Objective: To determine the diagnostic yield of cell blocks, prepared by the vapour fixation method, using laboratory supplies easily available at any low resource laboratory setup or outpatient department of a basic healthcare unit. Methods: Prospective descriptive study was carried out at Healthways Laboratories Rawalpindi, for 6 months from 1st January 2017 to 30th June 2017. Walk in patients referred to the lab for FNAC were selected by non probability convenient sampling. After preparing FNAC slides from first pass, the patients were briefed about the cell block material and after informed consent second dedicated passes were done to make cell blocks. Results: Out of 47 cases, there were 25 (53.2 %) breast lumps, 8 (17%) superficial collections, 7 (15.1%) lymphadenopathies, 6 (12.8%) thyroid swellings and 1 salivary gland swelling. Technique yielded moderate to high cellularity in 33 (70.2%) cases, 16 from malignant and 1 from benign breast lumps, 5 from thyroid, 3 from reactive and 3 from metastatic lymphnodes, 3 from abscesses, 1 from lipoma and 1 from salivary gland. Low cellularity 14 (29.8%) cases were from 5 benign and 3 malignant breast lumps, 2 hematomas and 1 case each from thyroid, metastatic lymphnode, abscess and lipoma. Good cellularity was achieved in 16 (84.2%) of 19 cases of malignant breast lesions, 3 (15.8%) were hypo cellular of which 1 was non-diagnostic on FNAC smear. Cell block diagnosis was comparable to FNAC in 35 of 47 (74.4%) cases. Non diagnostic cases on cell block were more, 13 versus 3 cases on FNAC. The kappa value of agreement in diagnosis was 0.64. Conclusions: Poor man’s cell block method is simplest and effective method of cell block preparation which must be advocated at basic healthcare units and low tech laboratory. Its diagnostic potential must be further explored.

Objective: To analyze radiological spectrum of HRCT in COVID-19 patients, clinically symptomatic but initially having negative RT-PCR. Study Design: Prospective cross sectional descriptive study. Place and Duration of Study: Radiology and Medicine Department, DHQ Hospital Rawalpindi, from June to November 2020 Methodology: The study included 90 patients presenting with clinical symptoms of COVID-19 but with negative RT-PCR. All patients underwent chest computed tomography (CT). Patients with positive COVID-19 RT-PCR test or serology on subsequent repeat test were included in the study. Patients having non COVID-19 HRCT features with negative RT-PCR were excluded from the study. Results: Out of 90 symptomatic, RT-PCR negative patients, 7 had normal chest CT. According to BSTI classification, 50 patients showed classic, 11 had probable and 22 had indeterminate features. Despite supportive clinical and CT features, 17 (18.89%) patients had negative RT-PCR tests on subsequent testing. Unilateral changes were in 8 (8.9%) and bilateral in 75 (83.3%). Most common finding was mixed pattern of peripherally distributed GGN and bronchocentric nodules in 37 (41.1%) patients. Consolidations were in 19 (21.1%), pure ground glass haze in 13 (14.4%), crazy paving in 4 (4.4%), fuzzy bands and arcades in 7 (7.8%), and subtle gravitational GGH in 3 (3.3%) patients. CT-SS classified 69 (76.7%) patients as mild, 10 (11.1%) as moderate and 4 (4.4%) as severe disease. Conclusions: HRCT with CTSS is an important tool for diagnosing and prognosticating COVID-19 infection despite negative RT-PCR, timely identifying and isolating COVID-19 cohorts preventing cross infection and also aiding in prompt symptomatic management.