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Background: It is an axiomatic truth that children of today are citizens of tomorrow, and upon them depend the well-being and welfare of the community. In a country like India, children fall prey to anaemia as a majority of them remain ill-fed and undernourished due to poverty and ignorance. If not detected at the earliest, this draconian disease will spread its tentacles so widely as to impair or endanger the very physical condition of children. Aim: To evaluate the clinical and hematologocal profiles of anaemic children coming to the paediatric department of GRH Madurai, To use an automated hemogram for precise morphological subtyping and to correlate hemogram results with etiology. Methods: All children aged 12 who presented to the GRH Paediatric Department with anaemia were evaluated. physical examination, proper history, and haematological parameters were studied. Follow-up of treated cases is done and special investigations are done in resistant cases of anemia. Results: Of 248 children with anemia studied, 147 children had Microcytic Hypochromic Anemia, 70 children had Normochromic Normocytic Anemia, 24 children had Dimorphic Anemia and 7 children had Macrocytic Anemia. Among microcytic hypochromic anemia 129 children (87.7%) had iron deficiency anemia, Thalassemia Major-12 (8.1%), Thalassemia Trait-4 (2.7%), One child had chronic anaemia and the other had HbE. Dimorphic anaemia was seen in 19 children (79.1%) with Iron Deficiency Anemia and 5 children with Chronic Disease Anemia. Twenty-nine percent. In normochromic normocytic anemia, Iron deficiency anemia was seen in 29 children (41.4%), Acute leukemia in 19 children (27.1%), Immune haemolytic anemia in 10 children(14.8%).In macrocytic anemia aplastic anemia seen in 5 children (71.4%) and megaloblastic anemia in 2 children.(28.6%) Conclusion: In the cross-sectional study, peripheral smear and complete hemogram studies were done in all children. Automated hemogram parameters like MCV, RDW, and Mentzer Index were correlated with the cause of anemia. Most children can get an exact diagnosis with simple tests like a peripheral smear and an automated hemogram.

1.Azmat Manzoor, Muhammed Tayyib, Tahira Tasnim.Anemia in school children Pak Postgrad Med J Mar 2003:14(1):44-7Department of Pathology, Post graduate Medical Institute, Lahore. 2.Balin A et al. Iron state in female adolescents. American Journal of Diseases of Children, 1992, 146:803-805. 3.Buetler E, Fairbanks VF: The effects of Iron deficiency: Iron in biochemistry and medicine II,edited by A.Jacobs,M Worwood,p393,Academic press, New York. 4.Bryan CP: The Papyrus Ebers. Appleton-Century-Crofts, New York, 1931. 5.Crosby WH.Pica JAMA1976:235:2765. 6.Duma H, Efremov G, Sadikario A, et al: Study of nine families with haemoglobin-Lepore. Br J Haematol 15:161, 1968. [PMID: 5675530]. 7.Fairbanks VF, Gilchrist GS, Brimhall B, et al: Hemoglobin E trait reexamined: A cause of microcytosis and erythrocytosis. Blood 52:109, 1979. 8.Gulbis. b. Eleftheriou A, Anganstiniotis M et al ;Epidemiology of rare anemias in Europe Exp Med BioL.2010.686:375-96 9.Haas JD, Brownlie T: Iron deficiency and reduced work capacity: A critical review of the research to determine a causal relationship. J Nutr 131:676S, 2001. 10.Heath CW, Strauss MB, Castle WB: Quantitative aspects of iron deficiency in hypochromic anemia. J Clin Invest 11:1293, 1932. 11.J.Patel,A.Patel,A.Kaur andV.Patel :Prevalence of Hemoglobinopathies in Gujarat-A cross sectional study.The Internet Journal of Hematology 2009 Volume 5:1-9. 12.Kapoor D, Agarwal KN, Iron status of children aged 9-36 months: ICDS project Indian Pediatrics 2002 Feb 136-44 13.L.Allen,b, De benoist, O. Dary and R.Hurrell ,guidelines on food fortication with micronutrients, WHO,Geneva,Switzerland,2006. 14.Lima CS, Reis AR, Grotto HZ,Saad ST, Costa FF:Comparison of RDW and a red cell discriminant function incorporating volume dispersion for distinguishing iron deficiency from beta thalassemia trait in a ptients with microcytosis: Sau Paulo Med J1996Sep Oct:114(5):1265-9. 