Chronic hepatitis; HCV genotypes in correlation with alanine aminotransferase level in patients in interior of Sindh

Objective: To determine the correlation between HCV genotypes and serum ALT levels in various patients of chronic hepatitis induced by hepatitis C virus, in our setup. Design: A prospective study carried out from August 2006 to December 2009. Setting: Research Medical Center LUMHS Jamshoro, Pathology Department Peoples University of Medical and Health Sciences Nawabshah and Biotechnology Department University of Karachi

Patients: A total of 344 HCV-PCR positive patients with different genotypes were evaluated 239 men and 105 women with ages between 18-55 years of age years were included in the study

Methodology: All the patients went for ELISA test for the presence of HCV antibodies by ELISA kit of Biokit Spain, then a 10.0 ml sample of blood was collected in a tube with separating gel, to obtain serum, which was O stored at -80°C, for the determination of HCV RNA by RT- PCR [Real time cephid smart cycler] and for determination of HCV-RNA genotypes by comparison in sizes of the products amplified by RTPCR using HCV genotype- specific primers, then subjecting the product to electrophoresis by Anagen kit. 5.0 ml of blood was also collected in a tube with separating gel, to obtain serum, which was stored at room temperature for the determination alanine aminotransferase by using UV enzymatic kinetic method

Results: when HCV genotypes were correlated with serum ALT levels, 09 cases were found < 50 mg % and among these 06 cases were of genotype 1a, 02 cases were of genotype 2a and one case of untyped. 55 cases shows serum ALT level between 50-100 mg % and among this majority of cases belongs to untyped category. 209 cases shows serum ALT level between 100-200 mg % and among this majority of cases belongs to genotype 3a. 71 cases shows serum ALT level >200 mg % and among this majority of cases belongs to genotype 3a

Conclusions: The data in the current study indicates the strong correlation between HCV genotypes and serum ALT levels. The genotypes 3a, 3b and 2 were found associated with high serum ALT levels and the genotype 1 was found associated with low levels of serum ALT

To evaluate the efficacy and reliability of commonly available tests for the diagnosis of dengue fever in children in Karachi

Diagnosis of dengue fever in financially constraint countries like Pakistan is usually made on immunochromatographic [ICT] based serological tests. To compare the diagnostic accuracy of commercially available dengue rapid immunochromatographic tests [ICT] with dengue ELISA in acute dengue infection in children. This retrospective study was carried out at the National Institute of Child Health, Karachi in the Department of Pathology from October 2010 to January 2011. Hospitalized children who fulfilled the WHO and CDC definition of probable dengue fever i.e. fever of 2 to 7 days with two or more than two of the associated symptoms like headache, retro orbital pain, myalgia, arthralgia, rash, hemorrhagic manifestation, leucopenia, thrombocytopenia and supporting serology were included in the study after taking informed consent from their parents / care givers. Malarial parasite positive cases were excluded from the study. Dengue ICT based IgG, IgM, IgA antibodies were done using rapid devices, dengue NS[1] was done on ICT rapid device and dengue IgM was done using enzyme linked immunosorbent assay [ELISA] by micro titer well plate. Data entered and analyzed on SPSS version 16. Out of 80 suspected cases [being a retrospective study it would be better that we give number of all suspected cases and then delete the numbers that did not have complete tests], 39 fulfilled the criteria of suspected dengue fever patients. Ages of these children ranged from 6 months to 13 years. There were 18 males and 21 females. Mean haemoglobin was 8.7g/dl and mean haematocrit was 26.3%. Elevated haematocrit was seen in 7.5% cases only. Mean WBC count was 6164/cmm, with leucopenia seen in 33.3% and leucocytosis in 5.12% cases. Thrombocytopenia was present in all cases except one. Positivity rate of dengue IgG was 25.64%, IgM 15.4%, IgA 43.59%, rapid antigen by ICT method 20.5% and ELISA IgM [by micro titer well- plate] was 76.9%. Sensitivity / specificity of dengue IgG, IgM, IgA and rapid antigen by ICT were compared with ELISA IgM [gold standard] and these were 33.3/100%, 16.67/88.89%, 50.0/77.78%, 23.3/88.8% respectively. ELISA IgM antibody [by micro titer well-plate] test was most reliable as compared to ICT tests. Among the ICT tests, dengue IgA antibody was superior to other tests

