Comparison between Thin Prep® Preparation (Liquid Based Cytology) and Conventional Pap Smears of Cervical Smear Cytology Lesions – A Study from Kanyakumari, Tamilnadu, India

BACKGROUND The major cause of mortality among women is cancer of the uterine cervix. It is the second most common cancer worldwide. Pap smear is done as a method of cervical screening to detect precancerous and cancerous lesions of the cervix. Early detection of these lesions prevent the number of deaths from cervical cancer. Liquid based cervical cytology was developed to improve the diagnostic accuracy of pap smears. The main purpose of this study was to compare the profile of distribution of cervical smear cytology lesions obtained by thin prep preparation (liquid based cytology) and conventional pap method among women in the age group of 25 – 60 yrs. METHODS This is a cross sectional study done among 110 women from the outpatient department of Obstetrics and Gynaecology. Conventional and liquid based cytology smears were taken simultaneously from the same women and reported according to the 2001 Bethesda system. RESULTS Majority of the women included in this study fall in the age group of 41 - 50 years [65 (59.1 %)]. Women with a history of persistant vaginal infection were 13 (11.8 %). Out of the 110 pap smears taken by both conventional and liquid based methods, unsatisfactory smears were not detected in liquid based cytology and 6 (5.5 %) unsatisfactory smears were found in conventional pap method. In liquid based cytology, inflammatory smears were detected more (80 %), atrophic smears (2.7 %), smears with features of atypical squamous cells of undetermined significance (ASCUS) were 4.5 %, low-grade squamous intraepithelial lesion (LSIL) were 3.6 %, and smears with high-grade squamous intraepithelial lesion (HSIL) were 0.9 %. Epithelial cell abnormalities were found to be high in liquid based cytology. CONCLUSIONS Abnormal epithelial lesions were detected more in liquid based cytology (thin prep method). The number of unsatisfactory smears were found to be decreased when compared to conventional pap method. KEY WORDS Bethesda Cervical Cytology, Cervical intraepithelial lesion, Conventional Pap Smear, Liquid Based Cytology Smear

Comparison of Staining Characteristics of Papanicolaou Stain and May-Grünwald-Giemsa Stain in Tzanck Smear Cytology

Introduction: Although the skin is more readily accessible to the cytological examination than any other organ, cytodiagnosis is much less frequently used in dermatology. Tzanck smears are routinely stained with May-Grünwald-Giemsa (MGG) stain. But, Papanicolaou (PAP) stain is known to yield polychromatic transparent staining with crisp nuclear and cytoplasmic features. Aim: To compare the staining characteristics of PAP stained and MGG stained Tzanck smears by using a scoring system. Materials and Methods: The present study was a cross- sectional study on Tzanck smears, conducted at a tertiary care referral Institute, PES Institute of Medical Sciences and Research (PESIMSR), Kuppam, Andhra Pradesh, India, from March 2016 to April 2017. In each case, two Tzanck smears were prepared. One smear was wet-fixed in isoproplyl alcohol and stained by PAP method. The other smear was air-dried and stained by MGG stain. Both the smears were evaluated for the staining characteristics by using a scoring system. The scoring system was indigenously designed for evaluating the stained sections. All the staining parameters such as contrast, cytoplasmic features, nuclear features and background were evaluated in the scoring system employed in the present study. Chi-square test and two sample t-test were used for statistical analysis. Results: Forty cases of Tzanck smears were analysed. Most common diagnostic entity was cutaneous infections in 18 cases (45%). The average scores of all the parameters of staining characteristics and the overall score were better in PAP stained smears than MGG stained smears. The p-values were statistically significant. Conclusion: PAP stain may be considered as a behooveful stain for the evaluation of Tzanck smear. It may be suggested that, although the PAP stained smears scored better than MGG statistically, both the stains may be used as complementary to each other.