15.Lozoff B et al. Behavioural abnormalities with iron deficiency. In: Pollitt E, Leibel RL, eds. Iron deficiency: brain biochemistry and behavior. New York, Raven Press Ltd., 1982:183-194. 16.Lozoff B. Methodologic issues in studying behavioral effects of infant iron-deficiency anemia. American Journal of Clinical Nutrition, 1989, 50:641-654. 17.Lozoff B, Jimenez E, Wolf AW. Long term developmental outcome of infants with iron deficiency. New England Journal of Medicine, 1991, 325:687-695. 18.M.A. Ehsani E.hagholi, M.S Rahiminejad, F. Seighali and A.Rashidi A New index for Discrimination between Iron Deficiency Anemia and Beta-Thalassemia Minor: results in 284 patients Pakistan Journal of biological sciences Year 2009/volume;12/Issue5 /page No 473-75. 19.MarshWL Jr Bishop Jw, Darcy TP. Evaluation of RDW Department of laboratory medicine, naval hospital, San diego, California Hematol,pathol.1987;1(2);117-23. 20.Michaels LA et al. Screening for HS by erythrocyte indices J Pediatr 1997:130:957-960 21.Molla et al JDMA-1992 May 42(5):118-121. 22.Pollitt E. Effects of a diet deficient in iron on the growth and development of preschool and school-age children. Food and Nutrition Bulletin, 1991, 13:110-118. 23.Pollitt E et al. Iron deficiency and educational achievement in Thailand. American Journal of Clinical Nutrition, 1989, 50:687-697. 24.Pollitt E et al. Cognitive effects of iron deficiency anaemia (letter to the editor). Lancet, 1985, 1:158.

Background: The second-leading cause of cancer-related deaths globally is breast cancer. The two main hormones that regulate the formation of breast tumours are oestrogen and progesterone. Hormone receptors can now be used to find out if someone has breast cancer and to treat it. Aim and Objective: The purpose of this study was to look at how oestrogen and progesterone receptors are expressed in breast cancer patients. This study looked at the significance of the Quick Score in relation to the histological grade of the tumour as well as the connection between oestrogen and progesterone receptors and clinicopathological factors. Study design: A total of 70 cases undergoing axillary lymph node dissection and a mastectomy for infiltrating duct cancer were included in the study. Cases of male breast cancer were not included in the investigation. Retrospective data was compiled, including the patient's age, tumour size, histological diagnosis, Bloom Richardson grade of the tumour, and lymph node metastases. Oestrogen and progesterone receptor immunohistochemistry was performed using commercially available antibodies from NOVACASTRA. Observation and Results: Tumor grade, tumour size, lymph node metastasis, and oestrogen and progesterone receptor expression had a statistically significant adverse connection. But there was no statistical link between the age of the patient and how the oestrogen and progesterone receptors were expressed. Conclusion: The current study showed that the expression of oestrogen and progesterone receptors goes down as the tumour gets worse, gets bigger, and spreads to more lymph nodes.

1. World Cancer Report. International Agency for Research on Cancer. June 2003. Retrieved 2009-03-26. 2. Desai SB, Moonim MT, Gill AK, Punia RS, Naresh KN, Chinoy RF. Hormone receptor status of breast cancer in India: a study of 798 tumors. Breast. 2000; 9:267– 270. doi: 10.1054/brst.2000.0134. 3. Dunnwald LK, Rossing MA, Li CI. Hormone receptor status, tumor characteristics, and prognosis: a prospective cohort of breast cancer patients. Breast Cancer Res. S 2007; 9:R6. doi: 10.1186/bcr1639. 4. John D Bancrofft 5 th edition. theory and practice of histological techniques. 5. Labvision Neo markers, immunohistology protocol 47790 Westinghouse Drive, Fremont, CA 94539, U.S.A. 6. Shi SR, et al. Appl Immunohistochem Mol Morphol 7;201-208, 1999. 7. Mohammed RH, Lakatau DJ, Haus E, Yasmineh WJ: Estrogen and Progestrone receptors in human breast cancer. Correlation with histologic sub type and degree of differentiation. Cancer 1986, 58. 