Distribution of HPV Genotypes in Patients with a Diagnosis of Anal Cancer in an Italian Region

Objectives: Anal cancer is a rare disease. However, its incidence is increasing in some population groups. Infection caused by Human Papillomavirus (HPV) is strongly associated with the risk of anal cancer, whose variability depends on samples, histology, and HPV detection methods. The aim of the study was to assess prevalence and distribution of HPV genotypes in patients diagnosed with anal carcinoma. Methods: An observational, retrospective study was carried out in a tertiary care hospital in North Sardinia, Italy. Specimens of anal cancer diagnosed from 2002–2018 were selected. Demographic, epidemiological, and clinical variables were collected to assess their relationship with the occurrence of anal cancer. Results: The overall HPV positivity was 70.0% (21/30), with HPV-16 being the predominant genotype (~85%). The highest prevalence of anal cancer was in patients aged ≥55 years. HPV positivity was higher in women (p-value > 0.05) and in moderately differentiated samples (G2) (p-value < 0.05). p16INK4a and E6-transcript positivity were found in 57% and 24% of the HPV positive samples, respectively. The OS (overall survival) showed a not statistically significant difference in prognosis between HPV positive sand negatives (10, 47.6%, vs. 4, 44.4%; p-value = 0.25). Conclusions: HPV-DNA and p16INK4a positivity confirmed the role of HPV in anal carcinoma. Our findings could support the implementation and scale-up of HPV vaccination in males and females to decrease the incidence of HPV-associated cancers. Further studies are needed to better clarify the prognostic role of HPV/p16 status.

Download Full-text

Seroprevalence of anti-SARS-CoV-2 IgG antibodies in hospitalized patients at a tertiary referral center in North India (Preprint)

10.2196/preprints.23937 ◽

2020 ◽

Author(s):

Dr. Animesh Ray ◽

Dr. Komal Singh ◽

Souvick Chattopadhyay ◽

Farha Mehdi ◽

Dr. Gaurav Batra ◽

...

Keyword(s):

Tertiary Care ◽

Age Groups ◽

Hospitalized Patients ◽

North India ◽

P Value ◽

Care Hospital ◽

Igg Antibodies ◽

Igg Antibody ◽

Increased Risk ◽

Significant Difference

BACKGROUND Seroprevalence of IgG antibodies against SARS-CoV-2 is an important tool to estimate the true extent of infection in a population. However, seroprevalence studies have been scarce in South East Asia including India, which, as of now, carries the third largest burden of confirmed cases in the world. The present study aimed to estimate the seroprevalence of anti-SARS-CoV-2 IgG antibody among hospitalized patients at one of the largest government hospital in India OBJECTIVE The primary objective of this study is to estimate the seroprevalence of SARS-CoV-2 antibody among patients admitted to the Medicine ward and ICU METHODS This cross-sectional study, conducted at a tertiary care hospital in North India, recruited consecutive patients who were negative for SARS-CoV-2 by RT-PCR or CB-NAAT. Anti-SARS-CoV-2 IgG antibody levels targeting recombinant spike receptor-binding domain (RBD) protein of SARS CoV-2 were estimated in serum sample by the ELISA method RESULTS A total of 212 hospitalized patients were recruited in the study with mean age (±SD) of 41.2 (±15.4) years and 55% male population. Positive serology against SARS CoV-2 was detected in 19.8%patients(95% CI 14.7-25.8). Residency in Delhi conferred a higher frequency of seropositivity 26.5% (95% CI 19.3-34.7) as compared to that of other states 8% (95% CI 3.0-16.4) with p-value 0.001. No particular age groups or socio-economic strata showed a higher proportion of seropositivity CONCLUSIONS Around, one-fifth of hospitalized patients, who were not diagnosed with COVID-19 before, demonstrated seropositivity against SARS-CoV-2. While there was no significant difference in the different age groups and socio-economic classes; residence in Delhi was associated with increased risk (relative risk of 3.62, 95% CI 1.59-8.21)

