Pathology Commons^™

Emergence Of Carbapenem Resistant Gram Negative And Vancomycin Resistant Gram Positive Organisms In Bacteremic Isolates Of Febrile Neutropenic Patients: A Descriptive Study., Seema Irfan, Faiza Idrees, Vikram Mehraj, Faizah Habib, Salman Adil, Rumina Hasan

Department of Pathology and Laboratory Medicine

Background:This study was conducted to evaluate drug resistance amongst bacteremic isolates of febrile neutropenic Patients with particular emphasis on emergence of carbapenem resistant Gram negative bacteria and vancomycin resistant Enterococcus species.

Methods:

A descriptive study was performed by reviewing the blood culture reports from febrile neutropenic Patients during the two study periods i.e., 1999-00 and 2001-06. Blood cultures were performed using BACTEC 9240 automated system. Isolates were identified and antibiotic sensitivities were done using standard microbiological procedures.

Results:

Seven twenty six febrile neutropenic Patients were admitted during the study period. A total of 5840 blood cultures were received, off …

Diagnostic Tool For Glanzmann's Thrombasthenia Clinicopathologic Spectrum, Natasha Bahadur Ali, Bushra Moiz, Mohammad Usman Shaikh, Salman Adil, Bushra Rizvi, Yasmeen Rahman

Department of Pathology and Laboratory Medicine

Objective: To platelet aggregometry and describe the clinical spectrum of Glanzmann's thrombasthenia diagnosed by platelet aggregometry.
Study design: A case-series.
Place and duration of study: This study was carried out at the clinical laboratories at the Aga Khan University Hospital, Karachi from January 2003 to January 2006.
Patients and methods: All patients irrespective of age and gender presenting with bleeding symptoms and having normal platelet count were evaluated. Demographic details, relevant clinical history along with results of complete blood count, bleeding time and platelet aggregation studies were retrieved through computerized data base and evaluated for the diagnosis of Glanzmann's thrombasthenia. …

The Expression Of Microrna Mir-107 Decreases Early In Alzheimer's Disease And May Accelerate Disease Progression Through Regulation Of Β-Site Amyloid Precursor Protein-Cleaving Enzyme 1, Wang-Xia Wang, Bernard W. Rajeev, Arnold J. Stromberg, Na Ren, Guiliang Tang, Qingwei Huang, Isidore Rigoutsos, Peter T. Nelson

Sanders-Brown Center on Aging Faculty Publications

MicroRNAs (miRNAs) are small regulatory RNAs that participate in posttranscriptional gene regulation in a sequence-specific manner. However, little is understood about the role(s) of miRNAs in Alzheimer's disease (AD). We used miRNA expression microarrays on RNA extracted from human brain tissue from the University of Kentucky Alzheimer's Disease Center Brain Bank with near-optimal clinicopathological correlation. Cases were separated into four groups: elderly nondemented with negligible AD-type pathology, nondemented with incipient AD pathology, mild cognitive impairment (MCI) with moderate AD pathology, and AD. Among the AD-related miRNA expression changes, miR-107 was exceptional because miR-107 levels decreased significantly even in patients with …

Glucose-6-Phosphate Dehydrogenase (G6pd) Screening In Pakistani Neonates: To Be Or Not To Be, Bushra Moiz

Department of Pathology and Laboratory Medicine

No abstract provided.

Longitudinal Tracking Of Cytokines After Acute Exposure To Tuberculosis: Association Of Distinct Cytokine Patterns With Protection And Disease Development, Rabia Hussain, Najeeha Talat, Firdaus Shahid, Ghaffar Dawood

Department of Pathology and Laboratory Medicine

Household contacts (HCs) of patients with tuberculosis (TB) are at higher risk of infection as well as the development of active disease. Longitudinal tracking of antigen-specific cytokines after acute exposure may significantly advance our understanding of the dynamic changes in cytokine patterns associated with disease establishment. To achieve this objective, we carried out a prospective cohort study with healthy HCs after exposure to TB. The patterns of cytokines (gamma interferon [IFN-gamma] and interleukin 10 [IL-10]) in response to mycobacterial antigens (culture filtrate [CF] proteins) and nonspecific mitogens (phytohemagglutinin [PHA] and lipopolysaccharide [LPS]) were assessed at 0, 6, 12, and 24 …

