Introduction: Needle Stick Injuries (NSIs) remain a prevalent occupational hazard among healthcare workers, particularly nurses and nursing students. These injuries pose substantial risks for the transmission of bloodborne pathogens, including Human Immunodeficiency Virus (HIV), Hepatitis B and C. Despite the implementation of safety protocols, NSIs continue to occur, necessitating an evaluation of healthcare professionals’ Knowledge, Attitudes and Practices (KAP) concerning injury prevention. Aim: To assess and compare the KAP regarding NSI prevention among nurses and nursing students. Materials and Methods: This cross-sectional study was conducted at Muzaffarnagar Medical College, Uttar Pradesh, India over a period of three months, from December 2024 to February 2025. A total of 207 participants were included, comprising 83 nurses and 124 nursing students, selected using proportionate stratified random sampling to ensure representation from both groups. The primary inclusion criteria were individuals currently working or studying in the nursing profession at the institution who consented to participate. Data were collected using a structured, self-administered questionnaire divided into four sections: demographic details and KAP. Demographic parameters included age, gender, educational qualification and work experience. Knowledge was assessed using multiple-choice questions, while attitude and practice were evaluated using a 4-point Likert scale ranging from “strongly disagree” to “strongly agree.” The study methodology involved initial orientation sessions, distribution of questionnaires during working hours and collection within 48 hours to ensure minimal data loss. Statistical analysis was carried out using Statistical Package for the Social Sciences (SPSS) version 24.0, with results expressed in frequencies, percentages, means and standard deviations. The chi-square test and t-test were used to assess associations and a p-value <0.05 was considered statistically significant. Results: The mean age was significantly higher among nurses (28.4±4.2 years) compared to students (22.1±2.8 years) (p-value <0.001). Gender distribution was comparable, with 27 males (13.0%) and 180 females (87.0%) (p-value=0.62). Work experience of ≤1 year was more common among nursing students (n=51, 41.1%) than nurses (n=10, 12.0%) (p-value<0.001). Good knowledge regarding NSIs was observed in 77 participants (37.2%), including 32 nurses (38.6%) and 45 students (36.3%); moderate knowledge in 107 (51.7%) and poor knowledge in 23 (11.1%) (p-value=0.853). A positive attitude was reported by 128 participants (61.8%), comprising 52 nurses (62.7%) and 76 students (61.3%); neutral and negative attitudes were seen in 59 (28.5%) and 20 (9.7%) participants, respectively (p-value=0.815). Good practices were reported by 115 participants (55.6%), including 47 nurses (56.6%) and 68 students (54.8%); moderate in 75 (36.2%) and poor in 17 (8.2%) (p-value=0.73), indicating no significant differences between the two groups in terms of knowledge, attitude, or practice. Conclusion: The study underscores the need for enhanced education and training programs to improve both knowledge and practices regarding NSI prevention. Continuous efforts are required to foster safer practices and ensure that healthcare workers, particularly nursing students, are adequately prepared to prevent NSIs in clinical settings.

Introduction: Thrombocytopenia, characterised by low platelet count, is a common haematological condition associated with various infectious diseases, including dengue and malaria. Understanding the relationship between the severity of thrombocytopenia and bleeding manifestations is crucial for effective patient management. Aim: To determine the clinical and aetiological profile of patients with thrombocytopenia and assess the association between the severity of thrombocytopenia and bleeding manifestations across different conditions. Materials and Methods: This cross-sectional study was carried out at a tertiary care hospital from July 2022 to January 2024 and a total of 197 patients with platelet counts below 150,000/μL were included. Patients were categorised based on their platelet counts and World Health Organisation (WHO, 1981) bleeding grades. Clinical data, including demographics, laboratory findings and bleeding manifestations, were collected and analysed. The need for platelet transfusion was assessed in relation to the severity of thrombocytopenia. Descriptive statistics were used and results presented in means and percentage. Results: Dengue (n=97, 49.2%), malaria (n=47, 23.9%) and sepsis (n=19, 9.6%) were the most frequent aetiological causes of thrombocytopenia, with P. vivax malaria diagnosed in 31 (65.9%) of the malaria patients. Physical examination revealed skin manifestations (petechiae, purpura, bruises, ecchymosis and hyperpigmentation) in 14 (60.9%) patients, followed by bleeding gums in 8 (34.8%) patients. The prevalence of moderate thrombocytopenia (75,000-150,000/μL) was noted in 73 (37.1%) patients, while only 40 (20.3%) had severe thrombocytopenia with platelet counts <25,000/μL. Among the 23 patients with bleeding, 16 (69.6%) had WHO grade 1, with 15 (65.2%) requiring platelet transfusion. Conclusion: The study highlighted the high prevalence of moderate thrombocytopenia in patients with dengue and malaria. Patients with moderate and severe thrombocytopenia presented with bleeding manifestations and required platelet transfusion.

