- India
ABSTRACTIntroductionEstimates of Within-Subject and between subject biological variation in South Asia are sorely lacking. Therefore, we attempted to estimate the short-term estimates of the same for Differential Counts (DC).MethodsThe... more
ABSTRACTIntroductionEstimates of Within-Subject and between subject biological variation in South Asia are sorely lacking. Therefore, we attempted to estimate the short-term estimates of the same for Differential Counts (DC).MethodsThe study was conducted on twenty eight healthy volunteers (15 males and 13 females). After morning collection of blood in K3-EDTA vials analysis was conducted in triplicate on the Sysmex XN-1000 analyzer for six consecutive days. The Within subject, between subject and analytical coefficient of variation of the DC was calculated from the results by nested repeated measures ANOVA after outlier exclusion. The Reference change values (RCV) were also calculated.ResultsThe within-subject variation for Eosinophil Count in our group from South Asia was greater than the published European and American studies. The between-subject variation in monocytes and basophils were also increased. Males and females showed similar biological variation for DC. The Within-sub...
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BackgroundClassification of breast leasions into different cytological groups (1-5) can accurately be done using the International Academy of Cytology (IAC) Yokohama System for reporting breast cytopathology. Fine needle aspiration biopsy... more
BackgroundClassification of breast leasions into different cytological groups (1-5) can accurately be done using the International Academy of Cytology (IAC) Yokohama System for reporting breast cytopathology. Fine needle aspiration biopsy (FNAB) of breast leasions has been considered to be the primary investigation in detecting breast cancers, especially in low-cost settings. The main objective of this study was to prospectively re-confirm the diagnostic accuracy of breast FNAB using the IAC Yokohama system. Additionally, separate separate secondary subgroup analysis was done to confirm the accuracy of breast FNAB excluding lymph-node positive and lymphadenopathy positive tumors.Material and methodsA prospective study was done in a tertiary care centre in North India on patients undergoing core-needle /incisional/excisional biopsy of breast lesions between 1st September 2019 to 30th November,2020 (519 biopsies on 487 unique patients). Of these 519 histopathology biopsies, 505 had co...
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Research Interests: Psychology and The Breast
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Research Interests: Psychology and The Breast
Research Interests: Psychology and The Breast
Our aim was to determine the prevalence of dengue among blood donors at a centre in north India during an outbreak. A retrospective cross-sectional study was conducted using stored serum samples of 369 blood donors at the All India... more
Our aim was to determine the prevalence of dengue among blood donors at a centre in north India during an outbreak. A retrospective cross-sectional study was conducted using stored serum samples of 369 blood donors at the All India Institute of Medical Sciences (AIIMS), Rishikesh between August and November 2016. Serum samples were tested by an immune-chromatographic rapid test for the screening of dengue markers (IgG/IgM and NS-1). We found prevalence rates of IgG and NS-1 to be 14.9 and 0.54%, respectively.
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Subclinical Iron deficiency appearing in blood donors after blood donation is a recognized problem. Donors at an increased risk of iron deficiency need to be identified. Blood donors meeting national selection criteria were included in... more
Subclinical Iron deficiency appearing in blood donors after blood donation is a recognized problem. Donors at an increased risk of iron deficiency need to be identified. Blood donors meeting national selection criteria were included in the study. Complete blood counts were done using Sysmex XP-100 three part hematology analyzer. Differences in RBC indices among donor groups defined by previous donations were then analyzed statistically. Six hundred and seventy three males and ninety six females were studied. In males, Kruskal-Wallis test showed significant differences between groups defined by number of donations for MCH and MCV ( value < 0.001), but not for MCHC ( value = 0.09) and RDW ( value = 0.6). Post-hoc tests showed statistically significant difference between donors having six or more donations compared to donors having no previous donations for both MCH as well as MCV. No significant difference was found between donor subgroups in females for any of the indices; however...
There is scant documentation of the stability of common haematological parameters on storage of blood samples under tropical conditions. KEDTA samples in multiple vials were taken from 20 healthy blood donors, baseline readings taken, and... more
There is scant documentation of the stability of common haematological parameters on storage of blood samples under tropical conditions. KEDTA samples in multiple vials were taken from 20 healthy blood donors, baseline readings taken, and stored at 33℃ and 37℃. Readings from the stored vials were taken after 1, 3 and 6 h. The percent change against the baseline readings at each time point for each storage temperature was calculated. Platelet counts showed an unacceptable shift within 1 h at 37℃ and 3 h at 33℃; red cell volume related parameters showed an unacceptable shift within 3 h at 37℃ and 6 h at 33℃. Haemoglobin, red blood cell count, white blood cell count and mean corpuscular haemoglobin remained stable for 6 h at both temperatures. The unacceptable change for many parameters on storage at ≥33℃ demonstrates the importance of ensuring pre-analytical control in regions experiencing such climatic conditions.