Clinical Presentation And Genotype Of Hepatitis Delta In Karachi, Tariq Moatter, Zaigham Abbas, Sabhita Shabir, Wasim Jafri

Department of Pathology and Laboratory Medicine

Aim:
To assess the clinical presentation and genotypes of delta hepatitis in local population.
Methods:
In this prospective study, 39 consecutive patients who were positive for HBsAg and hepatitis D virus (HDV) antibody were included. The patients were divided in two groups on the basis of presence or absence of HDV RNA and a comparative study was done. Genotype of HDV was determined in PCR positive patients.
Results:
Overall there is male dominance, in which 34 patients out of 39 (87.2%) were male. Twenty (51%) patients were from the adjacent areas of three provinces; Sindh, Punjab and Balochistan indicating the …

Epidermoid Cyst Of The Ovary, Romana Idress, Zubair Ahmad, Khurrum Minhas, Naila Kayani

Department of Pathology and Laboratory Medicine

Epidermoid cysts of the ovary are rare lesions and are uniformly incidental findings in hysterectomy specimens. They must be differentiated from mature cystic teratomas of the ovary, and some authors believe them to be monodermal teratomas. The histogenesis is still uncertain. We report an epidermoid cyst of the ovary which was an incidental finding.

Collecting Duct Carcinoma: An Incidental Finding In A Non Functional Kidney Secondary To Nephrolithiasis, Asim Qureshi

Department of Pathology and Laboratory Medicine

A nephrectomy specimen was sent to the laboratory for end stage renal disease secondary to nephrolithiasis. Initial sections incidentally revealed a tumor infiltrating the normal renal tissue. Further workup including cytochemical and immuno-histochemical stains confirmed it to be collecting duct carcinoma.

Comparative Predictive Value Of Three Prognostic Markers--S-Phase Fraction, Pcna And Mitotic Count On Axillary Lymph Node Metastasis In Carcinoma Breast, Shahid Pervez, Muhammad Nadeem Khan, Muhammad Israr Nasir

Department of Pathology and Laboratory Medicine

Background: Axillary lymph node metastasis is the single most important prognostic factor in carcinoma of the breast. Therefore, prognostic markers that may reliably predict probability of lymph node (LN) metastases are of great value. This study was conducted to compare the predictive value of two novel prognostic / proliferative markers i.e. S-phase fraction (SPF) and proliferating cell nuclear antigen (PCNA) in parallel with mitotic index.

Methods: Data of consecutive cases of infiltrating ductal carcinoma (IDC) breast diagnosed from July 2003 to July 2004 at the section of the Histopathology, The Aga Khan University Hospital, Karachi, were reviewed. A total of …

Polymorphism Of Hla-Dr And Hla-Dq In Rheumatoid Arthritis Patients And Clinical Response To Methotrexate--A Hospital-Based Study, Azra Arif I Ali, Tariq Moatter, Jawed Altaf Baig, Ahmed Iqbal, Azmat Hussain, Mohammad Perwaiz Iqbal

Department of Biological & Biomedical Sciences

Objective: To investigate the frequency and distribution of DRB1 and DQB1 alleles in Patients with rheumatoid arthritis (RA) and analyze the relationship between clinical response to methotrexate (MTX) and the HLA-DR and HLA-DQ genotypes in these patients.
Methods: In this case-control study, the HLA-DRB1 and HLA-DQB1 polymorphism in 91 RA patients and 91 healthy controls was done using polymerase chain reaction and sequence specific primers.
Results: There was no statistical difference in frequencies of HLA-DRB1*03, DRB1*04, DRB1*07, DRB1*10, DRB1*11, DRB1*12, DRB1*13, DRB1*14, DRB1*15 and DRB1*16 genotypes between patients and controls. However, DRB1*01 was found to be significantly more common (p=0.015) …

Subependymal Giant Cell Astrocytoma, Zubair Ahmad, Fouzia Rauf, Najamul Sahar Azad, Aamir Ahsan

Department of Pathology and Laboratory Medicine

Subependymal giant cell astrocytomas (SEGAs) are slowly growing tumours corresponding to WHO grade I. They are intraventricular and usually occur in the setting of tuberous sclerosis complex. They often result in obstructive hydrocephalus. Treatment is usually restricted to surgical resection, recurrences are rare and long term prognosis is excellent. We present a series of three cases.

