Pub Date : 2023-01-01DOI: 10.7860/njlm/2023/62526.2748
Anuja Gupta, Monika Matlani, Vinita Dogra
Introduction: Parasitic intestinal diseases caused by protozoans and helminths are important causes of gastrointestinal disturbances which are responsible for a high burden of morbidity and mortality as they are detrimental not only to paediatric and immunocompromised patients but also to adults and immunocompetent patients. Hence, it is important to know their burden in a geographical area to develop adequate control measures. Aim: To estimate the prevalence of various intestinal parasitic infections in symptomatic patients based on age, gender and immune status in a tertiary care hospital, New Delhi, India. Materials and Methods: A retrospective analysis of 1431 stool samples which were received in the Department of Microbiology VMMC and Safdarjung Hospital, New Delhi, from April 2019 to March 2020 was done. All samples were subjected to macroscopic and microscopic examinations and underwent, wet mount (saline and iodine) examination and Modified Ziehl- Neelson staining. Data was analysed using Statistical Package for Social Sciences (SPSS) software version 21.0 with two- tailed Chi-square test wherever applicable. Results: Males (61.36%) outnumbered females. Prevalence of parasites was more in adults (7.76%) than in children. Higher positivity (7.6%) was observed in immunocompetent individuals as compared to immunocompromised. Overall predominance of protozoans (98.26%) over helminths was noted. Entamoeba histolytica/dispar group (43.60%) was found to be the most prevalent parasite. Entamoeba histolytica/dispar group (5.64%) and Cryptosporidium spp. (5.94%) were most common amongst immunocompetent and immunocompromised patients respectively. Conclusion: A higher prevalence of intestinal parasitic infections in immunocompetent symptomatic patients was observed, requiring attention of clinicians as they are no longer limited majorly to immunocompromised patients. As no effective vaccine is available for these infections, so appropriate laboratory methods, microbiological expertise, proper sanitation measures, availability of potable water supply and properly cooked food are essential to control parasitic intestinal diseases.
{"title":"Spectrum of Enteric Parasitic Infections in Immunocompromised and Immunocompetent Patients in a Tertiary Care Hospital, New Delhi- A Retrospective Study","authors":"Anuja Gupta, Monika Matlani, Vinita Dogra","doi":"10.7860/njlm/2023/62526.2748","DOIUrl":"https://doi.org/10.7860/njlm/2023/62526.2748","url":null,"abstract":"Introduction: Parasitic intestinal diseases caused by protozoans and helminths are important causes of gastrointestinal disturbances which are responsible for a high burden of morbidity and mortality as they are detrimental not only to paediatric and immunocompromised patients but also to adults and immunocompetent patients. Hence, it is important to know their burden in a geographical area to develop adequate control measures. Aim: To estimate the prevalence of various intestinal parasitic infections in symptomatic patients based on age, gender and immune status in a tertiary care hospital, New Delhi, India. Materials and Methods: A retrospective analysis of 1431 stool samples which were received in the Department of Microbiology VMMC and Safdarjung Hospital, New Delhi, from April 2019 to March 2020 was done. All samples were subjected to macroscopic and microscopic examinations and underwent, wet mount (saline and iodine) examination and Modified Ziehl- Neelson staining. Data was analysed using Statistical Package for Social Sciences (SPSS) software version 21.0 with two- tailed Chi-square test wherever applicable. Results: Males (61.36%) outnumbered females. Prevalence of parasites was more in adults (7.76%) than in children. Higher positivity (7.6%) was observed in immunocompetent individuals as compared to immunocompromised. Overall predominance of protozoans (98.26%) over helminths was noted. Entamoeba histolytica/dispar group (43.60%) was found to be the most prevalent parasite. Entamoeba histolytica/dispar group (5.64%) and Cryptosporidium spp. (5.94%) were most common amongst immunocompetent and immunocompromised patients respectively. Conclusion: A higher prevalence of intestinal parasitic infections in immunocompetent symptomatic patients was observed, requiring attention of clinicians as they are no longer limited majorly to immunocompromised patients. As no effective vaccine is available for these infections, so appropriate laboratory methods, microbiological expertise, proper sanitation measures, availability of potable water supply and properly cooked food are essential to control parasitic intestinal diseases.","PeriodicalId":31115,"journal":{"name":"National Journal of Laboratory Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134966604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Pre-surgical screening of patients for COVID-19 by Reverse transcription-Polymerase Chain Reaction (RT-PCR) is essential before surgeries as a precautionary measure in view of preventing COVID-19 to the health care workers. The inception of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS- COV-2) posed major hurdles and challenges in conducting elective surgeries. Considering that COVID-19 is expected to continue to be a problem for the public health system in the near future, institutions will need to create risk mitigation strategies with meticulous resource management especially in high burden centers. Aim: To assess the role and need of repeat RT-PCR testing after an initial negative at a tertiary care center in view of the ever changing dynamics of COVID-19. Materials and Methods: A retrospective observational study was conducted at the Mobile Virology Research & Diagnostic Laboratory in the Department of Microbiology, ESIC Medical College & Hospital, Hyderabad between September 2020 to May 2021. Pre- surgical cases admitted at the facility during the study period with ≥72 h duration of stay who have been tested for SARS-COV-2 RT-PCR more than once within a period of one week were included. RT-PCR testing was performed according to standard protocols. Clinical and demographic data were collected, including reasons for re-testing. Results: A total of 2398 patients were admitted for surgeries during the study period, out of which 697 cases had a prolonged stay ≥72 h. In all of the cases, the initial test was negative, but 11 (1.58%) of them converted to positive. During the zenith of the second wave, the conversion rate was 4%, whereas it was only 0.2% during non peak periods. Conclusion: Hence, it was concluded that to optimise the usefulness of pre-surgical screening test for SARS-COV-2, repeat testing may be avoided in a low burden setting with timely reassessment based on local positivity rate. Each facility should continuously reassess their needs based on sudden local surges to optimise utilisation, especially when faced with resource constraints and changing paradigm of the pandemic.