Effect of Seaweed Ethanol Extract on Cholesterol Levels and Obesity in White Rats

Seaweed (EucheumaCottonii J. Agardh) is one of the biological resources found in coastal and marine areas. Seaweed contains secondary metabolites such as flavonoids, alkaloids, polyphenols and tannins which can reduce cholesterol levels in the blood. This study aims to determine the effect of seaweed ethanol extract on reducing cholesterol and obesity levels by comparing plasma cholesterol levels, body weight, and weight of vital organs (liver, kidneys and jantumg) of obese rats, mice given seaweed ethanol extract with normal mice . Rats were grouped randomly into 6 groups. group one was given 0.5% CMC Na, group two was given high fat diet food, group three was given simvastatin, group four was given seaweed ethanol extract 100 mg / kgbb, group five was given ethanol extract of seaweed 200 mg / kgbb and group six was given ethanol extract of seaweed 300 mg / kg with a long suspension of extract for 14 days. Measurement of cholesterol levels in the blood using the CHOD-PAP method, body weight and organs carried out by weighing. The results showed that seaweed ethanol extract has the effect of inhibiting an increase in plasma cholesterol levels and has anti-obesity potential at a dose of 300 mg / kgbb.

Colistin Heteroresistance among Extended Spectrum β-lactamases-Producing Klebsiella pneumoniae

Colistin-heteroresistant (CST-HR) Enterobacterales isolates have been identified recently, challenging the clinical laboratories since routine susceptibility tests fail to detect this phenotype. In this work we describe the first CST-HR phenotype in extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae isolates in South America. Additionally, we determine the genomic mechanisms of colistin heteroresistance in these strains. The CST-HR phenotype was analyzed by the population analysis profile (PAP) method, and mutations associated with this phenotype were determined by whole-genome sequencing (WGS) and the local BLAST+ DB tool. As a result, 8/60 isolates were classified as CST-HR according to the PAP method. From WGS, we determined that the CST-HR isolates belong to three different Sequence Types (STs) and four K-loci: ST11 (KL15 and KL81), ST25 (KL2), and ST1161 (KL19). We identified diverse mutations in the two-component regulatory systems PmrAB and PhoPQ, as well as a disruption of the mgrB global regulator mediated by IS1-like and IS-5-like elements, which could confer resistance to CST in CST-HR and ESBL-producing isolates. These are the first descriptions in Chile of CST-HR in ESBL-producing K. pneumoniae isolates. The emergence of these isolates could have a major impact on the effectiveness of colistin as a “last resort” against these isolates, thus jeopardizing current antibiotic alternatives; therefore, it is important to consider the epidemiology of the CST-HR phenotype.

Use of Immunohistochemistry in the differential diagnosis of Small Round Blue cell tumors.

Objectives: Objective of the study is to differentiate and sub-categorize malignant small round blue cell tumors by using immune-histochemistry. Study Design: Descriptive Observational study. Setting: Meezan Private Lab, Faisalabad, Pakistan. Period: 5 years, from July 2014 to June 2019. Material & Methods: Sample Size: 126 cases of Round blue cells tumors. Sampling Technique: Non probability purposive sampling. Data Collection Procedure: 126 cases which fulfilled the inclusion and exclusion criteria were selected for the study. All these cases were subjected to immunohistochemistry. The IHC technique used was based on Peroxidase anti-peroxidase (PAP) method. Based on site and morphological clues, initially Leukocyte common antigen (LCA), Myogenin, Cytokeratin (CK), Desmin, chromogranin, Neuron specific enolase (NSE), S-100, Smooth muscle actine (SMA) and CD99 were used. Further immune stains panels were used afterwards, as and when needed like CD20, CD3, CD30, BCL2, CD117, Ki-67, Tdt, synaptophysin, SMA, CD56, Melan A, HMB45 and WT1. Results: Out of 126 cases of small round blue cell tumors, 35 (27.8 %) cases were diagnosed as diffuse large B cell lymphoma, 6 as Lymphoblastic lymphoma, 4 as Burkitt’s lymphoma, and 6 cases as NK/T cell lymphoma. Ewing’s sarcoma/PNET (12/126, 9.5%) was the 2nd highest in frequency, followed by Rhabdomyosarcoma, Synovial sarcoma, Malignant melanoma, and Germ cell tumor, which were all 9/126 each with 7.1 %. Conclusion: Immunohistochemistry is an important tool for appropriate and clear differential diagnosis of malignant small round blue cell tumors of childhood.

