Medicine and Health Sciences Commons^™

Comparison Of Double Disc And Combined Disc Method For The Detection Of Extended Spectrum Beta Lactamases In Enterobacteriaceae, K Jabeen, A Zafar, R Hasan

Department of Pathology and Laboratory Medicine

Objective:
To compare double disc approximation and combined disc method for their ability to detect extended spectrum b lactamase (ESBL) production in enterobacteriaceae and determine the percentage of isolates which are falsely reported as sensitive in absence of ESBL detection, in a clinical microbiology laboratory of a tertiary care hospital between September-October 2002.
Methods:
Selected isolates were identified according to standard biochemical tests. Disc susceptibility tests were performed according to NCCLS. ESBL detection by combined disc [cefotaxime (30 ug) versus cefotaxime plus clavulanate (30+10 ug)] was compared with detection using double discs [amoxy-clavulanic acid (20+10 ug) and aztreonam (30 ug) …

Renal Teratoma: A Rare Entity, N Yaqoob, Z Ahmed, N Jafri, S Muzaffar, S H. Hasan

Department of Pathology and Laboratory Medicine

No abstract provided.

Topographical Expression Of Class Ia And Class Ii Phosphoinositide 3-Kinase Enzymes In Normal Human Tissues Is Consistent With A Role In Differentiation, Soha Salama El Sheikh, Jan Domin, Prakitpunthu Tomtitchong, Paul Abel, Gordon Stamp, El-Nasir Lalani

Department of Pathology and Laboratory Medicine

Background: Growth factor, cytokine and chemokine-induced activation of PI3K enzymes constitutes the start of a complex signalling cascade, which ultimately mediates cellular activities such as proliferation, differentiation, chemotaxis, survival, trafficking, and glucose homeostasis. The PI3K enzyme family is divided into 3 classes; class I (subdivided into IA and IB), class II (PI3K-C2α, PI3K-C2β and PI3K-C2γ) and class III PI3K. Expression of these enzymes in human tissue has not been clearly defined.

Methods: In this study, we analysed the immunohistochemical topographical expression profile of class IA (anti-p85 adaptor) and class II PI3K (PI3K-C2α and PI3K-C2β) enzymes in 104 formalin-fixed, paraffin embedded …

Renal Carcinoid Tumour, Z Ahmad, N Yaqoob, S Muzaffar, A S. Hussainy, S H. Hasan

Department of Pathology and Laboratory Medicine

No abstract provided.

Spectrum Of Cutaneous Appendage Tumors At Aga Khan University Hospital, N Yaqoob, Z Ahmad, S Muzaffar, M S. Gill, I N. Soomro, S H. Hasan

Department of Pathology and Laboratory Medicine

Objective: To determine the frequency of various types of cutaneous appendage tumors in our practice.
Method: This is a partly retrospective and partly prospective study conducted at the Department of Pathology, Histopathology Section, The Aga Khan University Hospital, Karachi between 1st January 1997 and 31st December 2001.
Results: One hundred sixty six skin appendage tumors were diagnosed during the study period. 87.3% were benign, while 12.6% were malignant. Male female ratio was almost equal. Mean age was 41.72 years. 37.34% showed eccrine differentiation, 14.45% showed apocrine differentiation and 41.56% showed pilosebaceous differentiation, 6.62% exhibited mixed differentiation. The 5 commonest tumors …

Male Breast Cancer, N Kayani, M N. Khan, Y Bhurgri, S Gill, M I. Nasir, T Siddiqui

Department of Pathology and Laboratory Medicine

Objective: To review cases of male breast cancer.
Settings: Histopathology Section, Department of Pathology, The Aga Khan University, Karachi.
Method: Fifty one cases of male breast cancer specimens, received during a period of 10 years, routinely processed and stained with Haematoxylin and Eosin were analyzed. Special stains and Immunohistochemistry were used in difficult cases.
Results: Male breast cancer affected individuals in the sixth and seventh decades of life with a mean age of 56.2 years. Infiltrating ductal carcinoma (IDC) was the predominant type. Skin involvement was seen in 27.45% of the cases. Breast lump was the most common presenting symptom …

