Objectives:The present study was undertaken to evaluate and highlight the importance of hematological scoring system (HSS) in the early detection of neonatal sepsis.Materials and Methods:The cross-sectional study enrolled 110 neonates who were clinically suspected of infection (study group) and normal neonates for comparison (controls), during the 1st week of life. All peripheral blood smears were analyzed using HSS of Rodwell et al., by pathologists blinded to the infection status of the newborns. HSS assigns a score of 1 for each of seven findings significantly associated with sepsis: Abnormal total leukocyte count, abnormal total polymorphonuclear neutrophils (PMN) count, elevated immature PMN count, elevated immature: Total (I:T) PMN ratio, immature: Mature (I:M) PMN ratio ≥0.3, platelet count ≤150,000/mm3, and pronounced degenerative or toxic changes in PMNs. Score of ≤2 was interpreted as sepsis unlikely; score 3-4: Sepsis is possible and ≥5 sepsis or infection is very likely. Blood culture was taken as a standard indicator for septicemia. The perinatal history, clinical profile and laboratory data were recorded and correlated in each case. Each hematological parameter was assessed for its individual performance and also with the culture-proven sepsis. Sensitivity, specificity, positive and negative predictive values (NPVs) were calculated for each parameter and for different gestational ages. P value was also calculated for different parameters.Results:Out of the 110 infants, based on clinical findings and laboratory data were classified into three categories: Sepsis (n=42), probable infection (n=22) and normal (n=46). Out of these, 42 (38.2%) newborns had positive blood culture. 63 (57%) neonates were preterm and 47 (43%) term. Male: female ratio was 0.96:1. The P value was significant for the different gestational ages (0.0002) and sex ratio (0.003). Immature polymorphonuclear neutrophils (PMN) count was the most sensitive and I:M PMN ratio, the most specific indicator of sepsis. For sepsis and probable sepsis, I:T PMN count and immature PMN count have highest sensitivity whereas I:T and I:M PMN ratio have highest specificity. HSS has much higher sensitivity and specificity in preterms than in term neonates. Positive predictive value and NPV is also higher in preterm than term for HSS. It was also seen that with increasing scores, the likelihood of sepsis also increased.Conclusion:The sensitivities of the various screening parameters were found to be satisfactory in identifying early onset neonatal sepsis. It is a simple and feasible diagnostic tool to guide towards the decision-making for a rationale treatment.

Worldwide, most hematology laboratories have now changed over from the labor intensive manual methods of testing to 3-or 5-part differential automated hematology analyzers. Although laboratory personnel and hematopathologists handling the automated data are familiar with the basic interpretation and benefits of numerical data, the seemingly complex graphical representation of the red cell data in the form of histograms and cytograms is often ignored. At times, these can provide vital information that may not even be apparent in the automated numerical data. 1 Characteristic red cell cytogram patterns indicative of common hematological conditions are being presented in this paper. Materials and MethodsThis study presents a compilation of characteristic red cell cytograms generated by Advia-120 (Siemens Healthcare Diagnostics, Deerfield, IL), 2 a 5-part differential system (Technicon H1 series) used in the hematology laboratory of a tertiary care teaching institution. The cytograms have been compiled over a 2-year period from blood samples (approximately 200 per day) received for routine complete blood counts (CBC) in the laboratory. Approximately 140,000 cytograms have been analyzed during the study period. Single test requests were not run through the Advia-120 and were done manually. Dipotassium ethylenediaminetetra-aceticacid (EDTA) blood was used for testing and the tubes for sample collection were prepared in-house. AbstractBackground: Graphical data output from automated hematology analyzers, especially those related to red blood cells, have been traditionally ignored in favor of the more frequently used numerical values. This study presents characteristic red cell cytograms generated by Advia-120, a 5-part automated hematology analyzer, as seen in common hematological conditions.

