Ascitic fluid culture in cirrhotic patients with spontaneous bacterial peritonitis

Objective: to determine the frequency and compare the culture yield of bacterial isolation by conventional and blood culture BACTEC bottle techniques in cirrhotic patients with spontaneous bacterial peritonitis [SBP]

Study Design: cross-sectional comparative study

Place and Duration of Study: pathology Department, Bannu Medical College, Bannu, KPK, from January 2012 to December 2013

Methodology: paracentesis of 20 ml of ascitic fluid tapped from cirrhotic patients with SBP was carried out by a single technologist. The analysis included differential leukocyte count [DLC], while 5 ml each of the fluid was inoculated into conventional culture media and BACTEC blood culture bottle. All the data were analysed on [SPSS] version 16 to determine frequencies with percentages and mean values with standard deviation. Chi-square test was used for comparing the yield of conventional and blood culture bottle methods. P-value was considered significant if < 0.05

Results: in 105 cases of ascitic fluid analyses, 27 [25.72%] had positive ascitic fluid culture whereas 78 [74.28%] had negative ascitic fluid culture. Ascitic fluid culture was positive in 6 cases by conventional culture media and in 27 cases by BACTEC culture bottle media [p < 0.001]. Bacterial isolation was obtained by both culture methods in 6 cases [p < 0.001]

Conclusion: direct bedside inoculation of ascitic fluid by BACTEC culture bottle method has better yield as compared to conventional culture method

Histopathological pattern of intracranial tumors in a tertiary care hospital of Peshawar, Pakistan

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

Symbolic Representation of Daughter in Sindhi Culture

The paper analyzes symbolic representation of a daughter as a Niyani [goddess] and Satt Qur'an [seven Qur'ans], and associates it with her sexuality. It is argued that these symbols are a means of control to protect virginity and regulate sexuality of women

role of spiritual attitude in child-rearing in predicting the psychological hardiness of mothers with handicapped children

Objective: Providing care to children who have disability is often a stressful experience, yet spiritual beliefs may help mothers to be patient, tolerant and hard in coping with child-rearing difficulties. This study examined the relationship between the spiritual attitudes of mothers of handicapped children to child-rearing and psychological hardiness

Methods: In a descriptive correlational study, 120 mothers of handicapped children who were referred to the rehabilitation clinics of the University of Social Welfare and Rehabilitation Sciences [Rofeideh, Akhavan and Sina clinics] were selected through purposeful sampling and answered the Sanctification of Parents Scale [SPS], and Personal Views Survey [PVS]. Data were analyzed by SPSS-20 software and statistical procedures including Pearson correlation and multiple regression analysis were used

Results: Results showed that spiritual attitudes to child-rearing are significant predictors of hardiness in mothers

Discussion: It seems like having spiritual attitudes in difficult situations such as providing care for disabled children plays a significant role in mother's patience and hardiness

Blood morphology of patients suffering from malaria

To find out changes in peripheral blood of patients suffering from malaria. Descriptive case series. The study was conducted at Shah Noor Medical Laboratory, Bannu Khyber Pakhtoon khawa from 1[st] May 2014 to 31[st] August 2014. In this study 160 cases of malaria patients were selected by non probability random sampling technique with informed consent of the patients. These patients were subjected to complete blood counts performed by Hematology analyzer Sysmex 21 and manual method using Neubaur's chamber and thick and thin films stained with Giemsa stain to confirm malarial parasite. The data was recorded in preformed designed proforma and was analysed by using a Statistical Package for Social Sciences [SPSS] version 16 for percentages, means and standered deviation. Out of 160 patients 93 [58%] were males and 67 [41.87%] females. Most 59 [36.8%] were in the age range of 1-10 years. Plasmodium vivax found in 135 [84.3%] and Plasmodium falciparum in 25[15.6%] cases. Minimum total leukocyte count [TLC] was 1300/cmm and maximum was 19500/cmm, Low Hemoglobin level was 4.50 g/dl and high value was 15.20 g/dl. Platelets minimum count was 35000/cmm and maximum was 590000/cmm. Anemia was present in 103 [64.37%], thrombocytopenia was present in 65 [40.62%], leucopenia was present in 34 [21.25%], bicytopenia was present in 24 [15%] and Pancytopenia was found in 5 [3.12%] of cases, where as high TLC was encountered in 6 [3.75%] cases. This study shows that person suffering from malaria have significant changes in blood morphology especially cytopenias causing morbidity and mrtality needs special attention regarding accurate diagnosis and prompt treatment to avoid the complications

Histological patterns of endometrial lesions in endometrial curettage specimens of abnormal uterine bleeding patients

