Leishman Stain Research Articles

Erroneous Automated WBC Differentials—A Case Series

Background and Aims: Peroxidase deficiency is one of the commonly inherited phagocytic defects. It has been also found to exist as a transient phenomenon in association with some clinical conditions. But that it can interfere and cause erroneous automated differential WBC count is something which is not commonly known. Materials and methods: Complete blood counts were analysed using Advia 2120i and Coulter DXH 900 haematology analysers and manually reviewed on peripheral blood smear stained with Leishman stain. Results: Peroxidase deficiency in neutrophils and eosinophils resulted in them getting counted as monocytes by the analyser causing pseudomonocytosis, pseudoneutropenia and pseudoeosinopenia. These were detected by a slide review and by reanalysing the samples on an analyser which worked on a different principle. Conclusion: There is a need to confirm monocytosis given by analysers working on the peroxidase principle with an alternate method. This will prevent needless medical investigations for pseudoneutropenia, pseudoeosinopenia and persistent monocytosis, thus preventing unwarranted mental agony and financial burden to patients. It also helps to save the laboratory’s reputation. A careful review of instrument flags not only helps reach an accurate result but sometimes they can also aid in the diagnosis of a rare potential genetic disorder like MPO deficiency.

Effect of Addition of Phenol on the Quality of Leishman Staining

Effect of Addition of Phenol on the Quality of Leishman Staining

Understanding the Puzzle of Primary Breast Lymphoma: An Experience in a Tertiary Care Center in North India.

Background Breast carcinoma is the most common cause of death in women arising primarily from either epithelial or stromal components. Primary breast lymphoma (PBL) is a less common type of neoplasm arising from the lymphoid tissue and is classified as non-Hodgkin's lymphoma (NHL). PBL is a rare tumor that accounts for less than 1% of total primary malignant neoplasms of the breast. The majority of PBLs are of B-cell origin; the most common histological type is diffuse large B-cell lymphoma (DLBCL) followed by follicular lymphoma (FL) and other T-cell and B-cell lymphomas. Material and methods We conducted this five-year retrospective descriptive PBL study from July 2019 to May 2024 at a tertiary care center in North India. We included 11 cases of diagnosed PBL based on morphology and confirmation by at least one lymphoid differentiation marker, that is, leukocyte common antigen (LCA). We retrieved paraffin-embedded blocks from the archive and conducted routine hematoxylin and eosin (H&E) staining and Leishman's stain. We applied an extended immunohistochemistry (IHC) panel to confirm the microscopic findings. We used the Dako® (Agilent Diagnostics & Genomics Group) antibody with a dilution of 1:100. Results In this study, patients' mean age was 46.8 years (32 to 84 years). Radiological findings indicated that the tumor was indistinguishable from carcinoma. Microscopic findings showed that cells were medium to large lymphoid cells displaying moderate pleomorphism, centrally placed nuclei, vesicular to coarsely clumped chromatin, and scant cytoplasm. IHC showed one case of T-cell origin (ALCL) and 10 of B-cell origin. Among the B-cell cases, four were DLBCL, four were high-grade NHL likely DLBCL and two were high-grade lymphoma. Conclusion Primary breast lymphoma is a rare tumor that closely resembles breast carcinoma clinically as well as radiologically. This study is an effort to highlight the importance of clinical, radiological, and histopathological parameters as well as immunohistochemical features in confirming diagnosis. We also emphasize a treatment protocol and survival outcome in hopes that this knowledge will provide an understanding of early diagnosis and proper management of disease.

