Gireesh V. Achalkar

Abstract

Introduction: The most common cause of sudden cardiac death is ischaemic. Such patients may have an occlusive recent thrombosis in one or more major coronary arteries. An area of stenosis of 85 per cent is the best discriminating level for increased mortality. Objective: To study the cardiac causes of sudden death. Materials and Methods: 200 medicolegal cases of sudden death requested for pathological examination of heart were studied. A careful study of the information given by the police and forensic medicine experts was done. The heart was examined macroscopically for clots, thrombi, any anomalies, tumors or any other pathological signs. The sections of the organ were studied. Results: A total of 200 cases were studied with 120 males and 80 females. Majority of them (70%) weighed less than 300 grams. Only 2 weighed more than 350 grams. Cardiomyopathies were recognized in 30 specimen. Dilated cardiomyopathy was most common among them and accounted for 20 cases. Conclusion: Personal experience of studying such patients, suggests that the majority of deaths are indeed cardiac. The various causes of sudden cardiac death must be correlated with pathological findings to arrive at a definitive diagnosis. Keywords: Autopsy, Heart, Ischemia, Thrombosis, Ventricular fibrillation.

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Abstract

Introduction: Breast Carcinoma has emerged as most common type of malignant tumor in women surpassing cervical carcinoma which was commonest few decades ago. Hence a proper diagnostic protocol is very much necessary for diagnostic, management and prognostic purposes. Immunohistochemistry has helped to some extent in this aspect. Materials and Methods: Both H&E stained sections and IHC sections for ER, PR and Her2 were studied. The Hormone receptor status was correlated with age, grade and type of tumor. Results:  Total cases analyzed in the present study were 50. Infiltrating ductal carcinoma was 45/50(90%) and others were 5/50(10%). IDC was the most common one and triple negative tumors being 34.83% Hormone receptor status was more in younger patients than older ones. And there was positive association with smaller size of the tumors. Their expression was higher in grade I tumors at 85% than in grade III tumors at 10%. The smaller tumors less than 2cm showed triple positively more frequently than larger tumors more than 2cm. Conclusion: In the present study the breast carcinoma in younger patients having smaller size of tumor was frequently positive for ER, PR and negative for Her2/neu than older patients with larger size of the tumor. Immunohistochemical study of breast carcinoma must be routine so as to help the clinician for better management of patients. Keywords: Breast carcinoma, Infiltrating duct carcinoma, Immunohistochemistry (IHC), Estrogen receptor (ER), Progesterone receptor (PR), Human epidermal growth factor receptor-2(HER2.

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