Tropical Journal of Pathology and Microbiology

Serum adiponectin among different stages of type 2 diabetes mellitus patients

2021-09-07T17:35:13+0530

Background: Type 2 diabetes mellitus is a chronic metabolic disorder that leads to micro and macrovascular complications. Nephropathy is the most common microvascular complication. For diagnosis of nephropathy in T2DM patients by using urinary albumin, this is not a sensitive and specific biomarker because it is elevated in other conditions. we aimed to evaluate the serum adiponectin for early detection of nephropathy in patients with type 2 diabetes mellitus.

Methods: A total of 60 subjects were included in the present study and further subdivided into 30 patients T2DM with normoalbuminuria, 30 patients with microalbuminuria. All the patients were included after obtaining institutional ethical permission and consent forms. Blood and urine samples were collected from all the subjects and proceed with further analysis. Appropriate statistical analyses were used for different types of data analysis.

Results: Increased levels of FBS, PPBS, HbA1C and serum adiponectin were observed in two groups of T2DM patients. Statistically elevated levels of serum Urea, Creatinine and Uric acid levels were observed in patients T2DM with microalbuminuria when compared to T2DM with normoalbuminuria. The serum adiponectin was positively correlated with FBS, PPBS, HbA1C, Urea, Creatinine, Uric Acid and Urinary Albumin in patients with two groups of T2DM.

Conclusion: This study concluded that measuring the serum adiponectin levels may be useful for the early detection of nephropathy in patients with T2DM.

Association of serum prostate-specific antigen with Complete Blood Counts in patients with prostatic cancer

2021-09-07T17:36:50+0530

Background: Prostate cancer is the second most common cancer and one of the most leading causes of death in men worldwide. The prostate-specific antigen (PSA) as a screening method showed that there has been a slight decrease in prostate cancer mortality. Effective biomarkers in screening and diagnosis would be beneficial for avoiding unnecessary operations. The predictive and prognostic value of complete blood count (CBC) has been manifested by recent studies. We aimed to determine the association of serum PSA with Complete blood counts in patients with prostate cancer.

Method: The present study included 100 subjects, 50 patients diagnosed with new prostate cancer and 50 patients with prostate cancer. All the was undertaken in the central diagnostic laboratory at VIMS and RC. Blood samples were collected from all the subjects after taken permission from the institutional ethics committee and consent form. The haemoglobin, RBCs, MCV, MCHC, RDW will be analysed by using laboratory standard methods (Beckman coulter LH-780) and The serum PSA levels are estimated by commercially available kits based on enzyme-linked immunosorbent assay (ELISA).

Results: In the present study found significantly elevated levels of a prostate specific antigen in both groups of prostatic cancer patients. The reduced levels of hemoglobin, red blood cells, platelets, neutrophils were observed in prostatic cancer patients when compared to newly diagnosed prostate cancer patients. The PSA levels were negatively correlated with total blood counts.

Conclusion: This study suggests that the elevated levels of prostate specific antigen were useful for diagnosis and prognosis of prostatic cancers, along with the monitoring of complete blood count may be useful for the treatment of patients with prostatic cancers.

A comparative study of various screening tests of Asymptomatic Bacteriuria in pregnant women attending Antenatal Outpatient Department’

2021-09-08T13:16:32+0530

Introduction: Urinary tract infections are the most common bacterial infections in pregnancy. Asymptomatic bacteriuria (ASB) refers to the presence of bacteria in the urine of an individual without symptoms of urinary tract infection. ASB which occurs in 2-11% of pregnancies is a major predisposition to the development of pyelonephritis.

Aims and objectives: The aims and objectives of the study were to: Study the effectiveness of various screening tests: urine microscopy, gram stain, catalase test, leukocyte esterase test and nitrite test and to compare their sensitivity, specificity, positive predictive value and negative predictive value. Materials and

Methods: The study included 500 pregnant women attending the outpatient department over 18 months. The urine samples collected in sterile containers were screened for urine microscopy, gram stain, catalase test, leukocyte esterase test and nitrite test. The samples were processed on CLED (Cysteine lactose electrolyte deficient) agar as the standard against which other screening tests are identified.

Results: Gram’s stain (89.34%) was the most sensitive of all and the least reliable test was the catalase test among the methods of screening tests.