Drug sensitivity pattern of salmonella thphi

To evaluate the susceptibility pattern of Salmonella typhi to different drugs in a tertiary care hospital at Karachi. Descriptive study. Clinical pathology laboratory of National Institute of Child Health, Karachi from May 2004 to June 2005. Eighty isolates of Salmonella typhi grown from blood cultures were included in the study. These isolates were identified by routine culture technique and later confirmed by slide agglutination method. Sensitivity for the following antibiotics ampicillin, chloramphenicol, cotrimoxazole, ciprofloxacin ceftriaxone and cefixime was measured by Kirby Baur method. The isolates were found to be resistant to ampicillin 52.5%, chloramphenicol 45%, cotrimoxazole 57.5%, ciprofloxacin 48.75%, ceftriaxone and cefixime 0%. Among 80 isolates, 38 [47.5%] were sensitive to first line of drugs, out of which, 11[28.94%] were resistant to ciprofloxacin. Among 80 isolates, 42 [52.5%] were resistant to first line of drugs. Out of 42 MDRS, 29[69.04%] were resistant to ciprofloxacin. It may be concluded that the trend of resistant strains of Salmonella typhi against newer drugs has reached to an alarming situation. Instead of waiting for newer drugs to come into market, we should use with care what we already have

Neonatal sepsis in NICU: bacterial isolates and their sensitivity pattern

To assess the prevailing pathogens and their sensitivity pattern to antibiotics in our Neonatal Intensive Care Unit [NICV]. This was a descriptive study carried out from 1[st] July 2004 to 30[th] June 2005, at National Institute of Child Health, Karachi: All the neonates admitted into NICU with strong suspicion of neonatal sepsis were included in the study. A total of 687 cases with suspected sepsis were admitted and blood was sent for culture and sensitivity. Out of 687 cases, 319 [46.43%] were positive on blood culture. Frequent offenders were gram negative organisms 295 [92.48%]. Out of 295 gram -ve blood culture, Enterobacter was the most common pathogen [52.88%, n=I56], followed by Klebsiella [22.37%, n=66], Pseudomonas [21.0%, n=62], E.coli [2.0%, n=6], Citrobacater [1.35%, n=4] and Serratia. [0.33%, n=1]. Among grams +ve organisms [7.52% n=24] Staph aureus was the main causative organism [n=17] followed by Streptococcuspneumoniae [n=4] and streptococcus spp [n=3]. Multi-drug resistant gram -ve organisms are emerging as significant pathogens among cases of neonatal sepsis in our NICU

study of 100 children with enteric fever

This study was conducted at the Department of Paediatric Medicine at National Institute of Child Health [NICH], Karachi, from January, 2003 to December, 2003. Hundred children were admitted with Enteric fever and studied prospectively. These accounted for about 1% of the total admissions. Inclusion criteria was positive blood and / or bone marrow culture. Majority of patients [95] had blood culture positive for Salmonella typhi. Salmonella para-typhLA found in 3 cases and Salmonella para-typhi B in 2 cases only. Bone marrow culture was positive in 25% patients. Majority of the isolates were sensitive to all the primary and the 3rd generation cephalosporins. The patients were between the ages of 5-10 years. Male to female ratio was 2:1. Presenting symptoms were mainly fever, vague abdominal symptoms, anorexia, nausea, vomiting, diarrhoea, headache and cough. One patient presented with a picture of hepatic failure with favorable outcome. Two patients developed arthritis and one developed enteric perforation with fatal outcome

Pulmonary function tests in heroin-addicts at Karachi

Pulmonary function tests were performed on 50 heroin addicts ages ranging between 20-45 years who were known to be "dragon chasers" only. 50 tobacco smokers of the same age group were included in the study. [Controls] to compare the extent of pulmonary involvement caused by tobacco alone and tobacco plus heroin [since all heroin addicts were also cigarette smokers]. Forced vital capacity [FVC], forced expiratory volume in the first second [FEV1], forced expiratory volume in the first second as a percentage of forced vital capacity [FEV1 / FVC] and forced expiratory flow between 25% - 75% [FEF 25% - 75%] were measured. Both groups showed a reduction in all the spirometric variables as compared to the predicted values. The degree of reduction was more marked amongst the addicts as compared to cigarette smokers. Possible etiologic consideration to explain these findings is a direct effect of the drug on alveolar capillary membrane and terminal airways. We suggest that heroin addicts be examined for pulmonary abnormalities and along with the withdrawal of drug, be treated to avoid chronic obstructive pulmonary disease