Introduction: Oral Cavity Squamous Cell Carcinoma (OCSCC) is one of the most common cancers worldwide and a leading cause of morbidity and mortality in certain parts of the world like South-Central Asia. In the year 2005, the histologic risk assessment model was introduced by Brandwein Gensler for OCSCC to predict disease outcome and included risk factors like Perineural Invasion (PNI), Worst Pattern Of Invasion (WPOI), and Lymphocyte Host Response (LHR), which have a strong association with Local Recurrence (LR), Disease-Free Survival (DFS) and Overall Survival (OS). Aim: To evaluate WPOI in OCSCC and analyse its association with other histopathological prognostic indicators in patients who have undergone primary surgery. Materials and Methods: This cohort study was conducted in Department of Pathology at Regional Cancer Centre, Thiruvananthapuram, Kerala, India, from January 2023 to December 2023. A total of 100 cases of OCSCC diagnosed and treated between January 2018 and December 2021 were reviewed and clinical, histopathological and treatment data were analysed. The histopathological features analysed included grade, Lymphovascular Invasion (LVI), PNI, WPOI, LHR, tumour size, Depth of Invasion (DOI), margin status, bone invasion and lymph node status. The follow-up details of patients with respect to recurrences or terminal event was recorded from the medical records as of December 2023. Statistical Package for the Social Sciences (SPSS) version 28.0 was used for analysis. Chi-square tests and Fisher’s exact test were used to analyse association between WPOI in OCSCC and other histopathologic prognostic indicators. A p-value of <0.05 was considered significant. results: Most common pattern of invasion was WPOI 4, comprising 61 patients. WPOI 3 was present in 38 patients and only one case with WPOI 5. A statistical significance between WPOI 4 and the presence of PNI and LVI, with p-values of 0.017 and 0.012, was observed. There was no statistical significance between cancer stage and POI (p-value=0.885), LHR and POI (p-value=0.686), or tumour differentiation/grade and POI (p-value=0.298). The OS for POI 3 was 97.1%, while OS for POI 4 was only 86%. conclusion: This outcome demonstrates that the existence of WPOI 4 may be a predictive factor of the presence of LVI and PNI, which are established risk factors of aggressive tumour behaviour and poor prognosis in OCSCC.

Leiomyoadenomatoid Tumour (LAT) of the uterus is an exceedingly rare neoplasm characterised by the intermingling of Adenomatoid Tumour (AT) components within a leiomyoma. A very small number of cases of LAT have been documented in the literature to date, and this case series presents three cases of LAT diagnosed at our institution. An ultrasonogram of all three cases showed large uteri with multiple intramural fibroids, except for one patient with subserosal fibroids, for whom surgery was performed. Histopathological examination of some of the nodules revealed smooth muscle bundles infiltrated by small tubular structures lined with cuboidal cells. Immunohistochemical tests confirmed the diagnosis of LAT, showing positivity for calretinin and negative results for Cluster of differentiation 34 (CD34) and Cytokeratins (CK7 and CK20). As the mainstay of treatment is surgery, all patients remained asymptomatic after hysterectomy. This series highlights the significance of identifying LAT as a distinct pathological entity to prevent misdiagnosis and ensure proper treatment.

