Renuka Verma

Abstract

Background: Cardiac lesions are responsible for approximately 60-70% of sudden deaths. Histopathological examination of heart on autopsy plays an essential role in determining the cause of death. Aims and Objectives: The present study was conducted to analyse histopathological spectrum of various cardiac lesions in autopsy specimens. Materials and Methods: This retrospective randomized study was conducted in the Department of Pathology, Pt. B. D. Sharma, PGIMS, Rohtak, Haryana. A total of 1152 autopsies were analysed, irrespective of cause of death. Among them heart was included in 1062 autopsies, out of which 62 were autolysed. Hence, 1000 specimen of whole heart were included in our study. A detailed gross and microscopic examination was done and histopathological findings were correlated clinically. Results: Atherosclerosis was the most common cardiac lesion seen in 610 out of 1000 autopsied heart (61%), followed by ischaemic heart disease in 346 cases (34.6%). 27 cases had pericarditis, 23 cases revealed myocardial hypertrophy, 16 cases showed myocarditis, 11 cases had ventricular haemorrhage, 8 cases revealed changes of electrocution, 7 cases had tuberculosis, 6 cases had calcification of valve and 4 cases had metastasis from carcinoma. One case each of infective endocarditis, rheumatic heart disease and aortitis were also noted. The cause of death was not identified in 304 cases. Left anterior descending artery was most frequently involved vessels (35.02%) followed by left circumflex artery (33.41%) then right coronary artery (31.57%). Out of three major vessels 16.24% had single vessel involvement whereas 32.14% & 51.62% cases had two vessels and three vessels involvement respectively. Conclusion: Ischemic heart disease with coronary artery atherosclerosis was found to be the leading cause of death with triple vessel disease as the most common pattern of involvement.   Keywords: Autopsy, Heart, Histopathology.

Open full article page

Abstract

Introduction: Chronic liver disease is a disease of the liver that lasts over a period of six months or more, involving a process of progressive destruction and regeneration of the liver parenchyma leading to fibrosis and cirrhosis.In this study, we have compared three main tools to assess liver fibrosis including fibroscan, liver biopsy and non-invasive biomarkers. Materials and Methods: Inthis prospective study, a total of 30 cases of chronicliver disease were included. Fibrosis stage was assessed using fibroscan. In liver biopsy, Grading of fibrosis was done by modified activity grading system and staging was done using Ishak staging system. Serum markers were analysed using various scoring systems including AST/ALT ratio (AAR), AST/platelet ratio index (APRI), FIB-4 index and Forn Index. The obtained results were analyzed and evaluated using chi square test and area under receiver operator characteristic curve (AUROC) using SPSS version 20. Results: A significant association was found between fibroscan and Ishak fibrosis stage (p 0.049), fibroscan and APRI (p 0.02) and FIB-4 and liver biopsy (p 0.03). AAR and Forn index did not have any significant association with either fibroscan (p 0.969 and 0.889) or liver biopsy (p 2.56 and 0.98). Conclusion: The accuracy of fibroscan in evaluating fibrosis is comparable to that of liver biopsy. Thus, liver biopsy can be replaced with fibroscan in the future. Though, the non-invasive biomarkers are useful in assessing fibrosis, a combination of these markers may perform better than each alone.  Keywords: Chronic liver disease, Liver biopsy, Fibroscan, Non invasive biomarkers.

Open full article page