Department Of Pathology Research Articles

Cytomorphological spectrum of breast fine needle aspiration cytology using the International Academy of Cytology Yokohama System and evaluation of associated risk of malignancy–A retrospective study in a tertiary care cente

BackgroundFine-needle aspiration cytology (FNAC) of the breast is a well-established technique that aids in the preoperative identification and differentiation between nonneoplastic and neoplastic breast lesions. Breast lesions can be efficiently categorized into different cytological groups using the International Academy of Cytology (IAC) Yokohama System. The aim of this study was to classify breast lesions based on the proposed Yokohama system of reporting breast cytology and identify the need for a unified system of reporting breast lesions.Materials and methodsThis retrospective descriptive study was performed in the Department of Pathology, Government Medical College, Datia, M.P. from January 2019 to June 2023. A total of 762 FNAC slides reported during this period were retrieved, re-examined and reclassified according to the IAC Yokohama System. Histopathological diagnoses were also retrieved and correlated with the cytological findings wherever available.ResultsIn the present study, a total of 762 smears of breast fine needle aspirations were included and categorized using the IAC Yokohama System. There were 3.8% cases (29/762) in the C1 category (insufficient), 71.6% cases (545/762) in the C2 category (benign), 6.3% cases (48/762) in the C3 category (atypical), 3.1% cases (24/762) in the C4 category (suspicious for malignancy) and 15.2% (116/762) cases in the C5 category (malignant).ConclusionFNAC is a reliable diagnostic technique for the evaluation and management of breast lesions prior to surgery. Implementing the IAC Yokohama System for reporting breast cytopathology enhances the accuracy of diagnosing breast lesions, reduces missed diagnoses, and offers reliable estimates of risk of malignancy. Adopting the Yokohama system is a crucial first step in boosting the overall effectiveness of breast cytology reporting among clinicians and pathologists, which will ultimately lead to improved communication and patient care.

Histopathological analysis of skin adnexal tumors: An experience at a tertiary center.

Skin appendage tumors (SATs) are benign and malignant neoplasms. Although there are many studies on their clinical features and epidemiology in the literature, most of these studies have a small number of patients and are not classified according to the WHO 2018 classification. This study aimed to reveal the clinical and histopathological features of the SATs and compare the pre-diagnosis. Cases diagnosed with SATs in the last 7 years in the Pathology Department were re-evaluated according to the WHO 2018 classification. Patients' ages and genders, as well as the location and pre-diagnosis of the lesion, were all recorded. A total of 437 patients, 198 (45.3%) male and 239 (54.7%) female, were included in the study. Of 437 patients, 399 (91.3%) were diagnosed with benign SATs and 38 (8.7%) were diagnosed with malignant SATs. Most of the cases were benign tumors with follicular differentiation. Malignant SATs were seen in patients significantly older than benign ones. The majority of SATs were in head and neck localization. Mammary Paget's disease was the most common malignant SAT (n = 14, 36.8% of patients diagnosed with malignant SATs). It was noted that clinicians were less likely to consider a specific diagnosis of SAT before excision. SAT, a diagnosis that can be seen at any age and is difficult to predict clinically, may be malignant, especially in elderly patients. Histopathology is the gold standard in diagnosing SATs, and immunohistochemical staining may be useful in diagnosing tumors with uncertain histopathological features.

Reducing reflex first-line prescriptions in a surgical pathology laboratory: toward sustainable practice with positive economic and clinical effects.

In surgical pathology departments, reflex first-line techniques (RFLTs) are aimed at reducing workloads and addressing recent shortages of medical personnel. However, the impacts thereof on economic and diagnostic factors have been poorly addressed. Also, in the era of global warming, environmental considerations are crucial. This study assessed the economic and diagnostic efficacies of routine pathological RFLT and the quality of care and sustainability. Ten RFLTs of the Bordeaux University Hospital pathology department (six special stains, one cytology technique, and three immunohistochemical tests) were studied. First, a retrospective economic analysis evaluated the average cost of these RFLTs per slide and per year. Second, diagnostic relevance was prospectively surveyed. Third, the effects of changes made were analyzed over 2years. The ten RFLTs were associated with average annual costs of €46,708. Diagnostic relevance analysis indicated that most stains were unnecessary; only 17% were requested as second-line techniques. Elimination of 7/10 tests afforded annual cost savings of €22,522 and reduced the workload by 5568 tests/year, without compromising the workflow or diagnostic quality. Seven of ten RFLTs could be eliminated without compromising diagnostic quality or the workflow. This afforded not only financial benefits but also positive social and environmental impacts. We offer valuable insights into appropriate practices in surgical pathology laboratories. Collaboration between the medical and technical teams was crucial; other healthcare sectors would also benefit from our approach.

