Comparison of different screening methods including digital rectal examination (DRE) and estimation of serum prostate specific antigen (PSA) had been done for detection of cancer prostate at initial stages in 186 patients presenting with prostatism. The detection rate of raised serum PSA (> 4 ng/dl) was found significantly higher than that of abnormal DRE because it could detect cases of prostate cancer at very early stages. On the other hand using abnormal DRE alone as criteria for biopsy, large number of these cases, specially at early stages, would have remained undetected (36.9%) thereby giving false low incidence. Serum PSA was found raised in pre neoplastic conditions (73.9%) like PIN and AAH also, majority of which were missed on DRE (65.2%). Raised serum PSA was found in many benign conditions (36.7%, false positive) also, hence prostatic biopsy is advised to confirm malignancy.

Infertility is a problem affecting 10-12% of couples. Zinc is necessary for growth, sexual maturation and reproduction. Semen analysis is helpful in ascertaining the evidence of spermatogenesis, sperm transport, sperm quantity and quality and also provides clue to the functioning of the accessory glands i.e. seminal vesicles and prostate. The present study was conducted in 50 oligospermic infertile males and control group consisting of 25 normospermic known fertile males. Semen and Serum samples were obtained from each case in study as well as control group. Semen and serum were processed by wet ash method. The seminal and serum zinc levels of each case in study and control group were estimated. Statistically, serum zinc and semen zinc levels were significantly lower in infertile patients than fertile males. A significant correlation was observed between serum and semen zinc levels in study group.

The levels of immunoglobulin, C3-Activator and C3c in the sera of members of staff who have been continuously engaged for upwards of 10 years in the microbiological routine laboratory of a teachings hospital were determined. These were compared with the local normals, with those of the junior members of staff in the same laboratory but who had put in less than 5 years continuous service and with a control group. The means in all five determinations were much higher in the senior members of staff than the normal standards of the area, particularly the IgG, which was almost double the local normals. The levels for the junior staff were on the whole slightly higher than the control group. The increase in the levels of immunoglobulins with corresponding increases in C3-Activator and 3Cc suggest that immunological reactions, with the binding of complement in the alternate and classical pathways of activation are taking place in most of these senior workers. In the absence of any manifest illness in the senior staff, the findings may suggest a high degree of immunological protection.

Biopsies of cervix uteri from 166 patients with benign and malignant lesions (12 normal, 48 inflammatory lesion, 6 adenocarcinoma, 2 adenosquamous carcinoma and 98 from squamous cell carcinomas) were studied histochemically. The stains used were PAS with/without diastase, AB/PAS (pH 2.5) and OR/AB. In inflammatory lesions neutral mucin was predominent which was replaced by sialomucin and sulphomucin in endocervical polyps. In malignant lesions sulphomucin was predominent. Seventeen percent cases of squamous cell carcinomas needed reclassification after mucin staining. Of the fourteen large cell non-keratinizing squamous cell carcinomas, 12 were reclassified as squamous cell carcinoma with mucin secretion and 2 as adenosquamous carcinoma. One case of small cell non-keratinizing squamous cell carcinoma was reclassified as moderately differentiated adenocarcinoma. None of the keratinizing carcinomas had evidence of mucin secretion. Mucin histochemistry should be done routinely on non-keratinizing squamous cell carcinomas to pick up more cases of carcinoma with evidence of mucin secretion which can be missed on routine haematoxylin and eosin stains. Such carcinomas are known to pursue a more aggressive clinical course and have a poorer prognosis than non-mucin secreting type of squamous cell carcinoma.

Shedding of Cryptosporidium parvum oocyst was studied in experimentally infected Jersey-Sindhi cross bred calves. Three 7 day old bull calves housed in isolation were orally infected with 10(8) oocysts of Cryptosporidium parvum. The prepatent and patent period of the experimental infection were 5 and 4 days respectively. Maximum oocyst output [2 x 10(5) oocyst per gram (OPG) was observed on the 7th day post inoculation (PI). The mean total oocyst output was 2.5 x 10(7). Diarrhoea started on the second day of oocyst shedding.

