Vol 16, Issue 1, January-March, 2026

Background: Lymphadenopathy has varied causes, from reactive to malignant. Fine-Needle Aspiration Cytology (FNAC) is a rapid, minimally invasive, cost-effective diagnostic tool. The Sydney System (2019) standardises lymph node cytology, enhancing consistency. This study assesses its applicability, accuracy, and diagnostic performance in a tertiary center. Materials and Methods: A prospective observational study was carried out in the Pathology Department at a tertiary care rural hospital in Maharashtra from May 2024 to April 2025. All lymph node FNAC cases received during this period were included. Clinical details were systematically recorded, and smears were categorized using the Sydney System for Lymph Node Cytology. Based on available follow-up, histopathological correlation and Risk of Malignancy (ROM) were determined. Data were compiled in Microsoft Excel and analyzed descriptively. Results: Patient ages ranged from 6-months to 94-years (mean 32.6-years), with a slight female predominance (M:F = 0.98). Among 208 cases, 53% involved cervical nodes, and 85.1% were classified as L2 (Benign). L5 (Malignant) and L4 (Suspicious) accounted for 5.3% and 4.8%, respectively, while L1 and L3 each comprised 2.4%. Histopathological follow-up (24 cases) showed ROM values of L2 7.7%, L3 50%, L4 100%, and L5 100%. Using expanded criteria, FNAC sensitivity, specificity, PPV, NPV, and accuracy were 91%, 92%, 91%, 92%, and 91.7%. With strict criteria, sensitivity was 83%, specificity 100%, PPV 100%, NPV 92%, and accuracy 94.4%. Conclusion: The study validates Sydney System’s utility for lymph node cytology, showing predominantly benign cases, common cervical involvement, and high diagnostic accuracy with sensitivity (>80%) and specificity (>90%). Keywords: Fine Needle Aspiration Cytology (FNAC), Lymphadenopathy, Sydney System, Lymph Node Cytology, Risk of Malignancy (ROM).

Atypical pneumonia refers to forms of pneumonia not caused by typical pathogens like Streptococcus pneumoniae, and may present with non-classical symptoms. Haemolytic anaemia, a rare but serious complication, involves immune-mediated red blood cell destruction. We retrospectively reviewed five female patients admitted between December 2024 and February 2025 with confirmed atypical pneumonia and immune haemolytic anaemia. All patients presented with respiratory symptoms, anemia, and positive Direct Coombs Test (DCT), and were confirmed positive for Mycoplasma pneumoniae via lgM or urine antigen. Management included macrolides or fluoroquinolones, steroids, and blood transfusions where necessary. All patients showed clinical and radiological resolution. This series underscores the importance of early diagnosis and intervention in such complex clinical scenarios. Keywords: Hemolytic anemia, Atypical Pneumonia.

Background: Chronic obstructive pulmonary disease (COPD) is one of the top three causes of death worldwide. Since COPD is a chronic and progressive disease it produces health related problems as well as economic and social burden to patients and families. In these patients, exercise capacity, health- related quality of life and participation in daily activities are often impaired out of proportion to lung function impairment. Pulmonary rehabilitation is not frequently included in the integrated care of patients and is often inaccessible to patients. Aim: To assess the impact of pulmonary rehabilitation on exercise capacity (6 Minute Walk Test), lung function (FEV1) and quality of life in COPD. Materials and Methods: Sixty patients in the age group 40-80 years who were diagnosed with COPD as per GOLD guidelines were included in this study. Detailed evaluation was done. Pulmonary rehabilitation offered patient education, breathing exercises, chest physiotherapy, and exercise training. A 6MWT, Spirometry (FEV1), SGRQ, BORG dyspnoea scale was assessed initially and after 12 weeks of the programme. Results: Pulmonary rehabilitation program for 3 months was associated with statistically significant and clinically relevant improvement in physical performance. The mean improvement in 6MWT was 57 meters. Quality of life which was measured by the SGRQ score improved by more than 10 points while the BORG scale dropped significantly from 5.05 to 3.35. The mean FEV1 which was 62.43 at baseline, improved to 62.88 after pulmonary rehabilitation, but the result failed to achieve the desired level. Conclusion: This study clearly demonstrates that, pulmonary rehabilitation plays a definite role in the management of COPD patients. Outpatient based pulmonary rehabilitation resulted in significant improvement in exercise tolerance, dyspnea scale (BORG) and quality of life; although there was no significant improvement in lung function. Keywords: 6MWT, COPD, Pulmonary Rehabilitation, Quality of Life.

