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Introduction: COVID 19 pandemic caused by SARS-COV2 virus has taken a toll all over the world. The susceptibility of various diseases like Helicobacter Pylori, Hepatitis B virus and Norwalk Virus and even SARS Corona Virus 1 have been associated with ABO blood groups. However, very limited data is available regarding the COVID 19 susceptibility and ABO blood groups. Methods: In the present report we investigated 500 admitted patients who were RTPCR positive for corona virus. Significant Tests were applied to study association of blood groups vis a vis disease severity, ICU admissions and assisted ventilation. Results:  We found out that Type A blood group is more susceptible to severe COVID 19 infection, even though maximum patients were of type B blood group. We also found that type A blood group needed more ICU admission and assisted ventilation then non type A groups and difference was statistically significant. Conclusion: Patients with type A blood group COVID 19 patients with type A blood group might require more vigilant surveillance and aggressive treatment measures. Further studies are required to validate the disease susceptibility.

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Background and objectives: Soft tissue is a non-epithelial extraskeletal tissue of the body. Soft tissue tumors (STTs) are the most commonly diagnosed neoplasms. Fine needle aspiration cytology (FNAC) is minimally invasive, quick, and a definitive diagnostic modality. Biopsy for histopathology is the gold standard method for diagnosis but is invasive. The aims of this study were to determine the utility of FNAC in the diagnosis of STTs and correlate it with histopathology and to evaluate factors that cause discrepancies between FNAC and histopathology.
Methods: This retrospective, record-based study was done on STTs received for FNAC and histopathology examinations at the Department of Pathology, MIMS, Mandya from January 2018 to June 2021.
Results: A total of 74 cases of FNAC with histopathological correlation were available. Seventy one cases (95.9%) were benign and three (4%) were malignant according to FNAC. Discordance was seen in one case of low grade myxofibrosarcoma, which was diagnosed as benign spindle cell tumor on FNAC. The sensitivity, specificity, positive predictive value, and accuracy of FNAC in diagnosing malignancy were 75%, 100%, 100%, and 98.6%, respectively.
Conclusion: Our findings indicate that FNAC is beneficial preoperatively as it differentiates between benign and malignant lesions in most cases. In the case of low grade myxofibrosarcoma, bland tumor cells led to a benign diagnosis on FNAC, but histopathology allowed sampling of a larger area of the tumor and the right diagnosis was made. Biopsy is the gold standard, but FNAC has high specificity in diagnosing malignant tumors and prevents unnecessary extensive, radical surgery for benign lesions.

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Background and objectives: Lesions of the head and neck region are routinely encountered by clinicians, in patients across all age groups. Diagnoses range from reactive inflammatory conditions to malignancies. Cancer is among the leading causes of death in India. Head and neck cancers account for 23% of all cancer incidents in males and 6% of all incidents in females in India,. Fine needle aspiration cytology (FNAC) of cervical masses is an easy, effective, and relatively inexpensive technique. The aim of this study was to determine occurrence of various head and neck swellings and classify them under various categories.
Methods: The present study included 100 cases of palpable cervical swellings who had been referred to the AMC MET Medical College, Ahmedabad (India) from June 2018 to October 2020.
Results: The majority of cases were lymph node swellings (57%), followed by thyroid swellings (23%), salivary gland swellings (12%), and soft tissue swellings (8%). Among all cervical region swellings, tuberculous lymphadenitis and thyroid lesions were the most prevalent. 
Conclusion: The findings suggest that lymph node swellings are most commonly observed in the cervical area, and that the majority of them are inflammatory, requiring medical treatment rather than surgery. Moreover, FNAC is a straightforward, quick, and cost-effective way to distinguish between non-neoplastic and metastatic malignant lesions, which could help timely surgical interventions.  

