Iron status was estimated in 463 heterozygous beta-thalassaemics to delineate the effect of iron deficiency (ID) on the haematological parameters and expression of HbA2 in these patients. One hundred and twenty six (27.2%) traits had coincident ID. These iron deficient traits had a significantly (p < 0.0002), higher prevalence of anaemia (90.5%) as compared to iron replete traits (71.5%). Mean haemoglobin concentration was significantly lower (p < 0.0001) in beta-thalassaemics with ID (10.7 +/- 1.5) g/al as compared to those without ID (11.6 +/- 1.6 g/dl). Mean MCV and MCH were significantly lowered (p < 0.0001) in patients of beta-thalassaemia trait (BTT) with ID than in these without ID. Mean HbA2 was not significantly different in the two groups of traits and was elevated (> or = 3.5%) in all except one patient. However, mean HbA2/cell was significantly (p < 0.05) lower in traits with ID. The effect of ID in BTT was apparent with significant lowering of haemoglobin concentration and increased prevalence of anaemia. Iron therapy is warranted in iron deficient traits and would help in significantly raising their haemoglobin concentration. Elevation in HbA2 values was striking and could be used with reliability for diagnosis of BTT even in the presence of ID.

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Twenty two patients with tumours or tumour-like conditions of the para-testicular region (PTR) were diagnosed over a 5 year period. Of these, 16 (73%) were benign with only one true neoplasm (papillary cystadenoma). The tumour-like conditions were comprised of 6 cases of adenomatous hyperplasia of epididymis, 4 cases of spermatic granuloma, 2 cases each of spermatocele and nodular-fibrous proliferation and one mesothelial cyst. Three patients with spermatic granuloma gave a history of trauma. No case of adenomatoid tumour was encountered. Six malignant neoplasms were diagnosed (27%) all of which were sarcomas. Five were primary to the PTR and one was a metastatic deposit from a primary leiomyoblastoma of the mesentery. Among the 5 primary sarcomas were 2 cases each of rhabdomyosarcoma and leiomyosarcoma, and 1 case of liposarcoma. The patient with leiomyoblastoma presented first with a measenteric mass which was followed a month later by a rapidly growing mass in the scrotum. Immunohistochemical staining (IHC) and Electron microscopy (EM) were done in this case. Intra-cytoplasmic myofilaments as well as desmosomes were observed. The patients ranged from 14 to 65 years of age and most presented with painless mass in the scrotum. Follow-up was not possible due to practical difficulties.

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A case of paragonimiasis in a civet cat with a new Paragonimus sub species in Manipur, India.

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In our study we investigated 100 couples of unexplained infertility in order to detect the presence of anti-spermatozoal antibodies. Both auto-immunity and Iso-immunity have been found responsible in 12.5% of couples of primary infertility & 10% of couples of secondary infertility. As many as, 21% of cases of unexplained infertility were attributed to presence of antibodies in sera of infertile couples. Here, we highlight the importance of anti-spermatozoal antibodies testing in the first instance itself in cases of unexplained infertility.

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398 symptomatic cases of vaginitis and 43 asymptomatic healthy women were subjected to cervical cytology and microbiological investigations for detection of Bacterial vaginosis, G. vaginalis, T. vaginalis, C. albicans and M. hominis. Cervical inflammatory changes were reported in 81.4% of cases and 60.4% of controls (p < 0.05) and were significantly associated with Bacterial Vaginosis and G. vaginalis infection (p < 0.01). Cervical inflammation was detected in all cases of Trichomonasis.

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Langerhans cell Histiocytosis--a lesion characterised by proliferation of a variant of epidermal dendritic cell is one of the several syndromes in which histiocytes play a principal role in pathogenesis outside the context of inflammatory and metabolic storage disease. Seven cases were diagnosed as Langerhans cell Histiocytosis over a period of six years. The mode of diagnosis was Fine needle aspiration in 2 cases, open biopsy in four, and both biopsy and FNAC in one. The age range was from 2 months to 58 years and four of the seven patients were males. The lesion was unifocal in 3 cases (two in bone and one involving skin and soft tissue), multifocal in 3 and systemic in one. Electron microscopy was done in one case to demonstrate Birbeck granules. Immunohistochemical demonstration of S 100 protein was done in one case. The clinicopathologic spectrum of Langerhans cell Histiocytosis is brought out in this presentation of seven cases.

