Wet mount microscopy a better diagnostic tool for bacterial vaginosis screening than gram staining

To compare Wet smear and Gram staining for Clue cells in screening Bacterial Vaginosis [BV] in a clinical setting where laboratory facilities are not readily available. Cross-Sectional .This study was conducted in the Department of Microbiology, Basic Medical Sciences Institute Jinnah Postgraduate Medical Center Karachi. High vaginal swabs [HVS] were collected from Gyne and Obstetric Department of Jinnah Postgraduate Medical Centre, Karachi, from Jan 2005 to Feb 2007. One hundred and fifty high vaginal swabs [HVS] were collected from married females with or without complain of vaginal discharge. BV was diagnosed on the basis of clinical Amsel's criteria BV was diagnosed. Subsequently, clinical diagnosis was compared with laboratory based diagnosis for each woman. Two methods used were Wet Mount and Gram Staining. Out of total 150 cases, 100 females were complaining of vaginal discharge and after clinical assessment by Amsel's criteria 34 [34%] were diagnosed as cases of BV. Fifty females as [as controls] were those who were not complaining of any discharge. But among this group 8 [16%] were discovered to be suffering from BV. With the help of wet mount, the clue cells were visualized in 61 [40.7%] cases, while by Gram staining 54 cases [36.0%] were seen. BV screening is important as it affects both groups of females with or without complains of discharge. For easier recognition of clue cells, which are an excellent predictor of BV, wet mount is better as compared to Grams staining method

Comparison of methods for diagnosing bacterial vaginosis

To determine the laboratory method that best predicts Bacterial Vaginosis. Descriptive Observational study. This study was conducted in the Department of Microbiology, Sindh Medical College [DUHS] and Basic Medical Sciences Institute, Jinnah Postgraduate Medical Centre, Karachi from Jan. 2005 to Feb. 2007. A total of 150 randomly selected women were included in this study from OPD of various tertiary care hospitals and family planning clinics of the city. In this study we compared and calculated the sensitivity, specificity and predictive value of positive and negative tests for wet mount, Gram stained vaginal smears and Gardnerella vaginalis [G.vaginalis] cultures with clinical sign Amsel's criteria [Gold standard], for the diagnosis of bacterial vaginosis [B.V]. We diagnosed 54 [36%] cases of bacterial vaginosis by Gram's staining method, 61 [41.7%] cases by Wet Mount method, and 42 [28.0%] cases by Amsel's criteria and 47 [31.3%] cases by culturing. Amsel's criteria were comparable with other laboratory tests for diagnosis of BV. Culture was laborious, expensive and least sensitive method

Management of iatrogenic ureteral injuries analysis report at urology department, Nishtar hospital Multan

To review the etiology, diagnosis and treatment of iatrogenic ureteral injuries. The study was carried out at Department of Urology, Nishtar Hospital, Multan from December 2007 to December 2010. A total of 24 adult patients were included in the study. All patients were evaluated in terms of clinical presentation, physical examination and investigations. Different techniques including open repair and endoscopic maneuvers were performed as treatment modalities for ureteric injuries. Out of 24 patients, 13 patients were female and 11 patients were males. Age of patients ranged from 20 years to 60 years. Out of 13 female patients, eleven developed lower ureteral injuries secondary to obstetrics and gynaecological procedures. Remaining two female patients had ureteral injuries following ureteroscopy for lower ureteral stones. Eleven female patients had different symptoms including partial or total incontinence of urine, flank pain, symptoms of UTI, high grade fever, sepsis, anuria and urinary leakage. Patients who underwent URS or URS in situ lithotripsy had lower ureteral stones. Most of them had lumbar pain, symptoms of UTI, frequency, urgency and difficulty in micturation. Two patients had retention of urine for which they were catheterized. One had broken segment of DJ stent. Different techniques were employed, ureter re-implantation for distal ureteral injuries was performed in ten patients. For minor lacerations and suspected urinary leakage following URS for stone disintegration at lower ureter, ureteric catheter or DJ stent was placed. latrogenic uretral injuries are rare following gynaecological, obstetrical and endourological procedures but are liable to occur due to inherent anatomic factors. Prompt diagnosis and institution of appropriate corrective surgical procedures often result satisfactory outcome

Acute myocardial infarction: evidence for a sex-age interaction

Women with acute myocardial infarction have higher in-hospital mortality than men mainly due to greater age on presentation. To evaluate the age specific sex difference in in-hospital mortality of acute myocardial infarction. Descriptive study. Coronary Care Unit and cardiology ward of Nishtar Hospital Multan from 15th of September 2002 till 30th of April 2003. Four hundred and fifty patients of acute myocardial infarction who fulfilled our inclusion criteria were studied while they were admitted to the hospital. Patients were divided into four groups according to age and sex i.e. Group I [male <45 years], Group II [male >= 45 years], Group III [female <45 years] and Group IV [female >45 years]. In-hospital mortality was compared between different age groups by Chi-square test. The total in-hospital mortality was 76[16.9%]. In Group III none of the patients expired. In Group I in-hospital mortality was 6[7.1%] patients followed by Group II 50[18.3%] patients and Group IV 20[23.3%] patients p<0.019. In-hospital mortality was greater in Group IV than in any other group. Group IV patients were more frequently diabetic and hypertensive than patients in any other group. Group IV patients presented late to the hospital. There was no significant difference in site of myocardial infarction in different groups. Higher Killip class was observed in Group II and IV p<0.05. Streptokinase injection was given less frequently in Group IV than in any other group p <0.012. Only 34[39.5%] patients in Group IV had no complication during hospital stay while more patients in other groups had uneventful hospital stay. Female sex is associated with higher in-hospital mortality in older age group as compared to the male patients of same age group. p<0.001

Hysterosalpingography as a diagnostic tool in patients with infertility

To evaluate the role of HSG as a diagnostic tool in a tubal factor infertility. HSG was performed on 100 infertile patients after excluding other causes of infertility. Tubal factor was found in 34% of patients as a cause of infertility

Use of 12.5 mm poly venyl ethylene [Pve ] hose pipe as a traction stent for palliation of dysphagia in advanced/ inoperable carcinoma esophagus

From March 2000 to November 2003, 39 PVE funneled hose pipe pieces were inserted as esophageal stents in 27 males and 12 females with mean age of 60 years [range=42-82 years]. Average hospital stay was 7 days [range = 5-20 days]. Procedure related morbidity was 40% while mortality was 10.25%. There was little effect of age, sex, type and level of tumor on morbidity and mortality. In patients who could be discharged home, dysphagia score improved form average of 4.2 to 2.5. Average post procedural survival was 4.2 months. 7 [20%] patients required readmission for stent malfunction. Only five of them required a second procedure to re-establish the passage. Slipping of stent occurred in only one case where a second stent was inserted. Our technique for manufacturing and insertion of the stent is described. Review of literature and a discussion to support our practice is included. We conclude that although self expanding metallic stents are the current gold standard world wide for palliation of dysphagia due to advanced carcinoma of esophagus, a molded PVE stent can be used in place of conventional traction and pulsion tubes where affordability is a problem. Using the described technique a reliable relief of dysphagia with acceptable morbidity and mortality rates can be achieved