Download Full-text

ACUTE MYOCARDIAL INFARCTION;

The Professional Medical Journal ◽

10.29309/tpmj/2013.20.03.700 ◽

2013 ◽

Vol 20 (03) ◽

pp. 332-340

Author(s):

ATIF SITWAT HAYAT ◽

MUHAMMAD ADNAN BAWANY ◽

JAWAD AHMED QADRI ◽

Kiran Khalil

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Heart Block ◽

Complete Heart Block ◽

Tertiary Care ◽

Anterior Wall ◽

P Value ◽

Inferior Wall ◽

Care Hospital ◽

Significant Difference

Background: Ischemic heart disease is the most common cause for complete heart block (CHB) and sudden death. Heartblocks may occur as complications of acute myocardial infarction (AMI) and are associated with increased mortality. The aim of thisstudy is to determine the frequency of complete heart block (CHB) in acute myocardial infarction at a tertiary care hospital. Place andduration: This study was conducted in Cardiology Department of Liaquat University of Medical and Health Sciences from 1st August2009 to 31st January 2010. Study Design: Cross sectional and descriptive study. Materials and Methods: ST segment elevation equal toor more than 1mm (0.1mv) in two of these leads II, III and aVF. Rise in serum creatinine kinase level (CPK Level) more than twice thenormal value along with CK-MB fraction more than 6% of CPK value. Patients with history of chest pain, shortness of breath, nausea,vomiting and unconsciousness were enrolled in the study. The cardiac enzymes tropinin T was also performed at bed side by venousblood sample. Results: Total of 87 patients were included, prevalence of heart blocks was 27.58%. Anterior wall MI was in 50(57.5%)patients. Of these, 13(54.2%) had complete heart block. Inferior wall MI was in 37(42.5%) cases, of these, 11(45.8%) were found withcomplete heart block. There was no significant difference between anterior wall MI and inferior wall MI with complete heart block (P value> 0.05). Mortality was 2.3% with anterior wall MI. Conclusions: Development of complete heart blocks has important prognosticsignificance. Complete heart block was frequent complication of myocardial infarction.

Download Full-text

Italian observational study on HPV infection, E6, and p16 expression in men with penile cancer

Virology Journal ◽

10.1186/s12985-020-01424-9 ◽

2020 ◽

Vol 17 (1) ◽

Author(s):

Narcisa Muresu ◽

Giovanni Sotgiu ◽

Laura Saderi ◽

Illari Sechi ◽

Antonio Cossu ◽

...

Keyword(s):

Penile Cancer ◽

Tertiary Care ◽

Hpv Infection ◽

Molecular Techniques ◽

Care Hospital ◽

Hpv 16 ◽

Hpv Dna ◽

Diagnosis And Prognosis ◽

Significant Difference

Abstract Background Human Papillomavirus (HPV) infection is one of the most important causes of cancer. It can play a role in cervical and extra-cervical cancers. Penile cancer is rare, even if an increasing trend was recently reported. Aim of the present study was to assess the prevalence and distribution of HPV genotypes in cases of penile cancer diagnosed in Sardinia, Italy. Surrogate markers of HPV infection (i.e., E6 and p16 genes) were also evaluated in all cases. Methods An observational, retrospective study which recruited all cases of penile cancer diagnosed between 2002 and 2019 at a tertiary care hospital in Sardinia, Italy, was carried out. HPV-DNA detection and genotyping were performed by Real-time PCR. Specimens were tested for oncogene E6 mRNA and for p16(INK4a) expression. Results HPV prevalence was 28.1% (9/32); HPV-16 was the most prevalent genotype (7/9, 77.8%). p16INK4a positivity was found in 66.7% of the samples with a statistically significant difference between HPV-positive and -negative groups. E6-transcript was detected in 71% of the HPV-16 positive samples. The overall survival was not statistically different between HPV-positives and -negatives. Discussion The present study confirms the etiologic role of HPV in penile cancer and supports the adoption of vaccination strategies in men and women. Further studies should clarify the diagnostic and prognostic role of E6 and p16 proteins. Conclusion HPV infection can favor the occurrence of penile cancer, whose diagnosis and prognosis could be improved with the implementation of validated molecular techniques.