Conclusion: Urine culture is considered to be the gold standard in detecting ASB in pregnant women. Gram’s stain of urine is a good screening test when compared to other screening methods. Screening for bacteria in all trimesters is necessary to prevent the dangerous complications associated with ASB.

Cytomorphological study of Benign breast lesions in a Tertiary Care Hospital

2021-09-29T10:58:15+0530

Background: Benign breast disease is one of the most common breast lesions in the reproductive age group. Fine needle aspiration cytology (FNAC) is one of the preliminary tests done to detect breast lesions which help in early detection and management. Studying the cytology features of various benign breast diseases was the aim of this study.

Methods: This study is a cross-sectional retrospective study conducted in the Department of Pathology from 2015 to 2020. Clinical details and cytology features were collected from the Department records.

Results: A total of 430 cases were collected during the study period. Age groups ranged from 16-40 years. All the cases were females. The spectrum of lesions was composed of fibroadenoma, fibrocystic change, breast abscess, fibroadenosis, granulomatous mastitis, etc.

Conclusions: Breast lumps are a common cause of anxiety and apprehension among patients. FNAC helps in rapid diagnosis and early management of lesions. It also helps in preventing unnecessary invasive surgeries in non-neoplastic and benign breast diseases.

The Spectrum of Malignant Breast lesions by Fine Needle Aspiration Cytology in a Teaching Hospital

2021-09-29T12:22:03+0530

Background: Fine needle aspiration cytology (FNAC) is one of the preliminary tests done to detect malignant breast lesions, which help in early detection and management. Studying the cytology features of various malignant breast diseases was the aim of this study.

Results: A total of 75 cases were collected during the study period. All the cases were females. The spectrum of lesions was composed of Ductal carcinoma followed by one point each of Mucinous carcinoma, Malignant Phyllodes tumour and Lobular Carcinoma.

Conclusions: FNAC helps in rapid diagnosis and early management of malignant breast lesions.

Comparison of various principles of coagulation tests in handling hemolysed blood samples

2021-09-29T13:03:08+0530

Background: Rejection of hemolysed samples for coagulation test is the standard practice. However, when clinicians deal with extremely sick patients where repeat sampling is difficult to obtain, rejection of the sample is a lost opportunity for the lab physician to assist inpatient care. Proceeding with the test and providing a clinically helpful interpretation of the results will ensure the active participation of the laboratory physician. Different principles of coagulation testing handle the hemolysed samples differently. It is essential to know the best principle to proceed with the hemolysed sample if need be. This study set out to estimate the predictive values of post-hemolytic sample coagulation test results with various coagulation test principles.

Methods: This is a prospective experimental study where the non-hemolysed samples were processed for coagulation tests. Part of the sample was deliberately hemolysed, and the coagulation tests were repeated.

Results: Two hundred and forty-eight samples were studied. A median of 11% hemolysis was achieved experimentally. The mean difference in prothrombin time between pre and post hemolytic samples with normal PT was 0.9 and with abnormal PT, it was 1.1 seconds. The same for APTT was 4.9 and 1.1 seconds, respectively. The majority of the samples showed prolonged coagulation post hemolysis. Positive (PPV) and negative (NPV) predictive values for prothrombin time are 97.3 and 73.4%, respectively. Similarly, PPV and NPV for APTT are 97.4 and 47.1%, respectively.

Conclusions: Samples with normal values after hemolysis are more likely to be normal.

Histopathological study of lower gastrointestinal tract lesions

2021-10-05T13:40:53+0530

Background: The benign lesions of the lower gastrointestinal tract are responsible for a large number of morbidities. The microscopic examination of and determination of histological types of malignant lesions help to decide treatment options and to predict prognosis. The histopathological study is the Gold standard for the diagnosis of intestinal lesions.

Aims and Objectives: To study the prevalence of various lower gastrointestinal tract lesions site-wise, age-wise and gender-wise and to compare the obtained results with other studies.

Materials and methodology: A retrospective study of 600 various lower gastrointestinal tract lesions sent for histopathological examination at Pathology department of tertiary care centre, VS General Hospital, Ahmedabad is carried out.

Results: Among all the 600 cases, non-neoplastic lesions 572 (95.34%) are far more common than neoplastic lesions 28 (4.66%).

Conclusion: Non-neoplastic lesions are common in the small intestine, while the large intestine harbors most malignant lesions.

