Post-mortem pulmonary tuberculosis: comparison of available diagnostic methods.

Tuberculosis (TB) caused by Mycobacterium tuberculosis remains a serious public health threat with the World Health Organisation (WHO) reporting 5.8 million cases and 1.3 million deaths in the year 2020 due to TB. TB can be diagnosed by imaging, histopathological and bacteriological methods with culture remaining the gold standard. This study was performed to look at the sensitivity and specificity of post-mortem computed tomography (PMCT) imaging when compared to culture in diagnosing pulmonary tuberculosis. This was a retrospective comparative study looking at post mortem cases where lung tissue samples sent for TB culture at Hospital Kuala Lumpur were compared against PMCT imaging. Exclusion criteria included contaminated samples, decomposed cases, immunocompromised subjects and those below 18 years of age. Subjects included 80 medico-legal autopsy cases at the National Institute of Forensic Medicine, Hospital Kuala Lumpur, Malaysia who had whole body PMCT done in accordance with the Institute's protocol and tissue samples sent for bacteriology culture for tuberculosis. PMCT findings were positively associated with acid-fast organisms in 23.5 out of 33 cases (71.2%). Our study also showed that PMCT had a sensitivity of 71.3% and specificity of 54.3% (95% CI: 39.5-68.4) in diagnosing TB based on the protocol set in this study. This study showed that there was relatively good agreement between radiological PMCT findings and bacterial culture, suggesting that radiological examination is a relatively reliable tool for preliminary screening and possible diagnosis of TB prior to a postmortem examination which would be beneficial in reducing the risk of transmission of TB to health workers during autopsy.

Post-mortem pulmonary tuberculosis: comparison of available diagnostic methods

@#Tuberculosis (TB) caused by Mycobacterium tuberculosis remains a serious public health threat with the World Health Organisation (WHO) reporting 5.8 million cases and 1.3 million deaths in the year 2020 due to TB. TB can be diagnosed by imaging, histopathological and bacteriological methods with culture remaining the gold standard. This study was performed to look at the sensitivity and specificity of post-mortem computed tomography (PMCT) imaging when compared to culture in diagnosing pulmonary tuberculosis. This was a retrospective comparative study looking at post mortem cases where lung tissue samples sent for TB culture at Hospital Kuala Lumpur were compared against PMCT imaging. Exclusion criteria included contaminated samples, decomposed cases, immunocompromised subjects and those below 18 years of age. Subjects included 80 medico-legal autopsy cases at the National Institute of Forensic Medicine, Hospital Kuala Lumpur, Malaysia who had whole body PMCT done in accordance with the Institute’s protocol and tissue samples sent for bacteriology culture for tuberculosis. PMCT findings were positively associated with acid-fast organisms in 23.5 out of 33 cases (71.2%). Our study also showed that PMCT had a sensitivity of 71.3% and specificity of 54.3% (95% CI: 39.5–68.4) in diagnosing TB based on the protocol set in this study. This study showed that there was relatively good agreement between radiological PMCT findings and bacterial culture, suggesting that radiological examination is a relatively reliable tool for preliminary screening and possible diagnosis of TB prior to a postmortem examination which would be beneficial in reducing the risk of transmission of TB to health workers during autopsy.

Brain Metastasis of Atrial Myxoma: Case report.

Metastasis of an atrial myxoma to the brain is extremely rare. Thus far there are only 17 cases reported, including our present case. Most of the brain metastases manifest only in 3 to 6 decades, after an average time frame of one to two years after surgical removal of parental tumour. We present a case of brain metastases of atrial myxoma in a teenager of the youngest age among all reported cases, unusually as early as 15 years old. The progress of the metastatic process had been insidious for three years after heart surgery, The imaging demonstrated a rather sizeable tumour by the time when the patient is symptomatic. The location of the metastatic tumour is anyhow superficial to the cortical surface, enabling complete surgical excision of the tumour easily achievable with favourable outcome.

Recurrent bilateral orbital myositis: case report and review of the literature.

Orbital myositis in children is uncommon. Recurrence is a major challenge in management. An 11-year-old Malay girl who presented with bilateral orbital myositis with recurrent attacks of diplopia is reported.

Hepatotoxic potential of Malathion in the freshwater teleost, Cirrhinus mrigala (Hamilton).