Download Full-text

Surgical-site infections in emergency abdominal paediatric surgeries at a tertiary-care hospital in Pakistan

Journal of the Pakistan Medical Association ◽

10.47391/jpma.1107 ◽

2020 ◽

pp. 1-9

Author(s):

Ali Faisal Saleem ◽

Huma Faiz Halepota ◽

Hasaan Omar ◽

Areeba Zain ◽

Muhammad Arif Mateen Khan

Keyword(s):

Abdominal Surgery ◽

Surgical Site Infection ◽

Tertiary Care ◽

Stable Condition ◽

University Hospital ◽

P Value ◽

Care Hospital ◽

Site Infection ◽

Significant Difference ◽

Pathogen Occurrence

Abstract A retrospective chart review was carried out in children (neonates to 18 years) who underwent acute surgical abdominal exploration during 2012-2016 at the Aga Khan University Hospital, Karachi, to evaluate the post-operative surgical site infection rates in emergency paediatric abdominal surgery. Incidence of surgical site infection (SSI) was estimated. P-value was calculated, chi-square and non-parametric tests were performed by comparing pre-surgical and post-surgical procedure pathogen occurrence and pre-procedure wound status. Pathogen occurrence related to time-trend of 98 paediatric patients who underwent emergency abdominal surgery was plotted. Of the 94 who were discharged in stable condition, it was found that there was no significant difference between pre- and post-surgical pathogens. Escherichia coli (n=10) was found to be the most common pathogen. Contaminated wounds were associated with higher SSI (p=0.036, OR 1.95 95% CI 0.7-5.4). Continuous...

Download Full-text

Prostatic lesions: Histopathological study in a tertiary care hospital

Journal of Manmohan Memorial Institute of Health Sciences ◽

10.3126/jmmihs.v4i1.21133 ◽

2018 ◽

Vol 4 (1) ◽

pp. 12-19

Author(s):

S. Bhatta ◽

S. Hirachan

Keyword(s):

Histopathological Examination ◽

Benign Lesion ◽

Tertiary Care ◽

Histopathological Study ◽

P Value ◽

Care Hospital ◽

Significant Difference ◽

Nodular Hyperplasia ◽

Malignant Lesions ◽

The Mean

Background: Prostatic lesions like Nodular hyperplasia of prostate, inflammation and carcinoma are common causes of morbidity and mortality in males. The incidence of these lesions increases with age. This study was conducted with the objective of evaluating histopathological pattern of prostatic lesions.Methods: This was a retrospective study conducted at KIST Medical College from Jan 2014 to Jan 2018. The study included ninety six prostatic specimens received in department of pathology. Hematoxylin and Eosin stained slides were retrieved and reviewed. The specimens and slides were analyzed according to type of specimen, age of patient, histopathological pattern and final diagnosis. Results were analyzed using Statistical Package for Social Science (SPSS, version 21) for Windows. Independent t test was used to correlate the mean age between patients with benign and malignant lesions. P value less than 0.05 was considered as statistically significant.Results: The most common benign lesion was nodular hyperplasia of prostate 86(89.58%). Malignant lesions comprised 8 (8.34%) cases of all prostatic lesions. All the cases of prostate carcinoma were adenocarcinoma. The most frequent Gleason score was 9. Mean age for benign and malignant lesions were 69.6 ± 8.1 years and 72.9 ± 5.2 years respectively. There was no significant difference in the mean age between patients with benign and malignant lesions (p value 0.27).Conclusion: Benign lesions of prostate are more common than malignant lesions. Histopathological examination of prostate specimens have important role in diagnosing various benign and malignant lesions, especially to rule out incidental carcinoma.JMMIHS.2018;4(1):12-19