{"title":"Pre-surgical Screening for SARS-CoV-2 Testing in Elective Procedures in High Burden Resource Limited Settings: A Retrospective Observational Study","authors":"Swathi Suravaram, Imran Ahmed Siddiqui, Shazia Naaz, Vivek Hada, Mahamad Wajid, Prasanth Gurijala, Padala Chaitanya Goud, Srinivas Maddur","doi":"10.7860/njlm/2023/59393.2744","DOIUrl":"https://doi.org/10.7860/njlm/2023/59393.2744","url":null,"abstract":"Introduction: Pre-surgical screening of patients for COVID-19 by Reverse transcription-Polymerase Chain Reaction (RT-PCR) is essential before surgeries as a precautionary measure in view of preventing COVID-19 to the health care workers. The inception of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS- COV-2) posed major hurdles and challenges in conducting elective surgeries. Considering that COVID-19 is expected to continue to be a problem for the public health system in the near future, institutions will need to create risk mitigation strategies with meticulous resource management especially in high burden centers. Aim: To assess the role and need of repeat RT-PCR testing after an initial negative at a tertiary care center in view of the ever changing dynamics of COVID-19. Materials and Methods: A retrospective observational study was conducted at the Mobile Virology Research & Diagnostic Laboratory in the Department of Microbiology, ESIC Medical College & Hospital, Hyderabad between September 2020 to May 2021. Pre- surgical cases admitted at the facility during the study period with ≥72 h duration of stay who have been tested for SARS-COV-2 RT-PCR more than once within a period of one week were included. RT-PCR testing was performed according to standard protocols. Clinical and demographic data were collected, including reasons for re-testing. Results: A total of 2398 patients were admitted for surgeries during the study period, out of which 697 cases had a prolonged stay ≥72 h. In all of the cases, the initial test was negative, but 11 (1.58%) of them converted to positive. During the zenith of the second wave, the conversion rate was 4%, whereas it was only 0.2% during non peak periods. Conclusion: Hence, it was concluded that to optimise the usefulness of pre-surgical screening test for SARS-COV-2, repeat testing may be avoided in a low burden setting with timely reassessment based on local positivity rate. Each facility should continuously reassess their needs based on sudden local surges to optimise utilisation, especially when faced with resource constraints and changing paradigm of the pandemic.","PeriodicalId":31115,"journal":{"name":"National Journal of Laboratory Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134967282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.7860/njlm/2023/51713.2687
Nidhi Prasad, Dipali Prasad, Vidyut Prakash, Kalpana Singh, K. Shashi, Sangeeta Pankaj, K. Bimal
Introduction: Rubella is an acute viral infection predominantly affecting children and adults. Although natural infection with rubella provide lifelong immunity, but, primary infection in pregnant women during the initial days of pregnancy may result in spontaneous abortion, stillbirth, or a baby born with Congenital Rubella Syndrome (CRS), which can be prevented by vaccinating the susceptible non immune females one month prior to planning conception. Aim: To determine rubella virus immune status and demographic profile of women in childbearing age group, and counsel all Rubella virus infection susceptible women for vaccination prior to planning pregnancy. Materials and Methods: A cross-sectional observational study was done at Indira Gandhi Institute of Medical Sciences (IGIMS), Patna , Bihar, India, on 112 apparently healthy, asymptomatic women in the 18-45 years age group coming for preconceptional counselling and primary and secondary infertility treatment during April 2017 to March 2019, whose serum rubella Immunoglobulin G (IgG) antibody testing was done by Enzyme- linked Immunosorbent Assay (ELISA). The data regarding their rubella virus immune status, age, parity and occupations were coded and recorded in MS Excel spreadsheet program. The Statistical Package for the Social Sciences (SPSS) version 23 (IBM Corp.) was used for data analysis. Results: Out of the total 112 women {92 (82.1%) housewife and 20 (17.9%) professionals} included in this study , a total of 67 (59.8%) women tested positive for rubella IgG antibody and 45 (40.2%) tested negative for rubella IgG antibody. The mean age of the rubella virus seropositive immune patients and seronegative susceptible women was 27.72±4.83 years was 26.09±4.68 years respectively. Among the 67 seropositive patients, maximum antirubella virus IgG seropositivity (71.4%) was seen in more than 35 years age group and maximum seronegativity 23 (46.9%) was seen in 18-26 years age group. There was no direct association of occupation and parity with rubella immune status. Conclusion: Higher rate of antirubella IgG seronegativity amongst younger age groups and nulliparous women renders them susceptible to primary Rubella virus infection. Hence, Rubella IgG antibody screening, proper counselling and prompt rubella vaccination for all primary Rubella virus infection susceptible women is necessary one month prior to planning conception, to avoid foetal congenital malformations during subsequent pregnancies.