Risk factors and microbiological features of surgical site infections

2021-10-06T16:48:53+0530

Background: Surgical site infections are the infections of the tissues, organs or spaces exposed by surgeons during the performance of an invasive procedure manifested in the postoperative period within 30 days after a surgical procedure and up to one year if an implant was placed in the patient. SSI is still higher in India as compared to western data leading to increased morbidity and mortality. This study aimed to analyse the factors associated with SSI and its microflora in a tertiary care centre.

Methods: A descriptive cross-sectional study was done for one year in a tertiary care centre in Bareilly, U.P. All the patients who underwent surgeries related to git pathology in the surgery department, either emergency or elective with surgical site infections, were included in this study. Patients less than 18, all cases operated else were, or re-operated were excluded from this study. All traumatic abdominal surgeries were also excluded from this study.

Results: The present study revealed SSI was associated with 82 (9.4%) cases among elective and 80 (21%) in emergency surgeries. Superficial incision SSI was found to be most common (90 cases), followed by deep incisional SSI (60 patients) and organ/space SSI (12 cases). Minor intestine surgeries were most commonly associated with SSI. The microbiological organism most widely isolated was E. Coli (41.2%), followed by Staphylococcus aureus (27.5%), Klebsiella (16.5%), group A beta-haemolytic Streptococci (9.1%) and Pseudomonas (5.5%).

Conclusions: Surgical site infection still causes considerable morbidity and high cost to the health care system and is becoming increasingly crucial in medico-legal aspects. Prevention of SSI requires a targeted approach to improve health care workers' knowledge, practising the guidelines strictly regarding asepsis and optimising the patient before surgery. Reduction in rate of SSI will improve cosmesis and make the results of operations better as a whole.

“The Study of Bacteriological Agents of Chronic Suppurative Otitis Media Aerobic Culture and Antibiotic Sensitivity Testing Pattern at a Tertiary Care Hospital in and around Rajamundry: A cross-sectional study”

2021-10-08T18:56:14+0530

Introduction: Chronic suppurative otitis media is a chronic infection of the middle ear and mastoid cavity which if not treated leads to partial or total loss of hearing and even life-threatening complications like meningitis and Intracranial abscess. Hence it is important to treat the persistent ear discharge in CSOM according to the antimicrobial sensitivity of the organism isolated.

Methods: This is a prospective cross-sectional study done in 135 clinically diagnosed patients of CSOM at GSL medical college and General Hospital, Rajamundry, Andhra Pradesh from May 2019 to October 2019. Sterile swabs were used to collect pus from discharging ear and were inoculated onto Blood and MacConkey agar for 24-48 hrs, and identification of organisms was done by using standard biochemical reactions and antibiotic sensitivity testing done by using modified Kirby- Bauer method as per CLSI guidelines.

Results: A total of 156 strains were isolated from 135 patients in the present study of which Pseudomonas aeruginosa and Staphylococcus aureus were amongst the most isolated pathogens in culture. Imipenem showed the most sensitivity against Pseudomonas, subsequently levofloxacin and piperacillin. Linezolid was the most sensitive versus Staphylococcus ensued by ciprofloxacin and cloxacillin.

Conclusions: In the present study of Chronic suppurative otitis media patients, Pseudomonas and Staphylococcus were highly prevalent and showed increased resistance to beta-lactams and commonly used antimicrobial drugs. Antimicrobials like imipenem, piperacillin, and quinolones are effective against most cases of chronic suppurative otitis media. Successful treatment and avoidance of antimicrobial resistance would be achieved by the appropriate use of antimicrobials with sufficient evidence.

Diagnosis of Sinus Histiocytosis with Massive Lymphadenopathy (Rosai-Dorfman Disease) by Fine Needle Aspiration Cytology in a Paediatric patient

2021-10-09T13:28:52+0530

Rosai-Dorfman Disease (RDD) is also known as Sinus Histiocytosis of Massive Lymphadenopathy (SHML). Clinically Rosai-Dorfman Disease is characterized by massive, painless, bilateral cervical lymph node enlargement, often mimics lymphoma. Microscopically, it shows dilatation of lymphatic sinuses occupied by numerous lymphocytes and proliferation of histiocytes with abundant pale eosinophilic cytoplasm containing engulfed lymphocytes or plasma cells- emperipolesis.