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BACKGROUND Thyroid cancer is the most common malignant endocrine cancer worldwide. The diagnosis and distinction between benign and malignant thyroid neoplasm, especially in follicular patterned thyroid lesions is still difficult. Of the various immuno histochemical markers, Galectin-3 was most reliable in diagnosis of thyroid carcinoma. AIM To study diagnostic utility of Galectin-3 in thyroid neoplasm. METHODS This was laboratory based diagnostic study, where 92 cases of thyroid neoplasm (48-malignant and 44 benign) were analyzed for Galectin-3 expression. The Galectin-3 staining was quantitatively evaluated as percentage of positive tumor cells and qualitatively for intensity of staining. When membrane ± cytoplasmic immunoreactivity of Galectin-3 was present in more than 10% of tumor cells was considered as positive staining. RESULTS Galectin 3 expression was significantly higher in thyroid cancer as compared to benign thyroid neoplasm (p<0.001). 33/35 cases of PTC were positive for Galectin-3 expression. Galectin-3 expression was significantly higher in FTC as compared to FA (p <0.01). Galectin-3 was also useful to differentiate between FVPTC and FTC (p<0.01) and FVPTC from other benign neoplasm (<0.01).The sensitivity, specificity, positive predictive value and negative predictive value in differentiating benign and malignant thyroid neoplasm were 83.33%, 100%,100%, 84.62% respectively. CONCLUSION Galectin-3 is a potential marker in differentiating benign and malignant thyroid neoplasm. It can used as sole marker for differentiating PTC and benign thyroid neoplasm and also useful to differentiate between FVPTC and FTC. [ABSTRACT FROM AUTHOR]

Introduction: Malignant mixed Müllerian tumor (MMMT)/carcinosarcoma is an exceptionally rare tumor, representing just 1%-5% of all gynecological malignancies, but leading to 15% of gynecological malignancy-related deaths, with an occurrence of <2/1,00,000 women/year. Material and Methods: Twenty-one patients with MMMT of the uterus accounting for 1.7% of total uterine malignancies were included in the study. The histologic subtypes of the carcinoma and sarcoma components were examined and recorded. The proportions of carcinoma and sarcoma components were semi-quantitatively evaluated and recorded within the primary tumor site in the hysterectomy specimen. Among the metastatic sites and recurrent tumors, the histologic component (carcinoma vs. sarcoma) was evaluated. Results: Of these 21 cases, the carcinomatous component was further subtyped as 11 cases with endometrioid morphology, four cases each of clear cell and serous morphology, and two cases had undifferentiated epithelial component. Most of the tumors had carcinomatous components and 55% of tumors were high grade. Prognostic factors include the presence of bleeding (P = 0.05) which is associated with poor outcomes. Other known prognostic factors like myometrial invasion (P = 0.46) and stage of disease (P = 0.86) did not show any prognostic significance in present study. Conclusions: The elderly age, higher stage, and a poorly differentiated tumor are associated with poor outcomes. Utmost efforts should be made to educate women in early cancer detection by creating awareness on risk factors and symptoms. Study on the trends of gynecological cancers is essential to plan and evaluate cancer control programs. [ABSTRACT FROM AUTHOR]

Dedifferentiated Liposarcoma (DDLPS) is a rare subtype of liposarcoma with a high preponderance of local recurrence and distant metastasis. The frequent site of DDLPS is the retroperitoneum, followed by the limbs and trunk. The primary omental DDLPS is very rare and only a few cases have been reported in the literature. Here we report a rare case of primary giant DDLPS of omentum with intraperitoneal metastasis in a 61year old woman. The present case report adds to our knowledge, that a case of intraperitoneal DDLPS can mimic ovarian cancer clinically and should be considered in the differential diagnosis of a pelvic mass in postmenopausal women. [ABSTRACT FROM AUTHOR]

