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

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 individualwithout symptoms of urinary tract infection. ASB which occurs in 2-11% of pregnancies is a majorpredisposition to the development of pyelonephritis. Aims and objectives: The aims and objectivesof the study were to: Study the effectiveness of various screening tests: urine microscopy, gramstain, catalase test, leukocyte esterase test and nitrite test and to compare their sensitivity,specificity, positive predictive value and negative predictive value. Materials and Methods: Thestudy included 500 pregnant women attending the outpatient department over 18 months. The urinesamples 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 lactoseelectrolyte 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 thecatalase test among the methods of screening tests. Conclusion: Urine culture is considered to bethe gold standard in detecting ASB in pregnant women. Gram’s stain of urine is a good screeningtest when compared to other screening methods. Screening for bacteria in all trimesters isnecessary to prevent the dangerous complications associated with ASB.

Risk factors and microbiological features of surgical site infections

Background: Surgical site infections are the infections of the tissues, organs or spaces exposed bysurgeons during the performance of an invasive procedure manifested in the postoperative periodwithin 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 carecentre. Methods: A descriptive cross-sectional study was done for one year in a tertiary care centrein Bareilly, U.P. All the patients who underwent surgeries related to git pathology in the surgerydepartment, 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. Alltraumatic abdominal surgeries were also excluded from this study. Results: The present studyrevealed SSI was associated with 82 (9.4%) cases among elective and 80 (21%) in emergencysurgeries. Superficial incision SSI was found to be most common (90 cases), followed by deepincisional SSI (60 patients) and organ/space SSI (12 cases). Minor intestine surgeries were mostcommonly 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-haemolyticStreptococci (9.1%) and Pseudomonas (5.5%). Conclusions: Surgical site infection still causesconsiderable morbidity and high cost to the health care system and is becoming increasingly crucialin medico-legal aspects. Prevention of SSI requires a targeted approach to improve health careworkers' knowledge, practising the guidelines strictly regarding asepsis and optimising the patientbefore surgery. Reduction in rate of SSI will improve cosmesis and make the results of operationsbetter as a whole.

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

Background: Fine needle aspiration cytology (FNAC) is one of the preliminary tests done to detectmalignant breast lesions, which help in early detection and management. Studying the cytologyfeatures of various malignant breast diseases was the aim of this study. Methods: This study is across-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 totalof 75 cases were collected during the study period. All the cases were females. The spectrum oflesions was composed of Ductal carcinoma followed by one point each of Mucinous carcinoma,Malignant Phyllodes tumour and Lobular Carcinoma. Conclusions: FNAC helps in rapid diagnosisand early management of malignant breast lesions.

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

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 toobtain, 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 theactive participation of the laboratory physician. Different principles of coagulation testing handle thehemolysed samples differently. It is essential to know the best principle to proceed with thehemolysed sample if need be. This study set out to estimate the predictive values of post-hemolyticsample coagulation test results with various coagulation test principles. Methods: This is aprospective experimental study where the non-hemolysed samples were processed for coagulationtests. 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 wasachieved experimentally. The mean difference in prothrombin time between pre and post hemolyticsamples with normal PT was 0.9 and with abnormal PT, it was 1.1 seconds. The same for APTT was4.9 and 1.1 seconds, respectively. The majority of the samples showed prolonged coagulation posthemolysis. Positive (PPV) and negative (NPV) predictive values for prothrombin time are 97.3 and73.4%, 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.

Serum adiponectin among different stages of type 2 diabetes mellitus patients

Background: Type 2 diabetes mellitus is a chronic metabolic disorder that leads to micro andmacrovascular complications. Nephropathy is the most common microvascular complication. Fordiagnosis of nephropathy in T2DM patients by using urinary albumin, this is not a sensitive andspecific biomarker because it is elevated in other conditions. we aimed to evaluate the serumadiponectin for early detection of nephropathy in patients with type 2 diabetes mellitus. Methods: Atotal of 60 subjects were included in the present study and further subdivided into 30 patients T2DMwith normoalbuminuria, 30 patients with microalbuminuria. All the patients were included afterobtaining institutional ethical permission and consent forms. Blood and urine samples were collectedfrom all the subjects and proceed with further analysis. Appropriate statistical analyses were usedfor different types of data analysis. Results: Increased levels of FBS, PPBS, HbA1C and serumadiponectin were observed in two groups of T2DM patients. Statistically elevated levels of serumUrea, Creatinine and Uric acid levels were observed in patients T2DM with microalbuminuria whencompared to T2DM with normoalbuminuria. The serum adiponectin was positively correlated withFBS, PPBS, HbA1C, Urea, Creatinine, Uric Acid and Urinary Albumin in patients with two groups ofT2DM. Conclusion: This study concluded that measuring the serum adiponectin levels may beuseful for the early detection of nephropathy in patients with T2DM.

