Objectives:To assess the association of adenomyotic foci with co-existing benign ovarian cysts.Methods:This prospective cross-sectional study consisted of 100 consecutive hysterectomy specimens referred to Histopathology Section of Pathology Department, Peshawar Medical College, Peshawar, Pakistan by its attached teaching hospitals from January 2011 to December 2012. Hematoxylin and eosin stained sections were examined for adenomyotic foci and the presence of co-existent ovarian cysts. For evaluation of estrogen receptor (ER) status immunohistochemical stains were applied and H-scoring system was used with a score >50 as positive.Results:Out of the 100 hysterectomy specimens, 25 cases had both adenomyosis and ovarian cysts. The ER status of adenomyotic foci was positive in 20% cases and negative in 80% cases. The commonest type of ovarian cyst was hemorrhagic luteal cyst (28%), followed by serous and mucinous cystadenoma (20%) each. Out of the 28% cases of functional cysts, 71.5% were ER positive and 28.5% were ER negative. The p-value for association of ER status of adenomyotic foci with functional cysts was 0.0004; however, p-value was not significant in comparing cases with controls. All 72% cases of nonfunctional cysts were ER negative. However, 44% of functional cysts were not associated with adenomyotic foci.Conclusion:This study concludes that besides functional ovarian cysts, other local factors may be responsible for the development of adenomyosis.

Background: In histopathology, inter-observer variability is frequently encounterleading to diagnostic dilemma. Endometrial biopsies are one of them where multiple factorsincluding hormonal influences make the interpretation difficult. The aim of the article was tofind the interobserver variability level between two consultants on endometrial biopsies byapplying kappa and ICC analysis. Study Design: Prospective study. Setting: Department ofPathology Peshawar Medical College Peshawar from Health Care Centre, University Town,Peshawar. Period: March to August 2013. Methods: This study consisted of 102 endometrialbiopsies of infertile women on 22nd or 23rd day of menstrual cycle. All cases were examined bytwo consultants separately and formed their opinions independent of each other according toNoye’s criteria. Their opinions were categorized as those in agreement, with minor disagreementand with major difference in opinion. Results: Agreement of opinion was established only in 34(33.3%) cases. There was disagreement in 68 (66.7%) of cases. Out of these 68 cases, 46 (68%)belonged to the category of major conflicting opinion. In case of minor conflicting opinion,there was difference in specific day of the phase of menstrual cycle. The Kappa coefficient andICC statistics was performed which gave the overall results as fair agreement. Conclusion:The main cause of disagreement was difficulty in applying the criteria for effects of hormonalinfluences on endometrial biopsies leading to subjective interpretation.

Objectives: To study the morphological spectrum of endometrial changes with the thyroid hormone levels in infertile women. Methods: This cross sectional study was conducted at Department of Pathology, Peshawar Medical College, Health Care Centre and Madina Medical Laboratory, Peshawar from April 2013 to August 2013. Total 160 cases of infertile women were included in the study. Biopsies were taken on 22-23rd day of menstrual cycle. Statistical Analysis was performed using SPSS version 19 statistical program. Difference between endometrial findings of patients with normal thyroid profile and abnormal one were analyzed for statistical significance using Chi square test. Probability values p ≤ 0.05 were considered statistically significant. Results: In our study, majority infertile women were euthyroid (80%), followed by hyperthyroid (18%) and only two% to be hypothyroid. The correlation of endometrial morphology with thyroid hormones levels turned out to be insignificant. While correlating histological details of endometrial biopsy with thyroid hormone status, we found significant association of leukocytic infiltrate with thyroid hormone levels. Conclusion: This study shows that thyroid hormones may have role in early leukocytic infiltration into stroma, and a possibility of immune modulation by altered thyroid hormones in causing infertility. doi: https://doi.org/10.12669/pjms.36.5.1791 How to cite this:Nasir S, Ziaullah S, Alam S, Khan MM. Morphological spectrum of endometrium with thyroid hormone profile in infertile female population of Khyber Pakhtunkhwa province of Pakistan. Pak J Med Sci. 2020;36(5):---------. doi: https://doi.org/10.12669/pjms.36.5.1791 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

… Background: In histopathology, inter-observer variability is frequently encounter leading to diagnostic dilemma. Endometrial biopsies are one of them where multiple factors including hormonal influences make the interpretation difficult. The aim of the article was to find the interobserver variability level between two consultants on endometrial biopsies by applying kappa and ICC analysis. Study Design: Prospective study. Setting: . Methods: This study consisted of 102 endometrial biopsies of infertile women on 22 nd or 23 rd day of menstrual cycle. All cases were examined by two consultants separately and formed their opinions independent of each other according to Noye's criteria. Their opinions were categorized as those in agreement, with minor disagreement and with major difference in opinion. Results: Agreement of opinion was established only in 34 (33.3%) cases. There was disagreement in 68 (66.7%) of cases. Out of these 68 cases, 46 (68%) belonged to the category of major conflicting opinion. In case of minor conflicting opinion, there was difference in specific day of the phase of menstrual cycle. The Kappa coefficient and ICC statistics was performed which gave the overall results as fair agreement. Conclusion:The main cause of disagreement was difficulty in applying the criteria for effects of hormonal influences on endometrial biopsies leading to subjective interpretation.