Rudolf Ludwig Karl Virchow (1821 – 1902) was a German doctor, anthropologist, pathologist, prehistorian, biologist and politician, known for his advancement of public health. Referred to as "the father of modern pathology," he is considered one of the founders of social medicine. he was associated with Benno Reinhardt in founding the Archiv für pathologische Anatomie und Physiologie und für klinische Medizin, world-famous as “Virchow's Archives.” He is cited as the first to recognize leukemia cells. More than 14 issues in medicine, surgery and pathology are named after Virchow. He founded the fields of cellular pathology and comparative pathology.
Message of the Chair
Message from the Chair: The Department of Pathology, established in 1967 under doyens like Dr.K.Radhakrishnan & Dr.Venugopal Shetty, serves a portal for pathology diagnosis, research and teaching in this southern city and the rural district around. This department has adapted to the medical needs of the patients in Tirunelveli Medical College & its affiliate hospitals. We are committed to accurate timely consultations and diagnoses in Anatomic & Surgical Pathology, Cytopathology, Laboratory Hematology, Clinical Pathology and Immunopathology. The Department has a postgraduate residency program, since 1982, with 7 residents a year. All of our residents have successfully passed their boards, a unique achievement, reflective of our commitment to education. In the same spirit, many of our graduate students have chosen pathology as their specialization later.
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HEAD OF THE DEPARTMENT – ROLL OF HONOUR
|1||Dr.S.Radhakrishnan MD DCP||1968||1969|
|2||Dr. Venugopal Shetty MD DCP||1969||1971|
|3||Dr. S.Arumugam MD DCP||1971||1972|
|4||Dr. C.Natarajan MD DCP||1972||1973|
|5||Dr. P. Seetha MD DCP||1973||1974|
|6||Dr. P.Natarajan MD DCP||1974||1976|
|7||Dr, V.Rajasekaran MD DCP||1976||1979|
|8||Dr. D.V.Gomathy MD DCP||1979||1989|
|9||Dr. A.Kalaivani MD||1989||2002|
|10||Dr. V.Paramasivan MD (Path) MD (FM)||2003||2008|
|11||Dr. Sithy Athia Munavarah MD||2008||2014|
Professor & Head of the Department:
Dr. Shantaraman Kalyanaraman MD
Dr. Swaminathan Kalyanasundaram MD
Dr. Suresh Durai Jeyasingh MD
Dr. Arasi Rajesh Chandran MD
Dr. S.Vasuki MD
Dr. V.Bagiyalakshmi MD
Dr. Johnsy Merla Joel MD
Dr. Hidhaya Fathima Kaleemullah MD
Dr. R.Sinduja Govindarajan MD
Dr. K.Mahalakshmi MD
Dr. G.Dharma Saranya MD
Dr. R.Chandru Mari MD
ANATOMIC & SURGICAL PATHOLOGY:
The Department of Pathology has a dedicated histopathology lab service for all material received from the theatres and wards of TVMCH and other affiliate hospitals. The laboratory has automated processing systems and undergoes quality assurance reviews between the pathologists. This unit of our department is the standalone supplier of rare specimens of tissue material for pathology museums in government run medical schools in the southern region of State of Tamilnadu.
The Department has a fully deployed Clinical Pathology unit in the TVMCH for patients being seen at the affiliate hospitals. All areas of Clinical study including the study blood, urine and body fluids are available. The lab routinely undergoes quality assurance reviews between the pathologists and with EQAS programs. The laboratory has automated Cell Counters, Automated Urine Analysis System and ESR analyser. This lab works 24x7 with a team of dedicated technicians.
The Department of Pathology has a dedicated Hematopathology service easily accessible for patients being seen at the TVMCH and other affiliate hospitals. All areas of Hematopathology are available for consultation including: study of peripheral blood, bone marrow, lymph nodes, or extra-nodal tissues. The lab routinely undergoes quality assurance reviews between the pathologists and with EQAS programs. The laboratory has automated Cell Counters, ESR analyzers and Coagulation Systems.
The Department has a dedicated cytopathology service including a PAP smear program for the Obstetrics & Gynaecology OPD and Wards, FNAC OP & Fluid Cytology services for patients being seen at the TVMCH and other affiliate hospitals. All areas of cytopathology are available for consultation including: study of surface nodules, CT Scan and Ultrasonogram Guided studies. The lab routinely undergoes quality assurance reviews between the pathologists.