Introduction: Fine needle aspiration cytology is the first line investigation for assessment of thyroid nodules. Amongst the thyroid nodules routinely encountered in clinical practice, goiter is the commonest. The colloid goiter has a variable cytomorphological features and therefore leads to many misdiagnosis. Aim and objective: To study the detailed cytomorphological features of colloid goiter in histologically proven cases, so as to reduce the discrepancy in cytological diagnosis. Material and Method: The study was done over a period of six months at Mahatma Gandhi Institute of Medical Sciences, Sevagram. A total of 100 histologically diagnosed cases of colloid goiter were taken and their detailed cytomorphological features were studied. Result: On detailed assessment of cytomorphological features of colloid goiter, it was found that they have a variable morphology. The cellularity of smears ranged from low cellular to highly cellular with various epithelial arrangements of follicular cells like loose aggregates and lying singly, honeycomb flat sheets with aggregates, follicular arrangement, syncytial clusters and occasional papillary clusters. 87% of cases showed presence of thin colloid while the 13% cases had both thin and thick colloid. The important finding was presence of Hurtle cells in 14% cases and lymphocytes in the background of 18% of the cases. The intranuclear cytoplasmic inclusion was noted in 2 cases leading to the discordant diagnosis of papillary carcinoma thyroid. Conclusion: Despite the fact that, fine needle aspiration cytology provides substantial diagnostic accuracy, there remains a definite low incidence of discordant diagnosis of colloid goiter; the vigilant look on all cellular and cytomorphological feature of colloid goiter can further avoid the discrepancy. [ABSTRACT FROM AUTHOR]

Holi is a festival of colours, traditionally celebrated by greeting others and applying various colours. These colours are synthetic dyes which may have harmful side-effects on the skin and mucocutaneous areas like the conjunctiva and oral mucosa. In India, these colours are prepared on a small scale and lack any quality checks. Here we present a case of a 43 years old female who developed angioedema with urticaria progressing into urticarial vasculitis after playing with the colours in the festival of Holi. This case report highlights the need to put manufacturing of Holi colours under the guidelines of the Food and Drug Cosmetic Act and the Bureau of Indian Standards [ABSTRACT FROM AUTHOR]

Iron deficiency anemia is most common nutritional deficiency disorder in India and remains a formidable health challenge. Girls in the period of later school age and early adolescence are prone to develop iron deficiency. Iron deficiency leads to many nonhematological disturbances which include growth and development, depressed immune function in infants; reduces physical work capacity; decreases the cognitive function in both infants and adolescents. Present study was done to know the prevalence of iron deficiency in both the anemic and non anemic school going adolescent girls, to assess the effect of iron deficiency on cognitive functions in anemic iron deficient and non-anemic iron deficient school girls in a village school situated in central India. Methods. A secondary school having girl students in the age group of 12-15 years studying in sixth to ninth standard was selected. Serum ferritin concentration was estimated by ELISA. For assessing the cognitive function mathematics score, one multi-component test for memory, attention and verbal learning and Intelligent Quotient scores of the students were used. Results. Scholastic Performance, IQ and Scores of Mental balance, Attention & Concentration, Verbal Memory and Recognition were decreased in iron deficient girls, both anemic and non anemic as compared to the non iron deficient girls. [ABSTRACT FROM AUTHOR]

Eosinophilic panniculitis (EP) is characterized by prominent infiltration of subcutaneous fat with eosinophils. The etiology is diverse. This is not a disease but represents a reaction pattern that may occur in a variety of circumstances. The exact pathogenesis of the disease is still unclear. We present the case of a 6-year-old girl child who was diagnosed with EP. [ABSTRACT FROM AUTHOR]

Background: In India, 3.6 million pregnancies are affected by preterm birth annually, with many infants dying or surviving with disability. Currently, there is no simple test available for screening all women at risk of spontaneous PTB in low income setting, although high resource settings routinely use cervical length measurement and cervico-vaginal fluid fetal fibronectin for identification and care of women at risk due to clinical history. In rural India, where the public health system has limited infrastructure, trained staff and equipment, there is a greater need to develop a low-cost screening approach for providing early referral, treatment and remedial support for pregnant women at risk of preterm birth. There is interest in the use of a salivary progesterone test as a screening tool preliminary evidence from India, Egypt and UK has shown promise for this type of test. The test requires further validation in a low resource community setting. Methods: The Promises study aims to validate and test the feasibility of introducing a low-cost salivary progesterone preterm birth prediction test in two rural districts in India with high rates of prematurity. It is a prospective study of 2000 pregnant women recruited from Panna and Satna in Madhya Pradesh over approximately 24 months. Demographic and pregnancy outcome data will be collected, and pregnancies will be dated by ultrasound sonography. Saliva progesterone will be measured by ELISA in samples obtained between 24–28 weeks of gestation. The association between salivary progesterone and preterm birth will be determined and the utility of salivary progesterone to predict preterm birth < 34, as well as < 30 and < 37 weeks assessed. Additional qualitative data will be obtained in terms of acceptability and feasibility of saliva progesterone testing and knowledge of PTB. Discussion: A validated cost-effective saliva test, which has potential for further adaptation to a 'point of care' setting will allow early identification of pregnant women at risk of preterm birth, who can be linked to an effective pathway of care and support to reduce preterm birth and associated adverse consequences. This will reduce both economic and emotional burden on the affected women and their families. [ABSTRACT FROM AUTHOR]