Background: Traumatic brain injury (TBI) is a leading cause of morbidity and mortality in the paediatric population. Owing to age-specific anatomical and physiological differences, children exhibit unique clinical presentations, injury patterns, and outcomes compared to adults. The objective is to study the clinical spectrum, radiological findings, and outcomes of traumatic brain injury in children. Materials and Methods: This hospital-based observational study was conducted in the Department of Paediatrics at a tertiary care teaching hospital. Children presenting with traumatic brain injury were evaluated for demographic profile, mechanism of injury, clinical features, Glasgow Coma Scale (GCS) at admission, radiological findings on CT scan, management, and outcome. Outcome was assessed using the Glasgow Outcome Scale at discharge. Results: A male predominance was observed. Falls were the most common mode of injury, particularly in younger children, while road traffic accidents were more common in older age groups. Vomiting, altered sensorium, and seizures were frequent presenting symptoms. On CT imaging, extradural hematoma, subdural hematoma, subarachnoid hemorrhage, cerebral edema, and skull fractures were commonly identified. Most patients were managed conservatively, while a minority required surgical intervention. Favorable outcomes were seen in the majority of cases. Poor outcomes were significantly associated with severe GCS scores and diffuse cerebral edema. Conclusion: Paediatric TBI demonstrates a wide clinical and radiological spectrum. Early diagnosis, prompt neuroimaging, and appropriate management result in good outcomes in most children. Preventive strategies focusing on fall prevention and road safety are essential to reduce the burden of paediatric TBI. Keywords: Traumatic brain injury, Paediatric head injury, Computed tomography, Glasgow Coma Scale, Outcome.

Background: Dry Eye Disease (DED) is a prevalent ocular surface disorder characterized by tear film instability, hyperosmolarity, neurosensory dysfunction and inflammatory changes, significantly affecting visual performance and quality of life. Its burden is increasing globally, driven by aging demographics, digital screen exposure, lifestyle factors, environmental pollution and systemic comorbidities. The aim is to determine the prevalence, severity, associated risk factors and treatment response of dry eye disease in a tertiary care hospital using TFOS DEWS II diagnostic criteria. Materials and Methods: A prospective observational study was conducted on 100 patients aged ≥18 years presenting with symptoms suggestive of DED. Clinical evaluation included Schirmer’s test, Fluorescein Tear Break-Up Time (TBUT), Rose Bengal staining, Lissamine green staining and tear meniscus height assessment. Environmental exposure, systemic disease history and lifestyle factors were recorded. Patients diagnosed with DED received lubricating eye drops and were re-evaluated after four weeks. Statistical analysis included Chi-square test, paired t-test and logistic regression; p<0.05 was considered significant. Results: The prevalence of DED was 23.68%, with higher occurrence among individuals >60 years and those reporting prolonged screen exposure, outdoor occupation, smoking, and use of air-conditioning. Diabetes mellitus showed a notable association with DED. TBUT <10 seconds was observed in 72.2% of affected individuals, indicating evaporative dry eye as the predominant subtype, whereas Schirmer’s test <10 mm was present in 38.9%, suggesting mixed pathology. Post-treatment follow-up demonstrated statistically significant improvement across all diagnostic parameters (p<0.001), including tear film stability and ocular surface staining scores. Conclusion: Dry eye disease is a common clinical entity with multifactorial etiology influenced by demographic, environmental, systemic, and lifestyle-related factors. The predominance of evaporative dry eye underscores the increasing role of digital screen exposure and environmental stressors. Early identification and targeted management significantly improve clinical outcomes. Keywords: Dry Eye Disease; TFOS DEWS II; Tear Film Instability; Meibomian Gland Dysfunction; Epidemiology; Digital Screen Exposure; Schirmer’s Test; Tear Break-Up Time; Ocular Surface Disease; Risk Factors.

Background: Spatial transcriptomics (ST) is a molecular technique that helps in gene expression mapping within intact tissue. Among the various approaches, Multiplexed Error-Robust Fluorescence in Situ Hybridization (MERFISH) is built on the power of single molecule RNA Fluorescent in situ hybridization which detect individual RNA molecules with high accuracy and sort out thousands of genes at once. Although the technique has been widely adopted across neuroscience, oncology, and developmental biology, its role in spatial transcriptomics is still limited. Objectives: This meta-analysis aims to evaluate its applications, accuracy, reproducibility and its comparison with other spatial transcriptomics. We also illustrated how MERFISH integrates with other multi- omics platforms and its role in biomedical research. Material and Methods: Systematic searches carried out across PubMed, Scopus, Web of Science and EMBASE (2014–2025). Data reporting of MERFISH based spatial transcriptomics carried out with either quantitative or qualitative outcomes. For data extraction PRISMA guidelines are followed. Quantitative analysis was performed on reproducibility measures, gene detection efficiency and spatial resolution while for qualitative synthesis we examined functional and clinical insights from the included studies. Results: Thirty-four studies (N = 34) met the inclusion criteria covering neuroscience, oncology, developmental biology, and pathology. Across these studies, MERFISH achieved >95% molecular detection accuracy and subcellular spatial precision. On comparing with other techniques like seqFISH+ and Slide-seqV2, MERFISH showed superior spatial resolution (50–100 nm) and maintained a strong multiplexing capacity (>10,000 genes). MERFISH integration with single-cell RNA-seq enhanced tissue-level transcriptome reconstruction and cell-type classification. Conclusions: MERFISH emerges as a highly reliable, high-throughput and advanced spatial transcriptomics platform with significant translational potential. Integrating MERFISH with computational modelling and multimodal imaging is expected to expand diagnostics, developmental biology and disease mapping applications. Keywords: MERFISH, spatial transcriptomics, single-cell analysis, multiplexed imaging, gene expression, tissue mapping.