Tapan Kumar Ghosh

Screening for thalassemia and other hemoglobinopathies in a tertiary care hospital of West Bengal: implications for population screening.

Hemoglobinopathies are common genetic disorders of hemoglobin, which can be prevented by population screening and offering genetic counseling. In absence of population-based screening for hemoglobinopathies, the hospital-based diagnosis register provide idea about the extent of problem in the community. The present study was undertaken to find out the burden of hemoglobinopathies and spectrum of this disorders among the population who were screened in the hospital-based screening program. A record-basedanalysis of subjects who underwent screening for hemoglobinopathies in Burdwan Medical College and Hospital over a period of 3 years and 4 months revealed that overall 29.3% of subjects were positive for hemoglobinopathies. Beta thalassemia heterozygous was the most commonhemoglobinopathy in this region closely followed by hemoglobin E heterozygous. In view of high prevalence of hemoglobinopathies in this region, a routine premarital screening program is needed for identification and prevention of high-risk marriages.

Forensic diagnosis and classification of snakebite (neurotoxic and haemotoxic) from renal changes at autopsy: morphological and histological determinants using a semi-quantitative method:

Mortality due to poisonous snakebite is an emerging public health concern. Of late, snakebite has drawn global attention. Snakebite is a well-known cause of renal pathology especially in the haemotoxic group. Deaths due to renal failure are very common in envenomation due to poisonous snakebite. In this investigation our aim was to devise autopsy-proven diagnostic criteria of snakebite from the renal changes to confirm and classify the type of snakebite in forensic casework. That would be of practical help to the forensic pathologist with access to limited resources. An arbitrary scoring system from histology was adopted for the present semi-quantitative analysis. The scoring system (with scores from 0 to 5) developed by the present study was effective, valid and was able to distinguish between snakebite and control. The score obtained at histology in cases of snakebite was significantly different from the control group (Mann-Whitney U = 71.5; P = 0.011). Using stepwise linear discriminant function (DF) analysis, the score (Mukhopadhyays score [MS]) was seen to be the only predictor of the type of snakebite. This model (DF = 1.05 × MS–1.78) could correctly classify 93.3% of the cases into neurotoxic and haemotoxic variety of offending snake. This is an effective, cheap and easy semi-quantitative method of distinguishing neurotoxic and haematoxic snakes from the renal changes at autopsy. It would be useful for practical application in centres where sophisticated biochemical or immunological analyses are not available due to limited resources.

Thrombocytopenia with absent radii (TAR) Syndrome in a male child: report of a rare case

Introduction: Thrombocytopenia with absent radii (TAR) Syndrome is a rare congenital defect presents with hypomegakaryocytic thrombocytopenia and bilateral radial aplasia and preserved thumb. Case presentation: A three and half year’s old male baby born out of non-consanguineous marriage with thrombocytopenia and bilateral absence of radius. Such type of anomaly has been previously reported in the children of a nonconsanguineous marriage was few. Conclusions: Though rare incidence, all thrombocytopenia with any skeletal deformity cases in newborn or infancy to toddler age group must be thoroughly investigated to exclude TAR syndrome. Case is presenting here because of rarity.

Detection of Serum Vascular Endothelial Growth Factors (VEGF) And Soluble Vascular Endothelial Growth Factors (sVEGF / sflt-1) of Pregnancy Induced Hypertension Mothers (PIH) With pathological changes of Placenta In a Tertiary Care Hospital of West Bengal.

Introduction: Pregnancy Induced Hypertension (PIH) results from imbalance between pro-angiogenic factors (VEGF & PIGF) and antiangiogenic factors (sVEGFR-1/sflt- 1) Subjects and methodology : A mixed random study comprising of random cases of different gestational ages 28-36 wks of PIH mothers along with control cases till completion of pregnancy after delivery. Age of enrolled mothers and their gestational age, blood pressure, serum free VEGF and sVEGFR-1(sflt1) were compared in both groups (control n=36, PIH n=36). Blood pressure of both control and PIH mothers just before and after delivery showed significant correlation (p 50% PCNA LI expression of 12 (40%) cases than control. Discussion &Conclusion : The elevated levels of systolic and diastolic blood pressure along with alteration of proangiogenic and angiogenic growth factors among PIH mothers than normotensive control may help to identify PIH mothers as early as possible and referring them to higher/tertiary centers for better management and prevention of its grave complications of PIH. International Journal of Human and Health Sciences Vol. 02 No. 01 Jan’18. Page : 25-30