Background: Endometrial carcinoma (EC) is the only gynecologic cancer with increasing incidence and mortality worldwide. This study aimed to determine association of cell proliferation marker CyclinD1, p53 and Ki67 with clinicopathological parameters and survival analysis in patients of EC., Material and Methods: One hundred twenty-four histological confirmed cases of EC treated at our institute were included in this study. The appropriate tissue blocks of cases which were retrieved from 2010 to 2015. The study period was from Jan 2018 to Jan 2020. Data pertaining to patient's clinical details, histopathological diagnosis, treatment and follow up was retrieved from Hospital information System. Immunohistochemical evaluation of Cyclin D1, p53 and Ki67 was done. Overall survival and Disease-free survival for each category were analyzed by the Kaplan-Meier method., Results: Of the 124 cases of EC, 108(87.09%) cases were of type I and 16 (12.89%) cases of type II. Overall positive staining of cyclinD1, p53 and Ki67 were noted in 53.22%, 42.22% and 32.3% cases respectively. The clinicopathological parameters affecting disease-free survival were age (p=0.039) histological types (p=0.007), and FIGO stage (p< 0.001). Elevated Ki67 index and p53 overexpression was associated with type II morphology (p= 0.001). Whereas Cyclin D1 expression was associated with type I morphology and poorly differentiated tumor., Conclusion: Cyclin D1 positive staining, p53overexpression and an elevated Ki-67index all had an independent prognostic significance in endometrial cancer. This panel of biomarkers may help to differentiate tumor behavior, and necessity for more radical surgery and post- operative chemotherapy. Key words: Endometrial carcinoma; cyclin D1; p53; Ki67; Survival analysis.

Introduction: India has an overall neonatal mortality rate of 28/1000 live births, with higher rates in rural India. Approximately 3.5 million pregnancies in India are affected by preterm birth (PTB) annually and contribute to approximately a quarter of PTBs globally. Embedded within the PROMISES study (which aims to validate a low-cost salivary progesterone test for early detection of PTB risk), we present a mixed methods explanatory sequential feasibility substudy of the salivary progesterone test., Methods: A pretraining and post-training questionnaire to assess Accredited Social Health Activists (ASHAs) (n=201) knowledge and experience of PTB and salivary progesterone sampling was analysed using the McNemar test. Descriptive statistics for a cross-sectional survey of pregnant women (n=400) are presented in which the acceptability of this test for pregnant women is assessed. Structured interviews were undertaken with ASHAs (n=10) and pregnant women (n=9), and were analysed using thematic framework analysis to explore the barriers and facilitators influencing the use of this test in rural India., Results: Before training, ASHAs' knowledge of PTB (including risk factors, causes, postnatal support and testing) was very limited. After the training programme, there was a significant improvement in the ASHAs' knowledge of PTB. All 400 women reported the salivary test was acceptable with the majority finding it easy but not quick or better than drawing blood. For the qualitative aspects of the study, analysis of interview data with ASHAs and women, our thematic framework comprised of three main areas: implementation of intervention; networks of influence and access to healthcare. Qualitative data were stratified and presented as barriers and facilitators., Conclusion: This study suggests support for ongoing investigations validating PTB testing using salivary progesterone in rural settings., Competing Interests: Competing interests: SAS (King’s College London) is supported by the National Institute for Health Research Applied Research Collaboration South London (NIHR ARC South London) at King’s College Hospital NHS Foundation Trust. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.)

