To evaluate the role of the scoring of micronucleated cell (MNC) to distinguish reactive mesothelial cells from adenocarcinoma cells in effusion fluid. A total of 20 cases of unequivocal metastatic adenocarcinoma and 15 controls with reactive mesothelial cell proliferation in ascetic fluid were selected for scoring of the MNC. The numbers of cells having micronuclei were counted per 1000 of the well-preserved cells in May Grunwald Giemsa stained slides in each case. The mean number of MNC in metastatic adenocarcinoma and reactive mesothelial cells were 21 + 6.53 and 2.93 + 2.63, respectively, per 1000 cells. Micronuclei frequency was significantly increased in adenocarcinoma patients compared with controls (Student's t-test, P < 0.001). The scoring of MNC can be used as an additional biomarker and to discriminate between benign reactive mesothelial cells versus metastatic adenocarcinoma in effusion fluids in difficult situation.

Background:Management of high risk obstetric patients.Aim:The present study was conducted to evaluate the primary causes of the admission of obstetric patients to Intensive Care Unit (ICU), the presence of co-morbid diseases, outcome of such patients, their survival rate as well as the factors which contribute to the maternal mortality.Settings and Design:A retrospective study was conducted in the Department of Obstetrics and Gynaecology and Anaesthesiology/ICU of our Institute.Materials and Methods:Sixty-one obstetric patients, who were admitted to ICU between 20 December 2006 and 31 January 2010, were evaluated for various factors responsible for their admission as well as their outcome.Statistical Analysis:At the end of study, the data were arranged systematically and subjected to statistical analysis using nonparametric tests and P value <0.05 was considered significant.Results:Majority of the 61 patients admitted in ICU were referred from the peripheral health centers, smaller nursing homes/hospitals and some even without proper primary care and mainly comprising uneducated and rural population. Hemorrhage, pregnancy induced hypertension, cardiac diseases, respiratory insufficiency and sepsis were the main causes for admission. A total of 18 patients among 61 died during their ICU stay in the hospital.Conclusions:In the developing countries, high risk pregnancy should be managed at peripheral centers with proper facilities, antenatal visits and timely referral. The intensive care help should be reserved for very high risk pregnancies with co-morbid diseases.

Objective: To assess the spectrum of lesions in the sinonasal region diagnosed on FNAC. Study Design: This is a retrospective audit of sinonasal lesions diagnosed on FNAC over a period of 12 years (1998–2009). Results: Out of a total of 79,851 FNACs, 158 (0.2%) were from the sinonasal region. FNAC was non-diagnostic in 20 (12.6%) cases. Infective/inflammatory lesions comprised of 30 (19%) cases including non-specific inflammation (19), fungal infection (7), tuberculosis (2), actinomycosis (1) and filariasis (1). Benign cysts (24; 15.2%) included epidermal inclusion cysts, mucocele and aneurysmal bone cyst. Benign bone tumors (4) comprised of giant cell tumor, fibrous dysplasia, chondroma, and osteoblastoma. Other benign tumors included lipoma (6), hemangioma (5), schwannoma (2), meningioma (1), pleomorphic adenoma (1), sebaceous adenoma (1) and other skin adnexal tumors (3). Malignant epithelial tumors (24; 15.2%) included squamous cell carcinoma (10), basal cell carcinoma (5), poorly differentiated carcinoma (4) and metastatic carcinoma (5). Two cases of chordoma and one case each of dermatofibrosarcoma pertuberance and hemangiopericytoma were seen. Sarcomas included sarcoma, not otherwise specified (4), rhabdomyosarcoma (3), osteosarcoma (2), chondrosarcoma (2), leiomyosarcoma (1), malignant fibrous histiocytoma (1), fibrosarcoma (1) and malignant peripheral nerve sheath tumor (1). There were cases of malignant small round cell tumor (11), non-Hodgkin lymphoma (3), plasmacytoma (2) and malignant melanoma (2). Conclusion: A variety of non-neoplastic and neoplastic conditions can involve the sinonasal region. FNAC is a reliable diagnostic procedure in a good number of cases, especially in the light of clinico-radiological data.

