The incidence and mortality of cervical cancer remains high in India even after sixty years of introduction of the Pap smear (cervical cytology) which is an effective means of identifying preinvasive lesions of carcinoma cervix. The morbidity and mortality due to cervical cancer has come down drastically in countries with well established screening programmes at national level. This study aims at screening women for cervical cancer opportunistically during their visit to hospital and to study various types of neoplastic and non-neoplastic lesions of the cervix by cervical smear study (Pap smear study). In the present study, a total of 350 cervical smears were studied. The age of patients ranged from 19 years to 80 years with mean age being 37.5 years. Out of 350 cases, the diagnosis of neoplasia was given in 43 cases and 258 cases were diagnosed as inflammatory smears. Forty-cases were normal and 9 cases were inadequate to evaluate. Forty-three patients who were found to have neoplastic lesions on cytology were referred for further investigations like colposcopy and biopsy to confirm the diagnosis and avail proper treatment. Limitation of the present study was small sample size as all female patients aged between 20 and 60 years visiting hospital were not included in the screening, other screening tests like VIA (visual inspection with acetic acid test) and HPV DNA (human papilloma virus) tests were not done. Until the time centrally organised screening programmes for cervical cancer are established in India, arrangements should be made for hospital based opportunistic screening for all women attending hospital. The cost effectiveness of different screening tests for cervical cancer should be evaluated.

IntroductionBrain tissue by virtue of its high water content is like a sea of water wrapped in tubes of fat with a bit of protein thrown in to hold it all together [1]. This inherently soft nature of brain tissue and high water content results in poor quality frozen sections due to ice-crystal artefacts. At the same time, this soft texture facilitates smear preparation which reveals the cytomorphology in detail. For intra-operative diagnosis of brain lesions, the neuropathologists use squash smear, imprints and frozen section techniques. Implementing cytology smears for intra-operative diagnosis of brain tumors is now well established in many neurosurgical centers [1][2][3] The aims of the present study were to evaluate the diagnostic accuracy and limitations of squash smears and frozen sections in the diagnosis of intracranial lesions, in comparison with paraffin sections and also to study the discordant cases. Materials and MethodsA total of two hundred and twenty one neurosurgical specimens including brain and spinal lesions were received in the Department of Pathology from January 2010 to December 2012, of which the neurosurgeon sent 110 cases for intra-operative consultation. These cases were studied retrospectively. Both frozen and squash preparation were performed on all cases and stained with hematoxylin & eosin (H&E). Squash smears were prepared by crushing (squashing) a small bit of tissue, about 1 cubic mm size, in between two microscopic glass slides and pulling it apart with gentle pressure to make it a thinner smear. Smears were immediately fixed in 95% alcohol and stained with rapid hematoxylin and eosin stain. Smears were stained in hematoxylin stain for 1 min followed by differentiation in 1% alcohol, and dipped in eosin for 1-2 dips, washed in water, and then mounted. In some cases smears were even stained with Pap and May-Grünwald (MGG) stains, wherever tissue was adequate enough. Frozen sections of 6 to 10 micrometer thickness were taken in Leica CE/CN cryostat. Sections were stained with H&E stain. Sections were stained with hematoxylin for 1 min, differentiated in 1% alcohol, dipped in eosin (1-2 dips), washed in water and mounted. The clinical (age, location, chief complaints) and radiological data was retrieved along with squash smear, frozen section and paraffin section slides. An intra-operative diagnosis was made after examination of the squash smears and frozen section slides. The diagnosis given on squash smears and frozen section was then compared with final diagnosis given on paraffin-embedded sections. Immunohistochemistry was performed in a few diagnostically challenging cases. Accuracy of squash versus paraffin section diagnosis and combined squash + frozen section diagnosis was determined. ResultsOf the 110 cases of open biopsies, 68 were males and 42 were females. The ages ranged from a minimum of 7 months to a maximum of 72 years. Majority of the cases were astrocytomas (32.7%) followed by meningiomas (21.8%) and schwannomas (10.9%). The diagnoses on squash smears correlated ...

The Chiari Malformation is a neural tube defect involving the posterior cranial fossa and the hind brain, characterized by herniation of the posterior fossa contents below the level of the foramen magnum. Four types were described by Hans Chiari in the late 19th century. Of these, Type III is exceedingly rare. We report the case of Chiari III malformation in a 24-week fetus by the integration of radiologic and autopsy findings which was conspicuous by the absence of high cervical spina bifida and the presence of occipital squama defect.

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