Dhananjay Shrikant Kotasthane

Abstract

Introduction: Gall Bladder (GB) diseases are one of the most common digestive system diseases, the prevalence of which is variable within India and ranges from 2-29%. Cholelithiasis (gallstones) is the commonest lesion and accounts for more than 95% of GB diseases. Gall bladder carcinoma showed regional differences in India with prevalence ranging from 0.52% in southern India and as high as 9.6% in northern India. Aims and Objectives: 1)To identify the morphological spectrum of diseases affecting the gall bladder. 2)To identify the most common histopathological lesion and its correlation with clinical and demographic data of the patient. 3)T o identify the frequency of Gall Bladder Carcinoma (GBC) and its correlation with clinical and demographic data of the patient and pre-existing lesions if any. Materials and Methods: This study was non-participatory descriptive study carried out retrospectively for a period of one year in the Dept. of Pathology, HIMS,from August 2018 to July 2019. All the specimens received in the study period were included in the study. The gross and microscopic findings on H & E slide were included in the study. The descriptive statistics w as applied to analysed data. Results: Total 86 cholecystectomy specimens were received in the Department of Pathology during one year study period. Non-neoplastic lesions (97.67%) of gall bladder outnumbered the neoplastic lesions (2.33%). Most common histopathological lesion was chronic cholecystitis (95.34%). Varied histopathological spectrum was seen comprising of chronic calculous cholecystitis (73.26%), chronic acalculous cholecystitis (13.95), chronic cholecystitis with cholesterosis (13.95%), Xanthogranulomatous cholecystitis (2.33)%), Acute calculous cholecystitis (1.16%), acute gangrenous GB (1.16%), GBC (2.33%). In non-neoplastic lesions, female predilection (70.24%) was seen over male (29.76%) accounting for F:M ratio of 2.4:1, two cases of GBC exclusively seen in females associated with gall stones. Nonneoplastic lesions were common between the age group of 26-50 years accounting for 67.45% where as neoplastic lesions were common in the age group of >60years. Conclusion: Chronic cholecystitis with pigmented gall stone was the commonest GB disease in the present study. The study also revealed that females have increased preponderance for the development of all the gall bladder diseases including malignancy. Non-neoplastic lesions were more common till 5th decade in the present study whereas females in the 5th and 6th decade of life were prone for malignancy of gall bladder which was associated with gall stones. Keywords: Gall bladder, Cholecystectomy, Histopathology.

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Abstract

Introduction: Quality lab reports require high degree of precision and accuracy. This study was undertaken to study pre-analytical errors as a quality measure in Central Clinical Laboratories of rural Tertiary Care Hospital. Materials and Methods: This study was a non-participatory observational study for a period of two months from 6/7/2019 to 6/9/2019 conducted at HIMS, UP, India. After obtaining clearance from Institutional Human Ethical committee, study was undertaken in Central Clinical Laboratory(CCL). The blood samples of OPD and IPD were included. Checklist for pre-analytical errors was followed. Results: Total 13604 blood samples were received in CCL in study periodand pre-analytical error was found to be 398 (2.93%). The commonest error was inadequate (underfilled/Overfilled) samples(1.15%), second commonest was Clotted sample (0.99%), Hemolyzed samples were 0.26%, Lipemic samples were 0.15%, and remaining were diluted sample, incorrect vaccutainer and sample spillage each accounted for 0.08%, followed by test ID form missing (0.06%) and specimen ID and order form mismatch (0.02%). There was a statistical difference between pre-analytical errors in IPD(3.68%) and OPD(0.87%) samples with p value less than Conclusion: Pre-analytical errors are avoidable and could be manage by preventive and corrective measures and proper education and skill enhancing training to paramedical staff and efficient monitoring by Lab managers. Keywords: Blood samples, Central clinical laboratory, Pre-analytical errors.

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