8. Ruder AM, Lubin F, Wax Y, Geiser A, Alfundary E, Chetrit A: Estrogen and progesterone receptors in breast cancer patients. Epidemiologic characteristics and survival differences. Cancer 1989, 64:196-202. 9. Ashba J, Traish AM: Estrogen and progesterone receptor concentrations and prevalence of tumor hormonal phenotypes in older breast cancer patients. Cancer detect prev 1999, 23 : 238-4. 10. Donegan WL. Prognostic factors: stage and receptor status in breast cancer.cancer 1992 ; 70; 1755-64. 11. Cianfrocca M, Goldstein LJ ; Prognostic and predictive factors in early – stage breast cancer: oncologist 2004, 9: 606 – 616. 12. Nidal M Almasri and Mohammed Al Hamad: Immunohistochemical evalution of human epidermal growth factor receptor 2 and estrogen and progesterone receptors in breast carcinoma. Breast Cancer Research 2005, 7:R 598- R604 doi : 10.1186. 13. Lisa K Dunwald, Mary Anne Rossing and Christopher 1 Li. Hormone receptor status, tumor characteristics and prognosis: a prospective cohort of breast cancer patients. Breast cancer Research 2007, 9: R 6 doi : 10.1186/bcr 639. 14. Killinc N, Yardiz M: P53, Cerb-2 expression and steroid hormone receptors in breast carcinoma: correlations with histopathologic parameters. Eur J Gnaecol Oncol 2004, 25: 606-10. 15. Nidal M Almasri and Mohammed Al Hamad: Immunohistochemical evalution of human epidermal growth factor receptor 2 and estrogen and progesterone receptors in breast carcinoma. Breast Cancer Research 2005, 7: R 598- R604 doi : 10.1186/bcr 1200. 16. Kuenen- Boumeester V, Van der Kwast TH, Claassen CC, Look MP, Liem GS, Klijn JG, et al. The clinical significance of androgen receptors in breast cancer and their relation to histological and cell biological parameters. Eur J Cancer. 1996 32 A: 1560-5. 17. Leake R, Barnes D, Pinder S, Ellis I,Anderson L, Adomson R: immmunohistochemical detection of steroid receptors in breast cancer : A working protocol. J Clin Pathol 2000; 53:634-5. 18. Desai SB, Moonim MT, Gill AK, Punia RS, Naresh KN, Chinoy RF (2000). Hormone receptor status of breast cancer in India : a study of 798 tumors. Breast a : 267-270. 19. Wells CA, Sloave JP, Coleman D, Munt C, Amendoeira I, Apostalikas N : Consistency of staining and reporting of estrogen receptor. Immunohistochemistry with in the European Union: An inter – laboratory study. Virchows Arch 2004; 445: 119 – 28. 20. Yamashita H, Ando Y, Nishio M, Zhang Z, Hamaguchi M, Mita K: Immunohistochemical evalution of hormone receptor status for predicting response to endocrine therapy in me4tastatic breast cancer. Breast cancer 2006; 13 : 74-83. 21. Lakmini KB Mudduwa. Quick score of hormone receptor status of breast carcinoma: correlation with the other clinicopathological prognostic parameters. 2009:52:2:159-163.

Background: The most prevalent genital tract cancer in Indian women is cervical cancer. An estimated 126,000 new cases of cervical cancer are reported each year in India. The Pap test is very important for early detection of cervical cancer and its precursor lesions. It also helps with the diagnosis of infectious and inflammatory conditions, such as finding the causative organism, benign epithelial changes caused by hormones, and changes caused by medications. Objective: Pap smear's usefulness in detecting cervix lesions that are non-neoplastic, premalignant, and malignant, as well as to ascertain the prevalence of different lesions, are both being studied. Results: Out of 308 instances, the vast majority were benign, including 294 (95%) cases of NILM (Negative for Intraepithelial Neoplasia), 5 (1.62%) cases of ASCUS, and 2 (0.64%) cases of each squamous cell carcinoma and LSIL. Conclusions: Preinvasive cervical epithelial lesions can be found using the highly helpful, straightforward, affordable, and safe Pap smear test. In light of this, cervical screening for women over 30 must be done regularly, and it must continue even after menopause.

