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Background and Objectives The status of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), and Ki-67 expression in core needle biopsy and excision specimens has concurrent results, but many show discordance. However, only a few studies on the subject are available in India. Therefore, this study aims to compare the ER and Ki-67 expression status in core needle biopsy and excision specimens of breast carcinoma. Materials and Methods In this cross-sectional analytical study, 50 breast carcinoma cases were histopathologically examined for ER and Ki-67 expression in both core needle biopsy and excision specimen. The interpreter was blinded for the evaluation of ER and Ki-67 expression index and the data obtained were analyzed using SPSS version 27. Results The average age of the participants was 50 years and breast lump was the most common presenting complaint in all the cases. The concordance rate of histological typing between core needle biopsy and excision specimens was 96%, and the majority were invasive ductal carcinoma (60%) and not otherwise specified (48%) having Nottingham histologic grade 3 (46%). The concordance rate between core needle biopsy and excision specimen for ER and Ki-67 expression was 86% (n = 43) and 54% (n = 27), respectively. Most of the cases were found to be luminal A type (38%). Additionally, the sensitivity, specificity, positive predictive value, and negative predictive value of ER between core needle biopsy and excision specimen were 78.79, 100, 100, and 70.83%, respectively; however, these were 44, 64, 55, and 53.33%, respectively, for Ki-67. Conclusion Although the concordance of the ER status between core needle biopsy and excision specimen was substantial, the discordance rate of Ki-67 was found to be high. Hence, relying solely on core needle biopsy for critical decision-making is inadvisable; however, core needle biopsy can be used as an initial procedure to examine histology and receptor status, Therefore, it is better to reconsider performing immunohistochemistry for the excision specimen, more importantly in ER-negative cases, to benefit the patient with targeted therapy.

Background:The pre-donation haemoglobin (Hb) estimation is the only laboratory test done on blood donors to determine an individual's eligibility to donate blood with an intention to prevent bleeding an anaemic donor. With availability of wide range of screening methods, no single technique has emerged as the most appropriate and ideal for screening blood donors. The primary objective of the study was to compare results of copper sulphate method and haemoglobin meter with the gold standard Cyanmeth hemoglobin (CyanHb) method. Materials and methods : Prospective observational study done in 238 blood donors. Sample analyses were done using Copper sulphate solution, haemoglobin meter and Cyanmeth haemoglobin method. Results : Mean values of three methods Cyanmeth haemoglobin, and Haemoglobin meter methods are 12.5±2.2, and 13.08±1.61 respectively. Haemoglobin values obtained by haemoglobin meter and copper sulphate methods were comparable, with sensitivity of 94.25% and 94.47% respectively. Conclusion : CuSo4 method and haemoglobin meter can be used alternatively based on resources available. The higher values obtained by CyanHb method could be due to turbidity factor of the lipids in the blood sample.

Background:Multiple choice questions (MCQ) are used in the assessment of students in various fields. By this method of assessment it is possible to cover a wide range of topics in less amount of time. However the reliability of the test depends on the quality of the MCQ. The MCQ can be evaluated based on the Difficulty Index (DIFI), Discriminatory Index (Dl) and Distracter Efficiency (DE). Objectives:To evaluate the MCQs based on the Difficulty Index (DIFI), Discriminatory Index (Dl) & Distracter Efficiency (DE) and develop a valid pool of questions.Also to assess learner performance and discriminate between students of higher and lower abilities. Materials and Methods:A total of 120 students were assessed based on multiple choice questions in pathology. The number of items were 20 and the number of distracters were 60. Data was entered and analyzed in MS Excel 2007 and simple proportions, mean and standard deviations were calculated. Results:Mean and standard deviations for DIFI, Dl and DE were 57.8 ± 17.4%, 0.27 ± 0.17 and 84.98 ± 20.2 % respectively. Out of the 20 items, 11 items had good level of DIFI (31 - 60%), eight (8) items were considered easy (DIFI >61%) and one (1) item was considered difficult (DIFI < 30). Mean Dl in present study was 0.27 ± 0.17. Analysis of the Dl showed good discrimination power in eighteen (18) of the items. Out of the 60 distracters, nine (9) were non -functional distracters (NFD) and were seen in eight items. Out of these, seven items had one NFD each and one item had two NFD. Conclusions:The study emphasizes on the importance of use of item analysis in construction of good quality MCQs and also in the evaluation of learner performance.

Background: ABO and Rh blood groups are most important blood groups in human beings. The frequency of four main blood group systems varies in population throughout the world and even in different parts of country. Objective if this study was to identify distribution of ABO and Rh blood group system. Materials and methods: The study was conducted in rural tertiary care hospital from January 2008 to December 2012. Data were collected from Blood Bank grouping records. All blood samples processed during period of observation were included in study. Results: During the period of observation total 43,103 numbers of blood groups were performed. Patient's samples were 28,305 and donor's samples were 14,798. The frequency of blood group O in our population was 42.0% (40.1% O Rh positive and 1.8% O Rh negative). The frequency of blood group B in our population was 27.3% (25.6% B Rh positive and 1.62% B Rh negative) followed by blood group A was 25.8% (24.3% A Rh positive and 1.4% A Rh negative) and blood group AB was 4.8% (4.4% AB Rh positive and 1.4% AB Rh negative) and a two Bombay blood group donors (0.0046%). Rh positive were 94.64% and Rh negative were 5.35%. Discussion: O positive blood group is significantly high in our population. Every transfusion centre should have a record of frequency of blood group system in their population. It helps in inventory management. Knowledge of blood group distribution is important for clinical studies, for reliable geographical information and for forensic studies in the population.

Autoimmune hemolytic anaemia (AIHA) is rare clinical disorder and requires efficient immunohematological and transfusion support. We report two cases of Immune hemolytic anaemia. A case of AIHA in congestive cardiac failure and second a known case of Giant cell arteritis with cold antibodies. Both the cases we encountered problems during cross matching.

Langerhans cell histiocytosis most commonly occurring in children, demonstrates a broad spectrum of clinical and radiologic features that may mimic those of infection as well as benign and malignant tumors. Osseous involvement is the most common manifestation. Recognition of the skeletal alterations is important so that the disease is considered as differential diagnosis. This disease is of unknown aetiology, non-specific clinical and imaging findings with diagnosis possible only on histopathological examination, will always pose a diagnostic challenge to the orthopaedic surgeon. Here by we are reporting two cases of eosinophilic granuloma that has presented with lytic lesion in the tibia and scapula. The clinico-radiological suspicion was either infection or tumour of the affected bones. Hence, core biopsy was done confirmed as eosinophilic granuloma on histopathology and immunohistochemistry.

Imerslund Grasbeck syndrome (IGS) is a rare autosomal recessive childhood disorder characterized by selective Vitamin (vit) B 12 malabsorption with asymptomatic proteinuria without any structural renal pathology. The patients stay healthy for decades with life-long parenteral vit B12. We report a case of young female who presented with pancytopenia and proteinuria, evaluated in local hospitals as chronic hemolytic anemia (autoimmune cause), finally diagnosed as IGS on complete evaluation. She was treated with injectable vit B12 (1000 μg cyanocobalalmin) and showed drastic recovery. IGS should be considered in patients with megaloblastic anemia not responding to oral vit B12 and associated proteinuria.