Assessing the Effectiveness of Neem oil and Microalgae in the Management of Cowpea (Vigna unguiculata L.) Leaf Spot Caused by Alternaria spp.

The current study aimed to assess the effectiveness of neem oil and microalgae in controlling leaf spot caused by Alternaria spp. in cowpea (Vigna unguiculataL.). The research was conducted during the Zaid season of 2022 at the Central Research Field of the Department of Plant Pathology, SHUATS, Prayagraj, Uttar Pradesh, using a Randomized Block Design with three replications and seven treatments. Analysis of variance (ANOVA) was utilized to draw conclusions from the data. Leaf spot disease caused by Alternaria spp poses a significant threat to cowpea crops, resulting in yield losses and decreased plant vigor. An in vivo study was carried out to evaluate the impact of different concentrations of microalgae combined with neem oil at 1% on plant growth parameters and Disease Intensity (%). The application of microalgae @540 grams in various splits and neem oil @1% was done. Among all the treatments, T4 (Microalgae 48gms @5 DAS 96gms@15,45 DAS + Neem oil @1% showed promising results. Notably, the T4 treatment significantly increased plant height (84.63 cm) and the number of branches(10.83) at60DAS. Moreover, an increased numberof nodules per plant (21.44) was observed at 75 DAS, indicating improved root health and nitrogen fixation. Additionally, the treatment led to longer pod length (34.44 cm) in three pickings, suggesting enhanced yield potential. Furthermore, the combined application of microalgae and neem oil resulted in a significant reduction in disease intensity, with a notable decrease of 24.47% compared to untreated plants and those treated with chemicals (Bavistin). This indicates that the use of microalgae and neem oil together effectively suppressed leaf spot disease caused by Alternaria spp. in cowpea, thereby improving plant health and productivity. In conclusion, these findings underscore the potential use of eco-friendly alternatives like microalgae and neem oil for managing leaf spot disease in cowpea cultivation. Further research in this area is recommended for sustainable agricultural practices.

[Accelerating the construction of digital and intelligentialized pathology and the prospects].

With the continuous development of informatization, digitalization and artificial intelligence technology, the working mode of the pathology department has gradually changed from the traditional manual check, paper circulation and physical carrier storage to the informatization process and digital storage. The traditional pathology discipline has ushered in unprecedented opportunities and challenges. Digital pathology department also emerge as the times require. Simultaneously, with the full integration of artificial intelligence technology in pathology department, the concept of "department of digital and intelligentialized pathology" was proposed. Based on information and digital technology, the digital intelligent pathology department integrates intelligent management system, optimizes the previous cumbersome management and workflow of the pathology department, develops advanced technologies such as intelligent material extraction, unmanned organization processing, artificial intelligence quality control, artificial intelligence diagnosis, and promotes the intelligent construction of the pathology department.

[Practical application of the Paris system for reporting urinary cytology].

Objective: To validate the diagnostic performance of the Paris system for reporting urinary cytology (TPS). Methods: A total of 7 046 urine cytology samples from 3 402 patients collected in the Department of Pathology, Beijing Hospital, China from January 2020 to January 2022 were analyzed. 488 patients had a biopsy or resection specimen during the follow-up period of 6 months. The sensitivity, specificity, risk of malignancy (ROM) and risk of high-grade malignancy (ROHM) of the TPS were evaluated using histological diagnosis as the golden standard. Results: Among the 7 046 samples, high-grade urothelial carcinoma (HGUC) accounted for 5.7% (399/7 046), suspicious for high-grade urothelial carcinoma (SHGUC) for 3.2% (227/7 046), atypical urothelial cells (AUC) for 8.4% (593/7 046), and negative for high-grade urothelial carcinoma (NHGUC) for 72.9% (5 139/7 046) including low-grade urothelial neoplasm (LGUN) for 0.8% (59/7 046) and insufficient samples for 9.8% (688/7 046). 488 patients had a bladder biopsy or resection in the follow-up of six months, including 314 males and 174 females, aged 27 to 92 years (average, 66 years). The ROHM of TPS was 94.7% in HGUC, 83.3% in SHGUC, 41.3% in AUC and 18.8% in NHGUC. The sensitivity and specificity of urine cytology were 70.1% (169/241) and 97.0% (162/167), respectively. The negative predictive value of NHGUC was 69.2% (162/234). Conclusions: The study has shown that TPS classification has high sensitivity and specificity, high ROHM for HGUC and SHGUC, and high negative predictive value for NHGUC. The application of TPS reporting system can better interpret the clinical significance of cytology samples, improve the accuracy of urine cytopathology and ensure continuous diagnostic consistency.