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This study aimed to investigate the analytical bias in haematological parameters induced by storage at 33 ºC. Blood from the diversion pouch of 20 blood donors were collected in K EDTA vials and stored at 33 ºC. Readings from each vial... more
This study aimed to investigate the analytical bias in haematological parameters induced by storage at 33 ºC. Blood from the diversion pouch of 20 blood donors were collected in K EDTA vials and stored at 33 ºC. Readings from each vial were taken at 0, 4, 6, 12, 24, 48 and 72 hours after collection on the Sysmex XP-100 analyser (Sysmex Corporation, Kobe, Japan). The percent difference from the baseline readings were calculated and subjected to a Wilcoxon signed rank test at a Holm corrected significance level of 0.05. A median percent difference, which was statistically significant and greater than the maximum acceptable bias (taken from studies of biological variation), was taken as evidence of unacceptable shift. If the median shift was lesser than the maximum acceptable bias, two one-sided Wilcoxon signed rank tests for equivalence were used to determine whether the percent differences were significantly lesser than the maximum acceptable bias. Haemoglobin, red blood cell count, ...
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Aim: This study aimed to investigate the analytical bias and imprecision in haematological parameters induced by storage at 4°C, 22°C and 33°C. Methods: Three K2EDTA anticoagulated vials of blood were collected from each of twenty blood... more
Aim: This study aimed to investigate the analytical bias and imprecision in haematological parameters induced by storage at 4°C, 22°C and 33°C. Methods: Three K2EDTA anticoagulated vials of blood were collected from each of twenty blood donors and stored at 4°C, 22°C and 33°C respectively. Readings from each vial were taken at 0, 4, 6, 12, 24, 48 and 72 hours after collection on the Sysmex XP-100 analyser. The mean and median shift of the parameters relative to the baseline and the coefficient of variation for each time-temperature combination were calculated. The shift was compared to the maximum acceptable bias. Results: Haemoglobin, Red Blood Cell Count, White Blood Cell Count, Mean Corpuscular Haemoglobin were stable for at least twenty four hours at 33°C. Haematocrit, Mean Corpuscular Volume and Platelet Counts were stable for less than four hours at 33°C. All the above parameters were stable for longer at 22°C and 4°C. The three-part differential count showed instability withi...
Cysticercosis is a common parasitic infection in many Asian countries. The histopathological features of this parasitic infection are well established, however, the subtle cytological features and their importance in diagnosing this... more
Cysticercosis is a common parasitic infection in many Asian countries. The histopathological features of this parasitic infection are well established, however, the subtle cytological features and their importance in diagnosing this condition need more elaboration. In this case series we have reiterated the role of fine-needle aspiration cytology (FNAC) in the diagnosis of cysticercosis in clinically unsuspected cases, thereby obviating the need for a biopsy. Sixteen patients presented with palpable subcutaneous swellings. The clinical diagnosis varied from tubercular/reactive lymphadenitis, lipoma to neurofibromatosis. These patients were subjected to FNAC of the swellings. In all 16 cases, a definitive diagnosis of cysticercosis was made on FNAC on the basis of characteristic features like parasite tegument/bladder wall and occasional hooklets. Features suggestive of host reaction were also observed, which included multinucleated giant cells, mixed inflammatory infiltrate with conspicuous eosinophils, histiocytes, and palisading granulomas. These findings were correlated with histopathology and patients were followed up. We noticed spontaneous resolution of the nodules after the FNAC in six patients. The cytological diagnosis of cysticercosis is quite straightforward in cases where the actual parasitic structures are identified in the smears. However, in the absence of parasitic fragments, features suggestive of host reaction should alert the cytologist to search for the evidence of cysticercosis in the smear, which can help in early and timely diagnosis and treatment of the disease. We also postulate that injury to certain parts of the larval form during FNAC procedure would result in degeneration of the parasite.