Download Full-text

CORRELATION BETWEEN HRCT SCORE AND SERUM FERRITIN IN COVID-19 PATIENTS WITH PNEUMONIA IN TERTIARY CARE HOSPITAL, MGM HOSPITAL AURANGABA

10.36106/paripex/7401843 ◽

2021 ◽

pp. 52-54

Author(s):

Saurabh Govind Pad ◽

Devidas Dahiph ◽

Saurabh Kakani ◽

Vimal Dugad

Keyword(s):

Serum Ferritin ◽

Pearson Correlation ◽

Tertiary Care ◽

P Value ◽

Care Hospital ◽

The Social ◽

Severe Group ◽

Positive Correlations ◽

Age Range

This study was aimed to correlate the HRCT score and serum ferritin in diagnosed cases of COVID19 patients with pneumonia.During the pandemic of COVID-19,there was sudden surge in the numbers of HRCT chest scans and along with this amongst the various laboratory investigations serum ferritin was done to observe the role of cytokines which helps in disease progression.The main purpose of this study was to correlate the severity of disease on HRCT chest scan with serum ferritin levels. Aim:To correlate the HRCT score and serum ferritin in diagnosed cases of COVID19 patients with pneumonia. Materials and methods: We included 59 patients (38 men, 21 women age range 18-78years) with documented COVID19 were reviewed. All patients underwent RTPCR tests and had a noncontrast HRCT scan done at presentation. Estimation of serum ferritin was analyzed by using chemiluminescence method.The subjects were divided into three groups:mild,moderate and severe on the basis of HRCT score. Each group's HRCT score correlated with serum ferritin. The details were recorded on a prestructured proforma. The Pearson correlation coefficient test was used for correlations, and p value less than 0.05 was defined as statistically significant.The data was analyzed using Statistical Package for the Social Sciences (SPSS). Results: Out of 59 patients,21 patients were included in the mild group,31 were included in the moderate group and 7 were included in the severe group.CT severity score was found to be positively correlated with ferritin levels (p < 0.001). Strong positive correlations were found between CT scores and serum ferritin in mild (r = 0.84),Moderate (r = 0.92) and severe group (r = 0.082)

Download Full-text

BREASTFEEDING TEMPORAL DISTRIBUTION TRENDS AMONG NEONATES IN TERTIARY CARE HOSPITAL IN LAHORE

Journal of University Medical & Dental College ◽

10.37723/jumdc.v12i2.538 ◽

2021 ◽

Vol 12 (2) ◽

Author(s):

Hamid Mehmood ◽

Zarmast Khan ◽

Abdul Rauf ◽

Ammara Waqar

Keyword(s):

Tertiary Care ◽

Mode Of Delivery ◽

Temporal Distribution ◽

P Value ◽

Care Hospital ◽

Chi Square ◽

Cross Sectional ◽

Factors Affecting ◽

Significant Difference ◽

Initiation Of Breastfeeding

ABSTRACT BACKGROUND & OBJECTIVE: Breastfeeding provides immunity against bacterial, viral, and other infectious diseases. More than four million new neonates die due to vaccine-related diseases in the first 28 days of their lives. It is therefore emphasized that breastfeeding in the first hours after delivery may save the neonate. The objective of this study was to determine the factors affecting the pattern of breastfeeding among the neonates and assess the frequency of early breastfeeding among neonates at Gulab Devi Hospital, Lahore. METHODOLOGY: It was a cross-sectional descriptive study. One hundred mothers were selected through convenient purposes sampling. Chi-square test applied for an association between mode of delivery and initiation of breastfeeding. RESULTS: The result of the study showed variability in the time of breastfeeding by the mothers from one hour to 24 hours after delivery. Pre-lacteal was given to 59 mothers, while 41 were not given with any pre-lacteal. A significant association was found between mode of delivery and initiation of breastfeeding with a p-value less than 0.001 CONCLUSION: The result of the study showed that variability in the time of breastfeeding by the mothers from one hour to 24 hours after delivery provided a significant difference in the production of the neonate in the first 28 days.

