This prospective randomized controlled study was conducted on 105 cases of pregnancy hypertension and 100 normotensive mothers in third trimester of pregnancy. The aim of the study was to determine the association between the elevated levels of maternal serum beta-hCG (MS-beta-hCG) with type and severity of hypertension and adverse pregnancy outcomes in these patients. Elevated levels were noted in 48.6% cases of pregnancy hypertension compared to controls, where the levels were elevated in 2% cases (P < 0.001). Elevated levels were more commonly seen in proteinuric pregnancy induced hypertension (32.4%) and also when the hypertension was severe (30.4%). The results of this study establish a strong association of elevated MS-beta-hCG levels with pregnancy hypertension and poor pregnancy outcomes in these patients.

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Fish meal extract bile esculin agar (FMBE) is prepared using Fish meal extract concentrate as the basal substance, for the selective isolation and presumptive identification of B.fragilis group. The efficiency of the medium was evaluated by growing stock cultures of B.fragilis groups as well as inoculating clinical specimens and comparing the results with Bacteroides bile esculin agar (BBE). All the 87 stock cultures of B.fragilis grew on FMBE and BBE. No other anaerobes tested grew on the medium. However 7 out of 65 neomycin resistant aerobes grew on the FMBE. From the 100 clinical samples, 62 strains of B. Fragilis group were recovered on FMBE and BBE, and 53 strains on supplemented BHIBA. The cost effectiveness, selectivity and the ability to detect esculin hydrolysis will enable FMBE as a suitable medium as comparable to that of BBE, if not superior.

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A total of 75 clinically diagnosed and radiologically evident cases suggestive of pulmonary tuberculosis were selected for study. Sputum sample of each patient was screened for AFB by Ziehl Neelsen staining and culture. On examination 20 smears were found positive for AFB and 55 smears were negative by concentration method. A total of 23 samples were found to be culture positive and 52 were culture negative. Of these, 22 stains were identified as Mycobacterium tuberculosis, one was identified as M. Scrofulaceum. Of the 75 patients 3 were seropositive for HIV-I antibodies. Out of these 3, one was found to be smear and culture positive and was identified as M. scrofulaceum. Other two seropositive patients were smear and culture negative for AFB.

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Epstein Barr-Virus (EBV) is a lymphotropic herpes virus, well recognised for its oncogenic properties. In recent years substantial evidence has accumulated supporting a role for EBV in the pathogenesis of Hodgkin's disease. The epidemiologic and histologic features of Hodgkin's disease (HD) have long indicated a possible infective cause. Our study involves the detection of the EBV encoded latent membrane protein 1 (LMP-1) in 45 cases of Hodgkin's disease using immunohistochemical methods. In this study we detected LMP-1 positivity in the Reed-Sternberg and Hodgkin's cells in 31% of cases of HD. In mixed cellularity the positivity was 21.7% while nodular sclerosis exhibited positivity of 50% of the cases. The lymphocyte depletion subtype showed 100% positivity. All cases of lymphocyte predominance and the single unclassified case were negative for LMP. The demonstration of LMP-1 in Hodgkin's disease has important implications since it is one of the latent gene products which produces B Lymphocyte transformation.

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Clinical and pathological findings in a case of aggressive angiomyxoma, a distinctive soft tissue tumour arising in the vulva of a young female are described. The neoplasm is non malignant, but locally aggressive.

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A total of 148 surgically removed benign and malignant breast lesions were studied to correlate cytomorphologial features in impression smears and histopathological sections. Mammograms were taken prior to surgery. Role of mammography in detection of non-palpable breast lesions was enlightened. Impression smears helped in quick diagnosis (intraoperative) and overall accuracy obtained was 97.4%. Cluster predominant and Grade II nuclear grading on smear pattern was seen in 58.8% and 57.4% cases respectively amongst the 68 malignant cases. 45% cases revealed non-palpable breast lesions on mammography which was later confirmed on histopathology.