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Hypocellular acute myeloid leukemia (AML) is an infrequent and challenging entity, and superinfection with coronavirus disease 2019 (COVID-19) could further complicate its diagnosis and management. It is characterized by low bone marrow cellularity, prominent cytopenias, and in many cases, clinically simulate aplastic anemia and hypoplastic myelodysplastic syndrome. We report a case of hypocellular AML-M2 in a 65-year-old male who was found to be COVID-19-positive. The cause of hypoplasia of bone marrow in such cases is still ambiguous and could be due to infiltration by blasts or co-infections. The cause of hypoplasia must be determined for proper management, which requires analysis of more such cases.
 

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Background and objectives: The coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2, a newly emergent coronavirus, first recognized in Wuhan, China in December 2019. Early identification of laboratory indicators helps in distinguishing severe patients from mild to moderate counterparts and can facilitate medical interventions, thereby lowering the mortality rate. The present study was done to evaluate the role of hematological parameters and basic coagulation parameters in the assessment of the severity of COVID-19.
Methods: This retrospective observational study was done at a tertiary care institute from May 2020 to May 2021. Hematological and coagulation profile was studied in 200 confirmed COVID-19 cases. Data related to age, gender, and clinical features were retrieved from patients’ records. Laboratory findings such as complete blood count neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, and coagulation parameters in different categories were compared.
Results: The majority of patients were males (59.5%) and with mild illness (52.5%). Moderate and severe illness was present in 30% and 17.5% of cases, respectively. The frequency of anemia, leucopenia, and thrombocytopenia was 62.5%, 6%, and 5.5%, respectively. Overall neutrophilia was seen in 40.5% of cases, whereas lymphopenia was seen in 39% of cases. Coagulation parameters were also much deranged in moderate and severe cases as compared to mild cases.
Conclusion: The hematopoietic and hemostatic systems are significantly affected by COVID-19. Careful evaluation of laboratory parameters assists clinicians in formulating a tailored treatment approach and in predicting disease severity.
 

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Background and Objectives: The outbreak of coronavirus disease 2019 (COVID-19) has become a public health emergency. This study aimed to investigate a possible correlation between COVID-19 severity and mortality and serum levels of ferritin and C-reactive protein (CRP).
Methods: This retrospective descriptive study was conducted on 75 COVID-19 patients hospitalized in a tertiary care hospital in Central Karnataka (India) from April 2021 to June 2021. Demographic details as well as clinical and laboratory parameters were retrieved from hospital records.
Results: Of 75 patients, 50 were survivors and 25 were non-survivors. Serum ferritin levels were significantly associated with mortality (p<0.040). There was no significant association between CRP level and COVID-19 severity or mortality (p>0.05).
Conclusion: This study revealed that serum ferritin levels can be used as a prognostic marker for COVID-19 patients.

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Background and objectives: In patients with coronavirus disease 2019 (COVID-19), white blood cell (WBC) abnormalities have been found worldwide with significant inter-regional differences. In the present study, we evaluated WBC parameters concerning COVID-19 positivity and severity.
Methods: In this cross-sectional study, total WBC count, absolute count of each type of WBC, neutrophil to lymphocyte ratio (NLR), and lymphocyte to monocyte ratio (LMR) were compared between 150 COVID-19 patients and 150 non-COVID-19 patients presenting with COVID-19-like symptoms. Also, COVID-19 patients were divided into severe and non-severe cases.
Results: The severity of the disease had no significant association with age or gender (p>0.05). Total WBC count, absolute neutrophil count, absolute monocyte count, and NLR were significantly lower (p<0.05), while LMR was significantly higher in COVID-19 patients compared to non-COVID-19 patients (p<0.05). Total WBC count, absolute neutrophil count, and NLR were significantly higher (p<0.05), while absolute eosinophil count and absolute lymphocyte count were significantly lower (p<0.05) in severe COVID-19 patients compared to non-severe patients.
Conclusions: Age is not a predictive factor for the severity of COVID-19. Routine WBC parameters are useful in predicting the severity of the disease in COVID-19 patients and can be used as prognostic indicators. Routine WBC parameters can also be used for repeat RT-PCR testing in COVID-19 suspected patients.

