Faculty

• Dr. Nikhil Choudhary
• Dr. Emihaka Warjri
• Dr. Alexandra K. Mawlong

• Dr. Chayasmita Mali
• Dr. Neoky Suiam

Introduction

The Pathology department at NEIGRIHMS comprise of a well-equipped 24/7 functional Hematology laboratory, Clinical Pathology laboratory, Histopathology laboratory, Cytopathology laboratory. A Molecular Diagnostic laboratory was established by the sponsored by the Department of Biotechnology, Government of India.

Infrustructure with Services rendered by the department

1. Hematology:
• Complete blood count analysis with 3 fully automated hematology analyzers.
• Automated Reticulocyte count analysis under the principal of flow cytometry by the Backman Coulter LH750.
• Coagulation parameters analysed by the Stagocoagulometer, available 24/7.
• Automated ESR analysers.
• Cytochemistry& Immunocytochemistry for peripheral blood and bone marrow aspirates as well as trephine biopsy.
• Flow cytometer (BD) with antibody panels for immunophenotyping of leukemia, lymphomas, stem cell enumeration.
• Tissue culture lab & karyotyping, PCR and real time PCR for diagnosis in hemato-oncology, facilitated by DBT.
• Testing for Hemoglobinopathiesby the Bio-Rad Variant HPLC machine
• Platelet Functional Analysis.
• Fluorescent in-situ hybridisation for molecular diagnosis of leukemia.
2. Clinical Pathology laboratory for analysis of various body fluids, supplemented by cytopathology laboratory.
3. Cytopathology & Gynaecologic Pathology:
• Fine needle aspiration cytology laboratory with supplementary techniques like cytocentrifuge preparations, cell block preparation.
• Liquid based cytology (Sure Path, BD Biosciences) as well as conventional cytological examination for analysis of gynaecological as well as non-gynaecological fluids.
• Flow cytometry on aspirates for diagnosis of haematological malignancies.
• Cytochemistry& immunocytochemistry.
4. Histopathology:
• The histopathology lab is equipped with automated tissue processor, microtomes and slide stainer
• Facilities for histochemistry and immunohistochemistry (IHC) are available.
• The department has facilities for more than 40histochemical stains.
• The immunohistochemistry panel consists of more than 45 antibodiesthat has facilitated typing and diagnosis of undifferentiated tumours, lymphomas and small round cell tumours etc.
• Hormonal receptors for breast carcinomas for therapeutic purpose.
• Marker for analysis of tumor proliferation like Ki-67, AgNORscore are available.
• Selected cancer markers for purpose of research are also available.
• Frozen section facility is available for intra-operative diagnosis.
• Electron microscopy lab, funded by DBT is in the process.
5. Renal Pathology:
• Renal biopsies with immunofluorecscence are routinely processed. This is the first institute to establish such services in north-eastern region.
6. Neuropathology:
• Facility for intra-operative crush smear as well as frozen section are available
• Immunohistochemistry markers for neural tumors diagnosis are available.
7. Immunopathology:
• Facility for analysis of auto-immune disease are available by ELISA as well as Indirect Immunofluorescence.
• Direct Immunofluorescence facility for dermatopathology is available.
8. Equipments purchased with the financial assistance of Department of Biotechnology:

Following equipment have been purchased with the financial assistance of Department of Biotechnology, Ministry of Science & Technology. Government of India in the Project titled “Prevalence of hemoglobinopathies in indigenous tribes of Meghalaya with genetic analysis and study on the role of genetic modifiers” and implemented by Dr Yookarin Khonglah, PI during the period of 2017-2020:

1. Automated HPLC machine. Make: Arkray Inc., Japan. Model: ADAMS A1c HA 8180T.

Academic Activities and Training

• MD Pathology since 2009 with intake of three students /year . 26 students completed  MD pathology so far.5 secured DM seats and 4 pursued fellowships subspecialities. 15 have joined as faculty or senior residents  at various prestigious institutes  in India. Rest working in private set up.

Research and Projects:

