Frequency of metastasis detection with diffusion-weighted whole-body imaging with background body signal suppression

Objective: To determine the frequency of metastasis detection with diffusion-weighted whole-body imaging with background body signal suppression

Study Design: A Cross sectional study

Place and Duration of Study: The study was conducted at Punjab Medical College and Allied hospital Radiology and Oncology departments, Faisalabad from January 14, 2010 to May 28, 2012

Patients and Methods: A total number of 86 patients of all ages and both sexes with histopathological diagnosis of carcinoma presenting to the outdoor department and admitted in oncology department of Punjab Medical college and Affiliated hospital were selected. Whole-body MRI was performed using a 1.5-Tesla system [Intera Release 9; Philips, Best, The Netherlands] with a Mobi-Trak moving tabletop and b value of 1000. Both the T1 weighted and the STIR images at each station were reconstructed. On MRI, a lesion of high signal intensity on DWIBS, a lesion of high signal intensity on STIR images and low signal intensity on T1 weighted images was considered to be a suspected metastasis

Results: Out of 86 patients, 70 [81.4%] had metastasis. Osseous metastasis was detected in 13 [18.6%] patients however in 57 [81.4%] patients, both osseous and extra osseous metastasis were detected. Liver metastasis was detected in 47 [82.5%] patients out of 57 patients with extra osseous metastasis. Adrenal metastasis was found in 12 [21.1%] patients, brain in 13 [22.8%] patients, lung in 19 [33.3%] patients, renal in 6[10.5%] patients and peritoneal dissemination was seen in 5 [8.8%] patients. Nodal metastasis was detected in 57 patients and maximum number of 19 lymph nodes were detected

Conclusion: DWIBS MRI is helpful in the early diagnosis of metastasis

Extended Spectrum beta-lactamases in pyogenic gram-negative bacilli

To determine the frequency, distribution and sensitivity pattern of extended spectrum beta-lactamases producing Gram-negative bacilli from pus samples. Cross Sectional Comparative Study Study, place and duration: This study was conducted at the Microbiology Department, Fauji Foundation Hospital, Rawalpindi over a period of two years from 04/ 2004 to 03 / 2006 Inclusion criteria: All pus samples were included. Exclusion criteria: Dried pus swabs were not included in the study. Multidrug resistance and ESBLs-production were studied in a total of 138 Enteric Gram-negative Rods [GNR] obtained from pus specimens by the help of double disc diffusion technique. Susceptibility testing was done to various groups of antimicrobials. Frequency of ESBLs-production was 56.5%. ESBLs-positivity was highest at 61-70 years of age group [24.3%], followed by 11-20 yrs [17.5%]. ESBLs-positivity in females versus males was 58.2%: 54.2% and highest in indoor patients [92.3%]. ESBLs-production was highest amongst Escherichia coli [55.1%] followed by Klebsiella pneumoniae, [29.5%], Pseudomonas aeruginosa [9.0%], Aeromonas spp [2.6%]. The antibiotics showing best activity against ESBLs-producing K pneumoniae and E coli were beta lactam beta -lactamase inhibitors [piperacillin /tazobactam 100% and 80%-] and carbapenems [imipenem 100% each and meropenem 75% and 100%] respectively. ESBLs producing GNRs had a more antibiotic-resistant profile than non- ESBLs producers. They were not only resistant to beta-lactams but showed cross-resistance towards a wide variety of commonly used other antimicrobials. ESBLs producers are more resistant as compared to non-ESBLs producers. Considering the high prevalence of ESBLs in Enteric Gram-negative rods, it is suggested that all such isolates should be tested for the production of ESBLs in the routine microbiology laboratory

Frequency of enteric gram negative rods isolated from various clinical samples

To determine the frequency of gram negative rods in both nosocomial and community acquired infections in our setting. This descriptive study was conducted at the Microbiology Department of Fauji Foundation Hospital, Rawalpindi over a period of two years [April 2004 to March 2006]. All pus, urine, blood and HVS received during the study period were included. Samples without properly filled forms, dried swabs and improperly transported samples were excluded. Two thousand and ninety one Enteric Gram Negative Rods [EGNR] were isolated over a period of two years, They were most commonly found in urine samples [40.7%], followed by pus [37.1%], HVS [12.0%], sputum [6.12%] and blood [3.92%] samples. The most common EGNR isolated was Escherichia coli [49.7%] followed by Klebsiella pneumoniae [23.4%], Pseudomonas aeruginosa [19.5%] and Proteus species [1.81%]. The most commonly isolated Enteric Gram negative rod from urine samples [n 852] was E. coli [622] followed by Klebsiella pneumonia [189], Providentia [18] and Enterobacter species [13]. The most commonly isolated Gram negative rod from pus samples [n 852] was Pseudomonas aeruginosa [290] followed by E. coli [227], Klebsiella pneumoniae [18] and Proteus species. The most commonly isolated EGNR from HVS samples was E. coli [130] followed by Klebsiella pneumoniae [68] and Pseudomonas aeruginosa [51]. The most common EGNR found in sputum [n 128] was Klebsiella pneumoniae [56] followed by Pseudomonas aeruginosa [40] and E. coli [30]. In blood samples the most common organism isolated was E. coli, followed by Pseudomonas and Klebsiella.