简介:风疹是一种急性病毒感染，主要影响儿童和成人。虽然自然感染风疹可提供终身免疫，但是，孕妇在怀孕最初几天的原发性感染可能导致自然流产、死产或出生时患有先天性风疹综合征(CRS)的婴儿，可通过在计划受孕前一个月为易感无免疫的女性接种疫苗来预防。目的:了解育龄妇女风疹病毒免疫状况和人口统计特征，建议所有风疹病毒感染易感妇女在计划怀孕前接种疫苗。材料和方法:在印度比哈尔邦帕特纳的英迪拉甘地医学科学研究所(IGIMS)对2017年4月至2019年3月期间来接受孕前咨询和原发性和继发性不孕症治疗的18-45岁年龄组的112名表面健康无症状妇女进行了横断面观察研究，其血清风疹免疫球蛋白G (IgG)抗体检测采用酶联免疫吸附试验(ELISA)。将患者的风疹病毒免疫状态、年龄、胎次、职业等数据编码并记录在MS Excel电子表格程序中。数据分析使用SPSS (Statistical Package for The Social Sciences) version 23 (IBM Corp.)。结果:本研究共纳入112名妇女(92名(82.1%)主妇和20名(17.9%)专业人员)，其中67名(59.8%)妇女风疹IgG抗体阳性，45名(40.2%)妇女风疹IgG抗体阴性。风疹病毒血清阳性免疫患者和血清阴性易感妇女的平均年龄分别为27.72±4.83岁和26.09±4.68岁。67例血清阳性患者中，35岁以上年龄组抗风疹病毒IgG血清阳性最多(71.4%)，18-26岁年龄组血清阴性最多(46.9%)。职业和胎次与风疹免疫状态无直接关联。结论:低龄人群和未生育妇女抗风疹IgG血清阴性率较高，易发生原发性风疹病毒感染。因此，有必要在计划受孕前一个月对所有原发性风疹病毒感染易感妇女进行风疹IgG抗体筛查、适当咨询和及时接种风疹疫苗，以避免在随后怀孕期间出现胎儿先天性畸形。
{"title":"Seroprevalence of Rubella Virus Infection in Susceptible Women of Childbearing Age Group Seeking Preconceptional Counselling and Infertility Treatment- A Cross-sectional Study from Eastern India","authors":"Nidhi Prasad, Dipali Prasad, Vidyut Prakash, Kalpana Singh, K. Shashi, Sangeeta Pankaj, K. Bimal","doi":"10.7860/njlm/2023/51713.2687","DOIUrl":"https://doi.org/10.7860/njlm/2023/51713.2687","url":null,"abstract":"Introduction: Rubella is an acute viral infection predominantly affecting children and adults. Although natural infection with rubella provide lifelong immunity, but, primary infection in pregnant women during the initial days of pregnancy may result in spontaneous abortion, stillbirth, or a baby born with Congenital Rubella Syndrome (CRS), which can be prevented by vaccinating the susceptible non immune females one month prior to planning conception. Aim: To determine rubella virus immune status and demographic profile of women in childbearing age group, and counsel all Rubella virus infection susceptible women for vaccination prior to planning pregnancy. Materials and Methods: A cross-sectional observational study was done at Indira Gandhi Institute of Medical Sciences (IGIMS), Patna , Bihar, India, on 112 apparently healthy, asymptomatic women in the 18-45 years age group coming for preconceptional counselling and primary and secondary infertility treatment during April 2017 to March 2019, whose serum rubella Immunoglobulin G (IgG) antibody testing was done by Enzyme- linked Immunosorbent Assay (ELISA). The data regarding their rubella virus immune status, age, parity and occupations were coded and recorded in MS Excel spreadsheet program. The Statistical Package for the Social Sciences (SPSS) version 23 (IBM Corp.) was used for data analysis. Results: Out of the total 112 women {92 (82.1%) housewife and 20 (17.9%) professionals} included in this study , a total of 67 (59.8%) women tested positive for rubella IgG antibody and 45 (40.2%) tested negative for rubella IgG antibody. The mean age of the rubella virus seropositive immune patients and seronegative susceptible women was 27.72±4.83 years was 26.09±4.68 years respectively. Among the 67 seropositive patients, maximum antirubella virus IgG seropositivity (71.4%) was seen in more than 35 years age group and maximum seronegativity 23 (46.9%) was seen in 18-26 years age group. There was no direct association of occupation and parity with rubella immune status. Conclusion: Higher rate of antirubella IgG seronegativity amongst younger age groups and nulliparous women renders them susceptible to primary Rubella virus infection. Hence, Rubella IgG antibody screening, proper counselling and prompt rubella vaccination for all primary Rubella virus infection susceptible women is necessary one month prior to planning conception, to avoid foetal congenital malformations during subsequent pregnancies.","PeriodicalId":31115,"journal":{"name":"National Journal of Laboratory Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71271381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.7860/njlm/2023/62618.2747
M Beulah, Joseph Latha Fathima
Introduction: Blood is one of the unique and precious gift that one person can give to another person. Most donors tolerate blood donation well, but sometimes donors can develop adverse reactions. Aim: To analyse the pattern of donor adverse reactions in blood donation in a tertiary care hospital in Bangalore, India. Materials and Methods: It was an ambispective cross- sectional study. Donors who developed adverse reactions over a period of three years from January 2018 to December 2020 (January 2018 to December 2019- retrospective and January 2020 to December 2020- prospective) in a tertiary care hospital in Bangalore were studied. The parameters analysed were the type of adverse reaction (systemic and local), the reaction in first-time donors or repeated donors, and the gender of the donor. Stata 2016 version was used in the analysis of data. Adverse Donor Reaction (ADR) is reported as a percentage and 95% confidence interval. The percentage of ADR in males and females was compared using the Chi-square test. Results: The population studied consisted of 37,007 whole blood donors, with 35347 (95.51%) males and 1660 (4.48%) females. Among 37,007 donors, 316 donors 316/37007 (0.85%) had adverse reactions out of which, 287 were males and 29 females. There were 238 first-time donors and 78 repeat donors. The Vasovagal Reaction (VVR) was the most common 307 donors (97.15%) systemic ADR seen. Local reactions were seen in 9 donors (2.84%). Conclusion: The number of donors who developed ADRs was low still it is desirable to reduce risks. The ADRs can be reduced by diligently following the screening protocols and carrying out the venipuncture precisely.
