Various coagulation tests like Prothrombin Time (PT) and Activated Partial Thromboplastin Time (APTT) are estimated by automated coagulation analyzers. The newer fully automated analyzers generate clot wave forms aPTT-CWA for these parameters are derived. In this study, the objective was to analyze clot wave form characteristics morphology and its first and second derivative values in cases with abnormal APTT. ACL TOP 300 generated curves for APTT in a total 125 patients with 20 normal controls are included. First derivative, second derivative, morphology of curve: sigmoid, biphasic, prolonged pre-coagulation phase, second derivative morphology like early and late shoulder, biphasic peak, delayed deceleration were the analyzed parameters. Wave clot forms of 125 patients were included in this study. Patients (M:F - 2.2:1, mean age: 46.9 ± 20 years). A spectrum of clinical conditions was Covid (20%), liver disease (23%), polytrauma (10.4%), cardiac diseases (8.8%), sepsis/DIC (7.2%), thromboembolism (7.2%), renal diseases (6.4%), bacterial infections (4%), dengue (4%), snake bite (1.6%) and factor deficiency (1.6%). Liver and heart disease showed a significant difference in acceleration and deceleration peaks followed by sepsis, dengue, polytrauma and sepsis/DIC. Deceleration peak was prolonged in patients of Covid (p<0.05). Sepsis and liver diseases showed prolonged first derivative peak (p<0.05). CWA is very easily available on all automated coagulation analyzers. It is inexpensive with fast turn round time. Both quantitative as well as qualitative informations such as velocity, acceleration of clot formation and wave pattern details were recorded. Our study highlights importance of quantitative and qualitative CWA parameters acquired by performing APTT test for the automated analyzers.

Gastric carcinomas rank 5th among all the cancers in India. The incidence increases with age and peaks during 5th to 7th decades. The most common location is gastric antrum followed by the lesser curvature. Her2 neu expression is reported as a frequent molecular abnormality in gastric adenocarcinomas associated with poor prognosis. The main aim was to study clinicopathological parameters of gastric carcinomas and study expression of HER2 in gastric adenocarcinomas. This was a 4-year cross-sectional observational retrospective and prospective study of 47 cases of gastric carcinomas. The clinical profile and pathological features were studied. HER2 expression in gastric adenocarcinomas was scored according to Hoffman system and its association with age, gender, histopathological type, grade was studied. FISH was done in cases of equivocal HER2/Neu expression.Of the total 47 gastric carcinomas, it was most commonly found in antrum. Mean age of presentation was 59.4 years with male: female ratio of 1.4:1. Of total 47 adenocarcinomas, 22 were tubular, 4 cases each of papillary and mixed adenocarcinoma and 17 were poorly cohesive carcinoma. There were 5 cases of grade I, 27 grade II and 15 grade III carcinomas. HER2 positivity was seen in 10 cases, 5 were equivocal and 32 were HER2 negative. We found statistically significant correlation between HER2 expression with histopathological grade (P=0.003) and age (P=0.014).Tubular adenocarcinoma was the common subtype and antrum was the commonest location. HER2 expression was significantly associated with grades and age in cases of gastric adenocarcinomas. This study helped us to know the trends of gastric carcinoma in our region. Use of immunohistochemistry and fluorescent in situ hybridization techniques additionally supports the use of targeted therapeutic modalities.