A Comparative Study of Peripheral Smear Findings with RBC Indices and Automated Analyzer Generated RBC Histograms in the Diagnosis of Anemia's

Abstract Introduction The red blood cell (RBC) indices generated by cell counters help in the morphological classification of anemia. The importance of microscopic examination of peripheral blood smears (PBSs) stained by Leishman stain cannot be used alone when it comes to interpretation of the underlying cause of anemia. Hence, all three RBC histograms, indices, and microscopic examination of PBSs are very essential for a complete assessment of anemia. Aims and Objectives To diagnose the type of anemia by examination of PBSs, automated cell-generated RBC histograms, and RBC indices and to compare and correlate the findings of RBC indices and automated cell-generated RBC histograms with PBS examination. Materials and Methods This was a prospective comparative study done on 500 cases of anemia for a period of 5 months from August 2023 to December 2023 in a rural tertiary care teaching hospital and all the patients' RBC indices, RBC histogram findings, and PBS findings were noted and analyzed. Results Among 500 samples, normocytic normochromic anemia consists of the majority of the cases 272 (54.4%), followed by microcytic hypochromic anemia cases 183 (36.6%), macrocytic anemia cases 27 (5.4%), normocytic hypochromic anemia were 10 (2%) cases, and dimorphic were 8 cases (1.6%). When compared with RBC histogram, 265 (53.0%) cases showed normal bell-shaped curve, 188 (37.6%) cases showed left shift, 27 (5.4%) cases showed broad based curve, 10 (2%) cases showed right shift, and 10 (2%) cases showed bimodal curve suggesting normocytic normochromic, microcytic hypochromic, normocytic hypochromic anemia, macrocytic, and dimorphic anemia, respectively. Conclusion This study showed a well correlation in the findings of the automated hematology analyzer with the microscopic examination. Histogram alone could be used as a screening method but when combined with RBC indices and PBS findings, they act as useful supplements and by correlating findings of all three, we could diagnose the majority of anemia.

Cytological Findings of Fine Needle Aspiration Cytology in Diagnosing Causes of Cervical Lymphadenopathy in Patients Attending Health Care Facilities of Janakpur, Nepal

Background & Objectives: Fine Needle Aspiration Cytology (FNAC) is a minimally invasive and inexpensive procedure that produces a rapid result. As cervical lymphadenopathies are common clinical findings with varied causes, FNAC may have an extremely important role in the diagnosis of various underlying clinical condition. Materials and Methods: A prospective multicentric study was conducted from September 2021 to June 2023 at Janakpur, Nepal. A total of 60 cases were included in the study. The procedure was performed in the cervical lymph node with a 10 ml syringe and 23 gauze needle. The obtained material was spread on the slides and stained with leishman stain and Papanicoloau (PAP) stain. Acid Fast Bacilli (AFB) stain was done for suspected cases of M. tuberculosis infection. Results: The diagnosis based on FNAC procedure were categorized as reactive lymphadenitis (21 cases, 35%), tuberculous lymphadenitis (14 cases, 23.33%), granulomatous lymphadenitis (8 cases, 13.33%), suppurative lymphadentitis (7 cases, 11.66%) and positive for malignancy (3 cases, 5%). The most common diagnosis in the current study of cervical lymphadenopathy was reactive lymphadenitis followed by tuberculous lymphadenitis. Conclusion: FNAC is a quick and reliable method to find the cause of cervical lymphadenopathy allowing appropriate diagnosis, timely management and further investigation if needed.

Importance of bone marrow examination in cases of pancytopenia: A morphological study in a tertiary care center

Background: Anemia, leukopenia, and thrombocytopenia are all combined as pancytopenia. It could be a symptom of many diseases that directly or indirectly impact the bone marrow. The cause of pancytopenia, however, differs depending on the location. An essential step in determining the cause of pancytopenia is bone marrow aspiration (BMA). Aims and Objectives: This study aimed to determine the causes of pancytopenia and the morphology of the bone marrow in pancytopenia patients. Materials and Methods: This study was carried out over a year in the pathology department of a tertiary care facility in central India. Patients taking chemotherapy or radiation therapy were excluded from the study. Inclusion Criteria: Cases with hemoglobin <10 g/dL, total leukocyte count <4000/mm3, and platelet count <100,000/mm3 were included in this study. The patient’s posterior iliac crest was used for BMA. The Leishman stain was used to color BMA smears for microscopy. Results: This study comprised 51 cases of pancytopenia, with acute leukemia and megaloblastic anemia accounting for the majority (11 cases each out of 51), followed by dimorphic anemia (10/51), hypocellular marrow (9/51). The clinical symptom of generalized weakness and pallor was present in all instances (100%) and was followed by fatiguability (72%) and dyspnea (48%). The last two least frequent symptoms, lymphadenopathy, and hepatomegaly, were also present in many patients. A significant proportion of pancytopenia individuals experienced lymphadenopathy and hepatomegaly, which were the last two least prevalent appearances. Conclusion: In most cases, bone marrow aspiration in pancytopenia patients aids in determining the underlying reason. Understanding the illness process, planning future research, and managing cytopenia patients can all benefit from it.