The Department runs immunopathology service that includes a wide panel of immunocytochemical and immunohistochemical stains. The lab routinely undergoes quality assurance reviews between the pathologists.
DEPARTMENT STATISTICS :
|STATISTICS OF THE DIAGNOSTIC PROGRAM|
|Course||Course Duration||No of Admissions / Year|
|MD Pathology||3 Years||7|
|II MBBS Course||1 year & 6 Months||150|
|DMLT Course||2 years||100|
GRADUATE ACADEMIC PROGRAMS
II Professional MBBS:
The department has an innovative, interdisciplinary graduate degree program designed to allow students to pursue advanced training in science, while simultaneously developing professional workplace skills that may include internships. Faculty within the Department of Pathology support graduate research projects sponsored by the I.C.M.R, T.N.S.R.C and T.N.S.E.T. The students train in Pathology during the 3rd to 5th semesters of the MBBS course. The GMP includes internship in Clinical Pathology & Laboratory Medicine for 2weeks.
Graduate Program – Course Coordinator: Dr.K.Swaminathan
Diploma in Medical Laboratory Technology: The department under affiliation with the King Institute Center, Chennai hosts a Clinical Laboratory Science Program with collaborative effort of Biochemistry, Microbiology and the Central Diagnostic Laboratory. The program offers training in four categorical areas of medical laboratory science: Chemistry, Urinalysis, Microbiology, Hematology, Hemostasis, and Immunology.
Diploma Program – Course Coordinator: Dr.Arasi Rajesh
RESIDENCY TRAINING PROGRAM
The Department of Pathology has 21 residency positions, typically 7 in each of the three years. Residents rotate in three month blocks with Anatomic & Surgical Pathology, Cytopathology, Hematopathology, Clinical Pathology & Transfusion Medicine fully integrated to complete their 36 months of core rotations (16 months of Anatomic & Surgical Pathology and 7 months each of Cytopathology & Clinical Pathology and 1 Month of Transfusion Medicine), electives (3 months) to complete the three years needed for The TN Dr MGR Medical University Board of Pathology. Rotations are personalized as much as possible to allow residents to gain appropriate experience in their areas of special interest. Throughout residency training, we place emphasis on individual instruction, assessment of the resident’s strengths and needs, and graded responsibility. Teaching is aimed at acquiring competency in all aspects of pathology and creating a desire for lifelong learning, but includes the information to pass Board examinations as well.
Residency Program – Course Coordinator: Dr.Suresh Durai.J
CME & TRAINING PROGRAMS
The department organised two CMEs’ in 2017
- Challenges in Surgical Pathology – A National CME (14,15 July 2017) under funding of Medical Council of India
- CME on Clinical Genomics (27,28 July 2017) under collaboration of CSIR-IGIB New Delhi
|Slide Discussion - Fridays|
|Dermato-Path Meet -Last Saturday|
|Technical Discussion - Alternate Saturday|
|Gross Randing -Wednesday|
|Slide Randing -Saturday|
|Journal Club - Alternate Saturday|
|Resident Session -Thursday|
|Research Review -Monday|
- Identification of Circular RNA CiRS-7 in Breast Cancer and determine its Predictive value as a novel biomarker of breast cancer among women in South Tamilnadu Communities
- Diagnostic immune-histochemistry with tissue microarray technique in Non-Hodgkins lymphoma
- A comparative study of the expression of Her2/neu in invasive ductal carcinoma of breast with & without carcinoma insitu.