{"title":"Pattern of Donor Adverse Reactions in Blood Donation in a Tertiary Care Hospital in Bangalore, India","authors":"M Beulah, Joseph Latha Fathima","doi":"10.7860/njlm/2023/62618.2747","DOIUrl":"https://doi.org/10.7860/njlm/2023/62618.2747","url":null,"abstract":"Introduction: Blood is one of the unique and precious gift that one person can give to another person. Most donors tolerate blood donation well, but sometimes donors can develop adverse reactions. Aim: To analyse the pattern of donor adverse reactions in blood donation in a tertiary care hospital in Bangalore, India. Materials and Methods: It was an ambispective cross- sectional study. Donors who developed adverse reactions over a period of three years from January 2018 to December 2020 (January 2018 to December 2019- retrospective and January 2020 to December 2020- prospective) in a tertiary care hospital in Bangalore were studied. The parameters analysed were the type of adverse reaction (systemic and local), the reaction in first-time donors or repeated donors, and the gender of the donor. Stata 2016 version was used in the analysis of data. Adverse Donor Reaction (ADR) is reported as a percentage and 95% confidence interval. The percentage of ADR in males and females was compared using the Chi-square test. Results: The population studied consisted of 37,007 whole blood donors, with 35347 (95.51%) males and 1660 (4.48%) females. Among 37,007 donors, 316 donors 316/37007 (0.85%) had adverse reactions out of which, 287 were males and 29 females. There were 238 first-time donors and 78 repeat donors. The Vasovagal Reaction (VVR) was the most common 307 donors (97.15%) systemic ADR seen. Local reactions were seen in 9 donors (2.84%). Conclusion: The number of donors who developed ADRs was low still it is desirable to reduce risks. The ADRs can be reduced by diligently following the screening protocols and carrying out the venipuncture precisely.","PeriodicalId":31115,"journal":{"name":"National Journal of Laboratory Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134967281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.7860/njlm/2023/55489.2698
P. Agrawal, K. Gupta, Pawan Nikhra, Mala Jain, M. Pandey, A. Pandey
Introduction: In the present era, the classification of lung carcinoma is not confined to Small Cell Lung Carcinoma (SCLC) and Non Small Cell Lung Carcinoma (NSCLC). Precise subtyping of lung carcinoma has a direct impact on patient management and prognosis. Further molecular study helps in identifying adenocarcinoma receptors, such as Epidermal Growth Factor Receptor (EGFR) and Anaplastic Lymphoma Kinase (ALK), which are useful in targeted therapy. Aim: To assess the role of Immunohistochemistry (IHC) in accurate diagnosis and subtyping of lung carcinoma and to analyse the prevalence of EGFR mutations and ALK rearrangement in lung adenocarcinoma. Materials and Methods: A retrospective hospital-based, observational study was conducted at the Department of Pathology of American International Institute of Medical Sciences, Udaipur, Rajasthan from January 2020 to August 2021. Total of 105 cases of guided core needle biopsies from lung and bronchoscopic biopsies were included. IHC markers were applied based on histopathological diagnosis from a panel of p63, Cytokeratin 7 (CK7), AE1/AE3, Thyroid Transcription Factor (TTF1), Napsin A, p40, synaptophysin, chromogranin, CD56 and Ki67. Adenocarcinoma cases were further analysed for EGFR mutations and ALK rearrangements. Data was tabulated and analysed statistically using Microsoft Excel to determine the percentage frequency distribution of cases. Results: Among 105, there were 88 males and 17 females and the mean age of the population was 60.57 years. The most prevalent subtype of lung malignancy was squamous cell carcinoma (44.7%) followed by adenocarcinoma (29.5%). The diagnostic accuracy of squamous cell carcinomas and adenocarcinomas on morphology was 93.1% and 84.6%, respectively and for small cell carcinoma it was 100%. Amongst 28 cases of adenocarcinoma, EGFR mutation was found in 46.42% cases whereas ALK mutation was found only in 21.42% cases. Conclusion: The study highlights the importance of IHC, and a substantial prevalence of EGFR mutations was found in patients with lung carcinoma.
