CONTEXT: Preeclampsia is often asymptomatic, and hence, its detection depends on signs or investigations. The platelet (PLT) parameters, in cases of preeclampsia with normal PLT count, are seldom analyzed. Hence, this study was undertaken to study the PLT parameters in nonthrombocytopenic preeclampsia cases. AIM: The aim was to evaluate the use of PLT indices as severity markers in nonthrombocytopenic preeclampsia cases. SUBJECTS AND METHODS: This prospective study was done on 120 cases of severe preeclampsia, 115 cases of preeclampsia without severe features, and 203 normal pregnant women admitted in the obstetrics wards during the study period of 1 year. The PLT indices obtained by analyzing anticoagulated blood were recorded. STATISTICAL ANALYSIS USED: Analysis of variance test was used to see the significance of association. Receiver operating characteristic (ROC) curve and binary regression analysis was used to estimate the cutoff value and examine the predictive value of the PLT parameters in the disease progression of preeclampsia. RESULTS: Even in the absence of thrombocytopenia, mean platelet volume (MPV) and PLT distribution width were significantly higher in severe preeclampsia group (P < 0.001) and were also positively correlating with mean arterial pressure (r = 0.38 and 0.20, respectively). ROC curve analysis showed that MPV had the highest area under the curve of 0.78 (95% confidence interval [0.719‒0.842]). Cutoff value of >10.95 fl for MPV was found to have significant predictive value for disease progression in preeclampsia. CONCLUSIONS: Even in the absence of thrombocytopenia, PLT indices, especially MPV, have a good diagnostic significance in detecting severe preeclampsia. Further studies are required to evaluate their role as biomarkers in preeclampsia.

INTRODUCTIONFine Needle Aspiration Cytology (FNAC) is a preliminary diagnostic procedure for wide spectrum of non neoplastic and neoplastic lesions. It is safe faster and cost effective procedure. It is quick, easy to perform and has high grade specificity and sensitivity. It is used as a primary investigation procedure in all the suspected neoplastic conditions before any surgery [1].Routinely various stains like Haematoxylin and Eosin (H&E), Romanowsky and Pap have been used for staining the FNAC smears. Romanowsky stains are routinely used for staining the blood films and air dried cytological smears [2]. The different types of Romanowsky stains available are MGG, Wright Giemsa stain, Leishman stain and Diff Quick. These stains allow better estimation of cell size, nuclear size, cell cytoplasm and identify ground substances by metachromasia [3,4]. MGG is routinely used in cytology for air dried smears in many laboratories. This stain demonstrates the cytoplasmic features but not the nuclear chromatin well and the procedure is time consuming and stain has tendency to precipitate [5]. Leishman stain is a good nuclear stain which is used widely in haematology [6].LG cocktail is a new staining technique with very few studies in the literature describing its applicability in cytology. Few authors have opinioned that LG cocktail stain provides an excellent cytoplasmic and nuclear staining comparable to Pap stain and superior to MGG in both staining quality and diagnostic ability in exfoliative cytology and also has a potential application in the screening programmes [6]. Hence, the study was done to evaluate the quality of staining of LG cocktail in air dried cytology smears and compare the quality of staining of LG cocktail with MGG. MATERIALS AND METHODSThis prospective study was done at a tertiary care centre. The number of cases studied was 100 for duration of two months.Before starting the study ethical clearance was taken from the Institutional Ethical Committee. It included all the patients who were sent to cytology department for FNAC. Informed consent was taken from patient for the FNAC procedure. Cases with inadequate material were excluded from the study. Extra slides were made from the FNAC material. These smears were stained with MGG (Himedia, India) and LG cocktail -Combination of Leishman stain (Chromo span, India) and Giemsa stain (Nice, India) respectively.A total of 200 slides were screened by two pathologists. The slides were stained with MGG by using conventional method. The LG cocktail was prepared by the using the following protocol [2]:1) The unit volume of Giemsa was mixed with equal amount of distilled water to prepare Giemsa working solution (1:1 dilution);2) An equal volume of Leishman's stain was filtered and mixed with an equal volume of the above Giemsa working solution (1:1);LG cocktail staining procedure [2]: The air dried smears were flooded with LG cocktail and left for one minute. An equal volume of buffer/distilled water was added and left for six minutes. The slides were washed ...

Kikuchis lymphadenitis: Is biopsy necessary in managing these patientsKikuchis-Fujimoto's is a benign, self-limiting, cervical lymphadenitis, fi ne-needle aspiration cytology (FNAC) plays a very important role in the diagnosis and management of these patients. We present a case of 30-year-old female presenting with supraclavicular lymphadenopathy and fever, diagnosed as Kikuchis-Fujimoto's lymphadenitis on FNAC with no recurrence or development of Lupus lymphadenitis even after 1-year of follow-up. Although Kikuchis-Fujimoto's is a rare cause of lymphadenopathy, FNAC is an important tool in diagnosing this entity and differentiating from tubercular lymphadenitis and Lupus adenitis. Presence of cresentric nucleated histiocytes engulfed karryorrhectic debris and monocytoid cells aids in the diagnosing. A defi nitive diagnosis made on FNAC can avoid biopsy and unnecessary diagnostic and therapeutic interventions in these patients. However, a look out for recurrence and development of Lupus with regular followup and serological examination is imperative.Key words: Fine-needle aspiration cytology, kikuchis-fujimoto's, lupus adenitis, tubercular adenitis INTRODUCTIONKikuchis-Fujimoto's disease (KFD) or histiocytic necrotising lymphadenitis was fi rst described by Kikuchis, simultaneously by Fujimoto's et al. in 1972. [1,2] Since then, numerous cases have been reported in both Asian and western population. Though a self-limiting disease that resolves on its own within few weeks and months, it is known to recur in 3-4% of cases. [3] Though fi ne-needle aspiration cytology (FNAC) is diagnostic in most of these cases, histopathological examination of the excised node is usually done to confi rm the diagnosis and differentiate from other causes of adenitis. CASE REPORTA 31-year-old female presented with fever (low grade, Intermittent), headache, edema, weight loss and pain in the right supraclavicular region of 3 month's duration. There was no history of cough with expectoration/weight loss/skin rash/joint pain or any other swellings in the body. On examination, she was febrile, with multiple nodules in right supraclavicular region. A diagnosis of viral fever with supraclavicular lymphadenopathy and was made, and she was treated symptomatically. Since her symptoms did not subside even after 1 week of treatment, the presumptive diagnosis of tubercular lymphadenitis was made, and laboratory workup was suggested. All her biochemical and hematological investigations were normal except an increase in erythrocyte sedimentation rate (80 mm at the end of 1 st h). Antinuclear antibody test was negative.An ultrasonography of right supraclavicular region revealed multiple nodes in upper and middle jugular areas largest measuring 1.4 cm across. A diagnosis of reactive lymph node enlargement was given.Fine-needle aspiration cytology of the node was highly cellular with a heterogeneous population of lymphocytes, histiocytes, cresentric nucleated histiocytes [ Figure 1] (histiocyte with cresentric nucleus and eosinophilic inclusions in ...

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