Systemic Mastocytosis: A Rare Entity, Naveen Naz Syed, Bushra Moiz

Department of Pathology and Laboratory Medicine

An 18 year old female presented with generalized maculopapular rash and headaches. The skin and bone marrow biopsy revealed numerous mast cells which stained metachromatically with giemsa and toludine blue stains and showed positivity with CD68 and CD117 on immunohistochemistry. Her clinical presentation and laboratory findings were consistent with the diagnosis of indolent systemic mastocytosis. Because of the benign course of the disease, patient was offered only anti-histamine drugs that were quite successful in alleviating her symptoms.

Mixed Epithelial And Stromal Tumour Of Kidney, Fozia Rauf, Nausheen Yaqoob, Akhtar Husain

Department of Pathology and Laboratory Medicine

Mixed epithelial and stromal tumour of kidney is a recently described, rare entity and includes cases previously termed as cystic hamartoma of renal pelvis and adult mesoblastic nephroma. We report a case of 36 years old female who presented with a history of recurrent loose stools for 5 years. During ultrasound abdomen, a solid right renal mass was incidentally found in upper pole of right kidney. On gross examination it was a 3.5 cm diameter mass which was microscopically composed of both epithelial and stromal components in the form of cystically dilated tubules and fascicles of spindle shaped cells. These …

Comparison Of Two Methods (Precipitation Manual And Fully Automated Enzymatic) For The Analysis Of Hdl And Ldl Cholesterol, Jawaid Jabbar, Imran Siddiqui, Qaiser Raza

Department of Pathology and Laboratory Medicine

Objective:
To compare accuracy and throughput time for the measurement of HDL and LDL cholesterol by manual precipitation and fully automated enzymatic methods.
Methods:
Fifty, serum samples collected over a 4 months period (February - May 2004) were analyzed for HDL and LDL cholesterol by two different methods i.e. precipitation manual and automatic enzymatic method in the section of chemical pathology, Department of Pathology and Microbiology, Aga Khan University Hospital, Karachi Pakistan.
Results:
The mean standard deviation for HDL Cholesterol by precipitation method and automated method were 43.12 +/- 8.97mg/dl and 43.86 +/- 10.34mg/dl respectively (p-value = 0.301). The …

Screening For Cystic Fibrosis: The Importance Of Using The Correct Tools, Uzma Shah, Tariq Moatter

Department of Pathology and Laboratory Medicine

Background: Cystic Fibrosis (CF) is a potentially lethal genetic disorder. The most frequent mutation worldwide in the Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) gene is designated as the Delta F508 mutation. This mutation was found in only 33% of Pakistani patients studied. Since the common Pakistani mutations remain to be identified, appropriate screening tools are required to identify disease. Sweat chloride determinations remain the gold standard for diagnosing CF. This study was done to emphasize the importance of using the correct tests.
Methods: The study was conducted at the Aga Khan University Hospital. The CFTR delta F508 mutation was tested …

M. Leprae Inhibits Apoptosis In Thp-1 Cells By Downregulation Of Bad And Bak And Upregulation Of Mcl-1 Gene Expression, Zahra Hasan, Mussarat Ashraf, Ali Tayyebi, Rabia Hussain

Department of Pathology and Laboratory Medicine

Background: Virulent Mycobacterium leprae interfere with host defense mechanisms such as cytokine activation and apoptosis. The mitochondrial pathway of apoptosis is regulated by the Bcl-2 family of proteins. Expression of Fas ligand and apoptotic proteins is found in leprosy lesions and M. leprae has been shown to activate pro-apoptotic Bcl-2 genes, Bak and Bax. However, the mechanism by which M. leprae modulates apoptosis is as yet unclear. We investigated expression of apoptotic genes in THP-1 monocytes in response to infection by M. leprae and non-pathogenic M. bovis BCG.
Results: M. leprae did not induce apoptosis in THP-1 cells, while BCG …

Validity Of Frozen Section In The Diagnosis Of Breast Lumps: 5 Years Experience At The Aga Khan University Hospital., Naila Kayani, Nuzhat Sultana

Department of Pathology and Laboratory Medicine

Abstract

Objective: To determine the accuracy of frozen section in the diagnosis of breast lump. Methods: Frozen section diagnosis given in consecutive breast biopsies performed in 5 years in our laboratory was evaluated against the final pathology report of permanent sections. Results: The Aga Khan University Hospital Lab receives more than 400 cases per year for frozen section. Three hundred and nineteen consecutive frozen sections of breast lumps examined from 1999-2003 were considered for analysis. Age of patients ranged between 22 and 90 years (mean age 49 years). In 316 cases (99%) there was no difference between the frozen section …