Purpose: Most of the studies regarding DNA damage in lens epithelial cells (LECs) of cataract patients have been done on lymphocyte or human LECs cultures. Studies of DNA damage directly in LECs of cataract patients are scanty and, to our knowledge, neither photographic evidence nor has a quantitative assessment of DNA damage have been put forward. In our study, we assessed and quantified DNA damage directly in the LECs of senile cataract patients, right after cataract surgery., Methods: LECs were taken from different morphologic types of senile cataract patients after surgery and DNA damage was immediately assessed by comet assay. Quantitative assessment of DNA damage was conducted using CometScore ™ software., Results: There were no prominent comets in most of the LECs of the control subjects, but comets were found in cataractous LECs. DNA fragments in the tail of the comet gave smearing (not banded), which was indicative of chemical damage (i.e., not site specific). DNA damage in the LECs of cataract patients was highly significant (p<0.001). DNA damage in cortical cataracts was significant (p<0.01) when compared to that of nuclear or posterior subcapsular cataracts, but the DNA damage between nuclear and posterior subcapsular cataracts was not significant. Furthermore, we found disrupted nuclear membranes in some of the nuclei in LECs of patients, but not in the control subjects., Conclusions: In senile cataract patients, LECs DNA was randomly damaged and this type of damage was possible by reactive oxygen species (ROS). The damage was found maximally in the cortical type of cataracts. Oxidative DNA damage of the LECs may be one of the etiology of senile cataractogenesis.

Background: Metaplastic carcinoma of the breast is a rare neoplasm that causes diagnostic difficulty on fine needle aspiration smears. Breast carcinoma in HIV-infected patients occurs at a relatively early age, with increased bilateral disease, unusual histology, and early metastatic spread with a poor outcome., Case: A case of metaplastic carcinoma of the breast arose in a 36-year-old woman who was seropositive for HIV. In the absence of a sarcomatous component and presence of obvious ductal differentiation on aspirates, a diagnosis of high grade infiltrating duct carcinoma, not otherwise specified, was made on fine needle aspiration cytology (FNAC)., Conclusion: This case underlines the limitations of FNAC in the diagnosis of metaplastic carcinoma of the breast. It also shows that it is imperative to maintain a high index of suspicion for rare pathologies in immunocompromised patients.

Pigmented villonodular synovitis (PVNS) is a proliferative disorder of the synovial lining of the joints. Although the cytological findings of this disorder have been described in the literature, there is no mention of intranuclear cytoplasmic inclusions in this entity. A 65-yr-old woman presented with a painful swelling on the ankle. In addition to other characteristic findings of PVNS, we found the presence of intranuclear cytoplasmic inclusions in the fine-needle aspiration (FNA) smears. The characteristic cytological findings of abundant mononuclear cells occurring singly and in papillary clusters, multinucleated giant cells, and hemosiderin deposition should aid in the diagnosis of PVNS and in its differentiation from melanoma and other soft tissue sarcomas, even in the presence of uncommon features such as intranuclear inclusions., (Copyright 2003 Wiley-Liss, Inc.)

A total of 101 individuals who showed AS pattern on haemoglobin electrophoresis were included in this study and various haematological investigations were carried out on them. Of these, 79 cases were grouped as AS patients. Twenty two healthy relatives of sickle anemia patients were grouped as AS controls. Twenty AA controls were also included in this study. Haemoglobin S (HbS) and hemoglobin A (HbA) quantitation was carried out. The frequency distribution of HbS percentage showed that maximum subjects had HbS levels above 33%. A female predominance was seen in subjects of sickle cell trait. Haemoglobin levels and total red cell counts of AS patients were found to be significantly lower than those of AS controls. Reticulocyte counts and hematocrit values of AS patients were found to be significantly higher than AS controls. MCV and MCH values of AS patients were found to be significantly lower, but MCHC was not significantly altered.

Background: Pleomorphic lobular carcinoma of the breast is associated with aggressive behavior., Case: Fine needle aspiration cytology was performed on a breast lump in a 55-year-old woman. The aspirates showed highly pleomorphic, large cells in a dyscohesive pattern, with a tendency of few cells to aggregate in small groups. A diagnosis of ductal carcinoma was made on cytology. On histology, the paraffin sections showed features of pleomorphic lobular carcinoma of the breast., Conclusion: The cytologic features of pleomorphic lobular carcinoma overlap with those of infiltrating ductal carcinoma. It is very difficult to make a diagnosis of pleomorphic lobular carcinoma prospectively on cytology. However, if Indian file arrangement and cytoplasmic vacuolation are present, pleomorphic lobular carcinoma must at least be suggested for the differential diagnosis as it has different clinical implications.