The aim of the present study was to evaluate the scope and the limitations of fine needle aspiration cytology (FNAC) in orbital and ocular adnexal lesions. This study was a retrospective audit of 389 cases of orbital and ocular adnexal lesions subjected to FNAC over a period of 12 years (1998-2009). The cyto-smears were reviewed and the lesions were categorized under different diagnostic categories in adult and pediatric population. Three hundred and one adult patients (age ≥15 years) and 88 pediatric patients (age ≤14 years) constituted the study group. In the adult population, there were 23.3% cases of infectious and lymphoproliferative lesions and 12.6% of benign cysts. In the pediatric population, 18.2% cases had infectious and lymphoproliferative lesions and 8% had benign cysts. Various benign tumors (9.6% in adults) included pleomorphic adenoma, meningioma, and schwannoma. Benign vascular tumors predominated in the pediatric population. A majority of malignant tumors in adults were lymphoreticular malignancies (12.6%); non-Hodgkin's lymphoma being the most common followed by malignant epithelial tumors (10.3%). Nearly 3.6% cases of soft tissue/bone sarcomas and 6.3% of metastatic tumors were seen in adult population. However, most of the orbital tumors in the pediatric population were malignant small blue round cell tumors (33%). FNAC is a cost-effective technique with good diagnostic value in the assessment of ophthalmic lesions, especially when sampling and interpretation are performed by experienced personnel in the light of clinico-radiological information.

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Objectives: Anemia during pregnancy is characterized by hemoglobin concentration <11 g/dl in pregnant women, which decreases oxygen carrying capacity of the blood to the body tissues. It is estimated that worldwide 41.8% of pregnant and 30.2% of non-pregnant women are anemic. This study aims to determine the prevalence and factors associated with anemia in pregnant women attending antenatal clinic at our tertiary care center. Materials and Methods: A cross-sectional observational study was conducted among 500 pregnant women attending antenatal clinic for the 1st time in the Department of Obstetrics and Gynaecology, AIMSR, Bathinda, for a period of 1 year. The hemoglobin was measured using automated cell counter method and those with hemoglobin level <11 g/dl were considered as anemic and were investigated further to be assessed according to the Indian Council of Medical Research classification. Data were collected using predesigned and pretested structured questionnaire. Results: The mean Hb concentration was 9.06 g/dl among the anemic group. Overall prevalence of anemia among pregnant women was found to be 408 (81.8%). Residence, educational status, monthly family income, occupation, gestational age, iron folic acid supplementation, dietary habits of not eating green leafy vegetables, meat and animal products, and drinking tea and coffee immediately after meal were the variables which had statistically significant association with the prevalence of anemia. Conclusion: Anemia control program should be executed more resourcefully in this vital segment of population. Awareness of above said factors is more important to prevent anemia rather than early diagnosis and treatment.

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BACKGROUND To study and compare the therapeutic efficacy and side effects of a 35% glycolic acid (GA) full face peel alone or in combination with a 10% or 20% trichloroacetic acid (TCA) spot peel for facial melasma. METHODS Thirty patients with facial melasma were randomly divided into 3 equal Groups A, B, and C. Group A was treated with a 35% GA full-face peel, Group B and C with 35% GA full-face peel followed by a 10% and 20% TCA spot peel respectively once every 15 days. Four peels were performed once every 15 days. The response to the treatment was evaluated by the percentage reduction in melasma area severity index (MASI) scoring. RESULTS All 3 groups had significant reduction of MASI, but there was no significant difference between the groups. Group A had minimum side effects. CONCLUSION Chemical peels with GA alone or in combination with TCA do result in a significant improvement in melasma, but the combination of the peels in the same sitting does not seem to have any additive or synergistic effect while they may increase the side effects.