1. Desai M. An assessment of community based cancer screening program among Indian women using the Anganwadi workers. J Obstet Gynecol India. 2004; 54:483-7. 2. Rani A et al. Int J Reprod Contracept Obstet Gynecol. 2015 Apr;4(2):439-441. 3. Sankaranarayanan R, Nene BM, Dinshaw K, Rajkumar R, Shastri S, Wesley R, et al. Early detection of cervical cancer with visual inspection methods: a summary of completed and ongoing studies in India. Salud Publica Mex 2003; 45:S399- 407. 4. Bal MS, Goyal R, Suri AK, Mohi MK. Detection of abnormal cervical cytology in Papanicolaou smears. J Cytol 2012; 29:45-7. 5. Mintzer M, Curtis P, Resnick JC, Morrell D. The effect of the quality of Papanicolaou smears on the detection of cytologic abnormalities. Cancer 1999; 87:113-7. 6. Mehta et al. NHL journal of medical sciences/Jan 2013/vol 2/Issue 1. 7. Globacon 2002, cancer incidence mortality and prevalence in india. 8. Afrakhteh M, Khodakarami N, Moradi A, Alavi E, Shirazi FH. A study of 13315 papanicolasmear diagnoses in Sohada hospital. J Fam Reprod Health 2007; 1:75-9. 9. Banik U, Bhattacharjee P, Ahamad SU, Rahman Z. Pattern of epithelial cell abnormality in Pap smear: A clinicopathological and demographic correlation. Cytojournal 2011; 8:8. 10. Anderson and Jones: false positive cervicovaginal cytology. acta cytol 41(6):267,1997. 11. Jena A, Bharathi T, Siva Kumar Reddy YK, Manilal B, Patnayak R, Phaneendra BV. Papanicolaou (Pap) test screening of staff members of a tertiary care teaching hospital in South India. J Clin Sci Res 2012; 1:174-7. 12. K.Park: Test book of preventive and social medicine,18th edi.2005; page no304-305. 13. Carmichael JA, Clarke DH, Moher D, et al. Cervical carcinoma in women aged 34 and younger. Am J Obstet Gynecol 1986; 154:264-9. 14. Task force convened by the Department of National Health and Welfare. Cervical cancer screening programs: summary of the 1982 Canadian task force report. Can MedAssocJ 1982; 127:581-9. 15. Hulka BS. Risk factors for cervical cancer. J Chronic Dis 1982; 35:3-11. 16. Mandakini M Patel et al national journal of community medicine 2011 :2-1 17. Summary chapter: IARC Working Group on Cervical Cancer Screening. In: Hakma M, Miller AB, Day NE, editors. Screening for Cancer of the Uterine Cervix. 18. Umarani MK et al. Study of cervical cytology in Papanicolaou (Pap) smears in a tertiary care hospital Indian Journal of Pathology and Oncology, October-December 2016;3(4);679-683. 19. Beinton A, Palintasa, Barrett Conner; estrogen depressive symptoms in postmenopausal women. J of Obst and Gyneccol 1986;80(1):30-33. 20. Kalpna Mital, Usha Agarwal, V K sharma, T B L Jaiswal; Evaluation of cytological an histological examinations in precancerous and cancerous lesions amongst gynaecological diseases; Indian J of Obst and Gyneccol 1989, 42(8):713-715. 21. S H Chauhan, O K Tayal, I J Kalia; detection of uterine cervical dysplasia and carcinoma cervix.; Indian J of Obst and Gyneccol 1990,17:419-421. 22. Spinilla A, Christiansenc, Belynger D et al.; The study of infection in cervical cytomorphology; Br Jr of Obst and Gyneccol 1997,20(5):398-409. 23. Sepehr N Tabrizi, Tappan R, Flense D.; The infectivity of HPV and HSIL; Br J of Obst and Gyneccol 1999; 42(3):167-71. 24. Thomas A, Corrara, Majoria M A, Kumar K R. The Bethesda System recommendation in reporting benign endometrial cells in cervical smears from postmenopausal women published by American Cancer Society.; Indian Jr of Pathol Microbial 2002; 25(1): 134-38. 25. Sherwani RK, Khan T+, Akhtar K, Zeba A et al. Conventional Pap smear and Liquid Based Cytology for Cervical Cancer Screening – A Comparative Study; Jr of Cytol 2007; 24 (4): 167-172. 26. Vaghela et al Analysis of abnormal cervical cytology in Papanicolaou smears at tertiary care center – A retrospective study :IJBAR (2014) 05 (01). 27. Sarma U, Mahanta J, Talukdar K. Pattern of Abnormal Cervical Cytology in women attending a Tertiary Hospital. IJSRP 2012;2. Available from http://www.ijsrp.org/research-journal-1212.php . 28. Gupta K, Malik NP, Sharma VK, Verma N, Gupta A. Prevalence of cervical dysplasia in western Uttar Pradesh. J Cytol 2013; 30:257-62. 29. Preetha George, Sumathy Rao. Cytology of uterine cervix by pap smear: a study from South India. Journal of evolution of Medical and Dental Sciences 2014; 3:13796-803. Available from http://jemds.com/latest-articles.php?at_id=5942. 