Diagnostic Accuracy of Different Histological Stains for Helicobacter Pylori Detection, taking Immunohistochemistry as Gold Standard

Aim: Helicobacter pylori infection has been ascertained to play pivotal role in the pathogenesis of chronic gastritis and gastric neoplasia.1The present study was performed to evaluate the diagnostic accuracy of H&E stain and Giemsa stain for the histological diagnosis of helicobacter pylori by taking immunohistochemical staining as a gold standard. Methods: A total of 155 cases were included in our study. The received biopsies were fixed in 10% buffered formalin, grossed and stained with H&E and giemsa stain. A board of histopathologists analyzed the morphological details to ascertain the diagnosis. The biopsies were stained by using immunohistochemical techniques against H. pylori antigens, and the procedure was performed according to the guidelines provided by the manufacturer considering the appropriate positive and negative controls for staining. IHC staining was evaluated autonomously and recorded on the proforma as positive and negative cases. Results: In our study, mean age was calculated as 38.4±11.57 years, 74(47.74%) were male and 81(52.26%) were females, frequency of H.Pylori on gold standard was recorded as 109(70.32%), the diagnostic accuracy of hematoxylin-eosin stain for helicobacter pylori detection by taking immunohistochemical staining as a gold standard measure was calculated as 63.30%, 65.22%, 81.18%, 42.86% and 63.87% for sensitivity, specificity, positive predictive value, negative predictive value and accuracy rate respectively, while these findings were recorded as 74.31%, 80.43%, 90%, 56.92% and 76.12% for Giemsa stain. Conclusion: We concluded that the diagnostic accuracy of H&E and Giemsa stains for detection of HP is promising and cost-effective method in our population. MeSH words: Helicobacter pylori, Immunohistochemistry, Hematoxylin, Pathology, Diagnosis

A COMPARATIVE ANALYSIS OF FNAC AND BIRADS IN EVALUATION OF PALPABLE BREAST LUMP

Breast lump is one of the most common complaint among female patients in India. FNAC is one of the important preoperative diagnostic modality in case of breast lesion. Correlation between BIRADS category and cytological findings are useful to establish an accurate preoperative diagnosis and further treatment protocols. In the present study, FNAC smear were stained by Leishman & Giemsa stain. Reporting was done in correlation with BIRADS category. Our study consisted of 80 cases of palpable breast lesions, of which 54 were benign and 26 malignant. The study showed overall 8 1.25% concordance with BIRADS category

Prevalence of Helicobacter pylori infection and its Associated Risk Factors among symptomatic Residents of Sulaimani city, Kurdistan region, Iraq, 2020

Helicobacter pylori (H. pylori) bacteria are a microaerobic Gram negative that colonizes in the gastric and duodenum of human. It can cause prolong infection in the human life if not treated. Many of the studies showed that infection by H. pylori can cause some important gastrointestinal illness, such as peptic ulcer, chronic gastritis, gastric adenocarcinoma and mucosa associated lymphoid tissue lymphoma. Recurrence is generally considered as H. pylori recrudescence infection after one year of eradicated treatment. There are many factors involved in the H pylori reinfection, such as the epidemiology of H. pylori infection, condition of the live, development of economical state, and health conditions. The Objectives of this study were to estimate the incidence and determine the risk factors of infection by H. pylori bacteria in dyspeptic patients in Sulaimani city. And the Aims are to estimate prevalence of the Helicobacter pylori and patients’ characteristics in Sulaimani city. This is a cross-sectional study, using a Urea breath test or stained the gastric sample with Giemsa stain, which is including adult participants aged (12-87) years during the period starting from 1 January until 31 December 2020 on Iraqi male and female patients were visiting –Center for Gastroenterology and Hepatology in Sulaimani, city, Iraq. Three hundred and four patients were included, all of them underwent Urea breath test only but eighty-one of the participants underwent endoscopy and stained the gastric sample with Giemsa stain. Urea breath test for Helicobacter pylori was positive in54.9% which have significant correlation with risk factor findings. Results: the incidence rate of H. pylori infection in our study is 54.9%, and mean age of the study participants was (40.49 ±16.39) one hundred and ninety-one cases 62.8% were female and 113 cases 37.2%were male. Infection by H. pylori bacteria is rife in dyspeptic patients; and is more common in the age group of 31-40 years. One of noninvasive test to diagnosis H. pylori is Urea breath test. In conclusions the rate of helicobacter pylori infection in our study is 54.9% among the symptomatic patients, and the overall incidence of H. pylori UBT and Giemsa stain detection rate were 73.4 and 26.6% respectively.