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Diabetes mellitus is one of the commonest medical conditions affecting humans. However, knowledge of diabetes mellitus in the context of blood transfusion is lacking. In this article, the eligibility of people with diabetes as donors,... more
Diabetes mellitus is one of the commonest medical conditions affecting humans. However, knowledge of diabetes mellitus in the context of blood transfusion is lacking. In this article, the eligibility of people with diabetes as donors, issues faced during blood component transfusion to diabetics and impaired glucose tolerance among chronic blood recipients will be discussed, along with discussion of the present state of evidence.
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... India. Address for correspondence: Professor Surendra Kumar Verma, E‐mail: skverma60@satyam.net.in. Sir,. Dermatopathic ... Pondicherry, India. Address for correspondence: Professor Surendra Kumar Verma, E‐mail:... more
... India. Address for correspondence: Professor Surendra Kumar Verma, E‐mail: skverma60@satyam.net.in. Sir,. Dermatopathic ... Pondicherry, India. Address for correspondence: Professor Surendra Kumar Verma, E‐mail: skverma60@satyam.net.in. ...
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To study random and the systematic error in breast cancer grading, to find the source of disagreements and measure the reliability of graders so that appropriate corrective action can be taken. Five independent observers graded 50 breast... more
To study random and the systematic error in breast cancer grading, to find the source of disagreements and measure the reliability of graders so that appropriate corrective action can be taken. Five independent observers graded 50 breast carcinoma slides from 50 consecutive breast cancer specimens according to the Nottingham criteria. The polychoric correlation was used to measure association. Stuart-Maxwell and McNemar tests were used to measure equality of thresholds. The polychoric correlation among observers was high (mean = 0.803, 0.712, 0.797 and 0.602 for the final grade, tubule formation, nuclear pleomorphism and mitotic figures, respectively). However, there were significant differences in thresholds (6, 7, 7 and 9 pairs of 10 showing significant differences in classification of grades/scores for final grade, tubule formation, nuclear pleomorphism and mitotic counts, respectively). The high polychoric correlations suggest that random error in grading breast cancers in this ...
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Fine needle aspiration cytology plays an important role in the preoperative assessment of soft tissue neoplasms. In a 40-year-old man presenting with a large soft tissue mass in the posterior aspect of thigh a diagnosis of myxoid... more
Fine needle aspiration cytology plays an important role in the preoperative assessment of soft tissue neoplasms. In a 40-year-old man presenting with a large soft tissue mass in the posterior aspect of thigh a diagnosis of myxoid liposarcoma was suggested on FNAC. Scrape smears of the excised mass showed an additional finding of round cell component. Histopathology confirmed combined myxoid and round cell liposarcoma (grade 2), which behaves aggressively when compared to pure myxoid liposarcoma.
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The diagnosis of soft tissue tumors is one of the biggest diagnostic challenges in pathology. In this study, we attempted to measure the accuracy of FNAC in diagnosing soft tissue tumors. All the cases of FNAC with cyto-histological... more
The diagnosis of soft tissue tumors is one of the biggest diagnostic challenges in pathology. In this study, we attempted to measure the accuracy of FNAC in diagnosing soft tissue tumors. All the cases of FNAC with cyto-histological correlation between January 2003 and August 2005 (a total of 72 cases) were collected and sensitivity, specificity, positive and negative predictive values measured. The sensitivity and positive predictive value for differentiating between benign and malignant lesions was 0.8421, while the specificity and negative predictive value was 0.9412 for the same. The main problem was false negatives due to a borderline or low grade spindle cell sarcoma being classified as benign. However, only 18 cases could be typed precisely. Therefore, FNAC has a role in the initial diagnosis of soft tissue sarcomas, but it should be used as a complement rather than a competitor to histopathology.
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Introduction Microarray analysis has revolutionized the role of genomic prognostication in breast cancer. However, most studies are single series studies, and suffer from methodological problems. We sought to use a meta-analytic approach... more
Introduction
Microarray analysis has revolutionized the role of genomic prognostication in breast cancer. However, most studies are single series studies, and suffer from methodological problems. We sought to use a meta-analytic approach in combining multiple publicly available datasets, while correcting for batch effects, to reach a more robust oncogenomic analysis.
Aim
The aim of the present study was to find gene sets associated with distant metastasis free survival (DMFS) in systemically untreated, node-negative breast cancer patients, from publicly available genomic microarray datasets.
