Detection of mycobacterium tuberculosis in clinical samples by smear and culture

To compare the smear stained by Ziehl-Neilsen [ZN] and Lowenstein-Jensen [LJ] medium for the detection of Mycobacterium tuberculosis in clinical samples from different categories. This laboratory based retrospective study was carried out at Sir Ganga Ram Hospital /Fatima Jinnah Medical College, Lahore over a 5 year period between January 2001and June 2006. A total of 798 clinical samples were collected from patients with a provisional diagnosis of tuberculosis. A ZN stain of smear and culture on LJ medium were performed for the detection of Mycobacterium. The specimen categories were sputum, pus, lymph node aspirate, urine and endometrial curetting. Out of 798 specimens received over the study period, only 46.3% [n=369] were respiratory whereas 53.7% [n=429] were non respiratory tract category samples. Among these, 3.578% were positive in ZN stain while 11.65% were positive on culture. Out of a total of 369 respiratory tract category samples, 38[10.3%] sputum samples were positive for AFB on both ZN and culture. Among the non respiratory tract category, 47[28.2%] pus, 26[31%] lymph node aspirates, 05[15.6%] urine, 05[3.42%] endometrial curetting were positive. Fifteen percent of clinical samples belonging to 05 different categories of specimens with a provisional diagnosis of tuberculosis, tested positive for Mycobacterium by both Zn stain smear and culture on LJ medium. Among these, 3.57% were positive for AFB on ZN smear and 11.65% were positive on culture on LJ medium. These conventional techniques have proved to be reliable testing tools for detection of Mycobacterium tuberculosis in our setting

Serum ferritin levels in pregnant women

Serum ferritin [SF] levels were estimated in 80 pregnant women and 20 non-pregnant women using radio-Immunoassay techniques. The mean serum ferritin level in non-pregnant women [43.5 +/- 29.70ng/ml] was significantly higher as compared to 19.25 +/- 12.19 ng/ml in pregnant women [P<0.01].Serum ferritin level differed according to the gravidity and use of haematinics. Serum ferritin was 28.2 +/- 13.57 ng/ml in primigravidae using iron supplements, 13.81 +/- 9.89 ng/ml. In primigravidae without Iron supplements, 25.0 +/- 16.59 ng/ml in multigravidae with Iron supplements and 10.0 +/- 8.9 ng/ml In multigravidae without iron supplements.The study also revealed that SF was deficient in 25% of non-pregnant women, 60% of primigravidae without iron supplements, 20% of multigravidae with iron supplements and 75% of multigravida without iron supplements. On the other hand SP was > 10 ng/ml In all primigravidae using Iron supplements