Quantitative analysis and comparison of mast cells in breast carcinomas and axillary lymph nodes

Introduction: The incidence of breast cancer is increasing throughout the world and it has become the major health problem. Many risk factors and prognostic factors of breast cancer have been identified. Inflammatory cells in the tumor stroma have gained increasing interest on recent time. Aims and Objectives: The study was undertaken to identify the prognostic impact of presence of stromal mast cells in breast carcinomas. Materials and Methods: It was an institution-based descriptive study with cross-sectional design. Total 44 specimens of postoperative breast tissue and dissected axillary lymph nodes of carcinoma breast were taken as sample. After processing of tissue, the slide was stained with hematoxylin and eosin stain and subsequently with toluidine blue stain. Counting of mast cells was done in toluidine blue stain. Results and Analysis: Among 44 cases, the mean age of patients was 45.32 years and infiltrating ductal carcinoma-no special type was the most common type. According to histological grading, Grade III was most common. The mean mast cell count in breast lump was 5.76/high-power field (HPF). The mean mast cell count in axillary lymph node was 11.20/HPF among 27 cases. It was observed that when the tumor grade increases, the number of must cell decreased per HPF. Conclusion: This study indicated that the number of mast cells in breast cancer was inversely correlated with the grade of this tumor.

Pitfalls in the cytodiagnosis of metastatic squamous cell carcinoma in the head and neck: A retrospective study

Background: Lateral neck swelling in an adult is a common presentation for primary and secondary malignant lesions. Metastasis from squamous cell carcinoma often leads to various secondary changes in the lymph nodes, which makes their diagnosis on cytology a difficult task. Sometimes, the primary sites remain occult and any false negative cytological diagnosis becomes a misleading factor. Aim: Our aim was to evaluate the efficacy of fine needle aspiration cytology (FNAC) in diagnosing metastasic squamous cell carcinoma in the head and neck, and to highlight the precautions that can reduce the rate of false negative diagnosis. Materials and Methods: Two thousand five hundred and twelve patients in an age range of 18 to 80 years and presenting with a solitary lateral swelling of the neck were selected for this study. Results: Three hundred and seventy positive and 45 suspicious cases of metastatic squamous cell carcinoma were detected by FNAC; there were 15 false negative cases. All of them were associated with cystic change, abscess, or necrosis. The primary sites for carcinoma were the tonsil, tongue, pharynx, and larynx. No primary site could be detected in three cases. Histopathological confirmation was done in all the cases. The specificity and sensitivity of FNAC in the detection of positive cases of metastatic squamous cell carcinoma were 96.05 and 96.5% respectively. Conclusions: Any lateral neck swelling in adult patients that is associated with cystic change, abscess, or necrosis on FNAC should be carefully searched for malignant cells. Clinical re-evaluation and image guided surgical biopsy should supplement FNAC in suspicious cases. In spite of the possible limitation of a false negative diagnosis, FNAC remains a useful tool in diagnosing metastasis with good certainty.

Clavicular metastasis, an initial manifestation of a malignant pheochromocytoma - a case report

We present a 55 years old lady having an unusual presentation of abdominal pain and a clavicular mass as the initial manifestations of a nonfunctioning malignant pheochromocytoma. Fine needle aspiration of the clavicular mass revealed a metastatic adenocarcinoma. A search for primary site revealed a mass in left adrenal and multiple space occupying lesions in the liver. The aspirations were identical to that from the clavicle. Surgical biopsy of the clavicular mass revealed, features of metastatic pheochromocytoma. Urinary catecholamine was normal. Malignant pheochromocytoma can present with atypical features and guided fine needle aspiration cytology can be a safe diagnostic procedure.