review of uterine cancers

Review of uterine neoplasms to evaluate the frequencies of different morphological types of uterine cancers and to compare the results with different age groups and the findings of other workers. Observational and comparative study. This study was conducted at the Department of Pathology, Basic Medical Science Institute, JPMC, Karachi from January 2002 to December 2011. A total of 927 cases of neoplastic lesions of the uterine corpus, received over a period of 10 years at the department of Pathology, Basic Medical Science Institute, JPMC, Karachi were reviewed. A total of 98 [9.45%] were uterine cancers including 82 [83.67%] carcinomas and 16 [16.32%] sarcomas. Adenocarcinoma was the commonest finding [66/98], followed by squamous cell carcinoma [10/98] and endometrial stromal sarcomas [7/98]. The mean age of uterine carcinomas was 51.48 years and of sarcomas was 41.87 years. Grade III Adenocarcinoma presented at relatively late ages [mean age 60.71 years] than grade II [mean age 56.37 years] and grade I [mean age 47.02 years]. Sarcomas were found to be of relatively high frequency in our study [16.32%]. Leiomyosarcoma [LMS] and endometrial stromal sarcoma [ESS] tend to occur at younger age than carcinosarcomas. Mean age of uterine carcinoma was found to be 51.48 years and of sarcomas 41.87 years. Grade I adenocarcinoma is more common in younger age groups than grade II and III adenocarcinoma. Finally the LMS and ESS are more frequent than malignant mixed mesodermal tumors [MMMT]

Detection of beta-lactamase and extended spectrum beta-lactamase from bacteria causing neonatal sepsis

The aim of the present study was to detect Beta-Lactamase and ESBL [Extended Spectrum of Beta-Lactamase] by bacteria causing neonatal sepsis. Observational Study. The study was conducted at the department of Microbiology, Basic Medical Science Institute of JPMC during the period of August 2009- July 2010. The blood samples were taken from babies admitted at National Institute of Child Health. The study included 200 babies between the ages of 1 to 30 days who were presumed to have sepsis on clinical grounds. Neonates who had already been given antibiotics prior to admission and those who had congenital anomaly were excluded. Two hundred [200] blood samples were processed for blood culture. In the laboratory, each specimen were inoculated on differential and selective [Blood agar, MacConkey agar and Chocolate agar] media accordingly. For beta-lactamase production, we performed Chromogenic Cephalosporin method and for ESBL [Extended Spectrum of Beta-Lactamase] we performed double disc diffusion method. Two strains of staphylococcus and single isolated strain of Haemophilus influenzae yielded positive beta-lactamase production. Two strains of each Enterobacter cloacae and Klebsiella pneumoniae and one strain of Escherichia coli were positive for ESBL production. According to our study, prevalence of beta-lactamase and ESBL in the total number of bacteria was low in NICH Karachi. Therefore, beta-lactam antibiotics remain the drug of choice in infections. ESBL detection must be routinely performed in clinical laboratories, as false reporting would result in treatment failure

Urinary tract infections [UTI] among females caused by staphylococcus saprophyticus

Staphylococcus saprophyticus is a uropathogen frequently isolated from young female outpatients presenting with uncomplicated urinary tract infections[1]. Antibiotic resistance in uropathogen is increasing worldwide in out patients as well as hospitalized patients[2]. Cross-sectional study. The urine specimens were obtained from Nephrology, Urology and gynecology/ Obstetric and outpatient departments of JPMC, Karachi for three years. They were processed in the Department of Microbiology, Basic Medical Sciences Institute, Jinnah Postgraduate Medical Centre, Karachi from May 2003 to May 2005. The proper and necessary records of the patient were maintained, then the samples were processed by the standard methods. Blood agar plates and MacConkey's agar plates were used for culture. The biochemical tests were done by using different sugar media, TSI, Simon citrate agar, urease, indole and MRVP tests. Out of 175 urinary pathogens isolated from female patients complaining from symptoms of UTI, 28 [16%] yielded Saprophyticus predominantly in pure culture and in high counts. In the age group of 18-28 years, this organism was found in 10 [36%], while in the age group of 29-39 years it was found in 8 female patients i.e. it was 28%. Hence it is observed that as the age advances staph saprophyticus becomes a rare finding so it is not a common organism in elderly males as well as females of all ages. But the sensitivity pattern must be seen to commonly use antimicrobial agents for proper and timely therapy