30. Sadhana Kothari, Arpit Gohel, Anupama Dayal, Rupal Shah, Shantibhai Patel. Pap smear - A tool for detection of cervical intraepithelial lesions in health check up schemes: A study of 36,740 cases. Int J Res Med 2014;3:12-5. Available from http://www.ijorim.com/archive_show.php?year=2014andissue=VOLUME%203,%20ISSUE%202. 31. Geetha Katheit, Shilpa Tiwari. Cytological pattern and demographic determinants of cervical cytology (Papanicolaou smear) in a tertiary centre of central India. European journal of biomedical and pharmaceutical sciences 2015; 2:1402-9. Available from http://www.ejbps.com/ejbps/abstract_id/517. 32. Geethu G. Nair et al Cytopathological pattern of cervical pap smears - a study among population of North Malabar in Kerala Indian Journal of Pathology and Oncology, October-December 2016;3(4);552-557 552.

Background: It is important to identify carriers of haemoglobin disorders in order to assess the risk of a couple having a severely affected child and to provide information on the options available to avoid such an eventuality. Ideally, screening should be performed before pregnancy. Preconception screening is directed at couples planning a pregnancy, while antenatal screening focuses on pregnant women. Common modes of prenatal diagnosis are chorion villus sampling (CVS), amniocentesis, and foetal blood sampling under ultrasonic guidance. Methods: The diagnosis of hemoglobinopathies and thalassaemias was by electrophoresis. Both agarose gel and cellulose acetate electrophoresis were used. But now, with advancing technology, the world-wide reference method of Hb typing is HPLC or High-Pressure Liquid Chromatography, based upon the principles of Cation Exchange chromatography. It is a technique that offers fast and easy thalassaemia testing along with simultaneous detection of the commonly occurring abnormal hemoglobins (Hb E, S, D and C). Results: Our findings, as well as those of a study conducted at M.G.M. Medical College and RMRC, ICMR Dibrugarh, show that the most commonly observed haemoglobinopathy in the tea garden labour community is Hb E, followed by Hb S. According to the study conducted by RMRC, Dibrugarh, the incidence of Beta Thal in N.E India is approximately 3.8%. Conclusion: The haemoglobin disorders are the most common clinically serious single gene disorders in the world. Most affected children are born in countries with limited resources where priority is given to tackling mortality from infections and malnutrition. Hereditary disorders receive little attention. The haemoglobin disorders are often regarded as incurable and hence “hopeless" and expensive to treat. Thus, prevention is always better in such a case, and the burden thalassaemia places on families is a key driving force in establishing the prevention programmes.

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Background: Breast cancer is a challenging genetic disease that is characterised by the accumulation of many molecular alterations. Studies on hormone receptors, including the oestrogen receptor (ER), progesterone receptor (PR), and the human epidermal growth factor receptor-2 (HER2/neu), are commonly carried out on breast cancer. It helps in deciding on the best course of treatment for the tumour as well as its prognosis. Objectives: Immunohistochemistry was used to look at the ER, PR, and HER2/neu receptor status of breast cancer as well as its histopathological diagnosis and presence. Results: Out of 65 instances, 36 (55.38%) cases (ER positive) and 29 (44.61%) cases (ER negative) were found. Similar to PR, 39 (60%) of the instances were found to be negative, while 26 (40%) revealed positive results. Her2 neu-negative results were found in 33 cases (50.76%), while positive results were found in seven (10.76%), nineteen (29.23%), and six (9.23%) cases. Conclusion: Hormonal therapy is most effective for tumours that express both ER and PR, while it is also effective for tumours that express only ER or only PR. HER2/neu works as a prognostic marker and a predictor of how well Trastuzumab (Herceptin) will work on breast cancer patients.

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