ABSTRACT
Background: Central Nervous System [CNS] tumors include brain and spinal cord tumors, where as metastatic tumors are extradural usually
Objective: To know the histopathological pattern of central nervous system tumors reported in Pathology Department Lady Reading Hospital Peshawar. Pakistan
Methodology: Study Design: Descriptive case series. Setting: Pathology department, Lady Reading Hospital, Peshawar. Pakistan. Duration: Six years, study from 1[st] January, 2008 to 31[st] December, 2012. Sample Technique: Convenient [non-probability] sampling. Central Nervous System [CNS] biopsy specimen were received in 10% formalin, labeled, gross performed, sections processed in alcohol, xyelen, wax, block prepared, freezed, microtome sections taken and processed for H and E staining, mounted and reported by Histopathologist. The inclusion criteria was any sufficient CNS biopsy specimen of any age, where as the exclusion criteria was insufficient and autolysed biopsy specimen. A minimum of three and maximum of eight 5 micron thick sections were taken from each specimen. Data was entered in SPSS version 15 and analyzed
Results: A total of 106 biopsy specimens were received in pathology laboratory with age range of 09 to 70 years, mean age was 37 +/- 15.18 years. Male to female ratio was 1.55:1. Astrocytoma was the commonest tumor 49 [48%] cases followed by meningioma 22 [21.%] cases and oligodendroglioma 6 [5.6%] cases. Amongst the 49 cases of Astrocytoma the age range was 10 to 66 years with mean age of 37 + 15.93. Male to female ratio was 1.72: 1. Grade I,II,III and IV were 7[14.2%],15[30.3%], 9[19.5%] and were 18 [36.6%] respectively. Amongst the 22 cases of meningiomas age range was 22 to 65 years, 20 [90.9%] cases were grade I meningionas and 2[9.9%] cases were of atypical meningiomas
Conclusion: Astrocytoma is the most common tumor of the central nervous system followed by meningioma and oligodendroglioma
Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Middle Aged , Aged , Tertiary Care Centers , Astrocytoma , Oligodendroglioma , Meningioma , MedulloblastomaABSTRACT
Objectives: To evaluate extended spectrum betalactamase [ESBL] in E.coli and Klebsiella pneumoniae in bacterial cultures and its frequency at LRH
Study Design: Cross sectional analytical study
Setting: Lady Reading Hospital, Peshawar
Period: June 2013 to December 2013
Methodology: Total of 1037 bacterial isolates including 614 E.coli and 423 of Klebsiellapneumoniae were evaluated. All cases were subjected to double disc diffusion method for ESBL detection using amoxacilln-clavulanic acid and a third generation cephalosporin as all ESBLs are hydrolysed by clavulanic acid. The data were analysed using SPSS-16
Results: Out of 1037 cases five ninety two [55%] were males and four fourty five [45%] were females. Of these, E. Coli were 614 [59.2%] and K. Pneumoniae were four twenty three [40.8%]. Of these 1037 isolates, four hundred and ninety five[47.7%] tested positive for ESBL enzyme. Frequency of ESBL positivity in E.coli isolates was 264 [43%] and in Klebsiellapneumoniae isolates was 231 [54.6%].Frequency of ESBL in pus was 34.3%[152/395],in urine, it was 31.8%[141/368], in blood it was 28.6%[127/233] and in sputum it was 5.1% [23/41]. Unit wise frequency of ESBL was surgical and allied 24.6% [109/283], medical and allied 21.4%[95/241], paediatrics 18.5% [82/203], obstetrics and gynaecology 23.2%[103/178] and outpatients 12.1%[54/132]. No significant correlation between ESBL positivity, gender, unit or specimen was found
Conclusion: ESBL positive isolates of E.coli and K.pneumoniaeshould be properly detected in routine laboratory workflow to avoid unnecessary use of otherwise effective antibiotics. These results indicate that such organisms are highly prevalent in our Hospital and need immediate
ABSTRACT
Objectives: to detect extended spectrum beta lactamase in E. coli and Klebsiella pneumonia in bacterial cultures and its frequency at Lady Reading Hospital, Peshawar
Methodology: this cross sectional analytical study was conducted at LRH between June 2013 to December 2013, a total of 1037 bacterial isolates in-cluding 614 E. coli and 423 of Klebsiella pneumoniae were evaluated. All cases were subjected to double disc diffusion method for ESBL detection using amoxacilln-clavulanic acid and a third generation cephalosporin as all ESBLs are hydrolysed by clavulanic acid. The data were analysed using SPSS-16
