Preeti Bajaj ¹, Mrunal Patil ², Balaji Almale ³

Affiliations
1 Department of Pathology, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik, IN
2 Department of Ophthalmology, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik, IN
3 Department of Community Medicine, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik, IN

Abstract

Medical teachers need training in pedagogic techniques in order to become better teachers. Despite the fact that our teaching techniques improve gradually over the years as we gain experience and also owing to continuous practice undertaken for different kinds of teaching learning situations; nevertheless educational technology has evolved ways and means for better development of teaching skills even at earlier stages by undertaking some methodical exercises, one of which is Microteaching. Microteaching, an innovative technique of teacher training, helps teachers to improve their teaching skills. It aims at development of competence in teaching skills through the practice of microteaching sessions1. In other words, it teaches teachers how to teach. This is especially important in cases of new faculty implying the budding teachers. Even an experienced teacher can benefit by this technique, particularly for learning some new skills1. The individual may be very sound in his/ her own subject but may not necessarily be a good teacher.

Keywords

Medical Education, Microteaching

Full Text

   

Preeti Bajaj , Jyoti Kasture , Balbir Singh Shah

Abstract

Gaucher's Disease (GD) is an autosomal recessive systemic lysosomal storage disorder which is characterized by glucocerebroside deposition in cells of the macrophage-monocyte system as a result of a deficiency in lysosomal P-glycosidase (glucocerebrosidase). GD is a rare genetic disorder. It is the most common amongst the lysosomal storage disorders. GD has been categorised into three types based on the presence of central nervous involvement1. Type 1 is a non-neuronopathic form that presents in childhood or early adulthood. Type 2 is acute neuronopathic form that presents in childhood. It progresses rapidly and is fatal. Type 3 is chronic non-neuronopathic form that presents in childhood but is slowly progressive. Here we describe a case of a three and a half year old male child in whom a diagnosis of Gaucher's disease was made based on bone marrow biopsy and later confirmed by glucocerebrosidase levels estimation.

Keywords

Gaucher’s Disease, Glucocerebroside.

Full Text

   

Shital Dharrao , Preeti Bajaj , S. V. Mahajan

Abstract

Embryonal Rhabdomyosarcoma (ERMS) is a malignant soft tissue tumour with phenotypical and biological features of embryonic skeletal muscle cells. It is rare in skeletal musculature of extremities and its pleomorphic variant is rare which is associated with worse outcome. Here we are discussing a case of three year old male child who has presented with recurrence of swelling in right gluteal region arising in gluteus maximus muscle who is a known case of Rhabdomyosarcoma (RMS) 1 year back at the same site. Patient was operated with wide local excision and underwent chemotherapy cycles.

Keywords

Embryonal, Pleomorphic, Rhabdomyosarcoma (RMS)

Full Text

   

Preeti Bajaj , Rajyaguru Devangana , B. S. Shah , Amrinder Kaur

Abstract

Acute Promyelocytic Leukemia (APL) is an extremely rare variant of acute myeloid leukemia. APL constitutes around 10-15 % of acute myeloid leukemia in adults. It is commonly diagnosed around 40 years age. Molecular/genetic studies exhibit chromosomal translocation between chromosome 15 and chromosome 17-t(15;17)(q22;q21) and PML-RARa rearrangement. Four variants of APL have been identified: The classic form M₃ hypergranular variant, the microgranular variant, the hyperbasophilic form and zinc-finger form-M₃r, identified by a different chromosomal translocation, between chromosome 11 and chromosome 17:t(11,17) (q23, q11-12).

Keywords

Acute Promyelocytic Leukemia, ATRA, PML/RARα

Full Text

   

Arjun Chakravarti ¹, Archana Ukey ², Preeti Bajaj ¹, Pradnya Saragade ¹

Affiliations
1 Department of Pathology, Dr. Vasantrao Pawar Medical College Hospital & Research Centre, Nashik-422003, Maharashtra, IN
2 Department of Pathology, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik-422003, Maharashtra, IN

Abstract

The complete blood count, peripheral blood smear, bleeding time, clotting time and renal function tests of 114 patients of chronic renal failure who had required hemodialysis for a period of at least 3 months prior to the commencement of this study were studied. The purpose of this study was to investigate the derangements in the haematological profile of chronic renal patients undergoing hemodialysis and to correlate the same with the duration and severity of the renal failure. The principal finding in the study was a 100% prevalence of anemia among chronic renal failure patients, which was predominantly of the normocytic normochromic type. Red blood cell count was reduced in nearly all (93%) of study patients. There was also a strong negative correlation (r = -0.74) between haemoglobin and duration of hemodialysis. However, a significant proportion of cases showed abnormal cells in the peripheral blood cells such as burr cells, schistocytes and pencil cells, suggesting other contributing factors to the anemia. Female patients also showed a significantly greater prevalence of increased red cell distribution width (>15%) as compared to males (p = 0.001) and a lower prevalence of normocytic normochromic anemia as compared to males (p = 0.009). White blood cell counts, platelet counts, and bleeding and clotting times were largely within normal limits, and none of these variables showed a statistically significant association with the duration of hemodialysis, or serum creatinine, or serum blood urea nitrogen. The inference from the study is that anemia is a major comorbidity in end-stage renal failure patients, with many factors contributing to it, and detailed workup and effective treatment of anemia is necessary in this group of patients.

