The national contextSince the changes in Section 11 funding [1] , different local authorities have responded in different ways to provide a service to their black communities. In general, there has been a decline in the quality and quantity of service provision to black communities. At the same time, qualified and experienced black staff have either been redeployed out of local authority service or been offered lower level posts or jobs that have nothing to do with service to black communities. The decisionmaking process has become even more dominated by non-black staff. Years of experience and community links have been lost. The effect has also been felt in black book trade which has suddenly seen a dramatic decline in funds made available for black material.It is in this context that the experience in Hackney should be seen. It reverses general national experience and sets new standards in quality of service to black communities. In addition, it has empowered black staff at all levels to be active in fundholding, in making, implementing and monitoring stock policy. Black and local suppliers have been used to supply all areas of stock, exposing the myth that black suppliers are not able to supply material required by public libraries. The model has been modified and improved over a period of over two years and is in the process of being formally structured into the new staffing structure following a comprehensive library review. The Hackney factorAfter years of decline, Hackney libraries are undergoing a process of radical transformation. Library staff, in a well-planned series of consultations, came up with a number of The authors Shiraz Durrani, John Pateman and Naila Durrani work in the London Borough of Hackney Libraries.
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Introduction: Ovarian tumours are rarely diagnosed early, patients presents only when the abdominal mass is appreciable in size. The current mode of treatment involves neoadjuvant chemotherapy with interval debulking surgery, followed by completion of the chemotherapy. The pathological examination of the interval debulking specimen allows an evaluation of the extent of the response to the chemotherapy and sensitivity of the tumour to the same. The Chemotherapy Response Score (CRS) developed by Bohm S et al., is being used to predict the prognosis of these patients. The advent of molecular genetics has allowed us to categorise tumours as per the mutations they possess, the prominent in High Grade Serous Carcinoma (HGSC) being TP53, BRCA1/2 and Homologous Recombination Deficiency (HRD). This knowledge is used to cater to the specific therapeutic needs of the patients. Aim: To apply the CRS to cases of high grade serous carcinomas of the ovary, presenting to the centre and association of the score with their survival. Materials and Methods: A total of 30 patients of high grade serous carcinoma of ovary who received neoadjuvant chemotherapy and had interval debulking surgery were included in the study. The histopathological examination of the resected specimen was done with special emphasis on the omental deposits and the degree of necrosis, fibrosis, inflammation, macrophages and residual tumour. Chi square statistics with p-value association of was done, to establish significance. Results: The histological parameters of necrosis, chronic inflammation and residual tumour in the omental deposits were found to be the most significant in association of to the CRS scores. Also, the CRS grading was associated with the survival of the patients. Conclusion: The CRS was found to associate well with the survival of the patients. This study recommends that CRS score be done in all post NACT high grade serous ovarian tumours, which will guide further treatment.
Introduction: For preoperative evaluation of patient with salivary gland lesion Fine Needle Aspiration Cytology (FNAC) is an effective technique, but due to lack of uniform system for reporting and also because of morphological heterogeneity and overlap between different lesions there are limitations, in its use. The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) was introduced which divides salivary gland lesions into six categories, guides in diagnosis and further management of Risk Of Malignancy (ROM) in different categories. Aim: The aim of the study was to classify salivary gland lesions according to MSRSGC and also evaluate for ROM in each category. Materials and Methods: This was a cross-sectional study looking at the data over a period of 3 years (2017 Jan to Dec 2019) in the Department of Pathology Chirayu Medical College and Hospital Bhopal. In this study salivary gland FNAC cases were categorised according to Milan System on cytopathology. Results: A total of 63 cases of salivary gland system FNAC were evaluated on cytology and classified according to MILAN system. Histopathological follow-up (correlation) was available in 47 cases. The risk of malignancy (ROM) in different categories was calculated. Category I Nondiagnostic constituted 25%, Category II Non-neoplastic comprised 0%, Category III Atypia of Undetermined Significance (AUS) showed 50% Category IV: (a) Benign showed 5.0% IV; (b) Salivary gland neoplasm of Uncertain Malignant Potential (SUMP) comprised 100%, Category V Suspicious for Malignancy (SM) comprised 100% and Category VI Malignant constituted 90%. Conclusion: MSRSGC is an evidence based effective system for salivary gland FNAC. It provides better communication with clinicians and improves over all patient care.
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