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Background: Membranoproliferative glomerulonephritis has in the recent past been regrouped into immune complex-mediated (ICM MPGN) disease (driven by the classical complement pathway) and complement-mediated (C3GN) disease (driven by the alternative complement pathway) based on pathogenetic role of alternative complement pathway and immunofluorescence deposits. The proposed regrouping lent therapeutic and prognostic support in managing the disease of MPGN. Aims and Objectives: The present study is undertaken to study the patterns of MPGN based on histopathological and DIF examination and sub-categorize the cases into mainly complement dominant and immune complex-mediated diseases for better prognostic and therapeutic utility. Materials and Methods: This is a prospective observational study carried out in a tertiary care center over a period of 2 yrs. The clinically suspected cases of MPGN were subjected to histopathologic and direct immunofluorescence examination (DIF), and the findings were interpreted in light of complement-mediated and immune complex-mediated MPGN. Results: Out of 620 renal biopsies, diagnosis of MPGN was confirmed both on histopathology and DIF in 36 cases accounting for 5.8% of all biopsies. Based on DIF findings, the various groups comprised 20 cases (55.6%) of immune complex deposits, 11 (30.5%) of C3 dominant picture, and 5 (13.9%) of Nil immune deposits. On analysis of the patterns on DIF, 16 cases (80%) of C3 + Ig group and 6 (54.5%) of C3GN group showed predominantly MPGN pattern. Crescentic glomerulonephritis, global glomerulosclerosis, and interstitial fibrosis were markedly observed in C3GN group. Conclusion: DIF is of immense prognostic and therapeutic value in managing cases of MPGN.

Introduction: Hirschsprung’s Disease (HD) is a common congenital disorder characterised by absence of enteric neurons along a variable length of large bowel involving a segment of the rectum and the adjacent proximal bowel. The definitive diagnosis is based on histopathological study of rectal seromuscular biopsies. Calretinin Immunohistochemistry (IHC) staining adds to the diagnostic yield as it allows better appreciation of the mature and immature ganglion cells including the segments with paucity of ganglion cells.Aim: To assess the usefulness of calretinin IHC in the diagnosis of HD as an add-on technique to routine Haematoxylin and Eosin staining. Materials and Methods: This was a prospective study carried out in the Department of Pathology, SCB Medical College, Cuttack during the period from August 2016 to July 2018. Full thickness rectal biopsy specimens were processed and subjected to routine Hematoxylin and Eosin Stain (H&E) staining and Calretinin IHC staining. A thorough search of ganglion cells was made in both types of stained slides. The observations were tabulated and compared for diagnostic accuracy. Statistical analysis was done using Statistical Packages for Social Sciences (SPSS) Inc, Chicago IL version 15.0 windows. Through, ANOVA and Chi-square test.Results: Calretinin IHC provided superior diagnostic yield compared to routine H&E staining. A total number of 45 cases were studied. Sensitivity of 95.4% and specificity of 55.5% were obtained. It also presented higher accuracy values, than H&E (p=0.49).Conclusion: Calretinin is a superior immunohistochemical staining method that serves as a reliable additional diagnostic tool for better morphological appreciation of ganglion cells and thereby helps in establishing the diagnosis of HD.