Objective: To see the association of endometriosis with other uterine conditions in our setup. Study Design: Descriptive Retrospective study. Setting: Private Lab in Faisalabad. Period: January 2010 to December 2019. Material & Methods: A total of 297 cases were evaluated in this study. We have included all endometriosis cases with associated other conditions of the uterus. In this study paraffin blocks and previous slides along with clinical data were analyzed according to the standard protocols. All the data including age, location of endometriosis, and association with other uterine conditions were noted and reported as percentages. Results: In this study, we analyzed 297 endometriosis cases, received during ten years. The age group ranges from 15 years to 75 years. The most common age group ranges from 26-30 years, 87(29%) cases, and the least commonly affected group was 71-75 years, only one case. The most common site of endometriosis was in the ovaries, 169(57%) cases. The most common associated other condition was benign tumor leiomyoma, 65(43%) cases while only one case of endometrial carcinoma was noted. Conclusion: This study concludes that ovarian endometriosis is the most common location and there is a strong association with another co-existing benign tumor such as leiomyoma. This signifies the possibility of common risk factors such as hyperestrogenism. Thus it is important to be aware of the possibility of co-existence of other conditions so that they can be treated at once in a single surgery.

Objectives: For the past 20 years Fine Needle Aspiration Cytology (FNAC) has evolved as the most sensitive diagnostic tool for the initial screening of patients with thyroid nodules. Unfortunately FNAC is complicated by a recognized false negative rate of approximately 5%. The clinicians could face the difficulty in the management of patient when a cytological diagnosis is atypical only. The objective of study is to evaluate the positive predictive value (PPV) of atypical thyroid cytology cases according to the Bethesda system taking histopathology as gold standard. Study Design: Cross sectional study. Setting: Department of Pathology at Shaikh Zayed Hospital, Lahore. Period: Six months i.e. from 25.11.2014 to 25.5.2015. Materials and Methods: Patients presenting with solitary thyroid nodules in the outpatient department and fulfilling the inclusion criteria were included after evaluation by thyroid function tests and thyroid scan, FNAC was performed and reported according to Bethesda system of thyroid reporting. Later on, cases underwent lobectomy, total or hemi-thyroidectomy, the tissue was received in 10% formalin solution in our pathology department and then processed, stained and examined. FNAC results of atypical cases were then compared with the definitive histological diagnosis which were considered the gold standard. The slides were examined and any differences were sought by consensus of two pathologists. Eighty cases were observed with 95% confidence level, 11% margin of error, using non-probability purposive sampling technique for sample collection. Data was analyzed by SPSS version 15 (P value <0.05). Results: The mean age of patients was 38 years with SD ± 2.16. There were 22 (28%) males and 58 (72%) females in our study. In this study, positive predictive value for Atypia of undetermined significance/ Follicular lesion of undetermined significance (AUS/FLUS), follicular neoplasm (FN), suspicious for malignancy and positive for malignancy were 33.3%, 25%, 66.6% and 100% respectively. Overall PPV of atypical cytology was 35.71%. Overall accuracy of FNAC was 86.30%, 87.50% sensitivity and 86.15% specificity, PPV value 43.75% and negative predictive value was 98.25%. Conclusion: Results showed that Bethesda system of reporting is helpful for the management of patients who falls in to undetermined categories as it categorically divide atypical cytology cases in to three definite categories  AUS, FN and suspicious for malignancy and these categories have different risks of malignancy. Thus can help to determine a better patient outcome due to proper clinical management of thyroid swellings.