To study Immunohistochemistry pattern of ER, PR, p53 and Ki67 expression in patients with endometrial adenocarcinoma (EC) and endometrial hyperplasia. A retrospective study of 78 cases were studied for a period of 02 year from June 2018 to May 2020, where in the clinical data included age, presenting complaints, menopausal status, history of hormonal treatment, ultrasound examination.Histopathological parameters were analysed as per WHO 2014 classification of endometrial hyperplasia into typical and atypical endometrial hyperplasia / Endometrial Intraepithelial Neoplasia (EIN) and endometrial carcinoma. ER, PR, p53 and Ki 67 IHC markers were done on cases diagnosed as endometrial adenocarcinoma and endometrial hyperplasia. Among 78 cases, there were 20 cases of EC and 58 cases of endometrial hyperplasia. EC was most commonly seen in sixth to seventh decade and hyperplasia was seen in fourth to fifth decade .There were 11 surgical specimens and 09 biopsies of EC. Out of total 20 cases, there were 17 cases of endometrioid adenocarcinoma and 03 cases were of papillary serous adenocarcinoma.ER, PR expression was seen in 10 cases of grade 1 endometrial carcinomas and 5 cases of grade 2 EC. p53 expression was seen in 01 case of grade 1 EC and 03 cases grade 3 EC. ER, PR, p53 all were negative in one case. Ki67 was &#60;10% in 11 cases, between 10-20% in 5 cases and &#62;20% in 04 cases. We followed up 15 out of 20 cases, out of which only 01 patient died of disease who was grade 1 endometrial carcinoma. Rest 14 had progression free survival (PFS) till date.All 58 cases of endometrial hyperplasia were reclassified complex and simple hyperplasia to typical and atypical hyperplasia (as per WHO Classification 2014). Out of 58 cases, 56 cases were typical hyperplasia and 02 cases atypical hyperplasia. ER, PR expression was positive in all the cases of typical and atypical hyperplasia. p53 expression was absent in typical and atypical hyperplasia with low Ki 67 index (&#60;10%). High ER, PR expression along with low p53 was seen in type 1 endometrial carcinomas compared to low or absent ER, PR along with strong p53 expression in papillary serous carcinoma (Type 2). The expression of ER, PR was high in typical hyperplasia as against high p53 expression observed in atypical hyperplasia.

Background: Gastrointestinal neuroendocrine tumors are rare slow-growing tumors with distinct histological, biological, and clinical characteristics that have increased in incidence and prevalence in the last few decades. This study is aimed to find out the incidence of neuroendocrine tumors among the gastrointestinal tumors and to grade gastrointestinal neuroendocrine tumors. Materials and Methods: A total of 119 cases of gastrointestinal tumors of gastrointestinal neuroendocrine was included in the study. The paraffin blocks were retrieved and slides were stained with routine Hematoxylin and Eosin, synaptophysin, chromogranin, and Ki67. The histologic grading was done based on mitosis and Ki-67 index as per WHO 2017 classification. Results: Out of 119 cases of Gastrointestinal Tract tumor, 13 (10.92%) constituted neuroendocrine tumors. Duodenum was the most common site (38%) followed by the appendix (23%). The majority (1.9%) of the cases were categorized as of grade 1 followed by 2.3% of grade 2 and 1.19% of grade 3.  Immunohistochemically, chromogranin, and synaptophysin were strongly expressed in all ten cases of neuroendocrine tumors. The Ki67 labeling index was <3 % in 10 cases, while it was in the range of 3 – 20 % in 2 cases and >20 % in one case. Conclusions: The incidence of gastrointestinal neuroendocrine tumors is on the rise. They should be considered in developing a differential diagnosis. Hence use of diagnostic modalities such as immunohistochemistry should be implemented for better treatment.

Colorectal cancer is the third most common cancer in both men and women. Environmental and genetic factors play a role in the development of colorectal carcinomaThe majority of colorectal cancers are sporadic, with hereditary cancer syndrome accounting for 10% of cases. Precursor lesions like adenoma that transform into adenocarcinoma cause the majority of colorectal cancers. : A total of 72 of colorectal malignancies were studied for histopathological features. The histologic features were studied for site, grade, tumor -infiltrating lymphocytes, Crohn -like lymphocytic reaction, mucinous histology, signet ring cell histology, and medullary growth pattern.: The mean age of the patients was 59.52 ± 11.80 years with M:F 1.76:1. Light microscopy showed TILs in 16 (22.2%) patients, followed by mucinous areas in 5 (6.9%), crohn like lymphocytic reaction in 4 (5.6%) and signet ring morphology in 2 (2.8%) patients.This study concludes that colorectal carcinomas are more common in 5th and 6th decade of life with slight male preponderance. The most common malignant lesion being moderately differentiated adenocarcinomas. This study highlights age and gender prevalence, as well as histopathological characteristics of colorectal carcinomas in this demographic region .