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Mucin histochemistry of colo-rectal mucosa was studied in 124 biopsies which included 28 specimens from normal mucosa, 35 inflammatory lesions, 20 polyps, 26 malignant lesions and 15 specimens from transitional mucosa. The stains used were Haematoxylin and Eosin, Periodic acid schiffs, Alcian blue--Periodic acid schiffs (pH 2.5), Orcein--Alcian blue and Periodic acid sodium borohydride saponification. Normal mucosa, mucosa from inflammatory lesions, juvenile and hyperplastic polyps had neutral mucin in traces along with O-acylated sialomucins and sulphomucins. Predominant changes in adenomatous polyps and malignancy were a significant loss of sulphomucins and O-acylation at position C7, C8 or C9 in sialomucins. The changes in transitional mucosa were more on the pattern of malignant lesions. The alterations in the amount and/or pattern of mucin in colorectal mucosa has been found to predate frank morphological changes of malignancy. A routine use of mucin histochemistry in suspicious colorectal biopsies might be helpful in diagnosing premalignant and early malignant lesions in otherwise apparently normal colorectal mucosa or mucosa with chronic inflammatory changes and thereby reduce mortality.

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Present study relates to the results of anti-PPD IgG, anti-A60 and antinuclear antibodies and PPD-induced delayed type hypersensitivity (DTH) in 17 anterior uveitis, (AU) patients. Results of anti-PPD IgG assay revealed detection of higher mean antibody level (O.D. 0.11 +/- 0.06) compared to healthy controls (O.D. 0.04 +/- 0.03), other eye disease controls (O.D. 0.05 +/- 0.003) and leprosy controls (O.D. 0.03 +/- 0.03). Anti-A60 IgM antibody assay revealed insignificant differences in mean antibody levels between various groups. Four of 17(23.5%) AU patients and 1(5.8%) subject each, belonging to other eye disease and healthy control groups had raised anti-nuclear antibody index. Findings of PPD skin test revealed detection of moderate to strong (2 to 4+) reactivity in 14 (82%). AU patients. Conversely, 13(76%) healthy controls and 8(47%) other eye disease controls gave mild (1+) reactivity. Results of this study suggested possible role of hypersensitivity to mycobacterial antigens in pathogenesis of anterior uveitis.

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Serum ferritin (SF) and lactate dehydrogenase (LDH) was estimated in 117 patients presenting with a breast lump and in 40 controls. Both pre and post treatment values were determined. Both the values were significantly higher in breast malignancies (p = 0.00) and also corresponded with the clinical stage and bulk of the tumour. The fall in post treatment values was proportional to the response to therapy. Persistent rise in values in the post treatment period was indicative of local recurrence of metastasis.

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Sixty HIV seropositive cases studied of inter-relationship of coexistent infections with tuberculosis and oral candidosis. Presence of oral candidosis either symptomatic/asymptomatic as revealed on microbiological studies have been recorded and the significance discussed. Presence of oral candidosis apparent of nonapparent with heavy growth, yield on culture in HIV seropositive cases could be considered a pointer of conversion of HIV infection to a disease. This observation needs further evaluation. Relevant literature reviewed briefly.

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A total of 734 serum specimens from various clinical disorders along with 100 control samples from healthy subjects were processed for estimation of serum IgG, IgA and IgM employing single radial immunodiffusion procedure. Immunoglobulin deficiency, either selective or combined was noted in 31 males and 24 females in all age groups. Of the 55 cases encountered it was secondary immunoglobulin deficiency which was seen on a larger scale and encountered in patients with Multiple myeloma (16 out of 32) followed by Leprosy (14 out of 250), Lymphoma (5 out of 43), Malaria (4 out of 137), Burns (4 out of 52), Rheumatoid arthritis (2 out of 69) and non lymphoreticular malignancies (1 out of 41) in decreasing order of frequency. Primary immunoglobulin deficiency was observed in nine cases comprising of six belonging to Idiopathic late onset immunoglobulin deficiency, two of dysgammaglobulineamia and a solitary case of Ataxia telangiectasia. Panimmunoglobulin deficiency was observed in six cases, 11 had a dual deficiency while 38 showed deficiency of an isolated class with selective IgA deficiency in 20 cases. Furthermore, one patient each had total absence of IgG or IgA while IgM was not detectable in seven patients. A high suspicion index along with a regular rapport between the clinician and the laboratory personnel is necessary in the diagnostic set up of immunoglobulin deficiency states.

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A case of mucinous adenocarcinoma of the renal pelvis is added to those so far reported. Association with long standing chronic infection and large renal calculi is emphasized. The occult gross appearance of most of these tumours may lead the pathologist to overlook their presence. Hence, any kidney with the proper setting must be carefully looked for this entity.