 

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Background: Autosomal dominant polycystic kidney disease (ADPKD) is a multisystem disorder characterized by progressive renal cysts formation and extra-renal manifestations. Infection within the cysts and abscess formation are rare but life threatening if left untreated. We present a rare case of peritonitis presentation due to intraperitoneal rupture of an infected cyst in a woman with polycystic kidney disease.
Case description: A 42-year-old woman presented with constant progressing abdominal pain and vomiting. She complained of abdominal distention, bloating, and a change in bowel habits from two days ago. On physical examination, bilateral enlarged masses of flanks, generalized tenderness, and distention of the abdomen were found. The patient received conventional therapy. After appropriate fluid and electrolyte management and rescue care, appropriate antibiotics were prescribed, and laparotomy was performed. The rupture of an infected cyst of the right polycystic kidney into the peritoneal cavity was the cause of peritonitis in this patient. She successfully underwent a right radical nephrectomy (32×21cm, and 3,300 gr). The postoperative period was uneventful and the patient was discharged from the hospital after a week.
Conclusion: Antibiotic therapy is the first step in the treatment of renal cyst infection. When primary antibiotic therapy fails, drainage of the infected cyst is recommended. In medically fit patients for surgery and patients who present with complications of the infected cyst, radical surgery and nephrectomy is the procedure of choice. The best outcome is achieved after nephrectomy.

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Background and objectives: Granulomatous disorders of the skin are frequently encountered in clinical practice and require histopathological confirmation due to a considerable etiological and clinical overlap. A single histopathological pattern may be produced by many causative agents and at the same time, a single cause can present with varied histopathological patterns. The present study was performed to evaluate the histomorphological patterns of granulomas in various granulomatous skin lesions and to identify the causative agents.
Methods: The study (both prospective and retrospective) was carried out in the department of pathology over 5 years. All skin biopsies were evaluated for the presence of granulomas. Detailed analysis of the histopathological pattern of granulomas was performed and categorization was made according to the type and etiology. Special stains were also used when required. A clinicopathological correlation was established with the Kappa statistic.
Results: Of 1,150 skin biopsies, granulomatous skin lesions were observed in 325 cases. Histiocytic granuloma pattern was the most common subtype (55.7%). The predominant etiology of granulomatous inflammation was leprosy (93.5%), followed by cutaneous tuberculosis (2.7%). The cases of Hansen’s disease showed a maximum clinicopathological correlation (58.5%).
Conclusion: Histopathological examination is the gold standard for the diagnosis and subtyping of granulomatous skin lesions. Varied morphologies of granuloma patterns were observed in our study, and infectious diseases were the causative agents in the majority of cutaneous granulomatous disorders. 

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Background: Blood transfusion is a potentially life-saving procedure that has many consequences and complications. Most of the complications are due to clerical and technical problems. Hence, the proper knowledge and skills of the personnel involved in blood transfusion are critical. Nurses are an integral part of blood transfusion procedures. Our study aimed to evaluate nurses' knowledge about safe blood transfusion practices in a tertiary care center in North Kerala.
Methods: This was a descriptive, cross-sectional study of 113 registered nurses involved in a blood transfusion procedure in a tertiary care center in North Kerala. The knowledge of the nurses was evaluated by using a questionnaire comprising 20 questions, of which 10 questions were about theoretical knowledge and 10 were about practical knowledge. Scores>75%, between 50% and 75%, and <50% were considered as good, fair, and poor knowledge, respectively.
Results: In our study, 44.25% of the nurses showed fair knowledge, and 32.7% had poor knowledge of knowledgebased questions. Moreover, 48.6 % had fair knowledge, and 14.16% had poor knowledge of practice-based questions. No statistically significant association was found between nurses' years of experience and theoretical and practical knowledge. A statistically significant association was found between the place of work and theoretical and practical knowledge. Many of the nurses lacked proper knowledge regarding the key aspects of blood transfusion.
Conclusion: We recommend more training programs to improve the knowledge and skills of the nurses to ensure the quality and safety of blood transfusion.