To study cytomorphological details in case of autoimmune thyroiditis

Various smears were readied, air-dried and fixed in ethanol for staining by May-Grunwald-Giemsa stain and Papanicolaou staining strategy. A nitty gritty assessment of the cytologic smears was done and includes like cellularity, sum and nature of colloid, Hurthle cell change, anisonucleosis of follicular cells, range of receptive lymphoid cells and other incendiary cells like eosinophils, macrophages, goliath cells and epithelioid cells were noted. Thyroid capacity tests were finished utilizing COBAS E analyser.In our study we found, 82% Females whereas 18% Males. Lymphocytic Thyroiditis 42%, Granulomatous Thyroiditis 31 & Hashimoto’s Thyroiditis 27%. Types of swelling and diagnosis with painless 71 % and painful 29 %. Cross-sectional Observational Study. A total of 200 thyroiditis cases studied with detailed history, thorough clinical examination and relevant blood investigations like Thyroid Profile were being done. The various studies on the correlation of cytomorphological spectrum and antithyroglobulin antibodies in autoimmune thyroiditis cases all acreoss the globe have great variations in their findings.

Multiattribute Analysis of Trichomonas vaginalis Diagnostics and Its Correlation with Clinical Complaints and Contraceptive Methods in a Symptomatic Egyptian Cohort

Background. Trichomonas vaginalis (T. vaginalis) infection has been long considered among the sexually transmitted diseases that possesses a clear effect on women’s health especially in the childbearing period. Methods. A 234 females of age range 18-45 years old attending the Gynecology and Obstetrics Outpatient Clinic of Kasr El Aini Hospitals were enrolled in a cross-sectional study. The taken vaginal swabs were subjected to wet mount microscopy, Giemsa stain, modified Diamond’s culture, and nested polymerase chain reaction (nPCR) amplification. Multiattribute and analytical hierarchy processes were conducted to detect laboratory utility. Univariate and multivariate analyses were done to detect the multiple risk factors that may be associated with Trichomonas infection. Results. Based on nPCR, the prevalence of trichomoniasis was 26.9%. Wet mount, Giemsa stain, and culture showed 100% specificity but of low sensitivity (28.57%, 28.57%, and 57.14%, respectively). On the multivariate analysis, nPCR showed the highest rank for diagnostic performance and culture had the lowest rank. For univariate analysis, there was a significant correlation between T. vaginalis infection and vaginal discharge, burning sensation, dyspareunia, and the use of intrauterine device (IUD) ( P value < 0.05). Conclusion. The routine screening of trichomoniasis using nPCR was reliable, sensitive, and specific. Also, it could financially be considered a more suitable option in batch screening. Significant higher rates of infection were reported among IUD users compared to condom or hormonal-based methods.

Nocardiosis in Cats - Clinical, Anatomopathological and Morphotintorial Characteristics