• Research:
• A well-equipped Research and Development laboratory under Department of Biotechnology, Ministry of Science and technology, Government of India was started in 2012-13. Various research projects are conducted under this lab, including:
• Antenatal screening& genetic profiling for hemoglobinopathies
• Study on prevalence of EBV in nasopharyngeal carcinoma.
• Pattern of Hematolymphoid neoplasm in north eastern region based on cytogenetic analysis and Immunophenotyping.
• Study of HPV in oral cancers.
• Pattern of non-neoplastic renal diseases in north eastern region based on light microscopy, immunofluorescence and electron microscopy.
• Projects under the department:
• Completed:
• Immunohistochemical Analysis of molecular markers in esophageal squamous cell carcinoma.
• Clinico-hematologic and biochemical profile of dimorphic anemia with bone marrow study.
• Prevalence of hemoglobinopathies in the newborn: a study on cord blood by HPLC.
• Immunohistochemical analysis of selective molecular markers in squamous cell carcinoma of oral cavity
• Analysis of HPV 16/18 DNA and its correlation with p16 in oral cavity squamous cells carcinoma in North Eastern India- funded by DBT thesis grant.
• Spectrum of glomerular diseases at NEIGRIHMS; study by Light and immunofluorescence microscopy- funded by DBT thesis grant.
• Analysis of Epstein Barr Virus encoded RNA (EBER) expression in nasopharyngeal carcinoma by CISH technique- funded by DBT thesis grant.
• Antenatal screening for Hemoglobinopathies with HPLC- funded by DBT thesis grant.
• Ongoing:
• A hospital based study of stroke in a tertiary care centre (NEIGRIHMS) and the study of anti-platelet effect of Aspirin in patients with ischemic stroke- funded by ICMR.
• Red blood cell antigen typing among the indigenous population of Meghalaya. (DBT twining project)
• Expression of GP-30 protein in breast cancers under twinning project with IIT Guwahati & NIRRH Mumbai. (DBT Twinning Project )
• Immunohistochemical analysis of selective biomarkers in cancers of prostate- institutional study.
• Analysis of BRCA expression in sporadic breast carcinomas- institutional study
• Liquipap based screening for oral cancers funded by DBT thesis grant.
• CD 4/8 count and Th17 cells in alcoholic liver disease funded by DBT thesis grant.
• Analysis of cervical Pap smear by liquid based cytology & HPV testing by PCR.
• Intraoperative crush smear of central nervous system with histopathological correlation.
• Analysis of CD64 as a marker in clinically diagnosed sepsis patient.
• A study on Helicobacter Pylori infection in patients with calculous cholecystitis- funded by DBT thesis grant.
• VILI screening in correlation with Pap smear- funded by DBT thesis grant.
• Study of EGFR prevalence in head and neck cancer patients and treatment of locally advanced HNC patient with targeted therapy ( with Meghalaya State Cancer Unit)
• 12  extramural projects from DBT, ICMR,NCG ;  2 funded faculty intramural projects  , 32 postgraduate thesis projects . 10 postgraduates were awarded DBT fund for research with more than 100 publications in pubmed journals.

Only Government institute in the north east with facility for
1 Florescent in situ hybridisation for genetic testing of leukemias and her-neu amplification testing for breast carcinomas
2.  Flow cytometry for immunophenotyping of leukemias and lymphomas
3.  HPLC for testing hemoglobinopathies,
4. Genetic testing for thalassemia
5. Complete processing of renal biopsy using special histochemistry, immunofluorescence and electron microscopy
6.Screening of   Autoimmune disorders using immunofluorescence and fully automated ELISA system
7. Platelet function tests using platelet aggregometry.
8. Cervical cancer screening using fully automated liquipap system
9. Immunohistochemistry with more than 50 markers for aiding the diagnosis of undifferentiated tumours, immunophenotyping of lymphomas and molecular subtyping of carcinoma and regular testing for therapeutic markers like ER/PR/Her2-neu, EGFR
10. Cryostat for  frozen sections aiding in the per-operative diagnosis for cancer patients including squash smears for CNS tumours.

• The department holds annual National CMLTE for continuing education  for lab technicians since 2011. Annual Hematology quiz for undergraduates and postgraduates 2010. Department Conducted North eastern regional chapter meeting of IAPM in 2004 and 2013. Annual Conference of Indian association of cytopatholgisits, CYTOCON in 2017 and several hands on workshops and CMEs.

Vision and Future plans of the Department

• To start fellowship in Hematopathology.
• To start PhD program in Molecular Pathology.

Original Publications from the department during the past 5 years:

