Efficacy of bronchial wash cytology and its correlation with biopsy in lung tumours

Objective: To evaluate bronchial wash cytology with histology in our set up

Material and Methods: Seventy three specimens were obtained by flexible fiberoptic bronchoscope at pulmonology department of Military Hospital Rawalpindi. All the preserved samples were processed under standard conditions. The slides were stained with Papanicolaou and Haematoxylin and Eosin stains

Results: A total of 73 patients were studied. The age range was 21 to 80 years . Male to female ratio was 8:1. Complete cytological and biopsy consensus was found in 55 [77.4%] cases. Cytology revealed 24 cases as malignant and nine as atypical/suspicious. Benign and inadequate were 29 and 2 respectively. Histopathology of these cases confirmed 24 [32.9%] as malignant and 29 [39.8%] as benign. True positive alongwith suspicious/atypical were 33 and true negative cases were 29. False positive was one case only whereas false negative cases were eight. The bronchial wash cytology showed sensitivity [80.5%], specificity [96.6%] and accuracy [87.3%]. Positive predictive value and negative predictive value were 97% and 78.4% respectively. The commonest types of tumours were squamous cell carcinoma and small cell carcinoma

Conclusion: It is concluded that bronchial wash cytology is a valuable tool and yields almost same information as biopsy. It is useful in patients with evidence of obstruction or risk of haemorrhage

Changing epidemiology and sensitivity pattern of vibrio cholerae at Rawalpindi

Objective: To establish the serotypes of Vibrio cholerae [VC] endemic in our set up and to determine the sensitivity pattern of the organism

Methods: The study was carried out on 123 isolates of Vibrio cholerae isolated from stool samples of patients of diarrhea. Samples were collected in plain containers/alkaline peptone water. Inoculation was done on TCBS agar, McConkey's agar and Salmonella Shigella agar. Identification of the organisms was based on, sucrose fermentation on TCBS agar a positive oxidase test and biochemical profile by API 20 E galleries. Serological confirmation was done by standard antisera. Biotypes were confirmed by Voges-Proskauer [vp] reaction, Polymixin B [50 i.u] sensitivity and sheep red cell haemolysis. Antibiotic sensitivity was carried out against Ampicillin, Tetracycline, Trimethoprim/Sulphamethoxazole, Erythromicin, Nalidixic acid, Ofloxacin and Ciprofloxacin by Kirby Bauer disc diffusion technique

Results: A total of 123 isolates recovered during the period 1997-2002 were studied. All strains belonged to sero type O1. Till 1998 all strains were of biotype EL Tor. Classical biotype appeared in 1999 and remained the dominant variety during 2000-2001. Year wise comparison of the antimicrobial sensitivity pattern shows that resistance to Nalidixic acid emerged in 1999 and is uniformly continuing whereas resistance to Ampicillin and Tetracycline has fallen to very low levels. No isolate was resistant to the fluoroquinolones

Conclusion: 1. Vibrio cholerae O1 is endemic in Rawalpindi. 2. EL Tor was the biotype causing epidemics predominantly in our set up till 1998. Now the Classical variety has emerged and both types are probably co-existing. 3. All the isolates in our study were completely resistant to Nalidixic acid but sensitive to the fluoroquinolones and Erythromycin. Ampicillin and Tetracycline which were earlier resistant have reverted to sensitive

Self reported smoking-quitting attempts and their outcomes in adult Saudi smokers in Riyadh, Saudi Arabia

To study the factors associated with quitting attempts and their outcome in adult Saudi smokers in Riyadh City, capital of the Kingdom of Saudi Arabia. Cross-sectional survey. Primary Health Care Centers [PHCCs] in Riyadh city selected by stratified random sampling. The subjects resident in each PHCC catchment area were selected by systematic sampling from their records in the PHCCs. Participants: One thousand, five hundred and thirty-four adults aged 15 years and over were interviewed during January - April 1994. Main outcome measure: Self reported smoking habits, quitting attempts and quitting outcomes. Fifty-four point three percent of all smokers attempted to quit mainly because of health and religious considerations. Only 52.6% of those who attempted to quit [28% of ever smokers] were successful quitters at the time of the study with an average quitting period of more than one year. Quitting attempts were significantly associated with ever married and the less educated smokers. Successful quitting was significantly more in females, unmarried and those with no university education. Age, income, duration and intensity of smoking were not significantly related to quitting attempts and their outcome. The majority of smokers tried quitting on their own with only 18.7% seeking assistance from smoking cessation clinics in the city and males were more inclined to do this than females. More than 48% of smokers who contacted smoking cessation clinics were not satisfied with services offered. Of those who failed to quit, 35% had primary failure [0-6 days quitting period] and 65% stopped for varying quitting periods ranging from 1 to 52 weeks. No significant association was found between both groups concerning the demographic variables studied or the duration or intensity of smoking. Smoking contacts, stress, boredom, foreign travel and withdrawal symptoms were important factors in relapsers. More than half of all smokers attempted to quit, mostly without assistance, but only half of them were successful. The existing smoking cessation clinics require to be evaluated and services need to be improved to attract the majority of smokers who wish to quit. In addition other forms of assistance such as mass media and anonymous quitting smoking activities must be looked at and probably more legislative action taken

Users' characteristics and satisfaction in the use of Olaisha primary health care centre in Riyadh, Saudi Arabia

The authors studied 560 patients using a primary health care centre [PHCC], and investigated factors related to their usage and their suggestions for the improvement of services. Distance, nationality and educational status were significant factors in usage patterns. Patients indicated shorter waiting time and satisfaction with the services were important reasons for using the PHCC. Suggestions for the improvement of service include expanded parking facilities and expanded laboratory services