Metanephric Adenoma: A Rare Benign Renal Tumour, Nausheen Yaqoob, Jai Pal Paryani, Naila Kayani, Mohammad Zafar Rafique, Raziuddin Biyabani

Department of Pathology and Laboratory Medicine

Metanephric adenoma is a rare benign renal tumour. We are reporting one histologically proven such case in a 23 year old male from Afghanistan. He presented with severe right flank pain since 3 weeks. Nephrectomy was done and histopathology was consistent with the diagnosis of metanephric adenoma. This novel renal mass has been reported to have benign clinical course despite its symptomatic presentation and large tumour size. There is no distinguishing radiological feature with can differentiate it from malignant tumours. So far, a uniformly benign clinical course has been associated with Metanephric adenoma, but given its relatively recent identification and …

Heterotopic Glial Tissue In Tonsil: A Case Report, Nausheen Yaqoob, Zubair Ahmed, Akhtar Husain

Department of Pathology and Laboratory Medicine

We describe a six month old boy with a mass in the left tonsil. It was present since birth and was enlarging progressively. It was completely excised. Histopathology showed a choristoma of neural origin composed of glial cells--astrocytes in a fibrillary background, and a choroid plexus. Immunohistochemistry confirmed the findings.

Lymphoepithelioma-Like Carcinoma Of Urinary Bladder: (Lelca), Nausheen Yaqoob, Naila Kayani, Jaipal Piryani, Mohammad Nasir Sulaiman, Sheema H. Hasan

Department of Pathology and Laboratory Medicine

Lymphoepithelioma-like carcinoma of the bladder (LELCA) is an uncommon neoplasm of the urinary bladder and up till now only 49 cases have been reported in the English literature. It is imperative to distinguish between lymphoepithelioma-like carcinoma and malignant lymphoma as primary bladder lymphoma is extremely rare. We report a case of a 55 year old lady who presented with the complaint of burning micturition and gross hematuria for the past 5 months. There were no other known comorbids. Pelvic ultrasound was normal. Cystoscopy showed a 4x4 cm sessile mass in the bladder. Histopathological examination was consistent with the diagnosis of …

To Compare The Total Cholesterol And Hdl-Cholesterol Before And After Ultra-Centrifugation In Lipemic Samples, Jawaid Jabbar, Imran Siddiqui, Syed Qaiser Raza, Ayaz Baig

Department of Pathology and Laboratory Medicine

Objective: It is an everyday routine in laboratories to encounter interference in the analysis of lipids. These likely interferences (hemolysis, icterus and lipemia) are countered by asking physicians and patients to send fresh and properly collected samples. At the Aga Khan University (AKU) Laboratory, we receive 2-3 lipemic/turbid samples per day. Previously it was our departmental policy to advise these patients to go for lipoprotein electrophoresis, which though accurate was time consuming and not cost effective. We therefore studied ultra centrifugation/airfuge as an alternate method to clear lipid interference and provide accurate, reliable and cost effective results.
Methods: Daily 2-3 …

Ductal Carcinoma In Situ (Dcis) In Karachi, Naila Kayani, Yasmin Bhurgri

Department of Pathology and Laboratory Medicine

Objective:
To study the frequency of ductal carcinoma in situ (DCIS) in a large pathology series. DCIS is a proliferation of non-invasive, malignant epithelial cells within the ductolobular system of the breast. It is a heterogeneous entity with several morphologic variants that differ in gross appearance, growth pattern, cytologic features, mammography, and malignant potential.
Methods:
The data of The Aga Khan University' Pathology Department, diagnosed on the basis of histopathology, during a 6-year period (1st January 1998 to 31st December 2003) was reviewed, all cases of DCIS studied, and data was analyzed with the help of analytical software SPSS.
Results: …

Trefoil Factor 2 (Tff2) Deficiency In Murine Digestive Tract Influences The Immune System, M. Baus- Loncar, J. Schmid, El-Nasir Lalani, I. Rosewell, R. A. Goodlad, H. G.W. Stamp, N. Blin, T. Kayademir

Department of Pathology and Laboratory Medicine

Background & Aims:

The gastrointestinal trefoil factor family (TFF1, TFF2, TFF3) peptides are considered to play an important role in maintaining the integrity of the mucosa. The physiological role of TFF2 in the protection of the GI tract was investigated in TFF2 deficiency.