{"title":"Significance of Immunohistochemistry Testing in the Diagnosis and Subtyping of Lung Carcinomas- A Retrospective Study from a Tertiary Care Centre in Southern Rajasthan","authors":"P. Agrawal, K. Gupta, Pawan Nikhra, Mala Jain, M. Pandey, A. Pandey","doi":"10.7860/njlm/2023/55489.2698","DOIUrl":"https://doi.org/10.7860/njlm/2023/55489.2698","url":null,"abstract":"Introduction: In the present era, the classification of lung carcinoma is not confined to Small Cell Lung Carcinoma (SCLC) and Non Small Cell Lung Carcinoma (NSCLC). Precise subtyping of lung carcinoma has a direct impact on patient management and prognosis. Further molecular study helps in identifying adenocarcinoma receptors, such as Epidermal Growth Factor Receptor (EGFR) and Anaplastic Lymphoma Kinase (ALK), which are useful in targeted therapy. Aim: To assess the role of Immunohistochemistry (IHC) in accurate diagnosis and subtyping of lung carcinoma and to analyse the prevalence of EGFR mutations and ALK rearrangement in lung adenocarcinoma. Materials and Methods: A retrospective hospital-based, observational study was conducted at the Department of Pathology of American International Institute of Medical Sciences, Udaipur, Rajasthan from January 2020 to August 2021. Total of 105 cases of guided core needle biopsies from lung and bronchoscopic biopsies were included. IHC markers were applied based on histopathological diagnosis from a panel of p63, Cytokeratin 7 (CK7), AE1/AE3, Thyroid Transcription Factor (TTF1), Napsin A, p40, synaptophysin, chromogranin, CD56 and Ki67. Adenocarcinoma cases were further analysed for EGFR mutations and ALK rearrangements. Data was tabulated and analysed statistically using Microsoft Excel to determine the percentage frequency distribution of cases. Results: Among 105, there were 88 males and 17 females and the mean age of the population was 60.57 years. The most prevalent subtype of lung malignancy was squamous cell carcinoma (44.7%) followed by adenocarcinoma (29.5%). The diagnostic accuracy of squamous cell carcinomas and adenocarcinomas on morphology was 93.1% and 84.6%, respectively and for small cell carcinoma it was 100%. Amongst 28 cases of adenocarcinoma, EGFR mutation was found in 46.42% cases whereas ALK mutation was found only in 21.42% cases. Conclusion: The study highlights the importance of IHC, and a substantial prevalence of EGFR mutations was found in patients with lung carcinoma.","PeriodicalId":31115,"journal":{"name":"National Journal of Laboratory Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71271514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.7860/njlm/2023/62796.2760
Kavitha Yelavath, CH Jyothi, T Divyagna, B Swapna Kumari
Introduction: Psoriasis is a long-lasting autoimmune disease mediated by T-lymphocytes and dendritic cells. Langerhans cells are a unique population of dendritic cells found in the epidermis, where they can be identified by Cluster of Differentiation 1a (CD1a) positivity. They play an important role in the pathogenesis of psoriasis. Aim: To evaluate the utility of immunoexpression of CD1a in the early diagnosis of psoriasis and to study the histopathology of skin biopsies from clinically diagnosed cases of psoriasis. Materials and Methods: A cross-sectional study was conducted from September 2017 to August 2019 at Gandhi Hospital, Secunderabad, Telangana, India. Skin biopsies were taken from 50 patients with psoriasis from the Outpatient Department (OPD). Histopathological features in early psoriasis were studied, and CD1a immunoexpression in lesional, perilesional, and distant skin was analysed. The data were analysed using Student’s t-test with the Statistical Package for the Social Sciences (SPSS) software. Results: Half of the cases were found in two age groups: 51-60 years (15 patients, 30%) and 11-20 years (10 patients, 20%). The majority of the cases were males (36 patients, 72%). Most of the biopsies were taken from the lower limb (24 patients, 48%), followed by the back (13 patients, 26%). In this study, the average number of CD1a positive Langerhans cells was highest (54.92±5.26) in perilesional skin compared to lesional skin (30±3.96), which was statistically significant (p-value=0.04). Conclusion: Based on the observations in this study, a strong positive reaction of CD1a in perilesional skin can be used to diagnose psoriasis in the early clinical stages, before full-blown clinical psoriatic plaques have appeared. Early diagnosis may prompt physicians to initiate treatment early
{"title":"Immunoexpression of CD1a and Histopathology in Lesional and Non Lesional Skin in Psoriasis: A Cross-sectional Study","authors":"Kavitha Yelavath, CH Jyothi, T Divyagna, B Swapna Kumari","doi":"10.7860/njlm/2023/62796.2760","DOIUrl":"https://doi.org/10.7860/njlm/2023/62796.2760","url":null,"abstract":"Introduction: Psoriasis is a long-lasting autoimmune disease mediated by T-lymphocytes and dendritic cells. Langerhans cells are a unique population of dendritic cells found in the epidermis, where they can be identified by Cluster of Differentiation 1a (CD1a) positivity. They play an important role in the pathogenesis of psoriasis. Aim: To evaluate the utility of immunoexpression of CD1a in the early diagnosis of psoriasis and to study the histopathology of skin biopsies from clinically diagnosed cases of psoriasis. Materials and Methods: A cross-sectional study was conducted from September 2017 to August 2019 at Gandhi Hospital, Secunderabad, Telangana, India. Skin biopsies were taken from 50 patients with psoriasis from the Outpatient Department (OPD). Histopathological features in early psoriasis were studied, and CD1a immunoexpression in lesional, perilesional, and distant skin was analysed. The data were analysed using Student’s t-test with the Statistical Package for the Social Sciences (SPSS) software. Results: Half of the cases were found in two age groups: 51-60 years (15 patients, 30%) and 11-20 years (10 patients, 20%). The majority of the cases were males (36 patients, 72%). Most of the biopsies were taken from the lower limb (24 patients, 48%), followed by the back (13 patients, 26%). In this study, the average number of CD1a positive Langerhans cells was highest (54.92±5.26) in perilesional skin compared to lesional skin (30±3.96), which was statistically significant (p-value=0.04). Conclusion: Based on the observations in this study, a strong positive reaction of CD1a in perilesional skin can be used to diagnose psoriasis in the early clinical stages, before full-blown clinical psoriatic plaques have appeared. Early diagnosis may prompt physicians to initiate treatment early","PeriodicalId":31115,"journal":{"name":"National Journal of Laboratory Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136207838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.7860/njlm/2023/56215.2746