Methods
Four microarray series (having 742 patients) were selected after a systematic search and combined. Cox regression for each gene was done for the combined dataset (univariate, as well as multivariate – adjusted for expression of Cell cycle related genes) and for the 4 major molecular subtypes. The centre and microarray batch effects were adjusted by including them as random effects variables. The Cox regression coefficients for each analysis were then ranked and subjected to a Gene Set Enrichment Analysis (GSEA).
Results
Gene sets representing protein translation were independently negatively associated with metastasis in the Luminal A and Luminal B subtypes, but positively associated with metastasis in Basal tumors. Proteinaceous extracellular matrix (ECM) gene set expression was positively associated with metastasis, after adjustment for expression of cell cycle related genes on the combined dataset. Finally, the positive association of the proliferation-related genes with metastases was confirmed.
Conclusion
To the best of our knowledge, the results depicting mixed prognostic significance of protein translation in breast cancer subtypes are being reported for the first time. We attribute this to our study combining multiple series and performing a more robust meta-analytic Cox regression modeling on the combined dataset, thus discovering 'hidden' associations. This methodology seems to yield new and interesting results and may be used as a tool to guide new research.
Microarray analysis has revolutionized the role of genomic prognostication in breast cancer. However, most studies are single series studies, and suffer from methodological problems. We sought to use a meta-analytic approach in combining multiple publicly available datasets, while correcting for batch effects, to reach a more robust oncogenomic analysis.
Aim
The aim of the present study was to find gene sets associated with distant metastasis free survival (DMFS) in systemically untreated, node-negative breast cancer patients, from publicly available genomic microarray datasets.
Methods
Four microarray series (having 742 patients) were selected after a systematic search and combined. Cox regression for each gene was done for the combined dataset (univariate, as well as multivariate – adjusted for expression of Cell cycle related genes) and for the 4 major molecular subtypes. The centre and microarray batch effects were adjusted by including them as random effects variables. The Cox regression coefficients for each analysis were then ranked and subjected to a Gene Set Enrichment Analysis (GSEA).
Results
Gene sets representing protein translation were independently negatively associated with metastasis in the Luminal A and Luminal B subtypes, but positively associated with metastasis in Basal tumors. Proteinaceous extracellular matrix (ECM) gene set expression was positively associated with metastasis, after adjustment for expression of cell cycle related genes on the combined dataset. Finally, the positive association of the proliferation-related genes with metastases was confirmed.
Conclusion
To the best of our knowledge, the results depicting mixed prognostic significance of protein translation in breast cancer subtypes are being reported for the first time. We attribute this to our study combining multiple series and performing a more robust meta-analytic Cox regression modeling on the combined dataset, thus discovering 'hidden' associations. This methodology seems to yield new and interesting results and may be used as a tool to guide new research.
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The present study illustrates the effect of using the consolidated total score (obtained on a 7-point scale by adding the tubular, nuclear and mitotic scores) as well as double reporting on the interobserver reliability of breast cancer... more
The present study illustrates the effect of using the consolidated total score (obtained on a 7-point scale by adding the tubular, nuclear and mitotic scores) as well as double reporting on the interobserver reliability of breast cancer grading by the Nottingham method. 50 consecutive breast cancer slides were graded independently by 5 pathologists. The interobserver reliability between the individual pathologists for final grade, total score and grade components was estimated by quadratic weighted kappa (kw). Similarly, the inter-observer reliability of double reported scores (obtained by averaging the reported scores of two independent pathologists) for independent observer pairs was estimated. The total scores gave higher reliability figures than the final grade both for individual pathologists and double reported scores. The double reported total scores and grade also gave significantly higher reliability figures than the individual scores and grade (average kw=0.65 and 0.78 for the individual and double reported total scores, respectively; 0.61 and 0.66 for the individual and double reported grades).Therefore, use of total scores in addition to grade as well as double reporting of the same significantly increases the interobserver reliability of breast cancer grading.
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... India. Address for correspondence: Professor Surendra Kumar Verma, E‐mail: skverma60@satyam.net.in. Sir,. Dermatopathic ... Pondicherry, India. Address for correspondence: Professor Surendra Kumar Verma, E‐mail:... more
... India. Address for correspondence: Professor Surendra Kumar Verma, E‐mail: skverma60@satyam.net.in. Sir,. Dermatopathic ... Pondicherry, India. Address for correspondence: Professor Surendra Kumar Verma, E‐mail: skverma60@satyam.net.in. ...