Introduction: Gestational Diabetes Mellitus (GDM) is a disease that is linked to a variety of disturbances in the carbohydrate metabolism, specifically recognised during pregnancy. It is crucial to detect gestational diabetes at an early onset because if the developing foetus is exposed to abnormal carbohydrate metabolism can lead to morbidity, such as macrosomia and unexplained Intrauterine Death (IUD). Aim: To compare serum ferritin levels in pregnant women with and without GDM. Materials and Methods: This was a cross-sectional study conducted at Father Muller Medical College Hospital, Mangaluru, Karnataka, India, from December 2018 to July 2020. Antenatal patients were studied under two groups: those diagnosed with GDM (test group) during routine antenatal check-ups (n=62) and another group of non GDM antenatal mothers (n=62). Serum ferritin levels from venous blood were estimated for both GDM and non GDM mothers between 24 and 34 weeks of gestation and analysed for the association between the groups using t-test. Results: The mean gestational age was 30.85±2.51 weeks in the GDM group and 30.23±2.29 weeks in the non GDM group (p=0.1744). The mean Body Mass Index (BMI) in the GDM group was significantly higher (25.06±1.55 kg/m2) compared to the non GDM group (24.73±1.81 kg/m2) (p=0.0023). Haemoglobin levels were similar between groups (p=0.3610). Serum ferritin was significantly higher in the GDM group (33.14 ng/mL) compared to the non GDM group (30.18 ng/mL) (p=0.003). Conclusion: The GDM is likely associated with higher serum ferritin levels compared to non GDM mothers. The increase in ferritin levels appeared to be independent of haemoglobin status. However, the high levels of ferritin observed in GDM group could be linked to higher BMI values rather than higher blood glucose levels. This indicates that serum ferritin levels in GDM mothers may be due to maternal fat and obesity, serving as an inflammatory marker.

Neuroendocrine neoplasms are unique, as many of them are associated with secretory properties and specific syndromes of uncontrolled hormone hypersecretion. Gastroenteropancreatic Neuroendocrine Tumours (GEP-NETs) represent the second most common digestive tract malignancy. Epithelial neuroendocrine neoplasms of the gastroenteropancreatic system are divided into Neuroendocrine Tumours (NETs) and Neuroendocrine Carcinomas (NECs). NETs are classified as G1, G2 and G3 based on their proliferative activity. NECs are further classified into Large Cell NEC (LCNEC) and Small Cell NEC (SCNEC) based on the morphology of the tumour cells. The present case series was aimed to present the histopathological spectrum of NETs of the GEP system with respect to clinical and imaging findings, as well as, the associated role of Immunohistochemistry (IHC) as a supplement to histopathological diagnosis. It consists of 10 cases collected over a two-year period from January 2022 to December 2023 at the State Cancer Institute, Gauhati Medical College, Guwahati, Assam, India. All cases of neuroendocrine neoplasms of the GEP system were included. There were seven resection cases and three biopsy cases. A total of (4/10) 40% of the cases belonged to the 40-50 years age group. A total of 5/10 (50%) cases were of the oesophagus, 2/10 (20%) were of the pancreas, and 20% (2/10) were of the rectum, while 1/10 (10%) was of the stomach. A total of 5/10 (50%) cases were SCNEC, 3 (30%) cases were mixed neuroendocrine non neuroendocrine neoplasms, and 2 (20%) cases were NETs (G1 and G3). GEP neuroendocrine neoplasms are sporadic, but they can be multiple and part of a familial syndrome. Assessment of the location and extent of GEP neuroendocrine neoplasms is crucial for management. Treatment consists of surgery, chemotherapy and somatostatin analogues. Challenges for the future include individualisation of treatment based on clinical and/or biological features and the evaluation of innovative therapies, including immunotherapy.