Objective: The present study was undertaken to study the variations in the Peak Expiratory Flow Rate (PEFR) with various factors like age, height, weight, body surface area (BSA) and the Body Mass Index (BMI) in healthy women of the Malwa region of Punjab, India. Material and Methods:Three hundred healthy women who were aged 20-50 years were selected from the Malwa region of Punjab and their PEFRs were determined. The influences of age, height, weight, BSA and BMI on the PEFR were studied. The PEFR test was performed by using a mini Wright Peak Expiratory flow meter. Results:The mean PEFR of the women of the Malwa region of Punjab was found to be 395.87 ± 56.81 litres/minute. The PEFR increased with an increase in the age, height, weight and the BSA, but it decreased with an increase in the BMI. Conclusion:This study generated the preliminary values of PEFR for the women of the Malwa region of Punjab, India.

Aim of the Study: Malaria is a major health problem in the tropics with increased morbidity and mortality. Thrombocytopenia is a common finding in malaria. Although a reliable diagnostic marker, prognostic implications could vary in the two types of malaria. This study was undertaken to assess the presence and severity of thrombocytopenia in malaria patients. Design: A total of 120 patients were included in the study and identified positive for malaria parasites on peripheral smear examination with conventional microscopy. Platelet count was done on a fully automated, quantitative, hematology analyzer. Results: Thrombocytopenia was noted in 63.33% cases. The mean platelet count in Plasmodium vivax (Pv) malaria was 1,27,652/μl (SD 78,269) with a range of 8000-3,50,000/μl, as against Plasmodium falciparum (Pf) malaria where the mean platelet count was 78,500/μl (SD 51,485) with a range of 9000-1,90,000/μl. Platelet count < 50,000/μl was noted in only 17.4% cases of Pv malaria as against 33.3% cases of Pf malaria. Conclusion: Although absence of thrombocytopenia is uncommon in malaria, its presence is not a distinguishing feature between the two types of malaria. Our study stresses the importance of thrombocytopenia as an indicator of acute malaria.

Xanthogranulomatous endometritis is an unusual pathological entity mimicking endometrial carcinoma. This shows sheets of foamy histiocytes alongwith other inflammatory cells. We, hereby, report a case of 45 year multigravida female with irregular menstrual history, clinically diagnosed as carcinoma and histopathologically turned out as xanthogranulomatous endometritis. So, this condition should always be dealt with caution, and pathologists and clinicians should be aware of it.

Hydatid cyst is endemic in central parts of India, caused by infection with Echinococcus granulosus larva leading to development of cysts. Liver is most commonly involved organ. Isolated splenic hydatidosis is a very rare entity and only small clinical series or case reports have addressed the issue of splenic echinococcosis. We, hereby, present a case of an isolated giant hydatid cyst in spleen of a 30-year-old lady. Splenectomy was done and the diagnosis was confirmed on histopathological examination. Thus, a hydatid cyst should be kept in mind in the differential diagnosis of cystic lesions of spleen.

Aim:We report the outcome analysis of retropubic radical prostatectomy (RRP) performed in 428 patients in terms of pathological findings, complications, and survival.Materials and Methods:Systematically recorded case reports forms of consecutive 428 RRPs done over a 14-year period were analyzed using the SPSS 14 software. Secondary analysis was done to evaluate era specific (pre and post 2002) changes in clinical features and survivals.Results:Seven-year overall survival (OAS), cancer-specific survival (CSS), and event-free survival (EFS) was 83.2%, 82.8%, and 69.8% respectively in our series. Era-specific survival showed higher CSS post 2002, and there was an increase in presentation with organ-confined disease. Univariate and multivariate analysis showed statistically significant impact on era specific outcome. With the improvement in techniques decrease in complications rate and increase in quality of life was noted.Conclusions:Our series spanning over decade demonstrates that RRP is viable option to offer cure to organ-confined carcinoma prostate. Further, there is evidence of stage migration and improvements in outcome in post 2002 patients. Although our series is modest in number, the success rates and outcome data matches those reported in the literature.

Adenomatoid tumor is a benign neoplasm of the male and female genital tracts arising from mesothelial cells. Fine needle aspiration cytology (FNAC) plays a pivotal role in its preoperative diagnosis. Therefore, it is imperative that pathologists should be well aware of its cytological features so as to avoid erroneous diagnosis and hence prevent unnecessary surgical interventions. We hereby, present a case of adenomatoid tumor of testis in a 41 year male diagnosed by FNAC and later confirmed by histopathological examination.