Leishman-giemsa cocktail, effective stain in air dried smear- An institutional study

FNAC is an outpatient procedure and has gained importance in mass screening programs. Staining procedure like MGG and Pap is time-consuming and needs trained persons. So there is a need for a staining procedure that is quick and easy to do. In this regard, LG cocktail has been suggested in many kinds of literature. LG cocktail is a combination of both Leishman and Giemsa stains, which has the advantage of both stains. This is a prospective study at department of pathology, VSSIMSAR Burla. A total of 153 cases were studied from the cytology section. The slides were simultaneously stained with MGG and LG cocktail. The slides were viewed and scored independently by different pathologists. Quality Index (QI) was calculated by dividing this score by the maximum score possible. Quality index of LG cocktail stain is 0.77 compared to MGG Quality Index 0.61. LG cocktail is better than MGG Stain overall staining quality, cytoplasmic and nuclear staining, and staining of background material. LG cocktail has better QI than MGG stain. Thus the use of LG cocktail in cytological staining may increase the overall efficacy by saving time and decreasing the manpower need. These two advantages can help us in mass screening programs and its use in the crowded out-patient department.

Correlation of RBC indices and RBC histogram obtained by automated hematology analyser with peripheral smear in the diagnosis of anemia

: The impact of early diagnosis and management of anemia on patient outcome has been tremendous. Although conventional microscopic examination of blood using peripheral smear is unequivocal, the advent of automated hematology analyzer has revolutionized the field of clinical hematology and its practice. This study highlights the efficiency and utility of specific parameters obtained by hematology analyzer and its comparison with peripheral smear in the diagnosis of anemia, also determines the sensitivity of the same.: 501 Ethylenediamine tetra acetic acid blood samples collected at a tertiary care teaching hospital in Karnataka during one and half years from February 2021 to August 2022, were run on the Sysmex 6-part automated hematology analyzer and simultaneous peripheral smears were prepared and stained using Leishman stain based on standard operating procedures. The histogram and peripheral smear findings were noted.: Among the 501 cases, there were 269(53.7%) cases of Normocytic Normochromic Anemia in which 82.9% showed normal curve, 145(28.9%) cases of Microcytic Hypochromic Anemia in which 92.4% showed shift to left, 31(6.2%) cases of Dimorphic Anemia in which 61.3% showed normal curve contrary to the expected double peak, 24(4.8%) cases of Macrocytic Anemia in which 83.3% showed shift to right, 23(4.6%) cases of Pancytopenia in which 39.1% showed normal curve and 9 cases of Normocytic Hypochromic Anemia. : The Automated hematology Analyzer provides highly valuable information with limited sample and is an essential tool in diagnosis, classification and management of anemia.