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The association between human immunodeficiency virus (HIV) infection and syphilis infection as an etiological factor in Gestational Trophoblastic Disease (GTD) was investigated by means of micro-enzyme linked immunosorbent assay (Micro-ELISA) and Treposcreen-Rapid Plasma Reagin Card Test in 138 sera from patients with Gestational Trophoblastic Disease. We have found only one sample to be positive for HIV infection and one for VDRL. These findings suggest a lack of an etiologic role for the HIV and Syphilis infection in GTD.

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Myofibroblastoma of the breast is a recently described entity. Since its first description in 1987, less than 50 cases have been reported. We present the first (reported) myofibroblastoma to be detected as a non-palpable mass on a routine screening mammogram and emphasize the importance of not mis-diagnosing this rare cellular lesion as malignant on frozen section. Review of the literature demonstrates changes in the clinical presentation of myofibroblastomas. Once considered more common in men than in women, myofibroblastomas are now being reported with increasing frequency in women. The age at presentation is a decade earlier, and not surprizingly, the size of the earlier detected lesion is smaller. Recently four different cytoskeletal phenotypes (V, VA, VAD and VD) of myofibroblastomas have been described, depending upon the vimentin (V), actin (A), and desmin (D) immunoreactivity. Whereas vimentin reactivity is universal, actin and desmin immunoreactivity is variable, desmin being more frequently positive than actin. As more is known about the clinical behavior of myofibroblastomas, their rate of recurrence and malignant potential, if any, the relationship of the cytoskeletal content to prognosis may become clearer. Currently, complete immunohistochemical analysis and electron microscopic examination of this interesting breast lesion is recommended. List of abbreviations-Vimentin (V), actin (A), and desmin (D), vimentin and actin (VA), vimentin and desmin (VD), vimentin, actin and desmin (VAD).

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Nucleolar organiser regions (NOR) are chromosomal segments coding for ribosomal RNA. The number of nucleolar organiser regions correlates with cellular proliferation and has a diagnostic and prognostic value in neoplastic diseases. The aim of this study was to study the morphologic subtypes of squamous cell carcinoma of the uterine cervix in biopsy and hysterectomy specimens and to determine the AgNOR counts in these morphologic subtypes. One hundred and seventy-nine cases of squamous cell carcinoma of the uterine cervix were classified into three morphological subtypes namely large cell non keratinising squamous cell carcinoma (113), keratinising squamous cell carcinoma (64) and small cell carcinoma (2). A correlation of histologic typing on biopsy and hysterectomy specimens was done in 142 cases with a complete correlation in 90.5%. Fifty-eight of these tumours were stained with silver nitrate to demonstrate Nucleolar organiser regions (AgNORS). The mean AgNOR count was higher (3.66) in keratinising squamous cell carcinoma, which is known to have a worse prognosis as compared to 3.04 in large cell non keratinising carcinoma and (3.45) in the two cases of small cell carcinoma of the uterine cervix.

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Malignant mesenchymal tumours of the breast are rare neoplasms. Their incidence varies from 1%-3% of all malignant breast tumours (1). Stromal sarcoma of the breast is an extremely uncommon tumour (2). We present a rare case of advanced stromal sarcoma of the breast successfully managed with radical surgery and radiotherapy.