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

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

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

Background: Prostate cancer is the second most common cancer and one of the most leadingcauses of death in men worldwide. The prostate-specific antigen (PSA) as a screening methodshowed that there has been a slight decrease in prostate cancer mortality. Effective biomarkers inscreening and diagnosis would be beneficial for avoiding unnecessary operations. The predictive andprognostic value of complete blood count (CBC) has been manifested by recent studies. We aimed todetermine 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 cancerand 50 patients with prostate cancer. All the was undertaken in the central diagnostic laboratory atVIMS and RC. Blood samples were collected from all the subjects after taken permission from theinstitutional ethics committee and consent form. The haemoglobin, RBCs, MCV, MCHC, RDW will beanalysed by using laboratory standard methods (Beckman coulter LH-780) and The serum PSAlevels 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 specificantigen in both groups of prostatic cancer patients. The reduced levels of hemoglobin, red bloodcells, platelets, neutrophils were observed in prostatic cancer patients when compared to newlydiagnosed prostate cancer patients. The PSA levels were negatively correlated with total bloodcounts. Conclusion: This study suggests that the elevated levels of prostate specific antigen wereuseful for diagnosis and prognosis of prostatic cancers, along with the monitoring of complete bloodcount may be useful for the treatment of patients with prostatic cancers.

“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”

Introduction: Chronic suppurative otitis media is a chronic infection of the middle ear and mastoidcavity which if not treated leads to partial or total loss of hearing and even life-threateningcomplications like meningitis and Intracranial abscess. Hence it is important to treat the persistentear 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 GSLmedical 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 andMacConkey agar for 24-48 hrs, and identification of organisms was done by using standardbiochemical reactions and antibiotic sensitivity testing done by using modified Kirby- Bauer methodas per CLSI guidelines. Results: A total of 156 strains were isolated from 135 patients in thepresent study of which Pseudomonas aeruginosa and Staphylococcus aureus were amongst the mostisolated pathogens in culture. Imipenem showed the most sensitivity against Pseudomonas,subsequently levofloxacin and piperacillin. Linezolid was the most sensitive versus Staphylococcusensued by ciprofloxacin and cloxacillin. Conclusions: In the present study of Chronic suppurativeotitis media patients, Pseudomonas and Staphylococcus were highly prevalent and showed increasedresistance to beta-lactams and commonly used antimicrobial drugs. Antimicrobials like imipenem,piperacillin, and quinolones are effective against most cases of chronic suppurative otitis media

Cytomorphological study of Benign breast lesions in a Tertiary Care Hospital

Background: Benign breast disease is one of the most common breast lesions in the reproductiveage group. Fine needle aspiration cytology (FNAC) is one of the preliminary tests done to detectbreast lesions which help in early detection and management. Studying the cytology features ofvarious benign breast diseases was the aim of this study. Methods: This study is a cross-sectionalretrospective study conducted in the Department of Pathology from 2015 to 2020. Clinical detailsand cytology features were collected from the Department records. Results: A total of 430 caseswere collected during the study period. Age groups ranged from 16-40 years. All the cases werefemales. The spectrum of lesions was composed of fibroadenoma, fibrocystic change, breastabscess, fibroadenosis, granulomatous mastitis, etc. Conclusions: Breast lumps are a commoncause of anxiety and apprehension among patients. FNAC helps in rapid diagnosis and earlymanagement of lesions. It also helps in preventing unnecessary invasive surgeries in non-neoplasticand benign breast diseases.

Histopathological study of lower gastrointestinal tract lesions

Background: The benign lesions of the lower gastrointestinal tract are responsible for a largenumber of morbidities. The microscopic examination of and determination of histological types ofmalignant lesions help to decide treatment options and to predict prognosis. The histopathologicalstudy is the Gold standard for the diagnosis of intestinal lesions. Aims and Objectives: To studythe prevalence of various lower gastrointestinal tract lesions site-wise, age-wise and gender-wiseand to compare the obtained results with other studies. Materials and methodology: Aretrospective study of 600 various lower gastrointestinal tract lesions sent for histopathologicalexamination at Pathology department of tertiary care centre, VS General Hospital, Ahmedabad iscarried out. Results: Among all the 600 cases, non-neoplastic lesions 572 (95.34%) are far morecommon than neoplastic lesions 28 (4.66%). Conclusion: Non-neoplastic lesions are common in thesmall intestine, while the large intestine harbors most malignant lesions.