Comparison of diagnostic efficacy of rapid diagnostic devices for Dengue virus infection-a pilot study

To compare the diagnostic efficacy of commercially available rapid diagnostic test devices for Dengue serology. To find out the sensitivity and specificity of rapid diagnostic devices with Elisa results as the Gold standard. During the dengue virus epidemic in Lahore a pilot study was conducted in order to evaluate the diagnostic efficacy of two most frequently used immunochromatographic rapid test devices in public sector hospitals. The results of both the kits were compared to each other. Sensitivity and specificity was calculated against results of ELISA as the reference gold standard. Results of kit-A revealed a very high false negative rate when compared to ELISA where actual prevalence rate shown by ELISA was 96.0% compared to prevalence rate of 44.0% with rapid diagnostic test device kit-A. Similarly the results of rapid test device Kit-B showed high false negative results for dengue virus prevalence. Actual prevalence rate of dengue fever shown by ELISA was 96.0% where as it turned out to be 50% with the kit-B rapid test device. Comparison of Results of two kits revealed no significant difference of test positivity rates. Rapid test devices based on immunochromatographic method supplied in the public sector hospitals are not reliable diagnostic tools for screening for dengue virus infection Health authorities need to review their strategy for supply of more reliable tools during epidemics in order to avoid false negative results

Extra pulmonary tuberculosis: an experience at Mayo hospital Lahore

To study the site and culture positivity of extra pulmonary specimens received from year 2000 to 2005. The work was done at the PMRC TB Research center, Mayo hospital Lahore. The centre receives specimens from all the leading hospitals of Lahore. A total of 2476 extra pulmonary specimens subjected for TB culture by standard proportion method and were analyzed. Majority [84.37%] of specimens received were rom pulmonary site while 15.6% were from extra pulmonary site. Overall culture positivity yield was 19.5%. Of the samples received majority [24.3%] were pleural fluid, followed by in descending order of frequency were 16% bronchial washing, 15.5% from genitourinary tract, 14.1% lymph nodes, 2.6% gastric aspirate, 2.5% endometrial,1.5% bone and 1.2% [CSF]. The culture positivity of these specimens were 24.3% for pleural, 16% bronchial, 24.87% genitourinary, 34.18% lymph nodes, 6% gastric aspirate, 4.5% endometrial,13.5% bone and 3.2% CSF. Extra pulmonary tuberculosis remains an important infectious disease, with commonest form being tuberculous lymphadenitis and genital tuberculosis. Physicians and health care providers should keep the diagnosis of tuberculosis high on priority and make efforts in prompt and efficient diagnosis and treatment

Role of fine needle aspiration cytology in the diagnosis of focal liver lesions

Fine Needle Aspiration [FNAC] of focal liver lesions was carried out at Allama Iqbal Medical College / Jinnah Hospital, Lahore and author's lab. in 108 patients between January 2000 to August 2002 to evaluate the role of FNAC in diagnosis of focal liver lesions and to find out different patholigies which present as focal liver. Out of these 108 patients, most of them [87.96%] were above the age of 40 with male preponderance [55.55%]. Morphologically, malignant lesions were more common [74.08%] with hepatocellular carcinoma[HCC] as the most common malignancy [42.59%] followed by metastatic malignancies [23.15%], undifferentiated malignancies [5.55%] and Non-Hodgkin's Lymphoma in 3[2.78%] patients while in two patients [1.85%] only normal hepatocytes were aspirated. In 13 [12.04%] patients aspirates were inadequate for any morphological evaluation. It is concluded that FNAC is a useful technique in evaluating the liver masses. However there are some difficulties which can be overcome by more experience in aspiration and better coordination between radiologist, pathologist and clinicians