Freshwater edible fish, Cirrhinus mrigala, were exposed to a sublethal concentration (3 microl/L) of commercial grade malathion (50% EC) for 5, 15, or 25 days. After each exposure period, the liver was removed to study biochemical alterations. An increase in free amino acids, protease activity, and acetylcholine (Ach) levels, in contrast to decrement in total, structural, and soluble proteins, and acetylcholine esterase (AchE) activity were observed at 5 and 15 days of exposure, but on day 25 of exposure, all values reached near normalcy. The restoration to normalcy implies that after 15 d of exposure, an oscillatory phase in protein turnover toward a more-synthetic phase seems to occur, leading to the establishment of recuperation and adaptation phenomena.

Sebaceous cell carcinoma of scalp - a rare presentation.

Sebaceous cell carcinoma of the skin is a rare malignancy of the skin appendages. Most commonly noticed in the orbital region. Extra orbital sebaceous cell carcinoma is extremely rare. The aggressive behavior of this tumor is still a matter of controversy. We present a case of sebaceous cell carcinoma in scalp region in young women.

Pancreatoblastoma: a rare tumour accidentally found.

A 15-year-old girl, who was previously well, complained of a mass in the abdomen after a minor motor vehicle accident. Physical and radiological investigations revealed a mass in the body of pancreas containing proteinaceous material and multiple nodules in both lobes of liver. Serological investigations for malignancy were normal. Histopathological examination of the resected specimen showed pancreatoblastoma. Pancreatoblastoma is an unusual malignant tumour seen in infants and children although rare cases have also been reported in adults. They are clinicopathologically distinct from adult pancreatic ductal carcinoma. The histogenesis, clinical features and treatment options are discussed along with presentation of the case.

Mucinous adenocarcinoma of the renal pelvis associated with lithiasis and chronic gout.

Diffusely-infiltrating mucinous adenocarcinoma of the renal pelvis associated with lithiasis and chronic gout is reported in a 61-year-old Malay man. The patient underwent left nephrectomy and vesiculo-lithotomy. This tumour is postulated to arise in response to chronic irritation of the urothelium.

Mature cystic teratoma: unusual presentation as anterior neck swelling.

The unusual presentation of a mature mediastinal cystic teratoma as an anterior neck swelling in a 29-year-old Malay woman is reported.

Cucumis trigonus Roxb. II. Diuretic activity.

An alcoholic extract of Cucumis trigonus was studied for its diuretic activity in albino rats using hydrochlorothiazide as a standard drug for comparison. The extract exhibited a dose-dependent saliuretic effect reaching a peak at 4 hours. Unlike hydrochlorothiazide, the extract does not affect potassium excretion.

Analgesic and anti-inflammatory activity in alcoholic extracts of Cucumis trigonus Roxburghii. A preliminary communication.

Alcoholic extract of Cucumis trigonus was studied for analgesic activity by tail clip method in mice with pethidine hydrochloride as standard drug and by hydrochloric acid-induced writhing in mice using sodium salicylate as standard drug for comparison. ED50 of the extract was found to be 2.5 +/- 1.9 and 2.5 +/- 1.7 mg/kg in the two methods, respectively. Anti-inflammatory activity was studied in carrageenin-induced oedema and cotton pellet-induced granuloma using phenylbutazone as a standard drug for comparison. In both the methods the extract exhibited statistically significant activity.

Utilization of audio-visual aids by family welfare workers.

PIP: Communication efforts have been an important component of the Indian Family Planning Welfare Program since its inception. However, its chief interests in its early years were clinical, until the adoption of the extension approach in 1963. Educational materials were developed, especially in the period 1965-8, to fit mass, group meeting and home visit approaches. Audiovisual aids were developed for use by extension workers, who had previously relied entirely on verbal approaches. This paper examines their use. A questionnaire was designed for workers in motivational programs at 3 levels: Village Level (Family Planning Health Assistant, Auxilliary Nurse-Midwife, Dias), Block Level (Public Health Nurse, Lady Health Visitor, Block Extension Educator), and District (District Extension Educator, District Mass Education and Information Officer). 3 Districts were selected from each State on the basis of overall family planning performance during 1970-2 (good, average, or poor). Units of other agencies were also included on the same basis. Findings: 1) Workers in all 3 categories preferred individual contacts over group meetings or mass approach. 2) 56-64% said they used audiovisual aids "sometimes" (when available). 25% said they used them "many times" and only 15.9% said "rarely." 3) More than 1/2 of workers in each category said they were not properly oriented toward the use of audiovisual aids. Nonavailability of the aids in the market was also cited. About 1/3 of village level and 1/2 of other workers said that the materials were heavy and liable to be damaged. Complexity, inaccuracy and confusion in use were not widely cited (less than 30%).^ieng