PENGARUH DIET EMULSI VIRGIN COCONUT OIL (VCO) TERHADAP PROFIL LIPID TIKUS PUTIH (Rattus norvegicus)

<p>ABSTRAK</p><p>Virgin Coconut Oil (VCO) merupakan salah satu produk panganfungsional yang populer di masyarakat. Cita rasa VCO dapat diperkayadalam bentuk emulsi mengandung sari buah nenas. Penelitian inidilakukan untuk mengetahui pengaruh diet emulsi VCO terhadap profillipid tikus (Rattus norvegicus) yang sebelumnya diinduksi hiperlipidemiadengan lemak babi 180g/100g ransum dan kuning telur bebek dengandosis 4 ml/hari. Penelitian dilakukan bulan Januari sampai Desember 2009di Laboratorium Balai Penelitian Tanaman Kelapa dan Palma Lain(BALITKA), Laboratorium FMIPA Universitas Sam Ratulangi Manado,Laboratorium UPHP (Unit Penelitian Hewan Percobaan) UniversitasGadjah Mada Yogyakarta serta Laboratorium PAU IPB Bogor. Delapanbelas tikus dibagi secara acak ke dalam 3 kelompok (6 tikus perkelompok). Kelompok I adalah kelompok kontrol yang diberi akuades,kelompok II diberi diet emulsi VCO, dan kelompok III diberi diet VCOmurni. Kandungan kolesterol total, HDL, LDL, dan triasilgliserol diukursetelah akhir perlakuan dengan metode enzimatik. Kadar kolesterol totaldiukur menggunakan metode CHOD-PAP, kadar kolesterol LDLmenggunakan metode PVS, kadar kolesterol HDL menggunakan metodeCHOD-PAP dan kadar triasil gliserol menggunakan metode GPO-PAP.Hasil penelitian menunjukkan bahwa konsumsi 0,945ml/hari VCO dan3,78ml/hari emulsi VCO selama 7 hari dapat menurunkan kadar kolesteroltotal, kadar kolesterol LDL, serta meningkatkan kadar kolesterol HDLdarah tikus Wistar secara signifikan (=0,05), sedangkan penurunan kadartriasilgliserol hanya ditunjukkan oleh konsumsi emulsi VCO (=0,05).Dengan demikian, emulsi VCO yang diperkaya dengan sari buah nenasberperan lebih baik dari VCO murni dalam menurunkan kolesterol padahewan uji tikus.</p><p>Kata kunci: Virgin coconut oil (VCO), emulsi VCO, profil lemak</p><p>ABSTRACT</p><p>Effect of Virgin Coconut Oil (VCO) Emulsion Diet onLipid Profile of White Rats (Rattus norvegicus)</p><p>Virgin Coconut Oil (VCO) is a functional food product that ispopular in the society. VCO-emulsion is a VCO emulsified with pineapplejuice. This study was conducted to find out the effect of VCO-emulsiondiet on lipid profile of mouse (Rattus norvegicus) strain wistar which wasalready treated by inducting hyperlipidemia using lard (180g/100g) andyolk (4ml/days). This research was conducted from January to December2009 at the Laboratory of Coconut and Other Palm Trees ResearchInstitute (BALITKA), the Laboratory of FMIPA Sam Ratulangi UniversityManado, the Laboratory of Experiment Animal Research Unit GadjahMada University Yogyakarta, and the Laboratory of PAU IPB Bogor.Eighteen mice were randomly divided into 3 groups. Group I was thecontrol group treated with aquadest only, group II was treated with VCO-emulsion diet, and group III was treated with pure VCO diet. The contentof total cholesterol, HDL, LDL, and triacylglicerol were measured at theend of the treatment using enzymatic method. In this study, there weresome methods used for measurements: CHOD-PAP method for level oftotal cholesterol, PVS method for level of LDL cholesterol, CHOD-PAPmethod for level of HDL cholesterol, and GPO-PAP method for measuringlevel of triacylglicerol. The study results showed that diet of 0.945ml/daysof VCO and 3.78ml/days of VCO emulsion for 7 days significantlydecreased the level of total cholesterol and the level of LDL cholesterol,and increased the level of HDL cholesterol in the blood of Wistar mouse(α=0.05). Whereas it was shown that only by diet of VCO emulsion(α=0.05) decreased the level of triacylglicerol. Thus, VCO emulsionsignificantly lowered cholesterol in the experimental mouse better thanpure VCO diet only.</p><p>Key words : Virgin coconut oil(VCO) , VCO emulsion, lipid profile</p>