A Cross-sectional Analysis of Conventional Leishman’s Stain versus Modified Leishman’s Stain: A Study Protocol

Introduction: The conventional Leishman’s stain and modified Leishman’s stain are widely used in medical laboratories for the microscopic examination of blood smears. The conventional stain provides good visualisation of cellular morphology, aiding in the identification of various blood cell types. The modified Leishman’s stain, on the other hand, incorporates alterations to enhance specific cellular structures, improving diagnostic accuracy. Need of the study: In the present study, the authors will observe the differences between the conventional staining method and the modified Leishman's stain method, as well as the advantages of the modified Leishman's staining over the conventional staining method. Aim: To compare Conventional Leishman’s Stain with Modified Leishman’s Stain. Materials and Methods: The cross-sectional study will be conducted from October 2022 to October 2024 at the Department of Pathology, Jawaharlal Nehru Medical College (JNMC), Sawangi (Meghe), Wardha, Maharashtra, India. Ethylenediamine Tetraacetic Acid (EDTA) blood samples will be used for staining. Conventional Leishman’s Stain employs the traditional Leishman’s staining method, while Modified Leishman’s Stain incorporates specific modifications aimed at improving staining quality and enhancing the detection of eosinophils and leukocytes. Several quality control parameters will be assessed, including staining quality, eosinophil and leukocyte visibility, and overall diagnostic accuracy for both peripheral blood smear samples. A panel of experienced haematologists, blinded to the staining technique, independently examines the slides to minimise potential bias. The numbers and morphological characteristics of eosinophils and leukocytes are meticulously recorded, and statistical analysis will be conducted to compare the two staining methods.

Cognition and its relationship with differential white cell count among obese undergraduates in Nigeria

Abstract Introduction: Studies have linked obesity with cognitive impairment and low-grade inflammation; however, results have been inconsistent. The aim of this study was to compare global cognitive function and its relationship with indices of obesity and total and differential white blood cell (WBC) counts in obese and normal-weight undergraduates in Kano, Nigeria. Materials and Methods: Eighty participants (40 obese and 40 normal weights) were randomly recruited for this case–control descriptive study. Anthropometric indices were measured according to the World Health Organization’s Stepwise protocol; global cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), while the WBC count was performed by manual Leishman staining technique. Data were analyzed on statistical package for social science using an independent t-test, Chi-square test of association, Pearson’s correlation, and simple linear regression. Results: The mean age of the participants is 24 years, obese a year older (t = -2.2, P = 0.030). There was no significant difference in global cognitive function score (MoCA score) between the obese and normal-weight participants (t = -1.08, P = 0.283). However, 40% of the normal weight and 42% of the obese participants had mild cognitive impairment. Similarly, the two groups did not differ in total and differential WBC count except for %monocyte, which was higher in normal-weight participants (t = 2.22, P = 0.029). None of the anthropometric and WBC indices correlated with the MoCA score; however, %monocyte was negatively correlated with body mass index (BMI) (r = -0.244, P = 0.029), waist circumference (r = -0.216, P = 0.050), hip circumference (r = -0.234, P = 0.037), and wait-to-height ratio (r = -0.245, P = 0.028) among the whole while %lymphocyte was negatively correlated with BMI (r = -0.311, P = 0.050) among obese participants. Conclusion: Obesity is not associated with a decline in cognitive function and inflammation in obese and normal-weight undergraduates in Nigeria.

Laboratory Evaluation of Transtracheal Wash (TTW) in Buffaloes Affected with Lower Respiratory Tract Infections

