary carcinoma, anaplastic carcinoma and medullary carcinoma. Conclusions: It was observed that standardized nomenclature of the Thy System has brought much needed clarity in thyroid FNAC reporting in the UK .Hence this study was undertaken to know its utility in this region of country. Keywords: Thy system; Thyroid; FNAC

AIM:The present study explored Cynodon dactylon hydro-ethanolic extract (CDE) effect on scopolamine-induced amnesic rats.MATERIALS AND METHODS:C. dactylon extract was subjected to antioxidant (DPPH and H2O2) and acetylcholinesterase enzyme tests by in vitro methods. Scopolamine (1 mg/kg, i.p) was administered to rats except for normal control. Donepezil (3 mg/kg, p.o), CDE (100, 200, and 400 mg/kg p.o) were administered to treatment groups. Behavioral paradigm: Morris water maze (MWM), elevated plus maze (EPM), and passive avoidance test (PAT) were conducted. Later, rats were sacrificed and brain homogenate was tested for levels of acetylcholinesterase, glutathione, and lipid peroxidase. Histopathology examination of cortex and hippocampus of all the groups was done.STATISTICAL METHOD:The statistical methods used were ANOVA and Tukey's post hoc test.RESULTS:CDE antioxidant activity was demonstrated by decreasing DPPH and H2O2 levels confirmed through in vitro analysis. Treatment group rats reversed scopolamine induced amnesia by improvement in spatial memory, decreased transfer latency and increased step through latency significantly (P<0.001) in behavior models such as morris water maze, elevated plus maze and passive avoidance task respectively. CDE modulated acetylcholine transmission by decreased acetylcholinesterase enzyme level (P < 0.001) and scavenging scopolamine-induced oxidative stress by increased reduced glutathione levels and decreased lipid peroxidation levels in the rat brain. CDE and donepezil-treated rats showed mild neurodegeneration in comparison to scopolamine-induced severe neuronal damage on histopathology examination.CONCLUSION:C. dactylon extract provides evidence of anti-amnesic activity by the mechanism of decreased acetylcholinesterase enzyme level and increased antioxidant levels in scopolamine-induced amnesia in rats.

BACKGROUND:Cervical cancer is the fourth most common cancer in the world, affecting mainly women residing in low- and middle-income countries. Progression from a pre-invasive phase to that of an invasive phase generally takes years and provides a window of opportunity to screen for and treat precancerous lesions.METHODS:This study is being conducted at four sites in north Karnataka, India. Community sensitization activities have been organized in the study areas to create awareness among stakeholders, including elected representatives, physicians, health care workers, and potential participants. Organized community based as well as hospital-based screening is being conducted using visual inspection with acetic acid (VIA). Screen positive women are referred to respective study hospitals for colposcopy and directed biopsy. Participants with confirmed high-grade cervical dysplasia (high-grade squamous intraepithelial lesions or HSIL) who fit all other eligibility criteria will be recruited to the study and will receive cryotherapy using CryoPop®, an innovative new cryotherapy device.DISCUSSION:There is a need to develop an inexpensive, simple, and effective cryotherapy device for use by frontline health care providers at locations where screening and timely treatment can be given, accelerating access to cervical cancer prevention services and minimizing loss to follow-up of women with precancerous lesions who need treatment.TRIAL REGISTRATION:Clinical Trial Registry - India CTRI/2019/01/017289 ClinicalTrials.Gov number NCT04154644 . Registered on November 6, 2019.

Horseshoe kidney is one of the most common congenital urologic anomalies, with an incidence of 1 in 400 live births. The presence of this type of fusion anomaly of kidneys with resultant progression to renal pathology sometimes may remain obscured or dormant, due to the person being asymptomatic for years, only to be incidentally encountered during an autopsy, or during a cadaveric dissection. Similarly, during routine cadaveric dissection, we came across with a list of variations along with congenital anomalous horseshoe kidney. In this case report, we discuss about anatomical variation and pathological findings of horseshoe kidney.