Introduction: Chronic Kidney Disease (CKD) patients undergoing haemodialysis are more prone for hypomagnesemia. A lack of magnesium can hasten the development of atherosclerosis and vascular calcification. The most widely used non invasive marker for assessing atherosclerosis risk is the measurement of Carotid Intima-Media Thickness (CIMT). The role of magnesium in cardiovascular health can be assessed by correlating serum magnesium levels with CIMT. Aim: To correlate postdialysis serum magnesium levels and atherosclerosis risk as measured by ultrasound-guided CIMT in CKD patients undergoing Maintenance Haemodialysis (MHD). Materials and Methods: A hospital-based cross-sectional study was conducted at KMCH Institute of Health Sciences and Research, Coimbatore, Tamil Nadu, India from May 2023 to July 2023. The study included 100 CKD patients undergoing MHD. Postdialysis, serum magnesium levels and CIMT were measured. Relevant laboratory investigations and clinical history were taken from the case records. Analysis of variance and Student’s t-test were employed for the statistical analysis of the data. The correlation between the parameters was assessed using Pearson’s correlation coefficient. Results: The mean magnesium level was 1.5±0.3 mg/dL, 36% of the study population had hypomagnesemia. The mean right- side and left-side CIMT in the study population were 0.56 mm and 0.6 mm, respectively. There was a negative correlation between CIMT and magnesium (Right CIMT r-value=-0.046, p-value=0.651; Left CIMT r-value=-0.066, p-value=0.512), but it was not statistically significant. CIMT showed a significant negative correlation with serum creatinine (Right CIMT r-value=-0.220, p-value=0.029; Left CIMT r-value=-0.126, p-value=0.216) and serum phosphate (Right CIMT r-value=- 0.256, p-value=0.017; Left CIMT r-value=-0.233, p-value=0.030). CIMT showed a significant correlation between with duration of hypertension (Right CIMT r-value=0.299, p-value=0.003; Left CIMT r-value=0.232, p-value=0.020) and dialysis (Right CIMT r-value=0.288, p=0.004; Left CIMT r-value=0.204, p-value=0.041). Conclusion: There was a negative correlation between CIMT and serum magnesium levels, but it was not statistically significant. Thus, decreased serum magnesium levels may be an additional risk factor, along with disordered homeostasis of calcium, phosphorous, duration of dialysis, diabetes and hypertension, for developing adverse cardiovascular events.

Introduction: Platelet count estimation is a critical diagnostic tool in various haematological disorders. In resource-limited settings, manual methods are often employed due to cost constraints. However, their accuracy compared to automated haematology analysers requires validation. Aim: To assess the accuracy, reliability and agreement of manual and automated platelet count estimation methods. Materials and Methods: A cross-sectional study was conducted at Swami Ramanand Teerth Rural Government Medical College, Ambajogai, Maharashtra, India from January to March 2024, involving 250 blood samples. Peripheral venous blood was collected in Dipotassium Ethylenediaminetetraacetic Acid (K2EDTA) tubes. Platelet counts of 250 patients were estimated using both manual methods (peripheral blood smear microscopy with Leishman stain) and an automated haematology analyser (Erba Manheim Elite 580). Data were analysed using Statistical Package for the Social Sciences (SPSS) version 29.0. Descriptive statistics, paired t-tests, Pearson correlation coefficient, Bland- Altman analysis, Intraclass Correlation Coefficient (ICC), and One-way Analysis of Variance (ANOVA) were employed. Statistical significance was set at p-value <0.05. Results: Of the 250 cases analysed, a strong positive correlation (r=0.98, p-value <0.001) was observed between manual and automated platelet counts. Bland-Altman analysis, which assesses agreement between two methods by plotting the difference against the average of the methods, revealed a mean bias of 5.72×10³/μL (95% limits of agreement: -0.01 to 11.45×10³/μL), indicating clinically acceptable agreement. Although a statistically significant difference (p-value=0.03) was found between mean counts, its clinical relevance was minor. Agreement remained consistent across age and sex subgroups, with an ICC of 0.98 (95% CI), reflecting excellent reliability. Conclusion: This study validates the manual platelet count estimation method as a reliable and cost-effective alternative to automated analysers in resource-constrained settings. However, rigorous training and adherence to standardised protocols are essential for accurate results. Further research is recommended to validate these findings in diverse populations and clinical scenarios, enhancing the applicability of manual methods in rural healthcare settings.