Determination Of Delay In Burn Around Time (Tat) Of Stat Tests And Its Causes: An Akuh Experience., Fareena Bilwani, Imran Siddiqui, Sarosh Vaqar

Department of Pathology and Laboratory Medicine

Abstract

Objective: To evaluate the delay and reasons of delay of turnaround time (TAT) of stat tests in the section of clinical chemistry of the clinical laboratory. Setting: Clinical Laboratory, Aga Khan University Hospital, Karachi. Patients and Methods: In our study turn around time (TAT) of stat tests were analyzed. Turn around time was specified as the time from receipt of the sample till the final verification of results (sample receipt time to result verification time). Delays were categorized into 15 minutes, 16-30 minutes, 31 to 60 minutes and >60 minutes. It was also noted as to which time of …

Renal Cortical Necrosis: A Case Series Of Nine Patients & Review Of Literature, Syed Sohail Ali, Syed Zulfiqar Rizvi, Suhail Muzaffar, Aasim Ahmad, Akhtar Ali, Sheema H. Hassan

Department of Biological & Biomedical Sciences

Background: The purpose of this study is to review cases of renal cortical necrosis (RCN) which we came across during a period of five years, confirmed on needle biopsy specimens, with literature available so far.
Methods: All renal biopsy records between January 1996 to December 2001 at the Aga Khan University Hospital, Karachi, Pakistan were reviewed to identify patients with histologically proven renal cortical necrosis. Seven patients were also referred by the department of Nephrology, Lady Reading Hospital, Peshawar, Pakistan. Patients' medical records were reviewed for demographic, clinical, and follow up data.
Results: There were total of nine patients identified …

Use Of Intravenous Anti-D In Patients With Refractory And Relapsed Immune Thrombocytopenic Purpura, R. Sajid, Salman Adil, Z. Fadoo, S. Sabir, Mohammad Khurshid

Department of Pathology and Laboratory Medicine

Objective: To determine the response to IV anti-D and its comparison with splenectomy as second line therapy in refractory and relapsed cases of ITP, in the Aga Khan University Hospital, Karachi.
Methods: A total of 23 patients with chronic ITP were treated with either anti-D or splenectomy as second line treatment. The patients were assessed for time to achieve a response to second line treatment, duration ofresponse and adverse events.
Results: There were 12 patients in the anti-D group and 11 in the splenectomy group. The mean platelet count at presentation was 9,000/cumm. The mean age was 8.9 …

Antipyretic, Parasitologic, And Immunologic Effects Of Combining Sulfadoxine/Pyrimethamine With Chloroquine Or Paracetamol For Treating Uncomplicated Plasmodium Falciparum Malaria, E. Hugosson, D. Tarimo, M. Troye-Blomberg, S.M. Montgomery, Zul Premji, A. Bjorkman

Pathology, East Africa

Sulfadoxine/pyrimethamine (SP) is increasingly used against malaria in sub-Saharan Africa because of chloroquine resistance. However, chloroquine may have a beneficial antipyretic effect. We therefore compared the combination of SP plus chloroquine, chloroquine alone, SP alone, and SP plus paracetamol in the treatment of uncomplicated Plasmodium falciparum malaria in 175 Tanzanian children (1-4 years old) in a randomized trial. Outcome variables were axillary temperatures every six hours, daily parasitemias, and serum levels of IgG antibodies to P. falciparum. Lower mean temperatures (6-48 hours) were achieved with SP plus chloroquine or paracetamol than with SP alone (P < 0.001) or chloroquine alone (P < 0.05). All three SP-treated groups showed high and similar parasite reduction (0-48 hours), whereas treatment with chloroquine alone was much less effective. Levels of IgG antibodies to P. falciparum increased significantly (P < 0.001) and similarly in the four treatment groups between days 0, 2. and 3. Thus, the addition of chloroquine or paracetamol to SP improved the clinical outcome, but did not affect the parasitologic response or antibody production.