Aims & Objective: To evaluate effect of lansoprazole on acute and sub-acute models of inflammation in rats. Materials and Methods: The study was carried out in two models of inflammation viz; carrageenan induced rat paw edema and foreign body induced granuloma. Animals were divided into three groups. Control group received 0.5ml of 1% gum acacia suspension while test groups received lansoprazole and aspirin. The rat paw volume was measured with the help of a mercury plethysmograph at regular intervals and percentage inhibition of edema was calculated. In sub-acute model of inflammation, two sterile cotton pellets and two sterile grass piths were implanted subcutaneously in the axilla and groin. The treatment was started on the day of implantation and was repeated every twenty-four hours, regularly, for ten days. On eleventh day, rats were sacrificed and mean granuloma dry weight of cotton pellets for various groups was calculated. The sections of grass piths were sent for histopathological studies. Results: In the present study, lansoprazole showed significant anti-inflammatory effect in acute as well as sub-acute models of inflammation when compared to control. Conclusion: Lansoprazole showed anti-inflammatory effect in the current study.

Role of Prothrombin time International normalized ratio and activated partial thromboplastin time in beta thalassemia major: A cross sectional study - IJPO- Print ISSN No: - 2394-6784 Online ISSN No:- 2394-6792 Article DOI No:- 10.18231/j.ijpo.2019.047, Indian Journal of Pathology and Oncology-Indian J Pathol Oncol

The present study aims at clinicopathological correlation of prostate carcinoma and correlation of Gleasons grade with preoperative Karnofsky Performance Status (KPS) and   preoperative total serum PSA levels. Total  33  histopathologically confirmed cases of  prostate carcinoma were studied and interviewed for determining KPS  preoperatively. Frequency of micturition (90%) was most common symptom. All cases in present study showed significantly increased PSA levels with moderate to high grade adenocarcinoma.  The most common Gleason’s grade and score encountered was 4 and 7 respectively.   No significant correlation found between Gleason’s score and KPS. However Age has significant inverse correlation with KPS. Thus patients presenting at relatively early age have better prognosis and treatment tolerance and are candidates for curative therapy. Thus PSA is reliable tumour marker. Higher grade produce more PSA. Gleason’s grading on biopsy helps in definitive diagnosis and predicting prognosis.

Retroperitoneal paragangliomas are rare neoplasms usually seen as histological surprises and can be confused with more common retroperitoneal neoplasms. The present case is reported to discuss the clinical presentation, radiological features, and histological features of a nonfunctioning retroperitoneal paraganglioma of unusual histology which presented as a diagnostic dilemma which was confirmed by immunohistochemistry.

Chondromyxoid fibroma (CMF) is a rare tumor, accounting for <1% of all bone tumors. It generally affects the metaphysis of long bones of the lower limbs and involvement of the upper limb is rare. It can be confused with chondroblastoma and chondrosarcoma. Its recognition and differentiation from other tumors are of paramount importance. Here, we report a case of CMF involving the right ring finger.

Iniencephaly is an extremely rare neural tube defect with incidence range from 0.1 to 10 in 10,000. It is diagnosed by a triad of fixed retroflexion of the head, variable degrees of cervical lordosis and dysraphism, and an occipital bone defect involving the foramen magnum. It is usually reported as an isolated anomaly and it rarely occurs along with anencephaly. We report here such a rare case of Iniencephaly in association with anencephaly and multiple rare congenital malformations such as asplenia, craniospinal rachischisis, occipital cervical spina bifida and congenital diaphragmatic hernia. It was rare type of congenital diaphragmatic hernia in which intestine coils were lying in front of vertebrae. These anomalies are rare in themselves.