Background- Evaluation of transtracheal wash (TTW) has been proved beneficial in the diagnosis and understanding the pathology of lower respiratory tract infection in species like equines and dogs. However, its diagnostic potential in buffaloes has not been explored much. This study elucidated the cytological and microbiological features of TTW in buffaloes. Methods- TTW was collected from 36 buffaloes (26 diseased and 10 healthy control) after adequately restraining and using baby feeding tube after giving a small stab incision at ventral neck region. After collection, TTW were subjected to cytological studies following staining with Leishman stain. TTW was also sent aseptically to laboratory for bacteriological culture. Results- The lower respiratory tract affections like aspiration pneumonia, suppurative pneumonia, fibrinopurulent pneumonia, chronic pneumonia and tuberculous pneumonia were diagnosed based on cytology of TTW in correlation with history and comprehensive clinical examination. The mean cell number (cells/HPF) in TTW of diseased buffaloes were significantly higher than control groups. In control groups, the predominant cells were alveolar macrophages followed by neutrophils, epithelial cells, lymphocytes and other cells which includes mast cells, fibroblasts and unidentified nucleated cells. Neutrophils were the predominant cells followed by macrophages in TTW of buffaloes diagnosed with suppurative, fibrinopurulent and aspiration pneumonia, whereas, alveolar macrophage were predominant in TTW of chronic pneumonia and tuberculous pneumonia affected animals. Four out of ten TTW samples from healthy animals were evidenced bacterial growth in which Staphylococcus spp. was the predominantly isolated bacteria. TTW samples from 20 out of 26 diseased buffaloes were found positive for bacterial culture from which a total of 30 bacterial isolates were obtained which include Staphylococcus aureus, Klebsiella pneumonia, Pasteurella multocida, Streptococcus spp., E. coli and Bacillus spp. Thus, TTW provides vital information about the ongoing pathogenesis in respiratory tract infection. It is suggested that, cytological and bacteriological culture of TTW samples should be carried out during the diagnosis and therapeutic intervention of respiratory tract infection in buffaloes.

ESTIMATION AND COMPARISON OF PLATELET COUNT: AUTOMATED ANALYZERVS MANUAL PERIPHERAL SMEAR METHOD

Accurately assessing platelet counts holds paramount importance in the realm of diagnostics and treatment. The adoption of automated methods within the diagnostic landscape is steadily growing, attributed to their multifaceted benefits. Nonetheless, automated analyzers sometimes yield erroneous results, particularly in scenarios involving particles of comparable sizes or instances of light scattering. These encompass fragmented red blood cells (RBCs), microcytic RBCs, and the presence of oversized platelets or platelet clusters. In response, the manual estimation of platelet counts using Leishmans stain validation gains significance. Method: this study encompassed the collection of blood samples from a diverse pool of 100 patients, including both inpatients and outpatients, spanning the period from 1st February 2023 to 31st July 2023. These samples, procured from GMC Doda and its affiliated hospital, were collected in ethylenediaminetetraacetic acid (EDTA) tubes. The manual platelet count was done, followed by a comprehensive comparative analysis with the counts obtained through automated platelet analysis. Results: the outcomes unveiled a nuanced trend, with manual slide-derived results slightly surpassing those generated by automated analyzers. Conclusion: This study concluded a discernible correlation between automated and manual methodologies for platelet count assessment. Nevertheless, in instances marked by exceedingly high or low platelet counts, the manual method holds its ground, ensuring precision by circumventing concerns like platelet clumping or uneven distribution.

Reticulated Platelet Count as a Diagnostic Tool in Immune Thrombocytopenia (ITP).

This study aimed to compare the reticulated platelet count between patients having thrombocytopenia secondary to autoimmune destruction (immune thrombocytopenia {ITP}), bone marrow failure, and healthy controls who presented to a tertiary care hospital in Karachi, Pakistan. A cross-sectional study wasconducted from February 2021 to October 2022 in the Department of Hematology, National Institute of Blood Disease (NIBD) Hospital in Karachi, Pakistan, that involved examining three groups: 30 patients with immune thrombocytopenia, 30 patients with thrombocytopenia secondary to reduced production from bone marrow, and 30 healthy controls. The study utilized the Sysmex XN-1000 (Hyogo, Japan: Sysmex Corporation) automated hematology analyzer to perform a complete blood count (CBC) test. Additionally, peripheral blood was stained with Leishman stain and examined under a microscope to eliminate pseudo thrombocytopenia and identify any abnormal cells or dysplasia. The immature platelet fraction (IPF) was then performed on Sysmex XN 1000 after ensuring adequate quality control. Finally, the data were analyzed using DATAtab (Graz, Austria: DATAtab) and SPSS version 25 (Armonk, NY: IBM Corp.). Of the ninety participants, the median age was 33 years with a range of 18-71 years. Patients with ITP had a significantly higher median IPF% (median=26.65, IQR=15-39.4) than thrombocytopenia due to bone marrow failure (median=9.25, IQR=4.55-14.30) and healthy controls (median=7, IQR=4.40-9.90), with a p-value of 0.001. The immune thrombocytopenia group demonstrated an increase in IPF% as platelet counts increased, indicating a significant moderate correlation between IPF% and platelets in these patients (r=0.438, p=0.016) and confirming that IPF% was an independent predictor for the detection of ITP. Reticulated platelet count may be a useful diagnostic tool to differentiate between ITP and thrombocytopenia caused by bone marrow failure. Because of its non-invasive nature, IPF is a valuable tool for expediting the management of thrombocytopenia associated with increased IPF.