Methods:

TFF2-/- mice were generated and differential expression of various genes was assessed by using a mouse expression microarray, quantitative real time PCR, Northern blots or immunohistochemistry.

Results:

On an mRNA level we found 128 differentially expressed genes. We observed modulation of a number of crucial genes involved in innate and adaptive immunity in the TFF2-/- mice. …

Psychomotor Skills For The Undergraduate Medical Curriculum In A Developing Country--Pakistan, Rashida Ahmed, Zoon Naqvi, Ineke Wolfhagen

Department of Pathology and Laboratory Medicine

Objective: To identify essential psychomotor skills for all the medical graduates of an undergraduate programme in Pakistan.
Materials and Methods: Twenty-five physicians practising in a tertiary care centre and ninety primary care physicians used a Likert's scale, ranging from "very essential" to"not required at all", to mark 99 psychomotor skills in the undergraduate medical curriculum in Pakistan.
Results: Overall the opinions of both the groups about the essential skills matched except for a few areas.
Conclusion: This study provides baseline data about psychomotor skills that a medical graduate in developing countries should be able to perform. Further studies will be …

Ovarian Primary Neuroendocrine Carcinoma Of Non-Small Cell Type: Report Of An Extremely Rare Neoplasm, Zubair Ahmed, Kanwal Aftab, Naila Kayani

Department of Pathology and Laboratory Medicine

Paraffin block sections of a uterus and ovarian mass from a 31 year old female were sent for second opinion to the Pathology Laboratory of Aga Khan University. Histologic examination and immunohistochemical features gave a diagnosis of primary neuroendocrine carcinoma of non-small cell type admixed with benign mucinous cystadenoma. This is a rare tumour with only eight being reported in literature.

Cystic Breast Lymphangioma, S N. Waqar, H Khan, S F. Mekan, N Kayani, A J. Raja

Department of Biological & Biomedical Sciences

No abstract provided.

Pleomorphic Liposarcoma In A Ten Year Old Child, Z Ahmed, H U. Shah, N Yaqoob, S Muzaffar

Department of Pathology and Laboratory Medicine

No abstract provided.

Impact Of Antibiotic Usage On Resistance In Microorganisms; Urinary Tract Infections With E-Coli As A Case In Point, N Sabir, Erum Khan, L Sheikh, Rumina Hasan

Department of Pathology and Laboratory Medicine

Objectives:
In this study, we sought to establish a correlation between consumption of flouoroquinolones in our hospital and the emergence of ofloxacin resistant strains of E. coli in the urinary specimens. Data of all urinary samples, received at Aga Khan University Hospital between January 1995 and December 2002, was retrieved and analyzed. Specimens yielding E-coli as an isolate were included in this study.
Methods:
E. coli Isolates showing >103 colonies were identified using standard microbiological techniques. Antibiotic susceptibility of E. coli was tested using Kirby Bauer disc diffusion method. Antimicrobial usage data, obtained through hospital Pharmacy as unit utilized per …

Frequency Of Hereditary Thrombophilia: An Akuh Experience., Safoorah Khalid, Raihan Sajid, Salman Adil, Mohammad Khurshid

Department of Pathology and Laboratory Medicine

Abstract

Objective: To determine the frequency of various causes of hereditary thrombophilia at a referral laboratory and the age and gender distribution.

Methods: This is a descriptive study incorporating a retrospective analysis of requests for thrombophilia screening sent to Clinical laboratory, Aga Khan University Hospital from November 1995 to May 2002.
Patients were screened for hereditary causes of thrombophilia including Protein C, Protein S, antithrombin III, Factor V Leiden and homocysteine. Frequency of each disorder; and age and sex distribution was determined.

Results: All the patients suspected clinically for thrombophilia were screened. Of the 2825 patients, 70 were diagnosed to …

Solid Cystic Papillary Epithelial Neoplasm Of Pancreas: A Series Of Three Cases With Review Of Literature, Z Ahmed, N Yaqoob, S Muzaffar, N Kayani, R Minhas

Department of Pathology and Laboratory Medicine

No abstract provided.