- Evaluation of her2/neu expression in malignant lesions of uterine cervix
- Cytomorphological evaluation of nodular and diffuse thyromegaly with emphasis on Bethesda system of reporting
- Quantification of microvessel density in breast carcinomas based on immunohistochemistry
- Comparative study of the diagnostic accuracy of conventional smears to cell block technique in minimally invasive procedures of pulmonary lesions
- Evaluation of expression of Her2/neu in gastric adenocarcinoma
- Study of the prevalance, etiology, contributory factors, correlation of the clinical and laboratory profiles and prognostic indicators of anemia in elderly patients presenting at a tertiary hospital in rural south Tamilnadu
- Evaluation of proliferative indices in pre-malignant and malignant lesions of cervix
- Pre-operative diagnostic and prognostic evaluation of carcinoma breast – conventional FNAC vs. Liquid based cytology
- Study on histological grading and receptor status (ER, PR, HER2/neu) in invasive breast carcinoma by immune-histochemical analysis using tissue microarray
- Significance of tissue micro-biopsies in fine needle aspiration cytology in diagnostic yeild
- p53 and ki67 expression in oropharyngeal precancerous lesion and their correlation with poor oral hygiene
- Typing of hemolytic anemia using a basic panel of investigations
- Detection of AFB & fungi on fine needle aspiration cytoloy of granulomatous inflammation using special stains and other special techniques
- Evaluation of prognostic indicators in non-hodgkin lymphoma – role of proliferative and apoptotic indices
- Study of patterns of urinary sediment in renal diseases
- Evaluation and comparative analysis of newer compound fixatives
- Study of morphometric pattern of gallbladder in cholecystitis
- Role of cell block in ascitic fluid cytology in the evaluation & staging of visceral malignancy
- A study of histomorphological profile of triple negative breast cancers
- Her2 neu & ki67 expression as immuno localisation in colorectal carcinoma
- Expression of CD56 & galectin-3 expression in follicular neoplasms of thyroid
- Expression of CK19 expression in papillary lesion of thyroid
- To determine the effectiveness of immuno-histo-chemistry in differentiating prostate adenocarcinoma from cancer mimickers
- Compound fixatives in microwave assisted tissue processing – a step towards formalin free laboratory.
- Comparative analysis of cytomorphologic features of thyroid lesions using various cytological staining techniques
- Utility of platelet indices as indicators of vascular complications in diabetes mellitus.
- A study of the placental changes in high risk pregnancies
- Evaluation of haematological scoring system in early diagnosis of neonatal sepsis.
- Evaluation of prognostic indicators in colorectal carcinoma – a comprehensive study to correlate staging, grading and proliferative indices
- A study on the coagulation profile and its clinico-pathological correlation of the haemophilia patients at the day care centre of tirunelveli medical college.
- Study of CD 56 expression in all papillary lesions of thyroid gland
- Mestatatic status of lymph nodes from radical surgical resections using cytokeratin as an adjuvant to standard staining methods – An Audit of the diagnostic yeild.
- Triple negative breast carcinoma – a search for a specific biomarker
- A study of the genetic determinant of Familial Adult Onset Myoclonic Epilepsy in a Unique community in South Tamilnadu
- Identification of Novel Genomic Marker as predictor of Sudden Cardiac Death in a specific South Tamilnadu population
- Search for a Specific Genomic Marker in predicting the occurrence of severe cutaneous adverse drug reactions for Carbamazepine in South Indian population
- Genomic Profile of Spino-Cerebellar Ataxia in South Tamilnadu – A study to establish proof of concept for specific drug discovery
- IL 6 and Alpha-TNF Levels as specific indicators to predict outcome in Dengue Shock Syndrome patients
- Hospital Based Cancer Registry
- Genomic Profile of Parkinsons Disease in South Tamilnadu – A study to establish proof of concept for specific drug discovery
- Estimation of soluble fms like tyrosine kinase1(sFlt-1) and placental growth factor (PlGF) in determining preeclampsia
- A study of incidence of Carotid artery intimal tear in cases of death due to antemortem hanging
- Risk of Recurrence of Ovarian Malignancy Algorithm (R-ROMA) – A Multivariate regression model for prediction of tumour residue in ovarian tumours using serial estimation of plasma CA 125 levels and digital SNP quantification
- Unexplained anemia of elderly and sirtuins SIRT 1 expression – an establishment of proof of concept in search of newer treatment options