Objectives: Determine the frequency of fungal infections in nasal polypi. Study Design: Cross sectional study. Setting: Histopathology Department at Shaikh Zayed Hospital Lahore. Period: Six months from 12/2/2015 to 12/8/2015. Material & Methods: Two hundred surgical resections/biopsies using 95% confidence level, with 7% margin of error were collected. Formalin fixed specimens of patients of both genders and 10- 60 years of age with nasal polyps received after surgical procedure in department of ENT. Grossing and processing was done. Hematoxyin & Eosin stained sections were examined by two consultant Histopathologists independently. The presence of fungal hyphae was confirmed by PAS and Silver stains. The study was approved by College of Physicians & Surgeons Pakistan. All the data was entered and analyzed by using SPSS version 20. Results: Out of 200 patients all the patients showed the prescence of inflammatory cells in polyps (100%) with predominantly eosinophils in their submucosa (82%). Fungus was present in 48 cases (24%) most of them were in the age group of 42-57 years (13%) and 31(15.5%) patients having BMI <30 and 17(8.5%) having BMI >30 were positive for fungus.30 cases were of Aspergillus (62.5%) and rest 8 were of Mucor (37.5%). The fungus positive cases were more in males (13.5%). 160 of the cases were of unilateral polyps (80%) and 40 were of bilateral polypi (20%). Only 8% of the patients having diabetes had fungal infection. Conclusion: Hence, the frequency of fungal infection in nasal polypi is low with Aspergillus being the commonest pathogen affecting males predominantly.

Objectives: We aimed to evaluate the effect of low serum ferritin levels on HbA2 values in BTT patients. Study Design: Cross-sectional study. Setting: Pathology department of University Medical & Dental College Faisalabad. Period: August, 2018 to July, 2019. Materials & Methods: One hundred and thirty seven subjects were included in the study after written informed consent. Those with serum ferritin < 10µg/L were taken as iron deficient. Based on serum ferritin levels, we divided our study participants into two groups (Group A Vs Group B). As ferritin is considered an acute-phase protein, 25/137 participants with leukocytosis were excluded from statistical analysis. We measured serum Ferritin on Cobas 6000 e611 and we assessed the red cell parameters on Sysmex (seven part differential XN 1000). Hb variants were analysed through High performance liquid chromatography (HPLC) based technique of BioRad D10. Results: After excluding 25 subjects with high Total leukocyte count (TLC), we are left with 112 subjects. We observed 26 participants in group A with Iron deficiency and 38 in group B with no Iron deficiency. Mean±SD serum ferritin in iron deficient group was 7.25±1.95 as compared to non-iron deficient group (87.63±7.35). Mean HbA2 value in group A was 4.56±0.04 and in group B it was 5.80±1.06 with significant statistical difference of P=0.0188. We also observed significant difference in the mean values of other Red cell indices (MCV, HCT MCHC, MCH) except for RBC count and RDW. Conclusion: This study shows that ID may reduce HbA2 levels. Overall, it does not essentially preclude the identification of BTT. It is recommended that Iron deficiency should be considered before measuring HbA2 levels in BTT.

Objective: The aim of this study was to evaluate the histopathological changes in the nephrectomy specimens. Study Design: Retrospective study. Setting: Private Lab, Located in Faisalabad. Period: January 2015 to December 2019. Material & Methods: A total of 113 cases were included in the study. In this study paraffin blocks and previous slides along with clinical data were analyzed according to standard protocols. Patient age, sex and histological diagnosis were noted and compared. Results: In this study we analyzed 113 cases, received during a five year time period. Out of which 60 (53%) were males and 53 (47%) were females. Most common age group ranges from 51 to 60 years and the least common affected group was 71 to 80 years. The neoplastic cases were 66 (58%) and nonneoplastic cases were 47(42%). Neoplastic were further sub- divided in to 3(5%) benign cases and 63(95%) malignant cases.  Most common neoplastic lesion was clear cell renal cell carcinoma, 49 (74%) cases and most common non- neoplastic condition was chronic pyelonephritis, 37 (78%) cases. Conclusion: Nephrectomy is the ultimate surgical procedure for the treatment of renal diseases. The 5th to 6th decade is the most common age group of patients affected by non- neoplastic conditions leading to non-functioning kidney. Malignant tumor like clear cell carcinoma is the most common malignant tumor in our society. Early clinical, radiological and histopathological diagnosis of renal diseases will help out patients for proper management. Thus every nephrectomy specimen should be evaluated through clinico –pathological correlation.