Validation and Evaluation of 5 Scoring Systems for Predicting Metastatic Risk in Pheochromocytoma and Paraganglioma.

Currently, 5 scoring systems have been proposed in the literature for predicting metastatic risk in pheochromocytoma and paraganglioma (PPGL): Pheochromocytoma of the Adrenal Gland Scaled Score (PASS), Grading System for Adrenal Pheochromocytoma and Paraganglioma (GAPP), Composite Pheochromocytoma/paraganglioma Prognostic Score (COPPS), Age, Size, Extra-adrenal location, Secretion type (ASES) score, and Size, Genetic, Age, and PASS (SGAP) model. To validate and evaluate these 5 scoring systems, we conducted a retrospective review of cases diagnosed as PPGL at the Department of Pathology, West China Hospital of Sichuan University, between January 2012 and December 2019. A total of 185 PPGL cases were included, comprising 35 cases with metastasis and 150 cases remained metastasis-free for over 8 years after surgery. The criteria of the 5 scoring systems were used for scoring and risk classification. The predictive performance of the 5 scoring systems was validated, compared, and evaluated using concordance index (C-index) and decision curve analysis (DCA). The C-indices for PASS, GAPP, and SGAP were 0.600, 0.547, and 0.547, respectively, indicating low discriminative ability. In contrast, COPPS and ASES had C-indices of 0.740 and 0.706, respectively, indicating better discriminative performance. DCA also showed that the predictive capability of COPPS was superior to that of ASES, with both outperformed PASS, while PASS had better predictive ability than GAPP and SGAP. Our analysis indicated that pathology-based scoring systems cannot accurately predict metastatic risk of PPGL. Establishing a precise prediction system requires integrating clinical, pathologic, and molecular information, using a scientific methodology for predictive factor selection and weight assessment.

Cultural, Morphological and Pathogenic Variability in the Colletotrichum capsici Isolates, Inciting Anthracnose and Fruit rot of Chilli (Capsicum annuum L.) in different Agro-Climatic Zones of Kerala, India

Aims: To study the cultural, morphological and pathogenic variability existing among the pathogen isolates of Colletotrichum capsici, inciting anthracnose and fruit rot of chilli in Kerala. Study Design: Completely randomized design (CRD). Place and Duration of Study: Department of Plant Pathology, College of Agriculture (Kerala Agricultural University), Vellayani, Thiruvananthapuram during 2018-2019. Methodology: A survey was conducted in the five agro-climatic zones (ACZs) of Kerala viz., Northern zone, Central zone, Special problem zone, High range zone and Southern zone to assess the incidence and severity of anthracnose disease. The various symptoms in the surveyed locations were also noted. Pathogen isolates were grown in PDA medium in the laboratory and colony characters (colour and mycelial growth rate of pathogen colonies) were observed. Also, the morphological characters viz., mycelial width, shape and size of conidia, acervular diameter, number and size of setae, appressorial size were recorded. Results: Maximum anthracnose incidence of 90 per cent and severity of 52.60 per cent were noticed at Regional Agricultural Research Station (RARS), Pilicode (Northern zone). Characteristic leaf spot, fruit rot and die-back symptoms were observed in the survey locations. Pathogen colonies showed different shades of white, off-white to grey turning brown or black with regular or irregular margins and concentric rings of black acervuli in the potato dextrose agar (PDA) medium. The diameter of growth of C. capsici isolates ranged from 7.20 to 8.60 cm at 7 days after incubation. All the C. capsici isolates initiated hyaline mycelium having a width of 1.73 - 2.36 µm and produced numerous sickle shaped conidia with a size range of 19.42 - 20.46 µm × 2.16 - 3.09 µm. Black coloured, circular or ellipsoidal acervuli (122.14 - 189.08 µm dia.) had 20 – 46 setae of length 74.13 to 107.30 µm. Also, brown or black appressoria of size 8.64 - 12.64 µm × 5.54 - 7.84 µm were formed in slide culture. Cc3 from College of Agriculture, Vellanikkara was obtained as the most virulent isolate producing a lesion size of 1.13 cm and PDI of 45.33 in the artificially inoculated chilli fruits (var. Vellayani Athulya) at 5 days after inoculation. Conclusion: All the nine C. capsici isolates exhibited variability in their cultural, morphological and pathogenic characteristics. Variability in phytopathogenic fungi helps in identifying novel and sustainable control methods to tackle the diseases incited by them. Understanding pathogen variability provides new insights for developing effective disease management methods. This will help in promoting sustainable agriculture and preventing severe crop losses.