Keywords

Anemia, Bleeding Time, Clotting Time, Complete Blood Count, Hemodialysis, Normocytic Normochromic.

Full Text

   

Girish Taori ¹, Archana Ukey ², Preeti Bajaj ³

Affiliations
1 PG Resident, Department of Pathology, MVP’s Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, Maharashtra, IN
2 Associate Professor, Department of Pathology, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, Maharashtra, IN
3 Professor and Head, Department of Pathology, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, Maharashtra, IN

Abstract

Introduction: Bone marrow examination is an important investigation in haematology which involves Bone Marrow Aspiration (BMA), Bone Marrow Imprint (BMI) and Bone Marrow Biopsy (BMB). Aim: Correlation of findings of bone marrow aspiration and imprint smears with biopsy in hematological disorders. Materials and Methods: It was a prospective study to correlate bone marrow examination findings by BMA, BMI and BMB of 111 patients in which bone marrow biopsy was done and correlated with aspirate and imprint smears. For aspiration Salah’s needle and for biopsy Jamshidi needle were used. Correlation of hematological and histopathological findings was done. Results: Megaloblastic anaemia was the commonest diagnosis followed by acute leukemia, nutritional anaemia, chronic leukemia, multiple myeloma, leukemia/lymphoma syndrome, and essential thrombocythemia. In case of dry aspirate or diluted marrow biopsy was useful to diagnose aplastic anemia, and secondary myelofibrosis associated with acute and chronic leukemia, multiple myeloma, leukemia/lymphoma syndrome and myelomonocytic leukemia. Aspirate and imprint smears were better for cellular morphology. Conclusion: Aspiration and imprint smears give better morphological details/cytologic diagnosis. In dry tap or diluted marrow, biopsy was more helpful in identifying architectural pattern, cellularity and fibrosis whereas imprint smears were more helpful for cellular morphology. BMA, BMI and BMB are complimentary to each other.

Keywords

Anaemia, Bone Marrow Aspiration (BMA), Bone Marrow Imprint (BMI) and Bone Marrow Biopsy (BMB), Haematology, Leukemia.

Full Text

   

Preeti Bajaj ¹, Sharad Ashok Waghachaure ², Archana Ukey ³

Affiliations
1 Professor & Head, Department of Pathology, Dr. Vasantrao Pawar Medical College Hospital & Research Centre, Nashik - 422003, Maharashtra, IN
2 3^rd year Resident, Department of Pathology, Dr. Vasantrao Pawar Medical College Hospital & Research Centre, Nashik - 422003, Maharashtra, IN
3 Associate Professor, Department of Pathology, Dr. Vasantrao Pawar Medical College Hospital & Research Centre, Nashik - 422003, Maharashtra, IN

Abstract

Introduction: Skin biopsy probably is the most important ancillary aid to confirm clinical diagnosis. The interpretation of many skin biopsies requires the identification and integration of two different morphological features – the tissue reaction pattern and the pattern of inflammation. Aim: To correlate histopathological diagnosis with clinical diagnosis in various non neoplastic skin lesions. Materials and Methods: The present study was a prospective and observational type of study. A total number of 197 participants were included after satisfying the eligibility criteria with due permission from Department of Dermatology. Only those patients who had given valid informed consent were included in the study. Results: Out of 197 biopsies studied, histopathological diagnosis in 167 biopsies (84.8%) was consistent with clinical diagnosis, while in 30 biopsies (15.2%) histopathological diagnosis was not consistent with clinical diagnosis. Conclusion: Out of 197 cases (M=111, F=86) biopsies studied, histopathological diagnosis was consistent with clinical diagnosis in 167 biopsies (84.8%), while in 30 biopsies (15.2%) the histopathological diagnosis was not consistent with clinical diagnosis. The skin biopsy remains the gold standard for diagnosis which can be supported with other techniques to confirm the diagnosis. This emphasizes the significance of histopathology in diagnosing non neoplastic skin disorders.

Keywords

Histopathology, Clinicopathological Correlation, Non Neoplastic Skin Lesions.

