morphological study of atypical uterine bleeding

To find out the Histopathological pattern of Endomyometrium in atypical uterine bleeding [AUB], also to study organic causes of AUB. A prospective, descriptive study. This study was conducted at the Departments of Pathology and Gynaecology and Obstetrics, Bolan Medical College Complex Hospital Quetta from January 2011 to January 2013. Specimens were received as endometrial curettage and hysterectomy specimens from patients hospitalized in the dept. of Gynaecology and Obstetrics of BMC Complex Hospital Quetta. This study included 300 women's presenting with AUB, irrespective of age and parity. A detailed clinical history followed by physical examination was also carried out in each patients to exclude systemic causes like psychological upsets and early pregnancy states and also exclude general physical abnormalities. After grossing and H and E staining all the sections were studied by group of pathologists. A Total 300 cases were studied, including 100 endometrial curetting's and 200 uteri in patients of atypical uterine bleeding at Bolan Medical Complex Hospital Quetta. The ages of these patients ranged from 20-69 years. Maximum numbers of cases were in age groups 40-49 years. Chronic endometritis [7 out of 100] 7% and the cystic hyperplasia [9 out of 100] 9% were the most important causes of atypical uterine bleeding in endometrial curetting's. No case of endometrial carcinoma was diagnosed in this series. The histological study of hysterectomy specimen revealed multiple leiomyoma's [135 out of 200] 67.5% and adenomyosis [38 out of 200] 19% as the commonest causes of atypical uterine bleeding. [2 out of 200] 1% case of leiomyosarcoma and [1 out of 200] 0.5% case of choriocarcinoma were diagnosed suggesting a lower frequency of uterine malignancy in our study. In conclusion leiomyoma's and adenomyosis are most important causes of AUB after 3[rd] decade of life. Fortunately the frequency of uterine malignancy [excluding cervix] including endometrial carcinoma is much low in our setup as compared to western studies

Vibrio cholerae; waterborne outbreak

To isolate the etiological agent of diarrheal outbreak, identification, antibiogram of isolated bacteria. Stool samples from patients and water samples from reservoir of water collected in transport media. Culture and sensitivity test were performed in Microbiology Laboratory of Bolan Medical Complex Hospital Quetta. The isolated strain was confirmed by National Institute of Health Laboratory Islamabad and Agha Khan University hospital laboratory Karachi. The outbreak was controlled by preventive measures. More than five thousand people affected in the outbreak, including all age and both sexes. Twenty three deaths [0.4%] occurred in this outbreak. The stool samples from patients and from 5 water reservoir tanks collected for analysis of etiological agent responsible for the outbreak. The stool and water samples revealed isolation of Vibrio cholerae Inaba, El Tor, which was sensitive to Ampicillin, Ciprofloxacin, Tetracycline, Doxycyline and intermediate to Choloramphenicol and Erythromycin. Resistant to Nalidixic Acid Polymaxin B, and Co-trimaxazole. The Vibrio cholerae Inaba, El Tor was the causative agent of this outbreak and the first outbreak which occurred in Balochistan due to Vibrio cholerae Inaba, El Tor

Waterborn outbreak of vibrio cholera O1 ogawa; in wadh area of balochistan

To isolate the etiological agent of severe diarrheal outbreak, identification, antibiogram of isolated agent and preventive measures to control the spread of infection. Samples of stool and drinking water supply of affected area collected in Cary- Blair transport medium, inoculated on various media. The isolated strains were identified as responsible for diarrheal outbreak tested against antibiotics. The strain and antibiogram was further confirmed by Agha Khan University Hospital Laboratory in Karachi. Bolan Medical College Hospital, Quetta. Isolation of Vibrio cholerae O1, Ogawa, El Tor, antibiogram against isolated strain, and control of spread of infection. The etiological agent responsible for severe diarrheal disease outbreak was Vibrio cholerae O1, Ogawa El Tor. in which 148 persons affected including all ages and both sexes. Four deaths [2.7%] reported out of these affected patients. The isolated strain was same in all patients and water source. Susceptibility to antimicrobial drugs was determined showing sensitivity to Ampicillin, Choloramphenicol, Ofloxacin, Tetracycline, Nalidixic Acid , Gentamycin and resistance to Polymaxin B, and Cotrimaxazole. The drinking source of water was a shallow well which was sealed and alternative arrangements of drinking water were made from another source. Vibrio cholerae O1, Ogawa El Tor, strains were isolated as etiological agent for severe diarrheal disease outbreak, which was spread through drinking water. The source of drinking water was contaminated due to rain in this area. The isolated strain was most common pathogen in this area for severe diarrheal disease outbreaks, and mostly it spreads through contamination of water source. The strategy applied for prevention of disease was successful and no further case was reported