1. Kalaragini, Khonglah Y, Raphael V et al'Cold spot assessment in Epithelial-Mesenchymal Transition: a histological predictor of tumor recurrence in oral cavity squamous cell carcinoma Indian J of Pathol & Microbiol 2021
2. Laishram D, Raphael V, Marbaniang E, et al. (July 05, 2021) Study of Programmed Death Ligand 1 and EGFR/HER2 Expression in Non-Small-Cell Lung Carcinoma With a  Clinicopathological Spectrum. Cureus 13(7): e16195.
3. Dutta S, Dey B, Raphael V, et al. (June 29, 2021) Tumour Behaviour of Low-Grade Papillary Urothelial Carcinoma: A Single-Centre Retrospective Study. Cureus 13(6): e16012. DOI 10.7759/cureus.16012
4.  Chowdhury Z ,  Raphael V ,  Khonglah Y,  Mishra J, Marbaniang E, Dey B. Melange of  lymphoepithelial lesions of salivary gland from North East india-A diagnostic conundrum.  Journal of Lab Physicians, 2021
5. Saurabh A, Dey B, Raphael V, et al. (October 29, 2021) Role of Coagulation Profile in Predicting Disease Severity Among Patients of COVID-19. Cureus 13(10): e19124. doi:10.7759/cureus.19124
6. ChoudhuriA, Raphael V, Dey B, Khonglah Y, Mishra J, Marbaniang E. Fine needle aspiration cytology of mediastinal masses. An Institutional Experience. J Family Med Prim Care2020;9:4205-9
7. Saurabh A, Raphael V, Dey B, Caleb H, Jagtap V. Expression of PDL1 and Her2neu in Gastric and Gastroesophageal Junction Adenocarcinoma. Indian J SurgOncol. 2021;12:144-151
8. Jajodia E, Raphael V, Shunyu NB, Ralte S, Pala S, Jitani AK. Brush Cytology and AgNOR in the Diagnosis of Oral Squamous Cell Carcinoma Acta Cytol 2017;61(1):62-70. 
9. Khonglah Y, Raphael V, Mishra J, Marbaniang E, Chowdhury Z, Dey B. Relooking the curriculum and assessment in undergraduate pathology. J Edu Health Promot 2019;8:116.
10. Dutta S, Dey B, Chanu S, Marbaniang E, Sharma N, Khonglah Y, Raphael V. A Retrospective Study of Placenta Accreta, Percreta, and Increta in Peripartum Hysterectomies in a Tertiary Care Institute in Northeast India.Cureus. 2020;12(11):e11399.
11. Jagtap VK, Ete T , Thangkhiew L, Marbaniang E, Marak A, Slong D , Tongper D ,  Lyngdoh NM,  Sarma A , TopnoN . Factors affecting High-Risk exposure amongst Health Care Workers(HCW): Audit of COVID-19 Risk Assessment Committee from Tertiary Care Centre in North East India . Journal of the Indian Medical Association.2021; 119:56-9.
12. Sarma S, Khonglah Y, Mishra J, Kakati A, Phukan P. Gliomas- An experience based on molecular markers. J Family Med Prim Care 2021; 10: 1341-6.
13. Wankhar B, Khan AY, Raphael V, Tongper D, Khongwar D, Lynrah KG. Enhancement pattern of differntiatedand undifferentiatedgastric carcinomaon multiphasic contrast enhancedcomputed tomography.Polish J of Radiology 2020
14. Khonglah Y, Raphael V, Mishra J, Marbaniang E, Chowdhury Z, Dey B. Relooking the curriculum and assessment in undergraduate pathology. J Edu Health Promot 2019;8:116.
15. Marbaniang E, Raphael V, Khonglah Y, Mishra J, Dey B, Chowdhury Z, Daniala C, Lynser D. Ultrasound-guided fine-needle aspiration cytology of gallbladder masses – A solution to diagnostic dilemmas.J of Medical Sciences & Public Health 2019
16. Shangpliang D, Dey B, Das J, Baishya P, Raphael V, Khonglah Y. Down syndrome presenting with different haematological manifestations: A case series of four cases. J Family Med Prim Care 2020;9: 2569-72
17. Verma S, Thakur BK, Raphael V, Thappa DM. Epidemiology of subcutaneous mycoses in North-East India: A retrospective study. Indian J Dermatol 2018;63:496-501.
18. Kasomova K, Sen A, Paulraj MG, Sailo S, Raphael V, Puro K. Roles of microRNA in prostate cancer cell metabolism. Int J Biochem Cell Biol 2018;23:109-116.
19. Jamil M, Bhattacharya PK, Raphael V, Khonglah Y, Lyngdoh M, Roy A. Spectrum glomerular diseases in adults: A study from North Eastern India. J Assoc Phys India 2018;66:36-39.
20. Marbaniang E , Lynser D, Raphael V, Handique A, Phukan P, Daniala C ,Khonglah Y, Mishra J, Dey B, Chowdhury Z.  Adequacy of sonographic  guided fine needle aspiration cytology (FNAC) in abdominal lesions highlighting on malignant pathologies – A 10 year experience. Oncology Signaling 2019;2: 4-10
21. Panda S, Das S, Agarwal M, Das A, Raphael V. Analysis of screening and diagnostic techniques for abnormal cervices. Scholars Academic Journal of Biosciences. 2019; 7(2): 101-4
22. Shah N, Khonglah Y, Raphael V, Swer B, Nath C, Singh AS. Antenatal screening for hemoglobinopathies with HPLC. Rec Adv  Pathol Lab Med 2018;4:1-8.
23. Chanu SM, Dey B, Rudrapal G, Panda S, Raphael V, Singh AS. An audit of primary ovarian pregnancy in a tertiary care hospital. Int J Reprod Contracep Obstet Gynecol 2018;7:3316-3319.