Histological Assessment for the effect of deodorant blocker on the blood cells of albino rat

Twenty Rats were used in the present study to evaluate the effect of the deodorant blocker on the blood cells of the rat including the white blood cells and red blood cells. The animals were distributed into Group A control Five Rats and Group B Five treated animals. 
 The animals were put in steel cages in the animal house of veterinary medicine college. water with food free putto animals the skin of whole animals was shaved at the dorsum and at the flank region, then deodorant blocker was applied daily by whipping those areas for 30 days continuously, otherwise the control group was applying the distill water on the shaved areas. After the end of the experiment, a drop blood from the tip of tail was obtained and spread on the slide for staining by Leishman stain. 
 The results of blood examination were indicated release of the lymphocytes and monocytes percentage in comparison of control, also the certain number of RBCs indicated macrocytic, microcytic, incomplete hemoglobin ring and target cells as deformities of RBCs. In conclusions; the deodorant blocker induced imitation of immune system via increase the number of lymphocytes and monocytes which consider as main factors for immune response in cases of extrinsic insults.

Fine Needle Aspiration Cytology of Lymphnodes: A Hospital Based study in a Tertiary Health Care Center in Southern Odisha

Introduction: FNAC is widely accepted the most accurate sensitive, specific, cost-effective minimally invasive OPD technique to establish the basic diagnostic information not only to relieve the anxiety of the patients but also to provide materials for microbial culture, and decrease unnecessary surgery from the visibly accessible superficial masses. It also distinguishes a benign from a malignant entity that can obtain tissue for immuno-phenotyping & molecular studies and obtain cellular & genetic material for storage also useful for staging and follow up including response to treatment in patients with known malignancies. Our study was conducted on 796 Outpatients including all age groups & sexes presenting with palpable enlarged lymph nodes not only for early diagnosis & treatment but also to reveal the burden of various categories of diseases in tribal areas where our institution is situated. Material & methods: FNAC was performed under aseptic precaution using a 22 to 24 Gauge needle attached to a 20CC disposable syringe. The aspirated material after smearing was treated with 95% ethyl alcohol for fixation and stained with H& E and Papanicolaou stain & air-dried smears are stained with Leishman stain. Modified Z-N stain was done wherever necessary followed by diagnosis based on clinic cytomorphological features. Result: Out of 796 cases the most common cause of lymphadenopathy in our study was found to be Tubercular lymphadenitis with 360 (45.22%) cases, the second most frequent entity was reactive lymphadenitis in 277(34.79%) cases followed by metastatic lesions in 47 (5.90%) cases and lymphoma 17 (2.13%) cases. Conclusion: FNAC is a simple, safe, reliable, and inexpensive method for early detection of various non-neoplastic (lymphadenitis) & neoplastic lesions (lymphoma & metastatic carcinoma) of enlarged lymph nodes which helped diagnose approximately 99% of cases.

Platelet activities in pregnant women living with Human Immunodeficiency Virus on HAART in Lagos , Nigeria.