- Is occult myelodysplasia a cause of unexplained anaemia of elderly – a search of a proof of concept
- Tirunelveli Bio Bank Initiative (TBBI)
- Immunohistochemical expression of estrogen receptors alpha and beta in prostate – as proof of concept for developing newer therapeutic options
- A comparative study of the levels of serum erythropoietin in patients with diabetic kidney disease and kidney disease of non diabetic etiology
- Comparison of the Effects of Purified Curcumin and Natural State Turmeric on the Angiogenesis in Zebrafish Embryo
- Role of Iodine and Selenium in Multi Nodular form of Hashimotos Thyroiditis in our community
- Estimation of Glycosaminoglycans / Proteoglycans (GAG/PG), N-Acetyl-β-D-glucosaminidase (NAG), and Neutrophil gelatinase-associated lipocalin (NGAL) levels in Urine – As early markers of Nephropathy in Diabetes Mellitus Type 2 Patients
- Is prealbumen band quantification an indicator of the clinical status of terminal cancer patients
- Effects of Natural State Ginger on the Haematopoiesis in Zebrafish Embryo as a proof of concept of a larger clinical role
- Effect of Life style modification including Yoga on Glycaemic Control among Newly Diagnosed Pre-diabetic Young Adults
- Study of prevalence of pre-hypertension in adolescent population of Tirunelveli city
- Role of Urinary Electrophoresis in prognosis of paediatric renal failure
- A hospital based study of immunological profile of neuropathies of undetermined aetiology
- Prevalence, risk factors and characterization of Cervical dysplasia among women of reproductive age group involved in beedi rolling occupation in Mukkudal Town Panchayat, Tirunelveli
- Serial Maternal Hemoglobin estimations during antenatal period as an indicator of Foeto-Maternal outcome – A cohort study in South Tamilnadu
- Risk factors for cardiovascular disease among school going adolescents in Kalloor
- A Retrospective Analysis of Rare Neoplasms Of Breast
- A Retrospective Analysis of Adnexal Tumors Of Skin
- A Retrospective Analysis of Neoplasms Of Salivary Gland
- A Study of Leprosy Lesions of the Skin
- A Retrospective Analysis of Soft Tissue Tumors
- A 3 year statistical analysis of the Diagnostic Accuracy Of FNAC
- A Study to evaluate AgNOR’s as a prognostic tool In Breast Carcinoma
- A study to evaluate the role Of Imprint Cytology in Lymph Node.
- Evaluation of Endometrial histo-morphology In Infertility (I.C.M.R)
- A Histo-morphological Profile Of Helicobacter Pylori Associated Chronic Antral Gastritis (T.N.S.R.C.)
- Evaluation of FNAC of Thyroid Lesions (I.C.M.R)
- A Study to evaluate the histo-morphology Of Placenta In High Risk Pregnancies (T.N.S.R.C.)
- Evaluation of the Bethesda System as a Reporting system for Cervical Cytology (I.C.M.R)
- A Study to evaluate the histo-morphology Of Placenta In Pregnancy Induced Hypertension And Its Effects On Foetal Outcome (T.N.S.T.C)
- A Study to evaluate the Role Of AgNOR’s In differentiation of Pre-Neoplastic Lesions Of Prostate (T.N.S.R.C.)
- Evaluation of Endometrial histo-morphology & Functional Disturbances Of Endometrium In Cases Of D.U.B (I.C.M.R)
- Evaluation of the Role Of Guided FNAC In Diagnosis Of Deep Seated Mass Lesions (I.C.M.R)
- Evaluation Of Marrow Iron Stores And Iron Chemistry In Iron Deficiency Anaemia
- Histo-morphological Evaluation Of Coronary Atherosclerosis – An Autopsy Study
- A Study Of Prognostic Factors In Carcinoma Breast and its correlation with AgNOR scoring
- Evaluation of Wet Mount Preparation with Toludine Blue In Cytological Preparation as a Rapid Staining Method.
- Evaluation of the histo-morphology Of Esophagus and Stomach in GERD and its association with Helicobacter Pylori Gastritis.
- Evaluation of NESTROFT as a Screening Tool For Thalassemia Patients
- Evaluation of the Incidence of Bone Marrow Micro-metastasis in Breast Carcinoma
- Gastric Antral Histo-morphology in Cases of Hpylori Associated Gastritis & Detection of Hpylori using Light Green Stain.
- Evaluation of Histo-morphological Patterns of Salivary Gland Lesions – A Retrospective Five Year Study.
- Evaluation of Bone-Marrow Profile in geratric patients Presenting With Anaemia
- Histo-morphological Profile of Endometrium in Perimenopausal Bleeding
- Retrospective Analysis of Ovarian Tumor and Tumor Like Conditions – A 3 Year Study
- Incidence of Cancer in a 5 Year Hospital Based Cancer Registry Observations
- Evaluation of Liquid Based Cytology in Comparison to Conventional Pap Staining Method in Evaluating Cervical Smear
- Evaluation of Value of Robinson’s Scoring System and AgNOR Score in Classification of Proliferative Epithelial Breast Diseases in FNAC
- Evaluation of Immuno-histochemical Profile of Papillary Carcinoma of Thyroid
- Evaluation of Immuno-histochemical Profile of Human Papilloma Virus on Cervical Histopathology.