Transrectal fine needle aspiration cytology (FNAC) was performed in 100 cases of prostatomegaly detected by digital rectal examination (DRE). The cytologic findings were compared with histolgic findings of material obtained by transurethral resection of prostate (TURP) in 84 of the cases. In addition, pre-prostatectomy transabdominal ultrasonography was done in 55 of the cases and the findings were compared with cytologic and histologic diagnoses. The accuracy of diagnosis by FNAC for benign lesions and carcinoma of prostate was 98.33% and 81.81% respectively. The accuracy of transabdominal ultrasonography for benign lesions was 91.66% but that for carcinoma was only 38.46%. The technique of transrectal FNAC was found to be simple quick, economical and easy to repeat with high accuracy and was suitable for outpatients.

A total of 62 patients of gastric carcinoma were studied to find a correlation between newer prognostic indicators like cell proliferative indices including Nucleolar Organizer regions (AgNORs), Ki 67 Labelling Index and Epidermal Growth Factor Receptor (EGFR) expression with the various, histopathological criteria and compared with 30 controls of non neoplastic gastric diseases. EGFR expression was positive in 48(77.4%) cases. The Ki 67 labelling indices ranged from 0 to 50% with a mean of 21.35 +/- 17.88% among the cases. AgNOR counts ranged from 1.64 to 4.49 with a mean of 3.41 +/- 0.81 among the cases. Positive EGFR expression correlated strongly with differentiation of the tumour, poorly differentiated tumours showing a higher positivity. EGFR positivity also showed good correlation with metastasis as well as with the invasiveness of the tumour. Ki 67 labelling indices correlated significantly with metastatic status, microscopic types and degree of differentiation of the tumour. A strong correlation was observed between AgNOR counts and metastasis as well as the microscopic type of the tumour. EGFR expression correlated strongly with Ki 67 scores and weakly with AgNOR counts among the patients of gastric carcinoma.

120 consecutive appendicectomies and 20 appendices from medicolegal autopsies were studied. The cases were grouped as. A: Acute appendicitis. B: Acute presentation, not diagnostic of acute appendicitis C: Elective appendicectomies D: Normal appendices from autopsies. Eosinophils and mast cells were counted in the muscularis, in Giemsa stained sections. The mean eosinophil and mast cell counts per mm2 were--A. 215.9; 26.5. B. 66.0; 32.1. C. 6.7; 25.8. D. 4.2; 19.6 respectively. Eosinophil count is significantly higher in A compared to others (p < 0.0001) and there was no range overlap with C and D. B is a heterogenous group with 37.5% having eosinophil counts in the range seen in A. Cases with mural eosinophil showed histological evidence of mast cell degranulation. Eosinophil infiltration of the muscularis is an early event universally seen in acute appendicitis. It is possible that the disease is triggered by Type I Hypersensitivity, and that infection is a later consequence.

The study describes the value of specific chlamydial IgM antibody detection by indirect immunoperoxidase assay (IPA) for early confirmation of cases of primary infertility and pelvic inflammatory diseases (PID) of chlamydial aetiology. Forty-eight infertile women and forty-six women with acute PID were screened. Seven (14.2%) infertility patients and twenty-one (45.6%) PID patients had positive titers for chlamydia trachomatis. The difference in incidence of antichlamydial antibodies in the study group as compared with control was statistically significant (p < 0.05). These findings suggest that in the absence of tissue culture facilities, detection of specific chlamydial IgM antibody is a sensitive serological marker for specific diagnosis of chlamydial infection.