Full Text

   

Preeti Bajaj ¹, Aakash Gupta ²

Affiliations
1 Professor and Head, Department of Pathology, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, Maharashtra, IN
2 Former PG Resident, Department of Pathology, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, Maharashtra, IN

Abstract

Introduction: Thalassemia and other hemoglobinopathies are the most common routinely encountered congenital anemias in India. Sickle cell anemia is very common, so a study to rule out all the hemoglobinopathies is essential. Aims and Objectives: The present study was conducted to diagnose various hemoglobinopathies among clinically suspected cases., the present study was conducted to diagnose various hemoglobinopathies among clinically suspected cases. Materials and Methods: A total of 212 cases cases were undertaken in this study after they met the inclusion and exclusion criteria. HPLC was performed on the samples received in the Central Clinical Laboratory of Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik, Maharashtra. Results: Out of 212 cases, 42 cases showed positivity for thalassemia or presence of abnormal hemoglobin, with 8% cases of Beta thalassemia trait, 1.88% cases of Beta thalassemia major, 4.7% cases of Sickle cell trait, 4.24% cases of Sickle cell disease and 0.94% cases of Sickle-thalassemia. Conclusions: HPLC is a fast, reliable, and cost-effective method to diagnose any suspected case of hemoglobinopathy.

Keywords

HPLC, Thalassemia, Hemoglobinopathies

Full Text

   

Archana Ukey ¹, Sheela chikhalikarsheela@gmail.com ², Preeti Bajaj ³

Affiliations
1 Professor, Department of Pathology, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, Maharashtra, IN
2 Assistant Professor, Department of Pathology, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, Maharashtra, IN
3 Professor and Head, Department of Pathology, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, Maharashtra, IN

Abstract

Novel corona virus is a new strain of corona virus family, caused by SARS-CoV-2, probably of bat origin, not previously identified in humans. The time between entry of virus in body and start of first symptoms is the incubation period of the disease. For COVID-19 the incubation period is from two days to fourteen days. COVID-19 disease spreads through small droplets from nose and mouth. Spread is also through skin contacts and even through air while speaking. Blood is an integral part of the healthcare system. During the COVID-19 pandemic blood transfusion services were affected worldwide. The blood transfusion service had to face many challenges also in India. Voluntary blood donation was decreased which is the main source of blood and blood components. In lockdown, problems of transport services, less staff, fear of getting infected all these factors affected the blood donation services. This pandemic has influenced the blood donation activities causing shortage of blood and blood components and thus affected the blood inventory. Hence the blood services had to make appropriate plans to meet the requirements of patients.

Keywords

Blood Transfusion Services, Blood Inventory, Corona Virus, Pandemic, Voluntary Blood Donation, COVID-19

Full Text

   

Devangana M. Rajyaguru ¹, Anupama R. Kolte ², Preeti Bajaj ³

Affiliations
1 Associate Professor, Department of Pathology, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, Maharashtra, IN
2 Former PG Resident, Department of Pathology, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, Maharashtra, IN
3 Professor and Head, Department of Pathology, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, IN

Abstract

Background: Diabetes is a silent killer. Looking at the alarming presence of diabetes and its morbidity and mortality in India, we need to diagnose this metabolic disorder accurately and at the earliest. We have carried out this study to determine correlation of fasting blood glucose, post meal blood glucose and glycosylated haemoglobin in type 2 Diabetes Mellitus and to find the cut off value of glycosylated haemoglobin to diagnose type 2 diabetes mellitus. Materials and Methods: A cross sectional study was carried out among 298 cases of type 2 Diabetes Mellitus attending a tertiary care centre in Maharashtra during August 2018 to August 2020. Results and Conclusions: Majority were males and in the age group of 41 to 50 years. Fasting Blood Glucose (FBS) and Postprandial Blood Glucose (PPBS) are strongly correlated to Glycosylated Haemoglobin (HbA1c). Association between FBS and PPBS is statistically significant. Correlation of PPBS and HbA1c is stronger than that of FBS and HbA1c. Cut off level of HbA1c is higher in the study subjects in comparison to standard cut off value of 6.5%.

