Haematoxyline & Eosin, Papanicolau, and May-Grünwald-Giemsa.

Background: Autosomal dominant polycystic kidney disease (ADPKD) is a frequent cause of end-stage renal disease. Despite improvements in blood pressure and conventional treatment, there seems not any significant impact on the need for renal replacement therapy in these cases. Inhibition of cyclic adenosine monophosphate pathway by tolvaptan was efficient in preclinical/animal studies and in clinical studies involving ADPKD patients; tolvaptan (vasopressin V2 receptor antagonist) has been recently released in the market to delay disease progression. Aims and Objectives: The aim of this study is to evaluate the role of tolvaptan in reduction of total kidney volume (TKV), total renal cyst volume, and decrease of progression of renal impairment and restoration of kidney function. Materials and Methods: We have screened 60 cases, of whom 54 were assigned to either tolvaptan group (36) or placebo (18). Overall 36 cases completed the trial (24 from tolvaptan group and 12 cases from placebo group). Estimated GFR (glomerular filtration rate) calculated and stages were noted. TKV and total cyst volume measured by ultrasonography at days 0, 30, 90, and 180 along with other vitals. The total number of patients enrolled was randomly divided into two broad groups by concealed envelop technique: Intervention group (with tolvaptan) and placebo or control group. The intervention group was given tolvaptan along with standard conventional management for ADPKD as per relevant stages. The placebo group was given placebo tablets with same size and color (multivitamin tablet) along with standard conventional management for ADPKD as per relevant stages. The periodic estimation of cyst volume, kidney volume, serum creatinine level, and estimated glomerular filtration rate recorded and analyzed with ANOVA method with confidence interval 95%. Results: Analysis of the data showed fewer ADPKD-related events per cases of follow-up with tolvaptan than with placebo. These results were confirmed by the analysis of the 1st time and after 6 months of study. Our data suggest that increase of TKV and total cyst volume was less in tolvaptan group as compared to placebo group. Overall, treatment effect on the growth of TKV was 0.219% per month with a P<0.0001. Conclusions: The administration of tolvaptan for 6 months was associated with slowed kidney growth and functional decline and with a reduced frequency of ADPKD-related complications among patients with a relatively preserved GFR.

Introduction: Urinary bladder is the most common site of malignancy in the urinary tract and the most common type of cancer of urothelial origin is urothelial cell carcinoma. This subtype constitutes more than 90% of bladder cancer. Histological grade of tumour is one of the most important predictive parameter for prognosis and biological behavior of urothelial carcinoma. As some crucial discordances may arise between pathologists because of subjectivity, so immunohistochemistry can be used for accurate diagnosis and prediction of prognosis. Aim: To study the immununohistochemical expression of B-Cell Lymphoma 2 (BCL 2) and Ki(Kiel)-67 markers and their association with tumour grade and stage in urothelial carcinomas. Materials and Methods: A descriptive cross-sectional study was conducted in the Department of Pathology of a tertiary care R G Kar Medical College and Hospital, Kolkata, West Bengal, India. West Bengal, India, on a total of 75 cases from January 2018 to June 2019. The study population comprised of cases of urothelial lesions as diagnosed by cystoscopy, who underwent standardized operative procedures. Relevant sections were taken from different parts of the fixed specimens. Histopathological Examination (HPE) was done to confirm the presence or absence of non-invasive and invasive carcinoma, and the depth of invasive tumour cells for pathological staging. Evaluation of the level of cytological and architectural disorder at low and medium magnification (100X and 200X) were done for grading. Cytological disorder were defined as abnormalities in nuclear size, shape, and chromatin, while architectural disorder were defined as abnormalities in the orientation of the cells in relation to each other and to the basement membrane of the papillae. Immunohistochemical analysis was done for Ki67 and BCL 2 expression in paraffin embedded sections in all the cases. In this study, chi-square test was done with International Business Management(IBM) Statistical Package for Social Sciences (SPSS), as per which, the association between two variables is statistically significant if p value is <0.05. Results: Out of total 75 cases(mean age: 67.3 years) analysed, 58 cases (77.3%) had Invasive type of bladder neoplasm, followed by low grade papillary urothelial carcinoma 10 (13.3%), and papillary urothelial neoplasm of low malignant potential 07 (9.3%). Ki67 expression in urothelial carcinoma has more significance because 59 cases (78.7%) showed high level expression (>20%) out of 75 cases, whereas only 12 (16%) cases show high level expression (4+) of BCL 2 marker. Conclusion: Ki67 overexpression is seen more commonly, than BCL 2, in high grade tumours as well as in advanced stage. So Ki67 may be used as a marker to predict aggressive behavior and to differentiate low grade and high grade tumours also.

Background: Stroke is the second leading cause of death worldwide. Intracerebral hemorrhage (ICH) accounts for 10% of all strokes, and about 35–45% of patients die within the 1st month. The scarcity of robust data on the validity and utility of the ICH score on the Indian population in a resource-poor health facility is a compelling factor for more study in this field, especially among the tribal population in this region. ICH score is a simple, easy-to-calculate prognostic indicator of hemorrhagic score. Aims and Objectives: The aim of this study is to estimate the prognostic significance of ICH score (both modified and the original) in hemorrhagic stroke in terms of mortality and morbidity and to analyze associated risk factors like mortality, morbidity, and motor recovery of hemorrhagic stroke in tribal and non-tribal population. Materials and Methods: The study was institution-based observational and prospective study of 120 new-onset hemorrhagic stroke cases diagnosed by clinical and radiological evaluation admitted in this medical college during the period of study. Along with history, clinical examination and CT scan brain guided ICH scoring is done, follow-up at the end of 1 week and at the 5th week including physical performance assessment and reviewing of records and certificates. P<0.05 was considered statistically significant. Results: The patients with modified ICH score 0 had 100% improvement whereas the improvement was seen in 54.84% of patients with scores 1 and 2. A total 50% of patients with scores 3 and 4 improved significantly. The incidence of hypertension was more in non-tribal population (70.45%) than total tribal population (56.25%) of study and Compared to non-tribal population (23.86%), tribals had more history of addiction (40.63%). Conclusion: Both the ICH Scores, modified and the original, were practical and valid predicting mortality in our setup. However, the modified one was more accurate and pragmatic in our study.