Diagnostic yield of transbronchial needle aspiration analysis of 30 cases

In our clinical set up transbonchial needle aspiration of lymph node and parenchymal lesions is an underutilized technique. This study was done to highlight the usefulness of this technique in the pulmonologists armamentarium. Thirty procedures were performed on patients with intrathoracic lymphadenopathy or parenchymal lung lesions in this study from October, 2006 to April, 2007. Patients with an easily accessible peripheral lymph node, bleeding diathesis and an already confirmed diagnosis were excluded from the study as were patients with a well visualized biopsiable endobronchial lesion. Nineteen patients [63.3%] on whom transbonchial needle aspirations were performed had intrathoracic lymphadenopathy while 11 [36.6%] had parenchymal lesions without endobronchial lesions which could be biopsied. Adequate samples were obtained in 23 patients [76.6%] chronic granulomatous inflammations which was diagnosed as tuberculosis in corroboration with other clinical and laboratory evidence was seen in 3 cases [10%]. Carcinoma was diagnosed in 6 cases [20%]. Thirteen cases [43%] were reported as normal and inadequate samples were obtained in 7 cases [23%]. Transbronchial Needle Aspiration [TBNA] is an effective method of obtaining cytological material from intrathoracic lymph nodes and parenchymal lesions and can provide a safe alternative to invasive mediastinotomy/mediastinoscopy and open lung biopsya

Pattern of cutaneous Leishmaniasis cases among troops and their families in Sibi

To determine the pattern of cutaneous leishmaniasis cases in Sibi and to form a base line data. Single center descriptive study. Place and Duration of Study: From Jan 2003 to Oct 2004 in CMH Sibi. A total of 293 patients of either age or sex with clinical features of cutaneous leishmaniasis or positive skin smear for LD body were included in the study. Out of 293 cases 283 [96.6%] were male patients and 10 [3.4%] were females. Mean age of presentation was 30 years. Number of lesions ranged from 1-14. Multiple lesions were seen in 40.9% cases only. Size of lesions ranged from 1-6 cm and most common size was 1 cm. 70% of lesions seen on upper and lower limbs followed by trunk and abdomen 15%, face 14% and genitalia 16%. Most common morphological pattern was non healing ulcer in 273 [93.17%] cases. Dry type was seen in 20 [6.8%] cases only. No over lap with visceral leishmaniasis was seen. Cutaneous leishmaniasis is quite prevalent in Sibi cantonment of Balochistan province of Pakistan. Most common presentation is non healing ulcer followed by psoriasiform rash. Majority of reasons were wet type but dry lesions were also seen. There is need to carry out further studies to identify where some different strain of parasite is involved

Risk of transmission of hepatitis-B and C viruses in upper gastrointestinal endoscopy-a hospital based study

A study was carried out at Gastroenterology department Military Hospital, Rawalpindi, from 6th June to 24th October 2002, to assess the risk of upper gastrointestinal endoscopic procedure as a route of transmission of HBV and HCV. One hundred consecutive patients reporting for endoscopy at Gastroenterology department, MH, Rawalpindi, fulfilling the inclusion and exclusion criteria were selected. Their base-line HBV and HCV status were assessed prior to endoscopy. They were then recalled after 04 months to re-assess the HBV and HCV status. Two patients [2%] tested positive for HBsAg, and none for Anti HCV antibodies, after 04 months of the procedure. One of the HBsAg positives had a history of unchecked blood transfusion after the endoscopy. Endoscopy is a very safe procedure provided strict disinfection techniquse are followed. However, staff and patient education regarding preventive methods against HBV and HCV remains the cornerstone in avoiding their transmission