Introduction:Thrombocytopenia due to insufficient thromboxane A2 activation has been an independent predictor associated with bleeding in some pregnant women living with HIV. More so, the elevation in the systemic vasoconstriction by the abnormal activation of platelets through thromboxane A2 is a multi-system disorder during pregnancy resulting in maternal hypertension which is one of the major underlying pathophysiological occurrences in women with preeclampsia. Materials and Method: A cross-sectional, descriptive study to determine platelet activities in pregnant women living with Human Immunodeficiency Virus on HAART residing in Lagos State, was carried out. A total of 80 samples were collected; 40 from pregnant women on HAART (group A), 20 samples from HIV negative pregnant women (group B) and 20 from non-pregnant HIV positive women on HAART (group C). The samples were analyzed using automated haematology analyzer (MIDRAY BC 10), platelets morphology was reviewed from blood films stained by Leishman stain and thromboxane A2 was quantified using standard ELISA technique. Data was analyzed with SPSS version 23.0. Values were considered significantly different at P < 0.05. Results:The platelets count results revealed the mean ± standard error of mean (SEM) in group A, group B and group C as 236.27 ± 11.40, 227.26 ± 16.44 and 246.21 ± 21.54 respectively ( p = 0.743). The Platelet distribution width (PDW) revealed the mean ± SEM in group A, group B and group C as 13.50 ± 0.42 ,13.36 ± 0.53 and 12.56 ± 0.52 ( p = 0.390 ) . As for mean platelet volume (MPV), the mean ± SEM for group A, group B and group C were 12.36 ± 1.96, 10.71 ± 0.37, and 10.45 ± 1.78 respectively(p = 0.671). The mean ± SEM of thromboxane A2 in group A, group B and group C were 367.65 ± 37.74, 135.85 ± 51.69 and 276.10 ± 50.90 (p = 0.02). Conclusion and Recommendation: This study showed platelet aggregation in group A, group B and group C were 7.5% , 0%, and 2%; and this could be one of the suggestive factors in the increase in coagulation activities found in pregnancy. Thromboxane A2 level reflects a recent activation of platelets, thus it serves as a good biomarker. It is recommended that research be conducted to establish reference ranges of Thromboxane A2 for categories of normal individuals, including pregnant women in Lagos while attention should be paid to platelet activity studies in the Prevention of Mother to Child Transmission (PMTCT) programmes, to prevent mortality of participants on account of platelet aberrations.

Study of prevalence of acute leukemia

Introduction: Cancer of the body's blood-forming tissues, such as the lymphatic system and bone marrow, is known as leukaemia.There are various forms of leukaemia.Some leukemia types are more prevalent in children. Most cases of other types of leukemia are in adults. Usually, leukemia affects white blood cells. Although there is no known cause of acute leukemia, certain persons are at higher risk due to factors including radiation exposure. Exposure to particular chemical substances, such benzene. Viruses such as the virus that causes human T-cell leukemia. Method: This research was done via observation.82 leukemia cases that were discovered in the pathology division of the Netaji Subash Chandra Medical College in Jabalpur make up the sample size for the current prospective study. In the present study the cases were in the range of 1-70 years Clinically questionable cases were sent to the Department of Pathology, where a complete blood counts was performed using an automated hematology analyzer and a peripheral leishman stain smear investigation. Patients who have received treatment for a prior diagnosis are excluded in this study.