Frequency of Hepatitis C in patients presented with isolated thrombocytopenia.

Objective: HCV-related thrombocytopenia poses challenges in infection and treatment. This study emphasizes screening for early thrombocytopenia as it signals hematological abnormalities, indicating bleeding tendencies and complications. Study Design: Cross-sectional Investigation. Setting: Pathology Department of Allama Iqbal Medical College and Jinnah Hospital. Period: November 2019 to November 2020. Methods: Included 180 participants with platelet counts <100,000/µl, normal hemoglobin, and WBC counts. Exclusions: anemia, leucopenia, prior Hepatitis C treatment, and platelet clumps. Data on age, gender, socioeconomic status, and family history were collected. Platelet counts and HCV detection utilized peripheral smears and venous blood samples, analyzed with SPSS version 25.0. Results: In a study of 180 thrombocytopenic patients of all ages were included with mean age 32. Among 34 HCV-positive cases, 102 had a family history, with age-wise distribution: 18, 14, 2. Gender: 20 males, 14 females. HCV-positive households: 21 positive, 13 negative. Significant p-values for age groups (p=0.000), non-significant for gender (p=0.281), socioeconomic status (p=0.083), and household HCV status (p=0.505). Conclusion: A significant association exists between decreased platelet count and Hepatitis C virus, providing valuable insights for screening in clinical settings.

Abstract PO5-13-11: Quantitative Assessment of HER2 Expression in Intraductal Neoplasms of the Breast

Abstract HER2 (ERBB2) is an established prognostic and predictive marker for patients with invasive breast cancer and used in HER2-targeted therapy. The clinical and biological significance of expression of HER2 protein in patients with intraductal neoplasms of the breast is not well characterized. In this study, we used our HS-HER2 (High Sensitivity-HER2) which is a CAP/CLIA certified laboratory derived test (LDT) using quantitative immunofluorescence (QIF). We evaluated HER2 expression in DCIS (ductal carcinoma in situ), LCIS (lobular carcinoma in situ) and benign lesions to correlate with their clinicopathologic characteristics. Thirty- eight cases of DCIS, and fourteen cases of LCIS and thirty benign cases were selected from the Yale Pathology department archives and 252 ROIs (regions of interest) were annotated by a board-certified pathologist. DCIS is classified according to the three-tier nuclear grading system: low, intermediate, and high-nuclear grade. LCIS is classified as PLCIS (pleomorphic variant) and CLCIS (classic LCIS) according to the WHO classification of breast tumors. Serial sections of FFPE tumor specimens were used to accurately quantify the HER2 expression by the HS-HER2 assay and the acquisition by QuPath v.04 with Qymia extension. According to the LOD (limit of detection,3 amol/mm2), LOQ (limit of quantification, 9 amol/mm2) and LOL (limit of linearity, 23 amol/mm2) of the optimized HS-HER2 assay as performed in our CLIA lab shows a broad range of HER2 expression in both DCIS and LCIS lesions, ranging from 0.7 amol/mm2 to 111.4 amol/mm2 in DCIS and 3.6 amol/mm2 to 49.9 amol/mm2 in LCIS. High grade DCIS lesions express higher average HER2 levels (111.4 + 0.7 amol/mm2) than combined low and intermediate grade DCIS (77.9 +1.9 amol/mm2) with no significant difference between low/intermediate and high-grade DCIS. CLCIS lesions express higher average HER2 level (49.9 + 3.6 amol/mm2) than PLCIS (35.1 + 5.4amol/mm2) but again this is not statistically significant. HER protein expression is relatively low in benign lesions ranging from 0.8 to 8.4 amol/mm2. Using the HS-HER2 assay, our results show quantitative level HER2 levels in DCIS and LCIS breast lesions. These findings may be important as HER2 targeted therapies that work in gene-unamplified cancer (HER2 conjugated ADCs) gain broader usage in the clinic. Citation Format: Nay Nwe Nyein Chan, Haiying Zhan, Revekka Khaimova, Thazin Aung, Charles Robbins, Patricia Gaule, David Rimm. Quantitative Assessment of HER2 Expression in Intraductal Neoplasms of the Breast [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-13-11.

