IntroductionClinical information (CI) is a key requisite to diagnose and report a specimen in histopathology. A timely dispatched report can help a clinician to confirm a diagnosis and initiate a prompt treatment plan while an unnecessary delay in reporting time can compromise patient's healthcare. The aim of this study was to ascertain the impact of the adequacy of CI provided by clinicians on the turnaround time (TAT) and to investigate factors pertinent to specimens, their handling, and diagnosis.MethodsThis retrospective study reviewed a total of 803 surgical specimens reported in a duration of four months (from December 2015 till March 2016) by the Department of Histopathology, FMH College of Medicine & Dentistry, Lahore, Pakistan. Frozen section and cytology specimens were excluded. CI was classified into three categories: short and focused, long and detailed, and deficient CI. Deficient CI was designated where the pathologist had to seek more information from the requesting clinicians. Total time taken by the histopathologist to complete a report was calculated after excluding weekends and holidays. Other factors like type of specimen, special staining, diagnosis of malignancy and source of referral were also studied. The data were entered and analyzed on SPSS 22.0 (IBM, Armonk, NY). Shapiro-Wilk test was used to measure the distribution.ResultsMost of the specimens (46.2%, n = 371) were reported within three days. Of these, most of the specimens (46.9%, n = 174) had a short and focused CI (p < 0.001). Majority of the specimens which were reported within four to five days (42.1%, n = 114) and after five days (62.1%, n = 100) were found to have a long and detailed CI in their requisition forms. Median TAT extended to six (4.00-7.00) days with the use of special stains (p < 0.001). One hundred and sixty-three (20.29%) of the total cases were diagnosed as malignant in which the median TAT significantly prolonged to five days (p < 0.001). Most of the specimens (80%, n = 60) received from the outside laboratories had a long and detailed CI in requisition forms. Endometrial tissue specimen was the predominant type received by the department (24.3%, n = 90).ConclusionAdequate CI is necessary for timely and error-free reporting of a specimen in surgical histopathology. A short, focused and concise CI is associated with a shorter TAT. Long and detailed CI is often seen with a complex surgical specimen that requires a longer time to report. Factors like specimen type, special staining, number of special stains and diagnosis of a malignancy also affect TAT.

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Heterotopic gastric mucosa (HGM) is gastric mucosal tissue outside the stomach. It can be discovered anywhere throughout the gastrointestinal tract and is mostly asymptomatic. HGM, although rare beyond the ligament of Treitz, should be included in the differential diagnosis in a young patient with a polyp causing obstructive symptoms or bleeding. Very few cases are published in literature. We describe a case of young male who presented with an episode of large amount of melena, from a bleeding jejunal lesion, diagnosed by endoscopy. Laparotomy and wedge resection of the jejunal lesion was done, and histopathology showed gastric heterotopia in a small jejunal diverticulum.

The Human Immunodeficiency Virus (HIV) is a global epidemic that impacts the lives of many individuals each year. There has been extensive research on HIV and AIDS, which allows the researcher to discover certain precautionary steps that can be taken as a means to reduce exposure. Some preventative measures presently recommended by reputable health experts and doctors consist of practicing safe sex, and participating in the frequent screening of blood specimens and other bodily fluids.

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Mucocele of the appendix is the accumulation of mucoid material in the appendiceal lumen. Although the terminology is imprecise, as it does not differentiate between the benign and malignant nature of the condition, preoperative recognition is imperative as spillage of the mucus during surgical handling can result in grave complications like pseudomyxoma peritonei. Mucocele developing in a stump of the appendix, i.e., a remnant of appendiceal tissue after surgical removal of an inflamed organ, is an extremely uncommon phenomenon, as not many cases are reported in the literature. In this review, all cases reported in English literature are discussed.

Objectives: To assess anxiety and depression symptoms during the coronavirus pandemic among health care professionals in Pakistan. Methods: This is a cross-sectional study where a questionnaire containing demographics, and a validated fear scale, depression, and anxiety scale was made on Google drive and was sent to health care workers as doctors, nurses, and paramedical staff working in six different hospitals in Pakistan, through What's app on smartphones from May 1 to Jun 30, 2020. Data was analyzed on SPSS. Results: The response rate was 80%. Of 400 participants, 263 (65.8%) were physicians, and 137 (34.0%) were nurses and paramedical staff.  57.0% were less than 40 years, whereas 18.3% were more than 50 years of age. Majority of participants 65.5 % (n= 262) experienced moderate level of fear and 16.5% (n= 66) had high level of fear. 19% feared death. 57.0% reported social media to be responsible for increasing their fear. On the depression and anxiety scale, 22.0% (n=87) reported moderate to severe depression and anxiety symptoms. A significant relationship was demonstrated between the depression level and age, education, profession (p < 0.001). Similarly, anxiety and depression scores were strongly related to the availability of Personal Protective Equipment (p< 0.001). Conclusion: 22.0% of healthcare professionals are suffering from moderate to severe anxiety and depression symptoms, whereas 65.0% had moderate symptoms of fear. The predictors are age, education level, and co-morbidities. A high level of fear, anxiety, and depression raises concern for their psychological well-being through different programs. Keywords: COVID-19; Healthcare workers; Psychosocial

We present results of four-corner carpal arthrodesis with the Acumed Hubcap circular plate performed at our unit. Eight patients underwent eight procedures over five years, for scapholunate advanced collapse (five wrists) and scaphoid non-union advanced collapse (three wrists). Outcomes included range of motion, quickDASH scores, and visual analogue scores for satisfaction. At final follow-up, mean flexion-extension arc was 56°, mean radial-ulnar deviation 29° and mean quickDASH score was 23/100. Mean score for satisfaction was 7.7/10 (77%). Seven out of eight (87.5%) patients said they would have it done again, and would also recommend it to others. Radiological union was achieved in all cases. One screw broke in one arthrodesis without causing symptoms. The functional outcomes with our use of the Hubcap are comparable to those reported in literature to date with other circular plates (e.g. Spider plate). There were no non-unions, which is the main reported complication with these plates.