- Evaluation of Histomorphological & Immuno-histochemical profile of Salivary Gland Tumors
- Evaluation of Incidence of Bone Marrow Micrometastasis in Cases of Gastro Intestinal Malignancies
- Evaluation of the Morphological Changes in Bone Marrow in patients on chemotherapy for Cancers
- A Six Year Cancer Surveillance Under ICD-O Nomenclature and Prediction of future burden In Tirunelveli District – A Pilot Study
- Evaluation, Grading and Immunohistochemical Analysis of Atherosclerosis of Aorta.
Publications (2015,2016 & 2017)
1.S.Raju, Shantaraman kalyanaraman, K.Swaminathan, A.Nisha, S.Praisid.Hemophagocytic lymphohistiocytosis syndrome in dengue hemorrhagic fever,The Indian Journal of Pediatrics 2014;81 (12) :1381 – 1383.
2.UmaN.Srivatsa,K.Swaminathan, K SithyAthiyaMunavarah, Ezra Amsterdam, K.Shantaraman. Sudden cardiac death in South India incidence, risk factors &pathology.Indian pacing & electrophysiology journal2016(4) 121-125.
3.Dina Mary M,Shantaraman K. Role of KI 67 and P16 as markers of Prognostic Indices in Premalignant and malignant Lesions of Cervix .Ijcmr, October 2017 volume 4 Issue 10.
4. Johnsy Merla , Shantaraman kalyanaraman .Thyroid cancer and nodular goiter of thyroid: An analysis of patients in rural South Tamil Nadu. Thyroid Research and Practice,September-December 2017 / Volume 14 / Issue 3 / Page : 106-111.
3.Raskin Erusan Rajagopal, Meenakshi Balasubramanian, Shantaraman Kalyanaraman. Raw turmeric and pure curcumin . A comparison of embryonic cytotoxicity in Zebra fish.IJBCP.2017 volume6 issue 8.
4.Meenakshi B ,Shantaraman K, Indhumathi M,Arumugapandian S.Mohan.Clinical profile & outcomes of snake bite poisoning in a tertiary care centre in south Tamil Nadu,IJBCP.Feb 2016,Volume 6 ,Issue 2 .
5.R.Sindhuja ,V.Bagiyalakshmi, K.Shantaraman.Histological profile of ovarian tumor in rural south Tamilnadu,IP- Journal of diagnostic pathology &Oncolocy,July 2017.
6.Suresh Durai, Johnsy Merla, Muthuselvi, Shantaraman. Evaluation of a New Compound Fixative: A step towards limited formalin exposure. Indian Journal of Pathology and Oncology.July-September 2017Volume 4 : Issue 3,Pages 413-417.
7.Dr.JohnsyMerla J., Dr.SureshDurai J.,Dr.Shantaraman K. Bone Marrow Aspiration Evaluation in Clinical Management of Anemia Among Low Socioeconomic Group In A Tertiary Care Hospital.IOSR Journal of Dental and Medical Sciences.July. 2017 Volume 16, Issue 7 Ver. II , PP 89-97.
8.Dina Mary M,Shantaraman K. Role of KI 67 and P16 as markers of Prognostic Indices in Premalignant and malignant Lesions of Cervix .Ijcmr, October 2017 volume 4 Issue 10.
9. Johnsy Merla , Shantaraman kalyanaraman .Thyroid cancer and nodular goiter of thyroid: An analysis of patients in rural South Tamil Nadu. Thyroid Research and Practice,September-December 2017 / Volume 14 / Issue 3 / Page : 106-111.
10. Meenakshi B,Nirmala Devi P, Radha M,Abdul Rahuman M.B,Shantaraman K. Profile of cutaneous adverse drug reactions of carbamazepine, IJBC, December 2017, Vol -6 Issue 12.
11.Shantaraman K, Meenakshi B, Sunitha K. Do students prefer research as a curriculum in MBBS? J.Evid. based Med. Health Feb- 2016.Vol-3, Issue 13.