Landscape of HER2-low breast cancer: Insights from a six-year study on prevalence and clinicopathological characteristics

Human epidermal growth factor receptor 2 (HER2)-low breast cancer has emerged as a subtype of breast cancer, defined by HER2 1+/2+ in immunohistochemistry (IHC) and absence of ERBB2 gene amplification on fluorescence in situ hybridization (FISH). Recent trials showed marked response of HER2-low breast cancer to novel anti-HER2 antibody-drug-conjugates. Data on characteristics of HER2-low breast cancer subtype is limited. Real-world data from the Anatomic Pathology Department of Hotel-Dieu de France, spanning 2017–2023, was retrospectively collected. HER2-positive patients were excluded to compare HER2-low to HER2-zero breast cancer subtypes. Clinicopathological characteristics between the groups were compared using a Chi-Squared test. Out of 1195 patients, we observed 341 (28.5 %) HER2-low breast cancers cases. HER2-positive breast cancer cases (n = 178; 14.9 %) were excluded. There was no significant difference in age and sex between HER2-low and HER2-zero group (p = 0.33 and 0.79, respectively). HER2-low breast cancer was associated with positive estrogen receptor status and positive progesterone receptor status (p < 0.001 and p = 0.01, respectively). Ductal adenocarcinomas were more commonly observed in HER2-low group (p < 0.001). When stratified by hormone (HR) status, 87.4 % of patients had HR-positive status and 12.6 % were HR-negative. Among the HR-negative group, HER2-low tumors tended to show lower proliferation index compared to HER2-zero tumors (25%vs.10 %, p = 0.04). This study showed that HER2-low is distinct from HER2-zero and is common among patients with breast cancer. Clinicopathological features such as histological type differ between HER2-zero and HER2-low breast cancer. Within HR-negative breast cancer, those with low HER2 expression exhibit a less aggressive profile compared to HER2-zero tumors.

Immunohistochemical (IHC) Expression of p16 in Various Grades of Oral Squamous Cell Carcinoma (OSCC) with Snuff Use in Tertiary Care Hospitals of Peshawar

Oral squamous cell carcinoma (OSCC) is a significant health concern, with various factors influencing its development and progression. Understanding these factors, including p16 expression and clinicopathologic features, is crucial for improved diagnosis and treatment. Objective: To compare various grades of OSCC based on immunohistochemical expression of p16 and clinicopathologic parameters. Methods: The comparative cross-sectional study was conducted at the Department of Pathology, Peshawar Medical College (PMC), and Peshawar Dental College (PDC) from August 2020 to August 2021. It included 53 cases of OSCC with documented snuff use history. Tumor sections were stained with Hematoxylin and Eosin and underwent immunohistochemical staining for p16 expression. Sample size calculation utilized G Power software. Statistical analysis was performed using SPSS version 20.0, employing the Chi-Square test to assess categorical variables. Results: Among the 53 OSCC cases, the majority were male (66.0%) with ages ranging from 26 to 85 years, the most common age group being 51-70 years. The tongue was the primary site for OSCC development. Well-differentiated cases were predominant (64.2%), followed by moderate (20.8%) and poor grade cases (15.1%). However, no significant association was found between p16 expression and OSCC grades. Notably, p16 expression tended to be higher in snuff users and well-differentiated OSCC cases, although not statistically significant. Conclusions: Well-differentiated OSCC cases exhibited the highest expression of p16, followed by moderate and poorly differentiated cases. However, no significant correlation was observed between p16 expression and OSCC in snuff users.

