Date Sheet

The final date sheet for the forthcoming Pharm-D Annual Examination is issued Yesterday (17-08-2012)

1st and 3rd Prof Proposed Date Sheet

1st Prof:


12-9-2012    (Organic Chemistry)
17-9-2012    (Biochemistry)
21-9-2012    (Physiology)
26-9-2012    (Pharmaceutics)
02-10-2012  (Maths/Stats)\
05-10-2012  (Anatomy/ Histology)


3rd Prof:

10-9-2012    (Pharmacognosy)
14-9-2012    (Dispensing/ Community Pharmacy)
18-9-2012    (Pathology)
24-9-2012    (Pharmacology)
28-9-2012    (Instrumentation)

Pathology Report

What is a pathology report?

A pathology report is a document that contains the diagnosis determined by examining cells and tissues under a microscope. The report may also contain information about the size, shape, and appearance of a specimen as it looks to the naked eye. This information is known as the gross description.

A pathologist is a doctor who does this examination and writes the pathology report. Pathology reports play an important role in cancer diagnosis and staging (describing the extent of cancer within the body, especially whether it has spread), which helps determine treatment options.

In most cases, a doctor needs to do a biopsy or surgery to remove cells or tissues for examination under a microscope.

Some common ways a biopsy can be done are as follows:

• A needle is used to withdraw tissue or fluid.
• An endoscope (a thin, lighted tube) is used to look at areas inside the body and remove cells or tissues.
• Surgery is used to remove part of the tumor or the entire tumor. If the entire tumor is removed, typically some normal tissue around the tumor is also removed.
Tissue removed during a biopsy is sent to a pathology laboratory, where it is sliced into thin sections for viewing under a microscope. This is known as histologic (tissue) examination and is usually the best way to tell if cancer is present.

What information does a pathology report usually include?

The pathology report may include the following information:

• Patient information: Name, birth date, biopsy date.
• Gross description: Color, weight, and size of tissue as seen by the naked eye.
• Microscopic description: How the sample looks under the microscope and how it compares with normal cells.
• Diagnosis: Type of tumor/cancer and grade (how abnormal the cells look under the microscope and how quickly the tumor is likely to grow and spread).
• Tumor size: Measured in centimeters.
• Tumor margins: There are three possible findings when the biopsy sample is the entire tumor:
• Positive margins mean that cancer cells are found at the edge of the material removed.
• Negative, not involved, clear, or free margins mean that no cancer cells are found at the outer edge.
• Close margins are neither negative nor positive.
• Other information: Usually notes about samples that have been sent for other tests or a second opinion.
• Pathologist’s signature and name and address of the laboratory.

I am leaving for UK inorder to start my Ph.D studies in September 2012 after receiving the prestigious  Commonwealth Scholarship. I am one out of three candidates from Pakistan who qualified for the award out of 200 applicants this year. Its all due to shear blessings of Allah SWT. 

Dear students, please pray for my further success!

POLYCYSTIC OVARIAN SYNDROME (PCOS)

Polycystic ovary syndrome (PCOS) is one of the most common female endocrine disorders. PCOS is a complex, heterogeneous disorder of uncertain etiology, but there is strong evidence that it can to a large degree be classified as a genetic disease.

PCOS produces symptoms in approximately 5% to 10% of women of reproductive age (12–45 years old). It is thought to be one of the leading causes of female subfertility and the most frequent endocrine problem in women of reproductive age.

The syndrome is associated with numerous morbidities, including infertility, obstetrical complications, type 2 diabetes mellitus, cardiovascular disease, and mood and eating disorders.

Etio-Pathophysiology

PCOS is a complex, heterogeneous disorder of uncertain etiology but the element of genetics is more likely to be involved.

The pathophysiology of PCOS is not well understood, mainly due to lack of knowledge of the location of the primary defect. There are several candidates: ovary, adrenal, hypothalamus, pituitary, or insulin-sensitive tissues.

Investigations have elucidated some of the interactions between these systems.

·         Insulin resistance leads to compensatory insulin hypersecretion by the pancreas in order to maintain normoglycaemia.

·         The resulting hyperinsulinaemia promotes ovarian androgen output and may also promote adrenal androgen output.