12. Swaminathan.K ,Shanthi P, Sheila Nair ,Madhavan M.Epstein Barr Virus in paediatric Hodgkins disease in India, Biomedicine. 2001.
13.Dr.JohnsyMerla J.,Dr.Srijanaki M.,Dr.Suresh Durai J.,Dr.Shantaraman K.,Dr.Swaminathan K , Histomorphological Profile and Immunohistochemical Analysis of Endometrium in Perimenopausal Bleeding: A 2 Year Study in a Tertiary Care Center. IOSR Journal of Dental and Medical Sciences, Dec.2015.Volume 14, Issue 12 Ver. I, PP 38-44.
14. Srijanaki,Johnsy Merla, Shantaraman K, Swaminathan K.Bone Marrow Morphology in Geriatric Patients with Anemia. International Journal of Health Sciences &Research ,November 2016,Vol.6; Issue: 11; 57-66.
15.Suresh Durai.J, Baba Krishnan.K, Madhavan.M, Rajasekaran.A. FNAC Testis & its predictive value in male infertility,The Indian Journal of Pathology & Microbiology.1996, Vol-39 , Page-56.
16.Johnsy Merla Joel, Suresh Durai ,Jeyasingh,Ponraj Chellaiah.Primary renal hydatidosis, Clinical cancer investigation , 2016; Vol-5 .
17. .Johnsy Merla Joel, Suresh Durai ,Jeyasingh, Shantaraman kalyanara ,Biliary cystadenoma – A case report.Journal of clinical & Diagnostic research 2016, Vol-10 (2) Page-19, 20.
18.Dr.S.Vasuki.,Dr.J.SureshDurai,Athira Sai.Clinico-pathological correlation in pleural effusion, IOSR Journal of Dental and Medical Sciences July 2016 Vol-15, Page-45-47.
19.Dr.K.Usha,Dr.J.Suresh Durai,Incidence of cancer in Tirunelveli Medical college & Hospital – A five year cancer surveillance project IOSR Journal of Dental and Medical Sciences ,May 2017 Volume 16 : Issue 5, Ver.VII.
20. Suresh Durai, Johnsy Merla, Muthuselvi, Shantaraman. Evaluation of a New Compound Fixative: A step towards limited formalin exposure ,Indian Journal of Pathology and Oncology,July-September 2017Volume 4 : Issue 3,Pages 413-417.
21.Dr.JohnsyMerla J., Dr.SureshDurai J.,Dr.Shantaraman K.Bone Marrow Aspiration Evaluation in Clinical Management of Anemia Among Low Socioeconomic Group In A Tertiary CareHospital, IOSR Journal of Dental and Medical Sciences July. 2017Volume 16, Issue 7 Ver. II , PP 89-97.
22.Dr.S.Vasuki., Dr.Vallimanavalan, Manojmurugan.K.Cytomorphological profile in cases of diffuse thyromegaly,IJSR (International Journal of scientific research) May-16. Vol.5, Issue-5.
23.Dr.Vasuki.S,Dr.K.Shantaraman.Study of hematologic profile in patients with intestinal malignancies.IJSR (International Journal of scientific research) March 2016. Vol.6, Issue -3.
24.Dr.S.Vasuki.,Dr.K.Swaminathan , V.S Lavanya. FNAC – Profile of lymphadenopathy in children IOSR-JDMS (Journal of Dental & Medical sciences,June 2016, Vol.15, Issue
25.Thangarajpriya, Venkatraj bagiyalakshmi. Evaluation of deferred causes in blood donor in tertiary care hospital, Tiruchirappalli, Tamilnadu. Jemds . October 2016.
26.V.Bagiyalakshmi , R Gopal , R Siva Elangovan .Prevalence of hepatitis B Virus infection among voluntary blood donor at tertiary care hospital International Journal of scientific study January 2017.
27.Dr.Lalitharani. N,Dr.Bagiyalakshmi.V, Incidence of TB among cases of peripheral lymphadenopathy,Indian Journal of applied sciences. June 2017.
28. K.Hidhaya Fathima ,J.Nilavu.Cytological grading of ductal carcinoma of breast in fine Needle aspirates & its correlation with histological grading Journal of evaluation of Medical & Dental sciences.October 2017 Issue 84 Vol. 61.