PENGARUH PEMBERIAN MINYAK IKAN GINDARA (Lepidocybium flavobrunneum) TERHADAP KADAR KOLESTEROL HDL TIKUS PUTIH HIPERKOLESTEROLEMIA

Gindara fish oil contains several active ingredients that are thought to increase HDL cholesterol levels in the blood. The increase in HDL cholesterol levels is caused by gindara fish oil containing ɷ-3, ɷ-6, and ɷ-9. Gindara fish oil content is around 12-20% of body weight. A study was conducted to determine the effect of Gindara fish oil (Lepidocybium flavobrunneum) on HDL cholesterol levels in hypercholesterolemic white mice fed high-fat feed. This research was conducted experimentally using 25 male white rats (Rattus novergicus, L.), aged 2-3 months with a weight of 150-200 g, which were divided into 5 random treatment groups, namely the K1 group (normal control) were fed standard, the K2 group (positive control) was given high-fat feed for 7 days, while the P1, P2, and P3 groups were given orally gindara fish oil at a dose of 54mg / 200gBB / day, 108mg / 200gBB / day, 216mg / 200g BW / day. Each treatment consisted of 5 mice which were examined 3 times the HDL cholesterol level by the CHOD-PAP method. Data obtained from the examination were analyzed using the Crucial Wallis test p 0.05 followed by a post hoct test. with Mann-Whitney. Research Results P1, P2, and P3 groups were significantly different from K1 (p = 0.008). Groups P1, P2, and P3 were significantly different from K2 (p = 0.008). Gindara fish oil with a dose of 54mg / 200g BW / day, 108mg / 200g BW / day, 216mg / 200g BW / day each can increase HDL cholesterol levels by 38% or 15.09 mg / dl, 50% or 25.92 mg / dl, and 59% or 34.51 mg / dl.

Prevalence of the carbapenem-heteroresistant phenotype among ESBL-producing Escherichia coli and Klebsiella pneumoniae clinical isolates

Objectives Carbapenem-heteroresistant (cHR) Enterobacteriaceae strains have been reported worldwide; however, the prevalence among clinical ESBL-producing Enterobacteriaceae isolates obtained from patients with repeated hospital admissions remains largely unknown. Methods Heteroresistance was screened by disc diffusion and confirmed by a modified population analysis profiling (PAP) method against ertapenem, imipenem, meropenem and ceftolozane/tazobactam. MIC testing was performed by broth microdilution against carbapenems and a panel of agents with potential activity against ESBL-producing strains. Results One hundred and seventy-three ESBL-producing meropenem-susceptible Escherichia coli and Klebsiella pneumoniae isolates were selected for testing. A total of 519 bacteria/carbapenem combinations were screened by disc diffusion; 84 combinations were identified as cHR. Modified PAP confirmed 70 bacteria/carbapenem combinations as heteroresistant; most (63%, 44/70) confirmed cHR colonies grew within the ertapenem zone of inhibition, followed by imipenem (30%, 21/70), then meropenem (7%, 5/70). In total, one-third of the unique patient isolates (32%, 55/173) were identified as being heteroresistant to at least one carbapenem; of those patients, 16% (9/55) had a carbapenem-non-susceptible isolate on subsequent visits. Only two cHR isolates screened positive for ceftolozane/tazobactam heteroresistance (1%, 2/173), of which one was confirmed heteroresistant by modified PAP. cHR isolates were more likely to be collected from a non-urinary source (e.g. respiratory) compared with non-cHR isolates (31% versus 19%, P = 0.02). MIC distributions of all tested antibiotic agents did not differ between non-cHR and cHR isolates. Conclusions Our findings raise concerns for the continued use of carbapenems as first-line therapy for ESBL infections and for the potential selection for strains with full carbapenem resistance.

