Predictive value of HLA-DR matching for nonreactivity in mixed lymphocyte culture (MLC) depends on matching for HLA-D

In white members of our panel who have been repeatedly typed, close association between the HLA-D and DR specificities was observed. The typings were concordant with both haplotypes in 71% of the North American white panel. In American Indians concordance was observed in 47%, and in American black panel members in only 24%. One-way MLC reactions between individuals matched for both HLA-DR and D were very low (15.8%). MLC reactions between individuals who were DR matched but D mismatched were found to be generally strong, with a mean DNV of 72.3%. It was concluded that the HLA-DR matching predicted the outcome of mixed lymphocyte culture reactions only when the individuals tested were matched also for HLA-D.

Early splenomegaly in homozygous sickle-cell disease: An indicator of susceptibility to infection

135 children with homozygous sickle-cell (SS) disease diagnosed at birth have been followed for 1--5 years. Severe bacterial infections were confined to those in whom the spleen was first palpable at or before 1 year of age and were commonest in those in whom the spleen was first palpable at or before age 6 months. Regular follow-up of children with SS disease diagnosed at birth will identify children particularly at risk of severe infections.

A comparative study of fine-needle aspiration cytology and histopathology in salivary gland lesions

Background: A wide variety of benign and malignant tumours originate in the salivary glands and insufficient tumour cells make their diagnosis difficult in some patients. The aim of this study was to evaluate the efficacy of fine-needle aspiration cytology in the diagnosis of salivary gland lesions and to correlate cytological findings with histopathology. Materials and Methods: This was a prospective study done from September 2002 to May 2004. Fine needle aspiration cytology was performed in 58 patients with clinically significant salivary gland masses. Results: Fine needle aspiration cytology categorized 67.24% of the salivary gland lesions as neoplastic and 32.76% as non-neoplastic lesions. Amongst the neoplastic lesions, 76.9% were benign and 23.1% were malignant cases. Histopathological examination revealed that 81.05% of the cases were benign and 18.95% were malignant. Fine needle aspiration cytology had a sensitivity, specificity and diagnostic accuracy of 81.82%, 100% and 96.55%, respectively. The positive predictive value and negative predictive value was 100% and 95.9%, respectively. Conclusion: Fine needle aspiration of the salivary gland is a safe and reliable technique in the primary diagnosis of salivary gland lesions. Although, limitations are encountered while predicting specific lesions on cytology, especially when dealing with cystic and some malignant lesions, this study has shown that fine needle aspiration cytology has a high sensitivity, specificity and diagnostic accuracy in diagnosing salivary gland lesions. Keywords: Salivary glands; Fine needle aspiration cytology; Histopathology DOI: http://dx.doi.org/10.3126/jpn.v1i2.5403 JPN 2011; 1(2): 108-113

Study of gastrointestinal stromal tumors with c-kit immunostaining

Background: Mutation of the C-KIT oncogene is the central event in gastrointestinal stromal tumors which are the most common mesenchymal tumors arising from the tubular gastrointestinal tract. Materials and Methods: A study was conducted in Patan hospital from April 2003 to May 2010. Mesenchymal tumors arising from the tubular gastrointestinal tract with the microscopic features suggesting gastrointestinal stromal tumor were included in the study. Results: A total of 22 cases were studied. The incidence was highest amongst the older age group (86.36%), than in younger people (13.63%). The tumor most commonly involved the small intestine (54.54%), followed by the stomach (36.36%). Most (59.09%) of the tumors were of huge size measuring >100 mm, and showed necrosis, hemorrhage and cystic degeneration. Mitotic activity was high (>5/50 high power fields) in 55% of the cases. Conclusion: C-KIT immunostaining showed positivity in 19 (86.36%) of the tumors in this study. Mutation of the C-KIT oncogene is seen in most of the gastrointestinal stromal tumors. Keywords: Gastrointestinal; Stromal tumors; C-KIT oncogene DOI: 10.3126/jpn.v1i1.4450 Journal of Pathology of Nepal (2011) Vol.1, 41-44

Understanding the Socio-Economic and Hygienic Status of Child Labourers in Nepal

Background The International Labour Organization (ILO) defines child labour as “work that deprives children of their childhood, their potential and their dignity, and that is harmful to physical and mental development. The ILO has estimated that in 2004, almost 218 million children (almost 1 in 7) aged 5-17 were involved in child labour worldwide, about 126 million under hazardous conditions. In Asian-Pacific region, 122 million children aged 5-14 were working as child labourers. It is imperative to know why the children are engaged in labour and what kind of effect child labour has in their health, education as well as the economy of their family. Methods This is a descriptive study which interviewed 313 child labourers working in different industries. It specially tried to assess the reasons why children joined the labour force, their family demographics, education and their general hygienic condition. Results 83.4% of child labourers joined labour because of poverty, 36.1% of them earned less than thousand rupees a month. 23.6% of them come from a big family with more than eight members. 30% (94) of them have not received even the primary level of education. Their overall hygienic condition is not satisfactory. Conclusion In Nepal, poverty is the most common cause of child labour and child labourers do not have a good hygienic condition.Key words: Child labour; Poverty; Earnings; Hygiene pressure DOI: http://dx.doi.org/10.3126/nje.v1i3.5573 Nepal Journal of Epidemiology 2011;1(3) 90-94