Download Full-text

Factors influencing Outcome of Extradural Hematoma in a Tertiary Care Hospital of Dera Ghazi Khan, Pakistan

The International Journal of Frontier Sciences ◽

10.37978/tijfs.v5i1.309 ◽

2020 ◽

Vol 5 (1) ◽

Author(s):

Liaqat Jalal ◽

Atta-ur-Rehman Khan ◽

Muhammad Shaukat Farooq ◽

Muhammad Tahir Nouman

Keyword(s):

Developing Countries ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

P Value ◽

Care Hospital ◽

Extradural Hematoma ◽

Medical College ◽

Poor Outcome ◽

Factors Influencing ◽

Significant Difference

Background: The outcome for this neurosurgical problem is still far from set target in many developing countries like Pakistan. Major proportion of cases presenting with EDH in hospital still has poor outcome. This poor outcome of EDH is attributed to many factors including weak health systems of most developing countries. Objective of study was to analyze factors influencing outcome among patients of head injury with an extradural hematoma before surgery admitted in neurosurgery department of Dera Ghazi Khan Medical College, Dera Ghazi Khan. Materials and Methods: This cross-sectional analytical study was conducted in neurosurgery department of Dera Ghazi Khan Medical College from January 2019 to December 2019 after ethical approval. All the patients with extradural hematoma of either gender admitted in the department during the study duration in which surgery was performed to evacuate extradural hematoma were included in the study. Data was collected by using preformed, pretested questionnaire. A vital signs and Glasgow coma scale record was maintained at thirty minutes interval. Computerized tomography was done in every patient. The EDH volume was calculated by using Peterson and Epperson equation a x b x c x 0.5. Data was entered and analyzed by using SPSS version 22. Chi square test was applied to observe any statistically significant difference between various strata if existed and p value <0.05 was taken as significant. Results: Total 237 patients with Extradural Hematoma (EDH) were admitted in neurosurgery department during the study period were included in study. More than half 136 (57.4%) patients were more or equal to the age of 18 years. Majority of the patients 218 (91.9%) in the study were male. Major cause of extradural hematoma among patients in this study was road traffic accident 154 (64.9%). The outcome of EDH was found to be significantly (p <0.001) associated with age of patients. More than ninety percent of the patients who were directly admitted to tertiary care hospital has good outcome as compared to 109 (60.2%) patients which were referred and difference in outcome was statistically significant (p<0.001). The volume of EDH is not significantly associated with the outcome (p=0.090). The GSC score of the patients at the time of admission is significantly associated with the outcome (p<0.001). Study findings showed that GCS score of the patients at the time of surgery was also found to be significantly associated with outcome of EDH (p<0.001). Conclusion: There is a strong association of outcome in extradural hematoma with age, gender and GCS of the patient. In higher GCS the outcome was excellent but in low GCS the outcome was poor.

Download Full-text

Recurrent Bacteria Involvement in Urinary Tract Infection among Diabetic Female Patients of Sukkur, Sindh

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i39b32199 ◽

2021 ◽

pp. 229-234

Author(s):