Ekstrak Hibiscus rosa-sinensis L. Memperbaiki Kadar Glukosa Darah Puasa dan Jumlah Sel Mast pada Model Tikus Diabetes Terinfeksi Mycobacterium tuberculosis

Background: The condition of hyperglycemia in Diabetes mellitus (DM) causes a disruption of the function of phagocytes that can facilitate M. tuberculosis infection. Immunostimulant from natural ingredients can help improve the condition of hyperglycemia an immune function. Objective: To analyze the effect of Hibiscus rosa-sinensis L. extract on fasting blood glucose level and the number of mast cell in TB-DM mouse model. Methods: This experimental study used 27 male Wistar rats, 8 weeks of age, 200-230 g weight, divided into 3 groups, K: Normal control group, P1: TB-positive mouse group P2: Group rat TB-DM + Hibiscus rosa-sinensis L extract dose 250 mg/kgBW and 3 time measurement of H + 7 DM, H + 14 DM and H + 21 DM. TB-DM model mice were prepared with the administration of nicotinamide (NA) 100 mg/kgBW and streptozotocin (STZ) 65 mg/Kg BW, TB agent 1.5 x 105 CFU. Fasting blood glucose levels were measured by GOD-PAP method and Pulmonary tissue is excised, made in paraffin blocks and stained with blue Toluidine to count the mast cells. Results: There was an improvement in the mean fasting blood glucose levels in the group treated with the Hibiscus rosa-sinensis L. extract of 250 mg/kgBW compared to the TB-DM group without extract therapy followed by decreased the number of mast cell. Conclusion: Hibiscus rosa-sinensis L. extract. improves fasting blood glucose levels and decreases the number of mast cell of TB-DM rat model.

The Effects of Tempeh Gembus, an Indonesian Fermented Food, on Lipid Profiles in Women with Hyperlipidemia

Background: Hyperlipidemia is the major precursor of lipid-related diseases. Consumption of high fiber foods may decrease lipid profiles. The fiber content in tempeh gembus is three times higher than regular tempeh. Objective: This study was conducted to investigate the effect of tempeh gembus on lipid profiles in women with hyperlipidemia. Methods: This research used the quasi-experimental design with nonequivalent control group design. Subjects were 41 women with hyperlipidemia, classified into 3 groups: control group, treatment group 1 given 103 g/day tempeh gembus, and treatment group 2 given 206 g/day tempeh gembus for 14 days. All of the groups received nutrition education. Total cholesterol and HDL-C were determined by CHOD-PAP method, triglyceride determined by enzymatic GPO-PAP method after subjects had been fasting for approximately 10 hours. LDL-C was calculated by Friedewald equation. Results: These results showed that consumption of tempeh gembus 103 g/day and 206 g/day decreased LDL-C 27.9% and 30.9% as well as decreased total cholesterol 17.7% and 19.8% respectively. However, HDL-C increased 3.91% and 8.79% and triglyceride increased 2.3% and 3.1%. Tempeh gembus given 206 g/day was more effective to decrease total cholesterol and LDL-C than 103 g/day. Conclusion: Increasing tempeh gembus consumption in women with hyperlipidemia should be addressed to decrease LDL-C and total cholesterol.