Background: Nocardiosis is an infectious bacterial disease that can cause cutaneous/ subcutaneous, pulmonary and systemic lesions in different species of domestic animals. The type of transmission occurs through mechanical lesions on the skin or contamination of wounds, in cases of skin involvement, inhalation of aerosols and ingestion of contaminated materials are involved in the pathogenesis of the respiratory and digestive form of the disease. This paper described 4 cases of nocardiosis in cats, addressing the clinical, anatomopathological and morphotintorial characteristics of Nocardia sp.Cases: Four cases of nocardiosis in cats were reviewed, in which data related to breed, sex, age, origin, clinical signs, macroscopic and histological lesions described in necropsy protocols were evaluated. The histological tissue sections stained with Hematoxylin and Eosin (HE) were evaluated in order to characterize the inflammatory response in each case. In addition, paraffin blocks of fragments from affected organ were selected to perform special histochemical staining techniques of Grocott Methenamine Silver (GMS), modified Ziehl-Neelsen, Gram Brown-Brenn and Giemsa stain which are the most characterized techniques used for histopathological diagnoses and it was also used an immunohistochemical test with polyclonal antibody anti-Nocardia sp. (non-commercial). The animals were adults of both sexes, mixed breed, not castrated and semi-domesticated. Neither immunosuppressive factors nor concomitant diseases were identified in the cases studied. The main clinical signs were apathy, anorexia, dehydration, phlegmon and draining tracts. Macroscopically, skin / subcutaneous tissue (3/4), skeletal muscle (2/4), lymph nodes (2/4), liver (2/4), omentum (1/4), spleen (1/4) were affected. In addition, it could be noted that mandibular bone (1/4), pleural tissue (1/4), left testicle (1/4) and Central Nervous System (CNS) (1/4) were also affected by this disease. Microscopically, regarding all cases, there was a pyogranulomatous inflammation in the affected organs. With respect to cases 1, 3 and 4, filamentous, branched, slightly basophilic structures in loose or individual aggregates in the interior of the pseudo-rosettes and in the necrotic areas were observed in the HE-stained tissue sections. In all cases submitted to special histochemical techniques, filamentous, branched, individual or loose aggregate structures were observed, the samples were impregnated with silver, and bacteria appear as blue using the Brown-Brenn Gram technique, and stained red in the modified Ziehl-Neelsen, and stained faintly pink in Giemsa stain. The bacteria were observed mainly in the border of the pyogranulomas, in the center of the pseudo-rosettes and in the necrotic areas, being compatible with the infection by Nocardia sp. All cases were positive for immunohistochemistry (IHC).Discussion: Nocardiosis was diagnosed in all cats in this study based on the anatomopathological findings associated with the visualization of the agent and its morphotintorial characteristics by using special histochemical stains and being confirmed by IHC. It occurs mainly in the cutaneous and/or subcutaneous tissues, with systemic involvement and death of the affected animals, in addition to affecting bone tissue considered an uncommon site for the disease. The diagnosis can be established based on the anatomopathological findings associated with the morphotintorial characteristics by using special histochemical stains, which are important for evidencing and morphologically characterizing the agent, as well as being confirmed by IHC.Keywords: disease in cat, pyogranulomatous inflammation, Nocardia sp.Título: Nocardiose em gatos - achados clínicos, anatomopatológicos e morfotintoriais Descritores: doença de gato, inflamação piogranulomatosa, Nocardia sp.

Case report: pneumonia caused by lophomonas

Lophomonas are protozoans that inhabit the intestine of termites and roaches, remaining in the environment as cysts. Once in the human body, these pathogens can cause infections at the level of any organ. This disease is characterized as an opportunistic infection of which have been documented by kidney allograft transplantation, use of corticosteroids, cytotoxic hemotherapy, liver transplantation, allogeneic transplantation of hematopoietic stem cells and infection with the human immunodeficiency virus. Because the mobile cilia could be easily identified as flagellated protozoa, it is considered that the bronchopulmonary samples should be submitted by trichrome stain, Pap smear and Giemsa stain as diagnostic test for pulmonary lophomoniasis. In this report of the clinical case, several immunosuppression factors such as pregnancy, idiopathic thrombocytopenic purpura and systemic lupus erythematosus, which caused pulmonary lophomoniasis, are taken into account.

Trichomonas gallinae Identification and Histopathological Study in Pigeon (Columba livia domestica) in Baghdad City, Iraq

Trichomonas gallinae causes avian trichomoniasis, which is one of the most common protozoan infections in birds worldwide. Therefore, this study was conducted to investigate and identify the Trichomonas gallinae in domestic pigeons (Columba livia domestica) by microscopic examination (direct smear and Giemsa stain) and histopathological examination in Baghdad city, Iraq, during the period from beginning of October 2018 to end of March 2019. Giemsa-stained cytoplasm with light purple and nucleus with dark purple, clarification of flagella, nucleus, and cytoplasm very well. Histopathological findings of infected birds showed gross existence of yellowish white caseous necrotic material in the oral cavity and esophagus. The histopathological examination in the larynx, esophagus, trachea, crop, liver, and lung as infiltration of inflammatory cell mainly (heterophils); thickening of mucosa because of extensive infiltration of heterophils and disruption of esophageal gland; the thickness in bronchi wall of lung due to glandular hyperplasia and muscular fibroplasia, in liver focal necrosis of parenchyma with mononuclear cell (MNCs) infiltration and granuloma composed of MNCs and heterophils. The current study may contribute in determining the histopathological changes of esophagus, trachea, crop, and liver of trichomoniasis- infected pigeons.