Spectrum of pathological lesions in acute renal failure

To determine the spectrum of pathological lesions in percutaneous renal biopsies of patients with acute renal failure [ARF] and to compare our findings with reported literature. Design: A single center based retrospective observational study. Place and Duration of Study: The study was conducted in the Department of Histopathology, Sindh Institute of Urology and Transplantation, Karachi over a period of seven years [April 1995 to April 2002]. Subjects and All the patients with ARF who presented to the emergency ward of SIUT between April 1995 and April, 2002 and in whom renal biopsy was performed, were included in this study. Patient's demographic and clinical data were collected from a review of patient's original surgical biopsy reports and case files. Pathological diagnosis was retrieved from a review of biopsy reports. Renal biopsies were received in 10% buffered formalin and processed for paraffin embedding and subsequent histopathological examination under the light microscope. A total of 158 patients were studied. Of these 57 were males and 101 females. Mean age of the patients in this series was 30.7 years with a range of 6 to 75 years. Of these 61[38.6%] had acute tubular necrosis, 36 [22.7%] acute cortical necrosis and 49[31%] patients had various types of glomerulonephritis [GN]. Eight patients [5%] had acute tubulointerstitial nephritis, 3 [1.8%] acute pyelonephritis and one patient had mucormycosis. This study showed that even in the selected population of biopsied ARF cases, there was a high prevalence of ischemic renal disease. A substantial number of cases in unexplained ARF on renal biopsy were due to various forms of glomerulonephritis

Spectrum of pathological lesions in cystoscopic bladder biopsies: a clinicopathologic study

To determine the clinicopathologic characteristics and frequencies of different pathological lesions in cystoscopic bladder biopsies in patients with bladder diseases. Design: A single- institution based retrospective observational study. Place and Duration of Study: The study was conducted in the Department of Histopathology, Sindh Institute of Urology and Transplantation [SIUT], Karachi over a period of five years [December, 1996 to December, 2001]. Subjects and All patients, who presented to the urology clinic of SIUT between December 1996 and December 2001 with haematuria, dysuria, urgency and frequency and in whom a cystoscopy and bladder biopsy were performed to elucidate the nature of underlying pathology, were included in this study. A total of 784 patients were studied. Clinical and demographic data and pathological diagnoses were retrieved from the original surgical biopsy reports. Bladder biopsies were received in 10% buffered formalin, gross examination done and processed for paraffin embedding. Histologic sections were stained routinely with Hematoxylin and Eosin, PAS and PAS with diastase. Sections were examined under the light microscope to document the pathologic diagnosis. Of the total 784 patients, 577[73.6%] were males and 207 [26.4%] were females with an overall male to female ratio of 2.8:1. Age range was wide [4 to 86 years]. The spectrum of pathological lesions included tumours: 497 cases [63.7%], followed by acute and chronic non-specific inflammation: 86[11%], cystitis cystica and glandularis: 40 [5%], Tuberculosis: 17[2.16%], squamous metaplasia: 13[1.65%] and a number of other rare lesions. Among the tumours, transitional cell tumours [TCC] were most common [95.3%]. Tumours were more common in males than in females [male to female ratio: 5.3:1] and peaked in 4th through 7th decades. Pathologic staging was possible in 89.7% of the cases. A majority of these cases [62%] presented with superficial disease, while in 38% the disease was muscle-invasive when first diagnosed. Grading was possible in all except two cases, which contained only necrotic tissue. A vast preponderance of tumours [74.5%] were well-differentiated, while 25.5% belonged to poorly-differentiated category [Grade 3 and 4]. In a significant number of biopsies: 105 cases [13.4%], no significant pathology was noted. TCC is the most common lesion in cystoscopic bladder biopsies

Helicobacter pylori infection- different methods of identification

The diagnostic yield of histology rapid urease test and culture was assessed for the detection of Helicobacter pylori [H. Pylori] infection in patients undergoing gastroscopy for dyspeptic symptoms. Histology was positive for H. Pylori in 80%, rapid urease in 63%, and culture in only 23% of cases

Association of helicobacter pylori with acid peptic disease in Karachi

The prevalence of H.pylori infection in 200 dyspeptic patients undergoing upper G.I. endoscopy was investigated by histology and rapid urease test. H.pylori was associated with 86% cases of chronic gastritis, 84.6% cases of duodenal ulcers and 78.5% of gastric ulcers. None of the 15 histologically normal gastric biopsies showed H. pylori

Correlation of endoscopic and histological diagnosis in upper gastrointestinal lesions

A correlation between endoscopic and histological diagnosis was studied in 240 patients undergoing upper gastrointestinal endoscopy for dyspeptic symptoms. The biopsies from one or all the three sites were taken from oesophagus [158], stomach [193] and duodenum [146] according to the presenting symptoms of the patients. There was a better correlation between endoscopic and histological diagnosis when a positive finding was seen by the endoscopists as compared to when the endoscopy revealed no abnormality. One out of six benign looking ulcers in oesophagus and 1 out of 9 benign looking gastric ulcers turned out on endoscopy, to be malignant on subsequent histology. Inflammation of oesophagus, stomach and duodenum were the most commonly missed lesions on endoscopy

placebo controlled trial of bismuth salicylate in helicobacter pylori associated gastritis

In a placebo controlled prospective clinical trial of bismuth salicylate in helicobacter pylori associated gastritis, 52 adult patients were randomly allocated to treatment with bismuth salicylate or placebo. Helicobacter pylori were totally cleared in 77% patients in bismuth group but none in placebo group [P<0.001]. Resolution of gastritis [P< 0.001] and improvement of symptoms [P <0.01] were significantly better in patients where H. pylori infection cleared as compared to patients where the infection persisted