M. Vaidya, A. Shenoy, Shruti Ganvir, N. Goel
Introduction: Intraoperative assessment of neurosurgical specimens using squash cytology and frozen sections is helpful to plan extent of surgery and determine adequacy of representative tissue. Combination of these techniques has been shown to increase diagnostic accuracy and rate of concordance with final diagnosis. Aim: To assess usefulness of squash preparation and cryostat sections in making intraoperative diagnosis and to compare accuracy of squash cytology and frozen sections with respect to the final histopathological diagnosis. Materials and Methods: In this cross-sectional study conducted at a tertiary care hospital in Maharashtra, India, 110 neurosurgical specimens received for intraoperative consultation were assessed over the period of two years (January 2016- December 2017). The squash smears and frozen section diagnoses were compared with the final histopathological diagnosis and their diagnostic accuracy was determined. Sensitivity, specificity, positive predictive value and negative predictive value were calculated using appropriate statistical method. Results: Predominant age group in this study was 41-50 years (n=31, 28.1%) with male to female ratio of 2.23:1. Gliomas were most frequently encountered tumours (n=48) with Glioblastoma forming the commonest subgroup (n=19). The diagnostic accuracy, sensitivity and specificity of squash cytology were 90.72%, 93.50% and 80.01%, respectively. The diagnostic accuracy, sensitivity and specificity of frozen section were 95.87%, 97.40% and 90.01%, respectively. Conclusion: The diagnostic accuracy, sensitivity and specificity were better for frozen section than squash cytology. A more accurate intraoperative diagnosis was achieved by combining the methods.
{"title":"Squash Cytology versus Frozen Section for Intraoperative Diagnosis of Lesions of Central Nervous System: A Cross-sectional Study","authors":"M. Vaidya, A. Shenoy, Shruti Ganvir, N. Goel","doi":"10.7860/njlm/2023/56215.2746","DOIUrl":"https://doi.org/10.7860/njlm/2023/56215.2746","url":null,"abstract":"Introduction: Intraoperative assessment of neurosurgical specimens using squash cytology and frozen sections is helpful to plan extent of surgery and determine adequacy of representative tissue. Combination of these techniques has been shown to increase diagnostic accuracy and rate of concordance with final diagnosis. Aim: To assess usefulness of squash preparation and cryostat sections in making intraoperative diagnosis and to compare accuracy of squash cytology and frozen sections with respect to the final histopathological diagnosis. Materials and Methods: In this cross-sectional study conducted at a tertiary care hospital in Maharashtra, India, 110 neurosurgical specimens received for intraoperative consultation were assessed over the period of two years (January 2016- December 2017). The squash smears and frozen section diagnoses were compared with the final histopathological diagnosis and their diagnostic accuracy was determined. Sensitivity, specificity, positive predictive value and negative predictive value were calculated using appropriate statistical method. Results: Predominant age group in this study was 41-50 years (n=31, 28.1%) with male to female ratio of 2.23:1. Gliomas were most frequently encountered tumours (n=48) with Glioblastoma forming the commonest subgroup (n=19). The diagnostic accuracy, sensitivity and specificity of squash cytology were 90.72%, 93.50% and 80.01%, respectively. The diagnostic accuracy, sensitivity and specificity of frozen section were 95.87%, 97.40% and 90.01%, respectively. Conclusion: The diagnostic accuracy, sensitivity and specificity were better for frozen section than squash cytology. A more accurate intraoperative diagnosis was achieved by combining the methods.","PeriodicalId":31115,"journal":{"name":"National Journal of Laboratory Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71271522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.7860/njlm/2023/59890.2688
Showkat Ahmad Lone, Tufail Ahmed, Umara Amin, Aashaq Hussain Allaie, Kowsar Jan, Amrit Pal Kour, Junaid Ahmad
Introduction: Timely diagnosis and isolation of cases is of paramount importance to contain the spread of a pandemic. The Coronavirus Disease-2019 (COVID-19) has emerged as a major health problem that needs concerted efforts for mitigation and control. Real-time Reverse Transcription Polymerase Chain Reaction (RT-PCR), the gold-standard diagnostic modality, has high cost and can be performed in special laboratories. Rapid Antigen Tests (RAT) has been developed to serve as an alternative and is recommended to use at point-of-care testing. Aim: To compare the case detection rate of RAT and RT-PCR and the possible role they may play in the pandemic mitigation efforts. Materials and Methods: In this retrospective study, all the samples collected during a nine-months period were analysed. Depending upon the criteria, either a RAT or RT- PCR was done on the samples. Data was analysed using descriptive statistics (frequencies, mean, standard deviation, and percentages). Results: A total of 8,29,745 samples were tested during the study period among which number of positive samples was 19,414 giving an overall positivity rate of 2.34% (0.20% to 12.58%). RAT positivity was 1.58% while RT-PCR gave a positivity of 4.26. Total number of positive cases identified by RAT and RT-PCR were 9,382 and 10,032, respectively. Conclusions: RAT is a low-cost alternative to the expensive RT-PCR with the added advantage of giving accurate and timely results. This can be a game changer especially in low-resource settings, which have witnessed a increase in the spread of COVID-19 during the latter part of the pandemic.