Results: patients' mean age was 40 years. Out of 1037 cases, 592 [55%] were males and 445 [45%] were females. Of these, E. Coli were 614 [59.2%] and K. Pneumoniae were 423 [40.8%].Frequency of ESBL positivity in E. coli isolates was 264 [43%] and in Klebsiella pneumonia isolates was 231 [54.6%].Frequency of ESBL in pus was 34.3%[152/395],in urineit was 31.8%[141/368], in blood it was 28.6%[127/233] and in sputum it was 5.1% [23/41].Unit-wise frequency of ESBL was surgical and allied 24.6%[109/283], medical and allied 21.4% [95/241], paediatrics 18.5%[82/203], obstetrics andgynaecology23.2% [103/178] and outpatients 12.1%[54/132]. No significant correlation between ESBL positivity and age, gender, unit or specimen was found
Conclusion: ESBL positive isolates of E. coli and K. pneumoniae account for a very high percentage of hospital-acquired infections. These results should be considered while prescribing penicillins and cephalosporins for treating gram-negative acquired infections
ABSTRACT
To determine the demographic characteristics and distribution of various reported prognostic factors of leiomyosarcoma [LMS] among subjects reporting to histopathology diagnostic centers of Aga Khan University [AKU] all over Pakistan between 2000-2004. This study analyzed 205 consecutive confirmed cases of LMS received during a period of four years. The data regarding age, sex and size of tumor was obtained from the pathology medical records. Data on grade and positivity of immunohistochemical stains was assessed and all the variables analyzed using SPSS version 12.5. Of the 205 specimens of LMS, 31 were received as blocks for second opinion. A hundred specimens were multiple fragments, and 74 were intact masses. Of the latter, 40% had clear margins. The mean size of the tumor was 7.23 cms. [95% CI 6.1; 8.4]. There were no cases of childhood LMS. Teenage LMS comprised 3% of all tumors. Grade 1 tumors were 16.6% of the total, 56.6% were grade 2, and 8.5% were grade 3. Vimentin positivity was observed in 97% of the tumors, desmin positivity in 56.7%, HHF35 positivity in 81.0%, s-100 positivity in 15.6% and cytokeratin positivity in 11% of the cases. The median age of LMS patients was 48.4 years, the mean age was 48.6 years [95% CI 45.9; 50.8] and male to female ratio was 1:1.2. The malignancy occurred a decade earlier in the females as compared to the males. The mean age of male cases was 52.3 years [95% CI 48.8; 55.8]; and of females was 45.2 years [95% CI 41.8; 48.6]. The mean age of teenage LMS was 17.2 years [95% CI 15.6; 18.7]. The most common symptom was a painless swelling. The most common sites were lower limb [24.4%] and pelvis [24.4%] followed by abdomen [20.6%] and head and neck [12.7%]. The least common sites were upper limb and chest [8.0% each]. Seventy five percent of the tumors with involved margins were more than 5.0 cms. in size whereas 47% of tumors with free margins were above 5.0 cms. in size. Approximately half the tumors in the males were less than 5.0 cms, as compared with 31.0% in the females. LMS in the extremities was equally common in both genders, but trunk LMS was nearly twice as common in the females. In our population, leiomyosarcoma occurs at a relatively younger age, has a late presentation; is more common in females as compared to males and usually excised incompletely. No genetic study for LMS has been published in Pakistan; these studies are recommended to determine the biological pattern of LMS in our population
ABSTRACT
Immunophenotypic characterization of high grade [pleomorphic] sarcomas and determination of their frequency, mean/median age, sex preferences and common sites in Pakistani patients. This study included 134 consecutive cases of high grade [pleomorphic] sarcomas diagnosed in adults above the age of 15 years in the section of histopathology at the Aga Khan University Hospital, Karachi during a period of two years. These high grade [pleomorphic] sarcomas were immunophenotyped using a panel including antibodies against Vimentin, Desmin, Smooth muscle Actin, S 100, CD34, CD68 and Cytokeratin etc by indirect immunoperoxidase. Of the 134 cases which were characterized, 38.1% were pleomorphic leiomyosarcoma, followed by pleomorphic rhabdomyosarcoma 14.9%, Malignant Peripheral Nerve Sheath Tumour 9%, pleomorphic liposarcoma 3.7% and pleomorphic storiform Malignant Fibrous Histiocytoma 0.7%. Thirty three% of cases could not be characterized further. Mean/ median age for Leiomyosarcoma was 50/50, for Rhabdomyosarcomas 33/22, for MPNST 42/41, for Liposarcoma 52/50 and for Malignant Fibrous Histiocytoma 46/46 respectively. The commonest site for leiomyosarcoma was lower limb [43%], for rhabdomyosarcoma head and neck [42%], for MPNST thorax [36.4%] and for liposarcoma abdomen [50%]. It was concluded that the most common pleomorphic sarcoma occurring in our adult population was Leiomyosarcoma, and that immunohistochemical stains are essential in most cases for further characterization of pleomorphic high grade sarcoma