Background: Endometrial curettage is one of the commonest invasive gynecological procedure in reproductive as well as post reproductive age in abnormal uterine bleeding

Objective: To determine the histological types of endometrial lesions in curettage specimens, of women having abnormal uterine bleeding

Methodology: This descriptive study was conducted in Bannu Medical College from 1[st] March 2011 to 31[st] May 2014. A total of 170 endometrial curettings were included in the study. The inclusion criteria was sufficient endometrial specimen from women of any age with abnormal uterine bleeding, where as the exclusion criteria was insufficient curetting specimen. A minimum of one sections and a maximum of three sections were taken from the endometrial specimen. Sections 5 micron thick were prepared and stained with H and E and reported by histopathologist. The data was entered and analyzed in SPSS version 17

Results: A total of 170 endometrial specimens were included in this study with age range from 21 to 73 years. The most common age group encountered was 31-40 years, in which 67[39%] cases of endometrial specimen were noted. The common histological lesion were secretory phase endometrium 54 [31.7%] followed by proliferative phase 47 [27.6%], retained product of conception 16 [9.41%], endometritis 13 [7.64%] and endometrial polyp 12 [7.05%]

Conclusion: This study showed that that endometrial curettage is a significant diagnostic tool in identification of the lesion leading to abnormal uterine bleeding in any age patients

Seminal volume in the investigation of male infertility

To determine the seminal volume among infertile males and the frequency distribution of hypospermic and hyperspermic patients in infertile males. Cross-sectional observational study. Department of Reproductive Physiology/Health, Public Health Laboratories Division, National Institute of Health, Islamabad, from 2002 to 2009. Semen examinations of infertile male were carried out according to the standardized method of the World Health Organization. Seminal volume of 2-6 ml were considered normal, while volumes less than 2 ml and higher than 6 ml were considered hypospermic and hyperspermic respectively. Out of 1521 patients, 355 were hypospermic [23.34%], 1046 were normospermic [68.78%] while 120 were hyperspermic [7.88%]. In the hypospermic cases, 57 out of 355 [16.05%] had a volume of less than 1 ml. Of those 57 patients, 34 were found to be azoospermic, 12 were asthenozoospermic, one each were terato and polyzoospermic, while 6 had normal counts. Among the hyperspermic patients [n=120], 3 were azoospermic, 24 were oligozoospermic and 19 cases [15.84%] had count within the normal range, while 1 patient was polyzoospermic. Significant differences [p < 0.05] were observed among azoospermic, oligoasthenozoospermic and teratozoospermic groups when comparing hypo and hyperspermic patients. Seminal volume is an important parameter for assessment of infertility investigation and its abnormalities constitute a valuable index of problems with the male partner, even if the count and motility are well within the acceptable limits

Hypertensive encephalopathy: a rare presentation of Williams-Beuren syndrome

A male child of four years is reported with Williams-Beuren Syndrome [WBS]. It was not recognized initially when he presented with odd facies and developmental delay since early infancy. The diagnosis was established later when he developed hypertensive encephalopathy secondary to bilateral renal artery stenosis, a congenital anomaly that must be looked for in such patients. No echographic evidence of congenital heart disease was found. Blood pressure estimation on routine physical examination of every child is emphasized. The diagnosis is mainly clinical as the definitive chromosomal studies are presently not available in Pakistan

Pattern of carcinoma of oral cavity reporting at dental department of Ayub medical college

Carcinoma of oral cavity is amongst the first ten commonest malignancies in Pakistan. Districts of Hazara [NWFP] and Northern Areas of Pakistan are among the high risk. areas. Here we present a report of oral cancers received in this center over a period of 10 years. This clinicopathological study consists of cases of carcinoma of oral cavity presenting to dentistry department of Ayub Medical College Abbottabad during 1993-2003. All cases were clinically examined and provisionally diagnosed. Biopsy was taken from all the lesions and the tissues submitted to histopathology department of Ayub Medical College. There were 50 carcinoma cases in the study, including 30 [60%] males and 20 [40%] females. Among these, 47 [94%] were diagnosed as squamous cell carcinomas, that consisted 30 [63.82%] males and 17 [36.17%] females. The other 6% lesions were histologically diagnosed as malignant melanoma, adenocarcinoma and acinar cell carcinoma. The age of squamous cell carcinoma cases was 41-71 years. The maximum number of squamous cell carcinomas [34%] effected buccal mucosa. The other common sites were lip [26%], tongue [21%] and gums [19%]. The results of this study are comparable with other such studies done in Pakistan and else where in the world showing commonality of factors associated with the development of the disease in this region of the country, which necessitates a detailed prospective study