Background : Thyroid Fine Needle Aspiration (FNA) has been widely used as a firstline investigation to assess thyroid nodules, as it is rapid, cost effective, safe and reliable. To bring uniformity and standardization in thyroid cytology reporting, “The Bethesda System for Reporting Thyroid Cytopathology” (TBSRTC) was introduced and it is gaining acceptance. This study has been undertaken to evaluate the reproducibility using TBSRTC system while reporting thyroid FNACs and to find out the utility of Bethesda system after correlating with the histopathology.Methods: A retrospective study was conducted in which 173 cases of thyroid aspirates were reclassified according to TBSRTC in to six categories by cytologist. Results: A total of 173 thyroid lesions were analysed. Category wise distribution of aspirates was Non diagnostic (ND) 9 (5.20%), Benign (BN) 145 (83.81 %), Follicular neoplasm (FN) 9 (5.20%), Follicular lesion of uncertain significance (FLUS) Nil, suspicious of malignancy(SM) 1(0.57 %) and malignant category 9 (5.20 %). Age and sex wise distribution was interpreted.Thyroid diseases were more prevalent in women and most common age group affected was 3rd to 4th decade. Out of 164 lesions which were satisfactory for evaluation,120 (73.17 %) were simple goitre , 15(9.14 %) were of thyroiditis, 6 (3.65%) were toxic goitre, 4 (2.43%) were thyroid cysts & 19 (11.57 %) were neoplasms of which benign included 1 (0.6%) Hurthle cell neoplasm and 8 (4.87 %) follicular neoplasm. Malignant lesions were 8 (4.87%) papillary carcinoma, 1 (0.6%) anaplastic carcinoma and 1(0.6%) medullary carcinoma.Conclusions: It was observed that standardized nomenclature of the Bethesda system has brought much needed clarity in thyroid FNAC reporting.. Along with malignant category, the FLUS, FN and SM categories carry higher malignancy risk. DOI: 10.21276/APALM.1340

Cryptogenic Multifocal Ulcerous Stenosing Enteritis (CMUSE) is a rare idiopathic disease of the small bowel. Its origin and pathophysiology has not been well described. Clinicopathologic features include unexplained ileal strictures with supercial ulceration. We present a case of a 31-year-old HIV positive lady who was admitted with complaints of recurrent abdominal pain and constipation. Laboratory investigations revealed iron deciency anemia. Ultrasonography of the abdomen showed dilated bowel loops and a subsequent barium follow through showed ve strictures in the ileum. Segmental small bowel resection with end-to-end anastomosis was performed. Grossly ileum showed ve ileal strictures. The diagnosis of CMUSE was made on histopathology after ruling out other causes of strictures. The present case highlights the importance of considering CMUSE in patients with chronic or recurrent episodes of intestinal obstruction with multiple small intestinal ulcers and strictures after other common causes have been ruled out.

The acute manifestations and subsequent complications call for early recognition and management of erythema nodosum leprosum (ENL). Its diagnosis is conventionally based on skin biopsy and slit skin smears. Fine needle aspiration cytology (FNAC) has been found to be a simple and useful tool in the diagnosis of this entity. Lymphadenopathy is a known manifestation of leprosy and its reactions. The present case is reported to underscore the importance of FNAC of lymph node in diagnosis of ENL. A 39-year-old male, known case of lepromatous leprosy on treatment, presented with fever, joint pains, raised lesions all over the body and enlarged bilateral inguinal lymph nodes. FNA of the lymph node revealed characteristic features of ENL. FNA of lymph nodes is simple, non-invasive, useful tool in early diagnosis of ENL.

Polycystic kidney disease (PKD) is a hereditary disorder of autosomal dominant or recessive inheritance. Horseshoe kidney is a common renal fusion anomaly during embryogenesis. Combination of both PKD and horseshoe kidney is rare, with an incidence of one in 1,34,000–8,00,000 live births.1 Less than twenty cases have been reported till date in adults and only one in the fetus.2,3 We report the autopsy findings of this rare anomaly in a fetus with brief review of literature.