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Primary adenocarcinoma is a rare tumour involving the fallopian tube. Two such cases are reported; the first case was associated with papillary carcinoma of the paratubal cysts and the second occurred in a young female.

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During 1992, 1993 and 1994 a total of 65, 123 and 142 faecal samples respectively yielded 9, 54 and 87 strains of V. cholerae. Simultaneous occurrence of EL TOR vibrio and non 01 (i.e. 0139) was noted during 1993 and 1994 with variations in relative and absolute prevalence of each serotype. Seasonal incidence is fairly consistent in this region. Both V. cholerae serotypes 01 and 0139 showed resistance to one or more drugs.

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Renal angiomyolipoma with tuberous sclerosis has not yet been reported in Indian literature. We report a case of bilateral angiomyolipoma associated with tuberous sclerosis in a 25 year old man.

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Wilms' tumour, an embryonic neoplasm, the most common renal tumour in childhood, had occasionally been reported in adults. Authors report two such cases and have reviewed the relevant literature. While Wilm's tumour in children classically demonstrates the curative potential of combined modality treatment, no such clear guide lines are available for those occurring during adulthood. Pathologic diagnosis of adult Wilm's tumour is difficult because of the multiplicity of undifferentiated adult tumours that must be considered in the differential diagnosis. As no predictive parameters for optimal therapy exist, a combination of surgery, irradiation and chemotherapy probably is indicated for all stages of disease.

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A total of 257 Proteus strains isolated from urinary tract infection, blood, wound and faeces were studied. Of the strains tested 31 (12 percent) were serum sensitive, 182 (71 percent) were serum resistant and the remaining 44 (17 percent) showed intermediate sensitivity to the pooled normal human serum (PNHS). Strains isolated from adult urines and blood cultures were significantly more sensitive than strains of faecal origin (p < 0.01). No significant difference was seen between strains from faeces and wounds.

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A case of multiple myeloma associated with HIV disease and hepatosplenomegaly presented to us as pyrexia of unknown origin, is reported. Because of paucity of such cases in the literature, the case is dealt in detail and the literature reviewed briefly.

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Metastasis of tumours are known to occur in the rarest of sites in the human body. But one of the truly rare phenomena in surgical pathology is to find the metastasis of one tumour into another. We report one such case of metastatic carcinoma in uterine leiomyoma from an occult primary site.

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Bacteriodes fragilis group can inhibit the phagocytosis and killing of co-existing aerobes. Forty six strains of B.fragilis group are tested for their ability to resist phagocytosis and inhibit the killing of indicator organism, E. coli by denoting the viable count. Among the species of B. fragilis group, the inhibitory index of the phagocytic system was the highest with B. fragilis followed by B. thetaiotamicron. None of the strains of B. fragilis group were phagocytosed or killed in this system. This property of resisting the phagocytosis and killing of E. coli by B. fragilis group might be the contributing factor towards their prevalence in mixed infections.

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In this study, clinical, histopathological and immunological profiles were analysed in ten patients with inflammatory myopathies. Polymyositis and dermatomyositis were more common than other forms of inflammatory myopathies. The pathogenetic mechanisms and distinguishing histopathological and immunological profiles between polymyositis and dermatomyositis have been highlighted.

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An attempt was made to study the histological and histochemical changes as well as immunohistochemical changes in desmin expression occurring in four types of clinical myopathies e.g. Chronic ischaemic myopathy due to Buerger's disease (Group I), Carcinomatous myopathy (Group II), Metabolic myopathy (Group III) and Muscular dystrophy (Group IV). The number of cases studied were 16 cases, 15 cases, 4 cases and 5 cases respectively. The study revealed: (i) a combination of normal, degenerated, necrotic and regenerating fibres in different proportions in all the four groups having maximum number of degenerated fibres in Group I and Group IV, relatively more number of regenerating fibres in groups III and absence of necrotic fibres in Group I. (ii) Altered tinctorial property in most of the fibres indicating degenerated and regenerating fibres in all the groups with Masson's trichrome staining against inconstant staining with PTAH appear to be a good indicator for myopathy. (iii) The Desmin expression was week and irregular in most of the cases with most of the fibres probably due to reduction of desmin content probably indicating degenerated fibres, appear to be a good indicator for myopathy. (iv) Chronic ischaemic myopathy showed close resemblance with muscular dystrophy though no typical or distinct distinguishing feature could be identified in these four groups.

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