Endobronchial Ultrasound Guided Transbronchial Needle Aspiration and Next Generation Sequencing Yields.

The use of endobronchial ultrasound (EBUS) is standard practice for lung cancer diagnosis and staging. Next generation sequencing (NGS) for detection of genetic alterations is recommended in advanced, non-squamous, non-small-cell lung cancer (NSCLC). Existing protocols for NGS testing are minimal and reported yields vary. This study aimed to determine the yield of EBUS samples obtained for NGS using a sampling protocol at our institution and assess predictive factors to form collection protocols. We reviewed EBUS bronchoscopies from 2016 to 2021 with non-squamous NSCLC diagnoses. For target lesions suspected to be malignant, the sampling protocol was: (a) two slides for on-site evaluation, (b) three to five fine needle aspirations rinsed into saline for immunohistochemical staining and in-house molecular markers, and (c) additional three to five rinses for NGS. Sufficiency for NGS processing was determined by the pathology department. Two hundred and seventy-eight non-squamous NSCLC samples were obtained by EBUS (205 adenocarcinoma; 73 not otherwise specified). EBUS was performed under general anesthesia in 75.5% of cases. The overall sample adequacy for NGS testing was 57.5%. Higher adequacy rates were observed when protocol was adhered to 66.0% versus 37.2% (p < 0.001). There was no statistically significant difference based on the size of the lesion or location of the sample. When a protocol of three to five dedicated needle rinses for NGS was followed, we nearly doubled our sample adequacy rate for NSG as compared to standard care. Studies are needed to determine the ideal collection and processing modality to preserve tissue samples for genetic sequencing.

Assessment of Various Substrates for Shiitake Mushroom (Lentinula edodes) Cultivation in the Agro-Climatic Conditions of West Bengal

Aim: This study aimed to evaluate the impact of different substrates on various stages of shiitake mushroom (Lentinula edodes) cultivation to optimize growth and yield. Study Design: A Completely Randomized Design with three replications for each treatment was employed to ensure statistical reliability. Duncan's multiple range tests were utilized at a significance level of 5% to evaluate differences between treatments. Place and Duration of Study: The research was conducted at the Mushroom Research Laboratory, Department of Plant Pathology, Palli Siksha Bhavana (Institute of Agriculture), located in Sriniketan, Birbhum district, West Bengal, throughout the year 2023. Methodology: Different substrates including lentil husks, rice straw, wheat straw, sawdust, and mustard pods were evaluated for their impact on spawn run completion, mycelial bump formation, and sporocarp formation durations. Each substrate's performance was assessed in terms of sporocarp production and biological efficiency. Results: Across the three strains (LE-01, LE-02, and LE-03), lentil husks consistently exhibited the shortest spawn run duration, averaging 34.59 to 37.00 days. Following closely, wheat straw displayed favorable performance with durations ranging from 39.20 to 41.23 days. Sawdust also proved efficient, albeit slightly longer than lentil husks and wheat straw. Conversely, maize cobs and sugarcane bagasse exhibited longer spawn run durations, averaging from 57.80 to 64.90 days. For mycelial bump formation, lentil husks again showed the shortest duration, averaging 42.67 to 45.77 days across the strains. Wheat straw followed suit with durations ranging from 48.93 to 50.20 days, while sawdust demonstrated favorable times albeit slightly longer. Conversely, maize cobs and sugarcane bagasse exhibited longer mycelial bump formation times, ranging from 68.11 to 74.40 days. For sporocarp formation, lentil husks and sawdust emerged as top performers with the shortest durations, averaging 76.66 to 81.52 days. Conversely, maize cobs exhibited the longest sporocarp formation time, averaging 97.43 days. In terms of sporocarp yield, rice straw yielded the highest, averaging 27.67 sporocarps per bag, followed by wheat straw with 24.33 sporocarps per bag. Lentil husks, while efficient in other aspects, produced an average of 21.78 sporocarps per bag, trailing slightly behind rice straw and wheat straw. Regarding yield and biological efficiency, sawdust displayed superior performance, yielding an average of 384.57 grams per 750 grams of substrate with a biological efficiency of 51.18%. Lentil husks and rice straw exhibited comparable performance in yield and biological efficiency, with lentil husks yielding 367.81 grams and rice straw yielding 333.09 grams per 750 grams of substrate, both with biological efficiencies around 47-48%. Conversely, mustard pods exhibited the lowest yield and biological efficiency, averaging 269.02 grams per 750 grams of substrate with a biological efficiency of 35.91%. Conclusion: The study underscores the importance of substrate selection in optimizing various stages of L. edodes cultivation. Lentil husks emerged as a promising substrate choice for rapid mycelial growth, but its sporocarp production lagged behind other substrates. Sawdust proved to be the top-performing substrate in terms of yield and biological efficiency, indicating its efficacy in supporting robust mushroom growth.