Silver colloid staining of nucleolar organiser regions (AgNORs) is used for assessing the proliferative potential of tumours. The present study aimed at evaluating the AgNOR indices in normal and reactive CNS tissue, benign and malignant CNS neoplasms. The study group comprised of tissue from 22 controls and 100 cases (53 benign & 47 malignant neoplasms). The mean AgNOR index of controls was 0.95, benign neoplasms 1.25 and malignant neoplasms 2.12. A statistically significant difference was observed in controls and cases (p < 0.001) and between benign and malignant tumours (p = 0.002). Mean indices for low and high grade astrocytoma also significantly differed (p < 0.001). Using ROC curves cut off values were obtained for differentiation of neoplastic from non neoplastic (AgNOR index 1.10), benign from malignant (AgNOR index 1.75) and low grade (I & II) from anaplastic (Gr III & IV) Astrocytomas (AgNOR index 1.62). A spectrum of gradually increasing AgNOR indices from normal, reactive, benign to low and high grade malignancy indicates the usefulness of this simple technique as a proliferative marker.

Pulmonary carcinomatous arteriopathy was seen at autopsy in three patients who presented with sub-acute cor pulmonale. All had adenocarcinomas of unknown origin. The arteries and arterioles showed fresh and organizing thrombi with narrowing or occlusion. Large muscular arteries also showed tumour cells within the thrombi. Lymphangitis carcinomatosis was also present to a variable extent.

Soft tissue tumours of eyelid constituted 28.9% of all eyelid tumours. Morphologically they were either vascular 32 cases (49.23%), neural 24 cases (36.92%), fibrous 6 cases (9.23%) or adipose tissue tumours 3 cases (4.62%). The age ranged from 1-30 years, haemangiomas and neurofibromas were present since birth. Upper eyelid was involved in 81.54% cases. Neurofibroma was associated with generalized lesions in 13.6% cases.

ESR (Westergen) correlated significantly with the iron status (as measured by Hb concentration, haematocrit, red cell count, MCH, P/H ratio, serum iron, TIBC and percent saturation of transferrin) in a group of pregnant women (PW) at term. Serum ferritin correlated negatively with the ESR but the correlation was not statistically significant. Serum ferritin levels of < 50 micrograms/L were present in 9 (34.6%) PW with ESR > or = 50 mm 1st hour and 5 (19.2%) PW with ESR < 50 mm 1st hour. The mean ESR in PW was 55.7 (+/- 22.9) and was > or = 50 mm 1st hour in 50% and < 75 mm 1st hour in 82.7%. The difference in the mean ESR in anaemic and nonanaemic PW was highly significant (p < 0.001), 87.5% anaemic PW with serum ferritin > 50 micrograms/L had ESR > or = 50 mm 1st hour, suggesting the possible effect of chronic infection in raising ferritin levels in these PW.

Acute myelofibrosis is a rare disorder. Five such cases have been diagnosed out of 3,149 Bone Marrow (B.M) Aspirations and Trephine Biopsies studied over a period of eight and a half years. Four out of five patients were males and the other female. Their age ranged from 14-71 years. Neither splenomegaly not red cell poikilocytosis (tear drop cells) were prominant features. B.M. trephine biopsy showed increase of atypical megakaryocytes/megakaryoblasts and marked fibrosis. There was rapid downhill clinical course of the disease in all cases.

A one step competitive Enzyme-Linked Immunosorbent assay (ELISA) method was developed to detect mycobacterial antigen in cerebrospinal fluid (CSF) for the diagnosis of tuberculous meningitis and compared with a standard competitive ELISA method. Indigenously prepared soluble extract of Mycobacterium tuberculosis H37 Rv was used as antigen. The study was conducted using CSF of 230 clinically diagnosed cases of tuberculous meningit is and 208 control subjects. A cutoff value of 0.57 ng/ml by the one step ELISA and 0.5 ng/ml by the standard ELISA method were determined. The specificity of both methods were 100% and positivity was 68.26% and 70.43% respectively. A follow up study was conducted in 63 cases at various interval of time after starting anti-tubercular therapy i.e. at 3 weeks (63 cases), 6 weeks (27 cases) and > or = 4-12 months (13 cases). It was observed that antigen levels decreased gradually, but were much above the cutoff range. Indigenously prepared antigen was compared with antigen prepared in other laboratories and standard molecular weight markers using SDS PAGE (Sodium Do-decyl Sulphate Polycrylamide Gel Electrophoresis).