Comparison of methods for diagnosing bacterial vaginosis

To determine the laboratory method that best predicts Bacterial Vaginosis. Descriptive Observational study. This study was conducted in the Department of Microbiology, Sindh Medical College [DUHS] and Basic Medical Sciences Institute, Jinnah Postgraduate Medical Centre, Karachi from Jan. 2005 to Feb. 2007. A total of 150 randomly selected women were included in this study from OPD of various tertiary care hospitals and family planning clinics of the city. In this study we compared and calculated the sensitivity, specificity and predictive value of positive and negative tests for wet mount, Gram stained vaginal smears and Gardnerella vaginalis [G.vaginalis] cultures with clinical sign Amsel's criteria [Gold standard], for the diagnosis of bacterial vaginosis [B.V]. We diagnosed 54 [36%] cases of bacterial vaginosis by Gram's staining method, 61 [41.7%] cases by Wet Mount method, and 42 [28.0%] cases by Amsel's criteria and 47 [31.3%] cases by culturing. Amsel's criteria were comparable with other laboratory tests for diagnosis of BV. Culture was laborious, expensive and least sensitive method

Seroprevalence of toxoplasmosis [by detecting IgM antibiodies] in women with repeated abortions

To determine seroprevalence of Toxoplasmosis in women with repeated abortions in our local population. Prospective Cross-sectional study. This study was conducted in the Department of Microbiology Basic Medical Sciences Institute [BMSI] Jinnah Postgraduate Medical Centre [JPMC] Karachi from April 2006 to May 2008. Sera from 130 pregnant and post-aborted women with history of repeated abortions [group A] and 50 pregnant women with no history of abortion [group B - as controls] were analyzed for Toxoplasma IgM antibodies by ELISA technique to see the prevalence of toxoplasmosis. 24% of women of group A and 14% of women of group B were seropositive for toxoplasma IgM antibodies. Most of the cases with toxoplasmosis have had their abortions in the first trimester. Gradual increase in Toxoplasma antibody positivity with increasing gravida was observed. Women with negative serological status are at risk of acquiring a primary infection during pregnancy, hence education regarding preventive measures should be provided to them and every pregnant woman may be advised for Toxoplasma IgM antibodies investigation

Susceptibility pattern of pathogens isolated from the prostatic tissue

There is significant incidence of bacterial growth in the prostatic tissue in the patients with Benign Prostatic Hyperplasia [BPH], whereas pre-existing urinary tract infection is not a reliable indicator by which this group can be identified pre-operatively and prostatic infection could be treated. To identify the presence of various types of bacteria and fungi in prostatic tissue and cultures from urine samples of patients undergoing transurethral resection of prostrate. Cross-sectional observational study design. This study was conducted at The Basic Medical Science Institute at Jinnah Postgraduate Medical Center [JPMC] Department of Microbiology Karachi from. The samples were processed by the standard protocol. Culture medium of Blood agar and MacConkeys agar were used and biochemical tests were performed by using different sugar media, triple sugar iron agar, Simon citrate agar, urease, indole, and MRVP tests. Out of 100 cases 25% showed identical type of growth, 11% cases had different type of growth in urine and prostatic tissue culture whereas 5% had no growth in urine while 32% had no growth in prostate only 32% had no growth in both urine and tissue culture. The significance of prostatic tissue culture of patients undergoing surgery facilitates prompt diagnosis and the ideal choice of antibiotic can shorten the duration of treatment

Is vancomycin the only choice for methicillin resistant staphylococcus aureus? results from a multi-centered study on antibiotic sensitivity pattern of staphylococcus aureus isolated from nosocomial infections

To observe the pattern of antibiotic resistance in methicillin sensitive and methicillin resistant staphylococcus aureus. Materials and Two hundred Staphylococcus aureus isolates from patients with hospital- acquired infections were collected. Methicillin resistance was determined by disc [oxacillin 1 micro g] diffusion method. Sensitivity to other antimicrobial agents was determined by Kirby Baurer disc diffusion method. The methicillin resistant Staphylococcus aureus isolates were found sensitive to vancomycin [100%], fusidic acid [88.5%], chloramphenicol [80.8%] and fosfomycin [61.5%]. All the isolates were highly resistant to other classes of antimicrobial agents. Methicillin resistant Staphylococcus aureus shows multi-drug resistance and infections caused by these isolates are difficult to treat. However our results show that beside vancomycin; fusidic acid, chloramphenicol and fosfomycin are good choices and should be tried for the isolates showing sensitivity to these agents