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Seventy-six cases of international meningiomas were studied using staining for Proliferating Cell Nuclear Antigen (PCNA) and silver nucleolar organizer regions (AgNORs) in order to find out any correlation of these parameters to the histological typing of the tumours and their biological behaviour. Histologically, 35 of the 76 cases were benign, 12 atypical and 19 malignant. Ten cases were recurrent. A male preponderance with a male: female ratio of 1.6:1 was noted. Five of 76 cases were in children below 15 years of age. Majority of the tumours were convexity meningiomas. Overall PCNA labeling index (LI) values ranged from 0.1% to 11.0%. Benign group had an LI of 0.9 +/- 1.42 whereas atypical, malignant and recurrent group had LIs of 4.06 +/- 2.33, 2.91 +/- 2.66 and 3.36 +/- 3.76 respectively. One way analysis of variance test showed a significant difference in the distribution of LI between benign versus atypical, malignant and recurrent group (P < 0.05). A highly significant difference was also observed between PCNA LI of recurrent benign group versus non-recurrent benign group (p < 0.01, wilcoxon Rank Sum Test). On further classifying the tumours based on LI values, it was observed that 30 of 41 (73%) cases of combined atypical, malignant and recurrent group (i.e. biologically more aggressive group) had LI of > 1%, whereas 26 of 35 cases (74%) belonging to the benign group had LI of < 1%. Overall AgNOR counts ranged from 1.27 to 3.11. No statistically significant difference was found in AgNOR counts amongst the different groups of meningiomas. There was no correlation between PCNA LI and AgNOR counts. It was thus concluded that PCNA LI but not AgNOR counts in the primary tumour could be of potential value for more accurate assessment of biologic behaviour of meningiomas in conjunction with the conventional A histological parameters.

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A total of 85 urine samples from 63 patients with neurogenic bladder, were subjected for pus cell counting and culture. Fifty nine (69.4%) samples showing significant bacterial growth were tested for the presence of antibody coated bacteria (ACB). One serum sample per patient was collected for the estimation of C-reactive protein. E. coli was the commonest bacterial isolate (45.8%) from the clinical samples followed by Ps. aeruginosa (20.3%) and K. pneumoniae (18.6%). Thirty two culture positive samples belonging to 27 patients, were found to be antibody coated. Of all the isolates, K. pneumoniae was antibody coated in higher proportion (63.7%) followed by Ps. aeruginosa (58.3%) and E. coli (55.6%). Immunoglobulin G was found in all the ACB positive samples, where as 87.5% of them were also coated with IgA class of antibodies. All patients with ACB in urine had raised serum CRP levels except one, where as all the rest of the patients had CRP level within normal limit. The presence of pus cells in urine and radiological abnormalities in the urinary tract were significantly higher in ACB positive patients than in ACB negative patients.

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One hundred four Rheumatoid factor (RF) positive Rheumatoid Arthritis (RA) patients fulfilling ARA criteria were screened for extraarticular manifestations. Rheumatoid nodules were present in 2.8% cases. Other extraarticular manifestations such as pulmonary, cardiac, occular, renal or GI involvement were absent in these cases. However, circulating immune complexes (CICs) were highly significantly raised in all the RA patients (P < 0.001). From amongst these cases a limited number (8 cases) have been subjected to qualitative and quantitative analysis of CICs to look for whether there could be any relationship between these and mild extraarticular manifestations that were being noticed in our groups of patients. Finding showed IgG-IgG CICs in five, IgG-IgM in two and IgG-IgA in one case. Quantitative analysis revealed mean IgG 4.97 +/- 1.7 IU/ml, IgM 14.58 +/- 5.53 IU/ml and IgA 5.08 +/- 1.53 IU/ml on LD Solugen plates. Serum concentration of C3 was not reduced (94.1 +/- 8.9 mg/dl). Low IgM contents of CICs and no reduction in complement level is the likely explanation for less severe inflammatory manifestations seen in our study. The conclusion and findings have been discussed in the light of observation reported by the Western workers.

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Present study has given an insight in to the value of the DNA in relation to other morphometrics. Breast cancer shows variability in clinical course in the same clinical stage. Cellular DNA content is an important prognostic parameter. Tumour tissue DNA content is correlated with known histopathological prognostic feature assessing its significance as prognostic parameter in 25 cases of carcinoma breast. The findings showed that cellular DNA content ranged between 1.5-5.08 ug/mg in cancer breast tissue with an average of 2.54 ug/mg as compared to an average of 1.34 ug/mg in normal breast tissue. The DNA content was higher in combined pattern, in poorly differentiated duct carcinoma and in patients with positive lymph node metastasis. No consistent relationship could be seen between cellular DNA and desmoplasia and lymphoreticular response in and around tumour.

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