EGFR is expressed in most of the cases of GBC. In well-differentiated adenocarcinoma, the EGFR expression is less compared to EGFR expression in poorly differentiated tumor, leading to the conclusion that the differentiation of the tumor and EGFR expression is inversely related. Thus, intensity of EGFR expression may correlate with aggressiveness of disease.

High Impact Acrylic is an excellent restorative material for reconstructing large sized cranial defects.

Various local flaps have been used for reconstruction of developmental and post surgical soft tissue defects of maxillofacial region. They include nasolabial flap, palatal pedicled flap, buccal fat pad, temporalis muscle and fascia flap. An ideal flap for all indications is yet to be found. Our experience with free dermal fat graft in the correction of deformities associated with Parry Romberg syndrome and oral submucous fibrosis is presented.

Introduction Cranial defects may arise due to trauma, infection, surgical ablation or errors in development. Restoration of such defects is important for esthetics, function and morale of the patient. Several materials are available. Each has its advantages and disadvantages. Search is on for an ideal material. Autogenous grafts remain the gold standard in reconstruction of such defects. However, the morbidity associated with their harvest, additional time required, the need for a second surgical site and the limited supply has led to the search for newer substitutes. Although many materials are available today including biologic and non biologic substitutes, there is still no consensus about the best material. In this article we describe our use of calcium phosphate cements for reconstruction of hemispherical cranial defects. Materials and Methods Cases requiring reconstruction of hemispherical cranial defects (more than 15 cm in any dimension) were selected for study. After exposing the defect under GA, titanium mesh was adapted to the defect for support. Then the calcium phosphate cement was prepared and injected on the mesh to establish good contour. The alloplastic insert in each patient was evaluated for: (a) Immediate post-operative complications (b) Restoration of contour and soft tissue support (c) New bone formation ascertained on HRCT at the end of 2 years. Patients were examined on postoperative first week, at 3 and at 6 months.High resolution computed tomography scans were taken at 2 years postop. There were two female and three male patients. Results There were no complications in the post operative period. The general condition of the patients improved post operatively. Even though the cements maintained their contour at 2 years, there were no signs of bone formation within the cement. Conclusion Calcium phosphate cement is a good bone substitute for use in cranioplasty. In defects requiring mechanical strength, it should be supported by a titanium mesh. It retains the contour but is not replaced by bone even after 2 years.

Porous polyethylene prefabricated implants are a good restorative material for reconstruction of large cranial defects.

BACKGROUNDMalaria is an important infectious protozoan disease and it has been estimated that worldwide there are 300 -500 million cases of malaria per year and 1.5 -2.7 million deaths. The early diagnosis of malaria is the key feature for its prompt treatment and prevention of complications. The study was conducted to statistically analyse other haematological parameters like platelet indices that is Mean Platelet Volume (MPV) and Platelet Distribution Width (PDW) along with platelet count. Correlation of the above was done with parasite density and type of species. An attempt was made to study whether platelet indices and counts are indicative of type of infection.

Background Tumor budding (TB) has been identified in many solid cancers and thought to be involved in invasion and is the initial step in the metastatic process. Limited information is available documenting the role of tumor budding in breast carcinoma. With this aim, the present study evaluates the association of tumor budding, tumor microenvironment, and its correlation with clinicopathologic parameters. Materials and Methods A total of 102 cases were archived and evaluated for peripheral and intra tumoral budding along with tumor microenvironment on hematoxylin and eosin (H&E) slides. Statistical Analysis Correlation between tumor budding, tumor microenvironment, and other classical clinicopathological parameters was studied by Chi-square test. A p-value less than 0.05 was considered significant. Results Females constituted 99 cases out of 102 and 3 were males. We found 55.9% and 44.1% of patients in the age group less than or equal to 50 and greater than 50, respectively. Also, 65.6% of cases presented with small tumor size less than or equal to 5 cm, 80.39% with lymph node metastasis, and 76.4% with lympho-vascular emboli. High peripheral tumoral budding (PTB) was seen in 45.10%, low peripheral tumoral budding in 54.9%, high ITB in 53.9%, and low ITB in 46.1%. Necrosis was found only in 39.21%. Significant statistical association of PTB was found with lymph node metastasis, lymphovascular emboli, and tumor necrosis, whereas ITB with tumor grade, lymph node metastasis, lympho-vascular emboli, and necrosis. Both PTB and ITB showed no statistically significant correlation with age and size of the tumor. Conclusion Tumor budding is an independent adverse prognostic factor in invasive breast carcinoma. However, further work is needed to establish a standard method for the quantification of this parameter, which will help in effective stratification of patients in terms of disease-free survival and likely outcome.

BACKGROUNDIncidence of dengue fever is on rise in India. We investigated the characteristics of Mean Platelet Volume (MPV) and platelet distribution width (PDW) in various risk categories of dengue fever. MATERIALS AND METHODSIn this prospective two months pilot study, 100 cases of NS1 antigen and IgM ELISA positive dengue were included. Platelet count for risk categorisation, MPV and PDW values were recorded. Statistical analysis was done using ANOVA (Fisher's test). RESULTSThere were 77%, 18% and 5% cases in no, low and moderate risk categories, respectively. In no, low and moderate risk categories, mean MPV was 8.6, 9.6 and 10.7 (fL), respectively. In no, low and moderate risk categories mean PDW was 16.4, 17.03 and 16.9, respectively. Overall, there was positive correlation between MPV and PDW (p= 0.066; r= 0.185), as also in low risk category. In moderate risk group, there was a negative correlation between MPV and PDW (p= 0.201; r= -0.686).