Samina Tarique ◽

Abdul Hussain Shar ◽

Syed Fiaz Hussain ◽

Akhtar Ali

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Tertiary Care ◽

P Value ◽

Care Hospital ◽

Cross Sectional ◽

E Coli ◽

Female Patients ◽

Significant Difference

Background: Diabetics are four times more prone to develop Urinary tract infection when compared to healthy individuals, the proposed risk factors behind this increase in susceptibility in diabetics are autonomic neuropathy resulting in incomplete emptying of bladder and glucose in urine which serves as a medium for bacterial growth. The aims of our study are to identify the frequency of recurrent UTI and to document most common prevalent organisms involved in UTI in diabetic females in tertiary care hospital of Sukkur. Methodology: It was a cross sectional study conducted at Microbiology Department of Shah Abdul Latif University Khairpur from January to December 2020. The sample size n=54 was calculated by open epi software. Participants who contented inclusion criteria i.e., female patients of age >18 years with diabetes mellitus for more than 5 years who were presented in OPD with UTI along with history of three positive urine cultures in the previous 12 months or two episodes in the last six months were recruited by simple random sampling technique. The urine samples were collected in sterile containers and the growth of organisms was observed on nutrient agar and MacConkey agar plates. Results: There was no any significant difference among occurrence of bacteria between both the groups i.e . However, the most associated microbes with uncontrolled HbA1c profile were E. coli (p-value = 0.004) followed by Micrococcus lutes (p-value = 0.021) and Shigella (p-value = 0.001). Table 1. Shows the frequency and percentages of bacteria associated with controlled and uncontrolled HbA1c levels. Conclusion: Most of the participants had uncontrolled diabetic profile i.e. HbA1c > 7, the prominent pathogen at our setting were E. Coli, Enterococcus species, Shigella species and Micrococcus lutes.

Download Full-text

Procalcitonin as a biomarker of bacterial infection in critically ill patients admitted with suspected Sepsis in Intensive Care Unit of a tertiary care hospital

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.37.7.4183 ◽

2021 ◽

Vol 37 (7) ◽

Author(s):

Afshan Bibi ◽

Nida Basharat ◽

Muhammad Aamir ◽

Zujaja Hina Haroon

Keyword(s):

Intensive Care ◽

Blood Culture ◽

Bacterial Infection ◽

Critically Ill ◽

Positive Blood Culture ◽

Critically Ill Patients ◽

Tertiary Care ◽

P Value ◽

Care Hospital ◽

Significant Difference

Objective: To compare the diagnostic accuracy of procalcitonin (PCT), C- reactive protein (CRP), total leukocyte count (TLC) and lactate in critically ill patients admitted with suspicion of sepsis. Methods: It was a cross sectional study conducted at the department of Chemical Pathology and Endocrinology AFIP, Rawalpindi, in collaboration with Medical and surgical intensive care units (ICU) of CMH Rawalpindi from January 2019 to December 2019. A total of 126 patients of both genders with age above 18 years and fulfilling the inclusion criteria of systemic inflammatory response syndrome (SIRS) were inducted in the study. Results: Out of 126 patients 82 (65%) patients have positive blood culture results. Male predominance was noted in patients with positive blood culture. Out of 82 patients with positive blood culture results 69(84%) patients have positive PCT results as well whereas 13(15%) patients with positive blood culture results have negative PCT values. 57(69%) patients had Gram negative bacterial infection and 25(30%) patients had Gram positive bacterial infection. Significant difference was noted between the medians of PCT in blood culture positive and blood culture negative group (p value< 0.05) whereas no significant difference was found between medians of CRP, TLC and lactate between blood culture positive and blood culture negative patients (p value > 0.05). ROC curve analysis of PCT, CRP and TLC were done, keeping blood culture as reference standard, PCT showed largest area under the curve (AUC) and clearly outperformed TLC and CRP. PCT showed AUC of 0.781 as compared to CRP and TLC, which was 0.568 and 0.617 respectively. PCT showed sensitivity of 93.9%, specificity of 47.7%, positive predictive value (PPV) of 77% and negative predictive value (NPV) of 80.8%. Conclusion: Higher NPV makes it a reliable marker for screening out sepsis in suspected cases. doi: https://doi.org/10.12669/pjms.37.7.4183 How to cite this:Bibi A, Basharat N, Aamir M, Haroon ZH. Procalcitonin as a biomarker of bacterial infection in critically ill patients admitted with suspected Sepsis in Intensive Care Unit of a tertiary care hospital. Pak J Med Sci. 2021;37(7):---------. doi: https://doi.org/10.12669/pjms.37.7.4183 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Download Full-text