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Background: A higher occurrence of raised homocysteine levels has been reported in individuals with type 2 diabetes (T2D), particularly those with macroangiopathy and nephropathy. Given that hyperhomocysteinemia is a risk factor for T2D, mitigating this condition could potentially benefit T2D patients. This study aimed to investigate the influence of homocysteine on T2D and cardiovascular disease (CVD), as well as the factors that modify homocysteine levels.
Methods: This cross sectional, observational study was conducted on 122 individuals in a tertiary care center in Western India. Data related to anthropometry, demography, and biochemistry were gathered following established standards. Statistical analysis was performed using Chi-square test. A P-value of <0.05 was considered statistically significant.
Results: The findings indicated a significantly larger percentage of hyperhomocysteinemia in males, smokers, and individuals with elevated fasting blood sugar and HbA1c levels. The proportion of subjects with high homocysteine levels was notably greater in those with high total cholesterol and triglyceride levels. A significant correlation was observed between increased serum homocysteine levels and decreased serum folic acid and vitamin B12 levels in patients with ischemic heart disease.
Conclusion: Elevated homocysteine levels are observed in smokers and diabetic patients, potentially leading to CVD. Furthermore, this study found a correlation between an increase in serum homocysteine levels and a decrease in serum folic acid and vitamin B12 levels in patients with ischemic heart disease.
 

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Background: The purpose of tissue processing is to strengthen the tissue and place it in a suitable environment for slicing without causing damage. In routine histopathology, decalcification of calcified tissues is a principal step before tissue processing. Thus, the aim of this study is to evaluate the effect of several decalcifying agents on morphological and antigenic preservation in canine mandibular tissue.
Methods: Four different decalcifying solutions, including 5% nitric acid (NA), 10% and 20% formic acid (FA), and 10% ethylene diamine tetraacetic acid (EDTA), were employed to remove mineral salts from specimens harvested from mandibular osseous tissues of four healthy Mongrel dogs (32 samples). The solutions were compared regarding the decalcification time, ease of tissue slicing, morphological organization after Alizarin red S staining, and osteocalcin antigenic preservation.
Results: Considering the short decalcification time and ease of sectioning, 5% NA) yielded better results than 10% and 20% FA and 10% EDTA (pH 7.4). In terms of the preservation of morphology and antigenicity of the tissue samples, 10% EDTA was found to be the most optimal solution, followed by 10% and 20% FA and 5% NA.
Conclusion: Our findings support EDTA as a highly preferred choice for the decalcification of canine osseous tissue when aiming for immunohistochemistry, despite its time-consuming nature. However, for general histological staining procedures, 20% FA and 5% NA are preferred.
 

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Background and objectives: Non-Hodgkin lymphoma represents a heterogenous group of lympho-proliferative malignancies with unique presentation and treatment response. This study was intended to assess the histomorphology of non-Hodgkin lymphoma subtypes and correlate with clinicopathological and immunohistochemical findings.
Methods: A retrospective study was conducted on all samples, diagnosed as non-Hodgkin lymphoma by histopathological analysis, with available immunohistochemical findings. Study was conducted in the department of pathology, for 24 months, during the period of March 2018 to February 2020. The specimens were fixed in 10 % formalin and representative sections were obtained.
Clinical details such as age, gender, location and presentation were recorded. Histopathological and immunohistochemical findings were correlated. Statistical analysis based on p value was performed.
Results: The study includes a total of 48 cases with a male predominance (56.3%). Cervical lymph node (35.4%) was the most common site. Extra nodal presentation was noted in 39.6% of the cases including stomach, testis, hard palate, para-sacral area and para-vertebral area. Diffuse large B-cell lymphoma (43.8%), followed by follicular lymphoma and mantle cell lymphoma were the most common subtypes. A statistically significant p value of 0.05 was obtained.
Conclusion: In our study, we found diffuse large B cell lymphoma (DLBCL) as the most common type of Non Hodgkin’s Lymphoma. Cervical lymph nodes were most common site of involvement. But involvement of sites like the testis and palate were also found, hence the probability of NHL in these rare sites should always to be considered.