{"title":"Can Rapid Antigen Tests Lessen the Burden on Testing Laboratories? An Evaluation of the Testing Methods during the COVID-19 Pandemic","authors":"Showkat Ahmad Lone, Tufail Ahmed, Umara Amin, Aashaq Hussain Allaie, Kowsar Jan, Amrit Pal Kour, Junaid Ahmad","doi":"10.7860/njlm/2023/59890.2688","DOIUrl":"https://doi.org/10.7860/njlm/2023/59890.2688","url":null,"abstract":"Introduction: Timely diagnosis and isolation of cases is of paramount importance to contain the spread of a pandemic. The Coronavirus Disease-2019 (COVID-19) has emerged as a major health problem that needs concerted efforts for mitigation and control. Real-time Reverse Transcription Polymerase Chain Reaction (RT-PCR), the gold-standard diagnostic modality, has high cost and can be performed in special laboratories. Rapid Antigen Tests (RAT) has been developed to serve as an alternative and is recommended to use at point-of-care testing. Aim: To compare the case detection rate of RAT and RT-PCR and the possible role they may play in the pandemic mitigation efforts. Materials and Methods: In this retrospective study, all the samples collected during a nine-months period were analysed. Depending upon the criteria, either a RAT or RT- PCR was done on the samples. Data was analysed using descriptive statistics (frequencies, mean, standard deviation, and percentages). Results: A total of 8,29,745 samples were tested during the study period among which number of positive samples was 19,414 giving an overall positivity rate of 2.34% (0.20% to 12.58%). RAT positivity was 1.58% while RT-PCR gave a positivity of 4.26. Total number of positive cases identified by RAT and RT-PCR were 9,382 and 10,032, respectively. Conclusions: RAT is a low-cost alternative to the expensive RT-PCR with the added advantage of giving accurate and timely results. This can be a game changer especially in low-resource settings, which have witnessed a increase in the spread of COVID-19 during the latter part of the pandemic.","PeriodicalId":31115,"journal":{"name":"National Journal of Laboratory Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134955356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.7860/njlm/2022/49133.2563
Amiyabala Sahoo, R. Mahajan
Introduction: Diarrhoea is one of the commonest opportunistic infections seen in the course of the HIV disease and is a cause of considerable morbidity and mortality. Protozoan intestinal infections constitute one of the most important ailments affecting these immune deficient groups. Aim: To evaluate modified acid-fast staining technique with modified safranin technique in detection of enteric coccidian parasites and its correlation with Cluster of Differentiation (CD4) cell counts. Materials and Methods: A prospective cross-sectional study was done for a period of 16 months (November 2015 to March 2017) was conducted in 200 Human Immunodeficiency Virus (HIV) positive patients with diarrhoea in ABVIMS and Dr. RML hospital, Delhi, India. Three consecutive early morning stool samples (3-5 gm/3-5 mL) along with 3 mL venous blood in Becton Dickinson Ethylenediamine Tetra-Acetic Acid (BD EDTA) vial for CD4 cell estimation were collected. The smears were subjected to Kinyuon method and Modified Safranin Technique. Enzyme Linked Immunosorbent Assay (ELISA) for detection of Cryptosporidium antigen was also performed. All statistical analysis was performed using STATA version 16.1 software. Results: A total of 58 (29%) enteric coccidian parasites were detected. Isospora belli was the most common parasite in HIV positive patients followed by Cryptosporidium spp. The maximum parasitic isolation was in the patients with CD4 cell counts below 250 cells/μL. Conclusion: Routine screening of stool samples of HIV positive patients with diarrhoea should be undertaken for enteric coccidian parasites to prevent delay in diagnosis and prevention of morbidity and mortality associated with these infections.