An Evaluation of Platelet Indices in Newly Diagnosed Cases of Acute Myocardial Infarction

Acute myocardial infarction (AMI) is characterized by prothrombotic phenotype associated with endothelial dysfunction, an increase in platelet activation and systemic inflammation. Platelet aggregation and activation are crucial in the formation of thrombi and acceleration of atherosclerosis, associated with unstable angina, sudden cardiac death is brought on by an acute myocardial infarction. Objective: To evaluate the platelet-indices in newly diagnosed cases of acute myocardial infarction. Methods: This cross-sectional study was conducted during November 2022 to December 2023 in Pathology Department of Sheikh Zayed Medical College/Hospital Rahim Yar Khan. Samples were collected from the patients of AMI admitted to Emergency Ward and from healthy controls as well. Complete Blood Count (CBC) with platelet indices, platelet count, Mean Platelet Volume (MPV), Platelet Crit (PCT) and Platelet Distribution Width (PDW) were investigated on five-part automated hematology analyzer BT-PRO 2300. Analysis of the data was done by using SPSS version 20.0. Results: Total 140 patients were divided into a healthy control group (70) and newly diagnosed cases of acute myocardial infarction (70). Among diagnosed cases of AMI 46 (65.7%) had ST-elevation myocardial infarction (STEMI) and 24 cases (34.2%) got non-ST-elevation myocardial infarction (NSTEMI). It was found that AMI patients had lower platelet counts and PCT with higher MPV and PDW. Conclusions: It was concluded that the platelet indices (PDW, and PCT, MPV) are significant predictors of myocardial infarction. They might be applied as an easy, reliable, and economical way to anticipate an impending acute coronary event.

Correlation of IDH1 gene expression error in breast tumor biopsy in patients with invasive ductal carcinoma.

One of the most important cancers in terms of worldwide prevalence is breast tumors, which have been less investigated in correlation with the enzyme Isocitrate Dehydrogenase 1 (IDH1) gene. The aim of this study was that expression of this gene could have significant effects on the progression of metastasis and invasive disease in breast cancer patients. We used the molecular method of RT-PCR with SYBR-Green to analyze breast tumor tissue from patients with metastasis and non-metastasis, the latter confirmed by the pathology department of Shohada-e Tajrish Hospital (serving as a control group). Also, patients population and its relationship with the degree of tumor in the IDH1 gene was investigated. The IDH1 gene has shown high expression in patients with metastatic breast cancer rather than in patients with non-metastatic breast cancer. The metastatic samples were compared with non-metastatic samples for IDH1 mRNA expression. In this research work, 72.5% (29 samples) were up-regulated in comparison to 27.5% of samples (11 samples) that did not exhibit high expression (P=0.000). This study examined the IDH1 gene expression, suggesting that changes in this gene's expression could impact the prognosis of breast cancer. However, further research is needed to draw definitive conclusions.

Histomorphological Spectrum of Lung Lesions in Medico- legal Autopsy in a Tertiary Care Centre