Age, Temperature, And Parasitaemia Predict Chloroquine Treatment Failure And Anaemia In Children With Uncomplicated Plasmodium Falciparum Malaria, D.H. Hamer, W.B. Macleod, E. Addo-Yobo, C.P Duggan, B. Estrella, W.W. Fawzi, J.K. Konde-Lule, V. Mwanakasale, Zul Premji, F. Sempertegui, F.P. Ssengooba, K. Yeboah-Antwi, J.L. Simon

Pathology, East Africa

The prevalence of chloroquine-resistant Plasmodium falciparum malaria has been increasing in sub-Saharan Africa and parts of South America over the last 2 decades, and has been associated with increased anaemia-associated morbidity and higher mortality rates. Prospectively collected clinical and parasitological data from a multicentre study of 788 children aged 6-59 months with uncomplicated P. falciparum malaria were analysed in order to identify risk factors for chloroquine treatment failure and to assess its impact on anaemia after therapy. The proportion of chloroquine treatment failures (combined early and late treatment failures) was higher in the central-eastern African countries (Tanzania, 53%; Uganda, 80%; …

Fludarabine Induced Immune Thrombocytopenia In A Patient With Cd5 Positive B Cell Chronic Lymphocytic Leukemia, M. Usman, Salman Adil, R. Sajid, Mohammad Khurshid

Department of Pathology and Laboratory Medicine

Fludarabine is a purine nucleoside analogue, which inhibits DNA synthesis by inhibiting DNA polymerase and ribonucleoside reductase.1 It affects both dividing and non- dividing cells.2 Fludarabine possesses proven efficacy in the treatment of a variety of indolent B cell lymphoproliferative disorders including chronic lymphocytic leukemia3, low-grade non-Hodgkin's lymphoma4 and Waldenstrom macroglobulinemia.5 It is also a part of conditioning regimes in non-myeloablative bone marrow transplantation.6 The common side effects include myelosuppression, immunosuppression, and neurologic toxicity.7 The rare side effects are immune mediated hemolytic anemia8 and thrombocytopenia.9 Here we describe a case of a middle-aged lady who was diagnosed as B cell …

Cyclosporin Induced Fatal Rhabdomyolysis In A Young Patient With Acquired Aplastic Anemia: A Case Report, M. Usman, S. N. Adil, G. N. Kakepoto, Mohammad Khurshid

Department of Pathology and Laboratory Medicine

Cyclosporin is used as an immunosuppressive agent in the management of a variety of autoimmune disorders1 and in patients of organ transplant to suppress host immunity and prevent rejection.2 It is now well established that acquired aplastic anemia is secondary to immune mediated destruction of stem cells in the bone marrow3 and hence Cyclosporin is used as a first line immunosuppressive drug alone or in combination with anti lymphocyte globulin in the management of aplastic anemia.1 Rhabdomyolysis is a rare side effect of Cyclosporin.4 Here we describe a case of fatal rhabdomyolysis in a young patient who received cyclosporin for …

Chromosomal Abnormalities As A Cause Of Recurrent Abortions: A Hospital Experience, M. Azim, A.H. Khan, Z.L. Khilji, J.A. Pal, Mohammad Khurshid

Department of Pathology and Laboratory Medicine

Objective: To analyze the chromosomal abnormalities in couples with history of recurrent abortions.
Design: Retrospective study.
Setting: Cytogenetic section, Department of Pathology at the Aga Khan University Hospital. Karachi, Pakistan. Patients: Three hundred couples with history of recurrent abortions. Main outcome measure: Structural chromosomal abnormalities in carrier couples.
Results: G-banded chromosomes were analyzed from both partners of 300 couples who had had two or more spontaneous abortions. Sixteen (5.3%) couples showed a chromosomal aberration in one of the partners. Seven translocations, 5 inversions, 2 deletions and 2 sex chromosomal abnormalities were identified. There was an increase in …