Keywords

Fasting Blood Glucose, Glycosylated Haemoglobin, Postprandial Blood Glucose, Type 2 Diabetes Mellitus

Full Text

   

Preeti Bajaj ¹, Priyanka Sadashiv Baviskar ², Devangana M. Rajyaguru ³, Rajendra A. Chaudhari ³

Affiliations
1 Professor & Head, Department of Pathology, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik - 422203, Maharashtra, IN
2 Former PG Resident, Department of Pathology, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik - 422203, Maharashtra, IN
3 Associate Professor, Department of Pathology, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik - 422203, Maharashtra, IN

Abstract

Background: For early screening of the cervical lesion cervical smear is a sensitive test and most widely used system for describing Pap smear result is The Bethesda System. Aims and Objectives: The present study was conducted to look for the epithelial cell abnormalities in cervix using Bethesda system of reporting for cervical cytology, to implicate The Bethesda System of reporting (2014) during assessment of Pap smear, to detect cervical cancer and its pre-cancerous lesions (LSIL-Low grade intraepithelial lesion and HSIL-High grade intraepithelial lesion) at an early stage by Pap smear examination and to create awareness about cervical cancer and importance of Pap smear as a screening test in disease prevention. Materials and Methods: The present study was undertaken at a tertiary health care, out of 250 cervical smears, we excluded 10 smears which were inadequate to opine. So, the total of 240 smears got reported according to The Bethesda System 2014. Observations and Results: The youngest patient was 18 year old and the oldest was 75 year old female. A total of 4% Pap smears were reported as unsatisfactory. The most common complaint of patients was discharge per vaginum which accounts for a total of 38% followed by abdominal pain is showed in 8% of cases. The most common infection was bacterial vaginosis followed by candida, Trichomonas. The frequency of normal (NILM) cases was 78%. ASCUS was found in 4.58%, LSIL was found in 9.17%, HSIL was found in 1.67% & SCC was found in 3.33% cases. Proportion of LSIL was more in age group 41-50 years i.e. 21.15%. Conclusion: Pap test has significant utility worldwide. Bethesda system which is widely used for cervicalcytology is a uniform and standard method for reporting cervical smears. It also gives a descriptive diagnosis that aids the clinicians regarding individualized management of patients. It helps in prevention of invasive cervical cancer by timely detection and treating women having precancerous lesions. The effectiveness is determined by reduction in incidence and mortality.

Keywords

Bethesda System, Cervical Cancer, Infection, Pap Smear, Cervical Cytology

Full Text

   

Devangana Rajyaguru ¹, Preeti Bajaj ², Gayatri Soneta ³, Aakash Gupta ⁴

Affiliations
1 Associate Professor, Department of Pathology, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, Maharashtra, IN
2 Professor and Head, Department of Pathology, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, Maharashtra, IN
3 PG Resident, Department of Pathology, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, Maharashtra, IN
4 Former PG Resident, Department of Pathology, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, Maharashtra, IN

Abstract

Introduction: Severe COVID-19 can lead to critical illness, with Acute Respiratory Distress (ARDS) and Multi-organ Failure (MOF) as its primary complications, eventually followed by intravascular coagulopathy. Haematological changes are common in patients with COVID-19, which include reduced lymphocyte count and platelet count but normal white blood cell count and prolonged activated partial thromboplastin time. Using a simple test like platelet count for assessing the risk of mortality and early identification of severe cases will help in preventing the life threatening complications in patients of COVID-19. Aims and Objectives: To study trends of thrombocytopenia in patients of COVID-19 and to study the correlation between thrombocytopenia and severity of cases of COVID-19. Materials and Methods: The study was carried out in Central Clinical Laboratory in a tertiary care centre. A total of 138 random subjects who were admitted in the COVID ICU were included after they satisfied the eligibility criteria. The CBCs were analyzed on the Beckmann Coulter automated cell count analyzer with EDTA samples obtained from peripheral venipuncture of the patients. Platelet trends over the three samples were studied. Results: An average of all three platelets counts for the patients revealed an overall decreasing trend in cases of non survivors, whereas an overall upward trend was noted in the survivors. A total of 79 patients showed thrombocytopenia (platelet count less than 1.5 lakhs/mm3 ), during at least one of the tests.46 (33.33%) of these patients succumbed, whereas 33 (23.9%) patients survived. Decreasing trends or overall decreasing trends (Increasing then decreasing) were observed in larger number of non survivors as compared to survivors. Also increasing or overall increasing trends (decreasing then increasing) were common in the survivors. Discussion: Hematological changes are common in SARS patients. For thrombocytopenia, the possible mechanisms of SARS-CoV associated thrombocytopenia may include, 1. Direct infection of megakaryocytes and platelets potentially, inducing cell apoptosis and growth inhibition and/or 2. Immune damage of megakaryocyte progenitor cells or platelets; In addition, the lung damage in SARS patients may also play a role in inducing thrombocytopenia. Conclusion: In this study, we found that platelet count may be a simple, economic, rapid and commonly available laboratory parameter that could straightforwardly discriminate between COVID patients with and without severe disease, while the study of serial platelets counts as trends could help identifying those with a serious risk of mortality.

Keywords

COVID-19, Platelet Trends, Prognostic Marker, Thrombocytopenia

Full Text