Odontogenic tumours are a heterogenous group of lesions that range from hamartomas to benign and malignant neoplasms. 2022 World Health Organisation (WHO) classification classifies benign odontogenic tumours based on their origin from epithelial, ectomesenchymal, or mixed components of odontogenic apparatus. However, there have been isolated case reports and case series of hybrid odontogenic lesions having combined histopathologic features of two or more recognised odontogenic cysts or tumours, affecting the same primary site. These group of lesions are a challenge to pathologists and surgeons, as their histogenesis and clinical behaviour is poorly understood. Adenoid Ameloblastoma with Dentinoid (AAD) is one such variant showing features of both ameloblastoma and Adenomatoid Odontogenic Tumour (AOT) and a high propensity for recurrence. Hereby, the authors present a case of a 36-year-old male who presented with a slow growing right-sided mandibular swelling of five months’ duration. Radiologically, there was a well- defined unilocular radiolucent lesion with smooth margins related to 1st and 2nd premolars and 1st molar. Magnetic Resonance Imaging (MRI) revealed a mixed density mostly cystic lesion involving right mandible. Histologically {Haematoxylin and Eosin (H&E)} the tumour showed hybrid features of ameloblatoma and Adenomatoid Odontogenic Tumour (AOT), with dentinoid formation. Authors report present case owing to the rarity of the lesion, as fewer than 50 cases have been reported in the literature to date.

Introduction: Choledochal cyst is an uncommon congenital anomaly of the biliary tract, with a higher incidence seen in Asia. It is commonly associated with Pancreaticobiliary Malunion (PBMU). It is believed to be caused by two factors: weakness of the wall and obstruction distal to it. Choledochal cysts can be roughly classified into two types according to the shape of the common bile duct: cystic dilatation and fusiform dilatation. They may be intrahepatic, extrahepatic, or both. Recognition and management of choledochal cyst disease are important due to the risk of developing cholangiocarcinoma and various pathological changes in liver tissue. Aim: To investigate hepatocellular changes, with particular attention to fibrosis, in paediatric patients with choledochal cyst. Materials and Methods: A descriptive cross-sectional study was carried out in the Outpatient Department (OPD), Institute of Postgraduate Medical Education and Research, SSKM Hospital, Kolkata, West Bengal, India, from October 2017 to September 2019. A total of 48 cases from both sexes in the paediatric age group were collected over a period of one year and eleven months. After obtaining clinical histories, histopathological examinations were performed on all cases to diagnose choledochal cyst and to assess the associated hepatocellular abnormalities. Routine Haematoxylin and Eosin (H&E) stained slides were examined, and reticulin staining was also conducted for a better assessment of fibrosis in hepatic tissues. All available information was meticulously documented in tables and charts. For data analysis, Microsoft Excel 2007 and Statistical Package for Social Sciences (SPSS) software version 16.0 for windows were used. Results: Majority of the patients 23 (47.91%) were between 1 year and 6 years of age. There was variation in the histopathological findings, with age-wise distribution of different changes in liver tissue documented. Reticulin-stained slides showed prominent fibrosis in liver tissue, which is associated with poor prognosis. The data indicated that there were an equal number of patients (50%) with histologically proven liver cirrhosis in the <1 year and 1-6 years age group. There were no cases of cirrhosis in the >6-12 years age group. Eight cases of liver fibrosis were observed, ranging from mild to severe, while the remaining 40 cases presented with no fibrosis. Among those with fibrosis, 2 cases (25%) were in the <1 year category, 5 (62.5%) cases were in the 1-6 years category, and 1 (12.5%) case was in the >6-12 years category. Conclusion: Fibrosis and cirrhosis were found to be more common in children aged 1-6 years compared to older children. Reticulin staining is an excellent method for confirming the presence of increased fibrosis in the liver, and these findings are very helpful for assessing prognosis and following-up with patients.