Background: Organ specific pathological changes seen during autopsy give a clear idea of the cause of death. Lungs are one of the most important vital organs in the human body. They are almost always involved in terminal events of cardiovascular diseases.Autopsy is important not only to know the state of lungs but also to study the morphology of various diseases.Various studies have demonstrated that,20-30% of sudden deaths are due to underlying pulmonary pathology. Aims and objectives: The significance of this study is to highlight the spectrum of histomorphological features of lung lesions in medico-legal autopsies irrespective of cause of death. Material and Methods:This was a retrospectivestudy Medico legal autopsies over a period of 5 years carried out in the Department of Pathology in coordination with the Department of Forensic Medicine, Gulbarga Institute of Medical Sciences. Standard protocols are used for gross and histopathology processing. Results: After thorough histopathological examination, of total 100 cases, various lesions were identified in 93 cases, in 7 cases tissue was autolyzed. Majority cases seen in the age group of 20-40yrs with male predominance. The most common cause of death was Road Traffic Accident (RTA) and majority victims were males. The commonly observed pathological features congestion and oedema(44.4%), Pneumonia(26.8%),CVC(22.2%) tuberculosis(9.6%) and ARDS(6.6%). Conclusion: The present study observed and documented histomorphological spectrum of lung lesions in medico-legal autopsies and highlighted various pathological conditions which are either direct or indirect cause of death. This study emphasizes that spectrum of histopathological changes in lungs of autopsy cases irrespective of cause of death and highlights some incidental interesting findings in lungs.  

Massive Myocardial Calcification: A Rare Autopsy Finding

Introduction: Myocardial calcification is rare and occur by two mechanisms- dystrophic and metastatic. It can present with variable clinical manifestations like congestive heart failure, cardiomyopathy, arrhythmia and sudden cardiac death. Case Report: Post mortem viscera of a 50 year old male was received in the department of pathology with alleged history of burns, who died after two weeks of hospital treatment. There was no past history or investigation available in the post mortem papers. Whole heart, pieces of brain, both lungs, liver, spleen and both kidneys were received. On gross examination no abnormality was observed in any of these viscera. Microscopic examination revealed extensive calcification in anterior, lateral &amp; posterior walls of left ventricle of the heart. Sections from kidney showed features of chronic tubulointerstitial nephritis. Conclusion: Myocardial calcification is rare and mostly diagnosed incidentally or on autopsy. Extensive sampling of heart and other viscera might help in finding the etiology in such rare cases of massive calcification in myocardium . Antemortem diagnosis can be made with computed tomography (CT) scan and endomyocardial biopsy.

Democratizing Artificial Intelligence in Anatomic Pathology.

Artificial intelligence is a transforming technology for anatomic pathology. Involvement within the workforce will foster support for algorithm development and implementation. To develop a supportive ecosystem that enables pathologists with variable expertise in artificial intelligence to create algorithms in a development environment with seamless transition to a production environment. The development team considered internal development and vended solutions. Because of the extended timeline and resource requirements for internal development, a decision was made to use a vended solution. Vendor proposals were solicited and reviewed by pathologists, IT, and security groups. A vendor was selected and pipelines for development and production were established. Proposals for development were solicited from the pathology department. Eighty-four investigators were selected for the initial cohort, receiving training and access to dedicated subject matter experts. A total of 30 of 31 projects progressed through the model development process of annotating, training, and validation. Based on these projects, 15 abstracts were submitted to national meetings. Democratizing artificial intelligence by creating an ecosystem to support pathologists with varying levels of expertise can break down entry barriers, reduce overall cost of algorithm development, improve algorithm quality, and enhance the speed of adoption.

Optimized Method for High‐Quality RNA Extraction from Formalin‐Fixed Paraffin‐Embedded Tissues

AbstractRNA extraction from formalin‐fixed paraffin‐embedded tissues (FFPE) presents a notable challenge. Extracting RNA from FFPE tissues has been challenging due to RNA degradation and chemical bonding between RNA and proteins during the fixation process. This results in reduced concentration and quality of the extracted RNA from FFPE tissues, impacting subsequent downstream analyses. In this study, we present an optimized approach involves replacing the tissue temperature‐digestion step with tissue crushing and homogenization. RNA extraction was performed on 100 FFPE tissue blocks obtained from the archive of Pathology Department of Shiraz University of Medical Sciences. After deparafinization of the tissues, RNA was extracted using this modified method, and the results compared to those of a standard extraction procedure and commercial kits used for FFPE tissue. Then gel electrophoresis and Real time PCR were done to check the quality and integrity of the extracted RNA. The results show that the concentration of RNA obtained from this method was significantly (P value &lt;0.0001) higher than the other methods. In conclusion, we have successfully introduced a modified method that enables the extraction of high‐quality and intact RNA from FFPE tissue. This method stands as a reliable option for molecular biology studies necessitating precise RNA extraction.