·          High insulin levels also suppress hepatic production of sex hormone binding globulin (SHBG), which exacerbates hyper-androgenaemia by increasing the proportion of free circulating androgens.

·         Another factor that promotes ovarian androgen output is the fact that women with PCOS are exposed long term to high levels of LH. This LH excess seems to be a result of an increased frequency of gonadotrophin-releasing hormone (GnRH) from the hypothalamus.

The overall abnormal hormonal picture also probably contributes to incomplete follicular development which results in polycystic ovarian morphology.

Sign Symptoms

• Absent or infrequent periods (oligomenorrhoea): usually only occur once or twice a year
• increased facial and body hair (hirsutism): usually found under the chin, on the upper lip, forearms, lower legs and on the abdomen (usually a vertical line of hair up to the umbilicus)
• acne: usually found only on the face
• Subfertility/ infertility: infrequent or absent periods are linked with very occasional ovulation, which significantly reduces the likelihood of conceiving
• overweight and obesity: a common finding in women with PCOS that occurs due to insulin resistance which  prevents peripheral glucose utilization by the cells and thus glucose is stored as adipose tissue.
• miscarriage. one of the hormonal abnormalities in PCOS, a raised level of luteinising hormone (LH - a hormone produced by the brain that affects ovary function), seems to be linked with miscarriage. Women with raised LH have a higher miscarriage rate (65 % of pregnancies end in miscarriage) compared with those who have normal LH values.

Risk Factors

• Obesity
• Anxiety/ Depression 
• Epilepsy: Both epilepsy and the use of anti–seizure medications increase the risk of PCOS.
• Family History: Approximately 40 percent of first–degree relatives are affected.

Diagnosis

• For diagnosis, two of the following three criteria should be met, and other diseases with similar symptoms should be ruled out:
  • Menstrual irregularity: Lack of periods, decreased frequency of periods, or irregular bleeding may all occur.
  • Signs of increased androgen hormones: This may appear as hirsutism, acne, male–pattern baldness, or elevated testosterone concentration in the blood.
  • Polycystic ovaries, visible on transvaginal ultrasound:  The cysts (fluid filled sacs) in the ovaries can be identified with imaging technology. Ultrasound imaging is commonly for diagnosis.
• Several blood tests are necessary to evaluate the effects of the disease, including measurements of various hormones, blood glucose, and insulin.
• Because coronary artery disease is common in patients with PCOS, cardiovascular risk factors should be evaluated (e.g., high cholesterol levels), and further testing may be necessary, such as an electrocardiogram and stress testing. Smoking should also be discouraged.

Treatment

• Weight loss, increased physical activity, and diabetes medications (e.g., metformin) are usually necessary.
• Oral contraceptives are used to regulate the menstrual cycle and protect the uterus in women who are not interested in becoming pregnant.
• Hirsutism is treated by hair removal  and various medications, including oral contraceptive pills, anti–androgen medication (e.g., spironolactone), or gonadotropin–releasing hormone analogs (e.g., leuprolide).
• Acne is treated with topical or oral medications.
• Treatment of infertility is often necessary if the patient desires pregnancy. This may include medical therapies (e.g., clomiphene ormetformin) or assisted reproductive technologies (e.g., in–vitro fertilization).

PATHOLOGY PRACTICALS 9, 10, 11,12

Experiment No. 9

Gross Examination of Lipoma

Experiment No. 10

Gross Examination of Acute inflammation in Acute Streptococcal meningitis

The above image shows the important cardinal signs of acute inflammation:

The whole tissue presents redness, edema, glossy exudation of fluid which has obscured the Sulci (depressions). All these occurred due to Streptococcus pneumoniae infection, leading to Meningitis.

Experiment No. 11

Gross Examination of Acute Peptic Ulcer

Above image showsa  1 cm acute gastric ulcer  in the upper fundus. The ulcer is shallow and sharply demarcated, with surrounding hyperemia. It is probably benign. However, all gastric ulcers should be biopsied to rule out a malignancy.

Experiment No. 12

Gross Examination of a cut section of Polycystic ovaries

Gross and cut appearance of typical polycystic ovaries. Multiple small follicular cysts are apparent in the cut section.

Pathology Syllabus