The interobserver reproducibility of thyroid cytopathology using Bethesda Reporting System: analysis of 200 cases.

OBJECTIVE: To determine interobserver reproducibility of thyroid cytopathology in cases of thyroid fine needle aspirates. METHODS: The retrospective, descriptive study, was conducted at the Foundation University Medical College, Islamabad, using cases related to period between 2009 and 2011. A total of 200 cases of fine-needle aspirations were retrieved from the archives. Three histopathologists independently categorised them into 6 groups according to Bethesda reporting system guidelines without looking at previous reports. Kappa statistics were used for analysis of the results on SPSS 17. RESULTS: Of the 200 patients, 194 (97%) were females and 6 (3%) were males. The overall mean age of patients was 46 +/- 20 years. Kappa value calculated for observer-1 and observer-2 was 0.735; for observer-1 and observer-3, 0.841; and for observer-2 and observer-3, 0.838, showing substantial interobserver agreement. Histopathological correlation was available, for 39 (19.5%). Of these cases, 5 (13%) were 'non-diagnostic, 20 (51%) 'benign, 2 (5%) 'atypia of undetermined significance/follicular lesion of undetermined significance, 6 (15%) 'follicular neoplasm, 1 (3%) 'suspicious for malignancy, and 5 (13%) 'malignant. CONCLUSIONS: Good overall interoberver agreement was found, but discordance was seen when certain categories were analysed separately.

Effect of examination stress on blood cell parameters of students in a Pakistani medical college.

BACKGROUND: Physiological studies show that stress can alter the blood cells parameters in healthy individuals. We tried to determine whether exams in medical schools are stressful enough to produce such changes. METHODS: A randomized selection of female students from Women Medical College, Abbottabad, Pakistan, was carried out. After preliminary medical checkup blood samples were taken before and during exams. Students having temperature or high blood pressure at the start of study were excluded. Finally 37 students were included. Estimations of red blood cells, hematocrit, neutrophils, lymphocytes, eosinophils, monocytes, basophils and platelets were carried out. RESULTS: Compared with pre-examination results the blood samples taken during exams showed a significant decrease in eosinophil, basophil, lymphocyte and monocyte count. An increase in platelet and neutrophil count was also observed. No significant changes were observed in red blood cell and hematocrit readings. CONCLUSION: It is concluded that examinations in medical schools are stressful enough to produce changes in blood cells parameters which include increase in neutrophils, and platelets, while eosinophils, monocytes basophils and lymphocytes decreased in number.