Wet mount microscopy a better diagnostic tool for bacterial vaginosis screening than gram staining

To compare Wet smear and Gram staining for Clue cells in screening Bacterial Vaginosis [BV] in a clinical setting where laboratory facilities are not readily available. Cross-Sectional .This study was conducted in the Department of Microbiology, Basic Medical Sciences Institute Jinnah Postgraduate Medical Center Karachi. High vaginal swabs [HVS] were collected from Gyne and Obstetric Department of Jinnah Postgraduate Medical Centre, Karachi, from Jan 2005 to Feb 2007. One hundred and fifty high vaginal swabs [HVS] were collected from married females with or without complain of vaginal discharge. BV was diagnosed on the basis of clinical Amsel's criteria BV was diagnosed. Subsequently, clinical diagnosis was compared with laboratory based diagnosis for each woman. Two methods used were Wet Mount and Gram Staining. Out of total 150 cases, 100 females were complaining of vaginal discharge and after clinical assessment by Amsel's criteria 34 [34%] were diagnosed as cases of BV. Fifty females as [as controls] were those who were not complaining of any discharge. But among this group 8 [16%] were discovered to be suffering from BV. With the help of wet mount, the clue cells were visualized in 61 [40.7%] cases, while by Gram staining 54 cases [36.0%] were seen. BV screening is important as it affects both groups of females with or without complains of discharge. For easier recognition of clue cells, which are an excellent predictor of BV, wet mount is better as compared to Grams staining method

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

Histopathological study of 209 cases of early abortions

Determining the frequencies of various histological abnormalities of chorionic villi in cases of spontaneous abortions for better understanding of etiology and pathogenesis of the abortions. Cross sectional study. This study was conducted at the Department of Pathology Dow Medical College, Dow University of Health Sciences [DUHS] Karachi from January 2009 to December 2010. A total of 209 cases were included in this study from January 2009 to December 2010 and studied for the following variables e.g. age, date of last menstrual period [if given], period of amenorrhea [if available], history of previous abortions. This information was obtained from surgical pathological registers, request cards and copies of reports. The slides and paraffin blocks of cases coded as Abortions were collected from the files of Surgical Pathology of Department of Pathology Dow Medical College DUHS. The paraffin blocks were sectioned and stained with hematoxylin and eosin. A total of 209 cases of Abortions were studied. In order to find the commonest age group of abortions, the maternal age of the patients were divided into 5 groups with less than 20 years to more than 35 years. Maximum numbers of abortions were encountered in maternal age group of 31-35 years with 85 cases [40.66%] and minimum number of abortions seen in maternal age of< 20 years with 16 cases [7.65%]. Regarding the gestational period, it was provided in 117 cases. A maximum number of 45 cases [38.46%] were seen during 8-12 weeks of gestation and a minimum number of 10 cases [8.5%] were noted between 16-20 weeks. In the remaining 92 cases gestational period was assessed by estimation of presence / absence of nucleated RBCs in chorionic villi according to Salafia et-al. Histological changes found in the chorionic villi were classified into 3 types according to Rushton's classification. This included hydropic change of the villi [type-I] fibrotic change [type-II] and normal honey combed appearance [type-III]. Out of the 209 cases of abortions, 104 cases belonged to type-I, 81 cases classified as type-II and 24 cases as type-III. It is of empirical value that products of conception should be studied in detail then just to confirm that pregnancy was established. This is of significant importance in patients with recurrent and habitual abortions, so as to establish a probable cause and to manage future pregnancies

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

Frequency of malignant tumors: reported at a public sector university hospital a five year data based analysis

To determine the frequencies of common malignant tumors in relation to the variables of age, sex, histology and site of tumor. An cross sectional study. The study was conducted at the Department of Pathology Dow Medical College Dow University of Health Sciences Karachi from January 2006 to December 2010. The specimens and relevant data was collected from pathology report forms by examining 5 micro m thick slides prepared from paraffin blocks and staining with H and E and special stains e.g. PAS, Giemsa, Trichrome, and histopathological diagnosis was confirmed by microscopy. Statistical analysis was done on SPSS [Ver 16]. A total of 461 cases of malignant tumor were included from January 2006 to December 2010. adenocarcinoma were 227 [49.2%]. Squamous cell carcinoma with 190 cases [41.2%] were followed by Basal cell carcinoma 18 cases [3.9%]. The most common sites of malignancy were Oral cavity with 102 cases [22.1%], Breast 96 cases [20.8%] followed by Cervix 40 cases [8.7%]. Out of 461 cases, 171 were male [37.1%] and 290 [62.9%] were female. As in most developing countries, incidence of cancers is increasing in Pakistan. It is empirical that updated information on the frequency and epidemiology of malignant tumors be carried out. This will be beneficial in future health planning of the population at risk

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

Frequency of bacterial vaginosis and its rapid diagnosis in married females of child bearing age

The aim of this study was to see frequency to establish early diagnosis comparing various laboratory methods for detection of vaginosis in married women of child hearing age with or without vaginal discharge. 150 randomly selected non-pregnant, pregnant females with vaginal and without discharge were included in the study. The study was conducted between March 2001 to October 2001 at Microbiology Department, Basic Medical Sciences institute, Jinnah Post Graduate Medical Center, Karachi. Out of 150 high vaginal swabs, 100 females had complaints al discharge. 50% were just suffering from increased vaginal discharge, 28% Were due to bacterial vaginosis, 10% of candidiasis, 4% each of trichomoniasis and cervicitis and 3.3% were suffering from mixed infections. Amsel's Clinical criteria is accurate, sensitive and specific. Wet mount, Gram's staining are simple procedures for early diagnosis. It is concluded that Amsel's clinical criteria and Gram's staining are help-fill in rapid diagnosis in bacterial vaginosis. Conventional culture methods are not always reliable, are costly and lime consuming. It is advised that Amsel's criteria and Gram's staining should he adopted for diagnosis of bacterial vaginosis

Etiology of tinea corporis in Karachi

To find out the demographic distribution and species of dermatophytes causing tinea corporis in Karachi, Pakistan. Design: Prospective study. Place And Duration: This study was conducted in the Department of Microbiology, Basic Medical Sciences Institute, Jinnah Postgraduate Medical Centre, Karachi from September 2000 to August, 2001. Subjects and Ninety-nine patients having skin infections [clinically suspected cases of tinea corporis] were examined. The skin scraping were taken from active border of the lesions and subjected to direct microscopy and culture on mycobiotic agar [Difco] for isolation of dermatophytes. Various special media were used for species identification. Tinea corporis was generally predominantly seen in adult [74.8%] than in adolescent [14%] and children [11.1%]. Out of 99 cases 53 [53.5%] were males and 46 [46.5%] were females. Tinea corporis was relatively more common in males. 48 strains were recovered out of these 29 [60.4%] strains of Trichophyton rubrum, 09 [18.7%] strains of Epidermophyton [floccosum], 08 strains of Trichophyton violaecum and two strains of Trichophyton mentagrophytes. Tinea corporis was relatively more common in males. Trichophyton rubrum was the most frequently isolated dermatophytes. Species identification is necessary to prevent spread of infection and choice of appropriate antifungal agent