EVALUATION OF PANCYTOPENIA WITH BONE MARROW INTERPRETATION

Background: Pancytopenia is one of the most common clinico-haematological entity observed in our day to day clinical practice. It is a disorder in which all the three major elements of blood (i.e. red blood cells, white blood cells and platelets) are decreased in number. The causes of pancytopenia may be due to decrease in hematopoietic cell production in the marrow resulting from infections, toxins, malignant cell inltration, post- chemotherapy or post-radiation. Aims and Objectives: 1) To study the etiology and clinical presentation of pancytopenia in all age groups. 2) To correlate with bone marrow interpretation Materials & Methods: This is a prospective study which was conducted among 50 patients of pancytopenia in the Clinical Pathology, Government General Hospital,Kurnool from January 2021 to October 2022 Bone marrow aspiration was done by using Salah's bone marrow puncture needle. Smears were made from bone marrow aspirate (BMA) and stained by Leishman stain and special stains like Perl`s wherever necessary. The smears were assessed for cellularity, differentiation and maturation of erythroid, myeloid and megakaryocytic lineage, M:E ratio, Plasma cells, Lymphocytes and parasites/ abnormal cells. In the present study the commonest cause of Pancytopenia was Megaloblastic anemia (70%) follo Results: wed by Dimorphic anemia (20%). The less common conditions were Multiple Myeloma (6%),Chronic Myeloid Leukemia(2%),Acute Leukemia(2%). The present study concludes that com Interpretation and Conclusion: plete primary hematological investigations along with bone marrow aspiration in pancytopenic patients are helpful for understanding disease process and to diagnose or to the rule out causes of pancytopenia. These are also helpful in planning for further investigations and management.

Role of Bronchoscopic Cytology in Diagnosis of Pulmonary Lesions.

Respiratory cytology specimens such as bronchoalveolar lavage (BAL) and bronchial wash (BW) obtained using a fiberoptic bronchoscope are very useful in detecting or ruling out various inflammatory conditions, infections, and neoplastic lesions. A study was carried out to determine the usefulness of respiratory cytology in the diagnosis of pulmonary lesions and the limitations of cytology if any, and correlate the results of cytology with biopsies wherever possible. All bronchoscopic cytology and biopsy specimens received at the pathology laboratory of this tertiary care institute between June 2014 and May 2017 were analyzed. Cytology smears were stained with Leishman's stain, hematoxylin and eosin (H and E), Papanicolaou (PAP), and Ziehl-Neelsen (ZN) stain for all cases and special stains wherever needed. Slides prepared from biopsy specimens were stained with H and E. Immunohistochemistry was used for confirmation and further typing of malignant lesions and diagnosis rendered was compared with the corresponding cytology diagnosis. A total of 120 specimens of BAL or BW cytology with or without biopsy were analyzed. Thirty-three were diagnosed as non-specific inflammatory lesions. The most common malignancy diagnosed by cytology was adenocarcinoma followed by squamous cell carcinoma. Correlating BAL with biopsy specimens, the sensitivity, specificity, and diagnostic accuracy of BAL were 100%, 88.8%, and 91.6%, respectively. Correlating BW with biopsy specimens, the sensitivity, specificity, and diagnostic accuracy of BW were 85.6%, 85.6%, and 85.6%, respectively. Accurate diagnosis can be made from the examination of bronchoscopic cytology specimens in pulmonary inflammation, tuberculosis, fungal infections, and malignancies. Combining respiratory cytology with biopsy and ancillary techniques can aid in better subtyping of neoplastic lesions.

Platelet Satellitism

Platelet satellitism is a rare in vitro phenomenon presenting with platelets rosetting around neutrophils observed in peripheral blood smears prepared from blood samples anticoagulated with ethylenediaminetetraacetic acid (EDTA) but not with heparin sample. The subject was a 65-year-old woman presenting with pain abdomen at our hospital. As a routine investigation, complete blood count (CBC) was advised, and collection was done in EDTA vial. The sample was run in Sysmex Xs800i five-part hematology cell counter. The results of CBC were as follows: total leucocyte count: 15.59 × 103/uL; red blood cell count: 4.61 × 106/uL; hemoglobin: 12.8 g/dL; packed cell volume: 39.5%; mean corpuscular volume: 85.7fl; mean corpuscular hemoglobin (MCH): 27.8 pg; MCH concentration: 32.4 g/dL; and platelet: 26 × 103/uL. On preparation of blood smear and after staining with Leishman stain, the smear showed the formation of platelet rosette around the neutrophils. Platelet satellitism is, hence, defined as the formation of platelet rosetting or clumping around the neutrophils in sample collected in EDTA. Microscopic examination of samples collected in EDTA vial is important before commenting on platelet count.