简介:腹泻是艾滋病毒感染过程中最常见的机会性感染之一，是相当高的发病率和死亡率的原因。原生动物肠道感染是影响这些免疫缺陷群体的最重要疾病之一。目的:探讨改良抗酸染色法联合改良红花素技术检测肠球虫及其与CD4细胞计数的相关性。材料和方法:对印度德里ABVIMS和Dr. RML医院的200例人类免疫缺陷病毒(HIV)阳性腹泻患者进行了为期16个月(2015年11月至2017年3月)的前瞻性横断面研究。连续3次采集清晨粪便标本(3-5 gm/3-5 mL)，并取3 mL静静血于Becton Dickinson乙二胺四乙酸(BD EDTA)瓶中用于CD4细胞计数。采用金元法和改良红花苷法进行涂片。采用酶联免疫吸附试验(ELISA)检测隐孢子虫抗原。所有统计分析均使用STATA version 16.1软件进行。结果:共检出58只(29%)肠道球虫。HIV阳性患者中最常见的寄生虫是belli Isospora，其次是隐孢子虫，CD4细胞计数低于250个/μL的患者中寄生虫分离率最高。结论:应对艾滋病毒阳性腹泻患者的粪便样本进行常规筛查，检查肠球虫寄生虫，以防止延误诊断和预防与这些感染相关的发病率和死亡率。
{"title":"Evaluation of Diagnostic Techniques in Detection of Enteric Coccidian Parasites in Patients with HIV","authors":"Amiyabala Sahoo, R. Mahajan","doi":"10.7860/njlm/2022/49133.2563","DOIUrl":"https://doi.org/10.7860/njlm/2022/49133.2563","url":null,"abstract":"Introduction: Diarrhoea is one of the commonest opportunistic infections seen in the course of the HIV disease and is a cause of considerable morbidity and mortality. Protozoan intestinal infections constitute one of the most important ailments affecting these immune deficient groups. Aim: To evaluate modified acid-fast staining technique with modified safranin technique in detection of enteric coccidian parasites and its correlation with Cluster of Differentiation (CD4) cell counts. Materials and Methods: A prospective cross-sectional study was done for a period of 16 months (November 2015 to March 2017) was conducted in 200 Human Immunodeficiency Virus (HIV) positive patients with diarrhoea in ABVIMS and Dr. RML hospital, Delhi, India. Three consecutive early morning stool samples (3-5 gm/3-5 mL) along with 3 mL venous blood in Becton Dickinson Ethylenediamine Tetra-Acetic Acid (BD EDTA) vial for CD4 cell estimation were collected. The smears were subjected to Kinyuon method and Modified Safranin Technique. Enzyme Linked Immunosorbent Assay (ELISA) for detection of Cryptosporidium antigen was also performed. All statistical analysis was performed using STATA version 16.1 software. Results: A total of 58 (29%) enteric coccidian parasites were detected. Isospora belli was the most common parasite in HIV positive patients followed by Cryptosporidium spp. The maximum parasitic isolation was in the patients with CD4 cell counts below 250 cells/μL. Conclusion: Routine screening of stool samples of HIV positive patients with diarrhoea should be undertaken for enteric coccidian parasites to prevent delay in diagnosis and prevention of morbidity and mortality associated with these infections.","PeriodicalId":31115,"journal":{"name":"National Journal of Laboratory Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71269707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.7860/njlm/2022/50591.2568
Shashi Upreti, S. Petwal, Anupama Arya, Aditi Upreti, Narayan Mihir, Sana Umar
Introduction: Severe Acute Respiratory Syndrome Corona Virus-2 (SARS-CoV-2) causing Coronavirus Disease (COVID-19) has challenged the world. A complete blood workup as well as continuous tracking of haematological parameters play a vital role in revealing the risks of disease progression and eventually help in better treatment and outcome. Aim: To access the haematological parameters {Complete Blood Count (CBC), Neutrophil Lymphocyte Ratio (NLR) and Serum Ferritin (S. ferritin) levels} in COVID-19 patients to correlate its association with the severity of the disease. Materials and Methods: The present study was a cross-sectional study in which 200 patients who were confirmed as COVID-19 positive by real time Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR) in the month of July-August 2020 were included. Blood was collected from patients of COVID-19 using the routine methods and was evaluated for CBC and S. ferritin levels. Neutrophil Lymphocyte Ratio (NLR) was also calculated. Results: The NLR was positively correlated with severity of COVID-19. Patients with higher NLR levels were admitted to Intensive Care Unit (ICU) because of severity in their condition. In the present study, 42 of 47 (89.4%) ICU patients had S. ferritin levels >1000 ng/mL whereas only 8 (5.2%) of non ICU patients had S. ferritin levels >1000 ng/mL. Conclusion: The NLR and S. ferritin positively correlated with the severity of COVID-19 disease.
{"title":"Neutrophil Lymphocyte Ratio and Serum Ferritin Levels in COVID-19: A Cross-sectional Study","authors":"Shashi Upreti, S. Petwal, Anupama Arya, Aditi Upreti, Narayan Mihir, Sana Umar","doi":"10.7860/njlm/2022/50591.2568","DOIUrl":"https://doi.org/10.7860/njlm/2022/50591.2568","url":null,"abstract":"Introduction: Severe Acute Respiratory Syndrome Corona Virus-2 (SARS-CoV-2) causing Coronavirus Disease (COVID-19) has challenged the world. A complete blood workup as well as continuous tracking of haematological parameters play a vital role in revealing the risks of disease progression and eventually help in better treatment and outcome. Aim: To access the haematological parameters {Complete Blood Count (CBC), Neutrophil Lymphocyte Ratio (NLR) and Serum Ferritin (S. ferritin) levels} in COVID-19 patients to correlate its association with the severity of the disease. Materials and Methods: The present study was a cross-sectional study in which 200 patients who were confirmed as COVID-19 positive by real time Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR) in the month of July-August 2020 were included. Blood was collected from patients of COVID-19 using the routine methods and was evaluated for CBC and S. ferritin levels. Neutrophil Lymphocyte Ratio (NLR) was also calculated. Results: The NLR was positively correlated with severity of COVID-19. Patients with higher NLR levels were admitted to Intensive Care Unit (ICU) because of severity in their condition. In the present study, 42 of 47 (89.4%) ICU patients had S. ferritin levels >1000 ng/mL whereas only 8 (5.2%) of non ICU patients had S. ferritin levels >1000 ng/mL. Conclusion: The NLR and S. ferritin positively correlated with the severity of COVID-19 disease.","PeriodicalId":31115,"journal":{"name":"National Journal of Laboratory Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71270251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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