Most large series of patients with systemic lupus erythematosus (SLE) have revealed a very small group of patients who are persistently antinuclear antibody (ANA) negative with prominent dermatologic involvement but infrequent neurological and renal involvement. We present a very unusual case report of a young female with ANA-negative SLE presenting with lupus nephritis and oculomotor palsy without any dermatologic manifestations.

The mammary hamartoma is a poorly recognised benign breast neoplasm. For diagnosis one usually correlates the clinical, mammographic, gross and histologic features. This study of fifteen cases emphasises the histomorphologic criteria for diagnosis especially in the absence of mammographic picture, viz. a clinically palpable, well encapsulated mass which on histology shows normal breast epithelium admixed with fat, fibrous tissue and other mesenchymal elements. The epithelium in the hamartomas studied showed changes seen in normal breast especially in the progestational phase of the menstrual cycle. The stroma was either densely collagenous, hyalinised or cellular and admixed with fat in various proportion in thirteen cases, muscle in two cases and thick muscular arteries in four cases. It also showed pseudoangiomatous hyperplasia in seven cases. The importance of this change and probable evolution is discussed therein.

A patient from a rural background developed corneal ulceration following an insect hitting the eye. Corneal scrapings when processed for bacterial and fungal growth yielded Nigrospora, a contaminant fungus. This fungus has been quoted in literature as a common contaminant of no pathogenic significance. Herein, we describe its role as the causative agent of corneal ulcer, which has not been reported thus far.

Bombay phenotype is peculiar in that red cells are not agglutinated by antisera A, B or H; while serum contains anti A, B and H. Existence of modifying genes at independent loci with variable expression of ABO genes is postulated. We report here a case of partial suppression where antigens could be detected by elution tests and unlike classical Bombay type, normal amount of appropriate blood group substances were present in saliva. This case of para Bombay phenotype was detected as a result of discrepancy in cell and serum group ng. This highlights the importance of both forward and reverse grouping in ABO testing.

Multiple necrotizing skin lesions due to Fusarium solani in an elderly man with acute myelogenous leukemia is described.

We hereby report two cases of Bisalbuminemia for its extreme rarity in Indian literature. In an attempt to look for 'M' component, polyacrylamide gel disc electrophoresis of serum displayed observation. The saline eluates of the slower (variant in our cases) and the faster component showed a reaction of complete identify in the agar gel double diffusion test when tested against monospecific antialbumin antibody. The immunoelectrophoretic analysis also confirmed the antigenic similarity between the two fractions. A wider use of disc electrophoresis perhaps would disclose additional cases of Bisalbuminemia in normals and in disease states.

Lymphangioma occurring in an intra-abdominal location is reported to be extremely rare. A series of 5 cases is presented and the differential diagnoses and diagnostic features discussed. None of the cases were diagnosed as lymphangioma clinically. It is suggested that their true incidence may be unknown due to both silent clinical course as well as lack of awareness of clinical and morphological features.

Emerging infectious diseases are diseases of infectious origin whose incidence in humans has increased within the past decades or threatens to increase in the near future. The reappearance of a previously known infection after a period of disappearance or decline in incidence is known as re-emergence. Many factors are known to contribute to the emergence or re-emergence of a disease. For example, research indicates that newly emergent infections may result from changes in or the evolution of existing organisms, the spread of known diseases to new geographic areas or human populations, or the appearance of previously unrecognized infections in persons living or working in areas undergoing ecologic changes which increases individual exposure to insects, animals, and environmental sources which may harbor new or unusual infectious agents. An infectious disease may re-emerge due to a range of reasons, including the development of antimicrobial resistance and/or insecticide resistance among vectors, and the collapse of public health systems. Pathology and emerging infections, examples of emerging and re-emerging infections, the contributions of pathology to emerging infections, autopsy and emerging infections, global microbial threats, emerging and re-emerging infections in India, tuberculosis, nosocomial infections, the current status of infectious disease pathology, and combatting infectious disease threats are discussed.